This article by Atul Gawande concludes “Among a sample of patients in the top decile of Midicare spending in 2010, only a small percentage of costs appeared to be related to preventable ED visits and hospitalizations. The ability to lower costs for these patients through better outpatien care may be limited. (JAMA, June 26th) Click here to read full article.
News You Can Use
This Jama Internal Medicine “viewpoint (July 22nd) delves into three scenarios in “Choosing Wisely” recommendations as to what constitutes “overuse”: “do not repeat colorectal cancer screening for 10 years after a high quality colonoscopy is negative in average risk indificuals; “don’t use DEXA screening for osteoporosis in women youger than 65 or men younger than 70 with no risk factors”; and “dont init. The article suggests three concepts to aid in decision making: benefit-harm tradeoff; benefit-cost tradeoff; and consideration of patient preference. Click here to read full-text.
“Can physicians change their laboratory test ordering behavior? A new look at an old issue” and “Hospital clinicians’ responsiveness to assay cost feedback”by jmiller on August 9, 2013
These two articles investigate the implementation of feedback of the cost of lab tests and their subsequent ordering patterns. The two articles deal with cost containment strategies for lab tests. (JAMA Intern Med, July 29) Click here to read full text.
ASCO Special Article: Use of pharmacologic interventions for breast cancer risk reduction: ASCO practice guidelineby jmiller on July 15, 2013
This early release article (JCO early release) includes the specific risks and benefits associated with each chemopreventive agent. In women at increased risk of BC age >35 years, tamoxifen (20 mg per day for 5 years) should be discussed as an option to reduce the risk of ER – positive BC. In postmenopausal women, raloxifene (60 mg per day for 5 years) should also be discussed as options for BC risk reduction. These guideline recommendations are for use by medical oncologists, surgical oncologists, gynecologists, primary care physicians, and general practitioners. Click here to read full-text.
“Our work has focused on identifying the relationship of the insulin network to brain aging, and determining the mechanisms through which insulin dysregulation promotes AD pathological processes. Fortunately, insulin resistance and related factors can be identified prior to the onset of AD, at a stage where lifestyle modifications or therapeutic intervention may have the greatest likelihood of success.” (Journal of Alzheimer’s Disease, June 2013) Click here to read full-text.
“The authors have developed 7 recommendations to improve patient safety with respect to the deployment of EDIS’s (Emergency Dept. Information Systems). These include ensuring that emergency providers actively participate in selection of the EDIS product, in the design of processes related to EDIS implementation and optimization, and in the monitoring of the system’s ongoing success or failure. Our recommendations apply to emergency departments using any type of EDIS: custom- developed systems, best-of-breed vendor systems, or enterprise systems.” (Ann Intern Med, in press) Click here to read full-text.
Effective Monday, July 1, Dr. Khalid Ahmed will be available for Inpatient and Emergency Department psychiatric consultation.
Dr. Ahmed has extensive experience in the acute management of adult and pediatric psychiatric patients. For the last year, he has worked at Dorchester General and Adventist Behavioral Health. Dr. Ahmed completed his residency in child and adolescent psychiatry at Johns Hopkins University Hospital and his residency in general psychiatry at Drexel University College of Medicine. He is ABPN certified with a subspecialty in child & adolescent psychiatry.
Dr. Ahmed will be available from 8am until 4pm five (5) days each week to include a rotation to the weekends. Beginning on Monday, he can be reached via phone at extension 3767 or by placing a clinical consultation request for psychiatry in EPIC. For days that he is not on campus, Behavioral Health Clinicians will continue to be available to address immediate patient needs.