public health officials

California lags in drug-resistant infection reporting

Mon, 25 Feb 2008 06:59:56 -0500

Earlier this month, California public health officials announced they'd begin tracking community-based MRSA infections, e.g. those contracted in schools, gyms and other community settings. At the time they argued, in essence, that while community-based MRSA is less common than healthcare-acquired MRSA, it's not as well understood. Now, these officials are taking a drubbing. State health experts and consumer advocates are saying that this measure is woefully inadequate, given that the vast majority of MRSA infections occur in healthcare facilities. Epidemiologists say that in focusing on community-based forms of MRSA, California is behind at least 15 other states which are currently tracking MRSA within provider settings. In fact, several of those states not only are collecting facility-based data, but are making it available to the public or setting plans to do so.

The California Nurses Association is pushing to see infection-rate reporting made public for all of the state's 6,000-odd healthcare facilities. Meanwhile, hospitals continue to resist such disclosures, saying that such reporting would impose serious staffing costs and lots of taxing paperwork.

To learn more about California's infection-reporting plans:
- read this Los Angeles Times piece

Related Articles:
Report: MRSA moving out of healthcare settings. Article
Hospitals screen incoming patients for MRSA. Article

ALSO NOTED: PA plans $2M in nurse-training funding; NM plan pays $2M in P4P dollars to doctors; and much more...

Fri, 01 Feb 2008 06:59:50 -0500

> Pennsylvania has set plans to invest almost $2 million in nurse training. Article

> Molina Healthcare of New Mexico gave out $2 million in pay-for-performance incentive to its 275 physicians and groups in 2007. Article

> Minnesota's public health officials say that obesity could cost the state an extra $3.7 billion by 2020. Article

> HHS has officially accepted a new list of technical standards for health IT. Why does this matter? Well, providers that invest in technology using these standards are now eligible for safe harbor and Stark protection when they give the technology to doctors. FierceHealthIT

And Finally... This group of 650-year-old skeletons offers clues on the workings of the infamous Black Plague. Article

Case study: Tx. hospital 'cocoons' to contain whooping cough

Mon, 28 Jan 2008 06:59:54 -0500

Hoping to contain what is becoming an epidemic of whooping cough, Houston, Tx.-based Texas Children's Hospital has launched a program designed to contain the infection by immunizing family members. Hospital officials say that this program can effectively prevent whooping cough within the most vulnerable population, infants less than 6 months. More than 75 percent of infants who get whooping cough are infected by other members of their household; in 33 percent of the cases it's mothers, 16 percent of the time fathers and 19 percent of the time siblings.

Under this "cocoon strategy," parents who might spread the infection are given booster shots. The $35 shot will be given free of charge to 5,800 families the first year, delivering a total of about 17,000 shots. The program is funded by a joint grant from the Methodist hospital and Baylor College of Medicine.

The hospital is taking this step as the number of diagnosed cases of whooping cough in the U.S. spikes. More than 25,000 cases of the infection were reported in 2004 and 2005, three times more than in the 90s and at least six times more than in the 80s. Levels are at the highest they've been since the 1950s, public health officials say.

To learn more about the program:
- read this Houston Chronicle piece

Related Articles:
Signs point to flu vaccine shortage. Report
Study: Mass. has top vaccination rates. Report
CDC focuses vaccination study on teens. Report

Excess beds: If you don't get rid of 'em, the state will

Fri, 25 Jan 2008 06:59:59 -0500

Coopetition. Wow, to an armchair observer like me it sounds really sweet--the idea that rival hospitals in a marketplace can cooperate efficiently rather than conducting the nasty 'ol arms race or maintaining unneeded beds.

Let's face it, though--most of the time it just ain't happening. In particular, we're not seeing mergers between financially-sagging hospitals that might take excess beds offline fast enough to have a short-term impact on costs.

As we've already seen, New York's legislature took a look at the situation and say "heck, if the marketplace won't take excess capacity out of the system, we will." That's been painful for all concerned, and who's to say that the commission involved made the right choices? Nobody, but if it was going to happen, someone had to do it.

Now, it's looking like New Jersey is headed in the same direction. While the state isn't demanding that certain hospitals close, it's decided that in some cases, it's not going to throw them a life preserver if they're drowning, which is almost the same thing.

Guys, you don't have to be a prophet to see the writing on the wall here. After decades of dickering over Certificates of Need (the front end), states are finally reaching the point where they're willing to take licensed beds out of the marketplace. As I've argued before, I believe New York and New Jersey are just the first movers--and that other states will ultimately make similar steps.

If your hospital is in trouble--and you've ever thought about mergers, shared operating agreements or the like--I suggest you not only consider it, you let your local state legislators and public health officials know you're doing it. Let them know you're pro-active. Heck, maybe if you show that you know how things are going, you'll be on your state's commission, rather than being named one of the "non-essential" hospitals doomed to be left to die. - Anne

MD addresses misuse of addiction therapy

Fri, 25 Jan 2008 06:59:54 -0500

Maryland health officials are defending themselves against charges of potentially widespread misuse of addiction-treatment drug buprenorphine, arguing that there are adequate controls in place within programs that administer the drug to addicts. The drug, which is prescribed as Suboxone for addiction treatment, is sometimes sold by patients on the street--and addicts sometimes inject and snort the drug. In other states where the drug is readily available, such as Maine, Vermont and Massachusetts, some addicts have died after mixing it with other substances, according to recent reports.

However, public health officials told legislators this week that they're taking many precautions to protect this vulnerable population and avoid abuse of the drug. The city of Baltimore, for example, has 14 safeguards in place, including pill counts, tests for buprenorphine in patient urine and asking addicts if they've used the drug on the street. Baltimore has a $3 million initiative in place which has treated nearly 700 patients.

