Over half of the most costly claims contain medical errors

BOSTON –– Best Doctors^®, the world’s leading expert medical consultation service, today announced the release of a report detailing the high prevalence, costs, and impact of misdiagnoses and incorrect treatment plans on injured workers. The report uses thousands of injured worker cases to conclude that over half of the most costly five percent of claims contain medical misadventures that seriously compromise the recovery prospects of injured workers and drive up claims costs.

“There is a devastating physical, emotional, and financial toll caused by a misdiagnosis,” said Dr. Lewis Levy, Chief Medical Officer at Best Doctors, and a co-author of the report. “The impact can be even more overwhelming for an injured worker who may experience prolonged disability, household financial distress, and a career in jeopardy.”

Each year, there are an estimated 250,000 serious lost-time injuries, those with over 30-days of lost time at work. The report conservatively estimates that one quarter of them involve a misdiagnosis and/or inappropriate treatment. For the five percent most expensive workers’ compensation claims, the error rate is conservatively estimated at 50 percent. They range from confusing the symptoms of ligament strain with a bulging disc, to inappropriate surgeries and harmful drug interactions.

The financial toll on claims payers is exorbitant. The report determined that the current level of losses, which nationally is about $65 billion, might be some $15 billion less if major medical errors were prevented or promptly remedied.

The report includes four concise case studies of work injuries, which pinpoint problems with medical care and their burden on the workers and claims payers. The case studies were drawn from actual injuries. The report also includes a table showing the rate of diagnostic and treatment changes that occur in American medicine today, detailed by medical specialty common to treating work injuries.

This is the first in-depth report that addresses the full scope of the problem of medical misadventures in workers’ compensation. “If we are serious about addressing both the quality and high cost of healthcare, we as responsible clinical organizations must be much more attentive to this issue,” added Dr. Levy. Best Doctors will follow up with reports on how claims professionals can take into account the risk of problems in making key claims decisions.

VIEW THE REPORT HERE

About Best Doctors, Inc.:

Founded in 1989 by Harvard Medical School physicians, Best Doctors is a medical information services company that connects individuals facing difficult medical treatment decisions with the best doctors, selected by impartial peer review in over 450 subspecialties of medicine, to review their diagnosis and treatment plans. Best Doctors has grown to over 40 million members worldwide utilizing access to the brightest minds in medicine, analytics and technology to deliver improved health outcomes while reducing costs. For further information, visit Best Doctors at www.bestdoctors.com.

To schedule an interview with Best Doctors’ Executive Team, contact Justin Joseph at Ph: 617.359.5522 or jjoseph@bestdoctors.com.

BEST DOCTORS, the STAR-IN-CROSS logo, THE REINVENTION OF RIGHT and CRITICAL CARE INTERCONSULTATION are marks or registered marks of Best Doctors, Inc. Used with permission.

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The post The Prevalence and Threat of Misdiagnosis of Injured Workers appeared first on Best Doctors.

Understanding blood pressure readings

The only way to know if you have high blood pressure it to get it checked. If your doctor does find elevated rates, it’s important to monitor your numbers. Many pharmacies have blood pressure machines for you to measure it yourself, and there are also many personal monitors available.

The top number, systolic pressure, measures the vessel pressure when your heart beats. The second, called diastolic pressure, measures when your heart rests between beats. If in hypertensive crisis, you should seek medical care immediately. The American Heart Association explains what the level of risk is for your blood pressure readings:

• Healthy – 120/80
• Prehypertension – Less than 139/89
• Hypertension stage 1 –  Less than 159/99
• Hypertension stage 2 – Over 160/100
• Hypertensive Crisis – Over 180/110

Preventing and managing high blood pressure

The most critical component of preventing high blood pressure is a healthy lifestyle. Once diagnosed, properly managing the condition reduces the risk of stroke and other serious cardiovascular disorders. Lower your risk of hypertension or complications by taking these steps:

Keep a healthy weight	Exercise at least 30 minutes a day	Eat a healthy diet, drink plenty of water and limit alcohol	Reduce and manage stress	Quit smoking

What Are My Treatment Options?

