77 replies to this topic

[Michael Hardner]

mrs wyly works in medical administration and is short staffed(she works 10hr days 5 days per,she's not home yet so today it's 11hrs), so things don't get done asap because of a shortage of administrative help, but public demand for lower taxes has restricted funds to fill positions, then come the complaints "why does it take so long"...it's a never ending cycle...

I'd be really curious as to what administrators do... what all of the administrators do.

The system seems so archaic - so paper-based and so heirarchical... it just seems poorly managed to me.

[wyly]

I'd be really curious as to what administrators do... what all of the administrators do.

The system seems so archaic - so paper-based and so heirarchical... it just seems poorly managed to me.

paper based? you don't get out much paper is just hardcopy to store away as backup, mrs wyly's desk is like something from wallstreeet with multiple monitors tracking everything...what do you think administrators do? spend a moment and think of all the people it takes to run a hospital, the number of different jobs involved and then the volume of administration needed to keep that running smoothly...american MDs have about 4 times higher administration overhead in comparison to canadian mds

like the military for every frontline soldier(md) there is a support staff of 4-10 people keeping him/her supplied, fed, informed, paid, healthcare, etc...

Edited by wyly, 03 November 2011 - 08:44 PM.

[jacee]

This article is really interesting, as it echoes something that I've heard recently - namely that an aging population will not in fact put large strain on the healthcare system.

http://www.cbc.ca/news/health/story/2011/11/03/health-care-spending.html

I think they're saying they haven't seen it much yet, but the population bulge actually came in 1965. With the third/fourth/fifth children of the baby boom era, so it will go on for years yet, maybe peaking after 2030 when 'the bulge' is 65.
Lots of time to prepare.

[Evening Star]

My understanding is that the Millennial cohort is actually larger than the baby boomer cohort...?

[Michael Hardner]

paper based? you don't get out much paper is just hardcopy to store away as backup, mrs wyly's desk is like something from wallstreeet with multiple monitors tracking everything...

I just know that they still fax things, I still fill out paper forms whenever I go anywhere etc.

what do you think administrators do? spend a moment and think of all the people it takes to run a hospital, the number of different jobs involved and then the volume of administration needed to keep that running smoothly...american MDs have about 4 times higher administration overhead in comparison to canadian mds

1. I don't know what administrators do. They may be doing useful work, but they may not be working efficiently. The size and complexity of an operation isn't an indicator of how well it's run, obviously.

2. Comparisons to the US are not relevant unless you're looking to implement that type of system here.

like the military for every frontline soldier(md) there is a support staff of 4-10 people keeping him/her supplied, fed, informed, paid, healthcare, etc...

And you're comparing to the military... why ? Is that some kind of benchmark for well run organizations ?

Look - the healthcare system is a special case, but it needs more openness for people to understand exactly what they do, where resources are going and so on. There is no source for information that is commonly used by a public. We largely rely on press releases which more often than not have an agenda associated with them. CIHI is an exception.

[Smallc]

I just know that they still fax things, I still fill out paper forms whenever I go anywhere etc.

It's often simpler than; printing, signing, scanning, e-mailing, printing, singing, scanning, emailing, etc.

[noahbody]

The common belief is that an aging population will fuel demands for health-care services. Yet population aging has been a "very modest cost driver overall," the authors said.

The only conclusion I can come to is that the authors aren't very bright. Boomers will put an enormous strain on the health care system. Wait until they reach the age where they need long-term care.

[Smallc]

The only conclusion I can come to is that the authors aren't very bright. Boomers will put an enormous strain on the health care system. Wait until they reach the age where they need long-term care.

But that doesn't seem to be borne out in the evidence. The same is true of overweight people, who were preciously thought to increase the strain on the system.

[Michael Hardner]

The only conclusion I can come to is that the authors aren't very bright. Boomers will put an enormous strain on the health care system. Wait until they reach the age where they need long-term care.

So... CIHI is in the business of constantly analyzing healthcare statistics. It's commonly stated that boomers will be a problem, but the point is that CIHI (and almost CIHI alone) has DATA, so I would trust them over the common wisdom on this topic.

[wyly]

I just know that they still fax things, I still fill out paper forms whenever I go anywhere etc.

of course you still fill out paper they're not going to give you access to the computer network...the paperwork you fill out still needs to be put into the system by someone...

