Mark Larow
MedCity News
Originally posted January 1, 2019
Here is an excerpt:
Yet nowhere can AI have a more immediate and accessible impact than in patient matching. Currently, health systems have teams of data stewards and health information management (HIM) professionals dedicated to finding, reviewing, researching, and resolving records that their EHR or EMPI has flagged as “potential duplicates.” Essentially, these employees are spending hours each day looking at, for example, a record for Jane Jones and another for Jane Smith, trying to decide if both Janes are actually the same person and if her records should be merged.
Referential matching technology can automate 50-to-75 percent of this manual effort by being an intelligent and data-driven technology. It can automatically find and resolve duplicate records that EHRs and EMPIs have missed, enabling data stewards and HIM staff to focus on higher-value projects—while simultaneously lowering the operational costs and inefficiencies plaguing health systems by automating manual work.
Ultimately, automating the discovery and resolution of duplicate records with referential matching technology can reduce claims denials to save up to $1.5 million, reduce operational costs by at least $200,000, improve the ROI of EHR deployments, and enable value-based care and patient engagement initiatives by enabling more complete and accurate patient health histories.
Ethics
Health systems are increasingly making technology investments not just to reduce costs or improve efficiencies, but also because not using new technologies is becoming unethical. We have reached a tipping point where innovative new technologies are prominent, successful, and inexpensive enough for ethics to begin driving technology purchasing decisions.
The info is here.
Showing posts with label Improved Outcomes. Show all posts
Showing posts with label Improved Outcomes. Show all posts
Wednesday, February 6, 2019
Wednesday, November 29, 2017
The Hype of Virtual Medicine
Ezekiel J. Emanuel
The Wall Street Journal
Originally posted Nov. 10, 2017
Here is an excerpt:
But none of this will have much of an effect on the big and unsolved challenge for American medicine: how to change the behavior of patients. According to the Centers for Disease Control and Prevention, fully 86% of all health care spending in the U.S. is for patients with chronic illness—emphysema, arthritis and the like. How are we to make real inroads against these problems? Patients must do far more to monitor their diseases, take their medications consistently and engage with their primary-care physicians and nurses. In the longer term, we need to lower the number of Americans who suffer from these diseases by getting them to change their habits and eat healthier diets, exercise more and avoid smoking.
There is no reason to think that virtual medicine will succeed in inducing most patients to cooperate more with their own care, no matter how ingenious the latest gizmos. Many studies that have tried some high-tech intervention to improve patients’ health have failed.
Consider the problem of patients who do not take their medication properly, leading to higher rates of complications, hospitalization and even mortality. Researchers at Harvard, in collaboration with CVS, published a study in JAMA Internal Medicine in May comparing different low-cost devices for encouraging patients to take their medication as prescribed. The more than 50,000 participants were randomly assigned to one of three options: high-tech pill bottles with digital timer caps, pillboxes with daily compartments or standard plastic pillboxes. The high-tech pill bottles did nothing to increase compliance.
Other efforts have produced similar failures.
The article is here.
The Wall Street Journal
Originally posted Nov. 10, 2017
Here is an excerpt:
But none of this will have much of an effect on the big and unsolved challenge for American medicine: how to change the behavior of patients. According to the Centers for Disease Control and Prevention, fully 86% of all health care spending in the U.S. is for patients with chronic illness—emphysema, arthritis and the like. How are we to make real inroads against these problems? Patients must do far more to monitor their diseases, take their medications consistently and engage with their primary-care physicians and nurses. In the longer term, we need to lower the number of Americans who suffer from these diseases by getting them to change their habits and eat healthier diets, exercise more and avoid smoking.
There is no reason to think that virtual medicine will succeed in inducing most patients to cooperate more with their own care, no matter how ingenious the latest gizmos. Many studies that have tried some high-tech intervention to improve patients’ health have failed.
Consider the problem of patients who do not take their medication properly, leading to higher rates of complications, hospitalization and even mortality. Researchers at Harvard, in collaboration with CVS, published a study in JAMA Internal Medicine in May comparing different low-cost devices for encouraging patients to take their medication as prescribed. The more than 50,000 participants were randomly assigned to one of three options: high-tech pill bottles with digital timer caps, pillboxes with daily compartments or standard plastic pillboxes. The high-tech pill bottles did nothing to increase compliance.
Other efforts have produced similar failures.
The article is here.
Tuesday, November 21, 2017
Harnessing the Placebo Effect: Exploring the Influence of Physician Characteristics on Placebo Response
Lauren C. Howe, J. Parker Goyer, and Alia J. Crum
Health Psychology, 36(11), 1074-1082.
Abstract
Objective: Research on placebo/nocebo effects suggests that expectations can influence treatment outcomes, but placebo/nocebo effects are not always evident. This research demonstrates that a provider’s social behavior moderates the effect of expectations on physiological outcomes.
Methods: After inducing an allergic reaction in participants through a histamine skin prick test, a health care provider administered a cream with no active ingredients and set either positive expectations (cream will reduce reaction) or negative expectations (cream will increase reaction). The provider demonstrated either high or low warmth, or either high or low competence.
