tag:blogger.com,1999:blog-69912652582838007072024-03-05T21:45:13.550-08:00Tom DeSanto Health Care CommentaryInsight and inspiration on everything from medicine to marketing and beyond, since 2008Unknownnoreply@blogger.comBlogger104125tag:blogger.com,1999:blog-6991265258283800707.post-4371744143859214232013-03-15T08:31:00.001-07:002014-03-13T20:32:44.115-07:00Thank you to those who have been commenting. Unknownnoreply@blogger.com1tag:blogger.com,1999:blog-6991265258283800707.post-90428557864495266192012-08-23T16:33:00.000-07:002013-02-11T21:54:34.043-08:00<br />
<br />
Health care is ever-moving and changing. Every moment there is something new. <br />
But, for now, there's not much new on my blog. After 106 posts, I'm taking a break.<br />
<br />
My cumulative content is here for you to explore. Health care, in all its complex facets, always offers something to intrigue or inspire us. Enjoy!<br />
<br />
Thanks for reading.<br />
<br />
TomUnknownnoreply@blogger.com9tag:blogger.com,1999:blog-6991265258283800707.post-28818941169845003192012-05-17T14:52:00.000-07:002012-05-17T14:59:03.539-07:00<b>Medical Homes Can Improve Diabetes Care</b><br />
<br />
One of the problems with our health-care system is that it delivers care in a very fragmented manner. Patients seek medical treatment in a wide variety of places for a many different reasons. Although the treatment is somewhat coordinated, the frame of reference is on the individual episodes of care and not on the overall, cumulative effect on the patient's health.<br />
<br />
With managed-care companies requiring authorizations and electronic medical records providing continuity of data across patient visits, coordination of care is improving. As progress continues, the system is evolving toward patient-centered care.<br />
<br />
Patient-centered care has various meanings. In marketing, it is often used to describe convenience and comfort, such as providing easier access to related services or improving satisfaction among patients and their families. On a larger scale, it is used to describe a more holistic approach to care in which patients are not treated as the sum of their medical diagnoses, but as individuals whose medical needs are just one part of their health and well-being.<br />
<br />
Patient-centered care involves coordinating and delivering the full range of services that will optimize each patient's health. The intended results are more positive outcomes, increased cost efficiency and greater satisfaction.<br />
<br />
But how can we break down traditional "silos" of care and place the patient at the center? <br />
<br />
One answer is <b>medical homes</b>. This approach involves having a physician lead a team that is responsible for the continuous and comprehensive care of the patient, including coordinating and tracking delivery of care across the full spectrum of medical specialties, hospitals, physicians offices and social service providers.<br />
<br />
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj4zzPsvrOYcW2b3HRQa1OuI3-6iN2gM6LEP6ftfx60Om4eLJNJ3FHjQgBnmMEni6jeCOQSpe6MDKA7i2flFEV-Le94LbXRkwydkY2hXJYQkjGo2g8-QDypICsFDPnm97gj4FE1t71q5sBN/s1600/PhysRecog_PCMH2011_rgb.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj4zzPsvrOYcW2b3HRQa1OuI3-6iN2gM6LEP6ftfx60Om4eLJNJ3FHjQgBnmMEni6jeCOQSpe6MDKA7i2flFEV-Le94LbXRkwydkY2hXJYQkjGo2g8-QDypICsFDPnm97gj4FE1t71q5sBN/s1600/PhysRecog_PCMH2011_rgb.jpg" /></a>In a study recently published in <i>The Joint Commission Journal on Quality and Patient Safety</i>, researchers in Pennsylvania demonstrated that the medical-home model can improve outcomes in diabetes patients. By applying Patient-Centered Medical Home (PCMH) standards developed by the National Committee for Quality Assurance in 2011, physicians enabled patients to achieve lower levels for LDL, hemoglobin A 1 C and blood pressure, which are the key predictors of morbidity and mortality in diabetes. Patients involved in the study were also significantly more likely to comply with evidence-based clinical guidelines for diabetes care, such as yearly examinations of the feet and eyes. (<a href="http://live.psu.edu/story/54122" target="_blank">http://live.psu.edu/story/54122</a>)<br />
<br />
PCMH standards are likely to form the foundation for America's efforts at health care reform. Regardless of the outcome of the reform debate, medical homes are moving forward. More than 30 states have launched medical home projects, and the recent report from Pennsylvania confirms that diabetic patients who have medical homes achieve better outcomes. <br />
<br />
Beyond the profound implications for families with diabetes, PCMH has the potential to reduce the estimated $174 billion the U.S. spends on diabetes care annually. Hopefully, the imperative to save health care dollars will drive us to do something that really makes sense.<br />
<br />
— Tom DeSanto<br />
<br />
<br />Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-6991265258283800707.post-78885741343505224202012-04-10T12:04:00.002-07:002012-04-10T15:53:58.397-07:00<span style="font-size: small;"><b>Improve the Patient Experience through Multidisciplinary Marketing</b></span><br />
<br />
Marketers can play a vital role in improving patient experience.<br />
<br />
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgz6oG49pcAwLi7mXrT7VZeb6C5HTqMt3_hul3FkKeBuofkhEcXMH4qO8UBNO4Z8ynbVZayj1WGSQmw01R6RziTXPYP1NbpDHmuFzFyMSorHAKATFt6D4KNyfyhhz1EUKvZjcZQpE4Vv9RW/s1600/dreamstimefree_227199.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="133" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgz6oG49pcAwLi7mXrT7VZeb6C5HTqMt3_hul3FkKeBuofkhEcXMH4qO8UBNO4Z8ynbVZayj1WGSQmw01R6RziTXPYP1NbpDHmuFzFyMSorHAKATFt6D4KNyfyhhz1EUKvZjcZQpE4Vv9RW/s200/dreamstimefree_227199.jpg" width="200" /></a>By working closely with experts in other health system departments, we can provide insights and communications that enhance their efforts. Understanding and managing the preconceptions and expectations of patients and their families—and the staff members who serve them—is essential for success. <br /><br />
Here are eight ways marketers can help:<br />
<br />
1. Correlate internal patient satisfaction research with market-based studies to provide additional perspective for understanding patient opinions and attitudes.<br />
<br />
2. Assess patient experience in light of the claims and promises made in vision, brand and service-line communications. Are we who we say we are?<br />
<br />
3. Integrate operations and communications to be sure we are ready, willing and able to deliver experiences that meet or exceed expectations.<br />
<br />
4. Inspire front-line patient-care staff through simple, ongoing quality/satisfaction updates that praise their efforts and challenge them to improve.<br />
<br />
5. Develop simple training and motivational materials to help improve performance in areas where needed.<br />
<br />
6. Welcome patients and their families with friendly, practical and informative communications that ease anxiety by telling them what to expect during treatment.<br />
<br />
7. Examine and improve all aspects of communications with patients from initial contact with the physician referral line through episodes of care to interactions around insurance and billing.<br />
<br />
8. Report individual successes and overall achievement in providing positive patient experiences to your administration, staff, patients and community.<br />
<br />
By working in cross-functional teams across the healthcare enterprise, marketers can help organization keep an extra finger on the patients' pulse and develop communications that heal and strengthen relationships. We can also provide communications check-ups and preventive care to keep relationships healthy.<br />
<br />
Ideally, we can be members of a multidisciplinary team that focuses on providing an optimal outcome for patient experience.<br />
<br />
— Tom DeSanto<br />
<br />
<span style="font-size: x-small;">Image: dreamstime.com </span>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-6991265258283800707.post-52282174814534587702012-03-17T12:06:00.000-07:002012-04-10T16:08:12.764-07:00Branding is Believing<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhEDnNtCj3gnZaod5lV7R5aao3hiXILFJ1D2I-xiJFwy4PycoMkXe5mnt-5suJ42CD9GMzXX5Yu52uVfe_rWO_RJIIPiPubf-2yJrn-_qvjE0kNN7owIbMTwNjnI7kl3oMJ3seBKQgy9aqs/s1600/images.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="133" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhEDnNtCj3gnZaod5lV7R5aao3hiXILFJ1D2I-xiJFwy4PycoMkXe5mnt-5suJ42CD9GMzXX5Yu52uVfe_rWO_RJIIPiPubf-2yJrn-_qvjE0kNN7owIbMTwNjnI7kl3oMJ3seBKQgy9aqs/s200/images.jpg" width="200" /></a></div>
