90-day warranty on surgeries is a success on clarkhoward.com

Several years ago, Clark told you about how Geisinger Health System infuriated insurance and medicine people alike with a very innovative idea.

This Pennsylvania medical provider decided they would offer a 90-day warranty on elective heart surgery procedures. If anything went wrong during that period, the patient's return visits would be free.

Clark was ecstatic when Geisinger announced their policy. Now several years later, it's clear that their idea worked. Heart patients are doing much better at Geisinger, and the provider has been able to cut costs at its surgery centers by 15%.

How did they achieve that 15% drop in surgery costs? They took a cue from airline pilots. Before a flight, pilots in the cockpit go through an extensive pre-flight checklist to make sure every system is functioning and all procedures are being followed. They treat the airplane as a system.

Medicine, however, operates as a fiefdom, where things are non-systematized and everyone does their own thing. Geisinger's innovation involved coming up with a set of 40 procedural steps.

Their system, called Proven Care, has to be run through and check-marked before any patient can undergo heart surgery. It even includes steps to deal with the trouble-prone arena of making sure that medication is properly administered after the operation.

But the fact that this is revolutionary in medicine is just silly. This kind of systemization is what well-run businesses routinely have in place.

For example, the fatality rate on U.S. aircrafts is so low because of the emphasis on systematic safety. In the recent Buffalo crash, investigators are focusing on whether or not pilot safety procedures were properly followed. Therein they expect to find the likely leading cause of the crash.

Geisinger has reduced the fatality rate to zero -- not a single in-hospital death -- since implementing Proven Care. When they started, only 59% of patients were getting good systematic treatment. Now it's 100%.

According to The Washington Post, Proven Care has been so successful that Geisinger is now extending the 90-day warranty to other procedures, such as hip replacements and cataract surgery.

We all have a right to expect accountability from our medical providers.

What others are saying

Agree
My mother-in-law went in for a 'routine' knee replacement surgery and died after the surgery due to a blood clot in her early 60's, both her parents lived to 90 & 101. I felt it was some pre or post op error, but no action was taken to prove (or disprove) it. If something like this had been in place a wonder grandparent to my children would still be with us.
By Ms Smith @ 04/20/09 03:47:55 PMreport abuse
Agreed
It's about time; it's scary that we will resort to a socialized medicine system simply because we haven't streamlined the process of medicine.
By Aquaswim47 @ 04/16/09 01:30:12 PMreport abuse
Against the grain
I was a computer systems engineer before starting medical school and I can attest firsthand the idiocracy that goes on in medicine. I've thought a systems checklist should have been implemented long ago. However, I think the egos and insecurities of many medical professionals will make this hard to implement on a wide basis. Time constraints and costs are another hurdle to overcome. The last thing a bust doctor wants is more paperwork! In the end, I think this set of paperwork is actually beneficial whereas much of it now is utterly useless. These are just my opinions, though...
By Medical Student @ 04/16/09 12:56:58 PMreport abuse
Medical bills after payment
We live in Oregon, and the doctors/dentists here just take a person to the cleaners!

They tell you what it will cost, knowning that in 30 days, they can legally send you a bill, for any "Unpaid Balance" outside of what they quoted you before services. Plus, some of the really greedy ones, will not provide the "discount" your plan may have, and bill you for full office costs. We had one dentist, who was only suppose to charge us a $25.00 office visit, but they would bill us, 30 days later for his regular office visit of $130.00 dollars.

Now we are wil Kaiser, which is the closest thing to Socialized Medicine you can get in the U.S.A..

I think we should have 100% government controlled medical industry, I also think that the U.S.A. should pay 100% of the educational costs of becoming a doctor/dentist in the U.S.A.

Government controlled.
Government paid for....
By Oregon Resident @ 04/16/09 12:47:50 PMreport abuse
Geisinger
So simple a concept yet so out of reach for most hospitals! As a RN I was involved in implementing such a system to prevent blood stream infections from intravenous catheters. It worked and brought our infection rate down from an unacceptable 10% to zero in 15 months.
By Janice Aceto @ 04/16/09 10:08:08 AMreport abuse

Agree

My mother-in-law went in for a 'routine' knee replacement surgery and died after the surgery due to a blood clot in her early 60's, both her parents lived to 90 & 101. I felt it was some pre or post op error, but no action was taken to prove (or disprove) it. If something like this had been in place a wonder grandparent to my children would still be with us.

By Ms Smith @ 04/20/09 03:47:55 PMreport abuse

Agreed

It's about time; it's scary that we will resort to a socialized medicine system simply because we haven't streamlined the process of medicine.

By Aquaswim47 @ 04/16/09 01:30:12 PMreport abuse

Against the grain

I was a computer systems engineer before starting medical school and I can attest firsthand the idiocracy that goes on in medicine. I've thought a systems checklist should have been implemented long ago. However, I think the egos and insecurities of many medical professionals will make this hard to implement on a wide basis. Time constraints and costs are another hurdle to overcome. The last thing a bust doctor wants is more paperwork! In the end, I think this set of paperwork is actually beneficial whereas much of it now is utterly useless. These are just my opinions, though...

By Medical Student @ 04/16/09 12:56:58 PMreport abuse

Medical bills after payment

We live in Oregon, and the doctors/dentists here just take a person to the cleaners!

They tell you what it will cost, knowning that in 30 days, they can legally send you a bill, for any "Unpaid Balance" outside of what they quoted you before services. Plus, some of the really greedy ones, will not provide the "discount" your plan may have, and bill you for full office costs. We had one dentist, who was only suppose to charge us a $25.00 office visit, but they would bill us, 30 days later for his regular office visit of $130.00 dollars.

Now we are wil Kaiser, which is the closest thing to Socialized Medicine you can get in the U.S.A..

I think we should have 100% government controlled medical industry, I also think that the U.S.A. should pay 100% of the educational costs of becoming a doctor/dentist in the U.S.A.

Government controlled.
Government paid for....

By Oregon Resident @ 04/16/09 12:47:50 PMreport abuse

Geisinger

So simple a concept yet so out of reach for most hospitals! As a RN I was involved in implementing such a system to prevent blood stream infections from intravenous catheters. It worked and brought our infection rate down from an unacceptable 10% to zero in 15 months.

By Janice Aceto @ 04/16/09 10:08:08 AMreport abuse

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Apr 15, 2009 -- 90-day warranty on surgeries is a success

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