Concierge Emergency Medicine - State of the Art ER care in Houston

Nice!  Patients are handed a tablet pc to check in.  Also the facility has an onsite lab which can run 64 bit scans and the results are available almost immediately.  You can also sign up on your home computer as well. Be sure to watch the video at the link below.  Nice to be able to play a little X-Box while you wait or send the kids over to play too!  BD 

What is Concierge Emergency Medicine? The concept of concierge medicine has become increasingly popular over the past ten years. Concierge practices offer a higher level of service including more customized patient care, more comfortable upscale waiting and treatment areas and in many cases limited or no wait times. Like concierge practices, Concierge Emergency Medicine emphasizes comfort, convenience, personalized care, and a superior level of service not possible in a hospital based emergency room. By combining concierge-style customer service with emergency-level care, Concierge Emergency Medicine offers patients the highest quality medical care in a comfortable, convenient, and friendly setting. Emergency Health Centre is currently the only emergency care facility in the nation to offer this revolutionary concept in emergency medicine.

HOUSTON -- Flat-screen TVs, gourmet coffee and an Xbox are things that may be found in a fancy hotel's lobby, but what about in an emergency room's lobby?

"Each of our patients, when they arrive, will check in on a tablet PC. The PC is set up such that it stores their patient demographic information so they only have to fill it out once, the first time they come in," Goetze said,

 

All of those things can be found in the lobby of Emergency Heath Centre in Willowbrook. 

 

comfort, convenient & personalized Emergency Medicine

News story and video    Be sure to watch the video here...

and they say there are more facilities like this on the way!

Hat Tip (nice find):  GottaBeMobile

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Democrats Push Telecoms for NSA Disclosures - Privacy Issues

You may remember not too long ago Google denied the same request...but Google doesn't depend on wireless operating licenses from the FCC as do wireless carriers and the potential of having any of those at risk of being denied would cripple any wireless carrier in a heartbeat..so...did the telcoms have a choice in the matter?  Quest, who is also not a substantial wireless carrier also refused.  Recently is has also been disclosed that the FBI has a data base containing health records information as well, but again little is known here as well as far as what information is contained and how it was or would be utilized, thus the congressional investigation.  BD

Lawmakers claim privacy rights are being lost in the focus on homeland security. A group of U.S. House Democrats upped the pressure on Oct. 2 on the nation's major telecom carriers to account for their alleged complicity in turning over unauthorized telephone and e-mail records to national intelligence agencies, including the National Security Agency and the FBI.

Under the Foreign Intelligence Surveillance Act, the FBI may use what is known as National Security Letters to obtain—without judicial review—the records of businesses, including telephone companies and Internet service providers. In a March report, the Department of Justice's Inspector General found the FBI improperly obtained the telephone records and subscriber information from three telephone companies.

In letters sent to AT&T, BellSouth, Verizon and Qwest, the lawmakers requested the telecoms provide Congress with a detailed account of their dealings with the NSA, including the installation of any equipment on their networks designed to intercept Internet traffic. Democratic Representatives John Dingell and Bart Stupak, both of Michigan, and Rep. Ed Markey of Massachusetts signed the letters.

AT&T, Verizon and BellSouth have all been singled out in a number of accounts as providing the NSA with access to millions of customers' telephone records without the customers' knowledge or consent. Allegedly, Qwest was also approached by the NSA but refused to cooperate.

The Bush administration has admitted the program existed, but has been vague on other details."Since the Bush administration has been unwilling to discuss adequately this situation, I hope these telecommunications companies will be more forthcoming about the circumstances in which they have disclosed consumer information," Markey said.

Dems Push Telecoms for NSA Disclosures

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Fountain Valley Regional Hospital gets child-friendly ambulance - Orange County, CA

Television, DVD player...what more could you want...hmmm...maybe an X-Box...(grin)...BD 

FOUNTAIN VALLEY The Fountain Valley Regional Hospital is saying goodbye to scary ambulance rides and hello to a new pediatric transport service that is designed to keep children calm on their way to the hospital. The light-blue ambulances are decorated with silhouettes of children playing and each has a singing stuffed bear sitting on the gurney.

The vehicle also has a television, DVD player and sound system to help relax the children on the ride to the hospital. "We wanted to make (the ambulance ride) more family-friendly," said Dr. Zacharia Reda, who leads the pediatric department. The ambulances can carry seven passengers including a doctor, a nurse and a respiratory therapist, who can use the ambulance as an Intensive Care Unit to monitor and give special treatment to the child.

The new service will help bring children from more than 50 hospitals in Southern California to Fountain Valley Regional's pediatric Intensive Care Unit – one of two in Orange County. The other pediatric ICU center is at Children's Hospital of Orange County in Orange.

News: Fountain Valley Regional Hospital gets child-friendly ambulance | pediatric, children, orange, ambulance, fountain - OCRegister.com

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New hospital opens its doors - Orange County, CA

St. Joseph Hi-Tech hospital...of course it has wireless Internet access, but the one amazing feature that I had not heard of before is the window seats that convert to beds...where family members can catch a few winks..very novel and great idea to make it more comfortable for the family members when visiting...and 90% of the rooms are private..BD

ORANGE Robert Lawrence Balzer lays on a gurney at St. Joseph Hospital with two critical items sitting resting next to him: a portable heart monitor and a black bag stuffed with emergency medication. Five more minutes, his nurse, Anne Hainley says to the team of nurses and attendants crowding the hospital room.  The old hospital building will remain open, and a new healing garden and lobby will be open to visitors to both buildings. 

About 90 percent of the new rooms are private with flat-screen TVs, wireless Internet access and window seats that convert to beds where family members can sleep.

St. Joseph won't be the only hospital moving its patients in coming years. Hospital building is booming in Orange County as facilities rush to meet the 2008 deadline for the first round of state-mandated earthquake retrofitting requirements. St. Jude Medical Center and UCI Medical Center are among at least seven area hospitals with ongoing construction.

At least seven other Orange County hospitals are undergoing construction projects.

News: New hospital opens its doors | hospital, patients, new, balzer, joseph - OCRegister.com

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PJ Party just what the doctor ordered

Nice story about getting pajama donations for children who have been hospitalized...BD

If you saw a middle-aged man in ducky PJs jumping on a mattress at Seventh Avenue and McDowell Road in Phoenix last week, don't be alarmed. Michael Christopher, an emergency-room physician at of St. Joseph's Hospital and Medical Center, volunteered to don pajamas and jump on a bed at the busy intersection if at least 100 new pairs of children's pajamas were donated to the hospital within an hour. The good doctor said he knows firsthand what happens to clothing worn by children who arrive at the hospital in emergency situations.

PJ party just what the doctor ordered

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One in four hospital trusts fails to meet basic hygiene standards

Not just limited to the UK...Ireland and Norway also having issues...BD

NHS trusts in rural areas are among the worst in the country for providing good patient care, a report by the healthcare watchdog suggests. The performance of health service organizations appears to be improving overall but the medical postcode lottery continues to create regional variations in the quality of services, the Healthcare Commission says.

Related Story - Ireland

The Northern Health and Social Care Trust last night confirmed that 10 patients in a ward at the hospital were suffering from C-difficile-related diarrhoea - four of whom were admitted with it.

Related Story - Norway

Friday's case bring to 12 the number of listeria infections identified since October 1. Two of the infected patients have since died, probably because their immune systems were already weak because of their illnesses.

One in four hospital trusts fails to meet basic hygiene standards - Times Online

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Midnight Mammogram party mixes manicures, medical testing

A new twist for getting women to have their mammogram done...similar to the Botox parties that were once the rage a few years ago...all were requested to wear pink..."Midnight Mammogram and Manicure Parties"...and the booking of parties seems to be working well...booked through the end of November...BD

It was, as parties go, a different sort of girls' night out. The guests laughed. They drank glasses of wine and ate tiny desserts. They had their nails painted and their feet massaged. And then they got mammograms.  Although the imaging center pays for snacks, desserts, goodie bags and a manicure-pedicure team, CEO Paul Duck predicted the investment will pay off in coming years.

The latest twist in health care is the mammogram party -- a chance for women to invite a dozen of their friends to share the sometimes-unnerving experience.The parties, which are from 7 p.m. to midnight, enable women to host a private mammogram party for up to 13 of their female friends. When FRI executives came up with the idea, they limited the parties to 10 nights in October, but the schedule quickly booked up. Now parties are scheduled through the end of November.