Each generation either breathes new life into a brand or presides over its last breath.<br />
<br />
What do you believe? Take a moment to answer. <br />
<br />
1. Is the Encyclopaedia Britannica the authoritative source for information?<br />
<br />
Not anymore. Today, Britannica, established in 1768, ceased publishing its venerable printed volumes. We stopped believing.<br />
<br />
2. Are American cars as good as vehicles produced by foreign competitors?<br />
<br />
Maybe. A generation ago, the American auto industry led the world. More recently, it was flatlining until a Federal bailout shocked it back to life. Will it come back? Only if you believe.<br />
<br />
3. Is Apple the leading source for whatever is new and cool?<br />
<br />
Yes. In mid-2011, Apple surpassed Google as the world's most valuable brand by reaching an estimated value of $153 billion <span style="font-size: x-small;">(Brandz Top 100 Ranking.) </span>Apple made believers out of us.<br />
<br />
4. If you had a serious illness, where would you go for treatment? Where would you <b>never</b><b> </b>go?<br />
<br />
Most likely you know. Something influenced you to believe your care would be excellent or poor, perhaps the opinion of a physician, family member or friend. How we gather the information that shapes our beliefs is beginning to change. A recent poll found that 57 percent of consumers thought that "social media connections would have a strong impact on their likelihood to seek treatment at a hospital." <span style="font-size: x-small;">(YouGov Poll published in Becker's Hospital Review)</span><br />
<br />
What do you believe? Over time, brands rise and fall based on their ability to continually win the hearts and minds of their constituents. How? By remaining relevant and in a close relationship.<br />
<br />
Branding is believing.<br />
<br />
<i>— </i>Tom DeSanto<br />
<br />
<span style="font-size: x-small;">Image: Google Images </span><i><br /></i>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-6991265258283800707.post-89253378160801315112012-03-08T14:05:00.001-08:002012-03-17T12:23:36.859-07:00Measuring the "Where" to Enhance CareBy deploying real-time location systems (RTLS), health care providers are adding another dimension in the drive toward improving the quality, safety and efficiency of care.<br />
<br />
RTLS enables administrators to determine and track the real-time location of clinicians, patients and medical equipment. When coupled with workflow automation software technology, RTLS provides accurate, actionable information to aid in the optimal deployment of resources. It documents patient episodes of care to enable workflow and process improvement.<br />
<br />
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiR8W5JefTu-cWMSY5ANg9_a9kAJbr0MQFPa6DQYefzgzsXrSOfRqZQ02YKDAi-bukQm17y7zkZDZbsLpWJSTtFIC0yWloP7qNXtVKeNzGuqcU_0_PNe9y4ibmm1zAEUPCJ3rvv-khhmP4R/s1600/RTLS-WiFi_infrastructure.gif" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="151" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiR8W5JefTu-cWMSY5ANg9_a9kAJbr0MQFPa6DQYefzgzsXrSOfRqZQ02YKDAi-bukQm17y7zkZDZbsLpWJSTtFIC0yWloP7qNXtVKeNzGuqcU_0_PNe9y4ibmm1zAEUPCJ3rvv-khhmP4R/s200/RTLS-WiFi_infrastructure.gif" width="200" /></a>Real-time RTLS monitoring can help emergency departments improve patient throughput to avoid diversion of ambulances and the resulting loss of revenue. It can also provide documentation for patient-safety practices, such as hand-washing programs to reduce hospital-acquired infections, as well as compliance to many other protocols that affect outcomes and ratings.<br />
<br />
Having the ability to locate patients, physicians, nurses and staff quickly through RTLS enables providers to remain on-time for procedures and more effectively coordinate treatment. When RTLS tagging eliminates unproductive, frustrating hours wasted in equipment searches, nurses can spend more time with patients to improve quality of care and satisfaction. <br />
<br />
Hospitals and health systems that deploy RTLS technology have greater opportunities to improve quality, productivity and profitability. Knowing "where" is the next major leap in acquiring and applying data that can
help health care providers meet the demands of health-care reform.<br />
<br />
— Tom DeSanto<br />
<br />
<span style="font-size: x-small;">Image: Google Images, Barco.cz </span>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-6991265258283800707.post-90897800530537084342012-03-07T11:41:00.001-08:002012-03-10T20:28:34.385-08:00GTR: Getting a Handle on Genetic TestingGenetic tests currently are available for approximately 2,500 diseases. Burgeoning testing capability continues to spawn new products and services. The global market for genetic testing reached US$1.5 billion in 2010 is forecast to reach US$4
billion by 2015, according to RCNOS Industry Research Solutions.<br />
<br />
Such rapid growth makes it nearly impossible for researchers, physicians and patients to grasp the scope of genetic testing.<br />
<br />
In response, the National Institutes of Health launched the Genetic Testing Registry (GTR) on March 1, 2012. Developed by the National Center for Biotechnology Information, this online resource includes a searchable database of data voluntarily submitted by genetic test providers. Information includes the purpose and limitations of each test, what is measured, methods used and the name and location of the test provider. <a href="http://www.ncbi.nlm.nih.gov/gtr">http://www.ncbi.nlm.nih.gov/gtr</a><br />
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh-3zYGcR-edAsZkaajlOuaJ8qHpAsJUvudAoH5Sr2kfcTUFlijEpZY6E7VPoJI97AW_eGdhPTseoWHL1P4mZdwiGEqtw3RLV27i0dmC_AmGrvks7JssrgDxV1aezw7EToDk3yhwtmlq0h8/s1600/Picture+1.png" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh-3zYGcR-edAsZkaajlOuaJ8qHpAsJUvudAoH5Sr2kfcTUFlijEpZY6E7VPoJI97AW_eGdhPTseoWHL1P4mZdwiGEqtw3RLV27i0dmC_AmGrvks7JssrgDxV1aezw7EToDk3yhwtmlq0h8/s1600/Picture+1.png" /></a><br />
Consumers now have an online resource to explore possibilities and
receive referral information for the more than 2,700 certified genetic
counselors now practicing in the U.S. <br />
<br />
Medical professionals and researchers can find detailed information about tests' analytic and clinical validity, as well as a their ability to predict or improve outcomes. Peer-reviewed, clinical descriptions of more than 500 conditions and links to a depth of other valuable resources also are available.<br />
<br />
NIH Director Francis S. Collins said, "This registry will help a lot of
people — from health care professionals looking for answers to their
patients' diseases to researchers seeking to identify gaps in scientific
knowledge." <br />
<br />
The GTR is an important baby step in navigating the new world of genetic testing. We have a long way to go in establishing effective regulation and ethical application.<br />
<br />
— Tom DeSanto <br />
<br />
<br />
<br />Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-6991265258283800707.post-78286729954692674132012-03-06T10:38:00.000-08:002012-03-10T20:27:47.823-08:00Happy Birthday to One Smart Cookie<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgnCcpeYA0iQaSm6Yz2LsuqeHuhSo3l9RuL-x0O4gEwrVGQsvu1dcPBHrZXcrHoITirOcdeTCeZG4MSpTl2skDMQr3DZEt_zjCmli_2033nh8qFH_ScEyN5XoHPgF656mpfg8qgR9HADfLL/s1600/Oreo-Two-Cookies.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="101" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgnCcpeYA0iQaSm6Yz2LsuqeHuhSo3l9RuL-x0O4gEwrVGQsvu1dcPBHrZXcrHoITirOcdeTCeZG4MSpTl2skDMQr3DZEt_zjCmli_2033nh8qFH_ScEyN5XoHPgF656mpfg8qgR9HADfLL/s200/Oreo-Two-Cookies.jpg" width="200" /></a></div>
<span style="font-size: small;">Today we celebrate the 100th birthday of the Oreo, a beloved cookie and an iconic American brand.</span><br />
<br />
<span style="font-size: small;">But did you know that the Oreo was preceded in the marketplace by a remarkably similar cookie called the Hydrox? In 1908, the fledgling Sunshine Biscuit Company launched Hydrox, which rapidly became its flagship product.</span><br />
<br />
