The Health Care Blog – Page 951 – Everything you always wanted to know about the Health Care system. But were afraid to ask.

Above the Fold

Up in smoke

Nov 25, 2008• 1

By Sarah Arnquist

Taxing cigarettes is the single-most effective way to lower smoking rates, particularly among youth. And if we could lower smoking rates, we’d save hundreds of thousands of lives and billions of dollars each year.

Good Magazine demonstrates this strong correlation on a state-by-state basis in a fantastic interactive graphic. Go check it out.

In a related matter, I heard Matt Myers, president of Tobacco Free Kids, recently predict a federal cigarette tax increase to fund SCHIP. He said there’s strong bipartisan support, particularly to fund an expansion of children’s health coverage.

The demands for robotic surgery

Nov 24, 2008• 13

By Paul Levy

Many months ago,
I wrote about the da Vinci Robot Surgical System and expressed doubts
about whether there was evidence to support the clinical efficacy of
this equipment, as opposed to the marketing efficacy of the company
selling it. Well, the time has come to graciously say, “Uncle!”

Without
making any representations about the relative clinical value of this
robotic system versus manual laparoscopic surgery, I am writing to let
you know we have decided to buy one for our hospital.

Why? Well, in
simple terms, because virtually all the academic medical centers and
many community hospitals in the Boston area have bought one. Patients
who are otherwise loyal to our hospital and our doctors are
transferring their surgical treatments to other places.

Prospective
residents who are trying to decide where to have their surgical
training look upon our lack of the robot as a deficit in our education
program. Prospective physician recruits feel likewise. And, these
factors are now spreading beyond urology into the field of
gynecological surgery. So as a matter of good business planning,
concern for the quality of our training program, and to continue to
attract and retain the best possible doctors, the decision was made for
us.

So there you have it. This is an illustrative story of the health care system in which we operate

Paul Levy is the President and CEO of Beth Israel Deconess Medical
Center in Boston. He blogs about his
experiences at, Running a Hospital, one of the few blogs we know of maintained by a senior hospital executive.

Fostering an adult conversation about health reform

Nov 24, 2008• 8

By Robert Laszewski

Zeke Emanuel and Shannon Brownlee have an op-ed in Sunday’s Washington Post that should be required reading for anyone interested in health care reform.

The title is, “5 Myths About Our Ailing Health Care System.”

They suggest the “5 Myths” are:

America has the best health care in the world.
Somebody else is paying for your health insurance.
We would save a lot if we could cut the administrative waste of private insurance.
Health-care reform is going to cost a bundle.
Americans aren’t ready for a major overhaul of the health–care system.

At one level I can disagree with many of their points and at another I can agree with all of them — but they are right on all counts.

Hospitals hit by economic downturn

Nov 24, 2008• 2

By Jane Sarasohn-Kahn

Forty percent of American hospitals have seen drops in inpatient admissions, according to the American Hospital Association.

In the AHA’s survey, Report on the Economic Crisis: Initial Impact on Hospitals, it’s clear that hospitals are already experiencing the effects of the economic downturn.

CEOs are considering several cost-cutting tactics in dealing with this financial crisis:

56% of CEOs are postponing renovations or plans to increase capacity
45% are delaying purchase of clinical technology or equipment
39% are postponing investments in new information technology.

Electronic health records provide the foundation for clinical excellence

Nov 24, 2008• 5

By Scott Shreeve Scottshreeve

I have mentioned this many times but it bears repeating with three
recent news articles – the electronic health record itself is not a
game changer but it is a powerful information gathering tool.

However,
by gathering information in a single collaborative place, EHR
technology allows all clinical providers to measure, monitor, and begin
to improve the way they provide care. It is this later part, which is part of the overall organizational transformation enabled by the technology (not solely because of it), that allows an organization to achieve the promised high performance results of an often painful EHR implementation.

America’s CEOs set priorities for Obama Administration

Nov 21, 2008• 11

By Brian Klepper

This past Monday and Tuesday, The Wall Street Journal convened an extraordinary conference of about 100 CEOs to develop and recommend issue priorities for the new Administration. (See the participant list here.)

