The state of Maine and a nurse who had treated victims of the Ebola virus in West Africa reached a settlement deal on Monday, allowing her to travel freely in public but requiring her to monitor her health closely and report any symptoms. The settlement, filed in nurse Kaci Hickox's home town of Fort Kent, in Maine's far north, where she returned after being briefly quarantined in New Jersey, keeps in effect through Nov. 10 the terms of an order issued by a Maine judge on Friday. Hickox returned to the United States last month after treating Ebola patients in Sierra Leone and was quarantined in a tent outside a hospital in New Jersey for four days despite showing no symptoms.
Among the many ideas that have been tossed around for decades on how to bring down health care spending, none may be as well known as malpractice reform. Many people believe that it's the key to removing waste from the health care system and making the practice of medicine better. But a growing body of evidence shows that belief is most likely mistaken. The rationale for malpractice reform as cost control is somewhat complex. It assumes the existence of "defensive medicine," meaning that doctors order additional tests, or perform extra procedures or recommend more visits, all because they think those actions will protect them from being sued.
Although preventing infections should be at the top of a hospital's to-do list, a rapidly approaching penalty will soon give them a financial incentive to do so. Starting in 2015, hospitals will be ranked based on several different criteria. Those that land in the lower quartile of care could face a penalty of 1 percent reduction of reimbursement from the Centers for Medicare and Medicaid Services through the inpatient prospective payment system. The intent is to force hospitals to improve their care systems, and while it may have initial financial burdens on hospitals that fall in the penalty group, the long-term benefits are obvious.
To describe the current state of the healthcare CIO role, Jim Turnbull uses the military-inspired acronym VUCA: Volatility, uncertainty, complexity and ambiguity. Turnbull, CIO for University of Utah Health Care, says it's an "intense" time for hospital IT departments. As a result of the federal meaningful use incentive program, most have been busy with electronic health record (EHR) implementation. Most have hired outside help for this purpose as well. IT teams have had their heads down for the last three years, he says. "When they lifted up their heads, they realized the world had changed dramatically."
If former Health and Human Services Secretary Kathleen Sebelius was the poster child for the pitfalls of health care reform, then Patrick Conway might be the hidden face of the law's promises. A pediatrician and top administrator at Cincinnati Children's Hospital Medical Center until 2011, Conway is now leading the federal government's efforts to change the health care system – from one that rewards quantity to one that rewards quality. Right now, health care providers are generally paid – whether by an insurance company or the government's Medicare or Medicaid programs – for each procedure, each test and each patient appointment they conduct.
Researchers have developed a novel approach to the treatment of severe bacterial infections without the use of antibiotics. They hope it could someday offer a solution to the growing problem of antibiotic resistance, which is making some infections harder and harder to treat. However, the technique has only been tested in mice so far. In a new study, published Sunday in Nature Biotechnology, scientists from University of Bern in Switzerland engineered artificial nanoparticles made of lipids, called "liposomes," that are a lot like the membrane of host cells. The liposomes act as decoys for bacterial toxins, sequestering and neutralizing them. Bacteria without those toxins are defenseless and can be eliminated by the person's immune system.