When is too much data a bad thing?
“Here you go, doctor.”
My patient with incredibly well-controlled type 2 diabetes hands me his fingerstick log at his regularly scheduled office visit. Despite his multiple medical problems (congestive heart failure, coronary artery disease, chronic renal insufficiency, and gout, among others) his sugars have been incredibly well-controlled over the past several years.
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Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - June 7, 2014 Category: Journals (General) Authors: Fred N. Pelzman, MD Tags: Physician Primary care Source Type: blogs
Be courageous: help stop the pill madness
Medicine people give it a sterile-sounding name. Polypharmacy means giving too many drugs, usually to an elderly person.
But this practice is worthy of clearer words: dumb, dreadful or doctoring at its worst.
The idea to mention the growing problem of giving too many pills in combination came to me after reading this Medscape coverage of a trial of statin removal in patients nearing end of life. The randomized clinical trial was presented at the 2014 Annual Meeting of the American Society of Clinical Oncology. One group of patients had their statin stopped and the other group continued the drug as is the normal practi...
Source: Dr John M - June 6, 2014 Category: Cardiology Authors: Dr John Source Type: blogs
Pharos Innovations Meets Isaac Asimov
By AL LEWIS and VIK KHANNA Isaac Asimov once remarked that a sufficiently advanced technology was indistinguishable from magic. Were he alive today, Mr. Asimov might also remark that both advanced technology and magic got nothing on Pharos Innovations, whose website reports a world-record 79% reduction in admissions for congestive heart failure (CHF) patient monitoring. […] (Source: The Health Care Blog)
Source: The Health Care Blog - June 5, 2014 Category: Consumer Health News Tags: THCB Admissions congestive heart failure Patient Monitoring Pharos Innovations Source Type: blogs
Physicians are noncompliant too
Patient noncompliance.
I wasn’t very familiar with this term until I started my clinical rotations. But after just the first week, I started noticing that health care providers throw this phrase around all time.
We particularly like using it as an excuse. Why did this diabetic patient require a foot amputation? Why does this patient come in monthly with congestive heart failure exacerbation? Why did this patient suffer a stroke? It’s often simply attributed to patient noncompliance.
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Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out h...
Source: Kevin, M.D. - Medical Weblog - May 30, 2014 Category: Journals (General) Authors: Elaine Khoong Tags: Physician Hospital Primary care Source Type: blogs
How successful is AF ablation?
Let’s talk about success.
At first glance, knowing whether a medical or surgical intervention achieves success seems quite simple. An antibiotic clears an infection–or it does not. A surgery removes a tumor with clean margins–or it does not. An angioplasty and stent open an artery during a heart attack–or it does not.
In the case of treating atrial fibrillation, however, it’s not like that. And this is especially true when one considers the use of catheter ablation–the biggest hammer in the toolbox of an electrophysiologist.
The doubters ask: why can’t it be simple? They say ablati...
Source: Dr John M - March 24, 2014 Category: Cardiology Authors: Dr John Source Type: blogs
Transcript of podcast interview with Juliette Kayyem, candidate for Governor of Massachusetts
This is the transcript of my recent podcast interview with Juliette Kayyem, Democratic candidate for Governor of Massachusetts. Visit the original post to listen to the podcast and read a summary. This is part of a series of interviews with all nine candidates for Governor. The full schedule is available here.
David E. Williams: This is David Williams from the Health Business Blog. I’m speaking today with Juliettte Kayyem, candidate for Governor of Massachusetts.
Juliette, thanks for your time today.
Juliette Kayyem: Thanks for having me, David.
Williams: Juliette, does Chapter 224 represent the right approach to ...
Source: Health Business Blog - March 13, 2014 Category: Health Managers Authors: David Williams Tags: Podcast Policy and politics community hospitals election Governor health care health care reform health information technology healthcare Juliette Kayyem Massachusetts Source Type: blogs
Incoming President of IOM Outed as Member of Boards of Alnylam Pharmaceuticals, Medtronic and Pepsico
We just discussed how the new CEO of the National Quality Forum was revealed to be a member of the board of directors of Premier Inc, and discussed the implications of this apparently intense conflict of interest. Now another new leader of an influential non-profit organization dedicated to improving health and health care has also been shown to have major conflicts of interest.All Hail the New President of the Institute of MedicineIn 2010, we posted about a student protest of the salaries of some top administrators at Duke University, including then Chancellor of Health Affairs Dr Victor Dzau, at a time when the uni...
Source: Health Care Renewal - February 24, 2014 Category: Health Medicine and Bioethics Commentators Tags: Alnylam Pharmaceuticals boards of directors conflicts of interest Genzyme Institute of Medicine Medtronic Pepsico Source Type: blogs
mHealth – How Much Does it Cost and is it Clinically Effective?
I wrote in the beginning of 2012 that perhaps that year was the year for mHealth to ‘breakout. ‘ I cited several proclamations and organizational activities to support that claim. mHealth and the use of remote monitoring as an integrated healthcare offering is still not as prevalent as one would think it would be two years later. Even in the Telemedicine & E-Health LinkedIn Group, one sees angst at the low adoption rate of the use of telehealth solutions. Inevitably, when I speak with my colleagues and other people involved in healthcare, economic and clinical effectiveness questions prevail. Two specifi...
