Olive Oil Protects Against Stroke. Consuming copious amounts of olive oil may dramatically reduce stroke risk for older adults, according to a population-based study.

New Study Adds to Confusing Debate over Cell Phones and Cancer. A new study published in the American Journal of Epidemiology found that cell phone radiation generally cannot reach the cells where most brain tumors are located (Pizaazz will comment on this study this Wednesday).

HHS Announces Initiative to Stimulate Adoption of EHRs in Minority Communities. The Department of Health and Human Services’ Office of Minority Health and Quest Diagnostics have announced a program in which Quest will donate electronic health record  software and services to physicians in small practices serving minority populations in Houston.

US Births Fall Again on Weak Economy. The United States birth rate apparently fell for a third year in a row, but the declines may have hit bottom, the CDC said.

Restrict Imaging Studies, MedPAC Says. The Medicare Payment Advisory Commission has called on Congress to place restrictions on doctors who order substantially more diagnostic imaging services than their peers.

ONC Exams To Help Identify HIT Experts. The exams will allow individuals to demonstrate skills deemed essential for health IT professionals in the workforce. They can also be used by providers to assess the health IT competencies of their staffs.

Ford, Experts Research SYNC Health as a Tool For Chronic Disease Management. Leveraging Ford SYNC®, researchers developed glucose device connectivity and monitoring capability, location-based allergy and pollen reports and voice-controlled, cloud-based health management services.

Coronary CT Screening Does Not Impact Outcomes. Screening for atherosclerosis with coronary CT imaging in asymptomatic patients leads to more detection and treatment, but no significant change in outcomes, a study found.

Medicaid Officials Review States’ Plans To Block Abortion Funding. Federal officials are taking a hard look at a new Indiana law that withholds some public funding for Planned Parenthood, a development that could cost the state some of its Medicaid funding.

Johns Hopkins Releases Mobile Diabetes Guide. The POC-IT guide can be accessed on the iPad or iPhone. It is developed by Skyiscape in cooperation with clinicians at Johns Hopkins Medicine and is part of the POC-IT series, which includes antibiotic and HIV guides.

One-Third of Hospital ERs Have Closed in Past 20 Years. From 1990 to 2009, the number of hospital emergency departments in non-rural areas in the US declined by 27%, according to a study in this week’s JAMA.

iPhone ‘Rewards’ Help Teens with Glucose Control. Giving teens iTunes cash in return for taking blood glucose measurements via a smartphone app seems to be working in a new pilot project at the University of Toronto.

More Docs Using Video Chat for Routine Follow-Up Visits. A full 7% of physicians are using video-conferencing to talk with patients, according to new data from Manhattan Research.

Florida REC Reaches Hundreds with EHR Help. More than 700 Florida providers have enrolled in the Center for the Advancement of Health IT, a REC program that will help them implement EHRs and achieve Meaningful Use.

US Reserves Right To Respond Militarily to Cyberattacks. The declaration came in a new White House international cyberspace strategy document which also covers issues including the free flow of information, foreign assistance and cybercrime.

DOJ Decries Lack of Internet Protocol Data From Smartphones. Amid a national uproar over the belated, surprising news that mobile devices track your whereabouts, the Justice Department has expressed unhappiness with its inability to access such data.

Bandwidth Speed Limits Smartphone Use for Diagnostic Imaging. Researchers in Calgary are suggesting that the frame rate associated with 3G cellular networks is insufficient for practical use in viewing radiology images.

Primary Care Still Hard to Find in the Bay State. More than half the primary care practices in Massachusetts don’t accept new patients, and wait times for new patients continue to lengthen 5 years after the state passed its landmark healthcare reform law.

High-volume Hospitals Recommended for High-Risk Heart Transplants. Older, sicker heart-transplant patients are more likely to survive for one year after surgery if they were treated at hospitals that do a lot of transplants, a study showed.

Health Consumers Trust Traditional News over Social Media. A new poll shows that most people trust health and medical research information provided by traditional news sources more than that provided by social media and mobile devices.

iPhone To Dominate US Physician Smartphone Market. In a recent survey, 61% of US physicians said they intend to own an iPhone by year-end, 2011. That’s up from 39% at the beginning of the year. Among US smartphone users overall, 25% own iPhones.

