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Examining EHR Use Among Allergists & Immunologists

Examining EHR Use Among Allergists & Immunologists

Evidence suggests that several obstacles appear to prevent widespread acceptance of electronic health records (EHRs) among many physicians, including allergists and immunologists. However, several potential solutions may enable providers to benefit from EHR technology. The United States government has made multiple efforts to promote more widespread adoption of electronic health records (EHRs), including the $35 billion Health Information Technology for Economic and Clinical Health (HITECH) Act. Despite these efforts, results from several surveys suggest that physician satisfaction with, and adoption of, EHRs remains low. Thorough analyses on the current status of EHR use and the barriers keeping physicians, including allergists and immunologists, from adopting fully functioning EHR systems are lacking. “To date, there are no scholarly articles evaluating the use of fully functional EHRs from the perspective of an allergist or immunologist,” says Lawrence D. Frenkel, MD. For a review published in Allergy and Asthma Proceedings, Dr. Frenkel explored the goals of optimal EHRs, the reasons behind the lack of widespread adoption, and potential solutions to these problems. The Optimal EHR  “Locating specific information within paper records of complicated patients can be time-consuming and fraught with errors,” explains Dr. Frenkel. “Some information may not be recorded correctly, if at all, or may be difficult to find. EHRs, however, provide a template for completeness in the physical examination. Those who access carefully completed EHRs can easily see what physicians do and find as well as what was not done. For example, vital signs can be easily recorded and viewed longitudinally in EHRs. Current medications, their indications, and the clinicians who prescribed them are also easily accessed in an EHR. When...
Drugs Similar to Aspirin, Ibuprofen Could Help Treat Sepsis, Study Suggests

Drugs Similar to Aspirin, Ibuprofen Could Help Treat Sepsis, Study Suggests

A potentially life-saving treatment for sepsis has been under our noses for decades in the non-steroidal anti-inflammatory drugs (NSAIDs) most people have in their medicine cabinets, a new University of Colorado Boulder study suggests. Each year more than 1 million people in the United States contract sepsis, an overwhelming immune response to infection. It kills as many as half of those who contract it, sometimes within days, according to the National Institutes of Health. “NSAIDS like ibuprofen and aspirin are among the most prevalent pharmaceuticals worldwide, with over 30 billion doses taken annually in the United States alone. But their precise mechanisms of action are not entirely understood,” said Hang Hubert Yin, a biochemistry professor at CU Boulder’s BioFrontiers Institute and lead author of the new paper, published today in Cell Chemical Biology. “We provide the first evidence for a novel mechanism of action for NSAIDS, one we believe could have a direct impact on people’s lives.” Related Articles Evaluation of Sepsis Varies Across Newborn Nurseries NIH Scientists Illuminate Role of Staph Toxins in Bacterial Sepsis 5 Things to Know for New Sepsis Treatment Guidelines Hydrocortisone Doesn’t Cut Risk of Septic Shock in Sepsis But Yin’s research found that a subgroup of NSAIDs also act strongly and independently on another family of enzymes, caspases, which reside deep within the cell and have recently been found to play a key role in aggressive immune responses, like sepsis. “For instance, some chemicals derived from bacteria actually penetrate the cell and trigger the caspase response, prompting the cell to commit suicide. This also is known as apoptosis,” said Yin. “Such activation, in...
7.8 Million Deaths Worldwide Could Be Prevented Each Year if People Ate More Fruits and Vegetables

7.8 Million Deaths Worldwide Could Be Prevented Each Year if People Ate More Fruits and Vegetables

The more fruits and vegetables a person eats, the lower his or her risk of heart disease, stroke and premature death. You’ve heard it a thousand times, that little catchphrase with the magic number encouraging you to eat “five a day” of fruits and vegetables for better health. But it turns out that the real magic number is eight, according to a new comprehensive study just published in the International Journal of Epidemiology. The study, spearheaded by Dagfinn Aune, from the Norwegian University of Science and Technology (NTNU) and Imperial College London, shows that 7.8 million deaths worldwide could be prevented each year if people ate more fruits and vegetables. Aune says the more you eat, the lower the overall risk of heart disease, stroke, cancer and premature death. The study shows that the risk of dying prematurely from all causes was reduced by almost a third, and the risk of cardiovascular disease by about a quarter in people who ate 800 grams of fruit and vegetables every day, compared with those who ate very little or no fruits and vegetables. Related Articles Novel Diet Can Help Children With Crohn’s, Colitis Find Relief Most U.S. Children Consume at Least One Sugary Drink a Day Fruits, Vegetables, & Ischemic Heart Disease “The risk of heart disease, strokes and premature death decreased by 10.8 per cent for each 200 gram increase in consumption of fruit or vegetables–up to an intake of 800 grams,” Aune said. He stressed that the greatest impact from increasing a person’s daily intake of fruit and vegetables appears to be in people do not eat fruit and...
Two-Thirds of Clinicians Lack Knowledge of Diabetes-Related Foot Complication

