Thursday, December 24, 2015

MentalHealthDigitalInnovationChallenge

MentalHealthDigitalInnovationChallenge

MedStartr grew out of the New York Health Innovation Meetup Group, also called Health 2.0 NYC or just H2NYC.  H2NYC has been creating live events intended to foster an ecosystem around healthcare innovation since 2008.  We also have been recording them, livestreaming them, and publishing them online since 2010. Today our events bring the crowd to crowdfunding all over the World, jumpstarting healthcare innovation ecosystems everywhere we go.  To learn more about how we can help your organization or municipality please contact us.




Are we using technology in the field of mental health?



Barriers to care

1. Cost
2. Uncertainty about insurance coverage
3. Accessibility  (difficulty in finding care)
4. Societal stigma about therapy.

UPLIFT
The innovation challenge and answer

Smart phone based, and readily available for a one time fee of $ 10.00 Inexpensive, and scalable.
It uses a proven evidence based therapeutic process  CBT  (cognitive based therapy). CBT is the most evidence based therapy in development for 50 years. There have been 19 randomized controlled studies of computeried programs for depressed adults. Over 50% of people needing therapy for major depression do not get it. And only one in five received APA standardized treatment.

Uplift is an adaptive treatment. It if flexible and follows exactly the practice pattern of CBT, and assigns homework to the patient, verifying their progress.

At the current time there are no programs such as this available on the iTunes store or Google Play.

The need is apparent.  There are 12 million clinically depressed individuals who have access to a smart phone.

U.S mental health care $147 billion/year

Can therapy be computerized ?  According to Psious, a hardware/software combination Virtual Reality applicatioin is already being used by psychotherapists to duplicate anxiety producing scenarios (anxiety, phobias such as agrophobia), During the process behavioral modification takes place.

Biofeedback Module

VR Headset and Smartphone

Courage is  a novel game playing platform for the treament of depression




These programs are still in the developer stages.  The efficacy of the program often is not apparent or proven to be credible. Developers must submit their applications using verified studies, published in a credible medical journal to be accepted by providers (physicians). Thereapeutic process may require FDA approval.  These steps take time, and are essential to any hope of success.



Wednesday, December 16, 2015

The Experts Were Wrong About the Best Places for Better and Cheaper Health Care - The New York Times

As part of his push for the Affordable Care Act in 2009, President Obama came to Central High School to laud this community as a model of better, cheaper health care. “You’re getting better results while wasting less money,” he told the crowd. His visit had come amid similar praise from television broadcasts, a documentary film and a much-read New Yorker article.
All of the attention stemmed from academic work showing that Grand Junction spent far less money on Medicare treatments – with no apparent detriment to people’s health. The lesson seemed obvious: If the rest of the country became more like Grand Junction, this nation’s notoriously high medical costs would fall.







































































































































































































But a new study casts doubt on that simple message.- Oops !
The Price Ain’t Right? Hospital Prices and Health Spending on the Privately Insured*
Moreover, whereas Medicare
hospital prices are set by a regulator (as is true for prices for health care services in most
countries), hospital prices for the privately insured are market-determined. However, this may change wth the Affordable Care Act, the transition from volume based reimbursement to new models of care, including quality of care and HEDIS scores which reflect hospital and  health care compliance with recomendations from NQAH.
Health care providers’
transaction prices – have been treated as commercially sensitive and have been largely
unavailable to researchers. As a result, there is a great deal that is unknown about how and why
health care providers’ prices vary across the nation and the extent to which providers’ negotiated
prices influence overall health spending for the privately insured. 
Add to that is the complex algorithm  upon which payments are based, including the DRG (Diagnostic Related Group). There are roughly 999 listed by CMS Future payments will be altered by a penalty for non-compliance with the standards... It is not really an incentive where hospitals would be rewarded with an increase in payments, but a penalty for not complying, another negative incentive. Do more, get paid less.


The research looked not only at Medicare but also at a huge, new database drawn from private-insurance plans – the sorts used by most Americans for health care. And it shows that places that spend less on Medicare do not necessarily spend less on health care over all. Grand Junction, as it happens, is one of the most expensive health care markets in the country for the privately insured – despite its unusually low spending on Medicare.
All of these figures were based upon 2011, prior to the Affordable Care Act. Stay tuned for more gobbledy-gook.








The Experts Were Wrong About the Best Places for Better and Cheaper Health Care - The New York Times

Thursday, December 10, 2015

Dr. Jay Parkinson - Why there’s no Uber for Healthcare Back in...

Dr. Jay Parkinson - Why there’s no Uber for Healthcare Back in...

Alarming News About Your Physician(s) Burnout increasing among U.S. doctors





Burnout among U.S. doctors is getting worse, according to a study that shows physicians are worse off today than just three years earlier.  Mayo Clinic researchers, working with the American Medical Association, compared data from 2014 to measures they collected in 2011 and found higher measures on the classic signs of professional burnout. More than half of physicians felt emotionally exhausted and ineffective. More than half also said that work was less meaningful.

The data dovetail with a recent JAMA study, which found much greater prevalence of depression among doctors in training than in the general population.

Washington Post
This should be alarming news for you as a patient. Why  ?  Is your physician worried about making payroll,overhead expenses,  saving for retirement, educating his/her children, and the immediate need for paying off astronomical student loans between $100,000 dollars and $250,000 dollars.  Shouldn't your physicians be using all their energy for caring for you and also continuing medical education.  The prospect of a medico-legal misadventure are highly probable in a physician's career.    The professional bar for performance is very high (as it  should be). The vast majority of physicians are not self-serving and have am ethical and moral interest in your health. Few enter the profession with the idea of becoming rich, only to  maintain a reasonable standard of living, educate their children and save for retirement. Their income results in a considerable tax responsibility.  If one is a small practice doctor the personal financial liabilities are immense for overhead, dues, subscription fees, professional society dues, state licensees, the cost of specialty recertification and more.
Taken together, experts say the problems require solutions that offer a systemic approach. All health care organizations have a shared responsibility to address the situation, they add.
The responsibility is not just for health care organizations, but is that of general society to protect those who sacrifice much to care for you..  When was the last time you asked your physician how he was doing ? If you like your doctor, perhaps a letter to your congressman or senator stating what you observe and not demand unreasonable bureaucracy being placed upon your caregivers.  They serve you, the patient, healthy, sick or otherwise.  They are not government employees unless they work for a state, county, or federal agency such as the Veterans Administration, military service, or public health agency. The vast majority of doctors are now seeking employment, just to  escape the endless worsening tunnels of managed care, federal regulations and mandates for automated medicine, electronic health records.  All of these factors shorten a career life add disability issues and increase the shortage of physicians..  There are few highly paid specialty groups, radiology, neurosurgery, and several interventional medical specialties, such as gastroenterology, and cardiology.  
It would be a unique experience to see how federal regulations could be designed to lower stress and cost for physicians. 
I am not holding my breath.




Burnout increasing among U.S. doctors - The Washington Post


Signs of depression are 'unacceptably high' among doctors in training, study finds