Princess Health andKynect has an app for smartphones .Princessiccia

Princess Health andKynect has an app for smartphones .Princessiccia

health insurance Kynect technology

Gusty 09:49 Add Comment

Kentucky's state health benefits exchange, Kynect, is offering a free mobile app that will provide "on-the-go" access to the health-insurance marketplace.

The  smartphone app will allow you to log in to your account, browse plans, report changes in your circumstances, take photos of required verification documents and upload those photos directly to your account.

It can also help determine if you qualify for low-cost or free health coverage, get information about your coverage options, find out enrollment dates and learn how certain life events can qualify you to enroll now.

It allows you to log in to your Kentucky Online Gateway Account, look at the status of your health care plan or application, get more information about your current health care plan, access alerts, notifications or messages related to your account and view and update contact information.

And if you have further questions, it can connect you to an insurance agent or nearby "Kynector."

The app is available for download in the iTunes Store for Apple devices or in the Google Play Store for Android users.

Princess Health andBaptist Health is first stand-alone health provider to become founding partner of Shaping our Appalachian Region effort.Princessiccia

Princess Health andBaptist Health is first stand-alone health provider to become founding partner of Shaping our Appalachian Region effort.Princessiccia

Appalachia Central Baptist Hospital economy governor health care

Gusty 18:02 Add Comment

Baptist Health has become the first stand-alone health-care provider to sign on as a founding partner in Shaping Our Appalachian Region, an initiative to improve the economy of Eastern Kentucky.

Baptist will work with SOAR to develop and implement health and education initiatives for residents of Appalachian Kentucky and has committed $150,000 to the initiative over the next three years, the organizations said in a press release.

�Baptist Health understands Eastern Kentucky because we have a proven and time-honored commitment to the health and well-being of our people,� Stephen C. Hanson, chief executive officer of Baptist Health, said in the press release. �Our participation in SOAR reflects this pledge. Besides Richmond, we�ve also got hospitals in Corbin and Lexington, along with outpatient facilities, doctors� offices and other services all over Eastern Kentucky, the rest of the commonwealth and indeed throughout the region."

The University of Kentucky was the first founding sponsor of SOAR, pledging $300,000 over the next three years and winning the right to use the UK HealthCare brand on SOAR materials as well as the university's general logo.

Gov. Steve Beshear and Congressman Hal Rogers formed SOAR in the fall of 2013 to create strategic plans to improve Eastern Kentucky's economy and quality of life.

�Our primary objective is creating and maintaining jobs across eastern Kentucky, and in order to do that, we need a healthy and well-educated workforce,� Beshear said in the release. �I�m pleased that Baptist Health understands the key connections among our efforts and the critical role that health will play in the future of this region."

Princess Health andResearchers discover why common blood-pressure medicine doesn't work for some people: your kidneys don't want to lose salt.Princessiccia

Princess Health andResearchers discover why common blood-pressure medicine doesn't work for some people: your kidneys don't want to lose salt.Princessiccia

blood pressure heart health research

Gusty 11:40 Add Comment

Each year, more than 120 million prescriptions are written around the world for thiazide drugs, which lower salt to treat high blood pressure. High blood pressure affects 28 percent of Kentucky adults, according to the state Department for Public Health. Thiazide drugs often save lives but are ineffective in some patients and only work for a time in others. A study by University of Maryland School of Medicine researchers has found a key reason for the failure.

Thiazides prevent salt from moving through the kidney, causing it to expel salt and water. However, the researchers found that the kidney seems to know "that it's losing too much salt and activates mechanisms to retain salt in other ways," said Paul Welling, a professor of physiology at the University of Maryland.

The researchers studied an animal model designed to prevent salt retention, which imitated the thiazides' effects. They discovered almost 400 genes that alter their activity to assist regulation of the kidney's salt control. Eventually, it might be possible to make drugs that affect the body's mechanisms that control how the body interacts with thiazides.

Welling and his colleagues also may have discovered a "biomarker" that could allow doctors to easily find out in which patients thiazides will not work. When the kidney is working against the thiazides, a certain molecule increases in the urine. "Now that we know more about these novel pathways and processes, we can begin to find new ways to help patients with high blood pressure," said Dean E. Albert Reece, vice president for medical affairs at the University of Maryland.

