http://conorato.posterous.com Personal opinions on healthcare, bio-tech, technogeekery, from public affairs guy at GE Healthcare. Not endorsed by my employer. posterous.com Tue, 31 Jan 2012 02:26:00 -0800 http://feedproxy.google.com/~r/ConoratosPosterous/~3/yh6GYqsPXCQ/annals-in-the-battle-against-heart-disease-pr http://conorato.posterous.com/annals-in-the-battle-against-heart-disease-pr <p> <div class="posterous_bookmarklet_entry"> <object data="http://emp.bbci.co.uk/emp/releases/worldwide/revisions/617329_617319/617329_617319_emp.swf" type="application/x-shockwave-flash" height="281" width="500"> <param name="quality" value="high" /> <param name="wmode" value="default" /> <param name="allowFullScreen" value="true" /> <param name="allowScriptAccess" value="always" /> <param name="flashvars" value="embedReferer=http%3A%2F%2Fwww.bbc.co.uk%2Fsearch%2Fnews%2F%3Fq%3Dheart%20attack&amp;embedPageUrl=http%3A%2F%2Fwww.bbc.co.uk%2Fnews%2Fhealth-16751793&amp;uxHighlightColour=0xff0000&amp;domId=emp-16751793-106316&amp;playlist=http%3A%2F%2Fplaylists.bbc.co.uk%2Fnews%2Fhealth-16751793A%2Fplaylist.sxml&amp;config=http%3A%2F%2Fwww.bbc.co.uk%2Fplayer%2Femp%2F2_0_29%2Fconfig%2Fdefault.xml&amp;fmtjDocURI=%2Fnews%2Fhealth-16751793&amp;config_settings_showShareButton=true&amp;config_settings_autoPlay=false&amp;config_settings_showPopoutButton=false&amp;config_plugin_fmtjLiveStats_pageType=eav1&amp;config_plugin_fmtjLiveStats_edition=Domestic&amp;config_settings_showUpdatedInFooter=true&amp;holdingImage=http%3A%2F%2Fnews.bbcimg.co.uk%2Fmedia%2Fimages%2F58126000%2Fjpg%2F_58126387_013672118-1.jpg&amp;enable3G=true" /> </object> <div class="posterous_quote_citation">via <a href="http://www.bbc.co.uk/news/health-16751793">bbc.co.uk</a></div> <p>In the last couple of weeks there's been a flurry of media attention around the positive effect prevention, early diagnosis and rapid intervention are having in reducing deaths from heart disease. This is great news.</p> <p>Some key articles below, a nice video report from the Beeb above, and right at the bottom - a good reason to wonder whether it's ALL IN VAIN!!!???</p> <p><strong>Poland: </strong><br />Over half of the recent fall in mortality from coronary heart disease attributed to reductions in major risk factors and about one third to evidence based medical treatments. <a href="http://bit.ly/x1yGXE">http://bit.ly/x1yGXE</a></p> <p>Denmark: <br />First time heart attack hospitalizations and subsequent short term mortality both declined by nearly half between 1984 and 2008. <a href="http://bit.ly/AicjFP">http://bit.ly/AicjFP</a></p> <p><strong>England: </strong><br />The death rate from heart attacks in England has halved in the last decade. Both prevention and improved emergency treatment have contributed to the decline in deaths <a href="http://bit.ly/yPqMr8">http://bit.ly/yPqMr8</a></p> <p><strong>A warning to developing nations from a nice editorial in the BMJ: </strong><br />As the world population ages and becomes more industrialised and urbanised, the decline in coronary mortality is predominantly in rich nations, while rates increase in dozens of others <a href="http://bit.ly/wJaHVC">http://bit.ly/wJaHVC</a></p> <p>And then they go and ruin it all by doing this - a full fried breakfast the weight of a small child - "The Kidz Breakfast". The spelling alone is enough to give me a coronary...</p> <div class="posterous_bookmarklet_entry"> <object data="http://emp.bbci.co.uk/emp/releases/worldwide/revisions/617329_617319/617329_617319_emp.swf" type="application/x-shockwave-flash" height="252" width="448"> <param name="quality" value="high" /> <param name="wmode" value="default" /> <param name="allowFullScreen" value="true" /> <param name="allowScriptAccess" value="always" /> <param name="flashvars" value="embedReferer=http%3A%2F%2Fconorato.posterous.com%2Fannals-in-the-battle-against-heart-disease-pr&amp;embedPageUrl=http%3A%2F%2Fwww.bbc.co.uk%2Fnews%2Fuk-england-norfolk-16757490&amp;uxHighlightColour=0xff0000&amp;domId=emp-16765465-60064&amp;playlist=http%3A%2F%2Fplaylists.bbc.co.uk%2Fnews%2Fuk-england-norfolk-16765465A%2Fplaylist.sxml&amp;config=http%3A%2F%2Fwww.bbc.co.uk%2Fplayer%2Femp%2F2_0_29%2Fconfig%2Fdefault.xml&amp;fmtjDocURI=%2Fnews%2Fuk-england-norfolk-16757490&amp;config_settings_showShareButton=true&amp;config_settings_autoPlay=false&amp;config_settings_showPopoutButton=false&amp;config_plugin_fmtjLiveStats_pageType=eav2&amp;config_plugin_fmtjLiveStats_edition=Domestic&amp;config_settings_showUpdatedInFooter=true&amp;holdingImage=http%3A%2F%2Fnews.bbcimg.co.uk%2Fmedia%2Fimages%2F58147000%2Fjpg%2F_58147421_kidz_breakfast_464.jpg&amp;enable3G=true" /> </object> <div class="posterous_quote_citation">via <a href="http://www.bbc.co.uk/news/uk-england-norfolk-16757490">bbc.co.uk</a></div> <p>&nbsp;</p> </div> <div class="posterous_quote_citation">via <a href="http://www.bbc.co.uk/news/uk-england-norfolk-16757490">bbc.co.uk</a></div> <p>&nbsp;</p> </div> </p> <p><a href="http://conorato.posterous.com/annals-in-the-battle-against-heart-disease-pr">Permalink</a> | <a href="http://conorato.posterous.com/annals-in-the-battle-against-heart-disease-pr#comment">Leave a comment&nbsp;&nbsp;&raquo;</a> </p><img src="http://feeds.feedburner.com/~r/ConoratosPosterous/~4/yh6GYqsPXCQ" height="1" width="1"/> http://files.posterous.com/user_profile_pics/1469342/picture_721.JPG http://posterous.com/users/37lAtgC4aXqV Conor McKechnie Conorato Conor McKechnie http://conorato.posterous.com/annals-in-the-battle-against-heart-disease-pr Fri, 13 Jan 2012 02:22:00 -0800 http://feedproxy.google.com/~r/ConoratosPosterous/~3/QBjx8mewPoo/design-space-chair-for-all-terrains-clever-an http://conorato.posterous.com/design-space-chair-for-all-terrains-clever-an <p> <div class="posterous_bookmarklet_entry"> <div class='p_embed p_image_embed'> <img alt="Media_httpimmediaftco_ollyo" height="192" src="http://getfile3.posterous.com/getfile/files.posterous.com/conorato/uvvvqCrrpiFAuGJzyDtvfscGccrqtpsEzrfhFAhEkxCDvoujCisegHipnnsz/media_httpimmediaftco_ollyo.jpg.scaled500.jpg" width="272" /> </div> <div class="posterous_quote_citation">via <a href="http://www.ft.com/cms/s/0/c59bdebc-3b99-11e1-bb39-00144feabdc0.html?ftcamp=rss#axzz1jKcEUjwN">ft.com</a></div> <p></p></div> </p> <p><a href="http://conorato.posterous.com/design-space-chair-for-all-terrains-clever-an">Permalink</a> | <a href="http://conorato.posterous.com/design-space-chair-for-all-terrains-clever-an#comment">Leave a comment&nbsp;&nbsp;&raquo;</a> </p><img src="http://feeds.feedburner.com/~r/ConoratosPosterous/~4/QBjx8mewPoo" height="1" width="1"/> http://files.posterous.com/user_profile_pics/1469342/picture_721.JPG http://posterous.com/users/37lAtgC4aXqV Conor McKechnie Conorato Conor McKechnie http://conorato.posterous.com/design-space-chair-for-all-terrains-clever-an Tue, 10 Jan 2012 03:37:00 -0800 http://feedproxy.google.com/~r/ConoratosPosterous/~3/79NBHEq3Z0w/dr-devi-shetty-indian-heart-surgeon-on-money http://conorato.posterous.com/dr-devi-shetty-indian-heart-surgeon-on-money <p> <div class="posterous_bookmarklet_entry"> <embed src="http://www.bbc.co.uk/emp/ukrp/revisions/674606_674817/674606_674817_emp.swf" allowfullscreen="true" type="application/x-shockwave-flash" wmode="opaque" allowscriptaccess="always" height="40" flashvars="embedReferer=&amp;embedPageUrl=http://www.bbc.co.uk/iplayer/console/p00mp490&amp;widgetRevision=674606_674817&amp;legacyPlayerRevision=293203&amp;config_settings_autoPlay=false&amp;config_settings_showPopoutButton=false&amp;config_settings_showPopoutCta=false&amp;config_settings_showFullScreenButton=false&amp;config_settings_stationAnimationUrl=http://www.bbc.co.uk/emp/channelbrands/{stationId}.swf&amp;config_settings_displayMode=radio&amp;domId=emp&amp;config=http://www.bbc.co.uk/iplayer/config/emp/&amp;playlist=http://www.bbc.co.uk/iplayer/playlist/p00mp490/&amp;holdingImage=undefined&amp;config_settings_bitrateFloor=0&amp;config_settings_bitrateCeiling=600&amp;config_messages_diagnosticsMessageBody=Insufficient bandwidth to stream this programme.Try our diagnostics page.