Posts Tagged ‘healthcare’

Incredible article.  A real eye opener in terms of common understanding of healthcare in the US.

JAMA Network | JAMA | The Anatomy of Health Care in the United States.

Favorite: “US health care is not a system, as it is neither coordinated by a central entity nor governed by individuals and institutions that interact in predictable ways.”

Just keeping track of this.  I had a minor role in data collection.


J Am Coll Radiol. 2012 Jun;9(6):403-8. doi: 10.1016/j.jacr.2012.01.006.

Physician documentation deficiencies in abdominal ultrasound reports: frequency, characteristics, and financial impact.

Duszak R JrNossal MSchofield LPicus D.


Mid-South Imaging and Therapeutics, Memphis, Tennessee 38120, USA.

Very nice link on Cool Tools: . This is a great product.





reform |riˈfôrm|  verb [ trans. ] Make changes in (something, typically a social, political, or economic institution or practice) in order to improve it.  (From OS X application Dictionary, v2.0.2)

There is obviously a lot at stake in the government’s current efforts to reform healthcare.  Healthcaare contains the constant moral dilemma of balancing resources with life, and also represents a huge percentage of economic activity that has its associated special interests.  Given that half of the spending in healthcare is currently controlled by the government guarentees that the decisions made will be the least common demoninator resulting from political compromise – or worse – a step backwards based on politiical self-interest.

Like many, I watched the beginning of this discussion with great optimism that some real reform would take place.  I have even spent a measurable percentage of my time (and more specifically my company’s time) participating in various programs for public input and advocacy, so a lot of the details are well understood.  But, I am becoming increasingly disappointed in the direction of the evolving legislation.  While the goals of expanding coverage are admirable and ultimately necessary, the path to get there is now looking more like 1960’s thinking and not 21st century thinking.  Back office agreements with the current system beneficiaries, fiscal manipulation, increased taxes, and retention of the current structure of employers, insurance, and claims.  All done under a forced deadline which will make sure that whatever we get is anything available before the deadline and not what is the right thing to do.  Add in a big effort to push the purchase of computer systems built on last centuries approach to healthcare (and largely rejected by physicians as useful for their work) to make sure we don’t move the infrastructure forward.

Let’s stop calling this reform and start calling this healthcare expansion under the current structure – a structure we know doesn’t work.  Anything that preserves the fee-for-service backbone is a vote for non-reform.  Solving the model of healthcare payment should be figured out before we even get into the debate of where to sit on the spectrum of nationalizing healthcare.

How about this: run any number of pilot projects that use a medical home model, primary care focus, community clinic focus, or anything that provides a market incentive for wellness.  And include incentives for the average patient to take responsibility for their own health.  And separate us from our employers so we have some idea what healthcare actually costs.  Publish the results of the pilots to figure out the best practices.  Here’s a great source for the pilot programs: use any of the existing federal programs.

Then we can start using the word “reform”.

Health Affairs Blog

Author: Lyle

Molly Coye and Joseph Kvedar published a healthcare reform piece on the Health Affairs policy web-log titled “Activating Patient Centric Health Care Reform”

It’s arguing that the federal investment in healthcare IT directly to EMR adoption is good but won’t create “reform” in healthcare (agreed).  But an investment in telehealth and patient centric – read “self managed” – control of chronic conditions will reform healthcare (unknown).  The authors feel market forces are against an effort in support of telehealth since it will reduce the need for encounters, which is the current revenue driver for healthcare – and the thing most in need of reform.

It’s a nice read for anyone interested in real healthcare reform.

Robots In Medicine

Author: Lyle

Rx robot does all except give shot Robots have been counting pills for quite a while, but this one now fills syringes.