<span style="font-size: small;">Hydrox would have celebrated its 100th birthday in 2008. Instead, its obituary ran in the <i>Wall Street Journal</i>: "The Hydrox Cookie is Dead and Fans Won't Get Over It." <span style="font-size: small;">(http://online.wsj.com/article/SB120069573721101481.html)</span></span><br />
<br />
<span style="font-size: small;">Why is one cookie in the grave and the other is a healthy centenarian?</span><br />
<br />
<span style="font-size: small;">Was Oreo the superior product?</span><br />
<br />
<span style="font-size: small;">Arguably not. Hydrox cookies had a loyal following. One review stated that Hydrox had a "tangy, less-sweet filling and a crunchier cookie that stood up better to milk." In a taste test conducted by <i>Advertising Age</i> in Manhattan in 1988, the final score was Hydrox 29, Oreo 16.</span><br />
<br />
<span style="font-size: small;">Two major product differences stand out among the cookie contenders. Hydrox contained no lard and was granted kosher certification. The Oreo contained lard and was granted U.S. Patent #0093009.</span><br />
<br />
<span style="font-size: small;">Many marketing pundits believe the real difference in longevity can be attributed to Nabisco's superior marketing muscle and distribution capability. In the battle for market share, Hydrox never really had a chance.</span><br />
<br />
<span style="font-size: small;">A number of marketing missteps also led to Hydrox's demise. In 1991, the Hydrox brand was revamped and represented by a character named Drox. Unfortunately, Drox soon bit the dust because he too closely resembled the Pillsbury Doughboy. Pillsbury sued and won.</span><br />
<br />
<span style="font-size: small;">In 1996, Hydrox cookies were reformulated with added sweetness and were renamed "Droxies" to increase their appeal among children. Although reminiscent of Coke's 1985 reformulation blunder, abandonment of the classic recipe was never repealed. The once-famous Hydrox cookie slipped into oblivion by 2003. A brief reprise occurred in 2008. And then, kaput.</span><br />
<br />
<span style="font-size: small;">Happy birthday to Oreo, a great product given long life by consistent and clever marketing. A visit to <span style="font-size: small;">www.nabiscoworld.com/oreo/birthday</span> shows why.</span><br />
<br />
<span style="font-size: small;">Celebrating 100 years, Oreo is one smart cookie.</span><br />
<br />
<span style="font-size: small;">What does this have to do with health care, you might ask. Smart marketing has everything to do with longevity and success in branding. Besides, you just took a healthy break with some Oreos without adding a single calorie to your diet. </span><br />
<span style="font-size: small;"><br /></span><br />
<span style="font-size: small;">— Tom DeSanto</span>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-6991265258283800707.post-38668551697824093492012-03-05T16:58:00.003-08:002012-03-10T20:26:53.885-08:00Look Before You Leap<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEguYzb3e_IeqAhUFtOjs6goRUecaEphMiCqWBJz0wJdyPWLOfwCwxllarjjw0eyp1IYHw-DqQNFQHNHTB69ugS3tXlPXvE3uNbpvk_Zk8AzcqPgfqJlYoUGWWjyAT81vx8745HSIWto8Xla/s1600/image.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="157" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEguYzb3e_IeqAhUFtOjs6goRUecaEphMiCqWBJz0wJdyPWLOfwCwxllarjjw0eyp1IYHw-DqQNFQHNHTB69ugS3tXlPXvE3uNbpvk_Zk8AzcqPgfqJlYoUGWWjyAT81vx8745HSIWto8Xla/s200/image.jpg" width="200" /></a></div>
Today is Leap Day, that extra day in February we earn every four years.<br />
<br />
It's not among the observances commonly marked by health-care organizations, but we can learn from how others have sought to seize the opportunity.<br />
<br />
"People jumped off tall buildings all around the country Wednesday, but no one got hurt," proclaimed the provocative lead-in to an AP story published online by the <i>Washington Post</i>, <i>Fox News</i> and <i>Newsday</i>.<br />
<br />
The story went on to say that parachutists leaped off skyscrapers in Miami, Detroit and Las Vegas to be filmed for an energy drink commercial. The energy drink wasn't mentioned by name, but one of the stories carried a photo with a parachute emblazoned with the Red Bull logo.<br />
<br />
The stunts were right on target because they fit the Red Bull brand promise of "giving wings to people who want to be mentally and physically active and have a zest for life." But when I went to the Red Bull website to learn more, there was no mention of Leap Day or the parachutists.<br />
<br />
Red Bull missed the opportunity to leverage its event in another channel. Social media could have connected to the website, which could have amplified the story and perhaps offered a promotion.<br />
<br />
When marking an observance or holding an event, be sure to look at all the possibilities. It pays to look before you leap.<br />
<br />
— Tom DeSanto<br />
<span style="font-size: x-small;"><br /></span><br />
<span style="font-size: x-small;">Image:AP Photo/Mel Evans Cropped</span><br />
<br />Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-6991265258283800707.post-19094056964031318352012-02-22T10:59:00.000-08:002012-03-05T16:22:35.782-08:00A Lesson from Linsanity<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhJfdIE6yRbP_jSPf1I7MROXOoXfSRTCIGbvI7OcgKG6DU-F5mwPHcB6whc1u9BJB-dhDElNNpjEM9vpFKENrTKxYZV1MgZgovlTks2-hdannVAbIHXGMYtGVuOaqsmnb4S5AgVVsBUD203/s1600/images.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhJfdIE6yRbP_jSPf1I7MROXOoXfSRTCIGbvI7OcgKG6DU-F5mwPHcB6whc1u9BJB-dhDElNNpjEM9vpFKENrTKxYZV1MgZgovlTks2-hdannVAbIHXGMYtGVuOaqsmnb4S5AgVVsBUD203/s1600/images.jpg" /></a></div>
Jeremy Lin, the Harvard player turned Knicks sensation, has inspired "Linsanity" by his recent streak of phenomenal performance. The media coined the phrase. Lin earned it on the court.<br />
<br />
In his recent Wall Street Journal article, Jason Gay insightful observed that "...'Linsanity' also feels like an organic, emphatic reversal of the contrived way stars have been packaged and processed, in sports and beyond."<br />
<br />
I can't help but compare "Linsanity" to the Republican presidential candidates who are jockeying for their party's nomination. Every nuance of reputation is genetically engineered in spin-doctor laboratories. Any wholesome natural goodness or inspiration is removed by excessive processing.<br />
<br />
In your media diet, which would you rather consume?<br />
<br />
With no artificial ingredients, additives, re-engineering or continual processing, organically grown brands are a healthy alternative. They're also less likely to leave a bitter aftertaste.<br />
<br />
Reputations are earned, not engineered. <br />
<br />
In health care, effective brands are organically grown when a dedicated staff understands the unique attributes that make their organization successful and demonstrates them in everything they do.<br />
<br />
<br />
— Tom DeSanto<br />
<br />
<span style="font-size: x-small;">Image: Google Images/ ABC News</span>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-6991265258283800707.post-56500205056606376742012-02-15T10:26:00.000-08:002012-03-10T20:26:27.210-08:00Komen's Branding NightmareTwo health issues that reach deep into the heart and soul of every woman are reproduction and breast cancer.<br />
<br />
Two philanthropic brands that immediately evoke those issues are Planned Parenthood® and Susan G. Komen for the Cure.® <br />
<br />
When Komen withdrew funding, loyal Planned Parenthood supporters expressed their outrage by demonstrating on the streets and blasting Komen in social media. Others immediately contributed toward replacing the lost funding.<br />
<br />
Komen supporters also have intense brand loyalty. Where were they?<br />
<br />
Even in the face of an epic error, Komen has earned enough goodwill to assuage disappointment and anger among its supporters. What Komen didn't generate was an acceptable answer for its actions. The inability to defend the decision seems to indicate that its leaders did not reach a solid consensus on how their decision might affect their supporters.<br />
<br />
Many women were forced to choose between two impassioned issues and the brands that reflect them.<br />
<br />
Planned Parenthood started out $680,000 in the hole from Komen funding cuts. Intense brand loyalty turned Planned Parenthood into a big winner with many new contributions and pressure that lead to the restoration of Komen funding.<br />
<br />
