Category: Uncategorized

Redefining STI & HIV Testing in the Netherlands | Erwin Fisser, Soa Aids Nederland

Jul 11, 2019

By JESSICA DAMASSA, WTF HEALTH

Soa Aids Nederland is a unique NGO in the Netherlands that is helping people get STI and HIV tests delivered directly to their homes. A government-funded NGO, the organization has created an extensive online questionnaire that is not only collecting data on sexual health, but also discreetly deploying testing kits to those who want a more private way to check for STIs. Erwin Fisser explains what’s next for the service — and the data that the extensive questionnaire is collecting.

Filmed at HIMSS/Health 2.0 Europe in Helsinki, Finland in June 2019.

Jessica DaMassa is the host of the WTF Health show & stars in Health in 2 Point 00 with Matthew Holt. Get a glimpse of the future of healthcare by meeting the people who are going to change it. Find more WTF Health interviews here or check out www.wtf.health.

Landmark Results Achieved in Aging and Chronic Disease: Danish Group Extends Disease-free Life by 8 Years

Jul 11, 2019• 3

By WILLIAM H. BESTERMANN JR., MD

New Scientific Breakthroughs Can Provide a Longer Healthier Life

Twenty-one years of follow-up comparing usual care with a protocol-driven team-based intervention in diabetes proved that healthy life in humans can be prolonged by 8 years. These results were achieved at a lower per patient per year cost. Aging researchers have been confident that we will soon be able to prolong healthy life. This landmark study shows this ambitious goal can be achieved now with lifestyle intervention and a few highly effective proven medications. These medications interfere with the core molecular biology that causes chronic disease and aging. These same medications will likely produce similar results in patients with congestive heart failure, chronic kidney disease, arterial disease, history of heart attack, hypertension, and angina. Simple medical interventions can extend healthy lifespan today.

Better Chronic Disease Management Can Improve Health and Lower Costs

90% of health care costs come from chronic diseases and aging which are both related. The same biochemistry that causes aging causes chronic disease. Eating processed food, gaining weight, smoking cigarettes, and sitting on the couch accelerate aging and chronic condition development. Those activities switch on genes that should be quiet. Eating real food, avoiding cigarettes, activity, lisinopril, losartan, atorvastatin, metformin, (and spironolactone) are now proven to extend healthy life by 8 years in patients who are at high risk of health catastrophes and early death! These medications all cost $4 a month except for atorvastatin which is $9 a month. The benefits continue even when best practice treatment stops probably because these treatments block signaling from dangerous genes that are inappropriately and persistently turned on.

Progress Will Require Extensive Health System Reengineering

Having better health and reducing health care costs can happen today. Surprisingly, the biggest barrier to progress is our current health care system. It is arranged around catastrophes, organ systems, and hospitals. These concepts are 100 years old. Chronic disease begins decades before the catastrophe, and it is related to aging. Age is the greatest risk factor for a heart attack. The same biochemistry that causes accelerated aging also causes heart attack and strokes. It makes little sense to see a cardiologist for a heart attack and a neurologist for a stroke. They are caused by the same molecular biology. The leading health care systems are beginning to recognize that. The interventions that slow aging and chronic diseases development impact every cell in the body. Every young person who is overweight or smokes has activated genes that make accelerated aging and chronic disease more likely. If these genes are switched on prior to having children, that risk is passed on to the next two generations.

Primary care teams organized to address chronic conditions and more rapid aging will provide lifestyle advice and medication that interfere directly with the biology that is causing the problem. The further upstream these individuals are when identified, the easier it is to slow aging and delay chronic disease onset. The path to better health at lower cost lies in the outpatient setting with primary care teams that are well-versed in molecular biology.

What’s the Difference Between ‘Digital Therapeutics’ & ‘Digital Drugs’? | Lina Behrens Flying Health

Jul 10, 2019

By JESSICA DAMASSA, WTF HEALTH

As a new crop of ‘digital therapeutics’ begins to redefine the Future of Pharma, health tech startups and their partners are starting to further refine how they explain (and clinically validate) the outcomes associated with their technologies. So, what’s the difference between a ‘digital drug’ and a ‘digital therapeutic’? Flying Health’s Director of Digital Drugs, Lina Behrens, explains…

Filmed at HIMSS/Health 2.0 Europe in Helsinki, Finland in June 2019.

