Category Archives: Health-Care

Perspectives on IBM Watson: Healthcare

Medical records, texts, journals and research documents are all written in natural language — a language that computers traditionally struggle to understand. The ability to deliver a single, precise answer from these documents could go a long way in transforming the healthcare industry. Watson, the IBM computing system designed to play Jeopardy!, could deliver such a solution.

IBM Watson: Countdown to Jeopardy!

On February 14, 2011, Watson, the IBM computing system designed to play Jeopardy!, faces its toughest challenge yet. Jeopardy! The IBM Challenge pits the two greatest champions in the show’s history against a machine that rivals their ability to deliver a single, precise answer to a Jeopardy! clue.

IBM Watson: Watson After Jeopardy!

Watson was optimized to tackle a specific challenge: competing against the world’s best Jeopardy! contestants. Beyond Jeopardy!, the IBM team is working to deploy this technology across industries such as healthcare, finance and customer service.

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[Health & Recession] Fewer deaths during a recession

The death rate went down as unemployment rose – a lesson for companies: overworked employees can be bad for business.

By Geoff Colvin, senior editor at large

October 28, 2009: 9:03 AM ET

(Fortune Magazine) — Profits are down at Hillenbrand, America’s largest maker of caskets. Admittedly, this fact sounds like the setup for a punch line, but the cause of the shortage in stiffs contains lessons for politicians and business leaders alike.

Hillenbrand’s CEO, Kenneth Camp, explained his company’s main problem this way in a recent conference call with analysts: “Continuing lower death numbers.”

As we grind through the longest recession in 75 years, Americans across the land are not dropping like flies. In fact, there’s a virtual epidemic of people not dying.

This rise in the living was predictable. The truth, little known but well documented, is that death rates decline and healthy living habits improve in tough economic times.

Extensive research by Christopher J. Ruhm, an economist at the University of North Carolina, shows that a one-percentage-point rise in the unemployment rate reduces the death rate by 0.5%. Those are U.S. results, but other studies show the same effect in Spain, Germany, and the 23 OECD countries in aggregate.

People live longer in recessions mainly because they become healthier, not because they face fewer external causes of death, such as auto accidents, which decline because people drive less, for example.

What’s more, the evidence of improved health shows up in ways beyond lower death rates. As unemployment gets worse, general medical problems become less prevalent: When the economy gets sick, people get healthier.

An important reason seems to be that people adopt smarter lifestyles in recessions, especially those people with the worst health habits. Chain smokers cut back. The indolent go to the gym. Even the severely obese start to lose weight. Combine those improvements and you get a healthier nation, even in the short period of a typical recession.

The obvious question is why people improve their habits when times turn bad. Statistical analysis shows that lower incomes aren’t the reason; strapped consumers apparently aren’t getting fitter because they must bike to work and survive on oatmeal and turnips.

Instead, one reason seems to be extra free time. Having no job means more time to hit the gym or just go for a walk. Exercise leads to weight loss, and research shows that it correlates with less smoking (though which causes which isn’t clear). Being unemployed or underemployed also means more time for sleep, which improves health.

Policymakers in Washington and CEOs can draw two important lessons from the recession’s effect on health.

Healthy living, not health care, is the issue.

A lesson for health-care reformers is that their focus, our system of insurance and care, isn’t the root cause of America’s high medical costs. The recent downturn in dead people is a reminder that the No. 1 culprit for rising health-care costs is lifestyle. It’s significant that recessions reduce smoking, inactivity, and obesity.

“Those three things drive chronic conditions,” says Cleveland Clinic CEO Dr. Delos Cosgrove, “and chronic conditions account for 75% of the cost of health care in the United States.”

If reformers haven’t figured out how to alter U.S. lifestyles — and they apparently haven’t — they shouldn’t expect dramatic results by changing how those costs are paid for.

Longer hours can lessen productivity.

A lesson for companies is that it’s possible to make employees work so hard that it’s bad for the business. If employees can’t find time for physical activity — or are exhausted after grueling 60-hour workweeks — the employer will pay a price in lost productivity and higher medical costs.

As for Hillenbrand (HI), the recession may be thinning profits, but the company is adapting to the long-term trend. A few years ago it introduced its Dimensions line of caskets for the extra-wide loved one. Sales are brisk.

How to run a healthy firm

1. Make it easy to be fit.

Not every company can afford a deluxe on-site gym like Google’s (GOOGFortune 500), but subsidized gym memberships cost an employer almost nothing. More companies should offer them.

2. Penalize vice.

You can offer financial incentives to employees with healthy habits, as Aetna (AETFortune 500) does, and even fire those who don’t stop smoking, a policy that CFI Westgate Resorts adopted six years ago. Yes, it’s legal in most places.

