National News

Health companies eye predictive software for patient care

Marketplace - American Public Media - Tue, 2014-03-11 00:05

Pharmacy giant Walgreens recently announced it has begun using predictive software to help guide patient treatment.  It’s just one of the latest efforts where healthcare hopes to standardize day-to-day operations.

With estimates that hundreds of billions of dollars is wasted every year on redundant or inefficient services, many industry leaders think healthcare needs to be more like Burger King, where a sandwich in Santa Fe tastes a lot like the sandwich in Seattle.

For some the path to slowing health costs may mean medical care has to look more like factory work.

As far as Walgreens executives are concerned, they think they may be on to something. The pharmacy chain is working with the IT firm Inovalon which, using data from more than 100 million patients, has developed algorithms to predict health problems.

Heather Helle who oversees Walgreen’s clinic business, says that data helps guide a nurse practitioner during a patient’s visit.

“You can think about it almost like a decision where if the answer to a particular question is ‘no,’ the system will guide the nurse practitioner down one particular path," she says. "If the answer to a particular question is ‘yes,’ the system will intelligently guide the nurse practitioner down the second path."

Let’s say a patient’s record shows he’s got multiple symptoms for diabetes but no official diagnosis. The computer flags that, and the Walgreens nurse practitioner zeros right in.

“We are able to streamline the visit, we’re able to reduce variation and we are able to deliver incredible value,” she says.

Whether it’s this predictive modeling, patient safety protocols at Johns Hopkins, or a Camden doctor’s office using new scheduling techniques, many in healthcare say the industry must industrialize. This may sound like some healthcare version of painting by numbers, and former Denver Health CEO Patricia Gabow says executives can over do it when it comes to standardizing care.

“It’s not just any routine, could be a routine that’s very wasteful. Or a routine that doesn’t yield high quality,” she says.

Another concern is if the rules are too rigid, patient care could suffer.  But right now, Harvard Business School Professor Clayton Christensen says a lack of doctor routines is threatening patient safety and driving up costs.

Routines – like Walgreen’s algorithms – may sound scary, says Christensen, but they are really just a way of sharing decade’s worth of doctor’s knowledge with people you don’t have to pay like doctors.

“Nurse practitioners can do even more consistently what doctors do today,” he says.

Christensen says healthcare costs will go down as lower-cost caregivers do more and more.

In Iraq, Anbar Faces Extremists Stronger Than Those U.S. Fought

NPR News - Mon, 2014-03-10 23:40

The extremists now committing a wave of attacks in Iraq's Anbar province are significantly better trained, funded and equipped than the al-Qaida-linked groups American soldiers battled there.

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In Iraq, Anbar Faces Extremists Stronger Than Those U.S. Fought

NPR News - Mon, 2014-03-10 23:40

The extremists now committing a wave of attacks in Iraq's Anbar province are significantly better trained, funded and equipped than the al-Qaida-linked groups American soldiers battled there.

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This Years Snowy Owl Invasion Was Good News For Scientists

NPR News - Mon, 2014-03-10 23:35

An unexpected invasion of the arctic birds has given researchers a rare scientific opportunity. They're fitting a few of the errant owls with GPS backpacks to track their return to the arctic.

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In Tsunami's Wake, Fierce Debate Over Japan's 'Great Wall'

NPR News - Mon, 2014-03-10 23:31

The government wants to build sea walls that will be 30 feet high in places and stretch for more than 200 miles. Some say the $8 billion effort is too costly and will ruin the beaches.

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Holder Speaks Out On Snowden, Drone Policy, Softening Sentences

NPR News - Mon, 2014-03-10 23:27

In an interview, Eric Holder says he's open to talking with Edward Snowden about terms of surrender. And the attorney general is unhappy with the vote to block a nominee to a top Justice Dept. post.

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U.S. Checks For Stolen Passports, But Other Nations Fall Short

NPR News - Mon, 2014-03-10 23:26

Two men apparently boarded Malaysia Airlines flight 370 with stolen passports. The U.S. has safeguards to prevent that from happening on U.S.-bound flights, but other nations are not as diligent.

