The Health Care Blog – Page 402 – Everything you always wanted to know about the Health Care system. But were afraid to ask.

Above the Fold

Post-HITECH HIT: Still Waiting

Sep 26, 2015• 18

By MICHAEL PAINTER, MD

When it comes to health information technology in the United States, are you an optimist or pessimist?

Do you think it’s likely people who want health information will soon have routine, seamless digital access to it?

Most physicians and hospitals have at least some sort of electronic health record, yet big adoption gaps remain among physicians as just over half now have electronic health records. We can declare success and move on, right?

Hardly.

Most of us still cannot get health information when we want or need it. Health professionals and care systems trying to implement value-based payment and delivery reforms struggle to get the information they need to do that transformation. Communities trying to improve the health of their citizens have trouble getting the data they need and turning it into useful information.Continue reading…

America’s Nursing Crisis

Sep 26, 2015• 1

By SUSAN DENTZER

Many of the nation’s nurses understandably erupted in anger when the co-hosts of ABC’s The View mocked Miss America contestant Kelley Johnson for her pageant-night monologue about being a nurse — and for wearing scrubs and a “doctor’s stethoscope” (their words) in the talent competition. The co-hosts, Joy Behar and Michelle Collins, have since apologized, especially for implying that only doctors use stethoscopes. “I didn’t know what the hell I was talking about,” Behar later said.

It would be easy to attribute this episode solely to the ignorance of some TV personalities, but as most nurses know, the problem goes far deeper. The fact is that much of the nation doesn’t really understand nursing, either.

It’s true that the public rates nursing in Gallup surveys as the most honest and ethical profession. Yet it’s unlikely that most Americans understand the range of critically important roles that nurse’s play across the health care continuum, from health promotion, prevention, and research, to palliative and hospice care.

How many Americans know that patients who obtain organ transplants will have far more contact with – and obtain more hands-on care from – a transplant nurse than a surgeon? Or that two-thirds of all anesthetics given to US patients are delivered by certified registered nurse anesthetists, rather than anesthesiologists with medical degrees?

Miss America Contestant Kelly Johnson on Nursing

Sep 26, 2015

By SUSAN DENTZER

https://www.youtube.com/watch?v=pF_TBmKzwls

Mercer’s Hard-to-Find “Winning Streak”

Sep 25, 2015• 1

By ROGER COLLIER

“The winning streak continues as employers predict another year of low health benefit cost growth in 2016.” – That’s the headline to the announcement from international benefits consultants Mercer Inc. of the preliminary findings from their latest employer survey.

Sounds good, right? Finally, healthcare costs are under control.

Unfortunately, reading the survey results gives another, very different impression.

What the survey actually found was that employers predict that health benefit costs per employee will rise by 4.2 percent on average in 2016—after they make planned changes such as raising deductibles or switching carriers.

The survey announcement enthuses about what it calls the “slow-down in the underlying cost growth”(that is, the increase ifno changes were made to employer plans). Specifically, without plan changes employer costs would have increased by 6.4 percent for 2016, and 7.1 percent in 2015. Mercer notes that the 2016 projection is the lowest rate of underlying cost growth seen since 2005, and that 2016 will be the fifth year of benefit cost growth below 5 percent.

So, is this good news?

Well, no. For three reasons.Continue reading…

What ONC Got Wrong in their Guidance on Telehealth

Sep 24, 2015• 5

By ROY SCHOENBERG, M.D.

Telehealth – which lets patients see a doctor immediately, anytime, anywhere – shows no signs of slowing. We are seeing this cross-industry, as more health plans make telehealth a benefit to members, and hospitals fold these services into new or expanded offerings for patients. Consumer-facing products are also on the rise. Patients can download an app and in minutes, have a FaceTime-like visit with a doctor for faster, more convenient care.

It was great then to see this week that the Office of the National Coordinator for Health IT (ONC) is picking up telehealth as a new focus – by issuing guidance for consumer companies in the design and delivery of these technologies. The problem is ONC issued guidance without learning first how telehealth is actually being used in the industry today, leading to some basic… let’s just call them “misunderstandings.”

A Parasite meets Wall Street

Sep 24, 2015• 13

By SAURABH JHA, MD

Toxoplasma gondii is a parasite that causes opportunistic infection in helpless people. It may have met its match. The cost of treating Toxoplasmosis, a rare but extant infection, just shot up exponentially. Drug-resistant strain, you ask? Have physicians in Infectious Disease gone mercenary, you wonder? No. A change in ownership.

