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Social Determinants of Health Impact Hospital Readmission Rates Print E-mail
Written by FHI's Week in Review   
Monday, 25 March 2019 16:33
 
Jacqueline LaPointe reports on a new study in a March 20, 2019 post in RevCycle Intelligence. New research in Health Services Research shows (not surprisingly) that social determinants of health are linked to hospital readmission rates. Therefore, accounting for disability, housing instability, and other social risk factors in value-based purchasing models can help level the playing field for safety-net hospitals.
 
Read more in the current issue of Week in Review>> https://conta.cc/2JHpd2j
 
Last Updated on Monday, 25 March 2019 16:38
 
Death By 1,000 Clicks: Where Electronic Health Records Went Wrong Print E-mail
Written by Fred Schulte and Erika Fry | Fortune via KHN   
Friday, 22 March 2019 17:33
 
Electronic health records were supposed to do a lot: make medicine safer, bring higher-quality care, empower patients, and yes, even save money. Boosters heralded an age when researchers could harness the big data within to reveal the most effective treatments for disease and sharply reduce medical errors. Patients, in turn, would have truly portable health records, being able to share their medical histories in a flash with doctors and hospitals anywhere in the country - essential when life-and-death decisions are being made in the ER.

But 10 years after President Barack Obama signed a law to accelerate the digitization of medical records - with the federal government, so far, sinking $36 billion into the effort - America has little to show for its investment. KHN and Fortune spoke with more than 100 physicians, patients, IT experts and administrators, health policy leaders, attorneys, top government officials and representatives at more than a half-dozen EHR vendors, including the CEOs of two of the companies. The interviews reveal a tragic missed opportunity: Rather than an electronic ecosystem of information, the nation's thousands of EHRs largely remain a sprawling, disconnected patchwork. Moreover, the effort has handcuffed health providers to technology they mostly can't stand and has enriched and empowered the $13-billion-a-year industry that sells it.
 

Last Updated on Tuesday, 16 April 2019 17:51
 
Judge Rules United Behavioral Health Guidelines Led to Denial of Claims Violations Print E-mail
Written by Vitale Health Law   
Tuesday, 12 March 2019 16:59
 
A California federal judge has issued a landmark ruling that could impact the way insurance companies cover mental health and substance use treatment. Chief Magistrate Judge Joseph Spero of the District Court for the Northern District of California ruled that United  Behavioral Health (UBH) used "flawed" internal guidelines resulting in the unlawful denial of mental health and substance use treatment for those it insured across the country, all in an effort to save money. UBH, which is owned by UnitedHealth, serves more than 60 million members. The case grew out of two consolidated class-action lawsuits (Wit, et. al. v. UnitedHealthcare et. al. and Alexander, et al. v. United Behavioral Health), filed in 2014 and heard by Judge Spero in 2017 during a 10-day bench trial.


Last Updated on Tuesday, 12 March 2019 17:03
 
FL Senate Signs Off On Smokable Marijuana Print E-mail
Written by FHI's Week in Review   
Monday, 11 March 2019 18:33
 
Dara Kam reports for News Service of Florida via Health News Florida on  Mar 8, 2019:
Bowing to a demand by Gov. Ron DeSantis, the Florida Senate on Thursday <3.7.19> overwhelmingly approved a measure that would allow patients to smoke medical marijuana if doctors deem it the proper treatment. Under the proposal, patients could buy up to 2.5 ounces of medical pot during a 35-day period and would be able to possess up to 4 ounces of cannabis at any given time. Smoking of medical cannabis --- which would have to be purchased from state-authorized operators --- would be banned in public places. The Senate's 34-4 vote in favor of the measure (SB 182) came two days after the start of the 2019 legislative session, and the House is expected to take up the measure Wednesday <3.13.19>.
Read more in the current issue of Week in Review>> https://conta.cc/2EW0kdt
 
Last Updated on Monday, 08 April 2019 11:18
 
‘Elbow grease’ may get the job done but could prove painful Print E-mail
Written by FHInews   
Monday, 11 March 2019 00:00
Hand and Upper Limb Orthopedic surgeon Dr. Alejandro Badia offers tips to reduce arm strain, avoid tennis elbow

Adding a little “elbow grease” helps get the job done but repetitively using too much “grease” can eventually lead to disabling elbow pain. So, says Florida-based orthopedic surgeon Alejandro Badia MD, who calls the medical condition “lateral epicondylitis” or “tennis elbow,” a persistent, debilitating injury that may develop in anyone who repeatedly overtaxes tendons and muscles in the forearm and elbow.  Forearm muscles control the extension and bending of the wrist; tendons connect muscles to bones. 

