Safety advocate sees ‘hope and hype’ In digital revolution

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"Robert Wachter, MD"By Michelle Andrews
KHN

Dr. Robert Wachter is a long-time patient safety advocate who has written extensively about the trends affecting quality and safety in health care.

Wachter, associate chair of the University of California-San Francisco department of medicine, years ago coined the term “hospitalist” and predicted the rise of that profession.

In his new book, “The Digital Doctor: Hope, Hype and Harm at the Dawn of Medicine’s Computer Age,” he turns his attention to technology in health care, and the risks and rewards as we digitize everything from medical records to office visits.

We talked recently about his new book. This is an edited and condensed version of that conversation.’

Q. As I read your book I couldn’t help thinking about the elderly. Many older people aren’t tech savvy. They’re intimidated by looking up information on computers, sending email to their doctors and the like. They’re also bigger health care users than many younger people. What needs to be done to help them get and stay engaged as technology advances?

Photo: Dr. Robert Wachter by Susan Merrell/UCSF)

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Narcotic Painkillers in Pregnancy Common, Harmful to Baby: Study – WebMD

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Blue Pregnant BellyUse of prescription narcotic painkillers is common in pregnancy and increases the likelihood a baby will be born small or early, or go through painful drug withdrawal, a new study finds.

These prescription painkillers, also called opioids, include drugs such as hydrocodone (Vicodin), oxycodone (Oxycontin), codeine and morphine.

Nearly 30 percent of the Tennessee mothers-to-be in the new study used at least one of these drugs while pregnant, and the associated risks went up if they also smoked or took antidepressants.

via Narcotic Painkillers in Pregnancy Common, Harmful to Baby: Study – WebMD.

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Diabetes testing in symptomless adults may not lower risk of death | Reuters

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GlucometerExpanding diabetes screening in adults to catch the disease early does not appear to keep people from dying of cardiovascular causes, according to a report designed to help shape U.S. treatment guidelines.

Earlier detection did seem to slow the progression of so-called prediabetes to full-blown diabetes, but it had no impact on the risk of death from heart or blood vessel disease 10 years later, researchers found when they analyzed studies conducted from 2007 to 2014.

via Diabetes testing in symptomless adults may not lower risk of death | Reuters.

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U.S. prescription drug spending rose 13 percent in 2014: IMS report | Reuters

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Twenty-dollar bill in a pill bottleU.S. spending on prescription medicines jumped 13 percent to $374 billion in 2014, the biggest percentage increase since 2001, as demand surged for expensive new breakthrough hepatitis C treatments, a report released on Tuesday showed.

Demand for newer cancer and multiple sclerosis treatments, price increases on branded medicines, particularly insulin products for diabetes, and the entry of few new generic versions of big-selling drugs also contributed to the double-digit spending rise in 2014, the report by IMS Health Holdings Inc found.

via U.S. prescription drug spending rose 13 percent in 2014: IMS report | Reuters.

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Most Common Drug Ingredient in the US Kills Emotions

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Three red and white capsulesCommonly found in pain relievers, acetaminophen gets rid of more than just physical agony – it also diminishes emotions.

“Rather than just being a pain reliever, acetaminophen can be seen as an all-purpose emotion reliever,” lead researcher said in a news release.

via Most Common Drug Ingredient in the US Kills Emotions.

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Rescue workers use apps to help save lives

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PulsePoint app

By Jenni Bergal
Stateline

When 911 dispatchers get a call that someone has collapsed and stopped breathing, they quickly notify first responders. In hundreds of communities across the U.S., they now also send out a smartphone app alert summoning citizens trained in CPR.

If those Good Samaritans arrive at the scene first, they can start resuscitation efforts until the professionals get there.

The mobile app is called PulsePoint, and it was devised to aid victims who have suffered cardiac arrest. It’s one of a number of apps that rescue workers, hospital staffers and patients themselves are using to try and improve responses to health emergencies and help save lives.

PulsePoint has helped save lives in cities such as Cleveland, where about 4,000 people have downloaded the app in the last year and 36 citizens have responded to almost three-dozen calls – including one Good Samaritan who helped save the life of a man who collapsed in traffic court.

“Apps used by citizens who want to help give them a way to be part of the structure of the emergency response program,” said Thomas Beers, emergency medical services manager at the Cleveland Clinic and coordinator for PulsePoint in the Cleveland area. Continue reading

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Hospitals leave downtown for more prosperous digs

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A sign marks the location of a proposed new St. Elizabeth’s hospital in O’Fallon, Mo., on 114 acres of farmland just off Interstate 64. (Photo by Phil Galewitz/KHN)

By Phil Galewitz
KHN

BELLEVILLE, Ill. – Nearly as old as the railroad that slices through this southern Illinois city just east of the Mississippi River, St. Elizabeth’s Hospital has been a downtown bedrock since 1875.

Started by three nuns from a Franciscan order in Germany, the Catholic hospital still seeks “to embody Christ’s healing love” to the sick, the aged and the poor, according to its mission statement.