Two-Thirds of Clinicians Lack Knowledge of Diabetes-Related Foot Complication

A recent survey found that a majority of doctors who are not foot specialists don’t know enough about a rare form of foot damage, which can lead to significant disability in patients. Diabetes can have several complications, including one common side effect: foot damage. Although some types are common, others are rarer. Among the lesser-known conditions is Charcot neuroarthropathy. “It is a rare foot condition that can cause significant deformity, disability and may lead to ulcerations and infections if it is not caught early in the disease process,” says Brian Schmidt, D.P.M., clinical instructor in internal medicine and member of the podiatry team at Michigan Medicine. Commonly known as a Charcot foot and/or ankle, the effects can be debilitating. Related Articles Outcome after protected full weightbearing treatment in an orthopedic device in diabetic neuropathic arthropathy (Charcot arthropathy) Managing Charcot Foot in Diabetes Many doctors, however, aren’t up to speed on the matter. Schmidt is the lead author on a new study, published in Clinical Diabetes and Endocrinology, that investigated how much non-foot-specialist clinicians know about the condition in an effort to understand how to better focus future educational forums on the topic. Of the 400 endocrinologists, internal medicine physicians and family medicine physicians who responded to a survey, more than two-thirds of respondents — 67.6 percent — described themselves as having poor or complete lack of knowledge of Charcot neuroarthropathy. Researchers also investigated how referring physicians treat the condition if they encounter it. Read the full press release...
4 Ways to Improve Patient Flow and Avoid Scheduling Problems

4 Ways to Improve Patient Flow and Avoid Scheduling Problems

The author of this article is Judy Capko, a practice management consultant with Capko & Morgan. Scheduling problems are a common practice-wide issue, but here are some helpful strategies to deal with this important work flow issue: Identify trends. Tools are available to better understand specific scheduling and to track patient flow problems. Look at 2 weeks of data to identify trends and causes of these problems. Establish a baseline. Determine what is considered “on schedule.” Be sure to look at scheduling patterns for total length of patient visits rather than appointment length. Adjust schedules. Some problems in work flow aren’t too difficult to fix, but the key is to schedule realistically based on the time needs of providers. Consider longer scheduled time slots for patients with multiple care issues. Efficiency can also improve if nurses are trained to take on more clinical-support responsibilities. Avoid double booking. Try scheduling “work-in” patients alongside a new patient visit. This enables physicians to see add-ons while nurses work up new patients. If booking demands of the practice persist, find long-term solutions rather than continue double booking. Ultimately, practices should work as a team to find the best solutions for scheduling and patient-flow issues. Before implementing any changes, consider the practice’s specific needs carefully. Click here for the complete...
Updated Guidance on Invasive Aspergillosis

Updated Guidance on Invasive Aspergillosis

The Infectious Diseases Society of America has released an updated guideline for treating invasive aspergillosis that stress the importance of early diagnosis and treatment to improve clinical outcomes. In 2008, the Infectious Diseases Society of America (IDSA) released a guideline on the diagnosis and treatment of aspergillosis, a fungal infection caused by the airborne mold Aspergillus. With more data emerging and the recent FDA approval of new drugs for aspergillosis, the IDSA has updated its guideline and published it in Clinical Infectious Diseases. The update focuses heavily on invasive aspergillosis, which can be fatal in 40% to 80% of vulnerable patients with widespread infection. “Since the last guideline, several developments have occurred regarding the drugs used for aspergillosis,” explains Thomas Patterson, MD, who was lead author of the guideline update. “Isavuconazole and a new formulation of posaconazole were approved by the FDA, and we now have more robust clinical experience with voriconazole.” Dr. Patterson notes that other factors have also changed the treatment landscape for aspergillosis, including further developed diagnostics, the influence of biomarkers like polymerase chain reaction (PCR), and increasing antifungal resistance. Diagnosis The updated guideline emphasizes that early diagnosis and therapy are critical to successfully treating patients with aspergillosis. “This has been well established, but the evidence is even stronger now to support it,” says Dr. Patterson. The guideline-writing panel stresses the importance of using cultures to establish a firm diagnosis, the etiology of infection, and help identify the organism to the species level. “This is important because of the variable susceptibilities that might be predicted from the different species,” Dr. Patterson adds.  “We also recognize that...
Listeria May Be Serious Miscarriage Threat Early in Pregnancy

