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Industry News
In California, some experts warn that the legalization of marijuana for recreational use could roll back some of the gains California has made in reducing tobacco use, Kaiser Health News reports. "There is a concern that there could be a potential renormalization of smoking," says Dr. Michael Ong of UCLA's David Geffen School of Medicine. Some are also concerned the tobacco industry could get into the marijuana market. Proponents of legalization argue the two products are different and should not be conflated. (Kaiser Health News)

In a Commonwealth Fund-supported survey of adults in 11 countries, American respondents reported poorer health compared to respondents in other countries. "In comparison to adults in the other ten countries, adults in United States are sicker and more economically disadvantaged. The resulting challenge to the US health system is compounded by higher health care costs, greater income disparities, and relatively low levels of spending on social services, compared to the other countries." ( Health Affairs )

Neighborhood violence can lead to biological stress in children, according to a small study published in JAMA Pediatrics. "This complex association points to the larger structural forces that shape child development, including neighborhoods as critical arenas influencing child health trajectories, with specific neighborhood conditions that can be successfully targeted for even greater effect on public health," researchers conclude. (JAMA Pediatrics)

Is a sales rep assisting your surgeon during surgery? It's possible one is offering technical expertise. "Our study raises ethical questions about the reliance of surgeons on device reps and device companies for education and surgical assistance and practical concerns regarding existing levels of competence among OR personnel," concludes a study published in PLOS ONE. Co-author Adriane Fugh-Berman of Georgetown University School of Medicine and director of PharmedOut questions how much influence reps wield, how necessary and costly are their services, and does their presence in the OR, which may not be disclosed to patients, raise ethical questions about informed consent? (Kaiser Health News; PLOS One)
Innovation & Transformation    
To vastly improve how physicians personalize care and eradicate disease, EHR vendors must incorporate storage of discrete genetic markers, make information about open clinical trials available to patients and continue tracking all patients for new actionable variants to help health care providers, research institutes and medical centers improve health care, says Brian Wells, associate VP of health technology and academic computing at Penn Medicine. EHR systems also should have actionable rule-based alerts, patient-finding features, external report abstraction support and ability to share genetic report data with patients through the patient portal, he says. (Healthcare IT News blog)

Kelly Kjelstrom, a specially trained community paramedic in Modesto, Calif., helps psychiatric patients avoid unnecessary visits to the emergency department by identifying problems, intervening and then de-escalating the situation. The Modesto pilot program launched a year ago. Similar projects are also underway in North Carolina, Minnesota, Texas, Colorado and Georgia. Other states have shown interest. Kevin Mackey, medical director of the Mountain Valley EMS agency which launched the Modesto program, says, "Emergency departments are bursting at the seams. This is at least a partial answer to giving people care in the right place at the right time." (Kaiser Health News)
Consumers & Providers
A new study suggests living near a retail clinic does not reduce visits to the emergency department by patients with low-acuity illnesses like influenza, urinary tract infections and ear aches. The study, published in the Annals of Emergency Medicine, found EDs in close proximity to retail clinics didn't experience a reduction of visits. According to researchers, this was the first study to explore the association between the opening of retail clinics and ER visits. (Modern Healthcare )
Ohio family physician Larry Ratcliff, MD, believes in the CMS Comprehensive Primary Care initiative, telling AAFP News that CPCi helped him transform his practice, improve patient care and bring joy back to the practice of medicine. He urged his family physician colleagues to apply for the upcoming CPC+ programs without hesitation. "This afforded me an opportunity to transform my practice. Even though I'm actually seeing more patients, I enjoy my practice a lot more now," said Ratcliff. (AAFP News )
Texas is one of 18 states that allow non-medical exemptions to the vaccines required for school attendance, but some parents are pushing to change that. Some parents are also urging state officials to make exemption rates publicly available so they can see how many of their child's peers have been vaccinated. (Kaiser Health News )
New & Noted   
HIT under Trump:  The future of health IT initiatives has substantial bipartisan support, according to Harry Greenspun, chief medical officer and managing director at Korn Ferry. But he warns that under Trump, the Office of the National Coordinator for Health IT could have a reduced role and staff. (report )

Biological fingerprints:  Bacteria are found on human skin, including microbes from bony fish, mollusks, chicken and baked goods. All of these were found on ATM keypads in Manhattan, Queens and Brooklyn. Skin bacteria were the most common, but the breakdown of the rest depends on the neighborhood. (The Washington Post )

Nursing shortage:  About a third of the nursing population is over 50 and either cutting back hours or approaching retirement while, at the same time, the cost of training nurses is rising to the point where they come out of school over $70,000 in debt. (Marketplace audio)
Kaiser Health News' Julie Rovner and Mary Agnes Carey, The New York Times' Margot Sanger-Katz and The Lancet's Richard Lane discuss the future of the Affordable Care Act under GOP control of both the White House and Capitol Hill. (podcast )
MarketVoices...quotes worth reading
"If one of those kids is incubating an infectious disease and the other kids aren't vaccinated, then it's going to spread like wildfire."--Catherine Troisi, an infectious disease epidemiologist at the University of Texas Health Science Center at Houston, quoted in a Kaiser Health News article on vaccinations.

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Wednesday, November 23, 2016