New England Journal of Medicine
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Artificial Pancreas Shows Promise in Diabetes Test
A portable artificial pancreas built with a modified iPhone successfully regulated blood sugar levels in a trial with people who have Type 1 diabetes, researchers reported Sunday.
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Beyond HIT Interoperability: Open Platforms are the Key
Open platforms in health IT are inevitable. Exactly when OPEN becomes health IT’s de facto reality is impossible to determine. But we can be certain that it will happen because healthcare businesses focused on quality improvement and cost-effective care will demand it Read More »
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Deconstructing the CDC’s ‘Snapshot’ Estimates
In 2013, the U.S. Centers for Disease Control and Prevention released estimates of how many people in the country die every year from antibiotic resistant infections: 23,000. The agency estimates that an additional 15,000 die annually from Clostridium difficile, an infection linked to long-term antibiotic use. The estimates, the agency said at the time, provided the “first snapshot of the burden and threats posed by antibiotic-resistant germs having the most impact on human health”...
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How Machine Learning May Revolutionize Medicine
Doctors will one day be able to more accurately predict how long patients with fatal diseases will live. Medical systems will learn how to save money by skipping expensive and unnecessary tests. Radiologists will be replaced by computer algorithms. These are just some of the realities patients and doctors should prepare for as “machine learning” enters the world of medicine, according to Dr. Ziad Obermeyer, an assistant professor at Harvard Medical School, and Dr. Ezekiel Emanuel of the University of Pennsylvania, who recently coauthored an article in the New England Journal of Medicine on the topic...
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Killer Care: How Medical Error Became America's Third Largest Cause of Death, And What Can Be Done About It
...The following year, researchers shook the profession with an article in Health Affairs entitled “‘Global Trigger Tool’ Shows that Adverse Events in Hospitals May be Ten Times Greater than Previously Measured.” Dr. David Classen, who did the seminal research for global triggers, served as lead author of the study, which looked at three mid-size to large (ranging from 550 to 1,000 beds) teaching hospitals associated with medical schools in the West and Northwest that participated on the condition of anonymity...When different detection methods were applied, global triggers found over 90 percent of events, the government’s Patient Safety Indicators (based on discharge summaries) found 8.5 percent, and voluntary reporting disclosed only 2 percent (afraid of censure and malpractice, doctors and nurses seldom willingly self-accuse). Classen, et al. warned: “reliance on voluntary reporting and the Patient Safety Indicators could produce misleading conclusions about the current safety of care in the U.S. health-care system and misdirect efforts to improve patient safety.”...
Mortal Coils: Why We Must Stop Tolerating Failing Health Tech
Today, data are scattered across thousands of database tables within any single electronic medical record (EMR) system, but also across dozens of other systems that hold pharmacy data, imaging data, insurance data, laboratory data, etc. Pretty much none of it is available on demand in any given clinical setting. The inevitable result of this disconnected galaxy of data "black holes" is mistakes, or if not outright mistakes, well-intentioned missteps based on lack of background data within the acute-care setting.
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On the Financial Conflicts of Interests of Medical Societies and Rising Drug Prices
The notion that health care prices are high and are rising continuously in the US should hardly be novel...We first posted about high drug prices in July, 2005, with the example of BilDil...But only a few days later we noted that three cancer costs had yearly costs in the five figures, and one, Erbitux, cost as much as $100,000. Most amazingly we noted that Thalidomid was priced at $25,000 a year...Since then, the ridiculously high prices of many tests and treatments, but most notably new drugs and devices, has been so widely covered, our discussion has been limited to special cases.,,
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OpenNotes Now: How the Movement Will Change the Physician-Patient Relationship
Every movement needs an early, visionary leader, and the OpenNotes movement has been no exception—it’s got Tom Delbanco, M.D. Delbanco, who practiced as an internal medicine physician for 40 years, several years ago joined together with Jan Walker, R.N. to initiate a movement that is now sweeping the country and changing healthcare—and creating numerous implications for healthcare IT leaders in its wake...
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Stories from Patients and their Caregivers Uncover Opportunities to Improve Healthcare Value
As a presidential election looms and the American economy struggles to recover, the spiraling costs of healthcare have become a contentious political focal point without an obvious solution. Yet for patients and their caregivers, opportunities to get more bang for our buck present themselves every day. Read More »
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The HITECH Era – A Patient-Centered Perspective
We appreciate the recent perspectives published in the New England Journal of Medicine on the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 and the positive impact that it and resulting health IT policies have had on U.S. health care.1,2 The perspectives highlighted the remarkable increase in adoption and use of electronic health records (EHRs) over the past eight years, thanks to the HITECH Act and to ONC’s and CMS’s implementation of it with major advice and help from the multi-stakeholder HIT Policy and Standards committees...
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The Staggering Cost Of An Epic Electronic Health Record Might Not Be Worth It
...[B]ecause it is no small task to deploy [Epic, Judith Faulkner] is there all the way to hand-hold jittery CIOs, and help them get millions of dollars in government subsidies by showing meaningful use of her EHR. Her not-for-profit clientèle will need every penny of those taxpayers’ dollars, but they won’t cover anywhere near the staggering cost of an Epic EHR. Read More »
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Veterans aren’t the only ones waiting for health care
But the big question with these stories about the VA is, "compared to what?" This scandal wouldn't exist if the VA didn't have performance metrics on its employees. If it didn't measure or care whether veterans get prompt appointments it could just do what the rest of the health-care system has done and not hold people responsible for these metrics. Read More »
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When Evidence Says No, but Doctors Say Yes
Fiirst, listen to the story with the happy ending: At 61, the executive was in excellent health. His blood pressure was a bit high, but everything else looked good, and he exercised regularly. Then he had a scare. He went for a brisk post-lunch walk on a cool winter day, and his chest began to hurt. Back inside his office, he sat down, and the pain disappeared as quickly as it had come...
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Why an Obscure Indian Journal Has an Impressive — and Growing — International Stature
Earlier this year a Canadian medical ethicist published a doozy of an essay1 claiming that the heavyweight New England Journal of Medicine was poorly vetting its authors and publishing shoddy studies. The piece drew lots of attention for those allegations. But what went unremarked, though perhaps just as notable, is the place where they appeared: The Indian Journal of Medical Ethics (IJME). The IJME isn’t on anyone’s list of most desirable places to publish...But for a relatively unknown and ostensibly local title...it has an impressive list of staff and contributors, and has been earning plaudits from the science community lately.
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