Medicare won't pay for hospital mistakes

This has been talked about for a while and it appears the new rules are going into place...BD

Hospitals in the future will be expected to pick up the cost of additional treatment required by a preventable condition acquired in the hospital. "The hospital cannot bill the beneficiary for any charges associated with the hospital-acquired complication," the final rules say. Congress in 2006 gave the Centers for Medicare and Medicaid Services the power to prevent Medicare from giving hospitals higher payment for the extra costs of treating a patient when infections and other preventable conditions occur during a hospital stay.

Those conditions are: objects left in a patient during surgery; blood incompatibility; air embolism; falls; mediastinitis, which is an infection after heart surgery; urinary tract infections from using catheters; pressure ulcers, or bed sores; and vascular infections from using catheters.

Medicare won't pay for hospital mistakes

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Brazil to pay for sex changes

Government ruled as a constitutional right...BD

Brazil's public health care system will cover the cost of sex-change operations, the government said, after a federal court ruled the procedure was a constitutional right. To qualify for health care, the operation will first have to be approved by a panel of doctors, after appropriate psychological and medical evaluations are made of the patient, the Health Ministry said in a statement.

Brazil to pay for sex changes: World: News: News24

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Doctors say Medicaid reimbursements are not enough- Ithaca, NY

 Another state facing the same issues...BD

ITHACA A recent study of Medicaid's physician reimbursements ranked New York 49th in the country, in front of only New Jersey. The poor relationship between doctors and the state Medicaid program is driving more local physicians to see fewer Medicaid patients. ADVERTISEMENT For many doctors, they are sad to say, it's become a question of the bottom line. For Dr. Rudolph Fedrizzi, an Ithaca gynecologist, a recent Medicaid reimbursement check demonstrated precisely the issue at hand. Fedrizzi has $17,000 in outstanding bills with Medicaid. This week he received a check from the state for $2. It cost them more to mail the check, he said.

The Ithaca Journal - www.theithacajournal.com - Ithaca, NY

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Doctors try new word: Sorry.

A little concern goes a long way, especially with Medicare threatening to stop payment for errors...view a recent story here...BD

The doctor walked into the hospital room with a discomforting mission. He was there to admit a medical mistake and apologize to his patient, a woman with breast cancer. The staff had given her the same injection twice by accident, causing her white cell count to soar, said Dr. Divyesh Mehta, chief of oncology at the University of Illinois at Chicago Medical Center. He recommended she stay in the hospital an extra day or two. "This is our responsibility, and we are very sorry for it," Mehta said, recalling the conversation.

Mehta, the head of oncology, learned of the double injection the next day, when someone from the hospital contacted the clinic. Before talking to Cephas, "I checked all the facts and I put myself in the shoes of the patient and asked myself what her concerns might be, so I could prepare truthful answers," he said.

Doctors try new word: Sorry. -- chicagotribune.com

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Hawaii: Health Insurers Report Losses

Big salaries and bonuses play a role...BD

Hawaii Medical Service Association posted a net loss of $4.3 million for the quarter, while Kaiser Foundation Health Plan Hawaii reported a $3.2 million loss. The losses follow criticism of HMSA for paying its chief executive $1 million last year and a shake-up at Kaiser, which began a cost-cutting program that led to 54 layoffs and a management overhaul.

Last year, HMSA paid its Chief Executive Bob Hiam a $620,000 salary and $497,117 performance bonus, after the company posted $2.1 billion in revenue.

Hawaii: Health Insurers Report Losses | Chron.com - Houston Chronicle

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Heart attack lands couple in debt

 

Debby Smith knew she was taking a chance going without insurance. When Smith completed a temporary job at Cornell, she was eligible to buy into Cornell's insurance through COBRA, as long as she paid the full premium for herself and her husband $800 a month. ADVERTISEMENT I was unemployed. Unemployment insurance wasn't enough to pay for it, Debby said. Her husband, Bill Neal, was already retired and drawing Social Security. Between Bill's Social Security and Debby's unemployment check, their income was meager: $865 a month.

Four years later, every bill but the biggest one — $13,000 owed to Robert Packer hospital — has been paid off. Because Debby couldn't afford the $400 a month that the hospital wanted her to pay, the bill was forwarded to a collection agency. Debby gave the agency her cell phone number so they couldn't contact Bill.

The Ithaca Journal - www.theithacajournal.com - Ithaca, NY

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FDA is rejecting more new drugs

 

TRENTON, N.J. - Under growing scrutiny since the blockbuster painkiller Vioxx was pulled from the market, the Food and Drug Administration in recent months has rejected a slew of experimental drugs or delayed their approval and required more data. Besides keeping drugs some patients might desperately need off the market, the rejections have battered drug company stock prices and are expected to increase the cost and time it takes to develop a new drug.

The FDA also has recently stiffened warnings on several drugs, most prominently diabetes drugs Avandia and Actos, and five months ago made Novartis withdraw its constipation drug, Zelnorm.

FDA is rejecting more new drugs - Health Care - MSNBC.com

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Alaska begins offering e-prescriptions

Last sate to join national tech network... there is a link on this page to the "free esprescribing initiative on the left hand side of this page...BD

ANCHORAGE, Alaska - Electronic drug prescriptions can be delivered to pharmacists in all 50 states for the first time this week as Alaska became the final state to join the technological bandwagon. In the past year, Georgia, South Carolina and West Virginia have all joined the national network, and the change in Alaska regulations means doctors hieroglyphic handwriting and prescription pads could soon be a thing of the past.

Electronic drug prescriptions, via handheld pocket computer, can be delivered to pharmacists in all 50 states for the first time this week.

