October 27th, 2009 by Berci in News
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Have you ever wondered what happens if there is a serious situation and you need an automated external defibrillator? According to Wikipedia:
An automated external defibrillator or AED is a portable electronic device that automatically diagnoses the potentially life threatening cardiac arrhythmias of ventricular fibrillation and ventricular tachycardia in a patient, and is able to treat them through defibrillation, the application of electrical therapy which stops the arrhythmia, allowing the heart to reestablish an effective rhythm.
Now Lucien Engelen from the Radboud University Nijmegen Medical Centre, The Netherlands launched a great project, AED4EU. Users can add places where AEDs are located and this database can be accessed through a new application, AED4EU on your mobile phone. Read more »
*This blog post was originally published at ScienceRoll*
October 12th, 2009 by DrWes in Better Health Network, Health Policy, Opinion
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From “War on Specialists” in the Wall Street Journal:
Take a provision in the Baucus bill that would punish any physician whose “resource use” is considered too high. Beginning in 2015, Medicare would rank doctors against their peers based on how much they cost the program—and then automatically cut all payments by 5% to anyone who falls into the 90th percentile or above. In practice, this rule will only apply to specialists. , Read more »
*This blog post was originally published at Dr. Wes*
October 6th, 2009 by GruntDoc in Better Health Network, True Stories
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I sent a guy with a normal EKG to the cath lab. Let me tell you my side of the story.
Dude was minding his own business when he started having crushing, substernal chest pain. I see dude by EMS about 45 minutes into his chest pain. He’s had the usual: aspirin, 3 SL NTG’s an IV, a touch of MS (I can abbreviate here, as it’s not a medical record) and is continuing to have pain.
He describes it like you’d expect (elephants have a bad rep in the ED), and looks ill. Frankly, he looks like a guy having an MI. Sweaty, pale, uncomfortable, restless but not that ‘I’ve torn my aorta’ look. The having an MI look.
Every EM doc knows the look. I didn’t ask about risk factors.
On to the proof: the EKG. EMS EKG: normal. ?What? Yeah, maybe there’s some anterior J-point elevation, but not much else. Our EKG: Normal. Read more »
*This blog post was originally published at GruntDoc*
October 6th, 2009 by DrWes in Better Health Network, Health Policy, News
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I just finished our first day at the Principle Investigator Meeting for the launch of the Catheter Ablation Versus Anti-arrhythmic Drug Therapy for Atrial Fibrillation (CABANA) trial in Philadelphia today. The trial is a 3000-patient patient trial performed at 140 centers around the world and jointly sponsored by the National Heart, Lung, and Blood Institute (NHLBI), a component of the National Institutes of Health (NIH), and industry (St. Jude Medical and Biosense Webster).
The trial will randomize 3000 previously untreated or incompletely treated patients at high risk of cardiovascular complications in the trial to two arms: 1500 patients to catheter ablation as primary therapy of atrial fibrillation and the other 1500 patients to conventional medical therapy with rate control or rhythm control strategies to determine if catheter ablation is superior to medical therapy at reducing total mortality (the primary endpoint). Secondary endpoints of a composite endpoint of mortality, disabling stroke, serious bleeding, or cardiac arrest will also be studied.
If done properly, this study stands to be a landmark trial for the field of cardiac electrophysiology and has huge ramifications for the treatment of patients with atrial fibrillation. Also, it doesn’t take a lot of rocket science to know that the government will be looking closely at the results of this trial to determine which treatment strategy will receive government funding. Read more »
*This blog post was originally published at Dr. Wes*
September 30th, 2009 by DrWes in Better Health Network, Health Policy, Opinion
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It’s the holy grail of physician payment reform: ending fee-for-service payments to doctors and, instead, pay doctors based on the quality of care they perform. Remarkably, Congress feels they’ve found the answer:
Thus, the new language in the Senate Finance bill would finally connect Medicare reimbursements to quality, as opposed to volume.
The measure gives the secretary of Health and Human Services, working with the Centers for Medicare and Medicaid Services, the power to develop quality measurements and a payment structure that would be based on quality of care relative to the cost of care. The secretary would have to account for variables that include geographic variations, demographic characteristics of a region, and the baseline health status of a given provider’s Medicare beneficiaries.
The secretary would also be required to account for special conditions of providers in rural and underserved communities.
Additionally, the quality assessments would be done on a group-practice level, as opposed to a statewide level. Thus, the amendment would reward physicians who deliver quality health care even if they are in a relatively low quality region.
The secretary of Health and Human Services would begin to implement the new payment structure in 2015. By 2017, all physician payments would need to be based on quality.
Wow. That sounds great! But there’s just one problem…
… how do we define “quality?”
Read more »
*This blog post was originally published at Dr. Wes*
