Patients and providers sometimes exhaust proven treatments for chronic disease and cancer treatments. The Food and Drug Administration approves drugs for human use only after the drug has passed a clinical trial.
HEALTH TRAIN EXPRESS Mission: To promulgate health education across the internet: Follow or subscribe to Health Train Express as well as Digital Health Space for all the updates for health policy, reform, public health issues. Health Train Express is published several times a week.Subscribe and receive an email alert each time it is published. Health Train Express has been published since 2006.
Sunday, May 29, 2022
Wednesday, May 25, 2022
Gov. Newsom signs landmark MICRA modernization bill into law
Gov. Newsom today signed AB 35 into law, and in doing so put an end to a decades long political battle and ushered in a new era of stability around malpractice liability.
Since California’s landmark medical malpractice reforms – the Medical Injury Compensation Reform Act (MICRA) – were enacted almost 50 years ago, they have successfully struck a balance between compensatory justice for injured patients while maintaining an overall health care system that is accessible and affordable for Californians.
Since that time, California’s physician and provider communities have repeatedly defended MICRA through expensive battles at the ballot, in the courtroom and in the legislature.
This year, we were again facing another costly initiative battle. The so-called Fairness for Injured Patients Act, which had qualified for the November 2022 ballot, would have obliterated existing safeguards for out-of-control medical lawsuits and would have resulted in skyrocketing health care costs. This act demanded that patients who are injured have the right to seek compensation from alleged providers who 'injured' them. The original MICRA act of thee1970s limited compensation to $250,000.
But for the first time in a generation, we were met with an opportunity to achieve a meaningful consensus between competing interests through a revised framework that could protect both the rights of injured patients while keeping MICRA’s essential guardrails solidly in place for patients and providers alike.
“With today’s signing of AB 35, we have achieved what few thought was possible,” said California Medical Association President Robert E. Wailes, M.D
AB 35 passed through the California Legislature with nearly unanimous support, demonstrating broad bipartisan support. As part of the landmark agreement reflected in AB 35, proponents of the Fairness for Injured Patients Act have withdrawn the initiative. The initiative cannot be returned to the November 2022 ballot.
California’s new modernized MICRA statutes will provide predictability and affordability of medical liability insurance rates for decades to come, while protecting existing safeguards against skyrocketing health care costs. It will also bring greater accountability, patient safety and trust by making it possible for physicians and patients to have a full and open conversation after an unforeseen outcome.
Under the modernized MICRA law reflected in AB 35, which will go into effect on January 1, 2023, the underlying principles of MICRA were preserved – ensuring access to care and protecting our health care delivery system from runaway costs. Important guardrails of MICRA will continue unchanged, including advance notice of a claim, the one-year statute of limitations to file a case, the option of binding arbitration, early offer of proof for making punitive damage allegations and allowing other sources of compensation to be considered in award determinations. Furthermore, a new provision has been added to the law that protects expression of sympathy by a health care provider to an injured patient and their family, allowing physicians to express empathy, benevolence and even statements of fault after an unforeseen outcome without fear that such statements or gestures will be used against them.
The element that has garnered the most interest surrounds changes to the limit on non-economic damages in medical malpractice cases, which has been $250k since 1975. As opposed to the ballot measure, which would have effectively eliminated the cap on non-economic damages entirely, under the agreement:
Cases not involving a patient death will have a limit of $350k on the effective date of January 1, 2023, with an incremental increase over the next 10 years to $750k and a 2.0% annual inflationary adjustment thereafter.
Cases involving a patient death will have a limit of $500k on the effective date of January 1, 2023, with an incremental increase over the next 10 years to $1 million and a 2.0% annual inflationary adjustment thereafter.
Other critical MICRA guardrails that will remain in place with modest updates include the ability to pay awards of future damages over time and limits on plaintiff's attorney's contingency fees. CMA has prepared a publicly available fact sheet that provides additional details on this important legislation.
“CMA is proud to have been part of this landmark achievement for the benefit of all Californians,” said Dr. Wailes. “We look forward to a new era of long-term stability around MICRA that will allow California’s physician and provider communities to focus on other ways to improve access to care and public health for all Californians.
Sunday, May 1, 2022
Digital Health News - Digital Salutem
Digital Health came upon the scene in 2005, with a nationwide effort to transform health care with digital transformation. Anyone practicing medicine would not recognize how healthcare would transform between 20012 and today, 2022.
Scientific peer reviewed journals in medicine have a plethora of articles documenting the efficacy and efficiency for better cost effective medicine and evidence based information to sustain it's utility and further development, and proof of ROI.
In 2020 as the COVID 19 pandemic exploded across the globe digital health allowed for our health system to not implode, even when stretched to overcapacity.
Computing power allowed for data analytics, tracking and reporting of the pandemic.
The World Health Organization and Johns Hopkins University produced daily maps and statistics individualized to state, and nationality of the pandemic as it progressed. These were available on the internet in real time.
Daily Moving Average (in real time)
3 new trends in eHealth
Here are 3 recent innovations or trends in eHealth:
Virtual clinics: Virtual clinics let you see an expert doctor remotely at home on your computer instead of having to travel outside your home (or waiting in line). The idea behind this type of solution is that doctors can make appointments from anywhere in the world instead of having doctors based around your area (which means you can get more high quality health care). This is great for consumers because it allows them to see specialists or other specialists outside their area (for example as part of an emergency room) but less so for patients because remote care requires trained staff who are highly specialized and often expensive to get hold of.
Remote Clinical Care: A lot of people simply do not want or need access to an actual doctor when they need help with their health issues, especially if they live far away from an actual hospital (which is why there are so many virtual clinics available). But if we combine remote clinical care with virtual clinics then you can get high quality accurate care anywhere any time, be it at home or online, without needing access to an actual doctor at all! This allows patients who might not feel comfortable calling out sick or going into hospitals on their own but still need help with something like diabetes or heart disease can go online and see someone who has experience treating those issues remotely rather than having them deal directly with doctors at hospitals near them.
Virtual medical centers: are used to provide services easier and more cost-effectively when you call. A virtual clinic is a planned contact by the Healthcare Professional Responsible for Care with a patient for the purposes of clinical consultation, advice and treatment planning. It has been found to increase patient access to healthcare services, enhance health outcomes, improve patient experience and make optimal use of scarce medical resources.
Digital Health has made possible Precision Medicine whereby treatments can be specifically tailored to individual patients.
The University of California San Diego (as well as many others) has developed a Digital Health Lab, founded by Professor Edward J. Wang as a joint research laboratory of UCSD Design Lab and the Electrical & Computer Engineering department of Jacobs School of Engineering.
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