Daraprim (pyrimethamine) is a nifty drug which kills parasites. It’s been around for eons. I still recall its name from my medical school pharmacology exam. The price of Daraprim, whose production barely costs a dollar, may rise from $13.50 a pill to $750 a pill, after the rights to distribute the drug were acquired by Turing Pharmaceuticals.

Why? The answer is best told by Michael Shkreli, the CEO of Turing, and former hedge fund manager. The reason why Shkreli has acquired a generic drug lying in a forgotten backwater, and raised the price of a magnitude more suited to the hyperinflation of the Weimar Republic, is to make profits. Lots of profit. If this answer seems inane, ask yourself why a former hedge fund manager would be interested in a rare disease of devastating consequences. Penitence is the wrong answer.

Uncle Sam, Yelped

Sep 23, 2015• 2

By NIAM YARAGHI

Yelp recently announced it had reached an agreement with the U.S. General Services Administration (GSA) to allow agencies to claim their pages and read and respond to reviews. This is yet another move by the current administration to become more transparent and effectively communicate with the public through new information technology opportunities. I believe transparency almost always leads to net positive outcomes and thus have been a fierce supporter of government’s efforts towards this end. However, creating Yelp pages for government agencies may not be the best way to increase transparency and communicate with the public.

You may not like the policy, but you should love the way the GSA is implementing it. Rather than spending millions of dollars of taxpayer money to create a dedicated website, which would have most likely faced the same challenges of Healthcare.gov, GSA decided to take advantage of the reliable, readily available and, most importantly, free platform offered by Yelp. While the benefits of this policy are yet to be shown, at least its implementation cost is very minimal.

The feedback provided through Yelp can potentially help the administration to assess the current level of quality its services at different locations and potentially monitor the effectiveness of its improvement policies.

How I Use P4 Medicine to Maximize Patient Engagement

Sep 23, 2015

By MOLLY MALOOF, MD SPONSORED CONTENT

The healthcare industry is changing as new models of care and reimbursement emerge. One of these approaches is P4 Medicine. P4 Medicine stands for predictive, preventive, personalized, and participatory. This approach deeply resonates with me because the philosophy is aligned with how I have been developing my medical practice, which is focused on optimizing health and avoiding disease. In my opinion, P4 Medicine is one of the best models for maximizing patient engagement.

The earliest manifestation of P4 Medicine began eight years ago at the Institute of Systems Biology when Dr. Lee Hood, MD, PhD, a physician scientist and creator of the automated gene sequencer, recognized that the application of systems biology to medicine would fundamentally alter our understanding of health and disease. This model has merged three powerful aspects of science and technology:Continue reading…

Health 2.0 announces Launch! and Traction Finalists

Sep 22, 2015

By DEEPA MISTRY

Big news for the Health 2.0’s upcoming 9th Annual Fall Conference!

Launch!

Our annual Launch! competition is on the last day of the conference, Wednesday, October 7^th. Ten digital health companies will demo their products for the first time. The audience votes for their favorites. Previous Launch! winners have included Castlight Health, Basis, and OM*Signal. This year’s finalists:

Bloom Technologies will debut their discrete, wireless wearable for expecting mothers to track contractions and other changes to improve maternal and neonatal outcomes.

Flow Health connects consumers, providers and payers around shared patient data including Patient Check-In, an iPad app replacing the standard medical clipboard.

Sensentia is a fully-automated inquiry using natural language processing and more to empower patients to make better health care decisions.

Diagnostic Error: The IOM Talks Trash (But Not Cash)

Sep 22, 2015• 1

By MICHAEL L. MILLENSON

To understand how a landmark new report on diagnostic error breaks the mold, go past the carefully crafted soundbite (“Most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences”) and rummage around the report’s interior.

You can’t get much more medical establishment than the Institute of Medicine (IOM), also called the National Academy of Medicine, author of the just-released Improving Diagnosis in Health Care. Yet in a chapter discussing the role played in diagnostic accuracy by clinician characteristics, there’s a shockingly forthright discussion of the perils of age and arrogance.

“As clinicians age, they tend to have more trouble considering alternatives and switching tasks during the diagnostic process,” the report says. Personality factors can cause errors, too: “Arrogance, for instance, may lead to clinician overconfidence.”

Wow. Sure, both those assertions are extensively footnoted and hedged later with talk of the importance of teams (see below). Still, given the source, this practically qualifies as “trash talking.”

Of course, those quotes didn’t make it into the press release. There, inflammatory language was deliberately avoided so as not to give opponents any easy targets. (Disclosure: I was an advocate of an IOM report on this topic while consulting to an organization that eventually helped fund it. After testifying at the first committee meeting, I had no subsequent involvement.)Continue reading…