The Health Care Blog – Page 280 – Everything you always wanted to know about the Health Care system. But were afraid to ask.

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Health in 2 point 00, Episode 6

Mar 7, 2018

This edition of Health in 2 point 00 comes from HIMSS. This one was done just off the show floor, but don’t worry–tomorrow we’ll be back to doing it outside a bar! So here goes! Jessica DaMassa asks me as many questions as she can squeeze in about health & technology in just 2 minutes–Matthew Holt

What to Decide When You’re Expecting

Mar 7, 2018• 5

By ERIN LANDAU and REENA AGGARWAL, MD

Selecting an obstetrician or midwife and birth center or hospital is arguably one of the most important decisions that a pregnant woman makes. This choice will determine many aspects of a woman’s pregnancy journey, including the likelihood that she delivers via C-section. To understand how women choose their obstetric provider and their delivery facility, Ovia Health has teamed up with Ariadne Labs to survey women and help shed light on this important decision-making process.

C-sections in America

Few would debate that the United States is experiencing a C-section epidemic. One out of every three babies is born via C-section, despite the fact that 1) research shows that most pregnant women prefer and plan for vaginal delivery and 2) the World Health Organization (WHO) has argued that 10-15% is the optimal cesarean rate, placing the US at double or even triple the optimal rate. As the most common major surgery performed in the United States, C-sections are responsible for 20,000 surgical complications and infections annually, and account for over $5 billion in excess medical spend each year. Although C-sections can be life saving interventions, they still pose significant risks to both mother and child. C-section rates have risen at alarming rates across the United States, and many people, both inside and outside the medical community, are dedicated to uncovering and reversing the root cause of this trend.

Deadline This Week For Your Special Rate For Health 2.0 Annual Conference

Mar 6, 2018• 2

SPONSORED POST

By HEALTH 2.0

Deadline This Friday To Grab The Lowest Price For The Health 2.0 Annual Fall Conference!

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Network with the right decision makers to grow your business: Rub shoulders with investors, partners, and innovators who will transform your business and expand your market reach through Health 2.0 programs including MarketConnect – connecting leading health care organizations with the most promising vetted technology companies to accelerate the health tech buying process.

Participate in our action-packed agenda: Join panel sessions on policy, innovation and technology including 3 CEOs, Launch, The Unacceptables, and Interoperability.

Experience new technological platforms: Watch over 150 live health tech demos from the newest innovative companies to gain insight to what’s new in the market.

Whether you’re looking for the next new innovation or to network with the most influential health care providers, developers, and start-ups; the 12th Annual Fall Conference is the place to be this fall!

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Myth No. 1: Quality of Care in the U.S. Health System is the Best in the World

Mar 6, 2018• 8

By PAUL KECKLEY

According to Gallup surveys, four of five Americans believe the quality of care they receive is good or excellent, and the majority think it is the best available in the world. Surveys by Roper, Harris Interactive, Kaiser Family Foundation, Harvard’s Chan School of Public Health, and others show similar findings. And the public’s view hasn’t changed in two decades despite an avalanche of report cards about its performance, a testy national debate about health reform and persistent media attention to its shortcomings and errors. But is the public’s confidence in the quality of the care we provide based on an informed view or something else? It’s an important distinction.

Two considerations are useful for context:

Measuring quality of care objectively in the U.S. system is a relatively new focus. And we’re learning we’re not as good as they think we are. Historically, the public’s view about “quality of care” has been anchored in two strong beliefs: 1-the U.S. system has the latest technologies and drugs, the world’s best trained clinicians and most modern facilities, so it must be the best and 2-the care “I receive” from my physicians and caregivers is excellent because they’re all well-trained and smart.

Health in 2 point 00 — Late night HIMSS18 edition

Mar 6, 2018

For reasons a little lost in the fog we have committed to doing an episode of Health in 2 Point 00 every day at HIMSS. As I didn’t meet my co-host Jessica DaMassa till late it was more like “Health in 22.00”. But we still covered a few topics (Google Cloud, Eric Schmidt, Pilots) from our none too private studio in the corridor at the Venetian!–Matthew Holt

AI Is Close to Giving Us the Ultimate Early Diagnostic Test For Breast Cancer

Mar 5, 2018• 1

By HUGH HARVEY, MD

1986 was a great year. In the heyday of the worst-dressed decade in history, the Russians launched the Mir Space Station, Pixar was founded, Microsoft went public, the first 3D printer was sold, and Matt Groening created The Simpsons. Meanwhile, two equally important but entirely different scientific leaps occurred in completely separate academic fields on opposite sides of the planet. Now, thirty two years later, the birth of deep learning and the first implementation of breast screening are finally converging to create what could be the ultimate early diagnostic test for the most common cancer in women.

A brief history of deep learning

1986: In America, a small group of perceived agitators in the early field of machine learning published a paper in Nature entitled “Learning representations by back-propagating errors”. The authors, Rumelhart, Hinton and Williams had gone against the grain of conventional wisdom and proved that by re-running a neural network’s output errors backwards through a system, they could dramatically improve performance at image perception tasks. Back-propagation (or back-prop for short) wasn’t their discovery (for we all stand on the shoulders of giants) but with the publishing of this paper they managed to finally convince the sceptical machine learning community that using hand-engineering features to ‘teach’ a computer what to look for was not the way forward. Both the massive efficiency gains of the technique, and the fact that painstaking feature engineering by subject matter experts was no longer required to discover underlying patterns in data, meant that back-propagation allowed artificial neural networks to be applied to a vastly greater array of problems that was previously possible. For many, 1986 marks the year that deep learning as we know it was born.