An important lesson for all of us is to remember that brand loyalty is a powerful force. We must always remember to very carefully consider our supporters when making decisions.<br />
<br />
—Tom DeSanto <br />
<br />
<br />
<br />
<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: left; margin-right: 1em; text-align: left;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhEXsnlkt9lU3Z7HK2obWYQaV8UQlSQgJ4ecbxLr-MFQ3udeWjMCCqkfVszOHT_m3X1TxX806NaFuN8p519MlQMstzWbAawOBmUMWHPkMGlDPGJLsZnOSv6jr9Kl9R3zxa4lnZEiWyb2G18/s1600/Vinegar.png" imageanchor="1" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhEXsnlkt9lU3Z7HK2obWYQaV8UQlSQgJ4ecbxLr-MFQ3udeWjMCCqkfVszOHT_m3X1TxX806NaFuN8p519MlQMstzWbAawOBmUMWHPkMGlDPGJLsZnOSv6jr9Kl9R3zxa4lnZEiWyb2G18/s400/Vinegar.png" width="271" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Vinegar Valentines were popular at the turn of the century. <br />
In honor of this Valentine's Day post, here's one for Komen.</td></tr>
</tbody></table>
<br />
<br />
<br />
<br />
<br />
<br />Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-6991265258283800707.post-69498280429051354472011-01-05T09:53:00.000-08:002012-03-10T20:25:42.144-08:00<b><span style="font-size: large;">Health Care: More Challenges, More Consolidation </span></b><br />
<br />
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEif22G9u0laoGcvR3oo3dYWUUE4OuDaVbf9gj2dqPpmgo-dvgStfcXUtS4HhV5l02UvhGgNxPQpHZZXcWt1XRvm-I-PSFN4NQ1jMrHzF1HZFVHhKb6V1pq_p_FJT8zlqM46sT6O9jeU5sCC/s1600/MergeSign.png" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEif22G9u0laoGcvR3oo3dYWUUE4OuDaVbf9gj2dqPpmgo-dvgStfcXUtS4HhV5l02UvhGgNxPQpHZZXcWt1XRvm-I-PSFN4NQ1jMrHzF1HZFVHhKb6V1pq_p_FJT8zlqM46sT6O9jeU5sCC/s1600/MergeSign.png" /></a>In 2011, consolidations continued to climb, up nine percent over 2010. According to Irving Levin Associates, 980 healthcare-related mergers and acquisitions with a total value of $227.4 billion occurred in 2011. Consolidations reached their last peak of $268.4 billion in 2006.<br />
<br />
Hospitals reflected the same trend. The value of the top ten hospital mergers and acquisitions for 2011 increased from $3.8 billion in 2010 to $5.6 billion. For all hospital consolidations, the value was approximately $7.3 billion.<br />
<br />
As financial pressures continue to grow, more hospitals are likely to join forces to meet challenges such as decreased Medicare reimbursement, cuts in state Medicaid spending, investment in electronic medical records, movement toward forming accountable care organizations, increases in uncompensated care and uncertainty about health care reform.<br />
<br />
According to Moody's Investor Services, hospital consolidations have a positive effect because they increase competition in local markets, improve efficiencies and provide added leverage with payers. Conventional wisdom about economies of scale supports their conclusion.<br />
<br />
<div class="separator" style="clear: both; text-align: center;">
</div>
<div class="separator" style="clear: both; text-align: center;">
</div>
However, a 2006 study of the previous wave of more than 700 hospital mergers and acquisitions in the 1990s presents a different picture. It demonstrated that when hospitals merged, prices increased by 5 percent or more and quality remained unchanged or decreased slightly. The hospitals were able to save costs, but the amount saved was proportional to the degree of integration achieved. Many times operational, financial and cultural barriers impeded effective consolidation and its benefits. Based on my experience as a marketing consultant with hospitals that merged and "demerged," I've seen how disruptive and counterproductive consolidation can be. The process is enormously complex and emotionally charged.<br />
<br />
As hospitals join forces to meet challenges, they face an entirely new set of challenges. Researchers at Boston University identified eight factors that are essential to successful integration: strategic vision, governance, leadership, organizational culture/values, financial systems, clinical services, information systems and support functions. Hopefully, hospital leaders can learn from the past and reap greater benefits from consolidation.<br />
<br />
— Tom DeSanto <br />
<br />
<span style="font-size: x-small;">Sources: American Hospital Association data; , "How has hospital consolidation affected the price and quality of hospital care?", Research Synthesis Report No. 9, Willian B. Vogt, PhD and Robert Town, PhD, 2006; "A Conceptual Framework for Successful Hospital Mergers,"Alan Cohen, ScD, Boston University. Image:<span style="font-size: x-small;"> </span></span><span style="font-size: x-small;">Google Images</span>Unknownnoreply@blogger.com1tag:blogger.com,1999:blog-6991265258283800707.post-67247562306993464592010-11-26T10:58:00.000-08:002012-03-10T20:25:19.397-08:00<b><span style="font-size: large;">Improving Chronic Disease Outcomes with mHealth</span></b><br />
<br />
More than 100 million people in the U.S. have at least one chronic condition, and the number is growing.<br />
<br />
More than 270 million people in the U.S. subscribe to wireless services, and the number is growing.<br />
<br />
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgTFwYv07omfwVxN3ErAecaKfiAVFxm2HXKfkFpGhnNxXDiNlL0z7d-fVy2nu1ssnKykZObUvGj3lAEUwFEZJITPARE2Gl9NouixL7ml6oki5TmsA_Yr7wBUrDcBO1489Q_XWnSvuxc2uCu/s1600/Report-mHealth-To-Drastically-Reduce-Costs-Associated-With-Chronic-Disease-Care-2.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgTFwYv07omfwVxN3ErAecaKfiAVFxm2HXKfkFpGhnNxXDiNlL0z7d-fVy2nu1ssnKykZObUvGj3lAEUwFEZJITPARE2Gl9NouixL7ml6oki5TmsA_Yr7wBUrDcBO1489Q_XWnSvuxc2uCu/s200/Report-mHealth-To-Drastically-Reduce-Costs-Associated-With-Chronic-Disease-Care-2.jpg" width="133" /></a>What if wireless technology could be used to remotely monitor chronic conditions and to remind patients to manage them effectively?<br />
<br />
People with chronic conditions could enjoy better health and avoid preventable medical and hospital visits. And, because chronic diseases account for 75 percent the $2.3 trillion America spends on health care, we could begin to control runaway costs. <br />
<br />
That's just one of the many possibilities of mHealth — the use of mobile technology to support health outcomes.<br />
<br />
A widely cited study by Myer, Kobb and Ryan reported that home telemontoring, video visits and coordinated care helped reduce emergency room visits by 40 percent and hospital admissions by 63 percent among elderly veterans with a variety of chronic diseases.<br />
<br />
It is estimated that if patients with congestive heart failure, diabetes, chronic obstructive pulmonary disease and other chronic conditions agreed to have their doctors monitor them remotely and guide their self-care via mobile wireless applications, the result would be a $21.1 billion annual reduction in costs for emergency care, hospitalization and nursing home care.<br />
<br />
As wireless technology continues to advance and its application to mHealth grows, the U.S. has an enormous opportunity to help its citizens better manage chronic disease and improve the effectiveness of our health-care system.<br />
<br />
— Tom DeSanto<br />
<br />
<span style="font-size: x-small;">Sources: Information Week, MobiHealthNews, homehealthnews.org, healthcarereformmagazine.com. Image: research2guidance</span>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-6991265258283800707.post-49262576574341640102010-11-06T16:34:00.000-07:002012-03-07T10:19:14.003-08:00Overcoming Cancer's Stealth Capabilities<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: right; margin-left: 1em; text-align: right;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiO7OjQvOolrEShRfZQustnbHnIR3j9yvH8xh50OnfVg-IbMZB1sjJME79Imiot5hYhsb762qllHgiUq_heNdUHhyS4lv6NExm_mvUjKj5JQEuaS0LZIyz1YlEQ3Siq8i6eD8KZfs5Lh1Nf/s1600/57797-1.jpg" imageanchor="1" style="clear: right; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="145" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiO7OjQvOolrEShRfZQustnbHnIR3j9yvH8xh50OnfVg-IbMZB1sjJME79Imiot5hYhsb762qllHgiUq_heNdUHhyS4lv6NExm_mvUjKj5JQEuaS0LZIyz1YlEQ3Siq8i6eD8KZfs5Lh1Nf/s200/57797-1.jpg" width="200" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-size: x-small;"> Immune system attacking a cancer cell</span></td></tr>
</tbody></table>
Cancer cells have a stealth capability that enables them to avoid detection and destruction by the immune system. That's why cancer can sneak up on us and multiply unchecked.<br />
