Health Updates 11 June 2012

  • Can patient photos help cut medical errors?: “Putting children’s photos in their electronic hospital charts could help reduce one types of medical error, a study published Monday suggests.  Policymakers have been pushing hospitals and doctors to replace their old-fashioned paper records with electronic ones.  The goal is to improve the quality of people’s medical care — which includes preventing errors.  But e-records have not eliminated human error.  And in some cases, hospital patients may get a test or treatment intended for someone else because the doctor mistakenly put an order in the wrong electronic chart.  In 2009, a quality-improvement  program at Children’s Hospital Colorado found that such misplaced orders were the second-most common reason that patients received care not meant for them.  ‘We were surprised by that,’ said Dr. Daniel Human, the chief quality officer at the Aurora, Colorado, hospital and lead researcher on the new study.  Doctors may put an order in the wrong record if, for instance, they have multiple records on their screen  at a time.  ‘You can think you’re in one person’s chart, but really be in someone else’s,’ Hyman explained.  To help cut those types of errors, the hospital changed its computer system so that each order for a test or treatment triggered an ‘order verification screen,’ which included a photo of the child in question.  And the move seems to have paid off….Of course, misplaced orders are only one source of medical error.”  Patient privacy concerns are a real issue as well, and many parents do not want their children photographed.  Dr. Hyman noted again that patient identification errors are a significant risk.  He added that if your child is in the hospital, you should make sure you understand the general treatment plan.  “Then if, for example, staff comes to give your child medication that you were not aware he should be getting, you can speak up.” (Reuters Health)
  • Head injury‘s location key to concussion effects: “Abnormalities that occur in various areas of the brain and change over time may explain why concussions affect people differently, according to a new study.  Patients can have widely varying responses to concussions.  Most recover with no lasting problems, but as many as 30 percent have permanent effects, such as a personality change.  Previous research has shown there are differences between the brains of people who have suffered concussions and people who haven’t, but it hadn’t been determined if there were differences between the brains of concussion patients.  ‘Most researchers have assumed that all people with concussions have abnormalities in the same brain region,’ study lead author Dr. Michael Lipton…at Albert Einstein College of Medicine in New York City, said in a college news release.  ‘But that doesn’t make sense, since it is more likely that different areas would be affected in each person because of differences in anatomy, vulnerability to injury and mechanism of injury,’ said Lipyon….Using a special type of software to analyze the brain images, the researchers found that concussion patients have unique patterns of abnormalities in different brain regions and that the abnormalities change over time. It may be possible to use this new approach to assess concussion patients, predict which head injuries are likely to have long-term neurological effects and evaluate the effectiveness of treatments, Lipton said.” (HealthDay)
  • Sept. 11 health fund given clearance to cover cancer: “A federal health official’s ruling has cleared the way for 50 different types of cancer to be added to the list of sicknesses covered by a $4.3 billion fund set up to compensate and treat people exposed to toxic smoke, dust and fumes in the months after the Sept. 11, 2001, terrorist attacks.  The decisions, released on Friday, came as a vindication for hundreds and perhaps thousands of people who have claimed – often in the face of resistance from public health officials – that their cancers were caused by their exposure to the dust cloud and debris thrown up by the attacks.  It will allow not only rescue workers but also volunteers, residents, schoolchildren and passers-by to apply for compensation and treatment for cancers developed in the aftermath of the attacks.  The cancers will not be officially added to the list of covered illnesses until after a period of public comment and review that could last several months.  The decision, by Dr. John Howard, director of the National Institute for Occupational Safety and Health, comes despite a current absence of evidence linking the attack to cancer, causing some skepticism among epidemiologists.  It also reduces the amount of money for people suffering from ailments more conclusively linked to the Sept. 11 attacks, namely lung and other respiratory sicknesses.  And it poses a number of logistical challenges, since it will be difficult if not impossible to separate people who developed cancer as a result of ground zero from those who would have gotten the disease anyway, and because cancer diagnoses are likely to be made years after the deadline for applying for compensation passes in 2016.” (NY Times)
  • US lags in bettering value of healthcare: “The US faces major obstacles in the effort to document variations in health outcomes and improve clinical practice through value-based healthcare, according to a report from industry consultants.  While the US health system has the highest per capita cost of the 12 nations studied — spending 17.6 % of its gross domestic product on healthcare — it ranked at the bottom in terms of readiness to implement a value-based care system.  The fragmented nature of the healthcare system has severely limited the collection and use of national health-outcome data.   In a value-based health system, variations in health outcomes are documented, leading to potential changes in clinical practice.  ‘Making the data available allows clinicians to identify best practices and helps steer resources toward the clinical centers and specific clinical interventions that achieve the best results,’ according to a statement from the Boston Consulting Group that issued the report.”  National registries are an important catalyst to improve health outcomes over time, and “by identifying variations in outcomes within the same population, registries make it possible to benchmark and assess comparative performance…’.  There are major gaps in this nation’s registries, especially when compared with other western countries; the government could do much more to support information-gathering and could offer incentives to make collecting and sharing health outcome data more attractive. (Emily P. Walker, MedPage Today)

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