Two April events: #Crowd-sourced #health care, #science and the lay #press

Your scribe here, Tinker Ready, appears at the second event on science and the media.

Deleterious Me: Whole Genome Sequencing, 23andMe, and the Crowd-Sourced Health Care Revolution

Anne Wojcicki

With panel discussion by Archon Fung, Jeremy Greene, Sanford Kwinter, and Jonathan Zittrain. Moderated by Sheila Jasanoff.

April 17, 2012, 5:00pm–7:00pm

Emerson Hall, Room 105

Co-sponsored by the Harvard University Center for the Environment, the Harvard School of Engineering and Applied Sciences, and the Harvard University Graduate School of Design.

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Standing Up for Science Media Workshop

Part of the Cambridge Science Festival

Broad Institute | 7 Cambridge Center

Cambridge, MA 02142, United States

Tuesday April 24, 2012

10.00 am Registration

Map of the location: http://g.co/maps/fn2uh

10.30 – 12.00 pm Science and the media

What happens when research announcements go wrong, statistics are

manipulated, risk factors are distorted, or the discussions become polarised?

Panellists: Dr Shawn Douglas, Fellow at the Wyss Institute for Biologically

Inspired Engineering; Professor Lorna Gibson, Professor of Materials Science

and Engineering, MIT; Dr Willy Lensch, Principal Faculty and Faculty Director of

Education, Harvard Stem Cell Institute.

12.00 – 1.10 pm Group work and lunch. Lunch will be provided.

1.10 – 2.30 pm What are journalists looking for?

How do journalists approach stories, balance the need for news and

entertainment with reporting science, and deal with accusations of polarising

debates and misrepresenting facts?

Panellists: Gino del Guercio, documentary filmmaker, Adjunct Professor, Boston

University’s College of Communication; Tinker Ready, freelance health and

science writer, Boston Health News & Nature Boston; Stephen Smith, City

Editor, Boston Globe.

2.30 – 3.10 pm Group work

3.10 – 4.15 pm Standing up for science – the nuts and bolts

Practical guidance for early career researchers to get their voices heard in

debates about science, how to respond to bad science when you see it, and top

tips for if you come face-to-face with a journalist.

Panellists: B. D. Colen, Sr. Communications Officer for University Science,

Harvard University; Leonor Sierra, Science and Policy Manager, Sense About

Science; Luke Stoeckel, Director of Clinical Neuroscience and Staff Training,

MGH-Harvard Center for Addiction Medicine, & VoYS US Representative.

4.15pm Close and informal feedback

End of Day Please join us for a drink

Mass #teens and the morning after pill: More trouble getting #birth control #planb

Teens in Print, working with The New England Center for Investigative Reporting (necir-bu.org) produced a  piece inconsistancies in access to the morning after pill.

Worried that she might be at risk of being pregnant, a fifteen-year-old Boston Latin Academy student said she called her local Walgreens in Hyde Park and asked how old she had to be to buy the popular morning-after pill known as Plan B. The girl, who did not want to be identified, said a pharmacy employee told her that she had to be 18 or older with a valid ID to purchase Plan B. While she was eventually able to obtain the drug through a friend’s older sister, the girl said she was later surprised to learn that the minimum age to purchase the Plan B pill is actually 17 years old.

The girl shouldn’t have been taken aback. Because more than 24 months later, that Hyde Park Walgreens on Truman Highway was still dispensing misinformation. And a joint investigation by Teens in Print and the New England Center for Investigative Reporting at Boston University has found that this is not an isolated case. Teen reporters presenting themselves as consumers visited or called 24 pharmacies across the city, including that Walgreens, and discovered that personnel at 71 percent of them did not respond with the correct age or ID requirements needed to buy the emergency contraceptive pill.

“This is very serious stuff,” said Enki Gjeci, 18, from BLA. “If you are selling Plan B, you have to know the law.”

Harvard Meeting: Detecting disease digitally #health #map #gps #ddd

Keynote from last week’s Digital Disease Detection conference at Harvard. Link for more video.

