Friday, July 07, 2017


 The Wall Street Journal features an essay promoting smart medicine. The author of the essay is a cardiologist and author named Eric Topol. The essay's lead is "Our health-care system won’t be fixed by insurance reform. To contain costs and improve results, we need to move aggressively to adopt the tools of information-age medicine." Good point.  For example,
Smart medicine offers a way [to lower the cost curve], enabling doctors to develop a precise, high-definition understanding of each person in their care. The key tools are cheaper sensors, simpler and more routine imaging, and regular use of now widely available genetic analysis. As for using all this new data, here too a revolution is under way. Algorithms and artificial intelligence are making it possible for doctors to rapidly apply relevant medical literature to their patients’ cases, while “natural language processing” (that is, talking to computers) holds the promise of liberating them from keyboards during office visits.
One obvious practical effect of these developments will be to replace hospital stays with remote monitoring in the patient’s home. The Food and Drug Administration has already approved wearable sensors that can continuously monitor all vital signs: blood pressure, heart rate and rhythm, body temperature, breathing rate and oxygen concentration in the blood. The cost to do this for weeks would be a tiny fraction of the cost for a day in the hospital. Patients will be able to avoid serious hospital-acquired infections and get to sleep in their own beds, surrounded by family.
Other examples are offered. An interesting read as we wait for Congress to get back to town next week.

On other fronts --

  • The Centers for Disease Control has a new director-- Brenda Fitzgerald, MD who "has been the commissioner of the Georgia Department of Public Health (DPH) and state health officer for the past six years."
  • Yesterday the CDC issued a report on opioid prescription trends in U.S. counties over the ten year period ending with 2015.  "The amount of opioids being prescribed in the United States varies county by county. Half of US counties have seen a decrease in the amount of opioids prescribed from 2010-2015, but the highest prescribing counties still prescribe six times more than the amounts of the lowest prescribing counties." The CDC encourages doctors to follow the CDC's guidance on prescribing those drugs. 
  • MHealth Intelligence reports that 25 states have adopted an enhanced interstate nursing licensure compact.  "The eNLC, an enhanced version of the Nurse Licensure Compact originally introduced in 1997 and implemented in 2000, allows for registered nurses (RNs) and licensed practical/vocational nurses (LPN/VNs) to practice in any member state under one license. Licensing standards are aligned in member states so that nurses applying for a multistate license are required to meet the same standards, which include a federal and state criminal background check." Of course, this law facilitates the use of nurses in telehealth programs. 
  • Employee Benefit News reports that employers and investment advisors are encouraging workers to see and take advantage of the relationship between 401(k) retirement accounts and health savings accounts, e.g., it's important to build balances in both types of accounts for retirement. That's an interesting angle for FEHBP carriers of consumer driven plans to explore.
  • Health IT Security reports that the  "The National Health Information Sharing and Analysis Center (NH-ISAC) announced that it had a Petya ransomware vaccine, and also discussed mitigation tactics that organizations can follow to minimize the potential risk of infection."

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