Americans using tech to tackle their health and the health system
The Deloitte Center for Health Solutions released a survey report showing
that Americans are increasing their use of technology to improve their
health, navigate the health system and flex their shopping muscles in acting
like consumers instead of passive patients.
The report, "Health Care Consumer Engagement: No One-Size-Fits-All
Approach," found that 22 percent of respondents used technology to access,
store and transmit health records in the last year, up from 13 percent in
2013. Use was higher for those with major chronic conditions: 32 percent
compared to 19 percent in 2013.
The report also shows that 16 percent of respondents who needed care went
online for cost information, up from 11 percent in 2013. Millennials in this
group increased the most, 27 versus 17 percent. Further, 71 percent of all
those surveyed said they have not gone online for cost information but are
"very" or "somewhat" likely to use a pricing tool in the future.
When it comes to judging quality, 25 percent of all respondents used a
scorecard to compare the performance of doctors, hospitals and/or health
plans, up from 19 percent in 2013. The rate was highest in the youngest
cohort, with 49 percent of millennials who received care in the last year
using a scorecard compared to 31 percent in 2013.
The specter of a more customer-driven industry is causing many health
companies to transform into retail-focused organizations, said Scott,
impacting everything from strategy and scale to operations and human
capital. "For the enterprise, this is about more than a cool app â€“ this is
about making the end-to-end changes needed to better identify and engage a
more empowered purchaser."
The report identifies six consumer types emerging in today's market and
quantifies their size â€“ a framework that can help companies pursue
customer-segmentation strategies. The "casual and cautious" make up 34
percent of the surveyed market, followed by the "content and compliant" at
22 percent, the "online and onboard" at 19 percent, "sick and savvy" at 11
percent, "out and about" at 8 percent and "shop and save" at 6 percent. The
report gives depth on each segment's approach to healthcare.
Respondents most trust physician groups/medical practices/doctor's offices
as a reliable source of information on treatments, with 49 percent giving
this category a high rating. However, the scores for health insurance and
life sciences companies have doubled since 2010. Specifically, 21 percent
gave health plans a high rating, compared to 10 percent in 2010, while 18
percent gave life sciences companies a high rating, compared to 9 percent in
In other findings:
- 28 percent of respondents have used technology to measure fitness and
health goals, up from 17 percent in 2013.
- 23 percent have used technology to monitor a health issue, versus 15
percent in 2013.
- 40 percent of the surveyed technology users have shared their fitness or
monitoring information with their doctor.
- 63 percent of the surveyed technology users say their use of fitness or
monitoring technologies has led to a significant behavior change.
- 13 percent of respondents who take prescription drugs receive electronic
alerts or reminders; more than half express interest in using technology to
prompt them to take their medication.
Rates of conferring with doctors via email, texting or video have doubled in
the last two years, suggesting digital communication between consumers and
providers may continue trending upward.
48 percent of respondents prefer to partner
with doctors rather than have them make decisions for them, up from 40
percent in 2008, and 34 percent strongly believe doctors should encourage
patients to raise questions. However, only 16 percent of respondents who
received care report asking their doctor to consider treatment options other
than the one initially recommended.
Visit here for the report.
allergy skin testing helps combat a growing public health threat
Earlier this month, The U.S. Department of Health and Human Services (HHS),
the U.S. Department of Agriculture (USDA), and the U.S. Department of
Defense (DoD) announced the appointment of nationally recognized experts to
the Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria
(the Advisory Council).
"Antibiotic resistance is a growing public health threat across our
country," said HHS Secretary Burwell. "Work is underway to implement a
National Action Plan for Combating Antibiotic-Resistant Bacteria, a
research-driven plan to identify and coordinate action across the
administration to prevent and control outbreaks of resistant pathogens." Up
to half of all antibiotics prescribed are not needed at all because the
patient does not have a bacterial infection. Too often more potent
antimicrobial drugs are prescribed inappropriately because a traditional
drug has been rejected due to a suspected drug allergy.
