Jay Parkinson + MD + MPH = a doctor in NYC

Doyle signs health care transparency bill - The Business Journal of Milwaukee:

Sat, 13 Mar 2010 14:00:34 -0500

Doyle signs health care transparency bill - The Business Journal of Milwaukee: :

Wisconsin health care consumers can now price-shop. Gov. Jim Doyle signed the Health Care Transparency Bill Tuesday at Children’s Hospital of Wisconsin in Wauwatosa requiring health care providers to disclose the cost of the most common procedures they perform. It will help consumers get price estimates prior to a procedure, help make apples-to-apples comparisons on prices and help determine out-of-pocket costs prior to services occurring. “Nowhere else are people asked to buy a product before they know what the price is,” Doyle said in a statement. “This bill is a practical step forward that will help people better understand what their health care costs are before making important health care decisions.” Nancy Wenzel, chief executive officer of the Wisconsin Association of Health Plans, said the legislation parallels the efforts of many health plans in the state to empower consumer decision making. “With health care services taking more money out of consumers’ pockets, health plans gave their insured members another tool for managing their health care budgets,” Wenzel said. “As access to health care cost information increases, we expect consumer demand for the information will grow.”

Kevin Hsiu

Fri, 12 Mar 2010 20:30:21 -0500

Kevin Hsiu

I'm speaking at South by Southwest.

Fri, 12 Mar 2010 18:51:00 -0500

I'm speaking at South by Southwest.:

Sick Clicks: The Evolution of Health Online:

Will the Internet be the life support that saves the current U.S. health care system from death? As more people seek health information and alternative care through online mediums, a health care evolution is emerging where we are all the remedy.

Other speakers include:

Ted Eytan, MD (Kaiser Permanente)
Jay Bernhardt (CDC)
Caley VanCleave (FeelGoodNow)

So come see us…it’ll be awesome. I promise.

This visualization represents a year in color (summer is at the...

Fri, 12 Mar 2010 18:24:34 -0500

This visualization represents a year in color (summer is at the top, winter at the bottom).

via kottke

A nice interactive infographic from the AP that presents a few...

Fri, 12 Mar 2010 14:33:50 -0500

A nice interactive infographic from the AP that presents a few scenarios regarding how health insurance reform affects individuals. It doesn’t look pretty.

Montreal photographer Michael G. Manoukian has created a study...

Fri, 12 Mar 2010 12:02:28 -0500

Montreal photographer Michael G. Manoukian has created a study titled ‘Form and Function,’ a series of images that combine human x-rays with various tools. The work elegantly represents the relationship between form(the human image) and function(mechanical tools), demonstrating how both are inextricably linked and inform our understandings of each other respectively. Showing restraint and consideration with his choice of imagery, Manoukian’s ‘Form and Function’ provides an avenue for thoughtful consideration by the viewer. (via Michael Manoukian ‘Form and Function’ | Definitive Touch)

NHIN Direct: Open Healthcare Records and Government as a Platform - O'Reilly Radar

Fri, 12 Mar 2010 00:05:00 -0500

NHIN Direct: Open Healthcare Records and Government as a Platform - O'Reilly Radar:

My comment:

