Retail Health Care: Redux

So what do you do if you do not have a regular health care provider and you need preventive care or care for a simple illness? According to a new study by the nonprofit RAND Corporation, you are the type of patient who would patronize a retail health clinic.

If you have missed my prior postings on the subject and have not run across the concept elsewhere, a retail health clinic is a small clinic with limited facilities that is located inside another store. Pharmacies and big box stores seem to be the usual locations they spring up in, at least so far.

At the moment, the U.S. has approximately 1,000 of these clinics, and estimations say the number will grow to a possible 6,000 by 2011. The trend is still in its comparative infancy, but like many kids, it seems to be growing fast. The RAND study is the first recorded examination of the patient demographics for this new wave of retail health care.

Via The Washington Post:

"These clinics appear to attract patients who are not routine users of the current health care system. For these patients, the convenience offered by retail clinics may be more important than the continuity provided by a personal physician," lead author Dr. Ateev Mehrotra, a professor at the University of Pittsburgh School of Medicine, said in a RAND news release.

The numbers are interesting, and bear out my predictions of earlier posts. People seem to be gravitating to this as an alternative to the perceived cost and hassle of seeing a primary care doctor. To be frank I am looking forward to seeing some of these here in New Orleans. I would certainly consider using them if they were available.

• 43% of Retail Clinic patients were in the 18 to 44 age range as opposed to to 23% of those visiting primary care physician offices.
• 39% percent of Retail Clinic patients had a primary care doctor, compared with 80% surveyed nationally.
• Retail Clinic visits paid for out-of-pocket decreased from 100 percent in 2000 to 16 percent in 2007.
• Roughly 90% of visits to retail clinics were for preventive care (medical tests) or for treatment of simple conditions or immunizations . These same conditions make up 18% of primary care visits and 12% of emergency department visits.
  

SOURCE: "Retail Clinics Attracting Those Without Regular Doctors" 09/10/08
photo courtesy of ernestl, used under its Creative Commons license

Biden Speaks on Health Care, Slams McCain Plan

Well the airwaves, newspapers and Internet are full to bursting with news and commentary related to the Presidential race, particularly now that the VP choices have been made on both sides of the aisle.

On the Democratic Party's side, Sen. Joe Biden is moving forward as an outspoken and determined VP choice for Sen. Obama. In a recent speech in Mehlville, Missouri, speaking to a socially conservative, predominantly blue collar crowd, he tied the growing unease about health care to the rising unemployment that the community has recently experienced. He then issued a no nonsense warning to the crowd about the net result of the McCain proposal on this subject.

Via Jo Mannies at STL Today:

[...]taxing American workers' health care is not the answer, he said. Under McCain's plan, Biden said, a person earning $50,000 a year, with employer-provided health care worth $12,000 a year, would be subject to income taxes on all $62,000. Now, no taxes are levied on their health care benefits.

McCain has been highlighting his proposed $5,000 a year tax credit to offset some of that tax hike, but Biden said that at least $7,000 would still be subject to the tax.

Sen. Biden then went on to state that the change in structure proposed by the McCain ticket would cause more employers to drop health care coverage. An assertion that carries quite a punch, especially in the context of the American working class.

At a town hall earlier that day, Sen. Biden called it a "moral obligation" for the government to make health care available to all U.S. citizens.

SOURCE: "Bid focuses on healthcare, rips Republicans, in Mehlville stop" 09/10/08
photo courtesy of IowaPolitics.com, used under its Creative Commons license

Health Care High Tech

Technological advances are one of the things that we all hope will help drive down the overall cost of health care. Electronic medical records (EMRs) are frequently shown by a wide array of studies to cut a huge amount of administrative costs out of the overall equation. Other innovations could be extremely useful as cost cutters once out of the research phase.

CBCNews out of Canada takes a quick look at some of these advances, and also looks at the source. Their conclusion is that the real "cutting edge" of medical tech advancement is occurring in small companies and start-ups. Citing the more adventurous profile of companies that rely on angel investments and the need to maintain revenue streams on the part of larger, established ones, the article then proceeds to put forth a few examples.

Right off the bat, they go to what I consider one of the most important areas of medical tech: electronic medical records.

Philadelphia-based Hx Technologies wants to unlock the power of computer networks (a very '90s concept) and suck costs out of the system by making it easier to transport diagnostic images like CT scans. Amazingly, shuttling these images to doctors for second and third opinions is still done the old-fashioned way — by hand.

[...]Launched in 2000, Hx Technologies estimates that it can eliminate extra tests — and save the U.S. medical system $5 billion (US) to $6 billion a year — by storing medical images so they can be accessed in encrypted form over the Internet.

They then proceed to take a look at some other innovations, including (believe it or not) robot nurses. It is a fascinating view of the cutting edge.

SOURCE: "Hot technology that could change health care" 09/08/08
photo courtesy of Liz Henry, used under its Creative Commons license

Google Your Health Records

Ten years ago this week, a new search engine made its debut. Little did anyone know at the time what a phenomenon Google would become in the intervening decade. The phrase "Google it," has become enshrined in our collective lexicon as meaning "search the Internet." Even those who do not use the Internet much or often know its meaning. In short, Google has become enshrined in our culture in much the same way a scant few other brands have. Kleenex, anyone?