Nicholas A. Christakis, MD, PhD, MPH Harvard Professor of Medicine, Health Care Policy, and Sociology

Nicholas A. Christakis, MD, PhD, MPH, is a social scientist and physician who conducts research on social factors that affect health, health care, and longevity. He directs the Human Nature Lab at Harvard University.  Along with his long-time collaborator, James H. Fowler, Dr. Christakis had authored a book on social networks, published in 2009, Connected: The Surprising Power of Our Social Networks and How They Shape Our Lives.

Health Wonk Review: Wearing the Green for the St. Patrick’s Day Edition

Here in Boston, researchers have looked into that most pressing of St. Patrick’s Day health questions: Is Guinness really good for you? Red wine gets all the press, but Tufts researchers found a positive association between beer and bone density.

For this edition of the Health Wonk Review, we take a a look at the Irish Times and find that even with a national health plan, Ireland has to deal with barriers to care. One story details slow progress in the establishment of promised primary care centers, and another story, asks “Is the EU good for your health?”

So, while we refight the battle over birth control, the Irish health ministry – of the largely Catholic country — is releasing a “sexual health” app.

Back here in the new world, the great grandchildren of Irish immigrants celebrate their heritage as Linda Leu at the Health Access Blog writes about a report that “highlights the need for cultural competency and language access, to welcome all ethnicities from California (and America’s) diverse communtiies….The Importance of Equity in the Bridge to Reform: As St. Patrick’s Day celebrates Irish ethnic pride, we need to take note of the full diversity of our states and nation. As we get ready for 2014, remember the communities that will be newly served may not look (or speak) the same as those that the current system serves.” 

For the once-a-year step dancers,Gary Schwitzer at Health News Review answers questions about outcomes data on knee replacement surgery. Also see posts on the JGIM paper on  data on  shared decision-making in prostate cancer surgery & coronary stents decisions   and an online “Daily Deal” coupon for preventive MRI scan – disease-mongering du jour

Boston’s own David Williams notes: “Profits are up at Massachusetts health plans –should you be upset? On his Health Business Blog, he writes: The Globe reports higher profits and CEO compensation at Massachusetts health plans. But profit margins are low and if anything the CEOs are underpaid.”

More of the best of recent health policy posts

At The Hospitalist Leader, Brad Flansbaum examines physician pay,“fairness, and how it relates to the reinvigoration of primary care. Specialty physicians take note.”

Another post on health care providers — and their support teams – notes: “There’s been much discussion of the potential impact of health reform, aka Obamacare, on employment”  Joseph Paduda at ManagedCareMatters.com writes: “Most has referenced employers cutting jobs to avoid the mandate or save dollars for premiums.  What hasn’t received much attention are the new jobs – mostly high-paying ones- that will be created as more Americans are insured and seek coverage and care.”

Julie Ferguson of Workers’ Comp Insider asks “If you had to guess what workplace experienced most assaults by customers/patrons what would you guess? If you guessed healthcare, you would be right.” She informs us that 61% of all workplace assaults are committed by healthcare patients, according to a recent report issued by NCCI.

Two posts came in on shady practices.

Colorado Health Insurance Insider offers: Colorado AG Files Lawsuit Against Discount and Mini-Med Health Plan:  ”It’s a pretty typical website for that sort of product, with lots of great-sounding claims and sample cases where members have supposedly saved thousands of dollars.  But they also have a link for people who want to “become a reseller”.  And their process of getting recruits enrolled to sell the product is what has come under the watchful eye of the Colorado AG.”

 Calling it “The latest example of misbehavior by a large health care corporation,”  Roy M. Poses at Health Care Renewal writes : Gentiva’s Odyssey Healthcare Settles Again, Signs Yet Another Corporate Integrity Agreement and gets “little more than a financial wrist slap.  The case was about allegations that a for-profit hospice enrolled patients who did not meet the regulations for federal reimbursement for hospice care.  In particular, they were alleged to be patients who really did not seem to have extremely limited life expectancies.  It is true that enrolling such patients lead the government to pay more for their care than might otherwise be the case.  But the real problem is that patients may have been denied treatments that could have improved, or even lengthened their lives. 

