The KHIT Blog: A Master's in Health Policy and Law? UCSF/Hastings

Thursday, June 2, 2016

A Master's in Health Policy and Law? UCSF/Hastings

So, we're down here in the Verizon 1-Bar 'Bama Boonies for a family wedding this weekend (I'm hotspotting at the moment), after attending our grandson's college graduation at St. Olaf in Minnesota last weekend.

This UCSF/Hastings "Masters of Science in Health Policy and Law" thing arrived in my inbox this morning via my daily Healthcare Dive feed.

Whether you are a legal practitioner or a health professional, with the UCSF and UC Hastings College of Law Masters of Science in Health Policy and Law, you earn a respected degree to affect positive change in the health care field.

Designed for working professionals with either part-time or full-time options, the trans-disciplinary program features expert faculty who develop your understanding of the core areas, including policy-making, legal research and writing, health economics, program evaluations and more. This education prepares you to join the national movement in creating a culture of health, bridging the complexities of the legal system with the intricacies of health care.

The online format allows you to continue working while you progress through the curriculum, providing a unique opportunity to employ lessons learned in class to your profession in real time.

I suffer from a bit of reflexive dubiety with respect to these metatastically proliferating high-dollar Masters programs in the health care space. I get pitched all the time.

This one looks interesting, however. UCSF and Hastings both have default street cred with me. The faculty looks at first blush to have major chops. No Trump University here, LOL.

The MSHPL curriculum (core and electives):

HPL Seminar (6 units)
Health Policy (3 units)
How to Evaluate Policy-Relevant Research (3 units)
Organization and Finance (3 units)
Health Economics (3 units)
U.S. Health Care System and the Law (6 units)
Cost Analysis and Value-Based Care (3 units)
Program Evaluation (3 units)
Organization and System Change (3 units)
Advanced Policy Analysis (3 units)

Yeah. Goes to the myriad topics of interest to me on this blog.

I just know someone's gonna fuss at me for not including "patient experience/POV" in that. Can you say "centrally implicit"?

Again, we can have the snazziest Health IT that designers and coders can produce, but if the numerous other contending factors in health care function at significant and persistent cross-purposes, progress will be chronically hampered. The "Free Beer Tomorrow" thing will persist to disconcerting degrees. As I observed in 2009:

THE U.S. "HEALTH CARE" "SYSTEM"?
I will by no means be the first to note that our medical industry is not really a "system," nor is it predominantly about "health care." It is more aptly described as a patchwork post hoc disease and injury management and remediation enterprise, one that is more or less "systematic" in any true sense only at the clinical level. Beyond that it comprises a confounding perplex of endlessly contending for-profit and not-for-profit entities acting far too often at ruinously expensive cross-purposes...

See also my blog rants elsewhere going back years:

And my 1994 analytical grad school argument analysis of the JAMA Single Payer Proposal (pdf).

I'll have to drill down deeper into this MSHPL offering once I return home. Were I not too old (70) and too still-ailing post-tx (though I am back in the gym now lifting weights and again pursuing my hoops delusion), this looks like something I might do (there's never a shortage of things to learn). Though, among my reservations is the whole Online Learning thing. My old-coot chalk talk bias, I guess.
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UPDATE

Ouch.

Theranos Exposed

...The claimed breakthrough of Theranos was a streamlined process for laboratory blood analysis that promised to perform 30 tests on a single drop of blood with same-day results. This would eliminate the need for drawing vials of blood and replace that with a simple finger prick.

For any scientist there are immediate red flags. Each blood test, in a way, is its own technology. You don’t measure sodium in the blood the same way you measure glucose, or test for the presence of antibodies to a virus. Yet Theranos claimed to have revolutionized dozens of standard laboratory tests. This would require a massive amount of research and development, or the introduction of an entirely new technology.

Such technology does not come out of nowhere. Research builds upon other research and then is translated into practical applications. The myth of the lone researcher making breakthroughs in their garage is largely just that, a myth. But that image clings tightly to the public consciousness. This makes it easier to sell the narrative of the lone genius making breakthrough technology.

Perhaps the tech industry is especially susceptible to this narrative. A team of coders with a great idea can create a disruptive app that will change the game. Investors are looking for disruptive startups, nerds with a great idea and the next billion dollar company. Medical technology is different, however. There needs to be a paper trail, years of research leading up to the application.

Now that the true story of Theranos is coming out, it seems obvious in retrospect that the whole thing was a scam...

My prior Theranos posts here. Forbes just downgraded Theranos founder and CEO Elizabeth Holmes' estimated net worth from $4.5 billion to zero.

Ouch, indeed.
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More to come...

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Brave New Health

Commonwell Health Alliance

Another important read (pdf)

I love this kind of stuff. It sustains and humbles me. "As politicians, advertisers, salesmen, and propagandists for various political, economic, moral, religious, psychic, environmental, dietary, and artistic doctrinaire positions know only too well, fallible human minds are easily tricked, by clever verbiage... Common language—or at least, the English language—has an almost universal tendency to disguise epistemological statements by putting them into a grammatical form which suggests to the unwary an ontological statement. A major source of error in current probability theory arises from an unthinking failure to perceive this."

Quotes

"An economist is a person who sees something that works in practice and tries to figure out whether it will work in theory."

- J.D. Kleinke, medical economist
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"The only person who enjoys change is a baby with a wet diaper."

"Every misspent dollar in our health care system is part of somebody's paycheck.

