MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'healthcare quality'. Sat, 03 Sep 2011 02:27:23 +0100 http://www.medworm.com/index.php?rid=4862552&cid=t_99534_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmore-bureaucracy-quality-healthcare-measured-with-check-boxes%2F2011.05.24 With the news that Wellpoint, one of the largest insurance companies in America, will cut off annual 8% payment increases to about 1,500 hospitals if they fail to “test” high enough on 51 quality measures, they have officially defined “quality” health care as checkboxes. Yep, checkboxes. You see how do insurers know if we offer each of our patient’s nutritional guidance or exercise counseling? Well, they check to see of doctors have clicked on a yellow warning box advising we do this. If we have, then not only is that doctor a fine, “quality” doctor, but the hospitals (and it’s computer system and scores of administrative staff that compile and submit this data) are real, fine, “quality” hospitals. That’s all there is to it.... Better Health blogs http://www.medworm.com/rss/comments.php?id=4862552 Tue, 24 May 2011 11:00:00 +0100 4862552 http://www.medworm.com/index.php?rid=4642596&cid=t_99534_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcms-never-events-incentivize-physicians-to-avoid-caring-for-high-risk-patients%2F2011.03.27 In 2008, the Centers for Medicare and Medicaid Services (CMS) announced it would no longer pay for the treatment of “never events,” i.e., certain medical conditions in hospitalized patients which the Feds deem to be universally avoidable under all circumstances. These conditions included: * Decubitus ulcers * Two kinds of catheter-associated infections * Air embolism * Mediastinitis after coronary bypass surgery * Transfusing patients with the wrong blood type * Leaving objects inside surgery patients * In-hospital falls Then, having been delighted with the results of its original list (or dismayed that healthcare costs continued to skyrocket despite its original list) CMS subsequently proposed declaring several new conditions as “never events,” including: (more…) *... Better Health blogs http://www.medworm.com/rss/comments.php?id=4642596 Sun, 27 Mar 2011 17:00:46 +0100 4642596 http://www.medworm.com/index.php?rid=4233186&cid=t_99534_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fgetting-quality-and-profit-out-of-medicine%2F2010.12.06 Looking for a great story about the state of hospital care in America? Look no further. The Health Care Blog has a great article by hospitalist Dr. Robert Wachter that sums it up nicely. It’s about money. Thats how hospitals get paid. That’s how everyone gets paid. It will always be about money. We don’t pay doctors, nurses, or administrators with smiley faces and candy canes. We pay them with cold hard cash. For example: One of the physicians, an invasive cardiologist, stopped me in my tracks. “Actually, our hospital already provides a tremendous amount of support and feedback,” he said. “When I perform a catheterization or angioplasty, a hospital staff member watches the entire procedure, she sometimes suggests mid-course corrections, and as soon as I’m do... Better Health blogs http://www.medworm.com/rss/comments.php?id=4233186 Mon, 06 Dec 2010 15:00:00 +0100 4233186 http://www.medworm.com/index.php?rid=4086267&cid=t_99534_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhy-comparing-the-performance-of-doctors-is-trouble%2F2010.10.20 Who do you think is likely to be a better doctor: A board certified graduate of one of the top medical schools in America, or a non-certified doctor trained in a foreign country? If your answer is “I have absolutely no idea,” then you’re probably spending a lot of time looking at the “report cards” that pass for measures of health care quality. And you’re probably confused. Researchers in Pittsburgh studied 124 process-based quality measures in 30 clinical areas. These process measures are the state-of-the-art ways in which government and private insurers are checking up on the quality of medical care. They include things like making sure patients with heart problems are prescribed aspirin, and that women get Pap smears. The researchers compared these measures against other,... Better Health blogs http://www.medworm.com/rss/comments.php?id=4086267 