Source: Medical Connectivity Consulting - February 24, 2014 Category: Technology Consultants Authors: BMoorman Tags: Remote Monitoring Source Type: blogs
Keeping Tabs on Patients Post-Discharge Via Telemonitoring
Home telemonitoring of newly discharged patients by hospital personnel has a bright future as long as healthcare payers support the concept and are willing to reimburse for it. A recent article discussed a new telemonitoring initiative at the Partners health system in Boston in collaboration with Philips (see: Partners keeps tabs on patients at home). Below is an excerpt from a recent article about this topic:
With an eye on reducing hospital readmissions and boosting patient care coordination, Partners HealthCare at Home, a division Partner's HealthCare in Boston, is rolling out new telemonitoring technology. Th...
Source: Lab Soft News - February 20, 2014 Category: Pathologists Authors: Bruce Friedman Tags: Healthcare Business Healthcare Delivery Healthcare Information Technology Hospitals and Healthcare Delivery Medical Consumerism Medical Research Source Type: blogs
Spring Thaw?
Interesting. It is winter in New England, but you wouldn't necessarily know it. It isn't cold, but it isn't warm, either - about 42-43 degrees Farenheit. Raining. The rain probably explains why I don't feel especially well. Mild sore throat and a little bit achy. I'm hoping that the concoction of over-the-counter medication I took earlier does its job. The sooner the better; I have to work tonight.Yesterday should have been the first day of classes for me in PA school. I've been a bit sad because of not being able to go. While I'm hopeful that I'll be able to go next year I'm not terribly certain about it happening. Mainly...
Source: Life in Manch Vegas - January 14, 2014 Category: Ambulance Crew Source Type: blogs
Court Evades US Concern Over False Claims And Side Effect Reports
Here is a ruling that is nothing but anticlimactic. After a few months of anticipation, a federal appeals court decided not to rule on an issue raised last summer by the US Department of Justice in a whistleblower case against a drugmaker – whether the failure to report adverse events can form the basis for filing a lawsuit citing the False Claims Act.
Here is the background, all of which is from our earlier story: A year ago, a federal court judge tossed a pair of whistleblower lawsuits that were filed by a former safety consultant, Helen Ge, who alleged Takeda misrepresented or altered descriptions of adverse events fo...
Source: Pharmalot - December 12, 2013 Category: Pharma Commentators Authors: esilverman Source Type: blogs
Once Again, The Pound Of fat Comes From The Primary Care Physician
My dear medicare patients. The government has just screwed you. Did you know it? Probably not, probably you have no idea about what the government is proposing to do. But it is going to have profound effects on the quality of the care you are about to receive. You are confused? You are surprised? Let me explain. The government is proposing to change the way it pays doctors for outpatients visits. According to modern healthcare, medicare intends to pay physicians a flat rate for each visit. That's right, a healthy sixty five year old with a cold will lead to physician charges that a...
Source: In My Humble Opinion - November 30, 2013 Category: Family Physicians Authors: Jordan Grumet Source Type: blogs
Weird wheat re-exposure reactions
As the world of people who are wheat-free continues to grow, I am witnessing a range of weird re-exposure reactions when people, intentionally or inadvertently, get re-exposed.
Among the peculiar reactions:
Congestive heart failure–A woman with a clear-cut syndrome of wheat intolerance that was evidenced by diabetes, excessive expression of small LDL particles (around 2000 nmol/L at the start), high triglycerides, gastrointestinal distress, widespread joint pain, and a peripheral neuropathy (impaired coordination, reduced sensation to the legs), and negative blood markers for celiac disease, improved substantially a...
Source: Wheat Belly Blog - November 18, 2013 Category: Cardiology Authors: Dr. Davis Tags: Re-exposure syndromes Source Type: blogs
Finally! Physician performance measurement questioned in the NEJM!
In 2006 I participated in a Medscape debate about P4P – April 2006: Point/Counterpoint on Pay for Performance
Here are some of my thoughts then:
The pay-for-performance movement (and does not the phrase evoke a sense of moral virtue?) assumes that physicians will provide better care if we provide financial incentives to do the right things. The concept has great validity on its face. Pay-for-performance has become a sound-bite phrase, which politicians eagerly adopt.
So who could oppose motherhood, apple pie, and quality? No one can oppose the drive for improved quality, but I do oppose current efforts to adopt pay-f...
Source: DB's Medical Rants - November 7, 2013 Category: Health Medicine and Bioethics Commentators Authors: rcentor Tags: Medical Rants Source Type: blogs
Johnson & Johnson to Pay More Than $2.2 Billion to Resolve Criminal and Civil Investigations - DoJ
Johnson & Johnson to Pay More Than $2.2 Billion to Resolve Criminal and Civil Investigations
Allegations Include Off-label Marketing and Kickbacks to Doctors and Pharmacists
WASHINGTON - Global health care giant Johnson & Johnson (J&J) and its subsidiaries will pay more than $2.2 billion to resolve criminal and civil liability arising from allegations relating to the prescription drugs Risperdal, Invega and Natrecor, including promotion for uses not approved as safe and effective by the Food and Drug Administration (FDA) and payment of kickbacks to physicians and to the nation’s largest long-term care phar...
Source: PharmaGossip - November 5, 2013 Category: Pharma Commentators Authors: insider Source Type: blogs