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After delay, U.S. builds four new nuclear reactors

Marketplace - American Public Media - Mon, 2014-03-10 23:08

It’s been three years since the Fukushima disaster prompted Japan to try weaning itself from nuclear power, though that’s a position it now seems poised to reverse. In the U.S., four new reactors are under construction after a long lull.

Don’t call it a nuclear renaissance: The economics of nuclear power are a tough sell, especially in a time of cheaper natural gas.

"The idea that public fearfulness or the resistance of environmental groups is what killed nuclear power in the U.S. has always been nonsense," says Peter Bradford, a former member of the Nuclear Regulatory Commission.

Bradford says nuclear plants are expensive to build and hard to finance. Plus, electricity demand is lower than expected.

N.Y. Governor Says College For Inmates Will Pay Off For Taxpayers

NPR News - Mon, 2014-03-10 23:07

Andrew Cuomo says funding prison college classes will cut recidivism rates. But critics say it's unfair to pay for prisoners' educations while middle-class families struggle with college costs.

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Turning Food Waste Into Fuel Takes Gumption And Trillions Of Bacteria

NPR News - Mon, 2014-03-10 23:06

A Brooklyn waste treatment plant has become an unlikely lab for an ambitious effort to turn millions of tons of food scraps from New York City's apartments and restaurants into renewable energy.

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Customer Surveys Are Here To Stay. Suggestions For Improvement?

NPR News - Mon, 2014-03-10 23:02

Companies want to know what you think of their product — and they're not afraid to ask. Surveys might be annoyingly pervasive to customers, but they provide valuable information for a low price.

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Democrats Are Up All Night Talking About Climate Change

NPR News - Mon, 2014-03-10 22:13

Democrats took to the Senate floor Monday night to talk about global warming and planned not to let up until morning. Senate Majority Leader Harry Reid got the dusk-to-dawn talkathon started.

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'Fatal Vision' Author Joe McGinniss Dies At Age 71

NPR News - Mon, 2014-03-10 21:57

McGinniss, who announced last year that he had been diagnosed with inoperable prostate cancer, died from complications related to his disease. He died at a hospital in Worcester, Mass., Monday.

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Senate OKs Bill To Combat Military Sexual Assault

NPR News - Mon, 2014-03-10 21:45

The Senate overwhelmingly approved a bill late Monday making big changes in the military justice system to deal with sexual assault. The measure now goes to the House.

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The Internet Will Be Everywhere In 2025, For Better Or Worse

NPR News - Mon, 2014-03-10 20:01

A new report by the Pew Research Center predicts that the Internet will magnify our awareness of the world, eliminate privacy and become as embedded in our lives as electricity is today.

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What do stores do with unsold merchandise?

Marketplace - American Public Media - Mon, 2014-03-10 14:22

Marketplace listener Blake Waller from Denmark, South Carolina asked us what retailers like Wal-Mart, Kmart and other big box stores do with items they don't sell. We went off in pursuit of the (complicated!) answer.

When it comes to food, retailers throw away around 45 billion tons each year. That's about 10 percent of what's on the shelves. A lot of stores donate food that hasn't perished. Walgreens, for example gives away about 5 million pounds of food a year to charity according to Reuben Slone, who runs supply chain for the company. 

But when it comes to clothing, household goods or anything with a brand name, it gets a little more complicated. 

James Merwin can attest to that. It was 2008 and he had a problem. Actually, he had 30,000 problems.

Merwin was working for a bathroom fixture company at the time. This was when the housing bubble had just burst. People stopped building houses -- and they stopped buying toilets to put in them.

"You go very quickly to almost bursting at the seams with product everywhere," Merwin says. "We had to not just fill our own warehouses; we paid a premium to store it somewhere else because we didn’t have space for it."

