Tuesday, August 03, 2004

Job Loss, Rising Premiums Take Toll on Employer Health Coverage in 2003
A "Tracking Report" from the Center for Studying Health System Change - "Against the backdrop of a sluggish economy and rapidly rising health insurance premiums, the proportion of Americans under age 65 covered by employer-sponsored insurance fell dramatically from 67 percent to 63 percent between 2001 and 2003. Although the decline in employer coverage could have spurred a large increase in the uninsured, the proportion of Americans without health insurance did not increase significantly, according to findings from the Center for Studying Health System Change's (HSC) Community Tracking Study Household Survey. Expansion of public health insurance—including Medicaid and the State Children's Health Insurance Program (SCHIP)—forestalled a significant increase in the uninsured, as the proportion of the under-65 population enrolled in public coverage increased from 9 percent to 12 percent. .."  
  

Health Care: National Strategy Needed to Accelerate the Implementation of Information Technology
A GAO report (in Adobe Acrobat format), available at the Open Minds web site - "The use of IT can yield benefits in clinical care and associated administrative functions as well as in public health. Health care organizations reported that electronic medical records (EMR) improved the delivery of care because, among other reasons, more complete medical documentation was available to support the provider’s diagnosis. In addition, EMRs could greatly facilitate the reporting of public health information associated with the early detection of and response to disease outbreaks. ... [T]he lessons learned that were reported to us by health care organizations that have successfully implemented solutions could be used by other organizations to accelerate the adoption of health IT. These lessons recognize the importance of reengineering business processes, gaining users’ acceptance of IT, providing adequate training, and making systems secure."  
  

The Decade of Health Information Technology: Delivering Consumer-centric and Information-rich Health Care; Framework for Strategic Action
A 178-page July 2004 HHS report (in Adobe Acrobat format) by Tommy Thompson and David Brailer, available at the Open Minds web site, that "outlines 12 strategies that will achieve four goals critical to the President’s vision. These goals include: introduction of information tools into clinical practice, electronically connecting clinicians to other clinicians, using information tools to personalize care delivery, and advancing surveillance and reporting for population health improvement."  
  

Mental Health in the House of Corrections
A June 2004 report (in Adobe Acrobat format) by New York's Correctional Association, made available at the Open Minds web site - "The Correctional Association’s two-year study of mental health care in New York State prisons—which involved 22 visits to 20 correctional facilities, survey interviews with over 400 inmates on the mental health caseload and focus groups with correction officers, mental health staff and prison administrators—reveals both systemic problems and service deficiencies as well as some model programs. Specifically, the prison system’s sole psychiatric hospital has not been expanded since it opened in 1980, despite a tripling in the inmate population since that time. System-wide, staff and treatment beds have not kept pace with the increasing volume and severity of mental illness among incoming inmates. Model programs exist within the system, notably the 11 residential Intermediate Care Programs for victim-prone inmates with chronic mental illness and the Central New York Psychiatric Center, a treatment-rich facility with a total capacity of 206 beds: 189 for state inmates and 17 for county inmates with acute mental health needs."  
  

Filling behavioral health-service gaps
An APA Monitor article on testimony by an Jalie A. Tucker, chair of APA's Board of Professional Affairs, to the Institute of Medicine on ways to improve behavioral health access and quality - " The IOM Board on Health Care Services has appointed a committee to examine the application of mental health to recommendations for improving quality and delivery of health care put forth in IOM's 2001 report, "Crossing the quality chasm--a new health system for the 21st century." Tucker and several other mental health representatives offered their testimony to help the board meet its charge of forming an agenda for mental health. The IOM committee plans to gather testimony from a variety of stakeholders and deliver its report during the summer of 2005. " See also information available online on the IOM's health care quality initiatives.  
  

Why Should We Swallow What These Studies Say?
Opinion piece in the Washington Post by Jerome Kassirer, editor in chief emeritus of the New England Journal of Medicine and a professor at the Tufts University School of Medicine - "In a society rife with conflicts of interest, disclosure of such conflicts is usually a good tonic. In finance, we can read the fine print and decide whether to invest or seek other advice. We can hedge our bets. But in medicine, where decisions on treatment can have lasting effects, mere disclosure isn't enough. Patients need advice they can act on without having to calibrate how likely it is to be biased. Physicians and scientists with financial ties to the pharmaceutical industry should not just have to disclose conflicts -- they shouldn't be permitted to issue guidelines at all. But they are permitted, and they do so routinely..."  
  

Influenza in Early Pregnancy Linked to Schizophrenia
Medscape Medical News story - "Influenza in early pregnancy may be associated with schizophrenia, according to the results of a nested case-control study published in the August issue of the Archives of General Psychiatry. The investigators suggest that an antibody response, rather than infection, may explain this association."   
  

County prevails in federal lawsuit vs. NAMI (Florida)
Story in the St. Augustine Record - "A federal lawsuit and appeal filed in 2000 against the St. Johns County Commission by the National Alliance for the Mentally Ill has been dismissed after a long legal battle that cost the county $100,000. But it still may not be over. County Attorney Dan Bosanko said Monday that the ruling on the case -- which involved a request in April 2000 to open the county's first mental health residential facility -- came on procedural grounds. The National Alliance's attorneys raised many legal issues, but the trial judge -- as well as the appellate court -- dismissed the case because the alliance did not have "standing." In other words, no specific patient or group was damaged. ... But a National Alliance attorney said Monday that he plans to file motions for a rehearing this week..."  
  

State upgrades efforts to improve Oakwood (Kentucky)
WKYT story - "The state has taken over management of a mental institution and turned to a consultant to create an operating plan that could make the facility a model nationwide. Oakwood once was one of the country's largest state institutions for people with mental retardation. In 2002, the Justice Department concluded an investigation that found patients were mistreated and neglected. In response, the state added workers, brought in more doctors and provided more activities for residents. But the state decided those efforts were not enough..."