CDC Offers $35,000 in Prizes for Best Flu Educational Applications. Awards will go to developers who create the best mobile or Web applications that educate the public about influenza prevention.

Indiana to Cut Planned Parenthood Funding. Republican Governor Mitch Daniels plans to sign restrictive abortion legislation and make Indiana the first state to cut off all government funding for Planned Parenthood.

Hair Loss Prevention Robot Approved by FDA. The Artas System, by Restoration Robotics, identifies and harvests permanent hair follicles which can then be implanted manually where needed.

HHS Launches Value-Based Purchasing Program. The program will reward hospitals for the quality of care they provide to Medicare beneficiaries. Measures to determine quality will focus on how closely hospitals follow best clinical practices and utilize health information technology.

Many have proposed that retail clinics—which provide health services from a few square feet carved out of grocery stores and pharmacies—could represent a means by which  the poor and uninsured can access health care.

It turns out however, that few such clinics exist in poor neighborhoods.

According to a recent study, retail clinics follow the money to affluent suburbs, just like most businesses and for that matter, most health care providers.

Craig Pollock and colleagues at the University of Pennsylvania matched the zip codes of 930 retail clinics with US census data describing the income and racial makeup of these areas.

They found that only 123 clinics had been set up in areas defined by the Feds as medically underserved. Regions featuring at least one retail clinic had a lower percentage of Hispanic and Black residents, lower family income, and higher rates of home ownership.

The write-up appears in the Archives of Internal Medicine.

“Many people have promoted retail clinics as a cure for access to care for the underserved,” the University of Pittsburgh’s Ateev Mehrotra told the Washington Times. “These findings show that’s unlikely to happen.”

Pollock’s group concluded that financial incentives may be required to lure the clinics to underserved areas. 

Retail clinics feature customer-friendly hours of operation and are usually staffed by nurse practitioners. They give immunizations and treat minor conditions such as skin rashes and upper respiratory illnesses. The services typically run between $40 and $75. Prices are usually posted.

Some, but not all retail clinics accept insurance.  CVS Caremark and Walgreens are the largest operators of retail clinics. Together, they run about 1,200 of them. States with the highest numbers of retail clinics are Florida (with 147), then Texas, California and Illinois.

Harvard scientists have found that as people age to a point where they become eligible for Medicare, the improved access to care it assures is associated with reductions in racial and socioeconomic disparities in health status.

That supports a contention made by many that universal coverage could narrow the US’ appalling gaps in the quality and outcomes of care for non-whites and the poor.
 
Before reaching these conclusions, John Ayanian and colleagues performed observational and quasi-experimental analyses of cross-sectional data from the National Health and Nutrition Examination Survey. Data had been collected between 1999 and 2006 from adults aged 40 to 85 years old.
 
The scientists found that measures of disease control improved significantly across all racial and socioeconomic subsets during the 7-year study period, which had the effect of preserving racial disparities noted at study onset…until that is, people reached an age where they qualified for Medicare.

That’s when the gaps narrowed dramatically.

Once people with hypertension enrolled in Medicare, Black vs. white disparities in systolic blood pressure dropped by 4.2 mm Hg, a 60% reduction.

Similarly, Medicare enrollment was associated with a 70% reduction in Black-white disparities for hemoglobin A1c levels, a measure of diabetes control. There were similar reductions in disparities when people were stratified according to educational status. 

“Universal health insurance may reduce persistent disparities we’ve seen for far too long in Americans from different racial or ethnic groups,” Ayanian told BurrillReport. He’s a professor of medicine and health care policy at Harvard Medical School and Brigham and Women’s Hospital.
 
The write-up is in the Annals of Internal Medicine.

“The results of this study make it clear that guaranteeing access to affordable insurance for all Americans is the essential first step toward…a healthier America,” said Karen Davis, president of the Commonwealth Fund, which funded the study.

