Value-based Care
Redefining the Physician’s Role in Cost-Conscious Care: The Potential Role of the Electronic Health Record
14 Jul, 2019 | 19:52h | UTCViewpoint: Redefining the Physician’s Role in Cost-Conscious Care: The Potential Role of the Electronic Health Record – JAMA (free for a limited period)
“Displaying price information in EHRs could mark the next step in the transformation of the practice of medicine… The next generation of EHRs should include prices for the majority of medical products and services: medications, laboratory testing, surgical procedures, and physician visits.”
Cochrane Review: Pay for Performance for Hospitals
8 Jul, 2019 | 10:10h | UTCPay for performance for hospitals – Cochrane Library (free)
Summary: Pay for performance (payment or penalty methods to encourage hospitals to increase quality of care) – Cochrane Library (free)
Related Systematic Review: The Effects of Pay-for-Performance Programs on Health, Health Care Use, and Processes of Care: A Systematic Review – Annals of Internal Medicine (free)
See also: Impact of Financial Incentives on Early and Late Adopters among US Hospitals – The BMJ (free study and commentaries) AND Research: Pay-for-performance fails to perform (link to abstract and commentaries) AND Value-Based Purchasing: Time for Reboot or Time to Move On? – The JAMA Forum (free)
“We found either no difference at all or only a very slight effect for most P4P programs.”
Selection of the Top 36 International Choosing Wisely Recommendations by the Romanian Society of Internal Medicine
5 Jul, 2019 | 02:47h | UTCRelated: Choosing Wisely: Case Studies from the Top 10 Recommendations Across Campaigns – The Commonwealth Fund (free case studies)
See complete lists of low-value practices: Choosing Wisely U.S. / Choosing Wisely UK / Choosing Wisely Australia AND Choosing Wisely Canada
10 Medical Myths We Should Stop Believing. Doctors, Too.
2 Jul, 2019 | 05:57h | UTC10 Medical Myths We Should Stop Believing. Doctors, Too. – The New York Times (10 articles per month are free)
Original Study: Meta-Research: A Comprehensive Review of Randomized Trials Leading to “Medical Reversals” in Three Medical Journals (free)
Perspective: Challenging the Resistance to Palliative Care
28 Jun, 2019 | 07:42h | UTCSurvey Snapshot: Challenging the Resistance to “Palliative” – NEJM Catalyst (free)
Study: Inpatient Physician Continuity Associated with Speedier Patient Discharge
28 Jun, 2019 | 07:38h | UTCCommentary: Inpatient physician continuity associated with speedier discharge at one hospital – ACP Hospitalist (free)
Study: Same‐Day Discharge After Elective Percutaneous Coronary Interventions Seems Safe
27 Jun, 2019 | 10:39h | UTCEditorial: Same‐Day Discharge After Elective Uncomplicated Percutaneous Coronary Interventions (free)
Commentaries: Same-Day Discharge Safe After Elective PCI, Canadian Study Affirms – TCTMD (free) AND New study suggests same-day discharge after non-surgical heart procedure could save money and free up hospital beds – ICES (free)
Related Study: Same-Day Discharge After Elective PCI Seems Safe and Reduce Costs (free)
Choosing Wisely – Case Studies from the Top 10 Recommendations Across Campaigns
26 Jun, 2019 | 01:24h | UTCChoosing Wisely: Case Studies from the Top 10 Recommendations Across Campaigns – The Commonwealth Fund (free case studies)
See complete lists of low-value practices: Choosing Wisely U.S. / Choosing Wisely UK / Choosing Wisely Australia AND Choosing Wisely Canada
Related Commentary on Twitter
ICYMI – the @commonwealthfnd released a series on #choosingwisely featuring 10 case studies of implementation of campaign recommendations in Canada, USA, Japan, Switzerland, New Zealand and Brazil ! Read all 10 cases here: https://t.co/nWj1EnSczd pic.twitter.com/c9IFgSEEzp
— Choosing Wisely Canada (@ChooseWiselyCA) June 25, 2019
Opinion – “Debating Whether Checkups Are Time Wasted or Time Misused”
20 Jun, 2019 | 06:38h | UTCDebating Whether Checkups Are Time Wasted or Time Misused – JAMA (free for a limited period)
Related Cochrane Review: General Health Checks for Reducing Illness and Mortality (free)
Consensus Statement: Enhanced Recovery After Surgery in Bariatric Surgery
20 Jun, 2019 | 09:27h | UTCRelated: Enhanced Recovery After Surgery (ERAS) Society Guidelines (free articles)
Academic Medical Centers: Too Large for Their Own Health?
