EMR Toolkit 2007 from the Ablet Factory

For the small practice needing an EMR without spending a fortune...$295.00 for a single user.  You will need a copy of One Note as well.  The report formats are great..  If you have a favorite Word or PDF document, you can add it to the software as an "ink" template.  Be sure to check out the other software on the site as well.  Once you understand the concept of One Note, with each column on the left being a "book", the tabs across the top being the "chapters", and the columns/tabs on the right being "pages", it all makes perfect sense and a great way to organize and create patient charts without a huge investment for the small practice.  BD

OneNote2007 EMR Toolkit -  A PAPERLESS OFFICE !!  Now Supporting OneNote 2007

—For physicians with a Tablet computer who are dissatisfied with current EMR solutions and want a portable, productive solution for patient chart/document management.

The Ablet Factory is pleased to announce the release of its latest product, OneNote2007 EMR Toolkit.  Following the release of previous Toolkits, this product supports the new Microsoft One­Note 2007.

A new graphical user interface (GUI) and faster operation make this version the one to purchase.  Also included is the new Microsoft Ribbon Control.  An easier and discoverable way to do your tasks.  The Ablet Factory will assist in importing your custom forms and templates.

 

—For physicians with a Tablet computer who are dissatisfied with current EMR solutions and want a portable, productive solution for patient chart/document management.

EMR Toolkit 2007

Additional Products from the Ablet Factory

Video on EMR Toolkit 2007

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Your Fat Pet Have Diabetes?

Humans are not the only ones at risk...good reading if you are a pet owner...BD

A new obesity epidemic is rising, and it's not in children or adults -- the epidemic is striking animal companions. Obese and overweight pets are at greater risk of developing Type 2 diabetes. In a country where 50 percent of adults are overweight, and one in five is considered obese, the nation's pets are also at risk.

"Fifty-seven percent of American pets are overweight or obese, and they are at serious risk."

As with humans, pets can develop warning signs when they are on the path to developing diabetes. Excessive water drinking and urination are two red-flag signs, as well as pets that develop a bony appearance even though they have a huge appetite.

ABC News: Does Your Fat Pet Have Diabetes?

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Alcohol Powder Invented

Not good news for the Brits who's physicians are trying to take on the problem of alcohol with minors...BD 

Dutch students have invented powdered alcohol. The latest innovation in inebriation, called Booz2Go, is available in 20-gramme packets that cost 1-1.5 euros (70 pence-1 pound).

Top it up with water and you have a bubbly, lime-coloured and -flavoured drink with just 3 percent alcohol content.

"We are aiming for the youth market. They are really more into it because you can compare it with Bacardi-mixed drinks," 20-year-old Harm van Elderen told Reuters.

Van Elderen and four classmates at Helicon Vocational Institute, about an hour's drive from Amsterdam, came up with the idea as part of their final-year project.

"Because the alcohol is not in liquid form, we can sell it to people below 16," said project member Martyn van Nierop. The legal age for drinking alcohol and smoking is 16 in the Netherlands.

Alcohol Powder Invented - WhatsTheCrack.net

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I felt paranoid practicing medicine

Opinion from one MD...BD

During the last several weeks, I have asked you to consider some of the factors which I feel have been responsible for the large percentage of our Gross National Product which is needed for health care. I have also tried to explain why I got feelings of paranoia when so many people intimated that we physicians were primarily responsible for this escalation of medical costs. This week I want to go one step farther and let you know how big business involvement in health care has resulted in many patients getting inadequate care.

If the physician does just a little less for each patient (s)he sees, the more free time (s)he will have. Not only that, in many cases the size of an annual bonus (or the amount actually deducted from his/her salary) reflects the total overall cost to the company for those patients assigned to that physician. Therefore it is to the physician’s benefit to limit the number of referrals to specialists or to obtain additional testing.

I felt paranoid practicing medicine - The Bluffton News-Banner

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Family considers suit after man dies in broken wheelchair

Medicare would not repair or replace the chair...contract issue?  Van service also stopped as they had not been paid by Medicare...BD

A disabled Queens dad died from head trauma he suffered in a fall from a damaged wheelchair he battled Medicare for months to fix or replace, his grieving family said.

The wife of Jan Plattner, 52, is now considering legal action, saying Medicare stopped paying for services that could have prevented her husband's death last month. Medicare would not cover a replacement wheelchair, said Duncan, in spite of numerous calls she and her husband made. In August, Plattner, of 141st St. in Jamaica, took a spill on the floor of a nearby donut shop when a wheel and leg piece on his motorized chair came apart, his family said.

A Queens company called to service the chair in July refused to repair it because Medicare would not cover the work, a company manager said."He said, 'I didn't know I joined an HMO.' But someone probably told him to sign something," the manager said.

Making matters worse, a van service stopped pickups for Plattner's doctor's appointments because they had not been paid by Medicare throughout July and August, his wife said.

Family considers suit after man dies in broken wheelchair

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IHHI Announces Second Quarter Earnings

Status of affairs for Orange County, CA hospital chain...BD 

IHHI reported consolidated net operating revenues of $95.4 million for the three months ended September 30, 2007, an increase of $10.1 million, or 11.8%, from the comparable period in 2006. Operating income for the three months ended September 30, 2007 was $4.1 million compared to an operating loss of $4.6 million for the same period in 2006. The consolidated net income for the three months ended September 30, 2007 was $1.1 million, or $0.01 per share, versus a net loss of $7.0 million, or $0.08 per share, during the same period of 2006. The net loss for the same period in 2006 was $7.8 million before recognition of the change in fair value of derivative (this is a non-GAAP measure).

Management commented further that the improved operating results do not yet reflect the reduced borrowing costs resulting from its refinancing efforts which took effect on October 9, 2007. The results of the refinancing are expected to be displayed in the Company's future results.

IHHI Announces Second Quarter Earnings

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Rep. Buyer blames VA hospital in laptop thefts, jeopardized IDs

Security breach story of the week belongs to the VA..happened back in 2006...getting congressional attention...BD

An Indiana congressman says the Veterans Affairs hospital in Indianapolis failed to follow new safety protocols, leading to a possible breach of veterans’ personal information last weekend.

