Diagnostic errors in pediatrics

From the abstract of the Pediatrics journal article "Errors of Diagnosis in Pediatric Practice: A Multisite Survey":

The overall response rate was 53% (N = 726). More than one-half (54%) of respondents reported that RESULTS The overall response rate was 53% (N = 726). More than one-half (54%) of respondents reported that they made a diagnostic error at least once or twice per month; this frequency was markedly higher (77%) among trainees. Almost one-half (45%) of respondents reported diagnostic errors that harmed patients at least once or twice per year. Failure to gather information through history, physical examination, or chart review was the most-commonly reported process breakdown, whereas inadequate care coordination and teamwork was the most-commonly reported system factor. Viral illnesses being diagnosed as bacterial illnesses was the most-commonly reported diagnostic error, followed by misdiagnosis of medication side effects, psychiatric disorders, and appendicitis. Physicians ranked access to electronic health records and close follow-up of patients as strategies most likely to be effective in preventing diagnostic errors.

CONCLUSION Pediatricians reported making diagnostic errors relatively frequently, and patient harm from these errors was not uncommon.

Click here to access the abstract. 

Big changes in store for Britain's health care system

From the New York Times article:

Perhaps the only consistent thing about Britain's socialized health care system is that it is in a perpetual state of flux, its structure constantly changing as governments search for the elusive formula that will deliver the best care for the cheapest price while costs and demand escalate.

Even as the new coalition government said it would make enormous cuts in the public sector, it initially promised to leave health care alone. But in one of its most surprising moves so far, it has done the opposite, proposing what would be the most radical reorganization of the National HealthService, as the system is called, since its inception in 1948. 

Click here to access the NYT article.

Technology and docs

From the Physicians Consulting Network's press release:

Compared to two years ago, primary care physicians (PCPs) and specialist doctors alike have dramatically increased their use of electronic health records (EHRs), and they are expecting to spend less time with sales reps in the coming six months.

The study of nearly 11,000 health care professionals also shows that more than half of PCPs and specialists already have smartphones, and that many are using them for email, shopping, e-detailing – and survey taking.

Click here to access.  Hat tip to Pharmalot.

Safety and clinical research...

From the LA Times article:

The suspension of some research at a prominent Columbia University brain-imaging lab because of sloppy practices could have repercussions beyond that laboratory, potentially affecting brain-imaging studies nationwide and raising questions about the safety of participants, research experts said Saturday.

Click here to access the article. 

Fourfold increase in abuse of prescription narcotics in last decade

From the SAMHSA news release:

“The non-medical use of prescription pain-relievers is now the second most prevalent form of illicit drug use in the nation, and its tragic consequences are seen in substance abuse treatment centers and hospital emergency departments throughout our nation” said SAMHSA Administrator Pamela S. Hyde, J.D. “This public health threat demands that we follow the President’s National Drug Control Strategy’s call for an all out effort to raise awareness of this risk and the critical importance of properly using, storing, and disposing of these powerful drugs.”

Click here to accessthe SAMHSA news release.  Click here to access the full report.

Relaxed rules on EHR

From the New York Times article:

The federal government issued new rules Tuesday that will reward doctors and hospitals for the “meaningful use” of electronic health records, a top goal of President Obama.

The rules significantly scale back proposed requirements that the health care industry had denounced as unrealistic.
...
Standards in the new rules are less demanding and more flexible. Doctors will have to meet 15 specific requirements, plus 5 chosen from a list of 10 objectives. Hospitals will have to meet 14 requirements, plus 5 chosen from a menu of 10 goals.
...
To meet the new standards, doctors will have to transmit 40 percent of electronically. Under the proposal, 75 percent of prescriptions had to be sent electronically. prescriptions

 Click here to access the NYT article.

June/July issue of The ACCME Report now available

The report includes a link to the 2009 Annual Report as well as a link to complete a survey.  Click here to access.

Mass. House reverses gift ban legislation

From the Arlington Advocate article:

Reversing course on a new law aimed at diminishing the influence ondoctors of pharmaceutical and medical device companies, the House on Wednesday voted to strike the so-called gift ban law, which critics say has hurt commerce in the medical and restaurant industries.

It will be interesting to see what happens during the reconciliation process that needs to take place in committee!  Click here to access this article. 

Berwick to head CMS

From the Baltimore Sun article:

President Barack Obama bypassed the Senate Wednesday and appointed Dr. Donald Berwick, a Harvard professor and patient care specialist, to run Medicare and Medicaid.
...
Medicare has been without an administrator since 2006, and the White House says the need to fill the post is critical because of its role in implementing the new health care law. Medicare is to be a key testing ground for numerous aspects of the new law, from developing new medical techniques to trying out new payment systems, and the White House says a permanent leader is key with deadlines approaching.

Click here to access the Sun article. 

From the Washington Post article:

Berwick has praised Britain's National Health Service, and he told an interviewer last year: "The decision is not whether or not we will ration care -- the decision is whether we will ration with our eyes open. And right now, we are doing it blindly." He has also said that "any health-care funding plan that is just, equitable, civilized and humane must -- must -- redistribute wealth from the richer among us to the poorest and less fortunate.''

Click here to access the WP article.

Medical garbage or waste or both?

From the New York Times article:

The health care industry has a garbage problem.

It’s not just that hospitals, doctors’ offices, clinics and other health facilities generate several billion pounds of garbage each year: buried in that mountain of trash are untold numbers of unused disposable medical devices as well as used but recyclable supplies and equipment, from excess syringes and gauze to surgical instruments.

The problem, fueled by a shift toward the use of disposables that made it simple to keep treatment practices sterile, has been an open secret for years, but getting the health care industry to change its habits has not been easy.

Click here to access the NYT article.

ICMJE posts updated disclosure form

Click here to access.

Healthcare.gov now live

Click here to check it out.

AAMC report "In the Interest of Patients...."

From the AAMC press release:

A new report by the AAMC (Association of American Medical Colleges) urges U.S. teaching hospitals to establish policies that manage financial relationships between physicians and industry so that they do not influence patient care. "In the Interest of Patients: Recommendations for Physician Financial Relationships and Clinical Decision Making" provides guidance on how academic medical centers can identify, evaluate, and disclose conflicts of interest in clinical care.