Saturday, April 7, 2018

Naloxone Stops Opioid Overdoses. How Do You Use It? - The New York Times

The United States surgeon general issued a rare national advisory on Thursday urging more Americans to carry naloxone, a drug used to revive people overdosing on opioids.

The last time a surgeon general issued such an urgent warning to the country was in 2005, when Richard H. Carmona advised women not to drink alcohol when pregnant.

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https://www.nytimes.com/2018/04/06/us/naloxone-narcan-opioid-overdose.html

Smartphones becoming primary device for physician and patient communications | Computerworld

Hospitals are making significant investments in smartphone and secure mobile platforms to enable communications between clinicians and between them and patients, according to a new survey.

Nine of 10 healthcare systems plan significant investments in smartphones and secure unified communications over the next 12 to 18 months, according to the results of the survey, performed in person by Spyglass Consulting Group; the survey included more than 100 healthcare professionals working in hospital environments.

Smartphones being provided to hospital workers for communications are a 50/50 mix of purpose-built devices for the healthcare industry and consumer models, such as the Apple iPhone or Android phones, according to Gregg Malkary, managing director of the Spyglass Consulting Group.

"The whole idea of patient-staff communications is a relatively new concept," Malkary said, referring to the 2012 requirements set down by the federal government's "meaningful use" of electronic healthcare records (EHR) standards. "So, when you look at these investments in smartphones and secure mobile communications, they really are driving clinical transformation as they try to address ... requirements.

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https://www.computerworld.com/article/3268055/healthcare-it/smartphones-becoming-primary-device-for-physician-and-patient-communications.html?

Can Doctors Choose Between Saving Lives and Saving a Fortune? - The New York Times

To understand something about the spiraling cost of health care in the United States, we might begin with a typical conundrum: Imagine a 60-something man — a nonsmoker, overweight, with diabetes — who has just survived a heart attack. Perhaps he had an angioplasty, with the placement of a stent, to open his arteries. The doctor's job is to keep the vessels open. She has two choices of medicines to reduce the risk for a second heart attack. There's Plavix, a tried-and-tested blood thinner, that prevents clot formation; the generic version of the drug costs as little as 25 cents a pill. And there's Brilinta, a newer medicine that is also effective in clot prevention; it costs about $6.50 a pill — 25 times as much.

Brilinta is admittedly more effective than Plavix — by all of 2 percentage points. In a yearlong trial of 18,600 patients, 10 percent died from vascular causes, heart attack or stroke on Brilinta, while about 12 percent did on Plavix. Should the doctor prescribe the best possible medicine, assuming that the man has private health insurance that will pay the bulk of the costs? Or should she try to conserve health care costs by prescribing the cheaper medicine that is nearly as good? And consider this: If the cost to you was the same — you have maxed out your co-pay and will end up with the same out-of-pocket expenditure — would you agree to take the slightly inferior drug to benefit the system as a whole? You've just had a heart attack, for God's sake. You pay thousands of dollars for health insurance. Is it fair to ask you to bear the slightly increased risk to enable some broader social good?

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https://www.nytimes.com/2018/04/03/magazine/can-doctors-choose-between-saving-lives-and-saving-a-fortune.html

Sunday, April 1, 2018

Providing hospital-level treatment at home for very sick patients - The Washington Post

Phyllis Petruzzelli spent the week before Christmas struggling to breathe. When she went to the emergency department on Dec. 26, the doctor at Brigham and Women's Faulkner Hospital near her home in Boston said she had pneumonia and needed hospitalization. Then the doctor proposed something that made Petruzzelli nervous. Instead of being admitted to the hospital, she could go back home and let the hospital come to her.

As a "hospital-at-home" patient, Petruzzelli learned, doctors and nurses would come to her home twice a day and perform any needed tests or bloodwork.

A wireless patch would be affixed to her skin to track her vital signs and send a steady stream of data to the hospital. If she had any questions, she could talk via video chat anytime with a nurse or doctor.

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https://www.washingtonpost.com/national/health-science/hospitals-are-germy-noisy-places-some-acutely-ill-patients-are-getting-treated-at-home-instead/2018/03/30/5fcb5006-2155-11e8-badd-7c9f29a55815_story.html?