This is a very funny interview from the Daily Show. We can't embed the video, but you can follow the link below to view.
Comedy Central - Media Player
Pharma Rep Interview from the Daily Show
This is a very funny interview from the Daily Show. We can't embed the video, but you can follow the link below to view.
Comedy Central - Media Player
Medical Building set on fire
Was the intent to burn medical records? One more reason to ditch the paper files and back up your data...BD
NORTH HOLLYWOOD, CA (AP) -- Police in North Hollywood arrested a man this morning on suspicion of setting fire to files in a medical building.
Police say the man fled officers responding to a burglar alarm at the building, but that he was quickly apprehended and found to be carrying a lighter.
Several medical files were found inside in flames.
The man was arrested on suspicion of arson. There's no word yet on his connection to the medical files that were burned.
Source: KNX - *
Medicare audits raise questions - claims rejected and classified "medically unnecessary"
The California Hospital Association raised concerns in November that PRG-Schultz was targeting rehabilitation hospitals that cared for Medicare patients after knee or hip replacement surgery. The hospital association said that PRG-Schultz had reviewed thousands of cases dating to 2002 and had rejected nearly all as medically unnecessary.
Melinda Staveley, president of the 38-bed Rehabilitation Institute in Santa Barbara, Calif., said that more than 100 such cases from her nonprofit institution had been rejected. The facility could face repayment of more than $2 million.
California’s U.S. House members will soon follow with a joint letter of their own asking for an investigation.
The auditing program was set up as a demonstration project initially focusing on the three highest-cost Medicare states: California, New York and Florida. Separate contractors are used for each state. PRG-Schultz is the only for-profit contractor among them.
Source: www.kansascity.com | 05/18/2007 | Medicare audits raise questions
School officials at risk of firing - poor record keeping and student health records are part of the issue
In today's world of technology, it is almost a shame that paper folders are still being used. If you read the comments below it states how they have to go through a "whole roomful of folders" to find the records. The same thing happens with physicians and hospitals too who are still relying on the paper chart too. From the article, it appears jobs are apparently on the line here for lack of organization and perhaps use of a little updated technology. As a parent, this could send out a message to entertain some type of family personal health record so even if immunization records are not available from the school, a family health record file might help you keep this things in check. BD
The Baltimore school system has threatened about 120 principals with disciplinary action, including termination, if their schools fail to provide a complete set of records for each student by the end of this month.
Warning letters were sent to the principals recently after two state audits turned up evidence that missing and incomplete student records have become a widespread problem in city schools.Another audit conducted in April 2005 found, among other things, missing health records among the more than 1,300 general student records examined.
Maryland education regulations require schools to have information on enrollment, attendance and promotion for all students. In April 2005, state officials pulled a random sample of student records at 43 city high schools and found missing standardized test scores, incomplete immunization requirements and outdated information on students' addresses.
State officials say many systems require their schools to use a uniform recordkeeping system - with some using computers - but the city does not.
"They just have a little manila folder, where they stick records in it and put it in filing room," said Carol Ann Baglin, assistant state superintendent for special education and early-intervention services. "So when we go out and ask for records, they have to go through a whole roomful of folders to dig them out."
Source: School officials at risk of firing - baltimoresun.com
Hospital CIO makes the top 100 List for IT Innovation and Development
This is an online publication called E-Week who just recently published their top influential CIOs for the last year. If you keep up on recent medical articles on the web, you do find Beth Israel frequently in the news!
Congratulations to Dr. Halamka!
#57 John Halamka M.D., Beth Israel Deaconess Medical Center
As a physician turned CIO, Halamka has been a prominent pioneer in electronic medical records and other health care IT initiatives
http://www.eweek.com/
Congratulations to Dr. Halamka!
#57 John Halamka M.D., Beth Israel Deaconess Medical Center
As a physician turned CIO, Halamka has been a prominent pioneer in electronic medical records and other health care IT initiatives
http://www.eweek.com/
Chapter 2 - Are you still just using your Cell Phone for phone calls - Paramedics and Cardiologists work with wireless technology -saving lives
This article surely has to tweak the interest of any Cardiologist! It is amazing once you give this some thought as the once categorized potential enemy of diagnostic equipment in the medical area is now saving lives. Mayo Clinic has also substantiated this a while back with their findings too. Amazing too is that this system has been in place since June in 2006! Again, this says a lot for professionals jumping outside the box and finding a mobile solution that can in fact save lives and improve the quality of health care.
Being able to view an EKG on the cellphone ahead of the patient arriving can truly be a lifesaving technique and it has cut the time in half to begin treatment! BD
Imagine paramedics mobilizing a team of cardiologists and nurses within minutes of arriving at the home of a person who is having a heart attack, simply by pressing a button that sends an electrocardiogram (ECG) over a wireless network. That's exactly what's being done at a Newark, NJ, medical center, and it's dramatically improving the quality of care, according to a study honored as the best abstract presented at the 30th Annual Scientific Sessions of the Society for Cardiovascular Angiography and Interventions (SCAI), May 9-12, 2007.
At UMDNJ, for example, it took an average of 61 minutes in 2005 just to notify a cardiologist that a patient with a heart attack had arrived at the emergency room. Coupled with the assignment of on-call cardiologists to more than one hospital and the catheterization laboratory's 5 PM closing time, it was virtually impossible to begin catheter-based treatment within 90 minutes. In fact, the average door-to-intervention time-an alternative term used in this study to reflect the full range of catheter techniques available to interventional cardiologists-was nearly 146 minutes in 2005.
Under the guidance of Marc Klapholz, M.D., director of the Division of Cardiology at UMDNJ, the wireless system went live in June 2006. It enables paramedics to use Bluetooth technology to send an ECG not just to the emergency room but also to a receiving station in the cath lab. From there the electrocardiogram is automatically converted to a PDF file and forwarded via the hospital intranet to several e-mail addresses set up just for that purpose.
The on-call cardiologist receives a text message with instructions to download the electrocardiogram for viewing on a smart phone. The file also includes the phone number of the paramedic who initiated transmission of the electrocardiogram, so the cardiologist can immediately be in contact with the ambulance crew. Patients who are clearly having a heart attack are whisked directly to the cath lab.
