Category: Uncategorized

The Patient Safety Movement Turns Ten

Dec 2, 2009• 56

By BOB WACHTER

On December 1, 1999, the Institute of Medicine released a report entitled To Err is Human: Building a Safer Health System. Although its authors hoped to spark a national movement, they had little cause for optimism. After all, early efforts by advocates like Berwick and Leape and organizations like the National Patient Safety Foundation had barely moved the needle of public and professional attention.

The IOM Report succeeded beyond its framers’ wildest dreams, and the movement they spawned turns ten today. Please indulge me while I spend a nostalgic moment recalling the remarkable spin that launched the patient safety field. I’ll then segue to a summary of my assessment of what we’ve accomplished over the past decade (I outline this more fully in an article in this week’s web version of Health Affairs, which I hope you’ll take a look at).Continue reading…

The Leaning Tower of Jello: Why No-one Believes Health Reform will be Deficit Neutral

Dec 1, 2009• 42

By JEFF GOLDSMITH

President Obama has promised not to sign any health reform legislation that increases the federal deficit. This promise recognized rising public concern about an Argentinean fiscal trend that, unchecked, could leave us with $19 trillion in federal debt in a decade.

Without that pledge, given the current economic climate, health reform would be one dead mackerel.

Some clarifications are essential here. I’m a Democrat and fervent Obama supporter. I voted for him twice (and that was just in the Virginia primary). I’m proud of our President. He has first class economic and healthcare teams. He deserves credit for not postponing health reform. He’s right: it’s simply not tolerable, morally or economically, for a wealthy nation to continue having close to 50 million uninsured people.

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Dec 1, 2009

Death by a Thousand Cuts

Dec 1, 2009• 5

By ROBERT LASZEWSKI

The Congressional Budget Office (CBO) issued a report today saying that if the Reid bill becomes law, the price of non group policies would be about 10 percent to 13 percent higher in 2016 than it would be under current law. The CBO projects that small group and large group premiums would be about the same in 2016 as they would have been anyway as the benefits of the bill would offset some of its new costs.

But what is likely to happen to health insurance rates in 2010, 2011, 2012, and 2013 before any of the bill’s benefits occur for both the insurance markets and consumers?

I would suggest Democrats not overlook the potential for political fallout in those years.

By delaying the start of most health insurance reform benefits—including insurance subsidies and underwriting reforms—until January 1, 2014 the Reid health care bill creates a real risk of unintended political consequences for the Democrats.

Or, maybe I should have said almost certain consequences that Reid may not have thought of.

Spotlight on Health 2.0: Consumer Aggregators from SF ’09

Nov 30, 2009

Every week we bring you a video from the world of Health 2.0. This week we're featuring a video from our latest conference in San Francisco on October 6-7, 2009. Hear the latest from WebMD, Google Health and Microsoft.

To see more videos from past Health 2.0 conferences, or to purchase the entire conference DVD sets from '07 & '08 click here. 2009 DVD sets will be available shortly, please check back for updates.

Can’t A Man Grow a Mustache for Money?

Nov 30, 2009• 2

Hey Folks,

If you squint really hard you can almost see Ian's mustache This is Ian Kibbe, Associate Editor at THCB, with a request for your help.

This
month, I've become involved in a global charity that is bringing much
needed attention to cancers that affect men, namely prostate and
testicular cancer. Movember, is an international
organization that raises funds and awareness in support of men's health
by encouraging men to grow mustaches or "Mos," as they say in Australia, in the month of November.

I'm currently growing my Mo while raising funds and awareness for prostate and testicular cancer
research. It's like I'm running a marathon, but I've replaced the
running with the awkwardness of trying to grow facial hair, which if
you saw me you'd think was just as painful. (There's a mustache in that picture of me, I swear!)

This is the final week to collect donations before the Movember Gala, and I'm reaching out to all those who are able to contribute. Please take a minute to donate if you can.

I realize that this all sounds pretty silly, but to date, Movember has raised $47
million globally making it the world’s largest charity event for men.

The
funds raised go to the Prostate Cancer Foundation and the Lance
Armstrong Foundation (LIVESTRONG).

Where’s the magic with electronic medical records?

Nov 27, 2009• 15

By MICHAEL PAINTER, MD

Last week a new article from The American Journal of Medicine entitled, “Hospital Computing and the Costs and Quality of Care: A National Study” by Himmelstein, et al. appeared in my Twitter stream. In fact, Brian Ahier (@ahier), whom I and about 3300 other tweeps like me follow, sent me a DM asking for thoughts. In that article the authors sort of breathlessly conclude that current hospital computing has minimal impact on quality and no impact on cost. Shocking. Actually, it’s the kind of gotcha article that really grates—the kind that isn’t particularly helpful to anyone as the authors seem intent on drawing sweeping conclusions from pretty limited data.