Alaska begins offering e-prescriptions - Health Care - MSNBC.com

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Hospital using barcode technology to reduce medicine errors

90,000 medications scanned in only 2 weeks...BD

The eMAR system combines Bluetooth wireless technology and hand-held scanners to read barcodes -- just like the barcodes used in supermarkets. Under the system, individual dosages of drugs are bar coded in hospital's pharmacy, then tracked from the pharmacy to the nursing unit to the patient's bedside. At admission, all patients are given barcoded bracelets to be used for identification. The nurse scans a patient's bracelet at the bedside before medications are administered. If the nurse scans the wristband and medication, and the software detects a medication interaction, incompatibility or allergy, the eMAR system alerts the nurse. During the hospital's first two weeks of using eMAR, 90,000 medications were scanned; 6,000 alerts were noted -- 1,200 of which had clinical implications, the hospital said.

Hospital using barcode technology to reduce medicine errors - Philadelphia Business Journal:

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CardioChek P·A Technology-Labs on the spot in the office...

This could certainly help eliminate some lab visits with having the information on the spot....lipids in minutes...BD

Efficiency: In about two minutes* – in an exam room, waiting room or office – nurses or technicians with a hand-held CardioChek PlA can obtain results from a quick and easy fingerstick. No blood tube draw. No centrifugation or shipping. No waiting for the lab. No re-charting. No telephone calls to give the patient results.

Effectiveness: Accurate results are in the chart for the physician-patient encounter. Deal immediately with the situation. Counsel the patient face-to-face with immediate test results.

Economy:
Increase Revenues - Covered by Medicare and most carriers.

Reduce Costs - Free up nursing and staff time.

CardioChek PlA Technology
The underlying technology of the CardioChek PlA System employs innovative concepts to emulate the complex chemical analysis, sample preparation and measurement methods of clinical labs in a simple format suitable for untrained operators.

Operating Principle
A precise volume of whole blood is dispensed on to the application window of a PTS Panels Test Strip that has been inserted into a CardioChek PlA analyzer. Red cells and other non-plasma components are removed from the plasma. The plasma reacts in a precisely controlled manner with a series of chemically impregnated membranes, ultimately producing a color change in the final membrane layer. The analyzer measures the color intensity from the color spectral profile and compares to lot-specific calibration information contained in the MEMo Chip to calculate an accurate result. The analyzer then displays the result, simultaneously triggers a printout (if the dedicated printer is attached), and stores the test information in memory for later recall.

CardioChek P·A Technology

Hat Tip:  Medgadget

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What's Your Color Giveaway - 10,000 entrants will win a Ultra Mini Meter

Looks more like an mp3 music player..if you are a diabetic, sign up to enter...BD

Take the dull out of diabetes testing! The OneTouch® UltraMini" Meter in 4 crowd-pleasing colors! Pink Glow. Silver Moon. Limelight. Jet Black. With the OneTouch® UltraMini" Meter, blood glucose testing will never be dull again. So pick your color. Match it to your cell phone. Your car. Your yoga mat. Your mood. Whatever you choose, youll get a small, sleek meter that gives you a number quickly, then slips back into a pocket or purse, so you can just get on with your day.

The OneTouch® UltraMini™ Meter comes in Pink Glow, Limelight, Jet Black, and Silver Moon. It’s not just colorful—it’s testing made small and simple. And it uses OneTouch® Ultra® Test Strips, covered at the lowest co-pay by more health plans than any other test strip.

OneTouch® UltraMini" : What's Your Color Giveaway

Hat Tip:  MedGadget

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Kaiser HMO CEO backs Schwarzenegger's health reform

Payers not in agreement as well...some have a lot to lose...BD 

CHICAGO (Reuters) - The chief executive of the biggest health maintenance organization in the United States said on Thursday he backs key elements of California Gov. Arnold Schwarzenegger's proposal to extend health-care coverage to millions of uninsured individuals. Schwarzenegger's $12 billion pitch to provide health insurance in the estimated 6.5 million without insurance in the most populous U.S. state would seek higher taxes from doctors and hospitals and asks health plans to limit profits.

For health plans, a controversial element of Schwarzenegger's plan is a proposal that would require health plans to spend at least 85 cents of every dollars in premiums on medical care, according to Wall Street analysts.

WellPoint Inc., the biggest health plan by membership and a major player in the California health insurance sector, is seen as being the biggest at risk because historically it has spent the least on medical care out of premium dollars in the state.

Kaiser HMO CEO backs Schwarzenegger's health reform | Health | Reuters

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Is universal health insurance on the horizon?

 

WASHINGTON It isnt streamlined, it isnt logical, but Americas cobbled-together system of paying for medical care does cover 85 percent of the population. And despite the chorus of pleas for a sweeping redesign of America's medical insurance system as the 2008 presidential race heats up, a top-to-bottom makeover seems less likely than a series of reforms that aims to fill in gaps in coverage.

Whether the new president is a Republican or a Democrat, a redesign will be difficult to pull off . Insurance companies, pharmaceutical firms and medical device makers , all of whom have a vested interest in averting radical change, are big campaign contributors and are strongly represented by lobbyists in Washington.

That helps explain Congress’ reluctance to do more than tinker with a system that left an estimated 44 million Americans without health insurance last year.

