Archives for July 2009

Don’t Get Burned With Your Sunscreen

July 30, 2009 | by

With summer upon us in full force, many people are eager to get out and enjoy some time in the sun. However, prolonged ultraviolet (UV) light exposure poses a threat during summer months. Indeed, for an increasing number of U.S. adults, sunburns are becoming more and more common [1]. Although sunburn can be the immediate result of the sun’s UV rays, repeated overexposure can lead to wrinkles, discoloration and other signs of premature aging of the skin, as well as skin cancer.

Protect yourself from the sun

Sunburn results when the amount of sun exposure exceeds the ability of melanin, the body’s protective pigment, to shield the skin. Using sunscreen regularly is one of the best ways to ensure protection from the sun and avoid skin damage. Sunscreen creates an effective barrier on the skin, absorbing or reflecting the sun’s UV radiation. With all the different sunscreens on the market, have you ever wondered how well your sunscreen works compared to other brands? A recent investigation by the Environmental Working Group (EWG), a non-profit advocacy organization that provides useful health resources to consumers, evaluated 1,620 brand-name sunscreens and found that 60% offer inadequate protection from the sun or contain ingredients with significant safety concerns.

Medpedia: Reliable Crowdsourcing of Health and Medical Information

July 24, 2009 | by

According to a recent survey by the Pew Internet & American Life Project, 61% of adults look online for health information [1]. Surprisingly however, three-quarters of those searching don’t consistently check the source and date of the health reference they find [2]. Indeed, searching for health information online is dangerous and finding credible, up-to-date sources of health information can be a challenge.

Wikipedia is the Web’s most popular free online encyclopedia. If you’ve ever searched for health or medical content online, Wikipedia articles typically appear at or near the top of search engine results. Nevertheless, Wikipedia’s medical entries are prone to manipulation and are not reliable [3]. Moreover, in many cases you don’t know who has contributed content nor their background or expertise.

Wisdom of crowds is the new model for innovation on the Internet in which collective knowledge is thought to be superior to the intelligence of the few. Nevertheless, not all crowds are wise. Recent cases and new research suggests that crowdsourcing is only truly successful when it is focused on a specific task and when the most effective collaborators are involved [4].

Enter Medpedia.

medpedia-logo

The Medpedia Project is a long-term, worldwide initiative to develop an online collaborative source of health and medical information for medical professionals and the general public. A joint effort with Harvard Medical School, Stanford School of Medicine, Berkeley School of Public Health, University of Michigan Medical School and other global health organizations, the intent of Medpedia is to be a repository of up-to-date unbiased medical information, contributed and maintained by health experts around the world and freely available to the general public. Unlike Wikipedia, which allows anyone to modify pages, Medpedia content creators and editors are required to have an M.D., D.O. or Ph.D. in a biomedical field; each contributor has an author page detailing their qualifications and background.

Francis Collins Nominated to Head NIH

July 15, 2009 | by

Last week, President Barack Obama nominated physician and geneticist Francis Collins as the next Director of the National Institutes of Health (NIH) [1]. From 1993 — 2008, Dr. Collins was the first Director of the NIH’s National Human Genome Research Institute (NHGRI). He led the U.S. government’s Human Genome Project, which decoded the DNA sequence of 20,000 — 25,000 genes.

francis-collins

In the past, Collins’ research laboratory at the University of Michigan has identified a number of important genes, including those responsible for neurofibromatosis, cystic fibrosis, Huntington’s disease and genes for adult onset (type 2) diabetes. More recently, Collins has been a proponent of personalized medicine or genomic medicine, which leverages specific genetic knowledge for the delivery of effective healthcare. Medscape interviewed him about genomic research and personalized medicine two years ago, where he said that incorporating individualized medicine into the mainstream will necessitate a change in healthcare economics. As NIH Director he will undoubtedly have a voice in the ongoing healthcare reform debate in Washington.

In his announcement on Wednesday, President Obama said [1]:

The National Institutes of Health stands as a model when it comes to science and research. My administration is committed to promoting scientific integrity and pioneering scientific research and I am confident that Dr. Francis Collins will lead the NIH to achieve these goals. Dr. Collins is one of the top scientists in the world, and his groundbreaking work has changed the very ways we consider our health and examine disease. I look forward to working with him in the months and years ahead.

Consumer Hospital Comparison Website Now Includes Quality Data On Readmission Rates

July 9, 2009 | by

Launched in 2002, the Hospital Quality Alliance (HQA) is a national public-private initiative that includes hospitals, physicians, nurses, federal agencies, quality experts, and consumer and business groups. HQA members collaborate to make meaningful, relevant and easy-to-understand information about hospital performance accessible to the public and to inform and encourage efforts to improve quality.