Wed, 20 Oct 2010 20:00:37 +0100 4086267 http://www.medworm.com/index.php?rid=4082093&cid=t_99534_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Facos-the-gathering-storm%2F2010.10.18 Those of you who’ve read this blog for any length of time know that I have been a pretty strong advocate for healthcare reform. This has been primarily motivated by my passion for universal coverage, but also with my frustration with the cost of the current healthcare system, the generally crummy outcomes, and the overall level of fragmentation in the whole affair. Even today, I had to repeat blood tests on a cancer patient who came to the ER. He had had blood tests at the cancer center ACROSS THE STREET before presenting, but, so sorry, our computers don’t talk to theirs and it’s after 5pm now, so forget about getting those results.  So it’s with a mixture of enthusiasm and dread that I consider the coming onslaught of accountable care organizations (ACOs). What ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4082093 Mon, 18 Oct 2010 19:00:00 +0100 4082093 http://www.medworm.com/index.php?rid=4055714&cid=t_99534_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmobile-health-joy-or-dismay%2F2010.10.11 Last month, PricewaterhouseCoopers (PwC) issued a report, Healthcare Unwired, examining the market for mobile health monitoring devices, reminder services, etc. among both healthcare providers and the general public. One of the big take-away points seems to be that 40% of the general public would be willing to pay for mobile health (or “mHealth”) devices or services ranging from reminders to data uploads — and the reaction by insiders is either joy (40% is good) or dismay (40% is not enough). PwC estimated the mHealth market to be worth somewhere between $7.7 billion and $43 billion per year, based on consumers’ expressed willingness to pay. Deloitte recently issued a report on mPHRs, as well — and there is tremendous interest in this space, as discussed in J... Better Health blogs http://www.medworm.com/rss/comments.php?id=4055714 Mon, 11 Oct 2010 16:00:27 +0100 4055714 http://www.medworm.com/index.php?rid=3729960&cid=t_99534_113_f&fid=36670&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fmsdn%2Fhealthblog%2F%7E3%2F3pA3jRe95KE%2Fmake-sure-your-health-organization-has-enough-power-when-you-flip-the-switch.aspx My favorite health futurist and commentator, Ian Morrison, offers another provocative essay in this week’s online edition of Hospitals and Health Networks .  In “ Flip the Switch ” he explores two prominent themes in the healthcare industry, both...(read more) (Source: HealthBlog) HealthBlog blogs http://www.medworm.com/rss/comments.php?id=3729960 Tue, 06 Jul 2010 20:28:12 +0100 3729960 http://www.medworm.com/index.php?rid=3420516&cid=t_99534_105_f&fid=39124&url=http%3A%2F%2Fwww.jeffreymlevinemd.com%2Fageism-the-new-york-times-and-geriatric-medicine%2F After reading an article entitled “The Geezers’ Crusade” by columnist David Brooks in the Op-Ed pages of the New York Times last week I felt compelled to comment on it.   The article begins on an encouraging note, pointing out how society’s views of human aging are evolving from negative to optimistic.  Once viewed as a [...] (Source: Jeffrey M. Levine MD | Geriatric Specialist | Wound Care | Pressure Ulcers) Jeffrey M. Levine MD | Geriatric Specialist | Wound Care | Pressure Ulcers blogs http://www.medworm.com/rss/comments.php?id=3420516 Tue, 09 Feb 2010 15:03:07 +0100 3420516 http://www.medworm.com/index.php?rid=3420518&cid=t_99534_105_f&fid=39124&url=http%3A%2F%2Fwww.jeffreymlevinemd.com%2Fskin-surveillance-under-medical-devices%2F Most educational materials on pressure ulcers tell you that the most common areas for pressure ulcers are under boney prominences such as the sacrum, ischium, and heels.   However, an area that is frequently under-emphasized in pressure ulcer education is skin breakdown under medical devices.   