Does a Healthy Diet Prevent Chronic Disease? CME/CE


While overweight and obesity affect 70% of adults in the United States, only a minority of individuals report receiving dietary advice from a healthcare provider. In part this may be due to the myriad diet plans available. The current review provides a succinct and evidence-based analysis of different dietary plans Continue reading

15 Top Medical Organizations Agree on Hormone Therapy Use

10 years have passed since Women’s Health Initiative raised questions

After 10 years of debate regarding the risks and benefits of hormone therapy, 15 top medical organizations have come together to issue a statement of agreement regarding the benefits of hormone therapy for symptomatic menopausal women. Continue reading

Prescription Drug Use Under Watch

The goal is to identify those who may abuse prescription drugs.

Software designed by a local physician to “score” patients’ risk for prescription drug abuse will be used in a federal pilot study looking at prescription practices.

NarxCheck, developed by Dr. Jim Huizenga, an emergency department doctor at Kettering Medical Center, and Eagle Software Corp., will be used in the study, which is sponsored by the U.S. Department of Health and Human Services. Continue reading

Real Doctors, Onscreen: VA Program Makes Online House Calls on Vets

A new pilot program will allow veterans in the Midwest to access behavioral health, oncology and post-operative care services wherever they have Web access. Using telehealth technology — a combination of streaming video, e-mail and text applications — the system is designed to help veterans in geographically remote areas or with mobility issues to conveniently contact clinicians and support services. Continue reading

Telemedicine in the Work Site

A feasibility study, with patient and provider satisfaction

We examined the use of telemedicine for improving access to care in a work-site clinic. A prospective study of 100 patients was conducted over a four-month period in a work site that housed 700 employees. Sinusitis (10 visits), upper respiratory tract infections (9 visits), otitis media (9 visits), hypertension (9 visits) and back pain (8 visits) were the most common reasons for the visits. In 99 visits, clinicians were of the opinion that the telemedicine visit felt similar to a face-to-face visit. For most of the visits (67), patients strongly agreed or agreed that telemedicine had a positive effect on their relationship with the health-care provider. The otoscope, microscope and stethoscope telemedicine peripherals were important in aiding diagnosis (and ruling out other causes) in about 55% of the visits (upper respiratory tract infection, sinusitis, otitis media, cough, sore throat, nevi, rhinitis and ear wax related concerns). The ability for the patient to watch their ENT examination and see any associated abnormalities was appreciated by many patients. Physicians, nurses and patients were capable of using the technology with little trainiing.

Source for Story:

Prathibha Varkey , Kay Schumacher, Claudia Swanton, Barbara Timm and Philip T Hagen
Division of Preventive, Occupational and Aerospace Medicine, Mayo Clinic, Rochester, Minnesota, USA

How to Save $40 Billion in Health Care Costs

What It Costs to Start-Up an Electronic Health Electronic health records (EHRs) broaden access to patient data and provide the platform for pushing evidence-based decision support to clinicians at the point-of-care. This promotes optimal care for patients, reduces medical errors, optimizes the use of labor, reduces duplication of tests, and by the way, improves patient outcomes. When done in aggregate across all health providers, a team from McKinsey estimates that $40 billion of costs could be saved in the U.S. health system.

Reforming hospitals with IT investment in the McKinsey Quarterly talks about the American Reinvestment and Recovery Act’s (ARRA) $20+ billion worth of stimulus funding under the HITECH Act and estimates that 80% of existing hospital IT applications will be affected by the regulation. Hospitals will be spending about $120 billion to meet the adoption and meaningful use provisions of the Act. This equates to $80,000 to $100,000 per hospital bed. ARRA incentive payments will cover roughly 20% of this cash outlay, meaning that $60-80K won’t to covered.

But McKinsey says, “Hold on!” There are ways to recoup the spending gap between HITECH incentives and cash-out-of-the-hospitals-budget. McKinsey’s research calculates that optimizing labor, reducing adverse drug events and duplicate tests, and adopting revenue cycle management can help the average hospital save $25,000 to $44,000 per bed each year. That gets to the $40 billion in annual savings when multiplied across all hospital beds in the U.S.

In operational terms, the savings accrue through:

* Managing inpatient beds more efficiently using equipment-scheduling software

* Optimizing the use of clinical equipment

* Determining optimal staffing

* Reducing administrative waste

* Reducing adverse drug reactions through computerized-physician-order-entry (CPOE) which cost $8,000 to $15,000 per bed each year (up to $3 million for a 200 bed hospital)

* Managing the revenue cycle by billing unbilled services, equivalent to 0.4% of hospital services, or $4,000 per bed.

Jane’s Hot Points: The McKinsey team rightly points to three critical success factors for maximizing health IT investments that the most wired, effective hospital-adopters have learned: get critical buy-in among clinicians and hospital execs early in the HIT adoption process; ‘radically’ simplify health IT architecture; and, elegantly plan and execute.

It’s the implementation phase in health IT adoption that so often gets short-shrift. McKinsey notes that Canada’s hospital system devoted 30% of its entire budget to change management. That’s a big number, but it’s also where rubber meets road: a capital outlay of $N million is the easy part of HIT adoption. The follow-on implementation resources, both in terms of sheer dollar volume and labor/staffing, along with disruption of clinical workflow, is the hard part. But getting to meaningful use will require no small amount of implementation effort in the form of evangelism, education and training, and ongoing assistance and support.

Sex still Important for Men age 70 to 95

Remaining sexually active is important for men – even those age 70 to 95, found in a survey conducted by Australian researchers. The study was initiated to find out what sort of factors influence sexual activity in elderly men.

43 Percent of Elderly Men would prefer more Sex

In the sampling of relatively healthy men, researchers found 43 percent would prefer to have sex more often. The survey included 3274 men aged 75 to 95 years, 85 percent of whom provided information about their sex lives.

Almost half (48.8%) of the respondents said sex was “somewhat important”, and 30.8 percent had at least one sexual encounter in the last year.

Researchers gathered information via questionnaires from 1996 to 1999, 2001 to 2004 and again from 2008 to 2009, assessing the men’s social situation and medical history.

The men again answered questions about their sex life from 2008 to 2009. The researchers evaluated hormone levels from 2001 to 2004 in an effort to garner more information about just how many elderly men are sexually active and what keeps them that way.

Men without health problems including diabetes, osteoporosis, prostate cancer, low testosterone levels, depression, and not on medications that might interfere with erections remained the most sexually engaged.

Other factors that limited sexual activity included partner’s lack of interest in having sex and simply not having a partner.

For almost half of the elderly men surveyed, sex remained an important part of life and 43 percent reported a desire to have sex more frequently. The findings have implications for clinicians who should discuss sexual activity with elderly male patients.

Annals of Internal Medicine 2010