&amp;config_settings_language=en&amp;guidance=unknown" quality="high" width="380" /><div class="posterous_quote_citation">via <a href="http://www.bbc.co.uk/iplayer/console/p00mp490">bbc.co.uk</a></div> <p>The west needs to learn lessons from modern Indian healthcare: </p><p>Despite the "hard" probing by the BBC's Stephen Sackur, Devi Shetty puts forward a strong case for the "industrialisation" of healthcare in an effort to reduce costs, increase access and improve quality. </p><p>So much of what he says cuts against the emotional grain of how people feel about how healthcare should be provided - especially for those of us in the warm embrace of our publicly-funded systems. </p><p>The numbers are staggering: India needs to do 2.5 million heart surgery procedures a year - currently capacity is at 90,000. </p><p>Shetty is building a huge hospital in the Cayman Islands to offer healthcare to Americans at half the price they can currently access. Extraordinary, but even more extraordinary is what he is doing in India and planning for Africa - training is the key thing - he is calling for a global health university. Really, he's a visionary... </p><p>My favourite Shetty quote: "You invest in healthcare, and you are going to make a country healthy and wealthy".</p></div> </p> <p><a href="http://conorato.posterous.com/dr-devi-shetty-indian-heart-surgeon-on-money">Permalink</a> | <a href="http://conorato.posterous.com/dr-devi-shetty-indian-heart-surgeon-on-money#comment">Leave a comment&nbsp;&nbsp;&raquo;</a> </p><img src="http://feeds.feedburner.com/~r/ConoratosPosterous/~4/79NBHEq3Z0w" height="1" width="1"/> http://files.posterous.com/user_profile_pics/1469342/picture_721.JPG http://posterous.com/users/37lAtgC4aXqV Conor McKechnie Conorato Conor McKechnie http://conorato.posterous.com/dr-devi-shetty-indian-heart-surgeon-on-money Fri, 16 Dec 2011 04:26:00 -0800 http://feedproxy.google.com/~r/ConoratosPosterous/~3/jnvgcPaxLwI/political-collaboration-with-drug-companies-m http://conorato.posterous.com/political-collaboration-with-drug-companies-m <p> <div class="posterous_bookmarklet_entry"> <blockquote class="posterous_medium_quote">It&rsquo;s worrying that we still see pharmaceutical products as the mainstay of improving health in the future when the evidence tells us, should we listen to it, that the biggest gains to be made to health are social, political and&nbsp;environmental.</blockquote> <div class="posterous_quote_citation">via <a href="http://www.margaretmccartney.com/blog/?p=1248">margaretmccartney.com</a></div> <p>This is from a post prompted by announcement that the UK government is proposing allowing commercial organisations access to anonymised patient record data.</p> <p>There are privacy concerns, yes, but Margaret has hit on another thing that has been missed by most commentators: We need to stop thinking that the answer to our healthcare woes lies in the consumption of more better medicines and drugs. Yes, it's good to develop better, more targetted therapies that are more likely to help the right patient at the right time, but we know that the best interventions in healthcare are preventative lifestyle changes, and then, where possible, an early diagnosis...</p> <p>I am really struggling with this - it's a very big thinky scratchy-beard conundrum.</p> <p>I talk to pharma all the time, and I think access to anonymised data could really help companies and health systems make smart decisions that improve patient care - but I think this needs to be reciprocated - if governments are going to allow commercial organisations free access to the data collected on publicly-funded EMR systems, commercial organisations should commit to releasing ALL the data from ALL the clinical trials regarding their medicines.</p> <p>It's about transparency, openness and fairness. Last time I checked, I thought these were good things.&nbsp;Biased under-reporting of clinical trials&nbsp;harms patients, wastes money and is against the tenets of good science.</p> </div> </p> <p><a href="http://conorato.posterous.com/political-collaboration-with-drug-companies-m">Permalink</a> | <a href="http://conorato.posterous.com/political-collaboration-with-drug-companies-m#comment">Leave a comment&nbsp;&nbsp;&raquo;</a> </p><img src="http://feeds.feedburner.com/~r/ConoratosPosterous/~4/jnvgcPaxLwI" height="1" width="1"/> http://files.posterous.com/user_profile_pics/1469342/picture_721.JPG http://posterous.com/users/37lAtgC4aXqV Conor McKechnie Conorato Conor McKechnie http://conorato.posterous.com/political-collaboration-with-drug-companies-m Wed, 30 Nov 2011 11:28:55 -0800 http://feedproxy.google.com/~r/ConoratosPosterous/~3/kdVWmG0pG3s/breastcancer-screening-and-the-practice-of-go http://conorato.posterous.com/breastcancer-screening-and-the-practice-of-go <p> <p>There is currently lots in the mainstream media and the medical press about the on-going debate on mammography screening for breast cancer. The <a href="http://bit.ly/vXNDbQ">BMJ&rsquo;s letter pages</a> this week devote a double spread to responses to Mike Richards&rsquo;, the UK DoH&rsquo;s national clinical director for cancer and end of life care, commissioning of an independent review of the evidence on the effect of screening mammography on cancer mortality and over-diagnosis. Add to this the new <a href="http://bit.ly/sgBUQS">Canadian guidelines</a> recommending that women between the ages of 40 and 49, and not stratified as predisposed to cancer due to family history or genetics, not be routinely screened for breast cancer.</p> <p>I cannot add to the debate as I am not a breast cancer expert, have not conducted research, nor indeed even a thorough reading of the hundreds of publications in the field. However, I think the debate highlights some things that are relevant to <strong><em>how we think about scientific evidence</em></strong> and its role in driving policy and personal health decisions:</p> <p><strong>Show me the data<br /> </strong>First, guidelines and decisions that influence the healthcare of millions of people must be made based on a neutral, independent, transparent, evidence-based, scientifically robust assessment of all the latest available data interpreted in the most transparently unbiased way possible. Integrity demands it, as should the people on whose behalf these guidelines are being drawn up. &nbsp;The Canadian guidelines, for example, make &ldquo;no recommendation &hellip; for women aged 75 and older, <strong><em>given the lack of data.&rdquo;</em></strong></p> <p>The UK&rsquo;s National Institute for Health and Clinical Excellence is a body that was set up in 1999 to conduct appraisals of medicines, technologies and clinical practice based primarily on robust evaluations of the science behind claims of efficacy and cost-effectiveness. Its independence has made it a credible and authoritative voice on what the UKs health system should and should not do in a wide range of disease pathways. So respected is it, that NICE guidelines are often <a href="http://www.nice.org.uk/niceinternational">adapted for use in other countries</a>. This is a good thing, I think.</p> <p><strong>Neutrality &amp; transparency command respect<br /> </strong>Second, bias and vested interests destroy public confidence in science and healthcare decision-makers. Without the credibility of neutrality and scientific rigor at the outset, the risk, indeed the inevitability, is that those with pre-entrenched points of view on such guidelines will seize upon outcomes detrimental to their points of view and kick up a huge media fuss that clouds the public&rsquo;s understanding (remember them, they&rsquo;re the ones whose interests are supposedly being looked out for). This makes the slanging match the story, as opposed to helping the public improve their knowledge and health literacy.</p> <p><strong>Change is constant, progress is made, embrace it<br /> </strong>Third, when guidelines are implemented, it is natural for commercial organisations and clinical vested interests to align themselves around those guidelines in order to ensure that their products and services, careers, disciplines and specialities are successful and sustainable in the long term. I don&rsquo;t think there is anything wrong with healthcare professionals aligning their career interests, or indeed companies their business interests, with the needs of the patient and the healthcare system, especially if those needs have been established through thorough consideration of the latest evidence: the more these interests can be aligned with those of improved patient outcomes for more patients at a lower cost, the better.</p> <p>I digress. We need to recognise that when these interests align, &nbsp;they will of course then have a further interest in the guidelines remaining as they are for as long as possible, and this is a less good thing. <strong><em>All groups, whether commercial, clinical or advocacy-focused should have the best interests of the patient and healthcare system at their core</em></strong>.