Source: Transmitting ECGs To Cardiologists By Smart Phone Cuts Treatment Time In Half
Mastering Medicare Part D details can help save on prescription costs
Good article written by a senior with some good advice on handling the donut hole..and today if you make an error and find yourself not covered, keep in mind you can perhaps find some of these medications covered for $4.00 via the retailers linked on this page.
As a senior in this community, I have had to educate myself on the complexities of the Medicare Part D drug insurance.
I spent much time and research on this very complicated topic and I thought that I understood the issues well. But, of course I did not.
Here are two matters to be careful about as you purchase your drugs on this program:
1. The insurance companies will charge you for a full month's co-pay, even if you purchase less than one month of drugs; even only a few days' worth. The insurance companies do not state this in their literature. Indeed, the wording would indicate otherwise. So buy your drugs in monthly increments.
2. Crossing the boundary into the so called "doughnut hole" brings with it several pitfalls. This is due to the fact that the computation of total drug costs is not based only on how much you spent previously. Rather, it includes the new purchase as well. Here is a hypothetical example (numbers will differ for different plans, but the principle holds for all):
Total combined drug payments for you plus insurance is $2,120.
The initial coverage limit is $2,400, after which you pay 100 percent of the cost, while you pay only a $28/month co-pay for Tier-2 drugs before you reach your limit.
You order 3 months of a Tier-2 drug with a total drug cost of $100 per month.
This adds an additional total cost of 3 x $100, or $300.
You are now over the $2,400 limit with $2,120 + $300 or $2,420 and the insurance company will charge you the full $300 for your purchase.
But you will pay only $28 per one month of drugs if you order drugs for only two months and your total cost is $2,120 + $200 or $2,320, which keeps you under the $2,400 limit.
You then order for one more month for which you will be charged the full $100.
You now have three months of drugs at a cost to you of 2 x 28 + 100 or $156, rather than the $300 that the insurance wanted to charge you at first.
There are additional complications that cause you to pay more than you might think, such as paying the full price of $100 for the last month, even though you are $80 under the "doughnut" limit of $2,400.
These matters are quite complex and very difficult to deal with. But you will be ahead financially if you watch out for the above two issues.
Source: Jewish Review: Mastering Medicare Part D details can help save on prescription costs
UMPCs, Media Extenders, XBox, what can we learn from the consumer side of Technology
This is a great article from JK on the Run. As always I try to feature ideas that also would have some real use in the Medical arena and this looks like a potential winner to me. A Physician's Office, a hospital could benefit from some additional use with digital media too. In this example they are using a UMPC mini tablet to stream media to a large flat screen TV. Notice the UMPC at the bottom of the picture. The XBox extender provides the connectivity via the Media Extender. Since the release of the XBox 360, it can do a little bit more than just allowing XBox games. For presentations, lectures, etc. this provides a real nice method of streaming media captured on the UMPC to the large screen. Follow the link at the bottom to read the entire article. This can also give robotic surgeons the perfect reason for adding an XBox to their network for practice as there have been many articles on the web about the hand skills of surgeons being improved by playing video games too. (I know, what an excuse for getting an XBox..(smile).
This is another example on finding one more additional use for your UMPC and thank to the folks at JK on the run for enlightening us! BD
(Update for the nearsighted like me: there is a hard-to-see UMPC that's serving up music via WiFi just in front of the HDTV!)You can set up a Windows Media Extender to have your Vista-based UMPC act as a media server over a wired or wireless LAN. Since I don't have an Ethernet jack in my family room for the Xbox 360, I set everything up over WiFi. There's not much effort required either: the Windows Media Extender dialogs walk you through everything: you just need your devices on the same network and you'll need to enter an 8-digit code provided by your Xbox 360 on your UMPC. It takes about five minutes to do the setup.
Source: jkOnTheRun: AppleTV replacement: a UMPC and an Xbox 360?
CMS Open the door for the First Round Of Competitive Bidders for Home Health Care
A statement issued by CMS yesterday included the reminder that homecare providers must meet quality standards and be accredited by a CMS-approved deemed accreditation organization or be pending accreditation in order to submit a bid. The accreditation deadline for the first round of competitive bidding is August 31, 2007.
Source: Key Deadlines Loom Ahead For First Round Of Competitive Bidders
Dumped On Skid Row, Anderson Cooper Reports On The Practice Known As "Hospital Dumping" - 60 Minute Report
60 Minutes to air the news story this weekend, May 20th. Story preview available via the link below. BD
Paraplegic Gabino Olvera was "dumped" from a Los Angeles hospital. (CBS)
"These may be the perfect victims because a homeless individual dumped on Skid Row disappears into the chaos of Skid Row within minutes. It's hard for us to find them and get the evidence we need."
(CBS) It's happened so many times in Los Angeles that cameras have been set up near homeless shelters to catch it on tape, because it's illegal as well as immoral. It's called "hospital dumping."
Hospitals put homeless patients in a van or a taxi and drop them on the city's Skid Row, sometimes dressed in only a flimsy gown, even if they're not healthy enough to fend for themselves.
In one of the latest incidents, the patient "dumped" was paraplegic Gabino Olvera, left to pull himself by his hands on the street. It was the van driver's fault, says the head of the hospital where Olvera was a patient. Hollywood Presbyterian acting CEO Kaylor Shemberger, appears in a 60 Minutes report about hospital dumping by CNN's Anderson Cooper to be broadcast Sunday, May 20, at 7 p.m. ET/PT.
Source: Dumped On Skid Row, Anderson Cooper Reports On The Practice Known As "Hospital Dumping" - CBS News
Unmanaged, Diabetes Drug Costs Could Surge Nearly 70 Percent within Three Years
As insurers and major companies work on revising their current compensation plans for many generic drugs, be sure to keep on top of this so you are not hit with the "shell shock" at the pharmacy window someday to find out that the drug prescribed by your MD may no longer be covered. As well as the links to retailers on this page for 300-400 drugs for $4.00 for a 30 day supply, mail order can also be of real value as well in keeping your medications affordable. Your physician knows best and some of the affordable generic drugs may offer economic relief for many who might otherwise choose to not fill a prescription based on affordability. Formularies and coverage change quite frequently and recently I read where Medicare is also working on some revisions as well. BD
Programs to encourage the use of lower cost generic drugs and health plan design initiatives that encourage the use of mail service could mitigate pricing pressures in this category. Health plan initiatives to encourage more preventive care can also curb spending growth.
