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 'hospitals'. Sat, 03 Sep 2011 01:47:38 +0100 http://www.medworm.com/index.php?rid=5181798&cid=t_92178_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-features-of-a-bundled-payment-for-care-improvement-project%2F2011.09.01 Many health care provider organizations have not been overly eager to jump onto the Accountable Care Organization (ACO) bandwagon, citing high startup costs and uncertain returns on investment given the complexity of the program.  Well, recently, the CMS Center for Innovation has announced the Bundled Payment for Care Improvement initiative.  This initiative incorporates elements of earlier CMS demonstration projects — the gainsharing demos and ACE (acute care episode) bundled payments demonstrations which the HealthBlawger has helped a number of clients around the country qualify for in the past — and builds on the broad authority granted to the CMS Center for Innovation under health reform. The advantages to proceeding with a Bundled Payment for Care Improvement project inc... Better Health blogs http://www.medworm.com/rss/comments.php?id=5181798 Thu, 01 Sep 2011 21:00:08 +0100 5181798 http://www.medworm.com/index.php?rid=5181972&cid=t_92178_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Fclosing-walter-reed-what-twitter-users-are-saying [View the story "The closing of Walter Reed: What Twitter users are saying" on Storify] (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=5181972 Thu, 01 Sep 2011 18:14:59 +0100 5181972 http://www.medworm.com/index.php?rid=5182343&cid=t_92178_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F09%2Fnurses-and-physicians-as-exercise-role-models-for-patients.html Everyone seems to be in agreement that most Americans lead lives that are far too sedentary. The solution to this problem, and many of the problems associated with a sedentary lifestyle, is exercise. However, motivating people to pursue a more active life is enormously challenging. Perhaps a good place to start is understanding that nurses (and also physicians) often function as role models for patients. A recent article raises this issue (see: Calling Nurses to Exercise as Role Models for their Patients). Below is an excerpt from it: Nurses, just like many of their patients, struggle to find time and motivation to exercise. But a new study may give these all-important caregivers some additional pressure and responsibility: nurses’ attitudes can influence whether their patients commit to... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5182343 Thu, 01 Sep 2011 12:15:56 +0100 5182343 http://www.medworm.com/index.php?rid=5181746&cid=t_92178_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FZJ8wLbS9szU%2F Ah, the simple act of hand-washing. It’s a simple, cheap way to prevent spreading infection in hospitals. And yet, research suggests compliance with so-called “hand hygiene” guidelines is less than 50% in many hospitals. Proposed solutions have included penalizing doctors and nurses who don’t follow the rules, sending in undergrad volunteers to look over the shoulders of staff, using video surveillance to identify offenders and employing high-tech sensors to gauge whether a health-care worker has recently used alcohol gel. Adam Grant, an organizational psychologist and associate professor of management at the University of Pennsylvania’s Wharton School, had a different idea. When he spent time in the hospital for the birth of his first daughter, he noticed signs te... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=5181746 Wed, 31 Aug 2011 21:01:16 +0100 5181746 http://www.medworm.com/index.php?rid=5181737&cid=t_92178_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F31%2Fthe-challenges-of-payment-reform-and-administrative-simplification%2F As both a Canadian and an analyst who focuses on US healthcare, I have an abiding curiosity in comparisons between the US and Canadian systems, so it was with great interest that I read the recent Health Affairs article by Dante Morra and coauthors entitled “US Physician Practices Versus Canadians: Spending Nearly Four Times As Much Money [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5181737 Wed, 31 Aug 2011 16:57:12 +0100 5181737 http://www.medworm.com/index.php?rid=5182344&cid=t_92178_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F08%2Fproject-costs-of-obesity-to-crush-us-and-uk-health-systems.html A recent article in Lancet discussed how the global obesity epidemic would "crush" the U.S. and U.K. health systems with its associated increased long-term, disease-associated costs (see: Obesity to crush health care systems globally: study). Although the use of the word "crush" may seem overly dramatic, I think that it's appropriate in this context. Below is a brief summary of the article: Rising prevalence of obesity is a worldwide health concern because excess weight gain within populations forecasts an increased burden from several diseases, most notably cardiovascular diseases, diabetes, and cancers....These trends project 65 million more obese adults in the USA and 11 million more obese adults in the UK by 2030, consequently accruing an additional 6—8·5 mil... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5182344 Wed, 31 Aug 2011 12:53:20 +0100 5182344 http://www.medworm.com/index.php?rid=5182345&cid=t_92178_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F08%2Ftulaboratory-based-genetic-counselors-reduce-the-cost-of-ordered-tests.html Appropriate test ordering by clinicians is a key aspect of clinical laboratory management. It can save time and money. One of the most obvious goals of this approach is to cull out duplicate test orders when the patient in question is clinically stable and the additional results are useless. The number of test cycles to arrive at a diagnosis can also often be reduced by immediately ordering a more specific test rather than repetitive groups of less-specific tests. The more specific test may be more expensive than the others but the total cost of testing may be less. In general, clinicians often require the most advice when ordering molecular and genetic tests. They tend to be the most expensive, most complicated, and require the most interpretive skill. ARUP Laboratories has published a wh... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5182345 Tue, 30 Aug 2011 12:54:47 +0100 5182345 http://www.medworm.com/index.php?rid=5174713&cid=t_92178_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Fend-beginning-and-launch-i2o When Dr. Farzad Mostashari, the national coordinator for health information technology, addresses more than 4,700 healthcare professionals at the Allscripts Client Experience in Nashville on Monday morning, Aug. 29, he’s likely to discuss one of the most exciting developments in healthcare today – and perhaps surprisingly, it won’t be the meaningful use of electronic health records.  read more (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=5174713 Sun, 28 Aug 2011 16:48:46 +0100 5174713 http://www.medworm.com/index.php?rid=5169511&cid=t_92178_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F08%2Fwill-hired-executives-let-healing.html Hospital - noun, 1.  a charitable institution for the needy, aged, infirm or young  2.  an institution where the sick or injured are given medical or surgical care, Merriam-Webster             - noun.  1.  an institution providing medical and surgical treatment and nursing care for sick or injured people, Oxford DictionaryTwo recent NY Times articles raise concerns that changes in leadership may cause hospitals to stray from their original purpose.  Cook County Health and Hospitals SystemThe first NY Times article discussed leadership of Cook County Health and Hospitals System (in the Chicago, IL area). This is a public health system whose mission was traditionally "to serve Cook County... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=5169511 Fri, 26 Aug 2011 18:20:00 +0100 5169511 http://www.medworm.com/index.php?rid=5159861&cid=t_92178_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F08%2Ffepic-beaker-ready-or-not.html There is going to be a lot of money made as the result of the potentially large-scale deployment of Epic's immature LIS called Beaker. One of the first in line to shake this money tree will be KLAS. Here is their announcement of a report on this topic by the company (see: Epic Beaker: Ready or Not?): The laboratory market typically sees little movement. Because of the expense and complexity from a laboratory system’s deep penetration into a hospital, laboratory systems are not changed frequently. If providers do change, it is rarely from a more sophisticated solution to a more immature one. One product that seems to be bucking that trend is Epic Beaker, Epic’s newly available laboratory solution. Of surveyed Epic hospitals currently using other laboratory solutions, over half are p... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5159861 Fri, 26 Aug 2011 13:19:45 +0100 5159861 http://www.medworm.com/index.php?rid=5158920&cid=t_92178_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F25%2Frisk-shifting-in-health-care-and-its-implications-part-two%2F Yesterday, in the first installment of a two-part Health Affairs Blog post, Troyen Brennan and Thomas Lee discussed the shifting of risk they see taking place in the health care system, from insurers and employers to provider and patients. In part two below, Brennan and Lee discuss the implications of this shift for various health [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5158920 Thu, 25 Aug 2011 18:02:47 +0100 5158920 http://www.medworm.com/index.php?rid=5159862&cid=t_92178_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F08%2Fdoes-epic-have-a-near-monoply-for-large-hospital-emrs.html Joseph Conn, who writes for ModernHealthcare.com, picked up on one of my blog notes about the Epic EMR dominance in larger hospitals (see: Not yet an Epic monopoly or conflict). Here is his note: Bruce Friedman, in a post on Lab Soft News says, "Epic has achieved a near monopoly of the (electronic health-record systems) installed in the largest U.S. hospitals." And writing in the Washington Examiner, Lachlan Markay, an investigative writer with the conservative Heritage Foundation's Center for Media and Public Policy, reveals that Epic Systems Corp. CEO Judith Faulkner not only has made campaign contributions to Democrats but also has served as a member of the federal Health Information Technology Policy Committee, which "holds in its hands the future of health informat... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5159862 Thu, 25 Aug 2011 12:51:59 +0100 5159862 http://www.medworm.com/index.php?rid=5159351&cid=t_92178_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FdflHJn4aeTM%2Fbundled-payments-for-care-improvement-initiative-announced-by-cms-center-for-innovation.html Many health care provider organizations have not been overly eager to jump onto the Accountable Care Organization (ACO) bandwagon, citing high startup costs and uncertain returns on investment given the complexity of the program.  Well, recently, the CMS Center for Innovation has announced the Bundled Payment for Care Improvement initiative.  This initiative incorporates elements of earlier CMS demonstration projects -- the gainsharing demos and ACE (acute care episode) bundled payments demonstrations which the HealthBlawger has helped a number of clients around the country qualify for in the past -- and builds on the broad authority granted to the CMS Center for Innovation under health reform. The advantages to proceeding with a Bundled Payment for Care Improvement project include the... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=5159351 Thu, 25 Aug 2011 11:17:08 +0100 5159351 http://www.medworm.com/index.php?rid=5158922&cid=t_92178_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F24%2Frisk-shifting-in-health-care-and-its-implications-part-one%2F Editor’s Note: Below, in the first installment of a two-part Health Affairs Blog post, Troyen Brennan and Thomas Lee discuss the shifting of risk they see taking place in the health care system, from insurers and employers to provider and patients. In part two tomorrow, Brennan and Lee will discuss the implications of this shift [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5158922 Wed, 24 Aug 2011 15:50:18 +0100 5158922 http://www.medworm.com/index.php?rid=5159317&cid=t_92178_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Fhospital-marketing-are-you-ready-patient-experience Social media in healthcare is evolving and finding its way into operational and clinical tools and this has been where much of my focus has been lately.  However, I do want to check-in with where healthcare social media got it's start and a recent survey of hospital marketers will help us with this. Some interesting survey results were released not long ago and I want to share the link to the report and highlight a couple of things.  By 2013, hospital marketers predict: read more (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=5159317 Wed, 24 Aug 2011 12:52:46 +0100 5159317 http://www.medworm.com/index.php?rid=5159423&cid=t_92178_118_f&fid=34850&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBusinessBlog%2F%7E3%2FmW47YCkM4-w%2F I’m taking a break from blogging this week so am rerunning some favorite posts from 2010. Please visit the original post to comment. In Health care’s dilemma: Competition or collaboration? the Washington Post’s Steven Pearlstein points out that health care reformers tend to favor integrated care providers like the Mayo Clinic, which deliver affordable, quality care. But, as he says: Here’s the dilemma: The only way for the health-care industry to move toward accountable care is to further accelerate a process of consolidation that has already reduced competition and increased market power. Hospitals are once again busily buying up physician practices and outside laboratories that used to compete with them, incorporating them into their “systems.” And independent physicians who ... Health Business Blog blogs http://www.medworm.com/rss/comments.php?id=5159423 Wed, 24 Aug 2011 12:03:53 +0100 5159423 http://www.medworm.com/index.php?rid=5158873&cid=t_92178_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F08%2Fmore-executives-prospering-despite.html Cases that demonstrate the contrast between compensation given to the hired executives of health care organizations and their or their organizations' performance continue to appear.  Last week we discussed how freely million dollar plus compensation is given to executives of nominally non-profit hospitals, and discussed how well some executives were paid just prior to charges of financial mismanagement, arrests or guilty pleas that drove them from their jobs.I have also found a series of cases of executives whose pay seemed disproportionate in the context of their institutions' financial difficulties.  Here they are, discussed in alphabetical order.Greenwich Hospital, ConnecticutAccording to GreenwichTime.com, here is the context:Greenwich Hospital went under the k... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=5158873 Tue, 23 Aug 2011 16:26:00 +0100 5158873 http://www.medworm.com/index.php?rid=5159864&cid=t_92178_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F08%2Fepic-as-a-victim-of-its-own-success.html Katherine Rourke, who blogs over at Hospital EMR and EHR picked up on one of my recent notes about Epic (see: The Feasibility of Using the Epic EMR as a "Platform" to Extend Its Functionality) and posted the following note: Could Epic End Up The Victim Of Its Own EMR Success? Here is a copy of her commentary with a few minor edits. Boldface emphasis is mine: In essence, the [recent Lab Soft News] post makes three key points: Epic is implemented, or soon will be, in virtually every large U.S. hospital Epic keeps very close control of how its system is implemented and developed in an effort to control performance Given this desire for control, Epic isn’t likely to let other vendors create software to interoperate with its EMR If the Lab Soft News author has his facts right, Epi... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5159864 Tue, 23 Aug 2011 12:46:33 +0100 5159864 http://www.medworm.com/index.php?rid=5159319&cid=t_92178_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Ffive-rights-staffing-maximizing-clinical-and-financial-benefits-acuity-system Hospitals and health systems often purchase acuity systems as a valuable tool to allocate nursing resources based on patient care needs. However, these organizations don’t always use their acuity systems to their full capability. In many cases, at least one of what we call “the five rights of staffing” is absent. According to “the five rights of staffing,” an acuity system should give hospitals: 1)    the right number of staff 2)    with the right skills read more (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=5159319 Tue, 23 Aug 2011 12:39:23 +0100 5159319 http://www.medworm.com/index.php?rid=5159424&cid=t_92178_118_f&fid=34850&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBusinessBlog%2F%7E3%2FLoT9TklsCeA%2F I’m taking a break from blogging this week so am rerunning some favorite posts from 2010. Please visit the original post to comment. In Health Insurers Get Tough on Hospital Prices, the Wall Street Journal reports that health plans and employers are using narrower provider networks to negotiate lower prices with hospitals. The idea is that hospitals should be willing to make concessions when that gives them the opportunity to exclude their competitors from a health plan’s network. No doubt this approach works, at least up to a point. Aetna is excited enough about the idea to brag about it at a recent conference. Apparently the company is even bringing its employer customers along to hospital negotiations to show it isn’t bluffing. But the approach isn’t as productive or sustainable... Health Business Blog blogs http://www.medworm.com/rss/comments.php?id=5159424 Tue, 23 Aug 2011 12:00:59 +0100 5159424 http://www.medworm.com/index.php?rid=5158985&cid=t_92178_87_f&fid=38805&url=http%3A%2F%2Fwww.denisesilber.com%2Fehealth%2F2011%2F08%2Finternet-evaluations-healthservices.html While internet rating sites for physicians in the US have been around for a number of years and a number of specialized sites are now part of the online health landscape (HealthGrades, RateMDs, and others), this is not the case in Europe in general, and France in particular, despite the presence of Yelp, GoogleMaps, and other US-based sites that allow for physician ratings. Health care professionals in France believe that physician rating will lead to either a) friendly reciprocal reviews amongst professionals (I'll evaluate you, you'll evaluate me, and we'll all evaluate each other) or b) unjustifiedly negative patient reviews. There is simply insufficient trust in crowdsourcing re docs. While French sites such as Le Guide Santé and Hôpital.fr do allo... Denise Silber's eHealth blogs http://www.medworm.com/rss/comments.php?id=5158985 Mon, 22 Aug 2011 23:00:00 +0100 5158985 http://www.medworm.com/index.php?rid=5158935&cid=t_92178_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FDE9jY4KlZcI%2F More heart-attack patients now than five years ago are getting a potentially life-saving procedure to open blocked arteries within the recommended time  frame, a new study shows. The so-called “door-to-balloon” time refers to how long it takes for heart attack patients who need an angioplasty  — an opening of the blocked artery using a catheter — to receive one once they’ve gotten to the hospital. The recommendation is to get the procedure within 90 minutes. Every minute is precious, because the longer patients go without the procedure, which restores blood flow to the heart, the lower their odds of survival. In 2005, only 44% of patients were getting treated within the recommended 90 minutes. But by 2010, that had increased to 91%, with 70% treated in less than ... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=5158935 Mon, 22 Aug 2011 20:30:42 +0100 5158935 http://www.medworm.com/index.php?rid=5158974&cid=t_92178_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F08%2Fmany-doctors-and-nurses-embrace-alternative-medicine.html Your doctor or nurse might be more likely than you to turn to dietary supplements and alternative therapies such as acupuncture and chiropractic care, according to a recent study in the journal Health Services Research. It found that 76 percent of health-care workers reported using alternative or complementary therapy in the preceding year compared with 63 percent of the general population. Researchers at the University of Minnesota and elsewhere analyzed data from the Centers for Disease Control and Prevention’s 2007 National Health Interview Survey, the most current nationally representative data available on the use of complementary and alternative medicine in U.S. households. The most common reason given by health-care professionals for use of complementary or alternative medici... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=5158974 Mon, 22 Aug 2011 20:00:00 +0100 5158974 http://www.medworm.com/index.php?rid=5159865&cid=t_92178_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F08%2Fsix-major-disruptions-still-to-come-in-halthcare.html Predictions about strategic shifts in healthcare intrigue me. There is always the question in one's mind about whether you agree with the list. A recent article was labeled as a list of healthcare "disruptions" but otherwise caught my attention (see: 6 Major Disruptions Still To Come In Healthcare). Here's the list stripped of the accompanying brief explanations: Conversion of physicians to electronic health records. Removing the responsibility of records-sharing from the patient. The rise of the genomic signature as part of the medical record. Moving the responsibility [for] care and outcomes from the provider location to the consumer location. The rise of health avatars. The change in physician compensation from fee-for-service to fee-for-outcomes. What interested me... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5159865 Mon, 22 Aug 2011 12:15:33 +0100 5159865 http://www.medworm.com/index.php?rid=5158874&cid=t_92178_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F08%2Fwhat-goes-up-non-profit-hospital-ceo.html We have frequently discussed the disconnect between incentives, particularly total compensation, given to the leaders of health care organizations and their roles, or lack thereof, in improving the health care of their patients or the public. One measure of that disconnect is how leaders' pay continues to defy gravity while the economy continues to suffer, and health care dysfunction continues to fester.In particular, total compensation given to CEOs of ostensibly not-for-profit hospitals and hospital systems is increasingly passing the magic $1 million mark. A round up including two recent articles and others from the last four months that we have not discussed before revealed more "million dollar babies" amongst the ranks of these leaders.  (Note that most of the data... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=5158874 Fri, 19 Aug 2011 18:37:00 +0100 5158874 http://www.medworm.com/index.php?rid=5139647&cid=t_92178_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F08%2Fbest-and-brightest-behaving-badly.html To err is human, and any group of humans can be expected to include those who stray.  However, the constant spin that surrounds most top leaders of health care organizations seems to suggest that these people are different.  In particular, the lavish compensation given leaders of health care organizations is often justified by claims that those in leadership positions are the best and the brightest.  Catching up after a vacation afforded me the opportunity to go through a large volume of news stories, leading to a collection of those from the last year that showed the contrast between such compensation and behavior that was far from the "best and the brightest. "North Memorial Health Care CEO Pleads Guilty to Engaging in ProstitutionAs reported by the Minneapo... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=5139647 Thu, 18 Aug 2011 21:02:00 +0100 5139647 http://www.medworm.com/index.php?rid=5140318&cid=t_92178_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F08%2Fcan-hospitals-become-more-health-outcome-oriented.html I have previously discussed some of the problems associated with fee-for-service and the need for hospitals and physicians to be more oriented to health outcomes (see, for example: Performing Procedures Can Be Lucrative for Physicians). I think that most people understand that the pursuit of outcomes is superior to fee-for-service but the challenge is revamping our reimbursement system to favor the former approach. A recent note by written by Dave Chase, the CEO of Avado.com, a health technology company, made this same point very eloquently (see: Making Newspaper Industry Mistakes).  Below is an excerpt from it: Now consider healthcare in the U.S.: There’s a clear understanding that the industry must shift its focus towards outcomes from “do more, bill more” orientation....Prev... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5140318 Tue, 16 Aug 2011 13:41:41 +0100 5140318 http://www.medworm.com/index.php?rid=5139683&cid=t_92178_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FIyG05aaQWBI%2F Viagra Protection: A federal judge ruled yesterday that a Pfizer patent on the erectile-dysfunction treatment Viagra is valid and enforceable, protecting the blockbuster drug against generic competition until 2019, the WSJ reports. Teva Pharmaceutical had proposed a generic version of the drug, arguing that certain claims of that 2019 Pfizer patent were invalid, the paper says. Cheap Screening: Hospitals are advertising inexpensive low-dose CT scans for current and former smokers on the heels of a government study that found such lung-cancer screening can save lives in a certain group of people, Kaiser Health News reports. But the study didn’t fully answer questions about who might benefit from the screening and how they should be screened, and the tests produce a lot of false positi... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=5139683 Tue, 16 Aug 2011 12:43:51 +0100 5139683 http://www.medworm.com/index.php?rid=5131063&cid=t_92178_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F08%2Fdeclining-autopsy-rates.html Discussion About Reinventing the Autopsy; Reinventing the Autopsy: CT Imaging as a Routine Part of the Procedure; NYT Highlights the "Virtopsy" Used for All Military Autopsies). The virtopsy would undoubtedly be more accurate than the classic autopsy. It also could be performed less expensively and more quickly. You can refer back to my previous notes for more details about its advantages. It is currently the norm for the U.S. military and also widely adopted in countries such as Switzerland. As noted in the excerpt above, one of the major reasons for the decline in the autopsy rate is that it's time-consuming and thus expensive. It's also an uncompensated hospital service. Needless to say, family members are also often reluctant to allow the procedure on relatives withou... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5131063 Mon, 15 Aug 2011 17:40:33 +0100 5131063 http://www.medworm.com/index.php?rid=5130872&cid=t_92178_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FX8JuuH6We8U%2Fpartners-health-care-acquiring-neighborhood-health-plan-the-800-pound-gorilla-and-the-fig-leaf.html Partners Health Care (the dominant provider network in Greater Boston) and Neighborhood Health Plan (a local mostly-Medicaid HMO) just announced that the former intends to acquire the latter, and maintain it as a separate operating entity.  No money will change hands between the parties, but an unspecified amount of money will be given by Partners as grants to community health centers where NHP members receive much of their health care services. Gary Gottlieb, CEO of Partners, graciously allowed that it would not seek to interfere with the current referral patterns of NHP members to the two local safety-net hospitals (which get disproportionate share hospital payments; Partners hospitals do not). The deal is contingent on several layers of regulatory review, including review by the Commo... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=5130872 Sun, 14 Aug 2011 20:35:15 +0100 5130872 http://www.medworm.com/index.php?rid=5118635&cid=t_92178_87_f&fid=38805&url=http%3A%2F%2Fwww.denisesilber.com%2Fehealth%2F2011%2F08%2Fhealthcare-socialmedia-internet.html At Doctors 2.0 & You, the "& You" referred  to the fact that the health care system is (or should be) a very, if not fully, interconnected world. However, this is still a work in progress. To connect  people within their own country, as most health care is still local, is already a challenge and to go beyond national borders presents an even greater challenge given language and travel requirements. Personal and collective resources both play a rôle. The advent of healthcare social media will help accelerate the connection, where basic resources are available. But much more needs to and will be done! However, the international language, despite  the improvement of automatic translation tools, tends to be English (or globish ;-) and, given as well, ... Denise Silber's eHealth blogs http://www.medworm.com/rss/comments.php?id=5118635 Wed, 10 Aug 2011 23:00:00 +0100 5118635 http://www.medworm.com/index.php?rid=5118798&cid=t_92178_118_f&fid=34850&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBusinessBlog%2F%7E3%2Fln1SiY2xOQg%2F After reading the July edition of Health Affairs, I’m concerned about the impact of Accountable Care Organizations (ACOs) on cost trends in the US health care system. In The Accountable Care Organization: Whatever Its Growing Pains, The Concept Is Too Vitally Important To Fail, Francis Crosson of the Kaiser Permanente Institute for Health Policy plays down the various criticisms of ACOs (that they may stifle innovation, unleash a torrent of regulation, and rely too heavily on fee for service payment methodologies) and argues that we need to help them succeed because there are no good alternatives. If not, both public and private payers will probably be forced into across-the-board reductions in payment rates to providers, because the state of the economy will require cost reductions,... Health Business Blog blogs http://www.medworm.com/rss/comments.php?id=5118798 Wed, 10 Aug 2011 17:45:25 +0100 5118798 http://www.medworm.com/index.php?rid=5118600&cid=t_92178_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2F0nhUIx08wws%2F Dire Straits: A new report from Moody’s says that nonprofit hospitals have been squeezed by a drop in elective surgeries and by state Medicaid cuts, and stand to be pressured even further by Medicare cuts stemming from the health-care overhaul law and future deficit-reduction efforts, the WSJ reports. A review of 401 hospitals financial results from 2010 finds only 4% revenue growth, the lowest since Moody’s started tracking these stats 20 years ago, with 20% running a loss on an operating basis. Most of the hospitals had margins of 5% or less. Working on Settlements: Johnson & Johnson said in a regulatory filing that it has a tentative agreement to resolve misdemeanor criminal charges over its marketing of the antipsychotic Risperdal, though certain issues are still not fi... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=5118600 Wed, 10 Aug 2011 12:41:26 +0100 5118600 http://www.medworm.com/index.php?rid=5119007&cid=t_92178_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F08%2Fethical-questions-posed-by-office-emr-by-epocrates.html Epocrates is a very successful smartphone app for physicians. The company recently announced the availability of an electronic health record (EHR) (see: Epocrates electronic health record raises new possibilities and ethical questions). Below is an excerpt from an article about this new product that may raise some ethical concerns: ...Targeted to small and solo physician practices, the [Epocrates EHR product] is a web-based software-as-a-service platform which will be offered on a monthly-subscription basis. At launch , it includes a native iPhone app that appears to include access to patient records as well as e-prescribing functionality, with iPad support reportedly in the works. Epocrates EHR will also include support for billing/coding, data analysis and reporting, and an interesting t... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5119007 Wed, 10 Aug 2011 12:00:00 +0100 5119007 http://www.medworm.com/index.php?rid=5118629&cid=t_92178_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F08%2Fbody-imaging-chain-hit-with-fines-for-unnecessary-medical-scans.html Colorado health officials levied a $3.2 million fine against Heart Check America for performing unnecessary X-rays and CT scans on consumers without a licensed doctor's request or oversight. The penalty—the largest ever imposed by the Colorado Department of Public Health and Environment—comes after months of investigation into alleged operating violations, including using "unfair and deceptive business practices" to sway consumers into committing to too many costly medical screenings. A recent Consumer Reports Health report on treating heart disease suggests that such scare tactics by clinics and medical groups are becoming more commonplace. Kimberly Lovett, M.D., a physician at Kaiser Permanente and a member of the San Diego Center for Patient Safety at the University of C... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=5118629 Tue, 09 Aug 2011 18:00:00 +0100 5118629 http://www.medworm.com/index.php?rid=5107479&cid=t_92178_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FkrelOZaRn9g%2F Conclusions: Studies by two researchers suggesting things like obesity, smoking and depression can spread through social networks like infectious diseases are coming under fire, the New York Times reports. Other scientists have criticized the methodology and have said observational data can’t be used to support their conclusions. The researchers, Nicholas Christakis and James Fowler, say their work has limitations but “maintain that their conclusions are robust,” the paper says. Image: iStockphoto (Source: WSJ.com: Health Blog) WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=5107479 Tue, 09 Aug 2011 12:56:39 +0100 5107479 http://www.medworm.com/index.php?rid=5107481&cid=t_92178_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2F6siekMksKWs%2F Ask anyone who’s spent time in the hospital — patients get a lot of blood taken over the course of their stay. A blood test can provide crucial information that can’t be gotten any other way. But sometimes there may be a downside. A study of heart-attack patients just published online by the Archives of Internal Medicine finds that blood loss from diagnostic tests is associated with acquiring anemia in the hospital. And anemia — a decrease in the red blood cells or in the specific protein that carry oxygen throughout the body– is associated with poorer health and a higher risk of death. The study looked at data from 17,676 heart-attack patients in 57 hospitals between 2000 and 2008. None of them had anemia when they were admitted, but over the course of their ... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=5107481 Mon, 08 Aug 2011 20:21:28 +0100 5107481 http://www.medworm.com/index.php?rid=5107667&cid=t_92178_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2F2-ways-hospital-new-construction-provides-long-term-growth-strategies At a medical office conference I attended, influential hospital executives stated that investing their capital in infrastructure needs and health information technology (IT) took priority over building new or renovating existing hospital ancillary facilities. However, the many advantages to  new facility construction support hospital growth strategies and has the potential to help the long term viability of any health system. read more (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=5107667 Mon, 08 Aug 2011 12:24:12 +0100 5107667 http://www.medworm.com/index.php?rid=5107909&cid=t_92178_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F08%2Fwould-the-fda-swallow-an-over-the-counter-lipitor.html Pharmaceutical manufacturers are growing increasingly concerned because so many of their block-buster drugs are coming off patent and reverting to generics (see: Some Interesting Insights into the Use of Generic Drugs). One of Pfizer's responses has been to propose that its well-established Lipitor brand now be sold over-the-counter. This, of course, requires regulatory approval (see: Reader Consult: Would the FDA Swallow an OTC Lipitor?), Below is an excerpt from the article: Pfizer is hoping to milk even more dollars from its blockbuster Lipitor by introducing an over-the-counter version of the cholesterol-lowering drug, the WSJ [recently reported], citing people familiar with the matter. Whether Pfizer can get the FDA to swallow an OTC statin is another matter entirely. The WSJ repo... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5107909 Mon, 08 Aug 2011 12:00:00 +0100 5107909 http://www.medworm.com/index.php?rid=5103325&cid=t_92178_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2F7rtOjVhiExQ%2F The U.S. economy added more jobs than expected last month. And the health-care industry showed particular strength, with 31,300 new jobs — higher than the average monthly increase seen in 2007, before the recession hit. Here’s the Bureau of Labor Statistics chart showing sector-by-sector job growth, and here’s the overall report, which shows non-farm payrolls rose by 117,000 while the unemployment rate dropped slightly to 9.1%. As the WSJ reported last month, health-care employment had been robust during the recession, but showed some weakening in the June report. That changed in July. Hospitals alone added 14,000 new jobs after losing 2,000 jobs the previous month. Ambulatory care also added jobs — 6,300 in doctor’s offices and 3,100 in home health-care servi... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=5103325 Fri, 05 Aug 2011 16:30:44 +0100 5103325 http://www.medworm.com/index.php?rid=5096197&cid=t_92178_87_f&fid=38962&url=http%3A%2F%2Fwww.healthbeatblog.com%2F2011%2F08%2Fus-rumor-and-hospital-report.html Introduction: Below a post by Paul Levy, the former President and CEO of Beth Israel Deaconess Medical Center in Boston. For the past five years he kept an online journal, Running a Hospital. He now writes as an advocate for patient-centered care, eliminating preventable harm, transparency of clinical outcomes, and front-line driven process improvement at one of my favorite blogs: Not Running a Hospital. Levy’s post originally appeared on The Health Care Blog (THCB).   I should add that, as a journalist, I have watched lists like this one being compiled at various magazines: “The Best Colleges in the U.S.”  “New York’s Best Doctors,”  “The Best Motels in America”. . ..  Who puts them together?  Young journalists who know no more than the rest ... Health Beat blogs http://www.medworm.com/rss/comments.php?id=5096197 Thu, 04 Aug 2011 21:14:49 +0100 5096197 http://www.medworm.com/index.php?rid=5096198&cid=t_92178_87_f&fid=38962&url=http%3A%2F%2Fwww.healthbeatblog.com%2F2011%2F08%2Fhospital-ceos-reveal-their-top-priorities-.html While reading Paul Levy’s post on hospital rankings, I couldn’t help recall an  American College of Health Care Executives (ACHE) survey that he discussed on “Not Running a Hospital” back in March of 2010.  The ACHE asked hospital CEO’s about their top concerns. Below, a table shows the results: “Patient Safety” and “Quality of Care” ranked at the bottom of their list of priorities. Granted, from 2004 to 2007 these issues moved up in the rankings, but CEOs still were more likely to worry about “financial challenges,” “the cost of caring for the uninsured,” and “Doctor/hospital relations.”  They might as well have been the CEOs of auto companies, who worry about  first about profits, then costs, then labor relations, roughly in that orde... Health Beat blogs http://www.medworm.com/rss/comments.php?id=5096198 Thu, 04 Aug 2011 21:14:02 +0100 5096198 http://www.medworm.com/index.php?rid=5097117&cid=t_92178_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F08%2Fhospitalists-add-to-the-cost-of-healthcare-according-to-recent-study.html This study should come as no surprise to anyone. Here's what I think may be occurring: Hospitalists work for health system CEOs who place a high value on a shorter length-of-stay (LOS) for patients. The will thus tend to discharge patients as soon as possible. CEOs have been conditioned over the past many years to relish shorter LOSs because the measure has attained the status of a quality indicator and also because shorter LOS patients are more profitable. I also assume that hospitalists tend to favor discharge of patients to rehabilitation or nursing facilities rather than to home because they do not know them well and also to ensure a speedier, medically supervised recovery. Almost everyone agrees about the solution to this problem. It is stated clearly in the excerpt above: &quot... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5097117 Thu, 04 Aug 2011 14:35:03 +0100 5097117 http://www.medworm.com/index.php?rid=5096146&cid=t_92178_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F04%2Fdeficit-and-debt-politics-a-wake-up-call-for-the-health-care-industry%2F Editor’s Note: Below, Jonathan Oberlander analyzes the implications of the recently enacted agreement to increase the nation’s debt ceiling. See also Joe Antos’ analysis of the same topic on Health Affairs Blog. The 2010 Affordable Care Act (ACA) called for significant Medicare savings.  All told, the Congressional Budget Office projected that the law would trim [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5096146 Thu, 04 Aug 2011 12:22:41 +0100 5096146 http://www.medworm.com/index.php?rid=5096673&cid=t_92178_118_f&fid=34850&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBusinessBlog%2F%7E3%2FxkuDhxV1aZ4%2F This is the transcript of my recent podcast interview with Jeff Terry of GE Performance Solutions. David E. Williams:            This is David Williams, co-founder of MedPharma Partners and author of the Health Business Blog.  I’m speaking today with Jeff Terry.  He’s Managing Principal of Clinical Operations for GE Performance Solutions.  Jeff thanks for being with me today. Jeff Terry:            Good morning. Williams:            Jeff, tell me about capacity management.  Why is that something hospitals have to be concerned about? Terry:            Capacity management is important because it’s among the top two or three financial levers available for hospitals today and it’s becoming more important. However ACOs play out, however in... Health Business Blog blogs http://www.medworm.com/rss/comments.php?id=5096673 Thu, 04 Aug 2011 01:13:23 +0100 5096673 http://www.medworm.com/index.php?rid=5096467&cid=t_92178_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Funitedhealth-improving-rural-healthcare The UnitedHealth Center for Health Reform and Modernization released a white paper on Modernizing Rural Health Care. To quote from the UHG presser: read more (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=5096467 Wed, 03 Aug 2011 13:18:59 +0100 5096467 http://www.medworm.com/index.php?rid=5096470&cid=t_92178_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2F2-healthcare-facility-design-trends Today hospital executives can say that their facilities are unlike their predecessors ten years ago, but in another ten years from now health facilities will be even more sophisticated and advanced than the most modern centers today. Being able to see ahead of the curve to accommodate future situations is key for any health facility to stay successful and thrive as market conditions change, patient preferences switch, and amenities not thought related to hospitals are suddenly in high demand. read more (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=5096470 Wed, 03 Aug 2011 12:12:30 +0100 5096470 http://www.medworm.com/index.php?rid=5097119&cid=t_92178_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F08%2Fsome-interesting-insights-into-the-use-of-generic-drugs.html We are obviously in an era in which most drug prescriptions will default to a generic product when available. A recent article discussed how drug prices are about to plummet on the basis of expiring pharmaceutical company patents. Most, if not all, of these patent-protected drugs will be replaced by generic equivalents (see: Drug prices to plummet in wave of expiring patents). Included in the article were some fascinating facts about generic drugs. Below is an excerpt from it: The cost of prescription medicines used by millions of people every day is about to plummet. The next 14 months will bring generic versions of seven of the world's 20 best-selling drugs, including the top two: cholesterol fighter Lipitor and blood thinner Plavix....Between now and 2016, blockbusters with about $2... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5097119 Wed, 03 Aug 2011 00:31:50 +0100 5097119 http://www.medworm.com/index.php?rid=5096191&cid=t_92178_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F08%2Fa-quarter-of-heart-surgeons-are-above-average-in-updated-ratings.html Eighty-one of 323 surgical groups that perform heart bypass surgery got three stars (above average) in updated ratings published today by Consumer Reports and the Society of Thoracic Surgeons. In addition, 237 got two stars (average) and 5 received one star (below average). While several states require heart surgeons to report heart surgery data, many surgical groups—even some with just one star—voluntarily share that information with the public. Why? Because they know that ultimately translates into better care, as it helps surgeons identify the areas where they need to improve. In fact, the willingness of surgeons to track their performance has led to some important improvements, including a dramatic reduction in mortality over the past 10 years. For example, the differen... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=5096191 Tue, 02 Aug 2011 11:01:00 +0100 5096191 http://www.medworm.com/index.php?rid=5086171&cid=t_92178_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fnew-program-at-usf-health-hopes-to-mold-more-empathetic-physicians%2F2011.08.01 Can we teach empathy to the next generation of physicians?  The University of South Florida Health thinks so and they’re putting it on the line this week with the launch of the SELECT program, a new curriculum intended to “put empathy, communication and creativity back into doctoring.” The SELECT (Scholarly Excellence. Leadership Experiences. Collaborative Training.) program will offer 19 select students unique training in leadership development as well as the scholarly tools needed to become physician leaders and catalysts for change. During their first week on campus, instead of the old-style medical school tradition of heading to the gross anatomy lab, SELECT students are immersed in leadership training centered in empathy and other core principles of patient-centered care. The h... Better Health blogs http://www.medworm.com/rss/comments.php?id=5086171 Mon, 01 Aug 2011 12:00:15 +0100 5086171 http://www.medworm.com/index.php?rid=5086165&cid=t_92178_87_f&fid=38805&url=http%3A%2F%2Fwww.denisesilber.com%2Fehealth%2F2011%2F07%2Finfographic-doctors.html ++ Click to Enlarge Image ++Image Source: Spina Bifida Info.com (Source: Denise Silber's eHealth) Denise Silber's eHealth blogs http://www.medworm.com/rss/comments.php?id=5086165 Sat, 30 Jul 2011 23:00:00 +0100 5086165 http://www.medworm.com/index.php?rid=5077862&cid=t_92178_118_f&fid=34850&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBusinessBlog%2F%7E3%2FHROzwrIlAiY%2F When I lived in Hong Kong years ago I used to read about crazy stories happening in places like the Phillipines, where a woman supposedly gave birth to a fish. Hundreds of people came to see the miracle/freak show and it made for some light entertainment around the region. We don’t have a lot of stories like that in the US, but we do have some equally outlandish medical billing tales. Here’s one from FierceHealthcare about a woman whose estate received a $9.2 million bill from a hospital in Tampa, FL. The patient had progressive dmyelinating neuropathy and passed away a couple years ago. The patient’s mother Holly Bennett accused the hospital of not feeding her daughter and giving her too much morphine, which, she claimed, resulted in the patient’s weight falling to... Health Business Blog blogs http://www.medworm.com/rss/comments.php?id=5077862 Fri, 29 Jul 2011 21:40:13 +0100 5077862 http://www.medworm.com/index.php?rid=5078059&cid=t_92178_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F07%2Fcancer-survivorship-and-the-role-of-pcps.html I have posted a number of previous notes about cancer survivorship (see: Cancer Survivorship, an Emerging Subdiscipline in Oncology; "Chemo Brain" Can Persist for Three to Five Years; Exercise Can Help Reverse; New Research Casts Spotlight on "Chemo Brain"). However, I have not given much thought to exactly which physicians would administer long-term care to cancer survivors. A recent article addressed this topic (see: Study: Doctors differ in how best to care for America's 12 million cancer survivors). Below is an excerpt from it: There are major differences between oncologists and primary care physicians regarding knowledge, attitudes, and practices required to care for American's 12 million cancer survivors. That is the key finding of the first national... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5078059 Thu, 28 Jul 2011 19:00:12 +0100 5078059 http://www.medworm.com/index.php?rid=5077642&cid=t_92178_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F07%2F28%2Fu-s-health-spending-projected-to-grow-5-8-percent-annually%2F All health care spending in the United States is projected to grow at an annual average rate of 5.8 percent for the period 2010 through 2020, 1.1 percentage points faster than expected growth in Gross Domestic Product (GDP). By 2020, health care spending is projected to be 19.8 percent of GDP, nearly one-fifth of economic [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5077642 Thu, 28 Jul 2011 13:48:45 +0100 5077642 http://www.medworm.com/index.php?rid=5069642&cid=t_92178_118_f&fid=34850&url=http%3A%2F%2Fwww.healthbusinessblog.com%2Fwp-content%2Fuploads%2Fcapacity.mp3 Capacity management is one of the top two or three drivers of hospital profitability. With continued reimbursement squeezes and the emergence of global payments, strong capacity management will be needed for survival. In this podcast interview, Jeff Terry of GE Performance Solutions and I discuss: The difference between capacity utilization and occupancy The microeconomic and macroeconomic consequences of improved capacity management The interrelationships among strategy, technology, operations, process improvement, scheduling and governance in capacity management Similarities and differences with other industries This topic may sound dry to you, but it’s one of my favorites! Share (Source: Health Business Blog) Health Business Blog blogs http://www.medworm.com/rss/comments.php?id=5069642 Wed, 27 Jul 2011 19:24:16 +0100 5069642 http://www.medworm.com/index.php?rid=5069832&cid=t_92178_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F07%2Fbetter-quality-services-when-doctors-manage-hospitals.html I have most commonly worked in hospitals where the CEO's major strengths were in financial management -- they were not MDs. Once, in the Army, I worked in a hospital where both the commander and deputy commander were physicians. My general impression has been that the former executives tended to stress the need for quality of care but often had little real understanding about the processes for achieving quality or the true cost of these processes. A recent article caught my attention and asks the question whether hospitals should be run by physicians (see: Should Hospitals Be Run by Doctors?), Below is an excerpt from it: The conventional wisdom is that doctors should focus on patient care, and managers with a business or administrative background are better suited to running the day-t... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5069832 Tue, 26 Jul 2011 18:15:43 +0100 5069832 http://www.medworm.com/index.php?rid=5069583&cid=t_92178_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Fwhat-are-you-afraid I read a post earlier today talking about concerns of a healthcare organization that would be sharing its data with its patients.  One of the concerns was that sharing the data (with a competitor) would make it easier for the patient to get care elsewhere. read more (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=5069583 Tue, 26 Jul 2011 13:26:54 +0100 5069583 http://www.medworm.com/index.php?rid=5069468&cid=t_92178_87_f&fid=38805&url=http%3A%2F%2Fwww.denisesilber.com%2Fehealth%2F2011%2F07%2Fsurgery-journal-on-socialmedia.html My attention was drawn to a series of articles in the July 2011 subscriber-reserved issue of Surgery concerning the importance of social networks for the medical profession.  Each author explains why he or she considers social media  important and provides examples of their relevance  to doctors.Please read on for highlights   Social media in medical school education Katie M. Wells, MD, Macon, GA. Graduate from the Mercer University School of Medicine, Macon, GA; and General Surgery Resident, Department of Surgery, The Ohio State University, Columbus, OH Examples: Facebook for arranging meetings, sharing information YouTube for visual learning about complex science subjects, physical exam maneuvers, diagnostic procedures. YouTube, iTunes, for onl... Denise Silber's eHealth blogs http://www.medworm.com/rss/comments.php?id=5069468 Mon, 25 Jul 2011 23:00:00 +0100 5069468 http://www.medworm.com/index.php?rid=5062305&cid=t_92178_109_f&fid=38950&url=http%3A%2F%2Fwww.shockmd.com%2F2011%2F07%2F25%2Fsocial-media-use-by-us-hospitals%2F Buffer From a structured review of websites of 1800 US hospitals focusing on their Facebook, Twitter and Youtube accounts: 21% used social media More likely to be large, urban hospitals run by nonprofit, nongovernment organisations More likely to participate in graduate medical education Used social media to target a general audience (97%) Provide content about the entire organization (93%) Announce news and events (91%) Further public relations (89%) Promote health (90%). In short, used social media for unidirectional communication. Thaker SI, Nowacki AS, Mehta NB, & Edwards AR (2011). How U.S. hospitals use social media. Annals of internal medicine, 154 (10), 707-8 PMID: 21576547 Buffer   No related posts. (Source: Dr Shock MD PhD) Dr Shock MD PhD blogs http://www.medworm.com/rss/comments.php?id=5062305 Mon, 25 Jul 2011 05:48:25 +0100 5062305 http://www.medworm.com/index.php?rid=5057719&cid=t_92178_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhy-im-afraid-for-anyone-to-enter-the-healthcare-system-ever%2F2011.07.23 Alright, I admit that the title of this post is a little dramatic. But it really does seem that most people I know socially have had a bad experience with the healthcare system lately. Take for example my friend whose 3- year-old went to the hospital for a common pediatric procedure – the little girl was overdosed on a medicine, aspirated, got pneumonia, went into respiratory distress (noticed first by her mom) and remained in the pediatric ICU for several days. The hospital staff swept the overdose under the rug, and outright denied it happened when faced with direct questioning. As outrageous as that all is, my friend chose not to pursue action against the hospital and staff for their error and behavior. She just “let it go” because no permanent harm had occurred. Anoth... Better Health blogs http://www.medworm.com/rss/comments.php?id=5057719 Sun, 24 Jul 2011 01:18:24 +0100 5057719 http://www.medworm.com/index.php?rid=5057810&cid=t_92178_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2Fs59FGFWkjts%2Fhealth-care-social-media-getting-health-care-providers-off-the-dime.html I had the opportunity to share some thoughts recently aimed at getting health care providers off the social media bench and into the game in a new online community / group blog, HealthWorks Collective.  I invite you to check out the community at large, hosted at Social Media Today, and to check out my post there, in particular.  I opened with one of my favorite explanations of why health care provider organizations should be involved in social media.  If you are interested in learning more, please watch this space for announcements of upcoming webinars and speaking engagements (some are listed here), and feel free to contact me if you'd like to arrange to have the HealthBlawger present to your group, or facilitate a retreat.  David HarlowThe Harlow Group LLCHealth Care Law and Consult... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=5057810 Fri, 22 Jul 2011 19:18:36 +0100 5057810 http://www.medworm.com/index.php?rid=5050553&cid=t_92178_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F07%2Fdoctors-are-better-at-spotting-skin-cancer-than-you-are.html Not only are doctors more likely to find melanoma than patients, but they tend to find them earlier, when they are easier to treat. That’s the finding of a study out this week in the Archives of Dermatology. Researchers at Memorial Sloan-Kettering Cancer Center in New York City looked at the records of 394 patients, who had a total of 527 melanomas. In patients who had been treated at the hospital for at least three months, 82 percent of the melanomas were found by doctors, not patients. In new patients, 63 percent were found by doctors. Cancers found by doctors also tended to be thinner, meaning that they were not as advanced. Skin cancer is the most commonly diagnosed cancer in the U.S. While melanoma accounts for only 5 percent to 6 percent of skin cancers, it causes roughly 75... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=5050553 Fri, 22 Jul 2011 12:15:00 +0100 5050553 http://www.medworm.com/index.php?rid=5050519&cid=t_92178_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2Fr4jobby2deg%2F Neonatal intensive care units around the country are participating in quality programs to improve care for the most vulnerable babies, today’s Informed Patient column reports. But the quality-improvement movement is at the center of a dispute between some neonatologists and the American Board of Pediatrics, with the doctors protesting requirements that they demonstrate “meaningful participation” in quality-improvement activities as part of the board’s certification maintenance process. The rule applies to doctors who are to be newly certified, or were due to be re-certified anytime after 2010. The board has approved ten quality-improvement programs around the country that qualify for the process, including one sponsored by the large for-profit Pediatrix Medical Group — which empl... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=5050519 Tue, 19 Jul 2011 14:44:25 +0100 5050519 http://www.medworm.com/index.php?rid=5050823&cid=t_92178_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Fit-or-not-cost-matters We are a nation awash in price tags. Except, it often seems, when we want to know what a piece of legislation is going to cost. That’s the conclusion we reluctantly reach after trying, just out of curiosity, to find out the potential cost of a recently introduced HIT bill. read more (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=5050823 Tue, 19 Jul 2011 13:55:40 +0100 5050823 http://www.medworm.com/index.php?rid=5050562&cid=t_92178_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F07%2Fhospital-acquired-infections-common-and-deadly-in-trauma-patients.html In this study, researchers found that trauma patients who develop serious bloodstream infections are six times more likely to die during their stay than those without an infection. And people who develop other infections, such as pneumonia or MRSA, are 1.5 to 1.9 times more likely to die. Patients with infections also had hospital stays roughly twice as long and hospital costs roughly twice as high as those who didn’t have infections. In an editorial accompanying the article, H.Scott Bjerke, M.D., at the Research Medical Center in Kansas City, Mo., says: Infections make trauma patients sicker and sicker patients do worse; they die more, they consume more resources, and they stay longer. Or as my teenage son would say, ‘Duh, Dad, everyone knows that.’ So why do we need... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=5050562 Mon, 18 Jul 2011 22:01:00 +0100 5050562 http://www.medworm.com/index.php?rid=5051263&cid=t_92178_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F07%2Fa-different-paradigm-for-analyzing-the-competition-between-cerner-and-epic.html In a recent note, I discussed the competition between the Cerner and Epic EMRs and quoted another blog, Chilmark Research, to the effect that Cerner was moving in new strategic direction, emphasizing a network of services to provide communities of care (see: Cerner Fights Back in the EMR Market: A Community Network of Services + PHR). Such an approach is sometimes referred to as the development of a care coordination platform. I concluded that Epic's approach closely coincided with the business model currently favored by hospital executives and would probably continue to succeed in the market. Vince Kuraitis responded to my note with a comment that included a link to a lecture he had recently delivered titled Platform Wars (see: Platform Wars). The presentation can also be accessed at ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5051263 Mon, 18 Jul 2011 13:43:40 +0100 5051263 http://www.medworm.com/index.php?rid=5050827&cid=t_92178_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2F4-ways-digital-hospital-signage-improves-hospital-experience Hospital signage benefits are most easily seen through the enhanced navigation experience provided for patients, but benefits also come with a multitude of other factors. From bolstering brand identity to reducing administration costs, hospital signage is a growing industry with a continuous supply of new and sophisticated tools that spread hospital communication. read more (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=5050827 Mon, 18 Jul 2011 12:10:12 +0100 5050827 http://www.medworm.com/index.php?rid=5029239&cid=t_92178_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F07%2Ffemr-based-order-sets-as-a-locus-of-control-of-hospital-based-physicians.html In a recent note, I discussed the evidence-based physician order sets that were being deployed at the University of Kansas Hospital (see: Evidence-Based Order Sets Deployed at the University of Kansas Hospital). At the end of the piece, I commented on the very large number of them and speculated that many of them would probably never be used as a practical matter. Here is the specific quote: Here's what I don't understand about the deployment of standardized order sets. Why develop 240 when most physicians will use only a small number of them? In the current case, I am sure that Zynx Health wants to prove the worth of its product to the University of Kansas Hospital and it provides bragging rights to have 240 of them. Even differentiating them by type of patient, my guess is that p... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5029239 Fri, 15 Jul 2011 14:06:50 +0100 5029239 http://www.medworm.com/index.php?rid=5028563&cid=t_92178_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Fit-true-acos-arent-going-away If you aren’t in an accountable care organization or planning to join one, chances are you are just plain sick of hearing about them. Some people have called ACOs the HMOs of today, indicating they are likely to be just another newfangled idea for containing healthcare costs that will die along the wayside. read more (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=5028563 Fri, 15 Jul 2011 04:19:50 +0100 5028563 http://www.medworm.com/index.php?rid=5028117&cid=t_92178_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F07%2F14%2Fmedicaid-expansion-and-reform-hopes-and-lessons-from-california%2F Editor’s note: In addition to Autumn Kieber-Emmons (photo and bio above), this post is coauthored by Tom Bodenheimer and Kevin Grumbach. Bodenheimer is Professor of Family and Community Medicine at University of California, San Francisco. Grumbach is Professor and Chair of the Department of Family and Community Medicine at UCSF and Chief of Family and [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5028117 Thu, 14 Jul 2011 18:21:45 +0100 5028117 http://www.medworm.com/index.php?rid=5029240&cid=t_92178_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F07%2Fcerner-fights-back-in-the-emr-market-network-of-services-for-a-community-of-care.html In my opinion, Cerner is facing a formidable competitor, Epic, in the high-end, larger hospital EMR space (see: Why Does Epic Keep Hammering Cerner? Mr. HIStalk's Opinion; Is Cerner Modifying Its EMR Business Model?). John Moore who blogs over at Chilmark Research recently posted a long piece suggesting that Cerner is crafting a new strategy in order to compete more effectively with Epic. He suggests, first, that It emphasizes support for "communities of care" (i.e, city, region, state, employer). Cerner also intends to provide a "PHR with an ecosystem of third party apps." This will serve as a replacement for the now departed Google Health product (see: Google Health Calls It Quits; Lessons Learned about PHRs or Not). Here is a link to John's note (see: Steppin... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5029240 Thu, 14 Jul 2011 14:02:53 +0100 5029240 http://www.medworm.com/index.php?rid=5028187&cid=t_92178_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F07%2Fcdc-releases-new-guide-on-preventing-infections-in-outpatient-clinics.html More than three-quarters of all operations in the U.S. are now done in outpatient clinics, not hospitals. But many of those clinics don’t adhere to standard infection-prevention practices. To help correct that problem, the Centers for Disease Control and Prevention today released new guidelines meant to prevent infections in in “ambulatory” surgery centers, primary-care offices, endoscopy clinics, and pain-management clinics. The new guide is based on existing CDC guidelines now used mostly in hospitals. The guide includes a checklist meant to prevent infections from injections, poor hygiene, and other causes. Among other recommendations, it suggests that all outpatient practices have at least one individual with specific training in infection control on staff or regular... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=5028187 Wed, 13 Jul 2011 20:51:06 +0100 5028187 http://www.medworm.com/index.php?rid=5028136&cid=t_92178_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FkUilAEHGz9M%2F Two new surveys give a snapshot of how bad the drug-shortage problem has become. The Institute for Safe Medication Practices has called the recent rash of shortages “unprecedented.” Today, the American Hospital Association and American Society of Health-System Pharmacists reported what their members are saying. (The WSJ wrote about this issue earlier this year.) The AHA says that 99.5% of the 820 community hospitals that responded to the group’s June survey reported experiencing at least one drug shortage in the past six months. A full 44% reported shortages of 21 or more different drugs. All treatment categories were affected, hospitals said, with 80% or more respondents experiencing shortages of surgery/anesthesia, emergency care, cardiovascular, gastrointestinal/nutrit... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=5028136 Tue, 12 Jul 2011 17:02:22 +0100 5028136 http://www.medworm.com/index.php?rid=5029242&cid=t_92178_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F07%2Fffighting-obesity-the-reastaurant-angle.html Eating out frequently, and particularly at fast food joints (see: What Americans Eat; More Calories and Increased Restaurant Food Consumption), can pose a threat to your health. A recent article quantified this threat in a way that I had never seen before (see: Fighting Obesity: The Restaurant Angle). Here it is the article unedited: Guess what? Eating out leads to weight gain. In fact, the USDA calculated that for each weekly meal outside the home, we gain 2 pounds of body weight annually. Here are two more interesting facts: About 30% of our total calories are consumed outside the home This is double what it was just 30 years ago. Why is eating out so hazardous to our waistline? Mostly because portion sizes are much bigger today than in the past. Restaurant owners know that consumers... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5029242 Tue, 12 Jul 2011 16:27:37 +0100 5029242 http://www.medworm.com/index.php?rid=5028193&cid=t_92178_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F07%2Fgoing-to-the-hospital-this-month-beware-the-july-effect.html Patients admitted to teaching hospitals in July are slightly more likely to die during their stay, and tend to have longer hospital stays and higher hospital charges, according to a study published online today by the Annals of Internal Medicine. Why? Possibly because July is when experienced trainees graduate and new, less experienced ones start. Researchers from the University of San Francisco School of Medicine reviewed 39 studies to determine the effect of trainee changeover on patient outcomes. They noted that while there was considerable variation among hospitals, overall patients tended to fare worse in the month of July. John Q. Young, M.D., co-author of the study, said in a press release, At year-end, teaching hospitals experience a massive exodus of highly experienced physic... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=5028193 Mon, 11 Jul 2011 22:01:00 +0100 5028193 http://www.medworm.com/index.php?rid=5029243&cid=t_92178_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F07%2Fcancer-diagnostic-scandal-at-duke-more-regulation-of-ldts-1.html I have posted a number of previous notes about those diagnostic tests consisting of a set of biomarkers plus an computer algorithm used to interpret the results. This type of lab test was previously referred to as in-vitro diagnostic multivariate indexed assays (IVDMIAs) by the FDA. More recently, they have been called laboratory developed tests (LDTs). Historically, this type of test was also referred to informally in the industry as home-brew. A simple definition for an LDT is that the test reagents are developed by a single lab and all of the testing is performed by that lab. IVDMIAs/LDTs can be used for various purposes including the detection of the presence of a neoplasm in a diagnostic workup using serum. A second purpose has been to analyze the antigens present on a patient's t... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5029243 Mon, 11 Jul 2011 14:57:43 +0100 5029243 http://www.medworm.com/index.php?rid=5028632&cid=t_92178_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2Fj1wDO3_RgCk%2Fhealthcare-associated-infections-what-is-the-message-and-what-can-we-do-about-them.html   The good people at GE and JESS3 have come up with an HAI infographic.  It's pretty, and it conveys the horrible information that many of us already know -- healthcare associated infections kill about 100,000 people a year, and add $35 billion a year to our collective health care bill (here in the US of A); 5% of hospital inpatients end up with an HAI. So what do we expect the world to do with this infographic?  The FDA has rolled out new cigarette package warnings, including graphic photos, that are presumably intended to so sicken potential purchasers of cigarettes that they drop the pack of cigarettes and run screaming from the counter.  In more measured terms, the FDA says: The introduction of these warnings is expected to have a significant public health impact by decreasing... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=5028632 Fri, 08 Jul 2011 18:18:39 +0100 5028632 http://www.medworm.com/index.php?rid=5008681&cid=t_92178_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F07%2Fthe-epic-emr-as-a-platform-extending-its-functionality-with-other-products.html For a number of reasons, Epic has achieved a near monopoly of the EMRs installed in the largest U.S. hospitals (see: ShandsHealth Goes Live with Epic; Company Penetration of the Hospital Market; Why Does Epic Keep Hammering Cerner? Mr. HIStalk's Opinion). In my opinion, this trend poses a significant challenge for healthcare in general. Here's a quote from the first of these two notes describing the nature of this challenge: Epic...has a reputation of closely controlling the installation and development of its EMR software products. This is the basis for its record of successful system installations and part of the appeal of the product to hospital CEOs and CIOs. Furthermore, the evolution of clinical hospital systems (e.g., EMRs, LISs, RISs, etc.) is a critical element in the over... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5008681 Fri, 08 Jul 2011 13:31:58 +0100 5008681 http://www.medworm.com/index.php?rid=5008112&cid=t_92178_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F07%2F08%2Fchallenges-for-hospitals-payment-readmissions-governance-and-access%2F Four papers in the newly released July 2011 issue of Health Affairs examine key topics for hospitals, including the extent to which hospitals “cost shift” to private payers; the success of efforts to reduce avoidable rehospitalizations; new responsibilities for hospital boards of trustees as a consequence of the Affordable Care Act; and expanding access to [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5008112 Fri, 08 Jul 2011 12:07:18 +0100 5008112 http://www.medworm.com/index.php?rid=5008077&cid=t_92178_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F07%2Fbeing-non-profit-hospital-ceo-means.html When my arm was twisted heartily to see the movie "Love Story" a very long time ago, I could never understand why so many audience members sighed upon hearing that immortal line, "love means never having to say you're sorry."  I could not understand it then, and still cannot.However, it seems that for reasons that are not any more clear, being the CEO of a not-for-profit hospital or hospital system also means never having to say you are sorry, as shown in some recent stories from the media. Not Sorry for LeavingOriginally published in the Fargo (ND) InForum:The merger 1½ years ago of Sanford Health and MeritCare created a new entity that doubled in size and covers a service area of more than 130,000 square miles.But the unified health care giant needed only one top executive, and the... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=5008077 Thu, 07 Jul 2011 19:59:00 +0100 5008077 http://www.medworm.com/index.php?rid=5008682&cid=t_92178_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F07%2Fshould-diagnostic-test-scheduling-be-personalized.html I have posted previous notes about the need for periodic mammograms including the frequency of routine screening based on age (see: Shift to Digital Mammography Results in Increased Patient Recalls; Confusion Caused by Conflating "False Positive" and "Overdiagnosis" in Breast Cancer). Now comes news of research suggesting that mammogram screening should be personalized (see: Mammogram scheduling should be personalized, not based on age alone: study). The article caught my attention because of the use of the term personalized. Here is an excerpt from the article: Mammograms should not be done on a one-size fits all basis, but instead should be personalized based on a woman’s age, the density of her breasts, her family history of breast cancer and other factors includin... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5008682 Thu, 07 Jul 2011 16:12:55 +0100 5008682 http://www.medworm.com/index.php?rid=5008683&cid=t_92178_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F07%2Fstakes-escalate-for-employees-who-smoke.html I keep thinking that the lives of cigarette smokers couldn't get much worse but I always seem to be wrong The spots where you can grab a smoke at work keep getting smaller and at a greater distance from one's desk. It's also getting tougher for smokers to even secure a job (see: Health Systems Use Their Regional Dominance to Muscle Insurance Companies; Cleveland Clinic no-smoking policy has locals talking). Employers are now adding surcharges to smokers' health insurance coverage to offset their higher rate of health problems and expenditures (see: Companies Get Tougher with Employees Who Smoke). Such charges, of course, are in addition to the ever-increasing cost of cigarettes including taxes. States are trying to balance their budgets, in part, on the basis of higher sin ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5008683 Wed, 06 Jul 2011 17:10:30 +0100 5008683 http://www.medworm.com/index.php?rid=5008114&cid=t_92178_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F07%2F06%2Fhypercostitis-political-theater-in-massachusetts%2F The Play’s the Thing. America boasts the highest health care costs on God’s green earth, and Massachusetts spends more per capita than any other state. Some might say we have a problem. On June 30th, Massachusetts completed four days of hearings on run-away medical costs — what drives them and how to rein them in. [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5008114 Wed, 06 Jul 2011 16:35:34 +0100 5008114 http://www.medworm.com/index.php?rid=5008684&cid=t_92178_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F07%2Fa-very-bad-idea-health-insurer-to-purchase-troubled-health-system.html We are rapidly transitioning to an era of Big Medicine characterized by most significant decisions being made in concert by Big Payers (insurance companies and the federal government), Big Insurance Companies, and Big Pharma (see: Physician Private Practice Declines; the Last Barrier to Emergence of "Big Medicine"). This trend is accelerating due to the fact that more than half of young doctors are taking salaried positions with health systems (see: Hospitals Use Their Medical Schools, Residencies for Later Physician Recruitment). Small private physician practices will no longer be part of this mix. Now comes the news that, at least in the Pittsburgh area, there are plans for an insurance company to purchase a large health system (see: Health care in the balance: Highmark to buy ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=5008684 Tue, 05 Jul 2011 15:42:33 +0100 5008684 http://www.medworm.com/index.php?rid=4992644&cid=t_92178_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F07%2F01%2Fhealth-affairs-systems-innovations-briefing-reminder-and-time-change%2F On July 7, 2011, Health Affairs will unveil its July 2011 issue, “New Directions In Systems Innovations.” The issue explores ongoing innovations in health care organization, delivery and financing across a broad front – from Vermont’s recent passage of single payer legislation, to new responsibilities for hospital boards of trustees as a consequence of the [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4992644 Fri, 01 Jul 2011 19:43:20 +0100 4992644 http://www.medworm.com/index.php?rid=4984704&cid=t_92178_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F06%2Flower-blood-tranfusion-rates-as-a-metric-for-high-quality-care.html Generally speaking, I think that the amount of blood transfused to a patient can and should be used as a metric for the quality of care delivered by physicians, particularly surgeons. I have long been aware of differences in transfusion rates by hospitals or by regions of the country. Much of this can be explained by local customs and norms rather than well defined standards of care. When I was a blood banker back in the 1970's, one of the hospital cardiac surgeons would frequently transfuse six units of blood for a CABG when type-and-screen was the common blood order for the same procedure at the Cleveland Clinic. Once again, or perhaps still, the amount of blood being transfused is in the news. (see: Too many blood transfusions? New standards urged). Below is an excerpt from a recent... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4984704 Thu, 30 Jun 2011 13:03:47 +0100 4984704 http://www.medworm.com/index.php?rid=4984413&cid=t_92178_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FNYfw_VMWbrM%2F Avastin Vote: An FDA appeals panel made up of outside experts voted 6-0 to recommend the agency remove Avastin’s approval for breast cancer, the WSJ reports. Panel members said studies showed the Roche drug provided no meaningful benefit to patients while raising the risk for serious side effects. The ultimate decision on the drug’s breast-cancer indication rests with FDA head Margaret Hamburg. Regardless of what she decides, the drug will remain on the market since it’s approved for other cancers. Focus on Fenugreek: The search for the culprit in the E. coli outbreak in Germany and, most recently, France, has focused on fenugreek seeds from Egypt, the New York Times reports. Sprouts from contaminated seeds are “implicated in both outbreaks,” according to a Eu... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4984413 Thu, 30 Jun 2011 12:42:44 +0100 4984413 http://www.medworm.com/index.php?rid=4984705&cid=t_92178_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F06%2Fwupmc-patient-portal.html In a recent post, I speculated about some of the reasons why I thought that Google Health was exiting the personal health record (PHR) business (see: Google Health Calls It Quits; Lessons Learned about PHRs or Not). Shortly after posting this note, an article came across my desk discussing the success of UPMC's patient portal and the fact that it was now going mobile (see: UPMC's patient portal goes mobile). Below is an excerpt from the article: A health portal used by patients and doctors at the University of Pittsburgh Medical Center (UPMC) is now accessible on iPhones and iPads, thanks to the new mobile HealthTrak application. With its innovative approach to managing patient health - through technology like eVisits and tethered records - easy access to the portal is becoming mor... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4984705 Wed, 29 Jun 2011 13:11:10 +0100 4984705 http://www.medworm.com/index.php?rid=4975817&cid=t_92178_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FTaXTY80hIAM%2F Too many people are getting blood transfusions they don’t need. That’s the word from an HHS advisory committee meeting earlier this month, the Associated Press reports. While transfusions are certainly called for in some circumstances — trauma, to name one — there are alternatives to routine transfusions for certain conditions and operations. What’s the harm in getting a transfusion just to be on the safe side? Well, first, banked blood is a unique and limited resource, so it makes no sense to use it if you don’t need to. In rare cases people can have a bad reaction to transfused blood, the AP says. And while the blood supply is routinely screened for HIV, hepatitis C and other pathogens, there is some concern that new pathogens may pose a potential thre... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4975817 Tue, 28 Jun 2011 19:43:59 +0100 4975817 http://www.medworm.com/index.php?rid=4975818&cid=t_92178_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FxGAgcGwnaZg%2F How’s the diabetes treatment in Wisconsin? Or the access to after-hours medical care in California? The Robert Wood Johnson Foundation has rolled out a new online directory of 224 health-care quality reports that compare local physicians and hospitals. The idea is that consumers can get localized, quantitative information on measures such as how often patients in a certain medical practice receive their recommended screening tests or how long mothers typically spend in a given hospital after a cesarean section. The specific measures will vary by report. Note the emphasis on “quantitative.” These reports, 197 of which cover specific states, all use performance data based on nationally recognized standards on quality and cost. All are freely available. The more subjective p... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4975818 Tue, 28 Jun 2011 16:57:01 +0100 4975818 http://www.medworm.com/index.php?rid=4976215&cid=t_92178_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F06%2Fevidence-based-order-sets.html I am generally unenthusiastic about the term "evidence-based-medicine" (EBM) because it's often used synonymously with high-quality care. For the most part, however, I do see value for what are called "evidence-based order sets." The University of Kansas Hospital has recently gone live with 240 such order sets developed by Zynx Health’s clinical decision support unit. Here is an excerpt from the press release (see: The University of Kansas Hospital Goes Live with ZynxOrder and ZynxCare Integrated into EHR): ...The University of Kansas Hospital has gone live with 240 evidence-based order sets deployed via computerized provider order entry (CPOE)....The implementation of evidence-based order sets and plans of care within an EHR will enable The University of Kansas H... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4976215 Tue, 28 Jun 2011 13:12:07 +0100 4976215 http://www.medworm.com/index.php?rid=4975812&cid=t_92178_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F06%2F27%2Fnew-cardiac-surgery-programs-improving-access-or-duplicating-services%2F With cardiac services contributing 25 to 40 percent of a hospital’s net revenues, do new cardiac surgery programs improve access or exacerbate the duplication of services? To answer this question, the authors of a new Health Affairs Web First article published June 23 examined Medicare claims data to identify where new cardiac surgery programs were [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4975812 Mon, 27 Jun 2011 19:35:27 +0100 4975812 http://www.medworm.com/index.php?rid=4975813&cid=t_92178_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F06%2F27%2Fhealth-affairs-briefing-new-directions-in-systems-innovation%2F On July 7, 2011, Health Affairs will unveil its July 2011 issue, “New Directions In Systems Innovations.” The issue explores ongoing innovations in health care organization, delivery and financing across a broad front – from Vermont’s recent passage of single payer legislation, to new responsibilities for hospital boards of trustees as a consequence of the [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4975813 Mon, 27 Jun 2011 14:36:16 +0100 4975813 http://www.medworm.com/index.php?rid=4976216&cid=t_92178_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F06%2Fon-the-demise-of-google-health.html I am an unabashed fan of Google. However, if the company suffers from anything, it's a corporate sense of hubris. The founders think that almost any problem can be solved by their engineering mentality and their "search" business model. It turns out that launching a personal health record product was not that easy a nut to crack so the company is now withdrawing from the business (see: Google Shuts Down Medical Records And Health Data Platform). Here's Mr. HIStalk's take on the demise of Google Health (see: Monday Morning Update 6/27/11): Google predictably did what its know-it-all technology company predecessors have done over the years: dipped an arrogant and half-assed toe into the health IT waters; roused a loud rabble of shrieking fanboy bloggers and reporters...... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4976216 Mon, 27 Jun 2011 13:33:50 +0100 4976216 http://www.medworm.com/index.php?rid=4975995&cid=t_92178_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Fincreasing-hospital-efficiency-growing-value-mid-level-providers Mid-level providers, commonly called registered nurses (RNs) or physicians’ assistants (PAs) are a beacon of hope for struggling hospitals as the physician attrition rate and the number of aging Americans continues to spiral upwards. RNs and PAs may help lower costs as well as increase patient care for hospitals in several ways. Two of them are: Medicare reimbursements and reduced readmissions. Reimbursements: read more (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=4975995 Mon, 27 Jun 2011 12:52:54 +0100 4975995 http://www.medworm.com/index.php?rid=4968920&cid=t_92178_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F06%2Fhosptals-use-medical-schools-and-postgraduate-training-for-physicians-recruitment.html There is a major trend now occurring with young physicians seeking salaried hospital positions rather than entering private practice (see: More Doctors Giving Up Private Practices; The Increasing Tempo of Physician Practice Purchases by Hospitals). The number of hospitalists is exploding (see: Father of Hospital Medicine Has Mixed Review 15 Years Later). Here's a quote from this article about hospital medicine: Hospital medicine is entering a new growth phase that will capitalize on what it does best, "providing a brand of service and value," according to its founding father, Robert Wachter, MD, ...who established the specialty some 15 years ago....The exponential growth of the specialty was a surprise to many. In 2003, 29% of US medical centers had hospitalists; by 2009, the... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4968920 Fri, 24 Jun 2011 11:39:31 +0100 4968920 http://www.medworm.com/index.php?rid=4968451&cid=t_92178_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2Fw-yJm8SPKh0%2F The Institute of Medicine’s new report on preventing obesity in children from birth to age 5 makes a number of reasonable but hardly surprising recommendations: parents should regularly monitor children’s growth, boost their physical activity and encourage healthful diets. One recommendation that caught the Health Blog’s eye was the committee’s emphatic endorsement of breastfeeding –  exclusively for the first six months and then with complementary food until the child is at least 1 year old. The report recommends that hospitals’ informational materials “show no pictures or text that idealizes the use of breast-milk substitutes,” that health professionals shouldn’t give formula samples to moms and there shouldn’t be any advertisi... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4968451 Thu, 23 Jun 2011 17:07:52 +0100 4968451 http://www.medworm.com/index.php?rid=4968921&cid=t_92178_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F06%2Fpathology-resident-travel-awards-available-for-pathology-informatics-2011-conference.html The Association for Pathology Informatics is awarding a limited number of stipends of $1,500 to attend the Pathology Informatics 2011 Conference at the Pittsburgh Wyndham Grand hotel in Pittsburgh. The conference will take place on October 4-7, 2011. Awardees must be residents, post-doctoral students, or fellows in accredited teaching programs. This is the premier pathology informatics conference in the country with three workshops, three discipline tracks, multiple keynote plenary lectures, 44 participating faculty members, and more than 40 exhibitors. Last year's PI-2010 presentation marked the first of these events. The conference represents a merger of two long-standing pathology informatics meetings, APIII and Lab InfoTech Summit. The application deadline for awards is August 1, 2... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4968921 Thu, 23 Jun 2011 12:55:56 +0100 4968921 http://www.medworm.com/index.php?rid=4968647&cid=t_92178_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Fwhat%25E2%2580%2599s-driving-your-ehr-adoption The Centers for Medicare and Medicaid Services recently announced it has paid out more than $75 million for the meaningful use of electronic health records under the American Recovery and Reinvestment Act (ARRA).  Is this really spurring adoption? read more (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=4968647 Wed, 22 Jun 2011 19:04:07 +0100 4968647 http://www.medworm.com/index.php?rid=4960179&cid=t_92178_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Fwhat%25E2%2580%2599s-driving-your-ehr-adoption The Centers for Medicare and Medicaid Services recently announced it has paid out more than $75 million for the meaningful use of electronic health records under the American Recovery and Reinvestment Act (ARRA).  Is this really spurring adoption? read more (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=4960179 Wed, 22 Jun 2011 19:04:07 +0100 4960179 http://www.medworm.com/index.php?rid=4960336&cid=t_92178_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F06%2Fpfizer-integrating-telemedicine-into-clinical-trials.html I have a special interest in clinical trials dating back to my five-year stint on the IRB (Institutional Review Board) at my hospital. I therefore read with some interest the news that Pfizer was integrating telemedicine (i.e., remote subject participation) into one of its clinical trials (see: Pfizer Integrating Telemedicine into Clinical Trials). Here is an excerpt from the article Pfizer is starting enrollment of its first ever investigational drug trial with remote patient participation. The trial, aptly named Research on Electronic Monitoring of OAB Treatment Experience (REMOTE), is a study to assess the safety and efficacy of Detrol LA (tolterodine tartrate), a treatment for overactive bladder. The main goal is to determine whether the results of the pilot REMOTE “virtual trial” ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4960336 Wed, 22 Jun 2011 14:59:22 +0100 4960336 http://www.medworm.com/index.php?rid=5036349&cid=t_92178_118_f&fid=34850&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBusinessBlog%2F%7E3%2F2WdChE5vCMc%2F In addition to my consulting work and writing the Health Business Blog, I’m chairman of the board of Advanced Practice Strategies (APS), a medical risk management firm that provides litigation support for malpractice defense and an eLearning curriculum focused on enhancing patient safety. To learn more contact: Timothy Croke, Director of Demonstrative Evidence Group. tcroke@aps-web.com or 617-357-0553 ext. 6664. Here’s the Advanced Practice Strategies case of the month. Judgment for the Defense Paraesophageal Hiatal Hernia Following Nissen Fundoplication In June 2003, the 41-year-old male plaintiff underwent an elective Nissen fundoplication to address a 10-year history of symptoms from gastroesophageal reflux disease.  An endoscopy performed just prior to the procedure h... Health Business Blog blogs http://www.medworm.com/rss/comments.php?id=5036349 Wed, 22 Jun 2011 12:59:16 +0100 5036349 http://www.medworm.com/index.php?rid=4952775&cid=t_92178_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F06%2F21%2Fsetting-the-record-straight-on-drug-shortages%2F John Goodman of the National Center for Policy Analysis (NCPA) says in a June 8 Health Affairs Blog entry that the Public Health Service 340B drug discount program is part of a “web of [federal] regulations that are preventing life saving drugs from reaching the patients who need them.” More specifically, he says that the [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4952775 Tue, 21 Jun 2011 17:15:59 +0100 4952775 http://www.medworm.com/index.php?rid=4953380&cid=t_92178_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F06%2Fshands-installs-epic-interesting-facts-about-epic-coverage-in-the-us.html ShandsHealth is a large health system located in Gainsville and Jacksonville, Florida. Like many of the high-end and academic health systems with 500 beds or more, it is converting to the Epic EMR (see: Shands' new records system should simplify things). Here is a brief listing of the new features of this EMR as listed in the press release: Shands patients will no longer have to fill out their medical history and prescription information every time they visit a Shands hospital, faculty clinic or emergency room.... All Shands patient records are instantly available to all Shands health-care providers. Patients will no longer have to fill out their medical history and prescription information every time they visit a Shands hospital, faculty clinic or emergency room. Prescriptions are se... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4953380 Mon, 20 Jun 2011 13:32:33 +0100 4953380 http://www.medworm.com/index.php?rid=4953062&cid=t_92178_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2F4-innovative-hospital-programs-driving-efficiency A new Health and Human Services (HHS) initiative, Partnership for Patients, is calling hospitals to focus on nine specific types of medical errors where the potential is great for increased care. The initiative has two over arching goals: keep hospitals patients’ symptoms from worsening, and facilitate patients’ treatment process from the hospital environment to other care settings. This ambitious project’s goal is to reduce readmissions by 20% by 2013. read more (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=4953062 Mon, 20 Jun 2011 12:14:47 +0100 4953062 http://www.medworm.com/index.php?rid=4953044&cid=t_92178_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FfDeOPTZnEYY%2F #bbpBox_82695997494530048 a { text-decoration:none; color:#0000ff; }#bbpBox_82695997494530048 a:hover { text-decoration:underline; } Looks like Estonia is the new model for system wide EHR http://bit.ly/liYLwe June 19, 2011 11:27 pm via TweetDeckReplyRetweetFavorite @boltyboy Matthew Holt I’m always fascinated by other countries EHR implementations. So many other countries are interesting to consider since they’re missing so many of the barriers that make EHR adoption and even more specifically health information exchange between EHR software so difficult. Nice to learn more about the success that Estonia has had adopting EHR software. I’d like to learn a lot more about what’s being done with international EHR implementations. #bbpBox_82462900882644992 a { t... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4953044 Mon, 20 Jun 2011 07:02:57 +0100 4953044 http://www.medworm.com/index.php?rid=5036352&cid=t_92178_118_f&fid=34850&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBusinessBlog%2F%7E3%2Fe5nK7qL0nKo%2F Reducing readmissions is becoming increasingly important for hospitals. In the olden days (and still to some extent now) a readmission was simply a new opportunity to earn revenue on the same patient. But as payment models evolve toward refusing payment for preventable readmissions and as readmission rates are used as publicly reported quality measures, this is changing. Today’s Hospitalist has a fascinating article on the topic: Think you can predict readmissions? Thing again; Doctors are clueless when it comes to guessing which patients will bounce back. It reports on a Journal of General Internal Medicine paper (Inability of Providers to Predict Unplanned Readmissions) that documents attempts to improve on readmission prediction models. The authors’ hypothesis was that physi... Health Business Blog blogs http://www.medworm.com/rss/comments.php?id=5036352 Fri, 17 Jun 2011 16:53:31 +0100 5036352 http://www.medworm.com/index.php?rid=4952740&cid=t_92178_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F06%2F17%2Fnursing-times-2011-vol-107-no-22%2F This article describes the findings from a national survey to establish the prevalence of malnutrition in the UK. Data was collected from care homes, hospitals and mental health units. Contact the Library for a copy of this article. Filed under: Current Awareness, Journals Tagged: Acute Hospitals, Care Homes, Hospitals, Malnutrition, Mental Health Units, Nutrition, Nutritional Screening Tools (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=4952740 Fri, 17 Jun 2011 15:19:02 +0100 4952740 http://www.medworm.com/index.php?rid=4945219&cid=t_92178_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F06%2Foffice-emrs-as-a-risky-investment-for-physicians.html Although some may view physician office EMRs and hospital EMRs as first cousins, I view them in a much different light. In previous notes, I discussed how community-based physicians and the professional societies that represent them are complaining to governmental bodies about the inadequacies and cost of office EMRs, particularly those for small practices (see: Cost of Deployment of EMRs in Physician Offices;  Barriers to the Deployment of Physician Office EMRs; "Usability Failures" of EMRs Frustate Physician Users). Here's a quote from my most recent post regarding physician office EMRs: It's no surprise to me that the "usability of [physician office] EMRs doesn't appear to be the focus of the federal government when establishing meaningful use standards ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4945219 Fri, 17 Jun 2011 12:08:48 +0100 4945219 http://www.medworm.com/index.php?rid=4934534&cid=t_92178_118_f&fid=34850&url=http%3A%2F%2Fwww.healthbusinessblog.com%2Fwp-content%2Fuploads%2Fbrientaco.mp3 Hospitals and other providers that are planning to form Accountable Care Organizations (ACOs) must make sure to put a robust information infrastructure in place to enable them to manage patient care and expenses effectively. In this podcast interview, PatientKeeper CEO Paul Brient comments on the ACO draft regulations and discusses the interaction between ACO activities and Meaningful Use requirements for health information technology. ACOs have many of the characteristics of the capitated provider organizations that emerged in the 1990s. And while many of them have fallen by the wayside, capitation has endured in some places, especially California, where groups such as HealthCare Partners use PatientKeeper tools in a capitated environment. Share (Source: Health Business Blog) Health Business Blog blogs http://www.medworm.com/rss/comments.php?id=4934534 Thu, 16 Jun 2011 21:16:09 +0100 4934534 http://www.medworm.com/index.php?rid=4945220&cid=t_92178_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F06%2Fthomson-reuters-to-sell-its-healthcare-unit.html The healthcare unit of Thomson Reuters is up for sale. John Moore who blogs over at Chilmark Research has posted two blog notes about this news (see: Likely Suitors as Thomson Reuters Exits Healthcare; also see Additional Thoughts on Thomson Reuters). Here's an excerpt from the first of them: ...Thomson Reuters (TR) announced that it intends to sell off its healthcare unit. A logical first response is: What they heck, why would they sell right now when the healthcare market is so hot and shows no signs of letting up? Thomson Reuters is a well-respected brand in healthcare and as healthcare organizations (providers and payers) of all sizes look to more effectively run their operations, TR’s portfolio of healthcare solutions are well positioned. This isn’t the first time they have tr... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4945220 Thu, 16 Jun 2011 12:46:36 +0100 4945220 http://www.medworm.com/index.php?rid=4945221&cid=t_92178_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F06%2Falgorithms-as-the-next-generation-of-innovative-laboratory-and-clinical-tests.html I was somewhat surprised by a recent article suggesting that algorithms themselves will constitute a new type of medical test. The short article cited the work of Predictive Medical Technologies as a basis for this claim. The company software generates health predictions based on previous clinical data for ICU patients (see: Algorithms are the new medical tests; How data and algorithms help doctors make use of real-time data). Below is an excerpt from the article: Predictive Medical Technologies claims that it can use real-time, intensive care unit (ICU) monitoring data to predict clinical events like cardiac arrest up to 24 hours ahead of time. Effectively, the startup's algorithms are new types of medical tests that an ICU doctor can take into consideration when deciding on a course ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4945221 Wed, 15 Jun 2011 15:05:24 +0100 4945221 http://www.medworm.com/index.php?rid=5036353&cid=t_92178_118_f&fid=34850&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBusinessBlog%2F%7E3%2FZlKcE0trJG4%2F I’ve been a board member and financial supporter of the Hearts & Noses Hospital Clown Troupe for ten years, but always struggle to convey in words exactly what the troupe does and how special it is. The clown aspect people think they get, but it’s hard to explain how empowering the professionally trained, dedicated volunteers are to the thousands of children and families they serve. I’ve accompanied the clowns in the hospital so I understand it. I’m thankful that a donor has funded this wonderful video that lays it out for those who can’t see them in person. To learn more, please visit the website or Facebook page and consider making a donation online. Share (Source: Health Business Blog) Health Business Blog blogs http://www.medworm.com/rss/comments.php?id=5036353 Wed, 15 Jun 2011 14:07:20 +0100 5036353 http://www.medworm.com/index.php?rid=5036356&cid=t_92178_118_f&fid=34850&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBusinessBlog%2F%7E3%2Fm5l0cCrs0mo%2F Today’s Hospitalist (Ready to let patients hit the panic button?) describes the experience of St. Joseph’s Hospital in Orange, CA, which has implemented a “Condition H” (as in “Help”) system that allows patients and family members to activate the hospital’s rapid response team on their own as a last resort. Staff were concerned it would be overused for non-emergencies and by chronic complainers, but if anything there has been too little use. After three years, there have only been 70 Condition H calls at the 525 bed center. That equates to less than two per month for the whole hospital, or one call per bed every 22 years! It’s a little hard to understand from the article why utilization is so low. The system has been well publicized, with pos... Health Business Blog blogs http://www.medworm.com/rss/comments.php?id=5036356 Mon, 13 Jun 2011 18:45:26 +0100 5036356 http://www.medworm.com/index.php?rid=4934459&cid=t_92178_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Ffive-factors-showing-growth-medical-real-estate An article headline caught my attention the other day, “A thriving medical industry is a boon for the building.” That statement rings true from my perspective. The medical industry is doing well, and with halted construction projects from the economic downturn back on track, medical real estate’s potential is coming into full swing. There are five main contributing factors for this growth: market economics, healthcare reform, aging Baby Boomers, increase in outpatient centers and a patient centric hospital experience. read more (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=4934459 Mon, 13 Jun 2011 12:26:52 +0100 4934459 http://www.medworm.com/index.php?rid=4921404&cid=t_92178_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F06%2Fhip-and-knee-surgery-riskier-at-quieter-hospitals.html Hip and knee replacement surgery is riskier in hospitals that carry out fewer operations, researchers have found. People are more likely to get blood clots or die at quieter hospitals, compared with hospitals that perform the operations regularly. According to the American Academy of Orthopaedic Surgeons, around 800,000 hip and knee replacement surgeries are performed in the United States each year. A joint replacement can help people with severe arthritis move around more easily and have less pain, but it involves major surgery and things can sometimes go wrong. In the study, which looked at the medical records of around 30,000 people, hospitals that performed more than 200 hip or knee replacements each year had better results. Patients treated in hospitals that performed fewer operatio... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=4921404 Sat, 11 Jun 2011 14:00:00 +0100 4921404 http://www.medworm.com/index.php?rid=4921409&cid=t_92178_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F06%2Fhospitals-that-make-their-data-hard-to-find.html One of the most important things to know about a hospital is how many of its patients develop infections. But hospitals often don’t release that data. To help motivate them, we put together a list of teaching hospitals that haven't made their information on infections easily accessible to the public. “The best hospitals know that sunlight is the best disinfectant, so they are willing to publicly report even if their performance is not yet optimal,” said Leah Binder, chief executive officer of The Leapfrog Group, a nonprofit organization that focuses on improving health care in hospitals, in part by encouraging them to report information on infections and other measures. For this analysis, we focused on hospitals that are members of the Council of Teaching Hospitals, ex... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=4921409 Fri, 10 Jun 2011 15:56:00 +0100 4921409 http://www.medworm.com/index.php?rid=4921764&cid=t_92178_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F06%2Fmore-on-chemo-brain.html I continue to be interested in the topic of "chemo brain" (see: New Research Casts Spotlight on "Chemo Brain"). I have this vision of cancer patients complaining of foggy thinking but their physicians struggling to understand the nature of the problem and design suitable treatment (see: Cancer survivors can't shake pain, fatigue, insomnia, foggy brain). Here an excerpt from another article about it: When people finish treatment for cancer, they want to bounce back to their former vital selves as quickly as possible. But a new Northwestern Medicine study -- one of the largest survivor studies ever conducted – shows many survivors still suffer moderate to severe problems with pain, fatigue, sleep, memory and concentration three to five years after treatment has ende... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4921764 Fri, 10 Jun 2011 14:48:33 +0100 4921764 http://www.medworm.com/index.php?rid=4921377&cid=t_92178_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2F1EmFLo4w4a4%2F Talk to anyone for very long about how to improve health care in the U.S. and you eventually hear something along the lines of: “We have to start paying physicians for getting and keeping people healthy instead of for doing as many procedures and tests as possible.” According to a report from Merritt Hawkins, a big physician search and consulting firm, that isn’t yet happening to a significant degree in the real world. The company’s annual report on recruiting incentives finds that 74% of the jobs they recruited for in the year ending March 31 featured a performance bonus. Of those that offered such a bonus, in 90% of the cases it was linked to “fee-for-service style volume.” Meantime, fewer than 7% of the jobs offering bonuses rewarded physicians for me... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4921377 Thu, 09 Jun 2011 19:16:22 +0100 4921377 http://www.medworm.com/index.php?rid=4921427&cid=t_92178_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fnew-who-report-more-than-1-billion-people-are-disabled%2F2011.06.09 The World Health Organization (WHO) and the World Bank just revealed the first-ever global estimate of disability. The report suggests that at least 1 billion people are currently disabled, and about 1/5 of those are experiencing significant difficulties with their activities of daily living. Since  people with disabilities experience poorer health, lower educational achievements, fewer economic opportunities and higher rates of poverty than people without disabilities, this vulnerable segment of the population needs much closer attention. I’m a physical medicine and rehabilitation (PM&R) specialist by training, and there are only about 8000 of us in the United States. Some have called PM&R specialists: “primary care physicians for the disabled” and I think that&... Better Health blogs http://www.medworm.com/rss/comments.php?id=4921427 Thu, 09 Jun 2011 18:00:37 +0100 4921427 http://www.medworm.com/index.php?rid=4921569&cid=t_92178_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Fremember-your-story I fell in love with healthcare while working as a radiology technician aide at a well-known imaging center in Dallas during college. I was working late one evening with one of our senior technicians, when I realized the profound opportunity a relationship between healthcare and technology could provide. No sticky read more (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=4921569 Thu, 09 Jun 2011 16:45:59 +0100 4921569 http://www.medworm.com/index.php?rid=4921765&cid=t_92178_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F06%2Fa-new-take-on-personalized-medicine.html The overarching definition for personalized medicine has always been the following: the right drug for the right patient at the right time (see: Further Consideration of the Definition for Personalized Medicine; Term "Personalized Medicine" More About Business than Healthcare Delivery). Implicit in this definition has been the idea that the "right drug" will exploit the biologic weaknesses of a patient's tumor. The classic example has been the use of the monoclonal antibody trastuzumab, marketed as Herceptin, for breast tumors that overexpress the HER2/neu protein. A recent article discusses a subtle but interesting paradigm shift relating to personalised medicine and the workflow of cancer care (see: Personalized Medicine Redefines How Docs Treat Cancer). Below is ... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4921765 Thu, 09 Jun 2011 13:17:43 +0100 4921765 http://www.medworm.com/index.php?rid=4921411&cid=t_92178_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F06%2Fboston-beats-new-york-in-cr-hospital-ratings.html The Boston vs. New York rivalry isn’t just the Red Sox vs. the Yankees. It’s which city, each known for its prestigious hospitals, has better medical care. Well, when it comes to preventing hospital-acquired infections at least, Boston wins, according to our updated hospital Ratings. For this comparison, we looked at hospitals that are members of the Council of Teaching Hospitals (excluding Veteran Administration hospitals) that are in either the Boston hospital-referral region (Boston, Cambridge, and a few neighboring towns); or in the three New York City hospital-referral regions (the five boroughs plus certain neighboring suburbs). We looked at the two most serious kinds of infections: bloodstream infections in intensive-care units that are linked to central-line catheters... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=4921411 Thu, 09 Jun 2011 13:00:00 +0100 4921411 http://www.medworm.com/index.php?rid=4911833&cid=t_92178_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F05%2Ffda-gearing-up-to-regulate-apps-and-social-media-or-not-2.html I have gotten used to a degree of vacillation from the FDA regarding various lab regulatory issues. A  recent chapter in this drama was the agency's ambiguity about lab tests originally called IVDMIAs and subsequently referred to as laboratory developed tests (LDTs). Now comes news that the agency may, or may not, regulate medical smartphone/tablet (i.e., mobile) apps and the use of social media by pharmaceutical companies (see: FDA Reportedly Gearing Up to Regulate Apps). Below is an excerpt from the article: From a no less august source than American Medical News comes a report that the FDA is considering the regulation of medical apps.  See “FDA Signals it Will Regulate Medical Apps“.   The article quotes a source who relayed that at a town hall meeting h... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4911833 Wed, 08 Jun 2011 13:03:11 +0100 4911833 http://www.medworm.com/index.php?rid=4911471&cid=t_92178_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F06%2Fwhere-to-find-a-safe-hospital.html In which hospitals are you least likely to pick up an infection? Our updated hospital Ratings include eight elite ones that reported zero surgical-site infections and zero bloodstream infections. We also identified 36 hospitals with the enviable record of having no bloodstream infections in both our 2010 and 2011 Ratings. This year we were able to include Ratings on central-line bloodstream infections for 1,119 hospitals in the District of Columbia and every state except Arkansas, Hawaii, Montana, North Dakota, South Dakota, and West Virginia. Of those hospitals, 142 (almost 13 percent) reported zero infections, compared with 11 percent last year. Particularly impressive are the 36 hospitals that had zero bloodstream infections in two consecutive reports. For surgical-site infections,... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=4911471 Wed, 08 Jun 2011 10:50:00 +0100 4911471 http://www.medworm.com/index.php?rid=5036361&cid=t_92178_118_f&fid=34850&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBusinessBlog%2F%7E3%2FNaQYQkGR-R4%2F It seems that Medicare’s focus on reducing readmissions to hospitals is stimulating renewed attention to hospital discharge planning and communications. I’ve found it shocking how patients are often abruptly transitioned from high tech, high touch hospital care to their homes with minimal discharge instructions or after receiving information that’s on a 10th generation photocopy and barely pertains to their case. Most of the discharge initiatives are your very basic blocking and tackling: making sure all the relevant information is organized, having a nurse go over it with the patient, and having someone call a day or two after discharge to make sure things are well understood. When you think about it, reimbursement really is a factor in why discharge communications have been so poor... Health Business Blog blogs http://www.medworm.com/rss/comments.php?id=5036361 Wed, 08 Jun 2011 00:34:30 +0100 5036361 http://www.medworm.com/index.php?rid=4911446&cid=t_92178_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FmrLV7gLbBZE%2F With looming cuts to Medicare payments for preventable readmissions,  hospitals are stepping up efforts to improve discharge planning and follow-up once patients go home, today’s Informed Patient column reports. So many organizations are jumping into the readmissions space that the Commonwealth Fund and the John A Hartford Foundation last year funded an “action guide” to help health care executives sort through the programs. One solution getting growing attention is Project Red — for Re-Engineered Discharge — developed by Boston University; in a study at Boston University Medical Center the program and its after-hospital care plan for patients reduced readmissions by 30%. Brian Jack, the Boston University researcher who developed RED, tells the Health Blog that under a new ... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4911446 Tue, 07 Jun 2011 13:29:01 +0100 4911446 http://www.medworm.com/index.php?rid=4911447&cid=t_92178_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FLgEdoVoucfk%2F One-Two Punch: Companies are increasingly testing combinations of cancer drugs in earlier-stage trials, attempting to deliver a knockout blow to the disease and prevent it from becoming drug-resistant, the WSJ reports. At the American Society of Clinical Oncology meeting, GlaxoSmithKline reported early-stage data on two experimental drugs being used in tandem; meantime, Bristol Myers-Squibb and Roche last week signed a deal to test two melanoma treatments together. Side effects are a big concern when two drugs are used together. Health-Care Burden: Retired Maj. General Arnold Punaro, a member of a military advisory group, says that given the rising costs of health-care and pensions, the Department of Defense is on the path to becoming “a benefits company that may occasionally kill a ... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4911447 Tue, 07 Jun 2011 12:47:52 +0100 4911447 http://www.medworm.com/index.php?rid=4911473&cid=t_92178_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F06%2Fteaching-hospitals-not-always-best-for-patient-safety.html When you’re really sick you’re best off in a large teaching hospital in a big city, right? Not necessarily, at least when it comes to patient safety, according to our new hospital Ratings. What they found: While many well-established teaching hospitals do well at preventing potentially deadly hospital-acquired infections, others don’t. We looked at bloodstream infections that patients developed in intensive-care units while on central-line catheters, or tubes used to deliver fluids, medication, and nutrition to patients. The data came either from one of the 18 states that publicly report hospital-infection rates, or from The Leapfrog Group a nonprofit organization in Washington, D.C., that focuses on improving health care in hospitals. We focused on hospitals that are... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=4911473 Tue, 07 Jun 2011 11:00:00 +0100 4911473 http://www.medworm.com/index.php?rid=4902700&cid=t_92178_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F06%2Fweb-vido-chats-as-an-important-component-of-patient-care.html This article instead emphasizes the need for a "more equal dialogue between patient and clinician and improve the nature of the relationship."  Some patients tend to get overwhelmed in a formal medical setting and may not address all of their problems with  the physician. They may also think that "the doctor is too busy to bother with my petty complaints." With video chat, the patient remains on his or her home turf and hence the discussion may be conducted on a more equal footing. (Source: Lab Soft News) Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4902700 Mon, 06 Jun 2011 18:47:23 +0100 4902700 http://www.medworm.com/index.php?rid=4902521&cid=t_92178_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Fovercrowding-er-spurs-new-facility-development Even before accounting for the mass influx of Americans rushing to hospitals’ emergency departments from healthcare reform, EDs are in serious need of fine tuning as over crowding and escalating inpatient costs are on the rise. According to the Centers for Disease Control and Prevention, emergency department visits increased 117 million from 2007 to 2008 and it shows no sign of slowing. No sticky read more (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=4902521 Mon, 06 Jun 2011 12:21:14 +0100 4902521 http://www.medworm.com/index.php?rid=4893643&cid=t_92178_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2F2B2X0b39ekw%2Faco-pgp-demonstration-cms-dont-kick-a-unicorn-when-its-down.html There has been a significant outcry against the proposed ACO regs: everything's wrong and nothing's right about them, or so some would have us believe.  (The comment period is still open, and CMS is still soliciting input; much of the outcry is a form of posturing and negotiation ... not that there's anything wrong with that.) Today's "nattering nabobs of negativism" focus on: the estimated price tag for complying with the regulatory requirements (IT and other infrastructure incuded), the slim chance of success by ACOs in righting the wrongs of decades of bloat in the health care system, the premature pledging of allegiance to an idea only partly proven through the PGP demo, the likelihood of failure due to the whole endeavor's being tied to FFS reimbursement, on the one hand, and due to... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4893643 Fri, 03 Jun 2011 12:40:18 +0100 4893643 http://www.medworm.com/index.php?rid=4893370&cid=t_92178_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F06%2F03%2Fsuccess-factors-for-creating-accountable-care-organizations%2F Healthcare organizations across the country are learning how to adapt to the concept of an Accountable Care Organization (ACO). Having been closely involved in Intermountain Healthcare’s evolution as a prototype ACO, we offer our experience in making that transition. Intermountain Healthcare is a not-for-profit, integrated, healthcare system serving Utah and southern Idaho. With 23 hospitals, [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4893370 Fri, 03 Jun 2011 12:15:06 +0100 4893370 http://www.medworm.com/index.php?rid=4893434&cid=t_92178_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F06%2Fpatients-cell-phones-may-carry-dangerous-bacteria.html Hospital-acquired infections often stem from poor hand washing or a mishandled catheter, but there’s another culprit right at your fingertips—your cell phone, suggests a study published in the June issue of the American Journal of Infection Control. It found that cell phones used by patients and their visitors were twice as likely to be contaminated with potentially dangerous bacteria as those carried by people who worked in the hospital. Researchers looked at 200 cell phones from patients, visitors, and health-care workers at a hospital in Turkey, and took swabs of the phones’ keypad, mouth piece, and ear piece. Roughly 40 percent of the patient’s phones and close to 21 percent of health-care workers’ phones tested positive for pathogens. Seven of the patie... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=4893434 Thu, 02 Jun 2011 21:20:00 +0100 4893434 http://www.medworm.com/index.php?rid=4893933&cid=t_92178_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F06%2Fpseudo-certification-from-chime-is-anyone-taken-in-by-this.html Mr. HIStalk reports on the CHIME CIO credentialing program (see: News 5/27/11): CHIME reports that 109 individuals have earned Certified Healthcare CIO designation since the credentialing program was launched in July 2009. I said it was a dumb idea then and I’ll stand by that opinion now. Obviously the credential hasn’t exactly gone viral if only 109 out of thousands of hospital CIOs have signed on over two years, voluntarily jumping onto the hamster wheel of spending hospital money on renewals and going to CHIME meetings to earn CE. To each his own, but I’d be embarrassed to use a non-educational  credential earned by passing a multiple choice test of job-specific knowledge (designed by asking CIOs what they do on the job, then testing them to see if they theoretically know ho... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4893933 Thu, 02 Jun 2011 19:06:55 +0100 4893933 http://www.medworm.com/index.php?rid=4902527&cid=t_92178_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Fhit-lessons-learned-scotland My trip to Scotland provided a remarkable opportunity to exchange ideas and experiences. Scotland has nearly 100% adoption of electronic health records among general practioners and is making good progress in hospitals with innovative built/bought inpatient systems. As in most countries, health information exchange is still evolving, but novel databases supporting disease management at the community level and an emergency care summary exchange are already live. Here's what I learned while in Scotland: No sticky read more (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=4902527 Wed, 01 Jun 2011 13:33:08 +0100 4902527 http://www.medworm.com/index.php?rid=4883568&cid=t_92178_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F05%2Fare-doctors-overwhelmed-by-drug-warnings.html There are now so many warnings of potential side effects on drug labels that physicians may miss the important ones for their patients, researchers have warned. The lists of possible adverse effects on medication leaflets are a familiar sight for consumers. While it's important to know the risks as well as the benefits of a medication, it is easy to get overwhelmed by all the things that might go wrong. But what about doctors? Long lists of potential adverse effects are one thing. But they also need to think about whether the drug interacts with any other medications you take, whether it's suitable for someone of your age, with your medical conditions, and whether it contains anything that you're allergic to. Researchers set out to see what doctors have to contend with. They assessed al... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=4883568 Tue, 31 May 2011 20:25:00 +0100 4883568 http://www.medworm.com/index.php?rid=4883553&cid=t_92178_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FrrKa2cYtV7Q%2F Contaminated Cucumbers?: There’s finger-pointing over the source of an E. coli outbreak that has killed 14 people in Germany and sickened hundreds there and in other countries, the WSJ reports. An EU spokesman says cucumbers from Spain have been pegged as possible sources of contamination by the bacteria and that another batch from the Netherlands or Denmark is also being investigated; Spanish officials say the outbreak didn’t begin in that country. Efficiency in Medicare: Hospitals are displeased with a provision of the health-care overhaul law that will make health-care spending for individual Medicare beneficiaries — even after they’ve left the hospital — a measure of institutional performance, the New York Times reports. Hospitals say they can’t be r... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4883553 Tue, 31 May 2011 12:47:10 +0100 4883553 http://www.medworm.com/index.php?rid=4883915&cid=t_92178_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F05%2Fus-south-poses-greatest-risk-of-cognitive-decline.html A tier of U.S. Southern states is commonly referred to as the "stroke belt" because of its high prevalence of this condition (see: Drop Me Off at the ER as Soon as I Finish My Fried Fish Dinner). Now comes evidence that people in the this same area  also have a higher risk of cognitive decline as a component of this neurologic spectrum (see: U.S. South Has Higher Risk of Cognitive Decline). Below is an excerpt from the article U.S. South Has Higher Risk of Cognitive Decline For decades public health researchers have known that individuals living in the American South displayed an increased risk of stroke and other forms of cardiovascular disease. A new study finds that individuals living in this region also have a greater incidence of cognitive decline compared to other reg... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4883915 Tue, 31 May 2011 11:58:46 +0100 4883915 http://www.medworm.com/index.php?rid=4872494&cid=t_92178_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F05%2Fclinical-trials-increasingly-move-offshore.html This article provided me with a new insight into the increased tempo of migration of clinical trials to China. As noted above, China is currently the world's third largest market for pharmaceuticals and by 2015 will become the second largest. Not only can clinical trials be performed for a lower cost in China but the market for pharmaceuticals in the country is also huge. One of the objections to clinical trials overseas for drugs that will be sold in the U.S. is that the research subjects are genetically different than the U.S. population. Here's an excerpt from an article that raises this issue (see: Clinical trials overseas raises quality control issues): [Seth Glickman, M.D., a senior scholar at Duke's Fuqua School of Business] says social ecology and genetics may also play... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4872494 Fri, 27 May 2011 11:43:30 +0100 4872494 http://www.medworm.com/index.php?rid=4872495&cid=t_92178_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F05%2Fincidentalomas-revisited-revisited.html I recently posted a note about so-called incidentalomas, lesions often "accidentally" discovered during CT scans that have been ordered on the basis of other diagnostic concerns. You may want to refer to it to refresh your memory about the topic (see: How to Avoid the Risks of a CT Incidentaloma). Dr. Mark Pool who blogs over at The Daily Sign Out has posted a a well-thought-out note that extends this discussion in some interesting ways (see: Incidentalomas revisited). Below is an excerpt from it: Dr. Bruce Friedman posted a thoughtful blog on Lab Soft News recently concerning "incidentalomas" ....This post happened to coincide with a new working committee at my hospital commissioned with developing a virtual clinic for following patients who have incidental lung nodule... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4872495 Thu, 26 May 2011 23:24:39 +0100 4872495 http://www.medworm.com/index.php?rid=4862948&cid=t_92178_155_f&fid=34629&url=http%3A%2F%2Flabsoftnews.typepad.com%2Flab_soft_news%2F2011%2F05%2Fshould-hospitals-set-up-private-social-networks-to-server-their-patients.html A recent article about how Toyota is setting up a private social network for its customers stimulated my thinking about how this idea might apply to hospitals and their patients (see: Toyota Owners To Get a Private Social Network). Below is an excerpt from it: Toyota has teamed up with Salesforce.com to create Toyota Friend, a private social network for owners of Toyota cars. The network will be accessible through PCs, tablets and smartphones, giving Toyota customers the ability to connect with their dealerships, cars and Toyota itself. For example, your car could send you an alert when its battery needs recharging, and you would be able to connect to your dealership to get maintenance tips and service information. Toyota Friend will primarily be a private network for Toyota car owners, bu... Lab Soft News blogs http://www.medworm.com/rss/comments.php?id=4862948 Tue, 24 May 2011 13:57:59 +0100 4862948 http://www.medworm.com/index.php?rid=4862537&cid=t_92178_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F05%2Fct-angiography-a-treatment-trap.html Many healthy patients undergoing CT angiography—a high-tech and widely advertised test increasingly being used to screen for heart disease—are being lured into a prevention trap. That’s one of the conclusions I draw from a major study and editorial being published online today by the Archives of Internal Medicine. Why? I’m concerned that people who undergo the test, which uses multiple CT scans to produce a three-dimensional image of the heart, often go away thinking either that they are free of the disease or, if the results are worrisome, that it saved their life by identifying heart disease early. But the study published today found that while people who got the test were more likely to be treated aggressively, including with invasive and potentially risky proce... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=4862537 Mon, 23 May 2011 21:01:00 +0100 4862537 http://www.medworm.com/index.php?rid=4862492&cid=t_92178_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F05%2F23%2Fjust-another-hospital-weekend-or-life-and-death%2F Suppose you need to drive from Boston to San Francisco, about 3200 miles, over the next 7 days.  At an average speed limit of 55 mph you could accomplish this by driving about 10 hours a day, including stops for rest and food breaks; a grueling but not impossible journey. Now suppose that gas stations [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4862492 Mon, 23 May 2011 19:25:39 +0100 4862492 http://www.medworm.com/index.php?rid=4852987&cid=t_92178_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Fsuperfreakonomics-healthcare-it I recently attended a conference at which Stephen Dubner, co-author of the best-selling books Freakonomics and Superfreakonomics, gave a keynote. Though he was speaking to a room full of email marketers, his story was peppered with anecdotes from the world of healthcare. He specifically, and quite humorously, told the story of Cedars-Sinai’s efforts to encourage doctors to wash their hands more often in an effort to reduce patients’ hospital-acquired infections. No sticky read more (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=4852987 Mon, 23 May 2011 12:48:05 +0100 4852987