Category Archives: Health News

UCSF to Use Dignity Health Digital Platform to Increase Health Access

Partnership Puts Information in the Hands of Patients to Transform their Health Care Journeys

Dignity Health and UCSF Health are collaborating to develop a state-of-the-art digital engagement platform that will provide information and access to patients when and where they need it as they navigate primary and preventive care, as well as more acute or specialty care.

The platform, which ultimately aims to serve as a model for health systems nationwide, will be hosted by Dignity Health. The two health care organizations will leverage technological expertise and cloud-based infrastructure that Dignity Health has developed for its 40 hospitals. As one of the nation’s top-ranked academic medical centers, UCSF Health will contribute its extensive knowledge of the patient experience in specialty care.

The two health care organizations will develop a trusted path of digital access across the patient journey using the proprietary cloud-based platform of Dignity Health, one of the nation’s largest health systems.

“Our collaboration with Dignity Health will empower patients and their families with digital health care and connectivity, while simplifying the provider experience,” said Shelby Decosta, senior vice president and chief strategy officer for UCSF Health. “Together, with Dignity Health, we are opening new pathways for health care organizations to create a superior experience for their own patients and ultimately, for patients nationwide.”

In the first phase of the digital collaboration, UCSF is redesigning the user experience of its web and mobile properties and leveraging Dignity Health’s technical expertise to re-envision how the medical center delivers information to patients. The personalized, mobile-responsive infrastructure is supported by rich analytics and machine learning. In later phases, UCSF’s Center for Digital Health Innovation and Dignity Health will map out the multiple pathways that patients follow in moving from primary and secondary care to more acute care services, to create a robust digital system that connects patients and providers, while providing patients with the information they need throughout the process.

Continue reading UCSF to Use Dignity Health Digital Platform to Increase Health Access

Updated Osteoporosis Screening Guidelines Released by USPSTF

The US Preventive Services Task Force (USPSTF) published its final recommendations this week on the screening of women for osteoporosis to prevent fractures. The updated guidelines include level B recommendations for the screening of women aged 65 years and older, as well as for younger women who have experienced menopause and also have an increased risk.

graph of osteoporotic fractures compared to other diseases for article, Updated Osteoporosis Screening Guidelines Released by USPSTF“Osteoporosis causes bones to weaken and potentially break, which can lead to chronic pain, disability, loss of independence, and even death,” the USPSTF said.

“Clinicians can help women avoid fractures by routinely screening those who are 65 and older, as well as younger, postmenopausal women at higher risk for osteoporosis — such as women who have low body weight, who smoke cigarettes, or whose parent has broken a hip.”

The final recommendations, which were published online June 26 in JAMA, apply to older adults without a history of prior fragility fractures or health conditions that could weaken bones.

The USPSTF noted that evidence was insufficient to determine whether men would benefit from osteoporosis screening to prevent fractures.

“While both men and women can develop osteoporosis, there’s less evidence to know whether screening and current treatments prevent fractures in men without a history of fractures,” USPSTF vice chair Alex H. Krist, MD, MPH, said in a news statement.

“More studies are needed that look at how well treatments work in men who have not had a fracture,” he said.

In updating its similar guidelines from 2011, the USPSTF conducted an evidence review of 168 articles on the issue of osteoporosis screening that were determined to be of fair or good quality.

[SEE FULL STORY HERE]

Will Your Melanin Protect You From The Sun?

summer beach fun scene for article, Will Your Melanin Protect You From The Sun?For many people, the dog days of July mean grabbing an ice pop, lounging outside, and letting the summer sun hit your skin. And for people of color, we’re often doing those things sans sunscreen. After all, our melanin will protect us. Right?

Not so fast.

This week on Ask Code Switch we’re taking on a question from Liz Mitchell, from New York. She writes:

“Dear Code Switch,

I’m biracial, and my black family don’t use sunscreen – if anything they use oil at the beach. My white mom has always been all about sunscreen. I used to be like, ‘I got melanin, I’m fine.’ But my white grandpa died of skin cancer, and since then I’ve felt like I’m inviting the cancer into my body whenever I step outside. Sorry to be grim, but I’d love to hear other POCs thoughts and practices around skincare and skin cancer.

Peace,

Liz”


Hi Liz,

I hear you. I, too, grew up with a black dad who would laugh at the mere thought of sunscreen, and a white mom who needed to reapply seven times in an afternoon. And like you, for most of my life, I never really worried about protecting my skin from the sun. “Black don’t crack” wasn’t a phrase I really heard a lot growing up. If anything, it was “black don’t burn.”

That mindset is incredibly common. In 2006, John McCann, a columnist for the Herald-Sun in Durham, N.C., talked about how his family would get greased up before going outside. “This goes back to when I was a little kid, and momma used to slick me down with Vaseline,” he wrote. “Despite how hot it is…black people all over this country will lotion up before leaving the house. Got to get rid of that ash. … And yet we won’t use sunscreen.”

