Shaw's Eco-Logic

Health care information technology: Is "IT" the answer?

One of the most highly publicized aspects of Obamacare involves the forced implementation of Electronic Health Records (EHRs). Billions of dollars have been set aside to encourage health care providers to develop "meaningful use" of EHRs.

My latest HND piece takes a hard look at EHRs, and the general impact of technology on health care. I note, for example, that health care is the only field of endeavor whereby technology has increased, rather than decreased costs. I delve into the dark side of why the government is really pushing EHR implementation, and how they are missing the boat on monitoring outcomes.

Also included is a plug for an up-and-coming computer tech support company, based in New England.

Read the complete article.

Can caffeine become a drug of abuse?

This week's HND piece looks at the world's number one psychoactive drug, and those rare instances in which it actually can be abused.

Back in 2002, the so-called "CABs" or Caffeinated alcoholic beverages were introduced. It did not take very long before these were widely abused by youth—the principal "benefit" being that one could achieve a state of "alert intoxication." Of course, they were still impaired, and in some cases could reach near toxic levels of alcohol, since the usual protective mechanism of falling asleep would not occur. Driving was another problem.

The FDA forced most of these products off the market, but now there is new wrinkle: Caffeine powders, which can be added to any beverage. These are cheaper to obtain and are easier to use than the CABs, and have caused quite a controversy.

Read the complete article.

The dangers of going off-label with prescription drugs

This week's HND piece explores a phenomenon that is more widespread than most people think. For starters, some estimates peg the extent of this practice at around 20 percent of all prescriptions written.

Not to make too fine a point of it, but since the use is off-label, by definition, there is little if any conventional scientific validation of these drug indications. Of course, given the state of science these days, as well as the politics of drug approvals, some of the best-selling FDA-approved drugs don't have much science behind them, either.

For the most part, off-label use is based on plenty of anecdotal evidence that such practices are safe and effective—unless the off-label use is strictly driven by cost. Sadly, that is definitely the case regarding the off-label use of Avastin^®—a cancer drug—instead of Lucentis^®, for the treatment of neovascular (wet) age-related macular degeneration. Lucentis carries an FDA approval for this indication, and Avastin does not.

To make matters worse, part of the reason that Avastin is cheaper than Lucentis is that practitioners are compounding individual doses of it from bulk supplies, and many cases of infection are attributable to such activities. As you might suspect, these eye infections can be quite serious.

But, as we have said so many times in the past, the very most important thing in health care—on a superficial level, anyway—is cost, so by all means keep on compounding. I guess such practices are are whole lot easier than actually addressing the real sources of out-of-control health care costs.

Some day, we can talk about the outrage whereby at least 40 percent of all radiology is done for defensive purposes, only. Think that might be driving up health care costs? Then there's the indisputable fact that hospital residents (except for surgeons and anesthesiologists) spend at least 70 percent of their time on paperwork. For primary care docs is can be as high as 90%. Trust me, these factoids are only the tip of the proverbial iceberg. Eliminate waste and fraud, and you can save at least half of the current health care budget. Probably much more than that.

Read the complete article.

A look at health care real estate

As my latest HND piece indicates, this portion of the real estate market, deemed by many to be virtually recession-proof, is starting to show some signs of weakness—at least in certain regions. And now that Obamacare is anything but a sure thing, the doubts continue to pile up.

Among other sources, I cite Kiplinger's Personal Finance, and talk to some real experts from BRC Advisors, based in Beverly Hills, CA. Yep, there are even challenges in that rarefied environment!

In less affluent regions of the country, thoughtful observers wonder how long the old model of redundant private medical offices, housing practices that are barely solvent, can be sustained.

Read the complete article.

Dry labbing and how it might be affecting you

This HND piece looks at dry labbing, referring to a practice whereby labs simply fabricate results, usually to please the client. The clients—in current controversies—are manufacturers of dietary supplements. The term is sometimes also used in a broader sense, to indicate overall shady or misleading activities perpetrated by labs, their consultants, or the manufacturers themselves.

Dateline NBC recently ran a segment on dry labbing, setting up a sting intended to expose a suspect lab. I discovered, though, that like way too many so-called exposés, the process here was not exactly simon pure. Instead, the show was set up to deliver the maximum shock value, built on a pretty shaky foundation.

Even if the extent of the dry labbing problems might be overblown in the current hype, the natural products industry would be well advised to start policing their own, or the Feds will be only too glad to step in and take over.

Read the complete article.

Johnny comes marching home...to work in health care

This HND piece starts off explaining why our country is losing so many jobs, and then suggests that job-seekers—as well as salespeople—should focus on enterprises that can't leave. These would include academia, agriculture, finance, government, mining, utilities, and, of course, health care.

According to the Bureau of Labor Statistics, jobs in health care rose to 14.19 million in October 2011 from 13.88 million a year earlier. Even though there are probably more jobs in this field than applicants, employers are still looking to improve the odds of making a good hire. That's why many health care institutions are taking a special look at military veterans.

David C. Dickey, former major in the Marine Corps, and now CEO of The Patriot Group Inc. puts it this way:

You're going to get a bright, reliable, and motivated individual. This is not to imply that the rest of society may not also have these traits. Rather, it's just that a preponderance of veterans seem to exhibit this. They've been asked to do more with less, and in many cases, to operate independently, given tasks to complete with little or no supervision—and that happens frequently.

Read the complete article.

Hoarding, etc.

This HND piece starts off discussing pathological hoarding, and then segues into the far more common problem of clutter—both physical and mental.

What's the difference between living in a cluttered house and being a hoarder? Ultimately, the hoarder will find it difficult or impossible to remove items to clean up the mess, until such point that it might become life-threatening. But, there are also hoarders who are extremely neat, and given enough space, could easily hide their compulsion.

That's why we also discuss a "Structured Interview for Hoarding Disorder," identifying six criteria, all of which must be met to give the examiner a diagnosis of pathological hoarding. We then introduce you to professional organizer Carmen Coker, who can help you get organized virtually.

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Skin deep

This HND piece focuses on our largest organ—the skin. We discuss its profound reaction to the turmoil that may be going on inside you, referencing Ted Grossbart's breakthrough book, as well as the interesting research from Japan's Hajime Kimata, in which laughter is shown to be great medicine for those with skin conditions.

We also spotlight topical abdominal toning creams, including a new product from Aviator Skin and Hair.

Read the complete article.

Do well by doing good

My latest HND piece expands on this Ben Franklin quote, noting that charity is essential to the operation of our health care system. Overall, Americans are quite charitable, and I describe how some people in the real estate industry have come up with innovative ways to give back to the community.

Read the complete article.

To fix health care, first do no harm

Here's one for you...

In this piece, I consider health care reform—from a Karmic point of view. It should come as no surprise that there is plenty of bad Karma floating around in this space. My take is that as long as we are stuck in our awful "disease care" model that we insist on calling "health care," the Karmic debt will just keep increasing.

Surely, the financial debt show no signs of being alleviated, either.  

One part of the article that might surprise you is how poorly health care workers treat each other—especially how older docs treat the younger ones.  I also take a dim view on the current movement to restore the so-called doctor-patient relationship.

Read the complete article.