By MICHAEL L. MILLENSON
Three government experts on a health tech conference panel discuss
the urgency of releasing actionable data; all are women. A more senior
official, another woman, gives a TED-style talk making the same case. And a
four-person, private-sector panel debates privacy and ethics; three of the four
Health Datapalooza, a conference begun with government
sponsorship a decade ago, proclaims its goal as “data liberación” – freeing
health data from deep within federal agencies and giving it to patients and
entrepreneurs. But in 2019, women’s “liberación” seems to have become an
Interestingly, while women’s status in tech was the focus of
a plenary panel on diversity and inclusion, the panelists seemed oblivious to
the robust participation of women in their own meeting.
To put some data behind my subjective impressions, I went
back and examined the list of speakers, who came from a wide range of organizations
and included individual patient activists. I counted 89 men and 99 women. Liberación,
A blistering attack by the national editor of the New England Journal of Medicine against the “less is more” movement in medicine omitted that the publication’s former editor-in-chief played a foundational role in popularizing the idea of widespread medical waste.
The commentary in late December by Dr. Lisa Rosenbaum, “The Less-Is-More Crusade – Are We Overmedicalizing or Oversimplifying?” has attracted intense attention. Rosenbaum berates a “missionary zeal” to reduce putative overtreatment that she says is putting dangerous pressure on physicians to abstain from recommending some helpful treatments. She also asserts that the research by Dartmouth investigators and others who claim 30 percent waste in U.S. health care, in which she once fervently believed, is actually based on suspect methodology.
What Rosenbaum fails to mention is that the policy consensus she seeks to puncture – that the sheer magnitude of wasted dollars in U.S. health care offers “the promise of a solution without trade-offs” – originated in the speeches, articles and editorials of the late Dr. Arnold Relman, the New England Journal’s editor from 1977 to 1991.Continue reading…
When the government announced recently that a patient safety partnership with hospitals had saved 87,000 lives and nearly $20 billion over four years, there was an oblique reference to the role played by “financial incentives.”
Left unsaid was that a quiet effort has been going on for years to persuade hospitals they can make more money preventing harm than by allowing it to occur. In recent years, that’s included articles in the medical literature looking at the profitability of preventing serious bloodstream infections in critically ill infants in the neonatal intensive care unit(NICU) and in kids with leukemia.
For adults, there have been analyses of the financial impact of serious infections and surgical complications. In a presentation I heard earlier this year, a vendor mentioned the return on investment (ROI) of a technology that more rapidly detects when a post-surgical patient unexpectedly stops breathing.