December 9th, 2009 by DrEdwinLeap in Opinion, True Stories
Tags: Abuse, Disability, Drugs, Emergency Medicine, Game Of Life, Greenville News, Illicit Drug Use, Parenting
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Three of my children love to play the game ‘Life,’ where players choose college or career and are paid, take out loans, pay taxes, have families and all the rest as they navigate towards retirement. I especially love playing with them when they each become frantic, not for the highest income, but to finish the game with the most children. Along the way, my daughter is even naming her kids as the tiny blue and pink pegs fill up her little plastic car. (Talk about your parental validation!)
But after playing, then thinking back on my week at work, I fear that we could easily make a new game that was more familiar to many modern kids. I suppose we’d have to call it ‘The Game of Death,’ or maybe just ‘The Game of Pain.’ Read more »
*This blog post was originally published at edwinleap.com*
December 9th, 2009 by KevinMD in Better Health Network, Health Policy, Opinion
Tags: Cost, Electronic Medical Records, EMR, Finance, Primary Care, Quality, Safety, Technology
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Have electronic medical records made a difference in patient care?
According to a study looking at digital medical record adoption of 3,000 hospitals, electronic records have made little difference in cost or quality of care.
That’s discouraging, considering that the government is investing billions of dollars into the technology.
Very few physicians use electronic record systems effectively. For instance, many are simply scanning paper records into a computer, which provides minimal benefit. It’s difficult to track quality improvement data doing that. The problem is further compounded by the archaic interfaces that the current generation of EMRs have, which is akin to a user interface circa Windows 95.
It’s no wonder that most doctors find electronic medical systems actually slows them down. The next generation of systems needs to focus on facilitating the doctor-patient encounter, rather than being an impediment. Taking a few lessons from Google, and improving the user interface would be a good start.
Only then can EMRs realize the potential relied upon by the government and health reformers.
*This blog post was originally published at KevinMD.com*
December 7th, 2009 by Happy Hospitalist in Better Health Network, Health Policy, Opinion
Tags: Crisis, Culture, Emergency Medicine, Health Insurance, Health Lifestyles, Healthcare reform, Internal Medicine, Personal Responsibility, Welfare
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I got an email today laying out the reality of our current health care debate. Is it a crisis of culture or a health care crisis. I am a firm believer in taking responsibility for one’s actions. I believe those who chose not to practice healthy lifestyles should pay more for the consequences of their actions than those who do. I believe the solution to our health care finance quandary lies not in controlling the cost of treating disease, but rather in upholding the personal responsibility all Americans have to themselves and their country.
What does the distribution of health care dollars look like among the American population? While we know that 50% of our population spends only 3% of health care dollars, we also know that 50% of our health care dollars are spent by 5% of our population, a population of chronic disease sufferers who’s diseases are, by and large, a direct result of the personal decisions they chose to make on a daily basis. For the most part, genetics alone is no longer an excuse. We knew very well that lifestyle directly affects the expression of disease by genes. Read more »
*This blog post was originally published at The Happy Hospitalist Blog*
December 5th, 2009 by DrStanleyFeld in Better Health Network, Health Policy, Opinion
Tags: Budget Neutrality, Costs of Healthcare, Finance, Healthcare reform, Hidden Costs, House Bill, Senate Bill
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President Obama said he will not sign a healthcare reform bill that was not budget neutral. You can view this statement at 3.50 minutes into this video clip.
The only way that can happen is if the healthcare expenses in both bills are hidden, unrealistic expense estimates are or expenses deflected to other areas in the budget. The Senate and House bill do both. Read more »
*This blog post was originally published at Repairing the Healthcare System*
December 4th, 2009 by drval in Opinion
Tags: EMR, Family Medicine, Physicians, Primary Care, PWC, Quality, Technology
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As I sit here in a medical innovation conference - I find myself becoming more and more angered by one of the speakers. A man with an MBA and fancy title from PriceWaterhouseCoopers is lecturing us about how doctors are essentially money-grubbing, change-resistant, quality-care avoiding “pains in the you-know-what,” obstructing progress in healthcare reform and blocking technology adoption.