</p> <p>This means accepting, demanding, even, periodical review and improving the way things are done, and accepting that you may need to change and do things differently, and in extreme cases, recognise that your speciality, or service, or product, becomes redundant because of advances in other areas.</p> <p>It&rsquo;s tough to hold yourself to account like this, and there are a plethora of examples in the medical field where potential advances in access to improved care at lower costs with better outcomes are being, or have been, held up because the &lsquo;new&rsquo; threatens the &lsquo;old&rsquo;.</p> <p>We ought to accept that guidelines ought to be reviewed, when advances in&nbsp; medicine and technology move significantly beyond what was common practice when the existing guidelines were established. No one, after all, treats schizophrenia with frontal lobotomy any more, the science has moved on.</p> <p><strong>Good science well explained helps patients<br /> </strong>Fourth, and most important, politically or commercially driven slanging matches between opposing camps on a debate do not help the patient. They urgently need scientifically sound consensus to help inform their healthcare decision-making. And the patient should be our primary concern. One day that patient will be you, it will be me, it will be our children and loved ones. Who would want them treated other than in a way based on the soundest possible assessment of the evidence? So, ask for the evidence.</p> <p><a href="http://www.senseaboutscience.org//pages/a4e.html" target="_blank"> <img title="Ask for evidence button" src="http://www.senseaboutscience.org//data/images/Logos/a4e_button_with_web_address_2011_sept_28.gif" height="141" alt="Ask for evidence button" width="199" /> </a></p> </p> <p><a href="http://conorato.posterous.com/breastcancer-screening-and-the-practice-of-go">Permalink</a> | <a href="http://conorato.posterous.com/breastcancer-screening-and-the-practice-of-go#comment">Leave a comment&nbsp;&nbsp;&raquo;</a> </p><img src="http://feeds.feedburner.com/~r/ConoratosPosterous/~4/kdVWmG0pG3s" height="1" width="1"/> http://files.posterous.com/user_profile_pics/1469342/picture_721.JPG http://posterous.com/users/37lAtgC4aXqV Conor McKechnie Conorato Conor McKechnie http://conorato.posterous.com/breastcancer-screening-and-the-practice-of-go Thu, 27 Oct 2011 08:04:54 -0700 http://feedproxy.google.com/~r/ConoratosPosterous/~3/kzzLC1ycs9U/all-the-links-on-the-breastcancer-breastscree http://conorato.posterous.com/all-the-links-on-the-breastcancer-breastscree <p> <p>I've been following the discussion in the UK on the NHS breast screening programme. It's a long-running cost-benefit debate, and decisions about it should be made on good science and good access to information. If anything, this will clarify things and help better inform women.</p> <p>Here are the links that I have been reading or listening to:</p> <p>BBC 5Live discussion on Victora Derbyshire's talk show between some brave patients (inc. one with dense breasts, one undergoing chemo while on the phone whose diagnosis took 8 months), &nbsp;GP Margaret McCartney and&nbsp;Professor Peter Gotzsche:&nbsp;<a href="http://www.bbc.co.uk/iplayer/console/b016bkqv">http://www.bbc.co.uk/iplayer/console/b016bkqv</a></p> <p>Margaret McCartney on informed consent, DCIS and patient information in <em>The Independent:&nbsp;</em><a href="http://ind.pn/vjbupG" target="_blank">http://ind.pn/vjbupG</a></p> <p>and on her blog:&nbsp;<a href="http://www.margaretmccartney.com/blog/?p=1192">http://www.margaretmccartney.com/blog/?p=1192</a></p> <p>Mike Richards,&nbsp;<span style="color: #333333; font-family: arial, sans serif; font-size: 12px;">national clinical director for cancer and end of life care at the DoH writes in the BMJ</span>:&nbsp;<a href="http://bit.ly/tkHHeC" target="_blank">http://bit.ly/tkHHeC</a></p> <p>And Mike Richards on video (with an annoying ad to begin):&nbsp;<a href="http://bcove.me/6lmz9bec" target="_blank">http://bcove.me/6lmz9bec</a></p> <p><span style="color: #333333; font-family: arial; font-size: 10px; line-height: 13px;">&nbsp;</span></p> <p><span style="font-family: arial, sans serif; font-size: small;"><span class="name" style="font-style: inherit; font-family: inherit; line-height: inherit; vertical-align: baseline; padding: 0px; margin: 0px;"><a href="http://www.bmj.com/search?author1=Susan+Bewley&amp;sortspec=date&amp;submit=Submit" class="name-search" style="font-style: inherit; font-size: inherit; font-family: inherit; line-height: inherit; vertical-align: 0px; color: #333333; text-decoration: none; padding: 0px; margin: 0px;">Susan Bewley</a></span><span class="contrib-role" style="font-weight: bold; font-style: inherit; font-family: inherit; line-height: inherit; vertical-align: baseline; padding: 0px; margin: 0px;">,</span><span class="contrib-role" style="font-style: inherit; font-family: inherit; line-height: inherit; vertical-align: baseline; padding: 0px; margin: 0px;"> professor of complex obstetrics, Division of Women&rsquo;s Health, King&rsquo;s College London calling for a review of the NHS's screening programme in the BMJ:&nbsp;<a href="http://bit.ly/w0ZjLP" target="_blank">http://bit.ly/w0ZjLP</a></span></span></p> <p> <p>I'm no doctor, and no expert, but I am learning that women diagnosed with breast cancer today can expect a very different treatment paradigm than what their mothers may have experienced. Their cancers' genetic profiles can be assessed to determine how aggressive they are, what their chances of recurrence are, and which drug regimes they will or, very importantly, will not respond to. Diagnostics and treatment are advancing, and changing the face of the what medicine will look like - making it personalized.</p> <p>Here's an example of what Personalized Medicine :&nbsp;A Dying Cancer Patient's Plea For Personalized Medicine - Forbes <a href="http://onforb.es/vTnJL2" target="_blank">http://onforb.es/vTnJL2</a></p> <p><div class='p_embed p_image_embed'> <img alt="Dna-breast-cancers" height="240" src="http://getfile5.posterous.com/getfile/files.posterous.com/temp-2011-10-27/tcaisnvyqbJBCubymGfrFDhpImxklFjhhjwGkjoouADhckImruGuHJCGBvfx/DNA-breast-cancers.jpg.scaled500.jpg" width="320" /> </div> </p> </p> </p> <p><a href="http://conorato.posterous.com/all-the-links-on-the-breastcancer-breastscree">Permalink</a> | <a href="http://conorato.posterous.com/all-the-links-on-the-breastcancer-breastscree#comment">Leave a comment&nbsp;&nbsp;&raquo;</a> </p><img src="http://feeds.feedburner.com/~r/ConoratosPosterous/~4/kzzLC1ycs9U" height="1" width="1"/> http://files.posterous.com/user_profile_pics/1469342/picture_721.JPG http://posterous.com/users/37lAtgC4aXqV Conor McKechnie Conorato Conor McKechnie http://conorato.posterous.com/all-the-links-on-the-breastcancer-breastscree Wed, 26 Oct 2011 07:55:00 -0700 http://feedproxy.google.com/~r/ConoratosPosterous/~3/HJ0ommZPcrA/i-like-this-mike-richards-to-lead-a-review-of http://conorato.posterous.com/i-like-this-mike-richards-to-lead-a-review-of <p> <p>When people in the Dept of Health in the UK, such as Mike Richards, lead reviews of evidence, the result, we must hope, is that the recommendations are followed and that they are truly in the best interests of patients. This is a nice little sofa discussion by the folks at the BBC. <object data="http://www.bbc.co.uk/emp/external/player.swf" type="application/x-shockwave-flash" height="390" width="500"> <param name="quality" value="high" /> <param name="wmode" value="default" /> <param name="allowFullScreen" value="true" /> <param name="allowScriptAccess" value="always" /> <param name="flashvars" value="playlist=http://playlists.bbc.co.uk/news/health-15457949A/playlist.sxml&amp;config=http://www.bbc.co.uk/player/emp/2_0_19/config/default.xml&amp;config_settings_showPopoutButton=false&amp;config_plugin_fmtjLiveStats_pageType=eav2&amp;domId=emp-15457949-7471&amp;config_plugin_fmtjLiveStats_edition=Domestic&amp;fmtjDocURI=/news/health-15444879&amp;embedReferer=http://www.bbc.co.uk/news/health/&amp;config_settings_showUpdatedInFooter=true&amp;config_settings_showShareButton=true&amp;embedPageUrl=http://www.bbc.co.uk/news/health-15444879&amp;holdingImage=http://news.bbcimg.co.uk/media/images/56285000/jpg/_56285054_jex_1212440_de27-1.jpg&amp;config_settings_autoPlay=true&amp;uxHighlightColour=0xff0000&amp;config_plugin_fmtjLiveStats_pageType=eav6&amp;config_settings_autoPlay=false&amp;config_settings_showFooter=true&amp;config_settings_showPopoutButton=false&amp;config_settings_showPopoutCta=false&amp;config_settings_addReferrerToPlaylistRequest=true" /> </object> </p> </p> <p><a