The Health Care Blog – Page 213 – Everything you always wanted to know about the Health Care system. But were afraid to ask.

Above the Fold

The ABCs of Beginning a Clinical Encounter

Jun 4, 2019• 1

By HANS DUVEFELT, MD

You’re running late and many things didn’t go right today. You knock on the door and enter the exam room with an apology. If you’re like me, you have a few papers and an iPad or a laptop in your hand. You sit down and open the patient’s chart in your device or perhaps on the big desktop, eyes not exactly locked on the patient.

Only after getting to where you need to be in the computer do you really look the patient in the eyes. Your body language has been one of hurry and distraction. Now you try to repair the damage of that, so you try to show you’re settling down now, at least for a few moments. You might sigh, move your arms in a gesture of relaxation and say something to get the history taking underway.

So far, you’re failing. I do that often, too.

Here’s what we all know we need to do, but often don’t; we should follow these ABCs:

A – Attention:

Clear your mind. It doesn’t matter what happened in the other room with the other patient, or on the phone with the insurance company or the smug specialist or ER doc who pointed out the diagnosis you missed. Open the door (I always knock first) and immediately look at the patient. Make eye contact and observe them. Pay attention to how they look, what they are signaling. The computer can wait; a few moments of focused attention will usually save you time in the end. After all, red or teary eyes, a leg cast, a big bruise or change in grooming can make the visit go in a direction you wouldn’t have expected from he listed chief complaint. How many times have we heard a patient comment about another doctor: He didn’t pay attention to me. Do we always do that ourselves if we’re rushed or preoccupied?

One of Europe’s First Publicly-Traded Digital Therapeutics Startups | Pierre Leurent, Voluntis

Jun 3, 2019

By JESSICA DAMASSA, WTF HEALTH

For over 15 years, first from Paris and now from their headquarters in Boston, MA, Voluntis has supported over 600K users needing diabetes and oncology care. As one of the first companies in digital therapeutics to go IPO on Euronext Paris ($30M), they have seen the health tech industry explode in recent years. Hear from CEO Pierre Leurent on the radical changes he’s witnessed in digital therapeutics to date, and where Voluntis is headed next.

Filmed at the Frontiers Health Conference in Berlin, Germany, November 2018.

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.

Virtual’ Clinical Trials Eliminate Human & Animal Testing | InSilico Trials CEO Luca Emili

Jun 2, 2019

By JESSICA DAMASSA, WTF HEALTH

The future of clinical trials no longer requires testing on humans or animals for R&D and regulatory approval. Startup InSilio Trials has created an environment where pharmaceutical and medical device companies can run clinical trials in a simulated environment. Their first project was with the FDA, and they’ve since signed a five year cooperation agreement. Yes, this is for real! Find out more about this truly revolutionary new technology.

Filmed at the Frontiers Health Conference in Berlin, Germany, November 2018.

The European Digital Health Ecosystem Matures | Roberto Ascione, Healthware International

Jun 1, 2019

By JESSICA DAMASSA, WTF HEALTH

European health startups and health tech investors are turning their attention to a new market: Europe. Where the US healthcare system once seemed the only path to mass adoption, now the European healthcare market, with its proliferation of Big Pharma and med device companies, has opened itself up to the digital health community — offering EU startups the chance to grow and mature closer to home. Watching the space closely is on of Europe’s first, loudest, and most ardent supporters of digital health, Roberto Ascione, CEO of Healthware International. How does he see the market taking shape? What’s next for European healthcare companies in terms of scaling and integrating new revenue streams based on the digital transformation of healthcare? Listen in to find out.

Filmed at the Frontiers Health Conference in Berlin, Germany, November 2018.

Health in 2 Point 00, Episode 82 | Talkspace, Heal & Apple

Jun 1, 2019

Today on Health in 2 Point 00, I’m back (despite Jess’s attempt to replace me). In Episode 82, Jess asks me about Talkspace’s $50 million raise, Heal getting flack for adding telehealth to their house call service, and Apple acquiring Tueo Health last year—and we’re just now hearing about it. Jess also gets riled up by Pokemon Sleep and Pillo’s $11 million raise. —Matthew Holt

Predictions and Parachutes

May 31, 2019

By SAURABH JHA, MD

What does it take to create a decision rule? In this episode of Radiology Firing Line podcast Saurabh Jha (@RogueRad) has a discussion with Robert W. Yeh MD MBA about the deep thought and complex statistics involved in creating a decision rule to guide therapy which have narrow risk-benefit calculus, specifically a rule for how long patients should continue dual anti-platelet therapy after percutaneous coronary intervention. They also discuss the motivation behind the legendary, and satirical, parachute RCT published in the recent Christmas edition of the BMJ, which delighted satirists all over the world.