This week at ID Week, experts discuss how penicillin skin testing may help
improve antibiotic stewardship in the hospital setting and how testing can
improve access to the most appropriate antibiotics. With new guidance under
development on antibiotic prescribing, there is increasing interest in
penicillin skin testing and how such testing may be used to improve
antibiotic stewardship. Penicillin allergic patients are significantly more
likely to receive fluoroquinolones, vancomycin, and clindamycin than
non-allergic patients. These medications are part of a class of antibiotics
that are being overprescribed which may contribute to antibiotic resistance.
ID Week 2015TM is an annual meeting of the
Infectious Diseases Society of America (IDSA), the Society for Healthcare
Epidemiology of America (SHEA), the HIV Medicine Association (HIVMA) and the
Pediatric Infectious Diseases Society (PIDS). With the theme "Advancing
Science, Improving Care,. IDWeek 2015 takes place October 7-11 at the San
Diego Convention Center in San Diego, California. For more information,
CMS finalizes rule
modifying meaningful use requirements
Over the past several years, CMS has seen increasing numbers of physicians,
clinicians, and hospitals using EHRs to improve patient care. More than 70
percent of eligible physicians and other clinicians and more than 95 percent
of eligible hospitals have successfully used EHRs and received incentive
payments from the federal government. That represents great progress from
the days when a doctorâ€™s handwriting needed to be interpreted and paper
records could be misplaced.
CMS has heard from physicians and other providers about the challenges they
face making this technology work well for their individual practices and for
their patients. Doctors in particular have expressed ongoing concern over
increasing requirements for the use of EHR technology and frustration at
competing reporting requirements among programs. Providers also have
described the challenge of planning for and reporting on complex and
numerous meaningful use requirements.
In recognition of these concerns, the regulations CMS is announcing make
significant changes in current requirements. They will ease the reporting
burden for providers, support interoperability, and improve patient
outcomes. For example, the regulations: Shift the paradigm so health IT
becomes a tool for care improvement, not an end in itself.
This new framework will be based on the landmark bipartisan legislation --
the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) â€“ that
requires the establishment of a Merit-based Incentive Payment System (MIPS)
and consolidates certain aspects of a number of quality measurement and
federal incentive programs for Medicare physicians and other providers into
one more efficient framework.
CMS views the regulations released as a bridge to the new payment system for
physicians and providers and look forward to receiving input about how best
to incorporate the EHR Incentive Programs into the new payment system. This
rule moves us beyond the staged approach of â€śmeaningful useâ€ť by 2018 and
helps us collectively move forward to a system based on the quality of care
delivered, as opposed to quantity. CMS will use this feedback to inform
future policy developments for the EHR Incentive Programs, as well as
consider it during rulemaking to implement MACRA, which we expect to release
in the spring of 2016 and other rulemaking as appropriate.
As part of the new regulations, CMS is announcing an additional 60 day
public comment period to facilitate additional feedback about our vision for
the EHR Incentive Programs going forward. In the interim, although the
majority of physicians have not received negative payment adjustments under
Medicare, CMS knows that some physicians are not ready to qualify for the
EHR Incentive Programs and are concerned about these adjustments.
They intend to use their administrative flexibility to help physicians and
other providers who are making efforts to adopt and use this technology to
succeed. They encourage providers to submit requests for a significant
hardship exception from the payment adjustment through the existing request
The goal is to give patients unprecedented access to their own health
records, empowering individuals to make key health decisions. The sharing of
information among providers helps consumers avoid unnecessary tests and
treatments, reducing consumersâ€™ costs and improving safety.
In 2015, providers need to report on their use of EHRs for any continuous 90
days within Calendar Year 2015 (or within the period October 1, 2014 â€“
December 31, 2015 for hospitals) by February 29, 2016. This may be extended
to the end of March if providers need more time. For 2016 and 2017 for both
Medicare and Medicaid providers (and 2018 for Medicaid providers), providers
that are new to the EHR Incentive Programs need to have additional
flexibility and can report on any 90 days.