Tissue damage under medical devices is therefore frequently overlooked when performing skin [...] (Source: Jeffrey M. Levine MD | Geriatric Specialist | Wound Care | Pressure Ulcers) Jeffrey M. Levine MD | Geriatric Specialist | Wound Care | Pressure Ulcers blogs http://www.medworm.com/rss/comments.php?id=3420518 Fri, 15 Jan 2010 23:18:40 +0100 3420518 http://www.medworm.com/index.php?rid=3079425&cid=t_99534_113_f&fid=36670&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fmsdn%2Fhealthblog%2F%7E3%2F8MVWpNf8qh8%2Fit-s-what-you-do-next-with-your-emr.aspx Yesterday, I had the honor of delivering a luncheon keynote address at the LifeScience Alley annual conference and exhibition in Minneapolis.  Despite the major snowstorm that swept the Midwest this week, more than 1200 people showed up for this...(read more) (Source: HealthBlog) HealthBlog blogs http://www.medworm.com/rss/comments.php?id=3079425 Thu, 10 Dec 2009 18:18:19 +0100 3079425 http://www.medworm.com/index.php?rid=2511554&cid=t_99534_113_f&fid=34623&url=http%3A%2F%2Fhealthnex.typepad.com%2Fweb_log%2F2009%2F06%2Fsmarter-healthcare-channel-via-gbs-video-studio.html With healthcare reform taking centerstage in Washington in the weeks and months ahead, we wanted to share this section of clips in the IBM Global Business Services Video Studio, which debuted with the launch of IBM's new consulting organization, Business Analytics & Optimization. (Source: HealthNex) HealthNex blogs http://www.medworm.com/rss/comments.php?id=2511554 Fri, 19 Jun 2009 18:36:16 +0100 2511554 http://www.medworm.com/index.php?rid=2463093&cid=t_99534_113_f&fid=34623&url=http%3A%2F%2Fhealthnex.typepad.com%2Fweb_log%2F2009%2F06%2Fare-medical-costs-the-leading-cause-of-us-bankruptcies-.html The 60 Second Science Blog, from Scientific American, reports:"Analyzing data from 2,314 randomly selected 2007 (pre-mortgage-meltdown) bankruptcy filings revealed that most of those who had claimed bankruptcy because of medical expenses had health insurance, owned homes, were in their mid-40s and had middle class incomes. " (Source: HealthNex) HealthNex blogs http://www.medworm.com/rss/comments.php?id=2463093 Mon, 08 Jun 2009 13:31:48 +0100 2463093 http://www.medworm.com/index.php?rid=2424240&cid=t_99534_113_f&fid=34623&url=http%3A%2F%2Fhealthnex.typepad.com%2Ffiles%2Fpcmh.mp3 Download Patient Center Medical Home (MP3)The Patient Centered Medical Home: Blogger Briefing on new white paper from IBM's Institute of Business Value, and IBM Healthcare & Life Sciences.With: Dr. Paul Grundy, Director, IBM Healthcare Transformation Jim Adams, IBM Center for Healthcare Management Ed Mounib, Healthcare Lead, IBM Institute for Business Value Smarter Healthcare on ibm.com (Source: HealthNex) HealthNex blogs http://www.medworm.com/rss/comments.php?id=2424240 Wed, 20 May 2009 16:42:53 +0100 2424240 http://www.medworm.com/index.php?rid=2424241&cid=t_99534_113_f&fid=34623&url=http%3A%2F%2Fhealthnex.typepad.com%2Fweb_log%2F2009%2F05%2Fpatientcentered-medical-home-blogger-briefing.html This study makes the realistic case for why and how stakeholders can participate in PCMH initiatives, identifies critical issues and makes recommendations for best practices to increase the likelihood of initial success and sustainability. (Source: HealthNex) HealthNex blogs http://www.medworm.com/rss/comments.php?id=2424241 Tue, 19 May 2009 21:08:59 +0100 2424241 http://www.medworm.com/index.php?rid=2210313&cid=t_99534_113_f&fid=34623&url=http%3A%2F%2Fhealthnex.typepad.com%2Fweb_log%2F2009%2F02%2Fsmarter-planet-healthcare-this-weeks-focus.html This week, Smarter Planet moves to the pressing issue of healthcare.  As the "op-ad" thought leadership story for this vital topic notes:"The problems with our healthcare system are well known and well documented and endlessly debated. What's not so apparent is that many of them arise because our healthcare system isn't, in fact, a system."Adam Christensen's post on the Building a Smarter Planet blog picks up on how of all aspects of smarter planet, healthcare is understandably one that is both deeply personal, as well as a societal front that we all have a vested interest in.On the Smarter Planet Tumblr site, we've added a channel for all posts the touch on the way in which healthcare is becoming instrumented, interconnected  and... HealthNex blogs http://www.medworm.com/rss/comments.php?id=2210313 Mon, 23 Feb 2009 15:43:55 +0100 2210313 http://www.medworm.com/index.php?rid=2115532&cid=t_99534_113_f&fid=34623&url=http%3A%2F%2Fhealthnex.typepad.com%2Fweb_log%2F2009%2F01%2Fmy-pwer-personal-wellness-el.html MY PWeR (Personal