href="http://conorato.posterous.com/i-like-this-mike-richards-to-lead-a-review-of">Permalink</a> | <a href="http://conorato.posterous.com/i-like-this-mike-richards-to-lead-a-review-of#comment">Leave a comment&nbsp;&nbsp;&raquo;</a> </p><img src="http://feeds.feedburner.com/~r/ConoratosPosterous/~4/HJ0ommZPcrA" height="1" width="1"/> http://files.posterous.com/user_profile_pics/1469342/picture_721.JPG http://posterous.com/users/37lAtgC4aXqV Conor McKechnie Conorato Conor McKechnie http://conorato.posterous.com/i-like-this-mike-richards-to-lead-a-review-of Tue, 25 Oct 2011 05:56:00 -0700 http://feedproxy.google.com/~r/ConoratosPosterous/~3/4CYvRD-FC_c/the-more-you-use-it-the-better-value-you-get http://conorato.posterous.com/the-more-you-use-it-the-better-value-you-get <p> <p>Here's a thought that crashed into the media spolight in the UK this morning by a&nbsp;<span style="font-family: verdana, arial, sans-serif; font-weight: bold; line-height: 16px;">Commons Public Accounts Committee&nbsp;</span><a href="http://www.parliament.uk/business/committees/committees-a-z/commons-select/public-accounts-committee/news/high-value-equip/" target="_blank">&nbsp;report into the use of high-value capital equipment in the NHS</a> [stifle those yawns, folks, this is interesting] :</p> <p><span style="font-size: medium;"><strong>If you buy expensive kit, the more you use it, the better value you get from it - so use it 24/7!</strong></span></p> <p>Not exactly groundbreaking, is it? The NHS is the 7th (?) largest employer in the world. Take a report to the CEOs of the biggest 6 and tell them that they are not maximising return on investemnt in their capital equipment, and I think you'll see them act decisively. The PAC report essentially says: club together to maximise buying power, and <a href="http://en.wiktionary.org/wiki/beasting#English" target="_blank">beast </a>the kit you buy.</p> <p>I would like to see this in the NHS too - <strong>if you have a nice shiny CT or MRI, please, run it all day and all night</strong> - how else can you get the most out of it, reduce waiting lists and increase efficiency? Of course I understand there are staffing capacity issues and shift patterns - but these don't stop other industries getting the most out of their capex:</p> <p>This has been brewing in my mind ever since my father was hospitalised earlier this year following a series of heart attacks [he's fine now, read about it here&nbsp;<a href="http://kmckeck.posterous.com/">http://kmckeck.posterous.com/</a>], and he berated the fact that he could not get an angiogram over the weekend when admitted to hospital on a Friday morning. They don't run the interventional diagnostic suite after 5 pm Friday and before 8 a.m. Monday.</p> <p>"I'd have been livid if I'd found out my capex was lying idle 70% of the time it could be running," he fumed.</p> <p>He has had a long career as an exploration geologist and in his time ran some pretty extreme gold mining operations in far-flung places. I was lucky enough to get to visit these, deep mines in darkest Sumatra, open pits on south Pacific islands, wild camps in the depths of the Amazon rainforest, and the bush in Botswana and Katanga, Zaire (see below).<div class='p_embed p_image_embed'> <a href="http://getfile5.posterous.com/getfile/files.posterous.com/temp-2011-10-25/jrGourbBzHdwhczjiIsszyuwdhsmwvgsmhhhBIgawxhfxmBoHrdJtnebgiqq/pg_5_annl_report.jpg.scaled1000.jpg"><img alt="Pg_5_annl_report" height="153" src="http://getfile3.posterous.com/getfile/files.posterous.com/temp-2011-10-25/jrGourbBzHdwhczjiIsszyuwdhsmwvgsmhhhBIgawxhfxmBoHrdJtnebgiqq/pg_5_annl_report.jpg.scaled500.jpg" width="500" /></a> </div> </p> <p>I grew up around projects where big multinationals were making colossal invesments in equipment with a long view to the return on the investment. And even in these extraordinary places, under pressing conditions, heat, dust, humidity, lack of infrastructure, political chaos, the operations ran around the clock.</p> <p>As a kid I never thought to question the fact that <strong>the mines ran all day, every day, all year. </strong>It just made sense - investors want a return, so they beast the kit. I remember watching the night shifts of workers go down damp humid shafts in jungled mountains, thinking, "Of course, it's dark down there anyway."</p> <p>In the UK, <strong>we, the public, are the investors in the healthcare system</strong>. My taxes buy expensive diagnostic kit and operating theatres. For my money,&nbsp;I want a decent return - a fully-functioning, efficient, world-beating health service focused on keeping people healthy and diagnosing disease early &nbsp;please. Much of the time we get that, but I'm livid to find that much of my capex is lying around idle between 6 p.m. and 8 a.m. weekdays and all weekends.</p> </p> <p><a href="http://conorato.posterous.com/the-more-you-use-it-the-better-value-you-get">Permalink</a> | <a href="http://conorato.posterous.com/the-more-you-use-it-the-better-value-you-get#comment">Leave a comment&nbsp;&nbsp;&raquo;</a> </p><img src="http://feeds.feedburner.com/~r/ConoratosPosterous/~4/4CYvRD-FC_c" height="1" width="1"/> http://files.posterous.com/user_profile_pics/1469342/picture_721.JPG http://posterous.com/users/37lAtgC4aXqV Conor McKechnie Conorato Conor McKechnie http://conorato.posterous.com/the-more-you-use-it-the-better-value-you-get Thu, 20 Oct 2011 05:08:00 -0700 http://feedproxy.google.com/~r/ConoratosPosterous/~3/JMUROy1LTfg/thoughts-on-earlydiagnosis-and-the-young-how http://conorato.posterous.com/thoughts-on-earlydiagnosis-and-the-young-how <p> <p>Here's a conundrum that I am sure smarter people than me are pondering. It was brought to my attention by a cancer patient. A young one: 40 years old, and receiveing palliative chemotherapy, tweets:</p> <p><span style="color: #444444; font-family: Georgia, Palatino, Helvetica Neue, Helvetica, Arial, sans-serif; font-size: 21px; line-height: 27px;">"I am 40, when I have chemo I notice the ones who have stage 1 cancer with chemo to kill any stray cells are...</span></p> <p><span style="color: #444444; font-family: Georgia, Palatino, Helvetica Neue, Helvetica, Arial, sans-serif; font-size: 21px; line-height: 27px;">the elderly people, many of my age r having palliative chemo as cancer has spread. This is [a] direct result ..</span></p> <p><span style="color: #444444; font-family: Georgia, Palatino, Helvetica Neue, Helvetica, Arial, sans-serif; font-size: 21px; line-height: 27px;">of those older having been regularly screened while younger ones have not, hence cancer caught later :( "</span></p> <p>&nbsp;</p> <p>We champion, rightly, the idea of early diagnosis across so many disease areas, and for some, there are national screening programmes designed to catch these conditions, most often cancers, early.</p> <p>Early detection, diagnosis and treatment, the rationale goes, makes for better clinical outcomes and reduced healthcare costs. This is a good thing.</p> <p>The UK cancer screening programmes target the people most at risk, again, rightly so, and stratified by aged group: women between 50 and 70 for breast cancer, and between 25 and 65 for cervical cancer; men and women between 60 and 69 for bowel cancer.&nbsp;<a href="http://www.cancerscreening.nhs.uk/index.html">http://www.cancerscreening.nhs.uk/index.html</a></p> <p>All well and good, and much progress is being made. <strong>But what about the outliers?</strong></p> <p>Those that develop, for no clearly understood reason, cancer when they are younger and are not captured in the screening programmes. Their diagnoses are pre-disposed to being made late, and the sad irony is that they are the ones that stand to gain most in terms of life quality and years of life from an early diagnosis.How do we get to them and their cancers early enough to save them, and the impact of their illness on those around them and the finances of the healthcare system. (apologies for that, but in a system of limited resources, cost-effectiveness is what NICE is counting).</p> <p>Yes, risk profiles can be augmented by family histories, lifestyle factors and genomic testing, perhpaps helping to expand screening groups to those who need it most (e.g. those carrying BRCA1 and BRCA2 mutations); but mostly this is about awareness.