Is universal health insurance on the horizon? - Politics - MSNBC.com

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How to save thousands on your health care

This woman negotiated her payments down...something to think about and the article offers other ideas too on how to save on health care.  BD

After a car accident left Michelle Katz, a Washington, DC, nursing student, with persistent back pain and numbness in 1998, she consulted a neurosurgeon, who told her she'd need an operation to repair her slipped disk. Katz, then 26, didn't have health insurance, so she did the only thing she could think of: She negotiated. Katz offered to pay her surgeon and anesthesiologist a portion up front in exchange for a hefty discount and arranged a payment plan for the rest. When she got her hospital bill, she haggled with the billing department to drop some charges. All told, she ended up paying just half of the original $28,000 estimate. "Before this, I didn't think you could negotiate with your doctor," says Katz, 35, now a corporate health care consultant and author of "Healthcare for Less," which was inspired by her own experience. "But all you have to do is ask.

And ask you should — repeatedly. In 2007, a family of four covered by a typical preferred provider organization insurance plan (PPO) is expected to receive an average of $14,500 in medical services. If you fit that profile, about $5,100 of that will be your responsibility — in the form of premiums, co-pays, and deductibles. That's an increase of more than 8% over last year, following 5 straight years in which costs jumped more than 9% annually.

How to save thousands on your health care - Health Care - MSNBC.com

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Surgeons Use New High-Definition Robot During Living-Donor Kidney Transplant

One more use for the Da Vinci robotics system...BD

Surgeons at Rush University Medical Center are performing living-donor kidney transplants using a new high-definition robotic surgery system that offers improved precision, shorter recovery and smaller incisions for the donor patient. Utilizing the new high-definition da Vinci S Surgical System, the surgeon sits in a console a few feet from the patient and views the surgical site through a high-definition three dimensional viewer. The laparoscopic camera and robotic arms are inserted into the patient though four half-inch incisions. The surgeon uses hand controls and foot pedals to manipulate the robotic arms in the mechanically-assisted surgery. The fully intact kidney is removed through a small three inch bikini line incision. According to Dr. Kalyan Latchamsetty, a laparascopic surgeon at Rush, the robotic surgery offers many advantages over conventional laparoscopy surgery, in which the surgeon operates through small incisions using hand-held, long-shafted instruments.

Surgeons Use New High-Definition Robot During Living-Donor Kidney Transplant

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Training Grant To Further Program That Melds Life Sciences And Computers

More computer training...available with from a grant...BD

The UC Irvine Institute for Genomics and Bioinformatics (IGB) has been awarded $5.6 million over five years from the National Institutes of Health to continue training students to apply advanced computer and information technologies in the biological and medical sciences. The funding will be used to expand the interdisciplinary Biomedical Informatics Training (BIT) program, an initiative led by IGB Director and Chancellor's Professor Pierre Baldi and Professor G. Wesley Hatfield to train graduate students and postdoctoral fellows in the UCI Donald Bren School of Information and Computer Sciences (ICS), The Henry Samueli School of Engineering, and the schools of physical sciences, biological sciences, and medicine. One of only 18 such programs in the country, the BIT program in 2002 received from NIH the largest training grant of its kind.

Training Grant To Further Program That Melds Life Sciences And Computers

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Patients, It'stime to Unionize

opinion article from USA today, all you need to join is a past or future medical bill...BD

The night before a recent CT scan, I saw Sicko, Michael Moore's documentary on the health care system. The next morning, instead of my usual willful numbness during regular medical procedures, I felt a low fever of outrage at the nonchalant clerks who came in late, at the doctors who managed to screw up the semiannual order (I don't get iodine because I'm allergic) and the thousands of dollars this brief photo op would cost. This is no horror story. I was angry at my powerlessness and my routine subservience to the system lest it inconvenience me further or kill me: I commiserated with the clerks who had kept me waiting Oh, yeah, trains run late and it's really terrible having to stand in line at Starbucks; I cajoled the technicians into calling the doctor's office and having the order changed so we could proceed, and I forced myself not to think about all the people who were not adequately covered (I have Medicare and supplements) and couldn't afford my level of cancer treatment and follow-up.

USATODAY.com

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Hospitals sue county again over inmate medical costs - San Diego

And this was not the first instance....happened a couple years ago as well...BD

SAN DIEGO ---- For the second time in three years, several area hospitals have filed a lawsuit alleging the county has failed to pay them for medical care they have provided to jail inmates and people who have been arrested. The hospitals, which include Palomar Medical Center in Escondido, Pomerado Hospital in Poway, Tri-City Medical Center in Oceanside, Scripps Health and Sharp Healthcare, allege the Sheriff's Department failed to reimburse them for the medical services they provided from Jan. 1, 2006 to Dec. 31, 2006. Filed Aug. 10 in the San Diego Superior Court, the lawsuit asks the county to pay the hospitals a total of more than $1.3 million plus interest. Attorneys for the hospitals and the county could not be reached Thursday afternoon for comment.

Hospitals sue county again over inmate medical costs - North County Times - San Diego / County -

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Medicine: Medical Records Get Digital

Good article on "who's going to pay" ..everybody agrees we need electronic records, but hospitals and physicians need some help and assistance with the dollars...as well as training...the systems are no good without adequate training too.  BD

Aug. 16, 2007 - At first, Dr. Glen Landesman feared the electronic record system he and his two partners installed in their New Jersey family practice. While his computer-savvy colleagues eagerly anticipated eliminating bulky paper records, Landesman worried that his ability to care for patients would suffer as he struggled

A doctor at a hospital near Seattle checks an X-ray on a tablet PC

with the new technology. "I am not a computer person at all," he says. "So I was very resistant." Five years later, Landesman has been won over. With the electronic system, new prescriptions are automatically checked against existing ones for adverse interactionsand then sent directly to the pharmacy. Doctors and patients receive regular reminders about screenings and vaccinations. And in the long run, the practice will save money. "We improved in both efficiency and quality, and we're adding to our bottom line." says Landesman.

