Roji Intel Blog

Robert McNutt, M.D. 0
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Future of Health CareMedical Decision-MakingResearch
August 21, 2019

AI May Be the Future, But It’s Not (Yet) the Future of Clinical Research

Good medical practice depends on good clinical research. Without rigorous, replicable, reliable research findings, we cannot trust that our medical decisions are based on truth. To put it bluntly, flawed research leads to bad medicine. It’s essential that we get it right. In this series, I have argued for a more rigorous approach. The present model of clinical research is expensive, slow, studies insufficient populations of subjects—making generalizability difficult— and lacks power to examine important variations in clinical and personal characteristics of individuals. In my biased view, study design determines if research is being done. Without an appropriate design, we…
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Theresa Hush 0
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Consumers & PatientsFuture of Health CareValue-Based Health CareWomen and Health Care
June 12, 2019

Get the eBook “Not Second Best: Inject Value in Women’s Health Care”

Six months ago, I started writing about women’s health, in response to this simple question: What trends are emerging in health care for 2019? The New Year is filled with predictions about what is coming, and I thought this year’s list from health care leaders was too “last-year.” Artificial intelligence, medical science advancements in biologicals and genetic therapies, and business consolidation are not coming; they are already here and will simply go further. Witnessing the debate about health care rights in the country, and the increasing distrust of health care by consumers, I observed that most of those speaking are…
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Theresa Hush 0
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Consumers & PatientsFuture of Health CareValue-Based Health CareWomen and Health Care
May 15, 2019

How Providers Must Improve Value in Women’s Health

Writing the Roji Health Intelligence® series on gender disparities and other women’s health issues has been a revelation. As a woman who has worked in so many parts of the health care industry, I was already aware of basic gender disparities, risk levels, incidence of disease, and economic issues that are predominant among women. Most women in health care have had their knowledge and judgment doubted as both patients and professionals. Women everywhere encounter the economic barriers associated with affordable health care, some much worse than others, and every woman who is a mother struggles with balancing the interests of…
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Theresa Hush 0
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Consumers & PatientsFuture of Health CareValue-Based Health CareWomen and Health Care
May 1, 2019

Do “Women’s Health Centers” and Services Deliver on Value-Based Health Care?

Women make an astounding 80 percent of health care decisions for themselves and their families. But there’s a disconnect between what women need and how providers have organized health care for them. While Value-Based Health Care (VBHC) is struggling to achieve more value for every health care dollar spent, providers are simultaneously sabotaging women in their customer base. How? This might surprise you: through promotion of “women’s health” services. While providers may have good intentions for offering a dedicated place for women’s health needs, those services have actually fragmented care for women, especially those with more complex conditions. Let’s evaluate…
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Theresa Hush 0
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ACOsPerformance ImprovementRisk
April 17, 2019

Bootstrapped ACOs Facing Risk? Adopt Cost Strategies With Long Term RoI

The experimental phase of Medicare ACOs has been officially declared dead, per CMS. Going forward, ACOs must agree to take on financial risk for expenditures beyond their targets. That’s sobering news for the majority of ACOs still struggling to succeed. The reality is that most ACOs are bootstrapped—light on extra funding and dependent on existing tools to do more. In fact, about two-thirds of ACOs report that funding is their most significant challenge. And that is probably understated, since patient engagement problems (also reported by two-thirds of ACOs) and lack of data (reported by 40 percent) are remedied by solutions…
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Theresa Hush 0
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Future of Health CareValue-Based Health CareWomen and Health Care
April 11, 2019

When Women Call Out Medical Gaslighting, Providers Lose the Whole Family

A smart business would not deliberately blame customers for needing their services or accuse them of spinning fictions. A business dependent on customer loyalty and engagement for their success—and what business doesn’t?—would normally pay close attention to customer concerns in social and mainstream media. All the more so in health care, where the needs are generally much more significant, and the consequences of failing the patient are literally a matter of life or death. That’s why providers In Value-Based Health Care should pay close attention to the increasing din of “medical gaslighting” charges by women. These are not idle accusations.…
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Robert McNutt, M.D. 0
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Future of Health CareMedical Decision-MakingResearch
April 3, 2019

If Not Now, It’s Too Late: Simple Randomization Can Lead to False Inferences 
About Treatment Decisions

Medical decisions are best made on the basis of clinical science. Accurate research, shared between physician and patient, enables the patient to make an informed choice about risks and outcomes of treatment options. That’s how it should work, in theory. But in practice, even with the best shared medical decision-making, far too much clinical research employs faulty methodologies that limit the relevance of findings. This must change. In a recent blog post, I suggested that clinical science can improve by choosing more representative groups of people for study. Many clinical studies use convenience samples of patients rather than samples chosen…
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Theresa Hush 0
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Future of Health CareMedical Decision-MakingPopulation HealthValue-Based Health CareWomen and Health Care
March 28, 2019

Women with Autoimmune Diseases Fight Uphill Battle on Every Health Care Front

Our articles on women’s health care issues have focused on areas that must change in order to provide better quality and outcomes, to lower costs, to advance treatment, and to treat women respectfully and equitably as patients and providers. We have demonstrated how women have been sidelined from getting the right health care because of two key systemic obstacles that must be addressed: Cultural bias that prevents accurate clinical assessment of symptoms and diagnosis, adoption or use of protocols relative to women’s biology, and effective health care therapies, and Inadequate basic science and clinical research that will illuminate sex-differentiated biology…
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Theresa Hush 0
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Future of Health CareResearchWomen and Health Care
March 20, 2019

At the Heart of Gender Disparities in Health Care is Women’s Pain

Pain is a key symptom of injury or disease, and managing acute pain is usually one of the first services provided to patients. But if the patient in pain is a woman, the provider may require more convincing. Providers doubt that women’s pain is real and underestimate the level of pain for women. Substantial evidence shows that providers report higher levels of pain for men than for women. Gender stereotypes are so strong that in a recent pediatric study, participants evaluating a child’s pain reported higher levels when told that the child was a boy and lower if told it…
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Robert McNutt, M.D. 0
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Future of Health CareMedical Decision-MakingResearch
March 6, 2019

If Not Now, It’s Too Late: Clinical Science Is Futile If We Study the Wrong Population

In 1936, the Literary Digest, a respected national magazine, undertook a public opinion poll. Who would win the race between Republican Alfred Landon, governor of Kansas, and Democratic incumbent Franklin D. Roosevelt? Mock ballots were mailed to 10 million Americans. About 2.4 million responded—one of the largest survey samples ever created. Their prediction? Landon would carry the day. They were wrong—by a landslide for FDR. That’s because respondents were biased toward Landon and did not accurately represent the distribution of presidential preferences across all voters. Notably, George Gallop accurately predicted FDR’s victory using a smaller representative sample of about 50,000…
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