Hospital-at-home programs refashion care for chronically ill patients with acute medical issues, testing traditional notions of how to treat people who become seriously ill. Only a handful of the initiatives exist. The concept is getting more attention with increased pressure from the national health overhaul to improve the quality of medical care and lower costs. Hospital-at-home programs do both, according to research led by the concept's pioneer, Bruce Leff, director of geriatric health services research at Johns Hopkins School of Medicine in Baltimore.
Electronic health records have been held up as a way to improve medical care, but a new study suggests they are not necessarily making a difference in diabetes treatment. The study, of 42 physician practices in two U.S. states, found offices that used electronic records actually gave lower-quality diabetes care than those that stuck with old-fashioned paper records. On the bright side, diabetes management actually improved across all the practices over the course of the study period. But offices using electronic records lagged.
Designing an all-digital hospital needs to involve more than just selecting the right technology, said the IT lead for a new, paperless academic medical center being planned in Denmark. There need to be clear clinical goals instead of "technology for technology's sake," according to Jonas Hedegaard Knudsen, chief IT consultant for the new hospital in the works at the University of Southern Denmark in Odense. The new hospital, to cover about 2.3 million square feet of floor space, will be 20% to 30% smaller than the building it will replace, according to Knudsen, so design and workflows will both have to be more efficient.
Gov. Rick Scott's administration was back in a familiar place Tuesday, the courtroom, where two unions are challenging a plan to save money by privatizing healthcare to the state's 100,000 inmates. The state has already hired two out-of-state firms to do the work at a minimum cost savings of 7 percent a year. But the Florida Nurses Association and American Federation of State, County and Municipal Employees (AFSCME) say the privatization plan is unconstitutional and want Circuit Judge Kevin Carroll to block its implementation. The 2011 Legislature mandated the privatization through the use of budget language known as proviso.
The memorial service for Michael Southerland recently drew more than 200 people to the Unitarian Society in Northampton, Mass. Friends, neighbors and co-workers offered funny and moving stories. They sang; they cried. They hugged his wife and daughters. And they circulated petitions to put a "death with dignity" law on the Massachusetts ballot in November. The forms awaited signatures at the back of the hall, next to the guest book. November in Massachusetts would be plenty interesting this year. The Bay State will attract even greater attention, though, because this question is quite likely to be on the ballot.
The sleek, four-armed "da Vinci" robot has been called a breakthrough technology for procedures like prostate surgery. That's just the kind of impressive-sounding innovation that critics of the healthcare reform act say will be stifled by the new law, with its emphasis on cost control and the comparative effectiveness of new pills and devices. The Affordable Care Act will not reward this kind of innovation. The act will stimulate a panoply of true medical innovations. These may not be flashy; they might not even be visible to patients. But they will improve healthcare and lower costs.