In the Boston marketplace, Partners Healthcare is is replacing 30 years of self developed software with Epic. Boston Medical Center is replacing Eclipsys (Allscripts) with Epic. Lahey Clinic is replacing Meditech/Allscripts with Epic. Cambridge Health Alliance and Atrius already run Epic. Rumors abound that others are in Eastern Massachusetts are considering Epic. Why has Epic gained such momentum over the past few years?
Bariatric surgery, known for its often striking metabolic effects including mitigation of nonalcoholic fatty liver disease (NAFLD), alters the expression of genes in the liver, researchers found. In a small study that looked at liver biopsies from NAFLD patients before and after bariatric surgery, methylation changes associated with the disease phenotype were partially reversible.
Two men, Ted and Ron, were long-term professional colleagues. I do not believe that they were particularly close, but they had been acquainted during their working lives. Each had retired. In what was a remarkable coincidence, both men were diagnosed with nearly identical cancers. The tumors were of the same type, location and stage. They each came to see me, Ted first and then, several months later, Ron.
What defines physician burnout, and who exactly is suffering from it? Is burnout an actual clinical syndrome, a slang term connoting fatigue and boredom, or a hazy combination of the two? Which medical specialties have the highest rates of burnout, and are men or women physicians more susceptible? The more you read, the more you realize how much pop psychology and sloppy language are clouding an important issue.
Finding out which hospitals are best is like "a riddle, wrapped in a mystery, inside an enigma." Are you tired of seeing conflicting ratings from such once respected sources as Leapfrog, Medicare Compare, HealthGrades and Yelp? Does it confuse you when a hospital is ranked in the top 10 by U.S. News and World Report, but is "god-awful" according to Consumer Reports?
In case you missed it, there was a brief romance between thyroid surgeons and robots. Thyroid surgeons, itching to join the crowds migrating to robot-assisted surgery, came up with the idea to use the robot to perform thyroidectomies. As is often the case, the initial results were favorable. Then reality set in.
Both World War II and the race to the moon were events which pushed commercial development of technologies. I would submit that the ACA and HITECH have had the same effect on the development of many sectors of the digital health technology industry. I will cite five such areas.
We have entered a new era when it comes to the way individuals are able to collect, analyze, and share their health information. Yet we are still missing some basic data-driven technologies that I think would be very helpful both for me and for my patients, capabilities that I think could impact the ultimate driver of health – human behavior – for the better.
Hospitals like the University of Colorado have responded by studying why heart failure patients return to the hospital and what can be done to improve their transition back home. Hundreds of medical centers are testing strategies that revolve around several themes.
We usually assume that new medical procedures and drugs are adopted because they are better. But a new analysis has found that many new techniques and medicines are either no more effective than the old ones, or worse. Moreover, many doctors persist in using practices that have been shown to be useless or harmful.
With the crash of the Asiana 777, we’re hearing a lot about cockpit culture and how communication across a hierarchy sometimes fails, even when the very lives of the folks communicating (or failing to do so) are on the line. This isn’t a new concept, and isn’t unique to aviation. Many parallels have been drawn between aviation communication and healthcare team communications, especially when real or perceived hierarchies exist.
Given the inadequacies in care for discharged patients — a well-documented and common problem — is it any wonder that so many bounce back to hospitals after they’re sent home? Medicare, the government’s health care program for seniors, has trained its sights on the issue and is focused on trying to reduce the number of seniors readmitted to hospitals shortly after being sent home.
The idea that printed human intervertebral discs might be used in the near future seems especially exciting, because this procedure could impact so many people with the condition who struggle to find a treatment that reduces their pain.
When we tolerate a culture of disrespect, we aren’t just being insensitive, or obtuse, or lazy, or enabling. We’re in fact violating the first commandment of medicine. How can we stand idly by when our casual acceptance of disrespect is causing the same harm to our patients as medication errors, surgical mistakes, handoff lapses, and missed lab results?
Decisions in medicine are supposed to rest on concrete observations and hard evidence. Often, hard evidence does not exist or when it does, it isn’t used. Why is this? Concrete observations, too, are increasingly missed as we stare at computer screens longer and patients less. Yet we persist. Why? This is our reality now, our evolving medical world.