Increasing Interest in Merging the Specialties of Pathology and Radiology
In October, 2006, I posted a blog note suggesting that pathology should consider merging with radiology. The idea gave a number of people indigestion; one pathology chairman described it to me as a bridge too far (see:Ten Reasons for Merging Pathology/Lab Medicine with Radiology). In the interval of nearly 13 years a number of changes have occurred in the two fields and the idea "may" have gained some cautious supporters -- one of them perhaps may be the bloggerDimitri Merine who posted a note in the JACR Blog in December, 2018, that provided a balanced discussion of the idea (see:Radpathology/P...
Source: Lab Soft News - August 10, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Cost of Healthcare Diagnostics Digital Imaging in Pathology Healthcare Information Technology Healthcare Innovations Lab Industry Trends Lab Processes and Procedures Pathology Informatics Quality of Care Source Type: blogs
CVS's Caremark Expands Its Diabetes Care Program with Analytics and Coaching
Pharmacy benefit managers (PBMs) have been taking a beating in the news recently because attention is being directed to the fact that these companies are making high profits as the"middlemen" for prescription drugs (see:Reality check on PBMs and drug costs). For most patients, PBMs do not deliver any obvious service for them. I couldn't even find a web site for Caremark which is owned by CVS; you have to start at the CVS Health web page. This PBM narrative is changing because CVS knows how to impress healthcare consumers. All of this was derailed in a recent article (see:CVS Uses Analytics t...
Source: Lab Soft News - August 8, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Diagnostics Healthcare Innovations Medical Consumerism Preventive Medicine Test Kits and Home Testing Source Type: blogs
Dr. Alexa Will See You now -- An Extension of Paging Dr. Google
It's very common for healthcare consumers to query Google about the diagnosis and management of health problems. Almost 11 years ago, I blogged about the then increasingly familiar strategy of"paging Dr. Google" for advice (see:Paging Dr. Google! We Are Waiting for a Second Opinion.) We have now evolved to the reality of asking Dr. Alexa, in concert with Dr. Google, to help us solve even more of our medical problems (see:Doctor Alexa will see you now: Is Amazon primed to come to your rescue?). Below is an excerpt from an article on this topic, It's long and informative so link to it if the topic interests...
Source: Lab Soft News - August 7, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Diagnostics Electronic Health Record (EHR) Health Wearable Healthcare Information Technology Healthcare Innovations Medical Consumerism Medical Research Point-of-Care Testing Public Health Quality of Care Test Kits and Home Testing Source Type: blogs
Possible Way to Avoid Some Unnecessary Visits to Emergency Departments
I recently encountered an article that quantifies the resources expended by unnecessary patient visits to emergency departments (EDs) (see:Diverting avoidable emergency department visits could save healthcare $32 billion annually). Many such visits could have achieved the same results and less expensively in a physician's office. Below is an excerpt from the article:Diverting avoidable emergency department visits could save healthcare $32 billion annually. Primary care services rendered by hospital EDs come with substantially higher price tags than in primary care settings. Avoidable visits to emergency departmen...
Source: Lab Soft News - August 5, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Cost of Healthcare Diagnostics Healthcare Information Technology Healthcare Innovations Hospital Financial Medical Consumerism Medical Education Preventive Medicine Public Health Quality of Care Source Type: blogs
Some Hospitals Now Offering Price Estimates; More Transparency for " Shoppable " Services
It has been frequently stated that healthcare needs to be more consumer friendly (see:Making Hospital-Based Labs More Consumer Friendly). This applies partly to the pricing of hospital services. In prior blog notes, I have stated that a bill for an inpatient stay has little bearing on the cost of the services for the hospital (see, for example:Coding for Hospital Services; One Reason for the High Cost of Healthcare;Patients' Out-of-Pocket Healthcare Costs Rising; Expect More Consumer Backlash). A recent article indicated that some hospitals are beginning to offer price estimates to help ameliorate consumer dissatisfact...
