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Recycling medications, ending substandard care in prisons, and how user-centric design can improve health care

May 28, 2015

In order to bring you more of the news you want to read, RightCare Weekly summarizes and interprets three important articles and provides headlines linking to the many other articles and editorials you’ll find interesting. As always, RightCare Weekly presents articles related to moving our health care system toward the right care for all patients.

Join the conversation: Post your comments in our new section at the bottom of this page.

 

Features:

Medicine recycling in the United States may seem like a no-brainer, especially given a report that finds some 50 million people failed to have their prescriptions filled in 2012 because of costs. Once a prescription is filled but not picked up, it must be discarded. Billions of dollars in drugs from pharmacies and samples from doctors’ offices are going up in smoke, while patients do without needed medications. However, two forward-thinking programs are now rescuing unused drugs and are diverting them to those in need, like veterans and others who cannot afford them. In Forbes, Rawn Shah features PharmaCares, a nonprofit that collects and donates unused pharmaceuticals. And in Tulsa County, OK, the social services department is doing the same, as noted in NPR. There, dozens of retired physicians are collecting unused drugs from long-term care facilities and transporting them to a designated pharmacy, which in turn, dispenses them free of charge to the poor. In existence for more than 10 years, the program has filled more than 100,000 prescriptions valued at $16.8 million. A national effort mirroring these efforts could improve Americans’ health, while saving (even more) billions that could be put to better use.

 

A new report from Illinois offers a reminder that medical care in American prisons is often appallingly inadequate. Illinois prisons failed to provide competent medical care, adequate nursing, and even basic hygiene for inmates with serious medical needs; similar problems have been found in jails and prisons in LouisianaNew York, and other states, especially in caring for the mentally ill. Offering compassionate end-of-life care is also a challenge in the prison environment. At a minimum, the medical profession must stand for prisoners’ right to adequate health care at all times during their sentences. But ending mass incarceration may be a more powerful way to improve community health, since current incarceration policies are expensive and often unproductive, diverting public resources away from other policies that could improve health. Incarceration also tends to undermine former prisoners’ ability to support themselves and stay involved in their communities after being released.

 

In a Vox piece, Melinda Gates writes about why human-centered design, or user-centric design, is imperative in improving global health. At the most basic level, she says, design should begin with listening to the needs of the user, not the designer assuming he or she knows what the user wants. Gates cites examples of the good-hearted global health community providing condoms to women in African nations. However, many women complained that their partners wouldn’t use them. By engaging the user ahead of time, she argues, aids would have known that the women’s preference was injectable birth control, which lasts longer and is invisible. A user-centric design like this protects not only the health of the women, but also allows spacing between pregnancies, if desired. “When we better understand the realities of these women’s lives, we are able to design and deliver solutions that are more useful to them.” Health care delivery systems should take notice of user-centric models, as noted in a Mayo Clinic blog, written by Andy DeLao. He advocates for systems to design more opportunities for clinicians to connect with patients—instead of focusing on acquiring fancier creature comforts that they believe will allure patients. “Start designing a health care that allows us to connect. A system that rewards building relationships proactively,” he says.

 

Announcements:

  • Save the Date: Tuesday, June 2, 12 – 1 PM Eastern Time, join us for our second webinar to learn about implementing a RightCare Rounds at your institution. Our presenters are David Bor, MDBrandon Combs, MD, FACP and Hyung (Harry) Cho, MD.  Learn more and register.

 

  • The Lown Institute is accepting applications from incoming chief residents for the new RightCare Educator Program. Help shape a more rational medical culture by implementing RightCare Rounds in your institution. Deadline for applications is Tuesday, June 30. A small stipend will be provided. For more information, see here.

 

Headlines: 

Evidence-based medicine

 

Medical education

 

Hospital market power and productivity

 

Palliative care

 

King v. Burwell

 

Patient-centered care

 

Primary care

 

Elder care

 

Public health

 

Payment system

 

Patient safety

 

Overuse

 

RightCare Weekly is made possible through the generous support of the Robert Wood Johnson Foundation.