In this recently posted video, Charles Prober, MD, co-author of the paper and senior associate dean for medical education at the School of Medicine, medical school colleagues and Silicon Valley-based online learning pioneer Salman “Sal” Khan discuss this vision for a new medical curriculum.
via Using the “flipped classroom” model to re-imagine medical education | Scope Blog.
Sponsors of health care price and quality transparency initiatives often identify all consumers as their target audiences, but the true audiences for these programs are much more limited. In 2007, only 11 percent of American adults looked for a new primary care physician, 28 percent needed a new specialist physician and 16 percent underwent a medical procedure at a new facility, according to a new national study by the Center for Studying Health System Change (HSC). Among consumers who found a new provider, few engaged in active shopping or considered price or quality information—especially when choosing specialists or facilities for medical procedures. When selecting new primary care physicians, half of all consumers relied on word-of-mouth recommendations from friends and relatives, but many also used doctor recommendations (38%) and health plan information (35%), and nearly two in five used multiple information sources when choosing a primary care physician. However, when choosing specialists and facilities for medical procedures, most consumers relied exclusively on physician referrals. Use of online provider information was low, ranging from 3 percent for consumers undergoing procedures to 7 percent for consumers choosing new specialists to 11 percent for consumers choosing new primary care physicians.
Conclusions
In fee-for-service Medicare, the dispersion of patients’ care among multiple physicians will limit the effectiveness of pay-for-performance initiatives that rely on a single retrospective method of assigning responsibility for patient care.
http://www.nejm.org/doi/pdf/10.1056/NEJMsa063979
Findings: PCPs vary in their threshold for referring a patient, which results in both the underuse and the overuse of specialists. Many referrals do not include a transfer of information, either to or from the specialist; and when they do, it often contains insufficient data for medical decision making. Care across the primary-specialty interface is poorly integrated; PCPs often do not know whether a patient actually went to the specialist, or what the specialist recommended. PCPs and specialists also frequently disagree on the specialist’s role during the referral episode (e.g., single consultation or continuing comanagement).
http://onlinelibrary.wiley.com/doi/10.1111/j.1468-0009.2011.00619.x/pdf
Conclusions. PCPs’ referral decisions are influenced by a complex mix of patient, physician, and health care system structural characteristics. Factors associated with more discretionary referrals may lower PCPs’ thresholds for referring problems that could have been managed in their entirety within primary care settings.
Just this month, a tech news article showcased how Harvard scientists are considering that “sharing discoveries is more efficient and honorable than patenting them.” This idea embodies the true spirit of a successful professional learning network: collaboration for its own sake.
As educators, we aim to be connected to advance our craft. On another level, we hope to teach students to use networks to prepare for them for a changing job market. But what is the best way to approach PLNs?
via 20 Tips for Creating a Professional Learning Network – Getting Smart by Miriam Clifford.
ABSTRACT
Adoption studies of social media use by clinicians were systematically reviewed, up to July 26th, 2011, to determine the extent of adoption and highlight trends in institutional responses. This search led to 370 articles, of which 50 were selected for review, including 15 adoption surveys.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3422846/pdf/amiajnl-2012-000990.pdf
Abstract
PURPOSE:
While patients often use the internet as a medium to search for and exchange health-related information, little is known about the extent to which patients use social media to discuss side effects related to medications. We aim to understand the frequency and content of side effects and associated adherence behaviors discussed by breast cancer patients related to using aromatase inhibitors (AIs), with particular emphasis on AI-related arthralgia.
via Online discussion of drug side ef… [Pharmacoepidemiol Drug Saf. 2013] – PubMed – NCBI.
Abstract
There has been a tremendous growth in the use of social media to expand the visibility of various specialties in medicine. The purpose of this paper is to describe the latest updates on some current applications of social media in the practice of vascular surgery as well as existing limitations of use. This investigation demonstrates that the use of social networking sites appears to have a positive impact on vascular practice, as is evident through the incorporation of this technology at the Cleveland Clinic and by the Society for Vascular Surgery into their approach to patient care and physician communication. Overall, integration of social networking technology has current and future potential to be used to promote goals, patient awareness, recruitment for clinical trials, and professionalism within the specialty of vascular surgery.
via Social media in vascular surgery. [J Vasc Surg. 2013] – PubMed – NCBI.
Abstract
This paper describes our considerations and methods for implementing an open-source centralized research data repository (CRDR) and reports its impact on retrospective outcomes research capacity in the urology department at Columbia University. We performed retrospective pretest and post-test analyses of user acceptance, workflow efficiency, and publication quantity and quality (measured by journal impact factor) before and after the implementation. The CRDR transformed the research workflow and enabled a new research model. During the pre- and post-test periods, the department’s average annual retrospective study publication rate was 11.5 and 25.6, respectively; the average publication impact score was 1.7 and 3.1, respectively. The new model was adopted by 62.5% (5/8) of the clinical scientists within the department. Additionally, four basic science researchers outside the department took advantage of the implemented model. The average proximate time required to complete a retrospective study decreased from 12 months before the implementation to <6 months after the implementation. Implementing a CRDR appears to be effective in enhancing the outcomes research capacity for one academic department.
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