India’s Mob Problem

Jul 10, 2019

By SAURABH JHA, MD

Recently, my niece gingerly confided that she was going to study engineering rather than medicine. I was certain she’d become a doctor – so deep was her love for biology and her deference to our family tradition. But she calculated, as would anyone with common sense, that with an engineering degree and an MBA, she’d be working for a multinational company making a comfortable income by twenty-eight. If she stuck with tradition and altruism, as a doctor she’d still be untrained and preparing for examinations at twenty-eight.

Despite the truism in India that doctors are the only professionals never at risk of starving, the rational case for becoming a physician never was strong. Doctors always needed a dose of the irrational, an assumption of integrity and an unbridled goodwill to keep going. Once, doctors commanded both the mystery of science and the magic of metaphysics. As medicine became for-profit, the metaphysics slowly disappeared.

Indians are becoming more prosperous. They’re also less fatalistic and expect less from their gods and more from their doctors. In the beginning they treated their doctors as gods, now they see that doctors have feet of clay, too. Doctors, who once outsourced the limitations of medicine to the will of Gods, summarized by the famous Bollywood line “inko dawa ki nahin dua ki zaroorat hai” (patient needs prayers not drugs), now must internalize medicine’s limitations. And there are many – medicine is still an imperfect science, a stubborn art, often an optimistic breeze fighting forlornly against nature’s implacable gale.

HardCore Health Podcast, Episode 2: Consumerism & Privacy

Jul 8, 2019

HardCore Health is back and on today’s show Jess & I start by addressing how hard it has become for the health care consumer to navigate the “in-and-out of network” system that exists in health care today, and later discuss how money is being poured into some of the strangest sounding startups ideas in the health tech industry. We have a special interview from the best health data privacy lawyer around, Deven McGraw, from Ciitizen, commenting on the new patient privacy legislation that was released and Jess also speaks to Fred Trotter about how he, Andrea Downing, and David Harlow wrote a letter to Facebook, addressing their concerns over the privacy of Facebook groups. Last, but certainly not least, we have a rant from Ian Morrison about price transparency. Enjoy! —Matthew Holt

Matthew Holt is the founder and publisher of The Health Care Blog and still writes regularly for the site.

Is “Medicare For All (Who Want it)” Enough?

Jul 8, 2019• 2

By MIKE MAGEE

In the 2^nd night of the Democratic Primary debate on June 27, 2019, Pete Buttigieg was asked whether he supported Medicare-For-All. He responded, “I support Medicare for all who want it.”

In doing so, he side-stepped the controversial debate over shifts of power from states to the federal government, and trusted that logic would eventually prevail over a collusive Medical-Industrial Complex with an iron lock grip on a system that deals everyone imaginable in on the sickness profitability curve – except the patient.

On July 30, 1965, President Lyndon B. Johnson signed into law “Medicare,” a national insurance plan for all Americans over 65. He did so in front of former President Truman, who 20 years earlier had proposed a national health plan for all Americans, and for his trouble was labeled by the AMA as the future father of “socialized medicine.”

For Truman, there was a double irony that day in 1965. First of all, the signing was occurring at around the same time as our neighbor to the north was signing their own national health plan, also called “Medicare”, but their’s covered all Canadian citizens, not just the elderly.

The second incongruity was that Truman was fully aware that in 1945, as he was being tarred and feathered as unpatriotic by taxpayers for having the gall to suggest that health care was a human right, those very same citizens were unknowingly funding the creation of national health plans as democracy stabilizers in our two primary vanquished enemies – Germany and Japan – as part of the US taxpayer funded Marshall Plan.

Was the IOM estimate of medical errors correct?

