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Dive into the research topics where Andrew J. Sussman is active.

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Featured researches published by Andrew J. Sussman.


The American Journal of Medicine | 2003

A cost-benefit analysis of electronic medical records in primary care

Samuel J. Wang; Blackford Middleton; Lisa A. Prosser; Christiana G. Bardon; Cynthia D. Spurr; Patricia J. Carchidi; Robert C. Goldszer; David G. Fairchild; Andrew J. Sussman; Gilad J. Kuperman; David W. Bates

Electronic medical record systems improve the quality of patient care and decrease medical errors, but their financial effects have not been as well documented. The purpose of this study was to estimate the net financial benefit or cost of implementing electronic medical record systems in primary care. We performed a cost-benefit study to analyze the financial effects of electronic medical record systems in ambulatory primary care settings from the perspective of the health care organization. Data were obtained from studies at our institution and from the published literature. The reference strategy for comparisons was the traditional paper-based medical record. The primary outcome measure was the net financial benefit or cost per primary care physician for a 5-year period. The estimated net benefit from using an electronic medical record for a 5-year period was 86,400 US dollars per provider. Benefits accrue primarily from savings in drug expenditures, improved utilization of radiology tests, better capture of charges, and decreased billing errors. In one-way sensitivity analyses, the model was most sensitive to the proportion of patients whose care was capitated; the net benefit varied from a low of 8400 US dollars to a high of 140,100 US dollars . A five-way sensitivity analysis with the most pessimistic and optimistic assumptions showed results ranging from a 2300 US dollars net cost to a 330,900 US dollars net benefit. Implementation of an electronic medical record system in primary care can result in a positive financial return on investment to the health care organization. The magnitude of the return is sensitive to several key factors.


Journal of General Internal Medicine | 2000

Communication Breakdown in the Outpatient Referral Process

Tejal K. Gandhi; Dean F. Sittig; Michael J. Franklin; Andrew J. Sussman; David G. Fairchild; David W. Bates

AbstractOBJECTIVE: To evaluate primary care and specialist physicians’ satisfaction with interphysician communication and to identify the major problems in the current referral process. DESIGN: Surveys were mailed to providers to determine satisfaction with the referral process; then patient-specific surveys were e-mailed to this group to obtain real-time referral information. SETTING: Academic tertiary care medical center. PARTICIPANTS: Attending-level primary care physicians (PCPs) and specialists. MEASUREMENTS AND MAIN RESULTS: The response rate for mail surveys for PCPs was 57% and for specialists was 51%. In the mail survey, 63% of PCPs and 35% of specialists were dissatisfied with the current referral process. Respondents felt that major problems with the current referral system were lack of timeliness of information and inadequate referral letter content. Information considered important by recipient groups was often not included in letters that were sent. The response rate for the referral specific e-mail surveys was 56% for PCPs and 53% for specialists. In this e-mail survey, 68% of specialists reported that they received no information from the PCP prior to specific referral visits, and 38% of these said that this information would have been helpful. In addition, four weeks after specific referral visits, 25% of PCPs had still not received any information from specialists. CONCLUSIONS: Substantial problems were present in the referral process. The major issues were physician dissatisfaction, lack of timeliness, and inadequate content of interphysician communication. Information obtained from the general survey and referral-specific survey was congruent. Efforts to improve the referral system could improve both physician satisfaction and quality of patient care.


American Journal of Roentgenology | 2006

Inpatient Radiology Utilization: Trends over the Past Decade

Amin Matin; David W. Bates; Andrew J. Sussman; Pablo R. Ros; Richard Hanson; Ramin Khorasani

OBJECTIVE The objective of our study was to assess patterns of use of radiology services for inpatients at our institution between 1993 and 2002. MATERIALS AND METHODS We retrospectively reviewed the administrative data about adult inpatients for fiscal years 1993-2002 in a 721-bed tertiary care institution. Examinations were coded according to imaging technique: conventional (plain films and fluoroscopy), sonography, nuclear medicine, CT, or MRI. We assessed workload trends using relative value units (RVUs). Linear regression analysis was used to assess the significance of trends for the number of examinations and RVUs per case-mix-adjusted admission (CMAA). RESULTS There was a significant decrease in the total number of examinations per CMAA (p < 0.001). This was due to significant decreases in the use of conventional studies (p < 0.001) and sonograms (p < 0.001), despite significant increases in the number of nuclear medicine (p = 0.046), CT (p < 0.001), and MRI (p < 0.002) examinations per CMAA. The RVUs per CMAA increased significantly (p < 0.01) during the study period. CONCLUSION Newer imaging technologies (nuclear medicine, CT, and MRI) are replacing older ones in the evaluation of inpatients. Despite the significant decrease in the total number of imaging examinations per CMAA, we observed a significant increase in RVUs per CMAA during the 10-year study period. Understanding the impact of this change in practice on the quality of care would be useful in justifying the increasing use of these new technologies, and decreasing their inappropriate use should be a priority in efforts that focus on controlling imaging expenditures.


American Journal of Medical Quality | 2008

When things go wrong: the impact of being a statistical outlier in publicly reported coronary artery bypass graft surgery mortality data.

