Pre-Existing Conditions: End the Game, Health Coverage for All Now April 22, 2009
Posted by Obi Jo in health insurance reform, pre existing conditions.Tags: underinsured, health insurance, health reform, pre existing conditions, health Insurance exclusions, health, Insurance, health care reform, health insurance access, health insurance reform, insurance access, Congress, healthcare, personal health responsibility, personal health mandates, uninsured, previous illnesses, health plans, patient care, medical care access, insurance benefits, President of the United States, cancer, portability
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The article referenced below says it all. First, the employee based system is outmoded and dates from a post-WWII reality that no longer exists. Persons change jobs and lose jobs. It happens every day. Additionally, employers should not be burdened with the need to deal with health insurance at all, in any form and at any level. It really is not their business (pardon the pun). It is an individual responsibility and should be an individual mandate as a responsible American citizen (see item 1 under “the plan” on this site).
Second, if you refer to “the plan” on this site, you will see under item 10 that pre-existing conditions, or current illness should in no way effect a persons ability to buy health insurance in the private market, or access alternative programs if they cannot afford private coverage (i.e. Medicare or Medicaid).
In summary, this situation should not exist in these United States of America. The solutions to this problem, as we have said over and over again, do not require a major legislative initiative or some bureaucratically created new agency, they require common sense and the willingness to act. Is our President listening? If we can bail out banks, insurance companies and auto companies with executive action, it is time to “bail out” all Americans when it comes to health care coverage and health insurance. Real Health Reform begins here . . . obi jo
With Son in Remission, Family Looks for Coverage
HUMBLE, Tex. — When Danna Walker left the second-floor conference room and returned tearily to her desk — where someone had already deposited a packing box for her belongings — her first thought was not of the 14 years she had worked for DHL or the loss of her $37,000-a-year salary.
It was of Jake. In three months, once her benefits ran out, how in the world would she provide health insurance for Jake, her mountainous, red-headed 21-year-old son, who had learned three years earlier that he had metastatic testicular cancer?
With Son in Remission, Family Looks for Coverage – http://www.nytimes.com/2009/04/21/us/21uninsured.html?scp=1&sq=With%20Son%20in%20Remission,%20Family%20Looks%20for%20Coverage&st=cse
(1) All persons must have health insurance from the private sector or government sponsored plans. – http://realhealthreform.wordpress.com/the-plan/details-on-the-plan/
(10) . . . pre-coverage physicals, pre-existing condition exemptions and the like will no longer be necessary – the premium is set and if I can afford it I buy it. I cannot be denied coverage for non-financial reasons. Companies will have to compete on efficiency of their systems and overall quality of their services - http://realhealthreform.wordpress.com/the-plan/details-on-the-plan/
www.blogburst.com
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Prescribed Informed Therapy April 21, 2009
Posted by Obi Jo in E Health.Tags: consumers, custom medical content, direct to consumer, E Health, EMR, health information, health information technology, information therapy, informed therapy, internet, medical records, news, outcomes, patient behavior, patient care, patients, personal health responsibility, PHR, physician behavior, physician prescribed information, reviewed medical content, updated medical content, web
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Many claim to have coined the term “information therapy”. The fact is that information “therapy” has been practiced by providers for decades, without their really knowing it. When each of us visits our doctors, we receive information – even if we don’t remember 90% of what we are told. Historically, physicians provided verbal information to patients and families about diagnosis, condition and treatments. They would usually supplement that with drawings, pictures or other visual aids. Over time those became more sophisticated, along with printing techniques. Patients now receive handouts, folders, brochures, booklets, pamphlets, even books about their medical problems. In the modern age, we have moved to videos, CDs and DVDs as well.
The advent of the web and broad internet access has allowed all to research medical information at will via their home computer links and networks. The positive news is that medical information is generally considered to be the most commonly searched for data according to most browsers (second only to adult content). However, with the demographics of the population favoring older individuals (75 million + baby boomers turn 50 between 1996-2014) the medical topics are likely to win out over time (and hormones!). Many sites have catered to the public demand for information by allowing open access (direct to consumer) models. To be sure some are quite good and well referenced with medical advisors and the like. Others are unilateral visions, which may or may not be balanced. Many are simply reproduced basics with little insight for active seekers of medical information.
