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Month: February 2015

Feedback Loop

• 14

By PHILIP ALLEN GREEN

flying cadeuciiRight now there are two patients in every room. One is made with flesh, bones, and blood. One is made with a monitor, a mouse, and a keyboard.

Both demand my time.

Both demand my concentration.

A little over two weeks ago I wrote the short story Please Choose One. I posted it online. The response it generated exceeded anything I could have ever imagined. It struck a nerve. People contacted me from all over the world, from all walks of life, about the story. Everyone, it seems, can relate to the challenge of having to choose between a person and a screen.

People sent me all kinds of suggestions and ideas. A few sent words of encouragement. Yet, what struck me the most about the people who contacted me was what they did not say. Not a single IT person argued the computer was more important than the patient. Not a single healthcare provider stated they wanted more time with the screen and less time with the patient. And finally, most importantly, not a single patient wrote me and said they wished their doctor or nurse spent more time typing and less time listening.

Medicine is the art of the subtle- the resentful glance from the mother of the newborn presenting with the suspicious bruise, the solitary bead of sweat running down the temple of the fifty three year old truck driver complaining of reflux, the slight flush on the face of the teenage girl when asked if she is having thoughts of hurting herself. These things matter. And these same things are missed when our eyes are on the screen instead of the patient.

Continue reading…

Health 2.0 Asia: Japan Conference Partnership

By SOPHIE PARK

Tokyo, Japan – Health 2.0 announces the Health 2.0 Asia partnership with MedPeer, Inc. to showcase the Health 2.0 Asia conference Japan on November 4-5, 2015. The conference will be the first of a series of events expanding the global presence for Health 2.0 in Asia. This conference will feature ground-breaking insights and leadership within the global health care technology industry while showcasing cutting-edge technologies for user-generated health care. The conference will become a forum for attendees to build networks for exchanging innovative ideas and developing new business parternships, which will promote active inbound and outbound investment within the health-tech industry. MedPeer, Inc. will expand Health 2.0 activities across Japan in collaboration with local chapters by holding a series of health-tech hackathons.

About Health 2.0

Health 2.0 is the premiere showcase and catalyst for the advancement of new health technologies. Through a global series of conferences, thought leadership roundtables, developer competitions, pilot programs, and leading market intelligence, Health 2.0 drives the innovation and collaboration necessary to transform health and health care.

Media Contact
Sophie Park
so****@********on.com

The Facebook Model for Socialized Health Care

• 5

By EDGAR T. WILSON

Screen Shot 2015-02-26 at 5.06.17 PMAs government involvement in U.S. health care deepens—through the Affordable Care Act, Meaningful Use, and the continued revisions and expansions of Medicaid and Medicare—the politically electric watchword is “socialism.”

Online, of course, social media is not a latent communist threat, but rather the most popular destination for internet users around the world.

People, whether out of fear for being left behind, or simply tickled by the ease with which they can publicize their lives, have been sharing every element of their public (and very often, their private) lives with ever-increasing zeal. Pictures, videos, by-the-minute commentary and updates, idle musings, blogs—the means by which people broadcast themselves are as numerous and diverse as sites on the web itself.

Even as the public decries government spying programs and panics at the news of the latest massive data-breach, the daily traffic to sites like Facebook and Twitter—especially through mobile devices—not only stays high, but continues to grow. These sites are designed around users volunteering personal information, from work and education information, to preferences in music, movies, politics, and even romantic partners.

So why not health data?

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The Digital Doctor: Automation, Aviation and Medicine

• 13

By ROBERT WACHTER, MD

Miracle Tow

 The story of Chesley “Sully” Sullenberger – the “Miracle on the Hudson” pilot – is a modern American legend. I’ve gotten to know Captain Sullenberger over the past several years, and he is a warm, caring, and thoughtful person who saw, in the aftermath of his feat, an opportunity to promote safety in many industries, including healthcare.

In my continuing series of interviews I conducted for my upcoming book, The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age, here are excerpts of my interview with Sully, conducted at his house in San Francisco’s East Bay, on May 12, 2014.

Bob Wachter: How did people think about automation in the early days of aviation?

Sully Sullenberger:  When automation became possible in aviation, people thought, “We can eliminate human error by automating everything.” We’ve learned that automation does not eliminate errors. Rather, it changes the nature of the errors that are made, and it makes possible new kinds of errors. The paradox of cockpit automation is that it can lower the pilot’s workload in phases of flight when the workload is already low, and it can increase the workload when the workload is already high.Continue reading…

A Master Class In Health Policy with Kavita Patel

• 3

By MATTHEW HOLT

flying cadeuciiThe HxRefactored Conference kicks off April 1st in Boston and we are excited to have Kavita Patel giving a Master Class in U.S. Health Policy.” Kavita is a Managing Director at The Brookings Institution in Washington, DC and has a long history working in health reform for both Ted Kennedy and at the Obama White House.  I interviewed Kavita to talk health care reform impact, insight, technology and and timing.

Matthew Holt: What are the most important changes that you are currently seeing due to Health Care Reform as well as in the health care system as a whole?