Mammogram party mixes manicures, medical testing -- OrlandoSentinel.com

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Riverside Electrician Can't Get Medical Care Three Years After His Injury on Job--Asks California Insurance Commissioner to Investigate

Greg Parr was injured over three years ago while working as an electrician. He fell and injured his left arm and shoulder. After more than three years, he still cant get authorization for needed care Outside the Workers Compensation Appeals Board in downtown Riverside, he told his story of how an insurance company has been able to get away with leaving him and his family I the lurch by overruling medical care recommended by his doctor that he needs to get back to work. He called for Insurance Commissioner Steve Poizner and Division of Workers Compensation Director Carrie Nevans to investigate insurance company abuse of "medical care review.

Fighting back tears, he says, "I am a single father, have diabetes and have lost my job and my sight in one eye since this injury at work. If the insurance company had approved the needed treatment, I would probably be back at work today."Greg Parr lost his health insurance as a result of his injury on the job. He says: “When the doctor removed me from work temporarily, I was fired! Because I was fired, I lost my health insurance. I can’t get better without treatment, and I am getting worse without the proper care. I still need surgery and I can’t get approval for needed care. My diabetes has been aggravated by the injury, the stress from getting poor medical care, and the financial disaster that has happened to my family since this injury. I have gone blind in my left eye, and my right eye is not far behind. I can’t wait any longer.

A Day in the Life: Riverside Electrician Can't Get Medical Care Three Years After His Injury on Job--Asks California Insurance Commissioner to Investigate - California Progress Report

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Free Medical Degree With Just One Small Catch

First graduating class of American Medical students arriving back in the US to pass medical tests.  Cashed in on the scholarship offered by Cuba...Medical students are exempt from the normal restrictions of travel to Cuba...BD 

OAKLAND, Calif., Oct. 18, 2007 (KGO) - A young East Bay woman is anxious to get started on her career in medicine, and she has Fidel Castro to thank for it. She was part of the first graduating class of American med students who studied in Cuba under a free, full-ride scholarship.

The offer was for a full six-year scholarship to the Latin American School of Medicine in Havana, Cuba. "I thought it was a great opportunity, almost too good to be true," says Kenya Bingham. Twenty-nine-year-old Kenya Bingham eagerly seized the opportunity. Her only obligation was to return to the United States and practice medicine in an underserved community.

"It's a verbal oath. It's not anything that we signed, and it's written. It's kind of like your own conscience," explains Bingham. "Once you become a doctor and you haven't paid anything for it, I mean, there are expenses, but your actual tuition, room and board is free, and think that. Then you, you know, it's just humanity, you want to give back and try and change. That's why you're a doctor."

"It did occur to me. It could be a possibility, however, I mean the fact of the matter is I'm a medical doctor now. I'm an M.D., and so that's neither here or there for me. I'm going to come back and I'm going to have patients and I'm going to help people get better and I'm actually going to do more preventive care to prevent disease and sickness," says Kenya Bingham.

Now she just has to pass the tests in this country that will enable her to continue to pursue her dream.

abc7news.com: Free Medical Degree With Just One Small Catch

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Senate Committee Discusses Cutting MA Plan Payments To Prevent Physician Payment Cut

The annual inquisition begins...does make one wonder if the government is perhaps is wanting to be out of the Medicare business?  By moving individuals into the private managed care plans, there is less administration to be handled for the traditional medicare plan..with the management being switched to private industry to manage, control, and keep cost effective lids on reimbursement.  Traditional Medicare allows one to choose your physician, while a private managed care requires an "in network" physician, thus one can't simply choose a physician openly if they are not in network. 

Physicians too are backed up against the wall as covering their costs as well as compensation for traditional Medicare continues to be cut and have to weigh their options to provide service and yet keep the doors of the practice open for all.  One has to wonder what will happen when private plan enrollment assumes the full driver's seat and traditional Medicare no longer will seem to be a viable option for consumers.  What will happen to compensation rates for physicians at this point?  Right now they are paid for the most part at a higher rate, but will the pendulum begin to swing the other direction down the road with provision heavy contracts? 

There have been recent articles about the insurers who offer managed care plans already getting ready for the next "marketing" swing to take place for additional enrollment, even to the effect that earnings for the 4th quarter could be impacted to a degree due to increased marketing costs to drive more seniors into the managed care arena.  If traditional Medicare ceases to be a real option for many, where is the future?  Will privately managed plans be the only reasonable  alternative available; and where will the compensation for the physicians lie when an overall majority of senior citizens are enrolled in plans managed outside the direct realm of Medicare?  Just some thoughts to ponder..as the number of choices appear to be dwindling  BD   

MA plans on average are paid 12% more than traditional Medicare, and some private fee-for-service plans are paid at twice the rate as traditional Medicare, according to CongressDaily. Baucus said there is going to be "some strong examination" of MA plans. Sen. Maria Cantwell (D-Wash.) said, "I think the fee-for-service area is a good area to look at" (CongressDaily, 10/18). However, Sen. Gordon Smith (R-Ore.) said, "There may be some trimming, but the general proposition is Medicare Advantage has taken hold, and it is the basis by which rural people get Medicare."

Senate Committee Discusses Cutting MA Plan Payments To Prevent Physician Payment Cut

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The Everett Clinic to stop accepting one Medicare plan - Seattle

Original Medicare plan is no longer accepted as the compensation does not equate...in other words the clinic receive  more from a Part D managed plan... could eventually kill Medicare as it is known today...managed care plans hold down costs according to the article...the clinics lose money on traditional plans and "break even" on the the Advantage plans...if further cuts take place without relief after the 1st of the year, it will become much more difficult for seniors to find physicians who will take traditional Medicare and force the rolls of Advantage plans to grow...that is if seniors want access to health care.  BD

When Connie Sawyer's longtime physician moved to Seattle from Sultan recently, she had a hard time finding a new doctor she liked. So the retired legal secretary turned to The Everett Clinic, one of Washington's largest chains of medical clinics, even though it is 20 miles from home. But the 71-year-old never got past the appointment desk. The doctor she wanted to see wouldn't take her because she is covered under the wrong kind of Medicare.Now 1,400 current patients of the The Everett Clinic are about to feel that same sting of rejection.

To keep their doctors, they'll have to switch to a different, managed-care Medicare plan.

Four out of five American seniors have Original Medicare, a fee-for-service plan that can be used with any doctor who participates in the program. The federal government pays the claims. The other 20 percent are enrolled in "private" Medicare Advantage plans, which are sold by commercial insurers and are set up either as fee-for-service or as managed-care plans, which generally restrict patients to a network of hospitals and doctors.

Local News | The Everett Clinic to stop accepting one Medicare plan | Seattle Times Newspaper

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House fails to override child health veto

Good bye to "Healthy Families" in California as we know it?  Let's hope not...the negotiations still continue...the extension runs through the middle of November for an agreement or deal to be made...other states face similar issues as well..Bush says he is ready to compromise...stay tuned...BD

The impasse in Washington has repercussions for California and other states that administer the State Children's Health Insurance Program, as the federal-state partnership is called. It was originally designed to cover children in families who earned too much to qualify for Medicaid but too little to afford private insurance. Funding for the program was set to expire Sept. 30, but Congress and Bush extended it through mid-November to try to resolve their differences.

California's program, known as Healthy Families, insures about 800,000 children, more than in any other state. Its director, Lesley Cummings, said she was drafting contingency plans to put children on waiting lists or even to drop some from coverage if federal funding is jeopardized.

If Washington policymakers remain deadlocked and continue to extend the current funding levels through next year, California would face a shortfall and would not be able to cover all the children it currently serves. Because of rising healthcare costs and cutbacks in employer coverage, several states find themselves in a similar predicament.

House fails to override child health veto - Los Angeles Times

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HMO posts healthy profits - UnitedHealth

Profits still rising, Part D, a contributor to overall rise...BD

UnitedHealth, the nation's largest health insurer, said quarterly profits rose 15% to $1.28 billion. Revenues jumped 3.9% to $48.18 billion as government-sponsored medical plans grew more profitable. But the company warned that it may not be able to sustain earnings growth in the fourth quarter, citing anticipated increases in marketing costs for its Medicare health plans.

Biz Buzz: HMO posts healthy profits

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Washable Keyboards and mice clean, safe and secure for the healthcare industry

Help with the MRSA battle...anti bacterial properties are embedded in the plastic used to make the products...and you can run them through the dishwasher...BD

This year over 2 million patients will contract an infection while seeking treatment in a US hospital. Of those, close to 100,000 people will die, making hospital acquired infections a Top 10 Killer of Americans. Complicating this epidemic, a strain of antibiotic resistant staph infection, MRSA, has emerged in hospitals worldwide. Recent studies have shown the computer keyboard and mouse to be a major source of cross-contamination infections. According to Dr. Daniel LePera, Bacteria that reside in the upper mouth or respiratory tract can travel to an in-office computer keyboard and survive as long as 24 hours. Viruses can live on them for one hour or more. A study reported at the American Society for Microbiology found that MRSA can survive on computer keyboards for up to 6 weeks. Increased dependence on computer technology has found the use of computers and their associated input devices to be much more common in patient care rooms and even operating rooms where open wounds are prime targets for such bacteria.

