Welcome to the Nexus of Ethics, Psychology, Morality, Philosophy and Health Care

Welcome to the nexus of ethics, psychology, morality, technology, health care, and philosophy

Thursday, August 2, 2012

Psychologist Who Wrote of Abuse Is Punished

By Timothy Williams
The New York Times
Originally published July 30, 2012

A federal health services psychologist who told superiors that an American Indian tribe was ignoring widespread child abuse on a North Dakota reservation has been reprimanded and reassigned, according to federal officials and documents.

The psychologist, Michael R. Tilus, director of behavioral health at the Spirit Lake Health Center on the Spirit Lake Indian reservation, describes himself as a whistle-blower. He wrote in an e-mail to state and federal health officials this spring about an “epidemic” of child abuse on Spirit Lake, which is in a remote area of northeastern North Dakota.

Among the recipients were officials with the Department of Health and Human Services and the Indian Health Service, which oversee most health care on Spirit Lake.  

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Dr. Tilus wrote that instead of being punished, he deserved whistle-blower protection under the Food and Drug Administration Safety and Innovation Act of 2012, which was signed into law by President Obama this month. That law extends military whistle-blower safeguards to federal Public Health Service officers.

Wednesday, August 1, 2012

Social Networking’s ‘Big Impact’ on Medicine

Eric Topol, MD
MedScape Today: The Creative Destruction of Medicine
Originally posted July 17, 2012

Here are some excerpts:


Everybody is familiar with Facebook, which soon will have 1 billion registrants and be second only to China and India as far as a community or population. What isn't so much appreciated by the medical community is that our patients are turning to online health social networking. These are such Websites as PatientsLikeMe, CureTogether, and many others.

Interestingly, patients with like conditions -- often chronic conditions, such as multiple sclerosis, diabetes, or amyotrophic lateral sclerosis (ALS) -- will find patients with the same condition on these networking sites. And these virtual peers will become very much a key guidance source. This is so different from the past, when all information emanated from physicians. In fact, now many of these individuals who use social networks trust their virtual peers more than their physicians, so this is a real change that's taken place. In addition to this, the social networking platforms, which are free, offer an opportunity we haven't seen before.

Doctor Shortage Likely to Worsen With Health Law

By Annie Lowrey and Robert Pear
The New York Times
Originally published July 28, 2012

In the Inland Empire, an economically depressed region in Southern California, President Obama’s health care law is expected to extend insurance coverage to more than 300,000 people by 2014. But coverage will not necessarily translate into care: Local health experts doubt there will be enough doctors to meet the area’s needs. There are not enough now.

Other places around the country, including the Mississippi Delta, Detroit and suburban Phoenix, face similar problems. The Association of American Medical Colleges estimates that in 2015 the country will have 62,900 fewer doctors than needed. And that number will more than double by 2025, as the expansion of insurance coverage and the aging of baby boomers drive up demand for care. Even without the health care law, the shortfall of doctors in 2025 would still exceed 100,000.

Tuesday, July 31, 2012

Impact of Deductibles on Initiation and Continuation of Psychotherapy for Treatment of Depression

Objective. To estimate the impact of deductibles on the initiation and continuation of psychotherapy for depression.

Data Source/Study Setting. Data from health care encounters and claims from Group Health Cooperative, a large integrated health care system in Washington State, was merged with information from a centralized behavioral health triage call center to conduct study analyses.

Study Design. A retrospective observational design using a hierarchical logistic regression model was used to estimate initiation and continuation probabilities for use of psychotherapy, adjusting for key sociodemographic/economic factors and prior use of behavioral health services relevant to individual decisions to seek mental health care.

Data Collection/Extraction Methods. Analyses were based on merged datasets on patient enrollment, insurance benefits, use of mental health and general medical services and information collected by a triage specialist at a centralized behavioral health call center.

Principal Findings. Among individuals with unmet deductibles between $100 and $500, we found a statistically significant lower likelihood of making an initial visit, but there was no statistically significant effect on making an initial or subsequent visit among individuals that had met their deductible.

Conclusions. Unmet deductibles appear to influence the likelihood of initiating psychotherapy for treating depression.

Monday, July 30, 2012

Healthcare Data Breaches Still Rising

By Deborah Hirsch
HealthTechZone Contributor
Originally published July 19, 2012

Here are some excepts:

The healthcare industry has the highest percentage of data breaches of any sector, according to a report by Symantec. Healthcare also had the highest number of reported breaches, at 43 percent, Patricia Resende reports.