Listeria May Be Serious Miscarriage Threat Early in Pregnancy

Listeria monocytogenes can cause miscarriage, stillbirth and premature labor in pregnant women. Listeria, a common food-borne bacterium, may pose a greater risk of miscarriage in the early stages of pregnancy than appreciated, according to researchers at the University of Wisconsin-Madison School of Veterinary Medicine studying how pathogens affect fetal development and change the outcome of pregnancy. “For many years, listeria has been associated with adverse outcomes in pregnancy, but particularly at the end of pregnancy,” says Ted Golos, a UW-Madison reproductive physiologist and professor of comparative biosciences and obstetrics and gynecology. “What wasn’t known with much clarity before this study is that it appears it’s a severe risk factor in early pregnancy.” Related Articles Acquired central hypoventilation following Listeria monocytogenes rhombencephalitis Fecal Transplant Feasible for C. difficile Infection in Pregnancy Risk of Certain Adverse Outcomes Up With Endoscopy in Pregnancy SMFM: No Benefit to Limiting Pregnancy Weight Gain in Obese Pregnant women are warned to avoid many of the foods — among them unpasteurized milk and soft cheese, raw sprouts, melon and deli meats not carefully handled — that can harbor listeria, because the bacterium is known to cause miscarriage and stillbirth, and spur premature labor. Those severe outcomes have resulted in a zero-tolerance regulatory policy for listeria in ready-to-eat foods. But when it occurs, listeria infection in pregnancy may go unnoticed. The few recognizable symptoms are nearly indistinguishable from the discomfort most newly pregnant women feel. Click here to read the full press release....
Innovative Treatment for Depression in Older People Proves Effective

Innovative Treatment for Depression in Older People Proves Effective

Psychological treatment can help older people who are suffering from lower-severity depression, prevent more severe depression from developing. An innovative psychological treatment can help older people who are suffering from lower-severity depression, say researchers at the University of York. It can also prevent more severe depression from developing. Depression is common amongst older people, with one in seven meeting the criteria for full-blown depression. Older people at the greatest risk of depression are those who suffer from loneliness and long-term illnesses, both of which affect this age group disproportionately. The CASPER clinical trial focussed on older people with lower-severity symptoms who are at the highest risk of becoming clinically depressed. CASPER is the largest-ever study of its kind and is reported in the Journal of the American Medical Association (JAMA). York based researchers showed that a simple and low-cost intervention reduced the symptoms of depression in older people (aged 65 and over). Related Articles Depression & Mortality in Older Diabetics The Long-Term Course of Depression in Older Women Anxiety, Depression May Up Mortality Risk for Some Cancers Antidepressants + Exercise Beneficial in Late-Life Depression Those who received the intervention were also less likely to be more severely depressed after a year. Older people were also less anxious and had improved quality of life compared to people who just received care from their GP. “We developed our Collaborative Care intervention after consulting with older people and considering evidence about effective treatments for depression.” said study manager, Kate Bosanquet, from the University of York’s Department of Health Sciences. “We used a simple psychological approach known as behavioural activation. Older people were...
Asthma Drugs Could Prevent Deadly Form of Pneumonia

