Diet and Nutrition. Natural Health, and Healthy Living

A surprise move by ONC/HHS indicates the wheels may be falling off health IT reform at about the same rate they've fallen off Democrats' broader health reforms.

David Blumenthal and his staff have unveiled two separate plans to test and certify EHR technology products and services. We don't think this is a good idea. We've supported the purpose and spirit of the ARRA/HITECH incentive programs, and believe ONC's/HHS' re-definition of EHR technology puts it on a trajectory to improve the quality and efficiency of health care in the U.S. But this recently-announced two-stage EHR technology certification plan bears all the marks of a hastily drawn up blueprint that, if rushed into production, could easily collapse of its own bureaucratic weight.

(more...)

As I noted in another post, the media seems to be turning “reconciliation” into an ugly word.

But “filibuster” is the word with a more unsavory history. (Thanks to HeathBeat reader Barry Carroll who sent me a link to the history of the word.)

“Filibuster” finds its root in the Spanish word “filibustero,” which means “pirate.” The filibuster was originally seen as an opportunity to “pirate” or “hijack” a debate.
(more...)

Every now and then, I read and enjoy a book, but only later fully appreciate it as its lessons and insights slowly become apparent. Judging by the number of times I’ve said, “That reminds me of Gawande’s observations about ___” over the past month, The Checklist Manifesto is one such book.

In this short, deceptively simple volume, Atul (who I count as both friend and inspiration) discusses the history of “the lowly checklist,” the impact of checklists on various industries, how he came to understand the value of checklists to medical care, and what makes a useful checklist. Most of this content could have been written by a thoughtful healthcare journalist. But Atul put his interest in checklists to practical use, spearheading a WHO initiative to test a checklist-based “safe surgery” program in 8 diverse hospitals around the world, an effort that saved hundreds of lives. His description of this program forms the core of the book.

(more...)

As many involved in the worlds of Health 2.0 and Information Therapy know, some of the most interesting experiments in the world of patient-physician engagement have been happening in the somewhat unlikely environs ofsmall townOklahoma. There the City of Duncan has put its employees (and their providers) into a system that incents (but doesn’t mandate)physicians to practice according to accepted guidelines, and incents (but doesn’t mandate) patients to read information prescribed by their physicians about their treatments (and tests them about it). The system then asks each party to rate the other.

(more...)

They said it couldn’t happen in Europe, that social media and online tools wouldn’t catch on, because the healthcare context was soooo different from the US. They said thatEuropeans don’t worry about access and cost, that they aren’t looking for information online because they they trust their doctors utterly and fully, and thatEuropean doctors don’t go online, except if they're Scandinavian.

Well, it just isn’t so! True collective intelligence will tell you that participatory medicine is a natural human instinct and that Health 2.0 is kicking up a storm in Europe this winter! Consumers and professionals are generating content everywhere, even though they don't necessarily cross language or country borders. Unfortunately, no one European organization is studying consumer health Internet usage trends on the same basis year after year, as is the Pew Foundation in the U.S. Nonetheless, there is empiric proof; during the current flu epidemic, information from informal sources in Europe is fully surpassing official data. Wikipedia is cited in a recent study by Manhattan Research as one of the most regularly used sites for physicians and consumers across Europe. Private initiative has generated many significant consumer/patient communities, several major physician community portals, online consultation sites, and more.

(more...)

Yesterday, but the U.S. Treatment Services Task Force announced that leeches aren't a particularly good treatment for most ailments. While noting that leeches might still be useful for certain specific circulation disorders, the USTSTF recommended against their use in other situations, like treating fever and abdominal pains.

Although the Task Force has no power to make anyone do anything, Rep. Dave Camp (R-Mich) was heard on NPR's Morning Edition saying, "Some people discounted the idea that the government would actually put people to death ... this actually is really showing how the insidious encroachment of government between the patient and their doctor plays out." Camp neglected to address the facts: (1) overuse of leeches is expensive, and science-based recommendations about appropriate use would save the government money without harming patients, and (2) bloodletting can lead to negative side effects, such as upsetting the body's natural humoral balance.

(more...)

"Our scientific age demands that we provide definitions, measurements, and statistics in order to be taken seriously. Yet most of the important things in life cannot be measured."

Dennis Prager, 1948 - radio host, lecturer, columnist, ethicist

"My first goal for Intermountain is that anytime a physician or nurse says, ‘In my experience’ when they’re talking to a patient, they mean ‘In my measured experience.’ ”

(more...)

In trying to think about the future of health care, thoughtful, intelligent people often ask, “Why can’t we just let the free market operate in health care? That would drive down costs and drive up quality.” They point to the successes of competition in other industries. But their faith is misplaced, for economic reasons that are peculiar to health care.

More “free market” competition could definitely improve the future of health care in certain areas. But the problems of the sector as a whole will not yield to “free market” ideas – never will, never can – for reasons that are ineluctable, that derive from the core nature of the market. We might parse them out into three:

(more...)

So the Fall Health 2.0 2009 conference in San Francisco at the Concourse Exhibition Center is over. The bunting is down, the cocktails are drunk, and everyone can get back to the sanctity of the WiFi enabled office or home. (Yes, we're sorry about that problem and need to stress that it was NOTHING to do with AT&T who graciously sponsored the conference but were NOT providing Internet access).

But it doesn't detract from the fabulous experience of seeing perhaps the most amazing line-up of health technology ever in one hall together--not to mention some of the biggest names in the Health IT world going toe to toe. Health 2.0 had over a hundred speakers andnearly 80 live demos and technologies on display on stage--not to mention 30 more in the exhibit hall. We featured Health 2.0 Tools for doctors, ePatients telling us what they needed, and a stirring address from CTO of the US, Aneesh Chopra. Then there was some remarkable integration over unplatforms in the tools panel--(I don't know how often Esther Dyson gives standing ovations but that was great to see). And there was so much more.

(more...)

The problem in the current political climate with the health care policy debate is that the real issues all too often get subverted. The travesty that momentarily turned end of life issues, quality of life, and palliative care, into ‘death panels’ is Exhibit A. It has been well characterized on The Health Care Blog by Bob Wachter with references to excellent articles in The New York Times and Joe Klein’s piece in Time. Like so many issues in health care reform the hysteria that ‘government’ was posed to step in and dictate our options as to how we would die and what final options we might have is sadly misplaced. Reality holds its own sadness because too few of us get to die the death we would choose and when we do choose our death it’s the current health care system and our trusted friends and family who inadvertently subvert our best intentions.

(more...)