And the costs continue to rise, with each breach costing organizations $5.5 million, and each compromised record, $194, the Symantec study reports. And even though the costs have dropped slightly from several years ago, according to a Ponemon study, healthcare is the one area where they have not. Physicians’ offices and small clinics say they have lost more than 54,000 patient records due to breaches since 2009.

And they’ve occurred all over the country, from Utah, where the files of almost 300,000 Medicaid patients were breached in March, to Boston, where the laptop of a Boston Children’s Hospital employee at a South American conference containing more than 2000 patient records was stolen.

The entire story is here.

Beth Israel Deaconess reveals health data breach

By Kyle Murphy, PhD
EHR Intelligence
Originally published July 20, 2012

The personal health information of close to 4,000 patients at Beth Israel Deaconess Medical Center (BIDMC) has been compromised after a physician’s personal laptop was stolen on May 22, says the Boston Globe. BIDMC officials could not be reached for comment.
 
 
Thanks to Ken Pope for this information.

Sunday, July 29, 2012

Hospitals Reaping Financial Benefits of Telehealth

By Karen Minich Pourshadi
Health Leaders Media
Originally published July 19, 2012

Here are some excerpts:

The passing of the years has softened resistance by patients to using this approach. Patients are now willing to forego an in-person visit with the doctor in order to get the care they need swiftly, without having to travel, and in some instances at a lower cost. Moreover, the reimbursement environment is changing. Whereas at one time payers rejected the notion of reimbursing e-health, now more are willing to pay for it. Plus, legislators nationwide are creating state laws requiring payers to reimburse for these services, though in many instances payers are doing so irrespective of mandate.

"Telemedicine can lower healthcare costs by reducing avoidable hospital visits and providing regular access to care in remote parts of the state, and it's more convenient for patients," says Georgia Partnership for TeleHealth CEO Paula Guy. The nonprofit telehealth provider works with more than 350 partners and 175 specialists and other healthcare providers and has handled some 40,000 patient encounters as of 2011.

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GPT has also placed telehealth into nursing homes. In 2011, using telehealth resulted in 160 ED visits being avoided, saving approximately $480,000 in ED cost, Guy says, "In the past, these older patients may have just called for an ambulance when they had a problem. But now patients can be seen by a doctor without an expensive ambulance trip to the ED. Plus they can use it for routine access to care, and by getting that they're less likely to end up in the hospital as frequently," Guy says.

Telehealth visits saved 310 miles and nearly six hours of traveling on average, according to a study by Children's Healthcare of Atlanta, a three-hospital system for children and teens. CHA reviewed 609 appointments over a nine-month period and noted that approximately 86% of patients would have missed school and more than 80% of parents would have missed a full day of work to go to the city for an in-office visit, according to data published in the Atlanta Journal-Constitution. Additionally, Guy explains that out of the 40,009 telehealth visits GPT tracked, a random sample showed an average savings of patient travel time of 124 miles per encounter and nearly $762,027 in fuel alone.

The entire article is here.

Saturday, July 28, 2012

EHR Adoption By Doctors Reaches 55 Percent

Kaiser Health News
Originally published July 19, 2012

Physician adoption of the electronic health record (EHR) may be at — or even past — the proverbial tipping point, or so suggests a government study released yesterday that is a litany of progress. In 2011, 55% of physicians reported having adopted an EHR, and of those, 85% said they were either somewhat or very satisfied with the technology, according to the report from the US Centers for Disease Control and Prevention (CDC). Roughly 3 in 4 physicians using EHRs said the software enhanced overall patient care. And 71% of digital physicians would buy their EHR program again.

More can be found here.

Friday, July 27, 2012

Actress urges action against human trafficking

By Andres Gonzalez
The Associated Press
Originally published July 17, 2012

Jada Pinkett Smith
Actress and activist Jada Pinkett Smith urged Congress on Tuesday to step up the fight against human trafficking in the U.S. and abroad.

The actress testified during a Senate Foreign Relations Committee hearing that she plans to launch a campaign to raise awareness and spur action against human trafficking and slavery. She said the "old monster" of slavery "is still with us," almost 150 years after President Abraham Lincoln issued the Emancipation Proclamation that freed slaves in the U.S.

"Fighting slavery doesn't cost a lot of money. The costs of allowing it to exist in our nation and abroad are much higher," the actress said. "It robs us of the thing we value most, our freedom."

The entire story is here.