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This page shows you the most recent publications within this specialty of the MedWorm directory.

CMS Updates Nursing Home Five-Star Quality Ratings
The Centers for Medicare & Medicaid Services (CMS) updated the popular Nursing Home Compare Five-Star Quality Ratings to incorporate new measures, giving families more information at their fingertips to help them make important decisions about care. These new measures look at successful discharges, emergency visits, and re-hospitalizations, and complement other nursing home measures previously announced in April.  Read more about the new updates here: https://nnlm.gov/bhic/gr5u. (Source: BHIC)
Source: BHIC - August 26, 2016 Category: Databases & Libraries Authors: terri ottosen Tags: Public Health Senior Websites medicaid Medicare nursing homes Source Type: blogs

Rocky Start to CMS ACO Program
Three of the 21 participants in CMS’ newest accountable care organizations program, the Next Generation ACOs, have withdrawn since the start of the year. Heritage California ACO in Northridge, Calif., River Health ACO in Harrisburg, Pa., and WakeMed Key Community Care in Raleigh, N.C. now leave the program with 18 ACOs. This model allows ACOs to assume higher risk for a promise of a higher reward than the Pioneer Model and Medicare Shared Savings Program. Leaving New Model The Next Generation ACO model uses a new benchmarking methodology that incorporates one year of historical costs as well as regional and national co...
Source: Policy and Medicine - August 26, 2016 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs

Funerals For Friends: How Public Health In Colorado Handles Growing Prescription Drug Misuse
A health leader from Colorado’s stunningly beautiful but economically challenged San Luis Valley sobered an afternoon crowd by declaring that his rural community was “flirting with an epidemic” of opioid overdoses and deaths. Hours later, statewide experts called that assessment of substance use in the West too optimistic. “It’s more like a shotgun wedding with an epidemic,” pronounced Robert Valuck, an epidemiologist, professor at the University of Colorado Denver Skaggs School of Pharmacy and Pharmaceutical Sciences, and coordinator of the Colorado Consortium for Prescription Drug Abuse Prevention. The opioid...
Source: Health Affairs Blog - August 25, 2016 Category: Health Management Authors: Michael Booth Tags: Drugs and Medical Technology Featured GrantWatch Public Health addiction Colorado Health Symposium Consumers Emergency departments Health Philanthropy Health Promotion and Disease PreventionGW Hospitals marijuana opioid epidemic Source Type: blogs

The Self-Care Rx
BY LEONARD KISH “The system only changes if we empower the one person who cares about their health the most – the patient. Over the next decade, I believe people will become the CEOs of their own health.” Vinod Khosla Self care is the future for the simple reason that nobody wants to be a patient. Of course we want care when we need it. We want to be well. We want a good life. We want independence. We want control, and we certainly don’t want to need care nor to lose control. And becoming a patient, for better or for worse, implies giving up control. Being a patient implies there are gatekeepers, there are ...
Source: The Health Care Blog - August 25, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs

In Kentucky ’s New Medicaid Plan Evidence Takes A Back Seat
On June 22, the Governor of Kentucky unveiled a Medicaid reform plan to replace its highly successful Medicaid expansion. The new Kentucky Medicaid plan is not innovative, instead relying on policies that have been shown to be counterproductive, decreasing coverage and access while increasing the health disparities that affect poor and vulnerable populations. Kentucky’s New Medicaid Proposal Under former Democratic Governor Beshear, Kentucky had one of the nation’s most successful Affordable Care Act (ACA) implementations, with an effective state exchange and expanded Medicaid program. Through Medicaid expansion, more ...
Source: Health Affairs Blog - August 25, 2016 Category: Health Management Authors: Roy Grant Tags: Costs and Spending Featured Insurance and Coverage Medicaid and CHIP Quality Healthy Indiana Plan Kentucky Medicaid expansion Source Type: blogs

Why we should remember our moments of vulnerability
During my first rotation of intern year, we took care of a woman who walked into the hospital with a kidney stone and never walked out. 52 years old, diabetic but otherwise healthy, she had been vacationing in Vermont with her son and extended family when she became sick with high fevers. When her symptoms didn’t improve, her son rushed her to our emergency room where an imaging scan revealed a kidney stone that was obstructing urine flow and needed urgent removal. Somewhere between the ER and the procedure suite, she suffered a cardiac arrest, likely the result of a severe infection caused by the obstructing stone. When...
Source: Kevin, M.D. - Medical Weblog - August 25, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/michelle-zhang" rel="tag" > Michelle Zhang, MD < /a > Tags: Physician Hospital Source Type: blogs

