Healthcare Spending After the Recession

May 12, 2009 | by

Yesterday, the American Medical Association (AMA) and five other major groups representing doctors, hospitals, insurance companies, pharmaceutical companies and union members delivered a letter to President Obama pledging to cut the U.S. growth rate for healthcare spending by 1.5 percent each year from 2010 through 2019 [1]. The coalition’s efforts are intended to supplement upcoming legislation aimed at decreasing healthcare costs for families, businesses and the government.

The savings — an estimated $2 trillion over the next decade — would come from changes in the public-private partnership and include:

  • Administrative standardization, simplification and transparency.
  • Aligning quality and efficiency incentives among providers to reduce over- and under-use of healthcare.
  • Encouraging coordinated care and adherence to evidence-based best practices and therapies.
  • Reducing the cost of doing business by developing technology and regulatory reform.

Although the proposed health expenditure savings is small, experts say it’s significant [2]. The very fact that health industry leaders have stepped forward to voluntarily restrain costs is itself encouraging; these are the same groups that opposed the healthcare reforms proposed by President Clinton in the 1990s.

Put Your Hands Together and Fight the Flu

May 7, 2009 | by

Although the immediate threat of H1N1 — the swine flu — appears to be benign, experts say that the emerging strain could return in a more virulent form in future flu seasons [1]. And with increasing reports of the swine flu close to home, hand washing is more important than ever. Indeed, hand washing is the best way to prevent infection and illness. Some scientists estimate that as much as 80% of all infections are transmitted by unwashed hands [2]. Hand washing is the single most important thing you can do to prevent the spread of infection and to stay healthy. As simple as it may be, there’s a trick to effectively washing your hands with soap and water.

handwashing

Kids learn early on in preschool that to truly prevent the spread of germs, you’ve got to wash your hands. Nevertheless, a dab of soap and a quick rinse isn’t effective. The key is to wash your hands for at least 20 seconds to ensure that you’ve removed the microbes. By rubbing your hands with soapy water, you pull dirt and oil from your skin. The soap lather suspends any germs trapped inside and are then washed away when rinsing.

Cancer Research Blog Carnival #21 – National Cancer Research Month

May 1, 2009 | by

Welcome to the 21st edition of the Cancer Research Blog Carnival, the monthly blog carnival that discusses what’s new in cancer research and includes posts covering cancer biology, cancer genetics, cancer diagnostics and cancer therapeutics. Concomitant with this edition is the start of National Cancer Research Month.

There’s a revolution occurring on the Web: those “authoritative” articles written on traditional, static websites are being replaced with blogs, wikis and online social networks. In the sphere of health, medicine and information technology, this “real-time Web” consists of many who are professionals in the field; their posts are listed below.
In the digital age, these are the characteristics of new media: recent, relevant, reachable and reliable.

In 2007, the United States Congress declared May National Cancer Research Month. The American Association for Cancer Research (AACR) secured resolutions to raise awareness of the critical advances in cancer research made by its 27,000 members and cancer researchers worldwide, and its efforts to ensure a secure future for continued progress against a group of diseases which strike one in every two men and one in every three women.

national-cancer-research-month

Today, ten million cancer survivors are alive in America due to advances in cancer research [1]. National Cancer Research Month reminds us that basic, clinical, epidemiological and behavioral research are essential to identifying causes and developing strategies for cancer prevention, diagnosis, treatment and cures.

With that, let’s find out more about what’s happening in cancer research this month.

Science and the Swine Flu

April 28, 2009 | by

You’ve likely heard news reports this week about the swine flu virus outbreak in Mexico. The swine flu or swine influenza produces regular outbreaks of respiratory disease in pigs and is caused by influenza type A viruses. Transmission of swine flu viruses between people has been reported in the past, but was limited to three people. Today, the World Health Organization (WHO) raised its pandemic alert to "phase 5", which means that people in at least two countries in one WHO region are spreading the disease [1]. This was done following an increase to "phase 4" several days ago because the virus was already widespread in differnet locations, with confirmations in Mexico, the United States, Spain and Scotland.

While the Centers for Disease Control and Prevention (CDC) has determined that the swine flu is contagious and is spreading from human to human [2], the WHO has indicated that most people infected with swine flu make a full recovery without the need for medical attention or antiviral drugs [3].

Sharing Genes on the Social Web: PatientsLikeMe ALS Genetics Search Engine

April 23, 2009 | by

This article was written by Hope Leman.

This is the kind of story that gets me out of bed before I go to work in a few hours at our small medical library and to try to get the news out of what should be a fascinating development in search, Health 2.0, Science 2.0 and public discussion of patient empowerment and in neurologic science generally. I have been sent through my connections at AltSearchEngines and Next Generation Science a link to the Marketwire press release “PatientsLikeMe Launches Genetics Search Engine for ALS Patients“.

plm-logo

I spent many hours in the amyotrophic lateral sclerosis community of Patients Like Me in 2007 — 2008 and still visit it occasionally. It is a remarkable instance of a close-knit group of people united by the personal tragedy of either having Lou Gehrig’s Disease (ALS) or caring for and/or about someone with it. The founders of Patients Like Me (PLM), Jamie and Ben Heywood, have since created similar online patient communities for Parkinson’s Disease, Multiple Sclerosis and so on.