Everyone agrees that small hospitals and medical practices do need help to join the digital world, but there's no consensus on who should pay the bill.

Medicine: Medical Records Get Digital - Newsweek Health - MSNBC.com

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Intel, Humana and Others Found Center: E-Prescribing

There is a link in the left hand side of this page for free e-prescribing as well that is sponsored by some of the same interests...BD

WASHINGTON (AP) -- Computer chip maker Intel Corp. and insurer Humana Inc. are joining with pharmacy trade groups to study ways to improve the management of prescription drugs. The two companies, along with Blue Cross and Blue Shield, American Academy of Family Physicians, Medical Group Management Association and Surescripts said Wednesday they will collaborate on a organization in Washington DC called the Center for Improving Medication Management.

Intel, Humana and Others Found Center: Financial News - Yahoo! Finance

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Know when it's time to fire your doctor

Good article with some good insight...not something we like to think about doing, but there are times when a fresh opinion and physician could help out if you feel you are not getting your issues addressed...BD

Dr. Jerome Groopman knew he needed to break up with his doctor. art.jerome.groopman.jpg Dr. Jerome Groopman says sometimes the doctor-patient relationship comes down to chemistry. Five years ago, when he started seeing his internist, everything was fine. But Groopman says that in time, the internist became more popular -- and hence more busy and harried -- right when Groopman needed him most. "I have a strong family history of high cholesterol and heart disease. Every male in my family has had a [heart attack] in his 50s and 60s," he says. "I was moving into middle age, and I just didn't feel that my doctor was looking at me as an individual, and taking those factors into account.

Know when it's time to fire your doctor - CNN.com

Hat Tip:  Kevin, MD

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Google and Microsoft Look to Change Health Care

 Mobile and portable devices are definitely part of the landscape..with eliminating stacks of paper so a physician can drill down and see what needs to be done without the time required to dig through a stack of paperwork..health care is still lagging behind the rest of the business world, and privacy issues play a big role as well.  BD

In politics, every serious candidate for the White House has a health care plan. So too in business, where the two leading candidates for Web supremacy, Google and Microsoft, are working up their plans to improve the nations health care.

The Google and Microsoft initiatives would give much more control to individuals, a trend many health experts see as inevitable. “Patients will ultimately be the stewards of their own information,” said John D. Halamka, a doctor and the chief information officer of the Harvard Medical School.

Microsoft will not disclose its product plans, but according to people working with the company the consumer effort will include online offerings as well as software to find, retrieve and store personal health information on personal computers, cellphones and other kinds of digital devices — perhaps even a wristwatch with wireless Internet links some day.

Google and Microsoft Look to Change Health Care - New York Times

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Man kisses ailing wife, hurls her from balcony

Stress and not being able to cope with medical bills slated as the reason...BD

KANSAS CITY, Missouri (AP) -- A man threw his seriously ill wife four stories to her death because he could no longer afford to pay for her medical care, prosecutors said in charging him with second-degree murder. According to court documents filed Wednesday in Jackson County Circuit Court, Stanley Reimer walked his wife to the balcony of their apartment and kissed her before throwing her over. The body of Criste Reimer, 47, was found Tuesday night outside the apartment building, near the upscale Country Club Plaza shopping district. Stanley Reimer, 51, was charged Wednesday. He remained jailed on $250,000 bond and was scheduled to be arraigned Thursday. In the probable cause statement filed with the charges, police said Reimer was desperate because he could not pay the bills for his wife's treatment for neurological problems and uterine cancer.

Man kisses ailing wife, hurls her from balcony - CNN.com

Hat Tip:  Kevin, MD

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Virtual PCs for consumers

If you are not aware of virtual PCs, good article to read up on...many web servers such as insurance companies use virtual servers quite a bit and many that you connect to via the web are virtual servers...this is basically loading an operating system on top of another operating system..very good for security reason too.  With a virtual PC, one could easily run a Linux or Unix operating system from their Windows operating system.  BD

Dell is partnering with VMware and SWsoft on the project, the new machines would use "vitalization" software to run multiple, software-generated computers on one machine. As well as PC owners being able to take advantage of features of two differing operating systems, there are many benefits for these kind of set ups. One being security. A virtual machine could run one system for every day computing tasks, while another would be used just browse the internet, limiting any security threats.

Dell working on virtual PCs for consumers - Pocket-lint.co.uk - gadget news and reviews

Hat Tip:  Engadget

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Blue Cross and Blue Shield of Florida Introduces BlueMedicare(SM) Group Retiree Products

More new health plans to review...who can keep up...BD

JACKSONVILLE, Fla., Aug. 16 /PRNewswire/ -- Blue Cross and Blue Shield of Florida (BCBSF) has announced the introduction of three new BlueMedicare(SM) group retiree coverage options: BlueMedicare(SM) Group Rx prescription drug benefit, BlueMedicare(SM) Group PPO and BlueMedicare(SM) Group HMO. These new options offer increased savings and allow employers to meet the challenge of providing coverage to Medicare-eligible employees, retirees and dependents.

Blue Cross and Blue Shield of Florida Introduces BlueMedicare(SM) Group Retiree Products - - insurancenewsnet.com

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Changes in Store for Industry-Funded Doctors' Education (CME)

 Sponsored CME now under the magnifying glass...BD

Now that the feds are picking up the tab for many Medicare patients prescription drugs, some senators are prying into doctors continuing medical education, or CME. Their questions could lead to changes in how CME, which most states require for doctors to renew their licenses, is funded and monitored. The senators want to know whether the billion dollars a year the drug and device industries are pouring into CME winds up making doctors prescribe too many expensive, brand-name medicines and devices. One of the guys theyre asking is Murray Kopelow, the M.D. who runs the Accreditation Council for Continuing Medical Education, which watches over more than 700 CME providers.

