Week of May 23-27, 2016

Health Care Leadership and Management

While health information technology (HIT) arrived with great promise and adoption has been quick, widespread acceptance has lagged, and EHRs remain a major concern among physicians of all specialties. Among the most contentious issues: interoperability, clinical workflow efficiency, and the myriad demands of reporting patient data. James Gessner, M.D., President of the Massachusetts Medical Society.  Seven Principles for Better Information Technology,

This new health monitor doesn’t just keep tabs on your heart rate with an EKG — it can also measure levels of lactate in the body to keep track of how much energy you’re exerting.  A Wearable Chemical–Electrophysiological Hybrid Biosensing System for Real-Time Health and Fitness Monitoring, 

Wearable electronics, like the Fitbits and Apple Watches sported by runners and early adopters, are fast becoming on-the-job gear. But collecting data on employees’ health—and putting that data to work—can trigger a host of privacy issues.  WSJ,

Healthcare transformation will require leaders to hone their skills as futurists.  The secret is not to view forecasting as the sum total of the strategy but rather to use it as one piece of a broader design and strategy. How to Be a Better Futurist, and Why It Matters to Health Care,

The Office of the National Coordinator for Health IT should consider developing a Precision Medicine Initiative (PMI) addendum to its Interoperability Roadmap, the agency’s Precision Medicine Task Force recommended this week.  Precision Medicine Taskforce, 

Meaningful use programs have been credited with increasing adoption of EHRs, however many stakeholders are not eligible for meaningful use incentives. When care transitions involve a patchwork of paper and electronic systems, a myriad of errors emerges, and the result is substantially less than optimal.  A Creative Plan That Could Help Providers Ineligible for Meaningful Use Not Get Left behind in the Paper World, 

It’s often difficult for clinicians and administrators to say they are sorry when something goes wrong with patient care. But a new online toolkit from the Agency for Healthcare Research and Quality can help clinicians eliminate that “wall of silence” and culture of secrecy.  Communication and Optimal Resolution (CANDOR) Toolkit,

As many forces push the health care system to experiment with and expand newer health care delivery models, it is critical to think about how we can best align provider and consumer incentives. Understanding How Payment and Benefit Designs Work Together in Health Care,

Both sides offered closing arguments Wednesday morning in federal court in Chicago. Their arguments capped eight days of testimony over whether the FTC’s request for a preliminary injunction to halt a merger between NorthShore University HealthSystem and Advocate Health Care should be granted.  Here’s the latest from the Advocate-NorthShore antitrust case,

Most people recognize that execution is a critical skill and strive to perform it well, but they may a) underestimate how important it is to their career advancement or b) not realize that you can improve on execution without working longer hours.  4 Ways to Be More Effective at Execution,

To help uncover some of the day-to-day challenges primary care doctors face, Harvard Medical School’s Gordon Moore, M.D., interviewed nearly two dozen doctors in a variety of practice settings in the U.S. and the U.K. About one-third of U.S. and U.K. primary care physicians are dissatisfied with their jobs.  Is Primary Care the Best and Worst Job in Medicine? Population health: Scaling up,

To scale population health management efforts to their specific systems, healthcare providers must think beyond clinical measures and partner with vital resources from inside and outside the industry, according to a new report from PwC. 

Nursing care plans have inspired interest in a new tool for person-centered care by a multidisciplinary team: the comprehensive shared care plan. Private and public stakeholders must synchronize their efforts to achieve this setting-agnostic coordinated care.  Making the Comprehensive Shared Care Plan a Reality, 

ACA Implementation
A new policy brief from Health Affairs and the Robert Wood Johnson Foundation considers how uninsurance rates are changing under the Affordable Care Act (ACA), which was implemented to decrease the number of Americans lacking health insurance.  New Health Policy Brief: Uninsurance Rates and the Affordable Care Act,

Health care quality and spending are national concerns, but care is delivered locally. Our online tool shows the “relative value” of care—the quality achieved per amount spent—for people 65 and older enrolled in traditional fee-for-service Medicare.  Quality-Spending Interactive, 2016 Update,

Looking for ways to save money and improve care, Medicare officials are returning to an old-fashioned idea: house calls.  Done right and paid right, house calls could prove to be a better way of treating very sick, elderly patients while they can still live at home. Doctors’ House Calls Saving Money For Medicare,

The concept of value-based health care is rapidly gaining traction in the U.S., yet implementation remains a significant challenge. We propose that in a true pay-for-value system, a national payment rate should be established and rooted in reality and adjusted for three factors.  Paying For Value: Perspective From the Front Lines,

The Centers for Medicare & Medicaid Services plans to launch a series of “Hospital Improvement and Innovation Networks” (HIINs) to strengthen patient safety, improve hospital care quality and reduce readmissions.  CMS Continues Progress toward a Safer Health Care System through Integrated Efforts to Improve Patient Safety and Reduce Hospital Readmissions,

Before the rollout of the ACA in 2013, monthly premiums in New York’s individual health insurance market often exceeded $1,000—unaffordable for many. By 2014, a range of new programs and new enrollment resulted in an average individual New York monthly premium of $430.97, along with drops in health plans’ expenses on a per member per month basis. Affordable Care Act Brings New Life—and Covered Lives—to New York’s Individual Market,

In the wake of MACRA’s passage in 2015, some are wondering whether the sprawling law—aimed at moving Medicare to pay physicians for the value rather than the volume of services provided—will favor larger practices at the expense of smaller ones.  Do Small Physician Practices Have a Future?

