Category: Uncategorized

HOSPITALS: Why We Don‘t Have Enough Nurses (It’s Not Low Wages) By Maggie Mahar

Oct 17, 2007• 29

THCB contributor Maggie Mahar returns today with another of her insightful pieces on the business of healthcare. If you haven’t yet done so, you are hereby commanded – yes, as in that’s an order – you should go pick up your copy of Money Driven Medicine: The Real Reason Healthcare costs so much, Maggie’s recent study of the forces at work in the healthcare marketplace.

Consider
this: In the San Francisco area, a nurse with a bachelor’s degree can
hope to start out with a salary of $104,000. The salary for a nursing
professor with a Ph.D. at University of California San Francisco starts
at about $60,000.

This goes a long way toward explaining why nursing schools turned
away 42,000 qualified applications in 2006-2007—even as U.S. hospitals
scramble to find nurses. We don’t have enough teachers in nursing
schools and the fact that the average nursing professor is nearly 59
while the average assistant professor is about 52 suggests that, as
they retire, the shortage could turn into a crisis. The most recent issue of JAMA (October
10, 1007) reports that in 2005 we had 218,800 fewer nurses than we
needed and by 2012, it’s estimated that we’ll be short some 1 million
nurses.

Hospitals have had to raise nursing salaries (as well they should),
not just because nurses are scarce but because, in our chaotic hospital
system, the work can be extraordinarily stressful.

Nurses know better than anyone just how many “adverse events” occur each day –even in the most prestigious U.S. hospitals.

“I’m terrified of killing someone,” one young nurse confided to me
about a year ago. After working in a hospital in Bermuda for a number
of years, she was bored, and had come back to work in New York, where
she had friends and family. She had worked in New York before, but she
wasn’t at all sure that she would stay. “In our hospitals, it’s just
too crazy,” she said.

Her story also sheds light on why nursing professors are willing to
work for $60,000 a year when they could, no doubt, more than double
their salaries if they were willing to wade into the fray at local
hospitals.

Continue reading post at HealthBeat

HEALTH 2.0: Sermo CEO Daniel Palestrant

Oct 17, 2007

Monday’s announcement that Sermo, the social
networking site for doctors, is teaming up with Pfizer has left the company one
of the most-talked about tech startups in the country. In this clip from
September’s Health 2.0 conference, Sermo CEO Daniel Palestrant introduces his
company’s business model and walks viewers on a guided tour through the Sermo
web site , talking about the reasons "the wisdom of crowds" promises
to be a potent force in medicine.

TECH: CCR Training Workshop

Oct 16, 2007• 2

The goal of the ASTM CCR Training Workshop is to give developers and
programmers in Health2.0, as well as traditional health IT, a "deep
dive" into the CCR standard, its schema, and current uses of the CCR
for portability and interoperability of health information exchange.
For those who don’t know about the CCR standard, it is an easily
implemented and widely adopted XML schema for capturing a "snapshot" of
a person’s most relevant health information, such as demographics,
diagnoses and problems, medications, allergies, immunizations, family
history, and care plans. It is an open and royalty-free standard
sponsored by numerous physician and medical organizations, including
the American Medical Association and the American Academy of Family
Physicians. Information on the next ASTM CCR Training Workshop can be
found on the home page of www.ccrstandard.com. David C. Kibbe, MD MBA and Steven Waldren, MD are faculty for the one-day workshop.

Aspen Report 2 – Healing Unbound: The Promise of Advancing Computational Power, Brian Klepper

Oct 15, 2007• 2

Laptop-attached ultrasound units that produce startlingly clear internal images for five dollars in the field. Organs that re-generate inside scaffolds. Drugs tailored to an individual’s biology. Micro-images of cancerous cells lit up by bio-chemical markers. Decision support tools that scan the physiological values in electronic health records for patterns too complex to be detected by an unaided clinician.

The advances available from dramatic improvements in computational capabilities were a recurring theme at the Aspen Health Forum, with experts from each discipline describing where the technology was leading us. I attended two sessions featuring Star Trek clips that predicted realities now within at least theoretical reach. (Prescient and corny, audiences nodded nostalgically.) Sessions on biotechnology, imaging, electronic health records (EHRs) and the hospital of the future highlighted the power that is being leveraged to improve care.

HEALTH2.0: Sermo, Pfizer: Big Pharma puts big toe in social networking waters

Oct 15, 2007• 9

You can’t trust those Brits. I get a super exclusive on the Sermo-Pfizer deal and those damn Brits at the FT break the press embargo. So much for “honour” amongst journalists!

