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Health Management Technology News
May 19, 2014

In this issue:
 

 Growing evidence points to systemic troubles in VA healthcare system

 The intoxicating appeal of waste and dysfunction: Healthcare through the eyes of an entrepreneur

 Walking the healthcare insurance tightrope

 How contagious pathogens could lead to nuke-level casualties

 Clinic brings healthcare to working uninsured

 6 recent hospital and health system layoffs


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Growing evidence points to systemic troubles in VA healthcare system

Three years ago Edward Laird, a 76-year-old Navy veteran, noticed two small blemishes on his nose. His doctor at the Veterans Affairs hospital in Phoenix ordered a biopsy, but month after month, as the blemishes grew larger, Laird couldn't get an appointment.

Laird filed a formal complaint and, nearly two years after the biopsy was ordered, got to see a specialist — who determined that no biopsy was needed. Incredulous, Laird successfully appealed to the head of the VA in Phoenix. But by then, it was too late. The blemishes were cancerous. Half his nose had to be cut away.

"Now I have no nose and I have to put an ice cream stick up my nose at night ... so I can breathe," Laird said. "I look back at how they treated me over the years, but what can I do? I'm too old to punch them in the face."

The Phoenix VA Health Care System is under a federal Justice Department investigation for reports that it maintained a secret waiting list to conceal the extent of its patient delays, in part because of complaints such as Laird's. But there are now clear signs that veterans' health centers across the U.S. are juggling appointments and sometimes manipulating wait lists to disguise long delays for primary and follow-up appointments, according to federal reports, congressional investigators and interviews with VA employees and patients.

The growing evidence suggests a VA system with overworked physicians, high turnover and schedulers who are often hiding the extent to which patients are forced to wait for medical care.

Read the full article from The Los Angeles Times
here


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The intoxicating appeal of waste and dysfunction: Healthcare through the eyes of an entrepreneur

Monday’s WSJ includes my review of Where Does It Hurt?, athenahealth CEO Jonathan Bush’s account of how the company was built, and more generally, how entrepreneurs might – and must — impact healthcare.

The review speaks for itself, but (following the inspired example of Christopher Chabris), I wanted to share some additional color.

While the deficiencies of our current healthcare system have been widely discussed and exhaustively lamented, it’s refreshing and instructive to see how these challenges look through the eyes of a seasoned entrepreneur.  And as Bush writes, “From an entrepreneur’s point of view, there’s something highly appealing, almost intoxicating, about waste and dysfunction in the industry.”

A stint as an army medic (he trained but never saw combat) showed Bush that with practice and discipline, “ordinary people” without extensive education could be taught to performing complex tasks, such as operating multi-million dollar missiles or performing battlefield tracheotomies” – a perspective that led him and Todd Park (now Obama’s Chief Technology Officer) to launch Athena Women’s Health, the midwife-driven obstetrics startup that ultimately became today’s athenahealth.  (See the review for details on this interesting evolution, and Atul Gawande’s first New Yorker piece, here, for an example of “training up” medical skills in practice, in the context of hernia repairs at the Shouldice Hospital in Canada.)

Where Does It Hurt? is a fast-paced, engaging narrative that faithfully captures the manic energy and rapidly cascading thoughts so evident in Bush’s popular conference presentations and widely-viewed 2013 TEDMED talk, “What’s Wrong With Profit In Healthcare?”

Fundamentally, Bush believes that the marketplace, for lack of a better word, is good.  “The marketplace works,” he explains.  “It rewards innovators, kills laggards, and provides consumers with better value and more choices…Only markets have the force and tenacity to drive the innovation and efficiency we need.”

Read the full article from Forbes here

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Walking the healthcare insurance tightrope

This month’s Harpers Index reports that 2,629 inmates in a Chicago county jail were successfully enrolled in Medicaid because of provisions contained in ObamaCare. Compared to the thousands of Americans who are scrambling to find affordable healthcare coverage for themselves and their families, it appears the inmates got the better deal.