In addition to healthy habits, the Mayo Clinic explains there are a number of medications use to treat high blood pressure. Some of the treatment drugs include:

• Diuretics, sometimes called water pills, which help your kidneys eliminate sodium and water from your bloodstream.
• Beta blockers, which reduce the workload on your heart and open your blood vessels, causing your heart to beat slower and with less force.
• Angiotensin-converting enzyme (ACE) inhibitors, which can help relax blood vessels by blocking the formation of a natural chemical that narrows them.
• Calcium Channel Blockers, which restrict calcium from entering the muscle cells of your heart and blood vessels. This allows blood vessels to relax, lowering your blood pressure.
• Alpha Blockers, which reduce nerve impulses that tighten blood vessels and allow blood to flow more freely.

Because there are so many different kinds of medications, it’s vital your physician has correctly diagnosed your high blood pressure and comorbidies, and is taking all of that into account when developing an effective treatment plan. If you’re unsure, a second opinion is the best way to ensure your diagnosis and treatment are correct.

The post One-Third of Adults Have High Blood Pressure: Do You? appeared first on Best Doctors.

Teladoc to Acquire Best Doctors to Provide a Comprehensive Virtual Healthcare Delivery Platform

Acquisition gives Teladoc an international footprint and significantly
expands breadth of healthcare solutions

PURCHASE, NY, June 19, 2017 — Teladoc, Inc. (NYSE: TDOC), the nation’s first and largest telehealth platform, announced today that it has entered into a definitive agreement to acquire Best Doctors, the world’s leading expert medical consultation company focused on improving health outcomes for the most complex, critical and costly medical issues. Teladoc is creating a new paradigm for how patients access care by delivering a powerful connected care platform – a single solution for addressing a complete spectrum of medical conditions, from non-critical, episodic needs to chronic, complicated medical conditions. By leveraging the proven portfolio of healthcare solutions from both Best Doctors and Teladoc, members will have one simple, virtual, patient-centric way to resolve their healthcare issues, improving outcomes and reducing costs.

“Today is a big day for patients and the greater healthcare system. At Teladoc, our vision has always been to provide the central, trusted source for consumers to find resolution to the broadest array of healthcare needs, on their terms,” said Teladoc CEO, Jason Gorevic. “Now with Best Doctors’ network of world-renowned experts in over 450 specialties, global footprint, and exceptional analytic capabilities, we are taking a monumental step towards making that vision a reality.”

Best Doctors has redefined the standard for addressing high acuity, complex care cases with a patient-centric clinical model proven to drive better outcomes for hundreds of the most high-cost medical conditions. Using advancements in analytics, cognitive computing, and an award-winning patient-centric process, the company brings the brightest minds in medicine to provide answers to the most complex medical concerns for their millions of members. The Best Doctors global network consists of 50,000+ medical experts who are peer-rated in a Gallup-certified poll as the top 5% of physicians in more than 450 medical specialties. In every major region of the world, the suite of Best Doctors solutions plays an important role in population health management, with the ability to monitor, react and positively affect change.

“By combining data and analytics with a focus on nothing but the highest standard for care, we’ve successfully created a better way for patients and their families across the globe to get resolution to the most life-changing medical conditions,” said Best Doctors CEO, Peter McClennen, who will continue to lead Best Doctors as president of the new division of Teladoc. “Now aligned as one greater organization under Teladoc, the impact we can make together is tremendous, delivering a paradigm shift in care access that comes with a phenomenal patient experience, unprecedented outcomes and cost savings.”

This acquisition builds on Teladoc’s successful track record of acquiring and integrating companies with common purpose, complementary capabilities, and access to new markets.

Teladoc will marry its award-winning technology, industry-leading engagement capabilities, and robust, scalable platform with Best Doctors’ world-renowned network of medical experts, analytics expertise, patient decision-support, and regional expertise on a global scale. The newly combined company offers a highly differentiated suite of virtual care delivery solutions for a broad range of market segments, spanning the full spectrum of employers to health plans and health systems. Furthermore, Teladoc will now develop and deploy global expansion plans, meeting a broader spectrum of care needs outside the U.S.

Additional Information

• Hear Teladoc CEO Jason Gorevic’s vision for the combined company here.
• Learn more about the announcement here.

Transaction Summary
This transaction is expected to close in July 2017 subject to regulatory approvals and customary closing conditions. Under the terms of the agreement, the purchase price consists of $375 million cash and $65 million of Teladoc common stock. Teladoc has secured committed financing from Jefferies Finance LLC and Jefferies Group LLC for $360 million, which combined with the company’s cash on hand, will fund the entire cash portion of the transaction. Piper Jaffray & Co. and Jefferies LLC. acted as financial advisors to Teladoc on this transaction and Latham & Watkins LLP acted as Teladoc’s legal advisor. William Blair acted as exclusive financial advisor to Best Doctors and Ropes & Gray LLP acted as Best Doctors’ legal advisor.

