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Health care quality metrics, examined: The Health Care Blog

Posted by on June 19, 2015

Summary: “In the future, doctors who provide better healthcare will be paid more. When a doctor gives good care, she will get credit. For factors out of that doctor’s control, she won’t be penalized,” Rachel Katz writes in this thoughtful and thorough explanatory piece examining quality metrics from a provider’s perspective on The Health Care Blog. “The patient, too, will be rewarded for taking care of his own health. In short, payments will align with good care, and good care will become more common. This is the promise of value-based care, which is coming, according to almost everyone. Medicare is pushing it. Private payers are preparing for it.Top providers are tooling up. And yet, the question lingers — how exactly do we measure quality? Today quality measurement is rigid, periodic, and manual. Here’s a peek behind the curtain of what we measure today — and what’s possible tomorrow.” Rachel Katz, Anatomy of a Healthcare Quality Metric,” The Health Care Blog.


Should you ‘Yelp’ your doc? Online patient reviews, reviewed.

Posted by on June 17, 2015

Summary: Quality ratings on medical procedures and providers, including Yelp, are a big issue. So I was interested in the online discussion in the last day or two on a piece by Casey Quinlan, the patient advocate (disclosure: and a friend of mine), about whether patients should “Yelp” their doctors. Anyone who’s interested should look at these two Storify collections. Voices were raised, from “Online Doctor Ratings Are Garbage” to “Your headline ‘Online Ratings Are Garbage’ mine ‘Patients Smarter Than You Think'” to “My point is that in absence of patient-useable data, people WILL Yelp. Fix THAT PERCEIVED NEED TO YELP.” Here’s Storify One and here’s Storify Two.


Home STD testing from Planned Parenthood. Discuss.

Posted by on June 17, 2015

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Summary: So what about at-home STD test kits? We started hearing about them a couple of years ago, and couldn’t decide if it is a good idea or not. Getting tested, yes — but not seen by a trained professional? Hmmm.



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Buying prescription drugs from Canada: One woman’s story

Posted by on June 15, 2015

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Summary: Buying medications by mail from Canada? You’re not alone. A friend from California explained how she started out on this path, and why she thinks this will save a lot of money — although, strictly speaking, the Food and Drug Administration considers the practice illegal, and has reportedly intercepted some shipments of medications from other countries.



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The new health care consumer: Hospitals and Health Networks writes about us

Posted by on June 10, 2015

Summary: “When shopping for care, consumers want to know what the doctor is thinking, how providers’ costs and quality compare, how patients rate providers, if personalized care is provided, and how safe the hospital is,” writes Lola Butcher in “Hospitals and Health Networks,” an online journal of the American Hospital Association. She mentions in the context of price transparency. Also, in a section marked “Framing the Issue;” she writes” “Consumers are learning that all health care providers do not deliver equal value. Most consumers do not currently have access to or understand how to evaluate the information they need to make smart health care choices. New entrants outside the health care industry are taking the lead in educating consumers about health care. Knowledge is power. Consumers are learning that they have options when it comes to health care.” Lola Butcher, The New Health Care Consumer, Hospitals and Health Networks.


Access to health care for LGBTQ people is limited, study finds

Posted by on June 6, 2015

Summary: Access to health care for LGBTQ people is a big issue, explored in this report by the Kaiser Family Foundation. “Lesbian, gay, bisexual, and transgender (LGBT) individuals often face challenges and barriers to accessing needed health services and, as a result, can experience worse health outcomes. These challenges can include stigma, discrimination, violence, and rejection by families and communities, as well as other barriers, such as inequality in the workplace and health insurance sectors, the provision of substandard care, and outright denial of care because of an individual’s sexual orientation or gender identity. While sexual and gender minorities have many of the same health concerns as the general population, they experience certain health challenges at higher rates, and also face several unique health challenges. In particular, research suggests that some subgroups of the LGBT community have more chronic conditions as well as higher prevalence and earlier onset of disabilities than heterosexuals. Other major health concerns include HIV/AIDS, mental illness, substance use, and sexual and physical violence. … Some LGBT individuals are more likely to experience challenges obtaining care. Barriers include gaps in coverage, cost-related hurdles, and poor treatment from health care providers. Several recent changes within the legal and policy landscape serve to increase access to care and insurance. … The implementation of the Affordable Care Act (ACA), the Supreme Court’s overturning of a major portion of the Defense of Marriage Act (DOMA), the subsequent legalization of same-sex marriage in many states, as well as recent steps taken by the Obama Administration to promote equal treatment of LGBT people and same-sex couples in the nation’s health care system have reshaped policy affecting LGBT individuals and their families.” Source: Health and Access to Care and Coverage for Lesbian, Gay, Bisexual, and Transgender Individuals in the U.S.,” The Henry J. Kaiser Family Foundation.