Among a number of newer available options, one of the more notable advances has been the use of “informed therapy” as championed by NorthPoint Domain (a division of IC Sciences). This Boston based company focuses on custom content, highly researched and documented, updated frequently by panels of medical experts supplemened with illustrations, charts, renderings and other media. They differ in approach from the direct to consumer brands by using a subscription model available only to physicians, clinics, hospitals, health plans, insurers, medical schools, medical systems and medical centers. The concept is that internet based information that in prescribed by the patient’s own doctor or provider, is more likely to be accessed, to be read, and to be understood. It is also likely to limit random internet searching resulting in much mis-information and thus worry and concern for patients as well as time consuming “re-education” for providers, that is often required on follow up visits.
Regardless of approach, patients are looking to better understand their medical conditions and the internet provides the best overall mechanism to accomplish that goal. However, directed or prescribed informed therapy would seem to offer a better option, more in keeping with the traditional ergonomics of the physician/patient relationship. Time will tell how this will play out in the market, but regardless, we will all be online checking out medical information for ourselves and loved ones . . . jomaxx
Physicians turning to information therapy to increase patient wellness.
Large managed-care groups like Kaiser Permanente and Group Health Cooperative are increasingly using electronic medical-record systems to help solve the age-old problem of getting patients to take better care of themselves. The trend is called “information therapy,” and it involves delivering reliable health information directly to patients to help them manage their conditions and make treatment choices. Health plans also are offering online self-management programs and virtual coaching sessions for a wide range of health issues. As doctors worry over the reliability of online data, a growing number of practitioners are pushing information therapy. And doctors without electronic systems are steering patients to medical Websites vetted by experts with the latest guidelines for a wide range of medical conditions and diseases. Many Kaiser Permanente members are using the “My Health Manager secure Website, which gives patients access to interactive Web tools to help them manage chronic conditions.
Online Records Get Patients Involved in Care – http://online.wsj.com/article/SB123733342732563543.html
Informed Clinical Sciences Corporation is a worldwide designer and developer of medical informatics instruments (MIIs) and systems for delivering electronic medical care – http://www.icsciences.com
NorthPoint Domain, Inc provides medical information services and Informed Care technology products designed to address health literacy concerns and deliver patient care oversight for the specialty specific practice – http://www.northpointdomain.com
Informed Medical Decisions – http://www.informedmedicaldecisions.org/
EMR (EHR) and HIPPA – http://www.emrandhipaa.com/emr-and-hipaa/2009/03/25/information-therapy-and-phr/
‘Information Therapy’ As Important As Other Medical Treatments Reveals Conference – http://www.medicalnewstoday.com/articles/38591.php
www.blogburst.com
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“Can Healthcare Reform Finally Happen?” April 19, 2009
Posted by Obi Jo in health reform.Tags: affordable health insurance, E Health, electronic medical records, EMR, health, health care, health insurance, health insurance reform, health reform, HIT, Hospitals, individual mandate, insurance access, mandated health coverage, Medicaid, medical care, medical system, Medicare, payment, personal health responsibility, PHR, physician behavior, physician payment, Physicians, underinsured, uninsured
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If you missed this, look for a replay on your local stations. One of the most even handed, open debates about health care reform we have seen. Highly recommend viewing for all interested in Real Health Reform, can serve as a great template for discussion and raised many of the issues we have been championing . . . obi jo
Monday, March 30, 2009
“Can Healthcare Reform Finally Happen?” featuring Tom Daschle, former U.S. Senate majority leader and Michael Leavitt, former U.S. secretary of Health and Human Services; moderated by Judy Woodruff, Emmy Award winning senior correspondent for PBS NewsHour with Jim Lehrer.