Tennis elbow primarily affects the extensor carpi radialis brevis (ECRB) muscle and tendon, resulting in often excruciating pain on the outside (lateral side) of the arm near the elbow.  Besides tennis players and other athletes, including Anglers (avid fishermen), factory workers and tradesmen, including carpenters, plumbers and painters, are prone to the injury. 

“Even do-it-yourselfers who decide to tackle a long-term project such as painting the house – a job that they are unaccustomed to doing -- may develop tennis elbow,” says Dr. Badia, noted expert in diseases and injuries of the upper limbs and founder and chief medical officer of the Badia Hand to Shoulder Center and OrthoNOW®.

“Repetitive bending and straightening of the elbow can stress, and eventually weaken and damage, the ERCB muscle, causing microscopic tears to develop in the tendon that connects the muscle to the elbow’s lateral epicondyle bone,” Dr. Badia explains. Dr. Badia adds that hard work doesn’t cause tennis elbow, but it does make it become more symptomatic in people who are predisposed due to minor tendon injury which reduce the blood flow to the tendons and joints.

An estimated 200,000 Americans are diagnosed each year as having the problem, which can significantly impact a person’s lifestyle, sometimes making it almost too painful to lift a mug of coffee with the affected arm or shake someone’s hand.

Scientists’ overall conclusion that a “wait-and-see” approach may be the best therapy for tennis elbow because the condition usually resolves on its own over time “is not an option for many patients,” Dr. Badia says. “It can take 12-18 months for tennis elbow to clear up without treatment. For athletes eager to get back into competition or workers whose jobs require constant use of arms, hands and wrists, time is of the essence.  They cannot afford to wait months,” says Dr. Badia.

In fact, Dr. Badia has successfully treated resistant tennis elbow in professional athletes, including former world’s top-10 tennis champion Marcelo Rios, whom he recently returned to competition within about a month after using an advanced therapy – ultrasonic percutaneous tenotomy with Tenex Health’s minimally invasive technology.
 
Developed by Tenex Health in collaboration with the Rochester, Minnesota-based Mayo Clinic, the minimally-invasive outpatient procedure is an option for patients whose tennis elbow has not responded to initial, nonsurgical therapies.

More conservative treatments include rest, application of ice to the affected elbow area, arm-wrist stretch exercises to enhance blood supply to the ECRB tendon, anti-inflammatory medications, growth factors found in platelet rich plasma (PRP) injections   and even use of radiofrequency and corticosteroid injections, Dr. Badia says.

“But in cases when the elbow tendon fails to heal because of poor blood supply, we have to remove the necrotic tissue.  With the Tenex Health technology, we use ultrasonic energy ablation to literally melt away the dead material and aspirate it through a small puncture wound with an instrument approximately the size of a syringe,” Dr. Badia says.  “The procedure requires less than 30 minutes to perform with the patient lightly sedated and since there are no stitches there is no scarring. “Unlike traditional surgery, which often requires months of healing, recovery from the ultrasonic procedure is “almost immediate,” with the affected elbow returning to full mobility right away and back to playing tennis within a few weeks, he says.

Of course, the best treatment for tennis elbow is prevention.  That’s why Dr. Badia offers these tips to workers and recreational sports players alike:
  • Warm up and do arm, wrist and even finger stretch exercises, especially prior to activities like tennis that require repetitive movements.
  • Engage in exercise regiments designed to strengthen the upper limbs, including wrist and elbow.
  • Learn to rely more on shoulder and upper arms to take some of the work off the elbow.
  • Avoid repetitive hand and arm movements; rotate work tasks.  If this is not possible, take breaks and even consider wearing an elbow brace.
  • Use on-the-job tools and sports equipment that are right for your grip and help take strain off the forearm muscles.  For example, a lighter-weight tennis racquet with string tension of 55 pounds or less can reduce stress on both arm and elbow.  Gloves or padding can absorb some of the shock when using tools. Dr. Badia also advises patients about the Xtensor reverse grip hand exerciser as a tool for recovering strength.
Dr. Badia concludes that this very popular condition can’t be avoided but early recognition and treatment are key to the best outcome and opportunity to get back to playing tennis and other sports or work activities.

Bio: Alejandro Badia, MD, FACS, internationally renowned hand and upper-limb surgeon and founder of Badia Hand to Shoulder Center and OrthoNOW®, a walk-in orthopedic care clinic.  He is a member the American Society for Surgery of the Hand, American Association for Hand Surgery and the American Academy of Orthopedic Surgeons. He is a specialist in treating all problems related to the hand and upper extremity including trauma, sports injury, joint reconstruction, nerve injuries and arthroscopic surgeries. Dr. Badia is co-chairing the upcoming STMS Tennis Medicine Meeting in Miami: https://www.tennismedicine.org/page/MiamiConference). To learn more about Dr. Badia, visit: www.drbadia.com.

Last Updated on Wednesday, 13 March 2019 16:03
 
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