Wednesday, August 30, 2006

The Biggest Skeleton in Your Doctor's Closet - Dr Vicki

The Biggest Skeleton in Your Doctor's Closet - Dr Vicki: "What are the consequences of focusing on disease? The focus on disease rather than health is a root cause of the dysfunction of our ailing health care system. It has lead to a culture of fear. We fear our own bodies, believing that that are vulnerable to break down and require the help of medical experts to heal. Evolving medical technology reinforces the notion that you need the help of your doctor to recover from illness. Here are some of the manifestations of concentrating on disease rather than health, and their consequences. Just like gravity draws all objects down hill, so, too, our inability to promote health leads to a downward decline. The words “health care“ imply that your doctor cares for your health. This is just not true. Doctors treat diseases."
It's an "illness-care system" which only tries to fix problems ( often very badly) after they arise !

How To Fix The Healthcare System

How To Fix The Healthcare System : "It would be a great advance in both quality and cost if somehow the American public came to understand that 'more care' is not by any means always 'better care,' and that new technologies and hospital stays can sometime harm more than they help. Patients need to ask more, 'Are you sure I need that?' and to trust that, often, the best care is the most conservative care."

How VA Hospitals Became The Best

How VA Hospitals Became The Best "Most private hospitals can only dream of the futuristic medicine Dr. Divya Shroff practices today. Outside an elderly patient's room, the attending physician gathers her residents around a wireless laptop propped on a mobile cart. Shroff accesses the patient's entire medical history--a stack of paper in most private hospitals. And instead of trekking to the radiology lab to view the latest X-ray, she brings it up on her computer screen. While Shroff is visiting the patient, a resident types in a request for pain medication, then punches the SEND button. Seconds later, the printer in the hospital pharmacy spits out the order. The druggist stuffs a plastic bag of pills into what looks like a tiny space capsule, then shoots it up to the ward in a vacuum tube. By the time Shroff wheels away her computer, a nurse walks up with the drugs. Life in a big-name institution like the Mayo Clinic? Not hardly. Shroff, 31, a specialist in internal medicine, works at the Veterans Affairs hospital in Washington, where the vets who come for the cutting-edge treatment are mostly poor."
The clever use of IT can help hospitals and doctors leapfrog and provide cutting edge care !

Sunday, August 27, 2006

Open Source Software: A Primer for Health Care Leaders

Open Source Software: A Primer for Health Care Leaders - :" As information technology in the health care industry evolves from an administrative tool for billing and bookkeeping to a clinical tool for improving the quality and efficiency of health care, the scope of information sharing is expanding beyond the walls of individual institutions. Achieving this level of integration will require that software models overcome a host of technical obstacles, and that they are accessible, affordable, and widely supported. This report from Forrester examines the development and distribution of open source software, a well-established software development model—and a potential solution to the looming challenges of integration—characterized by collaboration among individuals and organizations with common interests, sharing intellectual property, and a commitment to standards."

Open source and healthcare

Open source and healthcare : "The collaborative nature of open source software development harnesses worldwide knowledge and experience, and turns it into an engine for developing usable, affordable healthcare applications in a very short period of time. Given that open source is all about collaboration, the movement is a uniquely empowering and bridging initiative in its own right."

The open source electronic Personal Health Record

The open source electronic Personal Health Record: "The Tolven solution enables consumers to proactively ensure that their health providers have the latest information to guide them in their decision making. An electronic Personal Health Record provides the consumer with an intuitive web-based application to create, view, store and share healthcare information about themselves or on behalf of those they look after (e.g., aged relatives, children and those with disabilities); to communicate with their care providers; and to access needed health-related information relating to their specific conditions through the power of the internet; and to simply perform mundane tasks, like re-filling a prescription for themselves or one of their dependents – all with a minimum of effort."
I am very excited about this. I feel this is what "good " deeds are all about - using open source to help people take better care of their own health !