Two on workplace wellness:

“Wellness Program Implementation at WCS Looks a Lot Like Dating” says Kat Haselkorn Corporate Wellness Insights. This post details the similarities between customer satisfaction and romantic relationships. Although wellness program implementation and dating do not seem to have much in common, we have found that the process of making a client happy mirrors the act of keeping a romantic prospect satisfied. When it comes to setting up a wellness program, we do whatever it takes!

Henry Stern, LUTCF,  at the CBC InsureBlog writes about “Health vs Common $ense, challenging “the conventional wisdom that workplace health promotion programs work.”

And two on HIT:

“Competition today in healthcare encourages care providers to hoard patient data.”  says Vince Kuraitis of the  e-CareManagement blog in a post called “Stage 2 MU Rules : The proposed Stage 2 Meaningful Use rules support moving competition in healthcare to the right bases — sharing and adding value to patient health record data.

Health Affairs offers a post by Danny McCormick, of Harvard Medical School and the Cambridge Heath Alliance, and coauthors David Bor, Stephanie Woolhandler, and David Himmelstein. The title of the post is  “The Effect Of Physicians’ Electronic Access To Tests: A Response To Farzad Mostashari”

The four authors of the post are also the authors of an article in the March issue of Health Affairs. The article reported that electronic access to computerized imaging results (either the report or the actual image) by physicians was associated with a 40% -70% increase in imaging tests, including sharp increases in expensive tests like MRIs and CT scans; the findings for blood tests were similar. The article prompted a critical blog post by national health IT coordinator Farzad Mostashari.

Jason Shafrin writes: “Americans are a litigious culture.  The malpractice claims that make it to court, however, are not many as you may think.The Healthcare Economist explains why.

Finally, how does health care In the U.S. compare to other countries?  On the Disease Management Care Blog  Dr. Jaan Sidorov tests our knowledge of and finds: We’re not so bad after all!

So, our days of drinking black — or green  — beer are over. But, on Saturday I’ll boil up some cabbage and — sorry Walter Willett – and a hunk of  corned beef in honor of my Irish nanny and the Readys and Gradys  and Murphys who left their green shores and made their way across the sea to settle in Boston and New York.  Happy St. Patrick’s Day from BHN.

 

Overstated news promo of the week: Killer Hamburger!

While watching the usually solid New England Cable News last night, we took note of the promos for the Harvard School of Public Health study on the correlation between red meat consumption: “A serious new warning about the possible dangers of red meat.”

The report itself is a little more understated, but still…Walter Willett had been cranking out studies for year that show the less red meat the better.

Click here for the NECN  story.

Or better yet, click here for the much more reasonable Globe story.

Americans’ high consumption of red meat has long been linked to a host of health problems, including heart disease, diabetes, and cancer, and new research from the Harvard School of Public Health suggests that it may shorten a person’s lifespan and that cutting back on red meat by a serving a day could lower the risk of dying.

Talk on “The Future of National Health Reform” Monday night @ East Boston Library

The Future of National Health Reform” – John McDonough

When Monday, March 12, 2012, 6 – 7pm Where Boston Public Library, East Boston Branch 276 Meridian Street East Boston, MA 02128 Event type Harvard 375 Events Organization/Sponsor Harvard University and Boston Public Library Ticket Info Free 375 Celebration Event Type Campus Email community@harvard.edu Phone 617-495-4955 Note John McDonough will provide a presentation entitled “The Future of National Health Reform.” John McDonough is the Professor of the Practice of Public Health and Director of the Center for Public Health Leadership.

Labels don’t list questionable ingredients in conventional and alternative soaps, diapers and make-up

Nature Boston took a walk down the aisle of Whole Foods and  Rite Aid with Ruth Rudell to talk about the new study from Silent Spring Institute

From the press release:

Investigators tested products for the presence of hormone disruptors that raise concerns for breast cancer, growth, and reproduction, as well as chemicals associated with asthma. They found the highest concentrations in vinyl products, such as shower curtains and pillow protectors, and fragranced products, such as dryer sheets, and sunscreens. Of the alternative sunscreens tested, the product with the highest number of target chemicals was actually one marketed for babies and children.

