Evaluating the Needs of Cancer Survivors through Focus Groups and Surveillance Data

Public health has typically emphasized prevention and early detection, while the medical community has focused on treatment. Therefore, the ongoing needs of post-treatment cancer survivors are often overlooked. It has become essential for states and researchers to examine the public health needs of this growing population to promote their quality of life. In Michigan, data from the Michigan Cancer Surveillance Program (MCSP) and the 2015 Michigan Behavioral Risk Factor Survey (MiBRFS) in conjunction with cancer survivor focus groups were used to assist public health professionals understand the mental and physical health issues within this population.

The full article can be downloaded below.  

Consumerism Will Spark Change Across the Industry: My Top Seven Health IT Predictions for 2019

As we prepare to take on the challenges and opportunities of a new year, let’s lay out some of the industry’s macro trends and what they might mean to us in 2019.

This year, there is a theme. As patients, we have an increasingly consumer-oriented mindset—and rightfully so. We’re paying closer attention to the quality and value we’re getting for the money we’re spending. This “consumerization” of healthcare, along with constant technology innovation, is driving a tectonic shift across the industry, and it’s easy to be excited about what the future holds. 

After nearly 40 years in this business, I’d better be getting good at reading between the lines to understand what’s coming next. So without further ado, here are my top seven health IT predictions for 2019.

1. Consumerization of healthcare reaches tipping point
2. Telehealth, mobility and millennials will upend the who and where of care delivery
3. Consumers will demand healthcare price transparency
4. People will insist on the ability to easily share their health data -- forcing the industry to accelerate interoperability solutions
5. Increased interoperability will propel value-based care
6. Initially driven by government regulations, the health IT industry will take the lead on battling the opioid epidemic
7. The healthcare market will demand easier, more appropriate access to high cost specialty drugs

The full Surescripts article can be viewed at this link.  

The simple idea that could help end America’s opioid epidemic

I spent a lot of 2018 reporting on complex systems and policies that could help end the opioid epidemic, which is now the US’s deadliest drug overdose crisis ever.

But behind all the reporting that I did was a simple idea: America needs to see addiction as a medical condition, and approach addiction treatment like any other form of health care.

The full Vox article can be viewed at this link.  

IMPLANT FILES

Health authorities across the globe have failed to protect millions of patients from poorly tested implants, the first-ever global examination of the medical device industry reveals.

These articles from the International Consortium of Investigative Journalists (ICIJ) can be viewed at this link.  

Health insurance on demand? Some are betting on it

People with health insurance often pay for coverage they never use. A startup wants to shake that up.

It’s a radical idea: On-demand insurance that lets customers buy some of their coverage only if and when they need it, similar to how TV viewers might rent a new release from Amazon instead of paying every month for a pricey cable package they rarely use.

This approach from Bind Benefits is one of the latest wrinkles in a yearslong push by companies and insurers to control costs and make patients smarter health care shoppers. And it’s drawing attention from the nation’s largest health insurer, UnitedHealthcare, and some sizeable employers.

The full Associated Press article can be viewed at this link.  

Cost of Care Conversations: Practice Briefs

As part of the Cost Conversation projects, Avalere worked closely with the Robert Wood Johnson Foundation project grantees to synthesize the key themes and findings across their exploratory studies and create 7 Practice Briefs. These briefs are intended to act as actionable resources to clinicians, staff, and practice administrators interested in increasing the value and frequency of cost-of-care conversations in the clinical setting. The briefs cover the 7 key topics below.

• Why Do Cost-of-Care Conversations Matter?
• What Your Patients Aren’t Telling You: How To Partner with Patients To Help Manage the Hidden Costs of Healthcare
• How To Welcome Cost-of-Care Conversations in Your Practice
• Structuring the Conversation: How To Talk To Your Patients About the Costs of Their Care
• How To Integrate Cost-of-Care Conversations into Workflow
• Considerations for Facilitating Cost-of-Care Conversations with Vulnerable Patients
• Addressing the Most Common Barriers to Implementing Cost-of-Care Conversations

These briefs on the America's Essential Hospitals site can be viewed at this link.

Patient and public involvement in medical performance processes: A systematic review

The significance and recognition of patient and public involvement (PPI) have grown in many domains of health care in recent years propagating an evolution of “patient-centred care” and shared clinical decision making. This review indicates a need for a similar level of integration for PPI within medical performance processes as existing models are both fragmented and inadequate to have a meaningful impact on systems and processes that assess and monitor performance.

Feedback and complaints have both summative and formative elements, though the balance varies between different systems and even within systems. PPI can make a positive contribution to developing both elements, although the evidence presented in this review suggests that most doctors would prefer patient feedback and complaints to provide a primarily formative assessment of their performance and are cautious about the use of such data for summative purposes. Developing the formative element of feedback and complaints mechanisms with patients involved in the design of their structures and systems may have a greater impact on the professional development of doctors.

More broadly, quality improvement may act as a driver for PPI in medical performance processes to evolve beyond the level of providing feedback and lodging complaints, forming the foundation of a transition from a culture of contractual PPI that exists as part of the clinical interface between the doctor and patient, to that of collaboration that enhances the profession-society relationship.

The full article can be downloaded below.  

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.  

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.  

Now Mental Health Patients Can Specify Their Care Before Hallucinations and Voices Overwhelm Them

As the pendulum has swung from institutionalization to outpatient care, psychiatric advance directives (PADs) also offer a middle path by allowing patients to designate family members to speak for them when they’re too sick to do so themselves.

But some doctors and hospitals are wary that the documents could tie their hands and discourage treatment they consider warranted. Some worry the directives won’t be updated to reflect medical advances. Others question whether people with serious psychiatric conditions are ever capable of lucidly completing such directives.

Still, early research and experience suggest that PADs, authorized by law in 27 states and possible in others as part of conventional medical advance directives, could help some of the millions of people with serious mental illness cope better and guide doctors treating them.

The full article from the New York Times can be viewed at this link.