Grand Rounds Meaningful Use of ACO edition

Welcome to the latest edition of the Grand Rounds blog carnival, the weekly roundup of medical blog posts!The Blog That Ate Manhattan kicks us off with the Meaningful Use Song, surely the most antic entry I've ever hosted. Can't beat the zippy refrain "I am the model user of an EMR that's meaningful."[youtube=http://www.youtube.com/watch?v=tIOxpaOtoMI&w=501&h=306]CMS issued the final rule on Accountable Care Organizations last month, and several bloggers issued their own posts in response. What struck me was their diversity of views on what this all means:

• On one end of the spectrum HealthBlawg compares ACO regs to the camel with its nose under the tent: "the disruptive innovation that is intended to set the rest of the system off-kilter until it reaches a new status quo on the other side of the Triple Aim"
• At the other end, ACP Hospitalist reports that the MGMA's expert on ACOs opines that the new rule "Doesn't look like it's going to affect us right now."
• Somewhere in the middle come Highlight Health, "If patients show they like this new system, we could see a fundamental change in the American healthcare system" and InsureBlog, "As a medical practice manager, my main concern is still “How do I get paid?""

GlassHospital's answer to InsureBlog's question on how to run an efficient practice and make money in a capitated environment: act like an orthodontist. "I was overwhelmed by the efficiency of it all, the professional nature of the encounter(s), and my daughter entering a rite of passage (and how brave she was!) in no particular order."This being Grand Rounds (as opposed to the Health Wonk Review) we have some submissions on the practice of medicine and doctor/patient interactions:

• ACP Internist reports that "Providing information on death to cancer patients... is associated with improved care and to increase the likelihood of fulfilling the principles of a good death." At least in Sweden.
• Scepticemia (cool blog name by the way) ticks off some pet peeves about what doctors do, including: antibiotics for sore throat, needlessly prescribing pricey drugs, pumping saline into ER patients and doing knee surgery.
• Medaholic asks whether better use of the physical exam could save the system money. The blogger seems to think the answer is yes.

There were more than the usual number of posts related in one way or another to thinking:

• Will Meek, PhD celebrates the arrival of a new book by Daniel Kahneman with insights on two information processing systems: intuition and reasoning.
• Behaviorism and Mental Health explains two ways of looking at human activity: behaviorism and sin. "My primary objection to the notion of sin, however, is that it undermines human dignity and value."
• Laika's MedLibLog reviews research on evidence based point of care summaries.

On the patient empowerment front we have:

• Medical Lessons, who's none too pleased with recent anti-mammogram rhetoric. "Mam­mog­raphy may be the best way for middle-​​aged women to avoid the debil­i­tating and lethal effects of late-​​stage disease."
• DiabetesMine reminds us that November is National Diabetes Awareness Month and November 14 is World Diabetes Day
• DrPullen.com asks "What vitamins should I take?" and answers, "Most people who have a reasonably healthy diet are best taking no vitamins at all."

And finally, Supporting Safer Healthcare offers perspectives from the stone age of medical blogging. "Medical blogging in the early days was a heady experience.  The number of medical bloggers was small, and we often found ourselves connecting through shared interests and through Grand Rounds, a weekly collection of medical posts started that same year by Nick Genes, MD, of Blogborygmi.com."The Health Business Blog began around that time and first hosted Grand Rounds on June 27, 2005.That's it for now! Better Health hosts next week.