The names, Social Security numbers and dates of service of 12,000 veterans were compromised when three computers were stolen from the Roudebush Veterans Affairs Medical Center over the Veterans Day holiday weekend, officials said.

Rep. Buyer blames VA hospital in laptop thefts, jeopardized IDs | IndyStar.com

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'Fix hospital or we'll quit'

In Australia...physicians are threatening to quit....unless the hospital is fixed..BD

SENIOR surgeons are threatening to resign if the Government does not restore Royal North Shore Hospital to its former glory.

Their warning came as the couple who sparked the latest inquiry, Mark Dreyer and Jana Horska, broke down as they relived their ordeal of her miscarrying in the hospital's toilet. Silence fell over the room as Mr Dreyer detailed the night his wife lost their unborn child on September 25, when Ms Horska was 14weeks pregnant.

"There is no deadline to our ongoing grief and suffering," Mr Dreyer said.

Director of medical services Dr Sharon Miskell said there had been instances where equipment was broken, inadequate or non-existent.

"We are unable to perform surgery, we are delaying surgery," she said.

'Fix hospital or we'll quit' | NEWS.com.au

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National ePrescribing Patient Safety Initiative Supports Medicare Proposal to Adopt Additional Standards for ePrescribing

There is a link on the right hand side for resources to connect and get started...it is free for any physician who enrolls...BD 

By further developing the standards for electronic prescribing, CMS has passed another important milestone in the government's plan to encourage the adoption of electronic health records and build an interconnected healthcare system in the United States," said NEPSI Co-Chair and Allscripts Chief Executive Officer Glen Tullman. "The new standards ensure that physicians have all the information they need to provide improved care at lower cost. NEPSI supports the proposed technical standards and urges their rapid implementation." NEPSI is a coalition of the nation's leading healthcare and technology companies that is dedicated to eliminating preventable medication errors by providing free electronic prescribing technology to every physician in America. NEPSI is led by Allscripts and national sponsor Dell Computers, the world's leading computer company. Other companies sponsoring NEPSI are Aetna, Cisco Systems, eRx Networks, Fujitsu Computers of America, Google -- the coalition's Search Sponsor -- Horizon BCBS of New Jersey, Microsoft, NaviMedix, Quest Diagnostics, Sprint Nextel, SureScripts, Wellpoint, and Wolters Kluwer Health.

National ePrescribing Patient Safety Initiative Supports Medicare Proposal to Adopt Additional Standards for ePrescribing

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Infected transplant patient a ‘mess’ - Health care

This is so very sad...not only hepatitis but HIV all at once...and the fact that she had been doing well on dialysis too and is only in her 30s..BD

'Most important person did not know'
"The (organ) procurement group knew, the hospital knew, but the most important person did not know," he said. "The people that dedicate their lives to these transplant surgeries, they're just great people, but they need to bring the patient into the mix and let them make an informed decision."

U.S. Centers for Disease Control and Prevention guidelines were violated twice, the attorney said. One violation was not informing the woman about the donor's status and then not testing her afterward for HIV until just recently, after HIV and hepatitis were found during tests on another patient who was being evaluated for a second transplant.

Gift of Hope tested the organs and approved them for donation, telling the three hospitals that they came from a high-risk donor. None of the hospitals has said publicly what patients were told, citing doctor-patient confidentiality. They also have declined to identify the donor, the patients and what organs they received, citing privacy concerns.

Infected transplant patient a ‘mess’ - Health care- msnbc.com

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U.S. FDA Clears New Roche Anemia Drug; Sale Blocked

Approved, but cant' get it..BD

NEW YORK, (Reuters) Nov 15 - U.S. health officials have approved Roche Holding AG's long-acting erythropoiesis stimulating agent Mircera to treat anemia associated with chronic kidney disease, a Food and Drug Administration spokeswoman said Wednesday.

However, Roche has said it will not launch the drug in the United States after a Boston jury found the patents on Amgen Inc's top-selling anemia drugs to be valid. The decision effectively blocks Mircera sales in the United States.

U.S. FDA Clears New Roche Anemia Drug; Sale Blocked

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Medicare Continues To Reduce Improper Claims Payments, USA

More reasons to have the claims "scrubbed"...BD

The Centers for Medicare & Medicaid Services (CMS) announced that aggressive oversight efforts have resulted in a further reduction of the number of improper Medicare claims payments, which declined from 14.2 percent in 1996, to 4.4 percent in 2006, to 3.9 percent in 2007. This solid improvement is a result of continued efforts initiated by CMS and its contractors to use detailed data analysis in targeting areas where erroneous claims processing, inaccurate billing and provider error result in waste, fraud and abuse.

Medicare Continues To Reduce Improper Claims Payments, USA

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Derma Sciences Receives Second FDA 510K Clearance And Adds To Their MEDIHONEYTM Wound & Burn Dressings With Active Leptospermum Honey Line

Derma Sciences (OTCBB: DSCI), a manufacturer and marketer of advanced wound care products, announced that the FDA has given 510K clearance to the company's second dressing in the MEDIHONEY line. This dressing is indicated for use on wounds with light to moderate exudate, and - based on its hydrocolloidal properties - forms a gel when it comes into contact with wound fluid to assist in promoting a moist environment conducive to healing. Hydrocolloids are the most commonly used advanced wound care dressings, as most chronic wounds fall into the category of light to moderate exudate. In 2007 it is estimated that over $150 million in hydrocolloids will be sold in the US alone. The first MEDIHONEY dressing from Derma Sciences, cleared for use by the FDA in July 2007, is in an alginate base and is indicated for wounds with moderate to heavy levels of exudate.

Derma Sciences Receives Second FDA 510K Clearance And Adds To Their MEDIHONEYTM Wound & Burn Dressings With Active Leptospermum Honey Line

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Electronic, smokeless cigarette on the market...legal indoors

For only 99.95...battery operated and comes with a case...and this one is rechargeable too...BD

Crown7, a smokeless and tobacco-free electronic cigarette that is legal indoors, announced today its national launch in celebration of the Great American Smokeout®. The Crown7 product looks and acts like a cigarette without all the harmful side effects of traditional cigarettes. The Crown7 device replicates the act of smoking using a nicotine cartridge, a microchip and a water vapor mist. When the user inhales through the Crown7 tip, the battery-powered microchip activates an atomizer which creates a nicotine and smoke-flavored water vapor mist.

