We imagine all our readers are looking forward to the three day weekend, we know we are!

The first part of this week we were out in San Francisco for VentureBeat’s first HealthBeat. It was a great event and we were proud to have been a part of it as a media sponsor. For summaries from the various sessions visit: http://venturebeat.com/tag/healthbeat/.

On Wednesday HHS announced that over half of doctors’ offices and 80% of hospitals that provide Medicare or Medicaid will have electronic health records by the end of this year. To learn how/why read the USA Today article.

Kaiser Health News and NPR look at how individuals who don’t have a traditional checking or savings account will get health insurance. (more…)

In a 5-4 vote, the Supreme Court has upheld the Affordable Care Act, a decision that has many implications for the future of healthcare.  We’ve put together a quick round-up of resources to help break down the ruling and what it means to different people.

In case you missed it, you might want to take a look at the Justices’ opinion in full (PDF). And if the almost 200-page-long document is a little dense for you, thank goodness SCOTUSblog author Amy Howe has written it up in plain English.

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By Carrie Winans.

At Home

The Wall Street Journal reports on assembly men cutting health care revenue.  At a time when money is tightest, ambulance services and local health care may start to feel the squeeze.

The Los Angeles Times reports on Representative Jim McDermott’s bill which would enable states to offer universal health care.  It would create a Medicare for all program on a state-by-state basis for the first time.

Dream of retiring with your loved one someday? U.S. News hopes that you have $240,000 for out of pocket health care costs.

We’ve been asking a lot of politicians where they stand on women’s health care. Fond du Lac asks, where are the doctors standing?

The New York Times reports that the gains in the health system will be kept regardless of the Supreme Court decision.  The Obama administration comments on the future of health insurance.

Abroad

Saying Japan had a rough year is a bit of an understatement. However, the Huffington Post reports they may be able to breathe easier.  The UN found that the workers from Japan’s Fukushima Daiichi nuclear plant did not die from radiation.

Smart phone apps are taking over all realms of the world, including health care! The NY Daily News reports on the most popular apps internationally.  You’ll be surprised what some nations use most.

Adele Waugaman

By Adele Waugaman. It’s no secret that the rapid proliferation of social networks and the global spread of the mobile phone are transforming private and public sectors alike. The humanitarian world is no different.

In the music industry, network-centric technological innovations from Napster to Spotify have transformed the way we learn about, acquire, consume, and share music.  Similarly, in humanitarian crises, the democratization of information through connection technologies is enabling new actors to share and act on publicly available data about the crisis, local population needs, and the humanitarian response.

In an increasingly networked world, aid organizations find themselves having to adapt to these new information flows in order to retain their traditional roles at the center of the humanitarian system. These data streams are coming from groups who traditionally have not been perceived as part of the humanitarian sector — from volunteer mapping networks like the Standby Task Force and the Humanitarian Open Streetmap Team, to the local populations themselves.

Why is crowdsourced information helpful in humanitarian emergencies?

Take, for example, the need to locate health facilities after a major disaster.  In response to the Haiti earthquake, the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) asked the crisismapping community to locate and plot on a map 105 health facilities whose precise location was unknown (During the earthquake many buildings were heavily damaged or destroyed, including buildings that housed important government data and their curators). (more…)

By Carrie Winans. With spring in the air and new beginnings all around, it is nice to see some new changes in health care as well.  Here’s what happened this week while you were dreaming of warm weather:

At Home

In Oregon, a new approach to Obama’s health care has been put in place.  The Associated Press reports that if all 50 states adopted this approach the federal budget could save $1.5 trillion in the next decade.

If you’re wondering how your leaders are debating your reproductive health, ABC news gives you the spark notes version.

Were you excited to see Digital Health Records cut costs?  The New York Times cautions against breaking out confetti just yet, they may not help that much after all.

A Texas showdown sounds like something out of an old movie.  Instead, NPR uses the term to highlight some antiquated health practices.

Desperate Housewives’ Felicity Huffman guest writes for CNN about her views on women’s health care in America, an issue that needs some desperate improvement.

