What's New in Health Care Reform provides an overview of the past week’s news, updates, and commentary in health care reform and utilization management.
Tiny Device Is "Huge Advance" for Treatment of Severe Heart Failure
Almost two million Americans have severe heart failure, and for them even mundane tasks can be extraordinarily difficult. With blood flow impeded throughout their bodies, patients may become breathless simply walking across a room or up stairs. Some must sleep sitting up to avoid gasping for air. Drugs may help to control the symptoms, but the disease takes a relentless course, and most people with severe heart failure do not have long to live. Until now, there has been little doctors can do. But on Sunday, researchers reported that a tiny clip inserted into the heart sharply reduced death rates in patients with severe heart failure. In a large clinical trial, doctors found that these patients also avoided additional hospitalizations and described a drastically improved quality of life with fewer symptoms. The results, reported at a medical meeting in San Diego and published simultaneously in the New England Journal of Medicine, were far more encouraging than heart specialists had expected. Via NY Times.
Breastfeeding Better for Babies' Weight Gain Than Pumping, New Study Says
Research has already shown a link between breastfeeding and lower obesity risk for babies. But a new study finds another association: "Breast is best" for them even compared with giving babies breast milk out of the bottle. The benefits of direct breastfeeding included slower weight gain and lower BMI scores at 3 months, according to a Canadian study published in the journal Pediatrics. Still, even pumped breast milk was superior to none at all, in line with past research. Via CNN.
Ken Burns Turns His Attention to Mayo Clinic
After spearheading an epic, 18-hour documentary on the Vietnam War, acclaimed filmmaker Ken Burns has turned to more personal subject matter—one that knows him very intimately, too. Burns tackles the famed Mayo Clinic in his next film, exploring the history of the innovative Rochester, Minnesota-based hospital that has been dubbed “The Miracle in a Cornfield.” It has treated luminaries such as the Dalai Lama—and Burns. Via AP.
Excessive Drinking Killed More Than 3 Million People in 2016
Drinking too much alcohol killed more than 3 million people in 2016, mostly men, the World Health Organization said. The U.N. health agency also warned that current policy responses are not sufficient to reverse trends predicting an increase in consumption over the next 10 years. In a new report, the agency said that about 237 million men and 46 million women faced alcohol problems, with the highest prevalence in Europe and the Americas. Europe has the highest global per capita alcohol consumption, even though it has already dropped by 10 percent since 2010. Around a third of alcohol-related deaths were a result of injuries, including car crashes and self-harm, while about one in five were due to either digestive disorders or cardiovascular diseases. Cancers, infectious diseases, mental disorders and other health conditions were also to blame. Via CBS News.
Physician Burnout Taking Center Stage
Overall, 45% of residents reported at least one symptom of burnout—such as exhaustion—at least once a week, while 14% reported regret over career choice. While once a week may not sound like a lot, physicians who feel burnout this often are more likely than others to report thinking about suicide, making a major medical error and wanting to leave medicine, said lead author Lotte Dyrbye, M.D., MHPE, who co-directs the physician well-being program at the Mayo Clinic in Rochester, Minnesota. The problem is especially prevalent among physicians, Dr. Dyrbye said, noting that although doctors may have close to a 50% burnout rate, among other U.S. workers the rate is under 30%. Still, Dr. Dyrbye said, “We need more research in the field with good attention to method.” Via Washington Post.
Zapping Mutant DNA in Mitochondria Could Treat Major Class of Genetic Disease
CRISPR, the genome editor celebrated as a potentially revolutionary medical tool, isn’t omnipotent. Mitochondria, the organelles that supply a cell’s energy, harbor their own mitochondrial DNA (mtDNA) and mutations there can have devastating consequences including deafness, seizures, and muscle weakness. Genome editing might be a remedy, but mitochondria appear to be off-limits to CRISPR. Turning these results into a treatment will be tricky. The genes encoding the genome editors had to be introduced by viruses, and researchers have long struggled to make similar gene therapy efforts work. But, “These are the right experiments to get ready to go into people,” says molecular geneticist Stephen Ekker, Ph.D., of Mayo Clinic in Rochester, Minnesota, who wasn’t connected to either study. In fact, both groups are already aiming to launch clinical trials. Via Science.
Could Senolytic Therapies Cure Aging
In an article in the Journal of the American Geriatrics Society, Mayo Clinic aging experts said that, if proven to be effective and safe in humans, these drugs could be “transformative” by preventing or delaying chronic conditions as a group instead of one at a time. “Researchers at Mayo Clinic's Robert and Arlene Kogod Center on Aging developed the first senolytic drugs to target these harmful cells,” Mayo states in the article. “In a recent study led by The Scripps Research Institute, Mayo Clinic researchers and others confirmed that the senolytic drugs discovered at Mayo effectively clear senescent cells while leaving normal cells unaffected. The study, which was published in Nature Communications, also describes a new screening platform for finding additional senolytic drugs that will more optimally target senescent cells. The platform, together with additional human cell assays, identified and confirmed a new category of senolytic drugs, which are called HSP90 inhibitors.” This platform, said James Kirkland, M.D., Ph.D., Director of the Kogod Center on Aging and one of the authors of the study, “Senolytics Improve Physical Function and Increase Lifespan in Old Age” published in Nature Medicine in July, will help researchers identify other drugs that target aging processes. Via Forbes.
Mayo Clinic, Mass General, Nvidia Researchers Use AI to Create "Synthetic MRIs"
A team of researchers from Mayo Clinic in Rochester, Minnesota, Massachusetts General Hospital, and Brigham and Women's Hospital Center for Clinical Data Science—both in Boston—and technology vendor Nvidia developed an artificial intelligence model to generate "synthetic MRIs," according to a Nvidia blog post. A promising use for AI in health care is to help physicians interpret medical images. However, many health care organizations lack accurate and reliable imaging data needed to train these AI models. To address this issue, the research team developed a deep learning model that generates synthetic MRIs on which they can train future AI systems. Via Becker's Hospital Review.
Opioid Controlled Substance Agreements Safely Reduce Health Care Visits and Decrease Utilization
New research published in Mayo Clinic Proceedings found that adhering to a standardized care process model for opioid prescriptions appears to reduce the overall number of healthcare visits for patients on long-term opioid therapy, thereby decreasing utilization while maintaining safety. Researchers said the controlled substance agreement provides patients a structure and reduced the likelihood that they seek medical attention to further manage or diagnose their pain. Via Healthcare Finance News.
EpiPen Shortage Has Minnesota Parents, Pharmacies Scrambling to Find Lifesaving Medication
A nationwide shortage of EpiPens has Minnesota families and pharmacies scrambling to obtain the lifesaving medication devices, which are often the only option for people having severe allergic reactions. The shortage is one of several that have hit the nation’s drug market recently, including a new shingles vaccine, prompting federal lawmakers to call for the government to address gaps in pharmaceutical manufacturing. Via Star Tribune.