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A FICO Score For Medication Compliance?

In Keeping Score on How You Take Your Medicine, Tara Parker-Pope of the New York Times, reports on a new initiative from the Fair Isaac Corporation (FICO) known previously for its credit score ratings.  FICO has developed a Medication Adherence Score, using publicly identifiable information (like employment status, age and gender) to determine a patient’s score, which it says “can predict which patients are at highest risk for skipping or incorrectly using prescription medications.”

Parker-Pope reports, “By the end of the year, an estimated two million to three million patients will have been given a FICO medication adherence score and a total of 10 million patients are expected to be scored during the next 12 months…FICO officials say insurance companies and other health care groups will use the score to identify those patients who could benefit the most from follow-up phone calls, letters and e-mails to encourage proper use of medication.”

The FICO medication adherence score has not received a universally warm reception: e-Patient Dave and Society for Participatory Medicine member Alexandra Albin point out that the score only accounts for whether prescriptions are purchased, not whether the pills have actually been taken.

In a related effort, Geisinger Health Systems and CVS Caremark are conducting a study to assess whether enhanced doctor-pharmacist communication can help with medication adherence.  Shefali S. Kukarni reports in Tracking Down Patients Who Skip Their Drugs that, “The 18-month investigation will track a prescription from the moment it is submitted electronically to the pharmacy until it reaches the patient. If the patient does not pick up the prescription a ‘red flag’ or some form of notification will be sent to the doctor.”

But as Jessie Gruman recently blogged, there is no magic pill to cure poor medication adherence.   Read more »

*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*

Why Don’t More People Use Health Apps For iPhones And Droids?

Jessie GrumanI have been musing about why, despite our fascination with gadgets and timesaving devices, so few of us use the apps and tools that have been developed to help us take care of ourselves.

The range of options is staggering – my iPhone coughed up 52 applications for medication reminders just now – but most of us don’t make use of the (often free) high-tech help available to us.  There are hundreds of websites and portals to help us monitor our diets, physical activity and blood sugar, talk to our doctors by e-mail and understand our test results.  Apps can help us watch for drug interactions, unravel our test results, adjust our hearing aids and track our symptoms.  Devices can monitor whether our mom is moving around her house this morning or continuously monitor our vital signs.

Interesting ideas.  Modest pickup.

DSCF6172In an essay published in the May issue of the American Journal of Preventive Medicine supplement “Cyberinfrastructure for Consumer Health,” I make some observations about why this may be so, Read more »

*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*

Patients Don’t Want To Communicate With Their Doctors On Facebook

Patients may not want to discuss clinical matters via social media, but they’d gladly set pay their bills when reminded. Social media’s value in communicating with patients is limited to the administrative aspects of it.

Americans still want traditional ways of communication when they need a clinical consult. A survey finds 84% would not use social media or instant messaging channels for medical communication if their doctors offered it, according to the communications firm Capstrat.

Respondents were more favorable toward conferring with the doctor via e-mail (52%) than they were by Twitter and Facebook (11%), chat or instant messaging (20%) or a private online forum (31%).

Even among those 18 to 29 years old, 21% said they would take advantage of an online forum if their doctor offered it, while 72% would take advantage of a nurse help line if available.

Respondents said they’d take advantage of online appointment scheduling (52%), online access to medical records (50%), or online bill payment (48%).

“It appears consumers are willing to move administrative experiences such as bill payment and records access online, but when it comes to conferring with their health care providers, people still prefer more traditional communications,” said the firm’s president, Karen Albritton, in a press release. “The implications include a way for doctors to free up more time for their patients by moving the right interactions online, and an opportunity to forge stronger connections through personal interaction.”

Patients want the same convenience of online appointments and bill paying from their doctor that they get in other areas of their lives, reports a second survey.

73% of those surveyed would use a secure online option to get lab results, request appointments and pay medical bills. The first caveat is that this survey was done by Intuit. The company is best known for QuickBooks, but its health care division offers patient portals for doctor’s offices. The second caveat is that respondents were surveyed online, which would skew results to people digitally inclined anyway.

With those two caveats in mind, the survey also found that:
–Almost half would consider switching doctors for a practice that offered online access.
–81% would schedule their own appointment via a secure Web service and fill out medical/registration forms online prior to their appointment.
–78% would use a secure online method to access their medical histories and share information with their doctor.
–59% of generation Y respondents said they would switch doctors for one with better online access, compared to only 29% of baby boomers.
–45% of patients wait more than a month to pay their doctor bill, and when they pay, half still send a paper check in the mail.

*This blog post was originally published at ACP Internist*

Referral Communication: What Happens To Handoffs Between Primary Care Physicians And Specialists?

Far more primary care doctors report detailed referrals than do specialists report receiving them. The same applies in reverse. Specialists report returning quality consultations, while primary care physicians report receiving them far less often.

Researchers reported in Archives of Internal Medicine that perceptions of communication regarding referrals and consultations differed widely. While 69.3 percent of primary care physicians reported “always” or “most of the time” sending a patient’s history and the reason for the consultation to specialists, only 34.8 percent of specialists said they “always” or “most of the time” received the information. And, while 80.6 percent of specialists said they “always” or “most of the time” send consultation results to the referring physicians, only 62.2 percent of primary care physicians said they received it.

So where are the reports going? Read more »

*This blog post was originally published at ACP Internist*

Making 2011 “Meaningful”

Today, $27 billion in incentives begin for using electronic medical records, as office- and hospital-based providers begin to register for meaningful use criteria.

Providers must use a certified system according to Centers for Medicare and Medicaid meaningful-use guidelines for 90 consecutive days within the first year of the program to qualify. Eligible professionals can receive up to $44,000 over five years under the program. There’s an additional incentive for eligible professionals who provide services in a Health Professional Shortage Area. To get the most money, Medicare-eligible professionals must begin by 2012. By 2015, Medicare-eligible professionals and hospitals that do not demonstrate meaningful use get punished. Read more »

*This blog post was originally published at ACP Internist*

Latest Interviews

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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How To Make Inpatient Medical Practice Fun Again: Try Locum Tenens Work

It s no secret that most physicians are unhappy with the way things are going in healthcare. Surveys report high levels of job dissatisfaction burn out and even suicide. In fact some believe that up to a third of the US physician work force is planning to leave the profession…

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Latest Book Reviews

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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Unaccountable: A Book About The Underbelly Of Hospital Care

I met Dr. Marty Makary over lunch at Founding Farmers restaurant in DC about three years ago. We had an animated conversation about hospital safety the potential contribution of checklists to reducing medical errors and his upcoming book about the need for more transparency in the healthcare system. Marty was…

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