Financial Reporting and Business Outlook
Best Doctors generated 2016 revenue of $92.2 million, and generated $23.7 million of revenue for the first three months of 2017. Best Doctors is expected to generate in excess of $100 million in 2017 revenues. Best Doctors generated $5.6 million of net loss and approximately $6.5 million of Adjusted EBITDA in 2016 and $2.1 million of net income and $2.2 million of Adjusted EBITDA for the first three months of 2017.

– Teladoc reiterates its previously communicated second quarter 2017 guidance and commitment to achieving adjusted EBITDA break-even in the fourth quarter of 2017 independent of incremental positive contributions from Best Doctors.

– As part of its second quarter earnings report, after the expected close of this transaction, Teladoc will provide an updated full-year 2017 financial outlook and guidance for the combined company after completing valuation and related purchase accounting considerations regarding Best Doctors.

^{Note: Results from Best Doctors reported net of divested businesses. Adjusted EBITDA is a non-GAAP measure. Because Best Doctors’ calculation of this measure may differ from similar measures used by other companies, investors should be careful when comparing Best Doctors’ non-GAAP financial measures to those of other companies. A reconciliation of GAAP to non-GAAP results has been provided in this press release below under the heading “Non-GAAP Financial Measures.”}

Management Conference Call
Teladoc management will also provide additional details of the Best Doctors acquisition during a conference call today, Monday, June 19, at 5:30 p.m. Eastern Standard Time. Stockholders and interested participants may listen to a live broadcast of the conference call by dialing 877-201- 0168 or 647-788-4901 for international callers, and referencing participant code 39358429 approximately 15 minutes prior to the call. A live webcast of the conference call and supplemental presentation materials will be available on the investor relations section of the company’s website and an audio file of the call will also be archived for 90 days at ir.teladoc.com.

About Teladoc, Inc.
Teladoc, Inc. (NYSE:TDOC) is the nation’s first and largest telehealth platform. Recognized by MIT Technology Review as one of the “50 Smartest Companies,” Teladoc is forging a new healthcare experience with an innovative portfolio of virtual care delivery solutions. Currently, Teladoc serves more than 7,500 clients – from payers to providers to employers – and more than 20 million members who connect within minutes to Teladoc’s network of more than 3,100 board-certified, state-licensed physicians and therapists, 24/7. Teladoc’s services and solutions marry a highly engaging consumer experience with the latest in data & analytics, and a highly flexible technology platform. Teladoc has delivered more than 2.5 million medical visits for general medical, dermatology, counseling, psychiatry, sexual health, and tobacco cessation.

About Best Doctors
Founded in 1989 by Harvard Medical School physicians, Best Doctors is the world’s leading medical consultation company that connects individuals facing difficult diagnostic or medical treatment decisions with the best doctors, ranked by impartial peer review in over 450 subspecialties of medicine, to review their diagnosis and treatment plans. Best Doctors serves millions of members worldwide utilizing access to the brightest minds in medicine, analytics and technology to deliver improved health outcomes while reducing costs. A Best Doctors expert opinion led to a change or refinement of diagnosis in 37% of cases that the company reviewed, as well as a change or improvement of treatment plans in 75% of cases.

Media Contacts:
Courtney McLeod
Director of Public Relations, Teladoc
914-265-6789
cmcleod@teladoc.com

Maura Siefring
GCI Health for Teladoc
215-837-8450
Maura.Siefring@gcihealth.com

Investor Contact:
Jisoo Suh
Director of Investor Relations
914-265-6706
jsuh@teladoc.com

Cautionary Note Regarding Forward-Looking Statements
This press release contains “forward-looking statements” within the meaning of the safe harbor provisions of the U.S. Private Securities Litigation Reform Act of 1995 concerning Teladoc, Best Doctors, the proposed acquisition of Best Doctors and other matters. Forward-looking statements can be identified by words such as: “anticipate,” “intend,” “plan,” “believe,” “project,” “estimate,” “expect,” “may,” “should,” “will” and similar references to future periods. Examples of forward-looking statements include, among others, statements we make regarding the intended acquisition of Best Doctors, future revenues, future earnings, future numbers of members or clients, litigation outcomes, regulatory developments, market developments, new products and growth strategies, and the effects of any of the foregoing on our future results of operations or financial conditions.