Seal Shield Medical Grade Washable Keyboards and mice clean, safe and secure for the healthcare industry

Hat Tip:  Engadget

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FDA Announces Revisions To Labels For Cialis, Levitra And Viagra

To  address ringing in the ears side effect...BD

The U.S. Food and Drug Administration has approved labeling changes for erectile dysfunction (ED) drugs in the class that includes Cialis, Levitra, and Viagra, to display more prominently the potential risk of sudden hearing loss, and to guide consumers on what to do if they experience sudden problems with their hearing. In addition, the FDA plans to require the same changes in labeling for the drug Revatio, also a member of this drug class known as phosphodiesterase type 5 (PDE5) inhibitors. Revatio is used to treat pulmonary arterial hypertension (PAH). PAH is a serious medical condition in which continuous high blood pressure in arteries of the lungs weakens the heart muscle and often leads to right heart failure and death.

FDA Announces Revisions To Labels For Cialis, Levitra And Viagra

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Accounting firm to clean up Grady's finances

Update...the firm won't be paid a dime until they identify $10 million and then receive an average of 20 of the savings there after...BD

The Grady hospital board approved a deal Thursday with a global accounting firm to find inefficiences and clean up its finances. The deal with PricewaterhouseCoopers could cost Grady as much as $27 million, but could create savings and generate new revenue worth more than $135 million.

Accounting firm to clean up Grady's finances | ajc.com

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Novartis to cut 1,260 jobs from sales and marketing

Novartis today said it plans to eliminate 1,260 jobs from its US sales and marketing unit and replace its head of pharmaceuticals after announcing poor third-quarter earnings results. Joe Jimenez, who joined Novartis in April from Blackstone as head of the consumer healthcare unit, will step in to run the company's pharmaceuticals unit. Jimenez will trade places with Thomas Ebelin, who moves Novartis' smaller consumer unit responsible for OTC, animal medications and contact lenses.

Novartis to cut 1,260 jobs from sales and marketing - Medical Marketing and Media

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Horror for woman forced to give birth at home -South Wales

Lucky everything went ok..as they had no room for her...BD

A WOMAN about to give birth was twice turned away from the maternity ward at the Princess of Wales Hospital because there was no room. Now Elizabeth Jones and her partner Anthony Jones of Penybryn, Bryntirion, are calling for an inquiry into the running of maternity services by the Bro Morgannwg NHS Trust.

The trust has confirmed that the maternity department at Bridgend was closed for 12 hours last Thursday. There have been 11 closures of the unit so far this year. The drama began at 7am last Thursday when 24-year-old Ms Jones went into labour.

“We went to the hospital but the maternity department was jam-packed,” she said.  “I was told there were no doctors available, as they were all dealing with patients, and there were no beds.

Hospital horror for woman forced to give birth at home - Bridgend & Maesteg - South Wales Valleys - News - icWales

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In Diabetes, a Complex of Causes

New studies and potential new treatment could be on the horizon...BD

An explosion of new research is vastly changing scientists understanding of diabetes and giving new clues about how to attack it. Skip to next paragraph Health Guide * Type 2 Diabetes Multimedia The Bodys Role in DiabetesGraphic The Bodys Role in Diabetes Life Sciences Institute/ University of Michigan Study Fat tissue from a mouse that was fed a high-fat diet.

The fifth leading killer of Americans, with 73,000 deaths a year, diabetes is a disease in which the bodys failure to regulate glucose, or blood sugar, can lead to serious and even fatal complications. Until very recently, the regulation of glucose how much sugar is present in a persons blood, how much is taken up by cells for fuel, and how much is released from energy stores was regarded as a conversation between a few key players: the pancreas, the liver, muscle and fat.

New research suggests that a hormone from the skeleton, of all places, may influence how the body handles sugar. Mounting evidence also demonstrates that signals from the immune system, the brain and the gut play critical roles in controlling glucose and lipid metabolism. (The findings are mainly relevant to Type 2 diabetes, the more common kind, which comes on in adulthood.)

In Diabetes, a Complex of Causes - New York Times

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Health deal sought after veto upheld

13 votes short...BD

WASHINGTON - The Democratic-controlled House failed on Thursday to override President Bush's veto of a politically popular children's health bill, and the White House instantly called for compromise talks on a replacement. ADVERTISEMENT "As long as the bottom line is that 10 million children are covered. That's non-negotiable," responded Speaker Nancy Pelosi, D-Calif. She pledged that new legislation would be ready within two weeks, and within hours, key lawmakers met to consider changes in the vetoed measure. The maneuvering followed a 273-156 vote that left supporters 13 short of the two-thirds majority needed to prevail in a bruising veto struggle between congressional Democrats and a politically weakened Republican president.

Health deal sought after veto upheld - Yahoo! News

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Proctologist and the Balloons...

 

http://youtube.com/watch?v=CQmrB-BAgxM

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MRSA Superbug a bigger killer than AIDS

Scary statistics...32 invasive infections per 100,000 people...BD  

The Centers for Disease Control (CDC) in the United States says MRSA infections (methicillin-resistant Staphylococcus aureus) are more prevalent and invasive than previously thought. In the CDC's first overall estimate of the invasive disease it is estimated that more than 94,000 Americans are infected by the super bug MRSA MRSA is carried on the skin or in the nose of healthy people and has now escaped the hospital setting and is in the wider community.

Staph infections, including MRSA, usually start as small red bumps that look like pimples, boils or spider bites; these can quickly turn into deep, painful abscesses that require surgical draining. Sometimes the bacteria remain confined to the skin but they can also burrow deep into the body, causing potentially life-threatening infections in bones, joints, surgical wounds, the bloodstream, heart valves and lungs.

MRSA superbug a bigger killer than AIDS

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HMOs not meeting national standards in basic areas, report says

 

California HMO members are not getting all of the basic healthcare they need to prevent the onset and spread of cancer and other diseases and to reduce unnecessary expenses, a government report released today concludes. The California Patient Advocate's latest "report card" gives most of the state's health maintenance organizations barely passing grades for the care they arrange for their members.

Most HMOs got three stars, or "good," for their overall performance as rated by consumers. Two -- Blue Cross and Cigna -- received two stars, or "fair," from consumers. Aetna was the only HMO that got a single star, or "poor" rating, on the consumer survey.

HMOs not meeting national standards in basic areas, report says - Los Angeles Times

Health Care Quality Report Card

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UCLA Robot in ICU

Fascinating video watching the physician controlling the unit and talking with staff and patients.  The unit is called R2-6 and is currently in use at UCLA. 

They are also in use in other facilities today as well.   London      Detroit

http://youtube.com/watch?v=CdY2XRG481s

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California Says No To Human RFID Tagging

Good move in the privacy area...nobody should ever be forced into being "chipped"...RFID technology is good and can be used in many areas, such as tracking equipment, supplies, etc. but should never be something where we as humans would never have a choice.  In a past article posted, there was mention of a hospital CIO who voluntarily was "chipped" and his comments....BD

Halamka thinks of his microchip as another technology with practical value, like his BlackBerry. But it's also clear, he says, that there are consequences to having an implanted identifier.

"My friends have commented to me that I'm 'marked' for life, that I've lost my anonymity. And to be honest, I think they're right."

State Senator Joe Simitian (D-Palo Alto) announced today that Governor Schwarzenegger signed his Senate Bill 362, which would prohibit employers and others from forcing anyone to have a radio frequency identification (RFID) device implanted under their skin. The bill will go into effect on January 1, 2008. RFID tags are tiny chips with miniature antennae that can be embedded in almost anything. Using radio waves, RFID can help identify and track objects, animals, or people. Devices known as readers access the information on the tags. RFID technology is not in and of itself the issue. RFID is a minor miracle, with all sorts of good uses, said Simitian. But we cannot and should not condone forced tagging of humans. Its the ultimate invasion of privacy.

California Says No To Human RFID Tagging

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Docs turn to Botox to make ends meet

The changing family practice office...I'll take one flu shot, one Botox and schedule me for a chemical peel next week...oh and perhaps I should take a look at my LDL while I'm here...as payment compensation continues to dwindle for most who take insurance, there has to be some way to survive and sill provide basic services at the same time..and the courses have waiting lists for enrollment according to the article. 

