April 10th, 2011 by PeterWehrwein in Health Policy, Health Tips
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Opening Day, the first day of the 2011 major league baseball season, was March 31st. The first pitch was thrown a little after 1 p.m., and sometime after that baseball fans heard the first crack of the bat of a brand-new season.
Even nonfans can rejoice at this sign of spring, and a promise that summer days are ahead.
But you won’t hear the crack of the bat very much these days from other diamonds—Little League, high school, and college. It has been replaced by pings and thunks as most players at those levels now use metal bats or composite ones, which that are made with a mixture of materials, including graphite.
Players started using metal (usually aluminum) bats about 30 years ago. They last longer than wooden bats and send the ball farther. The composite models have come on strong more recently.
But there’s growing concern that nonwood bats may pose a safety hazard to fielders—especially pitchers— because they make a hit baseball go faster. The added speed gives fielders less time to react and, if they are hit, increases their risk of injury. Read more »
*This blog post was originally published at Harvard Health Blog*
April 3rd, 2011 by DavidHarlow in Health Policy, Opinion
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Health care social media continues to be a hot-button issue for hospitals and other provider types around the country. Health care provider organizations considering taking a first step into social media often articulate concerns about regulatory and legal barriers to the use of social media in health care. As regular readers of HealthBlawg know, I believe that an ounce of prevention is worth a pound of cure — in the health care social media arena as elsewhere. Careful planning up front will help you avoid the potential liabilities and pitfalls you may otherwise face in implementing a health care social media program. I invite you to take a look at this quick compendium of rules to live by, which I compiled with Dan Hinmon of Hive Strategies, and follow the link on the last page of the embedded presentation to download an expanded version. Read more »
*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*
July 11th, 2010 by Bryan Vartabedian, M.D. in Better Health Network, Humor, Opinion, True Stories
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They say transparency is king — the more you share the better you look. But I’ve got rules. Here are a few things you won’t find in my Twitter stream:
Beer. I was recently speaking at a meeting out of town and caught up with some friends at the end of the day to visit and have a beer. I was in a different time zone and noted on Twitter the specific microbrew I was enjoying. The following week in my clinic a parent commented on my social activity. While I’m no stranger to transparency, the realization of my visibility was eye-opening. It reminded me that everyone’s watching and 140 characters doesn’t offer enough space to explain the why, or the time zone, of what I’m doing. So I’ve sworn to keep activities like beer consumption out of my twitter stream.
My kids. I try to keep my children out of my social footprint as much as possible. But as most of you who follow me know, they sneak their cute little selves in on occasion. It’s unfortunate because everybody loves hearing about my kids. This is at the request of my wife who’s a booger about privacy. I do mention the occasional date night with my daughter but, by and large, you won’t hear much. Kids are great jumping-off points for personal digression, but we have to be careful about using them to our own advantage. Read more »
*This blog post was originally published at 33 Charts*
February 25th, 2009 by Dr. Val Jones in Health Policy, Opinion
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Pretty much everyone agrees that we need to improve the quality of healthcare delivered to patients. We’ve all heard the frightening statistics from the Institute of Medicine about medical error rates – that as many as 98,000 patients die each year as a result of them – and we also know that the US spends about 33% more than most industrialized country on healthcare, without substantial improvements in outcomes.
However, a large number of quality improvement initiatives rely on additional rules, regulations, and penalties to inspire change (for example, decreasing Medicare payments to hospitals with higher readmission rates, and decreasing provider compensation based on quality indicators). Not only am I skeptical about this stick vs. carrot strategy, but I think it will further demoralize providers, pit key stakeholders against one another, and cause people to spend their energy figuring out how to game the system than do the right thing for patients.
There is a carrot approach that could theoretically result in a $757 billion savings/year that has not been fully explored – and I suggest that we take a look at it before we “release the hounds” on hospitals and providers in an attempt to improve healthcare quality.
I attended the Senate Finance Committee’s hearing on budget options for health care reform on February 25th. One of the potential areas of substantial cost savings identified by the Congressional Budget Office (CBO) is non evidence-based variations in practice patterns. In fact, at the recent Medicare Policy Summit, CBO staff identified this problem as one of the top three causes of rising healthcare costs. Just take a look at this map of variations of healthcare spending to get a feel for the local practice cultures that influence treatment choices and prices for those treatments. There seems to be no organizing principle at all.
Senator Baucus (Chairman of the Senate Finance Committee) appeared genuinely distressed about this situation and was unclear about the best way to incentivize (or penalize) doctors to make their care decisions more uniformly evidence-based. In my opinion, a “top down” approach will likely be received with mistrust and disgruntlement on the part of physicians. What the Senator needs to know is that there is a bottom up approach already in place that could provide a real win-win here.
Some 340 thousand physicians have access to a fully peer-reviewed, regularly updated decision-support tool (called “UpToDate“) online and on their PDAs. This virtual treatment guide has 3900 contributing authors and editors, and 120 million page views per year. The goal of the tool is to make specific recommendations for patient care based on the best available evidence. The content is monetized 100% through subscriptions – meaning there is no industry influence in the guidelines adopted. Science is carefully analyzed by the very top leaders in their respective fields, and care consensuses are reached – and updated as frequently as new evidence requires it.
Not only has this tool developed “cult status” among physicians – but some confess to being addicted to it, unwilling to practice medicine without it at their side for reference purposes. The brand is universally recognized for its quality and clinical excellence and is subscribed to by 88% of academic medical centers.
In addition, a recent study published in the International Journal of Medical Informatics found that there was a “dose response” relationship between use of the decision support tool and quality indicators, meaning that the more pages of the database that were accessed by physicians at participating hospitals, the better the patient outcomes (lower complication rates and better safety compliance), and shorter the lengths of stay.
So, we already have an online, evidence-based treatment support guide that many physicians know and respect. If improved quality measures are our goal, why not incentivize hospitals and providers to use UpToDate more regularly? A public-private partnership like this (where the government subsidizes subscriptions for hospitals, channels comparative clinical effectiveness research findings to UpToDate staff, and perhaps offers Medicare bonuses to hospitals and providers for UpToDate page views) could single handedly ensure that all clinicians are operating out of the same playbook (one that was created by a team of unbiased scientists in reviewing all available research). I believe that this might be the easiest, most palatable way to target the problem of inconsistent practice styles on a national level. And as Senator Baucus has noted – the potential savings associated with having all providers on the same practice “page” is on the order of $757 billion. And that’s real money.
I highly recommend a bottom up approach, not top down. That’s how you win docs and influence patients.