1. I don't know what administrators do. They may be doing useful work, but they may not be working efficiently. The size and complexity of an operation isn't an indicator of how well it's run, obviously.

so you want to add another layer of clerical work(still more expense) to keep you informed of what every little cog in the machine is doing all day?...they do that themselves they don't need us micro managing them...

2. Comparisons to the US are not relevant unless you're looking to implement that type of system here.

it is relevant, it demonstrates how much waste there can be when not done properly...our administrative system is much more efficient...

And you're comparing to the military... why ? Is that some kind of benchmark for well run organizations ?

just an example of how many people that work behind those who get the attention...we focus on MDs and nurses but there are many more involved for those MDs and nurses to able to do their job...healthcare requires a massive complex organization to deliver the service, most people only see the tip of the iceberg, nurses and MDs...my last visit to the ER was 7hrs, 7hrs laying in ER watching/studying all the coming and goings of numerous people who are not nurse and MDs that make it all run smoothly...

Look - the healthcare system is a special case, but it needs more openness for people to understand exactly what they do, where resources are going and so on. There is no source for information that is commonly used by a public. We largely rely on press releases which more often than not have an agenda associated with them. CIHI is an exception.

do you really need to know how many rolls of toilet paper a hospital goes through in a day or how long it takes to change them or who keeps track of that?... knowing how much data some administration person inputs per day will mean what to you? how will you know if it's too little or a lot?...are the daily fires put out by the HR people going to understood by anyone, how are you going to attach an appropriate dollar figure to HR issues...really to people like you and me that type of data is meaningless, it serves no purpose only to add more expense by adding more administration costs to satisfy our casual curiosity...

Edited by wyly, 04 November 2011 - 10:22 AM.

[Michael Hardner]

of course you still fill out paper they're not going to give you access to the computer network...the paperwork you fill out still needs to be put into the system by someone...

You could fill out your own information online - once - and they could use it.

so you want to add another layer of clerical work(still more expense) to keep you informed of what every little cog in the machine is doing all day?...they do that themselves they don't need us micro managing them...

Your reaction is typical of those who haven't ever seen that organization can be improved, and also reflects experience with a heirarchical system where excessive top-down management is in place.

Even the word 'clerical' seems archaic when I see it these days.

So, no. The processes need to be revamped top to bottom and 4-5 administrators per front line worker reduced.

it is relevant, it demonstrates how much waste there can be when not done properly...our administrative system is much more efficient...

Again - not relevant. Who cares how bad it can be ? That conversation is for those who are happy with the status quo and don't want to improve.

just an example of how many people that work behind those who get the attention...we focus on MDs and nurses but there are many more involved for those MDs and nurses to able to do their job...healthcare requires a massive complex organization to deliver the service, most people only see the tip of the iceberg, nurses and MDs...my last visit to the ER was 7hrs, 7hrs laying in ER watching/studying all the coming and goings of numerous people who are not nurse and MDs that make it all run smoothly...

As I said, size or complexity doesn't really address whether it can be improved or not.

do you really need to know how many rolls of toilet paper a hospital goes through in a day or how long it takes to change them or who keeps track of that?... knowing how much data some administration person inputs per day will mean what to you? how will you know if it's too little or a lot?...are the daily fires put out by the HR people going to understood by anyone, how are you going to attach an appropriate dollar figure to HR issues...really to people like you and me that type of data is meaningless, it serves no purpose only to add more expense by adding more administration costs to satisfy our casual curiosity...

I can't imagine that it's run well, is all. I work with huge corporations every day and they aren't generally run very well so I don't expect that other operations are either.

[wyly]

You could fill out your own information online - once - and they could use it.

you are already in the system, each new visit must be documented, on each visit it must verified that you are who you say you are, so you need to provide proof(healthcard), plus the reason for the visit is usually different and that needs to documented as well...

Your reaction is typical of those who haven't ever seen that organization can be improved, and also reflects experience with a heirarchical system where excessive top-down management is in place.

oh really? that's part of mrs wyly's job, streamlining the system removing all the bumps and distractions making sure the daily adminstration runs smoothly, implementing new changes as they are introduced, which is often...

Even the word 'clerical' seems archaic when I see it these days.

oh please enough of PC, clerical is clerical if want to call it technical adminstrative assistant be my guest...

