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4 posts from November 2013


Will The 100,000 (& counting) Mobile Medical Applications Improve Health Care?: A Conversation with Janet Marchibroda (November 26th)

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According to Information Week there are now approximately 100,000 mobile medical applications (double the number from last year) and the market for these applications is expected to grow from $500 million in 2010 to $8 billion by 2018.  These applications promise to provide the consumer with everything from health and wellness information to cancer diagnoses.  What do we know about who uses mobile medical applications or digital therapeutics, why and to what effect?    

During this 22 minute interview Ms. Marchibroda describes four general categories of mobile medical applications, their parochial uses by the public, healthcare providers, employers and insurers, what's known about their effectiveness, potential downsides and why the FDA is regulating these (and future federal regulation of health information technology more generally).  

Ms. Janet Marchibroda is currently the Director of the Health Innovation Initiative and the Janet Marchibroda PhotoExecutive Director of the CEO Council on Health and Innovation at the Bipartisan Policy Center in Washington, DC.  Ms. Marchibroda also serves as a board member for Doctors Helping Doctors Transform Health Care.  Ms. Marchibroda previously led stakeholder engagement activities for the National Coordinator for Health Information Technology at DHHS, served as the Chief Health Care Officer at IBM, served as the founding Chief Executive Officer for eHealth Initiative (eHI) and also served as the Chief Operating Officer of the National Committee for Quality Assurance.  Among other awards she's been recognized as one of the Top 25 Women in healthcare by Modern Healthcare magazine.  Ms Marchibroda was graduated from the University of Virginia with a BS and from The George Washington University with an MBA.


Are Medical Errors the Third Leading Cause of Death in America?: A Conversation with Rosemary Gibson (November 21st)

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In 1999 the Institute of Medicine published "To Err Is Human," a report that shocked the medical establishment because it concluded as many as 98,000 Americans die annually from hospital caused medical errors.  In 2000 the highly respected scholar Dr. Barbara Starfield estimated medical errors or adverse events actually amount to 225,000 deaths annually making them the 3rd leading cause of death after heart disease and cancer.   Most recently a study published this past September in the Journal of Patient Safety estimated medical errors cause between 210,000 to 440,000 deaths annually.  Added to these sobering estimates is the fact there's never been an actual count of how many patients have been killed by medical errors and what progress that has been made in reducing errors, or at least the growth in the number of errors, has been charterized as "frustratingly slow" and "agonizingly slow."

During this 23 minute intereview Ms. Gibson discusses the prevalence of medical errors and why she believes the rate of medical harm is actually getting worse.  She explains why she believes both the medical community's response as well as federal and state government responses have been inadequate and what is needed to reverse this extraordinary number of medical-related deaths.       

Ms. Rosemary Gibson is a Senior Advisor at the non-profit Hasting Center, a research organization dedicated to addressing ethical issues in health, medicine and the environment.  Ms. Gibson is also an editor for Rosemary_gibson[1]JAMA Internal Medicine.  Previously, Ms. Gibson was a Program Officer at the Robert Wood Johnson Foundation where she addressed safety and quality issues particularly in palliative care.  Among other books Ms. Gibson is the author of "Wall of Silence, The Untold Story of the Medical Mistakes That Kill and Injure Millions of Americans."  Ms. Gibson serves on numerous boards including the Consumers Union Safe Project and among others she received the Lifetime Achievement Award from the American Academy of Hospice and Palliative Medicine.  Ms. Gibson is a graduate of Georgetown University and the London School of Economics.

To learn more about Ms. Gibson's work go to: http://www.amazon.com/s/?ie=UTF8&keywords=rosemary+gibson&tag=googhydr-20&index=stripbooks&hvadid=18834377909&hvpos=1t1&hvexid=&hvnetw=g&hvrand=187281419643604594&hvpone=&hvptwo=&hvqmt=b&hvdev=c&ref=pd_sl_6ynacw5hh2_b


Reforming Graduate Medical Education to Address the Healthcare Workforce Shortage: A Conversation with Dr. David Goodman (November 14th)

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It's estimated in the next few years the Affordable Care Act will add 25 million Americans to the health care insurance rolls.  In addition, 10,000 Americans age into Medicare every day.  Current estimates by the Health Resources and Services Administration and others show the country already has a shortage of health care providers, particularly primary care physicians, and the shortage is projected to grow substantially worse by 2025.   Since we can neither meet the demand nor improve supply without changes or improvements to medical workforce training what then can be done to reform federally-funded graduate medical education (GME), particularly since GME policy has been frozen since 1997.   

During this 17 minute interview Dr. Goodman discusses the adequacy of the current health care workforce, what can be done in the near term to improve supply particularly to reduce the maldistribution of providers, policy alternatives he is recommending to improve (or incent) provider supply via changes to federal funding of GME and how (any) reform to GME can avoid the consequence of more physicians simply accelerating health care spending without improving healthcare outcomes or population health.  (Please note: Dr. Goodman's comments are his own.)     

Dr. David C. Goodman is a Professor of Pediatrics, the Co-Principle Investigator of the Dartmouth GoodmanDavid[1]Atlas of Health Care and leads the Institute for Health Policy and Clinic Practice at Dartmouth.  His primary research interest is the relationship of outcomes to health workforce supply and its implications for health workforce policy.  He also leads and mentors a wide range of projects investigating the causes and consequences of variation in health care capacity and utilization. Dr. Goodman is the co-founder of the Wennberg International Collaborative, a research network that advances the study of unwarranted medical practice variation.   He is the author of numerous research publications and serves on several editorial boards.  Dr. Goodman was graduated from SUNY, Syracuse with a MD degree, he did his medical training at Johns Hopkins and earned a MS in epidemiology from Dartmouth.


Hospital-Acquired Infections Contribute to 100,000 Deaths Per Year, What's Being Done to More Effectively Treat Them: A Conversation with Amanda Jezek (November 13th)

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Conservative estimates show hospital-acquired infections (HAIs) sicken two million Americans, directly kill 23,000 and contribute to a total of 100,000 deaths each year.  The bacterial infection C. diff (Clostridium difficile) alone causes 250,000 people to be hospitalized annually.  Healthcare costs associated with these infections are estimated at over $50 billion.  These illnesses and deaths are largely the result of an overuse or misuse of antibiotics that causes bacteria to become over time drug or anti-microbial resistent.  (Fifty percent of all antibioticis prescribed for people are not needed.)  The CDC has recently termed these "nightmare bacteria." They pose, the CDC has stated further, a "catastrophic threat" to the public's health. 

During this 23 minute interview Ms. Jezek explains why antimicrobials are overused both in human and food animal populations, why drug companies have been pulling out of doing research in this area, what's being done to spur researchers to develop new anti-bacterials including the IDSA's 10 x 2020 program, what IDSA is doing regarding bacterial transplants, what's being done by the FDA under 2012 GAIN Act and what the Congress has tried to do, or is trying to do, to address this substantial public health problem.

Ms. Amanda Jezek is the VP for Public Policy and Government Relations at the Infectious Diseases Mail[1]Society of America (IDSA) which represents over 10,000 physicians and scientists.  In her position Amanda is responsible for policy development and advocacy on IDSA priority issues including antimicrobial resistance, antimicrobial and diagnositcs development, preparedness and federal funding.  Prior to joining IDSA, Amanda was the Deputy Director for Federal Affairs at the March of Dimes Foundation.  Amanda has lobbied for Mental Health American and worked as a Legislative Assistant and Press Secretary for Rep. Grace Napolitano (D-CA).  Amanda received her BA from Dartmouth College.