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You are here: Home / Home medical tests and health monitors: trendy but truly useful?

Home medical tests and health monitors: trendy but truly useful?

Oh, there’s no place like home — for medical testing and health monitoring these days.

The coronavirus pandemic has intensified interest in this growing area of health care. People spit into tiny tubes, clamp monitors onto their fingertips, swab the inside of their cheeks, and use all manner of devices with impressive electronic displays. 

But just because we can DIY for an array of measurements about our well-being, should we?

Maybe. And maybe not — for important medical, financial, and privacy reasons.

Sure, corporations may tell us that home exams and monitoring devices are fast, easy, discreet, and convenient — they almost make it all sound, well, fun. Let’s test the field and ensure the last laugh isn’t on you ….

Home medical tests and health monitors are trendy now. How useful are they?

Who likes going to a doctor’s office? You get to fight traffic, hunt for parking, and hang around in a waiting room with a bunch of people who might be contagious. No thanks!  But is that reason enough to fuel what could be big changes in the $25-billion market in medical testing, pushing more business to  direct-to-consumer, home medical screenings and monitoring devices?

A growing number of companies, aided by rapid advances in technology, think they can cash in.

The often-mentioned enterprises, with their varied approaches, include Everlywell, LetsGetChecked, myLab Box, and Truepill, as well as the big two in gene screens, Ancestry and 23andMe.

This list does not include outfits that have targeted products, including screens for specific diseases or treatments, or that offer tests and drugs for sexual function or reproductive health.

Testing companies, whose products are popping up on drug store shelves (alongside pharmacies’ own offerings) and through huge online retailers, are increasingly advertising, on the air and online. Everlywell got a publicity boost when its CEO pitched her company for investment funding on the popular TV show “Shark Tank” (see photo above).

The promoters of genetic testing, in the meantime, already have made major inroads with consumers, promising insights about not only customers’ ancestry but also their health and well-being.

One firm, for example, promises, as the Harvard Health Letter reported, to tell you if you have genetic “markers associated with an increased risk for developing Parkinson’s disease, late-onset Alzheimer’s disease, celiac disease (an autoimmune disorder triggered by the protein gluten in wheat, barley, and rye), and other disorders such as G6PD (a red blood cell condition), hereditary hemochromatosis (an iron overload disorder), and hereditary thrombophilia (a blood clot disorder).”

A fast-increasing array of options

Patients, of course, have determined — seemingly forever — if they are pregnant with home tests. They are growing accustomed to possibly passing by invasive colonoscopies for screening kits they can use in their houses. Consumers now confront pitches from other companies for an array of DIY products to learn if they have contracted sexually transmitted infections (especially HIV-AIDS), Lyme disease, and the coronavirus. They can check their cholesterol, blood sugar, and testosterone levels. They can find out if they may have vitamin deficiencies. They can show they haven’t abused substances, including alcohol and several different kinds of drugs, including prescription opioids. (Drug abusers are seeking out home test strips to ensure their illicit doses are not laced with powerful and often-lethal fentanyl).

That routine battery of blood and urine tests that doctors order when patients make a preventive care visit? Look around and there likely are over-the-counter versions that consumers can do from home.

Companies will charge the willing anywhere from a few dozen to a few hundred dollars for home tests, depending on their number and complexity. That may sound cheaper than what patients get billed for screenings by doctors, clinics, and especially hospitals (which may sneak in hefty charges to cover their big overhead). But there are some twists for the pocketbook that patients can’t ignore — and which will be detailed in a second …

An abundance of measuring tools

In the meantime, poke around a pal’s bathroom (yes, even the Dalai Lama snoops this way), and you may find that health devices abound now in  many homes.

We all have become comfortable having not just thermometers but digital scanning models. Many of us, wary of missing a coronavirus infection, bought pulse oximeters that pop on a finger and measure blood oxygen levels. These gadgets fit in well with the blood pressure monitors many already had. What house doesn’t have a scale where we weigh in every morning? And how many of us have a wall marked up with our heights or those of our kids?

Many of us also have become high-tech fans, eager to buy the latest cool devices, notably wearables. Whether they are fitness trackers or watches loaded with features, these tools can tell us our heart rates and sleep patterns. They also can combine with applications or apps on other smart phones or tablets to help patients monitor their diet, weight, exercise, hydration, and smoking. With more tech added in, they can provide snappy electrocardiograms useful for patients with heart conditions such as irregular heartbeat. There’s a smartphone ultrasound device on the market, too, though its appeal now seems limited to medical personnel.

