By JOE SELBY, MD

For more than a decade, the United States has faced an escalating opioid abuse crisis. The number of deaths associated with abuse of these prescription painkillers more than tripled between 1999 and 2012 and now outstrips the number associated with any other drug, according to the US Centers for Disease Control and Prevention. The problem is estimated to approach $56 billion in costs to society.

Often, opioid abuse or overuse is associated with patients seeking effective relief from the common and often devastating problem of chronic pain, which has been reported as affecting up to one in three US adults. People in pain often request opioid medications, not understanding that these drugs don’t effectively treat certain types of pain, don’t work well for many people, and can lead to a range of additional health problems.

Researchers, policy makers, clinicians, and their professional organizations are working hard to stem the opioid abuse epidemic, seeking ways to reduce overprescribing of these drugs by expanding the use of alternative and supporting therapies, as well as identifying more effective treatments for addiction.Continue reading…

By JOSHUA GRAY

Over the past year, our athenaResearch team has been working with the Robert Wood Johnson Foundation (RWJF) on ACAView, an initiative that provides researchers, policymakers and the public with regular updates on how the Affordable Care Act (ACA) is affecting physician provider practices. To accomplish this, we curate and analyze data from a nationally distributed sample of 16,000 providers on the athenahealth cloud-based network. This gives us a timely view into national physician practice patterns and an ideal platform for measuring the impact of health care reform on the day-to-day practice of medicine.

After reporting some initial findings a handful of times, we’ve recently published our comprehensive report from the first year of the ACA rollout: “ACAView: Observations on the Affordable Care Act: 2014” (PDF). Here are some of the more interesting findings from the data:

Many feared a surge of new patient volume. That hasn’t occurred.

In 2014, the coverage provisions of the ACA went into effect, with the intention of bringing millions of patients into stable physician relationships that would improve their health status. Just before the coverage expansion, some commentators expressed concern that physicians might lack the practice capacity to treat these new patients, many of them with unmet medical needs. That has not happened.Continue reading…

By THCB Bot

Josh Gray’s post above triggered a nice Twitter exchange between @ddiamond and @Neoavatara.

Interesting: Medicaid patients' visits to the doctor actually ↓ in non-expansion states. http://t.co/7wUMUiQsMf pic.twitter.com/cMNjyJkqbY

— Dan Diamond (@ddiamond) May 14, 2015

@Neoavatara In his post, @JoshGray_hit wonders if it’s because of how doctors shaped their patient panels — preferring insured folks.

— Dan Diamond (@ddiamond) May 14, 2015

By LYGEIA RICCIARDI and PETER LEVIN

In many families the mother serves as the Family Health CEO, managing healthcare for her parents, kids, spouse, and herself. It’s Mom who schedules the doctor’s appointments, hunts down the immunization records for school, sorts out the bills, and reminds you to take your pills. 

What a difficult slog! In a world where we can video chat for free, book our travel and pay our bills online, and even go to college without leaving the living room, simple things like getting a list of current medications are almost impossible.  As Family Health CEO, poor Mom fills out the same information on clipboards at multiple doctors’ offices, gets stuck in infuriating phone trees, and bombarded by incomprehensible paper bills and reports on the family’s health, while she never even sees some of the most important information such as lab test results.

Continue reading…

By JAAN SIDOROV, MD

For better or worse, policymakers, politicians and health leaders in the United States are committed to achieving paperless healthcare environment. Even if there is lack of high quality research and reasonable skepticism over the ultimate cost and quality merits of “e”care, there is no going back.

As a result, visitors to ehospitals and eclinics are increasingly surrounded by monitors that, in turn, are surrounded by providers. To gain their attention, patients need to have internet access to make appointments, update medications, obtain education and communicate with their doctor.

And what if they don’t have that access? For the last decade, that worry has been characterized as “the healthcare digital divide. ” As recently as 2014, it’s been documented that the lack of computer hardware and access can have important healthcare implications for persons with low socioeconomic status.

For the doctors and nurses staring at screens all day, the millions of Americans who are living paycheck to paycheck risk being out sight and out of mind.

But it turns out that that it doesn’t need to be that way.

Check out this telling report from the Federal Deposit Insurance Corporation on the “unbanked” and “underbanked.” Not having a bank account (unbanked) or using any financial services (underbanked) are linked to persons with low income, being of color, disability and being unemployed.

In other words, these are the very persons at risk of being on the losing end of the health care digital divide.

While there’s interesting data on how close to 8% of U.S. households are unbanked and just over 20% were underbanked, there were also these stunning observations:

“Relative to fully banked households (86.8%), underbanked households were somewhat more likely to have had access to mobile phones (90.5%) and smartphones (64.5% of underbanked households compared with 59.0 percent of fully banked households).”

Continue reading…