Deep Dive Analysis of 2017 Proposed Physician Fee Schedule
As we previously covered, in July CMS released its annual proposed updates to the Physician Fee Schedule. There are a number of potentially important areas of this proposal to our readers, including a section on Open Payments. The proposed rule can be found here, along with its page on the Federal Register website. The “Proposed Physician Fee Schedule 2017 - Open Payments Section” can be downloaded here. Comments are due to CMS by 5 p.m. on September 6, 2016. When commenting, refer to file code CMS-1654-P. Comments may be submitted electronically at regulations.gov. Follow the instructions for "submitting a comment." B...
Source: Policy and Medicine - August 25, 2016 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs

Research and Reviews in the Fastlane 148
Welcome to the 148th edition of Research and Reviews in the Fastlane. R&R in the Fastlane is a free resource that harnesses the power of social media to allow some of the best and brightest emergency medicine and critical care clinicians from all over the world tell us what they think is worth reading from the published literature. This edition contains 6 recommended reads. The R&R Editorial Team includes Jeremy Fried, Nudrat Rashid, Soren Rudolph, Justin Morgenstern and, of course, Chris Nickson. Find more R&R in the Fastlane reviews in the R&R Archive, read more about the R&R project or check o...
Source: Life in the Fast Lane - August 24, 2016 Category: Emergency Medicine Authors: Justin Morgenstern Tags: Education Emergency Medicine Infectious Disease Neurosurgery R&R in the FASTLANE EBM literature recommendations research and reviews Source Type: blogs

Deadlier than Ever Before: Here ’s How the Federal Government is Fighting Back Against the Opioid Epidemic
Deadlier than Ever Before: Here’s How the Federal Government is Fighting Back Against the Opioid Epidemic One of the federal government’s important roles is to take on our county’s most pressing issues and respond with solutions on a national scale. Responsible for killing nearly 50,000 people in 2014 alone, the opioid epidemic is clearly a crisis our country needs a sweeping and effective response to overcome. What tools does the federal government have in its pocket that can combat the opioid epidemic, and how can we be sure that they’ll work? Where national agencies can alter their policies to support opioid add...
Source: Cliffside Malibu - August 24, 2016 Category: Addiction Authors: sheilas Tags: Abuse Addiction Recovery Addiction to Pharmaceuticals Addiction Treatment and Program Resources Alcoholism Behavioral Addictions Current Events Drug Rehab Information Drug Treatment Mental Health addiction treatment center alcohol ab Source Type: blogs

Alzheimer's Sleep Issues Challenge Exhausted Caregivers
Exhausted caregivers often say that one of the hardest things for them is that they can’t get quality sleep. Even caregivers who have loved ones outside of their homes can have problems since they are still on call day and night for frequent emergencies. However, it’s the Alzheimer’s caregivers who have the hardest time since Alzheimer’s disease can cause severe sleep disruption. Experts still aren’t sure about all of the reasons for the poor sleeping patterns of people with Alzheimer’s disease. Doctors feel that there may be some change in the brain, perhaps the same as with other aging people but ...
Source: Minding Our Elders - August 24, 2016 Category: Geriatrics Authors: Carol Bradley Bursack Source Type: blogs

Self-Driving Health
By JACOB REIDER, MD Lots of news about this recently.  Five years ago, you would shake your head and say “no way – not in my lifetime.”  Now you know that this is our future.  It will be safer, will save billions of dollars, and will be have positive consequences we can barely imagine.  The kids need to go to soccer practice?  Send them.  Get the dog to the vet for his check-up?  Plop him in the car and off he goes. It’s real. It will happen.  Soon. So why is it so hard for us to imagine self-driving health?  Do we have a crisis of under-supply of primary care?  Yes.  Today we do .  But I wonder if th...
Source: The Health Care Blog - August 22, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Self-Driving Health Source Type: blogs

