波士顿儿童与保险公司联手加速儿科护理的转变

2009年11月4日

波士顿，大众。——波士顿儿童医院和它的医生正在创建一个独特的合作伙伴关系的国家的主要健康计划，以加快发展的儿科保健服务系统，扩大创新的方法和模式的照顾。的方法和模型，目前正在试行儿童的目的是改善健康状况，降低成本，通过消除在乎是不是有效的，过度使用。健康计划包括马萨诸塞州蓝十字蓝盾，哈佛朝圣保健和塔夫茨医疗计划--have agreed to an advisory role 和 to target funds toward the effort。 The Massachusetts Medicaid Program has also agreed to participate。

To work with insurers to develop a common approach 和 st和ards toward improving care 和 reducing costs， Children's 和 its physicians have volunteered a cut in fiscal year 2010 payment rates; in some cases reopening contracts to cut rates of increase， 和 in others agreeing to reduce rates of increase during current contract negotiations。 Children's 和 the health plans have agreed that a portion of these savings will be targeted to support these promising 和 novel approaches 和 models。 Investments will support SCAMPS (a revolutionary way to provide clinicians with immediate feedback on the success of their treatments)， new models 和 systems for pediatricians to work with specialists in coordinating care， 和 the most advanced pediatric information technology underpinning these efforts。

"Over the past several years， we've made patient quality 和 safety our top priority， invested in our clinical health information systems 和 tackled hospital-wide operational improvement，" saidS和ra Fenwick， President 和 COO 在孩子们的

"Those efforts have provided the confidence 和 platform on which to launch this next generation of clinical effectiveness tools 和 models， which the hospital 和 its physicians believe hold promise for transforming the health care system nationally，" addedPaul Hickey， MD， president of the医师组织在孩子们的

A 10-member advisory panel， with equal representation from Children's 和 the participating insurers， will provide valuable insight 和 strategic guidance for these 和 future efforts。 While insurers have broad experience with clinical quality metrics 和 appropriateness of care guidelines， few of those measures are specific to pediatrics。 It is believed that bringing together the broader experience of the insurers with the pediatric expertise of Children's 和 its physicians will help to st和ardize the approach to high quality， effective 和 efficient pediatric care。

New approaches， models 和 technologies for additional investment include:

SCAMPs (St和ardized Clinical Assessment 和 Management Plans)
Although everyone's goal is to deliver the optimal tests， procedures 和 treatments for each patient， as every physician knows， in most cases this has never been defined。 Physicians in the Cardiovascular Program at Children's have created a broad-based framework to not only address this problem， but to deliver better care at the same time。 The framework， known as SCAMPS， or St和ardized Clinical Assessment 和 Management Plans， uses the best evidence to guide testing 和 treatment decisions， 和 the best judgment of practicing cardiologists to st和ardize care plans for many common clinical situations 和 to capture data to continually refine the process。

"Children's 和 its doctors believe that the new framework will become the st和ard for quality improvement processes - how to create in real time widespread， continuous， data-driven quality improvement， including appropriate utilization 和 potential cost savings， 和 will quickly spread to other pediatric 和 adult care delivery，" saysJames Lock， MD， chief of心脏病学和 one of the architects of the pioneering approach。

综合护理模式
Currently， efforts to improve collaboration between pediatricians 和 pediatric subspecialists are underway。 This is a crucial element of the primary care model known as the family-centered Medical Home， in which a primary care provider typically works in partnership with families to coordinate care for their children。 The fund will exp和 和 accelerate implementation pilots to improve access， communication， 和 optimal utilization of resources across an integrated system which includes primary care physicians， specialists 和 hospital， with a particular focus on coordinating care for children 和 youth with complex 和 chronic conditions。

下一代信息技术
Advanced information systems are essential to the health care delivery system 和 are a critical component of Children's strategy moving forward。 In addition to the complicated systems needed for SCAMPs， the hospital has developed the first patient-controlled health record fed by two separate health care providers (pediatricians 和 specialists) giving patients a more complete 和 comprehensive view of their medical information。

"The complexity 和 uniqueness of pediatric care compared to adult care require an extra level of effort to measure 和 improve quality，" said Kathy Jenkins， MD， chief quality 和 safety officer 在孩子们的 "By creating a common platform for discussion in Massachusetts with all major payers， we should make significant progress in improving quality 和 effectiveness of care while contributing to the state's position as a health care 'learning laboratory' for the rest of the nation。"

接触：
Rob格雷厄姆
617-919-3110
rob。graham@childrens。harvard。edu

Founded in 1869 as a 20-bed hospital for children， 波士顿儿童医院 today is one of the nation's leading pediatric medical centers， the primary pediatric teaching hospital of Harvard Medical School， 和 the largest provider of health care to Massachusetts children。 In addition to 396 pediatric 和 adolescent inpatient beds 和 more than 100 outpatient programs， Children's houses the world's largest research enterprise based at a pediatric medical center， where its discoveries benefit both children 和 adults。 More than 500 scientists， including eight members of the National Academy of Sciences， 11 members of the Institute of Medicine 和 13 members of the Howard Hughes Medical Institute comprise Children's research community。 For more information about the hospital visit:www。childrenshospital。org\/newsroom。

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