The number of diagnosed cases of melanoma has been on the rise over the years but a recent British study reports that the "the epidemic may be due to diagnostic drift."

The report defines diagnostic drift as "the growing tendency to identify and treat benign lesions as malignant cancers," the New York Times reports.

"The study, published in the September issue of The British Journal of Dermatology, examined a cancer registry with 3,971 cases of melanoma and found that incidence increased 48 percent from 1991 to 2004, similar to the 44 percent increase reported by the Centers for Disease Control and Prevention over the same period for American whites. The disease is almost 20 times as common in whites as in blacks."

However, the research group found that almost all of the increase in diagnoses was in the earliest stage of the disease.

 “A lot of dermatologists will argue that they’re getting better at diagnosing melanoma, but I don’t think that’s very likely,” Dr. Marianne Berwick, a professor at the University of New Mexico said in the New York Times. “They’re taking a lesion that would not be diagnosed as melanoma 20 years ago and calling it melanoma.”

To read the full article and the implications of "diagnostic drift," click here: http://www.nytimes.com/2009/09/29/health/29mela.html?scp=20&sq=September+29+2009&st=nyt

In a step toward reducing mistakes and standardizing medical practices, North Shore-Long Island Jewish Health System, a major hospital group in New York, has announced the most sizeable effort to adopting digital health records.

The group's investment is a $400 million commitment that would put digital health records in 13 of its hospitals. The plan offers "its 7,000 affiliated doctors subsidies of up to $40,000 each over five years to adopt digital patient records. That would be in addition to federal support for computerizing patient records, which can total $44,000 per doctor over five years."

Stated the New York Times, "The federal program includes $19 billion in incentive payments to computerize patient records, as a way to improve care and curb costs. And the government initiative has been getting reinforcement from hospitals. Many are reaching out to their affiliated physicians — doctors with admitting privileges, though not employed by the hospital — offering technical help and some financial assistance to move from paper to electronic health records. "

Digital health records can improve the health outcome for patients and reduce costly administrative fees and costs for hospitals. "Indeed, the rationale for investing in digital records is that the technology can be used to help monitor and measure the results of care, providing the evidence needed to shift remuneration away from the current fee-for-service system, which encourages more tests, more procedures and more pills prescribed."

To read the full article, click here: http://www.nytimes.com/2009/09/28/technology/28records.html?scp=1&sq=September+28+2009&st=nyt

In all the old movies and sitcoms we tend to see someone peddling or selling the miracle drug; that tiny little pill that can make all of your pains and problems go away (or at least ease up a bit since usually those pills were nothing more than alcohol-laden sugar pills) and didn't cost all that much.

According to a recent article in the New York Times, pills and capsules are the newest rage in cancer treatment, expected to account for 25 percent of all cancer medicines in a few years.

While these wonder pills do indeed sound wonderful, considering they could replace expensive and harsh chemotherapy, they come with a tiny glitch: Most insurance companies won't pay for them.

Stated the article: "With oral cancer drugs, “the technology has outstripped the ability of society to integrate it into the mainstream in a smooth fashion,” said Carlton Sedberry, a pharmacy expert at Medical Marketing Economics, a consulting firm."

This is a classic case of technology outrunning the current standards and protocols that hospitals, physicans, patients and payers are used to following. However, with the right research and knowledge of up-to-date practices, new technologies in medicine -- such as the use of 'cancer pills' -- can become standard in practice. An independent review organization like AllMed can help you, whether you're a payer, hospital, physician or patient, know what's the most up-to-date protocol in healthcare.

To read the full article in the New York Times, click here: http://www.nytimes.com/2009/04/15/business/15pill.html?_r=1&ref=health 

The federal government has finally jumped on the IRO bandwagon with the approved $787 billion economic stimulus bill that provides substantial amounts of money for the federeal government to compare the effectiveness of different treatments for the same illness.

According to a recent New York Times article, "under the legislation, researchers will receive $1.1 billion to compare drugs, medical devices, surgery and other ways of treating specific conditions." These comparisons will likely become the touchstone for independent review organizations, payers and hospitals alike to use to establish standards of care that are based off of empirical evidence. The article states that the program is a response to a "growing concern that doctors have little or solid evidence of the value of many treatments."

Researchers also hope that the program will eventually save money by discouraging the use of costly, ineffective treatments; a vital improvement for the soaring cost of health care nationwide.

The Health and Human Services Department will have immediate access to the money, which can be spent over several years. The article reported that "some money will be used for systematic reviews of published scientific studies, and some will be used for clinical trials making head-to-head comparisons of different treatments."

In essence, the health care problem could very well be on the mend for hospitals, doctors, payers and consumers alike.

To read about political reactions, click here to view the full article: http://www.nytimes.com/2009/02/16/health/policy/16health.html?ref=health

Study for a test and you’ll earn a good grade. 

Follow the recipe and you’ll get a moist cake.

Water your garden and you’ll have luscious bouquets.

These instructions are almost innate truths to our lives: If-Then statements that make sense and we accept as the standard because they are time-tested, well-experimented paths to success in school, baking and gardening. We know that water helps plants grow because it has been researched. We know that a cup of flour instead of two cups for a recipe yields a better tasting product because it’s been tested. We can see from the A written in red at the top of test (or are children’s) that studying paid off. We accept these practices because they are standards.

Researchers are finding that some standards-of-care in the world of medicine have become the so-called standard without clinical guidelines, hard data or evidence. According to a New York Times article in December, a report in The Journal of the American Medical Association found that only about a third of clinical guidelines reviewed current medical evidence and fewer than half followed any kind of standard format.

The gap created by the failure to include and study evidence and standards posits a scary situation for patients because evidence-based guidelines are critical to protecting public health from bad medicine. You wouldn’t want to serve a cake with unmeasured ingredients to your friends just like you wouldn’t want to serve your patients via guidelines that lack evidence.

 In standardizing care through pay-for-performance incentives, large insurers like Medicare may increasingly reward doctors for following clinical guidelines. Before that happens, though, it will be critical to establish better standards for the standards — especially for children. Collaborating with an independent review organization like AllMed can help doctors and payers know what the evidence-based guidelines and standards-of-care for a breadth of medical diseases are. 

To read the full essay, click here