And here’s a twist: Many diabetics long have monitored their blood sugar levels with home tests — finger pricks and dip strips. Now they can get the results with a replaceable probe inserted under the skin and read from an electronic device. The set-up is known as a CGM or continuous glucose monitor. Access to the devices typically occurs only on doctors’ orders. But some non-diabetics have started to obtain the equipment (for example, from overseas vendors) and are using itas part of extreme observations of their diet and health, notably for athletic performance reasons.

It may be part of what the Wall Street Journal and other media have identified as the Quantified Self movement, with adherents tracking in minute detail a host of minute-by-minute measures of their health and well-being. Really? Are home medical testing and health monitoring just fuel for mass hypochondria or medical dilettantes?

As the saying goes: Let the buyer beware

Every medical intervention carries risks and benefits. And with home tests and monitors, it is important for consumers to consider crucial concerns like affordability, accuracy, and practicality.

Because patients struggle mightily already with health care costs, they should think hard before experimenting with testing and monitoring that is DIY and OTC (over the counter or non-prescription). Look carefully at the information that providers offer about paying for their products, and this reality may leap out at you:

Patients typically must pay for these services and devices out of their own pockets. Insurers might cover similar tests and gear — if doctors order them. But if you decide on your own to undergo an array of home screenings or to acquire nifty health-related hardware, be prepared to fork out for them — and they may not seem so cheap after all.

If you have health savings accounts, it is possible that these tax-advantaged plans may be used for your DIY testing and monitoring purchases. You will need to investigate (for example, by talking with your company’s HR folks) about this coverage. Your health insurer also may want to weigh in on who pays for OTC tests and monitoring devices, particularly because there are nuances, for example, about the cost of coronavirus testing during these pandemic times.

Before taking out your checkbook or credit card, investigate the prospective testing provider or monitoring product with rigor — and a healthy dose of skepticism.

Assessing DIY tests’ accuracy

The screening companies emphasize in their public materials the accuracy of the products, particularly that the same labs that work for doctors, clinics, and hospitals also handle their home products.

Consumers may wish to familiarize themselves with the certifications commonly cited, including the designations under the federal Clinical Laboratory Improvement Amendments or CLIA program and accreditation by the College of American Pathologists.

The federal Food and Drug Administration also oversees medical testing, broadly speaking, when it involves human blood or tissue samples, including home screenings.

As with all matters with the FDA, however, the agency has taken heavy criticism from safety and consumer advocates for failing to act as aggressively as possible to protect patients from bogus and risky DIY screenings (especially those sold directly to the public) and for its permissiveness with a booming category of screenings known as laboratory-developed tests. Critics most recently ripped the FDA for its poor and vacillating response to coronavirus tests, notably the previous administration’s decisions too often to simply wave ahead not only Covid-19 screenings but others, too. The agency does provide an online database of home tests it has approved (click here to access it).

Things can go awry

Let’s be clear about a fundamental challenge with the accuracy of medical testing and health monitoring, especially when performed by lay people at home. As Dr. Gary LeRoy, president of the American Academy of Family Physicians, told Time magazine: “A test is only as good as the specimen.”

The fastidious and the squeamish are less than ideal collectors of saliva, blood (even just a finger prick’s worth), and other bodily materials. And as LeRoy added: “With a poor sample, you’re more likely to get a false positive or a false negative.”

Patients should know that even samples and monitoring done by nurses or other trained health workers can go askew. Test results may vary, for example, depending on whether the patient adhered to instructions (for example, by fasting appropriately), or even at what time of day an individual was screened. Patients know their blood pressure may jump if they experience anxiety about a doctor’s office visit (aka “white coat hypertension”), or if they, say, ran up the stairs before slapping on a monitoring cuff. The readings may be different in the left versus the right arm. Regulators had to issue special guidance to patients who bought and were using pulse oximeters during the pandemic, warning that race, skin color, pigmentation, and tobacco use could through off the devices’ accuracy.

Experts have expressed concern about home tests and delays in their mail-in processing, particularly with the pandemic-related delays in service by the U.S. Postal Service and private carriers. Mailed samples also may be subjected to vagaries of weather (heat and cold). So far, it appears that materials stay stable and protected by packaging that providers have offered.

What to do with results?

