Troubled Teens Could Benefit from Online Access to Health Records, Say Researchers

 

From the 22 October 2012 article at ScienceDaily

 

 Online health records could be surprisingly useful for at-risk teenagers who cycle through the juvenile justice system. A new study from the Stanford University School of Medicine and the Santa Clara Valley Medical Center found that these young people have high rates of Internet use and an unexpectedly favorable attitude toward accessing their health records online.

Teens who get in trouble with the law could particularly benefit from online health records because they generally have worse health than other adolescents — and no one keeping track of the health care they do receive. These teens’ health problems range from spotty immunization histories to chronic diseases such as asthma, sexually transmitted infections, mental illnesses and substance abuse. And not only do poverty, difficult relationships with their parents and frequent moves make it hard for them to get consistent health care, these problems also increase the chances that doctors who are treating them will not have access to their medical histories..

…

The teens were enthusiastic about the option, with 90 percent saying it would be useful to have their health information automatically put online so they could access it later.

“I didn’t expect this level of interest because they don’t typically think of health as something that’s part of their daily lives,” Anoshiravani said, adding that these teens engage in risky behaviors that make them seem cavalier about their health.

These teens’ need for reliable and accessible health records is made even more urgent because they often do not have family members overseeing health-related chores, such as tracking immunizations and medications, checking lab results or recording their medical history. The lack of records is a problem not just in the short term but also when these teens reach adulthood, especially for those who survived serious medical events in childhood. “They may turn 18 and not know they were born with a heart defect that was surgically repaired,” Anoshiravani said.

Contrast that situation to a typical teenager. “A parent or grandparent is going with them to the doctor and keeping their health records,” Anoshiravani said, noting that troubled teens don’t have that help. And it’s not realistic to expect these teens to keep a hard copy of their medical file. “Carrying around pieces of paper that they could lose did not make sense to them, but having a place to check this information online did make a lot of sense,” he added.

The researchers were surprised to find that the teenagers would also share online health records: The vast majority of the respondents were willing to share their records with doctors and half said they would want to share the information with their parents.

The next step, Anoshiravani said, is to implement and test online health records for at-risk teens. The biggest challenge will revolve around the issue of information-sharing, since minors’ parents are entitled to see some parts of their health records, while other types of records cannot be shared with parents without the patients’ consent….

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Related articles

 

• Troubled teens could benefit from online access to health records, say Stanford researchers (eurekalert.org)
• Troubled teens could benefit from online access to health records (medicalxpress.com)
• ZweenaHealth.com Announces New Social Media Strategy (virtual-strategy.com)
• The great healthcare chasm: Patients want to email, access EMRs, but physicians still can’t (medcitynews.com)
• Fewer than one per cent of GP surgeries provide online access to health records (2020health.wordpress.com)
• Medicaid health records available online in Fla. (clickorlando.com)

 

Children’s Environmental Health (Informative Web Page with Links from the US CDC)

From the US Centers for Disease Control and Prevention (CDC) Children’s Environmental Health Web site

The environment affects children differently than adults. Because their bodies are still growing, children are at greater risk if they are exposed to environmental contaminants. Contaminants are anything that can cause something to become unclean, polluted, or not pure. They can be found anywhere and some are unsafe. A toddler playing in dirt contaminated with high levels of lead can become sick from lead poisoning. A child with asthma playing outside when the air quality is bad may have an asthma attack. Environmental hazards are not just outside, but can also be found inside a child’s home or school. Children living in older homes with lead-based paint can get sick from breathing lead dust or swallowing chipping paint. Drinking water from a private well and even a community water system is also a concern if it’s contaminated. Bacteria and other harmful chemicals can be a threat to anyone’s health, but especially to young children.

Click here for the Daily Air Quality Forecast

Related articles

• Organizations Urge Parents To Protect Children From Lead Poisoning (philadelphia.cbslocal.com)
• CDC Warns Laundry Detergent Pods Pose Health Risk (wibw.com)
• EPA Spends $1.2 Million to Provide ‘Asthma-Friendly Homes’ Training (cnsnews.com)

Supplies and Devices Are Biggest Cause of Hospital Cost Increase

There just might be a link between rising healthcare costs and hospital marketing of their procedures (some elective) which require expensive devices (as da Vinci) (I’m thinking).

And this marketing might be tied in with over diagnosing and fear of malpractice suits, perhaps…

From a recent email update received from AHRQ (US Agency for Healthcare Research and Quality

Medical supplies and devices represented nearly one-fourth (24.2 percent) of rising hospital costs between 2001 and 2006, according to a new AHRQ-funded study.    Among all types of hospital stays, the cost percentage impact for supplies and devices was nearly three times that of operating room services.  While rising inpatient costs are typically associated with imaging services such as computed tomography scans and magnetic resonance imaging, those services only contributed a 3.3 percent increase in the cost of an average hospital stay, the study found.   Because rising hospitals costs are an ongoing concern, payers and policymakers may want to explore the specific factors driving those costs and the factors associated with them, according to the study authors.  The study, “What Hospital Inpatient Services Contributed the Most to the 2001 to 2006 Growth in the Cost per Case?,” was published online in Health Services Research on September 4. Select to access the abstract on PubMed.®

[Principal Findings of this study – “Supplies and devices were leading contributors (24.2 percent) to the increase in mean cost per discharge across all discharges. Intensive care unit and room and board (semiprivate) charges also substantially contributed (17.6 percent and 11.3 percent, respectively). Imaging and other advanced technological services were not major contributors (4.9 percent).”]

