Sunday, June 26, 2011

Weekend Update

The House of Representatives takes its Fourth of July break this week and the Senate takes its break next week. The debt ceiling negotiations continue. On June 23, the House Appropriations Committee approved the financial services and general government appropriations bill which provides funding for the FEHB Program. The bill now goes to the House floor.

OPM has encouraged plans to address never events that should never happen in a hospital and are preventable, such as wrong side surgery. Kaiser Health News posted an interesting story  indicating that efforts to reduce wrong side surgery have not been successful so far.
 "I'd argue that this really is rocket science," said Mark Chassin, a former New York state health commissioner and since 2008 president of the Joint Commission, which has issued refinements to the 2004 directive. Chassin said he thinks such errors are growing in part because of increased time pressures. Preventing wrong-site surgery also "turns out to be more complicated to eradicate than anybody thought," he said, because it involves changing the culture of hospitals and getting doctors -- who typically prize their autonomy, resist checklists and underestimate their propensity for error -- to follow standardized procedures and work in teams.
Many experts say that medicine needs standardized rules similar to those in aviation, which bar takeoff until a pilot and co-pilot complete a prescribed checklist without interruption. Airlines have a vested interest in a culture of safety that [Philip F.] Stahel [M.D.] says medicine lacks. In surgery "sometimes people say, 'Well, this isn't quite right, but someone else will address it.' In aviation they don't do that, because the plane will crash and they will all die," he said.
 It's really up to the doctors and hospitals to get their act together now.

OPM also encouraged FEHBP plans in this year's call letter to take steps to address the problem of childhood obesity.  Last week  the U.S. Institute of Medicine issued a report making recommendations on steps that can help avoid early childhood obesity. According to a U.S. News and World Report article,
Recommendations include:
  • Limiting young children's television and other media use,
  • Requiring child-care providers to promote healthy sleeping practices,
  • Educating parents about age-appropriate sleep times and good sleep habits,
  • Requiring child-care providers to provide opportunities and environments that encourage physical activity,
  • Increasing efforts to promote breast-feeding,
  • Requiring child-care facilities and preschools to follow the meal patterns established by the U.S. Child and Adult Care Food Program.
This is hardly new advice, and it's difficult for the FEHBlog to see how health plans can help implement these sensible recommendations outside of perhaps their own work forces. Again the burden should be placed on the medical community.

In a surprising development, Google announced that it is shutting down its personal health record platform due to lack of interest according to The product will remain operational until the end of the year.  A commentary in the Washington Post suggests that the fee for service system is to blame. Microsoft's competing Healthvault product "looks to be alive and kicking" according to

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