“For those patients who depend on medications to avoid serious complications, compliance is paramount,” said Epstein. “Lower-cost drugs help remove barriers to compliance, as do safety programs that identify non-compliant patients and provide additional counseling to modify the behaviors and foster more positive outcomes.”
Windows ReadyBoost in Vista
Do you rely on portable USB drives for data? This is another advantage to using Windows Vista.
It's easy to use Windows ReadyBoost. When a removable memory device such as a USB flash drive or a secure digital (SD) memory card is first inserted into a port, Windows Vista checks to see if its performance is fast enough to work with Windows ReadyBoost. If so, you are asked if you want to use this device to speed up system performance. You can choose to allocate part of a USB drive's memory to speed up performance and use the remainder to store files.
Source: Windows Vista: Features Explained: Windows ReadyBoost
P4P without the pain? - Physicians in PHOs and IPAs are banding together to create registries that improve care and help them garner P4P
Are you using some type of "Registry Report" in your practice? This is not really anything new and some EMRs come with a module or section to help a practice easy compile the numbers. You really benefit with this feature being built in to the EMR as it can avoid duplicate data entry. If you are still on paper then this process can be very lengthy as noted below in have to manually comb through all the paper charts...this can absolutely be one huge task and a big disadvantage for continuing paper files. Again, something to think about as the article continues on to talk about how some EMRs do not include registry functions too. BD
They also have to comb through the charts to see when patients last had a test done if that occurred before the labs went online.
The real value of the registry, he says, is that it has helped him deliver better patient care. For example, it can help him see that some of his diabetic patients haven't been told to take a small dose of aspirin each day. "By looking at the whole population of diabetics, I can improve the care for all of them."
Perhaps because these kinds of incentives have been unavailable until recently, registries sponsored by PHOs or physician organizations are still not widespread. (See "Do disease registries=$$ rewards?" Medical Economics, Nov. 4, 2005) But a growing number of IPAs, health systems, medical groups, and health plans are investing in them as a way to improve care and facilitate clinical data reporting. Here's how physicians in two PHOs—one in Michigan and the other in Maine—are using and benefiting from electronic registries.
Most EHRs, Anderson notes, lack registry functions, even if they have good clinical prompts and alerts. For example, GE Centricity, which is popular among local practices, can't produce a "point-of-care report for the patient so the patient gets a self-report about where they stand and what's due." The doctors also can't use it to create lists for population management, he says. So some EHR users in the PHO are also using the registry, he notes.
IRS rules hospitals may assist physicians with healthcare IT
This has been a very hot disputed and conversational topic for years and it is a step in the right direction not to penalize "not for profit" hospitals who want to pursue this and provide assistance for their physicians on staff. The next item that enters into this arena, is do the non profits have the funds to accomplish this as well as motivation for a ROI (return on investment). Many physicians today have the experience of being on staff at both types of hospitals, non profit and those who do make a profit. In my travels it appears the "for profit" hospitals seems to be quite a bit ahead of the game simply due to financial availability, but all is not lost. The good news is that non profit hospitals have many choices today and can in fact provide this type of assistance with either low cost or no cost alternatives and any efforts in this area can have positive results. Even the "for profit" hospitals do not cover the tab entirely in providing the hardware necessary to operate the software, so there still in some type of investment required at both ends.
Non profit hospitals can easily take small steps to increase the interoperability of patient records, beginning with the most simple steps of education for a good start and helping their physicians on staff understand the value of technology and work as a team to make this a reality for better patient care. Competing with the "for profit" hospitals is a tough task, but the first step is to implement some type of of in house electronic records themselves and then perhaps expand this accessibility to the physicians on staff. As mentioned above, this is a fairly large project to undertake and there is also the competition with HMOs in regards to "who is going to be the ultimate data warehouse" of patient records, not to mention the integration of personal health records. The jury is still out on where and who will be the ultimate warehouse for patient health history, but this appears to be a good move in the right direction to move towards a paperless and interoperable system that will result in better patient care. As in any area of health care, education with technology will always be your best friend and help create a team effort to put more money to the bottom line for both the practice and the hospital. BD
Not-for-profit hospitals may provide financial assistance to staff physicians to “acquire and implement software that is used predominantly for creating, maintaining, transmitting or receiving electronic health records (EHRs) for their patients,” according to a directive issued by the Internal Revenue Service (IRS) last week.
“The reason this [ruling] is so important is that hospital providers are the lowest-cost resource for getting IT in physicians’ hands,” said Scott Wallace, president and CEO of the National Alliance for Health Information Technology, according to Healthcare IT News. “The incremental cost to extend a hospital’s IT to physicians is relatively low, and doing so takes away a huge obstacle for small physicians who want to move to EHRs.”
The IRS noted in the memo that “many hospitals plan to establish interoperable EHR systems to improve the effectiveness and efficiency of their medical care and to reduce medical errors,” and that “some believe that their medical staff need a financial incentive” to purchase and implement the software to connect with these systems.
Source: IRS rules hospitals may assist physicians with healthcare IT - 18 May 2007
EVICEL Receives FDA Approval
An adjunct to hemostasis in patients undergoing liver surgery when control of bleeding by conventional surgical techniques, including suture, ligature, and cautery is ineffective or impractical. Not indicated for the treatment of massive and brisk arterial bleeding.The U.S. Food and Drug Administration (FDA) today approved Evicel Fibrin Sealant, a liquid product that when applied topically helps control oozing from small blood vessels during surgical procedures.
EVICEL Fibrin Sealant (Human) is prepared from human plasma. As with all plasma-derived products, the potential to transmit infectious agents cannot be completely eliminated, including viruses and the Creutzfeldt-Jakob disease agent.
