Today's News and Commentary

About healthcare IT

Two of the country's largest HIEs team up to share data on Midwest patients: “Two of the largest health information exchanges in the country, Missouri Health Connection and the Kansas Health Information Network, have signed an agreement to enable providers to have access to 20 million patients' health records in Kansas, Missouri and some areas of surrounding Midwest states.” While this action is laudable the question remains why there need to be so many local efforts to integrate data bases when the federal government has been trying to launch The Trusted Exchange Framework and Common Agreement (TEFCA)- now in its second draft.

About health insurance

Development and Testing of Improved Models to Predict Payment Using Centers for Medicare & Medicaid Services Claims Data: “In this comparative effectiveness research study of risk models on 1 667 983 patients with 1 943 049 Medicare fee-for-service hospitalizations, use of present on admission codes and single diagnosis codes and separation of index admission codes from codes in the previous year improved models predicting payment that were compared with models based on Centers for Medicare & Medicaid Services grouped codes.” The study was done on data collected from July 1, 2013, through September 30, 2015, when ICD 9 codes were used. Such methodology would now need to be adapted using ICD 10 codes.

The ‘follow-up appointment’: This Washington Post article looks into medical debt for those living in rural areas. For example: “So far this year, Poplar Bluff Regional Medical Center has filed more than 1,100 lawsuits for unpaid bills in a rural corner of Southeast Missouri, where emergency medical care has become a standoff between hospitals and patients who are both going broke.”

Health Insurance Coverage Declined for Nonelderly Americans Between 2016 and 2017, Primarily in States That Did Not Expand Medicaid: “The uninsured rate climbed from 10.0 percent in 2016 to 10.2 percent in 2017, the first increase since 2013, after significant declines driven by the Affordable Care Act (ACA). This decline resulted in 700,000 more uninsured people in 2017 than in 2016.

The uninsured rate held stable in Medicaid expansion states at 7.6 percent, but increased from 13.7 percent to 14.3 percent in states that did not expand Medicaid.”

About public health

CDC, states investigating severe pulmonary disease among people who use e-cigarettes: Once again, vaping is not safe! According to the CDC: “94 possible cases of severe lung illness associated with vaping were reported in 14 states from June 28, 2019, to August 15, 2019.” What type of social media campaign will reduce vaping? Hint: scare tactics do not work.

Fast-Food Joints in the Neighborhood? Heart Attack Rates Likely to Go Up: This Australian study found that for “every additional fast-food outlet in a neighborhood, there were four additional heart attacks per 100,000 people each year…” Is there another role for zoning laws?

Nearly Half of U.S. Patients Keep Vital Secrets From Their Doctors: “Nearly half of U.S. patients don't tell their physicians about potentially life-threatening risks such as domestic violence, sexual assault, depression or thoughts of suicide, a new study finds.” How can we build trust between patients and their physicians? Perhaps we need more attention to strengthening relationships with a regular primary care physician instead of our current fragmented-care system.

Changes in Age Distribution of Obesity-Associated Cancers: Another reason to control the obesity epidemic in the young. These researchers found “there has been a shift of obesity-associated cancer burden to younger age groups and that interventions to reduce obesity and to implement individualized screening programs are needed.”

Impact of Carers’ Smoking Status on Childhood Obesity in the Growing up in Ireland Cohort Study: On a related theme…These findings of this Irish study “emphasize the health burden of childhood obesity that may be attributable to maternal smoking postnatally and through early childhood…”