</p> <p>Patients' awareness, public awareness, physicians' awareness; of symptoms, of lifestyles. And there you have the difficulty - the gap between knowledge and action, and the inconsistencies in people's understanding of disease risk. The "wait-and-see" approach in primary care.</p> <p>Many recognise these issues, many campaign on them; and perhaps slowly, along with breakthroughs in genomics, things are changing for the better. I hope so.</p> <p>None of which is much comfort to someone aged 40 undergoing palliative chemo for cancer.</p> <p>&nbsp;</p> <p>&nbsp;</p> </p> <p><a href="http://conorato.posterous.com/thoughts-on-earlydiagnosis-and-the-young-how">Permalink</a> | <a href="http://conorato.posterous.com/thoughts-on-earlydiagnosis-and-the-young-how#comment">Leave a comment&nbsp;&nbsp;&raquo;</a> </p><img src="http://feeds.feedburner.com/~r/ConoratosPosterous/~4/JMUROy1LTfg" height="1" width="1"/> http://files.posterous.com/user_profile_pics/1469342/picture_721.JPG http://posterous.com/users/37lAtgC4aXqV Conor McKechnie Conorato Conor McKechnie http://conorato.posterous.com/thoughts-on-earlydiagnosis-and-the-young-how Tue, 11 Oct 2011 07:36:00 -0700 http://feedproxy.google.com/~r/ConoratosPosterous/~3/0AqRBoP7jPg/interesting-views-on-health-as-a-social-pheno http://conorato.posterous.com/interesting-views-on-health-as-a-social-pheno <p> <div class="posterous_bookmarklet_entry"> <div style=""><strong style="display: block; margin: 12px 0 4px;"><a href="http://www.slideshare.net/EdelmanInsights/edelman-health-barometer-2011-global-deck" title="Edelman Health Barometer 2011: Global Deck" target="_blank">Edelman Health Barometer 2011: Global Deck</a></strong> <iframe scrolling="no" marginheight="0" marginwidth="0" src="http://www.slideshare.net/slideshow/embed_code/9566427" frameborder="0" height="355" width="425"></iframe> <div style="padding: 5px 0 12px;">View more presentations from <a href="http://www.slideshare.net/EdelmanInsights" target="_blank">Edelman Insights</a></div> </div> <p>Health is more than being disease free - yes. <br />The things with most impact on my health are things that I can control - yes.</p> <p>There is a knowledge -action gap in health...which means "we may well know what is good, but we sure as hell don't always choose it".</p> <p>The suggestion from <a href="http://www.slideshare.net/EdelmanInsights/edelman-health-barometer-2011-global-deck#" target="_blank">the health barometer by Edelman </a>is that:</p> <p>1 - peer pressure on better healthier living could help - yes - but peer pressure works both ways - go on then, just one more beer before I go. <br />2 - tools &amp; tech can help - yes, but tools and tech work against health too - see the Pizza Hut app, get fat featured on your phone <br />3 - companies need to help their employees live healthier - yes - but at the same time they want to get their pound of flesh...I know, believe me</p> <p>All well and good, but the more I learn about this, the more I think there's a combination of carrot and stick in getting people to live healthier.</p> <p>1 - smoking bans work. <br />2 - higher taxes on booze work <br />3 - a change in the law with added social stigma works (drink driving, seatbelts) <br />4 - targets for salt and fat reduction works <br />5 - banning trans fats works</p> <p>So? Now what? How much do we want to legislate for health? It's largely our own making, this explosion of unhealthy-lifestyle-led disease. It took 50 years, and we did a great job of getting fat and sedentary. How do we reverse it?</p> <p>More soon....</p> </div> </p> <p><a href="http://conorato.posterous.com/interesting-views-on-health-as-a-social-pheno">Permalink</a> | <a href="http://conorato.posterous.com/interesting-views-on-health-as-a-social-pheno#comment">Leave a comment&nbsp;&nbsp;&raquo;</a> </p><img src="http://feeds.feedburner.com/~r/ConoratosPosterous/~4/0AqRBoP7jPg" height="1" width="1"/> http://files.posterous.com/user_profile_pics/1469342/picture_721.JPG http://posterous.com/users/37lAtgC4aXqV Conor McKechnie Conorato Conor McKechnie http://conorato.posterous.com/interesting-views-on-health-as-a-social-pheno Fri, 16 Sep 2011 09:17:00 -0700 http://feedproxy.google.com/~r/ConoratosPosterous/~3/bwLi2ep3zYk/this-weekend-i-will-be-making-these-slackline http://conorato.posterous.com/this-weekend-i-will-be-making-these-slackline <p> <div class="posterous_bookmarklet_entry"> <div class='p_embed p_image_embed'> <a href="http://posterous.com/getfile/files.posterous.com/conorato/CyxvptsnJoEcxdhzmliqmdIBbAkopFqamilwlCCHFqsifgCuzDGeyrjbqasI/media_httpwwwfamilysl_tquGI.jpg.scaled1000.jpg"><img alt="Media_httpwwwfamilysl_tqugi" height="344" src="http://posterous.com/getfile/files.posterous.com/conorato/CyxvptsnJoEcxdhzmliqmdIBbAkopFqamilwlCCHFqsifgCuzDGeyrjbqasI/media_httpwwwfamilysl_tquGI.jpg.scaled500.jpg" width="500" /></a> </div> <div class="posterous_quote_citation">via <a href="http://www.family-slackline.de/images/family-slackline.jpg">family-slackline.de</a></div> <p>I searched high and low and came across all sorts of crazy designs, but have settled on the simplest. Time to get the jig-saw out.</p></div> </p> <p><a href="http://conorato.posterous.com/this-weekend-i-will-be-making-these-slackline">Permalink</a> | <a href="http://conorato.posterous.com/this-weekend-i-will-be-making-these-slackline#comment">Leave a comment&nbsp;&nbsp;&raquo;</a> </p><img src="http://feeds.feedburner.com/~r/ConoratosPosterous/~4/bwLi2ep3zYk" height="1" width="1"/> http://files.posterous.com/user_profile_pics/1469342/picture_721.JPG http://posterous.com/users/37lAtgC4aXqV Conor McKechnie Conorato Conor McKechnie http://conorato.posterous.com/this-weekend-i-will-be-making-these-slackline Fri, 16 Sep 2011 05:09:00 -0700 http://feedproxy.google.com/~r/ConoratosPosterous/~3/csj3DtPO984/in-case-you-were-searching-here-it-is-the-un http://conorato.posterous.com/in-case-you-were-searching-here-it-is-the-un <p> <p><br /><div class='p_embed p_file_embed'> <a href="http://conorato.posterous.com/in-case-you-were-searching-here-it-is-the-un"><img alt="" src="http://posterous.com/images/filetypes/pdf.png" /></a> <div class='p_embed_description'> <strong>NCDs_-_Draft_Political_Declaration_-_9_September_2011.pdf</strong> <a href="http://posterous.com/getfile/files.posterous.com/temp-2011-09-16/vzxCCBpAFloAhkbEnFyvFcfcAmlFuodoBmCgecsGisgvGbIoekpfrCmqfpcq/NCDs_-_Draft_Political_Declaration_-_9_September_2011.pdf">Download this file</a> </div> </div> Lots of talk about the pharma, food and drink industries lobbying for this to be watered down, targets to be removed, timescales lengthened etc.</p> <p>I think we need to be realistic and admit a few things [full disclosure - I work for a large healthcare technology and services company]:</p> <ol> <li>big food &amp; drink is here to stay</li> <li>big companies have expertise, innovate faster, are powerful, and can act effectively, with resources and money</li> <li>"we're good - they're evil" confrontation does not achieve anything: collaboration and mutal engagement is the way to make things happen</li> <li>big business has a vested interest in addressing the NCD epidemic; healthy employees are cheaper and more productive in the long run</li> <li>no one can fix this alone</li> </ol> <p>The stunning thing is that it got this far - testament to the fact that most governments have woken up to the spectre of non-communicable disease that threatens to bankrupt healthcare and push people around the world [back] into poverty. Yes folks - <strong>back </strong>- a good post on this here:&nbsp;</p> <p><em>NCDs drive people into poverty, while poverty results in rising rates of NCDs</em>. <a href="http://bit.ly/pp8YQH" title="NCDs drive people into poverty, while poverty results in rising rates of NCDs." target="_blank">http://bit.ly/pp8YQH</a></p> <p>I do still struggle with the "consumption drives growth" part of this, though. We are encouraged everyday to buy more stuff (not just junk foood and booze, but pointless plastic tat and digi-gizmos too), most of which we do not need, all in the interests of driving economic growth...Call it latent student politics, call it the shadow of baked-in euro-left social thinking, call it caring about the future of the world in which we live.