While I think this sounds pie-in-the-sky pretty, it’s all theoretical. First of all, electronic medical records (EMRs…sort of like electronic mail!) exist to solve two problems. The first is a billing/transactional problem. They’re designed to maximize physician reimbursement via upcoding for office visits and procedures. Docs are paid for office visits and procedures via highly specialized codes, not for quality, value, communication, or data analysis. Second, they’re designed to protect a doctor in court. That’s why the majority of information within an EMR is irrelevant to the actual clinical situation at hand. 95% of it is legal fluff and the rest is pertinent clinical information. Billing codes that aren’t actual personal diagnoses are meaningless to patients. Giving patients access to codes for 3 to 12 office visits a year isn’t that meaningful. It’s not enough data to even be considered dirty data. That’s not even considering the fact that we spend 1 hour with doctors a year on average and 8,765 hours on our own. Health is much more about our everyday behaviors than the clinical interactions we have documented in our doctors offices. Giving patients access to medical records simply gives them access to billing data and tests. If we think that labs and billing data changes health behaviors, I think we’re delusional. The real issue isn’t the data, it’s the desire to pursue happiness (and health is only one component of happiness) on a daily basis. Why do we want to behave in a healthy way to feel good today and decades in the future? What are other examples of people changing behavior because of data? We do change behavior based on communication…not so much data. We’re creatures of habit. Ninety to 95% of our activity can be predicted based on a months worth of data. I know that life is more fulfilling and more human with more effective means of communication and being social, but I can’t think of a situation where looking at data about my daily life has changed in any significant way the way I live my daily life for the better. I’d like to be proven wrong…
Modern medicine has extended the life of Americans by 40 years in the past 100 years. We solved the problem of dying children with clean water, vaccines, and antibiotics…hence the extra 40 years of life expectancy. Now we’re stuck with the problem of decades of unhealthy behavior and how to prolong our lives as 80-somethings. I’d rather focus on maximizing happiness in the most exciting and active years of our lives. Happiness and experience until we naturally fade away is the new health. Modern medicine with their pills and stents is surely not.

palahniukandchocolate: Human ingredients

Thu, 11 Mar 2010 10:28:49 -0500

palahniukandchocolate:

Human ingredients

How to save a friend from the brink.

Thu, 11 Mar 2010 09:39:00 -0500

How to save a friend from the brink.:

I’ve been thinking a lot about how we can prevent our friends and loved ones from taking their own lives (due to the number of celebrity suicides lately), and CNN publishes this:

For five days, Alexis Moore carefully planned how she would take her own life. She’s not a violent person, so she knew handguns were out. She settled on vodka instead, to be followed by a bottle of Xanax. She did it methodically. First, she says she drank the vodka for two hours. Then she lined up the 20 pills on the kitchen counter, taking a few at a time, going to her bedroom to cry and then coming back for more Xanax. After about six pills, just when she was beginning to feel woozy and lethargic, Moore heard a knock on the door and someone calling her name. She ignored him, even though she recognized the voice as someone she’d meet three days before at a business event. Then the man came around and banged on her bedroom window. She got up off the bed where she’d been sobbing and let him in. They sat down in her living room. She talked. He listened. By the end of the evening, she decided not to take her life. In the five years since, she’s never tried to commit suicide again.

What to say and do:

Tell her you don’t want her to die.

Send a card.

Say “I’m here.”

Bring a meal.

Don’t leave her alone.

Don’t say “I know how you feel.”

Don’t say “Just snap out of it.”

Don’t say “There was an earthquake in Haiti. Your situation isn’t that bad.”

Don’t ignore it. Don’t keep secrets.

haydenhunter: The debut performance of The National’s Terrible...

Thu, 11 Mar 2010 08:35:00 -0500

haydenhunter:

The debut performance of The National’s Terrible Love, the first song off their upcoming album High Violet.

May is going to be madness with new material from Ratatat, The National, Band of Horses, The New Pornographers, Broken Social Scene, LCD Soundsystem and probably a shit tonne of other’s too.

Long-term use of osteoporosis drugs linked to hip breaks

Wed, 10 Mar 2010 18:31:57 -0500

Long-term use of osteoporosis drugs linked to hip breaks:

I believe one day we’ll look back on chronic disease medications we’re supposed to take every day for decades and finally realize that reductionist medicine via a simple pill never really worked.

A Pharmacist’s Jail Cell Interview – What Good Does Blame Do?

