Health for life

The Department of Health and Human Services (HHS) has launched a "Million Hearts" campaign that is designed to prevent a million heart attacks and strokes in the next 5 years.  You can read about it in the New England Journal here or in Circulation here.  There is also more detail here at the HHS gov web site.

The campaign is crafted to address the "ABCS" a.k.a. aspirin, blood pressure control, cholesterol control and smoking in the U.S. population. The Feds propose to 1) consolidate just how ABCS will be specifically measured in any population, 2) remind and help manufacturers as well as users of EHRs that they can be tasked to addressing ABCS, 3) initiate a "pharmacist-led campaign.... (to) facilitate counseling about hypertension control," 4) launch an anti-tobacco marketing and community-based campaign, 5) push for food labeling in restaurants and 6) increase the measurement of sodium and fat consumption.  Details are in this table.

"Bravo!" says the DMCB.  When it reads about Million Hearts, its clear that the Feds are identifying population-based strategies, basing their interventions on demonstrated needs, increasing awareness of health risks, using patient-friendly education, helping consumers make the right choices and figuring out how to assess outcomes on an ongoing basis with a feedback loop.

If you agree on the DMCBs assessment of what the Feds are up to, you also agree that theyve they have launched a huge population health improvement (PHI) initiative.  The DMCB isnt making that up: if you compare the Care Continuum Alliance description of PHI here with the fundamentals of Million Hearts, youll see that the overlap is almost 100%.

Whats different is that the Feds are also using Million Hearts to 1) further justify the Affordable Care Act and the EHR meaningful use initiative, 2) leverage some potent government entities like AHRQ, CDC, CMS and the FDA, 3) distribute hundreds of millions in community grant money, 4) create a coalition that includes The Y, AHA, Walgreens, some professional pharmacy associations and AHIP, and 5) say some nice stuff about Mrs. Obamas childhood obesity program.  

All that makes perfect sense from a governmental as well as political process, but its still PHI.

"A hearty welcome to the fold!" says the DMCB.  HHS has finally decided to give millions of Americans access to PHI that combats atherosclerotic heart disease.  Better late than never, but based on what we know about the science of PHI in multiple other settings and assuming the government can pull this off, the DMCB is confident that a million lives being saved is within reach.  

A Disease Management Care Blog spawn is implacably opposed to a Romney Presidency.  The argument is that while theres admiration for Mitts successes as a businessman, running a government is better left to accountable politicians.

Which the DMCB appreciates. That doesnt mean there isnt a downside to the meddling of Republicans as well as Democrats.  Take health care for example.

Turbocharged by decades of direct government funding and favorable tax policies, insatiable healthcare consumer demand has created a medical-industrial bubble that is eating close to 20% of the U.S. economy.  Since Washington DCs direct costs are outstripping tax receipts, the same political process that got us into trouble is now supposed to get us out.  While the Presidents proposed 2013 budget has some painful cuts, thats nothing compared to the looming havoc being threatened by the coming fiscal cliff.  This is government accountability?

For a smaller example of the dysfunction created by government meddling, consider the electronic health record (EHR) mess.  Despite warnings from the DMCB that EHRs documentation capabilities enable increased billings for the same care, both Presidents Bush and Obama promoted the EHR as an informatics cost-reducing panacea. 

It turns out the DMCB was right. This OIG report raised the possibility that EHRs are behind a recent coding uptick, which was further examined in this telling New York Times article by Reed Abelson et al. 

Government response? This threatening warning to stop using a product as designed that our political class had promoted all along.

(Latest update: Reversing course on years of being conspicuously silent in the face of the Adminstrations health orm bullying, the hospitals are pushing back.   Nothing like the threat of budget cuts to clarify just who your allies are - and arent.  The cliff promises to be an interesting ride.)

I suppose its not fair to post just one government Twitter account (CDC on Twitter) when there are literally hundreds. The number has grown exponentially in the last few months.

Heres a directory of government agencies using Twitter:

GovTwit Directory

It includes Twitter accounts for each branch - Executive, Legislative Judicial - as well as state and local government, international sites, industry, academia, and news media.
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