</p> <p>Actually - and there's a whole book in this somewhere - call it the idea that we should do things well for the sake of having done it well, and that includes how we consume ...</p> </p> <p><a href="http://conorato.posterous.com/in-case-you-were-searching-here-it-is-the-un">Permalink</a> | <a href="http://conorato.posterous.com/in-case-you-were-searching-here-it-is-the-un#comment">Leave a comment&nbsp;&nbsp;&raquo;</a> </p><img src="http://feeds.feedburner.com/~r/ConoratosPosterous/~4/csj3DtPO984" height="1" width="1"/> http://files.posterous.com/user_profile_pics/1469342/picture_721.JPG http://posterous.com/users/37lAtgC4aXqV Conor McKechnie Conorato Conor McKechnie http://conorato.posterous.com/in-case-you-were-searching-here-it-is-the-un Fri, 16 Sep 2011 02:21:00 -0700 http://feedproxy.google.com/~r/ConoratosPosterous/~3/rF7yyQofZKA/seriously-some-marketeers-dont-spam-me-with-p http://conorato.posterous.com/seriously-some-marketeers-dont-spam-me-with-p <p> <p><div class='p_embed p_file_embed'> <a href="http://conorato.posterous.com/seriously-some-marketeers-dont-spam-me-with-p"><img alt="" src="http://posterous.com/images/filetypes/pdf.png" /></a> <div class='p_embed_description'> <strong>Memo_StyleREdacted.pdf</strong> <a href="http://posterous.com/getfile/files.posterous.com/temp-2011-09-16/jBbyBJcrBComwgipvizyCHnujDEAyfiGoFBqffEfAnHEuqCkmGbAchnAkxGu/Memo_StyleREdacted.pdf">Download this file</a> </div> </div> Recieved this morning proof that "social media strategy consulting" has reached new extreme lows of budget thievery.</p> <p>Note the subject-line - designed to draw my attention to something of strategic import to the business I work for. Are they serious?</p> <p>"You know, Bob, we really need to increase our Facebook likes - they are quality connections."</p> <p>I dont' think so, and growing a customer database by 350% in this case clearly means "getting a list of a whole bunch of people you can spam with annoying garbage".&nbsp;</p> <p>Which puts me in mind of Bill Hicks on Marketing -contains profanities, so apologies for that:&nbsp;<iframe src="http://www.youtube.com/embed/UEnA29wK7uM" allowfullscreen frameborder="0" height="417" width="500"></iframe></p> </p> <p><a href="http://conorato.posterous.com/seriously-some-marketeers-dont-spam-me-with-p">Permalink</a> | <a href="http://conorato.posterous.com/seriously-some-marketeers-dont-spam-me-with-p#comment">Leave a comment&nbsp;&nbsp;&raquo;</a> </p><img src="http://feeds.feedburner.com/~r/ConoratosPosterous/~4/rF7yyQofZKA" height="1" width="1"/> http://files.posterous.com/user_profile_pics/1469342/picture_721.JPG http://posterous.com/users/37lAtgC4aXqV Conor McKechnie Conorato Conor McKechnie http://conorato.posterous.com/seriously-some-marketeers-dont-spam-me-with-p Mon, 05 Sep 2011 05:24:00 -0700 http://feedproxy.google.com/~r/ConoratosPosterous/~3/kofJCZ_HI9Q/nearly-40-percent-of-europeans-suffer-mental http://conorato.posterous.com/nearly-40-percent-of-europeans-suffer-mental <p> <div> <p><strong><span style="font-size: medium;">Nearly 40 percent of Europeans suffer mental illness </span>(Reuters)</strong></p> <p>Edited from Reuters, the story is below, but as ever - the headline is hopeless, and states only a fact - it should have called for action: Early detection, diagnosis and treatment the only way to address burden of 165 million Europeans suffering with mental illness.</p> <p>My wife works in mental health, with children and adolescents, in one of the most deprived areas of the south east of England. She is, quite honestly, amazing, although she would never admit it herself. She never shares particulars, but her general observations drive me to the following comment:</p> <p>This study includes major neurological disorders such as Parkinson's and MS in addition to what, in my experience, people usually consider as "mental health" - anxiety, depression, addiction and schizophrenia.</p> <p>In the former, impact on loved ones and family features well in the debate. In the case of the latter, it is less prominent, and increased focus on the impact of mental illness on the lives of those around the patient should be welcomed.</p> <p>The long-term economic cost (never mind the emotional trauma and distress) of a single parent struggling with depression and addiction, possibly resulting in children being taken into state care, and the subsequent impact on their lives and ambitions, health and economic well-being may not have been studied here - but I can't imagine that what the authors of the study and David Nutt at Imperial College London is advocating can be anything other than common sense.</p> <p>Allow me to paraphrase - <span style="text-decoration: underline;"><strong>Early detection, diagnosis and treatment is better in the long term for the patient, the family, the health system and society and the economy as a whole:</strong></span> "If you can get in early you may be able to change the trajectory of the illness so that it isn't inevitable that people go into disability," he said. "If we really want not to be left with this huge reservoir of mental and brain illness for the next few centuries, then we ought to be investing more now."</p> <p>&nbsp;</p> </div> <div><span style="font-family: Times New Roman; font-size: medium;"> </span><div style="color: #000000; font-family: Arial, Helvetica, sans-serif; font-size: 13px; background-color: #ffffff; margin: 8px;"> <div class="posterous_bookmarklet_entry"> <blockquote> <div> <p>LONDON (Reuters) - Europeans are plagued by mental and neurological illnesses, with almost 165 million people or 38 percent of the population suffering each year from a brain disorder such as depression, anxiety, insomnia or dementia, according to a large new study.</p> <p>With only about a third of cases receiving the therapy or medication needed, mental illnesses cause a huge economic and social burden -- measured in the hundreds of billions of euros -- as sufferers become too unwell to work and personal relationships break down.</p> <p>"Mental disorders have become Europe's largest health challenge of the 21st century," the study's authors said.</p> <p>....</p> <p>Mental illnesses are a major cause of death, disability, and economic burden worldwide and the World Health Organization predicts that by 2020, depression will be the second leading contributor to the global burden of disease across all ages.</p> <p>...</p> <p>The four most disabling conditions -- measured in terms of disability-adjusted life years or DALYs, a standard measure used to compare the impact of various diseases -- are depression, dementias such as Alzheimer's disease and vascular dementia, alcohol dependence and stroke.</p> <p>...</p> <p>The researchers said it was<span style="text-decoration: underline;"><strong> crucial for health policy makers to recognize the enormous burden and devise ways to identify potential patients early </strong></span>-- possibly through screening -- and make treating them quickly a high priority.</p> <p>"Because mental disorders frequently start early in life, they have a strong malignant impact on later life," Wittchen said. "Only early targeted treatment in the young will effectively prevent the risk of increasingly largely proportions of severely ill...patients in the future."</p> <p>David Nutt, a neuropsychopharmacology expert at Imperial College London who was not involved in this study, agreed.</p> <p>"If you can get in early you may be able to change the trajectory of the illness so that it isn't inevitable that people go into disability," he said. "If we really want not to be left with this huge reservoir of mental and brain illness for the next few centuries, then we ought to be investing more now."