Wellness electronic Record) is an intelligent, comprehensive  system is equipped with 24 applications ranging from Electronic Medical Records to electronic prescriptions to transcription solutions. MY PWeR also assists with electronic billing, reporting and analytics, and many other practice management tools. Earlier this year Quantum announced the launch of the PWeR healthcare information platform and selected IBM as a cornerstone of its information management, storage, security and privacy focus.See more on the Smarter Planet: Healthcare channel on our Tumblr site. (Source: HealthNex) HealthNex blogs http://www.medworm.com/rss/comments.php?id=2115532 Mon, 19 Jan 2009 16:01:09 +0100 2115532 http://www.medworm.com/index.php?rid=1379357&cid=t_99534_113_f&fid=34623&url=http%3A%2F%2Fhealthnex.typepad.com%2Fweb_log%2F2008%2F04%2Ffrontline-docu.html I watch Frontline's Sick Around the World documentary last night and really recommend it to all as a sober examination of the healthcare issues that are such a high priority in America today. Here's a preview below.  You can watch the whole program online. What I found most insightful about T.R. Reid's reporting was the clear and practical way he looked at the pros and cons of the national health systems in the U.K., Japan, Germany and Switzerland.  Even more impressive was learning how Taiwan went about reinventing their healthcare system by drawing on the best elements of programs around the world. I certainly hope we can follow such a practical process to turn around the fragmented U.S. healthcare situation, which the Harvard-trained architect of the Taiwan program not... HealthNex blogs http://www.medworm.com/rss/comments.php?id=1379357 Thu, 17 Apr 2008 17:13:55 +0100 1379357 http://www.medworm.com/index.php?rid=1225241&cid=t_99534_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2008%2F2%2F12%2Flets-all-ask-secretary-leavitt-to-explain-hhs-schizophrenia.html Brian Klepper Regular readers will know that, last Sunday, I posted a column that pointed to HHS' schizophrenic behavior when it comes to the release of Medicare physician data. First they fight the consumer advocacy group Checkbook.org's lawsuit demanding the release of data in 4 states and DC. (The AMA's Board Chair has admitted that they lobbied HHS to appeal the court's finding that they should make the data public.) Then, a week ago last Friday, HHS announced a new program that would identify Chartered Value Exchanges (CVEs) in 14 communities - these are coalitions of employers, payers, providers and consumers - and then hand over the same physician data they've been fighting the courts to keep secret so these groups can combine them with data available from the private sector and cre... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=1225241 Tue, 12 Feb 2008 20:57:35 +0100 1225241 http://www.medworm.com/index.php?rid=950848&cid=t_99534_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2Fhealing-unbound-the-promise-of-advancing-computational-power.html Laptop-attached ultrasound units that produce startlingly clear internal images for five dollars in the field. Organs that re-generate inside scaffolds.  Drugs tailored to an individual’s biology. Micro-images of cancerous cells lit up by bio-chemical markers. Decision support tools that scan the physiological values in electronic health records for patterns too complex to be detected by an unaided clinician.The advances available from dramatic improvements in computational capabilities were a recurring theme at the Aspen Health Forum, with experts from each discipline describing where the technology was leading us. I attended two sessions featuring Star Trek clips that predicted realities now within at least theoretical reach. (Prescient and corny, audiences nodded nostalgicall... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=950848 Mon, 15 Oct 2007 11:24:57 +0100 950848 http://www.medworm.com/index.php?rid=936754&cid=t_99534_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2007%2F10%2F9%2Fsorry-theres-no-room-at-the-inn-in-other-words-we-are-not-ta.html Margaret Cary, MD MBA MPHRecently a friend mentioned that her sister had just moved to Boston, was looking for a doctor and asked for a recommendation."Let me contact my friend. He is on the faculty at Harvard Medical School and at MIT. I bet he will know the best doctors."Just like old times, right? When you need medical care, you ask a local doctor you trust.His answer? "Big problem.""There are no PCPs (primary care physicians) taking new patients at either MGH (Massachusetts General Hospital) or BWH (Boston Women’s Hospital). It is virtually impossible for someone to choose his internist anymore. Everyone's practice is closed. You can go to a practice where a junior person will be building up a panel. Those practices are either institution based, e.g., Hea... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=936754 Tue, 09 Oct 2007 02:00:19 +0100 936754 http://www.medworm.com/index.php?rid=886212&cid=t_99534_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2007%2F9%2F20%2Fhow-might-information-technology-actually-change-health-care.html Brian KlepperToday I’m in San Francisco for the Health 2.0 conference, billed as “User-Generated Health Care.” Organized by my pal Matthew Holt and his partner, Indu Subaiya, "Health 2.0" references "Web 2.0," social networking, applied to health care.  The meeting will feature top executives from high and low profile IT firms that either are already dedicated to or hope to play an important role in health care, like Google, Microsoft, Yahoo, Intel, Cisco, WebMD, Revolution Health, AthenaHealth, Sermo, and many other lesser known organizations, all discussing their strategies for leveraging data in new ways to create value for all health care constituencies.Elsewhere, I’ve referred to this as a “significant portion of market-based heal... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=886212 Thu, 20 Sep 2007 04:31:08 +0100 886212 http://www.medworm.com/index.php?rid=845687&cid=t_99534_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2007%2F9%2F6%2Fwelcome-to-health-care-wonk-review-september-6-2007.html Brian Klepper This week TDWI is delighted to take our turn hosting Health Care Wonk Review, a collection that highlights some of health policy's best observers. The quality of these 14 posts is very high, and well worth your time.As HWR has gained visibility and popularity, the number of submissions has risen. We couldn't publish them all, so chose the ones we thought were must-reads across industry sectors. (Apologies to those we didn't include this time.)Before we begin, a quick announcement. Envision Solutions, LLC and Trusted.MD Network have launched the second annual global survey of healthcare bloggers.  The companies are producing this poll to shed additional light on why people blog about health-related subjects.  Click on the link to learn about and take the survey.&nbsp... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=845687 Thu, 06 Sep 2007 12:41:21 +0100 845687 http://www.medworm.com/index.php?rid=797014&cid=t_99534_113_f&fid=34623&url=http%3A%2F%2Fhealthnex.typepad.com%2Fweb_log%2F2007%2F08%2Fthe-question-of.html   healthcare    Originally uploaded by nashih One of the most difficult discussions Americans can have with each other about U.S. healthcare is around the question of "quality." How good (or bad) is the typical care that a typical American gets? When some people hear that the U.S. ranked 37th in the World Health Organization's ranking of national healthcare systems, they often balk...."America has some of the best hospitals, doctors, and healthcare innovation in the world!", they usually respond. And they are right. But they've missed the deeper issue in the rankings, which gauge the overall, systemic quality of healthcare for entire national populations. The broad demographic reality of America healthcare (and the health of many Americans) often belie... HealthNex blogs http://www.medworm.com/rss/comments.php?id=797014 Mon, 13 Aug 2007 21:12:38 +0100 797014 http://www.medworm.com/index.php?rid=790533&cid=t_99534_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2007%2F8%2F9%2Fshow-me-yours-and-ill-show-you-mine-transparency-and-health-.html Brian Klepper Mention a health plan to doctors or hospital administrators, and they’ll likely bend your ear about how the performance feedback data they get from them are wrong, how their reimbursements are based on inaccurate data, and how they think the inaccuracies are intentional.Because they aggregate huge volumes of claims, health plans have the best patient and provider information. While many providers dismiss claims data as wholly inaccurate, they in fact contain a wealth of useful information about patients and their care that can be teased out using the very sophisticated analytical tools that are now readily available. These techniques permit credible evaluation of the relative performance of doctors by specialty and hospitals by service.  