How about a change?
I'm going to risk being accused of quibbling, but to a writer, repetition rings like a cow bell to the ear.
In reviewing the descriptions of all the federally funded Beacon Community projects, I heard the incessant clang of one ailment: diabetes.
Fourteen of the 17 Beacon projects are either exclusively or partially geared to finding some advanced way of using healthcare information technology to improve diabetes prevention and treatment, typically in some form of outpatient or home health setting.
The final two Beacon Community projects announced by HHS last week provide an example of this —how else to say it?—diabetic funding bias.
Cincinnati-based HealthBridge, a regional health information exchange, is to receive $13.8 million over three years for care-coordination programs for pediatric asthma, smoking cessation, and adult diabetes; while the Southeastern Michigan Health Association in greater Detroit was granted $16.2 million to prevent and better manage—you guessed it—diabetes.
In total, nearly $206 million of the $250 million in federal grants under the American Recovery and Reinvestment Act allocated to the Beacon Communities program—roughly 82%—will fund projects that target diabetes control.
So what, you might say? Diabetes is a serious national health problem.
No argument there. But according to Agency for Healthcare Research and Quality data, http://www.ca2.uscourts.gov/, diabetes ranked in a tie for seventh, with arthritis and other joint diseases, for the top 10 most costly U.S, ailments. http://www.whitehouse.gov/the-press-office/vice-president-biden-hhs-secretary-sebelius-announce-selection-15-health-it-pilot-c
In contrast, heart disease, No. 1 on the AHRQ list, which costs more than twice as much as diabetes, is mentioned just three times.
HHS Secretary Kathleen Sebelius proclaimed when she announced the first round of grants in May, “The Beacon Community Program will tap the best ideas across America and demonstrate the enormous benefit health IT will have to improving health and care within our communities.“
The Veterans Affairs Department has had for roughly seven years on its VistA electronic health records system a slick bit of graphing technology that clinicians use while working with diabetics, according to physician Lewis Coulson, a 39-year VA clinician and the associate chief of staff for compensation and pensions at the VA's Jesse Brown Medical Center in Chicago.
The system can gather, graph over time and color-code as many as three sets of data—as for blood glucose, weight and blood pressure—simultaneously. A patient may claim he has taken his medications religiously, but then, Coulson says, “I'll pull up the last six months and graph them on the computer.”
“When they see it on a screen, it reinforces good behavior,” Coulson says.
These Beacon Communities are supposed to be our healthcare “shining cities on a hill.” Do we really need to spend more than $200 million on 14 projects to come up with a new set of “best practices” for using IT to address a single, seventh-ranked disease? Couldn't we have sent a few more of them on a quest for solutions to other major healthcare problems?
I'm just saying.