Asthma Drugs Could Prevent Deadly Form of Pneumonia

Early administration may block infection of important cells deep in the lungs. Two drugs used to treat asthma and allergies may offer a way to prevent a form of pneumonia that can kill up to 40 percent of people who contract it, researchers at the University of Virginia School of Medicine have found. Influenza pneumonia results when a flu infection spreads to alveolar air sacs deep within the lungs. Normally, a flu infection does not progress that far into the lower respiratory tract, but when it does, the results can be deadly. “If infection is severe enough, and the immune response is potent enough, you get injury to these cells and are no longer able to get sufficient oxygen exchange,” explained UVA researcher Thomas J. Braciale, MD, PhD. “As a result of the infection of the cells, you can develop lethal pneumonia and die.” Related Articles New Guidelines: Managing Hospital-Acquired Pneumonia & Ventilator-Associated Pneumonia Community-Acquired Pneumonia Can Spread Year-Round Guidance on Treating Unexplained Chronic Cough Improving Pediatric Asthma Care But early administration of the two asthma drugs, Accolate and Singulair, could prevent the infection of the alveolar cells deep in the lower respiratory tract, Braciale’s research suggests. “The excitement of this is the possibility of someone coming to see the physician with influenza that looks a little more severe than usual and treating them with the drugs Singulair or Accolate and preventing them from getting severe pneumonia,” he said. “The fatality rate from influenza pneumonia can be pretty high, even with all modern techniques to support these patients. Up to 40 percent. So it’s a very serious problem when...
Proteins in Your Runny Nose Could Reveal a Viral Infection

Proteins in Your Runny Nose Could Reveal a Viral Infection

Scientists identify biomarkers in mucous that verify viral infection from cold or flu. Duke Health scientists have identified a group of proteins that, when detected in specific quantities in the mucous, are 86 percent accurate in confirming the infection is from a cold or flu virus, according to a small, proof-of-concept trial published online in the journal EBioMedicine. The researchers hope their initial work identifying the protein signature could aid the development of a quick, noninvasive doctor’s office test to determine the cause of upper respiratory illness and appropriate treatment. Widespread use of antibiotics for upper respiratory infections don’t benefit patients with viral illness and can contribute to antibiotic-resistant superbugs, Ginsburg said. More precise diagnoses of these infections could be another tool to curb the development of superbugs, he said. Related Articles Can We Create a Vaccine Against Common Cold? Common Pain Relievers May Increase Heart Attack Risk During Respiratory Infections | News Brief Sudden Drop in Temperature Increases Risk of Respiratory Infections Most people mistakenly believe they’re allergic to penicillin For the trial, researchers infected 88 healthy adult volunteers with a common strain of cold or flu virus. Some participants didn’t get sick. Among those who developed infections, researchers found a distinct set of 25 proteins in fluid samples they gathered by flushing about 2 teaspoons of saline through the participant’s nasal passages. Click here for more information on this study....
Healthgrades Names America’s Top Hospitals  for 2017

Healthgrades Names America’s Top Hospitals for 2017

See which hospitals made the cut for the top 50 and top 100 in the country. Healthgrades recently released its America’s Best Hospitals for 2017, naming America’s Top 50 Hospitals and America’s Top 100 Hospitals. According the Healthgrades, the top 50 hospitals are in the top 1% of hospitals in the nation for providing overall clinical excellence across a broad spectrum of conditions and procedures consistently for at least six consecutive years. The top 100 are in the top 2% of hospitals in the nation for exhibiting clinical excellence for at least three consecutive years. “These hospitals exhibit exceptional, comprehensive, and consistent quality year over year. Simply put, patients are more likely to have a successful treatment without major complications—and have a lower chance of dying—at America’s Best Hospitals,” says the report. Below is a list of the top 50 hospitals. Click on each one to see more in-depth ratings. ARIZONA Banner Estrella Medical Center Dignity Health – Chandler Regional Medical Center Mayo Clinic Hospital CALIFORNIA Cedars – Sinai Medical Center Eden Medical Center Hoag Hospital Newport Beach Huntington Memorial Hospital John Muir Medical Center – Walnut Creek Kaiser Permanente Woodland Hills Medical Center Mills-Peninsula Medical Center Mills Health Center Saddleback Memorial Medical Center- Laguna Hills Scripps Green Hospital Sutter Roseville Medical Center COLORADO Centura Health – Penrose Saint Francis Health Services St. Francis Medical Center North Colorado Medical Center Saint Joseph Hospital FLORIDA Delray Medical Center GEORGIA Northeast Georgia Medical Center Piedmont Fayette Hospital ILLINOIS Advocate Christ Hospital and Medical Center Advocate Good Samaritan Hospital Alexian Brothers Medical Center Carle Foundation Hospital Palos Community Hospital Presence Resurrection Medical Center St. Alexius Medical...
What Is the Future of Healthcare Under President Trump?

What Is the Future of Healthcare Under President Trump?