Forward-looking statements are neither historical facts nor assurances of future performance. Instead, they are based only on our current beliefs, expectations and assumptions regarding the future of our business, future plans and strategies, projections, anticipated events and trends, the economy and other future conditions. Because forward-looking statements relate to the future, they are subject to inherent uncertainties, risks and changes in circumstances that are difficult to predict and many of which are outside of the control of Teladoc and Best Doctors. Our actual results and financial condition may differ materially from those indicated in the forward-looking statements. Important factors that could cause our actual results and financial condition to differ materially from those indicated in the forward-looking statements include, among others, the following: (i) risks related to the acquisition of Best Doctors, including failure to obtain applicable regulatory approvals in a timely manner or at all, integration risks, exposure to international operations and failure to achieve the anticipated benefits of the acquisition; (ii) changes in laws and regulations applicable to our business model; (iii) changes in market conditions and receptivity to our services and offerings; (iv) results of litigation; (v) the loss of one or more key clients; and (vi) changes to our abilities to recruit and retain qualified providers into our network. For a detailed discussion of the risk factors that could affect our actual results, please refer to the risk factors identified in our SEC reports, including, but not limited to our Annual Report on Form 10-K and Quarterly Reports on Form 10-Q, as filed with the Securities and Exchange Commission.

Any forward-looking statement made by us in this press release is based only on information currently available to us and speaks only as of the date on which it is made. We undertake no obligation to publicly update any forward-looking statement, whether written or oral, that may be made from time to time, whether as a result of new information, future developments or otherwise.

Non-GAAP Financial Measures
The following table reconciles Best Doctors’ net income (loss) from continuing operations, net of disposed business, to EBITDA and Adjusted EBITDA for the periods presented:

^{1 Reflects elimination of divested business net income of $1,698 and $223 for the year ended December 31, 2016 and for the three months ended March 31, 2017, respectively.
2 Reflects elimination of the divested business interest expense of $2 for the year ended December 31, 2016.
3 Reflects elimination of the divested business income tax of $289 for the year ended December 31, 2016.
4 Reflects elimination of the divested business depreciation expense of $19 for the year ended December 31, 2016.}

To supplement the financial information presented in accordance with U.S. GAAP, Best Doctors uses EBITDA and Adjusted EBITDA, which are non-U.S. GAAP financial measures, to clarify and enhance an understanding of past performance.

EBITDA consists of net income or loss from continuing operations before interest, taxes, depreciation and amortization.

Adjusted EBITDA consists of net income or loss from continuing operations before interest, taxes, depreciation and amortization, stock-based compensation expense, gain on sale of business and change in fair value of warrant liability.
Best Doctors believes that the presentation of these financial measures enhances an investor’s understanding of its financial performance, and that making such adjustments provides investors with both meaningful information to understand its results of operations and the ability to analyze financial and business trends on a period-to-period basis by excluding certain items that

Best Doctors believes are not representative of its core business. Best Doctors uses certain financial measures for business planning purposes and in measuring its performance relative to that of its competitors. Best Doctors utilizes Adjusted EBITDA as the primary measure of its performance.

Best Doctors believes both financial measures are commonly used by investors to evaluate its performance and that of its competitors. However, neither EBITDA nor Adjusted EBITDA should be considered as an alternative to net loss before taxes, net loss, loss per share or any other performance measures derived in accordance with U.S. GAAP as measures of performance. EBITDA and Adjusted EBITDA have important limitations as analytical tools and you should not consider them in isolation or as a substitute for analysis of Best Doctors’ results as reported under U.S. GAAP. Some of these limitations are that:

• EBITDA and Adjusted EBITDA do not reflect the significant interest expense on Best Doctors’ debt;
• EBITDA and Adjusted EBITDA eliminate the impact of income taxes on Best Doctors’ results of operations;
• Adjusted EBITDA does not reflect the significant non-cash stock compensation expense which should be viewed as a component of recurring operating costs;
• Adjusted EBITDA does not reflect the significant non-recurring gains on the sale of businesses; and
• Adjusted EBITDA does not reflect the significant non-recurring charge associated with the change in fair value of warrant liability.

