Category: Science and Other News

Electronic Health Records and Adolescents’ Privacy

This blog has written about complaints from both physicians and nurses regarding the costs and time devoured by using Electronic Health Records, which have been imposed on practices despite not adding value.

In a JAMA article published earlier this month, three physicians discuss EHRs’ challenge to adolescents’ and parents’ privacy. So-called minor consent laws permit adolescents to secure health care services without parental consent for drug use, pregnancy and pregnancy preventions, STDs and mental health. These laws underscore the professional consensus that absent confidentiality, adolescents will be reluctant to seek care for sensitive health issues.

With paper records, care provided under minor consent laws was segregated from other medical records and difficult to access. Because EHRs aggregate information for all health care provided within a so-called integrated system, parents have the means to electronically access confidential information, often facilitated by web portals to the records.

FDA Regulation of Mobile Health Apps is a Real Threat

Do you want the Food and Drug Administration (FDA) to regulate your smartphone? Many in the booming digital health industry are indifferent to the risks of the FDA regulating apps as medical devices. As I noted in a recent Health Alert, the FDA’s current doctrine is to allow most new apps onto the market without regulation. However, this openness is defined only in rules written by the FDA itself, not legislation. Rep. Marsha Blackburn and others in Congress have proposed to amend the law to prevent the FDA from overreaching.

Entrepreneurs and patients who think that the FDA’s current posture is eternal should be aware of a campaign to regulate apps for health. Here’s a recent article from Mother Jones:

Online retailers like iTunes and Amazon offer thousands of apps promising all kinds of real-time information about your body — they can measure blood pressure, take your pulse, track your menstrual cycle, and tell you how well your lungs are working. Mobile health is one of the fastest-growing app categories: According to the consulting firm research2guidance, there are 100,000 mobile health apps on the market, double the number available two and a half years ago. The industry is worth some $4 billion today, and analysts predict that it will reach $26.5 billion by 2017.

Happy New Year 2015!

May you have a wonderful and prosperous New Year! All of us at the NCPA appreciate your support.

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Merry Christmas!

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NCPA will be closed December 22nd through December 26th.

We’ll resume blogging on Monday, December 29th!

Hiring in Ambulatory Clinics Back on Track in November; Other Health Jobs Lagging

Last Friday’s employment report caused some joy in the land: 321,000 jobs were added in November. My Forbes colleague Bruce Japsen cheered an “Obamacare jobs bump” in health services. If true, this would be an example of Bastiat’s broken-window fallacy: Broken windows create employment for glaziers, so the government should encourage breaking windows.

Similarly, Obamacare “broke” health care. So, we cannot be sure if jobs added in health care are adding value to society, or just a response to Obamacare’s making health care even more inefficient than it was.

However, there was no Obamacare jobs boom in November. As shown in Table 1 and Table 2, jobs in health care increased by 0.19 percent from October. Non-health nonfarm civilian jobs increased 0.23 percent. So, healthcare jobs increased at a marginally slower rate than other jobs.

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The Circular Firing Squad in U.S. Health Care

Who is to blame for the U.S. healthcare crisis? JAMA has published an opinion piece by three physicians illustrating a fundamental difficulty in identifying the causes of the healthcare crisis. Individuals construct “casual stories” to assign blame. Subjective narratives gain momentum among researchers, policy makers, journalists, and the public:

  • Payers: Insurers create barriers to health care (high deductibles and gatekeepers) and excessive administrative waste (billing and coding).
  • Life Science Industry: Manufacturers saddle patients and payers with excessively high prices and underinvest in novel therapeutics.
  • Physicians and Hospitals: Financial incentives have led clinicians and health care organizations to focus on delivering volume over value. Hospitals overinvest in high margin services (cardiology and oncology) and underinvest in essential services (obstetrics and psychiatry).

Happy Thanksgiving!

From all of us at the NCPA, we wish you and yours a happy and safe Thanksgiving!

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American Medical Association Backs Telemedicine Compact

Laptop and StethoscopeOur blog usually does not cheer the American Medical Association, because it is largely responsible for the Soviet-style centrally fixed prices that prevail in Medicare. Well, today we applaud the AMA for pledging its support to an important initiative that will increase the adoption of telehealth.

The Federation of State Medical Boards (FSMB) has developed an interstate compact to allow physicians licensed in one state to provide telemedicine services in other states which join the compact. It will greatly advance the effective adoption of telehealth nationwide. Yes, I am aware that the pure libertarian view is that licensing should be abolished and certification by private organizations govern the recognition of professions. Unfortunately, that is not on the radar screen. An interstate compact allowing physicians to practice telehealth across state lines is a very positive step that will pre-empt federal interference in professional licensing.

U.S. Property Rights Maintain Global Rank

The 2014 International Property Rights Index (IPRI), published by the Property Rights Alliance, ranks the United States 17th place overall in the world (from 17th in 2013 and 18th in 2011 and 2012). The IPRI is an annual comparative study that quantifies the strength of physical and intellectual property rights and ranks countries accordingly. The U.S. improved its legal and political environment from 2013 to 2014 via marginal improvements in control of corruption, judicial independence, and political stability. Its physical property rights score improved due to increases in the country’s access to loans and real estate. Likewise, the U.S. intellectual property rights score increased due to improvements in the country’s copyright piracy score.

The NCPA has emphasized the importance of intellectual property protection in health care and this blog has written about how pharmaceutical innovation in today’s regulatory environment could not be financed without patent protection. According to the IPRI, such dynamics exist globally between many macro indicators: with each annual edition of the index, statistical strength between economic production and protection of property rights has grown.

Hiring in Outpatient Clinics Froze Last Month

Hiring in health care continued its moderate pace in October. As noted in September, the rapid hiring in the health sector, especially in outpatient services, has slowed dramatically. Health care hired about 25,000 workers in October, increasing employment by 0.17 percent. Non-farm payrolls, excluding health care increased 0.15 percent. So, job growth in health care has settled down to a rate similar to the overall economy.

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