Even before taking home medical tests or buying monitoring devices, patients, practically speaking, should think through not only why they wish to have them but also what they will do with results — especially irregular findings.

The testing companies caution clients, as has just been noted, that results can vary, and one abnormal reading may not indicate problems. Some of the companies supply doctors to results and even consider whether a given test is medically appropriate.

That might be helpful if you don’t have a primary care doctor or specialists who treat you already.

If you do, take a guess what your practitioner might do when you call to discuss your results or metrics? They likely will order a repeat the test or ask you to come in to check the measurement you got on your device. Haven’t we seen this already with women who call their obstetrician-gynecologists after that test strip turns color at home? Hasn’t this been true when patients test HIV positive or discover with home kits that they may have other sexually transmitted infections? Just say your DIY cholesterol test shows you have unusually high levels — you’re checking in with your doctor or cardiologist, right, and do you think the specialists are going to rely on a home test in guiding your treatment?

Patients already are angry at redundancies and failures in the coordination of their care. It is infuriating to take the time and trouble to get medical records from one doctor, only to show up for a consultation with another and be told to repeat screenings and procedures recently done and clearly described already in your file. How will it feel to experience this anew with home tests for which you have shelled out big money, or to see repeated a monitoring you’ve conducted at home?

Making an existing health care problem even worse?

Just a reminder: Over-testing, over-diagnosis, misdiagnosis, and over-treatment plagued U.S. medicine in pre-pandemic times. It’s a topic worthy of a whole newsletter, and concerns are rising about this issue anew as patients return to greater normalcy in their health care.

As health officials try to contain medical services’ soaring costs, they have zeroed in on excesses that already added an estimated $200 billion in unnecessary expenses to our care, with over-treatment also costing 30,000 lives a year of older (Medicare) patients alone. It isn’t taking patients’ temperatures or checking their blood pressure or getting them one or two tests that reformers assail. It is the cascade of costly, invasive, painful, and unneeded tests and procedures that follow.

Doctors, who spend decades in formal training and in direct care, should scratch their heads as to why patients may race to get their own medical information from home tests and monitoring devices and then try to interpret it. They should consider how experts struggle with misdiagnoses already, with safety advocates providing these calamitous data points delivered about the topic (before the pandemic) and from the specialists group, the Society to Improve Diagnosis in Medicine:

“§ Every nine minutes, someone in a U.S. hospital dies due to a medical diagnosis that was wrong or delayed.
§ Roughly one in 10 patients with a serious disease is initially misdiagnosed
§ Diagnostic errors affect an estimated 12 million Americans each year and likely cause more harm to patients than all other medical errors combined
§ Misdiagnoses boost health costs through unnecessary tests, malpractice claims, and costs of treating patients who were sicker than diagnosed or didn’t have the diagnosed condition. Experts recently noted in a health care online report that inaccurate diagnoses waste upwards of $100 billion annually in the U.S.”

There also is the trenchant point, as made to NPR in a discussion about the DIY trend by Dr. Gilbert Welch, author of Overdiagnosed: Making People Sick in Pursuit of Health:  “You can’t test your way to health.”

When it comes to medical screenings and tests, more isn’t always better. Early detection may not be all that helpful with some conditions and diseases, contrary to popular belief.

Patients eager to experiment with home tests and monitoring should ask themselves a few more critical questions: Do you think your existing doctor is not doing enough already to advance or protect your health, including with appropriate testing and monitoring of your well-being and sharing with you and explaining the results? If you feel you must intercede with DIY approaches, why are you staying with your current doctor at all?

Shaking up hidebound medicine could be a plus. But will key safeguards also stay?

Multiple other problems exist with the do-it-yourself testing movement. 

For a start: Scams have abounded, notably with excessive claims for screenings. As Time magazine reported:

“It can … be hard to tell which tests are legitimate, says Dr. Patrice Harris, president of the American Medical Association. Laboratory-developed tests [LDTs] — a designation for diagnostics developed and used by a single laboratory — can often be sold in the U.S. without going through the FDA premarket review process, as long as they come from laboratories that meet certain compliance criteria. Everlywell, LetsGetChecked, Carbon Health and Nurx are not listed in the FDA’s database of agency-approved at-home tests. The FDA cautions that [LDTs], despite having gotten increasingly sophisticated and accessible over time, may overpromise and under-deliver, potentially giving customers incorrect results. One infamous example is the disgraced blood-testing company Theranos, which (although not an at-home test) benefited from the ‘lab-developed test’ loophole before being exposed as a scam.”