In addition, although depreciation and amortization are non-cash charges, the assets being depreciated and amortized will often have to be replaced in the future, and both measures do not reflect any expenditures for such replacements. Other companies in Best Doctors’ industry may calculate EBITDA and Adjusted EBITDA differently, limiting the usefulness of EBITDA and Adjusted EBITDA as comparative measures.

Best Doctors compensates for these limitations by using EBITDA and Adjusted EBITDA along with other comparative tools, together with U.S. GAAP measurements, to assist in the evaluation of its operating performance. Such U.S. GAAP measurements include gross profit, net profit or loss from continuing operations and other performance measures.

In evaluating these financial measures, you should be aware that in the future Best Doctors may incur expenses similar to those eliminated in this presentation. Best Doctors’ presentation of EBITDA and Adjusted EBITDA should not be construed as an inference that Best Doctors’ future results will be unaffected by unusual or nonrecurring items.

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VIEW PRESS RELEASE AS PDF

For more information, please visit www.teladoc.com/bestdoctorsannouncement or watch the video announcement.

The post Teladoc to Acquire Best Doctors appeared first on Best Doctors.

But what happens when that cancer is misdiagnosed?

“Often it takes a fair amount of experience, as well as technology, to make the precise diagnosis,” said Dr. Leonard Zwelling of the MD Anderson Cancer Center in an interview. Researchers at Johns Hopkins found that up to 1 in 5 cancer cases are misdiagnosed or misclassified, which is why getting a second opinion on the original pathology by an expert is crucial with every cancer diagnosis.

Ashifa, a Best Doctors member, was diagnosed with metastatic squamous head and neck cancer, a very aggressive type of cancer, after her doctors found and removed a small lump on her neck. Ashifa’s oncology team at the Tom Baker Cancer Centre in Calgary provided her with an aggressive treatment plan that called for 30 rounds of chemotherapy and concurrent radiation.

She was left reeling, struggling to reconcile her cancer diagnosis with an absence of any symptoms or even a definitive origin of the cancer, even after undergoing the surgery, a tonsillectomy and 16 biopsies.

One of the most important parts in Best Doctors’ reviews of cancer cases is the retesting of the original pathology. “We recognize that is it absolutely critical always to go the primary source, always to use the primary data, because misdiagnosis can happen anywhere,” said Dr. David Harrison, the U.S. medical director at Best Doctors.

Just before Ashifa was scheduled to started treatment, she got the “magic call” from Best Doctors. After a review by both an expert oncologist at the Princess Margaret Cancer Centre and by the Best Doctors’ medical director, they found no evidence of cancer.

“Best Doctors was incredible—they were very supportive, responsive and timely. Best Doctors saved my life, Ashifa said.

The post Best Doctors Corrected Ashifa’s Cancer Misdiagnosis appeared first on Best Doctors.

The first night offered a chance for networking at the Sagamore Pendry, a newly opened boutique hotel in Fells Point, Baltimore. The attendees, executives of many prominent health care organizations, had a relaxing evening mingling with the Best Doctors team and fellow attendees.

The second day was kicked off at the CareFirst BlueCross BlueShield Headquarters by Chet Burrell, CEO and President of CareFirst, whose welcome address explained why Best Doctors was important to CareFirst, and the conversation that followed featured engaging discussions on what optimal clinical quality was and the challenges in achieving it. Among the payer and provider organizations, we found many of the challenges in managing risk and quality care were due to the shortcomings in our health care delivery system.

The Best Doctors solution is uniquely designed to mitigate these shortcomings with our comprehensive solution:

• Focusing on the right diagnosis and treatment: Diagnostic accuracy is of the utmost importance—to both professionals and patients. Each time a patient receives a misdiagnosis or delay in diagnosis, it takes a mental and financial toll. However, as Mark L. Graber, MD, founder of the Society to Improve Diagnosis in Medicine said, “Diagnosis is hard. There are 10,000 diseases and only 200 to 300 symptoms.” Second opinions are a top solution to medical error, and Best Doctors prioritizes finding the right diagnosis and right treatment with peer-identified, nationally recognized experts who provide a non-biased review of the patient’s entire medical case. This yields significant improvement in the quality of medical care and member experience.
• Facilitating physician collaboration: “Best Doctors’ offering is brilliant. It works in concert with physicians and not in opposition to them. That is key,” said Juan Davila, Former VP Health Care Quality Affordability, BlueShield CA. Top experts review each case, and Best Doctors clinicians work with treating physicians to ensure the patient gets the best care, so the patient doesn’t have to go out of network. At CareFirst, 80 percent of treating physicians characterized the Expert Consult Report findings as “useful in the management of the member.”
• Lowering excessive costs: Patients get millions of dollars’ worth of care they don’t need—sometimes at a detriment to their health. In finding the correct diagnosis and treatment, Best Doctors can contain unnecessary costs. Over our 4-year partnership with CareFirst, we’ve reviewed 1,500 cases and saved an average of $10,000 for each case, though some saw much higher savings.
• Identifying high-cost cases: Technological innovations, like predictive health analytics, are helping payers and providers, such as ACOs, PCMHs and more, get a whole picture of a patient. Best Doctors uses powerful analytics to analyze claims and pharmacy data to identify patients who may be struggling with costly or complex conditions and proactively bring this to the attention of care managers or physicians.

