October 12th, 2010 by DrRob in Better Health Network, Opinion, Uncategorized
Tags: Definition Of A Patient, Description Of A Patient, Doctors' Perspective, Dr. Rob Lamberts, General Medicine, Healthcare Consumer, Musings of a Distractible Mind, Patients As Consumers, Patients As Healthcare Customers, Patients' Role In Healthcare, Role Of A Patient, What Is A Patient
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What is a patient? What do they do? What’s their role in the doctor’s office? Are they chassis on a conveyor belt? Are they puzzles for doctors to solve? Are they diseases? Are they demographics? Are they a repository for applied science?
Or are they consumers? Are they paying customers? Are they the ones in charge? Are they employing physicians for their own needs?
It depends. It depends on the situation. It depends on perspective.
Some physicians are very offended when the “consumer” and “customer” labels are applied to patients. They see this as the industrialization of healthcare. We are no longer professionals, we are made into “providers” — sort of smart vending-machine made out of flesh.
Patients, on the other hand, get offended when doctors forget who pays the bill. They see the exam room as a right, not a privilege. They think they should be the most important person in the exam room, being treated with respect rather than having to bow at the altar of doctor knowledge.
Who’s right? It depends. Read more »
*This blog post was originally published at Musings of a Distractible Mind*
October 12th, 2010 by Felasfa Wodajo, M.D. in Better Health Network, Interviews, News, Opinion
Tags: Apple, Doctors and Smartphones, Doximity, Dr. Felasfa Wodajo, ePocrates, iMedicalApps, iPad, iPhone, iTouch, Medical Apps, Medicine and Smartphones, Physicians' Use of Smartphones, Private Facebook For Doctors, Social Networking For Doctors
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Doximity is an app that launched on the App Store just over a week ago and has the potential to significantly change the way physicians use their smartphones.
The main focus of the app is physician communication, and for this it incorporates an innovative, secure SMS-like text service. But its real power lies in its deep incorporation of multiple databases of physician and related information.
In particular, the makers of the app carefully integrated data from the physician NPI and Medicare databases as well as lists of medical schools, hospitals, imaging centers and pharmacies. What they’ve produced is a surprisingly refined version 1 product that can quickly answer the myriad of small, practice-related questions that pop up all day long during a busy schedule. Read more »
*This blog post was originally published at iMedicalApps*
October 12th, 2010 by KevinMD in Better Health Network, Health Policy, News, Opinion, Research
Tags: Alarm Fatigue, Diagnosis and treatment, Dr. Kevin Pho, EHR, Electronic Health Record, Electronic Medical Record, Electronic Test Reporting, EMR, General Medicine, Harm Patients, Health IT, KevinMD, Medical Charting, Overwhelm Doctors, Patient, Too Much Data, Tracking of Test Data, VA Doctors, Veterans Administration, Wall Street Journal Health Blog, WSJ
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One of the supposed strengths of electronic medical records is better tracking of test data. In theory, when using more sophisticated digital systems, doctors can better follow the mountains of test results that they encounter daily.
But a recent study, as written in the WSJ Health Blog, says otherwise. Apparently, a study performed in 2007 found:
VA doctors failed to acknowledge receipt of 368 electronically transmitted alerts about abnormal imaging tests, or one third of the total, during the study period. In 4% of the cases, imaging-test results hadn’t been followed up on four weeks after the test was done. Another study, published in March in the American Journal of Medicine, showed only 10.2% of abnormal lab test results were unacknowledged, but timely follow-up was lacking in 6.8% of cases.
Consider that the VA has what is considered the pinnacle of electronic systems — their unified, VistA program that permeates all their hospitals and clinics. Apparently the problem is one of alert overload:
Hardeep Singh, chief of the health policy and quality program at the Houston VA’s health and policy research center, led both studies. He tells the Health Blog that doctors now receive so many electronic alerts and reminders — as many as 50 each day — that the important ones can get lost in the shuffle.
This is not unlike the alarm fatigue issue that I recently wrote about. Too much data — whether it is written or on the screen — can overwhelm physicians and potentially place patients at harm. Curating test results by prioritizing abnormals will really be the true power of electronic test reporting.
*This blog post was originally published at KevinMD.com*
October 12th, 2010 by Jennifer Shine Dyer, M.D. in Better Health Network, Health Policy, Opinion, True Stories
Tags: Dr. Jennifer Shine Dyer, Healthcare Costs, Healthcare Payment Responsibility, Healthcare reform, Hyperglycemia, Insulin Regimen, medicaid, Overtreatment, Pediatric Endocrinology, Socioeconomics, Type 1 Diabetes, Unnecessary Hospitalization, Unnecessary Medical Care
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A common question that I get as a practicing physician with a public health background is: “Why is healthcare reform so complicated?” I feel that the question of who’s responsible for healthcare payment is not always an easy one to answer. An example from my most recent weekend on call covering an academic pediatric endocrinology practice demonstrates this point:
“Bill” is a 16-year-old African American male on state Medicaid insurance with type 1 diabetes since the age of 10. He is followed regularly every three months by another colleague in the endocrinology clinic. Review of his last several clinic notes on the electronic medical record reveal that he has been in moderate control of his diabetes on NPH/Novolog twice-daily insulin regimen. Approximately one year prior he was changed to this insulin regimen due to concerns with missed insulin shots on another insulin regimen that provided superior control but which required four shots of insulin daily rather than the two shots daily on his current regimen. Read more »
October 11th, 2010 by Shadowfax in Better Health Network, Health Policy, Opinion, Research
Tags: Aaron Carroll, GDP, General Medicine, Global Healthcare Spending, Healthcare Costs, Healthcare Politics, Healthcare reform, Healthcare Spending In The U.S., Healthcare Spending Worldwide, Movin' Meat, Patient Protection and Affordable Care Act, Physicians' Salaries, PPACA, Shadowfax, The Incidental Economist, U.S. Healthcare System
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Aaron Carroll over at The Incidental Economist has been running an excellent series on healthcare spending in the U.S. and how much more we spend than the rest of the world on a per capita basis, as a percentage of GDP, and by category. It’s an excellent series and I wholly recommend it. Summary graph:
Hint: the U.S. is the lavender-ish line on top. As he says, is there anything about this graph that isn’t concerning? Read more »
*This blog post was originally published at Movin' Meat*
