Category Archives: Healthcare News

A Brief History of the Opioid Epidemic

America’s relationship with opioid medications has grown and changed over the past 100 years. Today, the medications are connected to a national public health epidemic.  The statistics are alarming, and getting worse.  Since the situation is complicated, everyone—from providers to patients to politicians—needs to be part of the solution.

Definition
Opioids include opium derived drugs (i.e. morphine and heroin) and synthetic drugs (i.e. hydrocodone, oxycodone, and fentanyl.)

A Brief History
Use of opioid medications began before the Civil War.  In 1898, Bayer Pharmaceuticals introduced heroin into the commercial marketplace. Opioid medications (including heroin) were widely available to treat a variety of conditions for the next twenty years.  During the 1920s, doctors recognized the addictive nature of these medications.  Heroin was outlawed in 1924.
For the next 50 years, doctors avoided prescribing opioid medications to minimize the risks of addiction. Popular belief began to change in the 1970s.  A few studies came out that questioned the widespread beliefs about the true addictive risks of opioid medications.  Over the next 30 years, three new opioid medications came out.
Percocet, Vicodin, and OxyContin brought the debate around opioid medications back into the forefront.  During the 1990s, doctors wrote millions of additional prescriptions for opioid medications annually.  Year over year, the total numbers increased throughout the decade.  Although as availability increased, more people became addicted or accidentally overdosed.  Once again, people began to question the safety of these medications.
Today, steps are being taken at local, state, and federal levels to combat the overuse of opioid medications and heroin.  Although illegal, heroin plays a role in the epidemic. Due to increasing restrictions on prescriptions, some patients find it easier to use heroin instead.  The opioid epidemic is a complex problem that needs a comprehensive approach to begin to reverse it.

Current Statistics

  • According to the American Public Health Association, prescription drug abuse has been the top public health concern since 1999.  Since that point, the rate has doubled in 29 states, tripled in 10 states, and quadrupled in 4 states.
  • Someone dies every 19 minutes from an unintentional overdose.
  • Drug overdoses are part of the reason that American life expectancy has declined.
  • In 2015, more than 52,000 people died from drug overdoses.  Two thirds were linked to opioids.
  • Deaths from drug overdoses are still on the rise.

According to the Department of Health and Human Services, 20 billion dollars is spent on emergency department and inpatient care for opioid poisonings.  Health and social costs related to prescription opioid abuse are closer to 55 billion dollars.



Health Crisis. Wikipedia, 17 April 2017, https://en.wikipedia.org/wiki/Health_crisis. Accessed April 25, 2017.
Lopez, German and Sarah Frostman. How The Opioid Epidemic Became America’s Worst Drug Crisis Ever, in 15 Maps And Charts. Vox. 29 March 2017. http://www.vox.com/science-and-health/2017/3/23/14987892/opioid-heroin-epidemic-charts. Accessed April 25, 2017.
Meldrum, Marcia. The Ongoing Opioid Prescription Epidemic: Historical Context. American Journal of Public Health, 2016 August, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4940677/. Accessed April 25, 2017.
Moghe, Sonia. Opioid History: From ‘Wonder Drug’ To Abuse Epidemic. CNN, 14 October 2016, http://www.cnn.com/2016/05/12/health/opioid-addiction-history/. Accessed April 25, 2017
Opioid. Wikipedia, 2 April 2017, https://en.wikipedia.org/wiki/Opioid. Accessed April 25, 2017.
Opioids: The Prescription Drug & Heroin Overdose Epidemic.  United States Department of Health and Human Services, 24 March 2016, https://www.hhs.gov/opioids/. Accessed April 25, 2017
Opioid Overdose. United States Centers for Disease Control and Prevention, 16 December 2016.  https://www.cdc.gov/drugoverdose/data/overdose.html. Accessed April 25, 2017.
The Opioid Epidemic By the Numbers.  United States Department of Health and Human Services, June 2016, https://www.hhs.gov/sites/default/files/Factsheet-opioids-061516.pdf  Accessed April 25, 2017
Prevention and Intervention Strategies to Decrease Misuse of Prescription Pain Medication.  American Public Health Association, 3 November 2015, https://www.apha.org/policies-and-advocacy/public-health-policy-statements/policy-database/2015/12/08/15/11/prevention-and-intervention-strategies-to-decrease-misuse-of-prescription-pain-medication. Accessed April 25, 2016.
Understanding the Epidemic. United States Center for Disease Control, 16 December 2016, https://www.cdc.gov/drugoverdose/epidemic/index.html.  Accessed April 25, 2017
Inside a Killer Drug Epidemic: A Look at America’s Opioid Crisis. New York Times, 6 January 2017, https://www.nytimes.com/2017/01/06/us/opioid-crisis-epidemic.html?_r=0. Accessed April 16, 2017.
Opioid Epidemic. Wikipedia, 13 April 2017, https://en.wikipedia.org/wiki/Opioid_epidemic. Accessed April 16, 2017.