Friday, August 25, 2006

Health Savings Account

Health Savings Account: "The Destiny Health Plan’s use-it-or-keep-it Health Savings Account (HSA) or Health Reimbursement Arrangement (HRA) allows you to control your health care spending. This is a health care spending account set up for you with a fixed amount of money to spend each year for your health care expenses. Use it to pay doctor's office visits, diagnostic tests, preventive care, alternative medicine, prescription drugs, hospitalization and surgical care. Any money you don’t use rolls over for your eligible expenses next year, and it earns interest along the way."
We are going to start seeing clever ways which will allow patients to control their own healthcare costs. This is going to be a major incentive to stay in good health - "health is wealth" may become literally true !

Why are healthcare consumers so passive ?

Why are healthcare consumers so passive ? : "'Consumerism is making an impact in every corner of the economy but the doctor's office,' he said. 'And that needs to change if we are to gain control of rising health care costs. The issue is 'value' -- the merging of cost and quality. Americans are unmatched in seeking value in their consumer-goods purchases, and it is critical that the health care system be adjusted to reward a similar degree of diligence.'"

Doctors versus patients - making difficult decisions in the ICU

The vast majority of the time, doctors are on the side of the patient. However, there are often difficult conditions ( which are fortunately very rare), when the doctor and the patient don't see eye to eye.
For example, consider the case of a 75 year old man who is in the ICU on a ventilator. He has led a rich and full life; and has ended up in the ICU because of a serious infection after surgery for a malignancy. He has been in the ICU for 6 days on aggressive life-support, but does not seem to be getting better. His heart functions with the medications; as do his kidneys and his brain; but it's not been possible to wean him off the ventilator - his protoplasm is not enough to keep life going on its own. The family is happy with all that has been done with him; and want him to die a peaceful death. They request the doctor to swith off the ventilator, so that he can die in peace. While the doctor understands their desires, he finds his hands are tied because he cannot comply with them. The law does not allow him to do so as long as the brain is alive ! He agrees not to perform heroic rescue measures - but this also means the patient is forced to remain on the ventilator until something bad happens. Life crawls on for the family, who are in a state of suspended animation, and are living life on a day to day basis.
This is an unfair situation - for everyone. For the patient, who is forced to survive with mechanical support he does not want; for the family, who is forced to see their father suffering; and for the doctor, who feels powerless, because he cannot do what is in the patient's best interests.
How do we resolve such issues ? The irony is that if the family could not afford to pay the medical bills, they would never have landed up in this tragic situation because they would not have been able to pay for the expensive ICU care . The reality is that this sort of "care" is really not care at all - it is an unhappy bind we are mired in, for all the wrong reasons.

When bad things happen to good people - dealing with a negative beta after IVF

Even though I have been doing IVF for the last 15 years, I still find it extremly difficult to tell a patient an IVF cycle has failed when her beta HCG results come back as negative. No matter how "perfect" the cycle, the outcome of an individual IVF cycle is always uncertain and uncontrollable. This is why a failure hurts - especially when the cycle goes the way it should and we have transferred beautiful embryos.
This is a difficult situation for both doctor and patient. I feel I have failed my patient and let her down by being unable to give her the pregnancy she so deeply desires. Doctors are human, too, and we also find it hard to deal with failure. Of course, I know in my heart of hearts that I have offered her the best possible medical treatment; and that medical technology has its own limitations - but it's still difficult to face failure. No matter what my brain says, the heart still hurts, because you do get attached to patients, and their drams become your dreams. Fortunately , the reason I don't burn out is that to balance the failures, I have the successes - couples whose lives have improved dramatically when they succeed after IVF. Every baby born gives me hope and faith that what I do is worthwhile !
For patients, on the other hand, a negative HCG is nearly as bad as dealing with the death of a loved one. In one sense, it is the death of a loved one - the death of the transferred embryos; and , even worse, the death of a dream.
Patients have many questions after a failed IVF cycle. Why did it fail ? What can we do differently the next time ? Often we don't have any answers because embryo implantation is a biological process we cannot control or monitor - and this makes matters even worse, because patients expect their doctors to have allthe answers. Not knowing causes fear and anxiety - "Will I ever get pregnant, now that even IVF has failed ? " What does the future hold for me ?
Patients often blame themselves when the IVF fails. Did I rest enough ? Is my uterus "bad" ? Why did my body " reject " the embryos ?
In addition to the factual questions, the failure opens old emotional wounds of low self-esteem. "I have let everyone down by failing the IVF cycle". " All that money gone down the drain".
We often need someone to blame when the cycle fails - and doctors are often the target of the anger ( and though this is often misplaced blame, I tell my patients to vent their anger on me, rather than on themselves ). I can handle the criticism, and I feel it's good for them to get it off their shoulders.
While many appreciate everything we have done for them, even when the cycle fails, a question which haunts most couples is - " Why me, God ? " Unfortunately, bad things do happen to good people - just like good things happen to bad people. It's hard to make sense of some of life's events. Mature people take the good with the bad - and carry on. "This too will pass" are the wisest words known to man - and we all have the resilience to deal with failure and move on.
Success after failure ( and just because one cycle has failed does not mean the chances of success in the next cycle go down) tastes even sweeter !

