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.
The World Economic Forum is live today via video streaming from Davos,Switzerland. Many health care related interviews with Bill Gates, Tony Blair and others. http://www.weforum.org/ Other issues regarding Information Technology, and World Health, Global Social Media Networking.
The Medicare web site, Medicare.gov offers a “Physician Compare” section. The stated goal is to be ‘patient centric’ to meet consumer needs. This section supposedly offers a means to search for physicians to compare their demographics and expertise as well as certifications.
I researched the site extensively for multiple providers who I know personally.
The amount of information was minimalistic, demographics, specialty and degrees, ( no mention of subspecialty) medical group name (if any) with no mention of hospital affiliations. There was no mention of re-certification status, when licensed. The main features most notably displayed was if the provider accepted assignment. (apparently an indicator of ‘quality”)
It is highly inaccurate. I did a search for a physician within 15 miles of my location and came up with one that had over 100 locations listed (not in a group).
I would label this web site as dangerous !!!
Hard to believe whoever was in charge of this let it slip through. Well intentioned but poorly implemented.
The Health Care Blog also has a post today by Micihael Millenson. Thanks to him. I will write Czar Berwick about this one. Suggest all of us do the same.
Today’s WSJ reports that Pharma is being squeezed from all sides.
Despite past news of huge billion dollar profits for Pharma, the ecosystem for pharmaceuticals has gradually eroded leaving pharma in a less tenable position. Pressure is mounting with health reform measures, while pharma has been hit hard by restrictive formulas, and the emergence of ‘generics’. Generics, once looked upon with suspicion and doubt have take over a large part of doctor prescribing habits. Doctors have been forced to prescribe generics by limitations of their patient’s plans and their formularies. Most generics are tier 1 (a classification of drugs in each formulary). It does not take long if you gaze at a typical plans formulary to see how much less the copay is for a generic drug. Specific drug formularies are easily found on plan websites.
Pharmaceutical R & D is expensive, as well as the FDA approval process, The previous model of marketing a new generation or modification of an older drug with attendant new patents (at a much higher price) will not work today. We have and will see a marked increase in new drug cycle times.
So bad is the situation that this documentary was written by the Bureau of Investigative Journalism (clickable link)
The NIH National Center for Drug Research (clickable)
“The National Institutes of Health has approved Obama’s decision to assist with funding for drug research and development through a Federal Research Center.
Federal officials concerned about the slowing pace of new drugs coming out of the pharmaceutical industry have decided to start a billion-dollar government drug development center to help create medicines.”
The New York Times reported on its website Saturday about the new effort that comes as many large drug makers, unable to find enough new drugs, are trimming back research
“ NIH chief Francis Collins is pushing ahead with ambitious plans to create a new center for translational medicine that will do some of the early-stage work for the drug development industry.
Collins' plan, endorsed by HHS Secretary Kathleen Sebelius and outlined over the weekend by the New York Times, is to bring together $700 million in R&D work under one roof at the National Center for Advancing Translational Sciences, where government scientists will pursue a billion dollars in funding to push the projects through the Valley of Death. Collins' blueprint calls for scientists to get enough proof-of-concept data in hand to whet pharma's appetite, spurring them to step in and finish the discovery work needed to obtain an approval.”
If I read this correctly, the FDA will have one arm to assess the safety of new drugs, and it’s sister NIH will be dueling.
There is some opinion the NIH has no business in pharma other than to provide basic science and early translational work. It may be a different story for Orphan disease and Orphan Drugs (clickable)
When all else fails, do a study. President Obama reigns supreme in this area.
Algorithms sound impressive, not like Algo Gores. This is what higher math is for…to prove the discontinuities of existence, the universe or whatever you are plagued with in modern times. Algos are supposed to make decision making easier with a formula or diagrams directing a ‘machine’ (computer) to make stem choices. (Best stem I have had was on an apple (not the computer)
works in the financial industry. They work worth with algorithms day in and out and while Mr. Daley may not be a hands on person, believe me he knows his “Algo Men” as all the banks have quite a few of them. Before I get any further I need to give attribution to Medical Quack whose recent posts have been in reference to Algo-Medicine and our great hope for the good side of “The Force”. Barbara, or as I like to call her “Ducky”, not to be confused with Ducky from NCIS’ whose forensic abilities defy most pathologists. (why don’t more pathologists blog?) (where was I now?)
Oh yes, Medical Quack always has an aggregation of topics that fuel my limbic system. This is not Ducky’s fault…..it’s a bit like shooting the messenger. Ducky, you bring a lot of bad Karma to the table. I like you very much. It keeps me grounded and diminishes my euphoria. Thank you very much.
Now what was the point of this post ??
My colleague and blog friend, The Hospitalist expanded better than I ever could about Jack Lalanne in his blog on Monday. It’s worth reading.
He was the original ‘health nut’. But he was ‘bolted’ down. He exemplifies the fact that we all die, but the journey to it can be a gradual slope of declining health, unhappiness, disability or a good quality of life until one goes over the cliff suddenly.
