Andy Oram

Endless organizations such as the National Association for Healthcare Quality (NAHQ) and the Agency for Healthcare Research and Quality (AHRQ) collect quality measures, and CMS has tried strenuously to include quality measures in Meaningful Use and the new MACRA program. We actually have not a dearth of quality measures, but a surfeit. Doctors feel overwhelmed with these measures. They are difficult to collect, and we don’t know how to combine them to create easy reports that patients can act on. There is a difference between completing a successful surgery, caring for things such as pain and infection prevention after surgery, and creating a follow-up plan that minimizes the chance of readmission. All those things (and many more) are elements of quality.

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The health care insurance industry looks like no other insuranceAndy Oram
industry in the world. When we think of insurance, we think of paying semi-annually into a fund we hope we never need to use. But perhaps every twenty years or so, we suffer damage to our car, our house, or our business, and the insurance kicks in. That may have been true for healthcare 70 years ago, when you wouldn’t see the doctor unless you fell into a pit or came down with some illness they likely couldn’t cure anyway.
The insurance model is totally unsuited for health care today...

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It’s no secret that getting people to engage in their health is one of our generation’s biggest challenges. Digital health engagement, especially, is often discussed as “a huge opportunity,” but the reality is that while people are interested in their health, it’s still incredibly difficult to get them to use digital tools consistently. Enacting behavior change is still a mostly elusive process...

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Marijuana legalization will unleash misery on Arizona, according to a wave of television ads that started rolling out across the state last month. Replete with ominous music, the advertisements feature lawmakers and teachers who paint a bleak future for Arizona’s children if voters approve Proposition 205, a measure that would allow people aged 21 and over to possess an ounce of pot and grow up to six plants for recreational use. “Colorado schools were promised millions in new revenues” when the state approved recreational pot use, says the voiceover in one ad. Instead, schoolchildren were plagued by “marijuana edibles that look like candy”...

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Women over 45 do not need a blood test to diagnose the menopause and X-rays are no real help to those with lower back pain, doctors have said. The advice, drawn up by the Academy of Medical Royal Colleges, features on a list of 40 treatments that bring little or no benefit to patients. The list is part of a campaign to reduce the number of unnecessary medical treatments. Patients are also encouraged to ask more questions about procedures. Medical experts from 11 different specialties were asked to identify five treatments or procedures commonly used in their field that were not always necessary or valuable...

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