America's Health Rankings: Annual Report 2018

America’s Health Rankings® was built upon the World Health Organization definition of health: “Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” Our model reflects that determinants of health directly influence health outcomes, with determinants accounting for three-quarters and outcomes accounting for one-quarter of each state’s overall score and ranking. Four categories of determinants are included in our model of health: Behaviors, Community & Environment, Policy and Clinical Care.

The full report can be downloaded below.  

Slides from 12.14.18 presentation by Walter G. Suarez, MD, MPH, Executive Director, Health IT Strategy and Policy, Kaiser Permanente at eHI's 12.4.18 Data Governance Advisory Board roundtable meeting.

Slides from 12.4.18 presentation by Mark Ropiecki, Executive Director, Care Compass at eHI's 12.4.18 Data Governance Advisory Board roundtable meeting.

Hospital Beds Get Digital Upgrade

A major manufacturer of hospital beds is seeking to transform the ubiquitous furniture into a source of medical data, the latest sign of hospitals’ digital transformation.

Hill-Rom Holdings Inc. said its newest hospital-bed model will include sensors to monitor patients’ heart and respiratory rates. The sensors will check a patient’s vital signs 100 times a minute and alert nurses when signs suggest the patient’s condition may worsen, said Hill-Rom Chief Executive John Groetelaars.

The full Wall Street Journal article can be viewed at this link.  

HEALTH POLL: Deferred care and prescription medication

This month’s Watson Health PULSE Healthcare Survey asked respondents about their ability to pay for healthcare services and prescription drugs. Overall, 20% of respondents said that they had postponed, delayed or canceled healthcare services during the last three months due to cost.

The full pdf of the survey results can be downloaded below.  

Considering Heroin-Assisted Treatment and Supervised Drug Consumption Sites in the United States

Current levels of opioid-related morbidity and mortality in the United States are staggering. Data for 2017 indicate that there were more than 47,000 opioid-involved overdose deaths, and one in eight adults now reports having had a family member or close friend die from opioids. Increasing the availability and reducing the costs of approved medications for those with an opioid use disorder (OUD) is imperative; however, jurisdictions addressing OUDs and overdose may wish to consider additional interventions. Two interventions that are implemented in some other countries but not in the United States are heroin-assisted treatment (HAT; sometimes referred to as supervised injectable heroin treatment) and supervised consumption sites (SCSs; sometimes referred to as overdose prevention sites). Given the severity of the opioid crisis, there is urgency to evaluate tools that might reduce its impact and save lives. In this mixed-methods report, the authors assess evidence on and arguments made about HAT and SCSs and examine some of the issues associated with implementing them in the United States.

The full RAND Corporation report can be downloaded below.  

Patient safety after implementation of a coproduced family centered communication programme: multicenter before and after intervention study

Families, nurses, and physicians coproduced an intervention to standardize healthcare provider-family communication on ward rounds (“family centered rounds”), which included structured, high reliability communication on bedside rounds emphasizing health literacy, family engagement, and bidirectional communication; structured, written real-time summaries of rounds; a formal training programme for healthcare providers; and strategies to support teamwork, implementation, and process improvement.

Although overall errors were unchanged, harmful medical errors decreased and family experience and communication processes improved after implementation of a structured communication intervention for family centered rounds coproduced by families, nurses, and physicians. Family centered care processes may improve safety and quality of care without negatively impacting teaching or duration of rounds.

The full article can be downloaded below.  

Prominent Doctors Aren’t Disclosing Their Industry Ties in Medical Journal Studies. And Journals Are Doing Little to Enforce Their Rules

One is dean of Yale’s medical school. Another is the director of a cancer center in Texas. A third is the next president of the most prominent society of cancer doctors.

These leading medical figures are among dozens of doctors who have failed in recent years to report their financial relationships with pharmaceutical and health care companies when their studies are published in medical journals, according to a review by ProPublica and The New York Times and data from other recent research.

In addition to the widespread lapses by doctors, the review by ProPublica and The Times found that journals themselves often gave confusing advice and did not routinely vet disclosures by researchers, although many relationships could have been easily detected on a federal database.

Medical journals, which are the main conduit for communicating the latest scientific discoveries to the public, often have an interdependent relationship with the researchers who publish in their pages. Reporting a study in a leading journal can heighten their profile — not to mention that of the drug or other product being tested. And journals enhance their cachet by publishing exclusive, breakthrough studies by acclaimed researchers.

In all, the reporting system still appears to have many of the same flaws that the Institute of Medicine identified nearly a decade ago when it recommended fundamental changes in how conflicts of interest are reported. Those have yet to happen.

The full ProPublica article can be viewed at this link.