Results: The impact of expectations on allergic response was enhanced when the provider acted both warmer and more competent and negated when the provider acted colder and less competent.
Conclusion: This study suggests that placebo effects should be construed not as a nuisance variable with mysterious impact but instead as a psychological phenomenon that can be understood and harnessed to improve treatment outcomes.
Link to the pdf is here.
Health Psychology, 36(11), 1074-1082.
Abstract
Objective: Research on placebo/nocebo effects suggests that expectations can influence treatment outcomes, but placebo/nocebo effects are not always evident. This research demonstrates that a provider’s social behavior moderates the effect of expectations on physiological outcomes.
Methods: After inducing an allergic reaction in participants through a histamine skin prick test, a health care provider administered a cream with no active ingredients and set either positive expectations (cream will reduce reaction) or negative expectations (cream will increase reaction). The provider demonstrated either high or low warmth, or either high or low competence.
Results: The impact of expectations on allergic response was enhanced when the provider acted both warmer and more competent and negated when the provider acted colder and less competent.
Conclusion: This study suggests that placebo effects should be construed not as a nuisance variable with mysterious impact but instead as a psychological phenomenon that can be understood and harnessed to improve treatment outcomes.
Link to the pdf is here.
Monday, August 28, 2017
Maintaining cooperation in complex social dilemmas using deep reinforcement learning
Adam Lerer and Alexander Peysakhovich
(2017)
Abstract
In social dilemmas individuals face a temptation to increase their payoffs in the short run at a cost to the long run total welfare. Much is known about how cooperation can be stabilized in the simplest of such settings: repeated Prisoner’s Dilemma games. However, there is relatively little work on generalizing these insights to more complex situations. We start to fill this gap by showing how to use modern reinforcement learning methods to generalize a highly successful Prisoner’s Dilemma strategy: tit-for-tat. We construct artificial agents that act in ways that are simple to understand, nice (begin by cooperating), provokable (try to avoid being exploited), and forgiving (following a bad turn try to return to mutual cooperation). We show both theoretically and experimentally that generalized tit-for-tat agents can maintain cooperation in more complex environments. In contrast, we show that employing purely reactive training techniques can lead to agents whose behavior results in socially inefficient outcomes.
The paper is here.
(2017)
Abstract
In social dilemmas individuals face a temptation to increase their payoffs in the short run at a cost to the long run total welfare. Much is known about how cooperation can be stabilized in the simplest of such settings: repeated Prisoner’s Dilemma games. However, there is relatively little work on generalizing these insights to more complex situations. We start to fill this gap by showing how to use modern reinforcement learning methods to generalize a highly successful Prisoner’s Dilemma strategy: tit-for-tat. We construct artificial agents that act in ways that are simple to understand, nice (begin by cooperating), provokable (try to avoid being exploited), and forgiving (following a bad turn try to return to mutual cooperation). We show both theoretically and experimentally that generalized tit-for-tat agents can maintain cooperation in more complex environments. In contrast, we show that employing purely reactive training techniques can lead to agents whose behavior results in socially inefficient outcomes.
The paper is here.
Monday, January 9, 2017
Medical students need to learn the potent medicine of empathy
By Wolfgang Gilliar
STAT News
Originally published September 29, 2016
Here is an excerpt:
How does empathy do this? A patient who feels emotionally connected to his or her doctor is more likely to disclose important medical information and to follow the doctor’s advice. That connection can serve as the basis for true teamwork, with the patient working proactively with the medical team to improve health. Simply put, patients who feel cared about feel better and do better.
There’s also great promise in osteopathic medicine, which couples traditional medical interventions with skilled, specialized, hands-on treatments for the body’s complex system of nerves, muscles, and bones. “Healing touch” isn’t just a metaphor. This simple physical action evokes trust in patients.
Without empathy, doctors run the risk of alienating their patients. The relationship can become one-sided, with the physician simply dictating treatments and the patient following orders. Core emotional needs can be ignored, leading patients to feel lonely and downtrodden. And that deterioration of mood can make it less likely that they will experience positive outcomes from treatment.
The article is here.
STAT News
Originally published September 29, 2016
Here is an excerpt:
How does empathy do this? A patient who feels emotionally connected to his or her doctor is more likely to disclose important medical information and to follow the doctor’s advice. That connection can serve as the basis for true teamwork, with the patient working proactively with the medical team to improve health. Simply put, patients who feel cared about feel better and do better.
There’s also great promise in osteopathic medicine, which couples traditional medical interventions with skilled, specialized, hands-on treatments for the body’s complex system of nerves, muscles, and bones. “Healing touch” isn’t just a metaphor. This simple physical action evokes trust in patients.
Without empathy, doctors run the risk of alienating their patients. The relationship can become one-sided, with the physician simply dictating treatments and the patient following orders. Core emotional needs can be ignored, leading patients to feel lonely and downtrodden. And that deterioration of mood can make it less likely that they will experience positive outcomes from treatment.
The article is here.
Wednesday, July 27, 2016
Doctors have become less empathetic, but is it their fault?