In a recent conversation with the Health Blog, Kopelow said ACCME will likely start sending auditors to CME lectures. We could have trained monitors observing CME presentations and reporting their findings to us, to see whether the presentations are straying from the rules, he said. The group hasnt yet decided whether the monitors would work undercover

Health Blog : Changes in Store for Industry-Funded Doctors' Education

Hat Tip:  Kevin, MD

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FDA To Review Children's Cough And Cold Medicines

 

The US Food and Drug Administration (FDA) has announced it is calling a meeting of its Nonprescription Drugs Advisory Committee next month to review the safety and effectiveness of medicines used to treat coughs and colds in children following recent concerns about their use, especially in infants below two years of age. Part of the review will cover reports of medical problems arising from incorrect use of cough and cold drugs for children, especially overdoses. For example, in some cases parents have not realized that different products may contain the same active ingredient and giving a child both at the same time results in a combined dosage that exceeds the safety level

FDA To Review Children's Cough And Cold Medicines

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Uninsured face health plan delays - Boston

Massachusetts struggling with getting everyone covered...BD

The number of people seeking state-subsidized health insurance has overwhelmed the offices processing applications, forcing some of the uninsured to wait months to get coverage, according to state officials and healthcare advocates.

Applicants routinely have to submit the same paperwork twice or even three times, because it is getting lost in state offices, advocates say, and many are getting confusing or contradictory information about whether they qualify. The loss of paperwork "happens to over 50 percent of our clients," said Camila De Oliveira, program director of the Community Action Committee of Cape Cod & Islands, which helps people apply. "The clients are getting frustrated. It was supposed to be a fast turnaround.

Uninsured face health plan delays - The Boston Globe

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Publix No Longer Will Match Retailers' Generic Drug Discounts

 

Florida-based Publix Super Markets on Wednesday announced it no longer will match a program by Wal-Mart that offers 30-day supplies of 143 generic drugs for $4 per prescription, the St. Petersburg Times reports. Publix said it now will focus on its antibiotics program (Bora, St. Petersburg Times, 8/9).
Publix on Monday began offering 14-day supplies of seven common, generic antibiotics at no cost to customers with a valid prescription, with no limit on the number of prescriptions a customer may fill. The supermarket chain will offer the no-cost antibiotics at its 684 stores in Florida, Georgia, South Carolina, Alabama and Tennessee (Kaiser Daily Health Policy Report, 8/7).

Publix No Longer Will Match Retailers' Generic Drug Discounts

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Meet the gang at the Computer Grannies Society

Great article about seniors using the Sahara I440D tablet PC...of course this is the one we give our top vote.  Not having a keyboard is also a huge convenience for the seniors as they can easily use the touch-screen to navigate the web, and then switch to the digitizer pen to continue on with some other production type activities...life without a keyboard can be easy and fun...BD

"My husband isn't home tonight. Would you like to..." reads the suggestive email on the computer screen.

Obviously, the sender has no idea that the recipient is 78-year-old grandmother Kikue Kamata.

"What does she want me to do?" an amused Kamata says. "I know I shouldn't open spam but sometimes I do because it's fun."

A high tech granny used to be considered an oxymoron. But in Japan, with its love of technology and a declining birth rate, a growing number of elderly are learning to surf the internet, finding it to be a crucial lifeline.                    

"I turn on my computer the first thing in the morning. It's a pleasure to see the e-mail that came overnight," says Kamata's friend, Roko Shinohara.

The absence of keyboards is a great relief for Japanese seniors who grew up in a culture that values handwriting rather than typing.

Meet the gang at the Computer Grannies Society - web - Technology - smh.com.au

Hat Tip:  Gottabemobile  (Thanks for the story!)

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TabletPCReview shakes down the Sahara i440D. Verdict: sweet slate

More comments on the new I440D from Tablet Kiosk...and the reference to the original review....great unit and there will be more to come. jkOnTheRun is a good source for tablet PC information at any time.  BD

It's easy to overlook the traditional Tablet PC space with all the buzz surrounding new UMPCs from HTC and Fujitsu. Tiffany Boggs reminds us that the TabletKiosk Sahara i440D slate is a viable contender for your hard earned dollar in her written review and supplementary video overview. I held the i440D back at CES but I have to tell you: the difference between now and then is black white. Really! I played with the white model but this black i440D just looks more appealing to me for some reason

jkOnTheRun: TabletPCReview shakes down the Sahara i440D. Verdict: sweet slate

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Companies using on-site health clinics to cut costs

An old idea that has been around for quite a while; however with privacy issues today with technology there's still a lot to be said and reviewed to see if if this is the right choice for you...BD

As companies try to rein in rising health care costs, workers in many industries are dealing with on-site health clinics. Large employers including Toyota Motor Co., Pepsi Bottling Group, Credit Suisse and Sprint Nextel have set up or expanded on-site health clinics in recent years.

Workers are not forced to use these company clinics, but companies provide financial incentives including lower co-pays, deductibles and the ability to see the on-site doctor on company time.  "The convenience would be great, but I think a lot of the employees would worry about the confidentiality," Schoeni said. "There is so much discrimination health-wise against certain diseases, against any type of depression or mental health problem. Employees don't want their employers to know they are being treated for depression or alcoholism or drug addictions."

But some workers and their advocates say the centers present a potential conflict. The same doctors taking care of the workers' private, ongoing medical needs may be in charge of treating them for work-related injuries, as is the case at Salisbury, Md.-based Perdue Farms.