http://adai.uw.edu/pubs/pdf/2015drugusetrends.pdf

Healthcare Systems Around the World

There are no easy answers in the debate about reforming the American health care system.  Any proposed solution needs provide better patient care and affordability than the current system does.  With a population of 324 million, finding these solutions is difficult.  Over the years, health care reform has come in different pieces of legislation. For President Johnson, it was the creation of the Medicare and Medicaid programs. Under President Clinton’s administration, HIPAA strengthened protections for patients.  In 2010, President Obama signed the Affordable Care Act that took steps to curb rising costs while expanding coverage to twenty million people.  With a new presidential administration, the debate about the future of the American healthcare system continues.  Given that, it is important for all Americans to understand different options for health care delivery systems.

American Health Care System—or the Fee-For-Service Model  

All health care services have fees associated with them.  When possible, those fees are first charged to the patient’s health insurance company.  After the insurance company processes and pays their part of the claim, the patient is responsible for the remaining balance.  If a patient lacks insurance, the entire bill goes to the patient. Every year, almost 2 million people declare bankruptcy due to medical costs.

The American government provides a variety of different insurance systems that provide different coverage levels to distinct groups of people, ranging from veterans to the elderly to children.  Yet, people are still stunned that the United States is the only wealthy country that doesn’t provide universal health coverage.

A National Health Service

In the United Kingdom, the government provides health care like all other public services (i.e. emergency responders and trash collection.)  Taxes pay for the government to operate medical facilities and pay doctors. Privately owned clinics and independent medical providers are allowed, but face restrictions.

National Health Insurance Plans—also called Single Payer System

In Canada, patients seek care from private sector doctors.  Their bills are paid by a government fund that everyone pays into.  Single payer systems have a strong negotiating position, and often pay lower prices for pharmaceuticals and services.

Since any solution needs to work better than the current system, debates about the American health care system will continue long into the future.  As Americans, it is important to remain educated about the options available.  Each health care delivery system faces a unique combination of strengths and weaknesses.  Ultimately, it will be up to the American people to decide how to shape the system as we move into the future.

Continue reading >

Security Updates, Consilidation, and Obesity Rates Feature in our 6/10 Healthcare News Roundup

Obesity rates rise among women, no change in men


According to an article published in the Journal of the American Medical Association, the national obesity rate in 2013-2014 reached 35% among men and 40% among women. The 40% number for women represents a linear increase since 2005, while obesity rates for men have remained relatively stagnant. Study authors suggest that insufficient data exists to make an accurate assessment of the causes for these trends, and recommend further studies be conducted.

Western State Hospital, Washington’s largest psychiatric hospital, agrees to ramp up safety measures

Western State Hospital has a reputation for being a dangerous work environment, where employees and patients have been subjected to violence in the past. Washington Governor Jay Inslee recently replaced the hospital’s CEO, Ron Adler, with an experienced manager of state mental health systems, Cheryl Strange. Federal Regulators and Western State Hospital have hammered out a detailed plan to correct the safety concerns.

Gray’s Harbor doctor encourages male patients to have uncomfortable conversations about men’s health

Dr. Stephen Reznicek, of Grays Harbor Community Hospital, has been building a top-tier urology clinic on the fourth floor of the hospital. The clinic helps to meet the huge demand for urology services in the area. The clinic anticipates future growth the an expanding medical team, including a new urologist later this year.

