Word: systemically
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Wind-power estimates have been made before, but the PNAS team drilled them down to greater detail. Using a simulation of global wind fields from NASA's Goddard Earth Observing System Data Assimilation System - a network of complex computer systems used to simulate and predict meteorology - McElroy and his colleagues could map the distribution of wind resources around the globe, then calculate how much electricity could be produced by tapping those breezes with current turbines, which can generate about 2.5 megawatts on land, and larger turbines that can generate 3.6 megawatts offshore. (Offshore winds tend to be stronger and more...
Ezekiel Emanuel got a memorable introduction to our haphazard health-care system on his first visit to a cancer ward as a medical student. The white coats were ordering a transfusion for a teenage girl, and since shyness does not run in his family - brother Rahm is President Obama's famously foulmouthed chief of staff, brother Ari a similarly silence-deficient Hollywood agent - he interrupted to ask why. Because she had Hodgkin's disease and her platelets were below 20,000, the team explained. Emanuel still had questions: Was there evidence for that protocol? Don't some hospitals wait until...
...billion into the stimulus bill to jump-start "comparative effectiveness research" into which treatments work best in which situations. Now they're pushing to overhaul the entire health-care sector by year's end, and they're determined to replace ignorance with evidence, to create a data-driven system, to shift one-sixth of the economy from "that's what we do here" to "that's what works." (Watch a video about a woman living without health insurance...
...Still, those savings could mean the difference between national solvency and fiscal catastrophe, so Obama is targeting two major barriers to data-driven medicine. The first is the perverse "fee-for-service" incentives that now plague our health-care system: hospitals get paid more if you stay longer and come back often; doctors get paid more if they do more tests and procedures - and you come back often. More services, more fees. "You've got to follow the money," says former Senator Tom Daschle, Obama's initial choice for health czar. "We reward volume, so that's what...
...have to worry about reimbursements that overvalue radiological tests and invasive prostate treatments, undervalue preventive care and watchful waiting and put zero value on returning a phone call or thinking about a case. "We've been able to buffer our staff from the harsh realities of the system, so they can concentrate on patient needs," says Dawn Milliner, a kidney doctor who oversees clinical practice throughout Mayo. "But it's not clear how long we can keep doing that...