Abroad

The euro isn’t the only thing to watch during the Greek Debt Crisis.  Reuters reports that several health care companies based in France, Germany, and the UK are trying to resolve their monetary issues with the struggling country.

While we’re busy worrying about our reproductive health, the World Health Organization is focusing on the health of women in rural areas.  The Voice of America highlights some of the struggles of the world’s poorest and least developed regions.

The following is a post by Annekathryn Goodman, MD who  is an Assistant Director, Vincent Gynecologic Oncology Division, Massachusetts General Hospital, Boston; Associate Professor, Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School and a resident of Boston.

By Annekathryn Goodman, MD. The loss of one loved soul punches a hole in the fabric of our universe. We experienced sadness and tragedy this past week when journalist Anthony Shadid died while reporting on the horrors of Syria’s war against its people.

Shadid was known to those of us who work at Massachusetts General Hospital in a small way – through his daughter, Laila. We know her through MGH’s own Marcela, ex-partner of Anthony’s first wife, Julie. Marcela is one of my work partners in the gynecological oncology department here. She and Julie broke up last year but Marcela has been an important part of Laila’s life since she was a baby, and remains so.

I am struck with how I can grieve for a man I have never met because I grieve for the people who love him. His death will now be a part of Laila’s identity. Growing up fatherless starting at the age of 10 will be part of the lens through which she views the world. We cannot protect her from that reality. But we can support her and the others who are impacted by this new hole in the universe. There is a circle of grief and meaning that radiates out from each death. In my imagination, I see this whole cloud of connection and meaning, sympathy and love that vibrates with each loss.

Of course as oncologists, we are all too familiar with that cloud. Now, one could imagine that these clouds of loss, familiar and sometimes daily, could bring us down. Maybe we should all be on anti-depressants. But, paradoxically, most of us are empowered by the work we do. The losses are unavoidable when dealing with cancer, but our reactions to it are completely in our control.

Reacting with love and support empowers us all. When Marcela called to tell us of Anthony’s death, John — the division chief of our department — immediately signed out her beeper so he could answer all of her calls. Whit, another doctor in our division, took on all her surgeries so she could be with Laila. Dr. Schiff, the chief of obstetrics and gynecology who no longer performs surgeries, donned scrubs and came down to the OR to ensure we were all okay. Texts and emails with words of support flew. We are a big village. Acknowledging this terrible pain honors the meaning of the life lost and how that life affected everyone else.

There was another, more personal, loss on Friday – my dog, SammyBear. I put him to sleep that evening after a two month illness with renal failure. Again, John helped me finish my last surgery so I could have time with SammyBear. I felt surrounded by love. (more…)

The following is a guest post by Jessie C. Gruman, PhD  the  president and founder of the non-profit organization Center for Advancing Health. It was originally published on the Prepared Patient Forum blog on December 7th.

By Jessie Gruman. Did you know that every nursing home resident in the U.S. must be asked every quarter whether she wants to go home, regardless of her health or mental status? And if she says yes, there is a local agency that must spring into action to make that happen.

This is the result of a 2010 Center for Medicaid/Medicare Services regulation aimed at helping keep older people in their (less expensive) homes rather than institutional settings. A New York Times article notes that the nursing home exodus, while modest to date, is building. This means the number of people with serious chronic conditions like congestive heart failure, diabetes and chronic obstructive pulmonary disease who draw heavily on community-based primary care services will grow. These returnees are joining their peers and the blossoming crowd of us Baby Boomers who intend to resist living in nursing homes with as much spirit as our parents did, while the consequences of our plump and sedentary lifestyles arrange themselves into a constellation of diabetes, congestive heart failure and COPD similar to the one that plagues our elders.

Much has been written about the overwhelming demand that caring for our collective chronic conditions will place on the primary care clinicians in our communities in the coming days. And many of the provisions of health care reform anticipate those demands: Accountable Care Organizations, Electronic Health Records, Patient-Centered Medical Homes. As each of these innovations staggers haltingly forward, the developers of patient-facing self-care technologies yap and nip at patient’s, health providers’ and payers’ heels, claiming the effectiveness of devices and apps that could easily today help older people with serious chronic conditions care for themselves and lower the cost of care.

