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Healthcare is in the midst of a dramatic shift, as new players surge into the business of health. The latest step in this evolution came Friday, with reports that Walmart is in discussions to partner with—or perhaps even acquire—Humana, one of the nation’s largest insurers. If these reports come to fruition, it would represent the latest in a series of new companies showing renewed interest in consumer health—a divergence in the way that the nation has treated health in years past. The move away from sick care to health preservation is built on six trends—and of those, a unifying theme is that the technological acumen and infrastructure is in place to support this shift. Consumerism It’s taken a while, but consumer-patients have taken more responsibility for their own care. For a generation now, an increasing number of people no longer rely solely on what they’re told by their medical providers. They’re researching medical conditions on the Internet and wanting to know more about their...

We can look back and see the most important medical issues from 2012-2019 from the Journal of the American Medical Association.  This is an in-depth compilation of the most significant published articles from the peer-reviewed JAMAs The articles have been selected by editors as the most important published by JAMA between 2010 and 2019. Click below to read them for free. The Top Articles from 2010-2019 The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) Mervyn Singer, MD, FRCP; Clifford S. Deutschman, MD, MS; Christopher Warren Seymour, MD, MSc; et alManu Abstract Importance  Definitions of sepsis and septic shock were last revised in 2001. Considerable advances have since been made into the pathobiology (changes in organ function, morphology, cell biology, biochemistry, immunology, and circulation), management, and epidemiology of sepsis, suggesting the need for reexamination. Objective  To evaluate and, as needed, update definitions for ...

Stem Cell Therapy is not ready for widespread unregulated use. MSCs and other stem cells offer remarkable potential but our understanding of their science and medical applications is not ready for unregulated, widespread use. The complexity of tissue repair and cell replacement makes it clear that the proliferation of questionable “stem cell clinics” and off-shore medical tourism offices promoting their autologous “stem cell treatments” of unknown and unproven efficacy will not solve patient maladies in a meaningful way. The divergence between reputable clinical trials and the premature marketing of stem cell products to the public has broadened the gap and led to confusion in the press as highlighted by Galipeau et al.15 There are over 700 clinics offering direct-to-consumer marketing of “stem cell” treatments.16 We cannot support or recommend any treatment utilizing MSCs that does not use characterized cell product, maintain accurate records, measure intermediate parameters, predeter...

""CMS and Medicare often do foolish things that cost much more than what they recover.  This year the OIG audit discovered there were overpayments of the EHR incentives for hospitals.  It represented less than  1 % of the total amount paid to hospitals.  There was no mention in EHR intelligence that overpayment was made to providers (physicians).  CMS is being 'generous by reducing the number of deviant hospital amounts from 96 million to about 1.6 million for some obscure reason of their own about the dates of incentive.  (Merry Christmas) (humbug to CMS) . They requested a 'voluntary' refund from the remaining criminal element of hospitals if they would do   'DUE DILIGENCE' by examining their cost analysis of their hospital and provide it to CMS. EHR intelligence did not report if there is a hard deadline for the report, or face further penalties such as being terminated from CMS. I realize that is a long stretch on my part, but worse things hav...

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In the typical emergency room, demand far outpaces the care that workers can provide. Can the E.R. be fixed? By Gina Siddiqui Illustrations by Golden Cosmos Well, maybe.  Back in the day (1965) when I rotated through the emergency room (called emergency department) the same question arose. Since that time many solutions have been attempted, with varying success.   My choices as a doctor in the emergency room are up or out. Up, for the very sick. I stabilize things that are broken, infected or infarcted, until those patients can be whisked upstairs for their definitive surgeries or stents in the hospital. Out, for everyone else. I stitch up the simple cuts, reassure those with benign viruses, prescribe Tylenol and send home. Up or out is what the E.R. was designed for. Up or out is what it’s good at. Emergency rooms are meant to have open capacity in case of a major emergency, be it a train crash, a natural disaster or a school shooting, and we are constantly clearing ...

Another time, another era. We here at Health Train have our own Wayback machine. I find it hard to believe it has over13 years since my idea to start a blog occurred.   Two Important Legislative Actions (Federal) House Subcommittee Passes Amended Health IT Bill June 09, 2006 The House Energy and Commerce Subcommittee on Health on Thursday approved by voice vote a bill (HR 4157) that would promote the use of health care IT, CQ Today reports (Schuler, CQ Today, 6/8). The legislation, sponsored by Reps. Nancy Johnson (R-Conn.) and Nathan Deal (R-Ga.), would codify the Office of the National Coordinator for Health IT within HHS and would establish a committee to make recommendations on national standards for medical data storage and develop a permanent structure to govern national interoperability standards. The bill also would clarify that current medical privacy laws apply to data stored or transmitted electronically (iHealthBeat, 6/8). Prior to approval, the subcommittee appro...

   The Global Measles Epidemic Isn’t (Just) About Measles Strong health systems, along with immunization efforts, are key to fighting disease around the world. By  Andrew Schroeder APRIL 20, 2019 6:00 AM Measles, once a common and deadly childhood illness which had been declared “eliminated” from many parts of the world including the United States, Canada and Europe nearly two decades ago, is back on the global health agenda.   Measles cases globally rose nearly 300 percent in the first quarter of 2019 as compared with the first quarter of 2018, according to surveillance data covering 190 countries released last week from the World Health Organization. Over 112,000 cases were reported to start this year, as opposed to just over 28,000 from the beginning of 2018. That year likewise saw a significant gain as compared to 2017. Although still not close to the shocking levels of the mid-20th century, when tens of millions of children were infected and millions died, the trend ...