Dying patients protest looming telehealth crackdown

“Online prescribing rules for controlled drugs were relaxed three years ago under emergency waivers to ensure critical medications remained available during the COVID-19 pandemic. Now, the U.S. Drug Enforcement Agency has proposed a rule that would reinstate most previously longstanding requirements that doctors see patients in person before prescribing narcotic drugs such as Oxycontin, amphetamines such as Adderall, and a host of other potentially dangerous drugs. The aim is to reduce improper prescribing of these drugs by telehealth companies that boomed during the pandemic. Given the ongoing opioid epidemic, allowing continued broad use of telemedicine prescribing “would pose too great … Read More

Digital cognitive behavioral therapy for insomnia on depression and anxiety: a systematic review and meta-analysis

“Insomnia is one of the most common sleep disorders, posing a significant public health concern, with an estimated prevalence of 10–30% among adults in the general population. These numbers are greater among patients, with reports estimating 69% prevalence among primary care patients. Insomnia disorder is defined by the Diagnostic and Statistical Manual of Mental Disorders – IV (DSM-IV) as the complaint for difficulty in initiating or maintaining sleep, or restorative sleep for at least 1 month. [..] Depression and anxiety are the most common comorbid mental disorders associated with insomnia which can also exacerbate the sleep disorder. Recently, epidemiologic studies … Read More


The New England Journal of Medicine’s Lisa Rosenbaum speaks with University of Pennsylvania’s internal medicine physicians Paula Chatterjee (also a health services researcher) and Atheen Venkataramani (also a health economist and founder of Penn’s Opportunity for Health lab) about the role of values in health care, social determinants of health and what physicians can do to improve U.S. health care. An excerpt of the audio interview: [Rosenbaum] Atheen, I know that you also had a formative experience, I think when you were a resident at MGH. Can you talk a little bit about that and how that experience informed your … Read More

Can A.I. Treat Mental Illness?: New computer systems aim to peer inside our heads—and to help us fix what they find there.

“Roughly one in five American adults has a mental illness. An estimated one in twenty has what’s considered a serious mental illness—major depression, bipolar disorder, schizophrenia—that profoundly impairs the ability to live, work, or relate to others. Decades-old drugs such as Prozac and Xanax, once billed as revolutionary antidotes to depression and anxiety, have proved less effective than many had hoped; care remains fragmented, belated, and inadequate; and the over-all burden of mental illness in the U.S., as measured by years lost to disability, seems to have increased. Suicide rates have fallen around the world since the nineteen-nineties, but in … Read More

Health Care Affordability: Iron Triangle Or Iron Curtain?

“The high cost of health insurance and health care services now affects not only the uninsured but also middle-class Americans with employment-based health insurance (ESI), enrollees in the Affordable Care Act exchanges, and Medicare beneficiaries. A popular concept in health policy discussions is the “iron triangle”: here, here, here, here, and here. These authors posit that it is impossible to increase access and quality of care while simultaneously reducing spending. That idea warrants further scrutiny. [..] evidence suggests that failure to improve affordability is primarily due not to a mathematical “iron triangle” constraint, but an “iron curtain” of stakeholders who are aware of promising alternatives but oppose their … Read More

ChatGPT-assisted diagnosis: Is the future suddenly here?

I have been framing the future of health care as diagnosis through face-to-face interactions for making a diagnosis (and getting the patient to buy-in to the treatment plan) and ongoing maintenance or surveillance using telemedicine with supporting technologies. This article has forced me to reconsider how we might deploy artificial intelligence to support patients and clinicians during the triage and diagnosis stages of a medical journey. “Symptom checkers serve two main functions: they facilitate self-diagnosis and assist with self-triage. They typically provide the user with a list of potential diagnoses and a recommendation of how quickly they should seek care, … Read More

Effect of a Telephone Health Coaching Intervention on Hypertension Control in Young Adults: The MyHEART Randomized Clinical Trial

“[Introduction] [..] MyHEART is a multicomponent, patient-centered, and theoretically based; it includes 4 evidence-based self-management components: (1) telephone-based health coaching with adult education specialists to teach and monitor self-management skills, (2) documentation of coach-patient telephone contacts, (3) individualized hypertension education materials, and (4) home BP monitoring. [..] The primary aim of this study was to evaluate the effect of MyHEART on clinical outcomes, ie, the change in systolic and diastolic BP (primary) and hypertension control (secondary) after 6 and 12 months, compared with usual care. [..] [Methods] [..] The inclusion criteria included (1) aged 18 to 39 years at enrollment; … Read More

The New Hospital at Home Movement: Opportunity or Threat for Patient Care?

Select Key Findings Policy Issues Debating the Future: Does H@H Save Costs and Improve Patient Care? “[..] Recent studies of cost savings from H@H programs range from 20 percent (Reese 2021) to 40 percent (Brigham and Women’s Hospital in Boston, Levine et al. 2020). But these findings are not generalizable as they are based entirely on single case studies of highly structured programs involving small samples of very carefully selected patients. For example, the study of Brigham and Women’s program examined 91 adults who were admitted to the hospital’s ED and randomly assigned to the hospital vs home for treatment. [..] While … Read More

Telehealth Best Practices: Dr Geoff Rutledge Of HealthTap On How To Best Care For Your Patients When They Are Not Physically In Front Of You

“[Authority Magazine’s Jake Frankel] can you articulate for our readers a few of the main benefits of having a patient in front of you? [Co-founder and CMO of HealthTap Geoff Rutledge] The most important point to emphasize is that the essential physician–patient interaction is direct face-to-face communication that allows a doctor to connect with their patient, engage with them, and enable them to share in detail what is going on with their lives and their health. And that this critical face-to-face communication can occur equally well either in an in-person, in-office setting or via high-resolution video and audio consultation. It’s … Read More

Internal Memo: Amazon Care to shut down, ‘not a complete enough offering’ for corporate customers

Excerpt – Amazon will stop offering its Amazon Care primary health-care services at the end of this year, according to an internal memo, after determining that it wasn’t “the right long-term solution for our enterprise customers.” The surprise move Wednesday is a major course correction in Amazon’s broader foray into healthcare. Amazon says the decision impacts only Amazon Care, and not its other health-care initiatives. “This decision wasn’t made lightly and only became clear after many months of careful consideration,” said Neil Lindsay, Amazon Health Services senior vice president, in the email to Amazon Health Services employees. “Although our enrolled … Read More