You can't blame the Docs here as they have to survive as well to be available for general health care and wellness that we all need...patients and doctors...caught in a Catch 22 and somewhat between a rock and a hard spot...will there ever be any balance in health care?  BD

Doctors have had enough. They're tired of insurance companies cutting how much they pay them to take care of us. They're fighting back with lasers, Botox and liposuction. The numbers aren't huge yet. But more and more family physicians, gynecologists and other specialists are performing cosmetic procedures to replace shrinking payments from HMOs and other insurers.

Need proof? Check out this month's annual meeting of the American Academy of Family Physicians. There, doctors who usually treat high blood pressure and diabetes will be able to choose from 10 continuing education courses in chemical peels, cosmetic fillers and Botox. "We've been doing it for four or five years," says Pamela Williams, assistant director of the academy's continuing medical education division. "But we're expanding the amount and frequency." The courses are so popular some have waiting lists. That's because doctors know what their patients want.

"In medicine today, everybody is looking for something to do where you don't have to deal with the insurance companies," says Dr. David Burkons, an Ohio gynecologist who added cosmetic procedures to his practice about eight years ago and has expanded the offerings since.

Health | Docs turn to Botox to make ends meet | Seattle Times Newspaper

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Stolen laptop prompts Administaff to alert 159,000 of possible breach

Security breach story of the week...BD

October 17, 2007 (Computerworld) -- Administaff Inc., a Houston-based provider of outsourced human resources services, this week began notifying about 159,000 former and current employees about a stolen laptop containing their unencrypted personal data. The information belonged to Administaff worksite employees in 2006, including 96,000 former workers and 63,000 current ones. A note posted on the company's site described the event as "random," with the personal information apparently not the target of the theft. "At this time, the company has no reason to believe that the personal information has been accessed or used improperly," Administaff said

Stolen laptop prompts Administaff to alert 159,000 of possible breach

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FDA Approves Chemotherapy Drug Ixempra For Advanced Breast Cancer

The US Food and Drug Administration (FDA) has approved a new chemotherapy drug called Ixempra (ixabepilone) for the treatment of advanced breast cancer. The announcement was made to the press by Bristol-Myers Squibb on 17th October, the maker of the new drug, who also said the drug will be available "within days". The drug was approved to treat patients with locally advanced breast cancer or with cancer that has started spreading to other parts of the body (metastatic), and is resistant or refractory to anthracyclines, taxanes, and capecitabine.

FDA Approves Chemotherapy Drug Ixempra For Advanced Breast Cancer

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Pharma and Medical manufacturers using robots

Medco uses robots to fill prescriptions...Stryker Orthopedics uses robots in manufacturing and packaging of their products...BD 

Industrial robots are on the march at pharmaceutical, life science and biomedical companies. Robot orders jumped 13 percent at such companies in the first half of the yearthe largest increase for any industry other  than car makers. The Robotic Industries Association (RIA), which publishes roboticsonline.com, says the increase topped the 11 percent rise in orders from health care companies in the first half of last year. New Jersey is home to the country's largest concentration of medical products and services companies, with manufacturers ranging from Merck & Co. in Whitehouse Station to knee- and hip-implant maker Stryker Orthopaedics in Mahwah, and service providers including pharmacy benefits manager Medco Health Solutions Inc. in Franklin Lakes.

http://www.njbiz.com/weekly_article_reg.asp?aID=28103793.3684039.938132.6886538.9324327.500&aID2=72155

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Hawaii using telemedicine from Ohio and vice versa

Through a digital PACS system, radiologists will be able to read and interpret images from both directions...good for late and after hours...BD

The North Hawaii Community Hospital is turning to technology to help alleviate the doctor shortage in at least one specialty on the Big Island. Radiology health care professionals from Cleveland Clinic, one of the nation's top-ranked medical facilities, will be providing their services to the Big Island hospital through telemedicine.

Using a new digital Picture Archive and Communication System -- or PACS -- the Big Island hospital is able to replace X-ray film with a digital imaging and storage system, meaning all images are now stored and transmitted electronically. The PACS system will allow North Hawaii Community Hospital to offer after-hours coverage and specialty consultation services for Cleveland Clinic and vice versa. A staff radiologist on duty in one location will immediately read an X-ray or Magnetic Resonance Imaging (MRI) film at the other after peak operating hours, bridging the time-zone gap.

starbulletin.com | Business | /2007/10/09/

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A profession is born to help people navigate the health care maze

The Health Care Advocacy  ....at the rates in this article, this appears to be as costly as hiring an attorney...BD 

Margalit Mathan and Peter August found themselves caught in a maze of medical appointments and conflicting professional opinions when their 7-year-old daughter developed serious eye problems related to her juvenile rheumatoid arthritis. The Berkeley family decided to consult yet another professional. They turned to a health care advocate, an adviser who specializes in helping patients and their families cut through the health care bureaucracy to find the help they need. "It's been this huge roller coaster with the medical system and negotiating her different needs and the different information we're getting from different doctors," said Mathan, a high school psychologist. Her daughter, Siona, was diagnosed two years ago with arthritis, a condition that can cause eye inflammation and, in Siona's case, led to glaucoma.

Pinnacle Care International, headquartered in Baltimore, employs about 55 advocates working in 10 states.

Unlike individual advocates, who can charge by the hour or set a fee based on time, Pinnacle sells a one-time membership of about $3,000 plus an annual fee that can go as high as $30,000. Its services are similar to "concierge" care, or a type of premium care that is offered by some physicians on a retainer basis.

A profession is born to help people navigate the health care maze

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The Doctors Co. to Grow by Acquiring Calif. Medical Liability Insurer

Physician-owned liability insurer The Doctors Company is expanding its market by acquiring SCPIE Holdings Inc., a provider of healthcare liability insurance in California and Delaware. Following the merger, The Doctors Company says it will insure nearly 19,000 physicians in California and become the largest insurer of physician and surgeon professional liability insurance in the U.S.

The Doctors Co. to Grow by Acquiring Calif. Medical Liability Insurer, SCPIE

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Aetna US acquires Goodhealth UK

Aetna expands it market to the UK and other countries..changes in benefits to take place immediately...does this sound familiar and similar to how business is done in the US?...BD 

In a move said to be unrelated to the change of ownership, Goodhealth has announced some changes in benefits to its International Healthcare Plan. They take effect immediately.  A leading American health company has bought UK-based international medical insurers Goodhealth Worldwide. Aetna, based in Hartford, Connecticut, announced completion of the deal early this month. The sum paid was not disclosed.

They have proved useful in expanding business in more than 100 countries. The company said it had maintained growth at “upwards of 35 per cent year-on-year over the past four years.” Last year it achieved £40 million in new business.

While many UK-based insurers have relied on offering straightforward policies with little variation in content – effectively an extension of UK domestic plans – Goodhealth tried a more flexible route.

The company will become a unit of Aetna Global Benefits, Aetna’s international business for expatriates. That division focuses on providing comprehensive benefit solutions to employees working, travelling and living in more than 100 countries.

Ronald Williams, Aetna chairman and chief executive, said: “This transaction fits well with Aetna’s stated strategy of making acquisitions designed to enhance the company’s capabilities and expand into new markets.”

Business as usual, says Goodhealth after acquisition by Aetna - Telegraph

Website:  http://www.goodhealthworldwide.com/home.asp

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Pressure is on hospitals to stamp out bacterial bugs

The story here says it all...BD

Physicians, safety advocates and government officials are mobilizing to prevent the infections that have stricken an increasing number of hospital patients over the past three decades.

According to a 2003 study published in the New England Journal of Medicine, the number of catheter-associated bloodstream infections in hospitals has nearly tripled since 1975. The Centers for Disease Control and Prevention has estimated that about 80,000 such infections in intensive-care units occur in the USA each year.

The most common contaminant is coagulase-negative staphylococci, bacteria often found in the skin and mucous membranes, the CDC says. The Institute for Healthcare Improvement reports these infections are so serious that 20% of patients who contract them will die.

"Here was a man who had waited on the transplant list for two years in hopes of getting a new heart, only to have the whole thing snatched away by a central line infection," says Shannon, who now heads the Department of Medicine at the University of Pennsylvania Medical Center.

Pressure is on hospitals to stamp out bacterial bugs - USATODAY.com

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On-site clinic helps Microchip cut costs, provide routine care

This company has now instituted an "on site" clinic for employees...a minimum of 300 plus employees is required to set up a facility as stated on the website...it sounds to be similar to a "private Minute Clinic" type of facility open to employees only and I didn't find any mention of what the cost would be to use the facility for the employee and it could be offered free, but I would guess that would be determined on how the facility and contract was set up.  BD

A health-care consultant operates the free clinic at Microchip's Chandler campus, with a nurse practitioner on site. Microchip does not have access to workers' sensitive health information. And the clinic blends wellness tips, such as smoking cessation and weight management, with traditional patient care. Since Scottsdale-based Clinical Resources Group opened the CareCorps work-site clinic at Microchip on May 1, Microchip has saved nearly $2,000 per day in health-care costs, according to Clinical Resources Group.