Silent Spring Institute’s earlier research, as well as the Centers for Disease Control’s biomonitoring studies, have found many of the study chemicals in people’s homes and bodies.  Now this study adds information about where the exposures are coming from in everyday products.   

Rudel pointed out that the exact impact of these chemical on human health remains unclear. Lab and animals test have linked endocrine disruptors to breast cancer, but critics say there is no proof the same thing happen in humans. They argue that the the risks of the chemicals – which hit the mainstream  with the 1996 publication of the book Our Stolen Future – have been overstated.

Here’s Rudel’s response:

Most of these endocrine disruptors are very, very difficult to study in humans,” Rudel said.  “There are so many different chemicals, we don’t know how to measure all the exposures, we don’t’ know how to add them up or which ones are acting together.”

It may be years before the full impact of hormone disruptors is well understood. In the meantime, Rudel thinks that some people may not want to take their chances. There are ways to avoid them – by using soap and water instead of chemical cleaners. And in some cases, like triclosan, they don’t offer much of a benefit, so it won’t be much of a loss.

If you want to getyon that plan, SSI has some suggestions about how to avoid these substances.

More at Nature Boston

Globe: Partners docs rewarded for taking on new, complex patients

Liz Kolawczyk does a good job talking to a lot of docs for this story:

The Harvard-affiliated hospitals are tying about 10 percent of doctors’ salaries this year to the size of their practice and the complexity of their patients’ illnesses.That means the hospitals’ 360 employed primary-care physicians can increase their pay, now roughly $200,000 a year for those who work full time, if they see more patients than the average, or if they have many patients with multiple medical problems. Their pay can fall if they take care of fewer people.

The Partners rep argues that the hospitals have “a social obligation to provide access to care.’’  The story includes a  more believable explanation for the change: payers are moving toward global payments driven by volume and quality. Doctors will be rewarded for keeping patients healthy, rather than for performing a lot of procedures. The quality measures are supposed to keep the new approach from turning into a 1990s-style managed care system that encouraged less care, not better care.

But, the approach sounds a little too HMO-like for some folks.

David Cutler, a health care economics professor at Harvard University, believes the changes are good for patients, as long as the hospitals follow through on their promise to provide qualified nurses and assistants to help doctors and the doctors are willing to delegate work to them.

“What people are afraid of is a return to the managed-care era where the doctor has to see patients every seven minutes and gets frustrated,’’ he said.

So, how to get at quality? Two studies in Health Affairs suggest that the path to better care remains elusive.

One found  “Medicare’s seven-year public reporting initiative for hospitals, Hospital Compare, had no impact on reducing death rates for two key health conditions and just a modest effect on a third. That’s the conclusion of a just-released study that raises questions about the initiative’s ability to improve the quality of care provided by the nation’s hospitals”

Another, done at Harvard, found that docs using electronic health records actually ordered more tests, not fewer, than those using paper records. Kaiser Health Newsreports

Researchers found that office-based physicians were actually 40 to 70 percent more likely to order an imaging test if they had access to computerized imaging results. The study is based on data from the 2008 National Ambulatory Medical Care Survey of 28,741 patient visits to 1,187 physicians.

EHRs may be yet another example of a health care solution that looks great on paper, but “when you actually try to implement it in real world settings with real patients” it may have some “unintended consequences,” says lead author Danny McCormick, a primary care physician and assistant professor of medicine at Harvard Medical School.

 

Never going to a Boston Emergency Department again #ED

Between an elderly father and a bum gall bladder, I got to know the Boston ED’s pretty well a few years back. The wait was at least an hour or two, usually much longer.

So, I note that the Cambridge Health Alliance has taken to posting wait times. Of one minute.

Granted, if it’s something they can’t handle, you’re shipped off to Boston. But, FYI.

Emergency Wait Times *

• 2 min

          Cambridge Hospital Campus     

• 2 min

  Somerville Hospital Campus

• 1 min

          Whidden Hospital Campus     

* Average wait time during four (4) hours as of 6:55:02 PM.

Video from Harvard forum on #Alzheimers #dementia

Also check out the science week in review over at Nature Boston and this week’s Health Wonk Review, a digest of health policy posts.

Alzheimer’s: What Is the Value of Knowing Early: A View Across Five Countries