Alzheimer's,Diagnostic Biomarkers of Alzheimer's Disease as Identified in Saliva using 1H NMR-Based Metabolomics,ecognizing early Alzheimer's disease,saliva

Diagnostic biomarkers in saliva show promise in recognizing early Alzheimer’s disease

Your spit may hold a clue to future brain health. Investigators at the Beaumont Research Institute, part of Beaumont Health in Michigan, are hopeful that their study involving small molecules in saliva will help identify those at risk of developing Alzheimer’s disease – a neurologic condition predicted to reach epidemic proportions worldwide by 2050.

Their study, “Diagnostic Biomarkers of Alzheimer’s Disease as Identified in Saliva using 1H NMR-Based Metabolomics” was published in the Journal of Alzheimer’s Disease.

Investigators found salivary molecules hold promise as reliable diagnostic biomarkers.

The study exemplifies the quest by scientists to combat Alzheimer’s disease, a degenerative brain disorder with no cure and few reliable diagnostic tests. In the United States, Alzheimer’s is a health epidemic affecting more than 5 million Americans. Investigators seek to develop valid and reliable biomarkers, diagnosing the disease in its earliest stages before brain damage occurs and dementia begins.

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Los Angeles Times,The Associated Press,The New York Times,The Star Tribune,The Washington Post,USA Today

The very real possibility of making babies from skin cells offers tantalizing hope, ethical quandaries

Researchers say in vitro gametogenesis — creating babies from skin cells — is only a couple decades away from being possible. That means a gay couple could have a child genetically related to both parents, but it also means someone could for all intents and purposes clone themselves. In other public health news: teens and mental health, maternal age, superbugs in hospitals, knee pain and more.

The New York Times: Babies from skin cells? Prospect is unsettling to some experts
Nearly 40 years after the world was jolted by the birth of the first test-tube baby, a new revolution in reproductive technology is on the horizon — and it promises to be far more controversial than in vitro fertilization ever was. Within a decade or two, researchers say, scientists will likely be able to create a baby from human skin cells that have been coaxed to grow into eggs and sperm and used to create embryos to implant in a womb. (Lewin, 5/16)

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American Academy of Actuaries,American Journal of Managed Care,billing,Health Affairs,Medicaid,telemedicine,The Kaiser Family Foundation

Research Roundup: Wait times; Telemedicine for mental health; Medicaid waivers

Each week, KHN compiles a selection of recently released health policy studies and briefs.

Health Affairs: Outpatient office wait times and quality of care for medicaid patients
We analyzed data on twenty-one million outpatient visits obtained from electronic health record systems, which allowed us to measure time spent in the waiting room beyond the scheduled appointment time. Median wait time was a little more than four minutes. Almost one-fifth of visits had waits longer than twenty minutes, and 10 percent were more than thirty minutes. Waits were shorter for early-morning appointments, for younger patients, and at larger practices. Median wait time was 4.1 minutes for privately insured patients and 4.6 minutes for Medicaid patients. After adjustment for patient and appointment characteristics, Medicaid patients were 20 percent more likely than the privately insured patients to wait longer than twenty minutes, with most of this disparity explained by differences in practices and providers they saw. (Oostrom, Einav and Finkelstein, 5/1)

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H. Tom Soh,monitor drug levels,Nature Biomedical Engineering,real-time biosensor

Experimental technology monitors and maintains drug levels in the body

As with coffee or alcohol, the way each person processes medication is unique. One person’s perfect dose may be another person’s deadly overdose. With such variability, it can be hard to prescribe exactly the right amount of critical drugs, such as chemotherapy or insulin.

Now, a team led by Stanford electrical engineer H. Tom Soh and postdoctoral fellow Peter Mage has developed a drug delivery tool that could make it easier for people to get the correct dose of lifesaving drugs. In a paper published in Nature Biomedical Engineering, the group showed that the technology could continuously regulate the level of a chemotherapy drug in living animals.

“This is the first time anyone has been able to continuously control the drug levels in the body in real time,” Soh said. “This is a novel concept with big implications because we believe we can adapt our technology to control the levels of a wide range of drugs.”

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Boston Medical Center,DataNext,National Center for Biotechnology Information,pharmacy-based analytics

Could pharmacy-based analytics finally address the paradox of reducing costs while improving quality?

Dawn DeAngelo, Chief Pharmacy Officer, Sentry Data Systems

Written by: Dawn DeAngelo
The National Center for Biotechnology Information recently reported that patient-centered care has made it to center stage in discussions of quality, particularly as insurance payments are increasingly linked to that provision. Clinicians, who have always worked with the best interests of their patients in mind, must now also consider a patient’s holistic care and drug regimens, especially with the industry-wide push for healthcare organizations to produce better outcomes. By reviewing a patient’s overall care and length of stay, and not just a drug’s cost, hospitals can begin to more fully understand trends and make more informed decisions.

Costs, charges and reimbursement, then, must be monitored very closely, and interdependencies between pharmacy and revenue integrity clearly understood. One way to accomplish this goal is through a comprehensive, real-time, patient data set that can provide the transparency needed to gain insights from pharmacy costs, charges and reimbursements, so hospital leadership can take costs out of the system and improve quality of care. That’s why so many of us are hopeful about the future of pharmacy-based analytics, which has the potential to truly transform how health systems care for patients by unlocking insights not found anywhere else.