Dr. Reznicek places an emphasis on non-invasive solutions for men with prostate and fertility concerns. One of the first hurdles to overcome with new patients is just starting the conversation. Urologists recommend regular check-ups, especially as men grow older.

Study finds that criminal activity is leading cause of healthcare data breaches

A recent study published by the Ponemon Institute has revealed that half of all privacy and security data breaches in healthcare are attributable to malicious criminal attacks. The remaining 50% of data breaches can be blamed on employee mistakes, third-party errors, and stolen computers & devices. Data breaches can result in medical identify theft, as hackers are able to acquire names, social security numbers, and other confidential information about patients.

In an interview with HealthcareITNews, Seattle Children’s Hospital IT security manager David Severski notes that security technologies need to be adapted to protect against these malicious attacks. “If you are not applying a data-driven, scientific approach to managing your resources, you are managing at best by instinct,” he added. “And in a competitive business world, instinct is not enough.”

Skagit Regional Health acquires Cascade Valley Hospital

Cascade Valley Hospital was the last independent hospital in Washington’s Snohomish County. Cascade Valley began looking for an opportunity to consolidate in 2013, when it became apparent that the independent hospital needed an influx of financial support to continue serving their rural community. A previous agreement to join PeaceHealth fell through in 2014. Patients in the region can look forward to expanded services and updated equipment.

June 3rd Weekly Healthcare News Roundup

OPEN ACT Could Encourage Pharmaceutical Innovation at Reduced R&D Costs

Drs. Klane White and David Fajgenbaum wrote in the opinion section of The Seattle Times that “There are 30 million Americans affected by 7,000 rare diseases, and, of those, only 5 percent have Food and Drug Administration-approved therapies.” The article calls for congress to pass the OPEN ACT, encouraging pharmaceutical companies to study the benefits of modifying existing drugs to be used for rare medical conditions.

Tacoma Hospital Alliance Seeks Additional Funds for Psychiatric Facility


MultiCare Health System and CHI Franciscan Health are planning a new psychiatric hospital in Tacoma. The $41 million project would create a 120-bed hospital in Pierce County, and the Alliance for South Sound Health is seeking funding from the Tacoma City Council and Pierce County to help with construction costs. The hospitals have requested $1.5 million from both municipal governments, and they’ve been pledged an additional $400,000 from the city of Auburn.

American Death Rate Has Increased for the First Time in a Decade

According to preliminary numbers from the National Center for Health Statistics, the death rate in the United States has increased for the first time since 2005. Some causes of death which have increased include Alzheimer’s disease, stroke, suicides, drug overdoses, accidents, and firearm deaths. The rate of death in 2014 was 723.2 deaths per 100,000 people, and it increased to 729.5 in 2015.

Olympic Medical Center Hires New Medical Oncologist

The Olympic Medical Center has found a replacement for their outgoing medical oncologist, Dr. Tom Kummet, MD. Dr. Rachna Anand, DO, who trained in oncology at Hahnemann University Hospital in Philadelphia, will take up the mantel. In addition to Dr. Anand, Olympic Medical Center has expanded their medical oncology department by bringing on nurse practitioner Tamara Montgomery, MSN, NPC-C, OCN.

Washington Healthcare News Roundup – May 27th Edition

Alaska Delays Medicaid Payments to Cover Budget Shortfall

Alaska’s Director of Health Care Services has notified Medicaid providers that their claims won’t be paid for an undisclosed period of time. In a letter sent to providers, Director Margaret Brodie states that “we are challenged by a tight budget situation” and therefore “it is necessary for us to temporarily pend some Medicaid claims while Medicaid funds are reallocated among accounts”.

University Partnership to Matriculate Largest Ever Med School Student Body in Spokane

Thanks to increased funding from the State, The University of Washington School of Medicine will be welcoming the largest ever student body. In partnership with Gonzaga University, Spokane, WA is set to see 60 new medical school students matriculate in August. In the midst of news reports about a coming physician shortage, this new public and private partnership indicates that the state is taking steps to address the shortfall.

1% of Physicians Create Lion’s Share of Malpractice Claims

A study by Studdert, Bismark, et al. in the New England Journal of Medicine has revealed that 32% of all malpractice claims paid out in the United States can be attributed to just 1% of physicians. The study also finds that doctors who have paid more than two claims have a 24% chance of doing so again within the following two years.