In state capitols across the country, health care lobbyists and consultants are pushing a relatively unknown provision of the Affordable Care Act (ACA): Section 1332. A serious, objective examination of the new Section 1332 federal guidance sparks far more questions than answers for policymakers.  The ACA’s Section 1332: Escape Hatch or Straightjacket for Reform?

On April 27, CMS released the proposed rule1 for implementing the Medicare Access and CHIP Reauthorization Act (MACRA). MACRA will overhaul Medicare’s physician payment system starting in 2019, placing most physicians in the Merit-Based Incentive Payment System (MIPS), a pay-for-performance system that adjusts payments based on measures derived from prior care.  Implementing MACRA: Implications for Physicians and for Physician Leadership, 

One goal of the ACA was to increase preventive care and improve health behaviors by expanding access to health insurance.  The authors find evidence consistent with increased use of certain forms of preventive care such as dental visits and cancer screenings but little evidence of changes in health behaviors and in particular, no evidence that risky health behaviors increased in response to health insurance coverage.  The Impact of Health Insurance on Preventive Care and Health Behaviors: Evidence from the 2014 ACA Medicaid Expansions,


When it comes to the health benefits of eating breakfast, don’t believe the hype, Aaron Carroll reports for New York Times’ “The Upshot.”, NY Times,

First lady Michelle Obama on Friday unveiled the much-anticipated overhaul of the nutrition labels you see on every packaged product.  Washington Post,

Insurance coverage among immigrants remains stubbornly low, in part, because many undocumented immigrants are simply ineligible for coverage. Yet some states, including New York, are honoring their immigrant histories by making coverage more accessible.  Huffington Post,

Researchers surveyed 178 late-stage cancer patients before they underwent a scan to update the classification of their cancer stage. Only 10 percent reported having recent conversations with their oncologists about their prognosis, even though their average life expectancy was about six months. Journal of Clinical Oncology,

Commenting on recent Gallup poll findings on “replacing the Affordable Care Act with a federally funded health system,” Drew Altman discusses how public opinion can change as health proposals move from the idea stage to real legislative debates.  WSJ,

We are describing health as if it is just another consumer good, and physicians and other health practitioners as the providers of those goods. That is the language of a job.  Dr. Abraham Nussbaum, 41, makes the case that doctors and patients alike are being shortchanged by current medical practices that emphasize population-based standards of care rather than individual patient needs and experiences.  Kaiser, 

The rapid growth of telehealth services for mental and behavioral care means employers should consider the rewards and risks associated with this delivery of health care, particularly when it comes to privacy and state laws.  Bloomberg,

According to a report released Monday by the Democratic staff of the House Committee on Energy and Commerce, the NFL pressured the NIH to cancel a $16-million grant to study football-related brain injuries to a prominent Boston brain researcher who the league claimed was biased. LA Times, 

Amid challenges to reduce wait times, the VA Health Care System is launching an initiative at its Palo Alto, Calif., branch with CVS Health to give veterans access to same day appointments. Becker’s,

Most ambulatory centers don’t offer a complete breadth of services while full-scale hospitals often offer more than the community needs. Micro-hospitals are emerging as a middle ground.  Advisory Board, 

Using a collaborative care model, we are integrating mental health into primary care at the country’s largest public health care system, New York City Health + Hospitals. Our program provides screening and treatment in the primary care setting and has demonstrated improved depression symptoms in more than half of enrolled patients. NEJM Catalyst, 

Could it be that Alzheimer’s disease stems from the toxic remnants of the brain’s attempt to fight off infection? Provocative new research by a team of investigators at Harvard leads to this startling hypothesis,  NY Times,

Some people describe Darwinian evolution as “only a theory”. Drug-resistance is not only one of the clearest examples of evolution in action; it is also the one with the biggest immediate human cost.  The Economist,  

The United States spends nearly twice as much per person on health care as other rich nations, but we’re no healthier for it. To change course, we must broaden our understanding of health as driven by more than what happens in the doctor’s office.  The Urban Institute, 

This report looks at the current health status of people aged 50 to 64 and compares them to the same ages in 1999. There will be about 55% more senior citizens who have diabetes than there are today, and about 25% more who are obese.  NPR,

Gastric surgery should be offered as a standard treatment option for people with diabetes and could help them control their condition for years without medication. In a joint statement published in Diabetes Care, the consortium said bariatric, or metabolic, surgery could have a significant benefit for thousands of patients. Diabetes Care,

Now that this resistance gene has shown up in the U.S., it could spread to other germs, creating infections that doctors will have no way to treat. That’s already happened in other parts of the world, including China. NPR,

A new study calls into question the standards used by the U.S. Food and Drug Administration to approve new cancer drugs, and whether those drugs are helping patients at all.  Mayo Clinic Proceedings,
A new law in New York State aims to make it easier to sign up to be an organ or tissue donor. The measure will ask anyone signing up for coverage through the state’s health insurance exchange if they’d like to register as a donor. Newsday,



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