This meeting brought together the nation’s industry power players. Several Senators and Congressional representatives participated, as well as Rahm Emanuel, the President-elect’s new Chief of Staff, and others who advise Mr. Obama.

Based on their business’ core focus, the attendees were assigned into four major areas: 1) Finance and the US Economy, 2) Energy and the Environment, 3) American and the Global Economy, and 4) Health Care.

Then in the General Session that followed, the focus groups’ recommendations were incorporated into a final list and reranked by all the participants. Here’s the graph showing the relative ranking of all issues.

Consumer-Generated Clinical Trials? Research Minus Science = Gossip

Nov 21, 2008• 7

By Val Jones MD

Valjones My readers know how passionate I am about
protecting the public from misleading health information. I
have
witnessed first-hand
many well-meaning attempts to “empower consumers” with Web 2.0 tools.
Unfortunately, they were designed without a clear understanding of the
scientific method, basic statistics, or in some cases, common sense.

Let me first say that I desperately want my patients to be
knowledgeable about their disease or condition. The quality of their
self-care depends on that, and I regularly point each of my patients to
trusted sources of health information so that they can be fully
informed about all aspects of their health. Informed decisions are
founded upon good information. But when the foundation is corrupt –
consumer empowerment collapses like a house of cards.

In a recent lecture on Health 2.0, it was suggested that websites
that enable patients to “conduct their own clinical trials” are the
bold new frontier of research. This assertion betrays a lack of
understanding of basic scientific principles. In healthcare we often
say, “the plural of anecdote is not data” and I would translate that to
“research minus science equals gossip.” Let me give you some examples
of Health 2.0 gone wild:

Fighting Alzheimer’s one ribbon at a time

Nov 21, 2008• 2

Ribbon By THCB Staff

Caring.com and the Alzheimer’s Association have teamed up to spread awareness about the disease through an online
Purple
Ribbon campaign.

The official campaign ended earlier this year with 1,000 blogs and websites displaying the purple ribbon, but ribbons are still available for creating. For each ribbon created, Caring.com donates $10 to the Alzheimer’s Association for education programs.

Anyone who wants to help
raise awareness for Alzheimer’s disease can create a free web ribbon with just a few clicks. You can personalize the ribbon with a
loved one’s name and it comes in different shades and sizes to
match your website or blog.

Also, if you’re an adult child or caregiver caring for a parent or loved
one with Alzheimer’s, visit the Alzheimer’s and Other Dementias section
of Caring.com for helpful information and resources.

Could a larger investment in primary care cure the health care system?

Nov 21, 2008• 19

By Deron Schriver

I’m going to go out on a big ol’ limb here by saying that 90 percent of our health care problems could be solved by rebuilding and refocusing our primary care delivery system.

It’s the issue most discussed issue in reform circles (aside from single-payer) and it makes perfect sense. Toyota has succeeded because it goes to great lengths to find the true source of quality issues. They have recognized that addressing root causes significantly limits efforts needed because you avoid treating secondary level problems that occur further down the line.

A highly trained, appropriately paid primary care physician with a focus on prevention, coordination and patient education could solve so many other problems. There are many preventable chronic illnesses out there driving up our costs.

A Great American Smokeout, but where’s the coverage to help people quit?

Nov 20, 2008• 1

By Mitchell Katz Mitchkatz

Today is the Great American Smokeout, and while San Franciscans are doing their part to help people battle nicotine addiction, I became aware recently that not all the health insurance plans for our county workers in San Francisco — nor in many other counties around California – were covering all of the smoking cessation benefits recommended by the Center for Disease Control.

The City of San Francisco has embraced a multi-faceted approach to reduce tobacco use, while protecting individuals from insurance coverage barriers as they battle their addiction to nicotine:

We have endorsed a policy calling on the health plans that provide health insurance coverage for City and County employees to offer comprehensive smoking cessation benefits consistent with Centers for Disease Control and Prevention guidelines.

The City of San Francisco covers smoking cessation services and treatments for the uninsured.

According to the CDC, the most effective health insurance benefits are those that include patient reimbursements for smoking cessation counseling and FDA-approved pharmacotherapeutic treatments, and reimbursements to clinicians for providing tobacco dependence treatment, just as they are reimbursed for treating other chronic conditions.