Source: JOHNSON & JOHNSON GATEWAY®: EVICEL
http://phx.corporate-ir.net/phoenix.zhtml?c=197979&p=NewsArticle&id=1000371
Hat Tip: Medical News
New Innovations to improve touch screen controls
You may not understand each level of the video, but the pictures paint 1000 words here as you can see the technology improvements for utilizing touch screens on mobile devices..BD
Retrieving the stylus of a pen-based device takes time and requires a second hand. Especially for short, intermittent interactions many users therefore choose to use their bare fingers instead. Although convenient, this increases targeting times and error rates. We argue that the main reason is the occlusion of the target by the user’s finger. We propose a pointing technique we call Shift that is designed to address this issue. When the user touches the screen, Shift creates a callout showing a copy of the occluded screen area and places it in a non-occluded location.
Source: shift homepage
Hat Tip: GottaBeMobile
Chargepod: Charges six mobile devices simultaneously with a single power cord
Now this is a device that truly makes sense! As our collection of portable devices increases this is a real handy way to "charge all" at once. The price is not bad either at $49.99 as you start adding up the cost of purchasing a charging unit for each device and you also have a mess of cords too that go along with charging each device. BD
Chargepod is a 6-way charging device that allows you to charge multiple cell phones, PDAs, headsets, and most other mobile electronics with a single power cord. Just pick out the manufacturer-specific adapters for your devices and throw away the dozens of power cords and wall warts that are cluttering your office and home. Chargepod uses voltage regulator technology and interchangeable power adapters to work with all of your mobile devices regardless of manufacturer or model.
Source: Chargepod: Charges six mobile devices simultaneously with a single power cord
Hat Tip: PocketPCThoughts
One Spooky Cuckoo Clock...
Engadget posted this story about a new concept in clocks...you have to give this one a chuckle...it is a real departure from your standard cuckoo clock I must say...BD
Source: http://www.engadget.com/2007/05/17/the-shining-cuckoo-clock-terrifies-on-the-hour-every-hour/
101 Things To Do with a Mobile Phone in Healthcare
This week I posted information relative to mobile health care. This page offers a free PDF format that goes several steps beyond the generalization point. Mobile phones can do much more today than just be there for making phone calls and again, "have the potential to save your life". This article does a good job in explaining how mobility with technology can prove to be one huge asset for healthcare. We live in the world of the "informed patient". BD
Before the arrival of the ‘informed patient’ the GP was expected to provide a diagnosis, then recommend a course of treatment. Today many patients believe they already have a diagnosis and merely wish to have it confirmed by a series of tests. The question is no longer ‘Doctor what is wrong with me?’ but ‘Doctor when can my treatment begin?’ Mobile and wireless ehealth will enhance and broaden the scope of this type of self diagnosis.
Peer pressure will drive the ehealth market, especially if consultants start reaping the benefits of venture capital backing and IPOs. The report states that, in the not too distant future, the ehealth market will enter a new phase where clinicians themselves encourage the automation of clinical processes.
While some of the applications are speculative, for example a mobile device to detect MRSA, others, such as SMS based patient reminders, have already been deployed and are earning revenue for vendors.
Source: Wireless Healthcare - Reports
Doctors face felony charges
SANTA ANA – It just took a few hundred bucks, or in one case, the promise of a tummy tuck, for the insured "patients" to lie down on the operating table in Buena Park.
There, at Unity Outpatient Surgery Center, doctors Michael C. Chan, William W. Hampton Jr. and Mario Z. Rosenberg were waiting, and performed more than 1,000 mostly unnecessary procedures to remove cysts, treat sweaty palms and hemorrhoids, prosecutors say.The three are accused of more than 1,000 unneeded surgeries at Buena Park center, bilking insurers of $30.5 million.
The three doctors were arrested Wednesday for allegedly bilking insurance companies out of $30.5 million while working at the now-shuttered Unity surgery center.
Dec. 2005 - Aug. 2006: Officials charge up to seven people with crimes such as illegally recruiting patients for Unity, capping, insurance fraud and tax evasion.
The Orange County Register: Article - News - Doctors face felony charges
Hospital Offers Surgery With a 90 Day Warranty
This is something I have not heard of until reading this article. It appears this hospital is making strides in the right direction to ensure safe and successful surgeries. BD
A nurse at Geisinger Wyoming Valley Medical Center in Wilkes-Barre, Pa., counted sponges after surgery to ensure none were left in the patient.
Even if a patient suffers complications or has to come back to the hospital, Geisinger promises not to send the insurer another bill.
Under the experiment, the hospital charges a flat fee for the surgery, plus half what it has calculated as the historical cost of related care for the next 90 days. Instead of billing for any additional hospital stays — which typically run $12,000 to $15,000 — Geisinger absorbs that extra cost.
But hospitals have been slow to focus their attention on standardizing the way they deliver care, said Dr. Arnold Milstein, the medical director for the Pacific Business Group on Health, a California organization of large companies that provide medical benefits to their workers. Geisinger “is one of the few systems in the country that is just beginning to understand the lessons of global manufacturing,” Dr. Milstein said.
Source: In Bid for Better Care, Surgery With a Warranty - New York Times
WinHEC 2007 -Mobile Medical Demo
This evening I was chatting with Chris DeHerrera, who has been attending the Microsoft WinHEC conference this week. One of the keynote speakers, Craig Mundie, was addressing how to use technology to diagnose and help the illiterate through mobile technology. I have included a couple pictures Chris has posted on the site. This is indeed an very interesting concept on how to help and reach those with mobile technology who are in need of health care.
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This picture above shows an opening screen on a Windows Mobile Cell Phone.
The next picture shows pictures to allow one to choose their symptoms and identify the part of the body with issues. Is it your tooth? Do you have a temperature?
I like the small yellow character on the bottom line, basically asking "did you barf".
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Anyway from the visuals, you get the picture on how easy a simple graphical interface can be for a user. This information can be received on a server application or kiosk to help offer assistance to anyone with a mobile cell phone that can talk, but perhaps cannot read or write.
And this brings us around to mobility and the ability to access information anywhere, with our choice of device whether it be a desktop PC, tablet PC, cell phone, regardless of whether or not one can read or write.
