The Health Care Blog – Page 405 – Everything you always wanted to know about the Health Care system. But were afraid to ask.

Above the Fold

The Donald Effect

Aug 24, 2015• 6

By PAUL KECKLEY

No one knows how Donald Trump’s meteoric rise to the top of the GOP primary race ends, its impact on Campaign 2016 or its domestic and foreign policy implications for the U.S. will play out. What we know is the man knows how to get a crowd, spark discussion, and steal media attention from his 16 GOP primary rivals. He has built his brand as a straight shooter on tough issues and unapologetic foil of political correctness.

Friday night, the Donald show flew into Mobile, AL, and lit up a crowd estimated at 20,000 at the University of South Alabama football stadium. He left town on Trump Air dominating the weekend’s media coverage, perplexing the pundits who were betting the Donald show would flame out.

Political theatre is prone to big stories like “the Donald”. He’s brash, cocky and unfiltered as he talks about dicey issues. He has simple solutions to immigration reform and the threat of ISIS. He promises to be a tough commander in chief in war zones and fierce negotiator in trade pacts. Healthcare is on his list as well.

How Stanford Med Got “Work-Life Balance” Wrong

Aug 24, 2015• 4

By KAREN SIBERT, MD

Did it ever occur to some of today’s physicians that many people work awfully hard and complain a lot less than they do about “burnout” and “work-life balance”?

Did it ever occur to them that “work-life balance” is the very definition of a first-world problem, unique to a very privileged class of highly educated people, most of whom are white?

Every day, I go to work and see the example of the nurses and technicians who work right alongside me in tough thoracic surgery cases. Zanetta, for instance, is the single mother of five children. She leaves her 12-hour shift at 7 p.m. and then faces a 60-mile commute to get home. She never complains, and unfailingly takes the extra moment to get a warm blanket for a patient or cheerfully help out a colleague

For Patient Safety: A Reversal. What Can Healthcare Teach the Aviation Industry?

Aug 23, 2015

By RHONDA WYSKIEL

There are more than 50 in-flight medical emergencies a day on commercial airlines — or one for every 604 flights, according to a study published in 2013.

What are the odds that two emergencies would occur on the exact same flight, above the Atlantic Ocean and hours from the nearest airport?

My colleague Mark, a critical care physician with whom I’d worked as an ICU nurse, and I were traveling to the Middle East for a patient safety conference. We were comfortably tucked into our seats, as he snored next to me.

It must have been about 3 a.m. when I was awakened by an overhead announcement asking for a medical doctor. I nudged Mark, asking him to press his call light.

As the flight attendant approached, I told her that Mark was a doctor.

“And she’s an ICU nurse, and we work together,” he said, gesturing toward me.Continue reading…

Will Private Exchanges Move Us Closer to Socialized Medicine?

Aug 21, 2015• 7

By BLAKE ASHBY

Private exchanges have become the next big thing in healthcare, the newest approach to controlling employers’ healthcare costs and maybe even a way of moving healthcare from a defined benefit to a defined contribution. But they are unlikely to control healthcare costs and the only thing they will move us towards is socialized medicine.

An increasing number of employers are having employees use online “private exchanges” to make their annual healthcare plan selections. According to an Accenture study, one in four employers is considering a private exchange and an estimated 30 million employees will select their employer-provided healthcare plan through a private exchange by 2017.

On the surface private exchanges are attractive. Instead of the employer choosing a healthcare plan for its employees, the employer gives each employee a set amount of money to spend on a healthcare plan of the employee’s choosing. The employees then use the online exchange to select plan parameters that best meet their needs. Employees are able to maximize the value they receive from their healthcare allotment. The employer is removed from the healthcare decision process, no longer providing a defined benefit, healthcare, instead just providing a defined financial contribution for the employees to spend as they see best.

Save the Hipsters

Aug 21, 2015• 1

By THCBist

Evil health plan marketing or genius? Such a fine line.

Except to see more spots like this one from Rocky Mountain Health Plans as the online marketplace for health insurance created by the Affordable Care Act continues to mature.

Filed under: Affordable Care Act, Unintended consequences. Hipster marketing schemes. Stuff our Editors Like.

Why Prisons Should Try Readmissions Penalties

Aug 19, 2015• 4

By STUART M. BUTLER

By the end of 2013 there were approximately 1.5 million people in state or federal prisons, and the U.S. incarceration rate is the highest in the world. And while there is debate about the relationship between this level of imprisonment and crime rates, there is considerable research to show that a spell of incarceration exacerbates economic and social conditions for families as well as former inmates, especially in low-income neighborhoods. That has led the Obama Administration and some interesting strange-bedfellow groups to call for alternatives to prison for some infractions.

