Today's News and Commentary

About healthcare IT

DoD and VA still working out how to create single EHR: You would think the government is "on the same page" with all its information systems. But the Department of Defense and the VA have been using different, non-interoperable health information systems for years. These systems were supposed to be harmonized using the commercial Cerner system; however, they are still not integrated. This story updates this sad saga of government infighting and waste.

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Artificial Intelligence (AI) Health Outcomes Challenge: The Center for Medicare and medicaid Innovation (CMMI) has announced it will issue a “challenge” to develop AI solutions in healthcare. The details are not yet out but for those who want to keep track of this initiative, the website has a link.

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Read a story about the project

IBM Watson teams with Brigham, Vanderbilt on $50M AI research initiative: On a related note, “IBM Watson Health is making $50 million investment in healthcare artificial intelligence with the aim of exploring how the technology can be used to improve patient safety and health equity. The company announced a 10-year investment in collaboration with Brigham and Women’s Hospital…and Vanderbilt University Medical Center to research the use of AI to address major public health issues.”

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2019 HIMSS U.S. Leadership and Workforce Survey: What’s on the minds of information system professionals? This annual survey provides some of the answers. Top on the list are “Cybersecurity, Privacy, and Security” and “Improving Quality Outcomes Through Health Information and Technology.” (See page 8 for the list). Of note is that “Precision Medicine/Genomics” is second from the bottom.

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About the public’s health

Large teams develop and small teams disrupt science and technology: As more large studies are being conducted in science, team characteristics are becoming more important. The authors of this fascinating study “analyse more than 65million papers, patents and software products that span the period 1954–2014, and demonstrate that across this period smaller teams have tended to disrupt science and technology with new ideas and opportunities, whereas larger teams have tended to develop existing ones.” The research gives hope to smaller groups working without the benefit of large organizations.

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Cancer statistics for African Americans, 2019: The American Cancer Society has issued its triennial report on this topic. The good news is that: “Overall cancer death rates declined faster in blacks than whites among both males (2.6% vs 1.6% per year) and females (1.5% vs 1.3% per year), largely driven by greater declines for cancers of the lung, colorectum, and prostate. Consequently, the excess risk of overall cancer death in blacks compared with whites dropped from 47% in 1990 to 19% in 2016 in men and from 19% in 1990 to 13% in 2016 in women. Moreover, the black‐white cancer disparity has been nearly eliminated in men <50 years and women ≥70 years.” Still, much needs to be done to fully remove inequities.

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CVS introduces new concept store with more health care, less retail: Structures of delivery systems are changing. Typical pharmacies have consumer goods in the front and the pharmacy at the back. CVS is going to set up HealthHUBs in stores devoting more space for wellness, including room for yoga exercises. It is an interesting twist in retail models.

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About health insurance

Push for Medicare buy-in picks up with '50 and over' bill: Some House and Senate Democrats have released a proposal to make Medicare available to those over 50 by being able to “buy in". LOTS of details need to be settled, though. Recall that “full” Medicare coverage (comparable to ACA exchange plans) requires Part A (“free” to current beneficiaries); Part B (which has an unlimited 20% coinsurance, income-determined premium, and a relatively small deductible); a supplemental plan to cover what A and B do not; and the Part D drug plan. Parts A, B and D are all subsidized by the federal government. Will individuals have to pay the full cost? Will the benefits be better and cheaper than buying an exchange plan? We need to wait and see.

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About quality

Weighing the Effects of Vertical Integration Versus Market Concentration on Hospital Quality: Research about the effects of industry consolidation in healthcare have been coming out for a number of years. In this latest study, research found: “Vertical integration [like physician practice acquisition] has a limited effect on a small subset of quality measures. Yet increased market concentration [like hospital mergers] is strongly associated with reduced quality across all 10 patient satisfaction measures.” The authors speculate that institutions are looking for increased efficiencies while individuals look for more time spent on caring. With consolidation and lessened competition, hospitals are not competing as much on patient satisfaction.

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