“When identifying and managing high-cost, highly complex patients, you have to work with multiple partners and bring both data and the experience of the providers that are taking care of the patients together to make true determinations,” said John Bulger, DO, MBA, Chief Medical Officer of Geisinger Health Plan. “Best Doctors will help us to educate our providers at understanding cues and will help us run algorithms on our data to identify the patients who will most benefit from an expert second opinion.”

Download the slides from one of our sessions, “Decreasing Cost and Improving Quality of Care in Highly Complex Cases” to learn how Best Doctors’ helps CareFirst put members at the center of their care, solving many of the issues both payers and providers face in health care delivery.

The post Health Care Execs See How Best Doctors is Solving Complex Cases appeared first on Best Doctors.

BEST DOCTORS TO SHOWCASE LEADING INNOVATIONS FOR PAYERS AND PROVIDERS TO HELP MAXIMIZE CLINICAL EFFICIENCY, CONTAIN COSTS AND IMPROVE PATIENT OUTCOMES

At America’s Health Insurance Plans (AHIP) Expo 2017, Best Doctors to lead the discussion on identifying and managing high-cost, high-complexity cases

BOSTON –– Best Doctors®, the global health company that solves the unsolvable in health care, will be showcasing some of its industry leading solutions for payers and providers at the 2017 AHIP Institute and Expo this week in Austin, Texas. As the conversation around identifying and managing high-cost, highly complex cases remains at the top of the industry’s agenda, Best Doctors will share some of its findings and results that have led to many of the nation’s most prominent payer and provider organizations choosing Best Doctors to help improve outcomes while lowering costs.

“When identifying and managing high-cost, highly complex patients, you have to work with multiple partners and bring both data and the experience of the providers that are taking care of the patients together to make true determinations,” stated John Bulger, DO, MBA, Chief Medical Officer of Geisinger Health Plan. “Best doctors will help us to educate our providers at understanding cues and will help us run algorithms on our data to identify the patients who will most benefit from an expert second opinion.”

“The nation’s leading health plans and provider organizations continue to turn to Best Doctors to help ensure the highest quality of care while containing costs,” said Peter McClennen, CEO of Best Doctors, Inc. “For each of these organizations and their millions of members, Best Doctors serves as a valuable partner in the proactive fight to manage complex cases before incorrect diagnoses and unnecessary treatment plans lead to physical and emotional distress, as well as avoidable financial issues.”

Best Doctors works collaboratively with primary care physicians to manage these high-cost, high-complexity cases. Three key factors differentiate the solutions offered by Best Doctors.

• Best Doctors possesses an operational culture of clinical excellence and rigor to solve each member’s challenge. Using the highest levels of medical intelligence, data synthesis, and clinical collaboration, Best Doctors is able to bridge gaps that often occur in highly complex cases.
• Through its technology-enabled services, Best Doctors offers indisputable, validated and repeatable ROI. With its emphasis on proactive risk identification, the Company is able to help its partners identify and then manage potentially high-cost cases.
• A 28-year history of driving health care change and developing relationships that mitigate data fragmentation, time constraints, bias-based incentives and barriers to data synthesis.

In its highly anticipated study rating population health management providers, KLAS Research rated Best Doctors among the highest ranked for its data tools, service and overall performance. In addition to its state-of-the-art analytics tools, Best Doctors is world-renowned for its ability to combat medical uncertainty and misdiagnosis. The company, which works with the top 5% of physicians in over 450 subspecialties of medicine, uses a unique process to bring together the brightest minds in medicine, cutting-edge technology and analytics to help members navigate increasingly complex health care systems around the world.