This was an idea that really appealed to the executive team here," said Gordon Parnell, chief financial officer of Microchip.
"The trends are encouraging, and the feedback from employees has been positive."
Joyce Apperson, a global-account program manager at Microchip, scheduled an appointment in early August when she suspected she had a urinary-tract infection. It was the type of appointment that Apperson normally would arrange with her primary-care doctor, but a busy schedule and convenient location prompted her to try the company clinic.

On-site clinic helps Microchip cut costs, provide routine care

Web Site:  http://www.carecorpsclinics.com/

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Electronic Records - or you are "out of network"

They anticipate losing some physicians with this move...and the burden of the expense is on the practice with no financial support and no choice as far as the program they would like to use...there is a higher reimbursement rate for using electronic records, but does this cover the expense of getting the software and hardware in place?  Again, the same question arises that has been posed so many times...is there any ROI for the physician?  BD 

While insurance companies are getting behind greater electronic communication among doctors and their patients by paying for such care, Partners HealthCare System is forcing the use of electronic health records on the physicians in its community network. Primary-care physicians who have not implemented or agreed to implement an EHR by Jan. 1, 2008, are out of the Partners network, said Tom Lee, chief executive officer of Partners Community HealthCare, the physicians network of the Boston-based hospital system. The implementation of EHRs throughout the physician network will allow information across the system to flow in a timely and more efficient manner, he said.

"We did it with a lot of care and thought; if you're going to be one of us, this is the criterion," Lee said. Partners hasn't lost any doctors yet as a result of the decision, but some physicians are complaining about the change. Lee said he recognizes that the mandate seems "tough." He added: "Believe me, some of (the doctors) are mad."

Partners expects to lose 15 to 20 primary-care physicians this year because of the mandate, and could lose some patients if those doctors stop referring them to Partners hospitals, Lee said.  There are about 5,000 doctors in the Partners network. The primary-care doctors have until the end of 2007 to implement either Partners' EHR or one created by GE Healthcare. If they don't have the EHR but sign an agreement to implement one in 2008, they will retain their network status. At this point, specialists have through 2008 to implement an EHR, but by Jan. 1, 2009, any physician still not connected is out of the network.

Mario Motta, another cardiologist in the network, called the mandate a "two-edged sword." Motta, who uses Partners' EHR, said that there is a benefit to having an EHR because insurance companies reimburse at higher rates for their use; however, the health system is not financially supporting their physicians to implement them. "They (physicians) are being asked to carry the freight," he said.

Modern Healthcare Online

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The Virtual Doctor...

But, CMS does not want to reimburse a physician every time he/she sends an email...so what justifies an online or email physician visit...a lot of gray area here yet to be established and will it ever be adequately established?  Also, with all the information available on the web today via "Dr. Google" and other avenues, will patients even use the online consultation instead of doing a web search?  The web is free and there will be a charge for online virtual visits with the physician...so the question is will this encourage better health care?  In the past, when calling your physician for help, unless it is a very simple refill routine or follow up questions on labs, etc. most physicians ask that you make an appointment and come in.  Some things still need to be seen first hand before an adequate diagnosis can be made..or you may end up with a "virtual diagnosis"...BD 

The doctor doesn't have to see you now. Thanks to new technology, patients may not always need a face-to-face visit with their doctor to get the care they need. And thanks to a growing awareness of this fact on the part of health plans, structured, Internet-facilitated and reimbursable "virtual visits" are on the verge of entering mainstream medicine. Virtual visits also are seen as a tool that will save money, provide convenient care and maybe do something to solve the problem of patients not having access to their doctors.

Eads is also the sole practitioner in a pilot study Kaiser Permanente of Colorado Springs is conducting exploring the use of virtual visits by in-network independent physicians. She receives $50 for an online consultation and said preliminary figures from 2006 show that Kaiser is saving between $70 and $120 on each virtual visit.

These arrangements began about five years ago, first with Blue Cross of Massachusetts and Blue Shield of California and have grown to include Aetna, Cigna HealthCare and WellPoint Blues affiliates. Tarkoff said RelayHealth-facilitated reimbursement programs were developed in Florida, Kansas City, Mo., and the New York City tri-state area, and are now being established in Illinois, New Jersey and Ohio.

But Medicare reimbursement is not imminent. "I don't want to reimburse a physician every time he sends an e-mail," said Kerry Weems, acting administrator for the CMS. While not opposed to reimbursing physicians for electronic care as part of an overall reimbursement package, per-e-mail reimbursement is something Weems currently opposes. Physicians might get "very adept" at e-mailing, Weems said.

Modern Healthcare Online

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Federal agencies stepping in to help financially stressed hospitals with pension plans...

Community and other hospital types are facing all types of financial problems today...due to uninsured patients, drop in compensation rates from carriers and Medicare...just lately there has been a move in California where television commercials promoting the support of Community Hospitals has been running on several networks...these hospitals received some relief from federal agencies...will this continue to be the trend of financially strapped hospitals in order to keep the health care system alive and well?  BD 

A federal agency has stepped in to rescue pension plans at three East Coast hospitals within the past month, highlighting the growing financial difficulties hospitals face. The Pension Benefit Guaranty Corp. said last week it took over Easton Hospital's pension plan because the Pennsylvania facility was unable to contribute enough. Earlier this month, it took over the pension funds of two hospitals in bankruptcy proceedings -- Brownsville General, also in Pennsylvania, and Brooklyn Hospital Center in New York.

In Brief | IndyStar.com

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Many Older Physicians Plan to Opt Out of Patient Care

I am starting to see some of these efforts as well in my daily travels and conversations...my personal opinion here is too that much of the dignity associated with health care is being eroded with new constraints and overhead arriving almost daily at the practice door...when you compare how a practice operates today compared to 10 years ago...well there almost is no comparison...yes health care is still being practiced but the methodologies, overhead, and politics (which really shouldn't even be here) have intervened to the point to where the dollar instead of better health care appears to be the #1 goal, something veteran MDs who have been there for us struggle with daily.  These are the folks that save our lives and the overall picture of the constraints and stress they work under is not always a pretty picture.  BD

IRVING, Texas, Oct. 15 /PRNewswire/ -- In the next one to three years, 48 percent of physicians between the ages of 50 and 65 are planning to retire, seek non-clinical jobs, work part-time, close their practices to new patients, and/or significantly reduce the number of patients they see, a new survey indicates. The survey, conducted by Merritt Hawkins & Associates, a national physician search and consulting firm based in Irving, Texas, suggests that many experienced physicians are seeking a way out of traditional patient care roles.

Should older physicians elect to remove themselves from patient care or significantly reduce the number of patients they see, access to physicians would be greatly reduced, according to Smith.

"Almost half the physicians in the United States are 50 years old or older," Smith observes. "An exodus of older doctors from medicine would be a disaster for patient care in this country."  The survey further indicates that many older physicians are underwhelmed by the work ethic of today's younger physicians. Sixty-eight percent of older physicians surveyed indicated that physicians coming out of training today are less dedicated and hard working than physicians who came out of training 20 to 30 years ago.

Survey: Many Older Physicians Plan to Opt Out of Patient Care

Hat Tip:  Kevin, MD

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Canada's Expectant Moms Heading to U.S. to Deliver

U.S. Health Care helping wit baby booming business in Canada...not enough room in current facilities to deliver newborn babies...deliveries are one item that can't be put on the waiting list...BD 

Mothers in British Columbia are having a baby boom, but it's the United States that has to deliver, and that has some proud Canadians blasting their highly touted government healthcare system. "I'm a born-bred Canadian, as well as my daughter and son, and I'm ashamed," Jill Irvine told FOX News. Irvine's daughter, Carri Ash, is one of at least 40 mothers or their babies who've been airlifted from British Columbia to the U.S. this year because Canadian hospitals didn't have room for the preemies in their neonatal units. "It's a big number and bigger than the previous capacity of the system to deal with it," said Adrian Dix, a British Columbia legislator, told FOXNews.com. "So when that happens, you can't have a waiting list for a mother having the baby. She just has the baby.

"I just want to go home and see my kids," she said from her Seattle hospital bed. "I think it's stupid I have to be here."