We have the Veteran’s Health Administration (VHA) to look to for the feasibility of those claims. The VHA has been using telehealth to support self care for veterans with serious chronic conditions since the late ‘70s. In a 2010 interview, physician Adam Darkins, Chief Consultant for Care Coordination Services at the U.S. Department of Veterans Affairs, said: “Much of the technology capability that is needed to support older adults in improving their health is already available; the pressing issue is how to increase the adoption and usage of these technologies.” The VHA currently supports more than 46,000 vets using simple phone-based technologies like the Health Buddy, a device that lives near your phone into which you enter your blood sugar, weight, or blood pressure with the understanding that your nurse and doctor are looking for changes that signal trouble and will call to discuss them if they see any. And the agency will vastly expand the scope of its investment in remote patient monitoring approaches in the coming years. (more…)

My mama told me you’d better shop around, as Smokey Robinson also told us. We now know it pays to shop the prices for digital imaging. The price of an MRI of the brain ranges from a low of $825 to a high of $3,600 within the Southeast region of the U.S. In the Northeast, the low is $1,540 and the high, $3,500. There are similar price “spreads” in other regions of the country for the same imaging study, and across other imaging modalities such as PET and CT.

The greatest regional variances by service type are for MRI scans of the brain, varying 747% between a low price of $425 in the Southwest to a high of $3,600 in the Southeast, based on an analysis from change: healthcare‘s Q2 2011 Healthcare Transparency Index.

USA Today reported on this study on June 30, 2011. Christopher Parks, founder of change:healthcare, pointed out that it’s not uncommon to find inter-regional differences of health prices. However, this is happening ”within a 20-mile radius in your own town,” Parks points out based on his firm’s research.

change:healthcare launched the Healthcare Transparency Index (HCTI) in Q4 2010 to analyze health claims data for various health care services and provide health care buyers with data about cost trends. The tool helps people identify savings opportunities for various health care products and services such as prescription drugs, dentistry, physician office visits, physical therapy, and imaging.

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By Robin Strongin. When the Obama Administration announced the new regulations expanding preventive care, ensuring that essential screenings and tests would be covered without co-pays for deductibles, my first thought was that this may be one of the most important provisions of health reform in terms of improving the overall health and well-being of the American people.

My second thought concerned forests, falling trees and sounds we may or may not hear.

The history of health care in the United States is, in large part, defined by sound policies and vital programs that are not accompanied by effective outreach to  the patients and consumers who have the most to gain from these innovations.  Thus, new provisions expanding preventive coverage have the potential to be like the proverbial tree falling in an empty forest.  If we don’t do a good job letting people know these services are more accessible, will they take advantage of them?

I think of the millions of people who are eligible for Medicaid or for Children’s Health Insurance Programs who aren’t enrolled.

I think of the widespread confusion that existed in the early days of the Medicare Part D prescription drug program until several organizations stepped in to conduct coast-to-coast information sessions with seniors.

And I think of the story that just appeared in the New York Times (http://www.nytimes.com/2010/07/15/health/15chen.html?_r=2&ref=health&pagewanted=print) regarding the growth in usage of the “medical home” model for health care.  (I prefer the term health home, but that’s for another post.) As Dr. Pauine Chen pointed out in the Times, empirical evidence is showing that the medical/health home – shorthand for greater care coordination between the patient’s primary care physician, specialists and other health care professionals – is working.  A demonstration project sponsored by the American Academy of Family Physicians showed that the new model was improving quality of care, efficiency of operations and physicians’ job satisfaction.

But patients hated it, because no one bothered explaining to them why their one-on-one relationship with their health provider was being replaced by a one-in-three or one-in-four relationship with multiple providers, even if it resulted in better care.

And, thus, does this new innovation in health care delivery fall within the proud history of U.S. health care in which great ideas are not linked with communication to the patient.

