Publicity surrounding the implementation of patient decision support interventions (DESIs) traditionally focuses on two areas of improvement: helping patients make better decisions AND lowering health care spending. The use of patient decision support interventions as a means to generate health care savings has been widely advocated, but the extent and quality of evidence is unclear.
A systematic review found that the evidence for savings was not as broad or deep as suspected. In addition, an examination of the quality of the economic analyses in the studies was performed. Not surprisingly for a young field, the quality has room for improvement. An assessment of the risk of bias in each study found a moderate to high risk across the studies that found savings. Eurekalert!
Close Observer of U.S. Health System Gets (an Uncomfortably) Closer Look
Arnold Relman, a long-time commentator on U.S. health policy, got unexpectedly immersed in the healthcare system last summer when he broke his neck in a fall. He recounts the experience in The New York Review of Books.
His narrative gives a patient's-eye view of his ordeal and subsequent recovery. He also offers this observation: "New technologies and electronic record-keeping affect how doctors do their work. Attention to the masses of data generated by laboratory and imaging studies has shifted their focus away from the patient. Doctors now spend more time with their computers than at the bedside." Journal Watch
Do doctors spend too much time looking at computer screen?
When physicians spend too much time looking at the computer screen in the exam room, nonverbal cues may get overlooked and affect doctors’ ability to pay attention and communicate with patients, according to a Northwestern Medicine® study.
Published online in the International Journal of Medical Informatics, the study found that doctors who use electronic health records (EHR) in the exam room spend about a third of their visits looking at a computer screen. Northwestern Medicine
When hospitals share patient records, emergency patients benefit, study suggests
As hospitals and doctors' offices across the country race to join online systems that let them share medical information securely, a new study suggests that these systems may already be helping cut unnecessary care.
Fewer emergency patients got repeated medical scans when they went to a hospital that takes part in a health information exchange, or HIE, according to new findings by University of Michigan researchers published online in the journal Medical Care. Eurekalert!
National plan for preventing healthcare-associated infections shows progress
Independent evaluators have found that measurable progress in reducing the rates of some targeted HAIs has been achieved under the umbrella of a national plan to prevent HAIs that was developed by the U.S. Department of Health and Human Services (HHS). The evaluation appears in a special February supplement to Medical Care. Eurekalert!
Ultrasound training should be implemented early into medical education programs
A paper in this month's edition of Global Heart (the journal of the World Heart Federation advocates including ultrasound in medical education programmes to realise the full benefits of the technology as early as possible. The review is by J. Christian Fox, Professor of Clinical Emergency Medicine and Director of Instructional Ultrasound at the University of California Irvine School of Medicine, CA, USA, and colleagues. Eurekalert!
Evidence rapidly building on utility of ultrasound in areas other than cardiology
A paper in this month's edition of Global Heart (the journal of the World Heart Federation) says there is mounting evidence regarding the utility of ultrasound in areas outside its traditional field of cardiology, with increasing use reported in general hospital wards, clinics, and even pre-hospital environments. The paper is by Associate Professor Bret Nelson and Dr Amy Sanghvi of Mount Sinai School of Medicine, New York, USA. Eurekalert!
Trust No Guideline That You Did Not Fake Yourself
Yesterday I read an interesting piece by Oliver Obst, “Trust no guideline that you did not fake yourself.” (Journal of EAHIL. 2013. v9 (4) p25) Obst references the German newspaper Frankfurter Allgemeine Zeitung, which reported several cases of fake practice guidelines. I don’t read German and it appears you must pay to access FAZ’s article archive, but if you read German and have access to the archive, the link to the article is here. According Obst’s summation of the article and Google Translate’s translated version of the abstract, the newspaper attributes thousands of deaths in Europe due to guidelines from the European Society of Cardiology and scientific misconduct. The Krafty Librarian
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