Companies using on-site health clinics to cut costs

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Surgery not as easy as it looks on TV

 Not for the weak at heart...story on how 200 non-medical observers watched an actual surgical procedure...there are links on this site to watch actual surgeries via OR and some even offer CME credit for physicians...BD

LONDON — If life imitated "Grey's Anatomy,” watching surgeries from the hospital viewing gallery would be the perfect time for having a heart-to-heart, or untangling a complicated love triangle. As a medical expert attempted to explain the pipes and tubes in the human heart, the huge projection screen behind him came alive with action. What had been the easily recognizable chest of a 68-year-old man was now cracked open with two large, strong-looking metal clamps, revealing what looked more like baked salmon covered in ketchup than the "blood and guts” most would imagine lay inside.

One quick slice through a yellowish, vein-ridden layer of fat, and they were going to see the heart in person.  Silence. Then a sharp, collective intake of breath, and there it was.The surgeons drew another gasp from the audience as they inserted a tiny camera into the spongy valve, revealing many long, white chords retreating into darkness, attaching the valve's flaps to a ventricle wall out of sight.

And with only one "Oh, shoot!” after a tear in the heart caused a spurt of blood, Wells and his team completed the surgery, restarted the heart, and closed up the patient, drawing applause from the audience.

NewsOK: Surgery not as easy as it looks on TV

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A new Da Vinci code- many systems are paying off faster than anticipated....

 New use for operating on fibroid tumors in the uterus...BD

For two years, Lorraine Olson suffered from pain and bleeding associated with fibroid tumors in her uterus. Doctors told her she would need a hysterectomy to remove the tumors. Then she heard that a relatively new technique soon would be available at United Hospital in St. Paul.

So Olson waited four more months to have the tumors removed using the science of robotics. There was good reason for Olson's planned patience. She was up and on her feet within days of her operation -- instead of the weeks it typically takes to recover from traditional open surgery -- she avoided an unwanted hysterectomy and her blood loss was significantly less.  "I think I broke ground for Minnesota women," Olson said recently. "I feel great. I would not even know that I had anything done."

"We do not get better [insurance] reimbursement. We're not making as much money as we do with the old method," said Mark Mishek, president of United Hospital."We took a pass on the da Vinci three years ago. We thought it was too expensive and we didn't think it would take off. Now we're ready to jump in with both feet. I'll ask for a second robot."

United spent a total of $1.6 million to buy the da Vinci machine and redesign the operating room to accommodate it, using funds from its hospital foundation."We're just scratching the surface. This is going to be huge," said Dr. Robert Gaertner, a urologist who works out of St. John's. Gaertner said the da Vinci began paying for itself after six months of use

A new Da Vinci code

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Medical students train on patient who feels no pain

 And he talks back too....BD

Chris Jones faced a rare medical emergency in the operating room the other day. Much to the astonishment of his anesthesiologists, his oxygen supply tanked during surgery.

Actually, the situation wasn't all that unusual. Medical students and residents are constantly saving his life.  Creating simulators is a big business. Depending on their function, human robot simulators can cost between $50,000 and $185,000.

Anesthesiology resident Juan Perrone intubates a robot in the operating room at the UW's Institute for Surgical and Interventional Simulation. The program teaches future doctors basic surgical skills and how to handle medical emergencies.

Jones is a robot, resembling a mannequin with a healthy tan, and part of the University of Washington's Institute for Surgical and Interventional Simulation. It's a two-year-old program that trains future doctors everything from basic surgical skills to how to handle medical crises. The permanent simulation center opened last month.

Jones is pretty complex for a mannequin and you won't see him modeling in any storefront windows. He can breathe, react to various drugs, twitch and even dilate his pupils. Oh, and he can talk, too.

When asked how he was doing, Jones moaned and said, "I'm really nervous," voiced by a technician speaking through a microphone next door.

Medical students train on patient who feels no pain

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Blue Cross cuts could mean less doctor time for patients

"Modest" profit?  Doctors reimbursements are already a "done deal"....the state of California continues their investigation into Blue Cross....BD

SAN DIEGO ---- Looming reimbursement cuts from Blue Cross of California could mean that doctors will be spending less time with patients, a local doctor said last week.
Reimbursement rates are what insurers pay contracted doctors for specific services ranging from routine office visits to surgical procedures and everything in between.

Officials for Blue Cross, the second largest private insurer in California and third largest in San Diego County, said they had cut some reimbursement rates but increased others. They also said that they were cutting rates to protect customers by keeping health insurance as "affordable as possible" while earning a modest profit.

Mazer said doctors are particularly unhappy because they, and consumer groups, believe that Blue Cross is cutting what it'll pay doctors and jacking up premiums for patients and shipping the profits out of state.  Jerry Flanagan, health care policy director with the Foundation for Taxpayer and Consumer Rights, testified that Blue Cross had shipped $6.5 billion out of the state between 2004 and 2006.

Flanagan, however, said that Blue Cross had been hiding other payments by shipping them to sister companies under the guise of doing work for Blue Cross.What might be more likely than doctors quitting, Mazer said, is that patients will feel the "trickle down" effect.

But Schmidt said the agency had no control over the doctors' reimbursement rates.
"Yeah, those are a done deal," Schmidt said.

Blue Cross cuts could mean less doctor time for patients North County Times - North San Diego and Southwest Riverside County News

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Attack victim suffers through health-care limbo

Very sad story and this could happen to any of us...health related bills passed in Texas still falling short as they are everywhere we look today in the US...BD

GALVESTON — Jennifer Holliday is too wealthy to qualify for indigent medical care in Angelina County, but poor enough to qualify for limited care at the University of Texas Medical Branch.  Before becoming one of the uninsured, Holliday earned $40,000 per year as a paramedic for a Lufkin ambulance service.