 

Americans Are Waiting To Inhale As Smokers Take Part In Annual Great American Smokeout(R)

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Cost-Effective Spinal Discography Device Receives FDA Clearance

Single handed device instead of the customary two handed angioplasty balloon device...BD 

Pinyons Medical Technology, Inc. announced it received U.S. Food and Drug Administration (FDA) clearance to market the PowrSyringe Monitor™ for use in discography procedures.
Discography is a diagnostic tool to physiologically determine if a diseased, herniated, or abnormal vertebral disc in the spine is causing discogenic back pain prior to treatment.

The PowrSyringe Monitor™ is a one-piece disposable hand-held medical device to deliver ergonomic and mechanical advantages to a high-pressure syringe for use in diagnostic discography. The PowrSyringe Monitor™ is similar to the previously FDA cleared PowrSyringe Injector™ with integrated crossing handles that advance the plunger into the barrel when the handles are squeezed by a clinician.

Cost-Effective Spinal Discography Device Receives FDA Clearance: Pinyons Medical Technology's PowrSyringe Expands With New Spine Indication

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

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Shriners Hospitals for Children System to Implement McKesson PACS at 22 Hospitals Across North America

 

ATLANTA--(BUSINESS WIRE)--Shriners Hospitals for Children has announced that it will implement advanced health care information technology (IT) from McKesson across its 22-hospital system. The contract includes implementation of McKesson’s top-rated picture archiving and communication system (PACS) as well as technology services that will create a secondary data center for improved disaster recovery. With the Horizon Medical Imaging™ system, radiologists, surgeons and other caregivers at Shriners Hospitals and its affiliates will be able to electronically capture, retrieve, view and store medical images, from ultrasound to multi-slice CT, at multiple locations. The goal is better access to information, reduced turnaround times and, most importantly, improved patient safety.

The result is flexibility for the physician to work at any location, at any time of day, and expedite service to referring physicians.

Shriners Hospitals for Children System to Implement McKesson PACS at 22 Hospitals Across North America : McKesson Corporate

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NACDS, NCPA Advance Legal Strategy, File Injunction To Protect Low-Income Patients' Access To Medications

Pharmacies also fighting not to have their reimbursements reduced from CMS..one more the attorneys...could impact the number of pharmacies we have today...as this pertains to Medicaid drops in compensation...BD

Below is a joint statement by Steven C. Anderson, IOM, CAE, president and chief executive officer of the National Association of Chain Drug Stores (NACDS), and Bruce Roberts, R.Ph., CEO and executive vice president the National Community Pharmacists Association (NCPA) regarding the filing of a motion for preliminary injunction challenging CMS-imposed Medicaid pharmacy reimbursement reductions. In addition, an economic report is included by Stephen W. Schondelmeyer, Pharm.D., Ph.D., Head of the Department of Pharmaceutical Care & Health Systems at the College of Pharmacy at the University of Minnesota.

"In less than three months, the pending rule put forth by CMS will go into effect, resulting in drastic reimbursement cuts for retail pharmacies. The injunction seeks to obtain an expedited review of the lawsuit given the short time frame pharmacies are facing.He further cites that the retail pharmacy industry could see a loss of 10,000-12,000 pharmacies - a vast majority of which would be pharmacies in rural or inner city urban areas - over the next few years.

While we are hopeful to have a success in court, it is imperative to encourage Congress to work with community pharmacy to find more appropriate and long-term cost-based models for reimbursement under Medicaid."

NACDS, NCPA Advance Legal Strategy, File Injunction To Protect Low-Income Patients' Access To Medications

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American Health Lawyers Association Holds Annual Fundamentals Of Health Law Program

Rising new field for attorneys?  With all the law suits today there certainly can't be a lack here for membership.  BD 

More than 350 healthcare attorneys from across the country will meet in Chicago from December 2-4, 2007 to attend the American Health Lawyers Association's 2007 Fundamentals of Health Law Program at the Marriott Chicago Downtown Hotel. With more than twenty separate sessions, this program is designed to be an excellent refresher for experienced health lawyers and a valuable training program for paralegals, new associates and in-house counsel.

American Health Lawyers Association Holds Annual Fundamentals Of Health Law Program

More at the web site:  http://www.healthlawyers.org/

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First Primate Embryonic Stem Cells Cloned By US Scientists

US scientists have successfully created cloned primate embryos for the first time and used them to make embryonic stem cells. Their work is published in the early online issue of the journal Nature.
Researchers at the Oregon National Primate Research Center (ONPRC) based at Oregon Health & Science University (OHSU) in Portland, Oregon, in collaboration with a number of other biomedical research organizations, have successfully produced monkey embryonic stem cells by using a new method to remove the nucleus of the eggs being used.

First Primate Embryonic Stem Cells Cloned By US Scientists

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Top 5 UltraMobile PCs -EO v7110 from Tablet Kiosk at the top

The number one choice in the UMPC category is the EO v7110 from Tablet Kiosk...look around the site under tablet pcs and you can find additional information here or visit the Tablet Kiosk web site. Visit our story from earlier this year with one of my clients, Dr. Rubin using the EO to keep track of all his patients charts on the unit...BD 

If you don’t know what UMPC means, it’s time you got an update. Could this be the start of computing 3.0? No way to tell, this gear is too new to call in terms of overall popularity and sales trends. It could be the Betamax of computing, but could easily wind up being a serious contender for your PC dollars. In case you’re living in a cave in Tora Bora at present, UMPC stands for UltraMobile PC. 

TabletKiosk presents the EO UMPC v7110 tablet PC. This under-a-grand model has a one-gig VIA C7-M low voltage processor, up to a gig of memory, Wi-Fi, Bluetooth, and Windows XP. If you have never used a tablet PC before, brace yourself for a the learning curve, don’t panic, and remember that it’s made for productivity AND portatbility. This ain’t made to replace your desktop, but it will serve you well on the road once you get used to the lack of a keyboard.

Top 5 UltraMobile PCs | GearCrave | Stuff you want to touch

Source:  GottaBeMobile    UMPC Buzz

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St. Joseph Health System Selects Microsoft’s Azyxxi to Optimize Treatment Decisions and patient care in California, Texas and New Mexico.

