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Value-based Care

Use of Medications of Questionable Benefit at the End of Life

20 Apr, 2017 | 14:34h | UTC

Use of Medications of Questionable Benefit at the End of Life in Nursing Home Residents with Advanced Dementia – Journal of the American Geriatrics Society (link to abstract – $ for full-text)

See also: Use of Medications of Questionable Benefit at the End of Life in Nursing Home Residents with Advanced Dementia – CBCNews (free) AND Many With Advanced Dementia Receiving Drugs of Uncertain Benefit – Medscape (free registration required)

“Too much use of meds of questionable benefit at the end of life: Just Stop.” (RT @DeeMangin see Tweet)

 


Mortality Trends After Surgical Safety Checklist

20 Apr, 2017 | 14:31h | UTC

Mortality Trends After a Voluntary Checklist-based Surgical Safety Collaborative – Annals of Surgery (link to abstract – free PDF available)

Sources: Global Health NOW Newsletter (free) AND South Carolina Hospitals Saw Surgery Deaths Drop After Implementing WHO Checklist – AJMC News (free) AND A simple checklist prevents deaths after surgery, a large new study suggests – The Washington Post (a few articles per month are free)

See also: WHO Surgical Safety Checklist – World Health Organization (free) AND A Surgical Safety Checklist to Reduce Morbidity and Mortality in a Global Population – New England Journal of Medicine (free)

 


Australasian Society for Infectious Diseases: low value interventions

20 Apr, 2017 | 14:30h | UTC

Australasian Society for Infectious Diseases: low value interventions – The Medical Journal of Australia (free) (RT @ChooseWiselyAU and @ASIDANZ see Tweet)

See also: Choosing Wisely initiative was launched 5 years ago in our April 5 issue.

The society has just released a selection of 5 low value interventions (details in the text):

 

– Prescribing antibiotics for asymptomatic bacteriuria.

– Taking a swab of a leg ulcer without signs of clinical infection and treating the patient with antibiotics against the identified bacteria.

– Treating upper respiratory tract infections with antibiotics.

– Investigation for fecal pathogens in the absence of diarrhea or other gastrointestinal symptoms.

– Ordering multiple serological investigations for patients with fatigue without a clinical indication or relevant epidemiology.

 


Value-Based Reforms Linked to Readmission Reductions

18 Apr, 2017 | 14:02h | UTC

Association Between Hospitals’ Engagement in Value-Based Reforms and Readmission Reduction in the Hospital Readmission Reduction Program – JAMA Internal Medicine (link to abstract – $ for full-text)

Sources: Value-Based Reforms Linked to Readmission Reductions – Medscape (free registration required) AND Richard Lehman’s weekly review(free – see below)

A program of incentives (Medicare Hospital Readmission Reduction Program in the US) was effective in reducing 30 day readmissions following infarction, heart failure, and pneumonia.

 


The hospital of tomorrow in 10 points

12 Apr, 2017 | 15:54h | UTC

The hospital of tomorrow in 10 points – Critical Care (free)

This is the first article in a new thematic series about the future of critical care (free)

 


How Many Pills Are Too Many?

12 Apr, 2017 | 15:56h | UTC

How Many Pills Are Too Many? – The New York Times (10 articles per month are free)

“Evidence has mounted about the dangers of taking multiple, perhaps unnecessary, medications” (from Tweet)

 


F.D.A. Will Allow 23andMe to Sell Genetic Tests for Disease Risk to Consumers

10 Apr, 2017 | 16:03h | UTC

F.D.A. Will Allow 23andMe to Sell Genetic Tests for Disease Risk to Consumers – The New York Times (10 articles per month are free)

See also: Before you send your spit to 23andMe, what you need to know – STAT News (free) AND 23andMe given green light to sell DNA tests for 10 diseases – Nature News (free) AND 23andMe Rides Again: FDA Clears Genetic Tests To Predict Disease Risk – Forbes (free) AND Too Much Information? FDA Clears 23AndMe to Sell Home Genetic Tests for Alzheimer’s and Parkinson’s – Scientific American (free)

“The controversial step will significantly expand direct-to-consumer testing – but what if the news is bad?” (from Scientific American above)

 


How hospitals could be rebuilt, better than before

7 Apr, 2017 | 15:44h | UTC

A prescription for the future: How hospitals could be rebuilt, better than before – The Economist (a few articles per monty are free) (RT @EricTopol)

“Technology could revolutionize the way they work”.

 


Are Virtual Doctor Visits Really Cost-Effective?

7 Apr, 2017 | 15:28h | UTC

Are Virtual Doctor Visits Really Cost-Effective? Not So Much, Study Says – Kaiser Health News (free)

“Perhaps telehealth visits don’t save money after all. Increased convenience can increase utilization” (RT @drval)

 


Nearly a third of tests and treatments are unnecessary

6 Apr, 2017 | 15:22h | UTC

Nearly a third of tests and treatments are unnecessary – CMAJ News (free) (RT @ChooseWiselyCA)

Press release: Canadians have more than 1 million potentially unnecessary medical tests and treatments every year – Canadian Institute for Health Information (free) 

See report: Unnecessary Care in Canada (free PDF)

Growing problem in many countries, making resources less available for treatments and conditions that matter.

