Check out the latest edition of the Health Wonk Review, posted today on Health Affairs Blog. It’s a Pot Luck edition so you’ll get a little bit of everything.
Safe at home
The opioid epidemic is truly devastating. Drug overdoses (mostly opioids) are a leading cause of death in the US, topping guns and car crashes. People don’t want to become addicted to drugs or die from overdoses, so why does it happen so often?
It often starts with a doctor writing a prescription for someone complaining of chronic or acute pain or following a surgical procedure. Little thought is given to the number of pills prescribed; extra pills are either consumed by the patient or left lying around in the medicine cabinet where they may be taken by family members or house guests who have developed a habit. When prescription pills run out and the cost of buying them on the black market is too high, users shift quickly to heroin, which is cheap, potent and readily available. The downward spiral can be steep.
Thankfully, the country is starting to get a grip on the opioid crisis. Health insurers are tightening up on opioid coverage, doctors are trying alternative therapies (like massage) or being more conservative in their prescribing. TV and newspaper stories are pointing out the perils.
Awareness is spreading, including to the younger generation. I’m really pleased to see that some colleges are offering “sober dorms” for students committed to a substance-free lifestyle. The idea is not brand new –a Rutgers program dates back to 1988—but it seems to be gaining traction as more schools try out the approach.
A number of schools offer housing for people in recovery, designed to prevent relapse. New Jersey has a new law requiring any college with more than one quarter of students living on campus to offer sober housing. Other schools are starting to offer sober dorms to students who are looking for a clean lifestyle, whether they are in recovery or not.
It’s also my impression that college administrators are doing more than they used to to enforce alcohol and drug laws, regardless of a dorm’s official designation.
Image courtesy of Stuart Miles at FreeDigitalPhotos.net
—
By healthcare business consultant David E. Williams, president of Health Business Group.
I’m here for your job
The US added 38,000 jobs in May, including 46,000 in healthcare. In other words, healthcare added more than 100 percent of the new jobs in the economy. That won’t happen every month, but it’s a pretty striking statistic.
What’s going on here?
I recently read The Second Machine Age: Work, Progress, and Prosperity in a Time of Brilliant Technologies, which basically argues that almost all jobs –including highly skilled ones– will be wiped out by automation, robots and artificial intelligence. Case in point: truck drivers and taxi drivers, who will be replaced by self-driving vehicles.
Job destruction is happening today on a large scale. Manual laborers have been vulnerable for a long time, but professionals are now under threat as well. There’s little opportunity in previously safe jobs like bookkeeper and paralegal. I firmly believe that a big driver of Donald Trump’s popularity is the alienation felt by many workers –including skilled ones– whom the economy no longer really needs or won’t need soon. It’s easy to blame free trade pacts, Chinese, Mexicans, and our feckless political leadership, but technology is actually the root cause.
The two big exceptions to job loss are healthcare and education, sectors that have been very slow to match the innovation pace established by the rest of the economy. That’s kept costs high and rising. As a result, Americans are getting killed by healthcare and education expenses at a time that incomes are stagnant.
Healthcare is always 10-20 years behind the rest of the economy (I’ll let someone else speak for education) so we can expect continued robust healthcare hiring for some time.
If the jobless future described in The Second Machine Age really comes to pass, society will be in serious trouble. I really don’t like the author’s idea of addressing joblessness by paying everyone a guaranteed minimum income. Sure people need an income, but they also need purpose in life, which often comes from having something productive to do on the job.
As I’ve been saying for years –for example Welcoming immigrants and robots to fill the nursing shortage and Robots are coming and they plan to treat you like a moron –I do think healthcare will eventually catch up with the rest of the economy and healthcare jobs will go by the wayside. But maybe there will be enough lag time that we will in fact preserve and invent meaningful jobs in healthcare, and that the healthcare field will lead the next wave for the re-humanization of the economy.
Image courtesy of Geerati at FreeDigitalPhotos.net
—
By healthcare business consultant David E. Williams, president of Health Business Group.
The latest edition of the Health Wonk Review is up at HealthBlawg. As usual, David Harlow is a step ahead of the rest with his social media toolkit. A blog post is not enough, so he’s added a “Blab” where he discusses the carnival.
Enjoy!
Alexa, what can you do for healthcare?
I bought an Amazon Echo this week and have been enjoying using it in the kitchen. I can ask, “Alexa, what time is it in Germany?” and it will tell me. Or I can say, “Alexa, play music by the Beatles,” or ask, “Alexa, how many ounces in a cup?” and it will let me know. It’s remarkably easy –and not at all frustrating– to use. The whole family is enjoying it.
Naturally I started almost immediately to think of healthcare uses, so I wasn’t at all surprised to pick up the Boston Globe yesterday and see that my friends from Boston Children’s Hospital are a step or two ahead. Chief Innovation Officer John Brownstein, PhD and clinical innovation director Michael Docktor, MD have launched a KidsMD app for the platform and are testing out uses for Echo in the OR, ICU and bedroom.
Although the article lays out some of the potential for Echo, overall I find it too dismissive, highlighting a software glitch, voice recognition problem, and asserting that “another layer of technology might frustrate staff.” The article ends with a quote from a Children’s engineer whose own kids aren’t interested in speaking with Alexa. None of this reflects my family’s experience.
What the article misses is that Echo represents the latest example of physicians bringing cutting edge consumer technology into the hospital and running circles around the standard tools offered by the IT department. In the real world, physicians are early and enthusiastic adopters of tools like the iPad and iPhone, and through the bring your own device (BYOD) movement they have upended the traditional, clunky hospital IT environment.
Here are some thoughts about what could make Echo so useful for healthcare:
I can foresee apps that help patients remember their customized care instructions, “Alexa, how often am I supposed to change my dressing?” or “Alexa, am I supposed to take my medication with food?”
I also think it will be useful for hospitalized patients who are trying to remember questions they want answered the next time their doctor or nurse comes around. There is a built in ability to say, “Alexa, add butter to my shopping list.” So there’s no reason it couldn’t compile a list of doctor questions as well.
These are the veritable tip of the iceberg, and I look forward to seeing a thousand (or more) flowers bloom as the healthcare field embraces Echo. “Alexa, I love you.”
—
By healthcare business consultant David E. Williams, president of Health Business Group.