HHS recognizes the importance of providing sufficient time for developers to
develop and certify new products for EHR Incentive Program compliance, as
well as allowing sufficient time for providers to implement new technologies
and adapt workflow. These rules provide a period of 27 months from final
rules to compliance during which developers will be able to develop and
certify their products and help providers fully implement those products
into their practices so that they can begin meeting the EHR requirements in
Developers can now begin developing health IT
products, including EHRs, which they intend to have certified to the 2015
Edition certification criteria requirements.
Visit CMS for the fact sheets.
Baby and maternal deaths soar in Sierra Leone amid Ebola
fears â€“ researchers
Maternal and newborn deaths in Sierra Leone have soared since the Ebola
outbreak in West Africa as fear of being infected and mistrust of health
workers deter pregnant women from giving birth in health facilities,
researchers said on Tuesday.
Deaths of women during or just after childbirth rose by almost a third and
those of newborns by a quarter between May 2014 and April 2015 compared with
the previous year, a study by the Liverpool School of Tropical Medicine
The number of women giving birth at health centers fell by 11%, and those
receiving care before or after birth fell by about a fifth, the study said,
despite most facilities across Sierra Leone being functional and adequately
The worldâ€™s worst recorded Ebola outbreak, which has killed 11,300 people in
Guinea, Liberia and Sierra Leone since it began in December 2013, has set
back progress on maternal health in the country, said the reportâ€™s lead
researcher, Susan Jones.
Maternal death rates halved in Sierra Leone between 1990 and 2013 yet it is
still has one of the highest rates in the world â€“ more than one in 100 women
dies in childbirth â€“ according to the World Health Organization.
Despite a persistent shortage of health workers, facilities across Sierra
Leone had similar numbers of doctors, midwives and nurses during the Ebola
outbreak as in the previous year, and were ready to provide maternal care,
according to the study.
Nurses interviewed for the study said many pregnant women refused to go to
health centers because they were afraid of being diagnosed with Ebola, while
others chose to visit traditional healers and herbalists instead.
Sierra Leone released its last two known Ebola patients 10 days ago and
began a new 42-day countdown to being officially declared free of the virus.
The study called for stronger referral
systems, a postgraduate medical training program and initiatives to inform
the public about the importance of antenatal and postnatal care and assisted
Visit the Guardian for the report.
diabetes research knowledge portal opens to public, scientists
Researchers funded by the National Institutes of Health and the Foundation
for the NIH (FNIH) have expanded a recently launched online library, called
a knowledge portal, which allows open-access searching of human genetic and
clinical information on type 2 diabetes. Individual data will remain
confidential. The portal External Web Site Policy includes information from
several major international networks, collected from decades of research.
A product of the Accelerating Medicines Partnership (AMP) for type 2
diabetes, the portal is aimed at advancing type 2 diabetes research and
treatment, and will include data from over 100,000 genetic samples obtained
from clinical consortia supported by the NIH and FNIH. AMP is an innovative
project of government, industry and nonprofit organizations working together
to speed research in type 2 diabetes, Alzheimerâ€™s disease, rheumatoid
arthritis and lupus.
The portal collects data from human genetic samples, since the animal and
cellular models that are typically used in diabetes drug development before
human testing do not always replicate human behavior. The portal provides a
way to identify the most promising therapeutic targets for diabetes from
troves of potentially relevant human data.
The knowledge portal makes genetic and clinical information searchable in
myriad ways, while keeping individual data confidential, to help researchers
identify and describe the effects of genes on disease. Searches can include
genes, gene variants and genetic regions, and can be cross-referenced with
associations between glucose and insulin measurements and other criteria.
The data can be sorted to include relevant genetic studies and the kind of
data collected, and allows researchers to test biological hypotheses, and
conduct many other analyses.
