Doctor Who?

From the New York Times article:

Researchers at the University of Chicago interviewed 2,807 adults admitted to the school’s hospital over a 15-month period. The patients were asked about the roles of the various physicians attending to them and to name the doctors on those teams. Medical teams consisted of three to four people, including medical students, residents and attending physicians.

Some 75 percent of the patients were unable to name a single doctor assigned to their care. Of the 25 percent who responded with a name, only 40 percent were correct. Those patients who claimed to understand the roles of their doctors were more likely to correctly identify at least one of their physicians.

Click here to access the article.

Delays in getting women with heart trouble to ERs

From the New York Times article:

But 647 patients, about 11 percent, were delayed, spending 45 minutes or longer in the care of emergency workers.

Women were 52 percent more likely than men to be among the delayed, said Thomas W. Concannon, an assistant professor of medicine at Tufts University who was lead author of the study, published this month in Circulation: Cardiovascular Quality and Outcomes.

It is not clear what caused the waits, he said, but other studies have suggested that heart problems in women are not recognized as readily by medical personnel.

Click here to access the NYT article. Click here to access the Circulation: Cardiovascular Quality and Outcomes journal article.

Mayo CME Consensus Conference Proceedings now available

The proceedings of the September 24-26, 2008 invitational Mayo CME Consensus Conference held at the Mayo Clinic in Rochester, MN, and co-sponsored by the Society for Academic Continuing Medical Education (SACME), the Accreditation Council for Continuing Medical Education (ACCME), and the Mayo Clinic has been posted online. Click here to access.

ACCME's New Approach to Transparency

Click here to read Dr. Kopelow's memo. I'd like to see ACCME require CME providers placed on probation to have to utilize a different accreditation statement, one that denotes that status.

Fair Market Value?

Check out the article on fair market value over at Pharmaceutical Executive, an excerpt:

The best approach is to rely on the knowledge base of fair market value that exists in other settings. Fair market value is a term of art. It's generally defined as a value negotiated at arm's length between a hypothetical willing buyer and a hypothetical willing seller. The IRS has very clear guidelines on methodologies that are acceptable from the standpoint of a fair market value standard. Those standards and the fair market value body of knowledge can generally be cross-walked to the determination of the fair market value of a compensation arrangement. For example, with traditional business valuations the primary approaches are cost, income, and market. Likewise, in a compensation valuation setting, consideration can be given to the same three valuation approaches—so we're using the guidelines and the techniques that were developed in business valuations and applying them to compensation valuation.

As CME providers conduct their annual review of their faculty honorarium policy, they might want to include this article as part of that review process. Click here to access the article.

$20 Billion allocated for Health IT

is included as part of the $825 economic stimulus proposal released by the House Appropriations Committee. From the iHealthBeat article:

Of the $20 billion, $2 billion would go to HHS' Office of the National Coordinator for Health IT (Ferris, Government Health IT, 1/15).

ONCHIT could use the funding to:

* Invest in IT architecture supporting health information exchanges and the national health information network;
* Provide grants to help health care providers adopt health IT products; and
* Train health care providers and IT professionals (Health Data Management, 1/15).

Some experts said that there are reports that at least some of the remaining $18 billion would be used to provide health IT grants to states (Government Health IT, 1/15).

Click here to access the article.

Updated AdvaMed Code

AdvaMed or the Advanced Medical Technology Association has updated their code of ethics and it takes effect July 1, 2009. Click here to access the updated code. Click here to access a comparison chart (compares old and updated code with the PhRMA code). A tad interesting, methinks, where they place "grand rounds" in their code.

FDA Guidance on "Good Reprint Practices" for Industry

Yep! The FDA has issued recommendations, but keep in mind this excerpt from the introduction:

FDA's guidance documents do not establish legally enforceable rights or responsibilities. Instead, guidances describe the Agency's current thinking on a topic and should be viewed only as recommendations, unless specific regulatory or statutory requirements are cited. The use of the word should in Agency guidances means that something is suggested or recommended, but not required.

