Tuesday, November 17, 2015

Growth of managed care in California

The number and characteristics of people in California who have been certified eligible for Medi-Cal is changing dramatically over the last several years. Here's some data I extracted from the following dataset: Statewide Medi-Cal Certified Eligible Individuals, by Aid Code, 2013 - 2015.



Where M1 (the light blue line) = "Adult 19 to 64 at or below 138% FPL Citiz/Lawful" and 3N = "AFDC-MN-1931(b) Non CalWORKS" (more info here: http://healthconsumer.org/cs0151931b.pdf). It would be interesting to dig deeper to understand the basis of this change (is this a true change, or just a change in definitions?).

Thursday, November 5, 2015

Patients taking control of their medical records

As an Emergency Medicine physician in the year 2015, it is really astounding to think that we landed a man on the moon more than 40 years ago, yet I have patients walking in the door who had tests done at a facility across the street yesterday and I can't access those records. Thankfully some states have taken this situation into their own hands and developed systems for sharing medical records, such as the CRISP system in Maryland. Alas, most states have not yet built health information exchanges, and even those that have (like Maryland) don't necessarily have a patient portal.

There are many different models for how medical records should be stored and shared in the future, and I'm not sure which model will win out in the end. What seems most compelling is for records to revolve around the patient (as opposed to the hospital), and two products out there that do this well (to my knowledge) are: PicnicHealth and Gliimpse. Both PicnicHealth and Glimpse will help retrieve, organize and store patients' data, but Gliimpse is free and Picnic is not. As compelling as these services are, I have yet to experience a single patient coming in to the ER and saying, "Doc, you can find my records by going to website x...."


Wednesday, November 4, 2015

Will 2015 be a monster flu season?

Much has been made of using Google Search data to predict health events, especially flu outbreaks. Here's how this flu season is proceeding compared to prior years:

The blue line represents the influenza trend for 2015, and so far it is the second highest year of the last 5 years. Note that the highest year was the 2012-2013 season which actually started off quite slow.

My piece on my experience with the healthcare system as an Emergency Medicine physician

My piece on the challenges and failures of the US healthcare system is being featured on the front page of Medium today. Would love to hear...