Wed, 10 Mar 2010 09:35:07 -0500

A Pharmacist’s Jail Cell Interview – What Good Does Blame Do?:

via Mark Graban:

Here’s one to ponder and comment on – does putting a pharmacist in jail for six months and ruining his career and life do anything to bring back a two year-old girl? Does it do anything to make future patients any safer? Watch this video from CNN about Eric Cropp, an Ohio pharmacist who was convicted and put in jail for six months after a fatal process error…

In 2006, Eric Cropp was a pharmacist at a Cleveland hospital when 2-year-old cancer patient Emily Jerry was killed by the medical error of a pharmacy technician. She was given a chemotherapy drug mixed with a salt solution 23 times more concentrated than the normal dose. But because Eric Cropp was the supervising pharmacist and should have caught the mistake, he was sent to jail. And that’s where I found him, confused, and struggling with regret.

My sense of outrage is overwhelmed by my sense of sadness over this whole case, between the tragic death of the little girl, Emily Jerry (more about the case and the girl), and about how the reaction does nothing to make other patients safer.

It *feels* good, maybe, to put a guy in jail… to hold him accountable, possibly to make an example of him. Cropp claims he was overworked and the pharmacy was chronically understaffed. Has a CEO or other hospital leader ever been convicted for systemic problems in a hospital? Whose fault is it if the pharmacy is overworked? Who goes to jail for that?

Health care costs: How Maryland keeps its costs down | The...

Wed, 10 Mar 2010 09:02:12 -0500

Health care costs: How Maryland keeps its costs down | The Economist

In 1977, Maryland decided that, rather than leaving prices to the vagaries of a marketplace where insurers and hospitals negotiate behind closed doors, it would delegate the task of setting reimbursement rates for acute-care hospitals to an independent agency, the Maryland Health Services Cost Review Commission. When setting rates, the Commission takes into account differences in labor markets and how much a hospital pays in wages; the amount of charity care the hospital does; and whether it treats a large number of severely ill patients. For example, the Commission sets the price of an overnight stay at St. Joseph Medical Center in suburban Towson at $984, while letting Johns Hopkins, in Baltimore Maryland, charge $1,555…Since the program started, the Wall Street Journal reports that Maryland hospitals have enjoyed a steady profit margin, unlike hospitals in other states that often make more money during boom years and less during a recession…

What is most remarkable is how state regulation of prices has contained costs. When the program began in 1977, the state’s hospital costs were 25% higher than the national average. Today, Maryland’s hospital costs are 2% lower than the national average.

I love this picture. Me. Barbara Bush.

Tue, 09 Mar 2010 23:41:52 -0500

I love this picture. Me. Barbara Bush.

via afterimg I should repost this about these 20 year olds who...

Tue, 09 Mar 2010 08:49:16 -0500

via afterimg

I should repost this about these 20 year olds who call themselves The xx:

snippets from this excellent article in The New Yorker:

The xx are, in the purest sense, a modern band: their music could not exist without the machines that make the noises and the machines that record them.

I can’t think of a working band that is as genuinely minimalist.

These are songs to be sung inches from someone’s ear, preferably with the lights off.

Play the album a few times and all of a sudden other pop music sounds abrasive and overstuffed and shouty. The lyrics are where the age of the band shows. Madley Croft and Sim exchange lyrics on iChat, and never discuss what they mean.The two share the vocal duties on most songs, though the effect is rarely that of a duet. They’re singing at the same time, but in parallel, not necessarily to each other. (They met when they were three, after all.) It’s as if they’re looking through the same window at different people.

And I don’t need these young musicians to have figured anything out. How much do teen-agers know about love? Not much. Desire? A lot. Anxiety, anticipation, regret, frustration, delight, fear? More than most of us, maybe

Making health simple: Living in such a complicated world can...

Mon, 08 Mar 2010 13:33:49 -0500

Making health simple:

Living in such a complicated world can seem so complex. But we’re creatures of habit. Ninety-three percent of our behavior is predictable.