Also from the document:

FDA does recognize, however, the important public health and policy justification supporting dissemination of truthful and non-misleading medical journal articles and medical or scientific reference publications on unapproved uses of approved drugs and approved or cleared medical devices to healthcare professionals and healthcare entities. Once a drug or medical device has been approved or cleared by FDA, generally, healthcare professionals may lawfully use or prescribe that product for uses or treatment regimens that are not included in the product's approved labeling (or, in the case of a medical device cleared under the 510(k) process, in the product's statement of intended uses). These off-label uses or treatment regimens may be important and may even constitute a medically recognized standard of care. Accordingly, the public health may be advanced by healthcare professionals' receipt of medical journal articles and medical or scientific reference publications on unapproved new uses of approved or cleared medical products that are truthful and not misleading.

It will be interesting to see what happens with the new administration. Click here to access the guidance document.

New clinician-consumer health info website

From the istockanalysis.com article:

A new educational Web site offers expert perspectives, advice and guidance on drugs, biological products and medical devices from the Agency for Healthcare Research and Quality's Centers for Education and Research on Therapeutics (CERTs), a federally sponsored network of more than a dozen leading research centers nationwide. The Clinician-Consumer Health Advisory Information Network (CHAIN) http://www.chainonline.org links clinicians and consumers with therapeutics information to assist in clinical practice and health care decision-making in areas where evidence is undergoing significant and rapid changes.

Click here to access the website.

ACCME makes headlines

From the New York Times article "Medical Journal Changes Its Policy After Criticism by Group":

But the Accreditation Council for Continuing Medical Education, in a letter to a cancer research newsletter, said the journal and its publisher, the Massachusetts Medical Society, had erred in failing to disclose “relevant financial conflicts of interests of the authors.”

The study failed to disclose that Dr. Henschke’s work had been underwritten in part by a $3.6 million grant from the parent company of the Liggett Group, a cigarette maker, something the journal editors said they had been unaware of.

Click here to read. What about content validation?

New California health care-related laws in effect Jan 1, 2009

From the CaliforniaHealthline article (the bolding is mine):

Hospital Infection Control

* SB 1058, also by Alquist, requires hospitals to screen certain high-risk patients for Methicillin-resistant Staphylococcus aureus and report their infection rates to the state. Beginning in 2011, the information will be accessible to the public on a state Web site.
* SB 158 by Sen. Dean Florez (D-Shafter) gives the state additional authority to look into infection outbreaks and complaints about lax infection control practices. The law also requires hospitals to provide education and training opportunities for workers (Rojas, Sacramento Bee, 12/27/08).

End-of-Life Care

* Doctors who treat terminally ill patients will be required to inform them on all end-of-life options, including hospice care and the right to refuse treatment.

Click here to access this article and read about even more health care-related laws.

Doctor appointments on the web

An online service that offers doctor appointments via a webcam will go live in Hawaii on Jan 15. From the New York Times article on this new service:

Patients use the service by logging on to participating health plans’ Web sites. Doctors hold 10-minute appointments, which can be extended for a fee, and can file prescriptions and view patients’ medical histories through the system. American Well is working with HealthVault, Microsoft’s electronic medical records service, and ActiveHealth Management, a subsidiary of Aetna, which scans patients’ medical history for gaps in their previous care and alerts doctors during their American Well appointment.

Click here to access. Disclosure: I have no financial relationship with this new service.

Editorial in the New York Times on the new pharma rules

Check out the New York Times editorial: "No Mugs, but What About Those Fees?" An excerpt:

The updated rules are the industry’s latest attempt to restore public confidence that doctors are prescribing medicines in the patient’s interest. The code still has too many loopholes.

Click here to access. What do y'all think?

Overprescription of fluoroquinolones?

From the Atlanta Journal Constitution article:

In 2007, U.S. patients received more than 40 million prescriptions for fluoroquinolone antibiotics, according to IMS Health, a health care information company. Some studies have found these drugs are often misprescribed, chosen first by doctors when other antibiotics are more appropriate — or when none are needed.

Click here to access the AJC article.