First west coast installation of the EHR, John Hopkins also uses Azyxxi...as well as New York Presbyterian Hospital on the east coast...

ORANGE, Calif., and REDMOND, Wash. — Nov. 15, 2007 — St. Joseph Health System has selected Azyxxi, the Microsoft unified health enterprise platform, making it the largest community-based hospital network, and the first on the West Coast, to adopt the platform to date. The multihospital health system joins the ranks of other prestigious organizations that have chosen Azyxxi to improve organizationwide access to clinical and patient data using existing IT investments.

Microsoft Corp.’s Azyxxi offers a new way to capture, store and present information, enabling healthcare systems to unlock data sitting in clinical, financial and administrative silos across organizations. As a result, caregivers can spend less time looking for information and more time providing high-quality care to patients.

Accessible on computers, tablet PCs and handheld devices, Azyxxi provides real-time responses to clinical, administrative and research-specific questions. Equipped with decision-support tools, the platform can also help physicians determine the best treatment options. Dr. Clyde Wesp, chief medical information officer for California-based St. Joseph Health System, views Azyxxi as one of the primary pillars in the hospital network’s initiative to leverage technological advancements to improve the quality of patient care

St. Joseph Health System Selects Microsoft’s Azyxxi to Optimize Treatment Decisions: Solution to improve hospital efficiency and patient care in California, Texas and New Mexico.

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Health Net punished for lying about contract cancellation bonuses

Most companies that are tied to any type of production policies usually have something like this to pay bonuses and incentives..I worked for a few that are not in the insurance business that did the same...but the incentives were tied to product sales and methodologies that saved time and money...not human lives...BD 

State health regulators fined Health Net Inc. $1 million Thursday for lying to investigators about paying employees bonuses based on the number of contracts they canceled after those policyholders got sick. The penalty was the first levied on a health insurer for withholding information about incentives given to its employees. Health Net, along with other major health insurers, is being investigated for combing through applications of members after they have filed claims to find mistakes or omissions that would justify revoking policies. Insurers say they resort to rescinding policies only when members lie about their health histories, but consumers say the questionnaires often are vague and misleading.

Health Net punished for lying about contract cancellation bonuses

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Patients Get More Control Control of Health Care Through Internet

Portals for physicians and patients can really help with communication process and allow the patient the opportunity to look up lab results and other information related to their health records.  No more sitting on the phone waiting for lab results...I think almost every patient has been there/done that,  and can relate to the convenience of not having to wait, plus the patient has access to email the physician with non urgent inquiries too.    BD 

Scott Royster was diagnosed with diabetes two years ago and is now trying to learn everything he can about the disease, including how to treat it.
   He's using a new web-based program that helps him keep track of most of his medical history.
  "See, I'm one of those that I love computer stuff and to be able to access stuff on my own instead of having to ask what's in my file....I can go look it up myself," said Royster.
  The "Internet Patient Portal" has now been rolled out at the "Amarillo Medical Specialists Office".  "It really improves the coordination of care in a lot ways. Patients can communicate with us if they're having a problem, a lot more easily," said Dr. William C. Biggs, an Endocrinologist.

Dr. Biggs said this program is especially great for diabetes patients because it allows patients to learn the results of their lab work more quickly.  Dr. Biggs said as far as he knows his office is the first in Amarillo to roll out the Portal.  He said 70 to 80% of his patients are introduced to the program.

KFDA - NewsChannel 10 / Amarillo, TX: newschannel10.com - Patients Get More Control Control of Health Care Through Internet

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Experts say obese women should be refused fertility treatment

A fertility organisation in Britain is saying that severely obese women should be barred from having National Health Service fertility treatment until they have lost weight.

According to new guidelines from the British Fertility Society (BFS), obesity reduces the chances that a woman will conceive naturally and decreases the possibility that fertility treatment will be successful.

The society says that those who are judged obese rather than severely obese should be "encouraged" to slim if they want fertility treatment and obese women could be banned from IVF until they lose weight.

The BFS says obesity increases the risk of complications during fertility treatment and pregnancy and endangers the health and welfare of both mother and child.

Experts say obese women should be refused fertility treatment

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Ping the Doctor in New York

The modern doctor, making house calls..answering emails on the web...costs $500.00 a year for patients to join.  We have covered a couple articles about Dr. Parkinson in the past. 

He doesn't even have an office.  Talks to patients via webcam...and he helps them find medications at a low cost.  BD

Parkinson decided to open his practice in cyberspace, where he recruits, diagnoses and even treats his patients online. He has no office. Instead, he makes himself available to his patients via email or text message.

He limits his practice to his own zip code, with few exceptions, and sees only patients between the ages of 18 and 40.

"I know who charges a good price and who has a good heart," says Parkinson. Physicians, too, contact him, saying, "I'd like to be a part of your unspoken network."

Parkinson says part of the reason he went into this kind of practice is because he believes the healthcare system, with its lack of transparency in pricing, is cheating patients, especially the uninsured.

http://potw.news.yahoo.com/s/potw/54996/the-real-life-web-md

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Nasty new cold virus claims lives across the U.S.

One more reason to keep things clean and sterile..scary that this one could hang around for weeks...BD

The CDC says controlling adenovirus outbreaks is a difficult task as the viruses can be shed in both respiratory secretions and faeces and can persist for weeks on environmental surfaces.

The virulent strain of adenovirus has already claimed the lives of 10 people and dozens more have been hospitalized say U.S. health officials.

According to the Centers for Disease Control and Prevention (CDC) since May 2006 there have been growing numbers of adenovirus 14 (Ad14) cases across the country with cases appearing in New York, Oregon, Washington state and Texas.

The CDC says the virus can cause severe respiratory disease at any age and to date 140 people have been sickened by the virus and more than 50 hospitalized, including 24 admitted to intensive care units; two of the 10 who died were infants.

Nasty new cold virus claims lives across the U.S.

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B-K Medical Introduces Pro Focus OR Dedicated, Fully Integrated, Surgical Ultrasound Scanner

One less thing on the floor and more room to move...and has 3D functionality...BD

The Pro Focus OR ultrasound system is designed to be a permanent part of the OR, mounted on the OR boom. The scanner's flat-screen monitor and control panel are mounted on flexible arms that can be positioned for optimal utility. Surgeons can access the ultrasound capabilities they need during surgery  quickly and easily.