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Thanks Chris for the updates on this week's conference. You can follow the link below for the full story and additional pictures.
http://www.tabletpctalk.com/events/winhec2007/keynote/mundie.shtmlWinHEC Interview with Bill Gates
This conference is going on in Los Angeles this week. I was not able to attend, but thanks to many friends and associates who are there, I am able to bring a little of the keynote information to the site. This is a bit of a commentary on my part, but for those of you who think your desktop PC is going to be the only element in today's world of technology, you might want to think again.
Mr. Gates in the video interview does a real good job in discussing mobility. This is why the blog here contains not only medical stories, but mobility information, including the use of cell phones with Windows Mobile, tablet pcs with inking. (Listen closely as he clearly mentions inking as another way of interacting with technology).
Why is this important in the health area? If you are a regular reader of this blog there have been numerous posts on how technology can potentially save your life if for no other reason! As technology continues to evolve in the medical arena, the very items folks may shun and overlook just might be the technology or device you need to save your life or that of a loved one.
Mobility is here to stay and it is a personal decision on all our parts as to where we need to focus and what serves to benefit our lifestyles, and I agree sometimes this can be a bit overwhelming at times. The whole idea is to also share this technology and news with others.
Are you still just using your cell phone for phone calls? Here's a quick example here, let's say you are diagnosed with a cardiac condition and your physician may need to monitor your heart. Do you know a blue tooth cell phone can work with other mobile medical devices to get the information quickly to your physician? It is really something to think about. By monitoring information in real time both you as a patient and your physician can easily benefit with a treatment plant and/or course of action that is specifically for you, something that just might save or extend your life. There are a few posts on this site in the recent past that can add more light to the subject.
Are you an MD waiting around for an transcriptionist to put your medical records in a file? Why not use a tablet PC with some dictation in real time to enter chart information? As an MD are you still relying on small pieces of paper in your pocket to complete patient chart data? Once information on a mobile device has been entered it can be transferred to an ER physician within seconds. As an MD are you still relying on an old paper chart to locate patient information? Paper charts - one person at a time can view the information, electronic records - many can view the same at once and even collaborate.
Again, with emerging mobile technology and innovations hitting the market, and with the FDA readily approving so many of these devices and their use, why procrastinate, especially when human lives are at stake. It is a learning curve, but something we all need to embrace with at least some minimal training, just like driving a car.
If you think that your desktop PC is 100% of the answer today with information, you might want to think again as restricting yourself to only using a desktop PC in today's world is just not the complete solution as Mr. Gates discusses in the interview. As technology continues to evolve, your co-workers, superiors, friends, patients, etc. simply will not be satisfied with having to wait for you to return to your desktop PC, or worse yet, rely on a crumbled piece of paper from your pocket for the information and communication they desire.
I hope the mobility solutions we feature here prove to be of benefit to bring these new and innovative technologies to light. As mentioned in the interview, mobile devices are designed to work with each other and are not separate and divided tools. Learning how to interact with mobility is something that should be on the agenda for all of us, as again it just might save your life someday!
http://www.microsoft.com/winme/0705/30100/Bill_Gates_WinHEC_Interview_MBR.asx
Can you read these prescriptions?
Round 2 on handwritten prescriptions..a picture tells a 1000 words and this example clearly brings this right to light...Why are physicians not taking advantage of the free e-prescribing offered by the National e-prescribing initiative? There is a permanent link on this site to the page for information and enrollment. Some physicians are already using other plans that have been commercially purchased with an EMR or simply sold separately. It continues to boggle my mind as to why more physicians haven't at least given this a try - IT IS FREE! The handwriting is so poor that this website has a a test going on to see who can accurately read this stuff! I'm glad it's not my script to give to a pharmacist. BD
Source: http://onthepharm.net/2007/05/doctors-handwriting-prescriptions.html
Where to go for free E-Prescribing once more: http://www.nationalerx.com/
Department of managed health care - State of California
Did you know the State of California has an information website? I know sometimes we get overloaded with resources and it becomes a major decision on where to go and how much time we can devote to research. Resources on the page are for both consumers and providers. BD
Consumer protection is the DMHC's top priority. We make sure that health plans follow California managed care laws and remain financially stable.
One item in particular that might be helpful is the HMO Help Center. There are levels for elevation if a claim solution has not been provided by the insurance carrier. The site recommends a complaint first be addressed with the insurance carrier before elevating to this level. BD
HMO Help Center
Call 1-888-HMO-2219 (1-888-466-2219)
TDD: 1-877-688-9891
There is no charge for your call.
The HMO Help Center is open 24 hours a day, 7 days a week.
The HMO Help Center can provide help in many languages.
You Can Apply for an IMR (independent Medical Review) if Your Health Plan:
- Denies, changes, or delays a service or treatment because the plan determines it is not medically necessary.
- Will not cover an experimental or investigational treatment for a serious medical condition.
- Will not pay for emergency or urgent medical services that you have already received.
Before You Apply
In most cases, you must complete your health plan's complaint process before you apply for an IMR. Your plan must give you a decision within 30 days or within 3 days if your problem is an immediate and serious threat to your health.
Source: http://www.dmhc.ca.gov/dmhc_consumer/pc/pc_complaint.asp
Provider Complaint System
The DMHC has developed a system of investigating and addressing unfair payment or billing patterns. As a result, an online Provider Complaint System was developed to evaluate claim reimbursement disputes If you are provider and would like to report a problem regarding claims payment, please complete an online Provider Complaint form.
Provider Line: 1-877-525-1295
Source: http://www.dmhc.ca.gov/providers/clm/clm_default.asp
Health Insurance Plans
I found this page with links to most of the major health insurance plans.
Source: http://www.ahip.org/content/default.aspx?bc=31|42|55
Health Decisions.Org also has some helpful information and the page is simple enough to allow you to drill down to find much of the information you may be looking for. I have found this page to point me in the right direction in many instances, even if the resources are not contained at the site.