And everyday the media reports on new research that suggests certain things are good or bad for you. It’s all quite confusing. We get so lost and so paralyzed by complicated details, we lose sight of making health simple. Don’t worry about whether or not coffee is good or bad for you. If the “science” of analyzing one substance and its effect on health hasn’t figured it out by now, the implications of that substance is mostly unknown for you as an individual. In fact, even the number one selling drug in America, Lipitor, designed to reduce your cholesterol has very little evidence to suggest it prolongs your life. In reality, our longevity is limited by our genes and our everyday behaviors.

All I ask is that you stop and think about your life today.

We’re all expected to live 82 years or so in the developed world. What do we want out of those years? Do you want to prolong your life at the end? Do you want to live to be 92 instead of 82? Or do you want to feel your best prior to getting old and limited by age? What do you think will give you the most happiness out of life? Living your life optimally as a young person? Or stretching your life out at the end for another decade of life as a slow-moving senior citizen?

Now, think about your everyday. Spend a few minutes and write down how you spend your day. What are you doing? What are you doing that’s probably good for you? What are you doing that’s probably not that great for you? What are you doing too much of? Not enough of? Make a list. It’s actually pretty simple. For everything you identify that’s not so great for you, write a simple way you can change that behavior.

Think about just three things– sleep, food, activity. Changes should be very, very simple. It’s things like taking the stairs instead of the elevator. It could be eating less meat. It could be sleeping 7 hours instead of six. It could be drinking with friends 3 nights a week instead of four. It could be one less hour of sitting in front of your computer.

Life really isn’t about your health. It’s about happiness. Health is just one component of happiness. So take a break every once in a while and sit down and think about a few small everyday things that have huge impact on your happiness.

video portrait of Drew Anderson by me.

thedailywhat: Talented Kids Being Talented of the Day: The...

Sun, 07 Mar 2010 11:42:13 -0500

thedailywhat:

Talented Kids Being Talented of the Day: The fifth-graders of the PS22 Chorus strike cute gold yet again with a heart-expanding cover of Pheonix’s “Lisztomania”.

This must be the longest a sure thing has ever had to wait to become a TV show.

[hyst.]

The Farm Bill, a massive piece of federal legislation making its...

Fri, 05 Mar 2010 23:51:06 -0500

The Farm Bill, a massive piece of federal legislation making its way through Congress, governs what children are fed in schools and what food assistance programs can distribute to recipients. The bill provides billions of dollars in subsidies, much of which goes to huge agribusinesses producing feed crops, such as corn and soy, which are then fed to animals. By funding these crops, the government supports the production of meat and dairy products—the same products that contribute to our growing rates of obesity and chronic disease. Fruit and vegetable farmers, on the other hand, receive less than 1 percent of government subsidies. The government also purchases surplus foods like cheese, milk, pork, and beef for distribution to food assistance programs—including school lunches. The government is not required to purchase nutritious foods. (via PCRM)

The Free Wheelchair Mission: Free Wheelchair Mission is an...

Fri, 05 Mar 2010 09:17:00 -0500

The Free Wheelchair Mission:

Free Wheelchair Mission is an international non-profit organization dedicated to providing wheelchairs for the impoverished disabled in developing nations.

I met Stefan Bucher at Design Indaba last week. He was there speaking about his Daily Monsters. He introduced me to this organization and we think it’s ingenious. We’re big fans of using off the shelf parts to solve the simple problems first. Health doesn’t need to be as complex as it is. It’s mostly about unique thinking for simple solutions that solve 90% of problems for 90% of people.

Each wheelchair costs $59.20! Donate a wheelchair here.

A little perspective on healthcare in other countries.

Thu, 04 Mar 2010 12:12:43 -0500

People always use other countries as examples of healthcare systems that are “better” than the United States. Here are the populations of those countries:

Norway = 4,861,100
Switzerland = 7,779,200
Sweden = 9,340,682
Cuba = 11,204,000
Australia = 22,174,000
Canada = 34,021,000
UK = 62,041,708
Vatican City! = 800

Number of Kaiser Permanente members in California = 8.6 million