Now the power of Google is being brought to bear on Electronic Medical Records. PublicRadio.org's Money Marketplace show takes a solid look at the newest news from the Internet titan, exploring both pros and cons of the new searchable online approach.

Of particular interest is the trust factor. Many people who wish to move to EMRs are worried about data mining, hackers and the other privacy bugaboos that come up whenever you discuss Internet-based programs like this.

WBUR's Martha Bebinger reports:

Still, I wonder, what will Google do with this information? HIPAA, the federal law that controls the release of patient records, does not govern these online medical records programs.

Halamka pulls up the Google Health privacy rules:

Halamka: We will never share your data. We will never data mine. We will never advertise based on your health data. You know, it's not, "Oh, I'm a diabetic; we're having a sale on glucometers at XYZ.com." They've truly built firewalls between the advertising and personal health record.

Carlton Doty: I think they're walking a fine line there.

Carlton Doty, a senior analyst at Forrester Research, says Google or Microsoft or any of their health records competitors are also creating a major advertising venue.

The article covers many other aspects of the system and includes a walk through the setup and a really useful analysis of the overall features of the new Google offering. Check out the transcript or listen to the original program here.

SOURCE: "Google's next search: Medical records" 09/06/08
photo courtesy of extraketchup, used under its Creative Commons license

Health Care In Campaign 2008

Ladies and Gentlemen, fasten your seat belts! The next 60 days or so will be abuzz as our esteemed candidates make their final lap in the race for the Oval Office. It's the final stretch and the point where the voting public really crystallizes their decision on whom to vote for.

Making an informed decision requires sound information. I hope the following is helpful in that regard.

• Research!America's President, Mary Woolley, talks with NPR about the findings of a questionnaire sent to both campaigns. A questionnaire requesting "policy details on issues such as health care coverage, stem cell research, the Medicare prescription drug benefit, and funding for NIH, FDA and CDC." [Listen Here]
  
  
• The Kaiser Network presents a new regular feature, Blog Watch. "Blog Watch, published on Tuesdays and Fridays, tracks a wide range of blogs, providing a brief description and relevant links for highlighted posts." [Blogwatch]

I will try to share as many resources as I can over the next two months. These are important decisions for our nation and the health of its citizens. It is our responsibility as citizens to become engaged for the benefit of both ourselves and our children. It is up to us to do our part. Our country needs health care reform now!

SOURCE: "Questionnaire Distills Candidates' Health Policies" 08/13/0
SOURCE: "Kaiser Network BlogWatch" 09/05/08
photo courtesy of CommandZed, used under its Creative Commons license

Hurricane Hiatus

Dear Readers,

Due to weather events in New Orleans, home of your Blog Editor, regular maintenance of this blog has been suspended. We expect to resume daily postings and management on Monday, September 8 -- weather permitting.

With Thanks for Your Understanding and Patience,

George "Loki" Williams

EMRs: My Thoughts in Exile

Regular readers have no doubt caught on to the fact that I am based in New Orleans. For the second time in three years this simple fact has caused me to take my family into exile as severe weather threatens my city. Gustav may have missed New Orleans, but his effects are felt by two million of us evacuated out of southern Louisiana.

The gridlock on the road was disturbing and constant. The A/C had to be switched off in order to conserve gasoline since there was no ready way to acquire more. Two of my cats almost died of heatstroke and my wife and I both became ill. Until last night, the prior three days had included only four hours dedicated to sleep, and those were spent on a friend's floor in the midst of numerous other refugees.

Now, as I sit in Ohio at my best friend's house, I think back on it. This is the second exodus that my family and I have undergone in the past three years. In the context of my work on this blog, it becomes especially meaningful. You see, if Electronic Medical Records were a universal standard, it could save lives in a situation like this.

Two million people evacuated according to the news. Two million including the elderly, the disabled and children. I know. I shared the road with them for endless hours as the southern heat beat down upon us. I had visions of medical emergencies occurring either on the road or when my fellows reach their destinations. For the most part, I would be willing to wager that medical records were often left behind. I know they were in our case.

If there were a solid standardized system in place to handle all of these records digitally, a lot of these issues would evaporate. What made me think of it was sitting here in Ohio on my friend's porch and having a wasp land on my arm. You see, I am highly allergic to insect stings. If it had tagged me, I would be on my way to the emergency room. EMRs would communicate this and my other allergies even if there was no one around to do so.

Think about it. I have often written about the way that EMRs would reduce medical costs, particularly admin costs. That is highly desirable. In the final analysis, it is the enhanced safety for my neighbors and friends that is of ultimate importance. Two million people. The newsman on CNN called it the largest evacuation in American history. That is in addition to those displaced by failing levees in the midwest and fires on the west coast.

They can save lives, and that, my friends, is the most important reason we need them.