FOXNews.com - Canada's Expectant Moms Heading to U.S. to Deliver - Local News | News Articles | National News | US News

Hat Tip:  Kevin, MD

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British 'Nurse of the Year' quits the NHS

Frustrated nurses also in the UK...same issues...not being heard...and constant reform...BD

Britain's star nurse has quit her job with the National Health Service (NHS) only eight months after being named 'Nurse of the Year'. The 37 year old mother of two will leave nursing to take up a teaching job. Justine Whitaker says she has quit because of the pressure constant health reforms place on frontline nursing staff. Whitaker has called on the Health Secretary Alan Johnson, to stop paying lip service to nurses and "hear what we are saying". Ms Whitaker is a Macmillan specialist clinical nurse with 20 years experience in the treatment of lymphoedema, the swelling of the lymph glands, at East Lancashire Primary Care Trust.

She has also invented a pain relief device to help men after prostate surgery, the Whitaker compression pouch is a garment which helps relieve painful swelling suffered by some men with prostate cancer and is used worldwide.

She says she is sorry to be leaving nursing but the impact of the constant reforms to the health service is grossly misunderstood by the government.

Ms Whitaker says while the government says it has talked to thousands of nurses and doctors they do not hear what they are saying.

British 'Nurse of the Year' quits the NHS

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Acupuncture before and during surgery reduces the need for powerful painkillers

Interesting study...if it can reduce the amount of painkillers needed after surgery that would certainly be right up there in my book..BD

A new study has found that using acupuncture before and during surgery significantly reduces the level of pain and level of painkillers needed by patients following surgery. According to anesthesiologists at Duke University Medical Center the amount of powerful pain killers needed for patients who received acupuncture was much lower than those who did not have acupuncture. This is important for the patient because it means the side effects associated with opioids such as nausea, vomiting and severe itching are considerably reduced.

The specialists who combined the data from 15 small randomized acupuncture clinical trials say such side effects can negatively impact on a patient's recovery from surgery and lengthen the time they spend in hospital. Dr. Tong Joo Gan, who presented the results of the analysis at the annual scientific conference of the American Society for Anesthesiology in San Francisco, says based on the results of the analysis, acupuncture should be considered a viable option for pain control in surgery patients.

Acupuncture before and during surgery reduces the need for powerful painkillers

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Unions give up on gov.'s health plan - California

Latest in the continuing story on California Health plans...BD

SACRAMENTO -- Abandoning their facade of cooperation, a coalition of California labor unions and consumer groups says it is gearing up a campaign to discredit Gov. Arnold Schwarzenegger's healthcare proposal as too expensive for many workers. Organizers say they will trail Schwarzenegger throughout California to challenge and rebut him, hold prayer vigils and news conferences, press elected officials to oppose his proposal and run critical ads on television. They plan to deride the governor's program as the "Arnold Middle-Class Gouge.

But the campaign could backfire by turning voters against big changes to the state's healthcare system, including methods favored by unions. That might benefit Republican lawmakers, Blue Cross of California and business groups that have opposed a wholesale overhaul along the lines envisioned by Schwarzenegger and Democratic leaders.
"There is a chance the voters might say, 'This is all too complicated and let's wait,' " said Mark Baldassare, president of the Public Policy Institute of California, a nonpartisan research group.

Unions give up on gov.'s health plan - Los Angeles Times

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Ben Affleck supports unionizing hospitals in Boston

Actor and film director Ben Affleck took time out today from promoting his new movie, "Gone Baby Gone," to stump for the powerful Service Employees International Union, which moved closer to launching a full-blown organizing campaign to unionize thousands of workers at Boston's teaching hospitals.  The union's effort also won the endorsement of Boston Mayor Thomas M. Menino, who attended the press conference. "The healthcare sector is the backbone of our economy," Menino said. "I want these workers to have the same benefits other hospital workers have."

Beth Israel Deaconess Medical Center, a Harvard-affiliated teaching hospital in the Longwood Medical Area, has been a focus of SEIU activity since it disclosed plans to organize Boston hospitals last year. On his blog, hospital chief executive Paul Levy said he respects employees' rights to organize, but will not sign the type of agreement proposed by SEIU.

Affleck supports unionizing hospitals - The Boston Globe

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Kaiser doctor, accused of negligence, remains on the job

Sad story here...jury may be out on this one for a while too...the one item that is a bit odd is the comment from his attorney where the physician threatened to go on a "hunger strike"?  Why would a professional physician make such a statement or threat?  Very strange indeed...BD

"I've been telling these guys for years that he was going to kill someone," said Dr. Gilbert Moran, the former ob-gyn chief. "And no one would listen."

It took 90 minutes and six tries -- the last with Safari on his knees, pulling. Horrified staffers -- and the boy's father -- looked on as baby Devin finally emerged. His skin was a bloodless white, his neck elongated and floppy.
His spinal cord had been severed.

Safari lashed out at a nurse. "What did you do to that baby? I gave you a good baby," he said, according to a complaint letter the nurse sent to her union representative.
Staffers at the Fresno birthing center were devastated and angry -- and not just because of the twin lost that night in 2005.

Schear, Safari's attorney, said his client never said he would burn himself, but did threaten to go on a hunger strike to protest harassment by his boss, Moran. Other physicians complained that Moran played favorites, he said.

Kaiser doctor, accused of negligence, remains on the job - Los Angeles Times

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The Medical Home: An Idea Whose Time Has Come ... Again

AAFP model - TransforMed...incorporates Medical Home components...and more coming, insurance companies are doing it, as well as self insured employers.   Medicare beginning the leg work to be completed no later than 2010 with CPT codes that will facilitate payment relative to a practice being qualified as a "Medical Home".  The article goes in to detail on what qualifications need to be met in order to qualify a practice...BD 

Family physicians have always known the value of a medical home, even when there was no term to describe it. Now, 60 years after the AAFP was founded, others are recognizing that medical homes may be the key to getting better value from the U.S. health care system. In recent months, a wide range of stakeholders including legislators, large employers, patient groups and organized medicine have begun championing medical homes as the centerpiece of a primary-care based approach to health care reform. The medical home that these plans envision is both old-fashioned and thoroughly modern - a blend of the personalized, comprehensive care that family physicians have been offering for decades and coordinated care that capitalizes on new technology and helps patients make sense of the increasingly complex health care system. Whether the concept takes root may depend on two key issues: whether payers can be convinced of the value of medical homes (and the need to pay more for them) and whether physicians can deliver what the medical home promises. This article describes progress in both areas. A future article will offer suggestions for physicians interested in further developing their practices' medical home characteristics.

In addition to needing an adequate care management fee, practices will need education to help them redesign their systems of care to meet medical home criteria, Smith says. Learnings from the TransforMED demonstration project and CME opportunities focused on medical homes will be instrumental in enabling practices to achieve these goals. "I'm very optimistic that with this help, an incentive, and a better understanding among patients and other providers of the value that a medical home provides, we can redesign our practices in a way that will serve everyone well," she says.

The Medical Home: An Idea Whose Time Has Come ... Again

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Copy and Paste: Medscape article for CME

You may need to register for this article, but one thing it drives home for all is over familiarity..and missing something in a medical record somewhere along the line here...BD 

The patient was admitted and received intravenous fluids and an infectious evaluation of her stool. The final line of the intern's admitting note also stated that the patient would receive subcutaneous heparin for venous thromboembolism (VTE) prophylaxis, although this was never actually ordered. The patient's care was transferred to a different team the following day, and the accepting intern copied and pasted the plans of the admitting intern into the new note within the electronic health record (EHR). The same note was then copied and pasted on 4 consecutive hospital days and cosigned by the resident and attending, and the patient was ultimately discharged having never received the intended VTE prophylaxis -- despite each day's note stating this as part of the plan. Two days following discharge, the patient developed acute shortness of breath and hypoxia and returned to the hospital, where she was diagnosed with a pulmonary embolus. Only at this admission, and after careful review of the medication record from the previous hospitalization, was it realized that the patient never received any VTE prophylaxis.

Cases From AHRQ WebM&M: Copy and Paste

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Backstage Pass: Working at Kaiser as an Internal Medicine Hospitalist

Interesting and good reading...from one who made a transition...BD

So many of you have sent me emails asking for this post. Here it is, words of wisdom from Kaiser IM hospitalists... I have a few friends who are IM hospitalists at Kaiser. This is what they had to say... What is a hospitalist? A hospitalist is the primary care physician who focuses on inpatient care. I chose to become a hospitalist because I grew weary of the day to day mad-house of ambulatory (clinic) work. Hospitalized patients tend to be "more interesting", and I feel more 'productive' (like I'm really helping sick people feel better) working in the hospital. Also, the business aspect is less cumbersome. I don't have to deal with managing people, a clinic, a business, etc. Also, since the hospital is open 24/7, the hours tend to be more flexible, and shift-like...which has it's perks.