Panetta Institute web site link – http://www.panettainstitute.org/lecture_series/lecture_series.htm
http://www.pbs.org/newshour/aboutus/bio_woodruff.html
http://bioguide.congress.gov/scripts/biodisplay.pl?index=D000064
http://www.sourcewatch.org/index.php?title=Mike_Leavitt
www.blogburst.com
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AMA Supports President’s 8 Principles for Health Reform April 17, 2009
Posted by Obi Jo in health insurance, health reform.Tags: AMA, American College of Surgeons, American Medical Association, choice, CMS, Congress, financing, health care reform, health information technology, health insurance, health insurance access, health insurance reform, health plans, health reform, insurance benefits, Medicaid, medical care access, Medicare, outcomes, patient care, patients, personal health responsibility, PHR, Physicians, population health, portability, President, President of the United States, underinsured, uninsured, universal healthcare
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The AMA has in recent years been very supportive of health system reform. This recent letter of support for the President’s 8 principles is but the latest in their active participation. This site would urge all involved to continue this work but to keep an open mind about options. It is true that the employer based system has evolved as somewhat of an anomaly based on social and political realities which followed WWII. In many ways it has worked well. The worst aspect of it, however, has been to remove from individuals a sense of personal responsibility to make sure that they and their loved ones have medical access (i.e. health insurance or other medical financial coverage). This, in large part, is the reason why so many Americans who have access and insurance coverage seem distanced from the economics of the system. In recent years, the rise in levels of deductibles and co-pays has raised awareness among many that they do have to play a role in overseeing their use of medical resources. In terms of the President’s 8 principles and the AMA’s support of them this site offers the following thoughts:
(1) The surest manner to protect family financial health, in terms of ruinous medical bills, is to make sure that all have access to care via appropriate coverage
(2) The only way to make health coverage affordable is to implement reforms in the manner by which health insurance finances are overseen.
(3) Universality is a goal, not an end point. Nothing in a free society can truly ever be universal in application, only universal in opportunity or access. The best we can do is make sure that all citizens have options by which they can access coverage and care.
(4) Portability in coverage is only of concern if the employer based system remains the norm. In that context, we of course would agree with that. However, if health insurance were a personal responsibility, portability would be a given and not require legislation.
(5) Choice is the key word. The concern of a having a general access government program is that it would likely, over time, crowd out market based competitors. The best role for government is oversight of private carriers while continuing to maintain various successful funded programs (Medicare, Medicaid, SCHIP, VA etc.)
(6) Prevention and wellness are laudable goals for the medical system. However, once again, personal responsibility must come into play. We see the extensive evidence regarding the dangers of smoking, alcohol, drug use, obesity, diet, lifestyle choices and leading a sedentary existence. In almost all of these cases, the system can only advise, encourage and educate. The health care system cannot mandate or enforce personal choices or behavior.
(7) Improving quality of care and safety are never ending goals of all health care providers and systems. E-health initiatives can go along way to achieving this goal. We have commented repeatedly on our enthusiasm for these programs (PHR, EHR, etc.) and have as well raised concerns over various items which will need to be addressed if implementation is to be widespread and rapid.
(8) Fiscal sustainability is perhaps the most difficult item to address. The system must be fluid enough to absorb changes in demographics as well as medical science. Thus, the baby boomers will place a strain on the system, just as changing demographics in the inner city, illegal immigration and other social forces have placed strains on the system. Rapid changes in medical science have occurred and will continue to occur at an ever increasing pace. The system must be able to integrate those changes while rewarding the investment, creativity and insight that brings about those advances, yet balancing the financial ability of beneficiaries to access those advances.
We would direct you to our post under “the plan” – http://realhealthreform.wordpress.com/the-plan/details-on-the-plan
These and many other complex items will need to be addressed to achieve the goal of Real Health Reform . . . jomaxx
AMA Supports Obama’s Principles for Health Care Reform and Outlines Framework for Action
April 15, 2009
This week, the American Medical Association sent a letter (PDF) to President Barack Obama offering physicians’ support for the administration’s eight principles for health care reform and outlining the association’s framework for action.