Source: Lab Soft News - August 4, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Cost of Healthcare Direct Access Testing (DAT) Healthcare Business Healthcare Information Technology Healthcare Innovations Hospital Financial Radiology Source Type: blogs
Technology Enables the Monitoring of Complex Patients at Home
I have blogged frequently about the decreasing number of inpatient hospital admissions (see, for example:Talking to Patients Helps Reduce Hospital Readmissions; Inpatient Admissions Decreasing; Implications for Hospital-Based Labs). One of the factors contributing to this decline are new healthcare models such as"hospital at home" for the care of sicker patients in their homes (see:Are Hospitals Becoming Obsolete; Consequences for Pathology and the Labs;Reducing the Cost of Care; Provide Home Care for Sicker Patients with Remote Monitoring). The majority of the patients suitable for this care approach are CCC pat...
Source: Lab Soft News - July 31, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Healthcare Delivery Healthcare Information Technology Healthcare Innovations Point-of-Care Testing Public Health Telemedicine Source Type: blogs
Eric Topol Emphasizes Keyboard Liberation: MDs Dictating EHR Notes
In my note of July 24 (see:Dictating EHR Physician Notes Using an Apple Watch with AI Assistance), I discussed how the dictation of physician notes into an Apple Watch enabled by voice recognition, NLP, and AI software could be used to facilitate physician notes entry into the EHR. This software support for physician dictation is necessary because there is no keyboard input available with Apple Watch to make corrections. I just listened to a podcast interview of Eric Topol (see:Eric Topol on making healthcare more human), author of a recent book on digital medicine (see:Eric Topol pens book on artificial intelligence in me...
Source: Lab Soft News - July 29, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Electronic Health Record (EHR) Healthcare Delivery Healthcare Information Technology Healthcare Innovations Hospital Financial Quality of Care Source Type: blogs
Health Systems Underinvest in PCPs; This May Cause Hospital Costs to Rise
I have posted a number of notes relating to the declining number of primary care physicians employed by health systems (see, for example:PCP and Family Physician Wait Times increasing 50% in Many Markets). I believe that this may be due, in part, to the fact that these executives believe that PCPs generate less revenue per capita than specialist physicians (see:Net Revenue Generation for Hospitals on the Basis of Physician Speciality). Such a hiring strategy may be shortsighted given that, as stated in my blog note of July 25, PCPs are responsible for allocating about 90% of total hospital costs (see:PCPs Responsible...
Source: Lab Soft News - July 28, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Cost of Healthcare Healthcare Delivery Healthcare Information Technology Healthcare Innovations Hospital Executive Management Hospital Financial Quality of Care Source Type: blogs
PCPs Responsible for Allocating About 90% of Total Hospital Costs
In a recent blog (see:Defining and Delineating the Changing First Tier of Healthcare), I wrote the following regarding the evolving role of physicians in the first tier of healthcare (i.e. primary care):Physicians work primarily in a supervisory role. The majority of them are, and will be in the foreseeable future, employees of health systems....Direct contact with patients and triaging will be mainly the responsibility of nurses, nurse clinicians, physician assistants, and other health assistants.All of these later personnel will be increasingly guided by diagnostic and predictive algorithms that will allow them to identi...
Source: Lab Soft News - July 25, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Clinical Lab Testing Cost of Healthcare Diagnostics Healthcare Delivery Healthcare Information Technology Healthcare Innovations Hospital Financial Predictive Analytics Public Health Source Type: blogs
Dictating EHR Physician Notes Using an Apple Watch with AI Assistance
One of the challenges posed by EHRs such as Epic is that their user interfaces (UIs) are clunky which is to say awkward and tedious. This is a problem for physicians who must input patient notes by keyboard, turning them into the most highly trained and costly data clerks in healthcare.Austin Regional Clinic has come up with a solution to this problem which was described in a recent article (see:Apple Watches, AI help docs dictate at Austin Regional, saving 2 hours a day). Below is an excerpt from it:Austin Regional had been searching for a solution that could help reduce the [EHR data entry] clerical burden on physi...
Source: Lab Soft News - July 25, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Clinical Lab Testing Electronic Health Record (EHR) Health Wearable Healthcare Information Technology Healthcare Innovations Medical Research Quality of Care Source Type: blogs
Defining and Delineating the Changing First Tier of Healthcare
Through various blog notes, many of them recent, I have been trying to sketch out the changes in the first tier of healthcare that I see occurring (see:Retail Drug Stores Emerging as Healthcare Hubs for First-Tier Primary Care;The"Proximity Advantage" Enjoyed by Retail, Walk-In Clinics Over Health Systems;Physicians Are Disappearing from the Front Line of Healthcare). This level is roughly synonymous with what we typically call primary care but now accompanied by a large dose of consumer-directed activities and responsibilities. Below are a number of statements summarizing the character and dimensions of this fir...