The portal is publicly searchable and can be
used as a tool to learn about genetics and health. However, only approved
researchers will be able to access detailed data, while the general public
can access aggregate results. Creators of the research engine are eager to
expand the network to include more national and international research
networks. The international source samples of genetic and clinical data will
be housed in their home networks to ensure use of each sample complies with
each countryâ€™s health information confidentiality rules.
Visit NIH for the report.
HSCA endorses GS1
USâ€™S attribute explorer, helps healthcare industry better serve information
The Healthcare Supply Chain Associationâ€™s (HSCA) Committee for Healthcare
eStandards (CHeS) announced its endorsement of national standard
organization GS1 USâ€™s new web-based application for standardized product
attribute definitions. The GS1 US Attribute Explorer is a centralized
repository that can be accessed by both commercial suppliers and purchasers,
and which provides globally standardized attributes and definitions â€“ giving
suppliers a streamlined method of identifying relevant attributes for their
product to industry purchasers, and empowering purchasers through accurate,
â€śHSCA and our member group purchasing organizations (GPO) are committed to
modernizing and reducing costs in the healthcare supply chain, supporting
global standards, and ensuring patient safety,â€ť said HSCA President and CEO
Todd Ebert, R.Ph. â€śThe GS1 US Attribute Explorer empowers both suppliers and
providers with the standardized data they need to get products to patients,
and help move products efficiently through a modern supply chain. It is a
win-win for all sides of the healthcare supply chain.â€ť
HSCA has collaborated with GS1 US to incorporate its Total Visibility
Project data into the application. The Total Visibility Project is the
product attribute standardization system of HSCAâ€™s member GPOs that
establishes the common, minimum set of product attributes that member GPOs
require to consider a product for purchase. By incorporating The Total
Visibility Projectâ€™s standards into GS1 US Attribute Explorer, healthcare
suppliers have a centralized means to identify and present the common
product attributes required by GPOs â€“ saving time, manpower, and cost on the
supplier end. GPOs and the healthcare providers they serve â€“ including
hospitals, clinics, nursing homes, and surgery centers â€“ are provided with
the accurate and timely data necessary to make smart purchasing decisions
that avoid inefficiencies like duplicative orders and labeling errors. The
GPO members of CHeS seek practical solutions for the implementation of
global data standards to enhance supply chain efficiencies, provider cost
management, and patient healthcare outcomes.
The GS1 US Attribute Explorer builds upon the
work of GS1â€™s Global Data Synchronization Network (GDSN) â€“ a worldwide,
web-based system that connects participating companies all over the world,
ensures their data is standardized and certified for global sharing, and
updates all participant databases in real time. The GS1 US Attribute
Explorer complements the power of the GDSN system by providing one
centralized, easy-to-use user-interface for finding attributes.
Visit here for the release.
value-based purchasing initial results show modest effects on Medicare
payments and no apparent change in quality-of care trends
The Government Accountability Office (GAO) found The bonuses and penalties
received by most of the approximately 3,000 hospitals eligible for the
Hospital Value-based Purchasing (HVBP) program amounted to less than 0.5
percent of applicable Medicare payments each year.
GAO found that safety net hospitals, which provide a significant amount of
care to the poor, consistently had lower median payment adjustmentsâ€”that is,
smaller bonuses or larger penaltiesâ€”than hospitals overall in the programâ€™s
first three years. However, this gap narrowed over time. In contrast, small
urban hospitals had higher median payment adjustments each year than
hospitals overall, and small rural hospitalsâ€™ median payment adjustments
were similar to hospitals overall in the first two years and higher in the
most recent year.
GAOâ€™s analysis found no apparent shift in existing trends in hospitalsâ€™
performance on the quality measures included in the HVBP program during the
programâ€™s initial years. However, shifts in quality trends could emerge in
the future as the HVBP program continues to evolve. For example, new quality
measures will be added, and the weight placed on clinical process measuresâ€”
on which hospitals had little room for improvementâ€”will be substantially
reduced. For many quality measures not included in the HVBP program, GAO
also found that trends in hospitalsâ€™ performance remained unchanged in the
period GAO reviewed, but there were exceptions in the case of three measures
that are part of a separate incentive program targeting hospital
This program focuses exclusively on readmissions and imposes only penalties.