The future of healthcare under President Trump and how healthcare providers can have a say in it.   Physician’s Weekly, along with Dr. Linda Girgis, MD, FAAFP, hosted a live Tweet Chat on Wednesday, Feb. 22, to discuss the current and future state of our nation’s healthcare system. More specifically, the discussion was centered around what President Trump and his administration are doing to improve healthcare, and what will happen with the current system in place.  While there are still many wheels in motion concerning policies, there have been numerous discussions among medical professionals and patients about what’s to come. Here are some highlights from the discussion. Let us know your thoughts on these topics. Question 1 Q1: What was the biggest news in healthcare during DT’s 1st 30 day, in your opinion?#TrumpHealthcare — Physician’s Weekly (@physicianswkly) February 23, 2017 A1: POTUS Donald Trump signing an executive order his first day in office to roll back the ACA. #TrumpHealthcare #TrumpHealthcare — LindaGirgis,MD (@DrLindaMD) February 23, 2017 A1 Although he has not released his “actual” plan, there is much he has said. #TrumpHealthcare — LindaGirgis,MD (@DrLindaMD) February 23, 2017 T1 There is always an intriguing tension between the revolutions in healthcare science and healthcare economics #trumphealthcare — Robert Mahoney (@mahoneyr) February 23, 2017 T1 That said, not much news so far. Conservatives want to repeal the Affordable Care Act. What they will replace it with? #trumphealthcare — Robert Mahoney (@mahoneyr) February 23, 2017 Question 2 Q2: Should the ACA be repealed? What should be kept? What needs fixing?#TrumpHealthcare — Physician’s Weekly (@physicianswkly) February 23, 2017 A2: A2: Although I have...
Infographic: Female vs. Male Nurses and Their Salaries

Infographic: Female vs. Male Nurses and Their Salaries

The prevalence of female nurses isn’t anything new in the United States. There are currently 3.2 million active professional female nurses across the country. According to a study from MidAmerica Nazarene University, however, the number of male nurses pale in comparison: 333,000 nationwide. “Unfortunately,” says Jerry Lucas, a registered nurse and the publisher of Male Nurse Magazine, “one of the biggest detriments to men entering nursing is TV shows and movies like Meet the Parents.” These days, though, some believe the stigma is waning. Dr. Barry Anderson, an assistant professor at the Medical University of South Carolina College of Nursing, is one of those people. “I think that has come with the increase in health care technology, competitive salaries, high job satisfaction, and that others are now recognizing that nursing is a great career,” he says. “People are seeing it as a worthwhile profession in which you can make really good money with career opportunities.” Conversely, the salaries for female nurses are actually lower even though they make up a big majority of this workforce. Click here to read more data on male vs. female nurses.    ...
Late‐Onset Asthma & Cardiovascular Disease Risks

Late‐Onset Asthma & Cardiovascular Disease Risks

Asthma is a heterogeneous syndrome in which presentations can vary significantly between patients. Although it is not usually recognized as such, there are different clinical subtypes of asthma, each with unique pathophysiology. Specific subtypes may be associated with an increased risk for cardiovascular disease (CVD). “Asthma and CVD may be interconnected, but studies indicating a cause-and-effect relationship between the conditions have been mixed,” says Matthew C. Tattersall, DO, MS. For a study published in the Journal of the American Heart Association, Dr. Tattersall and colleagues investigated if late‐onset subtype of asthma is associated with a higher risk of incident CVD. “This type of asthma tends to be more severe and more difficult to control with medications than early-onset asthma,” notes Dr. Tattersall. He and his colleagues followed participants from the Wisconsin Sleep Cohort who did not have CVD at baseline and tracked them for an average of nearly 14 years. The analysis involved 1,269 patients aged 47, on average; 111 of these patients had late-onset asthma whereas 55 had early-onset asthma. Important Findings “Our study showed that patients with late-onset asthma were nearly 60% more likely than those without asthma to experience a CVD event, such as a heart attack, stroke, heart failure, angina, and/or cardiovascular-related death,” Dr. Tattersall says. Study participants with late‐onset asthma were more likely than those without the disease to be a woman (67% vs 44%) and to have a higher BMI (32.2 kg/m2 vs 29.4 kg/m2). The average age of an asthma diagnosis in the late‐onset group was 39.5 years, compared with 8.9 years for the early‐onset group. However, there appeared to be no interaction...
New Guidelines: Managing Hospital-Acquired Pneumonia & Ventilator-Associated Pneumonia

