Posts Tagged "health care costs"

Shake It Up!

Disruptive Health Care Technology through Strategic Academic Partnerships

In 1982, the rock band “The Cars” had a #2 hit with “Shake It Up,” a quintessential pop tune about letting go of your conventional self and dancing all night. To some, 1982 may seem like a long time ago, but defying convention remains a pop-and-rock-music staple (think Taylor Swift’s “Shake it Off”). More recently, “shaking it up” has made its way into the formerly staid world of health care under the guise of “disruptive technology” (Carnegie Mellon University, 2015).

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The Relationship: Medicine Is Both Art and Science

The Question: Questioning the value of the annual physical exam for “healthy,” or asymptomatic, adults is nothing new, but the issue assumes greater significance in the current era of limited resources and the growing status of evidence-based care. Last month, The New England Journal of Medicine’s “Perspective” was devoted to the pros and cons of eliminating this time-honored, but poorly evidenced, practice. Before discussing these pieces, it seems only fair to tip my hand and admit I am (empirically, subjectively, limbicly) in favor of the annual check in with one’s PCP – whether one “needs” it, or not. The authors of both articles agree that the lack of standardization in the annual exam makes the epidemiological research weaker, i.e., lack…

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If the Triple Aim Lost a Leg, Would It Still Stand?

The Triple Aim is an oft-cited health care mantra frequently invoked by health care’s informed clergy. A recent expensive demonstration project has produced outcomes that suggest one of its legs may be missing in action. It’s not the hoped-for result, but does it necessarily ring the death knell for the Triple Aim? Don Berwick and the Institute for Healthcare Improvement (IHI) coined the term in 2008 to serve as a pithy aspirational antidote addressing upward spiraling health costs and poor outcomes in the United States. The US ranks first in the spend category—total health care costs as a percent of GDP (17.1 percent). This statistic might not be an issue if our health outcomes matched the ranking. Unfortunately, we also…

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Overkill: Unnecessary Care Is Low-Value Care

Solution lies in adhering to evidence that shows what works. Last month, Dr. Atul Gawande published a thought-provoking essay in The New Yorker about the millions of tests, drugs and surgeries that American people undergo every year, which won’t make them better, may cause harm, and costs billions. Sadly, this avalanche of unnecessary care is not confined solely to physical health care. Behavioral health and substance use disorder systems are also guilty of deploying what researchers call “low-value” care. This message is jarring, and the data indicating system failure is even more so. For example, only 25 percent of the 30 million Americans prescribed an antidepressant in a primary care setting every year show substantial clinical improvement. Given that common…

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