 


Choosing Wisely initiative was launched 5 years ago

5 Apr, 2017 | 21:50h | UTC

Choosing Wisely initiative was launched 5 years ago, and now has over 490 recommendations from 18 countries (all resources are free)

Lists from other countries: Choosing Wisely UK Choosing Wisely Australia / Choosing Wisely Canada

The Choosing Wisely is a leading effort to encourage conversations aimed at reducing unnecessary tests and treatments to improve value in healthcare.

 


American College of Radiology (ACR) Appropriateness Criteria Adds Topics

4 Apr, 2017 | 21:19h | UTC

ACR Appropriateness Criteria Adds Topics, Covers More Clinical Variants Than Ever Before (free)

Browse Appropriateness Criteria Topics (free)

Source: Newswise

This comprehensive guide from American College of Radiology (ACR) covers 230 topics with more than 1,100 clinical indications and has just been updated. It is a very useful resource for doctors in all specialties to guide which exam is most appropriate in each clinical situation.

 


To Screen or not to Screen?

4 Apr, 2017 | 21:25h | UTC

Free Online Course, Starts April 10. To Screen or not to Screen? Methods and health policies through case studies – University of Geneva and Coursera

 


Return on investment of public health interventions

3 Apr, 2017 | 19:25h | UTC

Return on investment of public health interventions: a systematic review – Journal of Epidemiology and Public Health (free)

Source: BMJ News ($)

“For every £1 invested in public health, £14 will subsequently be returned to the wider health and social care economy”. Based on the findings, the authors suggest that cuts to public health services are short sighted and represent a false economy, with substantial opportunity costs.

 


Impact of total knee replacement practice: cost effectiveness analysis

31 Mar, 2017 | 19:01h | UTC

Impact of total knee replacement practice: cost effectiveness analysis of data from the Osteoarthritis Initiative – The BMJ (free)

See also: Knee Replacement Should Be Reserved for More Severe Osteoarthritis, Study Suggests – Physician’s First Watch (free)

Total knee replacement for patients with osteoarthritis had minimal effects on quality of life in this study. Severely affected patients seem to benefit the most from the procedure.

 


New Lists from Choosing Wisely Canada

31 Mar, 2017 | 19:04h | UTC

New Lists from Choosing Wisely Canada – List of Items Physicians and Patients Should Question (all resources are free)

Critical Care / Pediatric neurosurgery / Sport and exercise medicine / Nursing / Long term care / Medical microbiology

Lists from other countries: Choosing Wisely UK / Choosing Wisely Australia / Choosing Wisely U.S.

The Choosing Wisely initiative aims to reduce unnecessary tests, treatments and procedures to reduce harm and promote value in healthcare.

 


Putting Patients First by Reducing Administrative Tasks in Health Care

29 Mar, 2017 | 17:13h | UTC

Putting Patients First by Reducing Administrative Tasks in Health Care: A Position Paper of the American College of Physicians (free)

See also: ACP: Stop Saddling Docs With Administrative Tasks – MedPage Today (free registration required)

“It’s time for all those involved in the healthcare industry to reevaluate and reduce the administrative task burden placed on clinicians” (from MedPage commentary above).

 


Value-Based Purchasing: Time for Reboot or Time to Move On?

29 Mar, 2017 | 17:03h | UTC

Value-Based Purchasing: Time for Reboot or Time to Move On? by Ashish K. Jha, MD – The JAMA Forum (free)

Pay-for-performance (P4P) as a policy tool does not seem to be improving health care quality or lowering costs.

 


Regression to the mean, and its importance in healthcare decisions

29 Mar, 2017 | 16:59h | UTC

Regression to the mean, or why perfection rarely lasts – The Conversation (free) (RT @PaulGlasziou)

“Regression to the mean, and its importance in healthcare decisions” (RT @Tammy_Hoffmann see Tweet)

 


Teleretinal Diabetic Retinopathy Screening

28 Mar, 2017 | 16:55h | UTC

Implementation and Evaluation of a Large-Scale Teleretinal Diabetic Retinopathy Screening Program in the Los Angeles County Department of Health Services – JAMA Internal Medicine (free) (RT @PreetiNMalani)

Editorial: Seeing the Effect of Health Care Delivery Innovation in the Safety Net (free)

A large-scale telemedicine diabetic retinopathy screening program increased overall rates of screening by 16.3%, and wait times for screening were reduced by 89.2%.

 


Healthcare Quality and Safety Online Course

28 Mar, 2017 | 16:50h | UTC

Just Started: Leading Healthcare Quality and Safety – Free Online Course from The George Washington University and Coursera (free)

 


Enhanced recovery after surgery

28 Mar, 2017 | 16:43h | UTC

Enhanced recovery after surgery: Current research insights and future direction – World Journal of Gastrointestinal Surgery (free)

 


Telehealth Doctor Visits

27 Mar, 2017 | 00:57h | UTC

Telehealth Doctor Visits May Be Handy, But Aren’t Cheaper Overall – NPR Health News (free)

Link to original article abstract ($ required for full-text): Direct-To-Consumer Telehealth May Increase Access to Care But Does Not Decrease Spending – Health Affairs

Costs have increased in this study because 88 percent of telehealth visits represented people who would not have gone to a doctor otherwise.

 


Surgeries are being performed with the patient awake

27 Mar, 2017 | 00:59h | UTC

Going Under the Knife, With Eyes and Ears Wide Open – New York Times (free access to 10 articles per month)

“More and more surgeries are being performed with the patient awake and looking on, for financial and medical reasons”.

 


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