About Best Doctors, Inc.:
Founded in 1989 by Harvard Medical School physicians, Best Doctors is a medical information services company that connects individuals facing difficult medical treatment decisions with the best doctors, ranked by impartial peer review in over 450 subspecialties of medicine, to review their diagnosis and treatment plans. Best Doctors has grown to over 40 million members worldwide utilizing access to the brightest minds in medicine, analytics and technology to deliver improved health outcomes while reducing costs. For further information, visit Best Doctors at www.bestdoctors.com.

To schedule an interview with a member of the Best Doctors Executive Team, contact Justin Joseph at Ph: 617.359.5522 or jjoseph@bestdoctors.com.

Best Doctors and the star-in-cross logo are trademarks of Best Doctors, Inc., in the United States and in other countries, and are used under license.

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Why Diagnostic Errors Happen

The causes of misdiagnoses are numerous and complex, involving both human error and systems issues. Near the top of the list is the U.S. health care system’s decentralized nature. It is not uncommon for a patient to have multiple medical professionals in different settings delivering uncoordinated care and communicating inadequately.

Additionally, a case is likely to have many medical records scattered across multiple sites. One survey estimated the average patient’s health is dependent on 200 or more pieces of paper in 19 different locations, and each single patient visit generates 13 pieces of paper. For complex cases, the thousands of related documents could be in even more different locations.

This lack of coordination can’t help but result in fragmented medical information, with no single practitioner having a full clinical picture. Therefore, it is easier for things to go wrong. For example, the heart patient cited earlier is even more susceptible to error if the clinicians involved in his case aren’t sharing all of the information or coordinating care.

Time compression also contributes to misdiagnosis. In general, doctors are only able to spend 13 to 16 minutes with each patient. Yet, the Annals of Family Medicine found the average primary care physician would need to spend almost 22 hours a day to provide all of the recommended acute, chronic and preventative care for a panel of 2,500 patients (the average U.S. panel is 2,300). These pressures leave little time for synthesizing patient information.

The increasing complexity of medical care doesn’t help either. In the last few decades, we have witnessed a profusion of medical and clinical advancements, from genomics to biologics. Digesting and optimizing this data explosion is no easy task. Patients in urban areas with academic medical centers or tertiary care hospitals may be able to access the latest advances in medicine, but others are often limited by geographic, cultural, behavioral or financial obstacles.

The Need for Changes Large and Small

The HMD’s Improving Diagnosis report proposes a number of solutions that can mitigate the pervasive problem of misdiagnosis, including:

• Facilitating more effective teamwork among health care professionals, patients and families
• Infiltrating education, training and technology with a commitment to diagnostic accuracy
• Adopting nonpunitive policies and practices
• Redesigning processes, communication methods and work systems
• Developing ways to identify and learn from errors

While improvements in several diagnostic-related areas are already in place or underway, many of the suggested changes are costly and require a great amount of time. Therefore, they are most likely to occur and evolve over the long term. Yet, misdiagnosis is an urgent issue that requires immediate action. Solutions that do not require a total transformation of delivery systems must be implemented.

The Value of an Additional Perspective

As diagnostic accuracy gains more attention, a growing number of strategies and systems are being implemented to address the problem. In addition to electronic medical records, these measures include data analysis, point-of-care technologies, health plan redesign, independent second opinions and other advances.

Second opinions, in particular, have been cited as a Top 10 solution for reducing diagnostic error by the National Patient Safety Foundation, the Cautious Patient Foundation and the Society to Improve Diagnosis in Medicine. Organizations that make second opinions readily available – most notably in cases involving surgery, critical care and chronic conditions – position themselves to more rapidly achieve goals such as the quality, cost and member experience goals of the Triple Aim.

As a complement to traditional second opinions, some employers and health plans offer remote second opinions, which do not require travel or in-person doctor visits. These services can avert harmful testing and treatment, decrease absenteeism, promote employee/member retention and ultimately save lives.

The post Combating the Impact of Diagnostic Error appeared first on Best Doctors.

People can wear all kinds of different hats: employee, spouse, parent, friend, advisor and, in many cases, caregiver. More than one in six U.S. employees has, in effect, a secondary job as a caregiver for a relative. A growing elderly population means, the number of employees who are caregivers is only going to increase. As pointed out in an article in Employee Benefit News, this raises the stakes for employers when it comes to supporting these employees who are also caregivers.