As health reform is implemented, both the public and private sectors need to do better, beginning with outreach to let people know about the new preventive care coverage and, more importantly, to ensure that Medicaid expansion and the new subsidies to help make private health insurance more affordable affect the people for whom they are intended.

By Lois Privor-Dumm. How many times have you seen a single photograph that has caused you to stop what you’re doing and find out more, tell a friend or donate money?  We read so much about the problems of the world today and, if you’re like me, unless the issue is already close to your heart, words alone may not be enough to register.

Salim Khan, 3 year old pneumonia survivor from Bijnor, India by Ándre J. Fanthome

A photo contest seems like such a simple thing, but it’s a way to enable a problem to reach into our hearts and minds.  Pneumonia is a leading killer of the world’s young children, but the disease has very real and practical solutions.  Although I see the statistics and understand the scientific pathways, nothing impacts me more than seeing how the disease affects families and children or reaches the heart of a pediatrician.  These moments are often captured powerfully with the click of a camera.  While one child with pneumonia may seem just like a number to many, it is these stories and images that can make a difference.

Photoshare, Kids 4, Health, the International Vaccine Access Center at Johns Hopkins Bloomberg School of Public Health and The Global Coalition Against Child Pneumonia are sponsoring a photo contest to find the image that will make a difference in our minds.  Nikon will award digital cameras to category winners.  And, if you’re fans of Ann Curry of the Today Show and Nicholas Kristof of the New York Times, you’re in luck.  They, along with a professional photographer, are the judges.   Submitting a photo that jumps off the page and tells an important story would be a great way to get your experience and talent, or that of a friend, family or colleague in front of our celebrity panel.  For more information, click here.  Details on the time and place of the photo exhibit to unveil contest winners and finalists will be announced shortly. (more…)

By Lynn Shapiro Snyder. There is nothing like a cold, hard statistic to hang your hat on. What better way is there to drive home your point in the courtroom, the conference room, the Senate chamber? But as much as numbers illuminate, they also obfuscate. Take, for instance, a recent New York Times article announcing that women outnumber men on our  nation’s payrolls. We have reached an historic milestone.

But before you break out the champagne, take a closer look. You actually do not need to search very hard. In fact, all it will take is a glance—one brief, passing glance into any of the thousands of corporate board rooms across America.

As of 2009, a wan 15.2 percent of Fortune 500 board members were women.  That means, for the average 10-person corporate board, there aren’t even two women in the room.  Suddenly the numbers aren’t looking so good. With women making up more than half of America’s workforce, how can there be so few women at the highest level where business decision-making gets done – the corporate boardroom.  The board recruits and retains the CEO and sets company policy.

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The U.S. Preventive Services Task Force unleashed a tsunami this week with new breast cancer guidelines that are suspiciously timed to current efforts to rein in burgeoning healthcare costs. Indeed, the recommendations appear to be geared towards reducing overtreatment by eliminating what the Task Force considers unnecessary follow up screenings and tests. The recommendations even suggest the breast self-examination (BSE) should be discontinued.

In essence, what the Task Force concluded was that while screening reduces deaths from breast cancer, it does not save enough lives to justify associated costs.

To exacerbate the controversy, the American Cancer Society has publicly stated that it does not endorse Task Force recommendations and in a detailed analysis suggested that in the review of the evidence, the committee got caught up in semantics (i.e. risk versus benefit) and that at the very least, computer modeling may be flawed in terms of its ability to translate statistical data into real life.

Meanwhile, the New York Times reports that many doctors are ‘staying the course,’ and in between anger and disbelief, women across the nation are crowding the phone lines trying to discern what is true and what’s not.

Have we all gone mad?

Obviously, these new recommendations will be echoing in the halls of hearings that will determine the future role of mammography in government-run health programs, private insurance programs and the current healthcare reform initiative. Already, Congress is calling for Hearings. But more importantly, is the debacle is a prime example of what ails our healthcare system and reflective some of the more important changes that must take place if we are ever going to move forward in a way that benefits all the players. Truly, who’s really in the driver’s seat?