It is so tied to the city that when the local economy slumped in 2009, the nonprofit St. Elizabeth’s gave $20 to every employee to spend on Main Street, sending hundreds of shoppers out to the mostly mom- and pop-owned stores.

But St. E’s, as locals call it, now faces its own financial troubles, largely a result of the costs of maintaining an obsolete facility and of treating more low-income and uninsured patients from Belleville and neighboring East St. Louis, one of the poorest cities in the Midwest.

After a decade of losing money, St. Elizabeth’s officials are taking a radical step: Like a small but growing number of hospitals around the country, they plan to close the 303-bed hospital and move elsewhere.

They are seeking state approval to build a $300-million facility seven miles northeast, in O’Fallon, a wealthier city that is one of the fastest-growing communities in the St. Louis region with new subdivisions, proximity to a regional mall and quick access to Interstate 64.

Describing plans to leave behind some services, including a walk-in clinic, St. Elizabeth’s CEO Maryann Reese insists the hospital is not abandoning the city or the poor. Continue reading

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FAQ: What are the penalties for not getting insurance?

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IRS logoIf you’re uninsured, you may have questions about possible penalties for not having coverage. The fine may be bigger than you expect. Here are the details:

Is everyone required to have health insurance or pay a fine?

Most people who can afford to buy health insurance but don’t do so will face a penalty, sometimes called a “shared responsibility payment.”

The requirement to have health insurance, which began in 2014, applies to adults and children alike, but there are exceptions for certain groups of people and those who are experiencing financial hardship.

What kind of insurance satisfies the requirement to have coverage?

Most plans that provide comprehensive coverage count as “minimum essential coverage.” That includes job-based insurance and plans purchased on the individual market, either on or off the exchange.

Most Medicaid plans and Medicare Part A, which covers hospital benefits, count as well, as do most types of Tricare military coverage and some Veterans Affairs coverage. Continue reading

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UW scientists, biotech firm may have cure for colorblindness | The Seattle Times

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EyeJay and Maureen Neitz, husband-and-wife scientists who have studied the vision disorder for years, have arranged an exclusive license agreement between UW and Avalanche Biotechnologies of Menlo Park.

Together, they’ve found a new way to deliver genes that can replace missing color-producing proteins in certain cells, called cones, in the eyes.

via UW scientists, biotech firm may have cure for colorblindness | The Seattle Times.

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Top five stories of the week

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Credit: Dan Shirly

Credit: Dan Shirly

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Coalition pushes for health care cost and quality transparency

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Twenty-dollar bill in a pill bottleBy Lisa Gillespie
KHN

As consumers increasingly are being asked to pay a larger share of their health bills, a coalition of insurers, pharmaceutical companies, and provider and consumer advocacy groups launched Thursday a new push for greater transparency regarding the actual costs of services.

The group includes AARP, Novo Nordisk, the National Consumers League, the Ambulatory Surgery Center Association, the National Council for Behavioral Health and Aetna.

Transparency means all consumers have the information they need to estimate cost and quality of health services.

Health care transparency, long a buzz word, means all consumers — whether they are covered by Medicare, work-based insurance or without coverage at all — have access to information enabling them to estimate accurately the cost of health services, and compare physician quality rankings and outcomes.

The initiative, “Clear Choices,”  will add to private and government efforts already underway to get more such information to patients, including Medicare’s Physician Compare, and the Health Care Cost Institute’s ‘Guroo,’ which culls data from private insurers to provide average prices regionally.

The group’s first priority is advancing the Medicare doctor payment legislationp ending in the Senate because it includes a provision requiring Medicare to release for broader use a substantial amount of data on claims at the provider level.

The group’s other objectives include:

  • Improving quality measures for doctors and hospitals so that patients will be armed with more comparative information.
  • Requiring hospitals to be clearer regarding what may or may not be included in their cost estimates for care.
  • Creating better tools for consumers to make medical decisions based on price, quality and safety of medical services.

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Radon may be linked to fracking, researchers suspect | marcellus.com

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Radiation Hazard SignRadon levels in houses near fracking sites in Pennsylvania are higher than in those in areas where there is no oil and gas drilling, according to a new study by Johns Hopkins University researchers.

The researchers cautioned that their findings don’t definitively tie hydraulic fracturing to higher levels of radon.

But they say they found a “statistically significant association” between a building’s proximity to a fracked well and to the amount of radon detected.

via Radon may be linked to fracking, researchers suspect | marcellus.com.

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Fewer U.S. Children Getting Melanoma: Study – WebMD

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Blue sky and white clouds (Panorama)The incidence of deadly melanoma skin cancer is falling among American children, a new study finds.

Researchers led by Dr. Lisa Campbell, of Case Western Reserve University and University Hospitals (UH) Case Medical Center in Cleveland, looked at national cancer registry data from 2000 to 2010.

They found that the overall number of new melanoma cases among children fell 12 percent each year from 2004 to 2010.

The reasons? Campbells team cited effective public outreach on the danger of UV rays from the sun or tanning beds, more kids playing indoors rather than outdoors and a rise in parental awareness of the importance of sunscreen and other sun-protective measures.

via Fewer U.S. Children Getting Melanoma: Study – WebMD.

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