Minnesota Governor Wants Online Health Records for All

From the Wall Street Journal Health Blog:

Online personal health records got a boost from Minnesota’s governor yesterday.

Tim Pawlenty said 50,000 state employees would be able to access their health records online next year, with a plan to extend access to everyone in the state by 2011, the Minneapolis Star Tribune reports.

Trust

From the NY Times:

A growing chorus of discontent suggests that the once-revered doctor-patient relationship is on the rocks.

The relationship is the cornerstone of the medical system — nobody can be helped if doctors and patients aren’t getting along. But increasingly, research and anecdotal reports suggest that many patients don’t trust doctors.

About one in four patients feel that their physicians sometimes expose them to unnecessary risk, according to data from a Johns Hopkins study published this year in the journal Medicine. And two recent studies show that whether patients trust a doctor strongly influences whether they take their medication.

Rural Medicine

From Rural Doctoring, Part of a series on becoming a physician who practices in a rural area:

Obviously, the remoteness of a community and the availability of medical services varies greatly in rural settings. The kind of medicine a doctor practices will vary as well. Family doctors are particularly well-trained to adapt to different practice scenarios. A popular definition of the specialty’s scope is an ability to diagnose and treat 90% of all patient problems. This includes ordinary childhood illnesses and chronic diseases of the very old, acute injuries, normal pregnancies, and common conditions requiring hospitalization.

Grassley Introduces Legislation to Assist “Tweener” Hospitals

From the Iowa Hospital Association Friday Mailing:

Iowa Senator Chuck Grassley has introduced legislation to improve Medicare payments for Iowa’s “tweener” hospitals. Most of these hospitals are designated as Medicare Dependent Hospitals and Sole Community Hospitals under the Medicare program. The Medicare bill that just became law improves payments for Sole Community Hospitals but contained no provisions that benefit Medicare Dependent Hospitals.

Sen. Grassley’s “Rural Hospital Assistance Act of 2008″ would benefit Medicare Dependent Hospitals by not adjusting their payments for area wages unless it would result in improved payments. It would also improve the existing low-volume add-on for low-volume rural hospitals, both Medicare Dependent and Sole Community, so that more rural facilities with low volumes would receive the assistance they need.

”These hospitals are the backbone of the rural health care system, and there’s no justification for Medicare not recognizing their unique situation and vital role,” Sen. Grassley said. “I’m committed to doing everything I can to make sure they’re treated fairly and not left in a perilous situation with Medicare.”

An angry response to yesterday’s Slate article

From Health Care BS:

As I have pointed out many times, a good deal of BS appears in the “news” media relating to health care. Few articles, however, reach the level of irresponsibility achieved yesterday in Slate.

The authors of this disgraceful piece of agitprop would have their readers believe that the people who run hospitals deliberately allow people to languish in their ERs for financial gain. The suggestion is not merely slanderous. It is absurd on its face.

Street Fentanyl Tied To Many Deaths

From the Wall Street Journal Health Blog:

Illicit versions of the painkiller fentanyl were linked to more than 1,000 deaths in this country between 2005 and 2007, the Centers for Disease Control and Prevention said yesterday.

The powerful painkiller, often mixed with cocaine or heroin and taken by injection, first caught the attention of the CDC in 2006, after it was connected to a wave of overdose deaths in Camden, New Jersey. Further investigation tied it to deaths in other cities, including Chicago, Detroit, Philadelphia and St. Louis.

Is Keeping Patients Waiting in the ER a Good Business Move?

From the Wall Street Journal Health Blog:

Those long emergency room waits that we are all familiar with may be good for a hospital’s bottom line, a couple of academic emergency medicine docs write today in Slate.

How’s that? Patients who show up at the emergency room are less likely than patients admitted to the hospital by a staff physician to need lucrative, procedure-driven care. And those ER patients may be more likely than those admitted by a doctor to have bad insurance or no insurance at all, they argue. (Though it is worth noting that one recent analysis found that the well-off made up much of the recent growth in ER traffic).

A hospital only has so many inpatient beds, so it makes economic sense to fill the beds up with the lucrative, well-insured patients admitted by staff physicians. That creates an incentive to keep ER patients in a holding pattern, waiting for an inpatient bed to open up. This practice, known as “boarding,” in turn keeps the emergency department stuffed to the gills, and makes wait times longer for patients who show up at the ER without an immediately life-threatening emergency.

Medpedia: Online Encyclopedia of Medicine

From Medgadget:

A group of American medical schools is working on a project to essentially collect and organize all medical knowledge in a Wikipedia-like form. Access to MedPedia will be available to all, but editing rights will be limited to M.D.’s and Ph.D.’s in relevant fields of research. Harvard, Stanford, the University of Michigan, and Berkeley will kick off the site with initial content and work with the rest of the medical community to make it comprehensive. With that in mind, the project organizers are calling on all M.D’s and Ph.D’s to register to become editors of what they believe will be the largest and most complete encyclopedia of medicine in history.

Dropping the Baton: A Qualitative Analysis of Failures During the Transition From Emergency Department to Inpatient Care

From the Annals of Emergency Medicine:

The transfer of a patient from the ED to internal medicine can be associated with adverse events. Specific vulnerable areas include communication, environment, workload, information technology, patient flow, and assignment of responsibility. Systems-based interventions could ameliorate many of these and potentially improve patient safety.

Staff Finds Rx for Hospital Via Board Game Strategy

Associated Press Stacom, Don

“Friday Night at the ER” provided department heads, managers and staff with an in-depth look at staffing levels, revenues and hospital administration after simulating a 24-hour period at Bristol Hospital in Connecticut. The program is based on a board game and divided staff into groups of four charged with managing growing numbers of patients and shortages of beds and nurses. The number of patients in the ER waiting room continued to increase during the game, and teams managing the operating room, critical care unit, medical surgical floor and the ER discovered that when they worked together the number of patients in the waiting room declined.