News & Commentary

Briefly Noted October 2017

Better cooperation between providers and health plans would speed up the shift to value-based health care, according to a Quest Diagnostics–Inovalon survey. And that transition will continue no matter what lawmakers might cook up, respondents believe. About 8 in 10 physicians and health plan executives said they believe the transition to value-based care will continue regardless of policy changes spearheaded by the federal government. The survey was conducted in April and included 302 primary care physicians and 150 health plan executives.

The American health system isn’t at all prepared to defend itself against cyberattack, reports the Sacramento Bee. The connectivity that enamors so many contains some risk. “From insulin pumps and defibrillators, and on to expensive CT scanners and MRI machines, medical devices are increasingly connected to networks,” the newspaper reports. “Patient medical records are online. When networks go down, physicians say it is like operating in the dark.” The headline on the story: “Cyber criminals’ next deadly target: Grandpa’s pacemaker”.

Emergency department staff can be the first line of defense in trying to prevent elder abuse. Often, visits to the ED are the only time providers get a chance to determine if an elderly person’s been abused, Kaiser Health News reports. ED doctors look for specific injuries. “For example, radiographic images show old and new fractures, which suggest a pattern of multiple traumatic events,” Kaiser reported. “Specific types of fractures may indicate abuse, such as midshaft fractures in the ulna, a forearm bone that can break when an older adult holds his arm in front of his face to protect himself”.

When Nora Harris, 64, was diagnosed with Alzheimer’s disease in 2009, the Oregon resident signed an advance directive preventing her life from being prolonged when the disease got worse. Those directives usually give named agents the power to withdraw artificial hydration and nutrition, but when that same nourishment is offered by hand, several states, including Oregon, draw a line, Thaddeus Mason Pope, director of the Health Law Institute at Hamline University in St. Paul, Minn., told Kaiser Health News. A local judge ruled against Bill Harris, Nora’s husband, last summer, concluding that state law mandates that she continue to receive help. “That court decision basically condemned Nora to the full extent of the Alzheimer’s disease,” Bill Harris said. “They gave her no exit out of this situation”.

For years, doctors have been telling patients to finish the entire prescription of anti­biotics even if they’re feeling better, but a study in BMJ by infectious disease experts say that that advice sometimes leads to patients taking the medications longer than necessary. The study states that “the idea that stopping anti­biotic treatment early encourages anti­biotic resistance is not supported by evidence, while taking antibiotics for longer than necessary increases the risk of resistance.”

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