Tuesday, August 22, 2006

Doctors Give Hope to Patients With Long Histories of Unexplained Symptoms - New York Times

Doctors Give Hope to Patients With Long Histories of Unexplained Symptoms - New York Times: "People with a long history of medically unexplained symptoms — aches, pains, fatigue, dizziness and other complaints for which doctors can find no physical cause — might finally find relief. Two new studies by researchers who specialize in the baffling condition called somatization syndrome, estimated to affect up to 3 percent of adults, suggest that the quest for a physical explanation may take on a destructive life of its own. Instead, those with the syndrome should focus on practical strategies to regain normal function and relieve symptoms, the researchers say."
Now we know why reassurance provided by a trusted doctor can be so powerful.

Monday, August 21, 2006

Blurring the line: Medical spas, other fields luring primary care docs

Blurring the line: Medical spas, other fields luring primary care docs : "The influx of medical spas to the Birmingham market and proliferation of medical clinics that specialize in noninvasive cosmetic procedures are the latest example of a national health-care system losing much-needed primary care physicians to more lucrative subspecialties. Dr. Mark Stafford, an internist with the University of Alabama at Birmingham Kirklin Primary Care Clinic, says the numbers of new doctors choosing primary care fields is at an all-time low and there doesn't appear to be any change on the horizon. 'They're being lured away to higher-paying fields with more controlled work environments such as radiology, dermatology and procedure-oriented fields,' he says, 'and we're not just talking about new physicians.'"
I guess doctors are going to go " where the money is " !

Coming soon: health clinics at Walgreens

Coming soon: health clinics at Walgreens: "More insurance plans are covering retail clinics because the clinics charge less than doctors' offices. If covered, a Take Care patient is charged the plan's co-pay. If not, the patient pays an average of $59 to $74. But many doctors are wary of the clinics, staffed by nurse practitioners or physician assistants.Dr. Frank Madda of the DuPage County Medical Society said chain clinics "will certainly drive many family-practice physicians, pediatricians and internists out of business. This will result in a decrease in the availability of physicians for all patients."
Turf battles - with a twist ! Actually, this may make healthcare delivery more efficient. These retail health clinics can serve as triage stations, so that only patints with more serious problems will need to go see their doctor. After all, most problems are self-limited and get better on their own, thanks to the body's own healing powers ( though doctors are always happy to take the credit !)

Sunday, August 20, 2006

10 ways to guarantee a lawsuit

10 ways to guarantee a lawsuit:" Here's some good—but often forgotten—news about 'the malpractice crisis': Most patients who suffer an injury as a result of medical negligence don't end up suing their doctors. Those who do, however, are often motivated not by the negligence itself, but by nonclinical factors like a lousy bedside manner or poor communication. These are the kinds of mistakes that are well within your power to fix. We interviewed malpractice attorneys—those who work for plaintiffs as well as for doctors—and risk management consultants to come up with the following list of 10 dumb things doctors frequently do that are likely to get them sued."

Placing The Patient At The Center Of Healthcare

Placing The Patient At The Center Of Healthcare" The fundamental issue is not technology at all, or even errant business processes. In fact, without some changes in the "culture" of healthcare, new technology will accomplish little. Why? Because the relentless advance of technology by itself doesn't fix things. It never has. Technology is never more than an enabler of good business decisions. Absent a complete understanding of the business problem, any "solution" will be flawed. The challenge facing healthcare today is, first and foremost, properly identifying the problems. So what's the missing part of the equation? The "voice of the customer." Call it an appreciation of how the needs and expectations of today's consumer have changed, or an understanding of just how disappointed patients have become with the current healthcare process. Ultimately, it means caring about what's important to patients, first and foremost.