18 Jun, 2019 | 06:40h | UTCAcademic Medical Centers: Too Large for Their Own Health? – JAMA (free for a limited period)
Related: Advancing the Academic Medical Center Value Debate: Are Teaching Hospitals Worth It? – JAMA (free for a limited period)
Author Interview: Academic Medical Centers—Too Large for Their Own Good? (free audio)
Opinion: The Business of Health Care Depends on Exploiting Doctors and Nurses
9 Jun, 2019 | 21:52h | UTCOpinion: The Business of Health Care Depends on Exploiting Doctors and Nurses – The New York Times (10 articles per month are free)
“One resource seems infinite and free: the professionalism of caregivers.”
Viewpoint: The Review of Systems, the Electronic Health Record, and Billing
9 Jun, 2019 | 19:34h | UTCThe Review of Systems, the Electronic Health Record, and Billing – JAMA (free for a limited period)
Author Interview: The Review of Systems, the Electronic Health Record, and Billing (free audio)
Study: Prevalence and Cost of Care Cascades After Low-Value Preoperative Electrocardiogram for Cataract Surgery
5 Jun, 2019 | 04:03h | UTCPrevalence and Cost of Care Cascades After Low-Value Preoperative Electrocardiogram for Cataract Surgery in Fee-for-Service Medicare Beneficiaries – JAMA Internal Medicine (free for a limited period)
Commentary: Cascades Of Care – American Council on Science and Health (free)
Related: Evaluation of an Intervention to Reduce Low-Value Preoperative Care for Patients Undergoing Cataract Surgery (link to abstract and commentary) AND Systematic Review: Routine Preoperative Medical Testing for Cataract Surgery (free)
Related Commentary on Twitter (thread – click for more)
Excited to share our work in @JAMAInternalMed TLDR: We looked at downstream cascades of care after low-value preoperative EKG for cataract surgery. 5-11 events/100 patients in following 90 days cost 10x more than initial EKGs. THREAD (1/7) https://t.co/LFYDsi7uyM #ARM19
— Ishani Ganguli MD, MPH (@IshaniG) June 3, 2019
[Abstract Only] Study: Estimating the Attributable Cost of Physician Burnout
29 May, 2019 | 01:50h | UTCEstimating the Attributable Cost of Physician Burnout in the United States – Annals of Internal Medicine (link to abstract – $ for full-text)
Commentaries: Physician burnout costs the US health care system approximately $4.6 billion a year – American College of Physicians (free) AND Doctors are burning out twice as fast as other workers. The problem’s costing the US $4.6 billion each year. – Business Insider (free) AND Physician Burnout Costs the U.S. Billions of Dollars Each Year – TIME (free)
Related: Physician Burnout Costs up to $17B a Year, Task Force Says (articles and commentaries on the subject)
Related Commentary on Twitter
The economics of doctor burnout: ~$5B/year, and that isn't even factoring in the cost of the doubling of medical errors https://t.co/fqn0LenWzl @AnnalsofIM pic.twitter.com/ZLNOhvYB1h
— Eric Topol (@EricTopol) May 27, 2019
The Escalating Global Burden of Serious Health-related Suffering: Projections to 2060 by World Regions, Age Groups, and Health Conditions
24 May, 2019 | 05:17h | UTCInvited Commentary: Global palliative care: from need to action – The Lancet Global Health (free)
“Immediate global action to integrate palliative care into health systems is an ethical and economic imperative.”
Choosing Wisely Canada-Top Five List in Hepatology
23 May, 2019 | 07:44h | UTCSee complete lists of low-value practices: Choosing Wisely U.S. / Choosing Wisely UK / Choosing Wisely Australia AND Choosing Wisely Canada
1 – Don’t order serum ammonia to diagnose or manage hepatic encephalopathy (HE).