Listen to their conversation here.

Our Cancer Support Group On Facebook Is Trapped

May 30, 2019

Our Experience on Facebook Offers Important Insight Into Mark Zuckerberg’s Future Vision For Meaningful Groups

By ANDREA DOWNING

Seven years ago, I was utterly alone and seeking support as I navigated a scary health experience. I had a secret: I was struggling with the prospect of making life-changing decisions after testing positive for a BRCA mutation. I am a Previvor. This was an isolating and difficult experience, but it turned out that I wasn’t alone. I searched online for others like me, and was incredibly thankful that I found a caring community of women who could help me through the painful decisions that I faced.

As I found these women through a Closed Facebook Group, I began to understand that we had a shared identity. I began to find a voice, and understand how my own story fit into a bigger picture in health care and research. Over time, this incredible support group became an important part of my own healing process.

This group was founded by my friends Karen and Teri, and has a truly incredible story. With support from my friends in this group of other cancer previvors and survivors I have found ways to face the decisions and fear that I needed to work through.

Facebook recently had a summit to share that groups are at the heart of their future. We had a summit of our own with some of the amazing leaders within the broader cancer community on social media.

Snoop Last Year’s Bayer G4A Startups, Then Apply

May 29, 2019

Role of Innovation in Addressing Social Determinants of Health

May 29, 2019

SPONSORED POST

By CATALYST @ HEALTH 2.0

Nearly a decade has passed since Healthy People 2020 positioned social determinants of health (SDoH) at the forefront of healthcare reform. As defined by the report, SDoH are the “conditions in the environment in which people are born, live, learn, work, play, worship, and age, that affect a wide range of health, functioning, and quality of life outcomes.” Examples of social determinants include:

Resources to meet daily needs (e.g., safe housing and local food markets)
Educational, economic, and job opportunities
Community-based resources in support of community living and opportunities for recreational and leisure-time activities
Transportation

The ability to influence social determinants largely falls outside of the health care system’s reach. Therefore, a key to address opportunities for health involves collaboration between health care and different industries such as education, housing, and transportation. Both the public and private sectors have made significant efforts to bridge the gap between physical, mental, and social care by experimenting with non-traditional partnerships.

The Center for Disease Control and Prevention (CDC) has spearheaded multiple programs with government agencies and community partners to achieve the goals outlined in Healthy People 2020. One of the most notable successes is the Childhood Lead Poisoning Prevention Program, an initiative by the CDC with the Department of Housing & Urban Development and the U.S. Environmental Protection Agency. Through housing rehabilitation, enforcement of housing and health codes, and partnerships with healthcare experts, the program helped Healthy People 2020 exceed their target of reducing blood lead level in children.

Other programs such as the “National Program to Eliminate Diabetes Related Disparities in Vulnerable Populations,” leveraged community partners and resources to increase food security, health literacy, and physical spaces for active living. In one of their projects, the program partnered with community health workers (promotoras) who spoke Spanish to engage with Hispanic/Latino communities where participation to Diabetes Self-Management Education (DSME) was low. The community health workers provided linguistically and culturally-sensitive materials that effectively increased participation in DSME among the targeted population. The outcomes from such initiatives have inspired more health and community organizations to work together to reduce health disparities.

Brief is Good

May 28, 2019• 1

By HANS DUVEFELT, MD

How long does it take to diagnose guttate psoriasis versus pityriasis rosea? Swimmers ear versus a ruptured eardrum? A kidney stone? A urinary tract infection? An ankle sprain?

So why is the typical “cycle time”, the time it takes for a patient to get through a clinic such as mine for these kinds of problems, close to an hour?

Answer: Mandated screening activities that could actually be done in different ways and not even necessarily in person or in real time!

Guess how many emergency room or urgent care center visits could be avoided and handled in the primary care office if we were able to provide only the services patients thought they needed? Well over 50% and probably more like 75%.

Primary Care clinics like mine are penalized if a patient with an ankle sprain comes in late in the year and has a high blood pressure because they are in pain and that becomes the final blood pressure recording for the year. (One more uncontrolled hypertensive patient.)