ObamaCare has forced many people to make gut wrenching decisions about their healthcare insurance -- for the first time in their lives, some are faced with the possibility of becoming uninsured. Men and women in their late 50s and early 60s are hardest hit -- many can’t afford to retire early, they are too young to enroll in Medicare and under the new law they are paying the highest premium cost because age is a factor that is now used to set premium rates.

Income is another factor. Under the law, qualified low-income individuals and families receive substantial financial assistance with the cost of their monthly premium, while individuals earning more than $45,960 (400% of the federal poverty level) don’t. Whether 60-year old single individuals earn$50,000, $60,000, $70,000, $80,000 or more, their monthly premium rate is the same and they are required to pay 100% of the cost. ObamaCare’s ban on pre-existing conditions may be a good idea, but linking age and income with premium rates is not.

Read the full article from American Thinker
here


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How contagious pathogens could lead to nuke-level casualties

What if nuclear bombs could reproduce? Get your hands on one today, and in a week's time you've got a few dozen.

Of course, nukes don't double on their own. But contagious, one-celled pathogens do. Properly packaged as a bioweapon, they could kill as many people as a hydrogen bomb would, or more.

Milana Trounce, MD, a clinical associate professor of emergency medicine, wants to get people to worry about this possibility. For the fourth year in a row, she is presiding over a course called Biosecurity and Bioterrorism Response, which aims to get students thinking about how to prevent bioterror and, in the event of a biological attack, what to do about it. More than 100 Stanford undergraduate, graduate, postdoctoral and professional students, representing disciplines ranging from public policy to biological science to engineering and bioengineering, have enrolled.

The course, which Trounce considers more of a forum or workshop, brings students together with guest lecturers from Stanford and other universities, as well as with biotech-company executives, think-tank denizens and current and former public-health and other government officials.

"I'm hoping to continue to grow this forum to figure out real-world solutions," she said.

Read the full article from Stanford School of Medicine here

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Clinic brings healthcare to working uninsured

For the past five years, the Agape Community Clinic in DeRidder has provided free medical services to working, uninsured residents.

Started by a group of volunteers, the non-profit clinic opened its doors in April 2009 and each Thursday provides services to those who do not have health insurance but are employed and whose family income doesn't exceed 200 percent of the federal poverty level.

"We explored the need and the resources we have with the group of volunteers for about a year when we made the decision to go ahead with it," said Dr. Henry Carter, who has worked with the clinic since its inception. "The clinic is a community service; it's not funded in any way whatsoever by public funds.

"It is supported by the community with volunteer donations and from philanthropic foundations."

"Agape" is a Greek word meaning "an intentional response to promote well-being when responding to that which has produced ill-being."

In addition to providing chaplain services via the Beauregard Area Ministerial Alliance, Agape "provides professional services by physicians and nurses every Thursday evening and in-house licensed pharmacists," Carter said.

Read the full article from Beauregard Daily News
here


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6 recent hospital and health system layoffs

The following six hospital and health system layoffs and workforce reductions were covered by Becker's Hospital Review in the last two weeks. They are listed below by number of employees and/or positions affected.

1. Yukon-Kushokwim Health to Eliminate 160 Jobs
Bethel, Alaska-based Yukon-Kushokwim Health Corp., a system that includes one regional hospital and several community clinics that serves 58 rural communities in southwest Alaska, announced plans to lay off 110 employees and leave 50 positions empty.


2. Mercy Medical Center-Des Moines Eliminates 136 Positions
Mercy Medical Center-Des Moines (Iowa) laid off 29 employees and will leave 107 positions vacant in a move orchestrated to cut $15 million.


3. St. Francis Healthcare of Hawaii to Lay Off 110
Honolulu-based St. Francis Healthcare System of Hawaii plans to lay off 110 employees and slash its hospice and home health services. The system plans to close one of its hospice units in Ewa Oahu by Sept. 30 and cease offering a home health program that served patients on Oahu and Kauai by June.


Read the full article from Becker’s Hospital Review here

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  READ ALL NEWS AT HEALTHMGTTECH.COM


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