Now, there may be some legitimate thinking behind that. According to the American Cancer Society, melanoma (the most common form of skin cancer) is more than 20 times more common in white people than in black people in the United States, with black people being diagnosed at a rate of about 0.1 percent. Latinos fall somewhere in the middle, with about 1 in 172 people being diagnosed with melanoma in their lifetimes.

But those numbers don’t tell the whole story. A study in the November 2016 Journal of the American Academy of Dermatology found that even though white people are the most likely to get skin cancer, they also had the longest survival time after diagnosis. Black people, by contrast, had the shortest survival time. In other words, the black people who get melanoma are more likely to die from it than the people from other racial groups.

There are a few factors that might contribute to those statistics. For one thing, black people are often diagnosed at later stages of the cancer than people from other racial groups. That could be because we often don’t see ourselves as being at risk, so are less likely to check ourselves (or go get checked out) for suspicious lumps and moles. It could also be because medical professionals make the same assumptions, and are less likely to be on the lookout for signs of skin cancer in darker-skinned patients.

Jacqueline Smith is a member of the Melanoma Research Foundation‘s Board of Directors. She’s also a self-described dark-skinned black woman who has survived two bouts of melanoma.

When does a condition become a medical issue?

 | MEDICAL CONDITIONS  

Doctor shrugging shoulders for article, When does a condition become a medical issue?It has become a sign of legitimacy to call a personal problem “medical.”  This aims to distinguish the problem from those of morality or character.  It implies both that the problem is serious, and that it is unbidden and largely out of the sufferer’s control.  Unfortunately, it isn’t clear what exactly qualifies as “medical,” so this label serves more as a rhetorical device than a scientific finding.

Alcoholism is the paradigm and perhaps least controversial example.  Through the 19th Century, alcoholism was variously declared a disease, or a matter of will and character.  The disease model gained prominence in the 1930s and 40s with the “powerlessness” identified in the 12 Steps of Alcoholics Anonymous, as well as researcher E.M. Jellinek’s descriptions of progressive stages and subtypes of alcoholism.  The American Medical Association declared alcoholism an illness in 1956 and has endorsed the disease model ever since, partly as a strategy to ensure insurance reimbursement for treatment.

The model expanded to include other abused substances with the formation of Narcotics Anonymous in the 1950s, and as a result of widespread recreational drug use in the late 1960s and early 1970s.  The specialty of addiction medicine was first established in 1973 in California.  The American Society of Addiction Medicine now states: “Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry.”  Proponents of the disease model of addiction cite many documented brain changes and a plausible neuropathology, as well as the presence of genetic risk factors, cognitive and emotional changes, impaired executive functioning, and disability and premature death.  The model purportedly destigmatizes addicts — they are no longer “bad” or “weak” people — thereby making it more acceptable for them to seek treatment.

Nonetheless, the disease model of addiction remains controversial.  In addition to the existence of alternative models, the disease model itself has been criticized.  Some believe it removes personal choice and responsibility, and actually contributes to the problem of addiction.  Others cite surveys of American physicians who consider alcoholism more a social or psychological problem — even a “human weakness” — than a disease.  Critics note that about 75 percent of those who recover from alcohol dependence do so without seeking any kind of help, and that the most popular and recommended treatment, Alcoholics Anonymous, is a fellowship and spiritual path, not a medical treatment.

[SEE FULL STORY HERE]

Study finds popular health news stories overstate the evidence

Joy Victoryphoto of Joy Vcitory is Deputy Managing Editor of HealthNewsReview.org. She tweets as @thejoyvictory.

A new study confirms something we here at HealthNewsReview.org have been emphasizing for many years: Health news stories often overstate the evidence from a new study, inaccurately claiming that one thing causes another — as in drinking alcohol might help you live longer, facial exercises may keep your cheeks perky, and that diet soda might be a direct line to dementia.Info graphic of percentage of people who get health info on social media

The researchers looked at the 50 “most-shared academic articles and media articles covering them” in 2015, according to data from the NewsWhip database. Seven of the 50 studies were randomized controlled trials, the gold standard for “causal inference” in medicine (meaning, one can reasonably infer that an intervention caused an outcome, but not always).

The rest were observational studies, which is what it sounds like: Observing people and then seeing what happens to them (or what happened to them, if it’s looking at data collected in the past). They are not true experiments, with a control and placebo group. Sometimes, with lots of observational data–after longterm, repeated findings in thousands of people from different studies that used terrific methodology– the evidence becomes so strong that it can make sense to change public health or medical practice based on only observational data. Smoking and lung cancer is one such case. But it’s also clear that the literature has become littered with poorly done observational studies that make causal claims that cannot be supported.