The other side of the prison coin is recidivism. Prisons are often called “correctional facilities” but that is a cruel joke – they do a dismal job in turning lives around. According to the U.S. Department of Justice, about two-thirds of released state prisoners were re-arrested within three years and three-quarters within five. Prison is a revolving door.Continue reading…

The New Laws for Hope(Lab)

Aug 18, 2015• 2

By MATTHEW HOLT

HopeLab, which is funded by the Omidyar eBay fortune, has for near a decade produced games to promote kids’ health, like Re-Mission for kids with cancer, and Zamzee, promoting activity for all children. But the real impact on the population of poor health environments for kids is only really just starting to be acknowledged more generally in society.

So it’s fabulous that HopeLab has appointed a new CEO, Margaret Laws. She was previously responsible for CHCF’s Innovation Fund, aimed at getting technology to move the needle for the underserved. She took the time to explain to me why she took her new role (think impact on children and their communities). And on a personal note, having known Margaret for several years, I think HopeLab made an excellent choice. This is a fascinating interview, even if the headline may be the worst pun in THCB history. Margaret also suggests where partners both in the health world and the tech world might work with HopeLab.

Bringing Clinicians, Patients, and Financial Administrators into a Common Conversation About Affordable Care

Aug 17, 2015• 1

By NEEL SHAH, MD and DAN MICHELSON

It all started a few years ago with an out-of-the-blue e-mail:

“Neel – I saw the work you are doing via the article in the journal ‘Leadership’. Congratulations as this is a great area of focus to pursue – the need to take down the complexity as it relates to cost/charge/reimbursement is a tough and an important issue. There may be some interesting ways we can collaborate. Best, Dan”

That e-mail would lead to a major initiative, a National Story Contest called The Best Care, The Lowest Cost: One Idea at a Time that we are launching this week. More on that below, but first a little more background.

At the time, Neel was finishing his clinical training as a physician and about to join the faculty at Harvard Medical School. Despite all that training, there was something that no one taught him: how his decisions were impacting what patients had to pay. Dan, who was leading Strata which is a company that helps hundreds of healthcare delivery systems with financial analytics, realized that most of these organizations didn’t have any access to cost data – they were flying blind.

Moving From Spaced Repetition to Spaced Learning

Aug 17, 2015• 1

By RITESH PATEL

Medical education is dynamic and constantly adapting to the needs of society. With new technological advances, scientific discoveries, and healthcare policies arising each day, the amount of information medical students are required to learn increases exponentially. Many describe the early years of medical education as a vicious cycle of cramming and forgetting with block exams, shelf exams, and board exams. Long-term retention is rarely rewarded and the integration across topics is limited. On the contrary, medicine IS a life-long learning process that is heavily dependent on the ability to attain, integrate, and apply data.

Unfortunately, time is limited, and as a result, cramming often prevails as the method of choice for many students. As medical students, we constantly find ourselves re-learning large amounts of information time and time again, always preparing for the next exam or hurdle, rather than thinking years down the line when we will be taking care of patients. This is very inefficient.

In June, Duke medical students wrote an article entitled “Want to enhance medical education? Use Spaced Repetition”. This article proposed a strategy that revolves around the cognitive technique known as spaced repetition. Spaced repetition takes advantage of time and reinforces one’s knowledge the moment before one forgets it. This technique involves reviewing material according to a schedule determined by a temporal relationship known as the “spacing effect”.

Protecting Americans from Preventable Infections: Working Together Will Save Lives

Aug 17, 2015• 4

By TOM FRIEDEN, MD

“Alone we can do so little; together we can do so much.” Those words spoken by Helen Keller nearly a century ago remain powerful and relevant today.

A new report from the Centers for Disease Control and Prevention (CDC) projects that thousands of lives could be saved every year if health care facilities and public health departments work together to track and stop antibiotic resistance – and if they communicate with each other about these infections to prevent spread from one facility to another.

Even if one health care facility follows all recommended infection control practices, antibiotic-resistant organisms can spread when patients are transferred among facilities. Even the best health care facilities can’t go it alone when it comes to antibiotic-resistant infections and C. difficile.

We need to protect our whole community; advance warning of possible antibiotic-resistant infections at one facility allows actions to be taken to prevent spread at the receiving facility.

New modeling data from CDC project that a community-wide approach – in which hospitals, long-term acute care facilities, nursing homes and health departments across an area work together – could reduce the number of patients infected with carbapenem-resistant Enterobacteriaceae (better known as CRE) by up to 70% over five years. CRE is a nightmare bacteria because it does not respond to most antibiotics and is extremely deadly should it enter the bloodstream – especially if a patient is already sick. A significant drop in these infections would be a life-saving scenario for patients.

Health care facility administrators are key to making this coordinated approach a success. Hospitals, long-term acute care facilities and nursing homes all need better systems to alert one another when transferring patients carrying drug-resistant bacteria and C. difficile. Strict infection control practices must be implemented in every health care setting, and clinical staff need access to prompt and accurate laboratory testing to identify antibiotic-resistant bacteria.