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UnitedHealth Group Releases A Somewhat Inadequate Report On Modernizing Rural Health Care

The UnitedHealth Center for Health Reform and Modernization released a white paper today on Modernizing Rural Health Care.  To quote from the UHG presser,

  • [The paper] projects an increase of around 5 million newly insured rural residents by 2019 – even as the number of physicians in rural America lags
  • Quality of care is rated lower in rural areas in 7 out of every 10 health care markets; both physicians and consumers in rural areas more likely to rate quality of care lower than those in urban and suburban markets
  • Innovations in care delivery – particularly telemedicine and telehealth – can absorb future strain on rural health care systems

The paper inventories the current state of health care for the 50 million Americans living in a rural setting — and it’s not pretty.  The question, of course, is why does rural health compare unfavorably to urban health metrics, and what can be done to improve matters? Read more »

*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*

Medical Apps Allow Doctors To Monitor ICU Patients Remotely

We have reported in the past on AirStrip, a smartphone and iPad app that allows a mobile doctor to monitor the vital signs of patients in an obstetric ward or an ICU. The reverse, where a fixed doctor monitors multiple remote patients is now entering the mainstream and already making a difference in many patients’ lives.

In a compelling anecdote recently reported in Computerworld, a man experienced cardiac arrest while shopping and was taken to a nearby community hospital. An intensivist, monitoring from an eICU miles away, was immediately consulted. The remote doctor guided the treating physicians as they initiated unfamiliar hypothermia therapy to preserve the brain, and continued to follow the patient remotely throughout his 10 day ICU stay.  Happily, the patient had a good outcome and is quoted in the article as an enthusiastic proponent of eICUs. Read more »

*This blog post was originally published at iMedicalApps*

AHRQ: Healthcare Access And Racial Disparities Not Improving

According to American Medical News, the U.S. health system is demonstrating better performance on most measures of health care quality, but it’s failing to improve access to care or cut racial and ethnic health disparities, according to two reports released in February by the Agency for Healthcare Research and Quality.  “Quality of care continues to improve, but at a slow rate,” said Ernest Moy, MD, leader of the team at AHRQ that produced the reports.  ”In contrast to that, focusing on issues of access to care, not much has changed.  Focusing on disparities in care, not much changed…Those are bigger problem areas than overall quality of care.”  Measures related to hospital quality are showing the most improvement.  For example, in 2005, just 42% of patients with heart attacks received angioplasties within the recommended 90 minutes of arriving at the hospital.  That figure improved to 81% by 2008.

While the quality improvement indicators are encouraging, the disappointing access and disparities numbers are not very surprising.

The US health care system is still largely focused on acute hospital based care.  It says we are doing better at what we are doing. Read more »

*This blog post was originally published at CFAH PPF Blog*

The Power Of Comprehensive Healthcare

Today, in a bold and not too distant place, 300 individuals who are at high risk for multiple health problems predictive of high mortality rates, are participating in a visionary experimental project for telemedicine and health monitoring.

Every day these individuals are tracked through GPS location. Their movement patterns and whereabouts easily can be observed by trained technicians who ascertain that the individuals are getting up and going about their daily activities in a normal fashion. Deviations in movements for any expected individual can be the earliest indicator that something has gone seriously wrong and might warrant an investigatory call or visit to look into a developing heath problem.
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Diagnosis And Care: Just A Phone Call Away

In my medical practice, I have a simple yet revolutionary idea: I get paid to answer the phone. Every one of my 3,000+ patients has my cell phone and email address so that they can reach me the instant they need help, which is no different than any of my friends or family who may be trying to reach me. Our practice motto: “Talk to your doctor anytime, anyway, anywhere.”

It’s not that I’m trying to not see you, or want to be impersonal or to practice risky healthcare. In fact, each of these common assumptions is pointedly wrong. By answering my phone, I can know my diagnosis and treatment worked (or not), or I can help someone avoid an ER visit or unnecessary office visit. My patients call me when they’re traveling, or at work, or from their car, at night and on weekends. There’ve been occasions that I need to see a patient NOW and I’ve come to the office a 2AM to keep someone out of an ER. No matter what, by picking up the phone to talk to my patients, I’m the first person in the healthcare system to know something is wrong, not the last.

Although good examples supporting the power of a doctor answering a phone occur daily, I have one I want to share with you. Read more »

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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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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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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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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