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HHS Recommends Toothless, Unfunded Plans To Reduce Health Disparities And Promote Disease Prevention

In the 1993 film Groundhog Day, Bill Murray plays a TV weatherman who finds himself trapped in a do-loop, covering the numbingly boring display of Punxutawney Phil, over and over again.

groundhog 194x300 HHS Serves Up Prevention LiteForgive those of us who follow news from the Department of Health and Human Services for feeling like Bill Murray in that movie.

Last month, HHS released an action plan to reduce racial disparities in health care. The plan called for new care models, more service delivery sites, a beefed-up health and human services workforce, and targeted efforts to reduce cardiovascular disease, childhood obesity and other scourges of minority populations.

Remarkably however, the plan came with no funding. Apparently, it was supposed to prompt agencies within HHS to assure that their own internal plans were aligned with the effort to reduce racial disparities. Worse yet, the plan involved only HHS itself. In effect, it assumed that a ‘medical model’ can solve racial disparities in health care. However as I argued here, these disparities aren’t about health, at all. They are about socioeconomic status, and HHS can’t fix that by itself.

Solving the problem of racial disparities in health care clearly requires input from many branches of government, including those involved with education, urban planning, transportation and more, in addition to HHS.

When it was all said and done, the HHS plan came off looking like a political stunt by the Obama administration. While the administration probably does want to fund a bona fide effort to reduce racial disparities, today’s incessant (and appropriate) focus on deficit reduction forced the administration to release a plan with no teeth. It isn’t going to make a dent in the problem. Read more »

*This blog post was originally published at Pizaazz*

AHRQ: Healthcare Access And Racial Disparities Not Improving

According to American Medical News, the U.S. health system is demonstrating better performance on most measures of health care quality, but it’s failing to improve access to care or cut racial and ethnic health disparities, according to two reports released in February by the Agency for Healthcare Research and Quality.  “Quality of care continues to improve, but at a slow rate,” said Ernest Moy, MD, leader of the team at AHRQ that produced the reports.  ”In contrast to that, focusing on issues of access to care, not much has changed.  Focusing on disparities in care, not much changed…Those are bigger problem areas than overall quality of care.”  Measures related to hospital quality are showing the most improvement.  For example, in 2005, just 42% of patients with heart attacks received angioplasties within the recommended 90 minutes of arriving at the hospital.  That figure improved to 81% by 2008.

While the quality improvement indicators are encouraging, the disappointing access and disparities numbers are not very surprising.

The US health care system is still largely focused on acute hospital based care.  It says we are doing better at what we are doing. Read more »

*This blog post was originally published at CFAH PPF Blog*

Healthcare’s Facebook

[Recently] the Wall Street Journal‘s front page story exposed a significant privacy breech of online personal information via the world’s most popular social networking site, Facebook:

Many of the most popular applications, or “apps,” on the social-networking site Facebook Inc. have been transmitting identifying information—in effect, providing access to people’s names and, in some cases, their friends’ names—to dozens of advertising and Internet tracking companies, a Wall Street Journal investigation has found.

The issue affects tens of millions of Facebook app users, including people who set their profiles to Facebook’s strictest privacy settings. The practice breaks Facebook’s rules, and renews questions about its ability to keep identifiable information about its users’ activities secure.

How could they? Imagine the nerve of marketers using Facebook ID’s to develop profiles on people using little socializing games! Facebook has a privacy policy! I was assured that if I set my privacy settings to “maximum,” this would never happen! To which I say: “Duh!” When it comes to money, people get awfully creative.

So while Facebook grapples with its latest public relations nightmare, we should realize our electronic medical record app vendors are doing exactly the same thing. Worse, it’s perfectly legal, even though each of use has been assured our privacy settings are set to “maximum” through the reassurances of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the The Patient Safety and Quality Improvement Act of 2005 (PSQIA). Read more »

*This blog post was originally published at Dr. Wes*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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