EM Physician - Backstage Pass: Working at Kaiser as an Internal Medicine Hospitalist

Hat Tip:  Kevin, MD

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Medical Tablet PC Evangelist and Programmer

From the Ablet Factory...Fritz Switzer the developer of One Note Add Ons...I somehow missed this and it never hurts to  review and take another look.  This video may have been done before the Medical Quack existed as well.  From a personal perspective, I like what he does and the One Note Add Ons are a perfect solution for the small practice for creating electronic records.  You will need a copy of Microsoft Office One Note, but almost any user of a tablet today realizes this is a "must" for keeping everything together and most folks will want some version of Microsoft Office available for other functions, such as Outlook for email and Word for other functions as well.  I have recommended the software for my clients and it is affordable.  Use the link below to visit the site and see what else is new and brewing at the Ablet Factory.  I'll be on the look out for any new developments here as well.  BD 

                   

 

 

 

           

 

http://www.youtube.com/watch?v=kRJjKaPxdTw

Visit the Ablet Factory

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Take Two E-Mails and iPhone Me in the Morning - The boutique practice

Now this physician put on his thinking cap...granted this is may not work for all, but he's definitely got some good ideas in the making here.  BD

Although many doctors routinely store medical records digitally and use e-mail to communicate with patients, Parkinson is among the first to conduct virtually all his business, well, virtually. Targeting patients ages 18 to 39 -- a relatively healthy, technology-friendly bunch -- Parkinson says he aims to provide cheap primary care for the hip-but-uninsured while keeping down costs for the insured.

Here's how it works: Pay Parkinson's $500 annual fee and you get an initial in-person consultation, at your home or office, that can last as long as two hours. After that, you're entitled to two additional visits; further face-to-face visits cost $150, which Parkinson's Web site calls an average fee for primary care physicians in New York.

For patients with whom he has held that initial consultation, he's available for routine questions online and appointments at a mutually convenient location weekdays from 8 to 5 and round-the-clock for emergencies.   And he blogs too.....

So, say you cut your finger while slicing your morning bagel. Parkinson suggests you e-mail him a digital image of the wound; he can tell whether it needs stitches or just a drugstore bandage. (And if there's any doubt, he'll send you to get it checked.)

Parkinson also offers his patients information about specialists and providers of lab work and other services in the New York area. So if you need an MRI, for instance, call Parkinson to find out where to get it done cheap. Want a flu shot? He'll refer you to a colleague who offers them at low cost. He also says he can steer clients toward good deals on prescription drugs.

Take Two E-Mails and iPhone Me in the Morning - washingtonpost.com

Dr. Parkinson's Site

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Survey: Californians favor 1-cent sales tax for health insurance

More than likely the only type of pool large enough to capture needed revenue...and everybody contributes..BD 

California voters would narrowly support a one-cent sales-tax increase to pay for health insurance, according to a survey. San Jose State University's Survey and Policy Research Institute found that 52 percent of the voters would be in favor of such an increase, while 38 percent would be against it.

Survey: Californians favor 1-cent sales tax for health insurance - Sacramento Business Journal:

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Ending Employer-Based Health Insurance Is a Good Idea

Someone finally said it...in all the recent postings here just on this blog and conversations I have had I don't get the idea that any employer today is happy about being saddled with administering health care and insurance for employees..just flat out due to not only cost, but the time...and this all has a tendency to impact their bottom line profits and many times can result in whether or not the company stays in business.  BD

The U.S. employer-based health-insurance system is failing," declares a new report by the Committee for Economic Development (CED). The CED is a Washington, D.C.-based policy think tank comprised of business and education leaders. And it is right: Employer-based health-insurance is indeed failing. Between 2000 and 2007, the percentage of firms offering health insurance benefits fell from 69 percent to 60 percent. The percentage of people under age 65 with employer provided insurance dropped by 68 to 63 percent. In absolute numbers, those covered by job-based insurance fell from 179.4 million to 177.2 million.

Employers are jettisoning health insurance because costs are out of control. Since 2001, premiums for family coverage have increased 78 percent, while wages have gone up 19 percent and inflation is up 17 percent. The consequence is that health insurance is the number one domestic policy issue in the 2008 presidential race.

Reason Magazine - Ending Employer-Based Health Insurance Is a Good Idea

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Study Of Siestas Finds Reduction In Blood Pressure

Now I have been waiting for a study of this type!  If afternoon siestas reduce my blood pressure, put me down for one every afternoon! 

Where does the benefit lie in an afternoon nap? Is it in the nap itself--or in the anticipation of taking a snooze? Researchers in the United Kingdom have found that the time just before you fall asleep is where  beneficial cardiovascular changes take place. This finding is part of a study entitled Acute Changes in Cardiovascular Function During the Onset Period of Daytime Sleep: Comparison to Lying Awake and Standing, found in the online edition of the Journal of Applied Physiology, published by The American Physiological Society. The study was conducted by Mohammad Zaregarizi, Ben Edwards, Keith George, Yvonne Harrison, Helen Jones and Greg Atkinson, of the Liverpool John Moores University in Liverpool, U.K.

Why do afternoon naps affect cardiovascular function? One reason could be changes in blood pressure. At night, our blood pressure and heart rate decreases as we sleep. Some researchers hypothesize that the lower blood pressure reduces strain on the heart and decreases the risk of a fatal heart attack.

Study Of Siestas Finds Reduction In Blood Pressure

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Digital Forms for Tablet PC

Quick video on using digital forms on a tablet pc...think of this as perhaps a medical records...or lab request...BD 

http://www.youtube.com/watch?v=a2DRWMP3fNM

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Tablet software... InkSeine from Microsoft Labs...

This is not available yet for public download, but wanted to include this video to show an idea of what's to come...exciting stuff...just think of how easy it will be to find, add information, etc. on a tablet with this new software...Ink Seine....labs, documents, etc.  BD  

InkSeine provides a really slick way to get at all your stuff without having to deal with the file system or switch to a separate "search application." With InkSeine, you can circle a handwritten phrase to create a query right in your notes, without having to transcribe it to a search box somewhere else. The query persists in-place as an icon that lives there and gets saved in perpetuity just like any other part of your notes.

InkSeine Features: What Makes InkSeine unique?

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Using the Sahara Dual-Mode Tablet PC for speech therapy

Great video showing using specific speech software with the Sahara Dual Mode tablet...no mouse required, just your hands and optional use of the stylus for inking input.  BD

http://www.youtube.com/watch?v=i5RslaMasaQ

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Tablet PC Input Panel with Chinese

Now why is this here?  I wanted to show how you can switch back and forth between languages with a Tablet PC.  In this example using the input panel, the user is going back and forth between Chinese and English.  As you can view this is pretty simple to do with the language packs.  In California, there might be a need to perhaps use both English and Spanish for notes and records.  Something to think about if you use more than one language and how simple it can be with a Tablet PC as there's more than just English available.  BD 

http://www.youtube.com/watch?v=u3VGFla2xig

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Some writing on a Tablet PC

This is a very simple video showing tablet inking with both Windows Journal and One Note.  The power of ink and how simple it can be.  Imagine how simple this makes record keeping in health care.  BD

http://www.youtube.com/watch?v=Gp91X3G3M-s

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California Gov. Schwarzenegger Vetoes Democrats' Health Care Overhaul Bill

This one was also expected to prompt a special session of the legislature to continue working on the health care bill..BD

In vetoing the measure, Schwarzenegger said, "This bill does not achieve coverage for all -- a critical step needed to reduce health care costs for everyone." He added that the bill "places an unreasonable financial burden on businesses" (Los Angeles Times, 10/13). In a statement, the governor said, "The time is now for all of us to return to the negotiating table, find middle ground and pass the comprehensive reforms we need to fix our broken health care system."

California Gov. Schwarzenegger Vetoes Democrats' Health Care Overhaul Bill

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Night-Time Acid Reflux Can Impact Sleep, New Studies Reveal

GERD can disrupt sleep according to the study...check the latest developments on GERD on the site...updated as new information arrives...BD 

Using the survey, researchers also assessed sleep impairment among patients experiencing frequent nighttime atypical manifestations of GERD. In this case, Dr. Dean and her colleagues evaluated the subgroup of respondents with GERD, as identified using the validated GERD screener. They found that atypical manifestations or symptoms of GERD (i.e. coughing, sore throat, snoring, wheezing, choking, and chest pain) were common among those with acid reflux. Of GERD patients, 74 percent had at least one nighttime atypical manifestation. For almost every daytime and nighttime atypical manifestation assessed, more than 20 percent of GERD patients reported their occurrence as frequent (more than 2 days or nights per week). Researchers also found that sleep impairment was more common among GERD patients with atypical manifestations compared to GERD patients with only typical or classic symptoms such as heartburn and acid regurgitation. For eight of the nine nighttime atypical manifestations assessed, the proportion of GERD cases reporting sleep impairment was significantly higher for GERD cases with the atypical manifestation compared with GERD cases without the atypical manifestation.