Nine Steps to Meeting Patient Needs

Patricia Seybold expressed these principals well in The Customer Revolution – How to Thrive When Customers are in Control. The key "customer-centered" principles she identifies have been adapted and paraphrased below for healthcare and patients specifically:

1. Create a compelling "brand personality."
2. Deliver a seamless experience to patients across channels and touch points
3. Care about patients and their goals
4. Measure what matters most – to patients
5. Value patients’ time
6. Place patient “DNA” [information] at the core of the system
7. Refine operational excellence
8. Design any new system or process with the expectation that it will need to evolve
9. Provide self-service access to services if possible, when and where the patient wishes

Healthology - Healthcare Today - How To Communicate With Your Doctor Using Email

Healthology - Healthcare Today - How To Communicate With Your Doctor Using Email: " Now that you understand the risks and benefits of email in patient care and you know what concerns your doctor might have, you’re ready to broach the subject with him or her. If your doctor already allows electronic communication and has invited you to communicate with her this way, then you’re all set. You should simply reassure your doctor that you will never use email for urgent or sensitive communication, that you will use it judiciously, and that you will conform to whatever rules your physician outlines for you."

Web Visits to the doctor versus going to the clinic

Web Visits to the doctor versus going to the clinic: "# Physicians preferred webVisits to office visits — more than half preferred the webVisit to an in-office visit for non-urgent medical issues.
# Reimbursement matters: Three in four physicians rated it as an important motivator to communicate online with patients.
# Patients loved using RelayHealth — more than three-quarters gave RelayHealth high marks, compared to telephone calls or office visits.
# Patient satisfaction ratings exceeded 90% when patients received responses by next business morning.
# Two-thirds of patients rated the quality of their webVisit highly when compared with an in-office visit, a percentage that rose to 87% when their physician responded by the next business morning."
The only concern many of my e-patients still have is - is it really the doctor who is answering the emsils himself ? Or is it an assistant ( who may not be as well informed) ?

Dr Tom Ferguson

Dr Tom Ferguson: "Tom Ferguson taught us that whenever the people are well-informed they can be trusted with their own health. We don't need doctors or health systems to rule our bodies. He envisioned health as an equal partnership between e-Patients, each other, and the professionals and systems that support them in their health."
Patients are the largest untapped healthcare resource !

This Site Knows a Cold Isn't a Rock Band - New York Times

This Site Knows a Cold Isn't a Rock Band - New York Times: "Mr. Shell said the company was, in one sense, a resurrection of, a business founded in 1999 with largely the same mandate: to develop a database of original medical content and information published by others, and allow users to search using layman's terms. That company failed to gain a broad following among consumers and, perhaps more notably, advertisers, and it shut down its consumer operations in 2001. When's original investors started to see life again in Internet advertising, they hired Mr. Shell to revive the idea, under the Healthline brand. Mr. Shell said several factors argued in favor of the company's success this time around. First, consumers remain deeply interested in online health information. Pharmaceutical and other medical advertisers, meanwhile, are starting to open their wallets more generously to the Web."
E-healthcare is going to become big once again - especially in developing countries like India, where the demand for reliable health information far outstrips the supply !

Smart Care via a Mouse, but What Will It Cost? - New York Times

Smart Care via a Mouse, but What Will It Cost? - New York Times: "Digital files are a building block in the creation of far more efficient markets in health care, medical experts say. That is what the enthusiasm is really about: not computers and software, but health information that can be easily shared, searched, measured and analyzed to determine what treatments and drugs are most effective, and at what cost.But efficient markets can be ruthless and unpredictable, threatening incumbent powers and producing losers as well as winners. An information revolution in health promises to be powerfully disruptive for some lucrative businesses in the industry, according to medical experts and economists, and could lead to more spending on health care instead of less."
The major benefit is that it will allow patients to make better informed decisions ! The marriage of Information Technology ( IT) with Information Therapy ( IT) will change the way medicine is practise today, because patients will have much more clout than they do today !