<br />
In a study released this week in <i>Science</i>, researchers were able to reveal and reverse cancer's stealth capability.<br />
<br />
Researchers hypothesized that stroma, the nonmalignant connective tissue that surrounds tumors, plays a role in helping cancer hide. They discovered that certain stroma cells express fibroblast activation protein (FAP), which is found in areas where the body needs to suppress the immune system (such as the uterus, placenta and areas of inflammation).<br />
<br />
To study the possible stealth mechanism, researchers bred transgenic mice with a genetic switch to turn off FAP-expressing (FAP+) cells. They injected the mice with cancer and allowed tumors to become well established. When they turned off the FAP+ cells, 80 to 90 percent of the tumors died within 48 hours. In further study with a group of mice with no immune systems, turning off FAP+ cells had no effect—verifying that the mice's immune systems killed the cancer.<br />
<br />
The study is a first step toward new therapies that could one day target FAP+ cells to unleash the immune system's ability to detect and destroy cancer cells.<br />
<br />
— Tom DeSanto<br />
<br />
<span style="font-size: xx-small;">Source: Kraman, M. et al., "Suppression of Antitumor Immunity by Stromal Cells Expressing Fibroblast Activation Protein-alpha," Science, 330:827-30, 2010. Image: Susan Arnold</span>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-6991265258283800707.post-46607624343760312412010-10-30T15:31:00.000-07:002012-03-10T20:24:39.626-08:00<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh6LOmW2zWspOMA1y4LqOCXEcUNK2YaXYVA1odcrYOrOjMoc0Chp_pmMR4ddci-9IIpSyn0GHsrI6S93seRfzgzjtCp2wgCix0L5QwrmwO1nHbyDpwNGWeDNxAaZHdSg-MMV9tvkeAqnOsB/s1600/_LadyJustice.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="190" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh6LOmW2zWspOMA1y4LqOCXEcUNK2YaXYVA1odcrYOrOjMoc0Chp_pmMR4ddci-9IIpSyn0GHsrI6S93seRfzgzjtCp2wgCix0L5QwrmwO1nHbyDpwNGWeDNxAaZHdSg-MMV9tvkeAqnOsB/s200/_LadyJustice.jpg" width="200" /></a><b><span style="font-size: large;">A Major Reversal: <br />
No Patents on Genes</span></b><br />
<br />
Gene patents have been issued for decades. The Patent and Trademark Office has granted thousands of patents on genes from various organisms, including about 20 percent of human genes. This has enabled the biotechnology industry to drive remarkable advances in medicine.<br />
<br />
In late October, the Department of Justice declared that human and other genes should not be eligible for patents because they are part of nature. <br />
<br />
The road to reversal began when a lawsuit was filed challenging patents covering the BRCA1 and BRCA2 genes and patent-holder Myriad Genetics' screenings that determine predisposition to breast and ovarian cancers. A district court judge in Manhattan ruled the patents invalid because genes carry important information, whether in the body or isolated from it, that can't be patented. His ruling prompted the government to reconsider its policy.<br />
<br />
A subsequent friend-of-the-court brief stated: "The chemical structure of native human genes is a product of nature, and it is no less a product of nature when that structure is 'isolated' from its natural environment than are cotton fibers that have been separated from cotton seeds or coal that has been extracted from the earth."<br />
<br />
Such a reversal and adamant position could endanger the progress being made in diagnostic testing and in development of highly effective new drugs designed to work in conjunction with the patient's genetic makeup. <br />
<br />
I often write about how this progress is already helping patients. BRCA2 screening provided early diagnosis to a cancer victim's children so they could avoid chemotherapy and invasive treatment. In clinical trials, patient-tailored cancer vaccines have brought remission in difficult cases. Extracted genes, and the potential they hold for improving people's lives, are not at all like the limited possibilities of extracted cotton fibers and coal. <br />
<br />
The government's stand on patenting genes is not merely a matter of principle. It's a matter of life and death for current and future patients who depend upon the medical advances made possible through the development and delivery of gene therapies.<br />
<br />
Appeals to the government's new stance are in progress. Let's hope they lead to a second reversal and further steps forward for biomedical science and the patients who benefit from it. <br />
<br />
— Tom DeSanto<br />
<br />
<div class="separator" style="clear: both; text-align: center;">
</div>
<span style="font-size: xx-small;">Source: New York Timeds. October 29, 2010. Image: Google Images </span>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-6991265258283800707.post-25777577082576596112010-10-20T11:49:00.000-07:002012-03-10T20:23:35.308-08:00Trying a New Answer to Cancer Costs<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjipCjMLwET8yw86gyy279coeHMhZvGOUGJwu7whrrhsIeYFcvlYRIX8LDjqdz1_WSNmPOI9AwpaNJ8W7aLvTm7MhI99d-OfDt6_clYt0IIUXz9FDfAOY_LWcZfRP05ZCXoGi6sCxu39I65/s1600/Picture+5.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="172" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjipCjMLwET8yw86gyy279coeHMhZvGOUGJwu7whrrhsIeYFcvlYRIX8LDjqdz1_WSNmPOI9AwpaNJ8W7aLvTm7MhI99d-OfDt6_clYt0IIUXz9FDfAOY_LWcZfRP05ZCXoGi6sCxu39I65/s200/Picture+5.jpg" width="200" /></a></div>
As cancer care costs continue to rise, UnitedHealth Group is looking for answers. It estimates that cancer drugs account for 35 to 40 percent of its spending on cancer treatment, and is testing a new way to compensate doctors for cancer care.<br />
<br />
<b>The Problem</b><br />
<br />
• Spending on cancer treatment is rising 15 to 18 percent annually, nearly double the rate of general health care costs.<br />
<br />
• Drugs account for an estimated 65 percent of an oncologist's income.<br />
<br />
• Customarily, doctors purchase cancer drugs, infuse them in their offices and then bill insurers for their cost plus a 15 percent profit margin.<br />
<br />
How can cancer costs be reduced while ensuring that patients receive proper treatment and doctors are compensated fairly?<br />
<br />
<b>Their Answer</b> is being tested in five cancer clinics for breast, colon and lung cancer. It works like this:<br />
<br />
• Doctors decide in advance which drugs they would like to use in the patient's treatment plan, from generic chemotherapeutic agents to more costly branded drugs.<br />
<br />
• UnitedHealth pays the doctors for whatever choice they make, but without the customary markup. Instead, the doctors receive a set fee that includes the profit they would have made, plus costs for managing patient care. <br />
<br />
• If the doctors use a drug not in the treatment plan, United Health Group covers the cost of the drug, but will not increase the separate payment covering markup and patient management.<br />
<br />
• In addition, treatment data would be shared among participating clinics to identify the most effective methods.<br />
<br />
<b>Reaction</b><br />
<br />
Some groups argue that the plan could provide an incentive for doctors to withhold treatment from patients, especially if the separate payment doesn't cover enough costs.<br />
<br />
I believe separating the ability to earn additional profit from prescribing more expensive drugs is a step in the right direction. We need to trust physicians to decide which drugs they prefer to use, cover the cost of those drugs and to provide them with collective data to support future decisions — without rewarding more expensive treatment options.<br />
<br />
The outcome from the test program remains to be seen. In the meantime, UnitedHealth Group is to be applauded for seeking answers that respect physicians' judgment and support their financial success.<br />
<br />
— Tom DeSanto<br />
<br />
<div class="separator" style="clear: both; text-align: center;">
</div>
<span style="font-size: xx-small;">Source: <i>Wall Street Journal</i>, October 20, 2010. Graphic: Google Images</span>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-6991265258283800707.post-47500873742778372352010-09-15T13:50:00.000-07:002010-11-02T14:23:58.946-07:00Maybe They Really Don't Hear Us<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg6G9Uf-4KtfJ-N21IuQfFi3sf5MUhCI2CLn9P4SCFPkXtSHE73IZ5PXxFV2UsLryJLnUWYzWs0dmQs583BkmiDlj0wLjbY24bY6zOjo0kYz8l5jvSXFHQFgbdodR44tHnRjWSBbnauSEKt/s1600/Picture+6.png" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="172" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg6G9Uf-4KtfJ-N21IuQfFi3sf5MUhCI2CLn9P4SCFPkXtSHE73IZ5PXxFV2UsLryJLnUWYzWs0dmQs583BkmiDlj0wLjbY24bY6zOjo0kYz8l5jvSXFHQFgbdodR44tHnRjWSBbnauSEKt/s200/Picture+6.png" width="200" /></a>Teens never seem to listen. Maybe it's because they really don't hear us.<br />