Three Words That Health Care Should Stop Using: Insurance, Market, and Quality (Part 1 of 2)
Reading the daily papers, I have gotten increasingly frustrated at the misunderstandings that journalists and the public bring to the debates of over health expansion, costs, and reform. But you can’t blame them–our own industry has created the confusion by misusing terms and concepts that work in other places but not in health. Worse still, the health care industry has let policy-makers embed the incorrect impressions into laws and regulations. So in this article I’ll promote the long process of correcting the public’s impressions of health care–by purging three dangerous words from health ca...
Source: EMR and HIPAA - August 22, 2016 Category: Information Technology Authors: Andy Oram Tags: Health Insurance Exchanges Healthcare Business Healthcare Reform Healthcare Reimbursement MACRA Meaningful Use Personal Musings Personalized Medicine Population Health Management Behavioral Health Health Care Costs Health Care Insura Source Type: blogs

LITFL Review 245
Welcome to the 245th LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chuck of FOAM. The Most Fair Dinkum Ripper Beauts of the Week Kidney-directed resuscitation. A flood of wisdom and evidence appraisal from Pulmcrit. Enter the world of renoresuscitation. [JS] Matthew Mac Partlin gives his own brief take on the VANISH trial on the Intensive Care Network, and asks the questio...
Source: Life in the Fast Lane - August 22, 2016 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: LITFL review LITFL R/V Source Type: blogs

CCG inequality indicators
Centre for Health Economics (CHE) - Indicators developed by CHE have been adopted by the NHS to help local areas reduce potentially avoidable A&E admissions arising from social inequality. The indicators focus on emergency admissions for patients with long-term conditions and they highlight variations between CCGs on inequality performance. Between April 2015 and April 2016, there were 264,000 excess hospitalisations associated with socioeconomic inequality. CHE have developed an online tool which allows you to explore inequalities within CCGs.Online toolPress release (Source: Health Management Specialist Library)
Source: Health Management Specialist Library - August 22, 2016 Category: UK Health Authors: The King ' s Fund Information & Knowledge Service Tags: Commissioning Local authorities, public health and health inequalities Source Type: blogs

The medicine needed for the emergency care service
This report, written jointly with the Royal College of Nursing, outlines key recommendations from both organisations on reducing the pressures on emergency medical services in the UK. The report calls for a commitment for education funding, provision of training time and a realistic workforce planning strategy for emergency care. It also highlights the need for a change in culture to enable emergency departments to be more collaborative and to adopt a hub structure.ReportPress release (Source: Health Management Specialist Library)
Source: Health Management Specialist Library - August 22, 2016 Category: UK Health Authors: The King ' s Fund Information & Knowledge Service Tags: Changing configuration of health services NHS measurement and performance Workforce and employment Source Type: blogs

Laughter? That ’s the sound of resiliency you hear.
Sometimes, the loudest sounds I hear in the emergency department are laughter. It may seem irresponsible. It may seem discordant. It may seem callous. To me, it is the sound of survival. It is the sound of resiliency. It is the sound of making it through the day. My father was at work when he suddenly became cold, clammy, and collapsed to the ground unresponsive. His staff did the right thing and called 911. He was rushed by ambulance to the emergency department. He had vital signs taken, an EKG done, and blood work drawn. It was an experience that shook my family. My dad, on the other hand, was exasperated. He minimizes h...
Source: Kevin, M.D. - Medical Weblog - August 21, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/cindy-winebrenner" rel="tag" > Cindy Winebrenner, MD < /a > Tags: Physician Emergency Source Type: blogs

The Manifest Presence of the President
“The president’s presence is already late to this crisis”: that weird phrase comes from yesterday’s widely shared editorial in the Baton Rouge Advocate:  “Vacation or not, a hurting Louisiana needs you now, President Obama.” It’s not just the man himself who’s missing: it’s his “presence.” “A disaster this big begs for the personal presence of the president at ground zero,” the editorialist insists.But why? Well, “it’s what chief executives sign up for when they take the oath of office.” Does it help? The Advocate acknowledges that “sometimes, presidential visits can get in the way ...
Source: Cato-at-liberty - August 20, 2016 Category: American Health Authors: Gene Healy Source Type: blogs

Physician outcomes should be quality measures
Quality measures began as tools to quantify the health care process, using outcomes, patient perceptions, and organizational structures associated with the provision of high-quality health care. Overall, the goals should focus on delivery of care that is effective, safe, efficient, and equitable.  Did you notice a particular word missing?  Yes, I missed the word physician too, because they have been left out of the conversation entirely. Measuring quality health care by a patient lab result is like recording a patient’s temperature by waving the thermometer near their face.  One has little to do with the other except ...
Source: Kevin, M.D. - Medical Weblog - August 20, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/niran-s-al-agba" rel="tag" > Niran S. Al-Agba, MD < /a > Tags: Physician Primary care Source Type: blogs

