Media To Consider 5/11/18

Books and Articles worth a Review… 

What Are You Reading? – I came across a statistic in the last week that was shocking at best.  The statement that drew my attention is that One third (1/3) of high school graduates and 42% of college graduates never read another book after completing their degree!  I actually couldn’t believe it.  So, I did some further research and the results come from a study done in 2003 by the Jenkins Group, Inc. – an independent publishing company.  So, what’s wrong with that?  In a period where transformational change is all around us – where are people getting their new information?  So, I did some research.  Here’s what I found:

  • According to the National Library Board, 68% of Americans get their news and information via print or digital sources; 41% via social media sources; and, 19% via books and e-books. 
  • The Pew Research Center basically did a similar study in 2016 with the same results.
  • A Reuters Institute study discovered that only 16% of the U.S. population paid for digital news last year with only half of those paying for a recurring subscription. In other words, only about 52 million Americans are getting their news this way. The remaining 274 million Americans are simply using Facebook, free news services and websites they like to supply them with “news”.
  • The Millennials and GenZ are more likely to pay for news subscriptions than any other generation although it’s still relatively low.
  • So, where do people get their news? Historically, it’s been via television, but that source is on the decline as well.  The upsurge in take home news for the clear majority of Americans is via social media.

Now – do these statistics cause you heartburn or, is it just me?  The era of Walter Cronkite or Huntley and Brinkley sourced, reliable and consistent information is over!  Anyone can throw “news” out on the web.  Folks – the combination of these data points is of major concern or am I becoming my father?

Media To Consider - 3/30/18

Books and Articles worth a Review…

Preparing For The Virtualist – As my regular readers will know, I’ve been an advocate for some time that we need to be considering how best to appropriately train clinicians to become “virtualist” care providers.  I do not believe that you simply take good clinicians, place them in front of a computer and say, “Have at it!”.  If we do not prepare these clinicians to understand the nuance of voice inflection, to detect the potential meaning of facial reactions, to understand the basics of large data analytics, to have a core understanding of the field of informatics – and, a host of other “to” items, the Health Care Virtualist will not be adequately prepared to provide high quality care in a virtual environment.  And, while I’m on the topic – this is NOT just a medical or physician’s domain.  I believe that if we are to be successful in adopting, adapting and effectively using tele-technologies – it will require a team model.  In essence, I’m making the argument that “virtualist” training should become a core element of training for all clinicians just like physiology, or microbiology, or pharmacology are consider part of the core curriculum.  There is the JAMA Virtualist article by Michael Nochomovitz, MD that advocates the need for considering a “Virtualist” specialty.  While that may actually evolve over time, I think the real discussion needs to be centered on cross-disciplinary approach toward “virtualist care” training for all clinicians.  Virtualist care will be the norm in the not-too-distant future – just like a stethoscope hanging around your neck.  

The Siren Call From The CDC – For those who missed it, Ken Thorpe and team had an article in Health Affairs last week on the lack of attention to a major, growing problem – antibiotic resistance.  There is not much known about the contribution of antibiotic resistance to rising health care costs.  So, the researchers reviewed the data from the Medical Expenditure Panel Survey to derive an estimate.  Their assessment was that antibiotic resistance adds about $1,400 or, about $2.2 billion annually across the entire nation. So, you can see that if we extrapolate the data on an international basis, the cost is very substantial.  More importantly, it’s growing at a very rapid rate. Something needs to be done and, it starts with educating physicians on the use of antibiotics and in how pharmaceutical companies manage antibiotic manufacturing – especially in foreign countries.  Dr. Thorpe’s team called for new infection prevention programs, antibiotics, and vaccines to prevent and treat antibiotic-resistant infections as an international priority. This is one of those looming problems that is on the horizon and my fear is that when the problem finally hits us on a massive scale – the health care community is going to look at one another in bewilderment.

Media to Consider 3/7/18

Books, Articles or Videos worth a Review…

 

Download Utopia! – The National Institute for Health Research (NIHR) at King’s College in London issued a report several weeks ago on “Using Telecare for Older People in Adult Social Care”.  The Brits are, in general, far ahead of the USA when it comes to social care as a dynamic in sustaining a viable environment for people of all ages to stay in the home rather than seek institutionalized services.  There is lots to learn from this seminal piece of work.  Download it, share with your colleagues and then consider how to move forward with implementation.  You’ll be ahead of the curve – unless you are already deep into a value-based reimbursement environment. 