Wednesday, August 16, 2006

Information asymmetry in healthcare

Information asymmetry in healthcare: "'Money is power in the marketplace,' Case said. 'Consumers will have more power because they'll be controlling more of the money.' Case also notes the problems caused by a lack of information in the health care marketplace. For example, he says, a consumer can go online and find a baseball signed by former pitcher Tommy John for sale, determine the reputation of the seller and easily compare prices. But someone needing so-called Tommy John surgery -- officially, ulnar collateral reconstruction, considered one of the major advances of sports medicine -- would be hard-pressed to find providers of that surgery and their track records."

Americans Carry Two Burdens When it Comes to Healthcare

Americans Carry Two Burdens When it Comes to Healthcare: "As indicated by a survey of almost 7,000 patients traversing Australia, Canada, Germany, New Zealand, the United Kingdom and the USA, not only do Americans pay much more for medical treatment than anyone else in the world but they also bear the brunt of the most medical errors. What's striking is that we are clearly a world leader in how much we spend on health care, clearly, we should be doing better. Other specialists agreed, saying the results offer the most recent evidence that the quality of care delivered by the U.S. healthcare system is seriously eroding even as health care costs skyrocket."
No wonder smart Americans are shopping globally for better healthcare !

Companies explore overseas healthcare

Companies explore overseas healthcare :"Carl Garrett, a paper-mill technician in Leicester, N.C., is scheduled to travel Sept. 2 to New Delhi, where he will undergo two operations. Though American individuals have gone abroad for cheaper operations, Mr. Garrett is a pioneer of sorts.
He is a test case for his company, Blue Ridge Paper Products, Inc., in North Carolina, which is set to provide a health benefit plan that allows its employees and their dependents to obtain medical care overseas beginning in 2007. "It's brand-new and nobody's ever heard of going to India or even South Carolina for an operation, so it's all pretty foreign to people here," says Garrett. "It's a frontier." Garrett's medical care alone may save the company $50,000. And instead of winding up $20,000 in debt to have the operations in the US, he may now get up to $10,000 back as a share of the savings. He'll also get to see the Taj Mahal as part of a two-day tour before the surgery. His two operations could cost $100,000 in the US; they'll run about $20,000 in India.'Medical tourism' is morphing into 'global healthcare.'"
Makes a lot of sense - for patients and their employers ! Hopefully, this will cause US hospitals to come down to earth and start offering realistic pricing so that medical care becomes affordable once again for the average US citizen !

Hospitals make comparison shopping impossible

Hospitals make comparison shopping impossible: "The Tribune found out the hard way how excruciating it is to comparison shop for medical care. When a reporter asked six hospitals to report what a consumer with a high-deductible plan would pay for a colonoscopy, a knee replacement, a routine birth and four other common procedures, the institutions refused."
( Maybe US hospitals are ashamed of how much they overcharge ! ) All clinics and hospitals should have a published list of their standard charges. If they choose to offer a discount to health insurance plans, they can do so - but patients have a right to know how much the "standard" fees are going to be !

Hospitals make comparison shopping impossible

Hospitals make comparison shopping impossible: "The Tribune found out the hard way how excruciating it is to comparison shop for medical care. When a reporter asked six hospitals to report what a consumer with a high-deductible plan would pay for a colonoscopy, a knee replacement, a routine birth and four other common procedures, the institutions refused."
( Maybe US hospitals are ashamed of how much they overcharge ! ) All clinics and hospitals should have a published list of their standard charges. If they choose to offer a discount to health insurance plans, they can do so - but patients have a right to know how much the "standard" fees are going to be !

The Information Therapy Plan - 12 Strategies

The Information Therapy Plan - 12 Strategies" Information therapy is the prescription:
- of specific, evidence-based medical information to a specific patient, caregiver, or consumer;
- at just the right time
- to help him make the right decision."
This is a paper every hospital, clinic and physician should read !

