In Health Services Research, Guy David and colleagues evaluate whether patient-centered medical homes (PCMHs) reduce emergency department (ED) visits among patients with and without chronic conditions. The authors use data from approximately 460,000 Independence Blue Cross patients enrolled in 280 primary care practices, all of which converted to PCMH status between 2008 and 2012. PCMH certification was associated with a 5-8% reduction in ED visits among a practice's chronically ill patients, but had no effect on patients without chronic medical conditions. These findings were...
It’s not easy to make the case that health care innovation can come from within…from the physicians and nurses on the front lines of patient care. Clinically-trained, path-driven, and time-starved, these clinicians may not appear to be the best source of disruptive change in health care.
It seems that nurses are getting a lot of bad press in England lately, coming under fire recently for being “uncaring.” In an article published in Nursing Standard, Linda Aiken of Penn’s School of Nursing contends that this erosion of public trust is the result of high workloads and low investment in nursing education, rather than any attitudes held by English nurses.
How do we get people and organizations to change, especially when what they are currently doing adds little value, is very costly, is perhaps outmoded, and may, at worst, be dangerous? This is the question Benjamin Roman and David Asch raise in their new Annals of Internal Medicine piece on "Faded Promises".
As health care reform rolls out, there is a growing focus on restructuring the health service delivery system in the hope of improving health care quality and "bending the cost curve." A key part of this focus has been on physician organization and, in particular, moving toward large, multispecialty physician groups or hospital-physician systems that can provide integrated, coordinated patient care (e.g., through "Accountable Care Organizations").
What do Edward Snowden and Daniel Ellsberg tell us about the appropriate use of personal health information?
Since Edward Snowden revealed that US agencies have been following social media, telephone data, and other seemingly private communications of US citizens, public reaction to his actions has been mixed. Roughly as many call him a traitor as call him a hero, and some simultaneously criticize his approaches and praise him for what he revealed.