3. Lead by example.

Employees focus on what matters to the boss. Everyone at Alcoa (AAFortune 500), for example, knows that CEO Klaus Kleinfeld, a marathoner, believes in healthy living.

Source: Fortune Magazine

[AP – Health Care] US health spending grew to $2.3 trillion in 2008

By ERICA WERNER, Associated Press Writer – 3 mins ago

WASHINGTON – The recession dramatically slowed U.S. health care spending to $2.3 trillion in 2008, but it still grew much faster than the economy as a whole, accounting for more than 16 percent of the nation’s economic output, says a new federal analysis.
The eye-popping figure of $2.3 trillion — that’s $7,681 per person — underscores the challenges confronting President Barack Obama and lawmakers seeking to overhaul the system. Obama has repeatedly cited spiraling health costs as one of the main reasons Congress needs to pass his health plan, and administration officials said the findings highlighted the need for quick action.

“This report contains some welcome news and yet another warning sign,” said Jonathan Blum, a top official at the government’s Centers for Medicare and Medicaid Services. “Health care spending as a percentage of GDP (gross domestic product) is rising at an unsustainable rate. It is clear that we need health insurance reform now.”
However, health care experts question whether there are significant cost-containment measures in the legislation passed by House and Senate Democrats before Christmas — and Republicans insist there aren’t. The new report could provide fodder for both sides as lawmakers work to reconcile the House and Senate legislation into a final bill in coming weeks.

“I agree we need reform, but both the House and Senate Democrat bills make the problem worse by increasing the cost of health care,” said Rep. Dave Camp of Michigan, top Republican on the House Ways and Means Committee. “They spend $1 trillion we don’t have and bend the curve the wrong way.”
Republicans cited earlier analyses by the Centers for Medicare and Medicaid that found the sweeping overhaul legislation that seeks to extend coverage to more than 30 million uninsured Americans over the next decade would lead to increased health care costs. Democrats counter that the bills begin to slow cost increases over time.
However, some cost-saving measures Democrats proposed were blocked or turned into pilot projects after lobbying by doctors, hospitals or other interest groups. One major attempt to bring down health costs is a tax on high-value insurance plans included in the Senate bill but opposed in the House; it’s likely to survive in some form though exactly how remains to be seen.

The new analysis by economists at the Centers for Medicare and Medicaid appears Tuesday in the journal Health Affairs. It found that total national health spending grew 4.4 percent in 2008, the slowest rate of increase since CMS began tracking health spending in 1960. By contrast, the growth rate in 2007 was 6 percent. The study seeks to measure all public and private health expenditures.

Still, the growth of health costs was higher than the overall growth in gross domestic product, which stood at 2.6 percent in 2008 before adjusting for inflation.
Health spending reached 16.2 percent of the gross domestic product in 2008, up from 15.9 percent in 2007. That added up to $2.3 trillion and far higher per-person expenditures than other industrialized countries, although the higher spending is generally not matched by better health outcomes, studies have found.
Even with the high spending, the recession made itself felt throughout the health care sector in 2008, with slowdowns in out-of-pocket spending, private insurance premiums and hospital spending — the latter largely because of loss of revenue from hospitals’ investment incomes.

The slowdown in health insurance premium costs might seem counterintuitive, given the complaints of increased health care costs coming from individuals and businesses large and small. Part of the reason is because of the jobs lost in the recession, forcing people off the insurance roles and shrinking the overall cost of premiums nationally. Enrollment in private health insurance declined from 196.4 million in 2007 to 195.4 million in 2008, the report said.
“Health care spending is usually somewhat insulated from the immediate impact of a downturn in the economy. But this recession has exerted considerable influence on the health care sector,” said CMS statistician Micah Hartman, a lead author on the report.

Medicare, the federal health insurance program for people 65 and older, was the only area where the rate of spending growth in 2008 was greater than in 2007. That’s partly because Medicare recipients are largely out of the workforce and therefore more insulated from the recession. Medicare hospital spending grew, and more patients shifted into privately run Medicare Advantage plans, which offer better benefits than traditional fee-for-service Medicare but also cost the government more.
The recession also had the effect of shifting a greater share of health spending onto the federal government as the passage of the economic stimulus bill last year sent billions to states to help them with their share of Medicaid costs, including some retroactive costs. Medicaid enrollment in 2008 rose along with unemployment, but overall spending on Medicaid services slowed anyway as cash-strapped states scrimped on costs.


[Medical Concerns] Autism Numbers Are Rising. The Question is Why?