The Pro Focus OR ultrasound system is the only fully featured OR suite that is off the floor and works as an integrated part of the operating room. The scanner is mounted on the OR boom, enabling surgeons to conduct surgical ultrasound procedures from within the sterile area – simply and efficiently.
The Pro Focus OR is a permanent part of the OR, so you always know where it is – no more rolling in. And, because the system is off the floor, it affords you freedom of movement. The system’s simplicity also means a reduction in cleaning and preparation time, for a quick turnaround.

B-K Medical Introduces Pro Focus OR Dedicated, Fully Integrated, Surgical Ultrasound Scanner

Web Site:  http://www.bkmed.com/scanners/surgicalfocus.asp

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More Than 30,000 Medicaid Providers In Seven States Owe More Than $1B In Federal Taxes, GAO Report Finds

Is this related in any way to the amount of compensation seen for Medicaid patients?  Just pondering...BD

More than 30,000 Medicaid providers, or about 5%, in seven states owe the federal government more than $1 billion in unpaid federal taxes for fiscal year 2006, according to an audit released Wednesday by the Government Accountability Office, USA Today reports (Wolf, USA Today, 11/14). The report, which will be discussed at a Senate Homeland Security and Governmental Affairs Permanent Subcommittee on Investigation hearing on Wednesday, follows a similar report in March that showed 21,000 federal health Medicare contractors and physicians failed to pay $1.3 billion in federal taxes in FY 2005 (Zhang, Wall Street Journal, 11/14). The Medicaid audit focused on providers in California, Colorado, Florida, Maryland, New York, Pennsylvania and Texas (Frommer, AP/St. Paul Pioneer Press, 11/13).

"We need to figure out how to ... stop those Medicaid medical providers from putting taxpayer dollars into one pocket while stiffing Uncle Sam by dodging their taxes

More Than 30,000 Medicaid Providers In Seven States Owe More Than $1B In Federal Taxes, GAO Report Finds

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Gamercize® - PC-Sport - USB connected to your computer

If you quit exercising, the mouse and keyboard will not function...this is for all of us trapped for house behind the computer...forcing us to get a little exercise...BD 

The low profile GZ Power Stepper fits neatly under a desk, connecting your USB plug and play keyboard or mouse with the GZ PC-Sport for a workout while sitting down. Toning workout at the office desk Toning workout at the office desk. 

If you slow down or stop, the keyboard or mouse will not function until you restart exercising. To take a break, set the GZ PC-Sport to the lowest level and you can use your keyboard and mouse without exercising. Improve fitness and afternoon energy levels by exercising during your lunch hour, right at your own desk. The GZ PC-Sport shows how well you are doing, and which of the 5 levels you have reached.

 

Gamercize® - PC-Sport

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Doctor with a Tablet PC- Technical Blogger

Doctors like gadgets...good article about a Microsoft writer and his discussion with his MD about tablets and using One Note..BD 

This past Monday I got a physical, you know the whole works. ....So am I bringing up my trip to put my compliments in print . . .

The Doctor walks in, with a tablet PC. All the questions he asks, he writes the answers on his tablet. He said he got it about two weeks ago, and so far was pretty happy with it.  The Doctor said he didn’t quite have the hang of One Note yet, so I gave him so pointers, and suggested he read the tutorial information that came with it.

We discussed his use of technology, he currently has a palm and a separate phone, I think I might have converted him to Windows Mobile 6, showing him my AT&T 8125. He liked having the PDA, phone and camera all in a single device.

Doctor with a Tablet PC « Thomas - Technical Blogger

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Microsoft SoftGrid Application Virtualization and Streaming in Healthcare - Help for Health Care IT

This story is for the IT geeks that read the blog....Beta software available now, formerly known as Soft Grid makes it easy for enterprise IT folks to roll out and support large scale applications through Virtualization.  This saves energy as well and can reduce server boxes.  Easy to roll out updates and cuts down desk top support since applications are running from a server and not installed on the actual PC, somewhat similar to terminal services, but using Virtualization to accomplish and it can run with terminal services as well.  The link to the case study from the hospital below shows some astounding savings.  Employees can be portable and can log on from any PC on the network, as applications are not tied to the local PC.  BD 

SoftGrid in Healthcare Simplify compliance, accelerate application deployments, and reduce perpetual patching Healthcare Healthcare organizations are faced with escalating costs, growing organizations and strict government regulations. All of this makes it an extremely challenging environment for IT: " Support many different types of users (clinical, administrative, research) with different computing needs. " Handle complex applications that can be time-consuming to deploy and support. " Deploy frequent compliance required updates and patches for validation to numerous applications that keep IT in perpetual state of patching. " Manage exploding server siloing because of heavy terminal server use and the inability of conflicting applications to run on the same server. " Support roaming users who share the same desktop but require different applications and configurations.  3 deployment modes: 

1. System Center Application Virtualization Management Server, which ships as part of the Microsoft Desktop Optimization Pack and Microsoft Application Virtualization for Terminal Services packages, enables dynamic streaming including package/active upgrades, and requires Active Directory and SQL Server;

2. System Center Application Virtualization Streaming Server, a lightweight version which also ships as part of the Microsoft Desktop Optimization Pack and Microsoft Application Virtualization for Terminal Services packages, offers application streaming including package/active upgrades without the Active Directory and database overheads, and enables administrators to deploy to existing servers or add streaming to Electronic Software Delivery systems; and

3. Standalone mode allows virtual application execution without streaming and is interoperable with Microsoft Systems Management Server/System Center Configuration Manger 2007 and third-party ESD systems. 

Upon deploying SoftGrid, ARMC immediately realized transformational benefits in terms of the way it manages applications, and the time and costs required to do so.

According to Gerringer, “When we first implemented SoftGrid we had planned on a 30-day trial, but it worked so well and so easily that we were able to confidently go into production right away. We turned our entire environment into a dynamic, service-based infrastructure. We can update even the most complex package for all our computers in one easy step."