JellyBean 046 with Ruth Bird
A sports mad yet sensible woman. It’s @DrRuthBird from #SMACCdub (She turned down free beer, paid for by @precordialthump, in order to talk to me and thus talk to you.) Sport! More sport! The Rio Olympics are in full flow. The European Football season has started. That means thousands and thousands of people all crammed into stadia all over England, Spain, Italy and so on. (Mostly men & not necessarily the fittest blokes.) If you put thousands and thousands of people in a big concrete bowl and get them stressed things happen. Ruth Bird has been the Crowd Doctor at Fulham FC for 4 years. She is not responsible for t...
Source: Life in the Fast Lane - August 19, 2016 Category: Emergency Medicine Authors: Doug Lynch Tags: JellyBean Eva Carneiro PitchSide medicine Ruth Bird Sports Medicine Source Type: blogs

Reforming Last-Resort Lending: The Flexible Open Market Alternative
Having spent the last month or so poring over writings on last-resort lending,* and especially writings dealing with the recent crisis and its aftermath, with the particular aim of discovering the best means for supplying last-resort credit when it ’s called for, and for not supplying it when it isn’t, I’ve reached a number of tentative conclusions that seem worth reporting. I report them despite their tentative nature so that I might be convinced sooner rather than later that I’m barking up the wrong tree, and also because, if I’m a ctually on to something, I might get others to help me flesh-out my ideas.I hast...
Source: Cato-at-liberty - August 18, 2016 Category: American Health Authors: George Selgin Source Type: blogs

Community Health Centers Are Essential to a Safety Net
By STEVEN FINDLAY Since we are in a political season, I’ll begin with one of the candidate’s positions on a facet of healthcare: Hillary wants to double funding for Community Health Centers (CHCs) over the next decade. Is that a good or bad thing?  If you’re inclined to think that’s good, please read on; I’ll reinforce your views.  If your impulses are in the opposite direction….well, I hope you’ll still read on; I’ll hope to convince you. By the way, I could find no mention by Trump of CHCs—no surprise there. The role CHCs play in healthcare has gone largely unheralded for years, eclipsed by sexier hea...
Source: The Health Care Blog - August 18, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs

Pregnancy increases risk of aortic dissection or rupture almost four fold – study says
There are several reports of aortic dissection and rupture during pregnancy, especially in those predisposed due to aortic disease. A recent study published in Circulation [1] by Kamel H and associates noted 5.5 cases of aortic complications per million patients during pregnancy and post partum period. The corresponding rate 1 year later was 1.4 per million. They had analysed the data from three US regions covering over six and a half million pregnancies in about 5 million women during the period from 2005 to 2013. The pregnancy related risk period was considered as 6 months before delivery to 3 months after delivery. An e...
Source: Cardiophile MD - August 18, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology Source Type: blogs

Flood Safety Tips
Due to the recent flooding disaster in the southern states these resources may be helpful to review. From the CDC – Flood home page and Flood Safety MedlinePlus topic page with information in multiple languages Floods FEMA home page Louisiana Floods (Source: BHIC)
Source: BHIC - August 17, 2016 Category: Databases & Libraries Authors: Michelle Burda Tags: Emergency Preparedness General Source Type: blogs

Research and Reviews in the Fastlane 147
In this report two cases where a new method for removing encircling objects from the penis using a ordinary condom was applied. The article in danish with a short abstract, but sufficient self explanatory images are provided. Recommended by Soren Rudolph Resuscitation Laina A et al. Amiodarone and cardiac arrest: Systematic review and meta-analysis. Internat J Cardiol 2016; 221: 780-8. PMID: 27434349 Amiodarone is dead in the dead! The recent ALPs trial in the NEJM grabbed headlines showing that there was no difference in survival to discharge in OHCA patients who got amiodarone versus lidocaine versus placebo. This s...
Source: Life in the Fast Lane - August 17, 2016 Category: Emergency Medicine Authors: Justin Morgenstern Tags: Education Emergency Medicine R&R in the FASTLANE Resuscitation Toxicology and Toxinology Trauma EBM literature recommendations research and reviews Source Type: blogs