Tuesday, August 15, 2006

Infertility - Coping with the Stress

Infertility - Coping with the Stress : "Almost every minute of conscious life you are engaging in self-talk (conversations in your head); if the self talk is accurate and realistic then you are able to function well, if it is irrational and untrue then you may experience stress and emotional upset. Consider your feelings and self talk regarding your partner if you both discover that the infertility problem lies with them and not you. Do you blame them? do you let it ruin your relationship? Do you feel victimised? Do you have a lot of self talk beginning with “If only…” or “What If…”. Consider your feelings and thoughts if you are told that you can never have a natural child of your own? The chances of your own thoughts becoming negative, irrational and destructive are very high. How do you control these thoughts and your own negative self talk? A practical and effective stress management exercise is controlling self talk. Research shows that a large part of our daily thoughts are negative thoughts whether the situation is a real one or an imagined one. Albert Ellis developed a system to attack irrational ideas and replace them with realistic statements. Ellis’s “Rational Emotive Therapy” is based on the idea that emotions have nothing to do with actual events. In between the event and the emotion is realistic or unrealistic self talk. It is the self talk that produces the emotions. Your own thoughts, directed and controlled by you are what create anxiety, anger, frustration, depression."

Saturday, August 12, 2006

A view of our clinic

Why me, God ?

Why me, God ? : Most infertile couples ask themselves this question - " Why me, God ? Why did you pick on me to be infertile ? Why can't I have a baby ?" I'd like to share this valuable insight from a mom who lost a deeply loved child. "... focusing on questions like 'Why did this happen to me?' or 'What did I do to deserve this?' are pointless, because those questions will never have an answer, let alone a good one. A better question to focus on would be 'Now that this has happened, what are we going to do about it?' I pondered this question, and realize that for right now, the answer is we are going to grieve and mourn. "

Thursday, August 10, 2006

Pricing health care? It's not that easy. | Chicago Tribune

Pricing health care? It's not that easy. | Chicago Tribune: "Health insurers are aggressively marketing medical policies with high deductibles--the amount people pay before coverage kicks in. Many experts contend these products will motivate Americans to shop for medical care, as they do for cars or computers. But basic data about what services cost generally aren't available. Medical providers and insurers consider this to be highly sensitive competitive information, and their contracts require that it remain secret. That leaves consumers with more financial responsibility for their care but without the tools to manage these expenses."
Why should this be such a secret ? Do hospitals have something to hide ?

How embryos develop in the IVF lab

Many people are still clueless as to what happens in the IVF lab. This slide show shows how embryos divide and develop in the incubator. Please note that these are not babies - they are just a collection of cells which have the potential to become human life when transferred into a receptive uterus.

Doing an embryo biopsy in the IVF lab for PGD

There's a lot of coverage about saviour siblings; and this slide show shows how we perform the procedure of embryo biopsy in the IVF lab when doing preimplantation genetic diagnosis ( PGD).

ICU Information Guide

ICU Information Guide: "How to get information from doctors and other medical professionals. When a patient is in an ICU, family members and friends will all want and need information. However the medical team caring for the patient must spend their time providing the best treatment for the patient. It is important that the family select a spokesman to liaison with the medical team. The family spokesman should write down all questions and concerns of the family. In turn, the spokesman should also take notes on the answers he/she receives in order to pass them on to family members. It is important to remember the recovery process involves a number of specialists who work as a team and information should be sought from all team members in order to understand the patient's situation."
The patient-friendly guide to the ICU. They need to add some photos; and also more information of what the patient goes through when in the ICU.

The Healthcare IT Guy

The Healthcare IT Guy: " Dr Aniruddha Malpani, MD, an IVF specialist (Malpani Infertility Clinic), is an ardent patient advocate. He is the founder of what he has dubbed the world’s largest free patient education library, HELP (Health Education Library for People) in Bombay, India; and has authored the book, How to Get the Best Medical Care. I invited him to write a guest article here to talk about Information Therapy; he believes healthcare is too important to be left completely up to the doctor and I found his ideas intriguing."

Wednesday, August 09, 2006

The leading cause of personal bankruptcy in the United States is unpaid medical bills.