Night-Time Acid Reflux Can Impact Sleep, New Studies Reveal

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Pfizer Signs Deal With Physician Social Networking Site Sermo

Sermo is the forum for anonymous discussions related to health care...and is increasing resources available for physicians to pose questions...BD

Pfizer on Monday announced an agreement under which physicians employed by the drug maker will be able to communicate with the 31,000 doctors that use Sermo, a medical social networking site, the Bloomberg/Fort Worth Star-Telegram reports (Bloomberg/Fort Worth Star-Telegram, 10/15). Sermo, founded in September 2006, provides a forum for licensed physicians to anonymously discuss diagnostic and treatment techniques, and it allows users to rank postings based on credibility. According to Sermo, membership increases by about 1,000 to 2,000 per week.

Pfizer Signs Deal With Physician Social Networking Site Sermo

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Fall Back Into Bed And Catch Up On Your Sleep

Good advice and I can certainly learn from this article as well...interesting how lack of sleep can affect so many different areas of your health...yet so many, myself included, with the fast pace world we live in today keep pushing the envelope to some degree....BD 

Clete Kushida, MD, PhD, of the Stanford Sleep Disorders Clinic at Stanford University Medical Center in Palo Alto, Calif., and a member of the AASM board of directors, says that, in modern society, work and family responsibilities often take precedence over sleep.

Ralph Downey III, PhD, director of the Sleep Disorders Center at Loma Linda University Medical Center in Loma Linda, Calif., says that an extra hour of sleep will go a long way toward rejuvenation, both physically and mentally. He adds that, while we can borrow more time to complete all of the activities on our "to do" list, we cannot borrow good health.

Fall Back Into Bed And Catch Up On Your Sleep - American Academy Of Sleep Medicine

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Surgery More Likely Than Angioplasty To Relieve Pain For Patients With Coronary Artery Disease

Interesting report that compares the 2 procedures...and study results...BD 

"Choosing a treatment for coronary disease has long been a difficult challenge," said AHRQ Director Carolyn M. Clancy, M.D. "But this new evidence-based report provides a vital reference to help doctors, patients, and their families make the best possible decision."

Patients with mid-range coronary artery disease are more likely to get relief from painful angina and less likely to have repeat procedures if they get bypass surgery rather than balloon angioplasty with or without a stent, according to a new report by the Agency for Healthcare Research and Quality, part of the U.S. Department of Health and Human Services. The analysis drew on 23 randomized controlled trials that compared treatments for patients with mid-range coronary disease treatable with either angioplasty or bypass surgery. As defined by the report, mid-range disease may occur in three ways: a single blockage of the vital left anterior descending artery, blockage of two arteries, or some forms of less-severe blockage of three arteries.

Surgery More Likely Than Angioplasty To Relieve Pain For Patients With Coronary Artery Disease

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FDA Approves DORIBAX(TM) For The Treatment Of Complicated Intra-Abdominal And Complicated Urinary Tract Infections

The U.S. Food and Drug Administration (FDA) has approved DORIBAX(TM) (doripenem for injection) as a new treatment for complicated intra-abdominal and complicated urinary tract infections, including pyelonephritis. DORIBAX has demonstrated activity against a wide range of Gram-positive(1) and Gram-negative(2) bacteria -- including Pseudomonas -- that cause these serious infections. DORIBAX belongs to a class of antibacterial agents called carbapenems, which are important for treating serious infections caused by Gram-positive and Gram-negative bacteria.

DORIBAX will be marketed to U.S. hospitals and other healthcare institutions by Ortho-McNeil, Inc. through its Institutional Franchise. The use of doripenem in the treatment of hospital-acquired (nosocomial) pneumonia, including ventilator-associated pneumonia, is under regulatory review in the U.S., and the use of doripenem for complicated intra-abdominal infections, complicated urinary tract infections and nosocomial pneumonia, including ventilator-associated pneumonia, is under regulatory review in Europe. Doripenem is licensed from Shionogi & Co., Ltd., which launched the product in Japan in September 2005 under the name, FINIBAX.

FDA Approves DORIBAX(TM) For The Treatment Of Complicated Intra-Abdominal And Complicated Urinary Tract Infections

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Medco to have prescription review system

Additional use of technology and pharmacists to help reduce interactions and errors relative to prescriptions...a 2nd set of eyes for the physician and especially helpful if more than one MD is writing prescriptions for the same patient..BD

The latest, possibly largest program was to be launched Tuesday by Medco Health Solutions Inc., a pharmacy benefit manager serving 60 million people. The Franklin Lakes-based company has trained 700 pharmacists so far, each on one of seven complex, chronic conditions, and set up a resource center for each condition at its mail order pharmacies.

WellPoint Inc., the biggest U.S. insurer, said it is starting such a service in-house, covering 14 different complex illnesses.

One is diver Greg Louganis, who has been HIV-positive for two decades. When his doctor prescribed an anti-inflammatory medicine recently, Medco called him and the doctor to say that drug might interfere with the AIDS medicines he takes, Louganis said. The doctor agreed and made an adjustment.

Computers flag incoming prescriptions for patients with those conditions — such as diabetes, cancer and infectious diseases — for a specialty pharmacist to review them if necessary. The pharmacists look for dosing errors, interactions with other drugs, whether the patient isn't refilling prescriptions as directed, or if a new medication would be better. Patients can call 24 hours a day, seven days a week with questions, even about effects of nonprescription drugs.

Medco to have prescription review system - Yahoo! News

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HIMSS Virtual Conference November 6-7

This is a virtual conference available from your desktop with CME credit.  It will also allow for questions and interaction with various portions of the presentations.  There is also a virtual exhibition hall whereby you can view technology hardware and software solutions and enable a live chat session if you desire and network with other attendees.  BD 

The HIMSS Virtual Conference & Expo is not a Web Seminar; it is a fully interactive event that incorporates online learning, live chat, active movement in and out of exhibit booths and sessions, vendor presentations, contests and more. Because the conference is 100 percent virtual, you can experience the expo from the comfort of your own desk. Save yourself the travel expenses and get right to the industry information and solutions you seek.

Attend 12 live educational sessions with esteemed industry speakers. Be eligible to obtain CE Credits. Have access to the content for three full months after the virtual event. The in-depth sessions you'll attend will cover topics such as: * Integration * Interoperability * EHR * RHIOs * ROI * Nursing Informatics It's the perfect addition to your schedule and your professional growth.

The Explosive Growth of Medical Tourism and What it Means to the Healthcare Industry

Until the past few years, globalization has impacted virtually every industry – except healthcare.  Not anymore. Highly-trained expat doctors and nurses are returning to their homeland to work in state-of-the-art hospitals…for a lot less money. The upshot? Countries like India can offer inexpensive, high quality medical procedures to North American and European patients…and they’re buying.

Who Will Attend

• CEOs
• CIOs/CTOs
• CFOs
• COOs
• CMOs
• Directors
• Department Heads
• Physicians
• Clinicians Nurses

HIMSS Virtual Conference

General Information:  http://www.himssvirtual.org/gen_info.asp

Registration Information:  http://www.himssvirtual.org/reg.asp

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American Academy of Family Physicians...Letters...do we need primary care - "not for me any longer, I'm driving a truck..."

Not good news by any means with the shortage of Primary Care physicians taking place all over...one MD is going to leave the practice to "drive a truck"...well the good news for this physician though is that good truck drivers are also in high demand ..so good luck with that class one license and let it roll - I'm sure you will be truly missed as will be the other 4 calling it quits. 

Here is the link to the original post from the AAFP to read the article and have access to posting comments.  Couple comments listed below...BD

"Thank you for Dr. Iliff's editorial. In the last six months in our community, five primary care physicians have called it quits. Some have gone into hospital medicine, some have gone into the more controlled atmosphere of nursing home medicine, some have gone into the fringe of nutritional medicine and one will simply be driving a truck cross-country commercially. The rest of us are running as fast as we can. We cannot accept any more patients. The medical students from the local university have decided on careers out of primary care. They are not as blind as we were entering practice."

"Doctors are only allowed to write letters while payers have access to lawmakers. It doesn't take a rocket scientist to see how this scenario is going to end."

Letters - October 2007 - Family Practice Management

Hat Tip:  Kevin, MD

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