Related articles

• Rising cost of inpatient care linked to medical devices and supplies (medicalxpress.com)
• Health care spending: Study shows high imaging costs for defensive purposes (jflahiff.wordpress.com)
• 9-part series on over-diagnosis (short reads from a health care journalist) (jflahiff.wordpress.com)
• Where do our wasted health dollars go to?(KevinMD.com)

  Excerpt:

  • Failure of care coordination ($25 to $45 billion wasted). I see examples of this all the time. Docs and hospitals don’t talk to each other, and patients don’t bring records—so tests get repeated, or (even worse), medicines are added on top of other (unknown) medicines, creating costly havoc. The patients suffer. Why does this happen? Docs (like me!) get paid to see patients, not to read charts and chase down forms. In fact, HIPAA “privacy” laws have made care coordination even more time-consuming and frustrating for everyone.
  • Failure of care delivery ($102 to $154 billion). I’m not really sure exactly what that means. I imagine they mean waste created by not treating medical conditions early, when they’re less expensive to address.
  • Overtreatment ($158 to $226 billion). In part, this is defensive medicine—docs do whatever they think they need to do to they don’t get sued. Show up in the ER with a headache? You get a $1600 CAT scan! Those tests not only cost money themselves, but they lead to more tests and procedures and costs that really aren’t making anyone healthier. (Except the medical-malpractice industry. They’re doing real well.) Overtreatment also includes steps taken by lazy doctors who find it quicker—and better for business—to just order the tests and treatments the patients expect, rather than doing what’s medically appropriate.
  • Unnecessary administrative complexity ($107 and $389 billion). We love filling out forms, and we love hiring staff to wait on hold for administrative pygmies at the insurance agency to approve Grandma’s catheters. Yup, that’s why we went to med school.
  • Noncompetitive pricing ($84 and $178 billion). “Noncompetitive”, I think, must be a euphemism for “batshit crazy”. Ever see a doctor or hospital’s price sheet? They’re locked up, guarded by poisonous lizards deep in an underground bunker. Prices have to be super-inflated so the insurance companies can negotiate them down to what they’ve already decided they’ll pay (when they get around to it, which is after they’ve paid for the VP’s executive jets and haircuts.) People who don’t have insurance, of course, get hosed.
  • Fraud and abuse ($82 to $272 billion). With this much money sloshing around, scumbag frausters (including some with MD degrees) crawl out and starting grabbing what they can. For every jerk the government finds and prosecutes, there’s a handful of other cockroaches to take their place. Though there’s certainly insurance fraud in the private market, there is far more abuse designed to extract money from government health programs. Insurance companies do what they can to guard against fraud, which could hurt their profits or drive them out of business. Government agencies just don’t seem as driven to control costs. I guess they figure we can always borrow more money from our grandchildren.
• Choosing Wisely – Conversation starters for office visits on choosing health care (jflahiff.wordpress.com)

  Choosing Wisely – a Web site that aims to “aims to promote conversations between physicians and patients by helping patients choose care that is:

  Supported by evidence
  Not duplicative of other tests or procedures already received
  Free from harm
  Truly necessary

• Electronic Medical Records Reduce Negative Outcomes and Related Costs After Patient Safety Events Occur (ahrq.gov)

• [Reblog] Use of patient decision aids may lead to “sharply lower hip/knee surgery rates & costs”
  

• Electronic Medical Records Reduce Negative Outcomes and Related Costs After Patient Safety Events Occur (ahrq.gov)

 

 

New Suicide Prevention Plan: 10/15/2012 [NLM Director’s Comments ]

From the Director’s page

Greetings from the National Library of Medicine and MedlinePlus.gov

Regards to all our listeners!

I’m Rob Logan, Ph.D. senior staff National Library of Medicine for Donald Lindberg, M.D, the Director of the U.S. National Library of Medicine.

Here is what’s new this week in MedlinePlus.

A comprehensive plan to reduce the number and impact of suicides in the U.S. recently was announced by the U.S. Surgeon General…

..

The Surgeon General’s National Strategy for Suicide Prevention is available at surgeongeneral.gov.

Meanwhile, a helpful introduction to suicide symptoms is provided by the American Society of Suicidology in the ‘overviews’ section ofMedlinePlus.gov’s suicide health topic page. A helpful guide about what to do if someone is suicidal is provided by the Mayo Foundation for Medical Research and Education in the ‘prevention/screening’ section of MedlinePlus.gov’s suicide health topic page.

The Mayo Foundation for Medical Research and Education also provides a helpful website, ‘Considering suicide? How to Stay Safe and Find Treatment’ in the ‘coping’ section of MedlinePlus.gov’s suicide health topic page.

MedlinePlus.gov’s suicide health topic page contains links to the latest pertinent journal research articles, which are available in the ‘journal articles’ section. Links to related clinical trials that may be occurring in your area are available in the ‘clinical trials’ section. From the suicide health topic page, you can sign up to receive email updates with links to new information as it becomes available on MedlinePlus.

To find MedlinePlus.gov’s suicide health topic page, type ‘suicide’ in the search box on MedlinePlus.gov’s home page, then, click on ‘Suicide (National Library of Medicine).’ Links to health topic pages devoted to depression, mental health and behavior, as well as social/family issues are accessible within ‘related topics’ on the right side of MedlinePlus.gov’s suicide health topic page.

As the Surgeon General’s report notes, improving prevention to offset a sobering rate of suicide is gaining new momentum in medicine and public health. We wish the Surgeon General’s National Strategy for Suicide Prevention every success.

Before I go, this reminder… MedlinePlus.gov is authoritative. It’s free. We do not accept advertising …and is written to help you.