Time Magazine – By ALICE PARK – Sat Dec 19, 10:35 am ET

One in 110 American children are considered to fall somewhere along the autism spectrum, according to the latest report released by the federal government. The new figure, which was released initially in October, comes from the most comprehensive set of data yet on the developmental health of eight-year-olds.

Increasing the previous federal estimate of 1 in 150, the new data suggest that 1% of children now exhibit some symptoms of an autism spectrum disorder (ASD), a collection of neurological conditions whose symptoms may range from mild social impairment to more serious communication, language and cognitive deficits. The estimate also represents a stunning 57% increase in prevalence since 2002, when health officials first began a nationwide effort to quantify the risk of autism in childhood. (See the top 10 medical breakthroughs of 2009.)

For the detailed report, published by the Centers for Disease Control and Prevention (CDC) on Friday, researchers combed through health and education records in 11 U.S. cities. In some sites, the rate of autism was as high as 12 cases per 1,000 children, but averaged across the country the final autism case rate was calculated at 9 per 1,000 children. That’s compared to a national rate of 1 per 2,000 children prior to the 1980s, and 6 per 1,000 children as recently as the 1990s.

The new figures also support past studies that suggest autism occurs more frequently in boys than girls. Federal statistics show that ASD prevalence jumped 60% among boys since 2002, compared with 48% among girls.

Experts note that the CDC database – the Autism and Developmental Disabilities Monitoring Network (ADDM) – is the closest thing to an ideal measure of autism’s prevalence. The data are culled from assessments made by health or developmental professionals, including pediatricians, psychologists and language and speech pathologists. In previous evaluations, autism estimates were based on less reliable parental reporting of symptoms or diagnoses.

Another strength of the ADDM network is that it allows researchers to track autism rates over time. For the current study, Catherine Rice, a behavioral scientist at the CDC’s National Center of Birth Defects and Developmental Disabilities, compared data from 10 sites in 2002 with the latest figures from 2006 – using a consistent definition of ASD – to determine that the prevalence of ASD had increased by 57%.

But as striking as the new figure is, it’s not clear how much of the rise reflects a true increase in ASD risk and how much is due simply to improved awareness and diagnosis of the disorders. Increased access to special education classes and other therapies may also be inflating the numbers, as educators and parents enroll more children in hopes of optimizing their learning environment. Indeed, CDC researchers found that among sites where they had access to both health and education records, the prevalence of ASD was higher on average than in sites where only health information was available.

“This is going to be a complicated story,” Rice told TIME, referring to the ongoing task of identifying reasons for the increase. “We know we’re not going to get a single answer. But we can use these data sets in addition to all the other research going on to look at the causes of autism and try to put this together.” (Read “New Evidence That Early Therapy Helps Autistic Kids”)

Previous studies looking at a narrower population of youngsters have suggested that as much as 40% of the rise in autism cases might be explained by broader diagnostic definitions and by heightened awareness of the condition. But that still leaves 60% of the increase unaccounted for. “Most scientists believe there is something more than just awareness and a broadening definition that is responsible for the rise,” says Dr. Gary Goldstein, president of the Kennedy Krieger Institute in Baltimore. “We are seeing some fraction of the increase that is probably due to more cases of autism.”

So, what is driving the soaring numbers? While recent studies have highlighted genetic changes that might be responsible, some experts caution that such changes happen over time, far too slowly to explain the recent rise in autism. “When you see an increase like this, you have to think it’s an environmental issue,” says Dr. Thomas Insel, director of the National Institute of Mental Health and chair of the NIH‘s interagency autism coordinating committee.

Since autism is generally diagnosed before age two, most scientists believe the factors that contribute to ASD occur during pregnancy, or in the months immediately following birth. A pregnant mother’s advanced age might be one such influence, along with certain behavioral and environmental exposures she or her newborn baby may experience – any combination of which could be interacting with their particular genetic makeup to promote ASD. Isolating the most causative culprits will be a challenge, say autism experts. “There is so much stuff out there, whether it is diet or infection,” says Goldstein. “We could make a list but it’s got thousands of things on it.”

The latest statistics underscore the looming public health problem that autism has become, and highlight the urgent need for research on causes and treatments, as well as better support services for families caring forautistic children. The CDC considers ASDs a significant public health concern, says Rice, and researchers across the country continue to discover new genes associated with the condition. But for advocates of families affected by autism, the efforts are still not enough. “We are really seeing exciting things happening, but the pace is too slow, it just doesn’t measure up to the size of the crisis,” says Geraldine Dawson, chief scientific officer of Autism Speaks, a leading autism advocacy group.

See TIME’s photo-essay “A Journey into the World of Autism”

See six tips for traveling with an autistic child.

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