Princess Health andStudy suggests that adolescent exposure to alcohol can negatively affect learning, memory and behavior in adulthood.Princessiccia

Princess Health andStudy suggests that adolescent exposure to alcohol can negatively affect learning, memory and behavior in adulthood.Princessiccia

alcohol behavioral health children children's health learning disorders research

Gusty 11:44 Add Comment

A study at Duke University suggests that repeated exposure to alcohol during adolescence causes long-lasting changes in the part of the brain that controls learning and memory. The study, published in the journal Alcoholism: Clinical & Experimental Research, helped explain how exposure to alcohol before the brain has fully developed can cause cellular and synaptic abnormalities and negatively affect behavior. Kentucky is ranked 9th in the nation for the percentage of children who drank alcohol before age 13 (25.1 percent), according to the state Department for Public Health.

"In the eyes of the law, once people reach the age of 18, they are considered adult, but the brain continues to mature and refine all the way into the mid-20s," said lead author Mary-Louise Risher, a post-doctoral researcher in Duke's Department of Psychiatry and Behavioral Sciences. "It's important for young people to know that when they drink heavily during this period of development, there could be changes occurring that have a lasting impact on memory and other cognitive functions.

Studies had shown that animals exposed to alcohol at an early age do not perform as well in memory tasks as those not exposed to it. The new study, which involved exposing young rodents to alcohol and waiting for them to grow into adulthood, found that the exposure also affects the hippocampus, the area of the brain that controls memory and learning. The researchers measured a cellular mechanism called long-term potentiation, which involves the strengthening of brain synapses being used to learn new tasks or bring up memories. Ideally, LTP should be high, especially in young people. The researchers found that the adult rodents exposed to the alcohol during adolescence had higher levels of LTP, which may seem to be a positive outcome but is actually not.

"If you produce too much LTP in one of these circuits, there is a period of time where you can't produce any more," said senior author Scott Swartzwelder, a Duke professor. "The circuit is saturated, and the animal stops learning. For learning to be efficient, your brain needs a delicate balance of excitation and inhibition�too much in either direction, and the circuits do not work optimally."

The researchers also observed a structural change in individual nerve cells: those exposed to alcohol at a young age have brain cells that appear immature, even in adulthood. "It's quite possible that alcohol disrupts the maturation process, which can affect these cognitive functions later on," Risher said. She also noted that the immature appearance of the cells might be associated with behavioral immaturity.

Princess Health and New Study Strengthens the Case that LDL Causes Heart Disease. Princessiccia

Princess Health and New Study Strengthens the Case that LDL Causes Heart Disease. Princessiccia

cardiovascular disease

Gusty 14:00 Add Comment

There is little remaining doubt in the scientific/medical community that high levels of LDL, so-called "bad cholesterol", cause heart disease. Yet in some alternative health circles, the debate continues. A new study adds substantially to the evidence that LDL plays a causal role in heart disease.

Read more �

Princess Health and Pollyanna Rhetoric, Proximate Futures and Realist's Primer on Health IT Realities in 2015. Princessiccia

Princess Health and Pollyanna Rhetoric, Proximate Futures and Realist's Primer on Health IT Realities in 2015. Princessiccia

Charlie Jarvis David Blumenthal Edward Ehlinger healthcare IT difficulties healthcare IT myths healthcare IT pollyanna Mark Leavitt proximate future subjunctivisation bias Trisha Greenhalgh

Gusty 09:33 Add Comment

Pollyanna statements about healthcare IT such as the following are still appearing, and are growing increasingly tiresome.  They are, at best, demonstrations of people with a fiduciary duty to have known better making fools of themselves.

Pollyanna: someone who thinks good things will always happen and finds something good in everything (Merriam-Webster, http://www.merriam-webster.com/dictionary/pollyanna)

Examples:

... Before ARRA, most surveys concluded that cost was the No. 1 barrier to EHR adoption. But as soon as it appeared that the cost barrier might finally be overcome, individuals with a deeper-seated "anti-EHR" bent emerged. Their numbers are small, but their shocking claims -- that EHRs kill people, that massive privacy violations are taking place, that shady conspiracies are operating -- make stimulating copy for the media. Those experienced with EHRs might laugh these stories off, but risk-averse newcomers to health IT, both health care providers and policymakers are easily affected by fear mongering.  (Mark Leavitt, former head CCHIT, http://www.ihealthbeat.org/perspectives/2009/health-it-under-arra-its-not-the-money-its-the-message.aspx)

and:

"The [ONC] committee [investigating FDA reports of HIT endangement] said that nothing it had found would give them any pause that a policy of introducing EMR's [rapidly and on a national scale - ed.] could impede patient safety."  (David Blumenthal, former head of ONC at HHS, http://www.massdevice.com/news/blumenthal-evidence-adverse-events-with-emrs-anecdotal-and-fragmented)

and:

"We don't think there's a great deal of data to substantiate that there are major safety problems with the majority of electronic health records systems in use today," said Charlie Jarvis, executive committee vice chair of the EHR Assn., a trade group that represents 46 organizations that supply most of the EMR systems implemented in medical practices. "These products are safe, dependable, time-tested and display a lot of the safety features we think are necessary to prevent problems going forward." (Charles Jarvis, erstwhile NextGen VP and holder of prestigious (and mysterious) "American Medical Informatics Certification for Health Information Technology", http://hcrenewal.blogspot.com/2011/11/two-opposing-views-of-ehr-1.html)

The most recent example highlighted on this blog is:

As Minnesota�s health commissioner, I work to improve the health of all Minnesotans. As a physician, I�m dedicated to providing the best care possible to patients. Secure electronic health records help achieve both goals by enhancing the safety, effectiveness, and efficiency of our health care system. With that in mind, I have been concerned to see some recent pushback on Minnesota�s requirement that all health care providers use electronic health records (EHR) by 2015 ... All Minnesota patients, whether they visit a small clinic, need mental health treatment, or receive care from multiple providers, stand to benefit from EHRs and the improved care coordination they make possible. (Minnesota's Heath Commissioner Dr. Edward Ehlinger, http://www.minnpost.com/community-voices/2015/04/electronic-health-records-advance-quality-care-all-minnesotans.)

Here is the tragic reality.

Recommended for reading, and for feeding to the press and to our elected officials:

Primer on health IT realities in 2015:

-------------------------------------------------

(1)  "Five biases of new technologies", Trisha Greenhalgh.  Br J Gen Pract. 2013 Aug; 63(613): 425
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3722815/

The most dangerous of these biases is the "subjunctivisation bias".  It results in clinical disruption, mishaps, injury and death:

Subjunctivisation bias: Much of the policy rhetoric on new technologies rests not on what they have been shown to achieve in practice but on optimistic guesses about what they would, could, or may achieve if their ongoing development goes as planned; if the technologies are implemented as intended; and in the absence of technical, regulatory or operational barriers.⁴ This is what Dourish and Bell call the �proximate future�: a time, just around the corner, of �calm computing� when all technologies will be plug-and-play and glitch-free.

(I point out a related bias - that of the hyper-enthusiastic technophile who either deliberately ignores or is blinded to technology's downsides, ethical issues, and repeated local and mass failures.  See http://hcrenewal.blogspot.com/2012/03/doctors-and-ehrs-reframing-modernists-v.html.)

(2)  ECRI Institute Deep Dive Study on Health IT risks (2012)
http://www.healthit.gov/facas/sites/faca/files/STF_Deep_Dive_Health_Information_Technology_2014-06-13.pdf

171 IT mishaps sufficient to cause harm reported voluntarily by 36 hospitals in 9 weeks; 8 injuries; mishaps likely contributed to 3 deaths as well.  Projected to a nationwide annual figure, the result is likely many thousands of times greater (see http://hcrenewal.blogspot.com/2013/02/peering-underneath-icebergs-water-level.html).

(3)  Letter to ONC from 37 Medical Societies (January 2015)      
http://mb.cision.com/Public/373/9710840/9053557230dbb768.pdf

This letter speaks for itself on exceptionally well-justified clinician dissatisfaction and alarm at the risks and disruptions posed by this technology in its current form and with present roles (e.g., the experimental use of clinicians as cheap data entry clerks).