The challenge facing employees and employers

When you consider the time and energy that employees have to dedicate to caregiving it’s easy to see how an employee’s performance at work can be impacted. On average, employees spend four years in the role of caregiver while providing 24 hours of assistance per week. As a result, caregivers miss six to seven extra days of work each year and, on top of missed time, cost about 8% more (13.4 billion per year) in healthcare spend.

Adding to the challenge is the fact that addressing the issue of caregiving can be difficult because most employees don’t even think of themselves as caregivers. Rather, they see the assistance they provide as “just doing what’s necessary”. Only 56% of employees report that their work supervisor is aware of their caregiving responsibilities.

Continue Reading

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Increasing Needs appeared first on Best Doctors.

“We argue diabetes is responsible for 12 percent of deaths in the U.S., rather than 3.3 percent that death certificates indicate,” Andrew Stokes, assistant professor of global health at the Boston University School of Public Health and lead study author, said in an interview.

What is diabetes?

In type 1 diabetes, the immune system destroys insulin-producing cells in the pancreas, making the body unable to produce enough insulin to process sugar. There is no clear cause for type 1 diabetes, and those with it are usually diagnosed before 40—most commonly in children. Type 2 diabetes, caused by genetics and lifestyle factors, occurs when the body can’t use the insulin it produces. Type 2 is by far the most common, affecting 95 percent of those with the disease.

Prediabetes, while less serious, is also dangerous. In people with prediabetes, their blood sugar is higher than normal, and without any lifestyle changes, they are likely to develop diabetes. Though these conditions collectively affect 1 in 3 people, most don’t know they have it. In fact, 25 percent of people with diabetes go undiagnosed, and that number jumps to 90 percent for prediabetes.

Prevention is the best cure

There is no cure for diabetes, and therefore, preventing it is so important.
Reduce your risk for type 2 diabetes by:

• Exercising for at least 30 minutes a day.
• Eating a balanced diet and limiting fats and sugars.
• Keeping a healthy weight.
• Maintaining healthy cholesterol and blood pressure levels.
• Quitting tobacco use.
• Partnering with your physician if you think you may be at risk.

If you’ve already been diagnosed, it’s crucial keep a healthy diet, exercise and work with your doctor. If not managed properly, these conditions can cause a variety of serious complications, including blindness,
kidney failure, heart disease, stroke and loss of toes, feet or legs. Women with diabetes, in particular, are
prone to heart disease.

Changing a national conversation

The study used findings from two national surveys to look at patient-reported diabetes and average blood sugar (A1C) levels. Researchers compared the death rates of those who participated to the information on their death certificates, looking at the complications of diabetes throughout their lives and whether or not the complications eventually had a cause in their deaths. Additionally, they found that over a five-year period, diabetics had a 90 percent higher mortality rate than those without it.

“These findings point to an urgent need for strategies to prevent diabetes in the general population. For those already affected, they highlight the importance of timely diagnosis and aggressive management to prevent complications, such as coronary heart disease, stroke and lower-extremity amputations,” Stokes said. “We hope a fuller understanding of the burden of disease associated with diabetes will influence public authorities in their messaging, funding and policy decisions, such as taxation of sugar-sweetened beverages and use of subsidies to make healthy foods more accessible.”

And reducing the instances of diabetes won’t only benefit our health. Annually, the U.S. spends $250 billion in medical costs and lost wages, which puts a financial burden on top of those already dealing with a major health issue. It can also affect work productivity and employee engagement. Because of these severe medical and financial consequences, it’s paramount that those with diabetes or prediabetes are correctly diagnosed, as well as correctly treating and managing their conditions.

The post Is Diabetes the Third-Leading Cause of Death? appeared first on Best Doctors.

When you emerge from a consultation with your doctor, there is a 10 per cent chance the diagnosis you just received is incorrect, according to a leading international advocate for patient safety.

“Diagnosis can be a challenge when you consider there are 10,000 diseases but only 200 to 300 symptoms, “says Dr Mark Graber, president of the Society to Improve Diagnosis in Medicine, on the eve of the first Australasian Diagnostic Error in Medicine Conference which begins in Melbourne today.

“If you are given a diagnosis with serious treatment implications or you are not responding the way you should to medication, a second opinion could save your life. Fresh eyes catch mistakes.”

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