Archive for September, 2009

How would you counsel this patient?

September 29th, 2009 | Popularity: 5%
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This 2:45 clip from this week’s “Brothers and Sisters” dramatizes one of the most difficult experiences patients and physicians face in health care (make sure you watch the whole clip).

I was struck by the way the physician pre-counseled Calista Flockhart’s character:

  • Should she have provided information differently?
  • What should she have said if the result from the test wasn’t going to come back the same day?

With this vignette and another on 30Rock that I posted about previously, I imagine that the shows are trying to show a real view of health care, and also, for those who have experienced these situations, the hope that maybe the way things are today could be different.

This may be especially true now that we know that 7.1 % of abnormal tests in general and a percentage of abnormal imaging results may go unreported to patients.

It will be interesting to watch as this story unfolds if the character and her family are as involved in the care as they want to be. Will the pathology result be available to the patient and her family online?


The Art of Health Reform | Medicine and Society

September 28th, 2009 | Popularity: 6%
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The Art of Health Reform | Medicine and Society – Colleague Rahul Parikh, MD (also a physician at Kaiser Permanente) writes about the 73 Cents mural in Washington, DC

Workers At California Auto Plant Left In Limbo : NPR

September 28th, 2009 | Popularity: 5%
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Workers At California Auto Plant Left In Limbo : NPR – I am saddened to hear this news. While analyst say it makes economic sense, the presence of the NUMMI plant and its innovative work processes helped me and others from other industries. I am glad I got to meet you, NUMMI.

Life in the Bell System

September 28th, 2009 | Popularity: 4%
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Life in the Bell System – Fascinating account of measurement systems gone awry in the 1960’s Bell System. As usual, there are many analogies to health care, specifically in the way it is financed.

Kaiser Permanente Medical Care Oral History Project / About the Project

September 28th, 2009 | Popularity: 5%
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Kaiser Permanente Medical Care Oral History Project / About the Project – Useful in some work I am doing to understand the genesis and meaning of KP HealthConnect to the physician population at Kaiser Permanente.

Photo Friday: Pentagon Memorial

September 25th, 2009 | Popularity: 5%
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This week’s photograph was taken at the Pentagon Memorial, designed so that “the nation may remember and reflect on the events that occurred on September 11, 2001.” In the background, you can see The Air Force Memorial.

A short description of the memorial’s design, from cnn.com:

The focus of the memorial is 184 cantilevered benches built over a pool of lighted water. Each bench is engraved on the end with the name of one of the 184 people who died on board Flight 77 or in the Pentagon that day.

The benches are arranged by age, with the bench of the youngest victim, 3-year-old Dana Falkenberg, in the far southeast corner and the bench honoring 71-year-old John Yamnicky in the northwest corner.

The benches for the 59 victims on board the plane are arranged so that someone reading the name on the end of the bench will face the sky where the plane came from. The 125 benches for the victims inside the Pentagon face the opposite direction, so someone reading the name will look up and see the south facade of the Pentagon, where the jet hit that day.



Science-Based Medicine; Re-evaluating Home Monitoring for Diabetes: Science-Based Medicine at Work

September 24th, 2009 | Popularity: 3%
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Science-Based Medicine » Re-evaluating Home Monitoring for Diabetes: Science-Based Medicine at Work – “Home glucose monitoring in type 2 diabetes is not justified by the evidence. It does not improve outcome, it is expensive, and it may decrease the quality of life of patients.”


Home blood glucose monitoring in type 2 diabetes — Reynolds and Strachan 329 (7469): 754 — BMJ

September 24th, 2009 | Popularity: 4%
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Home blood glucose monitoring in type 2 diabetes — Reynolds and Strachan 329 (7469): 754 — BMJ – “If the scientific evidence supporting the role of home blood glucose monitoring in type 2 diabetes was subject to the same critical evaluation that is applied to new pharmaceutical agents, then it would perhaps not have been approved for use by patients.” The emphasis on diabetes as “the” use case for remote monitoring may be misguided. This editorial discusses how we’ve gotten there (no one reimburses for blood pressure monitors, they do for diabetic test strips….)


Myths and Realities of Meaningful Care Plans

September 24th, 2009 | Popularity: 3%
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Myths and Realities of Meaningful Care Plans – Speaking of trust and transparency – I love that Group Health Cooperative physicians and leaders are “blogging as they go” with regard to their reinvention of primary care. They tell us, they don’t know exactly the best way to do some things on day one, but they are trying, and talking about it openly. Really, what is not to like about that.

“So that’s my new routine. Our current approach to “Care Planning” may change over time. EPIC may develop a slick new module with its own tabs and toolbars. I don’t know. What I do know is that by following a few simple conventions and “rules” as I have outlined above we can have a consistent, meaningful, and helpful way for our patients, their families, and our colleagues to know where to find their latest care plans. What’s not to like about that. To me it is a huge step towards providing patient-centered care that really works for everyone.”


The Great Trust Offensive – BusinessWeek

September 24th, 2009 | Popularity: 2%
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The Great Trust Offensive – BusinessWeek – In Reputation Institute’s latest Global Reputation Pulse study, ethics and transparency rose in importance to their highest levels ever. Good governance—characteristic of “a responsibly run company that behaves ethically and is open and transparent in its business dealings”—moved from the No. 4 driver of reputation in 2007 to No. 2 this year.

This is a nice article about how various organizations are working with their customers, transparently, to build trust, one of the most important assets they have. Sadly, there are no health care organizations profiled. What is yours doing to engender trust?