Discussing Health Courts in Wyoming

Earlier this month, Common Good and the Wyoming Health Care Commission co-hosted a public event on legal options to improve patient safety and reduce medical errors. The presentations are available on the Wyoming Health Care Commission's site and the Wyoming Business Report also covered the event.

While the links above convey content, I'd like to add a few comments about context and observations. 

• I think it's pretty cool that Wyoming is among the first states to engage in in this discussion on how medical liability reform can go beyond caps on damages to address larger issues, like system inefficiencies, patient safety, and inconsistencies in patient compensation (note: this sentence revised for clarification on 10/31/07).  As it stands now, there are plenty of complexities from the patient, provider, and legal advisor's perspectives, but the intent is to make the system more transparent and safer.  Kudos to the folks on the Health Care Commission and others who are willing to parse this out. 
• The first thing that struck me about being at this event in Wyoming was the landscape of the state, literally.  Whether you're flying or driving to Wyoming, you notice is that it's a rural place.  There are lots of wide open spaces.  Wide open.  Many readers may know that New Jersey (where RWJF is) has the highest population density of any US state at 1,138 people per square mile.  Wyoming has about 5 people per square mile.  The only state with a lower population density is Alaska.  I bring this up because the discussion about medical liability reform is often considered as a system-wide change, a system that can span across towns, a state, or even many states.  In Wyoming, the system has components in very remote areas.  Technology can erase some of the miles, but it can't make up all the resources, including specialty care, supportive care, or administrative staff. I like thinking about the components of implementation, but it makes my head spin to consider some of the logistical challenges of implementing health courts on the ground in Wyoming.  As other states travel down the path of medical liability reform, I'm interested to see how geography and density factor in to implementation.
• A recurrent theme in medical liability reform is transparency.  While you can make a system more transparent by making it simpler, the Tennenbaum Institute would argue that a system SHOULD be more complex.  Wouldn't it be fun and informative to test out the proposed system changes (for more and less complexity) on the Health Advisor?

Comments

[Paul Levy]

Not related to this, but please check out Grand Rounds today at http://runningahospital.blogspot.com/2007/10/grand-rounds-volume-4-number-6.html
Some moving and insightful stories about experiences in hospitals. Thanks.