The Bright Future of Pharmacies
The rapid development of medical technology affects every aspect of medicine and healthcare – and even the seemingly most remote and ivory-tower-like institution, pharmacy, cannot escape its transformative power. Let me show you the bright future of pharmacies. Although pharmacies play a key role in the healing process, the impression of patients about pharmacists and their drug store is often that they offer a type of commercial/business-like service. The doctor prescribes the appropriate medicine with the appropriate instructions, and the pharmacist provides it in exchange for money. A clear business. However, as the...
Source: The Medical Futurist - August 17, 2016 Category: Information Technology Authors: nora Tags: Future of Medicine Future of Pharma 3d printing gc4 Healthcare Personalized medicine pharmacies Source Type: blogs

Emergency physicians: You are not alone
Dear emergency medicine physicians: You aren’t alone. This is very important for you to realize. I mean, I know you aren’t ‘alone.’ You have spouses and children, parents, siblings, neighbors, dogs and cats. That’s all good. You need them.  Also, every shift is chock-full of people and their maladies, which you heroically manage day in, day out. Patients are everywhere. Some are sick, and some are injured, and many are addicted, and a few are just lonely. They’re inescapable. And nurses. They’re all around also. The ones who carry out your orders, tend to your patients, sometimes ignore what you say and con...
Source: Kevin, M.D. - Medical Weblog - August 15, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/edwin-leap" rel="tag" > Edwin Leap, MD < /a > Tags: Physician Emergency Source Type: blogs

E-Patient Update:   Registration Can Add Value To Care 
For those of you who end up seeking care in hospital emergency departments now and again, the following will probably be familiar. You’re spending the precious few minutes you get with the ED doc discussing your situation, having a test done or asking a nurse some rather personal questions, and a hapless man or woman shows up and inserts themselves into the moment. Why? Because they want to collect registration information. While these clerks are typically pleasant enough, and their errand relatively brief, their interruption has consequences. In my case, their entry into the room has sometimes caused a nurse or doctor t...
Source: EMR and HIPAA - August 15, 2016 Category: Information Technology Authors: Anne Zieger Tags: EHR Electronic Health Record Electronic Medical Record EMR EMR Technology HealthCare IT Hospital EHR Hospitals mHealth Population Health Management Value Based Reimbursement Alarm Fatigue e-Patient Health Insurance Hospital Reg Source Type: blogs

Cardiac Rehab Saves Lives. So Why Don ' t More Heart Patients Sign Up? : Shots - Health News : NPR
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Source: Dr Portnay - August 15, 2016 Category: Cardiology Authors: Dr Portnay Source Type: blogs

Emergencies: France, Mali, and Turkey Are Playing with Fire
(Source: The RAND Blog)
Source: The RAND Blog - August 15, 2016 Category: Health Management Authors: RAND Corporation Source Type: blogs

LITFL Review 244
Welcome to the 244th LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chuck of FOAM. The Most Fair Dinkum Ripper Beauts of the Week A gold, silver, and bronze performance in one week. An epic non-clinical focus three-for from Don’t Forget the Bubbles: The impacts of bullying on kids; A call for action against asylum seeker abuse on Nauru; and the effect of adults bullying i...
Source: Life in the Fast Lane - August 14, 2016 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs

How can we reduce violence against doctors?
There seems to be an epidemic of violence against doctors, and this has become a negative, vicious cycle. Doctors are actually scared of patients , and many are not willing to treat emergencies any more, because they don't want to be at the receiving end of the relative's ire in case the patient dies. They're now demanding security and protection because there have been so many incidents of angry and irate relatives beating up doctors for no fault of theirs. These video clips are going viral and they rouse a lot of ill-feelings in doctors who feel vulnerable and threatened. This makes the problem even worse, because they s...
Source: Dr.Malpani's Blog - August 13, 2016 Category: Reproduction Medicine Source Type: blogs

A miracle in the intensive care unit
She fit into the palm of his hand. That long nine months. Waiting desperately for that baby they thought they could never have. Jeff, football player from his high school days, met the love of his life, Bridget, at the school party. She was smart and beautiful; Jeff was big and burley, but as kind and gentle as a kitten. They hung out through their college days.. And finally said their “I do’s.” Within a few years, they tried and tried to have a baby. Year after year, MD after MD. And finally, Bridget was pregnant. Her water ruptured, a little too early, and Jeff drove her frantically to the hospital. Two...
Source: Kevin, M.D. - Medical Weblog - August 13, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/debbie-moore-black" rel="tag" > Debbie Moore-Black, RN < /a > Tags: Conditions Heart Infectious disease Source Type: blogs

