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Compliance Corner – News Round Up

July 27th, 2017 by Sharon L Nelson, MSN, RN, CNS, CIP, Executive Director, Consulting and Compliance Services

From the powerful computers we carry around in our pockets to self-driving cars and big data breakthroughs, it’s clear that what was once considered “future” is now everyday reality. This month, we’re interested in how we as humans are shaping our futures. The future is now—what are we doing about it?

In the research world, we work in possibilities and potentials, examining promising therapies for new and better ways to improve human health. Over on the clinical care side, the future of the systems for delivering care and treatment to patients continues to be a source of debate and dilemma in the U.S. In the NEJM Perspective article From Last to First – Could the U.S. Health Care System Become the Best in the World?, authors Eric Schneider and David Squires call attention to the performance of the U.S. healthcare system, noting that “despite offering some of the most specialized, technically advanced treatments in the world, U.S. health care fails to achieve the level of performance of the health care systems of other high-income countries.”

Identifying a pathway to the best performing healthcare system say Schneider and Squires, necessitates consideration and coordinated effort to address the challenges currently facing the U.S. system:

  1. Lack of access to health care: Declaring that “affordable and comprehensive insurance coverage is fundamental,” Schneider and Squires remind us that lack of insurance and delayed care contribute to serious health problems.
  2. Underinvestment in primary care: Other high-income countries dedicate a greater percentage of the countries’ professional workforce to primary care versus speciality care.
  3. Administrative inefficiency: “Coping with the byzantine layers of administration” – documentation of insurance coverage, benefits, services, payment, reimbursement – contributes to provider burnout and reduced quality of care. Patients must also try to manage confusing explanations of benefit, bills, and copayment.
  4. Pervasiveness of disparities in the delivery of care: Resources dedicated to a social safety net (for example, support for housing, education, nutrition and transportation), “may reduce the demand for emergency, hospital and long-term care services.”

In research, it seems we’re seeing the benefits of collaboration almost daily. Perhaps collaboration is the key here as well: by acknowledging these issues and working together to solve them, regulators, payers, providers and patients could create truly meaningful improvements to the future health of all Americans.

 


 

In her article In a Lab Pushing the Boundaries of Biology, an Embedded Ethicist Keeps Scientists in Check, Sharon Begley profiles the fascinating work of Dr. Jeantine Lunshof, philosopher/bioethicist and Assistant Professor at the Department of Genetics, University Medical Center Groningen, The Netherlands. Lunshof, embedded in the synthetic biology lab, raises and fields “good questions,” those that may seem to come out of futuristic science fiction: “What is the moral status of a primordial human brain nourished with a rudimentary heart and circulatory system, all inside a mouse scaffold? Can it feel pain? Should it not be created in the first place?”

Her Boston colleagues say Lunshof “performs a service in making them slow down to where the rest of the world is,” keeping societal concerns in focus and helping to avoid stumbles as science moves ever more quickly ahead. In addition to supporting the Department of Genetics, Lunshof’s work has helped her develop new ideas about bioethics, “

giving her field and the world outside the lab a fighting chance to keep up.”

Read more about Lunshof’s collaboration on the Personal Genome Project – the exploration of the concepts of anonymity and confidentiality, the development of the “open consent,” and her approach to balancing core values and ethical dilemmas in the exploration and application of CRISPR genome-editing technology.

 


 

For some more thoughts on our collective present and future, check out the podcast interview with one of our favorite writers and researchers Atul Guwande. He talks with Tyler Cowen about health, healthcare policy, CRISPR, and artificial intelligence.