MedPage Today, an online site that reports on science and medicine, explained further about the messiness of LDTs, as exposed in congressional inquiries:

“Five years ago, the House Energy & Commerce Committee held a hearing about LDT safety, after FDA staff highlighted 20 such tests that produced false positive and/or false negative results, or were flawed at the outset. Witnesses told the panel that LDTs were no longer a small-scale business, as they had become common for many diseases and were marketed more aggressively. Examples included a bogus genetic test for coronary heart disease using an assay to predict people’s response to statin treatments, and defective non-invasive prenatal tests where false results led to terminating healthy pregnancies. Cancer detection tests were also among the worst offenders.”

Testing companies that have become recent Wall Street darlings also have drawn sharp criticism, for example, with a major medical specialists group accusing a firm of making dubious claims as to how its home kits could help users detect a range of food allergies and deal with serious dietary issues based on substances found in their blood.

Companies have tried to blunt attacks and assist their users by improving the explanatory materials they provide and offering to work, confidentially, to link patients to doctors or genetic counselors to assist in interpreting results. But with all measures of health, a major question looms: What’s to be done with the information?

Who gets a say?

As tests become cheaper, easier, and more widely available, will loved ones and employers, to name a few potential parties of interest, demand that patients take them? Will your paramours insist that you undergo regular screens for sexually transmitted infections? Will bosses eventually overwhelm existing legal protections and insist that you regularly take tests to ensure you are not abusing alcohol or drugs? Many schools now require youngsters to provide negative coronavirus test results before attending in-person classes. Hawaii requires travelers to show similar negative results before allowing them in as tourists. These measures make sense in the midst of a lethal pandemic. What other disease-free status will we soon be required to prove?

Patients, with an eye to the future, also should worry about the confidentiality and potential exploitation of their medical information — any and all of it. Sure, companies swear up and down that they will protect your privacy. Just look, though, at how well, say, financial institutions or social media companies have safeguarded important information about you and your loved ones.

It is one thing to get new credit cards or open new accounts if financial data are breached. But what might wealthy corporations do with the comprehensive data that they accumulate from willing patients? We’ve gotten a clue from firms that have trafficked genetic tests targeted at people eager to know their family histories. Providing that information isn’t all the companies have been up to.

Hedge funds, Big Pharma, over-sharers

They also have been acquired by investment interests (aka hedge funds) or cut big money deals with Big Pharma. Companies, with smart experts’ help, can crossmatch your data, exploiting it to develop drugs and gain insights about you and your life. If corporations can find a lucrative pill that takes care of millions of heartburn cases in brown-haired folks with green eyes and a common heritage in Western Europe, they’d be happy to do so, skipping past years of clinical trials with genetic and other data. Is that a problem? It might be if your unique makeup enriches manufacturers and you never benefit in the deal. If the scenarios sound like science fiction, read the book or watch the film about Henrietta Lacks, a poor African American woman in Baltimore who died a terrible death of cancer — and launched an astonishing line of research, based on cells taken from her without her knowledge or consent.

Genetic data, of course, is supposed to be confidential. That has not prevented individuals from sharing it on public sites — complicating the lives of others who did not disclose their information. Disclosures by individuals distantly related has led law enforcement to solve cold cases involving terrible criminals. Disclosures about genetic testing have allowed people not only to discover families but also challenging relationships. Social media are filled with individuals of one race navigating the complexities of new-found siblings, cousins, or other relations of a different color and social class. Adoptees are struggling with the knowledge that they are the offspring of prolific sperm donors.

As we create more sources to generate data on deeply personal information on our health, we potentially can improve our well-being by providing experts invaluable bases for research — and we imperil our privacy and security from intrusive and exploitative use, especially without our careful consent. We can’t be casual about how we advance in these areas, for example, by allowing little-explained mass health testing at sports events (a plan, fortunately, nixed by Maryland officials). 

Disrupting establishment medicine

In the best-case scenario, the rise of easy, fast, and convenient medical tests and health monitoring may cut out the middle man again and loosen another aspect of establishment medicine’s grip on services. If home tests can, over time, show they can achieve accurate, reliable results at lower cost, could that pressure doctors, hospitals, and big labs to reevaluate the expense and cost variance of their offerings? It is a big if, of course, and public policy experts and doctors have called for a push to guarantee the accuracy and utility of all medical tests, including with increased professional education about their use in patients’ care.

