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We’re Making Fewer Babies: What To “Expect”

Recently I ran into the office manager for one of Houston’s largest pediatric practices. New patient visits are way down and their doctors are looking for ways to keep business rolling. The same day I picked up this piece in the Wall Street Journal which shows declining admissions and doctor visits as a national trend. This is bad news and shows how our faltering economy is finally working its way more visibly into healthcare.

And apparently we’re making fewer babies –- admissions to neonatal intensive care units are down. This is a problem. For large tertiary medical centers and hospitals specializing in maternal-child health, babies are the critical customers of a healthy operation.

A few thoughts on what to look for (or dare I say, what to “expect”) with fewer babies:

Pipelines. Look for tighter referral relationships between large tertiary centers and the smaller community hospitals that deliver babies in need of specialized care. Centers already aligned with ready-made networks should be well-positioned for the downturn. Read more »

*This blog post was originally published at 33 Charts*

Advances In Telemedicine Ease Patient Care

Ralph Terenzio, a patient with the Center for Connected Health, checks his blood pressure using remote monitoring equipment.Monitoring vital signs remotely saves time and money for everyone: patients, physicians, facilities and insurers. Heart failure is a particular target because its increasingly common, its easily triggered (by as little as too much salt on food, for example), it costs so much to manage in the hospital, and it’s so easily avoided.

Remote monitoring equipment made even easier with wireless connections can take vital signs, and even ask standard questions every morning. The equipment puts patients in contact with nurses once they detect warning signs. That human touch is key. Case managers can screen out false alarms (avoiding alert fatigue) and can direct patients to the physician when needed. ACP Internist covered remote monitoring technology in its March issue. (Wall Street Journal, ACP Internist) Read more »

*This blog post was originally published at ACP Internist*

Americans Are Cutting Back On Healthcare

The Wall Street Journal reported that overall medical use fell as patients had fewer doctor office visits, lab testing, and maintenance medications possibly due to the recession or as a result of consumer-driven healthcare in the way of higher deductibles and copays. This is very worrisome.

Certainly patients should have some financial responsibility for their care, but skimping on care will only result in Americans not becoming healthier, but sicker. Though the article cited some examples of patients saving money by not seeing their allergist for a refill of medication and simply calling for one and getting an athletic physical at a local urgent care clinic for $40 rather than $90 at the doctor’s office, these tiny behavior changes aren’t going to bend the cost curve in medical care. Read more »

*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*

Government Decisions About Avandia And Preventive Services

An FDA advisory panel has voted that the diabetes drug Avandia (rosiglitazone) can remain on the market, but recommended further warnings associated with its use. The panel was divided, the New York Times reported, with 12 of 33 members saying the drug should be removed from the market, 10 voting to restrict sales and strengthen the warning label, 7 recommending only strengthening the warning label, and 3 voting for no change. One panel member abstained. (New York Times)

The White House yesterday announced which preventive services would be available at no charge to patients under the new healthcare legislation. Adult patients who choose a health plan after September 23 will receive mammograms, diabetes screening, and tobacco cessation counseling, among other services, at no increased cost, but insurers have said patients will eventually pay in the form of higher premiums, the Wall Street Journal reported. (Wall Street Journal)

*This blog post was originally published at ACP Internist*

“Meaningful Use”: Does What You Do Qualify?

One doesn’t usually look to the Federal Register to define meaning or purpose (philosophers, yes, but bureaucrats?), but the federal government has officially ruled on what constitutes “meaningful use” — for the purposes of distributing dollars to clinicians for electronic health records.

The Wall Street Journal’s health blog has an excellent synopsis of the rule and the reaction from different interest groups and experts, and the New England Journal of Medicine has a very clear explanation and summary of its key elements by David Blumenthal, M.D., F.A.C.P., the federal government’s coordinator of health information technology. Read more »

*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*

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