The leading cause of personal bankruptcy in the United States is unpaid medical bills.: "The U. S. health-care system, according to “Uninsured in America,” has created a group of people who increasingly look different from others and suffer in ways that others do not. Half of the uninsured owe money to hospitals, and a third are being pursued by collection agencies. Children without health insurance are less likely to receive medical attention for serious injuries, for recurrent ear infections, or for asthma. Lung-cancer patients without insurance are less likely to receive surgery, chemotherapy, or radiation treatment. Heart-attack victims without health insurance are less likely to receive angioplasty. People with pneumonia who don’t have health insurance are less likely to receive X rays or consultations. The death rate in any given year for someone without health insurance is twenty-five per cent higher than for someone with insur-ance. Because the uninsured are sicker than the rest of us, they can’t get better jobs, and because they can’t get better jobs they can’t afford health insurance, and because they can’t afford health insurance they get even sicker. One of the great mysteries of political life in the United States is why Americans are so devoted to their health-care system."
Scary - I hope the rest of the world learns and does not repeat the same mistakes !
Health insurance plays a key role in the healthcare system in USA today, and this article describes what's wrong with it. Excellent discussion on "moral hazards"; and the social versus the actuarial model of providing insurance coverage.

FAQs About Consumer Directed Healthcare at Healthia

FAQs About Consumer Directed Healthcare at Healthia: "How does health insurance in America work? There are many different forms of health insurance plans those that cover medical services and prescription medicines, those that cover dental procedures, disability insurance that replaces income lost due to extended illness or disability, policies that pay for long term care, and so on. People typically refer to the plans that cover medical expenses as health insurance, and these plans are usually offered by employers to employees. Health insurance plans are generally sold and renewed on an annual basis. So when a consumer buys health insurance either directly or through an employer, the insurer agrees to pay for health expenses for a period of one year as long as the premiums are paid on time and the account is in good standing. Health insurance plans come in two primary forms fee-for-service or managed care."

Excellent primer on health insurance - everything you wanted to know but didn't know where to find out ! In the US today, getting good medical care depends more upon how smartly you select your health insurance plan than anything else !

Tuesday, August 08, 2006

The Web Returns to Health

The Web Returns to Health: "'The health category is the last frontier where the Internet has not yet transformed that industry, the way it has done for travel, finance, and commerce,' Wayne T. Gattinella, chief executive of WebMD Health Corp., said. Harnessing the Web to make health care more user-friendly has been a holy grail for entrepreneurs since the earliest days of the dot-com boom. But like many online content businesses, they failed because they could not figure out how to make money.
There were rumors earlier this year that Google was also looking into the delving into the online health information business, a development that does not surprise any of the current players. "I think you'll see several other companies coming into this space because it is such a huge marketplace and so underpenetrated at this point," Martin J. Wygod, chairman of WebMD, told analysts during a May conference call."

Monday, August 07, 2006

New opportunities in medical tourism

New opportunities in medical tourism: "The GlobalChoice Partner program allows our partners to leverage our medical travel network and relationships with Hospitals to help you build your business and provide the best possible medical experience for your client. The hospitals in our network have teamed with us so they can concentrate on providing world class medical care, while we manage the details of patient flow, assist with marketing their services, and oversee partner relationships and commissions. GlobalChoice Healthcare takes care of the details to help you build your business."

A Global Push for Web Services in Healthcare Delivery

A Global Push for Web Services in Healthcare Delivery: "Web services address issues of top concern to providers, payors, and patients around the world: high-quality care delivered in a cost-effective and convenient way. It's no surprise that Web services are being deployed globally, with individual twists to suit regional needs. And as healthcare services move onto the Internet, ensuring the integrity of health information and patient data has become paramount.
'Obviously you don't want someone hacking your heart—that is, getting access to your cardiogram or any of your medical records,' says security consultant Mike Grim, who advises hospitals and clinics on network security. 'Web services are an essential part of modern medicine, and patients are increasingly going to demand such services, but it's absolutely clear that such sensitive information has to be protected. The key is to make the information accessible to those who need it, and protect it from everyone else. Java technology-based smart cards are one way to do this.'"

Medical tourism

Medical Tourism: "This year alone, upwards of 500,000 Americans are expected to travel overseas to get their bodies fixed, at prices 30 to 80 percent less than at home, Business 2.0 reports. Medical tourism is rapidly becoming the top choice for consumers who grapple with hefty medical bills. With places like Costa Rica, the Dominican Republic, India, the Philippines and Thailand pitching their low-cost care, Americans are expected to help turn global medical tourism into a $40 billion-a-year industry by 2010, according to David Hancock, author of “The Complete Medical Tourist,” reports Biz 2.0 writer Krysten Crawford.
Although the trend is disruptive to U.S.-based hospitals and HMOs, an entirely new industry is springing up to service these healthcare travelers: medical tourism agencies. Not only do these companies act as middlemen between patients and foreign physicians, but they also find hospitals, schedule surgeries, buy airline tickets, reserve hotel rooms—and even plan sightseeing tours for recovering patients. Most important, they aim to reassure customers that “cheap” does not necessarily equal “poor quality.”"

