P4P – thoughts stimulated by Reinhardt — db's Medical Rants

More on pay for performance.


P4P – thoughts stimulated by Reinhardt — db's Medical Rants

Arch Intern Med -- Improving Primary Care for Older Patients: Challenge for the Aging Century: Comment on "Practice Redesign to Improve Care for Falls and Urinary Incontinence", October 25, 2010, Kao and Landefeld 170 (19): 1772

More on practice redesign

Arch Intern Med -- Improving Primary Care for Older Patients: Challenge for the Aging Century: Comment on "Practice Redesign to Improve Care for Falls and Urinary Incontinence", October 25, 2010, Kao and Landefeld 170 (19): 1772

Arch Intern Med -- Reforming Payment for Health Care Services: Comment on "Physicians' Opinions About Reforming Reimbursement", October 25, 2010, Chernew 170 (19): 1742

More on reimbursement reform

Arch Intern Med -- Reforming Payment for Health Care Services: Comment on "Physicians' Opinions About Reforming Reimbursement", October 25, 2010, Chernew 170 (19): 1742

Arch Intern Med -- Abstract: Practice Redesign to Improve Care for Falls and Urinary Incontinence: Primary Care Intervention for Older Patients, October 25, 2010, Wenger et al. 170 (19): 1765

evaluation of a practice re-design strategy


Arch Intern Med -- Abstract: Practice Redesign to Improve Care for Falls and Urinary Incontinence: Primary Care Intervention for Older Patients, October 25, 2010, Wenger et al. 170 (19): 1765

Arch Intern Med -- Abstract: Physicians' Opinions About Reforming Reimbursement: Results of a National Survey, October 25, 2010, Federman et al. 170 (19): 1735

Nobody said health care reform would be easy.


Arch Intern Med -- Abstract: Physicians' Opinions About Reforming Reimbursement: Results of a National Survey, October 25, 2010, Federman et al. 170 (19): 1735

Arch Intern Med -- Abstract: Physician Wages Across Specialties: Informing the Physician Reimbursement Debate, October 25, 2010, Leigh et al. 170 (19): 1728

Here are the data that Bruce mentioned yesterday documenting the gap in physician pay between primary care and other specialties


Arch Intern Med -- Abstract: Physician Wages Across Specialties: Informing the Physician Reimbursement Debate, October 25, 2010, Leigh et al. 170 (19): 1728

Interview With a Ghost (Writer) « The Scholarly Kitchen

Here is a bone-chilling blog posting.

Happy Halloween!

jd


Interview With a Ghost (Writer) « The Scholarly Kitchen

Argumentation: The Study of Effective Reasoning, 2nd Edition

At long last, here is the Teaching Company course in rhetoric that I mentioned a while back.

jd


Argumentation: The Study of Effective Reasoning, 2nd Edition

Eric Dishman: Take health care off the mainframe | Video on TED.com

A companion to the NEJM article about moving health care into the home. Interesting Rochester connection too!\

jd

Eric Dishman: Take health care off the mainframe | Video on TED.com

Why Health Care Is Going Home — NEJM

the next major restructuring of our health care system?

jd


Why Health Care Is Going Home — NEJM

Seth's Blog: Deliberately uninformed, relentlessly so [a rant]

Thoughtful commentary on the state of our society, part 2


Seth's Blog: Deliberately uninformed, relentlessly so [a rant]

The ACP Advocate Blog by Bob Doherty: The Muddle-Minded Middle

thoughtful analysis of the state of our society - part 1


The ACP Advocate Blog by Bob Doherty: The Muddle-Minded Middle

Complexity Matters » Some Environments Foster Innovation-What Should Your Work Place Look Like?

Remember from the beginning when we talked about the multi-disciplinary nature of health services research? We have also several times touched on the importance of combining methodological perspectives & thinking creatively about health service research. Here is a post that addresses these issues.

jd


Complexity Matters » Some Environments Foster Innovation-What Should Your Work Place Look Like?

Can Open Access Journals Guarantee Sound Methods? « The Scholarly Kitchen

Here is one for our "research career" series - more on the changing nature of scientific communications. Also, link to the scholarly kitchen website, a great way to follow this sort of thing.

jd


Can Open Access Journals Guarantee Sound Methods? « The Scholarly Kitchen

Ernest Madu on world-class health care | Video on TED.com

A perspective on how to create a health care system. Also, a brief introduction to the TED talks. In case you have not seen these before, they are an incredible source of ideas as well as examples of how to give a good presentation. Enjoy!



Ernest Madu on world-class health care | Video on TED.com

Demo: The Archimedes Outcomes Analyzer

A new approach to addressing some of the evaluation issues we have been discussing.