So Holliday, her arm mangled by a shotgun blast from a man who attacked her, must make the three-hour, 175-mile drive from her Lufkin home to Galveston for physical therapy twice a week.  Then a quirk in the law left her without any insurance at all. Her qualification for $900 monthly Social Security disability payments, her only income, made her ineligible for federal medical assistance for two years.

The single mother of a 7-year-old son still has shotgun pellets in her arm and needs surgery to restore the use of it. She lost her job and her health insurance after the 2005 attack, and now lives on $900 a month.  After losing her insurance, a life-threatening infection that ate a hole through her bone sent Holliday to the Lufkin Memorial Hospital emergency room last year.

The hospital expenses forced Holliday into bankruptcy. She lost her car and home, and now lives in a trailer. A collection agency calls incessantly demanding to know when she will pay her hospital bill, she says.

The financial pressure is piled on top of the emotional scars from her attack. "Some days I will completely break down," Holliday said. "There is no doubt I'll need counseling the rest of my life."

The Legislature this year passed a number of health-related bills influenced by Code Red, but none significantly changed the way the poor and uninsured receive health care, said state Rep. Jim Jackson.

Attack victim suffers through health-care limbo (w/video) | Chron.com - Houston Chronicle

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Health Insurance coverage now a divorce issue in the courts

New legislation in place in New York...BD 

The new law ensures provisions of a divorce settlement state whether or not a spouse will lose coverage; requires judges to notify parties of the termination of health insurance when they issue a divorce settlement; and gives judges discretion to grant a 30-day continuance so parties have a chance to obtain their own health insurance policy.

Covering the Hudson to the Catskills!

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Judge rules criminal fraud case against Idaho doctor is frivolous ...

 

In a rare victory, a physician turned the tables on the government and won nearly $300,000 in legal fees for what a Nevada federal trial judge found to be a frivolous health care fraud case.

The Justice Dept. accused otolaryngologist Mark Capener, MD, now in Idaho Falls, Idaho, of billing for endoscopic sinus surgeries that investigators alleged either were unnecessary or never performed, and of upcoding. Authorities accused the doctor of defrauding eight private health insurers, Medicare and Medicaid through his billing practices.

Instead, in many cases, "[the government] is just looking at CPT code usage and anybody out on the tail of the distribution is targeted for criminal prosecution," Parker said. "And that's not the same thing as intentional wrongdoing." If found guilty, doctors could face 10 years in prison, noted Parker, who assisted in Dr. Capener's suit.

Tate said that although Dr. Capener may have done more surgeries than what might be considered "normal" among other doctors, he did what was best for his patients.

AMNews: Aug. 20, 2007. Judge rules criminal fraud case against Idaho doctor is frivolous ... American Medical News

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Doctors Hangout - A Friendship and Social Networking Site for Doctors & Medical Students

Interesting and informative site...had some nice videos...and good spot to share notes and comments between MDs and medical students.  If you get squeamish over the site of blood, you may want to bypass the video page.  BD

http://doctorshangout.com/kickapps/service/displayHomePageExperience.kickAction?page=Homepage&as=4259 

Hat Tip:  Kevin, MD

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Most Canadians scoff at portrayal of their country as a health-care paradise

One from Canada gives their opinion on how the system works or doesn't work in their country...part of the problem, many of the Canadian MDS are moving to US...same issue we see here...a shortage and then the government begins rationing according to the article...BD

Many Canadians can't even find a doctor - about 10 percent are currently seeking a primary care physician. Canada now ranks 24th out of 28 countries in the number of doctors per thousand people, according to the Organization for Economic Cooperation and Development. When the government took over the health-care system in the early '70s, Canada ranked second.
    Why the decline? Over the last decade, about 11 percent of physicians trained in Canadian medical schools have moved to America. That's because doctors' salaries are paid for by provincial governments and subject to cost-conscious budget analysts. In fact, the average Canadian doctor earns only 42 percent of what his U.S. counterpart earns.
    But, it's not just about money. Doctors feel they can't practice the type of medicine they're trained for due to budget restrictions set by bureaucrats.
    These problems struck home two years ago, when I fought Canada's healthcare bureaucracy on behalf of my mother. Despite my best efforts, the government deemed her too old and sick to merit a doctor who could deliver the highest quality care. She died soon after.
    Even if health care is declared a "right" by Moore or others, there's a limited supply of it. And when that good can't be allocated by price, it must be delivered by government rationing.

Salt Lake Tribune - Most Canadians scoff at portrayal of their country as a health-care paradise

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Surf City considers medical marijuana ban -Huntington Beach, CA

 

HUNTINGTON BEACH Surf City is the latest city in Orange County to consider a ban on medical marijuana dispensaries.

The Planning Commission will hold a public hearing Tuesday to discuss the issue.  Other cities considering a ban on the dispensaries include Fountain Valley, Fullerton, Mission Viejo, Newport Beach, Seal Beach and Cypress.

The city has no medical marijuana dispensaries. An application for one in 2005 never panned out.

Recently, however, the city has received requests for a dispensary permit from three Marina High School students, officials said.

News: Surf City considers medical marijuana ban | city, marijuana, dispensaries, medical, commission - OCRegister.com

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The goal: Preserving health The obstacle: Medicare

One physician's opinion and statements on how it is becoming difficult to work and care for senior patients and still give some quality of life...and what the family practices goes through to support their patients...BD 

My patients and colleagues can't stop the aging process, but we can do something about the quality of their lives as they age. It is all a matter of spending tax dollars wisely.