<br />
Hearing loss among adolescents increased by 31 percent between 1988-1994 and 2005-2006, according to a study recently published in JAMA. <span style="font-size: x-small;">(JAMA2010;304[7]:772-778) </span><br />
<br />
The prevalence of any hearing loss among adolescents was 14.9 percent in the earlier group and 19.5 percent more recently. Although the reasons for the increase are unclear, risk from loud sound exposure from listening to music may be partly to blame.<br />
<br />
Hearing loss affects more than 6.5 million adolescents. Males are more likely to have it, as well as individuals from families below the federal poverty level.<br />
<br />
It's time for adults to pay attention to a trend that not only increases frustration within families, but could have significant educational and social implications for the next generation.<br />
<br />
— Tom DeSanto<br />
<br />
<div class="separator" style="clear: both; text-align: center;"></div><span style="font-size: xx-small;">Image: Titan Teens iPod desktop</span>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-6991265258283800707.post-34641649766152658602010-08-25T11:39:00.000-07:002010-11-02T11:41:58.866-07:00Recession Today Keeps Patients Away?<span style="font-size: small;">Doctor visits, hospital admissions, outpatient surgery, laboratory testing and prescriptions have all declined according to recent reports:</span><br />
<br />
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhNX5lZKE1Vdk8aKhqI4LEXbo8-Eb2K0CWJH4gLHUplGhgfoxPbmmry6zMOK4A2ZOcnUZ7zi0hAEWuwQ3jchOR_QyqyLHgEGZGOrrAylLRLGH3N1kSiTRFO_lakqtEjfaJxBFP2MEDaKoUk/s1600/Picture+2.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="188" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhNX5lZKE1Vdk8aKhqI4LEXbo8-Eb2K0CWJH4gLHUplGhgfoxPbmmry6zMOK4A2ZOcnUZ7zi0hAEWuwQ3jchOR_QyqyLHgEGZGOrrAylLRLGH3N1kSiTRFO_lakqtEjfaJxBFP2MEDaKoUk/s200/Picture+2.jpg" width="200" /></a>Doctor visits fell 7.9 percent in May 2010 compared to the same month in 2009. <span style="font-size: x-small;">(Thomson Reuters)</span><br />
<br />
Hospital admissions fell 2.3 percent in April 2010 compared to the same month in 2009. <span style="font-size: x-small;">(Thomson Reuters)</span><br />
<br />
Outpatient surgical volume fell 2.6 percent at AmSurg Corp. compared to 2009. <span style="font-size: x-small;">(same-facility procedures)</span><br />
<br />
Laboratory test volumes fell 2.3 percent in the first quarter of 2010 at Quest Diagnostics.<br />
<br />
<br />
New prescriptions for maintenance drugs fell in the first quarter of 2010 at CVS Caremark Corp.<br />
<br />
According to the <i>Wall Street Journal</i>, "such cutbacks have happened before in recessions, but the drop seems to be more pronounced this time, industry analysts say."<br />
<br />
Insured Americans are moving toward higher-deductible health plans and shouldering a greater amount of the cost of their care. As a result, they may be forgoing health care, especially when money is tight. The recession also may be causing people to delay or opt not to have elective procedures.<br />
<br />
Whatever the cause of the unexpected drop in utilization, it will have the effect of lowering America's health care expenditures. Some believe this goes beyond the recession and may be the advent of consumerism in health care and the beginning of more practical utilization of health care services.<br />
<br />
I say that this is a time when we must determine whether the decline in utilization is coming at a greater cost. Are people with chronic conditions receiving proper care to manage their health and prevent greater complications? Are people receiving immunizations and preventive care, especially children and older adults? Is it possible that the decline in utilization also is the result of the uninsured and underinsured choosing shelter, food and basic necessities over health care?<br />
<br />
Before we celebrate a victory for health care consumerism, let's examine the cost of free-market forces.<br />
<br />
— Tom DeSanto <br />
<br />
<div class="separator" style="clear: both; text-align: center;"></div><span style="font-size: xx-small;">Source: Wall Street Journal, July 29, 2010. </span>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-6991265258283800707.post-39405251414646539872010-08-11T13:03:00.000-07:002010-08-12T14:15:46.916-07:00Physicians Needed for Health Care Transformation<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgFgf2KPmlBlJavOrQgbjFq_h567Foj48nsn4BX8eY4FsV70_SI0BnRsx2DkgSufqIZIyj-ZQvPOrzg591GxYYO5BqyaxJzM8mO3kW2v747x_zmhpdRCtUMgzv6pU-S1wURRNLwndbi9Snc/s1600/Picture+2.png" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgFgf2KPmlBlJavOrQgbjFq_h567Foj48nsn4BX8eY4FsV70_SI0BnRsx2DkgSufqIZIyj-ZQvPOrzg591GxYYO5BqyaxJzM8mO3kW2v747x_zmhpdRCtUMgzv6pU-S1wURRNLwndbi9Snc/s320/Picture+2.png" /></a>Yesterday, MDNews.com, an emerging online news network for physicians, posted an edited version of my "Peer Perspective" submission on its website. Here is the full text: <br />
<br />
"As new health care reform laws drive us away from focusing on volume and more toward achieving greater value, physicians will have renewed opportunity to practice medicine as a science and art. Your expertise will be vital to setting and achieving higher standards of care and in squeezing out redundant or unnecessary costs. Focusing on volume has robbed physicians and their patients of the time it takes to provide comprehensive, consistent care. Focusing on quality has the promise of restoring more effective and fulfilling practice — if physicians embrace change and champion the role as leaders of transformation. It's easy to dismiss standardization, checklists and other quality and patient safety initiatives as an affront to freedom. In reality, they may actually serve to support physicians by removing risk and enabling you to excel as you apply your considerable talents and experience with an enhanced emphasis on achieving optimal outcomes."<br />
<br />
My hope is that physicians will rise up, cast off the chains of bureaucracy that have bound them, and lead us to new age of medicine.<br />
<br />
— Tom DeSanto<br />
<br />
<span style="font-size: xx-small;">Image: MDNews.com Website</span>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-6991265258283800707.post-44727595178265060592010-07-26T17:09:00.000-07:002010-07-26T17:09:52.038-07:00Summit Illuminates Health Care Transformation<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiRjcmcX41xb7QDB_TTWVKO-Qm_iia5S5EAlsRxdRKgrdulNDrTFJzF6q2MVmocjEqWsrsb4oeM2J5_JX2EF8_h_GfRUSRvFV76A5WSCN1ObDRwkJ9FYGdidhFaeZVpuKSKpocK9PXRgmFl/s1600/P7070236.JPG" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="141" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiRjcmcX41xb7QDB_TTWVKO-Qm_iia5S5EAlsRxdRKgrdulNDrTFJzF6q2MVmocjEqWsrsb4oeM2J5_JX2EF8_h_GfRUSRvFV76A5WSCN1ObDRwkJ9FYGdidhFaeZVpuKSKpocK9PXRgmFl/s200/P7070236.JPG" width="200" /></a>At this year's American Hospital Association Leadership Summit, I saw an impressive parade of luminaries shed light on many pressing challenges faced by the health care industry. <br />
<br />
Chesley B. Sullenberger, the pilot who landed ill-fated USAirways flight 1549 safely in the Hudson River, advised us that the routinized, safety checklists that made his heroics possible have an important place in health care. Contrary to current complaints, such lists would not rob doctors of their autonomy. Instead, checklists would ensure best practices and allow doctors to excel, while guarding patient safety.<br />
<br />
Al Gore, former vice president of the U.S., spoke of sustainability—a challenge faced not only in the economics surrounding our consumption of Earth's resources, but also in the delivery of health care.<br />
<br />
Steven D. Levitt, co-author of <i>Freakonomics</i> and <i>Superfreakonomics</i>, reminded us of the role of free market forces in health care. He warned that we may need to "make people decide between taking grandma off life support and paying for their kid's college education." <br />
