The Health Care Blog – Page 674 – Everything you always wanted to know about the Health Care system. But were afraid to ask.

Above the Fold

Mind the Gap

Dec 23, 2011• 22

By Stephen J. Downs

It’s a simple idea – show patients the notes that doctors write about them– but it’s also a dangerous idea … in the best sense of the word. It’s dangerous because the very idea forces a conversation and in the course of that conversation, some uncomfortable tensions surface. Jan Walker and Tom Delbanco, co-directors of OpenNotes, a project supported by the Robert Wood Johnson Foundation’s Pioneer Portfolio that enables patients to see their doctors’ notes via secure e-mail after a visit, published a preliminary set of results from their first study. Actually, it’s just a pre-study: they surveyed doctors and patients about their expectations of how the OpenNotes idea would play out. And what they found is fascinating – and uncomfortable.

Doctors and patients are clearly divided about the expected benefits and consequences of the OpenNotes intervention. On a wide range of possible benefits, ranging from a greater sense of control to increased medication adherence, doctors are more skeptical than patients. But what really jumps out are the responses to questions of whether patients would find the notes more confusing than useful, and whether the notes would make them worry more. The gap is dramatic. In each case, most doctors said “yes” while less than one in six patients agreed. Ouch. That’s a big gap and my sense is that we should be talking about what it means. From my perspective, it appears that many doctors are underestimating their patients and that this underestimation could lead to less patient engagement and ultimately poorer care. Call it a hunch.

Health 2.0 News

Dec 23, 2011

The VA’s Facebook strategy, funding for Jawbone’s health care device unit and a new list of the top data breaches of 2011 — over at Health 2.0 News

We Have Cancer

Dec 22, 2011• 21

By John Halamka, MD

Cancer. It’s a word that creates fear and uncertainty. Many of the doctors I know use the word “hate” whenever they discuss their feelings about cancer.

Last Thursday, my wife Kathy was diagnosed with poorly differentiated breast cancer. She is not facing this alone. We’re approaching this as a team, as if together we have cancer. She has been my best friend for 30 years. I will do whatever it takes to ensure we have another 30 years together.

She’s has agreed that I can chronicle the process, the diagnostic tests, the therapeutic decisions, the life events, and the emotions we experience with the hope it will help other patients and families on their cancer treatment journey.

Here’s how it all started.

On Monday, December 5, she felt a small lump under her left breast. She has no family history, no risk factors, and no warning. We scheduled a mammogram for December 12 and she brought me a DVD with the DICOM images a few minutes after the study. On comparison with her previous mammograms it was clear she had two lesions, one anterior and one posterior in a dumbbell shape. I hand carried the DICOM images to the Breast Center team at BIDMC.

On December 13 she had an ultrasound guided biopsy which yielded the diagnosis – invasive ductal carcinoma, grade 3.

Is Nanotechnology the New GMO?

Dec 21, 2011

By Marion Nestle

Food Navigator reports that UK experts are demanding public debate and regulation of nanomaterials in foods. Without that, they warn, nanotechnology risks “facing the same fate as genetically modified (GM) foods in consumer perceptions.”

Nanotechnology is about manipulating materials on the scale of atoms or molecules, measured in nanometers (nm), one billionth, or 10⁻⁹, of a meter.

Many companies are already using nanomaterials in agriculture, food processing, food packaging, and supplements. This is not something the public has heard much about. Food companies often don’t know whether or not they are using these materials.

Nanotechnology science is new, and the industry is unregulated.

The FDA’s nanotechnology web page links to a quite thorough 2007 report from a task force, but the agency’s only guidance to date tells companies how they can find out whether they are using nanomaterials.Continue reading…

Obesity Means Lower Pay

Dec 21, 2011• 5

By DOC GURLEY

I’ve written before about obesity issues – mostly related to soda and diet soda (the message – even diet soda isn’t good for you – try to drink water instead) and also that even being a little overweight can still result in health problems. But a new study, coming out of the National Longitudinal Study of Youth, shows that obesity can also impact you economically with obese people earning less than the rest of the population on average.