Be Ahead Of The Disruption Curve – There is lots of information available on the web and elsewhere on disruptive technology trends.  Disruption Hub is a “go to” website if you want to keep ahead of the curve.  In particular, you should check out the 18 Disruptive Technology Trends for 2018.  Now you know where I get some of my information…

 

What Do You Practice? – I recently was shown the video – What Do You Practice? – at church and I thought the message is something that is critically important for all of us who are involved in caring for people.  What we “practice” comes across in our demeanor, our approach, our mode of communicating, our approach to caring.  Not only is the message important but, the messenger is someone we are likely to hear from again in the future…

 

Comparing Health Care And Higher Education – I was recently interviewed by Southern New Hampshire University on the comparisons between health care and higher education.  There are some very interesting comparisons.  My opinion is these two industries are some of the last to be transformed by technology but, the pace is quickening.  You can check it out and get back to me with your thoughts…

Lamenting Lame Legislation – In 1996, the US Congress inserted a rider into the omnibus spending bill which stipulated that "none of the funds made available for injury prevention and control at the Centers for Disease Control and Prevention (CDC) may be used to advocate or promote gun control." Known as the Dickey Amendment and introduced by Rep. Jay Dickey (R-AK), Congress went even further by earmarking the $2.6 million which had been allocated for gun control research for traumatic brain injury research.  Who’s going to fight TBI?  So, why did Congress do that?  It seems that the National Rifle Association (NRA) felt that there was a bias in a 1993 study funded by the CDC which had found that guns in the home were associated with an increased risk of homicide in the home.  In essence, the amendment put a stop to any gun-related research by the CDC.  In fact, the author of the amendment in a 2012 op-ed piece, reversed course and regrets the role he played in dismantling the CDC’s nascent efforts to begin gun violence research.  President Obama tried to get the CDC back on track by calling for research on gun violence in 2013.  When nothing happened, the Democrats sent a letter to their colleagues in Congress asking to rescind the amendment.  However, despite their best efforts, the rescission did not pass and the Amendment was upheld for the 2016 federal budget.  Did Congress listen to the tobacco industry when it wanted to push aside research on smoking?  Or, how about the car industry and crash prevention?  How about coal miners and occupational diseases?  Isn’t this just plain stupid?  A lot of medical and health care associations have called for removal of the amendment but so far, they have not been successful.  Shouldn’t we at least consider the science in our policy deliberations or, is science now out the window?  After all, there really isn’t any global warming…

Did You Know? – In the wake of the Parkland shootings, some startling statistics are only now starting to be discussed.  Did you know that the USA has the distinction of holding the highest rates of substance abuse, suicide, and gun violence in the world?  So, what does the data show?  There will be 175 deaths from drug overdoses today and every day this year!  There will be 123 suicides and 43 gun violence deaths today, and every day this year!  The question then remains:  Why hasn’t the health care community stepped up to declare a public health crisis?  There are segments of health care – like mental health, psychiatry, psychology and other similar areas – that seem to be calling for action.  But, where are the hospital systems? The emergency room physicians?  The family physicians?  And, all the rest? 

From Sandy Hook To Parkland With No Action – In 2012, 20 first graders and 6 adults were killed by a gunman at Sandy Hook School in Newtown, Connecticut with an assault rifle and it caught our attention – for about 10 seconds!  Since that fateful day, there have been nearly 250 school shootings nationwide with more than 450 people shot and at least 138 killed!  Here is some pictorial data from the Gun Violence Archive that describes the situation better than words.  The dark dots are deaths and the light dots are injuries:

shootings

Note the last one.  It’s the Marjory Stoneman Douglas High School in Parkland, Florida. What’s more troubling is the number of mass shootings.  They have apparently gone up in recent years.  Why?  It’s the availability of assault weapons of all sorts.  For a complete analysis of the data, you need to read the February 15, 2018 article in The New York Times by Jugal Patel.  The health care community needs to be at the forefront of this debate but, we are not!   Why?  Let’s use our moral authority…

HUGE Increase in ACA Health Insurance Rates – “HUGE” is a new word that keeps getting bandied about so I thought I would apply it to the problem of health insurance rates.  The Urban Institute is now projecting an 18% increase in premiums for Affordable Care Act (ACA) plans.  Why?  The researchers noted that “the Trump administration’s efforts to loosen health insurance rules” is the primary cause – which is no surprise to those of us who have any knowledge of how health insurance works.  If you take the healthy people out of the risk pools by offering less-comprehensive plans, the sicker ones are left in the risk pool and the overall cost for the more fully insured group goes up.  It’s fairly basic.  Furthermore, the Urban Institute projects that another 2.5 million people will simply drop out of the insurance plans because the individual mandate is now dropped. In essence, by creating an unsustainable plan the Administration has guaranteed the “massive failure” of ACA program unless something is done.  Now, one could argue that the Urban Institute is very liberal and left – and, would be expected to offer up such an analysis. But, it’s also been predicted by another analytical shop – Fox News.  However, I could not find their research online – only their analysis 😊. 

In other news on the ACA front, 20 states filed suit against the federal government claiming the ACA is “no longer constitutional after the repeal last year of its requirement that people have health insurance or pay a fine.” Texas and Wisconsin led the effort by a coalition of conservative states.  So, there are several fronts in the war on ACA.  Keep your eye on all of them…

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