Any reform plan that Congress contemplates, with or without Moore's ideas, must balance the tough choices between cost savings and appropriate care. Physicians must be able to provide care in a reasonable manner. Medical students -- future doctors -- must want to become primary care providers for Medicare recipients in the future.

The system needs to allow us to provide the right care in the right setting at the right time, as in this example, before patients fall. Keeping an elderly patient mobile and out of an institution for as long as is medically possible makes both economic and medical sense. We need thoughtful, appropriate policies, not an over-regulated process.

Star-Telegram.com | 08/12/2007 | The goal: Preserving health The obstacle: Medicare

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World’s Best Medical Care?

Good article that recaps how the US ranks with some additional opinions by the author...Bd

Many Americans are under the delusion that we have “the best health care system in the world,” as President Bush sees it, or provide the “best medical care in the world,” as Rudolph Giuliani declared last week. That may be true at many top medical centers. But the disturbing truth is that this country lags well behind other advanced nations in delivering timely and effective care.

World’s Best Medical Care? - New York Times

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Hospital, infect me not

Good intentions here, but again the interpretation of how these results are culminated might not be clear.  BD

PATIENTS in hospitals should not end up worse off than when they were admitted because of an infection acquired during treatment. Yet thousands of people are stricken this way in Massachusetts and across the nation. Hospitals know their infection rates, and it's about time they made them public, to inform prospective patients of the risk and to put the staff on notice that they need to do better to prevent the spread of germs.

A report by a special investigative committee funded by the Legislature recommends that the state mandate reporting of infections in three common procedures: hip replacements, knee replacements, and the insertion of "central line" catheters, which can remain in patients for weeks to deliver chemotherapy or liquid food. Hospitals would report rates of other less common procedures to the Department of Public Health, but not have to release the information to the public

Hospital, infect me not - The Boston Globe

Hat tip:  Running A Hospital, Paul Levy CEO

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Orange County HMO Business- California

As the article states, we have a "mature" market here...in other words, it has been around California a lot longer than most places...BD

Health maintenance organizations in Orange County posted steady growth during the past year, though a pair of plans saw their enrollments surge.
The county’s managed care sector was relatively quiet last year, compared to 2005, when UnitedHealth Group Inc. bought out Cypress-based PacifiCare Health Systems Inc. for $9.2 billion.
The nine HMOs on this week’s Business Journal list reported a 6% increase in local membership to 1.23 million people, compared to 1.16 million the previous year.
The list is ranked by enrollment, with figures compiled from the California Department of Managed Care and the companies themselves.
OC and California are considered mature HMO markets—the state is an influential region in the growth and development of managed care.
HMOs work to control healthcare costs through a combination of preventive care, emphasis on steering patients to primary care doctors and carefully watching the use of more expensive specialty doctors.
Huge membership gains for HMOs were common back in the 1980s and 1990s, as businesses sought ways to control rising healthcare costs. The pace of enrollment has slowed considerably after different forms of health plans emerged.
Meanwhile, a backlash against HMOs from consumers, doctors and politicians also took a bite out of enrollment, though sentiments have improved during the past decade.

Orange County Business Journal Online

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Bill gives millions to favored hospitals

Interesting article on how secrecy is still alive and well.  This is a good thing overall, but it appears secrecy will not end any time in the near future.  For those hospitals who are getting some additional funds, I am sure they can all use it and any funding will help overall health care.  BD

WASHINGTON — Despite promises by Congress to end the secrecy of earmarks and other pet projects, the House of Representatives has quietly funneled hundreds of millions of dollars to specific hospitals and health-care providers under a bill passed this month to help low-income children.

Instead of naming the hospitals, the bill describes them in cryptic terms, so that identifying a beneficiary is like solving a riddle. Most of the provisions were added to the bill at the request of Democratic lawmakers.

One hospital, Bay Area Medical Center, sits on Green Bay, straddling the border between Wisconsin and the Upper Peninsula of Michigan, more than 200 miles north of Chicago. The bill would increase Medicare payments to the hospital by instructing federal officials to assume that it was in Chicago, where Medicare rates are set to cover substantially higher wages for hospital workers.

Lawmakers did not identify the hospital by name. For the purpose of Medicare, the bill said, "any hospital that is co-located in Marinette, Wis., and Menominee, Mich., is deemed to be located in Chicago." Bay Area Medical Center is the only hospital fitting that description.

Bill gives millions to favored hospitals | www.azstarnet.com ®

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Health Clinics Expand in Retail Settings

The cost and insurance coverage seems to be making it more attractive as well.  Many large companies are also putting clinics on premise as well.  I agree though for a quick visit the clinics can fill the bill, but it doesn't replace the primary MD in caring for your ongoing health.  BD

Increasingly, American consumers are shopping for health care the way they buy a hamburger or milk shake at a fast-food chain: By standing in line at a local store under a menu.

Store-based health clinics - which are staffed mostly by nurse practitioners and offer quick services for routine conditions from colds and bladder infections to sunburn - aren't just a health care fad anymore, but fast becoming a serious industry. 

About 7 percent of Americans have tried a clinic at least once, according to an estimate by the Convenient Care Association, an industry trade group formed last year. That number is expected to increase dramatically, as major pharmacy operators like Wal-Mart Stores Inc.and Walgreen Co. , partner with miniclinic providers like RediClinic and MinuteClinic to expand operations. The trade group estimated there will be more than 700 by year-end, up from the more than 400 now, and 2,000 by the end of 2008.

Health Clinics Expand in Retail Settings - Forbes.com

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