Healthcare Reform Already Starting?

As 2009 draws to a close, healthcare reform efforts continue to play out politically. At press time for our December 2009 issue, the U.S. Senate had just voted to begin debating its reform bill. But as debates were set to begin, new recommendations for routine mammograms and pap smears were causing their own controversies. Was advice on beginning such screenings later in life just the beginning of rationed healthcare, which some have argued reformists are seeking? Or do they represent independent efforts to identify effective healthcare based on patient outcomes? 

It seems as though some suggestions are already taking root, without legislation. Explains Laura Bix, assistant professor, Michigan State University, School of Packaging, who participated in this issue’s Editorial Advisory Board Roundtable: “The Centers for Medicare and Medicaid Services are looking at evidence-based medicine. For fiscal responsibility, they have to spend their dollars much more carefully.”

Payers may therefore be looking for healthcare traceability and accountability to better identify the actual therapies, procedures, and products employed in order to measure their outcomes. Packaging professionals may be called upon to help provide that traceability.

“This could be one of the big drivers behind Unique Device Identification (UDI) for medical devices to tie specific products and dollars spent to patient outcomes,” Bix says. “It is an interesting spin on cost efficiency and more complicated than traditional approaches.”

So do we need better data on individual packages for capture at the point of administration? Steve Hess, executive director of packaging technology, Merck and Company, Inc., says it is easier to think about data’s potential with vaccines. “Doctors’ offices may record lot numbers incorrectly, and manufacturers may get complaints on lot numbers that have never been produced. Our vision is that the doctor’s office captures all that data electronically, and those data can be accessed electronically whenever or wherever they are needed. That is the holy grail.” Hess sees a distinct role for packaging engineers: “It is how data are put on the package and how data are accessed.”

Of course, successful data capture will also require process changes for healthcare practitioners. “You can mandate manufacturers, but what about the hospitals?” asks D. Bruce Cohen, principal of PackTechPlus LLC. “During my two-and-half days in the hospital, no one scanned my wristband and then the medication I was given.” Cohen adds that he always thought “lawyers would force it because of the liability.” He notes that “electronic medical records are like portable insurance. It can be lifesaving.”

If healthcare reform legislation passes, “cost controls will definitely affect packaging professionals and packaging decisions,” notes Cohen.

But if it doesn’t, mere discussions of identifying therapies that result in better patient outcomes and of the need for greater healthcare efficiencies could still drive change on their own.

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