What I'm Reading (Apr. 21)

“Health systems and payers eager to trim costs think the answer lies in a small group of patients who account for more spending than anyone else.

If they can catch these patients — typically termed “high utilizers” or “high cost, high need” —  before their conditions worsen, providers and insurers can refer them to primary care or social programs like food services that could keep them out of the emergency department. A growing number also want to identify the patients at highest risk of being readmitted to the hospital, which can rack up more big bills. To find them, they’re whipping up their own algorithms that draw on previous claims information, prescription drug history, and demographic factors like age and gender.”

AI comes to healthcare, and it has found a home in payors’ ledgers; someday, it might be helpful to patients, but as the article from Stat suggests, that is a long way off. Health systems are using machine learning to predict high-cost care. Will it help patients?

“Let's discuss this very tragic case involving RaDonda Vaught, who was an ICU nurse who was recently convicted in Tennessee of criminally negligent homicide and gross neglect of an impaired adult. She accidentally administered a paralytic medication, vecuronium, instead of a sedative, Versed, which was ordered to sedate a 75-year-old patient who had a brain bleed and TBI. She was scheduled to have a PET scan. After receiving the wrong medication and not really being monitored in any true way, just being in the care of an MRI tech, she suffered cardiac arrest and subsequently died.”

If you are found to be criminally liable for a patient’s death, then medical care will end. There is no question about that. But was she negligent, yes, criminal, no? The criminal was the system that supported her behavior. Here is a more extended consideration from Medscape, Are All Medical Errors Now Crimes? The Nurse Vaught Verdict. It can be viewed or read.

This title says it all, How to Call Customer Service and Actually Get What You Want. Hopefully, it delivers!

“The time for cornflakes boxes has passed: now we have the internet. Having been printed on paper since the very first scientific journal was inaugurated in 1665, the overwhelming majority of research is now submitted, reviewed and read online. During the pandemic, it was often devoured on social media, an essential part of the unfolding story of Covid-19. Hard copies of journals are increasingly viewed as curiosities – or not viewed at all.

But although the internet has transformed the way we read it, the overall system for how we publish science remains largely unchanged. We still have scientific papers; we still send them off to peer reviewers; we still have editors who give the ultimate thumbs up or down as to whether a paper is published in their journal.”

Should we end publishing scientific papers and find a new way to spread the word? From The Guardian, The big idea: should we get rid of the scientific paper?