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21-01-2013 | Article

The week in review, January 13-19, 2013

medwireNews: This week's stories include: health IT failing to meet its potential; whole grain's identity crisis; ending mental health's second-class treatment; plans and beneficiaries follow the stars; patient protection needing to adjust to the lessons of healthcare.

Unfulfilled promise

Ever since the RAND corporation made a prediction in 2005 that annual savings of $81 billion would be achieved thanks to healthcare's incorporation of health information technology (IT), yearly healthcare expenditures have reached $800 billion.

Needless to say, something was wrong in that calculation. But according to a recent RAND analysis, the estimate was off not because of bad math per se but because it simply banked on the premise that healthcare would incorporate IT as readily as other industries, such as the financial sector.

What might be worse is that IT systems that are currently springing up are lacking a cohesive structure that may make it impossible to retrofit them later on to interoperate with other systems.

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Wheat from the chaff

When a consumer sees "whole grain" (WG) presented on a food package, they likely associate it with a healthful choice. Indeed, whole grains per se provide many ingredients that are favorable to health, but the way they are delivered in food products is another matter that lacks regulated standards.

The dearth of regulations that delineate what can be considered or called a WG, or marketed as having or containing WG provides wriggle room for the global WG market - projected to be worth over $24 billion by 2015 - to mix refined grains and sugars into "WG foods."

The lack of clarity ultimately benefits industry but not the consumers, schools, and workplaces who wish to decipher which WG products are healthful and which are marketing ploys. But a Public Health Nutrition study discovered a ratio that eases that decision.

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Mental urgency

On October 3, 2008, the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act was signed into law. The basic premise of the law requires group health plans that offer coverage for mental illness and substance use disorders to do so in a manner that is no more restrictive than the cover offered for medical and surgical procedures.

Millions of Americans with mental health and/or substance use disorders are bereft of much needed treatment - much of that owing to a gap in treatment services.

With the neglect of mental health now at the forefront of everyone's thoughts in light of the Connecticut shootings, key provisions of the mental health law have to be finalized - and several politicians have strongly urged that there is no more time to waste.

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Star struck

For numerous years, the Centers for Medicare and Medicaid Services (CMS) has created a quality scale star rating of Medicare Advantage plans to communicate to interested potential beneficiaries information that enhances the basis of their decisions.

The 1 to 5 star rating is meant to summarize measures of performance in, for example, the extent that enrollees receive appropriate screening tests, the number of complaints CMS receives about a plan, and the communication skills of a plan's physician.

With rating-based bonuses on the line, Medicare Advantage is making sure they get their act together to earn them while plan buyers are responding to the grading system too.

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General contribution

Medical science is emerging into the new paradigm of personalized healthcare that requires rigorous development and application of evidence-based medicine. This may ultimately require a maintainable learning healthcare system that provides appropriate care to patients while at the same time noting the results for future improvement.

To a group of Johns Hopkins bioethicists, the increasing overlap of treatment and research will require rethinking of human subject protection. Not only is the current way of determining and exercising patient protection often a waste of valuable resources, it is also ill conceived in that it should be based more on a sense of obligation on the part of the patient.

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By Peter Sergo, medwireNews Reporter