</p> </div> </blockquote> <div class="posterous_quote_citation">via&nbsp;<a href="http://news.yahoo.com/nearly-40-pct-europeans-suffer-mental-illness-230827577.html">news.yahoo.com</a></div> <p>&nbsp;</p> </div> </div> </div> </p> <p><a href="http://conorato.posterous.com/nearly-40-percent-of-europeans-suffer-mental">Permalink</a> | <a href="http://conorato.posterous.com/nearly-40-percent-of-europeans-suffer-mental#comment">Leave a comment&nbsp;&nbsp;&raquo;</a> </p><img src="http://feeds.feedburner.com/~r/ConoratosPosterous/~4/kofJCZ_HI9Q" height="1" width="1"/> http://files.posterous.com/user_profile_pics/1469342/picture_721.JPG http://posterous.com/users/37lAtgC4aXqV Conor McKechnie Conorato Conor McKechnie http://conorato.posterous.com/nearly-40-percent-of-europeans-suffer-mental Thu, 01 Sep 2011 01:40:00 -0700 http://feedproxy.google.com/~r/ConoratosPosterous/~3/mhzI2hBL6Qs/doctorsmissed-39-chances-to-diagnose-tumour-e http://conorato.posterous.com/doctorsmissed-39-chances-to-diagnose-tumour-e <p> <div class="posterous_bookmarklet_entry"> <div class='p_embed p_image_embed'> <img alt="Media_httpidailymailc_jfplx" height="423" src="http://posterous.com/getfile/files.posterous.com/conorato/ekuwGBucwurlhBrvuCpfAoeCnIcvahrcahergFAfivqlvnayGndGwDelbggc/media_httpidailymailc_JFplx.jpg.scaled500.jpg" width="233" /> </div> <div class="posterous_quote_citation">via <a href="http://www.dailymail.co.uk/health/article-2032108/Doctors-apologise-missed-39-chances-diagnose-tumour-killed-pensioner.html">dailymail.co.uk</a></div> <p>I would not usually share from the Daily Mail - I am not a great fan of the paper, despite the insight it gives you into the mores of middle-England. </p><p>But this story claiming "Doctors ... missed 39 chances to diagnose [a] tumour" - highlights that the improved practice of early diagnosis across the health service, particularly in primary care, is not just about numbers, stats and cost savings - it's personal. </p><p>These are stories of mothers, brothers, fathers, sisters, daughters and sons. Our loved ones. </p><p>I have no doubt that the health professionals involved are deeply sorry and at the time were acting with the best intentions; but is it enough? I don't know the case and am not a doctor, so I can't comment particularly, but the general point it supports is: </p><p>With the tools and processes and metrics and performance targets in place to drive earlier and accurate diagnosis of disease, these types of cases could be reduced dramatically. <a href="http://bit.ly/p2pAel">http://bit.ly/p2pAel</a></p></div> </p> <p><a href="http://conorato.posterous.com/doctorsmissed-39-chances-to-diagnose-tumour-e">Permalink</a> | <a href="http://conorato.posterous.com/doctorsmissed-39-chances-to-diagnose-tumour-e#comment">Leave a comment&nbsp;&nbsp;&raquo;</a> </p><img src="http://feeds.feedburner.com/~r/ConoratosPosterous/~4/mhzI2hBL6Qs" height="1" width="1"/> http://files.posterous.com/user_profile_pics/1469342/picture_721.JPG http://posterous.com/users/37lAtgC4aXqV Conor McKechnie Conorato Conor McKechnie http://conorato.posterous.com/doctorsmissed-39-chances-to-diagnose-tumour-e Thu, 01 Sep 2011 01:30:00 -0700 http://feedproxy.google.com/~r/ConoratosPosterous/~3/-aoicLs45KM/alarmist-headline-hides-truth-more-hospitals http://conorato.posterous.com/alarmist-headline-hides-truth-more-hospitals <p> <div class="posterous_bookmarklet_entry"> <div class='p_embed p_image_embed'> <img alt="Media_httpnewsbbcimgc_hghhu" height="171" src="http://posterous.com/getfile/files.posterous.com/conorato/AGkowqkIzjwJbnAaiwxckBAhcoDeIoqheosDjcotxqriznADBFanpqjuqqgy/media_httpnewsbbcimgc_HGhHu.jpg.scaled500.jpg" width="304" /> </div> <div class="posterous_quote_citation">via <a href="http://www.bbc.co.uk/news/health-14729191">bbc.co.uk</a></div> <p>Lord Crisp is is making a very good point, albeit not necessarily the one headlined by the BBC. As the rise of chronic non-communicable disease (cancer, heart disease, diabetes, dementia) begins to bankrupt health systems around the developed world, it will not be appropriate, nor will it provide the best care, nor will we be able to afford to carry out the bulk of our healthcare in large hospitals. Healthcare in the community, in the home and in smaller clinics and health centres is going to be instrumental in reducing costs, improving quality and increasing access to healthcare. </p><p><a href="http://www.bbc.co.uk/news/health-14729191">http://www.bbc.co.uk/news/health-14729191</a></p></div> </p> <p><a href="http://conorato.posterous.com/alarmist-headline-hides-truth-more-hospitals">Permalink</a> | <a href="http://conorato.posterous.com/alarmist-headline-hides-truth-more-hospitals#comment">Leave a comment&nbsp;&nbsp;&raquo;</a> </p><img src="http://feeds.feedburner.com/~r/ConoratosPosterous/~4/-aoicLs45KM" height="1" width="1"/> http://files.posterous.com/user_profile_pics/1469342/picture_721.JPG http://posterous.com/users/37lAtgC4aXqV Conor McKechnie Conorato Conor McKechnie http://conorato.posterous.com/alarmist-headline-hides-truth-more-hospitals Tue, 30 Aug 2011 09:51:00 -0700 http://feedproxy.google.com/~r/ConoratosPosterous/~3/ZU_SLItBUoo/european-men-need-to-get-their-health-acts-to http://conorato.posterous.com/european-men-need-to-get-their-health-acts-to <p> <p> <p style="margin-bottom: 12.0pt;">I plan on being around as long as possible for my kids and any grandchildren they may choose to bestow on me...but looking at the data you would think this was an exception among men in the EU:</p> <p style="margin-bottom: 12.0pt;">"High level of premature illness and death amongst men is preventable, concludes report"</p> <p style="margin-bottom: 12.0pt;">Us men are a serious health concern for the EU, it would seem. We are less likely to get our health problems checked early and go for regular preventative health checks, and when it comes to mental health, we are less likely to seek help....says <em>The Men's Health Report</em> published last week by the European Commission.</p> <p style="margin-bottom: 12.0pt;">Over half of premature deaths in men could be avoided the reports says, and the trend in the data "can be remedied in part by targeted policies and actions."</p> <p style="margin-bottom: 12.0pt;"> <p><strong><span style="font-size: 10.0pt;">Link to the report:</span></strong><br /> <a href="http://ec.europa.eu/health/population_groups/docs/men_health_report_en.pdf"><span style="font-size: 10.0pt;">http://ec.europa.eu/health/population_groups/docs/men_health_report_en.pdf</span></a></p> </p> <p>&nbsp;</p> <p>Guys....let's take this somewhat more seriously, no?</p> </p> </p> <p><a href="http://conorato.posterous.com/european-men-need-to-get-their-health-acts-to">Permalink</a> | <a href="http://conorato.posterous.com/european-men-need-to-get-their-health-acts-to#comment">Leave a comment&nbsp;&nbsp;&raquo;</a> </p><img src="http://feeds.feedburner.com/~r/ConoratosPosterous/~4/ZU_SLItBUoo" height="1" width="1"/> http://files.posterous.com/user_profile_pics/1469342/picture_721.JPG http://posterous.com/users/37lAtgC4aXqV Conor McKechnie Conorato Conor McKechnie http://conorato.posterous.com/european-men-need-to-get-their-health-acts-to Wed, 27 Jul 2011 08:19:00 -0700 http://feedproxy.google.com/~r/ConoratosPosterous/~3/AqQx2jSe80E/why-we-find-it-so-difficult-to-take-responsib http://conorato.posterous.com/why-we-find-it-so-difficult-to-take-responsib <p> <p>Thinking about this question - why people find it so difficult to take responsibility for their health - polarizes my thinking from one extreme to the other and back on a regular basis. on the one hand, I believe in the freedom of the individual to shape their own lives; on the other hand I believe we have a responsibility towards each other and t<span style="font-size: small;">o society as a whole. </span></p> <p>&nbsp;</p> <p><span style="font-size: small;">Case in point (<span style="color: #3f3f3f; font-family: helvetica, arial, sans-serif; line-height: 18px;">bearing in mind I live in a country with a single-payor socialized health system, and very good it is too</span>:</span></p> <p><span style="font-size: medium;"><span style="font-size: small;">Last week, my father had a successful heart bypass operation after a series of heart attacks</span> (</span><a href="http://kmckeck.posterous.com/undercovers-22">http://kmckeck.posterous.com/undercovers-22</a>) caused by severe coronary artery disease. He never smoked. He is far fitter than the average 68 year-old, cycling upwards of 100 miles/week. He eats a largely fish/vegetarian diet out of preference, has been very active all his life, and drinks in moderation, and he has been very proactive over the last 15 years in managing his health. Yet genetics through him a curve ball, despite this, and the UK's NHS has just spent ca. USD 20,000 re-doing the plumbing around his heart.</p> <p>&nbsp;</p> <p>Outside the hospital when I visited stood, an army of smokers, many of them far from their ideal BMI, many of them on drips, some in wheelchairs...and I thought "Really? Should the NHS be paying for this? Their irresponsibility is causing an unnecessary drain on health resources, " I ranted at my brother.