“The ongoing emphasis on health care from the White House signals that the administration is seizing this historic opportunity to improve the system,” said AMA President Nancy Nielsen, MD. “The American Medical Association is committed to health care reform that improves access to high-quality, affordable health care for all patients. Expanding access to care for all Americans will ensure that people can get the preventive care they need, which will keep them healthy and keep the nation’s long-term health care costs down.”
In the letter, the AMA highlighted the importance of building on the current employer-based system to promote individual choice and ownership of health insurance, the impact that liability pressure has on health care costs, and the need to remove antitrust barriers to quality improvement efforts. The AMA also voiced its support for health information technology, for efforts to improve the value the nation gets from its health care spending, and for greater care coordination.
The administration’s eight principles are: (1) protecting families’ financial health, (2) making health coverage affordable, (3) aiming for universality, (4) providing portable coverage, (5) guaranteeing choice, (6) investing in prevention and wellness, (7) improving patient safety and quality, and (8) maintaining long-term fiscal sustainability.
“We look forward to continuing our work with the administration and Congress to develop health care reform policies within the President’s eight principles,” said Dr. Nielsen.
http://www.ama-assn.org/ama1/pub/upload/mm/399/hsr-principles-letter.pdf
http://www.condron.us
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HIT Adoption, Implementation, Control – Caution Ahead April 15, 2009
Posted by Obi Jo in E Health, EHR (electronic health records), health reform.Tags: certified EHR, CMS, comparative effectiveness, Congress, E Health, efficacy, EMR, health care reform, health information technology, health reform, Hospitals, meaningful use, Medicaid, Medicare, Nationwide Health Information Network, NHIN, outcomes, patient care, patients, personal health responsibility, PHR, physician behavior, physician payment, Physicians, population health, quality
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A recent article published in the New England Journal of Medicine by Dr. David Blumenthal, newly appointed National Coordinator for Health Information Technology, has raised quite a stir. It clearly outlines the real intent of the major funding initiative placed in the new budget for health care, in particular for implementation of a “wired” health information system. This site has consistently applauded efforts to assist in the adoption and implementation of e-health systems to make better use of information. Many of the initiatives, time lines and incentives are outlined in the brief excerpt below (but in much greater detail in the article). There is much to commend, but equally much to raise major concern.
- The continued lack of basic uniformity in what data is really needed for effective care remains a major hurdle. These guidelines must be codified and continuously updated.
- The major cost associated with implementation of these systems nationwide. The current proposed incentives are below market costs and therefore unlikely to spur extended adoption.
- Who will determine what is what is a “certified EMR”? How will that determination be applied across the many specialities within the medical profession?
- Who will control use of the data and information within the system? If they are covered by HIPPA regulations, does that still mean the government may “mine” the data, not only for public health purposes, but for provider, or even patient profiling?
- Most worrisome of all, who will determine what is “meaningful use”? It would seem that the getting to the true intent of this final area is most troubling. If “meaningful use” is interpreted as adoption, implementation and integration within the system that will be one thing. If on the other hand, it is “double speak” for oversight of medical options, patient choices, medical opinions, medical decisions and medical judgments, then that is quite another thing.
- Perhaps the most chilling comment buried in Dr. Blumenthal musing is as follow: “That means taking advantage of embedded clinical decision supports that help physicians take better care of their patients.“ In other words, providers beware, you may well need to follow the embedded prompts and suggestions which will be built into the system or your profile may indicate that you are not providing quality care. This one comment sums up all the fears of seasoned physicians and surgeons. That medical training, experience and judgment will have to be surrendered to health policy determinations about what is and what is not appropriate care. The unprecedented amount of data collection that this project entails, could, if unchecked, potentially allow the federal government to use that data to mandate tests and treatments. Perhaps not directly, but by coercion via the monitoring and payment system. The resultant control will be the same.
