eHealth » Health Care policy

Presentation on Disease Registries using EMR data

John Sharp — Sat, 10 Dec 2011 22:23:46 +0000

On Dec. 2, I presented at the Center for Health Care Research and Policy at MetroHealth Medical Center on “Registry Using EMR Data: Chronic Kidney Disease Case Study.” This has been a successful registry which I am a coinvestigator on for the past 2 years. Some of the success factors include: a well-functioning interdisciplinary team, a systematic approach to the data, and a step-wise approach to publication and grant writing. It fits well into the IMO model of the Learning Healthcare System.

Slides are available here: http://www.chrp.org/seminars_past.asp

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Prevention and Lifestyle Changes – Potential for Health Care Reform

John Sharp — Tue, 19 Apr 2011 21:15:29 +0000

Dean Ornish

Today I heard Dean Ornish speak and came aware more convinced that prevention of disease through lifestyle changes can have a major impact on the future of health. Particularly, the potential impact on the epidemic of diabetes in the US is huge. We all have heard about how more and more of our population is becoming obese and the subsequent increase in diabetes and metabolic syndrome. If lifestyle changes can prevent even 10 or 20 percent of the progression to these serious conditions, imaging the impact on quality of life, work productivity and healthcare costs. This Thursday, Cleveland Clinic and Slate magazine will co-host a summit on Childhood Obesity.

Not only that, but he notes research on his website, Preventive Medicine Research Institute, that there is a potential impact on cancer and telomerase activity.

On a related note, a new interview with Daniel Kraft is posted on the TEDxMaastricht website. He talks about how mobile apps are just beginning to become available and used for lifestyle change but predicts that access to medical records and other patient empowerment tools will become common.

How can we get the word out, shift from unhealthy foods and lifestyles and move toward a healthier country?

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Hearing Atul Gawande speak about Checklists and Health Policy

John Sharp — Wed, 23 Mar 2011 00:50:26 +0000

Atul Gawande

Just returned from live tweeting of Atul Gawande at Cleveland Clinic Ideas and full of quotes and ideas. For instance, the evidence is building for use of checklists showing significant reduction in mortality and complications so that he states that if there was a drug that showed this kind of effect it would be adopted immediately, even faster than Viagra. Gawande also discussed two of his well known New Yorker articles:

In the end, he challenged the audience and the country to find one hospital which could reduce costs while not causing harm to set a model. He predicted that in the coming hospital wars, the ones which reduced cost while maintaining quality would win and others would lose (close).

Within the provocative statements was the voice of compassion and rediscovering the soul of medicine in the complex, competitive healthcare environment of today.

Check out the twitter feed from the meeting. And his book: The Checklist Manifesto and his checklists.

Final thought – why are hospitals not advertising that they endorse and complete adopt checklists? And why would anyone not have surgery in a hospital that does not use checklists? Why take the risk when the evidence is there?

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Health Care is Coming Home

John Sharp — Fri, 29 Oct 2010 02:45:49 +0000

In the New England Journal Journal of Medicine this week, a perspective article by a Cleveland Clinic physician, promotes the future of home care. Dr. Landers notes five major forces driving healthcare to the home.
1. Aging of the population
2. Epidemics of chronic disease
3. Technological advances
4. Health care consumerism
5. Escalating health care costs

In the conclusion of the article, he notes this as a long term trend perhaps taking decades. My view as a technology optimist, is that the combination of these forces will result in a faster pace of change with high tech home care being an integral part of the medical home.

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Curing Cancer Clinical Trials

John Sharp — Fri, 18 Jun 2010 02:55:13 +0000

The Institute of Medicine has issued another groundbreaking report, this time on cancer clinical trials. An editorial about the report in the New England Journal of Medicine titled, Cancer Clinical Trials — A Chronic but Curable Crisis, makes some bold statements, such as, “the program is bloated, cumbersome, inefficient.” Slow approval processes with multiple layers and poor recruitment levels are symptomatic.

Recommended changes include improving:

the speed and efficiency of the design,
launch, and conduct of trials;
innovation in science and trial design;
trial prioritization,selection, support, and completion; and
incentives for patient and physician participation

The full IOM report lays out participation of key stakeholders, particularly patients and physicians. The emphasis on patient participation is strong and reminiscent of the e-Patient White Paper. While the concept of the Lethal Lag Time is not directly mentioned, the overtones can be heard. I recommend this report as key to the future of the conduct of clinical trials including innovative approaches.

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Group on Information Resources (GIR) Leadership Institute

John Sharp — Wed, 07 Apr 2010 01:57:44 +0000

I have been invited to attend this leadership institute of the American Association of Medical Colleges. This “provides IT leaders the information and tools to understand how to excel at the nexus of academic, research, and clinical systems to support organizations as they move to more integrated and data driven models.” The five day institute in July is limited to 30 through a competitive process; I was nominated by my department chairman. I am looking forward to this interactive program. If anyone has participated or will be attending this summer, I’d like to hear from you.

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The Future of Primary Care

John Sharp — Sun, 13 Jan 2008 08:55:00 +0000

In an extended article on The Healthcare Blog, Brian Klepper writes on “ Bad Medicine: How The AMA Undermined Primary Care in America“. In a reaction to a Wall Street Journal article on the 10% cut in Medicare physician payments, he explains how the across the board cut changes nothing in terms on the erosion of primary care and family practice physicians in practice. He goes on to detail the failure of RVUs in balancing payments.

Although not related to ehealth, this is an important policy issue especially in an election season. Worth the read.

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