Health in 2 point 00 Episode 4, HIMSS18 kickoff special

Mar 5, 2018

In which Jessica DaMassa asks me questions about Uber, Apple, Verily, Eric Schmidt, Oliver Wyman and UPMC’s profits. All in 2 minutes in this HIMSS18 special edition. Watch out! As we are going to try to do this every day this week from HIMSS, if my stamina and liver cooperate. Thanks to UPMC, OneView HealthCare, Echo Ventures and GE Ventures for supporting patient and caregivers travel to HIMSS18–Matthew Holt

Learning to Listen

Mar 4, 2018

By ROSS KOPPEL PhD, FACMI

Every physician is taught to listen to patients. Every physician acknowledges it’s an essential skill. Yet, study after study shows physicians interrupt their patients within a few seconds of their patients’ oral presentation of their problem(s). The author, Prof. Terry Hannan, MD, teaches us to shut up for a few minutes. If we do so, medical care will be safer, more efficient, kinder, and patients will help clinicians be better healers.

This book convincingly demonstrates the value of listening to patients; of discovering what is missing or wrong in the chart, of understanding the real etiology, and of the all-powerful value of honest communication. The book is a passionate defense of the physician as a human being who can listen and communicate with patients to help heal and understand. The physician, granted awesome authority and respect by society, is in a unique position to help patients understand and heal themselves in addition to bringing the needed care and science for their benefit. Included here, is knowing when to prevent unneeded care.

All of that said, the reason everyone should read this book–both clinicians and lay readers–is for the short stories of patient’s lives and experiences as they impact their illnesses and the role of healthcare. The stories are inevitably warm, humane, sensitive, and insightful. They give us hope for humans’ ability to help others, or at least to understand and ease their pain.

Each of the stories is this very short book is only a page or three long. Each is personal and poignant. Each gives us hope for medical care and for humanity.

Ross Koppel PhD, FACMI is at the University of Pennsylvania where he is a Senior Fellow at Wharton’s Leonard Davis Institute of Healthcare Economics, at Penn’s Center for Public Health Initiatives and at Penn’s Dept. of Biostatistics, Epidemiology and Informatics. He is also adjunct Professor of Sociology at Penn. rk*****@*******nn.edu

The Time is Now to Develop and Implement a National Health Data Strategy

Mar 1, 2018• 8

By JASON CHUNG

The 19^th century was about the Industrial Revolution. The 20^th century, the Digital Revolution. As we march closer to the third decade of the 21^st century, it is becoming clearer that this century’s revolution will be the Data Revolution. After all, companies are monetizing it, countries are weaponizing it and people are producing it.

In the medical space, this has fostered conflicting aims. The promise afforded by collecting and analyzing digital health data for insights into population health and personalized medicine is tempered by haziness on who owns and leverages that data.

But even as government actors struggle with the question of how to regulate data, technological progress marches on. Given the dizzying array of technological products claiming medical benefits hitting the marketplace, regulatory agencies have had to contemplate, and take, drastic steps to keep up. For instance, in the past two years the FDA has taken the following steps:

In July 2016, the FDA clarified what constituted a “low-risk” device such as fitness trackers or mobile apps tracking dietary activity.
In June 2017, new FDA Commissioner Scott Gottlieb outlined his vision for a more streamlined process for digital technologies which moves from a “case-by-case” approach to one that allows developers apply consistent safety standards to innovation.
Just a month later, the FDA announced the pilot for a digital health pre-certification program for individual companies which allows those firms that demonstrate a “culture of quality and organizational excellence” and the need for minimal regulation to introduce products to be marketed as new digital health tools with less information communicated to the FDA, sometimes with no “premarket submission at all”.
By September 2017, nine companies, including tech heavyweights Apple, Samsung and Alphabet-backed Verily, had been selected for the pre-cert process.
On February 13, 2018, the FDA further specified that low-risk products would be evaluated by looking at the firm’s practices rather than the product itself and announced its intent to create a new Center of Excellence on Digital Health which would be tasked with establishing a new regulatory paradigm, evaluating and recognizing third-party certifiers and hosting a new cybersecurity unit to complement new advances.

With this flurry of activity, the FDA is clearly moving toward a principles-oriented and firm-based approach to regulating digital technologies. This means moving away from certifying medtech products to the producers.

The ACA’s Crucial Prevention Component

Mar 1, 2018

By Julio Frenk, MD

Concern around the Affordable Care Act has reached a fever pitch, as Republican members of the House have succeeded at shutting down the government because the law has not been defunded or delayed. Meanwhile, a handful of states continue their efforts to undermine its implementation, which begins this week. While I by no means want to downplay the urgency of this situation, I would like to offer some reassurance as to the patient’s ultimate prognosis — as long as we remain committed to funding public health prevention efforts.

From 2000 to 2006, I served as minister of health in Mexico, where I spearheaded Seguro Popular, a comprehensive national health insurance program that enrolled more than 52 million previously uninsured persons, achieving universal coverage in less than a decade. In Mexico, as in the United States, introducing such a fundamental reform meant confronting special interests, making pragmatic trade-offs, and facing seemingly insurmountable challenges.

Every health system reform in an advanced nation has gone through such valley-of-death moments. That is the nature of the political process. For a variety of reasons, the United States is coming late to the global movement for expanded health care, the only one of the world’s 25 wealthiest nations lacking some form of universal care as of last year. National reforms inevitably go through great transitions, from vision to legislation, and then from legislation to implementation.

There is always a gap between the ideal vision and the ultimate design — and there are always times of fear that the whole endeavor will collapse under the weight of competing interests. Importantly, there is also no end to the reform process as every nation’s health system continuously evolves.

I believe that the Affordable Care Act will survive this current crisis.