To learn more about problems with buprenorphine management:
- read this Baltimore Sun piece

Retail clinics go from concept to reality

Fri, 21 Dec 2007 06:59:54 -0500

Ah, retail clinics. They've generated a lot of heat over the past year, largely from the AMA and its affiliates, who have criticized the model as being a threat to patient safety. However, that hasn't done much to slow the growth this sector, which is backed by behemoths like CVS Caremark, Walgreens and Wal-Mart, not to mention a growing number of health systems and hospitals. This is heady stuff. With Wal-Mart's involvement, we got a look at a future where retailers control more of the healthcare dollar. Scary stuff if you're a provider executive!

Do retail clinics face obstacles to growth? No doubt. Opponents of the retail clinic industry aren't going to drop their resistance and walk away. Next year, for example, Massachusetts public health officials will decide whether CVS can add retail clinics to its pharmacies there--a move many Massachusetts medical organizations have vowed to quash. In Illinois, no doubt, physicians who sought an anti-retail-clinic law will remain up at arms. Still, I doubt these groups will have much success slowing down the juggernaut. During the past year, it became pretty clear that retail clinics will have a place in the care delivery system. Now it's a matter of how to adapt.

Study: Calif. death rates vary by race

Fri, 31 Aug 2007 06:59:56 -0400

Public health officials aren't quite sure why, but in California, African-Americans are dying earlier than whites, according to a new study. White Californian men are living an average of seven more years than African-American men. Homicides, sadly, account for part of the disparity, but so does heart disease. White women in California live an average of five years longer than African-American women, largely due to higher rates of diabetes and stroke among African-American women. In both cases, these epidemiological trends aren't enough to account for the disparities completely, so there's still some major causal questions to be answered.

Officials with the group backing the study, the Public Policy Institute of California, noted this gap has persisted over time. In fact, a similar gap has been observed nationally since 1900.

To learn more about the study:
- read this Los Angeles Times piece

Related Articles:
Medical homes cut racial care disparities. Report
Racial disparities persist in health outcomes. Report
Medicare should help fix disparities. Report
Researchers fight for ethnic diversity in trials. Report
San Francisco tracks biggest killers of its ethnic groups. Article

Study:Mass. has top vaccination rates

Fri, 31 Aug 2007 06:59:54 -0400

In Massachusetts, it seems, providers are doing a great job of delivering vaccinations to children. According to new data from the CDC, Massachusetts had 83.6 percent coverage for six critical vaccines for children aged 19 to 35 months, which well exceeds the national average of 77 percent. For the state's capital city, Boston, the compliance rate for this age range was even higher (81.4 percent), standing well ahead of large cities like New York and Chicago.

State public health officials said the high immunization rates come from programs helping to ensure children get their shots, along with a strong primary care system and numerous community health centers offering pediatric services. This year, the state will spend about $49 million for vaccine coverage, up $12 million from last year. The extra money will largely go towards coverage of rotavirus and meningitis.

To learn more about the state's programs:
- read this article from The Boston Globe

Related Articles:
Merck stops lobbying for mandated HPV vaccine. Report
CDC focus vaccination study on teens. Report
CDC releases flu vaccination plan. Report

Massachusetts opens door--a little--to retail clinic expansion

Wed, 18 Jul 2007 06:59:58 -0400

Seems like the Massachusetts Medical Society--or the AMA--has someone's ear. While state public health officials have opened the door to the emergence of retail clinics, their plans will also slow down a major Boston-area rollout by one of the largest and best-funded retail clinic operators. This gives at least a partial victory to a mixed group of providers who were fighting a proposed MinuteClinic expansion in the state.

Officials with the state's Department of Public Health have agreed in principle to allow retail clinic operators to begin opening locations in the state--if they follow a set of new regulations which will be issued Aug. 8. However, the decision effectively delays CVS from opening 20 to 30 Boston-area MinuteClinics. The company will have to reapply to open the clinics, preventing it from opening its first clinics this fall as expected.

Such a delay will do little to stem the competitive threat retail clinics pose to primary care physicians over the long haul. However, it may give Boston's PCP's a chance to rethink their business models a bit and perhaps roll out some competitive services of their own. Not only that, if AMA and affiliates are sincerely concerned about quality of care at the clinics--rather than simply posturing for competitive reason--the new regs may go some way toward reassuring them. Let's see how they react once CVS gets its approval and starts the rollout sometime next year.

To find out more about the retail clinic situation in Massachusetts:
- read this article from The Boston Globe

ALSO: Interested in how MinuteClinic performs on quality measures? Get one perspective from MN Community Measurement, a group of health plans, medical groups, physicians, patients and employers who rate quality of care in Minnesota. Report

Related Articles:
Physician retail clinic protests miss the point. Editorial
Wal-Mart plans 2,000 retail clinics. Report
Retail clinics keep advancing. Report
Retail clinics: Thousands on the way? Analysis
Providers see future with retail clinics. Report

ALSO NOTED: Humana spends $360M for benefits provider; WellSpot plans 100 retail clinics; and much more...

Mon, 18 Jun 2007 20:01:30 -0400

> Humana acquired an Atlanta-based dental and vision benefits company for $360 million. The company, CompBenefits Corp., serves about 14,000 employer groups in 22 states. Article

> The WellSpot retail clinic chain has aggressive expansion plans. It says it plans to open 100 clinics during 2008. Article

> Presidential candidate Barack Obama says his proposal allowing the federal government to negotiate directly with pharmaceutical companies could save big bucks. Article

> Michigan public health officials have added 150 prescription drugs to its drug price database. Article

And Finally... Meet diabulimia, a new and deadly epidemic among teenage diabetics. Article