Learn to Break the Cycle of Codependent Relationships
This article courtesy of Tiny Buddha. (Source: World of Psychology)
Source: World of Psychology - August 13, 2016 Category: Psychiatry & Psychology Authors: Psych Central Staff Tags: Publishers Relationships Tiny Buddha abuse Anger anxiety approval balance behaviors Bored Codependent Codependent Relationships Confirmation Control controlling Courage Depressed Emotions empty Fear Feelings guilt Source Type: blogs

Narrative Matters: On Our Reading List
Editor’s note: “Narrative Matters: On Our Reading List” is a monthly roundup where we share some of the most compelling health care narratives driving the news and conversation in recent weeks. In this month’s Narrative Matters essay, former Department of Health and Human Services (HHS) Secretary Louis Sullivan writes about growing up in rural Georgia and entering medical school as the only black student in his class. Sullivan graduated from Boston University School of Medicine in 1958 with only $500 in debt — hard to fathom when, today, med students might finish school owing some $150,000 to $250,000. Sulli...
Source: Health Affairs Blog - August 12, 2016 Category: Health Management Authors: Jessica Bylander Tags: Elsewhere@ Health Affairs Featured Narrative Matters On Our Reading List opioids Veterans Source Type: blogs

TASER Electric Stun Gun Integrated with ECG Cardiac Monitoring
What if your friendly local police officer could tase you for being an idiot and detect a cardiac arrhythmia at the same time? This is now a possibility thanks to a prototype system from researchers at Wake Forest Baptist Medical Center that combines a TASER electric stun gun with ECG biomonitoring. The cardiac monitor records the electric heart signals through the same electrodes that pierce the skin and deliver the electric shock. According to the researchers, this required little modification of the TASER, and in field tests conducted on a few very bold volunteers the researchers were able to confirm that the system w...
Source: Medgadget - August 12, 2016 Category: Medical Equipment Authors: Editors Tags: Emergency Medicine Military Medicine Source Type: blogs

Why Customer-Centricity Doesn ’ t Matter As Much As You Think It Does
By JEREMY WALLMAN Customer centricity has been a mantra of managed care organizations for well over a decade. If you listen closely, you can hear plaintive cries of our care providers, lamenting the labyrinthine, almost Kafka-esque system of prior authorization, reimbursement, meaningful use, and near-real-time obsolescence of medical technology. The crushing weight of reform, the perverted incentives created by volume-based reimbursement, and the soaring costs of doing business have created a situation, much like in public education, where our system is fueled primarily by the power of a dedicated and passionate community...
Source: The Health Care Blog - August 12, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs

Demand Congress to go on Medicare at the age of 65
Born in Canada, our mother came to the United States after World War II and blended into the Greatest Generation. Raising a family in the second half of the 20th century saw her contribute to a thriving American society then maintain retirement health on Medicare. But in her early 90s, this tranquility was threatened when her HMO hospital tried to kill her. She went to the emergency room with symptoms of the stomach flu, and ended up rapidly placed on palliative care with an erroneous diagnosis of end-stage liver cancer. Fortunately, after a long ordeal and because of our medical background, we thwarted hospital personnel ...
Source: Kevin, M.D. - Medical Weblog - August 12, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/gene-uzawa-dorio" rel="tag" > Gene Uzawa Dorio, MD < /a > Tags: Policy Geriatrics Source Type: blogs

A physician mother as the breadwinner. Here ’s how she did it.
I was afraid.  Really, I was more anxious.  This wasn’t any of the typical new mother fears I had been warned about. If fact, I didn’t even see this one coming.  I knew that it would be tough going back to work 3 months after my first daughter was born.  I knew I would miss her terribly.  I knew I had to figure out a pumping schedule with my colleagues to allow for my incredibly healthy, ED honed antibodies to protect her little system.  I knew I’d be sleep deprived, and have an emotional roller coaster of a time.  People had told me that.  It came with the territory.  I felt that would be difficult, but fin...
Source: Kevin, M.D. - Medical Weblog - August 11, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/marianne-haughey" rel="tag" > Marianne Haughey, MD < /a > Tags: Physician Emergency Source Type: blogs