The timing of changes in readmission trends provides some indication that
the use of financial incentives in quality improvement programs may, under
certain circumstances, promote enhanced quality of care. However,
understanding the extent of that impact depends on the results of future
Officials from selected hospitals GAO interviewed reported that the HVBP
program generally reinforced ongoing quality improvement efforts, but did
not lead to major changes in focus. In addition, hospital officials cited a
variety of factors that affected their capacity to improve quality.
The report evaluated the initial effects of the HVBP program on: (1)
Medicare payments to hospitals, (2) quality of care provided by hospitals,
and (3) selected hospitalsâ€™ quality improvement efforts. To determine these
initial effects of the HVBP program, GAO analyzed CMS data on bonuses and
penalties given to hospitals in fiscal years 2013 through 2015 as well as
data on hospital quality measures collected by CMS from 2005 through 2014,
the most recent year available. GAO also interviewed officials with eight
hospitals that participated in the HVBP program. Hospitals were selected to
include safety net, small urban, and small rural hospitals, as well as those
that were not part of any of these subgroups.
GAO found the bonuses and penalties received by most of the approximately
3,000 hospitals eligible for the Hospital Value-based Purchasing (HVBP)
program amounted to less than 0.5 percent of applicable Medicare payments
each year. GAO found that safety net hospitals, which provide a significant
amount of care to the poor, consistently had lower median payment
adjustmentsâ€”that is, smaller bonuses or larger penaltiesâ€”than hospitals
overall in the programâ€™s first three years. However, this gap narrowed over
In contrast, small urban hospitals had higher median payment adjustments
each year than hospitals overall, and small rural hospitalsâ€™ median payment
adjustments were similar to hospitals overall in the first two years and
higher in the most recent year.
GAOâ€™s analysis found no apparent shift in
existing trends in hospitalsâ€™ performance on the quality measures included
in the HVBP program during the programâ€™s initial years. However, shifts in
quality trends could emerge in the future as the HVBP program continues to
Visit GAO for the report.
Drug used to treat
cancer appears to sharpen memory
Can you imagine a drug that would make it easier to learn a language,
sharpen your memory and help those with dementia and Alzheimer's disease by
rewiring the brain and keeping neurons alive?
New Rutgers research published in the Journal of Neuroscience found
that a drug - RGFP966 - administered to rats made them more attuned to what
they were hearing, able to retain and remember more information, and develop
new connections that allowed these memories to be transmitted between brain
"Memory-making in neurological conditions like Alzheimer's disease is often
poor or absent altogether once a person is in the advanced stages of the
disease," said Kasia M. Bieszczad, lead author and assistant professor in
Behavioral and Systems Neuroscience in the Department of Psychology. "This
drug could rescue the ability to make new memories that are rich in detail
and content, even in the worst case scenarios."
What happens with dementias such as Alzheimer's is that brain cells shrink
and die because the synapses that transfer information from one neuron to
another are no longer strong and stable. There is no therapeutic treatment
available that reverses this situation.
The drug being tested in this animal study is among a class known as HDAC
inhibitors - now being used in cancer therapies to stop the activation of
genes that turn normal cells into cancerous ones. In the brain, the drug
makes the neurons more plastic, better able to make connections and create
positive changes that enhance memory. Researchers found that laboratory
rats, taught to listen to a certain sound in order to receive a reward, and
given the drug after training, remembered what they learned and responded
correctly to the tone at a greater rate than those not given the drug.
Scientists also found that the rodents were
more "tuned in" to the relevant acoustic signals they heard during their
training - an important finding Bieszczad said because setting up the brain
to better process and store significant sounds is critical to human speech
Visit EurekAlert for the article.