Hopefully this information will help provide greater motivation for people struggling with obesity since sometimes it takes more than a simple understanding of health and self interest to sufficiently motivate people to take action. But it also raises questions about the reasons for average lower pay.Continue reading…

Startup Incubator Healthbox Announces Its First Class

Dec 21, 2011

By Laura Montini

Chicago-based startup accelerator Healthbox Chicago-based startup accelerator Healthbox announced the inaugural class of ten companies to begin its program in January 2012. Healthbox comes from Sandbox, which manages the Blues venture funds. Healthbox’s program is similar to incubators Rock Health in San Francisco and Blueprint in New York City. But instead of the $20,000 Rockhealth gives (taking no equity), Healthbox will give class members $50,000 in seed capital in exchange for 7% equity, and the companies will also have access to a mentor network, forums led by business experts and a collaborative workspace–(they may though have to move to the wilds of Chicago). The program will culminate in April with Investor Day where participants will present their businesses to a targeted group of investors. Healthbox received hundreds of applications from 26 states and eight countries with concentrations on provider workflow, consumer health, informatics, pharmacy and more. Here are the companies that made the final cut:

Twenty-First Century Personalization of Health Care

Dec 20, 2011• 3

By Charis Eng, MD, PhD

The public perception of “personalized medicine” is askew: the term is often viewed as a common treatment option for rare genetic disorders. The truth is that the power of genetic and genomic information allows physicians to offer personalized health care to their patients.

Yet personalized health care is not new: ABO blood typing is a superb example of widespread genetics-based personalized healthcare dating back to World War II, and continues to have universal applicability and will for centuries to come.

Consider a more recent example: common associations for breast cancer accounts for almost three percent of all breast cancers whereas a “rare mutation” (BRCA1-2) alone accounts for 10 percent of all breast cancers. There are currently at least nine other breast cancer predisposing genes which help knowledgeable healthcare providers make the correct diagnosis and inform patients of risks of other cancers.

Health 2.0 News

Dec 20, 2011

Funding for healthcare-focused social gaming firm Keas, kudos for HealthyRoads and HealthBox announces its first grants for promising healthcare startups, and much more– over at Health 2.0 News

Scenario Planning in a Post-ACO and Post-ACA World

Dec 20, 2011• 1

By Jaan Sidorov, MD

In a prior post, I provocatively suggested that providers, hospital boards and policymakers should hedge their bets and prepare for the possibility of a “post-ACO world.” If the Group Practice Demo’s disappointing results are any guide, the likelihood of a happy ending for accountable care organizations is on numerical par with Congress’ approval rating. While I like the mutual “win-win” theoretical construct that underlies ACO gain sharing, it also recalls a life-lesson: want you want and what you get are usually two different things.

So, if the Feds have to eventually retreat on the non-success of ACOs, what will be left in its wake? More on that in future posts.

And while the uncertainty surrounding ACOs isn’t bad enough, I have also been astonished by the battered Euro, the appearance of hospital-employed cardiologists and the absence of a Lady Gaga Christmas album. Accordingly, I have learned my lesson and assume nothing.

The Defining Issue: Not Government’s Size, but Who It’s For

Dec 20, 2011• 20

By Robert Reich

The defining political issue of 2012 won’t be the government’s size. It will be who government is for.

Americans have never much liked government. After all, the nation was conceived in a revolution against government.

But the surge of cynicism now engulfing America isn’t about government’s size. The cynicism comes from a growing perception that government isn’t working for average people. It’s for big business, Wall Street, and the very rich instead.

In a recent Pew Foundation poll, 77 percent of respondents said too much power is in the hands of a few rich people and corporations.

That’s understandable. To take a few examples:

Wall Street got bailed out but homeowners caught in the fierce downdraft caused by the Street’s excesses have got almost nothing.

Big agribusiness continues to rake in hundreds of billions in price supports and ethanol subsidies. Big pharma gets extended patent protection that drives up everyone’s drug prices. Big oil gets its own federal subsidy. But small businesses on the Main Streets of America are barely making it.