- This fear needs to be addressed on the front end, not as an afterthought, if adoption of e-health systems is to become robust and fulfill it’s true potential for improvements in the health delivery system . . . obi jo
Stimulating the Adoption of Health Information TechnologyThe HIT components of the stimulus package — collectively labeled HITECH in the law — reflect a shared conviction among the fledgling Obama administration, the Congress, and many health care experts that electronic information systems are essential to improving the health and health care of Americans. However, proponents of HIT expansion face substantial problems. Few U.S. doctors or hospitals — perhaps 17% and 10%, respectively — have even basic EHRs, and there are significant barriers to their adoption and use: their substantial cost, the perceived lack of financial return from investing in them, the technical and logistic challenges involved in installing, maintaining, and updating them, and consumers’ and physicians’ concerns about the privacy and security of electronic health information. HITECH addresses these obstacles head on, but huge challenges await efforts to implement the law and fulfill President Barack Obama’s promise that every American will have the benefit of an EHR by 2014.
Still, major hurdles remain. The infrastructure to support HIT adoption should be in place well before 2011 if physicians and hospitals are to be prepared to benefit from the most generous Medicare and Medicaid bonuses. Meeting this deadline will be challenging. It takes time to develop and implement innovative federal programs, and it will take even more time to create the local institutions needed to support HIT implementation.
Second, much will depend on the federal government’s skill in defining two critical terms: “certified EHR” and “meaningful use.” That means taking advantage of embedded clinical decision supports that help physicians take better care of their patients.
N Engl J Med. 2009;360(15):1477–1479
GE Healthcare – http://www.gehealthcare.com/usen/about/commitment.html
Macy Foundation – http://www.macysinc.com/community/applicationprocess.aspx
HHS/HIT Home – http://www.hhs.gov/healthit
FOJP Service Corp – http://fojp.com/default.html
Partner’s Healthcare – http://www.partners.org
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Timely filing of health claims = health insurers rip off of providers and patients April 13, 2009
Posted by Obi Jo in health reform.Tags: CMS, Congress, exclusions, health, health care reform, health insurance, health Insurance exclusions, health insurance reform, health plans, health policy, health reform, healthcare, hospital billing, Hospitals, insurance benefits, insurance commissioners, insurance fraud, Medicaid, Medicare, patients, physician billing, physician payment, physician payments, Physicians, President of the United States, timely filing, underinsured
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Why is it that a service provided can be denied payment simply because the bill is late? This seems to not hold true for the IRS, most vendors, suppliers, providers of other goods and services. However, when it comes to medical providers, most often hospitals and physicians (as well as other health care providers) health insurers have been allowed, with the blessing of state insurance commissioners, to create arbitrary and capricious time lines for the filing of claims for payment. If the claim is not filed within this time frame, no matter its size or validity, it will simply not be paid, even though the service WAS provided. Anybody think this sounds a bit lame? Just another way for health insurance to avoid payment of claims? This site does. One of the key tenets of REAL HEALTH REFORM must be health insurance reform – it must lead the way. Timely filing rules, if they are to exist at all (and we would strongly argue they should not) should be relaxed and uniform to allow health providers and patients to deal with the insurance maze they often face. Medicare, Tricare (military) and Medicaid are among the most fair in this regard (usually with one year filing deadlines; and retroactive enrollment policies in the case of Medicaid). Certainly this “scam” needs to be put in its place. It is doubtful that 50 state insurance commissioners, all with political interests being brought to bear on them, could effectively resolve this. Timely filing needs to be derailed as a means to deny payment for just claims . . . timely filing reform needs to be part of health reform . . . and most ideally, it should be eliminated as a cause for non-payment all together . . . obi jo
Health insurers and plans are always finding ways to invent not paying a claim. One of the most popular claim denials is denying a claim that is “untimely”. Most health plans have a defined time period on which to submit a health insurance claim and if the claim arrives beyond this date, the claim is denied. A claim appeal is used to override this very common denial. However, the time frame may and usually does vary among carriers (60 days to as much as 365 days).