For starters, how can we draw any conclusions about the impact of widely adopted, meaningfully used electronic records until they’re, well, widely adopted? As research by Ashish Jha et al. highlighted in Chapter One of the recently released 2009 RWJF HIT Adoption report (results from that research also published in April NEJM) show that only 1.5% of hospitals have a comprehensive EHR system—and only another 8% have a so-called basic system. I’m not sure how one can draw important conclusions about national hospital computing given such an unbelievably low national rate of adoption.Continue reading…

Op-Ed: Major Reforms in the Financing and Oversight of Clinical Research Neededt

Nov 27, 2009

By KATHLEEN BOOZANG

Seton Hall University School of Law’s Center for Health & Pharmaceutical Law & Policy has called for major substantive reforms in the financing and oversight of clinical research. In a White Paper entitled “ Conflicts of Interest in Clinical Trial Recruitment & Enrollment: A Call for Increased Oversight,” the Center proposes legal and policy changes to address conflicts of interest in the relationships between industry and doctors that can create unwarranted risks to trial participants and to the scientific integrity of research.

Over 60% of testing of experimental drugs and medical devices now occurs in physicians’ private offices; unlike years past, industry funds a much higher percent of clinical trials than government, frequently paying researchers significantly more than government does. For some physician practices, conducting clinical trials represents a significant portion of their income.Continue reading…

Some conversations are easier than others

Nov 26, 2009• 3

We’re continuing a tradition at THCB started last year. Asking you to take a moment this weekend to discuss your desires for how to live the end of your life as meaningfully as possible–If you want to reproduce this post on your blog (or anywhere) you can download a ready-made html version here Matthew Holt

Last Thanksgiving weekend, many of us bloggers participated in the first documented “blog rally” to promote Engage With Grace – a movement aimed at having all of us understand and communicate our end-of-life wishes.
It was a great success, with over 100 bloggers in the healthcare space and beyond participating and spreading the word. Plus, it was timed to coincide with a weekend when most of us are with the very people with whom we should be having these tough conversations – our closest friends and family.
Our original mission – to get more and more people talking about their end of life wishes – hasn’t changed. But it’s been quite a year – so we thought this holiday, we’d try something different.

A bit of levity.

At the heart of Engage With Grace are five questions designed to get the conversation started. We’ve included them at the end of this post. They’re not easy questions, but they are important.
To help ease us into these tough questions, and in the spirit of the season, we thought we’d start with five parallel questions that ARE pretty easy to answer:

Silly? Maybe. But it underscores how having a template like this – just five questions in plain, simple language – can deflate some of the complexity, formality and even misnomers that have sometimes surrounded the end-of-life discussion.
So with that, we’ve included the five questions from Engage With Grace below. Think about them, document them, share them.

Over the past year there’s been a lot of discussion around end of life. And we’ve been fortunate to hear a lot of the more uplifting stories, as folks have used these five questions to initiate the conversation.

One man shared how surprised he was to learn that his wife’s preferences were not what he expected. Befitting this holiday, The One Slide now stands sentry on their fridge.

Wishing you and yours a holiday that’s fulfilling in all the right ways.

(To learn more please go to www.engagewithgrace.org. This post was written by Alexandra Drane and the Engage With Grace team. )

Prevention is Not Only Good Health Policy, It’s Good Economic Policy

Nov 24, 2009• 26

By KENNETH THORPE, PhD

The current debate around how to best control burgeoning health costs has pushed the issue of prevention to the forefront. That’s right where it should be. By shifting our health care to be more pro-active and prevention-oriented, we can make a major impact on common and costly chronic diseases such as diabetes. In turn, this will help to secure the financial stability of our health care system and continued economic growth and prosperity.

Over the past century, the burden of disease among Americans has shifted from acute and infectious illness to chronic disease. With more than 75 cents of every dollar in this nation spent on patients with chronic disease, prevention offers the opportunity not to spend more money — but spend smarter. By embracing prevention, we can help more Americans lead healthier, active lives free from disease, so that they can avoid costly complications and hospitalizations, and remain productive in their communities and workplaces.

Prevention today involves a lot more than flu shots, cancer screening, and annual checkups. It is a pro-active strategy of disease avoidance and mitigation that should be embraced throughout and beyond the health system. In the context of chronic illnesses such as asthma, cancer, depression, heart disease and diabetes, prevention runs the gamut from lifestyle changes to screening for risk factors and symptoms, to early intervention to slow or reverse disease, to active management of already present cases.