By aggregating claims with clinical and granular pharmacy data into a longitudinal patient data intelligence platform, healthcare organizations are beginning to gain access to tools that enable them to run evidence-based algorithms against the data to deliver actionable insights into their clinical, operational and financial processes, in near real-time. These targeted results can identify and address pharmacy-related opportunities to lower costs, capture additional revenue, manage utilization, reduce diversion, and improve quality.

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cybersecurity,Information Security at MEDITECH,Protected Health Information

Cybersecurity: 5 ways to keep your EHR data as safe as your patients

The hacking business has hit retail establishments, financial institutions, and now, more than ever, healthcare. It can get overwhelming when you see headlines of healthcare organizations getting attacked with ransomware, malware, viruses, loss of patient records, and all sorts of cybersecurity breaches.

The potential solutions and vendor options to protect your organization can cost a lot of money and can be overwhelmingly technical. What can you do? While it’s not possible to have absolutely perfect cybersecurity, here are 5 simple ways that can help you keep patient data safe.

1. Keep calm and assess the risk.

Don’t overreact. Doing an internal risk assessment is an essential step in looking at the likelihood and impact of potential threats. Identify what your organization has that’s valuable, vulnerable, and exposed. Make a list and then look at what probability or likelihood each has to an attack. If something were to happen, assess what financial, social, and economic impact it may have. For each risk area you identify, determine if you will mitigate (buy a control), transfer (buy cyber insurance for the gap), avoid (remove the vulnerability), or accept (perhaps it’s not cost effective to prevent).

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Congressional Budget Office,Harvard Medical School,RAND Corporation,telemedicine

Use of telemedicine for mental health in rural areas on the rise but uneven

Newly published research by Harvard Medical School and the RAND Corporation reveals a dramatic growth in the use of telemedicine for the diagnosis and treatment of mental health disorders in rural areas, but strikingly uneven distribution of services across states.

The results, published in Health Affairs, stem from analysis of telemedicine use among Medicare beneficiaries nationwide over10 years.

The study shows an average 45 percent jump per year in telemedicine visits between 2004 and 2014, among rural patients, with striking variation across states. Four states had no such visits in 2014, while in nine states, there were more than 25 telemedicine visits per 100 patients with serious mental illness.

The reasons for the dramatically uneven distribution remain unclear, but the study investigators say state laws that regulate the provision and reimbursement of telemedicine services for mental health appear to play some role.

“Our results highlight the growing importance of telemedicine in the treatment of mental health disorders in rural settings where access to mental health care is often problematic,” said study lead investigator Ateev Mehrotra, associate professor in the Department of Health Care Policy at Harvard Medical School.

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Modern Healthcare,Stat,The New York Times,Vanderbilt University Medical Center

This technology may allow computers to sniff out diseases

Patients give off a unique odor that can hold clues to any medical problems going on in their bodies, but it can’t be detected easily by humans. Also in technology news, doctors ponder the future of artificial intelligence and the role it has to play in medicine, and a look at Vanderbilt University Medical Center’s roll out of its new electronic health record system.

The New York Times: One day, a machine will smell whether you’re sick
Blindfolded, would you know the smell of your mom, a lover or a co-worker? Not the smells of their colognes or perfumes, not of the laundry detergents they use — the smells of them? Each of us has a unique “odorprint” made up of thousands of organic compounds. These molecules offer a whiff of who we are, revealing age, genetics, lifestyle, hometown — even metabolic processes that underlie our health. (Murphy, 5/1)

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"chemical imaging" system,'Volumetric' imaging method,Purdue University's Weldon School of Biomedical Engineering,stimulated Raman projection microscopy and tomography

‘Volumetric’ imaging method reveals chemical content, might lead to systems that eliminate need to draw blood for lab tests

A “chemical imaging” system that uses a special type of laser beam to penetrate deep into tissue might lead to technologies that eliminate the need to draw blood for analyses including drug testing and early detection of diseases such as cancer and diabetes.

The system, called stimulated Raman projection microscopy and tomography, makes possible “volumetric imaging” without using fluorescent dyes that might affect biological functions and hinder accuracy, said Ji-Xin Cheng, a professor in Purdue University’s Weldon School of Biomedical Engineering, Department of Chemistry and Birck Nanotechnology Center.

“Volumetric chemical imaging allows a better understanding of the chemical composition of three-dimensional complex biological systems such as cells,” he said.

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Advanced Alternative Payment Models,APMs,MACRA,Medicare Access and CHIP Reauthorization Act,Merit-based Incentive payment system,MIPS,Stoltenberg Consulting

MACRA considerations for physicians in 2017

Joncé Smith, Vice President of Revenue Cycle Management, Stoltenberg Consulting

Written by: Joncé Smith

Entering 2017 brings a huge degree of uncertainty amid major healthcare industry changes. In particular, the Medicare Access and CHIP Reauthorization Act (MACRA) holds several options for Medicare physician payment paths as healthcare providers interpret implications and exemption possibilities.

MACRA replaces the old sustainable growth-rate (SGR) formula for physician payment, shifting focus from the fee-for-service model to value-based care. Physicians must now pick from one of two reimbursement tracks: the Merit-based Incentive Payment System (MIPS) or Advanced Alternative Payment Models (APMs).

To help you better understand MACRA, we’ve outlined the program’s tracks below.

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