Last year, members of the HQA together with the Centers for Medicare & Medicaid Services and the Department of Health and Human Services created a consumer-oriented hospital comparison website called Hospital Compare. Hospital Compare provides information on how well hospitals care for patients with specific medical conditions or surgical procedures, as well as results from a survey of patients about the quality of care they received during a recent hospital stay.

hospital-quality-alliance

Yesterday, new quality data on hospital readmission rates was made available on the Hospital Compare website. The data includes hospital readmission rates for Medicare patients with heart attack, heart failure and pneumonia. This is especially relevant in today’s healthcare reform environment because the issue of hospital readmissions has been cited by policy makers and the Obama administration as a potential opportunity for improving healthcare quality and reducing unnecessary healthcare spending [2]. Indeed, a recent New England Journal of Medicine study found that almost one-fifth of Medicare beneficiaries discharged from the hospital were readmitted within 30 days; one-third were rehospitalized within 90 days [3].

Until now, hospitals have had only information on those patients who return to their own hospital, but not about patients who were readmitted to a different hospital. Using Medicare billing records from July 2005 to June 2008, the information on Hospital Compare shows how often a Medicare patient with one of these conditions returns to the same hospital or a different hospital within 30 days following their initial stay. Hospitals are placed in one of three categories based on their readmission rate in relation to a national readmission rate – “no different than the U.S. national rate”, “better than the U.S. national rate” or “worse than the U.S. national rate”. Each hospital’s readmission rate for the specific condition also can be compared to its state’s average. Additionally, each rate is shown as a single number, along with a confidence interval that indicates the range of certainty in which the hospital’s true performance falls.

The new quality data on hospital readmission rates is being added to existing information on how often hospitals take the right steps to provide care for their patients, as well as updated information on mortality rates. Available information includes statistics on a variety of quality measures such as:

  • Percent of surgery patients who were given an antibiotic at the right time (within one hour before surgery) to help prevent infection
  • Percent of surgery patients whose doctors ordered treatments to prevent blood clots after certain types of surgeries
  • Percent of heart attack patients given aspirin at arrival
  • Percent of pneumonia patients given the most appropriate initial antibiotic(s)
  • Percent of heart failure patients given discharge instructions
  • Percent of children who received reliever medication while hospitalized for asthma

In addition, Hospital Compare includes statistics on answers to a survey of patients’ hospital experiences, such as:

  • Percent of patients who reported that their doctors “Always” communicated well
  • Percent of patients who reported that staff “Always” explained about medicines before giving it to them.
  • Percent of patients at each hospital who reported that YES, they were given information about what to do during their recovery at home.

You can search for hospital information in your area using either a general search or a specific medical condition or surgical procedure search. The general search provides information on Hospital Process of Care Measures, Hospital Outcome of Care Measures, and Survey of Patients’ Hospital Experiences. The specific medical condition or surgical procedure search provides information on Hospital Process of Care Measures and Hospital Outcome of Care Measures (where applicable), Survey of Patients’ Hospital Experiences, and Medicare Payment and Volume. The Hospital Compare database is updated on a quarterly basis.

Interested in how your hospital stacks up to others in the area? Find and Compare Hospitals

References

  1. Vital New Quality Data on Hospital Readmission Rates Available on Hospital Compare Website. Hospital Quality Alliance press release. 2009 July 9.
  2. Health Reform’s Benefits for Middle Class Under Scrutiny. Kaiser Health News. 2009 Jun 25.
  3. Jencks et al. Rehospitalizations among patients in the Medicare fee-for-service program. N Engl J Med. 2009 Apr 2;360(14):1418-28.
    View abstract

Physician Failure to Report Abnormal Test Results to Patients

July 9, 2009 | by
ResearchBlogging.org

A new study published in the journal Archives of Internal Medicine finds that, on average, physicians fail to report clinically significant abnormal test results to patients – or fail to document that they had informed them – in one out of every fourteen cases [1]. In some practices, the failure-to-inform rate is as high as one in five abnormal results.

doctor-on-phone

Researchers at Cornell University’s Weill Cornell Medical College analyzed 5,434 patient records from 23 physician practices across the country, selecting 11 blood tests and 3 screening tests (mammography, Papanicolaou smear and fecal occult blood) commonly performed in the outpatient setting. They consulted with physicians in the appropriate specialties to define a range of clinically significantly abnormal values for each test. For each abnormal result then identified, the scientists searched the patient’s medical record for 13 types of events that occurred in most cases within 90 days suggesting that the patient had been informed. These events included a note stating that the patient had been informed, a repeat of the abnormal test or if a consultation or procedure was performed.