   
(4)  Joint Commission Sentinel Events Alert on Health IT (March 2015)   
http://www.jointcommission.org/assets/1/18/SEA_54.pdf

Late, but better than never.  Most of what's in this alert has appeared on this blog since 2004.   Footnote 1 (ECRI Institute PSO Deep Dive, the report linked above) is somewhat bizarrely used as a justification of the statement "EHRs have demonstrated the ability to reduce adverse events."  I do also note at the linked http://www.jointcommission.org/safe_health_it.aspx these statements:

• Poorly designed or implemented health IT can contribute to patient harm
• Health IT-related patient safety events can go undetected
• As health IT adoption becomes more widespread, the potential for health IT-related patient harm may increase

These could have come directly from my writings dating back over a decade here.  (Perhaps they did.)

(5)  Accenture - Fewer U.S. Doctors Believe It Improves Health Outcomes (April 2015)                    
http://www.businesswire.com/news/home/20150413005148/en/Increased-Electronic-Medical-Records-U.S.-Doctors-Improves#.VT5bmpOTqUk

This survey also speaks for itself.  A less formal nurses' survey is here:  http://hcrenewal.blogspot.com/2013/07/candid-nurse-opinions-on-ehrs-at.html

(6)  U.S. Centers for Medicare & Medicaid Services (CMS)
https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjc5Sf4nMN_8ru94JGGWglCefBw1O1K2WcOwRR8UMpvbpaOuWRm3-NVWGs6wnLuCiqyNgzZNNwjHW6lFNSziG_uAA36U2yJ1K3e8HfOMzFNxpgdRdSxtbG9It7_nbDMAXh3d5xHzZWD-OB9/s1600/CMS_Letter.jpg

FOIA response:  "We do not have any information that supports or refutes claims that a broader adoption of EHRs can save lives."  (But let us spend hundreds of billions of dollars and put patients at risk to find out...)

CMS: "we do not have any information that supports or refutes claims that a broader adoption of EHRs can save lives.  [Click to enlarge.]

In conclusion:

Next time you encounter pollyanna/head-in-the-sand statements about health IT that ignore the risks, throw this primer the way of the authors and audience of such statements.

-- SS

Princess Health andFederal agency offers a consumer-friendly website that ranks patients' experiences in your local hospitals .Princessiccia

Princess Health andFederal agency offers a consumer-friendly website that ranks patients' experiences in your local hospitals .Princessiccia

hospitals Medicare Patient Protection and Affordable Care Act poll rankings

Gusty 17:14 Add Comment

Consumers now have access to a website that ranks 3,500 hospitals around the country on patients' experiences to help them choose a hospital and better understand the quality of care participating hospitals offer, according to a Centers for Medicare and Medicaid Services press release.

The 12 star ratings on Hospital Compare are based on 11 of the publicly reported measures from the Hospital Consumer Assessment of Healthcare Providers and Systems Survey, and a summary rating for the survey. The survey asks patients questions about nine topics:communication with doctors, communication with nurses, responsiveness of hospital staff, pain management, communication about medicines, discharge information, cleanliness of the hospital environment, quietness of the hospital environment, and transition of care. This survey information is self-reported by patients and will be updated quarterly.

�The patient experience star ratings will make it easier for consumers to use the information on the Hospital Compare website and spotlight excellence in health care quality,� Dr. Patrick Conway, acting principal deputy administrator for the CMS, said in the release.

Consumers already have access to Medicare star systems to rate nursing homes, dialysis centers, private Medicare Advantage insurance plans and certain situations for physicians and group practices, but are they using it?

Not much, according to a recent Kaiser Family Foundation poll. It found that only 31 percent of those polled had seen any information comparing doctors, hospitals, and health insurance plans in the past 12 months. When asked specifically if they had seen information comparing prices or quality across plans and providers, fewer than 1 in 5 people said they had seen such information, and fewer than one in 10 reported using such information.

CMS said the website helps meet goals of the Patient Protection and Affordable Care Act, which calls for transparent, easily understood and widely available public reporting. The agency also reminds consumers that the site is just one tool to help them make a decision abut which hospital to use, and encourages them to talk to their health-care providers about hospital quality, and to use "multiple factors" when deciding about a hospital, such as clinical outcomes and other publicly reported data that is on the website.

To see the rankings:

• Go to the Hospital Compare website
• Type in your ZIP code, or the name of a particular hospital
• Click on "Search"
• Choose three hospitals, by clicking on the "Add to Compare" button
• Click on "Compare Now," located at the top of the screen
• Click on "Survey of Patients' Experiences"
• Scroll down and view star ranking and additional information results

This is a screen shot of the final screen, with a bar of options to click on.