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2012 Potpourri XVIII

By May 25, 2012Commentary

The theory behind the incentives, and ultimately, penalties, for adoption of electronic medical records and meaningful use of those systems is that patient care will be improved.  A dubious theory according to most research and the Annals of Family Medicine has yet another study to this effect.  Researchers compared 16 EHR-using and 26 non-EHR medical practices in regard to their achievement of care guideline compliance and intermediate outcomes.  The non-EHR practices actually showed better compliance and outcomes and the quality of care did not improve faster in the practices with EHRs.   (EHR Article)

A survey by the International Foundation of Employee Benefit Plans finds that about 70% of employers offer some kind of wellness benefit.  About 60% added a wellness benefit since 2008 and almost 24% added one since 2010, with two-thirds increasing their budgets for wellness programs.  Only about 22% of employers measured the ROI of the programs but of these, 80% said there was a positive return.  Most found that they got somewhere between a one to three times return.  The primary reasons employers give for offering the benefits is to control health care costs and to improve employees’ health, which might lead to greater productivity.   (Wellness Survey)

In another wellness related story, the company Wellness Coaches USA issued a 2010 Employer Outcomes Report.  According to the firm, which surveyed over 300 employers with 50,000 covered lives, very high rates of engagement, defined as at least one personal coaching interaction, were achieved, with an average of over ten.  The results were an increase in healthy behaviors and a drop in health risk factors, such as high blood pressure, obesity, lack of exercise and smoking.  No economic outcomes were provided, however.   (Wellness Outcome Report)

Relax coffee drinkers, well if you can after all those cups of java!  Apparently coffee drinking by itself is not associated with excess mortality.  In a very long term study of a large cohort of consumers researchers found that coffee drinkers, after adjusting for other factors, actually had lower mortality than non-coffee drinkers.  The bad news, however, is that coffee drinking tends to be associated with other bad health habits, like smoking and drinking, so on an absolute basis, mortality is higher.  So keep drinking that bitter, noxious brew, but drop the other bad habits!   (NEJM Study)

An article in the Archives of Internal Medicine looks at the outcomes of malpractice litigation against physicians.   The study examined over 10,000 claims closed between 2002 and 2005 and the results appear to support the notion that most of these claims are pretty frivolous, but are very burdensome to physicians in terms of the time taken to deal with the defense and the anxiety of having pending claims.  About 50% of claims resulted in litigation, about 54% of those were dismissed by the court, less than 5% went to trial and a verdict and in 80% of those cases the physician won.      (Malpractice Study)

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