Virtually all analytic... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=790533 Thu, 09 Aug 2007 22:41:34 +0100 790533 http://www.medworm.com/index.php?rid=757910&cid=t_99534_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2007%2F7%2F24%2Fcookbook-medicine-saves-lives.html by Pat Salber, MD In the early days of the clinical practice guidelines movement, doctors used to complain that it was “cookbook medicine.” As a pretty good cook, who still uses cookbooks, I say, great – when you follow the directions of experts, instead of “winging it,” you increase the odds of getting a good outcome.So it should be not a surprise that a new study, in the July 23 issue of Archives of Internal Medicine, found that outcomes of hospitalized heart-failure patients are improved when hospital personnel follow clinical guidelines. OPTIMIZE-HF (“Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure”) is a heart failure guidelines/quality improvement program adopted by the American Heart Associ... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=757910 Thu, 26 Jul 2007 00:49:41 +0100 757910 http://www.medworm.com/index.php?rid=744793&cid=t_99534_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2007%2F7%2F19%2Fshould-we-have-health-care-performance-transparency-by-whom-.html Brian Klepper Last week the New York Times reported that the state's Attorney General (AG) office threatened UnitedHealthcare (UHC) with a lawsuit if it proceeded with the September release of a physician profiling report. The details were fuzzy, but apparently the AG was responding to charges by different physician groups – the AMA and the St. Louis Metropolitan Medical Society were named  - that UHC's methodology is based purely on cost and does not consider quality. The Times piece includes this snippet:Linda A. Lacewell, a senior lawyer in the office of Attorney General Andrew M. Cuomo, wrote in the letter that the ranking would apparently be used to steer consumers toward selected doctors. “To compound the situation,” she wrote, “we understand that em... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=744793 Thu, 19 Jul 2007 23:30:07 +0100 744793 http://www.medworm.com/index.php?rid=733535&cid=t_99534_113_f&fid=34623&url=http%3A%2F%2Fhealthnex.typepad.com%2Fweb_log%2F2007%2F07%2Fhealthcare-pay-.html I haven't heard seen much about the important idea of "pay for performance" or (p4p) in healthcare -- the simple idea that doctors should be paid for the quality of the car they give, not just for doing x,y or z treatement-- until this story in the NY Times jumped out at me yesterday: Shift in Health-Cost Focus Is Said to Show Promise Welll worth reading. What P4P is all about is giving doctors the financial incentives to follow the best practice of care for a patient, rather than the current system, which rewards procedures and specific treatments rather than such a  quality-of-care metric. The catch here is that our current healthcare system doesn't deeply monitored or reward patient outcomes, only the dispensing of treatment.  While trying to find the story abov... HealthNex blogs http://www.medworm.com/rss/comments.php?id=733535 Fri, 13 Jul 2007 20:32:00 +0100 733535 http://www.medworm.com/index.php?rid=719793&cid=t_99534_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2007%2F7%2F7%2Fmy-friend-bob.html By Maggi Cary MD, MBA, MPHBob and Lara were my landlords, in their 60s, and lived across the nearly-two-lane road in the house they built over Adobe Canyon Creek in Sonoma County, California.I was Bob and Lara’s doctor—not in the come-to-my-office sense, but in the I’m-the-only-medical-person-in-the-family sense.  Bob developed a Dupuytren’s contracture, which is where a finger, or fingers, is drawn down toward the palm.  The connective tissue thickens and shortens, so moving the affected finger(s) is difficult.  