The Health Care Blog – Page 448 – Everything you always wanted to know about the Health Care system. But were afraid to ask.

Above the Fold

HIT Newser: Appalling Meaningful Use Penalties

Dec 23, 2014

By MICHELLE RONAN NOTEBOOM

Omnibus Bill Impacts HIT

The 2015 federal budget includes about $60.4 million for the ONC, which is less than the $75 million requested and on par with the 2014 budget. Congress allocated an additional $38.8 million to the HHS Office for Civil Rights, the agency that enforces HIPAA. Also in the bill: a controversial requirement for the ONC to decertify products that block health information sharing.

Appalling Meaningful Use Penalties

CMS reports that more than 257,000 eligible professionals will face penalties in 2015 for failing to meet Meaningful Use requirements. The AMA quickly announced it was “appalled by the news.”

Another Call to Cut Reporting Period

A group of 30 Republican House members call on HHS to shorten the 2015 Meaningful Use reporting period from 365 days to 90 days. A number of professional groups, including the AAFP and CHIME, support the extension.

From Foes to Financiers

Former Allscripts executives Glen Tullman and Lee Shapiro invest in Lightbeam Health Solutions, a population health management solution provider. Pat Cline, the founder and former president of NextGen, is currently Lightbeam’s CEO.

ATA Offers Accreditation

The American Telemedicine Association launches an accreditation program for providers offering online, real-time consults to patients.

The Value of Workplace Health Promotion (Wellness) Programs

Dec 22, 2014• 27

By RON GOETZEL

The recent Health Affairs Blog post by Al Lewis, Vik Khanna, and Shana Montrose titled, “Workplace Wellness Produces No Savings” has triggered much interest and media attention. It highlights the controversy surrounding the value of workplace health promotion programs that 22 authors addressed in an article published in the September 2014 issue of the Journal of Occupational and Environmental Medicine titled, “Do Workplace Health Promotion (Wellness) Programs Work?” That article also inspired several follow-up discussions and media reports, including one published by New York Times columnists Frakt and Carroll who answered the above question with: “usually not.”

There are certainly many points of contention and areas for continued discussion on this topic. It turns out that Lewis et al. and I agree on many things, and there are other areas where we see things differently.Continue reading…

Grading the Federal Health IT Strategic Plan

Dec 22, 2014• 4

By JAMES SALWITZ, MD

It is a heart pounding, head spinning, edge of your seat page-turner; the sort of rare saga that takes your breath away as it changes you, forever. It hints at a radically different future, a completely new world a few years away, which will disrupt the lives of every man, woman and child. Available now, from the National Coordinator for Health Information Technology (ONC), Office of the Secretary, United States Department of Health and Human Services, is finally, without further ado; the Federal Health IT Strategic Plan 2015 – 2020.

You think I am kidding. A satirical dig at another monstrous, useless, governmental report? Absolutely not. The concepts outlined in this blueprint will transform healthcare. It is a tight, clear, document, which at only 28 pages, delivers almost as much change per word as the Declaration of Independence. This may be the most powerful application yet of computerized information technology.

If you want to know where healthcare and health IT are headed, The Plan is absolutely worth a read.

I have only one complaint; it is coated with too much sugar. Restricted by policy structure and jargon, the report does not go far enough.

A User Interface Is Like a Joke

Dec 22, 2014• 6

By THCBist

HAT TIP: @Bob_Watchter, @Rosskopel

What has Surveyor Health been up to?

Dec 22, 2014• 2

By Matthew Holt

Erick & Linda von Schweber started Surveyor Health around the time Health 2.0 started back in 2007, with the BHAG of massively improving medication safety using some very complex technology. And it has taken them a long time to embed themselves in the bowels of some huge health care organizations and to start getting traction. But it is finally happening and the impact may be substantial. I interviewed Erick and he gave me a comprehensive demo and update on their latest results. If you care about drugs and clinical care, this is compelling (if not lightweight!) viewing. (I suggest you switch to full screen for the demo).

Flu Report: Providers Prescribing Antivirals at Higher Rate

Dec 19, 2014• 8

By IYUE SUNG

Earlier this week, we reported on the current rates of influenza-like illness (ILI), based on data from roughly one million patient visits on the athenahealth network. That report showed a steep increase in ILI rates for the week ending Saturday, December 13 (see previous post). It’s not certain that this season will be as severe as that of 2012-2013 (data for pediatrics suggests that is a real possibility); however, providers are testing for flu more consistently than previous years, and prescribing antivirals more often.

Our data shows that the number of flu tests ordered, per patient visit in which ILI is diagnosed, has risen each of the past two years (Figure 1, graph A). This season, providers are ordering flu tests at a rate of 0.53 tests per visit with an ILI diagnosis, compared to 0.37 for last season and 0.34 for 2012-2013. (Note: There can be multiple tests per patient visit, e.g. Type A and B.)

I Have DCIS, Should I Have a Bilateral Mastectomy?

Dec 18, 2014• 23

By ROBERT McNutt, MD

Benefit:

There is none. No women with DCIS have been included in a randomized controlled trial.

Harm:

Cosmetic outcomes are unclear; Second operations to fix the cosmetic outcome may be needed, but reasonable estimates for harm and complications do not exist as bilateral mastectomy has not been systematically studied in DCIS. A paper in Annals of Surgery found that out of 600 women at one institution, 42% of 209 women undergoing bilateral mastectomy had complications versus 29% of 391 women undergoing unilateral mastectomy (42-29% = 13%, added harm). Serious complications of bilateral mastectomy occurred in 14%; 4% with unilateral(14-4% = 10%, added harm).

Trade-off:

There is no trade-off between benefit and harm. Since there is no benefit, only harm is possible. Informed medical-decision-making requires a trade-off between added benefit and added harm. This is not the case for DCIS and bilateral mastectomy.

A Secret Playbook to Torment Doctors

Dec 18, 2014• 8

By PETER ELIAS, MD

A physician friend commented recently that he was being ‘meeting-ed to death’ and wondered if it was intentional. It turns out, he was on to something.

One of my colleagues has a neighbor whose sister’s piano tuner has a friend whose cousin is married to a nationally respected medical institution’s CEO. We were provided a copy of that institution’s management training course, on the condition that her identity not be revealed.

Here is the section on meetings:

Meetings as a Tool for Physician Control

Meetings are the ideal method for turning actively engaged and therefore troublesome physicians into apathetic sheep who are easy to manage.

Advice to Vivek Murthy: Be Nonpartisan, Use Common Sense and Move Americans

Dec 18, 2014• 28

By SAURABH JHA, MD

In defiance of dire predictions, children haven’t been sent to workhouses and women haven’t been chained to utensils after the GOP gained strength in the House and the Senate. And Vivek Murthy, the unabashed Obamaphile, was finally confirmed Surgeon General.

To be honest, I always thought the controversy surrounding Murthy’s nomination because of his stance on gun control was rather daft. Stopping doctors from pontificating over guns, such as the Docs versus Glocks legislation, is like banning me from trying to convert Pope Francis to Hinduism. The legislation is a parody not just for its own sake but because what it seeks to prevent is parody as well.

Murthy’s first challenge is to raise the position of the Surgeon General from that tokenism of a career UN bureaucrat to something vaguely useful. Which means Murthy must resist the call of banality, the banality of ideology and the ideology of making all of mankind’s imperfections public health problems.