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2010 Potpourri XXVII

By July 31, 2010Commentary

Given some of the issues that occur with human surgeons–leaving foreign objects in the body, operating on the wrong arm or leg, etc., many patients might be comfortable with a robot surgeon, and according to researchers at Duke, that time may come sooner rather than later.   The researchers have developed a robot that can identify and biopsy potentially diseased tissues, such as that  in breasts or the prostate.  The robot is guided by very sophisticated ultrasound sensors.   It will be interesting to see the patient, regulatory, and payer reactions to the potential use of autonomous robots for medical care.   (Robot Story)

A story reports on a study of how the Canadian government’s incentives for EHR use by physicians has worked.  Seven of the thirteen provinces have had subsidies for almost a decade but less than half of primary care physicians are using an EHR.   Alberta has the highest rate at only 40%.   As in the US, many Canadian doctors find implementation and training very burdensome.  The utility of some of the systems is also suspect.  (Canadian EHR Story)

A study led by UCLA researchers examined a new intervention to improve the consistency and quality of care for heart failure patients.  The intervention looked at seven care items that should be performed for these patients and found that the intervention improved the rates of five of them.   The study covered almost 35,000 patients at 167 clinics and utilized clinical decision support tools, chart audits with feedback to doctors and other techniques to improve adherence to guidelines.  No information was given on the cost of the program or its effect on health spending.  (Science Daily Story)

We’re not generally single-payer fans, but the screw-ups of various third-party payers, especially when more than one is involved, make you wonder.   A New Jersey paper has the story of a man who has been in the hospital for several years, although he could live at home if he had sufficient home health care assistance.  Medicare, Medicaid and a commercial insurer all have pieces of his coverage but no one appears to have the financial incentive to get him out of the hospital and at home, where he would not only have a better quality of life, but overall his health care costs would be far lower.   (New Jersey Article)

Behavioral scientists have known for some time that how information is presented may affect the response to it.  This is certainly true in health care.  A news article reports on a study in Germany that found that men were more likely to say they would get prostate cancer screening if they were told that a high percent of all men had gotten the screening than if they were told a relatively low percent had had such screening in the last year.   (Science Daily Story)

HealthGrades, a publicly traded company, is to be acquired by a large PE firm for what seems like a very rich price.  Anything related to health IT or information seems to be in vogue and highly valued.   PE firms are usually savvy investors, but this looks like a very good price for a company whose products and services aren’t necessarily unique.  There must be more than meets the eye; perhaps a belief that this information will be more useful in an individual insurance, exchange driven world.   (HealthGrades Release)

In a study with potential relevance to pay-for-performance incentives in health care, people were found to be more likely to cheat in performance that was rewarded by hitting targets than in some other performance measurement systems.  And the closer they were to hitting the goal, the more likely they were to cheat to get there.  (BE Journal Abstract)

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