Medical Technology

Advances in drugs, devices, and biological products that change the way health care is delivered. LDI Senior Fellows study the adoption and diffusion of medical technologies and assesses their impact on costs and quality of care.

Wearable Devices as Facilitators, Not Drivers, of Health Behavior Change

Feb. 3, 2015

Mitesh S. Patel, David A. Asch, Kevin G. Volpp

In a commentary in the Journal of the American Medical Association, Mitesh Patel, David Asch, and Kevin Volpp discuss the validity of claims that wearable devices promote long-term healthy behaviors. The authors contend that, although they may be useful in facilitating behavioral change in individuals already motivated to do so, using wearable devices to motivate people to instigate healthy changes is a challenge. Relatively high prices, potential inaccuracy of metrics, inconsistency of use, and difficulties in sustaining motivation are all significant barriers to success. Getting patients...

Prescription Drug Use under Medicare Part D: A Linear Model of Nonlinear Budget Sets

Feb. 1, 2015

Jason Abaluck, Jonathan Gruber, Ashley Swanson

In a NBER Working Paper, Jason Abaluck (Yale University), Jonathan Gruber (MIT) and LDI’s Ashley Swanson analyze the complicated decision problem faced by Medicare Part D enrollees in their use of prescription drugs. Enrollees must respond to prices that are difficult to find, and that may change as they spend more over time. As in other settings such as income taxation and electricity and cellular telephone markets, these sorts of nonlinear prices make it difficult to estimate behavior, as consumers may not follow rational models of consumption. The authors use Medicare Part D claims data...

The Role of Technical Advances in the Adoption and Integration of Patient-Reported Outcomes in Clinical Care

Feb. 1, 2015

Roxanne E. Jensen, Nan E. Rothrock, Esi M. DeWitt, Brennan Spiegel, Carole A. Tucker, Heidi M. Crane, Christopher B. Forrest, Donald L. Patrick, Rob Frederickson, Lisa M. Shulman, David Cella, Paul K. Crane

In Medical Care, Roxanne E. Jensen (Georgetown University) and colleagues, including LDI’s Christopher Forrest, explore the changing role of patient-reported outcomes (PROs) in clinical treatment. PROs, assessments of a patient’s experiences in a structured and standardized format directly from the patient themselves, are gaining recognition as key measures for improving the quality of patient care in clinical care settings. The authors examine five case studies across diverse health care settings and patient populations to explore how implementation barriers were addressed to promote the...

Development, Implementation, and Impact of an Automated Early Warning and Response System for Sepsis

Jan. 1, 2015

Craig Umscheid, Joel Betesh, Christine VanZandbergen, Asaf Hanish, Gordon Tait, Mark Mikkelsen, Benjamin French, Barry Fuchs

In the Journal of Hospital Medicine, Craig Umscheid, Benjamin French, and other Penn colleagues investigate electronic health record (EHR)-based interventions aimed at reducing sepsis-related mortality. Severe sepsis affects as many as three million patients in the U.S. annually and kills 750,000. Earlier intervention could help to lower the mortality rate, but identifying at-risk patients is a challenge. Umscheid and colleagues propose that a better screening mechanism would help providers recognize and treat sepsis right away. To test this, they conduct a study where the EHRs of adult...

The Payer Perspective on Sovaldi

Oct. 2, 2014

Sovaldi, the $84,000 Hepatitis C drug developed by Gilead Sciences, has sparked controversy while marching toward worldwide sales set to exceed $11 billion in 2014. The blockbuster drug’s price is the main sticking point in the debate: critics argue that the cost is unsustainable and will cause payers to restrict treatment for the estimated 3.2 million patients in the United States who live with Hepatitis C, some of whom will develop liver complications.