http://www.healthsymphony.com/index.htm
Physicians are online … a trend that cannot be stopped April 12, 2009
Posted by Obi Jo in E Health.Tags: CMS, Congress, E Health, EMR, health, health care reform, health information technology, health reform, healthcare, internet, medical care access, medical education, medical research, mobile, online health care, outcomes, patient care, patients, personal health mandates, personal health responsibility, physician behavior, physician education, Physicians, President of the United States, web, web based health records
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Physicians are now using the web more than ever in the daily routine of their practices. They check information, drug interactions, updated information on medical research as well as use a variety of e-tools to interact with patients. EHR (electronic health records) are the most talked about, but still the least evident of the daily uses of the internet by providers. E-prescribing, e-mail messaging, online consultation, informed medical therapy, physician directed medical information, online access to CME (continuing medical education) are but a short list of the ever expanding activities now commonly in use. This site has posited on the entire e-health initiative before. The genie is now well out of the bottle. There is no turning back. E-health is here to stay and as younger physicians enter the workforce, the use of the web and its various resources will be as second nature to them as video games are today to children. There are a number of web sources and enterprises, far too numerous to name here, which are attacking problems from different directions. Epocrates, which is the core subject of the comments below has been a well received leader in hand held applications for physicians and surgeons. Others include back office providers such as Athena Health, tailored physician prescribed information for patients via NorthPoint Domain (part of IC Sciences), general online information from a wide array of providers (such as WebMD). Additionally, almost all recognized professional medical societies and journals now have major online presences which allow for interaction, data sharing and updates for and among society members. Despite the many alarms raised regarding the overall state of health care in America, this site believes that market driven innovation is leading the way to change, far more quickly than any that would be driven by legislation . . . jomaxx
Making technology a part of the consultation
A January 2009 survey from Epocrates reports of US physicians surveyed that 58% go online for information at least twice a day; 75% claimed they searched online for information more often now than a year ago and 85% go online during or between patient consultations
In a previous survey in late 2008 findings showed that technology is becoming more prevalent in clinical practices, with 97% respondents reporting computer access at their practice or institution, and more than 50% working at a wireless facility. 75% of physicians report going online more today than a year ago. More than 70% go online for clinical information at least once a day, of which nearly 20% report using web-based resources five or more times per day.
Today’s doctors are using technology to check drug dosing, side effects, interactions or treatment guidelines during patient visits. Nearly 50 percent of physicians report they most frequently use the Internet during patient consultations, rather than between patient visits or after hours. Enhancing patient visits – Nearly 90 percent of physicians strongly agreed or agreed that accessing clinical information online improves patient satisfaction and communication. Specifically, physicians reported the use of an online resource helped:
- increase medication compliance
- decrease pharmacy callbacks
- patients appear more at ease
- some patients disclose information physicians would have not otherwise known
Epocrates Survey Identifies Trends in Online Resource Use Among Physicians – read @ http://www.prweb.com/releases/2008/11/prweb1607974.htm
Press releases for Epocrates – read @ http://www.newspad.com/all?q=epocrates&hitsPerPage=20
Informed Clinical Sciences Corporation is a worldwide designer and developer of medical informatics instruments (MIIs) and systems for delivering electronic medical care – read @ http://www.icsciences.com/index.cfm
Patient literacy options with physician prescribed and tailored medical information – read @ http://www.northpointdomain.com/
Physician practice solutions – read @ http://www.athenahealth.com/index.php
General medical information – read @ http://www.webmd.com/
Ed Freeman, a hero passes April 12, 2009
Posted by Obi Jo in patient care.Tags: Army, Congress, helicopters, heros, Medal of Honor, medicine, medivac, President of the United States, soldiers, US Army, veterans, Vietnam, wounded
