Bridging The Dental Divide: Overcoming Barriers To Integrating Oral Health And Primary Care
American systems of oral and systemic health—training, licensure, service delivery, and insurance—continue to operate in parallel. It is a fracture rooted in sociologic, political, and market forces rather than underlying physiology. Although the distinction may be artificial, the consequences for patients and providers are real. A growing evidence base points to the cost and quality shortfalls associated with having separate systems treat the same person.
Seeking to address these challenges, the Surgeon General recently called for more thorough integration of oral health and primary care. Roughly one in five A...
Source: Health Affairs Blog - January 19, 2017 Category: Health Management Authors: Brian Powers, R. Bruce Donoff and Sachin H. Jain Tags: Costs and Spending Health Professionals Population Health Public Health Quality Dental Care Federally Qualified Health Centers Oral Health Primary Care Source Type: blogs
Health Update
I finally made it to the doctor yesterday, needing medication for my asthma/bronchitis, and had kind of a laundry list of other issues since I had not been in for awhile.He prescribed the needed steroid I had come for (I have just given in since that is the only thing that works), then we moved on to my...I guess I do need to document this, my apologies to anyone reading this. My bowel movement issues?Not just blood, but once, only blood, and lots of it. That should suffice for details. I had to use a pad that day to catch all of the blood from the WRONG end!No, I did not race to the doctor when it happened,...
Source: bipolar.and.me - January 3, 2017 Category: Psychiatry Source Type: blogs
Health Update
I finally made it to the doctor yesterday, needing medication for my asthma/bronchitis, and had kind of a laundry list of other issues since I had not been in for awhile.He prescribed the needed steroid I had come for (I have just given in since that is the only thing that works), then we moved on to my...I guess I do need to document this, my apologies to anyone reading this. My bowel movement issues?Not just blood, but once, only blood, and lots of it. That should suffice for details. I had to use a pad that day to catch all of the blood from the WRONG end!No, I did not race to the doctor when it happened,...
Source: bipolar.and.me - January 3, 2017 Category: Psychiatry Source Type: blogs
OIG Issues Semiannual Report to Congress
Conclusion
As written in a January 2017 article in Life Science Compliance Update, it is too soon to tell the effect the Trump Administration will have on the pharmaceutical industry. This report and the recommendations contained therein highlight some of the focuses of OIG, but those have the propensity to change, depending on the incoming Administration.
Related Stories21st Century Bill Headed to President Obama’s DeskLeahy, Wyden Send Letter to DOJ Regarding DEA Enforcement ActionsAHR Holds Congressional Briefing Focused on Cost Growth (Source: Policy and Medicine)
Source: Policy and Medicine - December 29, 2016 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
ST prolongation in hypocalcemia
ST prolongation as a cause of QT interval prolongation is less common than other mechanisms of QT prolongation. In most cases it is a wide T wave or a combination of T-U which causes QT prolongation. QRS widening can also contribute to QT prolongation, though it is seldom a cause of QT prolongation beyond the upper limit of normal by itself. ST segment roughly corresponds to the phase 2 of myocardial action potential and ST prolongation without QRS widening or T wave widening is classical of hypocalcemia. This type of QT prolongation is less likely to cause the life threatening ventricular arrhythmia of torsades des pointe...
Source: Cardiophile MD - December 23, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology ECG / Electrophysiology ECG Library Source Type: blogs
The BIDMC CareKit app
The following is a guest blog post from Seth Berkowitz, MD, who authors many of the innovative apps in the BIDMC Crowdsourcing program:Beth Israel Deaconess Medical Center, a teaching hospital of Harvard Medical School, has developed BIDMC@home, a new app for engaging patients using Apple ’s CareKit and ResearchKit frameworks and the HealthKit API. The app provides a flexible framework to help patients manage their health from home, as directed by their physicians. The app will be piloted in several specific patient populations and will eventually be offered to BIDMC’s entire net work of over 250,000 patients.BIDMC@hom...
Source: Life as a Healthcare CIO - November 23, 2016 Category: Information Technology Source Type: blogs
Divorcing Reimbursement From Real-World Prices: Medicare Still Uses 2003 AWPs For Some Drugs
Average wholesale prices (AWPs) have long been recognized as a flawed payment benchmark because they are list prices that do not reflect the real-world prices available in the marketplace. For that reason, a common joke in the drug pricing world panned AWP as “Ain’t What’s Paid.”
After years of reports from the Office of Inspector General (OIG), analysis from the Government Accountability Office (GAO), and litigation that highlighted the flaws in AWPs, Congress required in 2003 that reimbursement of Part B drugs be set 106 percent of their average sales price (ASP). ASPs are calculated based on the prices at which ...
Source: Health Affairs Blog - November 21, 2016 Category: Health Management Authors: David Tawes and Marta Wosinska Tags: Costs and Spending Drugs and Medical Innovation Medicare Payment Policy Average wholesale prices durable medical equipment Medicare Part B Office of Inspector General Source Type: blogs
Avoid these common health perils of Thanksgiving
With Thanksgiving rapidly approaching, here are a few tips to help you avoid some common health hazards related to this holiday.
One of the more typical reasons for a trip to the emergency department on Thanksgiving Day (and most days, frankly) is accidental cuts to the hands. Be careful cutting up that turkey! Always use a carving fork, and although the household might be busy, try to avoid distractions when working with knives. Thankfully most such injuries can be repaired in the ED, but occasionally are bad enough to warrant being seen by a hand surgeon. For simple cuts to the hand, we generally place non-absorbable sti...
