11 de desembre 2019

Laboratory medicine as a data science

Data science, artificial intelligence, and machine learning: Opportunities for laboratory medicine and the value of positive regulation

Artificial intelligence (AI) and data science are rapidly developing in healthcare, as is their translation into laboratory medicine.
These are the four areas that the authors consider that AI will have impact:

  • Processes and care pathways
  • Laboratory test ordering and interpretation
  • Data mining, early diagnosis, and proactive disease monitoring
  • Personalized treatment and clinical trials
Meanwhile there is a long way ahead.

Jacob Lawrence, This is Harlem, 1943. Gouache and pencil on paper. Hirshhorn Museum and Sculpture Garden, Smithsonian Institution, Gift of Joseph H. Hirshhorn, 1966. Artwork © The Jacob and Gwendolyn Knight Lawrence Foundation, Seattle / Artists Rights Society (ARS), New York; photograph by Cathy Carver



03 de desembre 2019

The fight between commercialism and professionalism in medicine (3)

The Price We Pay
What Broke American Health Care--and How to Fix It


Health care is perhaps today’s most divisive, territorial political issue. But many of the needed solutions are not partisan; they’re American. We are at a pivotal juncture. Spending on health care threatens every aspect of American society. The time for commonsense reform has arrived. All of us can play a part in driving badly needed reforms, both in the marketplace and in the policy world.
As a society, we should embrace a basic set of patient rights, including a right to obtain a timely quote for a shoppable medical service. Lawmakers should look at the price transparency trails blazed by Florida, New Hampshire, and Maine. The prerequisite of any free market is viewable pricing information—not just inflated charges, but the actual amounts of settled bills. New policies should ensure a level playing field to make the free market functional again, to cut the waste and restore competition to the marketplace.
I disagree with the author. Competition it is not the tool for a fairer health care. Wishfull thinking will not drive us to an improvement.




01 de desembre 2019

The fight between commercialism and professionalism in medicine (2)

The Public Creation of the Corporate Health Care System

A second book on the same topic on US healthcare. And the regulatory messages are:
Despite the political uproar surrounding the ACA, many citizens, including the legislation's opponents, acknowledged the need for some type of reform. Indeed, ACA antagonists were most effective raising the specter of how federal programming would worsen health care rather than boasting about prevailing arrangements. Poor service distribution, fragmented care, and uneven service quality had long characterized U.S. medicine. But policymakers and voters were primarily concerned about the uninsured and the exorbitant costs that ranked American health care as the world's most expensive. These flaws helped push the ACA over the finish line. And the program has thus far proven resilient, withstanding presidential and congressional contests as well as significant court challenges.
The ACA built new rooms atop a defective, jerry-built edifice. The public option would have put the nation firmly on the path toward a nationalized, universal system by creating a government-managed plan and using regulations and mandates to enfeeble and eventually drive out private coverage. Readers can decide for themselves the wisdom of creating a centralized system. Nonetheless, because the ACA failed to secure fundamental, structural reform, it will be unable to rein in costs while also maintaining or improving the quality of care. Indeed, this narrative has illustrated how a fusion of public and private power constructed an institutionally tangled health care system that, even under the banner of comprehensive reform, policymakers were ultimately unable to rescue from the insurance company model.
Right now it seems that ACA is not enough. Let's wait and see.

29 de novembre 2019

The fight between commercialism and professionalism in medicine

Remaking the American Patient
How Madison Avenue and Modern Medicine
Turned Patients into Consumers

I've found this book of interest specially for europeans. Our health systems are currently under pressure. Public budgets are constrained and the private sector is growing. If you want to know what happens next, then this is the book to read. Just to prevent the disaster that comes afterwards, remember that US life expectancy has been declining in the last three years!. Maybe the time to act is now, just to avoid this predictable outcome. Take care.



28 de novembre 2019

Digital health transformation

Health in the 21st Century
Putting Data to Work for Stronger Health Systems

A new report by OECD highlights the potential digital health environment. We are still far from what they say. However, while reading it you'll be aware of its relevance. Chapter 5 is a must read:

Big data, and big data analytics, can be used at all three levels of health promotion and disease prevention – research, surveillance, and intervention – by:
-Allowing a more precise identification of at-risk populations, through a more comprehensive understanding of human health and disease, including the interaction between genetic, lifestyle, and environmental determinants of health;
-Enabling better surveillance of both communicable and non-communicable diseases; and
- Facilitating better targeted strategies and interventions to improve health promotion and
disease prevention.



21 de novembre 2019

Against the riggers

El enemigo conoce el sistema
Manipulación de ideas, personas e influencias después de la economía de la atención

Uno de los errores recurrentes de la izquierda es pensar que el populismo es la estrategia de los imbéciles, cuando la historia demuestra que no puede ser tan imbécil cuando consigue un éxito arrollador. Ya en Los orígenes del totalitarismo, Hannah Arendt explica que este tipo de estrategia está diseñada deliberadamente para desprender a la sociedad educada de sus recursos intelectuales y espirituales, convirtiendo a la población en cínicos o en niños, dependiendo del ego y el aguante de cada uno. Una doctrina del shock que precede a la escuela de Chicago y que ha sido característica de todos los totalitarismos contemporáneos, del nazismo alemán al estalinismo ruso, pasando por el fascismo italiano.

En un mundo eternamente cambiante e incomprensible, las masas han llegado hasta el punto de que podrían, al mismo tiempo, creer todo o nada, pensar que todo era posible y que nada era verdad... Los líderes de masas totalitarios basaban su propaganda en la correcta premisa psicológica de que, en esas condiciones, uno podía hacer que la gente creyera la declaración más fantasiosa un día, y saber que si al día siguiente les dieran la prueba irrefutable de su falsedad, encontrarían refugio en el cinismo. En lugar de abandonar a los líderes que les habían mentido, clamarían que supieron en todo momento que la declaración era mentira y admirarían a los líderes por su agudeza táctica superior.


08 de novembre 2019

How much do countries spend on health?

‌Health at a Glance 2019: OECD Indicators

The european country that spends the most is Switzerland 12,2% over GDP. In Catalonia this figure was 7,6% in 2016 (less than Greece). Per capita income in 2016 was 35% more in Switzerland than in Catalonia, while health expenditure was 60% more in Switzerland.  Where have the catalan taxes gone?. You know it and I know it. And everybody is aware that there is only one solution to have the appropriate public health expenditure. We have to say good bye as soon as possible.