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Sometimes, topics in medicine take on many forms. In this case, the form of a fearless Vietnam Army helicopter pilot who just “kept coming back”. Coming back for wounded soldiers. Coming back time and again. Coming back so that medical providers, doctors, surgeons, nurses and the entire medical team, might have a chance to save the lives of American soldiers wounded fighting for their country. Ed Freeman, Medal of Honor winner, has passed away. We are better for having him serve, and lesser for his passing. Real heroes just “keep coming back”, they do not quit, leave or fade away. Even when change is forced upon them, they find a way to serve. That is a goal we can all aspire to . . . obi jo
Read full content @ http://www.snopes.com/politics/military/freeman.asp
Medal of Honor winner Ed Freeman, USA
Comparative Effectiveness is really about the money April 7, 2009
Posted by Obi Jo in health reform.Tags: affordable health insurance, after care, baby boomers, CMS, comparative effectiveness, Congress, diagnosis, health, health care reform, health insurance, health insurance access, health insurance reform, health rationing, healthcare, hospice, Hospitals, Medicaid, medical care access, Medicare, nursing care, nursing homes, outcomes, patient care, personal health responsibility, President of the United States, rationing, rehabilitation, therapeutics, therapy
2 comments
Comparative effectiveness is what medicine has been doing since its modern inception some 2,500+ years ago. In the last century, the health care industry has spent billions researching drugs and devices for efficacy. Medical and surgical societies have endless symposiums on new methodologies of treatment and comparisons of those with older more well known modalities. So what is this really all about. Dr Kevin Pho, in his op-ed piece in USA Today clearly starts off showing that he is apparently lost in the therapeutic woods. To say that doctors “rarely” know the best treatments is not only disingenuous and misleading, but also truly incorrect. The vast majority of physicians and sugeons have a great deal of knowledge from various sources as well as accumulated experience upon which to draw to determine the best treatments for their patients. It is true, that some complex diseases do not have clear cut, single therapy solutions. That is only because we are yet to find them. Look at the history of polio treatment in the 20th century. Prior to the late 1950’s there was essentially a polio treatment industry with devices, therapies, rehabilitation programs and the like being offered and promotoed globally. Enter polio vaccine and the rest is history (along with iron lungs etc). Research for better treatments yields better treatments. The medical establishment is remarkably quick to adopt new therapies when they in fact work. To be sure, there are cases where delays have occurred, but for the most part, a new, successful treatment cannot be kept at bay for long.
So what is all this really about? Money. When baby boomers needed new schools and universities in the 1950’s, 1960’s and 1970’s they were built. Local, state and federal dollars were expended. But now that this generation is “coming of age” in an era when they will need more health care, extended care, rehabilitation, nursing care, after care and hospice care we suddenly have a health care crisis on what treatments are really effective. Make no mistake, forces are at work to ration care, limit options for seniors and reduce expenditures. After all the cheapest care is no care and the best financial outcome for any health care payer (be in private or the government) is the beneficiaries death – a final event which terminates all costs to the “system”. Sound cynical? Perhaps, but dealings with both the health insurance industry and federal payers has led this site to believe the worst. Indeed, some very responsible voices have raised these vary concerns (see references below). In the end, comparing treatments is nothing new. It is hard to believe than any federal bureaucracy with the hidden agenda of controlling costs will do a better job than the tens of thousands of dedicated individuals who work in the overall health care system daily. I would place more faith in their cumulative wisdom than any federal initiative . . . obi jo
Unbiased research for doctors is good medicine
Because doctors rarely are sure which treatments work best, they often prescribe the most aggressive therapy, or the newest drug or medical device, which likely will also be the most expensive.
The Obama administration is hoping the $1.1 billion for “comparative effectiveness research” in the recently approved economic stimulus package will help provide doctors data to make more informed decisions. Studies that compare drugs, medical devices and procedures should help determine what treatments benefit patients the most while cutting costs.
