Lessons in Health Care from Appleton, Wisconsin

This is a rush transcript from "On the Record," August 21, 2009. This copy may not be in its final form and may be updated.

GRETA VAN SUSTEREN, FOX NEWS HOST: "On the Record" is doing what your senators and member of Congress should be doing right now. We're checking out different health care systems to see what works. Our own Griff Jenkins and our "On the Record" producer Kerry O'Connor went to a hospital and a clinic in Appleton, Wisconsin, to investigate ThedaCare.


GRIFF JENKINS, FOX NEWS: With the raging debate over health care, town halls all across America, have we lost sight of one of the most important goals, delivering better care while cutting costs? Well, we found a system here in Appleton, Wisconsin, that does just that. It's called ThedaCare.

Dr. Toussaint, one of your biggest innovations, major innovations at ThedaCare is collaborative care. What is that? Can we see that?

DR. JOHN TOUSSAINT, CEO OF THEDACARE: Sure. The nurse doesn't have a special plan of care versus the doctor versus the pharmacist. They all work together in a collaboration to deliver the best care for the lowest price.

JENKINS: How does the collaborative care team work?

TOUSSAINT: Within the first 90 minutes of a patient admission, the -- you will -- the pharmacy, the pharmacist, the physician, the nurse will all enter the room...

JENKINS: We see them coming in now.

TOUSSAINT: They will all enter the room and -- with the patient, and in many cases, the patient's family. And this team will actually do the exam, ask the questions, develop a care plan actually as a -- as collaborative team.

JENKINS: And what do you guys do? Dan (ph), what are you?

UNIDENTIFIED MALE: I'm the pharmacist.

JENKINS: And Nicole (ph)?

UNIDENTIFIED FEMALE: And then I'm the nurse, and I use the care plan as a map to kind of guide the patient through from admission to discharge.

UNIDENTIFIED FEMALE: And I'm the physician (INAUDIBLE) and I kind of direct the team, introduce myself, make sure that the patient is comfortable and that their immediate needs for pain medicine or nausea are taken care. We examine the patient together, go over any abnormal findings. And that either goes in their patient education folder or right up here on the board for them, so they can see who's taking care of them, what the major things (ph) we are, what tests we have for them, and most of all, when they can get out of here.

JENKINS: As a patient, do you feel better, more secure, that you're getting better care to have a team working at once?

UNIDENTIFIED FEMALE: Oh, yes. It's (INAUDIBLE) organized. It cuts down my hospital time by quite a bit now.

UNIDENTIFIED FEMALE: Prior to collaborative care, nurses were spending up to three hours a shift looking for supplies. So we came up with this idea to have the nurse server (ph) right in each patient room with all the supplies you need right here. So no longer am I running down the hall to get an IV bag, they're right up here.

Watch Griff's full interviews:

Part 1

Part 2

Part 3

Part 4

Part 5

Part 6

TOUSSAINT: We have this number of patients that we care for at Appleton, and if you improve their total, you know, health -- in other words, their diabetes is better managed and they have fewer complications from diabetes and we have fewer heart surgeries -- that we get paid more. Think how that might change the way we deliver care in the United States. So we need to move to a population (ph) health type of payment system, whether it's a public plan or a private plan. And right now, there's nothing in the bills that has anything to do with that.

JENKINS: You wrote in an op-ed that if all the hospitals in the country -- I think there's about 5,000, 6,000 -- if all hospitals in the country modeled their programs after ThedaCare, that you could save in 10 years $400 billion in Medicare inpatient alone.

TOUSSAINT: That's correct. And so what we've found is that as we've redesigned inpatient care using these tools that I've been describing, that we've seen a 25 percent reduction in the total direct costs -- the total cost of care on inpatient.

JENKINS: How does ThedaCare deliver care? What is it that makes it so darn efficient?

TOUSSAINT: So what we are constantly doing is asking the question, Does every step that we do in a process deliver better value to the patient? And we actually have these maps. We will actually map out every single step in a care process.

JENKINS: Congressman, you were an allergy specialist and a doctor. You're in Washington now. What's wrong with the health care debate we're having today?

REP. STEVE KAGEN, D - WIS., PHYSICIAN: Everywhere I go across northeast Wisconsin, people are telling me the same thing. Hey, Dr. Kagen, let's fix what's broken and improve on everything else that we have already got at a lower price.

JENKINS: We're here in one of ThedaCare's 23 primary care facilities. The waiting time in waiting rooms -- cut down. The process -- very efficient. And the patients -- getting better care.

TOUSSAINT: These visual tracking centers are present everywhere at ThedaCare, in every clinic and every department in the hospital. And they track exactly what you'd see on a Toyota production floor, which is quality, people, service, delivery and productivity. What we're doing is measuring performance on a really almost minute-by-minute basis in this clinic in terms of how long it takes to turn -- to get lab results, for example, or how long -- or how are we doing on quality performance, or how are we doing, actually, on the productivity of the workforce, both the physicians and the staff.

KAGEN: The idea that no longer will an insurance company be able to discriminate against you because of a pre-existing condition -- if you're a citizen, you ought to be in the risk pool in the neighborhood -- well, that idea came from northeast Wisconsin.

JENKINS: While ThedaCare is unique to Wisconsin, programs in 14 other states had similar success applying the same principles. Major institutions like JohnS Hopkins University and UCLA have implemented programs just like it. The question now is, Why aren't the folks in Washington coming here to take a look at it? And why aren't we hearing more about it in the national debate?


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