plm-find-patients

I briefly met Ben Heywood at a recent Health 2.0 conference. Both he and Jamie are frequent speakers at Health 2.0 and Web 2.0-related gatherings and have been the subject of books and documentaries. The documentary So Much So Fast shows the courageous struggle their brother Stephen made against the ravages of ALS. The solidarity and love his family showed in that struggle is one of the most moving films ever made and should be viewed by literally anyone in the health sciences, encompassing as it does the minutiae of confronting ever growing disability and the quest to obtain accurate medical information in the Internet Age. The Heywood brothers have accomplished remarkable things across a variety of fields, notably in prodding the research establish to fast track research in ALS and to engage in far more transparent practices. They and men like Augie Nieto are the kind of people that leave one feeling that individuals can make a difference even in the face of such frightening specters as a diagnosis of ALS.

But I do have my qualms and concerns about some of the PLM initiatives. Even when papers about it appear in the standard medical literature in PubMed, the authors of the papers are usually affiliated in some way with PLM. It would be nice if there were at least a few by neurologists who have no relationship at all to PLM that reported on advances made as a result of the data acquired from the self-reports that PLM members upload to PLM databases.

The search engine is simply called the Genetics Search Engine, although it covers only ALS and thus is likely to create some branding confusion.

The PLM blog post announcing the launch of the new search engine states: “Today, we’re announcing the launch of our Genetics Search Engine for people with ALS. Imagine finding other patients just like you, down to the genetic level. Patients in our ALS community can now do that. (For patients who don’t see their genetic mutation right now, that’s alright. They can be the first with that genetic mutation to join our community and share information about the disease.) What does sharing genetics mean for research? By capturing data on familial ALS patients’ known genetics, such as the A4V or D90A mutations in superoxide dismutase 1 (SOD1) and the P56S mutation in vesicle-associated membrane protein-associated protein B (VAPB), we can learn more about the cause and effects of every kind of ALS and better our chances of advancing research and finding new treatments. Our goal in launching the Genetics Search Engine (and other upgrades like it) is to help patients find others just like them and enhance our understanding of the phenotype of each genetic mutation (i.e., different causes of ALS have faster or slower disease progression).”

This brings up some interesting issues:

  • As noted, there is the matter of branding. The wording “… other upgrades like it” suggests that this is the first of what may become a series of search engines for genetic mutations. That is an intriguing development and illustrates the genuine knack for marketing and technological innovation that has always made PLM a leader in the patient social networking space even as other such communities (such as Trusera) with much less drive to actually contribute to the medical science related to the travails of members have struggled to attract and retain users.

  • The Genetics Search Engine does not appear particularly innovative or interesting vis-a-vis search technology. It seems, indeed, to be fairly unspectacular and rudimentary in that respect. But it is certainly more handsome and engaging than ALSOD: the Amyotrophic Lateral Sclerosis Online Database, which covers only SOD1 mutations and is designed for medical professionals, not patients and the general public.

  • The wording “Imagine finding other patients just like you, down to the genetic level” is quite fascinating. ALS is a rare disorder and now patients can find in that small group an even smaller group and, now, so can researchers. This has all kinds of implications for organizing patients into lobbying groups for research into that particular mutation. That might actually advance research, given that the intense study of one gene or one mutation could benefit the entire ALS population. Alternatively, it could hinder advancement if a vocal group successfully wins earmarks for what turn out to be blind alleys. In any case, it is a brave new world in which people can form political, emotional and social bonds on the basis of genetic mutations. This is a good thing for public education in medical matters and public discussion of important scientific and bioethical matters.

  • The development of the search engine and what becomes of the data is something that all those intrigued by the era of personalized medicine will watch with intense interest. Some argue that such data will prove of limited utility for decades and that it is cruel and deceptive to suggest to patients that hours spent mastering the arcana of genetics will improve their short-term prospects and day-to-day quality of life. Indeed, part of the marketing muddle is that the press release does not make the distinction clear between familial ALS and the sporadic type, the former being much rarer. Jamie Heywood is quoted as saying:

    Beyond the research implications of what this means today, if you’re a patient with familial ALS, you can now use this information to make better decisions about your healthcare and learn from the experiences of others like you.

    But that group is a small subset of the greater ALS patient population as a whole and the press release makes it sound like the Genetics Search Engine is a potential boon for all ALS patients. It could be, but that isn’t made clear.

But one should not complain too much given the obvious solace and genuine enjoyment members find in PLM and the impressive amount of useful information exchanged there on matters of nutrition, respiratory care, assistive technology and such, necessary in the care of patients with this illness. The fact that PLM has 3,400 members worldwide alone is impressive given that there only an estimated 30,000 people with the disease in the U.S. in any given year.

It will be interesting to see what public comment discussion is engendered by this development vis-a-vis patient education and genomics, and the ethical and health information management issues raised by patients taking an ever more intense interest in the building blocks of their very beings and expecting frontline clinicians to treat them by utilizing such data.

This not just an ALS story. This is a new era in medicine.

About the author: Hope Leman writes about Health 2.0 and the e-patient movement at Significant Science. She is also a writer for AltSearchEngines, which covers hundreds of alternative / niche search engines. Hope is a research information technologist for a health network in Oregon and is also Web administrator of the grants and scholarship listing service ScanGrants.