Patients already are impatient when realizing that going to commercial labs and not using those at hospitals themselves can save them money. (A West Coast colleague reports that he exhausted his annual health insurance deductible of $1,800 or so with a panel of doctor-ordered screens, most of them routine. When he griped to his doctor, he recommended using a commercial lab nearby for a needed re-do of the tests in a few months. That lab’s fee: $195. The hospital facility, by the way, provided results as two pages of cryptic numbers, while the outside lab sent a multi-page explanation that included color-coded, graphic explanations of the data compared to norms.)

It may not make sense to force patients to trek to big, shiny buildings on sprawling hospital campuses to get their vitals checked and to undergo periodic, routine tests. We have seen this occur already, as medical centers have pushed routine treatments into urgent care centers in suburban malls and certain surgeries and imaging services into satellite facilities. The rise of telehealth, especially with doctors consulting with patients via online video, may work in many instances hand-in-hand with home testing and monitoring: It isn’t difficult to imagine how a doctor, to save her time and that of her patient, might work with a company and send out a set of routine tests to be completed before an online appointment. This not only could be a time-saver for already harried doctors, it would be nicer than having them plant their attention in a laptop or paper record, listing what screenings or health measures they want, right?

But here’s hoping that you and yours enjoy such great health in 2021 and beyond that you don’t need to monitor, test, or treat it!

Big boost is overdue for home health care

The Biden Administration wants to put a big new star onto home medical care, proposing to spend $400 billion to boost this vital aspect of Americans’ long-term health treatment.

The reasons have been underscored by the coronavirus pandemic:

Hospitals are tearing up our health care spending, devouring roughly a trillion dollars annually.

Nursing homes are not cheap either, costing those who can afford them roughly $100,000-a-year for a single. These and other long-term facilities also have proven to have major flaws in safeguarding residents and in providing them pleasant and happy places to live.

Our nation also is graying rapidly, with huge numbers of older adults wanting to stay in their own homes for as long as possible.

Alas, critics say, the nation for too long has lagged in dealing with urgent demographic and practical challenges that affect the lives of tens of millions of us. As the Washington Post reported:

“The prominence of the [administration’s] proposed home-care expansion shows how the issue has attracted the attention of a growing number of Democrats and influential groups … It also reflects the growing alarm by some experts about the nation’s inability to absorb the enormous growth in its elderly population — a challenge that threatens to strain an already limited workforce of caregivers; complicate the retirements of millions of people; and force many children, particularly daughters, out of the labor market to care for their parents. White House officials have also stressed they aim to improve the low pay and working conditions for caretakers.

“In 2018, the last year for which data are available, the United States spent about $130 billion on long-term care through Medicaid, with about $71 billion of that going to home care, according to the Department of Health and Human Services. Biden’s plan amounts to as much as $50 billion a year for home care in additional spending, close to doubling the existing amount.”

Those are heartening sums to advocates who have pressed politicians to deal with the nation’s long-term care crisis. But Republican critics and even those capable of a little fiscal calculation have doubts about the Biden initiative, as the New York Times reported:

“Mr. Biden’s proposal, part of his $2 trillion American Jobs Plan, is aimed only at bolstering Medicaid, which pays for somewhat over half the bill for long-term care in the country. And it is targeted only at home care and at community-based care in places like adult day care centers — not at nursing homes, which take just over 40% of Medicaid’s care budget. Still, the money would be consumed very fast. Consider a key goal: increasing the wages of care workers. In 2019, the typical wage of the 3.5 million home health aides and personal care aides was $12.15 an hour. They make less than janitors and telemarketers, less than workers in food processing plants or on farms. Many — typically women of color, often immigrants — live in poverty. The aides are employed by care agencies, which bill Medicaid for their hours at work in beneficiaries’ homes. The agencies consistently report labor shortages, which is perhaps unsurprising given the low pay. Raising wages may be essential to meet the booming demand. The Labor Department estimates that these occupations will require 1.6 million additional workers over 10 years.

“It won’t be cheap, though. Bringing aides’ hourly pay to $20 — still short of the country’s median wage — would more than consume the eight-year outlay of $400 billion. That would leave little money for other priorities, like addressing the demand for care — 820,000 people were on states’ waiting lists in 2018, with an average wait of more than three years — or providing more comprehensive services.”