The treatment is surgery and I recommended one of the top plastic surgeons in town.  Another friend did Bob’s anesthesia, blocking the nerves leading to the hand, much as dentists block nerves in your mouth, with Bob awake during t... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=719793 Sat, 07 Jul 2007 20:08:00 +0100 719793 http://www.medworm.com/index.php?rid=710249&cid=t_99534_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2007%2F7%2F5%2Fmr-orszags-surprise.html This report won’t sit well with the health care industry, particularly the drug, device and supply sector, which has won higher and higher profits by getting paid increasing dollars for new offerings that may or may not be better for patients. Go to OpenSecrets.org, and pull the data on lobbying expenditures by the health care sector. You’ll see that this same group represents half of all health care lobbying dollars. (More on that in a post next week.)But with this very focused, provocative and accurate report, Mr. Orszag has won the attention of key legislators as well as, hopefully, non-health care business interests, where the real power lies.  During a time when sound bites about universal coverage pass for meaningful discussion on reform, his analysis provided real c... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=710249 Tue, 03 Jul 2007 03:12:08 +0100 710249 http://www.medworm.com/index.php?rid=692597&cid=t_99534_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2007%2F6%2F23%2Frhios-translators-in-health-care-babel.html If you’re like me, your medical records are scattered all over your home region. (In my case, that’s lovely coastal Northeast Florida.) Over the years I’ve had several doctors: primary care physicians and specialists. I’ve been a hospital patient, and I’ve had outpatient procedures at doctor-owned facilities. I’ve had workups at several diagnostic centers and labs.The problem is that it’s health care Babel out there. No organization has my complete history because few if any of these organizations can share my medical records. Currently less than one-quarter of doctors store their patients’ information in electronic medical records that can be traded. And even if they did, the industry hasn't defined standards for records yet, so most systems... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=692597 Sat, 23 Jun 2007 15:35:46 +0100 692597 http://www.medworm.com/index.php?rid=682488&cid=t_99534_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2007%2F6%2F18%2Fif-it-ducks-then-its-a-quack.html Today I saw Constance Congdon's adaptation of Moliere's 17th century play, "The Imaginary Invalid" and was rolling in the aisle with laughter.  But, as in all things humorous, there is an underlying, stinging veracity that makes you ponder, seriously, the very topics that have made you laugh.First, some pictures, and then, the prologue to this wonderful play:               And now, back to the prologue of the play:"We are doctors come to warn you of the phonies out to harm you, could your guru be a schmuck?  If it quacks, then it's a duck!Your guru scoffs at your queries, and all his precious theories won't stand up to some flack?  If it ducks, then it's a quack! (Quack!)If you are... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=682488 Mon, 18 Jun 2007 00:49:36 +0100 682488 http://www.medworm.com/index.php?rid=650655&cid=t_99534_113_f&fid=34623&url=http%3A%2F%2Fhealthnex.typepad.com%2Fweb_log%2F2007%2F05%2Fguest_blogger_c.html (As the name suggests, HealthNex was always intended to be a nexus for ideas and exchange about ehealth and the evolution of healthcare into a true system. On that front, we're delighted to welcome Dr. Kvedar as a guest blogger, and encourage other experts who would like to join the conversation to contact us at healthnex@gmail.com with their interest in guest blogging here) Joseph C. Kvedar, MD, Director, Center for Connected Health, Partners HealthCare System, Inc. On May 8, the Center for Connected Health was privileged to co-sponsor a meeting in New York entitled: Personal Health Management: Adoption of New Benefits, Tools and Technologies.  