They found a “large disparity” between what was written in the news stories compared to what the research showed:

  • “44% of the media articles used causal language that was stronger than the academic articles” (and many of those studies were overstated to start with).
  • “58% of the media articles contained at least one substantial inaccuracy about the study.”

X ‘may be caused by’ Y

One way that news stories can overreach is by inaccurately using language that implies x caused y:

  • “may be caused by”
  • “seems to result in”
  • “is caused by”
  • “is due to”

    [SEE FULL STORY HERE]

How to make sure your vacation isn’t a medical disaster

Recently while traveling overseas, I found myself in a predicament not often encountered nor taught to health professionals. I was requested to address an emergency at 30,000 feet in the air. This got us thinking: How many patients consider the possibility of a medical emergency in the air?

photo of person in beach chair with full body cast for article, How to make sure your vacation isn’t a medical disasterPeople with chronic illnesses and the older population (who find themselves retiring and having more time to travel) need to be prepared so their vacation isn’t ruined by a health crisis.

Below are a few tips to stay safe while traveling:

If you have serious medical conditions, be sure your travel companion is prepared to help in case of an emergency. In the event you lose consciousness you need someone to convey information to those on board trained to help you, primarily the flight attendants, or, if you are lucky enough, a medic, emergency medical technicians (EMT), nurse, nurse practitioner (NP), physician assistant (PA) or physician.

This cannot be overstated enough — pack ANY medications you might need in an emergency in a carry-on bag. This includes an epi-pen, albuterol, aspirin, nitroglycerin, antihypertensives, non-steroidal anti-inflammatory medications, insulin, glucose supplement, anti-emetics, oxygen, etc. If you’re not sure if you should carry certain medications on board, discuss it with your primary care physician prior to traveling. TSA states, “Medications in pill or other solid forms must undergo security screening. It is recommended that medication be clearly labeled to facilitate the screening process. Check with state laws regarding prescription medication labels.” Make sure to have plenty of medication for your trip, plan to have your primary care physician call these into the pharmacy at least one week prior to travel. Be prepared for anything. Most airlines only carry a basic first-aid kit, oxygen and a defibrillator.

If you have medical conditions, see if your primary care physician prior to take off for a travel clearance. If your physician detects early warning signs of illness then the risks of travel may far outweigh the benefit.

If you have serious food or environmental allergies (e.g., anaphylaxis — a multi-organ, life-threatening allergic reaction) alert the flight attendants as you board (and have your EpiPen!). Though awareness of serious allergies to peanuts has increased they are still served on some flights. Other commonly served food products include soy and wheat.

[SEE FULL STORY HERE]

QuitMedKit: An Essential Guide to Tobacco Cessation App

Douglas Maurer, DO/MPH/FAAFP | 

Tobacco use remains the #1 preventable cause of morbidity and mortality in the United States and worldwide. Overall, cigarette smoking among U.S. adults (aged ≥18 years) declined from 20.9 percent in 2005 to 15.5 percent in 2016. Still, nearly 38 million American adults smoked cigarettes in 2016, according to the Centers for Disease Control and Prevention (CDC).

Screenshot of app for article, QuitMedKit: An Essential Guide to Tobacco Cessation App
And it’s FREE!

Smoking remains the leading cause of cancer, heart disease, stroke, lung diseases, diabetes, and chronic obstructive pulmonary disease (COPD). Efforts to promote tobacco cessation are encouraged at the national, state, local, and individual practice level. The CDC reports only California and Alaska spend the recommended amount on tobacco cessation.

National efforts have included tobacco taxes and smoking bans which have both proven effective. Efforts to prevent the initiation of tobacco use in youths include Tar Wars from the AAFP. More recently, the prescribing of apps for cessation has been utilized and shown to be effective. I have studied the Smartquit app myself via a randomized controlled trial in the military population (unpublished data) served by our residency program. What are the options for providers just wanting to counsel patients outside of a research study and/or paying for a smoking cessation app to prescribe?

The University of Texas MD Anderson Cancer Center has just released a new app called QuitMedGuide. The app was developed by Alexander V. Prokhorov, MD, PhD and Mario Luca, MS, at MD Anderson. The app is intended to assist healthcare providers in counseling and treatment of tobacco dependence. The app includes the evidence-based 5As approach, information on medications for cessation, tips on motivational interviewing, graphics to assist in cessation, and links to online resources.

Evidence-based medicine

Developed by the University of Texas MD Anderson Cancer Center, QuitMedKit uses the current 2008 US Department of Health and Human Services Clinical Practice Guideline for tobacco cessation. The app includes detailed information on the proven 5As approach to cessation, tips on motivational interviewing, and current FDA-approved medications for tobacco cessation.

Who would benefit from this App?