What’s Happening in Washington Healthcare – May 20, 2016 Edition

Nursing Shortage in Washington Will Grow to 7,000 by 2025

The impending shortage of medical practitioners looks to be dire. Washington State will be short 7,000 nurses by 2025 according to a 2014 study by the US Department of Health and Human Services (DHHS). 57,800 Registered Nurses were actively practicing in 2012, with an expected increase to 68,100 in 2025. The DHHS estimates that Washington State will require 75,100 RNs in order to meet the growing demand for aide in the state.

Overlake Hospital Accredited in Metabolic and Bariatric Surgery

The Overlake Medical Center has been recognized by the American College of Surgeons and the American Society for Metabolic and Bariatric Surgery as a Comprehensive Center, meeting high standards for quality in bariatric patient care. Overlake credits their superb staff and leadership surgeons for meeting and exceeding the highest expectations for structure, process, and outcomes.

Grays Harbor Community Hospital Provides Personal Care throughout the Perinatal Period

Lisa Herrick of GraysHarbor Talk investigates the qualities which make this community hospital such a destination for perinatal mothers. Staff are credited with exceptional leadership and experience among the physician and nursing team, who are integral to the welcoming environment at the Family Birth Center. Private birthing suites and post-partum rooms allow for each patient to have personalized care with highly-qualified practitioners.

Swedish Medical Center Seeks to Expand its Cherry Hill Campus

The Swedish Medical Center’s Cherry Hill Campus currently serves 380,000 neurological and vascular care patients annually. Already operating at 100% capacity, Swedish has predicted that 500,000 patients will seek care at this facility in coming years, and they’ve sought approval from the Seattle City Council to expand the campus to address this need. The project has become a contentious issue for neighborhood activists who argue that the additional 1.4 million square feet expansion will negatively affect traffic, community appeal, and sun exposure. The city council is expected to announce a decision shortly.

May 13th Weekly Healthcare News Roundup

To Meet the Provider Shortfall, Washington Healthcare is Expanding Beyond Seattle

An article by Mohammed Kloub posted on Crosscut.com highlights some of the efforts being made to make healthcare more accessible outside of the Seattle area. Citing the coming Elson S. Floyd College of Medicine opening in 2017 and a new partnership between Gonzaga University and the University of Washington, Kloub makes a compelling argument that high quality medical care will be more accessible in the Eastern part of the state in coming years.

Kaiser Permanente Encourages High Schoolers to Aim for Medical School


As Kaiser’s “Health Care Career Scholarship Program” enters its eighth year, external reviews have shown that the program is reaching a diverse student body across Washington and Oregon states. The program awards $2,000, $5,000, and $10,000 scholarships to one high school senior at each of 133 public high schools in their service area. The program has awarded scholarships to 900+ students, the vast majority of whom are from demographics racial and ethnic groups underrepresented in the healthcare industry.

As Physician Numbers Thin, Medical Scribes Help Handle the Increased Workload

Molly Rosbach, writing for the Yakima Herald, takes readers into the world of medical scribes in emergency rooms around Washington state. Medical Scribes allow medical practitioners to spend more time with patients without having to worry about paperwork in between visits. Medical Scribes, often pre-med students, are able to increase a hospital’s capacity for patient care while simultaneously learning about the process of seeing patients as a physician.

One emergency room doctor notes that “[b]y the time these kids start med school, they’ve literally witnessed thousands and thousands of patient encounters, and they’re light years ahead of their classmates”.

Study Suggests that Comparison Shopping is Ineffective at Reducing Out-of-Pocket Expenses

A survey of 450,000 employees has indicated that employees won’t always choose the least expensive option for the same treatments. The study, published in the Journal of the American Medical Association, actually found that only 10% of employees opened the price calculator, and of those the average out-of-pocket spending actually increased by an average $18.