By David Scales
Aeon Magazine
Originally posted July 4, 2016
Here is an excerpt:
The key resides in the nature of clinical empathy, which requires that the practitioner be truly present. That medical professional must be curious enough to cognitively and emotionally relate to a patient’s situation, perspective and feelings, and then communicate this understanding back to the patient.
At times, empathy’s impact seems more magical than biological. When empathy scores are higher, patients recover faster from the common cold, diabetics have better blood-sugar control, people adhere more closely to treatment regimens, and patients feel more enabled to tackle their illnesses. Empathetic physicians report higher personal wellbeing and are sued less often.
If the case for empathy is clear, the way to boost it remains murky indeed. New research shows that meditation and ‘mindful communication’ can increase a physician’s empathy, spawning a niche industry of training courses. Yet this preoccupation has missed the glaring deficits in the work environment, which squelch the human empathy that doctors possess.
The article is here.
Aeon Magazine
Originally posted July 4, 2016
Here is an excerpt:
The key resides in the nature of clinical empathy, which requires that the practitioner be truly present. That medical professional must be curious enough to cognitively and emotionally relate to a patient’s situation, perspective and feelings, and then communicate this understanding back to the patient.
At times, empathy’s impact seems more magical than biological. When empathy scores are higher, patients recover faster from the common cold, diabetics have better blood-sugar control, people adhere more closely to treatment regimens, and patients feel more enabled to tackle their illnesses. Empathetic physicians report higher personal wellbeing and are sued less often.
If the case for empathy is clear, the way to boost it remains murky indeed. New research shows that meditation and ‘mindful communication’ can increase a physician’s empathy, spawning a niche industry of training courses. Yet this preoccupation has missed the glaring deficits in the work environment, which squelch the human empathy that doctors possess.
The article is here.
Wednesday, April 17, 2013
Wellness Programs Aren't Working: Three Ideas that Could Help
By Mike Miessen
The Health Care Blog
Originally posted April 1, 2013
You’d be forgiven if, after reading last month’s Health Affairs, you came to the conclusion that all manner of wellness programs simply will not work; in it, a spate of articles documented myriad failures to make patients healthier, save money, or both.
Which is a shame, because – let’s face it – we need wellness programs to work and, in theory, they should. So I’d rather we figure out how to make wellness work. It seems that a combination of behavioral economics, technology, and networking theory provide a framework for creating, implementing, and sustaining programs to do just that.
Let’s define what we’re talking about. “Wellness program” is an umbrella term for a wide variety of initiatives – from paying for smoking cessation, to smartphone apps to track how much you walk or how well you comply with your plan of care, and everything in between. The term is almost too broad to be useful, but let’s go with it for now.
When we say “Wellness programs don’t work,” the word work does a lot of, well, work. If a wellness program makes people healthier but doesn’t save lives, is it “working”? What if it saves money but doesn’t make people healthier?
To be thorough and appropriately critical, let’s go with the following definition: a wellness program “works” if it improves the health of a population and reduces health care costs for that population. Full stop.
The entire blog post is here.
The Health Care Blog
Originally posted April 1, 2013
You’d be forgiven if, after reading last month’s Health Affairs, you came to the conclusion that all manner of wellness programs simply will not work; in it, a spate of articles documented myriad failures to make patients healthier, save money, or both.
Which is a shame, because – let’s face it – we need wellness programs to work and, in theory, they should. So I’d rather we figure out how to make wellness work. It seems that a combination of behavioral economics, technology, and networking theory provide a framework for creating, implementing, and sustaining programs to do just that.
Let’s define what we’re talking about. “Wellness program” is an umbrella term for a wide variety of initiatives – from paying for smoking cessation, to smartphone apps to track how much you walk or how well you comply with your plan of care, and everything in between. The term is almost too broad to be useful, but let’s go with it for now.
When we say “Wellness programs don’t work,” the word work does a lot of, well, work. If a wellness program makes people healthier but doesn’t save lives, is it “working”? What if it saves money but doesn’t make people healthier?
To be thorough and appropriately critical, let’s go with the following definition: a wellness program “works” if it improves the health of a population and reduces health care costs for that population. Full stop.
The entire blog post is here.
Saturday, June 30, 2012
Can Doctors Learn Empathy?
By Pauline W. Chen, MD
The New York Times - Well
Originally published June 21, 2012
Empathy has always been considered an essential component of compassionate care, and recent research has shown that its benefits go far beyond the exam room. Greater physician empathy has been associated with fewer medical errors, better patient outcomes and more satisfied patients. It also results in fewer malpractice claims and happier doctors.
The New York Times - Well
Originally published June 21, 2012
Empathy has always been considered an essential component of compassionate care, and recent research has shown that its benefits go far beyond the exam room. Greater physician empathy has been associated with fewer medical errors, better patient outcomes and more satisfied patients. It also results in fewer malpractice claims and happier doctors.
A growing number of professional accrediting and licensing agencies have taken these findings to heart, developing requirements that make empathy a core value and an absolute “learning objective” for all doctors. But even for the most enthusiastic supporters of such initiatives, the vexing question remains: Can people learn to be empathetic?
A new study reveals that they can.
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