2 – Don’t routinely transfuse fresh frozen plasma, platelets or give Vitamin K to reverse abnormal tests of coagulation in patients with cirrhosis prior to abdominal paracentesis, endoscopic variceal band ligation, or any other minor invasive procedures.
3 – Don’t order HFE genotyping based on serum ferritin values alone to diagnose hereditary hemochromatosis.
4 – Don’t perform computed tomography (CT) or magnetic resonance imaging (MRI) routinely to monitor benign focal liver lesions (ex. focal nodal hyperplasia, hemangioma).
5 – Don’t repeat hepatitis C viral load testing in an individual who has established chronic infection, outside of antiviral treatment.
(Under a Creative Commons license)
Cohort Study: Same-Day vs Different-Day Elective Upper and Lower Endoscopic Procedures
15 May, 2019 | 06:50h | UTCSame-Day vs Different-Day Elective Upper and Lower Endoscopic Procedures by Setting – JAMA Internal Medicine (free for a limited period)
Commentaries: Improving the Delivery of Common Medical Procedures to Achieve Value-Based Care – JAMA Internal Medicine (free for a limited period) AND When possible, upper and lower GI endoscopies should be done on same day – Johns Hopkins University School of Medicine (free)
The Development of Pathways in Palliative Medicine: Definition, Models, Cost and Quality Impact
15 May, 2019 | 06:34h | UTCThe Development of Pathways in Palliative Medicine: Definition, Models, Cost and Quality Impact – Healthcare (free) (via @Abraham_RMI)
Related Commentary on Twitter
A good overview of #PalliativeCare Medicine and its current place in #healthcarehttps://t.co/kTSPtERRTP pic.twitter.com/L8ApgmjC9G
— Raed Dweik, MD, MBA (@RaedDweikMD) May 13, 2019
How Organizations Contribute to Improving the Quality of Healthcare
5 May, 2019 | 16:16h | UTCHow organisations contribute to improving the quality of healthcare – The BMJ (free)
Related Commentary on Twitter
How organisations contribute to improving the quality of healthcare. @bmj_latest https://t.co/ZK31Tc9UFe pic.twitter.com/3Muy6MkZ0Z
— Krishnaprasad Karnad🇬🇧 🇮🇳 (@kpkarnad) May 4, 2019
Patient Engagement Survey: Why No Single Health Incentive Works
5 May, 2019 | 16:10h | UTCPatient Engagement Survey: Why No Single Health Incentive Works – NEJM Catalyst (free)
Enhanced Recovery After Surgery (ERAS) Guidelines for Perioperative Care in Gynecologic/Oncology
3 May, 2019 | 07:20h | UTCRelated: Enhanced Recovery After Surgery (ERAS) Society Guidelines (free articles)
Perspective: Using Behavioral Economics to Improve Healthcare and Prevent Doctor Burnout
26 Apr, 2019 | 01:59h | UTCUsing behavioural economics to improve healthcare and prevent doctor burnout – The BMJ Opinion (free)
New Marketplace Survey: Patients Lack Information to Reduce the Cost of Care
20 Apr, 2019 | 14:43h | UTCNew Marketplace Survey: Patients Lack Information to Reduce the Cost of Care – NEJM Catalyst (free)
Randomized Trial: Workplace Wellness Programs do Little to Improve Overall Health or Lower Spending
17 Apr, 2019 | 06:17h | UTCEffect of a Workplace Wellness Program on Employee Health and Economic Outcomes: A Randomized Clinical Trial – JAMA (free for a limited period)
Editorial: Employer Wellness Programs—A Work in Progress (free)
Commentaries: Workplace wellness programs may help people change certain behaviors but do little to improve overall health or lower spending, study shows – Harvard Medical School (free) AND How Well Do Workplace Wellness Programs Work? – NPR (free) AND Harvard Study On Workplace Wellness: Behaviors Change But Health Does Not — So Far – CommonHealth (free) AND Employee Wellness Programs Yield Little Benefit, Study Shows – The New York Times (free)
Related: Workplace Wellness Programs Don’t Work Well. Why Some Studies Show Otherwise (free)