So, no. The processes need to be revamped top to bottom and 4-5 administrators per front line worker reduced.

ah yeah it is, the process is constantly overhauled and fine tuned, shortage of admin staff and long hrs for management flies in the face of your claim of 4-5 adminstrators that you just pulled out of thin air...

Again - not relevant. Who cares how bad it can be ? That conversation is for those who are happy with the status quo and don't want to improve.

absolutely positively relevant, again part of mrs wyly's job assignment "find ways to reduce the time MDs spend on adminstration" so they can do more of what they are paid to do clinical, research, surgery etc...of course in your viewpoint that would be wrong because it would require hiring more admin people to look after MDs accounts, and we can't have that because admin people make a fraction of what MDs do, therefore wasteful...you'd prefer our already short in supply MDs spend more of their day doing clerical work...

I can't imagine that it's run well, is all. I work with huge corporations every day and they aren't generally run very well so I don't expect that other operations are either.

that's only because you have this taxpayer mentality that someone is wasting your money and you feel the need to constantly look over their shoulder all day to ensure they don't move from their desk...but the truth is joe public has no expertise in healthcare administration and your interferring would only screw things up...

Edited by wyly, 04 November 2011 - 12:17 PM.

[noahbody]

but the point is that CIHI (and almost CIHI alone) has DATA, so I would trust them over the common wisdom on this topic.

They don't have the necessary data to draw that conclusion. Here's more relevant data suggesting it will be a burden.

http://en.wikipedia.org/wiki/File:Spending_on_health_care_per_capita_by_age_group.png

[Michael Hardner]

you are already in the system, each new visit must be documented, on each visit it must verified that you are who you say you are, so you need to provide proof(healthcard), plus the reason for the visit is usually different and that needs to documented as well...

Which is why I have to manually write out my name, my address, my drivers license # etc.

The health card has a magnetic stripe on it, which I guess doesn't work.

oh really? that's part of mrs wyly's job, streamlining the system removing all the bumps and distractions making sure the daily adminstration runs smoothly, implementing new changes as they are introduced, which is often...

Interesting. How long has Mrs. Wyly been working in healthcare ?

oh please enough of PC, clerical is clerical if want to call it technical adminstrative assistant be my guest...

PC ? I don't think that's what it is. Such terms are a sign, to me, that organizations are old, job titles don't get revised etc.

ah yeah it is, the process is constantly overhauled and fine tuned, shortage of admin staff and long hrs for management flies in the face of your claim of 4-5 adminstrators that you just pulled out of thin air...

I thought I got that from your post above. Anyway, I don't trust the system to fix itself from within. Nothing personal, and nothing against the people who do these jobs (especially Mrs. Wiley) but I haven't seen that that works as well as it could.

The types of changes that are happening in the workplace now are nothing short of revolutionary, and you need to bring in specialists from outside to do it, from my experience.

absolutely positively relevant, again part of mrs wyly's job assignment "find ways to reduce the time MDs spend on adminstration" so they can do more of what they are paid to do clinical, research, surgery etc...of course in your viewpoint that would be wrong because it would require hiring more admin people to look after MDs accounts, and we can't have that because admin people make a fraction of what MDs do, therefore wasteful...you'd prefer our already short in supply MDs spend more of their day doing clerical work...

No - we were speaking of comparing to the US system, which isn't relevant. Benchmarks, though, are relevant. We don't benchmark against worse systems, we benchmark against our own systems.

that's only because you have this taxpayer mentality that someone is wasting your money and you feel the need to constantly look over their shoulder all day to ensure they don't move from their desk...but the truth is joe public has no expertise in healthcare administration and your interferring would only screw things up...

Joe Public has no experience in healthcare administration, but I'm not Joe Public. I work with organizations, including government organizations. All organizations, including my own, naturally erect firewalls against self-reporting, outside inquiry and so on. It's understandable that they do so, and it sometimes makes sense.

An example of where it makes sense is the eHealth scandal. A billion dollar operation was put on hold because of a cup of tea.

You have to build reporting and accountability into the systems. I hope I'm not coming across as blaming front line workers, or even administrators for the problem. The problem is with the public, or the lack of public. We don't pay attention to anything but politics, so we get the system we deserve.

[Michael Hardner]

They don't have the necessary data to draw that conclusion. Here's more relevant data suggesting it will be a burden.

http://en.wikipedia.org/wiki/File:Spending_on_health_care_per_capita_by_age_group.png

That's some good data, but I expect that CIHI has this information and more.