Walk while you work -Treadmill Workstation from the Mayo Clinic
The Mayo Clinic is addressing the obesity issue with a new treadmill workstation. Instead of sitting at our PCs, someday we might all be walking while we work. You can follow the link below to view an entire slideshow to learn more. This gives a whole new meaning to walking and chewing gum at the same time..BD
Source: http://www.mayoclinic.org/spotlight/levine-gallery.html
Hat Tip: Medlaunches
Robotic Patient
Something new for medical school, perhaps? BD
Researchers at Gifu University’s Graduate School of Medicine have developed a robotic patient that can respond verbally to questions about how it feels and move its body in ways that exhibit the symptoms of its ailment.
Modeled after an adult female and equipped with body parts that move in a smooth, human-like way, the android is designed to provide students with valuable hands-on experience in diagnosing rare medical conditions. For example, when suffering from myasthenia gravis — an often misdiagnosed neuromuscular disease leading to muscle weakness and fatigue — the robot tells the doctor its eyelids are heavy, and it changes its facial expression, slowly relaxes its shoulders and hunches forward.
Source: Sick robot takes med training to the uncanny valley ::: Pink Tentacle
Hat Tip: Engadget
Handling House Calls in a Managed-Care World
The academy includes doctors from medical centers that have house-call programs, as well as those in small practices. The organization is lobbying Congress for permission to bill Medicare and Medicaid using a Care Level-type model that includes monthly rates, rather than paying for each visit.
Dr. Henri Becker developed the model for Care Level in 1995, when he was the medical director of the Huntington Provider Group in Pasadena, Calif. Dr. Becker found he could cut repeat hospital admissions by treating the sickest patients at their homes, before their medical problems grew dire. In 2001, he teamed with Raouf Khalil, an entrepreneur who had sold a successful home-infusion business, to start the company.
Care Level has grown to about $65 million in annual revenue with 350 employees in California, Arizona, Pennsylvania, Texas and Florida. Mr. Khalil, the chief executive, would not disclose income amounts, but said the company was profitable. About 85 percent of its patients are in the Medicare trial, with the rest coming from commercial insurers.
Source: Handling House Calls in a Managed-Care World - New York Times
Some doctors don't like this Medi-Cal prescription
The debate continues on California's proposed physician tax...BD
This year's debate over healthcare has exposed a number of other fissures: between doctors with profitable practices and those who tend to the poor; between those who are paid for services and those who work in managed care; and between those reluctant to tamper with the current system and those who want to discard it.
"The rates are so low that a lot of doctors just can't afford to see these patients," said Dr. Paul Urrea, a pediatric ophthalmologist from Monterey Park. Urrea, who practices at White Memorial Medical Center in Montebello, favors the governor's proposal.
But some California doctors say that even though they don't work much with Medi-Cal, they still provide substantial care for the poor. Dr. Richard Corlin, a Santa Monica gastroenterologist and former CMA president, said his practice provided $250,000 worth of free care to the Venice Family Clinic last year.Doctors say Schwarzenegger's 2% assessment is excessive because it would not be placed on a doctor's net income but on all office revenue. Many doctors say it would amount to at least 4% of their take-home pay.
Source: Some doctors don't like this Medi-Cal prescription - Los Angeles Times
Portrait of an ER at the Breaking Point
This story is a true eye opener on the story of of an ER trauma center and well worth taking a look at...BD
“You want to give quality care but you can't,” said Charge Nurse Sherika Kimbrough. “We're at our breaking point.” Same goes for the physicians, who also have malpractice suits to worry about. Two years ago, Kellerman received a resignation letter from a top-notch doctor. “I can't take it anymore,” she told him. “I am so afraid of making a mistake that I'm vomiting in my driveway before I go to work.”
Postscript: since the time of this report, Grady's condition has worsened. The institution has had to slash costs to remain viable. Earlier this year, it offered buyouts to 560 older and more experienced personnel; 420 of them accepted. With the help of the consulting firm of Alvarez & Marsal, which specializes in rescuing companies, Grady is studying a host of other potential cuts, including its dialysis program and its neighborhood health centers.
Source: Portrait of an ER at the Breaking Point - Newsweek Health - MSNBC.com
Hat Tip: Kevin MD
Microsoft Math Released, for students, but I could use this too!
This is a great new release in the tablet area with inking support. I can always use a brush up on my math. I somehow think this could also be of help with the graph and equation solvers in every day use. BD
With Microsoft Math, students can learn to solve equations step-by-step, while gaining a better understanding of fundamental concepts in pre-algebra, algebra, trigonometry, physics, chemistry and calculus.
Microsoft Math provides a set of mathematical tools that helps students get school work done quickly and easily. With a full-featured graphing calculator that’s designed to work just like a handheld calculator, Microsoft Math offers a wide range of additional tools to help students with complex mathematics.
Source: http://www.microsoft.com/math/ProductDetails.aspx?pid=001&active_tab=Overview
Using a UMPC as a portable storage device - simply via USB
Chris over at TabletPCTalk.com has posted some interesting pictures on how your PC can control a UMPC from Tablet Kiosk. These pictures are from the WinHEC2007 event taking place in Los Angeles this week. If you venture on over to the site, you can also see the unit being used as a USB hard drive with an XBox 360. As a physician using a UMPC as a portable device, this combination could be a real plus when returning to the office to move files from the office PC to the portable unit easily or vice versa. You can see the screens from the UMPC clearly on the desktop monitor below. With any type of medical files security is a big concern so by using the UMPC for storage and portability, records are protected with all the normal security with Windows Vista or XP as well as hardware security, such as a fingerprint sign on provided on the UMPC. If you need to have portability with any medical documents, this appears to be a much more secure route rather than relying on a small flash drive. BD
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Source: http://www.tabletpctalk.com/events/winhec2007/exhibits/usbduet.shtml
The first demonstration shows a USB Duet-enabled TabletKiosk™ eo TufTab™ v7112XT UMPC computer connected directly to an Xbox 360 console through a standard USB cable. Because USB Duet allows UMPC machines to appear as simple USB storage devices, such as flash drives (which require no driver installation), the Xbox 360 system automatically detects the v7112XT as a new storage device and easily accesses its shared folder. The high-speed connection - up to 480Mbps -- enables full high-definition-quality video to be played back on the Xbox 360 console, and then displayed on an HDTV.
Linda at TabletPC2 also has posted additional information above and the photo below.