- Brent James, M.D., M.Stat

“We could do healthcare, at markedly higher quality, for everyone in this country, without rationing or denying anybody the care that they need, without having the government dictate how doctors practice or whether hospitals could expand, at half the cost we do it now.”

- Health Care Futurist Joe Flower

Most of the sciences, unlike parts of medical science, are not concerned with the impossible. There is not complementary and alternative physics, or chemistry, or biochemistry, or engineering. These disciplines compare their ideas against reality, and, if the ideas are found wanting, abandoned."

- Mark A. Crislip, MD

"Q: How much alcohol is too much?
A: More than your doctor drinks."

- a physician I once heard speak during a CME presentation

“Just because science doesn’t know everything, doesn’t mean you get to fill in the gaps with whatever fairy tale most appeals to you.”

- Dara O’Briain

'[I]t is one small step from using the computer for "helping" doctors to monitoring them, judging them, dictating to them what to do, and withdrawing payment for computer non-compliance. The use of computer data is a multi-edged sword. It can be used for the "good," facilitating diagnosis and treatment and making it more accurate and up-to-date, and for “evil,” invading privacy, inviting security breechs, and making decisions based on the opinions of remote authorities rather than those present at the patient-doctor encounter.'

- Richard Reece, MD

“[T]here ARE statistics which are non-political. Just because The Washington Post/Fox News reports the temperature is 75 degrees doesn’t mean it’s really snowing and sunscreen is a liberal/conservative plot. Even if you earn a living being ideological.”

- Michael L. Millenson

"It is a generally a fairly convincing argument that people shouldn’t have to be subsidized to undertake a change which is in their best interest.

The reconciliation seems to be that EHR is not supposed to make a doctor’s practice more efficient and higher quality. It is supposed to make the system of care more efficient and higher quality, which is not the same thing. Those of you who took calc recall that maximizing the total of variables is not achieved by maximizing any one variable and this is a perfect example of that.

Those of you have served in combat certainly noticed that too — if everyone works as a team the unit takes fewer casualties. If you try to save your own hide, you might, but at the expense of more casualties overall."

- Al Lewis

"There are two ideas to keep in mind about Bayesian reasoning and how we tend to mess it up. The first is that base rates matter, even in the presence of evidence about the case at hand. This is often not intuitively obvious. The second is that intuitive impressions of the diagnosticity of evidence are often exaggerated."

- Daniel Kahneman, "Thinking, Fast and Slow"

"Physicians apply advanced scientific knowledge, but they must do so without the favorable conditions that experimental scientists create for themselves. Multitasking is forced on physicians, often in chaotic environments and under severe time and resource constraints."

- Lawrence and Lincoln Weed, "Medicine in Denial"

"It’s time to stop the whining about Obama care and acknowledge we already have universal health care. We just pay for it in the stupidest way possible that ensures problems are that much more disastrous and complicated when they’re finally treated."

- Mark Hoofnagle, MD, PhD

"Every act of conscious learning requires the willingness to suffer an injury to one's self-esteem. That is why young children, before they are aware of their own self-importance, learn so easily."

- Thomas Szasz, MD
___

"Of course, one reason that process metrics* are so popular is that processes are much easier to define and measure than outcomes."

- The Skeptical Scalpel
___

"There is an “illusion of validity” for any random data point, a seductive sense that is colored by what we hope will be true. Mountains of pharmaceutical claims are often made from mere molehills of data."

- Danielle Ofri, MD
___

"Joy empowers people. It is a source of energy that enables people to hope and plan and change their lives for the better. Spend some time around someone who is relentlessly negative and how do you feel–drained, right? More and more research shows that joy is not something that just happens to you, like a bolt of lightening out of the blue. Joy is, instead, a habit to cultivate. Negative thinking and despair are the crabgrass of our souls–weeds that take root and spread, sometimes to all areas of life. Joy, in contrast, is a soul’s rose–hardy when cared for, able to put down roots over time and withstand disease and extremes. Like a rose, however, your joy can become blighted from neglect or harsh conditions. We all need to tend to our joy–to prune away the badness, and to know that, even though it may look like a prickly bare root, if you invest time in a joyous outlook, gorgeous things will bloom, even in the harshest conditions."

- Dr. Jan Gurley
___

"'Solutions' exist only in mathematics."

- Karen Martin
___

"The issue of how to regulate clinical software is, in the long run, indistinguishable from the issue of how to regulate medicine. The only difference is that medicine is practiced in the open, without secrecy, subject to peer review, and under a merit-based state license."

- Adrian Gropper, MD
___

"Economist, rope, tree: some assembly required."

- Source unknown

DISCLAIMER:

I write this blog wholly on my own time and my own dime. The views proffered are expressly my own as a concerned and active citizen/taxpayer (in addition to being the result of my substantive experience in the various IT fields), and in no way reflect any policy views of my former employer, notwithstanding that some of the thinking has indeed obviously been spurred by the implications of the work with which I have been doing for them.

FAIR USE POLICY
I cite a ton of news and web sources spanning the breadth of relevant technical and policy domains, sometimes at substantial length. I believe I remain well within the bounds of "Fair Use," as [1] I am not doing any of this for profit, [2] I always provide attribution and links -- which, [3] far from negatively impacting any copyright holders' commercial interests, might actually increase traffic to and interest in their offerings.

Nonetheless, should I post anything of yours regarding which you have any objection, just let me know and I will remove it forthwith.

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Thursday, June 2, 2016

A Master's in Health Policy and Law? UCSF/Hastings

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