By Paul Levy

JAMA published an article Aug. 27 by Toronto doctors Michael Detsky and Edward Etchells called "Single-Patient Rooms for Safe Patient-Centered Hospitals." Abstract here. (As usual, JAMA does not allow free access to public policy articles. When will they start to do that, I wonder?)

Here’s the summary:

Clinicians should advocate for single-patient rooms in any new hospital construction, expansion, renovation, or redesign. Single-patient rooms are permanent physical features that potentially could improve safety and patient satisfaction without the need for ongoing staff training, audits, or reminders. Money spent on capital costs to improve patient care may be more efficient than money spent on changing hospital culture and the behavior and attitude of health professionals. It is not necessary to wait 50 years for existing hospital structures to deteriorate before the full potential of single-patient rooms can be realized.

I do not disagree about the attributes of single-patient rooms, in terms of infection control, patient satisfaction, and optimal use of rooms for a diverse mix of patients. Also, they are strongly recommended in guidelines of the American Institute of Architects. I believe they will result in higher capital costs (and therefore higher annual carrying costs), but I do not think it likely that they will generate savings or efficiencies commensurate with those capital costs. In other words, they may not have a good rate of return, in strict financial terms, but they clearly will be the standard for new construction and renovations.

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By Sarah Arnquist

A clinic in Minnesota is routinely dropping patients with high-deductible health plans who aren’t paying their bills, the Star Tribune reports. "For the most part, these are college-educated and middle-class folks," Dr. Rochelle Taube told the Tribune. "We send them a letter and say unfortunately, we’re not able to care for you." Some clinics and doctors’ offices that aren’t dropping patients have had to exert more effort or new approaches to getting paid, "such as swiping a credit card at check-in just like at a hotel."

Sicker patients are better off getting bypass surgery than medicated coronary stents, according to the Wall Street Journal. Boston Scientific funded the study using its own stents. It’s the first head-to-head study of its kind, but hopefully not the last if analysts’ predictions are accurate that the failure to show stents as the obvious treatment of choice for complicated heart patients will lead to a drop in sales. The BSX stock price increased 1 percent Tuesday.

In 2006, U.S. pharmaceutical companies spent about $5 billion on consumer marketing campaigns, but the Washington Post reports a Harvard Medical School study in the British Medical Journal found the spending may have less impact on consumer behavior than previously assumed.

Also in BMJ, a review of Britain’s National Health Services records shows that patients undergoing a hip or knee joint replacement using the new resurfacing technique are more than three times as likely to need a replacement than if the joint were fully replaced and cemented. The study tracked more than 150 000 people who underwent a hip or knee replacement between April 2003 and September 2006. To learn more about the U.S. failure to track the safety of joint replacements, read this New York Times article.

How are Web 2.0
technologies like social networks, wikis and online communities
changing the face of the health care industry? How are hospital systems
and physician practices evolving as a result of rapid technological
change?  How can health plans evolve in
the face of emerging challenges with the help of new technologies and
new thinking? What will come of the recent controversies over genetic
testing and the privacy of patient data? Where does the hype over social networks and
user-generated content end and the reality begin?

Come learn more about these questions and many more at Health 2.0 on October 22nd – 23rd at the San Francisco Marriott.
You’ll meet industry insiders and new players entering the field. You’ll see
rapid-fire demos of new technologies and hear both expert reaction from
established players in the field and fresh perspectives from newcomers.
You’ll also get critical insight from industry observers as well as practical,
common-sense advice on employing these new technologies in your own
business or organization.

Confirmed speakers include: Google Health, Microsoft, Yahoo Health, Healthline, Cisco, Eliza, Silverlink, DestinationRX, AthenaHealth CEO Jonathan Bush, Sermo CEO Daniel Palestrant, HealthGrades CEO Kerry Hicks,  WebMD CEO Wayne Gatinella, Clay Shirky, author of "Here Comes Everybody: Organizing Without Organizations." Dr. David Kibbe, Jay Parkinson, M.D., Jane Sarasohn-Kahn, THCB’s Matthew Holt, Health 2.0’s Indu Subaiya,  CrossoverHealth founder Scott Shreeve, 23andMe and many, many more.

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By Sarah Arnquist

Google launches its own Web browser, Chrome. The latest competitive move with Microsoft is available for download today.

About 800 people in New Hampshire are about to lose their health insurance because the plans don’t meet the minimum requirements set by the state. Can you say unintended consequences of consumer protection laws?

The Joint Commission will now grade hospitals on their level of "cultural competency." The Commonwealth Fund will fund a panel to "explore how diversity, culture, language and health literacy issues can
be better incorporated into current Joint Commission standards or
drafted into new requirements."

The National Quality Forum has endorsed nine new national standards for health information technology in the areas of electronic prescribing, electronic health record, interoperability, care management, quality registries, and the medical home.

California steps into uncharted territory without a state operating budget. The Legislature’s failure to agree has led to the longest overdue budget in state history.