Saturday, November 21, 2009

Inside Surgery on the New Mammogram Guideline

More on why I'm appalled with Expert Panels taking over practice in the name of reform: we'll get political medicine looking for budget fixes; and that's exactly what's happening with this latest goofy guideline. Via Inside Surgery
The federal government released new guidelines this week that recommend some startling changes in how women should be screened for breast cancer.

Current recommendations call for most women to get a baseline mammogram at the age of 40 and to get yearly screenings thereafter.

However, the 17 member panel of the United States Preventive Services Task Force (none of whom are oncologists or breast specialists) that made the recommendations now say that women who are of average risk of contracting breast cancer should begin regular, routine mammograms at the age of 50 and that yearly mammograms are not necessary. They are also recommending that women abandon the practice of self breast exams.

Should one infer then that if the panel is not recommending mammogram screening and not recommending self-exam, they are not recommending any diagnosis of breast cancer before age 50?

Friday, November 20, 2009

Sam Shem at HIS talk on Mammograms and Health Care

at HIS Talk today,
Re: mammograms. An independent body, after review and analysis of eight clinical trials, comes out with EVIDENCE that mammogram screening in under-40-year-olds has little or no value. What happens? The radiologists are up in arms and the Obama administration, in the person of DHHS Secretary Kathleen Sebelius, tells patients to just keep doing what you did last year. And they want to cut costs by a billion dollars over the next decade to pay for national health insurance? If anyone really believes this country will ever control the costs of health care, they are living in a dream land!”

Interesting, too, that nobody’s paying much attention to the study that showed that electronic medical records haven’t improved outcomes or cost so far, even as the government is spending lots of money on those, too. At least EHRs have potential. In an economy where jobs are dying out, politicians don’t have the guts to make serious change since the people unhappy with health care don’t have the clout of those who like it just fine. I cited statistics here years ago saying that health care was making a staggering economy look robust because of rising costs, profits, and high employment, all unsustainable in a global economy.
I suppose the question then is how confident anyone can be the government as opposed to markets can make Health Care a sustainable sector in the economy.

Considering the Gov's placing its bets on tick-box medicine, voodoo economics on preventive med, and EHR; I'm not very confident. I think it has to do with politicians guts and lack there of. Sarah Palin maybe? She has guts.

Saturday, June 27, 2009

SAS: Over the healthcare horizon

Innovation, collaboration focus of 6th annual SAS Healthcare and Life Sciences Executive Conference

Some good video of John D. Halamka M.D and National Cancer Institute Director John E. Niederhuber speaking at this conference from SAS.

More on this in a bit but I'm still focused on Iran at the moment.

Sunday, April 12, 2009

The Buck Stops Here: Health Care Costs

More on this post later. Nuff now to say it points to the ethical choices it will be tough for Health Care reform to get its arms around.

Bob Brewin: Army medical center successfully tests health records system

From Bob Brewin's What's Brewin.
CHICAGO--The Madigan Army Medical Center in Tacoma, Wash., has completed a successful test of personal health record systems that allowed patients to access information contained in the Defense Department's AHLTA electronic health record system. Now the pilot project will be extended to the Navy National Medical Center in Bethesda, Md., and a civilian hospital system serving military patients in Virginia, Madigan officials told the annual Healthcare Information and Management Systems Society conference here this week.
He's been all over this.

Uwe Reinhardt: Defining ‘Health Care Reform’

Reinhardt brings his usual clarity to the dismal science. This time on Health Care Reform,
As a vertical economist, however, I naturally think of health care as just another economic sector with the following distinct facets:

1. a demand side (by which I mean patients or their agents, private and public health insurers, who procure health care and pay for that care)

2. a supply side (the providers of health care and of health care products)

3. a health-insurance system, intended to protect individuals and households from excessive financial loss due to medical bills, and also to help patients procure health care at negotiated prices

4. an information infrastructure supporting and linking patients, insurers and providers of care with one another, and

5. a regulatory infrastructure intended to keep transactions in this market honorable, fair to both sides, and oriented toward the ultimate social goals of a health system.

Ambitious as he is, the president would like to reform all of these facets of the health sector.
Read all of him.

More EHR

UPDATE 1-New military electronic records to be model for US includes the helpful paragraph chock full of links.

The White House did not say whether a commercial company would help design the electronic medical record system.

There are many that design such systems, including Cerner Corp (CERN.O), Eclipsys Corp (ECLP.O), Global Med Technologies Inc (GLOB.OB), Quality Systems Inc (QSII.O) and Allscripts-Misys Healthcare Solutions Inc (MDRX.O), IBM (IBM.N), General Electric Co (GE.N), Siemens AG (SIEGn.DE) and McKesson Corp (MCK.N).

Wal-Mart Inc's (WMT.N), Sam's Club unit is offering individual doctors a package including software and Dell (DELL.O) computers.

Experts say any national system would have to connect easily to other systems while protecting privacy.
...and now we know the vendors we'll be investing in.

Geek Doctor

Added a new informatics blog: Geek Doctor. He has a nice post on the elements of an EHR.

Helps to know what we're going to be investing a bundle into.