Kavita Patel:I would say the most important change is everybody is now intensely focused on transforming every aspect of health care, not only the consumer experience or people who are not already inside the health care system, but also for patients and then for their family members–whether it’s an insurance company that had massive numbers of enrollees, as a result of the Affordable Care Act and the last wave of 11 million people who signed up, or if it’s the one person’s primary care physician who is now looking at whether or not he or she should be part of the patient centered medical home, because he or she is kind of thinking through what the future of medicine will look like, as well as patients and consumers.Continue reading…

Why Can’t We All Just Get Along?

• 14

By KAREN  SIBERT, MD

flying cadeuciiAmerican anesthesiology reached a significant milestone last year, though many of us probably missed it at the time.

In February, 2014, the number of nurse anesthetists in the United States for the first time exceeded the number of physician anesthesiologists. Not only are there more nurses than physicians in the field of anesthesia today, the number of nurses entering the field is growing at a faster rate than the number of physicians. Since December, 2012, the number of nurse anesthetists has grown by 12.1 percent compared to 5.8 percent for physician anesthesiologists.

The numbers—about 46,600 nurse anesthetists and 45,700 physician anesthesiologists—reported in the National Provider Identifier (NPI) dataset for January, 2015, probably understate the growing disparity. Today, more and more physicians are leaving the front lines of medicine, many obtaining additional qualifications such as MBA degrees and embarking on new careers in hospital administration or business.

Physician anesthesiologists can expect that fewer of us every year will continue to work in the model of personally providing anesthesia care to individual patients. Clinical practice is likely to skew even more toward the anesthesia care team model, already dominant in every part of the US except the west coast, with supervision of nurse anesthetists and anesthesiologist assistants.

Continue reading…

The Tao of Wearables

• 18

By JOE KVEDAR, MD

Connected

The hype around wearables is deafening.  I say this from the perspective of someone who saw their application in chronic illness management 15 years ago. Of course, at that time, it was less about wearables and more about sensors in the home, but the concept was the same.

Over the years, we’ve seen growing signs that wearables were going to be all the rage. In 2005, we adopted the moniker ‘Connected Health’ and the slogan, “Bring health care into the day-to-day lives of our patients,” shortly thereafter.  About 18 months ago, we launched Wellocracy, in an effort to educate consumers about the power of self-tracking as a tool for health improvement.  All of this attention to wearables warms my heart.  In fact, Fitbit (the Kleenex of the industry) is rumored to be going public in the near future.

So when the headline, “Here’s Proof that Pricey Fitness Wearables Really Aren’t Worth It,” came through on the Huffington Post this week, I had to click through and see what was going on.  Low and behold this catchy headline was referring to a study by some friends (and very esteemed colleagues) from the University of Pennsylvania, Mitesh Patel and Kevin Volpp.

Continue reading…

A Shout Out to Our Sponsors

By THCBist

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That’s the power of Health Connections Brought to Life™.

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Weight Loss Fines Are Discriminatory and Counterproductive

• 69

By LEWIS, KHANNA and ROBISON

flying cadeuciiOne year ago in these pages, Harvard Medical School’s Stephen Soumerai wrote a scathing essay arguing that employer fines on overweight employees were ineffective.  We’re here to tell you that Professor Soumerai is a cockeyed optimist.  A new review in the American Journal of Managed Care shows that these fines transcend ineffectiveness.  They are counterproductive.

To begin with, forced corporate weight loss programs don’t work.  Of roughly 1000 wellness vendors promising weight loss, only one, the iDiet, has received validation.  Literally no other corporate weight loss program can check three simple boxes that are standard in medical research:

  1. The study was controlled the way grownups would define “controlled,” not using unmotivated non-participants as a control for motivated participants, which Health Fitness Corporation  inadvertently invalidated
  2. the program was sustained for 18 months, rather than eight weeks, which seems to be the new standard for get-thin-quick programs; and
  3. The results showed both high persistence and significant weight loss.

Even that study had significant limitations: One could argue that the sample was small and even 18 months was not a long enough period to determine if weight maintenance was likely to be permanent.

Continue reading…

What Do Women Know About Obamacare That Men Don’t?

• 27

By SUSAN DENTZER

Susan DentzerFor the second year running, more women than men have signed up for coverage in health insurance marketplaces during open enrollment under the Affordable Care Act. According to the Department of Health and Human Services, enrollment ran 56 percent female, 44 percent male, during last year’s open enrollment season; preliminary data from this year shows enrollment at 55 percent female, 45 percent male – a 10 percentage point difference.

What gives? An HHS spokeswoman says the department can’t explain most of the differential. Females make up about 51 percent of the U.S. population, but there is no real evidence that, prior to ACA implementation, they were disproportionately more likely to be uninsured than men – and in fact, some evidence indicates that they were less likely to be uninsured than males .

What is clear that many women were highly motivated to obtain coverage under the health reform law – most likely because they want it, and need it.

It’s widely accepted that women tend to be highly concerned about health and health care; they use more of it than men, in part due to reproductive services, and make 80 percent of health care decisions for their families . The early evidence also suggests that women who obtained coverage during open enrollment season last year actively used it.  Continue reading…