Insurer to track health records

Insurer to track health records: "Independence Blue Cross, the region's largest health insurer, is joining with 19 other Blue plans across the nation to form a massive database of health-care records that could enable employers, consumers and medical professionals to learn better what kind of care works best. These massive databases are part of a national trend to arm consumers with at least as much information in getting care as they have when buying a car. 'This has the potential to move us forward in our ability to give consumers the tools needed to make very difficult health-care decisions,' said John R. Lumpkin, director of the health-care group of the Robert Wood Johnson Foundation in Princeton. The Blues consortium could provide useful 'Consumer Reports' information on health care by analyzing real-life data from its 79 million members, he said."

Reduce the pain of injections

Reduce the pain of injections
: "Feel no pain! German researchers have discovered that coughing during an injection can lessen the pain of the needle stick. According to Taras Usichenko, author of a study on the phenomenon, the trick causes a sudden, temporary rise in pressure in the chest and spinal canal, inhibiting the pain-conducting structures of the spinal cord."

Sunday, August 06, 2006

The cost of conception

The cost of conception : "Physicians describe infertility as an epidemic, growing as more women choose to delay childbirth. More than 7.3 million Americans, or 1 in 8 women of childbearing age, had trouble getting pregnant or carrying a baby to term in 2002, the most recent data available from the Centers for Disease Control and Prevention. That's a jump of nearly 20 percent over 1995. About 1 percent of American babies born each year had help from in vitro fertilization, the American Society of Reproductive Medicine says. The percentage could be a lot higher. An estimated 50 percent to 80 percent of infertile couples never seek medical care because they can't afford it. Without coverage, one round of in vitro fertilization costs an average of $12,440, the American Society of Reproductive Medicine says. And, on average, women need two to three cycles to become pregnant."
This is why so many couples from the US come to India for IVF treatment. The cost of an IVF cycle in our clinic is only US $ 3500 - about one-fourth of that in the US - and our success rates are even better !

Saturday, August 05, 2006

Natural progression - open source in healthcare

Natural progression: "The shortcomings of IT solutions in the healthcare industry are well documented and understood, but the means to resolve them remain elusive. Open source, however, may allow users to enjoy the same variety of solutions as such other industries as banking and finance, telecommunications and manufacturing.

The advent of open source will prove to be a watershed event for healthcare. It will provide truly extensible and affordable solutions for the marketplace. Open source solutions will offer unprecedented flexibility and affordability, enabling institutions to more effectively address the complex challenges associated with data interoperability.

The most glaring deficiencies in existing healthcare IT solutions is the ability of existing systems to share patient data outside of a given organisational unit.

This can put lives at risk, add significantly to the expense and inefficiency of healthcare and produce frustrations for patients, service providers such as laboratories and pharmacies and governmental agencies responsible for monitoring disease and health status of populations."

Tuesday, August 01, 2006

The Top 10 Healthcare Innovations for 2006 --

The Top 10 Healthcare Innovations for 2006 -- "The Top 10 Healthcare Innovations for 2006
By Richard L. Reece, M.D. I recently gave 100 healthcare leaders from hospital, physician, supply chain and policy sectors a list of 35 major innovations and asked them to rank the top 10 that are transforming U.S. healthcare.
The poll revealed five major directions:
1. Information technology tools for consumers to better manage and pay for care are on everybody’s docket.
2. Consumer-driven healthcare has staying power.
3. Chronic care management will be huge.
4. Public-private partnerships to manage care for Medicare and Medicaid recipients will be a preoccupation.
5. Customized ambulatory care centers and chains to deliver high quality, cost effective patient services locally, regionally and nationally will flourish."
Lots of opportunities for entrepreneurs as healthcare evolves.

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