Jack, the original ‘Juicer"’ did not need MLM,Facebook, Twitter, Tumblr,MySpace, or coupons from Groupon to spread his ideas
So really, disciplined eating habits, exercise, avoidance of unhealthy stress counts more than blockbuster drugs and high tech enhanced hospitals. Accountable care organizations will do little for your longevity, politicians, not withstanding.
If Jack Lalanne could do all that in the 1950s and 60s, imagine what he would have done now…..that is if he did not spend his time surfing and blogging, twittering and face booking all day.
How about an internet enable set of barbells, or workout machine?I know someone out there has an iPad accessory to attach the iPad to my treadmill.
“YOUR HEALTH ACCOUNT IS YOUR WEALTH ACCOUNT!
LONG LIVE LIVING LONG!”
Long before HSAs !
For some of you the name of Jack Lalanne brings forth images of a ‘jumping jack’ on your TV screen, or memories of “Bally” gyms, the chain that Jack started.
He was among the first to popularize weightlifting and his physical fitness techniques – including the fingertip press-up – formed the centerpiece of The Jack LaLanne Show, which ran on American television from the 1950s to the 1980s. Long before the age of celebrity exercise videos, LaLanne was telling people how to get fit.
Jack left us yesterday at the age of 96 years. The original 20th century beacon of fitness and preventive living he was a disciplined man, At the time a version of Arnold Schwarzenegger.
Just a moment of science from us all to thank and remember him for starting it all. We will miss the juices as well.
“We” are going to introduce a new forum for ‘film” or digital productions regarding our health system. Here is our “World Class” presentation.
There is a bit of a new link on the right hand sidebar. Levin’s Shout Out. Expands the audience a bit.
With the U.S. and the U.K. heading full steam towards electronic medical records and other health IT applications, how much evidence is there that they improve care?
The Wall Street Journal speaks to this issue.
Let’s keep it all realistic. !!
Bird's eye view of more than a mile long rake as seen from Lowell's Observatory.(Arizona)
Clive Peedell in The Health Care Blog picks up today where I left off regarding the NHS in U.K. He correctly identified that the NHS white paper is a plan to dismantle the NHS by allowing market forces to operate to disengage the NHS from health care bit by bit. He call this task “creative destruction.” This NHS will not fall overnight because the market’s invisible hand will destroy it in a piecemeal fashion, leaving the unprofitable areas of healthcare firmly in public sector hands.
“The key policy levers enabling this to happen are:
1. The purchaser provider split, with GP commissioning consortia taking the leading role on the purchaser side of the divide.
2. Patient Choice.
3. Competition between a plurality of ‘any willing providers’.
4. Payment by Results with price competition.
5. Patient held budgets.
6. Foundation trusts becoming social enterprises and the abolition of the cap on their private income.”
This demonstrates the absolute power of economics. Sooner or later most if not all nationalized systems lose influence. They cost more than predicted, and collapse inwardly.
Mr. Obama, with his “community organizer” banner has had a steep learning curve in this regard. He either disregarded his lessons in Economics at Harvard, or failed to attend all the classes. Mr. Obama never ran a business. Observers, participants and voters see this as the reforms measures are put in place in the U.S.
Anyway, I digress, back to Mr. Peedell’s predictions.
Either way, moving to a more nationalized system, or leaving one is a messy process for doctors and hospitals. The players will remain the same, their checks will come from different payers, and the taxpayer will pay for it all.
The white paper is therefore designed to fulfill a longstanding Tory dream - to dismantle the NHS and replace it with the private sector, which will receive its profits from the UK taxpayer.
Health reform, either way is always a hot political potato, It is also political suicide to dismantle the NHS, so it is being performed using the political rhetoric of patient empowerment through the patient choice agenda, and clinician empowerment by giving GPs a budget of £80bn.
Amazingly, Andrew Lansley is getting away with it because there is far too little understanding and resistance from the medical profession, which is realistically the only group of people that can prevent this assault on the NHS.
Either way politicians lose votes. This most recent election in the U.S. demonstrates this phenomenon as the democrats lost control of the US Congress.
Clive Peedell is a consulting oncologist and is co-chair of Britain's NHSCA. He contributes regularly to: Hospital.dr.co.uk
…..(to be continued)
A tweet arrived this morning from a twit friend. The NHS is rapidly unraveling in the U.K. according to this tweet.
Thank you to Mike Broad and The Health Care Blog
Picture this scenario:
Health Secretary Andrew Lansley said: “In order to meet rising need in the future, we need to make changes. We need to take steps to improve health outcomes, bringing them up to the standards of the best international healthcare systems, and to bring down the NHS money spent on bureaucracy. (Hmmmm?) Andrew Lansley's health and social care bill will abolish England’s 152 primary care trusts
This sounds familiar.
The controversial Health and Social Care Bill has been published, paving the way for GPs to control 80% of the NHS budget from 2013.
Unions warn the plans are the first step towards privatizing the health service, while the health select committee said the way they have been rushed in has taken the NHS by “surprise”.
But the government argues the changes will improve care and accountability.
Accountability, isn’t that what Medicare and ACOs are planned for the U.S?
This sounds a lot like reverse engineering of the UK System that has grown to become so moribund that it must be carefully dissected to de-commission it.