New Guidelines: Managing Hospital-Acquired Pneumonia & Ventilator-Associated Pneumonia

The Infectious Diseases Society of America and the American Thoracic Society have released joint clinical practice guidelines on the management of adults with hospital-acquired pneumonia, or HAP, and ventilator-associated pneumonia, or VAP. Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) are estimated to account for 20% to 25% of all hospital-acquired infections, and about 10% to 15% of these cases are fatal. In 2005, the Infectious Diseases Society of America (IDSA) and the American Thoracic Society (ATS) published a guideline on the management of adults with HAP and VAP (HAP/VAP). Knowledge regarding the diagnosis and treatment of HAP/VAP evolved and changed substantially in the 11 years following the release of this guideline, according to Andre C. Kalil, MD, MPH. As a result of these recent advancements, the IDSA and ATS updated their recommendations (Table below) and published them in Clinical Infectious Disease. Key Updates For many years, antibiotic therapy courses were administered for 14 to 21 days, explains Dr. Kalil. “Duration of treatment varied greatly in the past because there was little evidence to delineate the optimal length of therapy in patients with HAP/VAP,” he says. “When the guideline panel pulled together a systematic review of the research from the last 10 to 15 years, it became evident that these patients can be treated effectively and safely with a shorter, 7-day course of antibiotic therapy. Most patients can clear the infection in the way we would expect. Some patients may require an even shorter course, whereas others may require a longer course. This variation depends on the improvement of clinical, radiologic, and laboratory parameters. That said, the consensus among the...
Bariatric Surgery in Adolescents

Bariatric Surgery in Adolescents

According to published data, severe obesity affects about 4.5 million children and adolescents in the United States, and another 22 million are classified as being overweight. With few effective treatments available for this patient population, there has been a recent emergence in the use of bariatric surgery in adolescents. “Severe pediatric obesity is fast becoming a public health crisis because these patients are likely to develop significant health problems later in life,” says Thomas H. Inge, MD, PhD, FACS, FAAP. Assessing Outcomes Most obesity treatment approaches are not successful for obese children, and this is particularly true for severely obese kids. Bariatric surgery has been used in teenagers for several decades but few prospective studies have examined changes in BMI and outcomes of modern bariatric procedures. Thus families and primary care providers have little hard evidence about clinical outcomes and risks after bariatric surgery in adolescents. To address this issue, Dr. Inge and colleagues recently published study findings in the New England Journal of Medicine that explored the efficacy and safety of bariatric surgery in adolescents. For the analysis, the authors used data from the Teen-Longitudinal Assessment of Bariatric Surgery study, which collects longitudinal prospective clinical and laboratory information on teenagers undergoing bariatric surgery at five centers in the United States. The investigators prospectively examined 242 adolescents undergoing Roux-en-Y gastric bypass (161 participants) or sleeve gastrectomy (67 participants) in the analysis. They then examined changes in body weight, coexisting conditions, cardiometabolic risk factors, weight-related quality of life (QOL), and postoperative complications through 3 years after the procedure. Patients in the analysis were between the ages of 13 and 19...
6 Ways to Achieve Successful Physician Partnerships

6 Ways to Achieve Successful Physician Partnerships

For physician partnerships to be successful, it is critical to pre-plan, have careful structuring, and maintain continued communication. Here are six areas that should be examined in great detail when undertaking this process: Structure: Think about how the practice is structure currently as well as potential future arrangements. Current owner(s): Consider internal perspectives to see what impact adding a physician partner would make. Potential partner(s): Keep in mind what the other physician wants from the partnership arrangement from a financial, operational, and strategical perspective. Creating a partnership: Consider how the partnership should be structured and think about factors like buy-in, real estate, the division of assets, and governance. Delivering partnership offerings: Be sure to understand all terms and tweak legal language in documents, if necessary. Ongoing communication: New partners should be on equal ground with other partners and brought up to speed with financial and operational metrics as well as any business ventures. Initiate regularly scheduled meetings in which business is discussed and all partners have the opportunity to have their voice...
Digital Health Technology Use in Seniors