</p> <p>&nbsp;</p> <p>At which point he (who is actually rather clever, and also works in health), pointed out: "Where do you draw the line? Do you refuse to treat drivers who crash their cars driving over the speed limit?" This caused a a collapse of moral reasoning. All I know, is that I don&rsquo;t know.</p> <p>&nbsp;</p> <p>So how does the payor (state or insurance company) encourage better health behaviours? I don't think there is one answer - I think there are many, and they are likely different for everyone - what would make you look after your health the way you should?</p> </p> <p><a href="http://conorato.posterous.com/why-we-find-it-so-difficult-to-take-responsib">Permalink</a> | <a href="http://conorato.posterous.com/why-we-find-it-so-difficult-to-take-responsib#comment">Leave a comment&nbsp;&nbsp;&raquo;</a> </p><img src="http://feeds.feedburner.com/~r/ConoratosPosterous/~4/AqQx2jSe80E" height="1" width="1"/> http://conorato.posterous.com/why-we-find-it-so-difficult-to-take-responsib Tue, 26 Jul 2011 09:11:00 -0700 http://feedproxy.google.com/~r/ConoratosPosterous/~3/zGwR569jtc8/we-lose-focus-on-early-diagnosis-at-our-peril http://conorato.posterous.com/we-lose-focus-on-early-diagnosis-at-our-peril <p> <div class="posterous_bookmarklet_entry"> <blockquote class="posterous_long_quote"><div class="leftHeading"><span class="headlineTitle">GE Healthcare warns UK MPs: We lose focus on early diagnosis at our peril </span> </div> <div class="leftHeading"> <span class="italicText"><i> Today </i> </span> </div> <div class="leftHeading"> <span class="italicText"><i> Ashley Yeo </i> </span> </div> <p> </p><div class="leftHeading marginTop10"> <p>The NHS reform in England wends its way ever onwards. The “pause” is well in the background and the NHS Future Forum has delivered its verdict, but there is much more debate to come before Royal assent is granted to the troubled Health and Social Care Bill. </p> <p>Ever present is the need for the NHS to make £20bn worth of savings, while maintaining clinical quality at a time of rising demand for healthcare. Patient outcomes and savings over the long term have risked becoming buried in the rhetoric and, some would say, over-politicisation of the public health service in England. </p> <p>Among the themes that need more, not less, focus is the value of early diagnosis of disease. GE Healthcare, a long-time strong advocate of the concept ( <a href="http://www.clinica.co.uk/home/news/GE-Healthcare-UK-interview-I-Using-the-early-health-model-to-transform-healthcare-delivery-192444?autnID=/contentstore/clinica/newsletterarchive/C00960976.xml" target="_new">www.clinica.co.uk</a>, 15 June 2007) has decided that matters cannot be left to drift.</p> <p>Global public affairs head at GE Healthcare Conor McKechnie tells <i>Clinica</i>: “Despite conclusive evidence proving early diagnosis to be cost effective, better for patient outcomes and the finances of the NHS, the uptake of improved clinical pathways focused on early diagnosis is proving slow and inconsistent.”</p> <p>With that in mind, the UK-based life sciences and diagnostics systems provider this month wrote a letter to English MPs to encourage them to actively support the implementation of early diagnosis in disease pathways in the NHS. This initiative was received positively. A longer version of the letter was sent to MPs on the health select committee.</p> <p>In aims to keep decision-makers focused at a time when there are many other issues competing for their attention, GE’s letter was accompanied by a seven-page briefing on early diagnosis by Karen Taylor OBE, formerly the director of health value for money studies at the UK’s National Audit Office. </p> <p>Ms Taylor, no longer with the NAO and now acting as an independent healthcare analyst, wrote that the NHS reforms, and in particular, the proposed changes to commissioning, have engendered a degree of inertia that threatens to undermine the implementation of important changes to NHS clinical care pathways. A key requirement in many of the pathways is the need for earlier diagnosis.</p> <p>Regardless of where responsibility for commissioning of services lies, early and accurate diagnosis can make an enormous difference. “But all too often, diagnosis is late and the interventions and treatment needed are consequently more aggressive, more costly and have poorer outcomes,” she writes.</p> <p>Early detection relies on use of advanced technologies to, say, pick up tumours much earlier and deliver more targeted treatment; detect cardiovascular disease before it has progressed too far; and image the brains of suspected stroke victims rapidly for as early treatment with thrombolytic drugs. The UK’s comparatively slow adoption of new technologies and treatment pathways means outcomes are often inferior to those elsewhere. </p> <p>“If the reformed NHS is to deliver improved patient care with improved outcomes, there needs to be investment in early diagnostic tools underpinned by modern IT systems,” says Ms Taylor. She stresses that investment in earlier diagnosis not only improves health outcomes but is more cost-effective. “The longer the NHS prevaricates, the greater the number of people that will be diagnosed late and the poorer their outcomes.”</p> <p>The paper includes costed case studies on cancer, rheumatoid arthritis, dementia, stroke and CHD. GE acknowledges that in many cases its initiative is preaching to the converted, but part of the aim of its current initiative is to raise awareness once more and keep it high. NHS managers have a tough task, now made tougher by having to reduce costs while keeping quality high.</p> <p>GE is seeking to pull together a formal group that includes a number of different players, including patients and the pharma industry, “generally those who are interested in outcomes and health economics” and address what can be done in the UK to improve the uptake of consistent, proven clinical pathways. </p> <p>The message that savings will be delivered down the line for trusts that make an upfront investment might be a hard one to convey given today’s tight budgeting. GE understands that. Mr McKechnie says: “A focus on early diagnosis must be maintained for the benefit of patients and for the UK’s long-term healthcare finances.”</p></div></blockquote> <div class="posterous_quote_citation">via <a href="http://www.clinica.co.uk/marketsector/ivds/GE-Healthcare-warns-UK-MPs-We-lose-focus-on-early-diagnosis-at-our-peril-318990">clinica.co.uk</a></div> <p>I am not, however, global public affairs head at GEHC - although it is flattering to be promoted thus...</p></div> </p> <p><a href="http://conorato.posterous.com/we-lose-focus-on-early-diagnosis-at-our-peril">Permalink</a> | <a href="http://conorato.posterous.com/we-lose-focus-on-early-diagnosis-at-our-peril#comment">Leave a comment&nbsp;&nbsp;&raquo;</a> </p><img src="http://feeds.feedburner.com/~r/ConoratosPosterous/~4/zGwR569jtc8" height="1" width="1"/> http://files.posterous.com/user_profile_pics/1469342/picture_721.JPG http://posterous.com/users/37lAtgC4aXqV Conor McKechnie Conorato Conor McKechnie http://conorato.posterous.com/we-lose-focus-on-early-diagnosis-at-our-peril Mon, 04 Jul 2011 02:56:05 -0700 http://feedproxy.google.com/~r/ConoratosPosterous/~3/o3Zli7U4E1U/patient-takes-control-of-blogs-own-care-hcsm http://conorato.posterous.com/patient-takes-control-of-blogs-own-care-hcsm <p> <p>So my dad has had this heart attack, and he is too fit to go straight in for the quad-bypass (CABG &#8211; pronounced &#8220;cabbage&#8221; &#8211; hilarious these doctors, aren&#8217;t they?), but not fit enough to cycle 120 miles a week, as is his wont.</p><p>He&#8217;s in for the long wait&#8230;and in primary care in the UK, if you don&#8217;t manage your own care, and take it by the horns, you just sort of get left to bumble along&#8230;which is interesting, especially if you are on a bunch of drugs to keep your ticker ticking as the NHS waiting-list counts down&#8230;whose ticker can tick longest? Read his exploits taking charge of his various drug reactions here: <a href="http://kmckeck.posterous.com/undercovers-14">http://kmckeck.posterous.com/undercovers-14</a> </p> </p> <p><a href="http://conorato.posterous.com/patient-takes-control-of-blogs-own-care-hcsm">Permalink</a> | <a href="http://conorato.posterous.com/patient-takes-control-of-blogs-own-care-hcsm#comment">Leave a comment&nbsp;&nbsp;&raquo;</a> </p><img src="http://feeds.feedburner.com/~r/ConoratosPosterous/~4/o3Zli7U4E1U" height="1" width="1"/> http://conorato.posterous.com/patient-takes-control-of-blogs-own-care-hcsm