This is the latest version of Big Pharma’s experiment to figure out how to replace the incredibly inefficient way it researches, sells to and communicates with doctors. The very baby steps of starting to cut those detail forces are just starting to be taken, but while those empires slowly get dismantled over the coming decade(s), something needs to be put into its place. eDetailing via video has been a bust so far, and putting those hot cheerleaders into the doctor’s office is getting more and more expensive.

So the deal is that Pfizer (and of course soon other pharmas) will be able to put information into the social networking site. This has great opportunity and great peril for big Pharma. Of course there’s lots of information that they can contribute, and lots of contacts that they can make. But on the other hand, they are definitely losing control over the message.

BLOGS: Looking for a potential TV star?

Oct 15, 2007

I had a note from a producer at Discovery looking for someone aged 18-29, who was/is ill/injured while uninsured or on an inadequate plan. This person would need to be a Maryland resident and willing to share their story on camera. Any takers? Email Kristen

POLICY: While Politicians Battle Over Expanding SCHIP, Children Are Dropped From the Program by Maggie Mahar

Oct 13, 2007• 10

At the moment, nearly everyone interested in the S-CHIP debate is focusing on October 18, the
day the US House of Representatives will try to override the President’s veto of an expanded State Children’s Health Insurance Program (SCHIP).

Unlike many of the critics, I favor the expanded program. Briefly, here are a few things to
keep in mind:

First, under the proposal, 70% to 80% of children in the program would be from
families earning less than twice the poverty level ($20,650 for a family
of four).

Granted families
of four earning up to $60,000 a year would qualify for the program
in most states. But given the fact that the average annual premium for
family coverage is now pushing $13,000, it is not at all unreasonable
to suggest that families earning $$60,000 before taxes cannot
afford private insurance.

In theory,
maybe these families could buy private insurance just for their children,
but it’s hard enough to buy individual coverage (when you don’t
belong to a group) –try finding individual insurance that covers
children only.

A Broad Vision of Health 2.0: Reformulating Data for Transparency, Decision Support & Revitalized Health Care Markets – Brian Klepper and Jane Sarasohn-Kahn

Oct 12, 2007• 8

Download health20_1011.ppt

Before you start reading, download the document above. It’s a single PowerPoint slide that’s animated to build. Go into presentation mode, then read along with the narrative below.

The term Health 2.0 refers to the concept, described by O’Reilly in September of 2005, of Web-based platforms that allow users to reformulate data for their own purposes. The Health 2.0 movement is rapidly gaining steam and traction, propelled by established and startup firms. The efforts displayed at the recent Health 2.0 meeting in San Francisco, convened by Matthew Holt and Indu Sabaiya, were both wide-ranging and narrowly focused. Even so, several end-of-day panelists noted that, at this early stage, Health 2.0’s definitions and translations into practice remain murky and fragmented.

We thought it might be useful to try to develop an image of how Health 2.0 MIGHT develop: what its working parts were, what kinds of information it would receive and generate, who its users would be and what its impacts might be. The image that has resulted is simplistic; it doesn’t try to explore any of the underlying mechanisms necessary to pull this off. But it does try to convey a vision of how innovators might come together to aggregate and reformulate large data sets from disparate sources to create tremendous new utility in the marketplace for patients, clinicians and purchasers of all types.

POLITICS: Forgotten children and unopened bills By Eric Novack

Oct 12, 2007• 8

On October 18th, the US House of Representatives will try to override the President’s veto of a greatly expanded State Children’s Health Insurance Program (SCHIP). As is so often the case, political rhetoric serves as a fog that obscures what the SCHIP legislation really is and who is most affected.

The Democrats believe that they win by losing. Republicans shout “socialized medicine”.

But the Democrats went even lower this past week by bringing out a 12 year old boy and his family to be the ‘poster child’ for SCHIP expansion.

POLICY: Michelle Malkin is really dumb

Oct 12, 2007

Yes, that headline is a blatant attempt to get some of the opprobrium Malkin and her nutty commenters are venting on Jon Cohn and Erza Klein.

A little background. Jon, being the sensible moderate, wrote a good article on why the SCHIP veto helps Universal Health Care, and then pointed out that the smearing of the kid from Baltimore whom the Dems put up to support S-CHIP was a dumb idea with lots on the far right failing to do basic fact checking. In fact the family in question was exactly the type that S-CHIP needs to help

In the NY Times today Paul Krugman puts this all into a little more narrow perspective. Suggesting that sliming Graeme Frost–the 12 year old kid in question, is just standard operating procedure for the Rush Limbaugh-types on the right, who have a pretty direct line into the Republican machine.