Walter H. Ettinger; Sharon M. Hylka; Robert A. Phillips; Lynn H. Harrison; Jay Cyr; Andrew J. Sussman

The public reporting of hospital quality and safety data is a growing phenomenon. Yet there are few reports of the effects of publicly reported data on individual organizations, particularly when the data show worse than expected performance. In this article, our hospitals response to having a mortality rate from coronary artery bypass graft surgery that was significantly higher than other programs in the Commonwealth of Massachusetts is reported. The data caused suspension of elective cardiac surgery at the institution, and an independent review of the program was undertaken. The effects of the suspension and publication of mortality data on quality and patient safety, the residency training program in cardiothoracic surgery, and the financial performance of the hospital are described. Several lessons were learned that may be of value to other health care organizations that experience a public crisis in clinical quality. (Am J Med Qual 2008;23:90-95)


Chest | 2018

Higher Priced Older Pharmaceuticals: How Should We Respond?

Richard S. Irwin; Scott Manaker; Mark L. Metersky; Robert P. Baughman; Tunde Otulana; Steven E. Weinberger; Andrew J. Sussman; Norine A. McGrath

We and our patients have been aware of the high cost of medications in the United States for decades; however, we are now witnessing a relatively new phenomenon: exponential price increases for some older pharmaceuticals that have been available for years. To assist practitioners in how to respond to the issue of higher priced pharmaceuticals, an interprofessional session was developed and held at CHEST 2016 in Los Angeles. The session proceedings and a few updates are presented here to summarize what pulmonologists; a sarcoidosis expert; a retired executive of a medical society, an executive of a pharmaceutical company and of a pharmacy; and an ethicist advise that we do about the problem. Because the comments presented at the session and in this manuscript represent the opinions of each author, this commentary in essence is a compilation of nine editorials. It does not represent a comprehensive discussion of the field of pricing of drugs. In reflecting upon the answers to the questions posed, and regardless of their sector of health care, all participants stated that they focused on the patient. However, actually providing patient-focused care (ie, the care defined from the patients perspective) is another matter. To significantly improve patient satisfaction and health-care outcomes, patient-focused care needs to embody the 3 Cs of (1) communication, (2) continuity of care, and (3) concordance of expectations (ie, finding the common ground). Therefore, we discuss how the 3 Cs apply to responses to higher priced pharmaceuticals.


Healthcare | 2017

Antibiotic stewardship in the retail clinic setting: Implementation in 1100 clinics nationwide

Jennifer M. Polinski; Sandra L. Harmon; Kimberly J. Henderson; Tobias Barker; Andrew J. Sussman; Nancy J. Gagliano

In light of increasing antibiotic resistance and a slowed antibiotic development pipeline, stewardship is more urgent than ever. To date, most stewardship guidelines and best practice recommendations for implementation focus on local or regional health care organizations. CVS MinuteClinic has implemented a consistent, evidence-based stewardship approach in its >1100 clinics in 33 states. The approach is associated with higher quality antibiotic use than that in primary care practices and emergency departments. Given MinuteClinics scale, sharing this approach and lessons learned may assist other organizations in implementing large-scale stewardship programs that foster judicious use of antibiotics for the publics health.


Chest | 2017

CommentaryHigher Priced Older Pharmaceuticals: How Should We Respond?Higher Priced Older Pharmaceuticals

Richard S. Irwin; Scott Manaker; Mark L. Metersky; Robert P. Baughman; Tunde Otulana; Steven E. Weinberger; Andrew J. Sussman; Norine A. McGrath

We and our patients have been aware of the high cost of medications in the United States for decades; however, we are now witnessing a relatively new phenomenon: exponential price increases for some older pharmaceuticals that have been available for years. To assist practitioners in how to respond to the issue of higher priced pharmaceuticals, an interprofessional session was developed and held at CHEST 2016 in Los Angeles. The session proceedings and a few updates are presented here to summarize what pulmonologists; a sarcoidosis expert; a retired executive of a medical society, an executive of a pharmaceutical company and of a pharmacy; and an ethicist advise that we do about the problem. Because the comments presented at the session and in this manuscript represent the opinions of each author, this commentary in essence is a compilation of nine editorials. It does not represent a comprehensive discussion of the field of pricing of drugs. In reflecting upon the answers to the questions posed, and regardless of their sector of health care, all participants stated that they focused on the patient. However, actually providing patient-focused care (ie, the care defined from the patients perspective) is another matter. To significantly improve patient satisfaction and health-care outcomes, patient-focused care needs to embody the 3 Cs of (1) communication, (2) continuity of care, and (3) concordance of expectations (ie, finding the common ground). Therefore, we discuss how the 3 Cs apply to responses to higher priced pharmaceuticals.


Obstetrics & Gynecology | 2000

Global capitation at a women's health referral center: the challenge of patient selection.

Andrew J. Sussman; Robert L. Barbieri; Troyen A. Brennan

Global risk capitation as a preferred payment method in heavily penetrated managed care markets poses important challenges for womens health care tertiary referral centers that employ participating primary care physicians. Global risk capitation agreements expose those centers to the adverse financial effects of high frequency of obstetric visits, costly infertility and neonatal care, and care of a disproportionate number of patients with complex, resource-intensive conditions.


The American Journal of Medicine | 1999

Assessing the value of hospitalists to academic health centers: Brigham and Women's Hospital and Harvard Medical School.

Brown; Halpert A; Sylvia C. McKean; Andrew J. Sussman; Victor J. Dzau


Academic Medicine | 2001

Primary care compensation at an academic medical center: a model for the mixed-payer environment.

Andrew J. Sussman; David G. Fairchild; Jonathan S. Coblyn; Troyen A. Brennan

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David G. Fairchild

Brigham and Women's Hospital

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David W. Bates

Brigham and Women's Hospital

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Dean F. Sittig

University of Texas Health Science Center at Houston

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Jonathan S. Coblyn

Brigham and Women's Hospital

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Louise I. Schneider

Brigham and Women's Hospital

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