In a sign of the increased demand, and potential profitability of home care, Humana, a health care giant, just announced that it will invest almost $6 billion in the business, buying out its partner in an existing venture and increasing its role.  

Even before the pandemic, experts also were sounding alarms about shortages not only in low-paid health workers but also with doctors and nurses. The medical colleges group in 2020 issued this distressing forecast: “The United States could see an estimated shortage of between 54,100 and 139,000 physicians, including shortfalls in both primary and specialty care, by 2033.” A study published in 2018 in a medical journal had this grim news on registered nurses: “There will be a shortage of 154,018 RNs by 2020 and 510 394 RNs by 2030; the South and West regions will have higher shortage ratios than Northeast and Midwest regions.”

The pandemic has only worsened staffing concerns in health care, with a recent Washington Post poll finding that half of those in the business feel burned out. The poll also found that 3 in 10 health workers, including doctors and nurses, are considering quitting the field.

As the nation grapples with a housing shortage, which is acute in big cities, there also will be a severe need to assist people in staying in their homes, including with adaptive measures to support them in doing so.

Technology also may play a big role in helping homeowners to stay put and healthy. Telemedicine — and not the hollow version done by terse telephone calls — may be combined with appropriate home medical testing and health monitors to ease strains on health workers, potentially maximizing the time of the most highly trained individuals (doctors and specialists) to allow other highly credentialed professionals (physician assistants, registered and practitioner nurses, and medical assistants) to deal with more routine care.

Expect to hear lots of new and different ideas about home medical care in the days ahead, as well as lots of howling about its costs. But there doesn’t seem to be any more road to “kick the can down.” Hard decisions and complex actions will need to occur.

A few dollars can go really far to help home safety

Before consumers sink big money into experiments with home medical tests and health monitoring devices, could they get a better return — in both their well-being and their pocketbooks — by putting a bit of this discretionary spending elsewhere?

As researchers have discovered, just a few dollars can go a long way to improving the health and safety of millions of us. But many governmental health-related programs do not cover these costs. The New York Times reported this:

“A team at the University of California, San Francisco, combed through national data and came up with an estimate, recently published in JAMA Internal Medicine: About 12 million people over 65, living in their own homes, could use equipment to help them safely bathe and use the toilet, two of the activities disabled older people most commonly struggle with. But about five million of them don’t have those items, even though they generally cost less than $50. Looking at Medicare beneficiaries in the National Health and Aging Trends Study in 2015, the researchers identified more than 2,600 people (average age: about 80) who needed such devices, based on measures like holding onto walls as they walked and being unable to rise unassisted from a chair.”

While these researchers focused on unmet needs among older adults, online comments on their posted study suggest that others with disability or debilitation could benefit significantly, too, from relatively low-cost items in the home. These include: chairs for use in the shower; grab bars — both near the tub or shower and beside the toilet; and elevated toilets or raised seats for them.

Similar, relatively inexpensive accommodation elsewhere in the home could, for example, improve the independence, diet, and well-being of elders or those needing extra support to stay on their own. The kitchen, too, would be safer and more convenient if it had grab rails in it, as well as stable and safe seating to allow an individual to handle cooking chores without long periods of standing. Cabinet doors and drawers might need easier-to-handle knobs and pulls. Families might want to invest in cooking gear and gadgets specially designed for simple and easy handling. Timers and alarms that are easy to see and set would be helpful to remind cooks to turn the stove and other heating elements on or off.

The New York Times article on affordable but lacking assistive supports underscored the increasing incidence and rising hazards posed by falls to millions of the aged or less agile.

Individuals could spend a few dollars and just a bit of time to safeguard themselves and their homes from this nightmare — decluttering and moving hazards like misplaced furniture or stray electrical cords. Risky spots could get nonslip mats or coatings. Floor coverings that slide, like rugs, can be tacked down. It may be cost effective to consider fixing or installing bannisters on stairs throughout the property, indoors and out.

Some folks will benefit from the added support of walkers or canes (notably the so-called quad models, with their broader base for added stability).

Those who long have mocked the frequent television ads for devices to aid seniors who “have fallen and can’t get up” can take advantage of new features in smart watches. The premium-priced Apple models, for example, now carry internal systems that can detect if wearers take a serious tumble. The watch, through its link to a smartphone, can connect users to emergency services, if needed.

