There’s a growing recognition within the medical-industrial complex that the patient is a key element of the enterprise, and that patient satisfaction, patient experience, patient engagement, patient activation, and patient-centeredness are very important. Some research shows that patient activation yields better patient outcomes, and that patient activation can be measured.
Patient-centeredness and patient engagement are two of the key metrics to be used by the feds in describing Accountable Care Organizations (ACOs), if the internecine battles within government are resolved soon enough to actually release draft ACO regulations in time to allow for sufficient advance planning for the January 2012 go-live date. (Wearing one of my many hats, I’ve had the opportunity to submit a response to CMS regarding the RFI on these metrics on behalf of the Society for Participatory Medicine.) These measures go into the “meaningful use” hopper as well, as meaningful use stage 2 metrics are being reviewed.
In recent years, the federales have been measuring patient experience using the Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys, and — coming soon to a bank account near you — there will be Medicare dollars tied to the scores on these questionnaires, not just dollars tied to the act of reporting scores.
As this emphasis on patient experience is unfolding, the Leapfrog Group is adding its voice to the chorus. I spoke this week with CEO Leah Binder and hospital survey director Matt Austin about the new patient experience measures they are adding to their 2011 hospital survey. In keeping with past practice, they will be asking hospitals to report three CAHPS measures (rather than asking folks to collect and report new measures). The three were selected as being representative of a hospital’s broader performance with respect to patient experience, and also because hospital performance on these measures is all over the map. Read more »
The National Geographic Channel is currently featuring the latest in organ generation technology in its “Explorer” series. Here’s a snippet from the full show:
Enriched chicken feed may have resulted in eggs having less cholesterol and more Vitamin D than previously measured, reports the U.S. Department of Agriculture (USDA).
A large egg today has about 185 milligrams of cholesterol, down 14 percent from 215 milligrams in 2002, according to new research from the USDA’s Agricultural Research Service, reports USA Today. Also, an egg today has 41 international units (IUs) of Vitamin D, up 64 percent from 25 IUs measured in 2002. (That’s still only about 7 percent of the 600 IUs recommended per day.)
The agency regularly does nutrient checks on popular foods, this time analyzing eggs taken from store shelves in 12 locations around the country. The American Egg Board said in a press release that hen feed is made up mostly of corn, soybean meal, vitamins and minerals. Nutrition researchers at Iowa State University are also looking into reasons why cholesterol in eggs is decreasing.
One egg a day fits within the average, healthy American’s diet, reports WebMD, citing research funded by the Centers for Disease Control and Prevention and by the American Egg Board — owners of the slogan “the incredible, edible egg.”
*This blog post was originally published at ACP Internist*
I’d like to talk about how rodents, relationships, and riding relate to overall health and wellness.
This idea comes from a nicely-written New York Times piece entitled, “Does Loneliness Reduce the Benefits of Exercise?” Here, Gretchen Reynolds reviews a few intriguing studies about how relationships may affect exercise, stress hormone levels, and intelligence. The combo caught my eye.
Anyone who pays attention to wellness knows that exercise produces more flexible arteries, more durable hearts, and leaner body shapes. These benefits are obvious, and honestly, sometimes a bit tiresome to write about.
To me, a far more interesting — and lesser known — benefit of regular exercise is that it might make us smarter. Here’s where the rodents come into the story.
As was summarized in the New York Times piece, when researchers allowed rats and mice access to running wheels they observed (a) that they all ran, and (b) those rats that did run scored better on rodent IQ tests, and actually grew more brain cells. This is a striking finding because nerve cells — unlike blood, GI and skin cells, which turnover rapidly — grow very slowly, if at all.
But that’s not the entire story. The Princeton researchers wanted to know whether the rat’s social relationships could have measurable biologic effects.
It turns out that rodents — like humans — are quite social. So social, in fact, that in these trials the brain-growing effect of exercise was blunted when rodents lived alone. Compared to rats and mice that lived in groups, those that were kept in isolation failed to grow new nerve cells in response to exercise. And importantly, isolated rats produced higher levels of stress hormones than those who lived in groups, even though both groups ran the same distance. Read more »
*This blog post was originally published at Dr John M*
Physicians said in a survey that noncompliance with advice or treatment recommendations was their foremost complaint about their patients. Most said it affected their ability to provide optimal care and more 37 percent said it did so “a lot.”
Three-quarters of patients said they were highly satisfied with their doctors. But they still had complaints ranging from long wait times to ineffective treatments.
Those are just some of the findings from two surveys, the first a poll of 660 primary care physicians conducted by the Consumer Reports National Research Center in September 2010 and the second a poll of 49,000 Consumer Reports subscribers in 2009. The magazine reported its results online.
In the doctors’ poll, physicians named these top challenges:
— 76 percent of doctors said when it came to getting better medical care, forming a long-term relationship with a primary care physician would help “very much.”
— 61 percent said being respectful and courteous toward doctors would help “very much,” while 70 percent said respect and appreciation from patients had gotten “a little” or “much” worse since they had started practicing medicine. This was a two-way street, since patients reported the same feelings.
— 42 percent physicians said health plan rules and regulations interfered “a lot” with the care they provided.
Also noted in the poll, 37 percent of physicians thought they were “very” effective when it comes to minimizing pain and discomfort for their patients, though 97 percent thought they were “somewhat” effective. But, 79 percent of patients said their doctor helped to minimize their pain or discomfort, according to the Consumer Reportsblog. The gap might be explained by doctors thinking of their overall effectiveness with all of their patients, including those with chronic pain conditions that are difficult to diagnose and treat, and who are as a group less satisfied with their physicians. Read more »
*This blog post was originally published at ACP Internist*
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