Source: Harvard Health Blog - November 18, 2016 Category: Consumer Health News Authors: Jonathan Nadler, MD Tags: Health Screening Source Type: blogs
Ushering In The New Era Of Health Equity
Editor’s note: Joseph Betancourt is one of the theme advisors for the June 2017 Health Affairs equity theme issue.
The passage of health care reform and current efforts in payment reform have fueled a significant transformation of the US health care system. An entire new set of structures is being developed to facilitate increased access to care that is cost-effective and high quality. High-value health care is the ultimate goal. Guided by the 2001 Institute of Medicine (IOM) report, Crossing the Quality Chasm, the nation has charted a path to deliver care that is safe, efficient, effective, timely, patient-centered, and...
Source: Health Affairs Blog - October 31, 2016 Category: Health Management Authors: Joseph R. Betancourt Tags: Featured Health Equity Population Health Quality MACRA Social Determinants of Health triple aim Source Type: blogs
We are all responsible for behavior change
Helping our patients make better health decisions can be a challenge. Whether we aim to get them out of bed in the hospital or off of the couch at home, factors contributing to follow-through may be complicated, and the best strategies to facilitate the right choices are seldom clear.
As providers, we would hope that a long and healthy life would serve as the most powerful incentive for behavior change, but with health decisions, consequences are not often direct or immediate enough for patients to always draw the right connections. In our system right now, it’s not explicitly understood who should be most responsible fo...
Source: Kevin, M.D. - Medical Weblog - October 4, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/john-corsino" rel="tag" > John Corsino, DPT < /a > Tags: Policy Health reform Source Type: blogs
DAPT Score to decide on utility of prolonged dual anti platelet therapy
DAPT score is based on the Dual Antiplatelet Therapy Study and is used to assess the risk/benefit ratio of prolonged dual antiplatelet therapy. Advanced age is given a negative score as it increases the bleeding risk. Age of 75 or above is given two points while age between 65-74 years is given 1 point. Current smoking, diabetes mellitus, myocardial infarction at presentation, previous percutaneous intervention (PCI) or myocarial infarction, stent diameter of less than 3 mm and Paclitaxel eluting stent, all get 1 point each. Congestive heart failure or left ventricular ejection fraction less than 30% and saphenous vein gra...
Source: Cardiophile MD - September 8, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology Source Type: blogs
Fatty Acid Metabolism and Age-Related Heart Failure
Researchers here propose that alterations in fatty acid metabolism in aged heart tissue make up one of the contributing factors to the age-related loss of function in the heart, a process that eventually leads to heart failure and death. As a mechanism this is is situated somewhere in the middle of the chain of cause and consequence that starts with molecular damage caused by the normal operation of metabolism, a sort of biological wear and tear, then passes through a complex series of reactions to that damage, some helpful and some harmful, and finally leads to functional failure in organs as the network of damage and con...
Source: Fight Aging! - September 8, 2016 Category: Research Authors: Reason Tags: Daily News Source Type: blogs
Research and Reviews in the Fastlane 150
This study demonstrated the decrease of both BNP and pro-BNP in obese patients presenting to the ED with CHF exacerbations. 10-20% were below the clinical cutoff points for the test. A much more useful test for these patients…ultrasound!
Recommended by: Jeremy Fried
Emergency medicine Davidson BL. The association of direct thrombin inhibitor anticoagulants with cardiac thromboses. Chest. 2015. PMID: 25254608
This paper is a commentary, so the level of evidence is not great but is fairly well substantiated and is pretty important to discuss the points it makes. NOACs have been associated with a lower ri...
Source: Life in the Fast Lane - September 8, 2016 Category: Emergency Medicine Authors: Nudrat Rashid Tags: Airway Anaesthetics Cardiology Education Emergency Medicine Intensive Care Pre-hospital / Retrieval R&R in the FASTLANE critical care literature recommendations research and reviews Resuscitation Source Type: blogs
Physicians are the emotional punching bags of society
The Washington Post featured an article by Dr. Michael Stein, “We all want doctors to be kind. But does kindness actually help us get better?” He presented intriguing but inconclusive data regarding the benefits of a “kind” doctor on control of diabetes or on perceived duration of colds for instances. In the end, Dr. Stein concludes, “At the moment, the best answer to the kindness contrarian is: Even if the evidence in favor of the therapeutic benefits of empathy is weak, there is no evidence that refutes the idea that empathy improves care. And too many patients have stories of how unkindness...
Source: Kevin, M.D. - Medical Weblog - September 1, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/jean-robey" rel="tag" > Jean Robey, MD < /a > Tags: Physician Primary care Source Type: blogs
The Need For Additional Flexibility In Medicare Advantage
The Centers for Medicare and Medicaid Services (CMS) has recently exercised its Section 1115A waiver authority to allow Medicare Advantage plans in seven states to offer benefit flexibility in the form of Medicare Advantage Value Based Insurance Design (MA-VBID). The model will launch on January 1, 2017 and run for five years.
The intent of the MA-VBID model is to incentivize high value utilization of health care by restructuring enrollee cost sharing and other benefits to be more clinically nuanced. Under VBID, enrollees face low or no cost for high-value clinical services but may have higher out-of-pocket costs for low-v...
Source: Health Affairs Blog - August 29, 2016 Category: Health Management Authors: Megan Katherine McGrath and Kenneth Thorpe Tags: Costs and Spending Insurance and Coverage Medicaid and CHIP Medicare Quality Aging Medicare Advantage Patient-Centered Medical Home Program of All-Inclusive Care for the Elderly Social Determinants of Health value-based insurance desig Source Type: blogs
