On any given day, you are likely to see headlines claiming that a new treatment is a clinical breakthrough in treating a particular condition. You may start receiving questions about this new treatment from patients, all the while wondering where the treatment came from and how you could have been caught off guard. You may also wonder whether the treatment actually lives up to the claims made about it in the press.
The sheer number of technologic advances makes it difficult to keep up with all of them. You literally could spend all your time in this activity, but you only have so much time to give. Complicating the time factor is whether a particular treatment actually lives up to its claims. Some notable instances of late have arisen in which it appears that a treatment was not all that it originally claimed to be. The recent controversy over hormone replacement therapy (HRT) is a case in point. Once thought to result in positive health outcomes with respect to heart disease and osteoporosis, questions are being raised as to whether HRT does more harm than good.
The same can be said for autologous bone marrow transplants (ABMT) as a treatment for breast cancer. Formerly thought to be a viable treatment, subsequent information indicated malfeasance on the part of researchers and overly optimistic results. Questions now are being raised as to whether ABMT actually reduces life expectancy rather than increases it.
Time constraints and methodologic difficulties notwithstanding, you can take some basic steps to keep pace with medical advances. The 6 steps below take into consideration that your time is limited, and there is no getting around the fact that some treatments will not live up to the promises made of them.
Step 1: carve out your niche
It is virtually impossible to keep up with all the technologic advances taking place in medicine today. Luckily, most case managers, like most medical professionals, work within a particular field of medicine. Use this specialty to keep your effort to a manageable level. If you mainly work with patients with diabetes, you need to focus on that area.
This is not to say that you should completely ignore general advances. As you will see below, several resources cover general advances in medicine. Pick one of these as your general information tool. As you use this tool, however, focus mainly on the areas about which you will receive the most questions. Use it as a beginning point from which you will drill down to information more pertinent to your main focus.
Step 2: set aside the time
This step actually may be the hardest of all. Once you have carved out your niche, you need to set aside some time to stay abreast of technologic changes. You may, however, feel guilty doing this. You have a job to do, after all, and may think that spending time reading about medical advances takes you away from doing that job.
Part of being a professional is keeping up with changes in your particular field. Medical advances are among the most pressing changes confronting case managers. A case manager who fails to keep up with a technologic advance in her or his field is akin to a physician who fails to stay informed about new treatments. Consider whatever time you spend on staying current as time well spent. It will help you improve the service that you provide to your patients.
Step 3: work in a group
Many people think they have to strike out alone when learning new material. Nothing could be further from the truth when it comes to keeping up with new technologies. Working as a group can help the performance of the entire unit where you work. It can help everyone to sharpen his or her skills while improving the services ultimately provided to patients.
There are a variety of means by which a group can function to follow new technologies. A group of case managers who work predominately with psychologic patients, for example, could divide assignments so that one person keeps up with treatments for depression, another with addictions, and a third with psychoses. Alternatively, the work could be divided so that each person focuses on a particular periodical or group of websites. Each approach has its benefits. The main point is that working as a group allows the net to be cast further. It also creates helpful discussion about what advances are taking place within a particular specialty or group of specialties.
Step 4: get some basic resources
Good resources are key to keeping up with medical advances, and many are out there. Some cost money, but many are free of charge. Below are 5 useful sources that will help you get started
•Among the best known of health services on the Internet is WebMD (www.webmd.com), a site that features breaking health headlines free of charge. A daily visit to this site is one means of keeping up with general health news.
•Journal Watch is a service that provides summaries of articles in such major publications as The New England Journal of Medicine and JAMA. Published semimonthly by the Massachusetts Medical Society, this publication could be scanned both for general information and articles in a particular field. Each summarized article contains information so that interested readers could easily locate and read the original in its entirety.
•PubMed is regarded as the on-line source for medical articles. One way of accessing PubMed is through the National Center for Biotechnology Information at www.ncbi.nlm.nih.gov. PubMed searches are an excellent means of finding abstracts and articles related to late-breaking health information.
•Information about the subscription service MDConsult is located at www.mdconsult.com. Users of the service will find not only excellent online medical textbooks and sources but also such features as Today in Medicine, Drug Updates, and This Week's Journals.
•Located under “Manuals” in the Provider section of www.bcbst.com, BCBST's Medical Policy Manual provides information on hundreds of new and established medical technologies. The site is searchable and includes policies that are updated at least every other year. Most policies include a source section that readers can use to find additional information.
Step 5: question authority
It is important to look at all medical information with a critical eye. Keep in mind as you read any source that even a peer-review process does not guarantee freedom from methodologic flaws or fake data. Additionally, there is a clear bias toward publishing positive clinical outcomes in medical journals based in the United States. Americans seemingly are not interested in hearing about treatments that are proven not to work. This preference adds impetus to taking steps to ensure that outcomes reported are as favorable as possible.
It helps to spend at least a little time learning about the discipline of evidence-based medicine. One of the best works in the field is Sackett et al's Evidence-Based Medicine: How to Practice and Teach EBM.
Step 6: organize your findings
There's nothing worse than coming across a piece of information, noting its importance, and then putting it someplace you will never be able to retrieve it. Begin your effort to stay informed with a method for filing information for easy retrieval. A computer-based method is best for storing a large amount of information in such a way that it can be searched easily. Regardless of whether you use paper or an electronic means, be sure to pick a method that is easy for you and that you will use.
Although the above steps involve an investment of time, the return should be great. Not only will you be able to provide better service to your patients; you also will enjoy the adventure of keeping up with key developments in your chosen field.
Rick Mathis, PhD, is manager of medical policy and Sharon Doyle, BSN, MS, CCM, CPHQ, is a medical policy clinical quality coordinator at Blue Cross Blue Shield of Tennessee
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