Digital Health Technology Use in Seniors

According to recent estimates, seniors aged 65 and older rank as the sickest, most expensive, and fastest growing segment of the United States population. “In recent years, there has been increasing desire to use digital health technology as a means to improve healthcare quality, cost, and safety,” says David M. Levine, MD, MA. “However, few studies have provided information about how digital health is being used by seniors in the U.S.” To address this data gap, Dr. Levine and colleagues published a research letter in JAMA. For the study, researchers examined data from the National Health and Aging Trends Study (NHATS), an annual in-home, computer-assisted survey that is given to community-dwelling Medicare beneficiaries aged 65 and older. “This is a nationally-representative data set that is drawn from the Medicare enrollment file through a complex sampling design,” says Dr. Levine. Each year, NHATS asks the same respondents about a variety of topics, including their daily use of non-health technology and how they use digital health to fill prescriptions, contact a clinician, address insurance matters, and/or research health conditions. The study by Dr. Levine and colleagues looked specifically at variables associated with digital health use. Key Trends “Our study showed seniors used digital health at low rates, with only modest increases from 2011 through 2014,” Dr. Levine says. Although cell phone and computer use were stable, small statistically significant increases were noted in other everyday technologies. The proportion of seniors who used any digital health increased from 21% in 2011 to 25% in 2014. The authors also found that seniors used everyday technology at a level that was below that of...
Taking a High-Priced Cancer Drug with a Low-Fat Meal Can Cut Cost by 75%

Taking a High-Priced Cancer Drug with a Low-Fat Meal Can Cut Cost by 75%

Taking one-fourth the standard dose of a widely used drug for prostate cancer with a low-fat breakfast can be as effective – and four times less expensive – as taking the standard dose as recommended: on an empty stomach. The study, a multi-center, randomized, phase-II clinical trial to be presented at ASCO’s 2017 Genitourinary Cancers Symposium in Orlando, FL, found that the 36 patients who took 250 milligrams of the drug with a low-fat breakfast had outcomes that were virtually identical to the 36 patients who took the standard dose, 1,000 milligrams of the drug on an empty stomach. The finding has significant financial implications. The drug, abiraterone acetate – marketed as ZYTIGA® – now retails for more than $9,000 per month. Even patients with blue-ribbon health insurance can have co-pays ranging from $1,000 to $3,000 per month. Related Articles Out-of-Pocket Cancer Costs High for Patients With Medicare Only Costs of Chemo for Breast Cancer Vary Widely in the United States New Anticancer Drugs Up Costs and Life Expectancy Considerably Improved Breast Cancer Screening Rates With ACA Patients taking abiraterone acetate typically stay on the medication for 12 to 18 months. Since 2011, according to the manufacturer’s website, more than 100,000 patients in the United States alone have filled prescriptions for abiraterone. If each of those 100,000 patients had taken the drug for 12 months and, theoretically, paid the list price out of pocket but took the lower dose with food, the 75-percent cost reduction could have saved them more than $6 billion. Read the full press release...
One in 4 ER Visits for Eye Problems Aren’t Actually Emergencies

One in 4 ER Visits for Eye Problems Aren’t Actually Emergencies

University of Michigan researchers envision ways to reduce inappropriate and costly emergency visits, including telemedicine and after-hours appointments. Pinkeye isn’t a medical emergency. Neither is a puffy eyelid. But a new study finds that nearly one in four people who seek emergency care for eye problems have those mild conditions, and recommends ways to help those patients get the right level of care. The national study, led by University of Michigan researchers, looks at nearly 377,000 eye-related emergency room visits by adults with private insurance over a 14-year period. The team has published its results in the journal Ophthalmology. Nearly 86,500 of those visits were for three conditions that don’t ever need emergency treatment, and cost much more to treat in an emergency setting while also adding to ER crowding. Only about 25,300 were for clear eye emergencies. The rest were somewhere in the middle. Related Articles Four ER Visits for Adverse Drug Events Per 1,000 People Certain Factors Predict Repeat ER Visits for Ureteral Stones Severe Symptoms, Ocular Pain Linked to Dry Eye Persistence Confocal Microscopy Aids Surgical Removal of Tumors From Eyelid The researchers then looked deeper at what drove inappropriate use of ER visits for conjunctivitis (pinkeye), blepharitis (swollen eyelids) and chalazion (eyelid bumps). Younger people, men, those with lower incomes or dementia, and people of color were more likely to seek emergency care for these non-emergency conditions. So were people who were “frequent flyers” in the emergency room, seeking ER care four times a year or more for non-eye problems. On the other hand, those who had been seeing an eye specialist – optometrist or...
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