Source: http://www.tabletpc2.com/Photo_Preview_from_WinHEC_2007.html
The new and simplified technology is a nice partnership for the UMPC made possible by PLX Technology.
PLX TECHNOLOGY TO DEMONSTRATE INDUSTRY'S FIRST USB DUET-ENABLED UMPC COMPUTERS
Revolutionary USB Duet Provides Ultra-Portable Machines with Fastest, Simplest PC-to-PC Connection
SUNNYVALE, Calif. - May 14, 2007 -- PLX Technology, Inc. (NASDAQ: PLXT), the leading global supplier of PCI Express®, USB and other standard I/O interconnect solutions, today announced it will demonstrate at the Windows Hardware Engineering Conference (WinHEC) in Los Angeles the industry's first Ultra-Mobile Personal Computer (UMPC) machines enabled with PLX's USB Duet™ technology.
CardioBelt from Monebo receives FDA approval
Interesting how the unit is making use of mobility with being able to connect to a Pocket PC or Smart Phone as well as a PC...BD
The CardioBelt™ consists of a simple sensor unit with three embedded electrodes, which may be wirelessly connected to a processor such as a PC, PDA/PocketPC, or Smart Phone or any special-application processing device.
There are two versions of the CardioBelt™. One has a separate electronics package and a disposable sensor belt. This is useful in applications such as home health care. The second version is completely self contained. In this case, the belt is dedicated to a specific owner.
The data analysis subsystem calculates the characteristic points of the QRS complex. A complex analysis algorithm develops a set of cardiac parameters which serve as useful indicators of cardiac conditions.
CMS Seeks To Begin 'Profiling' Inefficient Physicians
Could CMS be knocking at the physician's door next year? I am guessing here efficiency would mean in the direction of using technology to become more efficient as that is pretty much the foremost solution. In just my observations as a consultant a visual at any practice pretty much tells the story on how much technology might be in use. The offices still buried in total paper tend to display a much busier staff with faxing, files, etc. while those with some degree of technology in use seem to show a much calmer and organized office, less chaos and little or no paper chasing going on, allowing for more concentration on patient care. BD
CMS has the data and computer capacity to identify physicians who are inefficient compared with their colleagues and as early as mid-2008 might begin to contact those physicians and ask them to become more efficient, Herbert Kuhn, acting deputy administrator of the agency testified on Thursday at a House subcommittee hearing, CQ HealthBeat reports. At a House Ways and Means Subcommittee on Health hearing, Kuhn said that identification of inefficient physicians, or "profiling," would involve a comparison of the number of tests ordered by physicians for certain types of patients with the number ordered by colleagues in cases that have the same outcome.
Kuhn said that the largest concern about implementation of profiling involves the determination of how to use the results to educate physicians to become more efficient and whether to involve medical societies, Medicare quality improvement organizations or other groups in the process. He added that he expects CMS to implement profiling on a "broad scale" and target as many physicians as possible, "if not all physicians." In addition, Kuhn said that CMS could implement profiling without the passage of legislation.
Source: CMS Seeks To Begin 'Profiling' Inefficient Physicians
Washable Mouse and Keyboard
I think I could even use something like this in case of a coffee spill....BD
Spillseal offer both corded and wireless washable peripherals...
SpillSeal® protected 3 button scroll wheel mouse. Can be washed / sterlised and complies to NEMA4X and IP66.
SpillSeal® protected keyboard. Can be washed / sterlised and complies to NEMA4X and IP66.
Source: http://www.unotrononline.com/searchResult.aspx?CategoryID=10
HEART MONITOR RING
Not expensive...39.99, and FDA approved...BD
Heart monitor ring tracks heart rate during exercise and daily routines. Not bulky, like oversized arm monitors. FDA approved unit features stopwatch, continuous heart rate display (30-250 beats per minute), a maximum/minimum heart rate target zone and ten hour count up timer.
Recent Developments Related To Medical Malpractice In Two States
2 more states taking an active roll in malpractice lawsuits...BD
- Arizona: The Arizona House on Monday rejected a bill (SB 1032) that would have made malpractice lawsuits against emergency department physicians and staff more difficult for plaintiffs to win, the Arizona Republic reports. The legislation, which the state Senate approved in January, would have required plaintiffs in such malpractice lawsuits to provide "clear and convincing evidence" that the care they received did not meet professional standards, rather than a "preponderance of evidence."
Hospitals' move to e-files spurs a labor shortage
I don't think this is only limited to Massachusetts by any means, but this is the first time I have seen this addressed as I run across the same in my travels in California as well. Health IT changes rapidly and the old days of even a consumer picking up and CD and going online without security issues these days are gone..we need a blending of both physicians and IT to really make this thing work...BD
Massachusetts is among the leaders nationally in the use of electronic patient records and computerized drug prescribing. But its workforce is not keeping pace: The state lacks enough people who know how computers work and who understand how doctors diagnose and treat diseases.
It is a unique blend of skills that is increasingly in demand as the health system gets wired.
Source: Hospitals' move to e-files spurs a labor shortage - The Boston Globe
Rev up your engines with an i7210 UMPC - Your Tablet PC, Ultra-Mobile PC, and Mobile Internet Device news source
This is really a neat story from the folks over at GottaBeMobile...it is using a Tablet Kiosk UMPC to tune his car! Now I wouldn't suggest this for the novice, but if you own or plan to buy a UMPC for use in the medical arena, look what else it can do! I wouldn't suggest keeping medical records and the tuning software on the same device though for obvious reasons..
Thanks to the folks at GottaBeMobile for sharing this. BD
The Silence of the Fax
Last week I was visiting the offices of one of my clients, a small family practice in West Anaheim. I visit all different types of offices and each with their own level of technology in my travels.
After being there for over an hour, I recognized a "silence", something I don't always notice in other offices, and in this instance, it was a good silence, the fax machine! The office manager here, Christina, was on the ball and over a year ago, subscribed to and pays for an e-prescribing program for patient prescriptions. I asked her for a quick demonstration and she said "sure".