Medical students, primary care physicians, midlevels, hospital medicine physicians, nurses, pharmacists, or any provider who counsels patients on tobacco cessation.

[SEE ORIGINAL STORY HERE]

Lyra Health raises $45M to create a smart network for treating mental health problems

Treating issues with mental health can be a daunting and very sensitive task for anyone that is suffering from any kind of mental illness — but the problem for many is that a lot of patients just don’t know where to start, according to David Ebersman.

mental signpost graphic for article, Lyra Health raises $45M to create a smart network for treating mental health problemsThat’s where Lyra Health hopes to help. The service works with employers to offer a tool to their employees that helps them securely and confidentially begin to understand what kind of treatment they need to seek if they feel like they are suffering from any mental health problems. Employers naturally have a stake in this as they want their employees to stay health, but the goal is to offer a sort of safe space where users can benefit from years of growth in pattern matching and data to help them figure out where to start. The company said it has raised $45 million in a new financing round including Tenaya Capital, Glynn Capital Partners, Crown Ventures, and Casdin Capital. Existing investors that include Greylock Partners, Venrock, and Providence Ventures also participated in the funding round.

“We felt it was important to build an offering that would be helpful to all of the people who work at these companies and are suffering from a mental health condition like depression, or anxiety, or substance abuse,” Ebersman said. “A lot of the people we want to help don’t know where they’re starting. Trying to build and market something narrowly to a subset of the audience requires the audience to know they’re in that subset. Trying to build something more welcoming and engaging for a broader set of conditions felt to us to be a realistic response to the fact that not everyone can self identify. Fortunately technology really helps us with this — we can build a secure and confidential place where an employee can go and answer some questions that relate to their symptoms, severity, treatment preferences and use technology to match them for the right care.” Continue reading Lyra Health raises $45M to create a smart network for treating mental health problems

In helping smokers quit, cash is king, e-cigarettes strike out

Date: May 23, 2018
Source: University of Pennsylvania School of Medicine

Free smoking cessation aids, such as nicotine patches and chewing gum, are a staple of many corporate wellness programs aimed at encouraging employees to kick the habit.

info graphic showing stages of quitting smoking for article, In helping smokers quit, cash is king, e-cigarettes strike outBut, new research shows that merely offering such aids for free does not help employees quit, whereas supplementing them with financial incentives is three times more effective.

The study, led by researchers at the Perelman School of Medicine at the University of Pennsylvania, also provides the first large-scale evidence that offering e-cigarettes to known smokers is not effective at helping smokers stay smoke-free. The results are published today in the New England Journal of Medicine and may hold significant policy implications as the U.S. Food and Drug Administration continues to weigh e-cigarette regulation.

“Smoking remains the leading cause of preventable deaths in the United States, and nearly all large employers offer wellness programs aimed at getting people to quit. But, these programs vary considerably, and to date, there has been little evidence to suggest which designs and strategies are most effective,” said lead author Scott D. Halpern, MD, PhD…

[SEE REST OF STORY HERE]

Steep rise in insect-borne illnesses puts outdoor workers at risk: CDC

Atlanta — Disease cases stemming from mosquito, tick and flea bites more than tripled from 2004 to 2016 in the United States, and outdoor workers remain among those at risk, the Centers for Disease Control and Prevention states in a new report.

photo of tick on leaf for article, Steep rise in insect-borne illnesses puts outdoor workers at risk: CDC
Photo: andriano_cz/iStockphoto

According to CDC, cases of domestic disease such as dengueZikaLyme and plague totaled more than 640,000 in that time period. The agency identifies state and local health departments and vector control organizations as the primary defense, but notes that 84 percent of such organizations lack one or more of five core competencies:

  • Routine mosquito surveillance via standardized trapping and species identification.
  • Treatment decisions devised from surveillance data.
  • Killing mosquitoes and ticks at every life stage.
  • Routine vector control activities, including source reduction or environmental management.
  • Pesticide resistance testing.

The risk for developing insect-borne diseases increases as commerce moves insects to different areas of the country and worldwide, the report states. Mosquitoes and ticks can transport germs, while infected travelers can introduce and spread them.

Symptoms of insect-borne disease include body, muscle and joint pain; fever; rash; headaches; stiff neck; fatigue; and paralysis.

CDC offers tips to prevent insect stings and bites. Among them:

  • Wear clean, light-colored clothing that covers as much of the body as possible.
  • Bathe daily while avoiding cologne, perfume and perfumed soaps, shampoos and deodorants.
  • Maintain clean work areas.
  • Remain calm around flying insects, as swatting may prompt them to sting.
  • Perform daily skin and clothing checks for ticks, which tend to populate worksites near woods, bushes, high grass or leaf litter.
  • Use insect repellent with 20 percent to 50 percent DEET on exposed skin and clothing, reapplying as necessary.

    [SEE ORIGINAL STORY HERE]