Data are filtering in on Massachusetts’ grand plan to extend health insurance coverage to virtually all Bay Staters. The good news is just about everyone’s covered. The bad news is just about everything else.

When it comes to controlling health care costs, the state’s performance has been abysmal. Experts recently predicted that the state will spend $600 million more in 2009 on health care than in 2006, a 42% bump.

Now comes troubling data on a measure of access to care, emergency room visit volume.

In theory, the state’s new law should cut the costly visits because more people have access to PCPs that can either treat health situations before they reach crisis proportions or prevent them altogether.

In fact, ER visits went up 7% and the cost per ER visit jumped 17% in Massachusetts between 2005 and 2007, according to data shared with the Boston Globe.

The fraction of ER visits for non-urgent matters that could have been handled by a PCP remained unchanged at an astonishingly high 47%.

Massachusetts officials said several more years were required before accurate assessments could be made regarding the impact of their law on access to care.

The law actually went into effect half-way through the data collection period used to make the conclusions above, so they may have a point there.

Still, many worry that simply extending health insurance coverage isn’t going to control costs or improve access. They say the state needs to beef up its PCP corps before the program can work.

“Just because you have insurance doesn’t mean there’s a [PCP] who can see you,” said Sandra Schneider, VP of the American College of Emergency Physicians. “I am not surprised that visits went up.”

In 2006, Massachusetts enacted a law that vastly reduced the number of uninsured Bay State residents. There was one slight problem though. Scads of the newly insured couldn’t find primary care doctors to take care of them.

Wait times for routine office visits have soared in some parts of the state to 100 days and many residents have simply given up trying to find one.

These folks end up seeking care in ERs which is what they did before they were covered.

The problem scares the bejeesus out of officials in the Obama administration, who know that if the Big O has his way and 40-50 million Americans acquire health insurance in the blink of an eye, the same problem will play itself out nationwide.
 
What to do? Some suggest bumping medical school enrollment which would begin addressing the problem around the time the Big O wraps-up his second term, and that’s assuming any of the new graduates actually enter primary care.

Others recommend increased utilization of nurse practitioners and physician assistants, but last time we checked all these types are already happily employed, and training new ones is associated with lag time problems of its own.

Solutions with a quicker onset of action include expanding RN-staffed retail clinics with leveraged physician oversight, and opening the doors even more widely to foreign medical graduates.

Some even suggest overhauling the payment structure for physicians in a way that incents specialists to do some primary care.

Assuming policymakers have the stomach to take on physician payment reform in a way that doesn’t cause system-wide costs to skyrocket, the idea won’t go down well with specialists, regardless.

Listen to Peter Mandell, for example. The spokesman for the American Association of Orthopedic Surgeons told the New York Times, “we have no problem with financial incentives for primary care (but) if there’s less money for hip and knee replacements, fewer of them will be done for people who need them.”

In Q4 2008, WellPoint lost 288,000 covered lives, half of which were caused by rising unemployment and lost employee benefits.

“Economic conditions will continue to deteriorate and unemployment will continue to increase,” CEO Angela Braly sighed to analysts at the time. “This will impact commercial membership in 2009.”

She got that right.

The nation’s largest private insurer, which covers nearly 35 million lives, reported last week that it lost nearly half a million more members in Q1 2009, nearly 65% of which were due to layoffs or employees simply opting out of employer coverage.

That jaw-dropper was topped the next day by UnitedHealth Group Inc., the second largest insurer. The Minnesota-based company reported a drop of 900,000 in the number of people enrolled in its commercial health plans.

The news prompted economists to estimate that the uninsured population has swelled by at least 4 million people since the 2007 estimate by the Census Bureau pegged the number at 45.7 million.

The Kaiser Family Foundation estimates for example that for each percentage-point increase in the unemployment rate, the population of uninsured Americans grows by 1.1 million.

The findings were confirmed by Tenet Healthcare, a hospital chain that recently reported a 2% drop, year-over-year, in the number of admissions of patients with private coverage.

“It’s probably not a surprise that with all these people losing jobs, a lot will lose their health insurance,” Paul Ginsburg, president of the Center for Studying Health System Change told the Wall Street Journal.