Using SoftGrid, IT administrators no longer have to go from machine to machine to deploy software. Instead, they can quickly deploy applications by placing the software on a SoftGrid server and assigning application rights to users using Active Directory.  To update applications, administrators replace only the changed files on the SoftGrid Server. Network connected end users have immediate access to the latest version.  To eliminate an application, administrators simply take it off the SoftGrid Server. To terminate a particular user's rights, they simply remove access from Active Directory.  Cost-reducing: Help significantly reduce costly processes such as compatibility testing, as well as hidden costs. Customers have cut help-desk costs by up to 30% by reducing call volume for application-related problems, and reduced end-user downtime by up to 80% by easing challenges with business continuity of applications.

Because SoftGrid centralizes management of applications, users can only get the applications they have the right to run. Centralized control also enables IT to patch or upgrade once to the server and the next time the users access the network, their applications are updated without impacting their productivity.

Microsoft SoftGrid Application Virtualization and Streaming

Microsoft Health Care Case Studies:  http://www.microsoft.com/casestudies/search.aspx?ProTaxID=3123

Hospital Case Study:  http://www.microsoft.com/casestudies/casestudy.aspx?casestudyid=200443

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YEARS AFTER A STROKE - PROGRESS: Device awaiting approval from FDA

 

It was a slam-dunk moment of triumph - in slow motion - as Jane Arena used both hands to raise the ball and drop it through the basketball hoop.
Her face, which had been frowning in determination, relaxed into a smile and her soft ‘‘Whoooh!’’ told the story.
Nine years ago, at age 43, the Norton mother had a stroke that paralyzed the right side of her body. After months of therapy, she learned to speak and walk again but still couldn’t use her right arm and hand.

Then three months ago, Arena’s former therapist at Braintree Rehabilitation Hospital told her about a new robotic arm brace the hospital is testing.
After six weeks of training with the Myomo e100 robotic brace, Arena demonstrated some of her regained abilities with her right arm and hand.  Arena is among five patients in a clinical trial at the hospital of the new high-tech robotic aid. Braintree Hospital, which treats 400 stroke patients a year, is among three test sites for the device. It has not been approved yet by the federal Food and Drug Administration and cannot be sold. An FDA decision is expected later this year

Arena, who completed her 18 hours of training this week, will continue to do arm exercises at home without the brace and will be evaluated in three months.  Note: The Myomo e100 NeuroRobotic System is intended for clinical use by patients with their treating medical professional. The device has not been shown to be safe or effective as a functional aid for use in the home.

YEARS AFTER A STROKE - PROGRESS: Device awaiting approval from FDA (video in story)

Web Site:  http://www.myomo.com/therapy/mp_product.shtml

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WellPoint Unit to Adopt Doctor-Ranking Model: New York

The 3rd carrier...Aetna and United already agreed to new ranking policies...BD

NEW YORK (Reuters) Nov 14 - Health insurer Empire Blue Cross Blue Shield, a unit of WellPoint Inc, has agreed to adopt a New York state model for doctor-ranking programs, the state attorney general said on Wednesday.

WellPoint Unit to Adopt Doctor-Ranking Model: Cuomo

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Quality of Care in Our Hospitals: Paradoxes, Branding, and Leadership

CME credit article... discusses preventable nosocomial  conditions....13 from which CMS may select..BD 

CMS is the largest health insurer in the world, and as an agency of public health, it will be administering this statutory mandate and establishing this new standard of care. In the coming months, CMS will be releasing proposed and final roles for value-based purchasing, and it is expected that these will be closely modeled by the private healthcare insurance industry. All healthcare institutions will be judged by the same standards, and it is critical that all stakeholders understand how these new quality measures will be implemented.

Quality of Care in Our Hospitals: Paradoxes, Branding, and Leadership

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Cure for killer bug - but there's a catch

Gives a new meaning to the old saying that "one man's trash (or feces in this case) is another man's gold" if you will...but if it saved your life I guess one would get over the initial shock of the treatment...should be no problem finding donors at any rate...BD 

IN THE annals of medical history, this could go down as one of the most effective but stomach-churning treatments ever devised.

Scientists seeking a cure for a deadly superbug have successfully treated patients using human feces. Doctors involved in the trials admit there are "obvious aesthetic problems" in the treatment, which involves patients ingesting a liquidized sample of feces from a partner or close relative.

Trials in a Scottish hospital have shown patients suffering from the Clostridium difficile bug can be cured using 'donor stool' administered via a tube through the nose into their stomach. Traditional treatment of Clostridium difficile involves the use of antibiotics. But doctors at Glasgow's Gartnavel Hospital have conducted a trial of fecal transplants' on 12 patients for whom antibiotics had failed to stop repeated bouts of the infection.

The process takes about two weeks, during which donors are screened for suitability and other treatments are tried out. The key requirement is that donors should not have recently been on antibiotics themselves.  Doctors then mix the donated feces with water to allow it to travel through a tube. Despite the positive results, doctors stress that they still regard the fecal transplant as a "last resort" because it is cumbersome and the idea of is unpleasant.

Scotland on Sunday - Health - Cure for killer bug - but there's a catch

Kevin, MD

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Pharmacies Helps Seniors Navigate Medicare Part D Plan Changes

Medicare Part D is getting so confusing and difficult to figure out, even the pharmacies are getting in to the education and assistance mode....if you can't find enough help on the web or on the CMS site, well here's 2 more places to look...gee this is almost like getting your taxes done anymore!  I hope the information is helpful as the last thing one needs now is to have conflicting opinions from 2 different sources, but I imagine we might hear some of that as well.  There's also the Medicare Bus that is making the rounds in different parts of the country to help. 

Why not just make things simple to avoid all of this extra overhead!  BD

WOONSOCKET, R.I., Nov. 14 /PRNewswire/ -- As Open Enrollment for Medicare Part D approaches, CVS/pharmacy offers resources to help seniors select the most appropriate and cost-effective Medicare prescription drug plan. CVS pharmacists have been trained on Medicare Part D plan changes, and are available to provide counsel to seniors based on their unique prescription history and predicted changes for 2008. An online Medicare Part D Plan Decision Tool is available at http://www.cvs.com to help seniors compare plans based on their current or anticipated drug regimen.