All patients who have prescriptions were already listed in the data base, so adding a new medication was very simple. In addition, there was another screen to add a new patient as well. She said this sure makes the process manageable and we don't have to keep buying huge supplies of ink for the fax machine too. She said there was a small learning curve at the beginning on both her part and the part of the drug stores. Keep in mind this has been over a year when she got started and things since this time have streamlined a bit more. She said part of the issues with the fax was getting a fax every month for patients who had been given a prescription open for 12 months. Each month, the pharmacy was sending her a fax to confirm it was still valid. Well if you add this up over many patients and a number of medications, you can just imagine the number of faxes that were arriving every day to confirm prescriptions that were more than 30 days! She said the fax machine was going non-stop.
Once moved over to the new e-prescribing, the requests continued to come, to the e-prescribing software. This was still a lot of work to confirm such a long list of medications every day even with the software. After a little work and communication with the pharmacies this also began to fall in to place, with the drug stores now knowing that if there is a cancellation of a prescription, they will be notified from the physician's office and the extra leg work on their part to confirm each month was no longer required.
She also has a history now of when the patient filled the prescription and received a confirmation that the script was received by the pharmacy. That is big help knowing that the patient has followed through. It also helps he keep track of the pharmacies used by the patient, so she can immediately see and trends or changes in where the patient usually fills their prescriptions. She said this sure makes life a whole lot easier not having to rely on a paper chart to coordinate patient medications as they are all in the data base.
The software also allows for filtering and drilling down specific information as well. All these features in the software are designed to save time. Again, the one nice thing as an outsider like me was the "silence of the fax" and not seeing an office in a state of chaos racing to the fax machine all day! This was definitely one nice move towards going paperless and says quite a bit on how e-prescribing can really make the day-to-day life in a physician's office a little bit easier for all.
As a footnote, on the left hand side of this page, there is a link to the National E-Prescribing initiative where ANY physician in the United States can begin E-prescribing for free, so there's no cost involved. This is paid for by grants from the likes of Microsoft, Intel, Cisco, to name a few. It involves a short training session via the web and then you are set and ready to go.
Again, I can't comment enough here not only on lack of the chatter of a fax machine, but I definitely saw something else going on here, as they all had more time to devote to the patient without having to spend this time on administrating a paper chase. BD
Doctor/Dentist Office Caught Tossing Medical Records
It makes you wonder how often things like this really happen! If you read the entire article, one was running for city council? I wonder if he was elected? The comments quoted from staff members are indeed very sad if this is the case...BD
The Trouble Shooters spent several weeks checking the company’s trash dumpster and discovered bag after bag, filled with private medical records and personal information.
Social security numbers and dates of birth are all a person needs to steal a person’s identity.
Robbie Henwood refused to talk on camera about what we found. Off camera, Robbie Henwood claims he has no idea how his patients' records wound up in the trash.
But a former employee claimed the doctor was fully aware of what was happening and the staff even brought the problem to his attention two years ago.
“In that office we were told, keep your mouth shut, do your job, we can replace you,” the former employee said.
Source: Doctor/Dentist Office Caught Tossing Medical Records | WOAI.COM: San Antonio News
Can iPods make pacemakers malfunction?
For years we have all been told about the now downgraded use of cell phones in the medical offices and hospitals..and now there's a new potential culprit..the ipod? I guess from reading the article, if you have a pacemaker make sure you aren't carrying around an Ipod, or perhaps borrowing an Ipod from a friend..will be interesting to see as more develops on this story in time and it might be a good idea not to bring the Ipod into the examining room until more is known...BD
CHICAGO (Reuters) — IPods can cause cardiac implantable pacemakers to malfunction by interfering with the electromagnetic equipment monitoring the heart, according to a study presented by a 17-year-old high school student to a meeting of heart specialists Thursday.
The study tested the effect of the portable music devices on 100 patients, whose mean age was 77, outfitted with pacemakers. Electrical interference was detected half of the time when the iPod was held just 2 inches from the patient's chest for 5 to 10 seconds.
Jay Thaker, lead author of the study and a student at Okemos High School in Okemos, Michigan, concluded that iPod interference can lead physicians to misdiagnose actual heart function.
Source: Can iPods make pacemakers malfunction? - USATODAY.com
PPO merger cuts physician pay ... American Medical News
Contract shock: PPO merger cuts physician pay
MultiPlan and Private Healthcare Services are reconciling contracts for the merged entity. Doctors say this means fee cuts.
The AMA and numerous state medical societies are hearing complaints from physicians about what they say is a sudden reduction in rates by a large, independent PPO.
Source: AMNews: May 21, 2007. Contract shock: PPO merger cuts physician pay ... American Medical News
Physicians wary of new national database that makes liability data public ... American Medical News
HealthGrades says it will help patients make more informed choices. Doctors say such information is more complex than a paper report.
While physicians encourage patients to do their homework before choosing a doctor, they warn that HealthGrades Inc.'s new public national database of medical liability records might not tell the whole story.
The independent health care ratings company in March launched what it calls the first national database to combine all available public liability records. The data include closed claims reported through state agencies, such as medical boards or health departments, in 15 states: California, Connecticut, Florida, Idaho, Indiana, Massachusetts, Maryland, North Dakota, New Jersey, New York, Oregon, Tennessee, Virginia, Vermont and West Virginia.
![EZClaim[4]](http://lh4.ggpht.com/_v3zjJigoAPE/TG1-9etl5ZI/AAAAAAAAgqg/CRMlet5Pi5k/EZClaim44.png?imgmax=800 "EZClaim[4]")
Math–This Could be a Subject for Michael Moore to Explore and Document In a Movie
Screenings Too–Killer Algorithms Part 12–Medical Billing Codes Style
Assessing Consumer Credit Scores–Attack of the Killer Algorithms Chapter 21 With Flawed Data
Duping” Society Combined With A World of Rogue Algorithms & Flawed Data Continues In Markets As Seen With Knight Capital This Week-Attack of the Killer Algorithms Chapter 36
Study Fraud With EHR Technologies, Namely Medical Records/Billing Software Used by Hospitals– HHS And SEC Continue Getting Their Non-Algorithmic Fannies Kicked–Attack of the Killer Algorithms Chapter 46
SilverScript Senior Drug Program Sanctioned by Medicare Until the Payment And Billing Algorithms are Cleaned Up-Killer Algorithms Chapter 53
