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The Global Problem of Low-Value Care

Several studies of low-value care show the problem to be widespread and frequent. The rate of low value care occurs at rates of 5-8% of cases overall, and at a rate of ~25-42% in the elderly. Low-value care has several causes, including clinician, patient, and systems factors. Clinician factors may include bias in training, defensive […]

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Medically Unnecessary Tests Increase Costs and Safety Risks

Unnecessary medical tests raise the cost of care and introduce unnecessary patient safety risks. Surveys show that unnecessary tests are often ordered out of habit, or because staff overestimate the number of tests that attending physicians require. Over half of respondents felt that attending physicians would be “uncomfortable” with reduced testing, while 37% stated that […]

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EHR Usability Issues May Increase Patient Safety Risk

The EHR has become a standard tool of delivering medical care, but often suffers from user interface defects, lack of alignment with clinical workflow, and incomplete or ineffective user training. Electronic Health Records (EHR) faults can result in incomplete lab results or medical order overwrites due to cluttered or uninformative user interfaces, poor alignment with […]

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High Quality and Potential Cost-Savings of Generic Medication

Use of generic drugs saved the U.S. $1.68 Trillion between 2005 and 2014, but are still underutilized due to patient resistance. Generic drugs are often 30%-80% lower cost than brand-name equivalents, but a lack of patient understanding of generics is a barrier to higher adoption. Physicians can provide patient education to improve patient understanding and […]

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Federal and Social Measures of Quality for Nursing Homes Differ

Comparison between federal NHC quality measurement of nursing homes and their Yelp ratings shows little correlation. Researchers compared NHC and Yelp ratings for 675 NHs that had both ratings, and found weak correlation between the scores. The Yelp ratings for NHC 5-star facilities were significantly lower, but higher than the NHC Inspection rating. WBB Take: […]

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VA Closer to Offering Nationwide TeleHealth Services

The Veterans E-Health and Telemedicine Support Act of 2017 (H.R. 2123) passed the House Committee on Veterans’ Affairs and seeks to allow VA to use TeleHealth across state lines. Currently, VA physicians can only use TeleHealth across state lines if both the physician and patient are located in a federal facility. The new rule would […]

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Choosing Wisely: Randomized Trial Shows Little Effect

Randomized field trial showed no significant reduction in low-value care at primary care level, and no changes to imaging and antibiotic orders were sustained in a follow-up review. “Choosing Wisely” is an initiative by the American Board of Internal Medicine (ABIM). The authors found no change in the percentage of low-value orders for sinusitis and […]

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Medical Errors Affect One in Five U.S. Adults

In a nationwide survey of more than 2,500 adults, 21% reported having personally experienced a medical error that often resulted in lasting impact on the patient’s physical or emotional health, financial well-being, or family relationships. WBB Take: Medical error is arguably the third leading cause of death in the U.S., trailing only heart disease and […]

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The Antibiotic “Apocalypse”

Global burden of illness related to antibiotic resistance has reached 700,000 deaths per year, and is likely to reach 10 million per year by 2050. Colistin is an antibiotic of last resort, increasingly used because other antibiotics are no longer effective. However, the bacterial mutation mcr-1 that confers resistance to Colistin is rapidly spreading, reaching […]

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