The audience was made up of a healthy mix of corporate benefits managers, other executives, health care providers, technology companies, d... HealthNex blogs http://www.medworm.com/rss/comments.php?id=650655 Thu, 31 May 2007 14:34:00 +0100 650655 http://www.medworm.com/index.php?rid=611525&cid=t_99534_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2007%2F5%2F11%2Fmedicine-and-profits-an-unwholesome-alliance.html  “Oh Lord, lead me away from temptation… but not quite yet. St. Augustine . The New York Times in its May 9, 2007 issue, published a front page article about oncologists prescribing excessive amounts of anemia drugs to cancer patients on chemotherapy. The statistics are enlightening: the higher the “compensation” or monetary inducements offered to the oncologist-the higher the frequency and dosage prescribed. As they say on the TV commercial, “this drug is not for everyone”. Inappropriate prescription can actually cause harm, and recent studies showed that inappropriately high doses result in increased mortality. Response The American Society of Clinical Oncology distributed a letter to the members.  ASCO Responds to New York Times Article Add... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=611525 Sat, 12 May 2007 05:12:29 +0100 611525 http://www.medworm.com/index.php?rid=505487&cid=t_99534_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2007%2F3%2F27%2Fa-blockbuster-study-do-stents-prevent-heart-attacks.html Every once in a while a medical research study is published that significantly alters clinical practice. The paper on percutaneous coronary intervention (PCI) in patients with stable coronary artery disease, published in the prestigious New England Journal of Medicine on March 26, 2007, is one such study.  The results show that PCI plus optimal medical management (lifestyle changes and drugs) are no more effective than optimal medical management alone at preventing heart attacks and death in individuals with stable coronary artery disease. In the NY Times’ story about the study, Steven E. Nissen, MD, President of the American College of Cardiology, describes the study as a blockbuster. And, indeed it could lead to some folks’ blocks being busted (particularly stent co... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=505487 Wed, 28 Mar 2007 03:18:28 +0100 505487 http://www.medworm.com/index.php?rid=474150&cid=t_99534_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2007%2F3%2F15%2Famericans-are-saying-thanks-but-no-thanks-to-their-doctors.html This is an interesting story to follow yesterday’s post on supply-driven demand in healthcare. The results of a WSJ Online/Harris Interactive Health-care Poll are in and they show that many Americans don’t follow their doctors’ advice. It is pretty interesting stuff.Seventy-two percent (72%) of folks polled answered “often” or “sometimes” to the questions “based on what you know or have heard, how often do you think patients who have medical conditions experience problems because of being over-treated, for example, by getting too many treatments or by getting more aggressive treatment than is appropriate.” Only 5% of people said it never happens.Eighty-three percent (83%) of people said patients are often/sometimes under-treated. The po... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=474150 Thu, 15 Mar 2007 19:09:43 +0100 474150 http://www.medworm.com/index.php?rid=461129&cid=t_99534_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2007%2F3%2F9%2Fbest-not-to-get-really-sick-on-a-saturday.html When I doing my internal medicine residency, we all knew it was best not to be admitted to a teaching hospital in June and July when freshly minted MDs start their internship.  Now, a new study published in the journal, Stroke:  Journal of the American Heart Association, finds that it is better not to have a stroke on the weekend.  It turns out people admitted to the hospital with a stoke on a Saturday or Sunday have a higher mortality rate than those who get admitted on a weekday.  The American Heart Association issued the following statement about the study:"After adjusting for age, gender and other medical complications, researchers found that patients admitted on the weekend had a 14 percent higher risk of dying within seven days of admission com... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=461129 Fri, 09 Mar 2007 19:53:07 +0100 461129