Source: Lab Soft News - July 22, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Clinical Lab Testing Diagnostics Electronic Health Record (EHR) Health Wearable Healthcare Information Technology Lab Industry Trends Lab Information Medical Consumerism Point-of-Care Testing Predictive Analytics Public Health Refere Source Type: blogs
IBD and Liver Disease Link Revealed by Explorsys, Now an IBM Company
Researchers at Cleveland Clinic have discovered a relationship between IBD and non-alcoholic liver disease, postulating that immune factors are involved in both the intestinal and liver lesions (see:Studies Reveal Heightened Liver Disease Rates in IBD Patients Immune-mediated factors may be involved). Below is an excerpt from the article but make note of the reference to the use of Explorsys, a research tool owned by IBM:...Cleveland Clinic researchers and their collaborators have found that patients with inflammatory bowel disease (IBD) experience higher rates of nonalcoholic fatty liver disease, nonalcoholic steatohepati...
Source: Lab Soft News - July 20, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Diagnostics Electronic Health Record (EHR) Healthcare Information Technology Healthcare Innovations Medical Research Predictive Analytics Preventive Medicine Public Health Source Type: blogs
Integration of Patient-Generated Test Results with Those from Accredited Laboratories
In response to my note yesterday about direct-access-testing (DAT) (see:New Definition for DTC Lab Testing Prompted by EverlyWell Business Model), Andrea Pitkin, Ph.D., commented in the form of a presentation she had made at the last ASCLS annual meeting. She makes a number of important observations that I hope to comment on in upcoming days. For this note, I will address the following point copied from her comment:How are consumer testing and Patient Generated Health Data (PGHD) integrated and used within the medical record?Some apps allow upload to the physician's EHR. They should not be comingled with la...
Source: Lab Soft News - July 18, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Clinical Lab Testing Diagnostics Direct Access Testing (DAT) Electronic Health Record (EHR) Health Wearable Healthcare Information Technology Lab Industry Trends Lab Standards Medical Consumerism Point-of-Care Testing Public Health R Source Type: blogs
New Definition for DTC Lab Testing Prompted by EverlyWell Business Model
A recent article in Dark Daily convinced me that we need a new definition for direct-to-consumer (DTC) lab testing which has also been called direct-access-testing (DAT) (see:Direct-to-Consumer Lab Test Start-Up EverlyWell Puts Clinical Laboratory Tests on Shelves at CVS and Target). Below is an excerpt from the article:....Julia Taylor Cheek, Founder and CEO ofEverlyWell, a well-financed digital health company based in Austin —hopes to build a... disruptive business in the clinical laboratory industry....Cheek is talking about the same primary business strategy of letting consumers purchase their own lab tests....The co...
Source: Lab Soft News - July 17, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Clinical Lab Industry News Clinical Lab Testing Diagnostics Direct Access Testing (DAT) Healthcare Innovations Lab Industry Trends Lab Processes and Procedures Medical Consumerism Medical Research Reference Laboratories Test Kits and H Source Type: blogs
Reducing Healthcare Costs; Surgery at a Selected Hospital and Pharma Tourism
Individuals and self-insured companies have adopted various strategies to reduce the rising cost of healthcare for themselves and their employees. A recent article discussed howWalmart was flying employees who were candidates for particular surgical procedures to selected, distant hospitals for evaluation (see:Walmart Flies Employees to Top Hospitals for Surgeries in a Bid to Cut Healthcare Costs). Below is an excerpt from it:Walmart ’s answer [to rising healthcare costs] is its six-year-oldCenters of Excellence (COE) program. In partnership with third-party administrator Health Design Plus (HDP), Walmart directly contra...
Source: Lab Soft News - July 15, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Cost of Healthcare Healthcare Innovations Healthcare Insurance Medical Consumerism Pharmaceutical Industry Public Health Quality of Care Source Type: blogs
