emergency care


What If Our Health Care System Kept Us Healthy?

Rebecca Onie is the cofounder of Health Leads, the Boston nonprofit that helps doctors “prescribe” basic necessities (housing, food, heat in winter) to low-income patients, in addition to just medications.

In her recent TEDMed talk, she asks some radical question: What if our health care system actually kept us healthy? What if doctors could truly prescribe solutions, not just drugs? What if ER waiting rooms around the country weren’t just places to watch the clock and read old copies of Good Housekeeping, but rather, were transformed into service-oriented, patient-centered hubs where, in a brutal New England winter, a family could go and a volunteer could help that family get the heat turned back on? Listen to Rebecca’s talk and get inspired:

Why An Emergency Medic Might Ask About Your Race

In his column yesterday, The Boston Herald’s Howie Carr makes it sound like Massachusetts medics are so busy these days filling out forms about their patients’ race that they may ignore the medical emergency at hand.

Howie’s rants are often enjoyable to read for their inflamed wrath, but this one struck me as so oddly lopsided that I asked the Department of Public Health what was up. Howie included just this from the Department of Public Health statement: “Patient health and safety must always be an EMT’s highest priority. Collecting this information must not delay nor prevent patient assessment or the provision of care.”

Here’s the whole statement, which makes clear that this sort of collection of patient data is a national norm, not a PC liberal plot:

Patient health and safety must always be an EMT’s highest priority. Collecting this information must not delay nor prevent patient assessment or the provision of care. State regulations (105 CMR 170.347) require EMTs to collect a variety of background information from patients, including their name, address, age, race and ethnicity, past health history, and medications that they are currently taking. Of course, if a person objects to responding, they have the option not to respond.

For years, more than 25 states — representing every region of the country — have been collecting this data and submitting it to the National EMS Information System (NEMSIS), and the other 25 states have committed to doing so.

NEMSIS is funded by the U.S. National Highway Transportation Safety Administration (NHTSA) in order to standardize collection of EMS data by creating a uniform data set that is used to compare and assess the quality of provision of EMS across the country. Similar data is collected in other areas of the health care system, such as hospitals and nursing homes. The NEMSIS system will catch the EMS sector up to the rest of health care in terms of having data-driven assessment available, and provide a valid way for looking at what EMS is doing, what are patient outcomes, and how EMS can be improved. Massachusetts is in the early stages of data collection and has not yet begun submitting data to NEMSIS.

Clearly, collecting data on race is a way of detecting disparities in how patients of different races are treated. Howie writes: “This is about a sick obsession by the liberals with somehow proving “disparities,” which there certainly are in this country, only they’re exactly the reverse of what the moonbats would have you believe they are.”

In actual fact, the data on disparities suggest that they’re not only real, they’re deeper than many of us might suspect. Here’s a post of ours on a national Massachusetts General Hospital study that found black and Hispanic patients were treated differently for chest pain. And here’s an overview of racial disparities in health from the CDC, an institution not generally considered a bastion of political correctness.