Jul 5, 2019

By SAURABH JHA

In 1999, the Institute of Medicine (IOM) in their landmark report – To Err is Human – estimated that the number of deaths from medical errors is 44 ,000 to 98, 000. The report ushered the Quality and Safety Movement, which became a dominant force in all hospitals. Yet the number of deaths from medical errors climbed. It is now touted to be the 3rd leading cause of death. How easy is it to precisely quantify the number of deaths from medical errors? Not many physicians challenged the methodologies of the IOM report. Some feared that they’d be accused of “making excuses for doctors.” Many simply didn’t have a sufficient grip on statistics of measurement sciences. One exception was Rodney Hayward – who was then an early career researcher, a measurement scientist, who studied how sensitive the estimates of medical errors were to a range of assumptions.

Saurabh Jha (aka @RogueRad) speaks with Professor Hayward for the Firing Line Podcast about his research in JAMA published in 2001 – Estimating Hospital Deaths Due to Medical Errors: Preventability Is in the Eye of the Reviewer. It was a landmark publication of the time, and its objective methods have stood the test of time.

Rod Hayward a Professor of Public Health and Internal Medicine at the University of Michigan and Co-Director of the Center for Practice Management and Outcomes Research at the Ann Arbor VA HSR&D. He received his training in health services research as a Robert Wood Johnson Clinical Scholar at UCLA and at the RAND Corporation, Santa Monica. His current and past work includes studies examining measurement of quality, costs and health status, environmental and educational factors affecting physician practice patterns, quality improvement, and physician decision making. His current work focuses on quality measurement and improvement for chronic diseases, such as diabetes, hypertension and heart disease.

Listen to their conversation on Radiology Firing Line Podcast here.

What Oncology’s Figured Out About the EHR | Dr. Ed Kim of Atrium Health

Jul 4, 2019

By JESSICA DAMASSA, WTF HEALTH

Is there a silver bullet for making EHRs more useful to doctors? The Oncology team at Atrium Health thinks they’ve figured it out. From better integrating new info on FDA approved cancer treatments to just working with doctors and patients more intuitively, Dr. Ed Kim talks about how the underlying challenges health technologists need to address is figuring out what info is important to care delivery teams in the first place.

Filmed at Health Datapalooza in Washington DC, March 2019.

THCB Spotlights: Brooke LeVasseur, CEO of AristaMD

Jul 4, 2019

Today on THCB Spotlights, Matthew talks to Brooke LeVasseur, who is the CEO of AristaMD. AristaMD provides eConsults to empower providers to get patients faster access to care. The average wait time to see a specialist is one to two months, and the proportion of referrals to specialists that never happen can be incredibly high, at 40% in Medicare populations for instance. AristaMD aims to provide an efficient way for primary care providers to tap into the expertise of specialists to immediately start executing on a treatment plan without the patient having to wait or travel. Tune in to find out how AristaMD is actually rolling this out and get a demo of the platform.

Psychiatrist: My Medicine Raised Our Patient’s Blood Sugar, Can You Help? PCP: That’s a Dump!

Jul 1, 2019

By HANS DUVEFELT, MD

If my hypertensive patient develops orthostatism and falls and breaks her hip, I fully expect the orthopedic surgeon on call to treat her. I may kick myself that this happened but I’m not qualified to treat a broken hip.

If my anticoagulated patient hits his head and suffers a subdural hematoma, I expect the local neurosurgeon to graciously treat him even though it was my decision and not his to start the patient on his blood thinner. After all, brain surgery is tricky stuff.

Why is it then that primary care docs, sometimes myself included, feel a little annoyed when we have to deal with the consequences of psychiatric medication prescribing?

My psychiatry colleagues diligently order the blood work that is more or less required when prescribing atypical antipsychotics, for example. But when the results are abnormal I get a fax with a scribble indicating that the PCP needs to handle this.

We need to just deal with that and appreciate that there has been communication between treating providers. Because that doesn’t always happen. Particularly with medication prescribing, we don’t always get a notification from our psychiatry colleagues when a patient is started on something new because their records are so much more secret than ours.

The other day I sat in my monthly conference with staff from the Behavioral Health Home that I serve as the medical director for. I consult on clinical and policy matters.