Research and Reviews in the Fastlane 146
This study looked at the 111 (19%) that had an isolated fat pad (anterior sail sign and/or posterior fat pad) but no other injuries seen on the x-ray. The standard practice for these patients was an elastic bandage and a sling, with orthopaedics follow-up in 1 week. (Where I work, children generally get a plaster splint, as we are concerned about occult supracondylar fractures.) At the 1 week follow up, there were no significant injuries identified, although they did not routinely get follow-up x-rays. Only 1 patients was transitioned to a cast because of ongoing pain. Unfortunately, they did lose 17% of the patients to fo...
Source: Life in the Fast Lane - August 10, 2016 Category: Emergency Medicine Authors: Justin Morgenstern Tags: Education Emergency Medicine Orthopedics Pediatrics R&R in the FASTLANE Trauma EBM literature recommendations research and reviews Source Type: blogs

Suicide Prevention: Access To Behavioral Health Services Lacking
Suicide is a leading cause of death in the United States. From 2000 to 2014, it was the third most common cause of death among 10 to 24 year olds, the second most common cause of death among 25 to 34 year olds, and the tenth most common cause of death for all ages. The medical and work-loss costs of completed suicide are estimated to be over $51 billion. Suicide can have a devastating effect on the family and friends of the deceased. Depending on their relationship to a person who has committed suicide, those left behind are at greater risk for mental illness, substance use, and suicide. Self-inflicted injuries not resulti...
Source: Health Affairs Blog - August 10, 2016 Category: Health Management Authors: Ryan Mutter, Sean Lynch, Mir M. Ali, Brent Gibbons, Richard McKeon and Christopher Carroll Tags: Drugs and Medical Technology Featured Health IT Public Health Behavioral Health Mental Health mobile health SAMHSA suicide prevention Source Type: blogs

9 Reasons Why Failure Should be an Asset to Every Entrepreneur
You're reading 9 Reasons Why Failure Should be an Asset to Every Entrepreneur, originally posted on Pick the Brain | Motivation and Self Improvement. If you're enjoying this, please visit our site for more inspirational articles. You are an entrepreneur (or you definitely want to be one). And like all the other entrepreneurs, you are obsessed with success. Your work is your driving passion, and you probably equate failure with a personal shortcoming. Let’s face it - nobody wants to fail. But some failure is inevitable — at least it is if you ever hope to succeed. Here are nine reasons why failure is not the end of t...
Source: PickTheBrain | Motivation and Self Improvement - August 10, 2016 Category: Consumer Health Advice Authors: Soham Amatya Tags: confidence featured motivation success best self-improvement blogs build confidence how to be successful pickthebrain top 10 success lessons Source Type: blogs

Multiple choice questions are a terrible way to test doctors
Most people are surprised to hear that the way doctors are recertified every ten years is through a multiple choice test. “Really?” they’ll say. “You take a multiple choice test? As a doctor?” Unfortunately, after all these years that’s the most efficient way we can think of to evaluate professionals. But the method is so flawed. And your ability to answer questions on the multiple choice test isn’t necessarily linked with your ability to be a good clinician. Take a look at this question, for example: Which of the following statements regarding deep venous thrombosis is correct? Most calf vein thromb...
Source: Kevin, M.D. - Medical Weblog - August 9, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/jeremy-gabrysch" rel="tag" > Jeremy Gabrysch, MD < /a > Tags: Physician Emergency Hematology Source Type: blogs

NYTimes: Minorities Suffer From Unequal Pain Treatment
Roslyn Lewis was at work at a dollar store here in Tuscaloosa, pushing a heavy cart of dog food, when something popped in her back: an explosion of pain. At the emergency room the next day, doctors gave her Motrin and sent her home.Her employer paid for a nerve block that helped temporarily, numbing her lower back, but she could not afford more injections or physical therapy. A decade later, the pain radiates to her right knee and remains largely unaddressed, so deep and searing that on a recent day she sat stiffly on her couch, her curtains drawn, for hours.The experience of African-Americans, like Ms. Lewis, and other mi...
Source: Psychology of Pain - August 9, 2016 Category: Anesthesiology Source Type: blogs