His lack of understanding of the complexity of medical care was breathtaking. And yet, he expresses a sentiment that I’ve witnessed all too many times. Here are a few choice quotations: Read more »
December 4th, 2009 by DrDavisLiu in Better Health Network, Opinion
Tags: Caution, Dr. Google, ePatient, Expertise, Internet, Knowlege, NPR, Online, Social Media, Warning
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A recent article by NPR confirmed what many patients and doctors already know. The internet is leveling the playing field and allows individuals to access information easier and more quickly. Research by Pew Internet and American Life Project found:
- 61 percent of adults say they look online for health information - known as e-patients
- 20 percent of e-patients go to Internet and social-networking sites where they can talk to medical experts and other patients
- 39 percent of e-patients already use a social-networking site like Facebook
Yet as individuals embrace new technology, the New England Journal of Medicine found earlier this year that only 17 percent of doctors use electronic medical records. To say doctors are conservative and slow in adapting to new ways of communicating and accessing information would be an understatement. An article in TIME magazine proclaimed “Email Your Doctor” which graced newsstands in 1998! Email communications with doctors is still the exception rather than the rule. Read more »
*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*
December 3rd, 2009 by DrBryanVartabedian in Better Health Network, Opinion
Tags: Anonymous, Blogger, Blogging, Medical, Social Media
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I see it from time to time. The doctor with a voice who’s uncomfortable with transparency. They post and comment under the cozy blanket of putative anonymity. But it’s bad policy. Here’s why doctors need to be outed in social media:
Anonymity is a fantasy. It’s remarkably difficult to achieve. With small thoughts you can hide – in fact, no one cares who you are. If you offer anything worth hearing people will ultimately find out who you are. And the plaintiff attorneys will always sniff you out.
You need a reality check. Anonymity gives us phony security and opens the door for us to say the things we wouldn’t normally say. There’s no editorial influence more powerful than knowing that my patients and my boss are listening. While an incendiary rant may serve to vent frustrations and drive traffic, it just fuels the perception of doctors as cynical, frustrated folks. And we don’t need help with that. Read more »
December 2nd, 2009 by DrRichardCooper in Better Health Network, Health Policy, Opinion
Tags: Geographic Variations, Hospital Readmission Rates, Medicare, MedPAC, Poverty, Readmissions, Safety Net Hospitals
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According to MedPAC, 18% of hospitalizations among Medicare beneficiaries resulted in readmission within 30 days, accounting for $15 billion in spending. Since treatable chronic illnesses are responsible for many such hospitalizations, it is assumed that they represent failures of the health care system. MedPAC claims that 84% of readmissions are potentially preventable. However, as will become evident, most readmissions reflect differences in co-morbidities, poverty and other social determinants, all of which deserve attention, including better transition care, but few of which are under the control of hospitals. Nonetheless, health care reform assumes that regulators can accurately adjust for such risks and estimate the “excess.”
Both the House and Senate bills include reductions in payments to hospitals with “excess” readmissions. Payment would be reduced 20% for “excess” readmissions within seven days and 10% within fifteen days. Hospitals with 30-day risk-adjusted readmission rates above the 75th percentile would incur penalties of 10-20%, scaled to the time to readmission. Read more »
*This blog post was originally published at PHYSICIANS and HEALTH CARE REFORM Commentaries and Controversies*
December 2nd, 2009 by drval in News, Opinion
Tags: 2009, Beldina Atieno, Economy, Eric Goosby, Event, Global, HIV/AIDS, Infectious Disease, Jack Lew, Joy Phumaphi, Michel Kazatchkine, PEPFAR, World AIDS Day, World Bank
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What does America’s economic recession have to do with a school teacher in Kenya? A lot more than you realize. If there’s one thing I learned at the World Bank’s World AIDS Day event yesterday, it’s that our lives, economies, and health are all inextricably intertwined on a global scale.
Beldina Atieno (second from the left in the photo) traveled all the way from Nairobi to offer her first hand account of life as an HIV+ school teacher in Africa. Ms. Atieno’s story was both heart-wrenching and eye-opening. She was first diagnosed after her youngest daughter became very ill from an opportunistic infection, which prompted HIV testing in both daughter and mother. After discovering that they were both positive, she was abandoned by her husband and was plunged into poverty and despair. Read more »
December 2nd, 2009 by Happy Hospitalist in Better Health Network, Health Policy, Opinion, True Stories
Tags: CMS, Incentives, Pay For Performance, PQRI, Quality
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It’s official. Happy has now earned his CMS physician pay for performance PQRI Bonus for 2008, a direct deposit into Happy’s bank account. PQRI stands for Physician Quality Reporting Initiative. How much was my PQRI Medicare pay for performance bonus for calendar year 2008? A $2,500 check written out directly to Happy by the Medicare National Bank. CMS gives a wonderful overview of the history of PQRI . PQRI is the Medicare pay for performance program for physicians that was initiated by Congressional mandate in the latter half of 2007. Doctors have an opportunity to earn back 2% of their gross Medicare collections (which the government calls a bonus but which I call legalized theft) by submitting a grotesque amount of quality performance paper work to the Medicare National Bank. It’s one giant PQRI guideline game.
PQRI reporting is currently voluntary, but legislation in future years will certainly mandate reductions in payment for not submitting data, all but making this program a punitive standard. Many physicians failed to meet the requirements to get paid under CMS pay for performance program guidelines in the latter half of 2007, the first year for PQRI measures. Read more »
*This blog post was originally published at The Happy Hospitalist Blog*