It looks to me as if they are running in the opposite direction from the U.S. Health Reform.
I wonder what Dr Berwick is thinking now?
TED MED today released a series of videos from the October 2010 Conference.
The conference kicked off with Steve Colbert’s enthusiastic opening speech to the conference.
One of the topics near and dear to me personally is the session on Lung Transplantation in Cystic Fibrosis. One of the participants was a young woman who had received a pulmonary transplant and gave a wonderful inspiring opera recital. Any trained vocalist can attest to just how much strength and stamina an opera singer must have to peform. Truly an inspiring presentation:
The first presentation is Charity Tillemann-Dick whose personal story and the results of her pulmonary transplant are even more amazing!
Dr. Shaf Keshavjee from Toronto, who is pioneering new technology to help organ recipients, demonstrated how in vivo extracorporeal circulation allows ‘targetted therapy’ to make potential organs for transplantation more like ‘self’ to minimize organ transplant rejection.
Dr. Sanjay Gupta reports from Haiti about motivation in the setting of a tragic disaster. Sanjay related how he was so inspired about the reactions of the devastated people and their warm responses to visitors and aid workers.
Please note: Registration for TEDMED 2011 is open. The dates are October 25-28, 2011, once again at the magnificent Hotel del Coronado in San Diego.
The 2010 event sold out with a wait list hundreds long... so we encourage anyone interested in attending TEDMED 2011 to secure their seat now: www.tedmed.com/register
It is well worth the time and money to go.
The 3 Rs , long the basis of educational dogma in the United States has been supplemented, and at times replaced by word processors, spelling and grammar checks and calculators capable of calculating algebraic, trigonometric, and calculus ..
Add to this the spice of mobile apps, smart phones with cameras and the QR code
Any digital camera and web cam is capable of reading these ideograms and with the proper software spit out the message in old fashioned plain English, French, German, or whatever.
A QR (Quick Response or Quick Read) Code is a two-dimensional matrix/bar code. Users hold their phone up to the code displayed on a sign, in a book, on a computer screen, TV, or almost anywhere. The phone camera snaps the code and takes the user to a website or video with more information – no typing needed – just point and click.
The hieroglyphic figures encapsulate a new wave of capturing ,storing and transmitting information. They have been around for awhile in the shipping industry, the IRS, legal forms and provide a means of sorting documents and packages by machines. Bar codes may be on the way out. Their readers are more complex expensive,and require lasers. The beauty of these little beasts is that they are easily read by a camera.
If you hadn’t noticed health related applications abound:
For example, QR codes can be used to help patients use health information in specific contexts, such as when needing to:
IF you’re smart, here are 22 ways you will use QR codes in health care.
Those of you wishing to check this can get one of these apps for your camera smart phone. You can also obtain a web camera app if you don’t have a camera smart phone.
NeoReader, Optiscan, QR App, QuickMark
All of these QR apps can be downloaded from the download.cnet.com web site.
Pill cap 2.0 ? It’s time for your medicine cabinet to become IT literate. Yes, plans have been developed, the hardware and software ready to go. The carriers are dreaming big about subscriptions to a service that reads your medicine bottles over your bathroom sink. Gigaom reports that at C.E.S. 2011 the activity about tablets was intense, however there were other more profitable things going on behind those doors on the sides of the exhibit hall.
For example? Your medicine cabinet. AT&T said last week it would provide the service behind an innovative pill cap that will connect to its network and text users when it’s time to take their medicine, or it could text a caregiver.
The nifty little pill bottle top costs $10 per cap and requires a $15 per month service plan. That’s likely worth it for people who need reminders about the drugs they or a loved one are taking, but on a per-megabyte basis that $15 per month nets out to about $25 per MB, although it’s not clear if AT&T gets the full $15. The folks at Vitality, the maker of the cap, said the connected cap transmits less than 20 kilobytes of data per day over the network — a mere crumb when compared to bandwidth hogs watching streaming video on their iPhones.
Vitality relies on pharmacies to dispense drugs in GlowCaps. Chains bid on how many of the caps they can distribute and get paid each time they dispense a bottle with one. Vitality recently launched its program with Express Scripts, one of the largest pharmacy benefit managers, to distribute certain medications in bottles outfitted with its caps. When does a non-event become an event?
The device has been shown to lift adherence. Data from a Partners Healthcare study released last month shows adherence increased 27%. Patients adhered to medications 98-99% of the time when the pill cap's reminder services, along with financial incentives, were used, according to data collected by the Center for Connected Health, a division of Partners Healthcare.
“Across all bottles in the field, we see compliance above 85%,” added Reim. Compared to what he said is the going compliance rate of roughly 65%, plus or minus depending on the drug, “That kind of 20% improvement in compliance has ramifications for outcomes, sales and new sources of data.”
So your spouse or significant other, mother, father will no longer have to berate you ‘not to forget your cough syrup"'’.
In 2011 expect there to be an explosion of ‘intelligent home devices"’ broadcasting your compliance, vital signs, and also most likely biopsying your wallet. What’s in Your Wallet?