This is something that happens in varying degrees to almost every retailer -- from a pharmacy to a big box store. It’s called the "Bullwhip effect," and it means you ramp up to meet what you think demand is going to be, and then demand falls off. It’s at its worst with seasonal stuff like plastic Christmas trees or clothes that go out of fashion. 

Mark Barratt teaches operations and supply chain management at Marquette University. He says the first thing stores do is cut the price.

"Target has a pretty clear schedule of how long the product is sitting on the shelf before it gets discounted."

Barratt says big box stores like Target systematically cut the price until it’s roughly 70 percent off.

"If it's still unsold from there, they are likely to liquidate it or in some cases donate it," Barratt says. "Or sell it to one of these discount stores like T.J. Maxx or Marshalls."

But brands can be sensitive about their products ending up in outlets or in resale shops.

"The primary concern is the impact on the brand. Suddenly it’s, ‘Hang on a minute! We’ve spent all this time and money creating this image that we’re an upscale retailer, and now suddenly you can buy our products for 20 percent of the price if you’re just prepared to wait long enough and go to a different outlet store.”

And that same problem pops up with donating.

The trouble is, if you’re not careful, what you donate might end up on a Manhattan sidewalk sale, competing with you in front of your own store.

So many companies choose to shred, incinerate or simply throw away the stuff they can’t sell. That maybe part of the reason nearly 21 billion pounds of textiles end up in landfills each year, though a lot of that comes from us customers.

Barratt says the best way to deal with unsold merchandise is to not have much of it in the first place. 

That’s why the most powerful weapon in the corporate arsenal is logistics. 

Walgreens sells 18,000 different things at 8,200 different stores. That means they have to make 160 million predictions about how much merchandise to order and put out every week. Obviously, they use computers, but they also have some pretty complex data to crunch with those computers.

“What we’re trying to do is predict human behavior,” says Reuben Slone, who runs supply chain for Walgreens. “Everything that we do is based on a forecast, and that forecast is based on history.” 

Take cough syrup, for example.

"We use a lot of factors," Slone says. "Everything from weather reports to adjacent product that’s purchased. For example, if there’s a spike in aspirin and toothbrushes, that might be an indication there’s an outbreak.” 

They start predicting a year ahead of time, monitoring incidences of flu around the country.

"I tell people it’s like rocket science," Slone says. 

The key is having lots of history and data. And Slone says they’ve learned some fun tricks about demand this way.

"On Christmas Day we sell more bacon than anyone else in the United States. We even have a bacon report for the Christmas holiday to monitor that."

New products or fashion lines are what really involve some serious guesswork. But for any supply chain, one wrong move or bit of bad luck, and you can have a stack of 30,000 toilets on your doorstep. Just ask James Merwin.

"It’s as much an art as it is a science," Merwin says. "And it’s a rodeo, or as I like to say, it’s a roller coaster."

Whatever analogy you choose, you’ll be happy to know that Merwin did sell all of his toilets after all. He just had to discount them. No crushing or crumbling required.

Gas Exports Debate Makes Better Domestic Politics Than Geopolitics

NPR News - Mon, 2014-03-10 14:08

Not everyone agrees that more U.S. natural gas exports would be an effective lever against Russian President Vladimir Putin.

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Seattle Moves To Curb Uber, Other Ride-Share Services

NPR News - Mon, 2014-03-10 14:06

Taxi companies have been vocal opponents of web-based "ride-share" services, which they say have an unfair advantage because they're playing by different rules.

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Colorado Collected $2.1 Million In January Taxes On Recreational Pot

NPR News - Mon, 2014-03-10 13:56

Another $1.4 million in taxes and fees were collected from the sale of medical marijuana. This indicates that about $14 million worth of marijuana was sold during the first month of legalization.

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How An Aircraft Can Fall From The Sky Midflight

NPR News - Mon, 2014-03-10 13:56

There's much conjecture about what happened to Malaysian Airlines Flight MH370, which disappeared over the weekend. But planes can experience everything from bad weather to technical failures.

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