"With so many seniors having access to lower cost Medicare Part D plans in 2008, we encourage all seniors -- even those already enrolled in a plan -- to review their options," said Dave Purdy, R.Ph., Vice President, Pharmacy Operations for CVS/pharmacy.

DEERFIELD, Ill.--(BUSINESS WIRE)--Seniors are gearing up for the annual task of reviewing prescription Medicare Part D plans for the start of the open enrollment period tomorrow through Dec. 31. Again this year, Walgreens pharmacists will be one of the best resources for Medicare information, offering a free personalized report enhanced to make it even easier for seniors and caregivers to identify a plan that best fits their needs.

CVS/pharmacy Helps Seniors Navigate Medicare Part D Plan Changes

Walgreens Offers Support evaluating Medicare Part D Plans

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Female Condom - STDs - Medicine and Health

One more round and a new design..and seeking FDA approval...BD

The female condom has never caught on in the United States. But in the third world, where it was introduced in the late 1990s, public health workers hoped it would overthrow the politics of the bedroom, empower women and stop the AIDS epidemic in its tracks.

It did not. Female condoms never really caught on there, either.

 

Only about 12 million female condoms are delivered each year in poor countries, compared with about 6 billion male condoms. Couples complained that the female version was awkward, unsightly, noisy and slippery — or, as Mitchell Warren, who was one of its earliest champions, now says, “the yuck factor was a problem.” Many women tried it, but in the end, it was adopted mainly by prostitutes.

PATH is seeking approval from the Food and Drug Administration so the condom can be sold in the United States. And with the drug agency’s approval, it would be much easier to license the condom in poor countries or get a World Health Organization endorsement.

Female Condom - STDs - Medicine and Health - New York Times

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Lake Hospital System using new VaproSure system to help cut down on MRSA

A new device available to sterilize the air and cut down on contaminants and bacterial spread..BD

Lake Hospital System today announced it has invested in VaproSure ^TM Room Sterilizer technology, giving the hospital system a new weapon in the war against hospital-acquired infections. Developed by STERIS  Corporation -- the global leader in infection prevention and decontamination -- the VaproSure Room Sterilizer is the first product of its kind for the health care market.

Lake Hospital System is the first community hospital in the nation -- and the only hospital in Northeast Ohio -- to purchase the powerhouse piece of equipment that can reliably and safely sterilize all of the exposed surfaces in a room.

"The utilization of VaproSure technology will enable us to reduce the spread of biological contaminants and thereby more effectively protect our patients from infection," said Joyce Taylor, RN, CPHQ, chief quality officer/vice president of Quality Services for Lake Hospital System.

Lake Hospital System announcement

Web Site:  http://www.steris.com/defense_industrial/defense_vaprosure_demo.cfm

Hat Tip:  Medgadget

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Donda West's plastic surgeon sought the Hollywood limelight, despite problems

Celebrity doctor...DUIs and malpractice suits...BD 

The doctor who performed a tummy tuck and breast reduction on the mother of rapper Kanye West is a plastic surgeon to Hollywood's elite and something of a celebrity himself, with a TV show of his own and a number of appearances on programs from "Extra" to "Oprah."

What Dr. Jan Adams has not publicized, however, is that the state medical board is investigating whether to revoke or suspend his license over alcohol-related arrests; that he has been the target of malpractice lawsuits; and that he has paid out nearly $500,000 in civil settlements.

Adams, through his spokesman Kevin Williams, confirmed for The Associated Press that he operated on Donda West, who died Saturday night at a hospital after she stopped breathing at her home. She was 58.  Adams also sells a line of skin care products, including a product that lightens skin, and has written two books on plastic surgery, including the 2000 title "Everything Women of Color Should Know About Plastic Surgery."

Donda West's plastic surgeon sought the Hollywood limelight, despite problems - International Herald Tribune

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Computer system cuts wait time for AnMed Health patients

State of the art nurses station...BD 

ANDERSON COUNTY — AnMed Health employees experienced a “duh” moment when they saw the Awarix system demonstrated for the first time.

The hospital system in Anderson already wa s running almost entirely on computers. First, nurses stopped making notes on clipboards in patients’ door and started using computers for clinical documentation. Then, doctors started using computers in August to enter orders. Now, with the Awarix system, AnMed workers now can use computers to track patients’ progress through the hospital as well.

Computer system cuts wait time for AnMed Health patients : Local News : Anderson Independent-Mail

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HIV Transmitted By Organ Donation at Three Chicago Hospitals

This a truly a sad story...after the long wait for an organ...BD 

First, you're diagnosed with a life-threatening illness, and then you wait months and months on the UNOS list (along with about 100,000 other Americans) for an organ. But your case is rare; you actually get the transplant you need. Hurray! Unless you're one of four transplant recipients in Chicago whose new organs gave them HIV and hepatitis C. This is the first time in more than 20 years that donor organs have transmitted the virus.

The donor organs were tested for these and other diseases, but the tests were negative, "most likely because the donor had acquired the infections in the last three weeks before death," according to the Trib.

Chicagoist: HIV Transmitted By Organ Donation at Three Chicago Hospitals

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Doctors call for end to "cheap alcohol" in the UK

Doctors in the UK want to eliminate "cheap alcohol" to help keep folks healthier...and add a 10 percent tax...will expensive alcohol be next?  BD   

Leading doctors and charities highlighted the steep rises in alcoholic liver cirrhosis and drink-related deaths as they launched the Alcohol Health Alliance, which brings together 24 health groups to lobby for changes in drinking laws.  The Royal College of Physicians is openly in favour of a rise in alcohol taxation.

A further study by the Centre for Public Health at Liverpool John Moores University showed that more than half of all young adults consumed cheap supermarket drinks at home before going on a night out. "The issue is the discounted sales, and the Department of Health is already progressing research that is looking at that whole area of using discounted sales to get people to buy more."

Supermarkets are selling beer at a cheaper price than bottled water and risk fuelling the binge-drinking crisis, it has been claimed.  Apart from lobbying MPs for an increase of up to 10 per cent in alcohol tax, the organisation - to be called the Alcohol Health Alliance - is expected to push for warning labels and greater restrictions or even a blanket ban on alcohol advertising.

