By HANS DUVEFELT

1) EXERCISE MORE

I talk to people almost every day who think they can lose weight by exercising. I tell them that is impossible. I explain that it takes almost an hour of brisk walking to burn 100 calories, which equals one apple or a ten second binge on junk food. To lose a pound a week, you need to reduce your calorie intake by about 500 per day – that would be the equivalent of five hours of moderate exercise every day. We’d have to quit our jobs to do that.

2) EAT MORE FRUITS AND VEGETABLES

The other fallacy I hear all the time is that, somehow, adding “healthy” fruits and vegetables can make a person lose weight. I tell them that adding anything to their daily calorie intake will have the opposite effect. I more or less patiently explain that our job is to … Read the rest

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By KIM BELLARD

Those of us of a certain age remember the Timex slogan that bragged about its watches’ durability: “It takes a licking and keeps on ticking.”  A recent article about our military, of all things, made me wish we had a healthcare system that prized that kind of durability. 

I can never resist analogies between the U.S. healthcare system and the U.S. military system.  They’re both huge, they’re both wildly expensive, they both rely on a combination of high tech and front-line people, and they both protect us from threats.  In some ways, both are the best in the world, and, in other ways, both have weaknesses that are embarrassing. And, as I wrote last year, both are often still fighting the wrong wars. 

The article is by national security expert JC Herz on the Atlantic Council’s website: A plea to the Pentagon: Don’t sacrifice resilience on the … Read the rest

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By HANS DUVEFELT

Primary Care is now mandated to screen for depression, among a growing host of other conditions. That makes intuitive sense to a lot of people. But the actual outcomes data for this are sketchy.

“Don’t order a test if the results won’t change the outcome” was often drilled into my cohort of medical students. Even the US Public Health Service Taskforce on Prevention admits that depression screening needs to take into consideration whether there are available resources for treatment. They, in their recommendation, refer to local availability. I am thinking we need to consider the availability in general of safe and effective treatments.

If the only resource when a patient screens positive for depression is some Prozac (fluoxetine) at the local drugstore, it may not be such a good idea to go probing.

The common screening test most clinics use, PHQ-9, asks blunt questions about our emotional state … Read the rest

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By ADRIAN GROPPER

As COVID-19 vaccines become widely, if not fairly, available in different regions, both the public and private sector are working to develop vaccine credentials and associated surveillance systems.

Information technology applied to vaccination can be effective, but it can also be oppressive, discriminatory, and counter-productive.

But these systems can be tuned to reflect and address key concerns.

What follows is a list of ten separable concerns, and responsive design strategies. The concept of separation of concerns in technology design offers a path to better health policy. Because each concern hardly interacts with the others, any of them can be left out of the design in order to prioritize more important outcomes. Together, all of them can maximize scientific benefit while enhancing social trust.

1. Authenticity

An inspector should be assured that a vaccine certificate was not tampered with and that it was issued to the presenter. This need not imply … Read the rest

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By MIKE MAGEE

In the second half of the 19^th century, Emily Dickinson wrote a short poem that could easily have been a forward looking tribute to two American Presidents – one from the 20^th, the other the 21^st century.

Dickinson’s poem “A WORD is dead” is hardly longer than its title.

“A WORD is dead

When it is said,

  Some say.

I say it just

Begins to live

  That day.”

She certainly was on the mark when it came to President Franklin Delano Roosevelt’s signature legislation. FDR’s New Deal, extending from 1933 to 1939, ultimately came down to just three words – the 3R’s – Relief , Recovery, and Reform.

He promised “Action, and action now!”  This included a series of programs, infrastructure projects, financial reforms, a national health care program and industry regulations, protecting those he saw as particularly vulnerable including farmers, unemployed, children … Read the rest

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By JESSICA DaMASSA, WTF HEALTH

It’s another mega-round for a digital health chronic condition management startup, as Vida Health closes its $110M Series D – AND adds a pair of big-name insurers to their cap table. Vida’s Founder & CEO, Stephanie Tilenius, gets into the good news about the funding round, which was led by growth equity fund, General Atlantic, and brought managed care giant Centene (a Vida customer) and multinational insurer AXA into the mix.

Beyond the funding – and the extra “insurance side” endorsement it gives to the virtual chronic condition care space – what’s interesting about Vida now is how its “whole person” approach, which integrates physical health care and mental health care, is very much tilting to mental health these days.

While overall revenue has tripled since last year, Stephanie talks about how the 6000% year-over-year growth for her mental health services has played into that … Read the rest

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By KIM BELLARD

Raise your hand if you had to go through the Hunger Games labyrinth to score a COVID-19 vaccine earlier this year – figuring out which phone number(s)/website(s) to try, navigating it, answering all the questions, searching for available appointments within reasonable distances, and, usually, having to try all over again.  Or, raise your hand if you’ve had trouble figuring out how to use an Electronic Health Record (EHR) or an associated Patient Portal. 

Maybe you thought it was you.  Maybe you thought you weren’t tech-savvy enough.  But, a trio of usability experts reassure us, it’s not: it’s just bad design.  And we should speak up.

“Everyone everywhere: A distributed and embedded paradigm for usability,” by Professors Michael B. Twidale, David M. Nichols, and Christopher P. Lueg, was published in Journal of the Association for Information Science and Technology (JASIST) in March, but I didn’t see it until … Read the rest

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