Many homes would work better for their occupants if they installed motion-sensitive, LED nightlights. These have fallen in cost, often are packaged in quantities, and can briefly illuminate stairs, halls, bedrooms, and bathrooms so, for example, partners can attend to nature’s call in the middle of the night without stumbling or waking everyone. Those who are older or more sedentary may want to install timers on lighting in key living areas, so the spaces are brightened up at or before sunset. This can help avert the agitation, restlessness, or confusion often described as sundowner syndrome. 

Homeowners and renters, of course, can safeguard themselves and their loved ones by installing smoke and carbon monoxide detectors — and by keeping them working with fresh batteries.

It doesn’t take a lot of cash. But, based on spiking injuries reported by people homebound during the coronavirus pandemic, a good investment of time might be to find and at least watch online videos giving basic instructions on home improvement projects and use of various hand and power tools. It also could be beneficial to refresh your knowledge about ladders and their safe use and maybe to buy a short, stable model for interior use.

Recent Health Care Blog Posts

Here are some recent posts on our patient safety blog that might interest you:

  • The University of Virginia health system has decided to end decades of draconian bill collection, giving a reprieve to tens of thousands of patients and their families who faced harsh legal actions to recover crushing medical debt. The taxpayer-supported institution proclaimed itself “proud” that it will stop aggressively suing its own employees, university students, and hard-working and poor Virginians after they experienced illness and injury serious enough to require hospitalization. The university jammed the state courts with these actions, as well as liens against properties — including those of family members and not just patients themselves. The process to clear the debt-collection backlog may take a year or more.
  • Although Big Pharma has taken deserved heat for selling its drugs by slathering doctors with cheesy tchotchkes, lavish or even cheap meals, and pricey trips, as well as lucrative consulting and speaking opportunities, medical device-makers’ physician-payment programs also should get a tougher, deeper look. That’s because device manufacturers paid doctors $3.62 billion in the years 2014–17 — 1.7% of the revenue in their business sector and more than seven times the percentage of drug industry revenue spent on payments to MDs, according to a new study. The payments have come under increasing fire, as even the smallest sums — yes, even for a slice of pizza and a beer or a few sodas — may sway doctors in prescribing drugs or favoring treatments.
  • Even as the nation sees cause for optimism in its battle against the coronavirus, our struggles against substance abuse are falling far short of what’s needed. The opioid abuse and drug overdose crisis has worsened significantly during the pandemic and experts are warning that too many of us need to cut back from excess boozing. The New York Times reported that recent federal figures on the opioid crisis have back worse that officials feared
  • When doctors, hospitals, and insurers bellyache about malpractice claims with little evidence on their prevalence or outcomes, patients and politicians should push back: And they can cite the nightmares people in grievous circumstance have suffered when their constitutional right to seek justice in civil lawsuits gets stripped away. The Miami Herald and ProPublica, the Pulitzer Prize-winning investigative website, have conducted a joint, deep dive into Florida’s decades-old legislative experiment, purportedly to assist families struggling with infants’ birth-related and catastrophic disabilities. The state’s neurological injury compensation initiative also was promoted as a way to stem a problem seen mostly in anecdote and not evidence — obstetricians and other specialists supposedly fleeing Florida, reputedly due to spiking malpractice insurance costs. The media investigators, in a multipart series, have found that eliminating medical malpractice lawsuits for this slice of patients has benefited not the patients but instead, doctors, hospitals, and insurers.
  • While the federal Centers for Disease Control and Prevention has declared racism a serious threat to the nation’s health, establishment medicine finds itself mired in an angry scandal over doctors’ inability to recognize the term, much less its existence, or its considerable harms. An uproar at a leading medical journal might seem a tempest in an ivy-covered tower. But patients will want to track even a little the professional furor falling on the leaders of the respected Journal of the American Medical Association. Its website recently featured a podcast, for which doctors could get continuing professional education credit, in which host Ed Livingston, JAMA’s deputy editor for clinical content and “a white editor and physician, questioned whether racism even exists in medicine.”.
  • Although most states, including most recently Virginia, have eased restrictions on the recreational or medical use of marijuana, expectant moms should take note of serious studies that show pot, especially in heavy consumption, isn’t great for the health of unborn babies. Researchers at the University of California San Diego examined a decade of medical records of 5 million or so women in the Golden State, carefully comparing those who used marijuana heavily versus those who did not. Their results, published in a scientific journal, offered a warning.
HERE’S TO A HEALTHY 2021!

Sincerely,

Patrick Malone
Patrick Malone & Associates

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