Super-users of health services: Who are they? Here are some surprises.

Posted by on June 5, 2015

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Summary: Who are the super-users, people who go to the emergency room more than anyone else and consume a lot of services and a lot of health-care dollars? It’s not who you think, according to an analysis by California Healthline of a pilot program studying this question. Who are they? People who have things in common: Substance use, behavioral issues, early-life trauma and a lack of care coordination, according to this piece, “Surprising Results From Pilot Program Aimed at Medi-Cal ‘Super-Utilizers,'” by David Gorn, California Healthline Sacramento Bureau writer.


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Epic data story time: Innovative uses of open data, as told by us at the Datapalooza

Posted by on June 3, 2015

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Summary: I spoke twice at the Health Datapalooza in Washington, Sunday through Wednesday, May 31-June 3, 2015. Here’s a Storify (capturing real-time records of the event) on Wednesday, one element of a days-long event put on by the U.S. Department of Health and Human Services celebrating open data and its use to improve costs, quality and outcomes in health care in the U.S.

The Wednesday panel description: “This session will feature unique uses of government and private sector open data sources that are contributing to better consumer decision making and value based care. These exciting initiatives include unique, community-sourced guides to health care costs, revealing patterns of purchasing by consumers and creating deeper community engagement around cost transparency and the only free data set and API for information about individual medications, pill images, and drug identification. Moderator: Bryan Sivak, Former Chief Technology Officer, U.S. Department of Health & Human Services; Panelists: Charles Gellman, MSHI, Qwalcare; David Hale, National Institutes of Health; Jeanne Pinder,”

The Monday session I did not capture in this way, but was honored to speak on a panel moderated by Ben Harder of U.S. News and World Report, along with Josh Rosenthal of Rowdmap and Kevin Larsen, MD, Office of the National Coordinator of Health IT, pinch-hitting for Elizabeth Mitchell. President and CEO, Network for Regional Healthcare Improvement. The description: “Applications of Transparency: From Visibility to Action: As transparency in health care has emerged as a crucial enabler towards achieving the Triple Aim, myriad sources and types of information have become available in the last few years. Join this session to learn new ways of understanding the behaviors of patients and providers, and novel approaches to payment and delivery already underway.”


How many times did he do that operation? Volume as a quality proxy in health care

Posted by on May 30, 2015
Cleveland Clinic doctor ratings

Cleveland Clinic doctor ratings

Summary: It’s hard to judge quality in health care. What’s best: a good outcome? Good hospital experience? Shorter wait times? Less money spent for better results? It’s one of the toughest nuts to crack, along with price transparency. But there are some simple measures that can be used, including the very simple one of frequency or volume: how many times did someone do a thing, and does that mean they’re better at doing it than people who did it less? Quite possibly, as Cheryl Clark wrote recently in Health Leaders media: “After a decade in which physicians and observers focused on processes and outcomes, the pendulum is swinging back toward viewing volume as the best barometer of hospital quality.”


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A doctor writes: Price transparency, a Rosetta stone

Posted by on May 24, 2015
cost of cancer care

Dr. Robert Fogerty

Summary: This essay by Dr. Robert Fogerty, an assistant professor at Yale School of Medicine, appeared originally in MedPage Today, where it launched our pricing transparency partnership with MedPage Today. Re-posted with permission.

By Robert Fogerty MD

I tossed and turned during many sleepless nights as a cancer patient. Some nights from nausea, some from pain. Some from sadness, some even from being cold without hair. There were nights where I feared my next surgery or next treatment. Nights fretting about the scan or blood work — had it spread? Would I see my graduation in 3 months? These are all predictable and were largely understood by those around me.


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