MultiCare Implements ‘Period of PURPLE Crying’ Program to Soothe Fussy Parents

The National Center for Shaken Baby Syndrome has released a DVD and phone app designed to help parents cope with an overly-vocal newborn. Early adopters MultiCare Health System report that the program has been a success. One new mother reported that the app provided extra comfort by offering tips about when to worry about a crying baby, and some advice on how to get through a difficult phase. Read more about the Period of PURPLE Crying program at http://purplecrying.info/

What’s Happening in Washington Healthcare? May 6th Weekly Wrap-up

Jefferson Healthcare named as ‘Leader in LGBT Healthcare Equality’

Jefferson Healthcare has once again earned top marks in the Human Rights Campaign’s annual survey of health care facilities. Jefferson has met nondiscrimination and training criteria reflective of an organization that offers care inclusive of LGBT patients and their families.

Overlake Earns ‘A’ Grade for Patient Safety in April 2016 Hospital Safety Score

The Hospital Safety Survey, published annually by The Leapfrog Group, has recognized Overlake Medical Center as one of the safest hospitals in America for the third consecutive year.

Allen Institute releases powerful new data on the aging brain and traumatic brain injury

The Allen Institute for Brain Science has published a comprehensive online portal which enables the public to learn more about brain injury. Brain-map.org is the result of a collaboration between the Allen Institute, the University of Washington Medicine, Group Health.

Consolidation may be in vogue, but these Seattle-area health care companies remain independent

Edmonds Family Medicine, EvergreenHealth Partners, MultiCare Connected Care, Overlake Medical Center, Seattle Children’s and Virginia Mason have formed The Puget Sound High Value Network. The goal is to create competition for high quality and cost-effective care in the Seattle area, without consolidating organizations.

A National Physician Shortage is on the Horizon

IHC, inc has published a report on the future physician shortfall in America.The report projects there will be between 61K-94K fewer physicians than needed by 2025, and that demand for practitioners will increase at the same time as the population over 65 grows by 41%.

Medical errors revealed to be the third leading cause of death in America

Major research has been published in The BMJ Journal which warns that medical error causes more than 250,000 deaths annually. Researchers suggest that more data is needed in order to understand the problem, and propose death certificates be amended to more accurately reflect the cause of death.

Study finds that seven of the top 10 profitable US hospitals are nonprofits

An article in Health Affairs has determined that 7 of the 10 most profitable hospitals in America are not-for-profit organizations. Non profit status allows many organizations to avoid property and other taxes, which may contribute to reduced expenses. Hospital associations report that profitability should be an indication of proper management and greater efficiency, and that increased revenues are used to train staff and purchase better equipment.

 

Medical errors revealed to be the third leading cause of death in America

An article published in The BMJ Journal by Martin Makary and Michael Daniel on May 3rd, 2016 identified that medical errors are the third most common killer in the United States. The Centers for Disease Control and Prevention do not report medical error on death certificates, resulting in public ignorance as to the scale of fatal mistakes during patient care. Death certificates rely on the International Classification of Diseases coding system, which does not include a classification for “medical error”.

According to the researchers, medical error was the cause of death in 251,000 cases in 2013, beating lung disease, suicide and motor vehicle deaths combined. The two leading causes of death in 2013 were heart disease (661,000) and cancer (585,000). Examples of such errors include patients being handed the incorrect medication, infections from improperly sterilized equipment, accidental cuts on the operating table, and many more.

“Although we cannot eliminate human error, we can better measure the problem to design safer systems mitigating its frequency, visibility, and consequences” say the authors. “Strategies to reduce death from medical care should include three steps: making errors more visible when they occur so their effects can be intercepted; having remedies at hand to rescue patients; and making errors less frequent by following principles that take human limitations into account”. Of course another major strategy should be educating practitioners on best practices for those procedures which most commonly result in accidental deaths.

Clearly this study has implications for healthcare recruiters and human resources managers as well. When hiring for open positions it is crucial that an employer has the opportunity to interview the most highly qualified candidate. That isn’t possible if only one or two applicants express interest and show up for a job interview. Strong recruiting platforms are necessary to empower employers to survey a range of would-be employees, and that’s where the quantity of applicants breeds quality in eventual employee performance.

Patients should also be empowered to make intelligent decisions about their care. By publishing more data about medical errors, and utilizing resources like Hospital Safety Score, patients can choose the medical teams which are more likely to provide incident-free care.

 

Martin A Makary, Michael Daniel. “Medical error—the third leading cause of death in the US”. BMJ 2016;353:i2139