Surprise billing surprises everyone, except the insurance companies
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. In the past several years, there has been a dramatic increase in media attention concerning bills patients receive from health care professionals who are not in the network of providers their insurance company contracted with to provide health services. The out-of-network bills these patients receive have been termed “surprise bills” by the insurance industry, but are also often termed “balance” or “out-of-network” billing. Balance billing occurs when a patient receives a bill for the amount remaining between the out-of-net...
Source: Kevin, M.D. - Medical Weblog - August 9, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/sherif-zaafran" rel="tag" > Sherif Zaafran, MD < /a > Tags: Physician Medicare Source Type: blogs

Health Affairs ’ August Issue: Disparities, Hospital Financing, And More
The August issue of Health Affairs, a variety issue, includes a collection of articles that show the extent of health disparities in the United States and describe approaches designed to address them. There are also articles covering hospital financing, Medicare, and other topics. Documenting active life expectancy disparities: black and white differences remain Research previously published, in Health Affairs and elsewhere, has described racial differences in life expectancies. However, very few studies have focused on long-term trends in active life expectancy by race. Vicki Freedman of the University of Michigan and Br...
Source: Health Affairs Blog - August 8, 2016 Category: Health Management Authors: Lucy Larner Tags: Elsewhere@ Health Affairs Disparities Health Affairs journal Medicare Advantage Source Type: blogs

Common Arguments against Immigration
This report finds more problems with immigrant assimilation in Europe, especially for those from outside of the European Union, but the findings for the United States are quite positive.The third work by University of Washington economist Jacob Vigdor compares modern immigrant civic and cultural assimilation to that of immigrants from the early 20th century (an earlier draft of his book chapter ishere, the published version is available in thiscollection).   If you think early 20th century immigrants and their descendants eventually assimilated successfully, Vigdor’s conclusion is reassuring:“While there are reasons t...
Source: Cato-at-liberty - August 8, 2016 Category: American Health Authors: Alex Nowrasteh Source Type: blogs

Weird emails from Independence Blue Cross via its IT outsourcing partners: showing yet more health IT industry trust-destroying incompetence
In the past week I ' ve received two emails that made me highly suspicious of medical/insurance identity theft.The emails came from Independence Blue Cross, ibx.com, into the email account I receive normal mailings from them, and seemed to indicate someone had created an unauthorized user account (I redacted my email address below):Aug. 5, 2016:From: noreply@ibx.comDate: Fri, Aug 5, 2016 at 7:19 PMSubject: User CreatedTo:[my email address redacted]User Created With UserId - userId20392, Password - password20392July 27, 2016: From: noreply@ibx.comDate: Wed, Jul 27, 2016 at 1:59 PMSubject: User CreatedTo: [my email addr...
Source: Health Care Renewal - August 8, 2016 Category: Health Management Tags: Connecture healthcare IT difficulties healthcare IT incompetence IBX.com Independence Blue Cross Inflow medical record confidentiality Source Type: blogs

How to Build Better Metrics: Focus on Physician Outcomes
By NIRAN AL-AGBA, MD Quality measures began as tools to quantify the healthcare process, using outcomes, patient perceptions, and organizational structures associated with the provision of high-quality health care. Overall, the goals should focus on delivery of care that is effective, safe, efficient, and equitable.  Did you notice a particular word missing?  Yes, I missed the word physician too, because they have been left out of the conversation entirely. Measuring quality healthcare by a patient lab result is like recording a patient’s temperature by waving the thermometer near their face.  One has little to do wit...
Source: The Health Care Blog - August 8, 2016 Category: Consumer Health News Authors: John Irvine Tags: 2016 Town Hall Source Type: blogs

Metrics Should Be About Physician Outcomes
By NIRAN AL-AGBA, MD Quality measures began as tools to quantify the healthcare process, using outcomes, patient perceptions, and organizational structures associated with the provision of high-quality health care. Overall, the goals should focus on delivery of care that is effective, safe, efficient, and equitable.  Did you notice a particular word missing?  Yes, I missed the word physician too, because they have been left out of the conversation entirely. Measuring quality healthcare by a patient lab result is like recording a patient’s temperature by waving the thermometer near their face.  One has little to do wit...
Source: The Health Care Blog - August 8, 2016 Category: Consumer Health News Authors: John Irvine Tags: 2016 Town Hall Source Type: blogs