Unbiased research for doctors is good medicine - read @ http://blogs.usatoday.com/oped/2009/03/unbiased-resear.html
Cato paper: Comparative-effectiveness research is crucial – Cato Institute; Washington – reads @ http://blogs.usatoday.com/oped/2009/04/cato-paper-comparative-effectiveness-research-is-crucial.html
Cost-Effectiveness Information: Yes, It’s Important, but Keep It Separate, Please! - read @ http://www.annals.org/cgi/content/full/148/12/967
U.S. to Launch Comparative Effectiveness Research with Stimulus - read @ http://aidemocracy.wordpress.com/2009/02/16/us-to-launch-comparative-effectiveness-research-with-stimulus/
The Other $700 Billion Question Can behavioral economics bail out the problems with healthcare spending? – read @ http://gmj.gallup.com/content/111778/Other-700-Billion-Question.aspx
U.S. to Compare Medical Treatments – read @ http://www.nytimes.com/2009/02/16/health/policy/16health.html
A Better Way to Generate and Use Comparative-Effectiveness Research – read @ http://www.cato.org/pub_display.php?pub_id=9940
Medical Research Provision Provokes Fiery Debate: Will Care Be Rationed? – read @ http://bulletin.aarp.org/yourhealth/policy/articles/medical_research_provision.html
Health IT adoption and implementation, steady as she goes . . . April 6, 2009
Posted by Obi Jo in E Health, EHR (electronic health records).Tags: access, CMS, Congress, E Health, EMR, health, health care reform, health information technology, health reform, healthcare, HIT, medical care access, online consultation, online health care, patient care, patient health record, patients, personal health responsibility, PHR, Physicians
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Despite the slow adoption, this site fully agrees that it is inevitable that online medicine, in all forms, is going to bloom over the next decade. There are simply too many factors at play to keep he use of health IT at bay for much longer. Cost issues are one, but the costs associated with failure of adoption far outweigh the costs of implementation. Along with the fundamental technical issues of implementation and adoption, an array of professional, social and privacy issues must be addressed. For example, the current licensing system for physicians needs amending so that physicians can “practice” medicine freely on the web, across state lines. This may include some form of national licensing or at least some form of national reciprocity between all state licensing boards. Additionally, there needs to be more direct linkage between patients and providers via the internet since many, many times, the real need of patients is for communication and information, not necessarily face to face encounters. This will entail some form of e-commerce solution (all of which have already been fully worked out in the retail sector of the economy) as well as insurance coverage at some level. Health IT’s time is now. We are ready to contribute with REAL solutions for continued REAL HEALTH REFORM . . . obj jo and jomaxx
Small percentage of Americans have personal health records.
Although online personal health records — controlled by patients themselves…have been available for years, only a small percentage of Americans have them today. One reason for the low rate of adoption is that typing one’s personal health information into an online form is time-consuming, mind-numbing, and error-prone. In an effort to overcome that challenge, Microsoft and Google have announced partnerships in recent months with large healthcare providers…to explore transferring patient data automatically into personal health records. In addition, the Obama administration plans to spend $19 billion over the next few years to accelerate the adoption of electronic health records in doctors’ offices and hospitals. Experts note that personal health records…hold considerable promise, but much depends on how complete the information is in them.
Healthcare IT seen as making progress toward mainstream implementation.
There are innovators, intriguing experiments and lots of interest, yet healthcare IT has not gone mainstream. Still, the direction is clear, and only the pace of the shift is in question. The Obama administration’s plan to spend $19 billion to hasten the adoption of electronic health records will give “more impetus to the shift toward Internet-style computing. And there is plenty of evidence of the emerging transition being demonstrated and announced this week at the health information technology’s big annual conference and trade show in Chicago, sponsored by the Healthcare Information and Management Systems Society (HIMSS). Some examples that progress is commencing, including a joint project, announced on Sunday, between the CDC and GE Healthcare to deliver individually tailored public health alerts to electronic health records in doctors’ offices and a Mayo Clinic and IBM collaboration on a website for searching records and data stores of all kinds in medicine.
A Hospital Is Offering Digital Records – read @ http://www.nytimes.com/2009/04/06/technology/companies/06health.html?_r=2&ref=health
Health Care Industry Moves Slowly Onto the Internet – read @ http://bits.blogs.nytimes.com/2009/04/05/health-care-industry-moves-slowly-onto-the-internet/
Healthcare Information and Management Systems Society (HIMSS) – read @ http://www.himss.org/ASP/index.asp