Demo: The Archimedes Outcomes Analyzer

Seth's Blog: Getting smart about the hierarchy of smart

another view on pay for performance from a different perspective.


incidentally, a very interesting blog to follow for new ideas and forward thinking


Seth's Blog: Getting smart about the hierarchy of smart

SocialMediaToolkit_BM.pdf (application/pdf Object)

New toolkit from the cdc about using social media for public health work - no reason why it shouldn't work for HSR work too.

jd

SocialMediaToolkit_BM.pdf (application/pdf Object)

Legislating against Use of Cost-Effectiveness Information | Health Policy and Reform

Nice followup to our discussion today.

jd

Legislating against Use of Cost-Effectiveness Information | Health Policy and Reform

Arch Intern Med -- Abstract: Hospitalists and the Quality of Care in Hospitals, Aug 10/24, 2009, López et al. 169 (15): 1389

2nd article about hospitalists and quality of care

jd


Arch Intern Med -- Abstract: Hospitalists and the Quality of Care in Hospitals, Aug 10/24, 2009, López et al. 169 (15): 1389

Arch Intern Med -- Do Hospitalists Improve Quality?, Aug 10/24, 2009, Centor and Taylor 169 (15): 1351

first of 2 articles discussing effects of hospitalists on the quality of care

jd

Arch Intern Med -- Do Hospitalists Improve Quality?, Aug 10/24, 2009, Centor and Taylor 169 (15): 1351

JAMA -- Abstract: Cancer Screening Among Patients With Advanced Cancer, October 13, 2010, Sima et al. 304 (14): 1584

An unanticipated consequence of screening guidelines. Timely for our session this thursday.

jd



JAMA -- Abstract: Cancer Screening Among Patients With Advanced Cancer, October 13, 2010, Sima et al. 304 (14): 1584

ACP: InternistWeekly - 12 October 2010

A new IOM report regarding the role of nurses in healthcare from the ACP news feed.

Nurses tapped for more training, bigger role in health care

The Institute of Medicine says nurses' roles, responsibilities and education should change significantly to meet the increased demand for care expected from health care reform.
Further, nurses should train alongside other health professionals and assume leadership roles in redesigning care, stated the report. Nurses should undergo residencies, increase their ranks of those with bachelor's degrees from 50% to 80% by 2020, ensure that at least 10% of their baccalaureates enter a master's or doctoral program within five years, and double the number of doctoral candidates.

There are more than 3 million nurses in the U.S., and because of their direct patient contact and the proportion of time the profession spends in direct patient care, "Nurses should be full partners, with physicians and other health professionals, in redesigning health care in the United States," the report said.
Once nurses are trained, scope of practice limits should be lifted, the report stated, as should insurance and regulatory hurdles, so that the health system can reap the full benefit. Scope of practice barriers are particularly problematic for advanced practice registered nurses (APRNs), the report found.

Studies of advanced practice nurses and the experiences of health care organizations, such as the Veterans Health Administration, Geisinger Health System, and Kaiser Permanente, that have increased the roles and responsibilities of nurses in patient care show that these nurses deliver safe, high-quality primary care.
In one example, the VA had been transforming itself since the 1990s in anticipation of an aging veteran population. The results of the VA’s initiatives using both front-line RNs and APRNs showed that patients received significantly better health care based on various quality-of-care indicators such as mammography, flu and pneumococcal vaccination, cancer screening and other conditions than patients enrolled in Medicare’s fee-for-service program. In some cases, the study showed, between 93% and 98% of VA patients received appropriate care in 2000; the highest score for comparable Medicare patients was 84%. Meanwhile, spending per enrollee rose much more slowly than in Medicare, by 30% from 1999 to 2007 compared with 80% for Medicare over the same period.

The report is the product of a study convened by the Robert Wood Johnson Foundation Initiative on the Future of Nursing, which will organize a national conference at the end of November to discuss implementation.

The conclusions aren't without detractors. The American Medical Association responded, "Nurses are critical to the health care team, but there is no substitute for education and training. Physicians have seven or more years of postgraduate education and more than 10,000 hours of clinical experience; most nurse practitioners have just two-to-three years of postgraduate education and less clinical experience than is obtained in the first year of a three year medical residency. These additional years of physician education and training are vital to optimal patient care, especially in the event of a complication or medical emergency, and patients agree."



ACP: InternistWeekly - 12 October 2010

The ACP Advocate Blog by Bob Doherty: Should Medicare pay less for less effective care?

Nice discussion of how to pay for health care - variation on our pay for performance series.

The ACP Advocate Blog by Bob Doherty: Should Medicare pay less for less effective care?

Health Affairs

This week, Health Affairs came out with an issue largely devoted to comparative effectiveness research - a wonderful followup to our session last week. Here it is:

Health Affairs

Medical Education Innovation Is Needed To Improve Health Care – Health Affairs Blog

This one speaks for itself: If we are to change how medicine is practiced, we need to appropriately change the way we train the practitioners.

Also includes a healthy menu of other blogs that address health care issues.

jd

Medical Education Innovation Is Needed To Improve Health Care – Health Affairs Blog

Implementation Timeline - Kaiser Health Reform

very useful timeline about how the health care reforms are being implemented.

Implementation Timeline - Kaiser Health Reform

Gmail - MDM - DECISIONS study supplement released online

This is timely on the eve of our session on medical decision making.


Gmail - MDM - DECISIONS study supplement released online

Bending The Cost Curve – Health Affairs Blog

Followup to our discussion yesterday about the health care reform goal of reducing health care costs


Bending The Cost Curve – Health Affairs Blog