<br />
Dee Dee Myers, former White House press secretary, reminded us of the direct, positive correlation between the percentage of women in top leadership roles and achievement of success. Although health care provides many opportunities for women, leadership roles continue to be scarce.<br />
<br />
Newt Gingrich, former Speaker of the House, warned of the enormous competitive pressure coming from China and India. He said health care providers will need to deliver very high quality at a much lower cost or face the prospect of bankruptcy.<br />
<br />
Ian Morrison, health care futurist, reiterated that health care reform is moving our industry from focusing on volume to creating value. Glenn Steele, Jr., President & CEO, Geisinger Health System, and his leadership team discussed how they develop programs that simultaneously improve care and provide increased value. They prove that transformation is already in progress.<br />
<br />
Many speakers explored approaches to the complexity of implementing changes mandated by new health care reform legislation, as well as the challenges of improving outcomes while squeezing out costs. The convergence of so many experts and accomplished professionals offered enlightenment and some rays of hope in the storm.<br />
<br />
— Tom DeSanto<br />
<br />
<span style="font-size: xx-small;">Image: Tom DeSanto</span>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-6991265258283800707.post-3189552536290896352010-07-15T16:19:00.000-07:002010-07-15T16:19:51.138-07:00Childhood Obesity: Signature Project Sounds the Alarm<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjdeUC6lCsOMa7O6QnToIqLV2p3dLbkzgEL3r_AAaDSWTuFinfTv0d_RnBN2AeE4sd_X2eB8rkN_Eh8WG16Ce4SO29SFlodMuhBDm45MZsDfZM5HwNlVGUjKOXiAmvY51XLG1Ap6YPcv8Ds/s1600/0315-AOBESITY-01-MICHELL-OBAMA-OBESITY-MOVE_full_380.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="133" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjdeUC6lCsOMa7O6QnToIqLV2p3dLbkzgEL3r_AAaDSWTuFinfTv0d_RnBN2AeE4sd_X2eB8rkN_Eh8WG16Ce4SO29SFlodMuhBDm45MZsDfZM5HwNlVGUjKOXiAmvY51XLG1Ap6YPcv8Ds/s200/0315-AOBESITY-01-MICHELL-OBAMA-OBESITY-MOVE_full_380.jpg" width="200" /></a></div>First Lady Michelle Obama has made childhood obesity her signature project. Speaking out on the issue is a noble start to overcoming an alarming problem.<br />
<br />
Obesity has tripled among America's adolescents. It rose from 5 percent in 1980 to more than 18 percent in 2008. Among children 8 to 11, obesity increased from 6.5 percent to 19.6 percent. <span style="font-size: x-small;">(CDC)</span><br />
<br />
Associated risks for obese children include increased incidence of heart disease, high blood pressure, diabetes, breathing problems, sleeping difficulties, low self-esteem, depression and anxiety. <span style="font-size: x-small;">(American Academy of Child & Adolescent Psychiatry)</span><br />
<br />
Continuing risks during adulthood are dire. Computer generated forecasts, reported in the <i>New England Journal of Medicine</i> in 2007, estimated that by 2035 the prevalence of coronary heart disease will be 5 to 16 percent higher than today due to childhood obesity.<br />
<br />
Major culprits for the epidemic include poor dietary habits and a more sedentary lifestyle, most likely learned from parents. A recent study reported the overall obesity rate among adult Americans was 33.8 percent in 2008. <span style="font-size: x-small;">(<i>Journal of the American Medical Association</i>, January 20, 2010)</span><br />
<br />
Obesity is an enormously complex issue. Changing the underlying social and cultural causes will require a sea change. Making incremental progress will require the cooperation to implement—and sustain—practical measures that can make a difference. <br />
<br />
In 2004, the Centers for Disease Control and Prevention (CDC) released a report outlining ten key strategies schools could take to combat childhood obesity. It continues to issue reports, guidelines and tools. Are they working?<br />
<br />
A study reported in <i>Health Affairs</i> in March 2010 offers some hope. San Francisco State University researchers compared body mass index data from students in fifth and seventh grades before and after California adopted regulations banning sodas, highly sweetened beverages and junk foods in pubic schools. Based on eight years of data, researchers found that before the measures were enacted, obesity rates were increasing in all groups. In the three years after the ban, obesity rates slowed in all study groups except fifth-grade girls. <span style="font-size: x-small;">(UPI)</span><br />
<br />
To stay healthy, children need guidance in schools and at home. Actions speak louder than words. America has been taking some action against childhood obesity with limited success. Maybe what we've needed is the First Lady's words.<br />
<br />
— Tom <span class="goog-spellcheck-word" style="background: none repeat scroll 0% 0% yellow;">DeSanto</span><br />
<br />
<span style="font-size: x-small;">Image: Kevin <span class="goog-spellcheck-word" style="background: none repeat scroll 0% 0% yellow;">Lamarque</span>/Reuters </span>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-6991265258283800707.post-45133264734435994742010-06-24T14:03:00.000-07:002012-03-10T20:21:04.379-08:00Medicare Cuts: A Zero-Sum Game or Worse<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiUX2pvRTM4OdPSl19hKh_Lk6RapHYafEu06y2J5pVqrcZpOz1efTmSMFQQOtuicIVTmOvNTtDQGcxNEchr2EGorh6emvm3IocoI7tSF9CthFfkS9K6q4QOhyphenhyphenZnQ2gt5tV6onXOUVkQgdBx/s1600/pickpocket12112006.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiUX2pvRTM4OdPSl19hKh_Lk6RapHYafEu06y2J5pVqrcZpOz1efTmSMFQQOtuicIVTmOvNTtDQGcxNEchr2EGorh6emvm3IocoI7tSF9CthFfkS9K6q4QOhyphenhyphenZnQ2gt5tV6onXOUVkQgdBx/s200/pickpocket12112006.jpg" width="200" /></a>While Congress debates the "doc fix," Medicare has reduced payment to physicians by 21.2 percent.<br />
<br />
The Senate passed a bill that would provide a 6-month, 2.2-percent hike in payments instead. The House has not. <br />
<br />
If the bill eventually passes, the cost of reprocessing claims is likely to wipe out the physicians' 2.2-percent increase. Medicare would also spend about 30 cents per claim on reprocessing.<br />
<br />
The result? A loss of resources and goodwill. And a negative impact on patient care.<br />
<br />
Physicians may be inclined to see fewer Medicare patients. Already more than 17 percent restrict the number of Medicare patients in their practice. The rate among primary care physicians is 31 percent.<span style="font-size: x-small;"> (Based on 9,000 physicians surveyed by the American Medical Association)</span><br />
<br />
Physicians may also change how they treat patients. When Medicare payment rates were reduced for outpatient administration of chemotherapy drugs starting in 2005, physicians responded by switching chemotherapy agents. They were less likely to dispense the drugs with greater cuts in profitability and moved to higher-margin drugs instead, offsetting some of the savings intended by the legislation. <br />
<br />
Congress can try to cut costs by reducing payments to physicians. But, in the end, it's likely to be a losing proposition. Real health care reform will come when government chooses to put its trust in physicians, instead of putting its hands in their pockets.<br />
<br />
UPDATE: Temporary sanity prevails. From modernhealthcare.com, Friday, June 25:<br />
<br />
"... the House passed on a 415-to-1 vote legislation that replaces a 21.2% Medicare physician pay cut with a 2.2% raise through November. The White House announced Friday that President Barack Obama has signed the bill into law."<br />
<br />
Another temporary fix. The sad saga continues...<br />
<br />
<br />
<br />
— Tom DeSanto<br />
<br />
<span style="font-size: xx-small;">Sources: Health Affairs, June 17; USA Today; Image: Google Images</span>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-6991265258283800707.post-16114387391182354512010-06-16T12:07:00.000-07:002012-03-10T20:20:24.075-08:00Battle on the Front Line of Patient Safety<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhiLJy88ugqL42KaDEl-53-AZqArxkeG_17KwIT3CH1H_c84BhLMdS4X7FsA0Exn9fQjMW1Sw0CEq4YgpbxmCeGwHa9jYuQFHWXybmCzXSRZM0_h-Qi08s4XQFe1jjIMNX8n-OEzdFc4dhB/s1600/Picture+1.png" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhiLJy88ugqL42KaDEl-53-AZqArxkeG_17KwIT3CH1H_c84BhLMdS4X7FsA0Exn9fQjMW1Sw0CEq4YgpbxmCeGwHa9jYuQFHWXybmCzXSRZM0_h-Qi08s4XQFe1jjIMNX8n-OEzdFc4dhB/s200/Picture+1.png" width="158" /></a>Nearly 12,000 nurses in the Minneapolis/St. Paul area went on strike on June 10. Their chief complaint was that business decisions are adversely affecting the standards of nursing care and patient safety.<br />
