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Friday, January 13, 2017

On Call by Casey Ross
Good morning! On Call will be taking Monday off in observance of Martin Luther King Jr. Day. We'll be back on Tuesday. In the meantime, here's the latest news on hospitals and health care. For more coverage, follow @statnews on Twitter or like us on Facebook.

Quote of the Day: RFK Jr. on chairing a committee for Donald Trump

“The complete lack of other credible leaders on this particular issue makes my decision necessary."

This is the reason Robert F. Kennedy Jr. gave in deciding to temporarily leave his role as the attorney for the Waterkeeper Alliance to chair a commission on vaccine safety, Politico reported yesterday. Donald Trump's aides have said the president-elect is still pondering whether to create such a panel, but Politico reports that discussions have been underway for a month — and RFK Jr. seems pretty certain he'll be involved.

All this leaves us with a big question about his quote, specifically the use of the word “credible.” Tell us what you think. Is there a need for a vaccine safety commission? And if so, should RFK Jr. be leading it? Email your responses to casey.ross@statnews.com and we may feature them in an upcoming edition.

On the front lines: A future where disease is diagnosed by smartwatch

Stanford Geneticist Michael Snyder wears an array of biosensors (Steve Fisch/AP) 
Michael Snyder was on a flight to Norway when he noticed something peculiar: His blood oxygen level was going down and his heart rate was increasing. Then came the fever and other signs of illness.

The Stanford geneticist began to worry about a recent trip he’d taken to rural Massachusetts. In Norway, he convinced a doctor to give him a prescription for doxycycline, known to combat Lyme disease. Later tests confirmed he had indeed been infected with the Lyme microorganism.

If this story sounds like something out of a futuristic science flick, it sort of is. Synder detected his symptoms by wearing seven biosensors as part of a digital health study. The results of that study, reported in PLOS Biology, show that using wearable sensors to track changes in heart rate, skin temperature, and blood oxygen could help flag the onset of illness. Snyder, who still wears seven biosensors, envisions a future where algorithms could be developed to alert consumers to an array of diseases. But is there a danger of information overload?

“For me and many others, there is no such thing as too much information,” Snyder said. “Much like your car has 400 sensors it all relays to a simple dashboard, this can be done for people, where a sensor could relay information to your smartphone with simple alerts.”

New research: What it means when death certificates are wrong

A new report by the CDC flags a frightening statistic: More than 45 percent of death certificates at a group of Missouri hospitals incorrectly identified the patient’s cause of death.

The report highlights research by the Missouri Department of Health and Senior Services, which uncovered significant over-reporting of renal and heart disease and under-reporting of cancer at hospitals in Kansas City and St. Louis. The CDC said that accurate reporting is of “paramount importance,” since such data are used to direct public health initiatives and funding for clinical programs and research.

Incorrect reporting not only skews our our understanding of how diseases are affecting the population, it undermines efforts to improve medical care. The silver lining in all this? Missouri has figured out a way to test the accuracy of death certificates, and is taking corrective action by training personnel involved in death records data entry.

How to navigate a medical culture that refuses to admit mistakes

Medical errors cause 250,000 deaths per year in the United States, making them the third leading cause of death behind heart disease and cancer, according to a study by researchers at Johns Hopkins. If that seems alarming, consider this finding from another national research team: Most doctors would try to obscure their role in the mistake, and most wouldn’t apologize.

So, what is a patient to do? In a First Opinion for STAT, Dr. Lawrence Schlachter says patients should ask direct questions if they suspect a medical error. What they too often hear in response, he writes, is the carefully-parsed language of a medical culture that refuses to own up to its mistakes.

Read more.

Number of the day: $35.7 billion

That’s the amount of care hospitals doled out for free in 2015. It sounds like a lot, but it represents the lowest level of uncompensated care in 26 years, according to a recent report by the American Hospital Association.

Which brings us to this: The Senate on Thursday took the first procedural steps toward repealing Obamacare, whose grand bargain for providers was to give them more insured, paying customers (i.e. less uncompensated care), in exchange for reductions in Medicare reimbursements.

But, if more than 20 million Americans lose insurance coverage over the next decade as some predict, that uncompensated care number is about to balloon again. And so the law’s grand bargain is being replaced with a gaping question: Who is going to pay for their care?

Referrals

  • Trump says his team has a plan to replace Obamacare (The Hill)
  • A woman dies of a superbug resistant to every antibiotic available in the US (STAT)
  • Health claims increasing for kids with Type 2 diabetes (Kaiser Health News)
  • Remembering the contributions of genetics pioneer Oliver Smithies, dead at 91 (New York Times)  

Have a news tip or comment you want to send me?

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Stay well, and come back Tuesday,
Casey

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