<br />
Registered nurses are on the front line for patient safety. Research proves it.<br />
<br />
In a study released in the May/June 2010 issue of the <i>Journal of Hospital Medicine</i>, lead author Jeremy Sussman, MD, MS, concludes that "cuts to hospital staffing can hurt interactions between health care providers and patients, threatening robust nurse-to-patient ratios, which have been shown to affect patient safety."<br />
<br />
A 2006 study found that hospital with high RN staffing had lower rates of five adverse patient outcomes (urinary tract infections, pneumonia, shock, upper gastrointestinal bleeding and longer hospital stays) than hospitals with low RN staffing.<br />
<br />
Another study demonstrated that a 10 percent increase in the proportion of nurses holding a bachelor's degree was associated with a 5 percent decrease in two adverse outcomes: the likelihood of surgical patients dying within 30 days of admission and the odds of failure to rescue.<br />
<br />
Mass layoffs of 50 or more hospital employees (with an increasing number of nurses and clinicians) reached a record high in April 2010 according to <i>American Medical News</i>. Nursing strikes, judicial action and lawsuits are running rampant from Pennsylvania to California. Add to this the projected nursing shortage and it's easy to imagine a serious decline in patient safety.<br />
<br />
Dr. Sussman and his colleagues suggest that the federal government could connect hospitals' financial stability to patient safety. For example, government stimulus funds could be used to enable hospitals to employ nurse discharge advocates who could help reduce rehospitalization by providing instructions for compliance with medication doses and follow-up visits.<br />
<br />
Government funding could also be earmarked to support nurses and clinicians by providing new technologies and methods that have been proven to reduce medical errors. According to the website Dead by Mistake, "every year approximately 200,000 American patients die preventable deaths as tools to make them safer go unused."<br />
<br />
The number of innocent casualties is already too high for America not to take bold steps in the battle for patient safety.<br />
<br />
— Tom DeSanto<br />
<br />
<span style="font-size: xx-small;">Sources: Sussman, Halasvamani, Davis (2010),"Is the current recession compromising hospital quality?," University of Michigan, Journal of Hospital Medicine, Volume 5, Issue 5; Lovell (2006), "Solving the nursing shortage through higher wages," Washington, DC: Institute for Women's Policy Research; Aiken, Clarke, Sloane, Sochalski, Silber (2002), "Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction," JAMA, 288, 1987-1993; Image: Minneapolis </span><i><span style="font-size: xx-small;">Star Tribune</span></i>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-6991265258283800707.post-10939509838390896262010-06-04T12:53:00.000-07:002012-03-10T20:19:16.546-08:00Beyond the Headlines: U.S. Cancer Costs Double<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi0Guh3p43mfmdBOx0x3k2LSDzNxonB_FPzax0iN2vt3c3_HM1Cv-kBbW23Afet8Pt_RRALyDv5suIhDXRPLqWV6O7AhN0eGgu9DooheJDsugvjuOmHQjhypOSE0Zk_xz0U8qPZ2sYHK9hJ/s1600/Picture+4.png" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="150" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi0Guh3p43mfmdBOx0x3k2LSDzNxonB_FPzax0iN2vt3c3_HM1Cv-kBbW23Afet8Pt_RRALyDv5suIhDXRPLqWV6O7AhN0eGgu9DooheJDsugvjuOmHQjhypOSE0Zk_xz0U8qPZ2sYHK9hJ/s200/Picture+4.png" width="200" /></a>"US Cancer Costs Double in Nearly 20 Years" was the headline of a recent Associated Press article. At first thought, it's easy to conclude that the major driver is expensive cancer treatment. Maybe not.<br />
<br />
The article covered a new study conducted by the U.S. Centers for Disease Control and Prevention. Among the surprising findings:<br />
<br />
- Rising costs were driven by increasing numbers of cancer patients.<br />
<br />
- Costs from inpatient care dropped from 64 percent to 27 percent.<br />
<br />
- The percentage of total U.S. medical costs from cancer treatment remains at 5 percent, unchanged for decades.<br />
<br />
Among caveats for drawing conclusions:<br />
<br />
- Data doesn't include diagnostic tests and scans.<br />
<br />
- The study covers data between 1987 and 2005.<br />
<br />
It's likely that the advent of very expensive cancer therapies and greater frequency of cancer screenings over the past five years are contributing to an ongoing rise in costs. Hopefully, this may continue to be offset somewhat by the shift to less expensive outpatient care.<br />
<br />
The study also reminds us that demographics will play a significant role. The number of older Americans is increasing rapidly and they're living longer. With age comes the greater possibility of developing cancer. <br />
<br />
When we study current costs, will we discover an even greater increase as we multiply a growing number of patients and increasingly more expensive treatment costs? Most likely.<br />
<br />
Will cancer patients be able to afford treatment? <br />
<br />
Between 1987 and 2005, the proportion of cancer costs paid by private health insurance rose from 42 to 50 percent while out-of-pocket costs fell from 17 percent to 8 percent. That finding was unexpected, but welcome news.<br />
<br />
Did that trend continue between 2005 and 2010? Headlines about the increase in personal bankruptcies due to catastrophic medical costs would tell us otherwise. <br />
<br />
We can't know for sure until we look beyond the headlines.<br />
<br />
— Tom DeSanto<br />
<br />
<span style="font-size: x-small;">Source: Associated Press article by Mike Stobbe published by google news; Graphic: Tom DeSanto </span>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-6991265258283800707.post-75551971332034968052010-05-14T15:31:00.000-07:002010-06-04T13:00:16.645-07:00Solemn Remembrance: Mother's Day U.S.A.<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEihD93uVe_oVvSXuIUo4JA2p4lpPxjWcMF0zsla5kMMbnIVTEpEPPCp0utggLWBel1pBEzxUpdfP_R7b5L3O0SVd_pXWPXrmmorb9JGeJw-kI8iSb8NIjHoUY-YhxgAeQBt5ffRcPexie84/s1600/Flag+Half+Staff.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEihD93uVe_oVvSXuIUo4JA2p4lpPxjWcMF0zsla5kMMbnIVTEpEPPCp0utggLWBel1pBEzxUpdfP_R7b5L3O0SVd_pXWPXrmmorb9JGeJw-kI8iSb8NIjHoUY-YhxgAeQBt5ffRcPexie84/s200/Flag+Half+Staff.jpg" width="120" /></a>In honor of Mother's Day, Save the Children® released its annual Mother's Index. It ranks how well mothers and children fare in 160 countries based on health, education and economic status.<br />
<br />
The best place for mothers was Norway. The worse was Afghanistan. The United States, as wealthy and advanced as we are, came in at 28th place among more developed countries.<br />
<br />
Maternal and infant mortality rates, as well as less generous maternity-leave policies, were cited as major contributors to the United States' low ranking.<br />
<br />
Both Portugal (#19) and Greece scored higher (#24.) These countries have far fewer resources to support mothers. If we take the magnitude of per-capita health-care expenditure as one measure, we find that Portugal spent $1,897 and Greece spent $2,197, while the U.S. spent $6,096. <span style="font-size: x-small;">(United Nations Human Development Report 2007)</span><br />
<br />
We all know high health-care expenditures do not automatically equate to better health. With health-care reform in motion, we can do something about it. But major stakeholders such as federal and state government, providers, physicians, insurers and consumers are battling over what they may have to "give up" in the name of progress.<br />
<br />
The United States is already giving up the health and welfare of future generations. Where's the voice for the mothers and infants who die needlessly? Whatever happened to "as American as motherhood and apple pie?"<br />
<br />
<span style="font-size: small;">— Tom DeSanto</span><br />
<span style="font-size: xx-small;"><br />
</span><br />
<span style="font-size: xx-small;">Image: Google Images</span>Unknownnoreply@blogger.com0