Doctors call for end to cheap alcohol - Telegraph

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Medicare bus tour travels area to help with enrollment

The Medicare bus?  BD 

Counselors from the Centers for Medicare & Medicaid Services (CMS) will stop in Newport News and Suffolk on Friday to help Medicare patients update their health benefits.
The "Working Together for Better Health" bus tour will provide help to patients reviewing their health and drug coverage, compare their current plan with other available options, educate patients about the $3,600 drug coverage assistance and help fill out applications and forms. Flu shots and health screenings will also be available on site.

Medicare bus tour travels area to help with enrollment -- dailypress.com

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If FDA Moves Some Meds Behind the Counter, Some Health Plans Say They Are Unlikely to Cover Any Patient Medication Costs

 Nice to have some over the counter availability, but what about the cost, will the drugs no longer be covered by insurance plans?  Some may pay if you consult with the pharmacist according to the article, but still too soon to know...it sounds like Dr. Google for the diagnosis information and then off to the pharmacy.  Employer provided insurance will also enter the picture, depending on the contract on whether or not any coverage will be allowed.  Aetna doesn't cover any over the counter and Well Point has given out coupons for a discount...BD   

Although none have made a final decision, some health insurers say they likely will not cover any patient medication costs should the Food and Drug Administration (FDA) proceed with a proposal to move some medications to behind-the-counter (BTC) from prescription status. Other insurers say they may pay for such expenses, and add that they have covered members' expenses for other over-the-counter drugs in the past. Among the items they'll consider are whether the medication is included on the formulary or benefit plan, and whether the drug provides significant clinical benefit in comparison to other medications used to treat the same conditions.

But most say they stopped covering other medications, such as the antihistamine Claritin, when the drugs were made available over the counter (OTC). They say they may do the same with BTC medications, depending on the drug and its intended use. And all say that if coverage changes must be made, they will give members as much advance notice as possible.

If FDA Moves Some Meds Behind the Counter, Some Health Plans Say They Are Unlikely to Cover Any Patient Medication Costs

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Labour's 'reforms' destroying the NHS

The insurance companies interests extend beyond the US and are becoming entrenched in the UK..deja vu for the large profits over there with insurance companies that have been seen here?  Many of the players are the same.  BD 

But the NHS is being destroyed by attrition, and if the latest "reforms" are not stopped, it will be too late to erect barricades. On 5 October, the Health Secretary, Alan Johnson, approved a list of 14 companies that will advise on and take over the "commissioning" of NHS services. They will be given influence, if not eventually control, over which treatments patients receive and who provides them. They are assured multimillions in profits.

They include the US companies UnitedHealth, Aetna and Humana. These totalitarian organisations have been repeatedly fined for their notorious role in the American health-care system.  These companies are new Labour's friends. Simon Stevens, Blair's former health policy adviser, is now a CEO at UnitedHealth. Julian Le Grand, writing in the Guardian as a distinguished professor, gives his learned approval to the "reforms" - he, too, was Blair's adviser.

This has caused a wholly unnecessary "financial crisis" that is the catch-22 rationale for allowing more profiteers to take over what was a Labour government's greatest achievement. Will we allow them to get away with it?

New Statesman - Labour's 'reforms' destroying the NHS

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With Health Costs Rising, a Tougher Sell for Hospitals

Especially in the non profit area...many of whom's existence would not be possible without a strong foundation effort for donations.  BD

While Americas private and public medical institutions continue to have success raising money $8 billion last year alone fund-raisers and others say that the rising cost of health care is an issue they must address sometimes with potential donors.

But some fund-raisers say there is more need to show that hospitals are trying to contain costs. At White Memorial Medical Center in East Los Angeles, which serves a primarily low-income Hispanic community, the hospital raised $31 million among many of its patients, said Mary Anne Chern, the president of White’s foundation.  White Memorial is contributing to the community, the hospital discussed its efforts to save money by trying to keep nurses from leaving. Hiring a nurse can cost $70,000 to $85,000, if you include the money in recruiting and training someone, Ms. Chern said, so the hospital is trying harder to retain nurses to avoid those costs.

With Health Costs Rising, a Tougher Sell for Hospitals - New York Times

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MEDISON Launches New Ultrasound System: ACCUVIX V10

The advanced ultrasound system ACCUVIX XQ has been widely recognized worldwide for its advanced technology and stability, but a new unit is about to steal its thunder. Produced by South Korea-based MEDISON Co Ltd (CEO: J. B. Choi) ACCUVIX XQ was ranked, according to the Klein Report, in second place in the number of units sold in 2005 as well as 2006 in the US$200 million American obstetrics and gynaecology ultrasound market. However, the XQ has now been superseded by the latest in the line: the ACCUVIX V10.

"The brand new ACCUVIX V10 integrates various proven technologies from the existing ACCUVIX line," said MEDISON. "However, this unit upgrades accuracy and efficiency with new technologies, while optimizing user convenience with its ergonomic design." The V10's high definition 17" LCD monitor provides optimised resolution of 2D, 3D and 4D image quality. The system has various built-in functions enabling speed and accuracy. Users can save images and review them with ease, enabling more efficient management of patients and effective diagnoses.

MEDISON Launches New Ultrasound System: ACCUVIX V10

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Intel vPro Keeps Hospital Infrastructure Alive and Kicking

VPro is every IT managers dream...makes life a whole lot easier to deal with...additional monitoring features right from the console and the ability to keep PC users up and going in times of need...especially when a virus is found..VPro will take the PC off the network to avoid infecting additional PCs and Servers... if you have questions, post them here and we can perhaps answer some questions about VPro. and be sure to visit the Intel website for more information..a good health care investment.  BD 

"Our physicians can be impatient, and with good reason," said Carolyn Kraus, the NW Newborn IT specialist tasked with keeping the group's infrastructure online. "They're here 24/7, and we're not. It's crucial that the computers are up and running." 

Kraus, along with One Tech, a solution provider in Hillsboro, Ore., piloted a program that included Intel vPro PCs in May and discovered that remotely managing and securing machines saved time, money and stress, she said.

"We can remotely power on a PC, power-reset a system to a clean slate, and get a hardware inventory or event log anytime," Kraus said. "I can diagnose and resolve problems without leaving my desk, even if the OS or a hard drive is down."

Intel vPro Keeps Hospital Infrastructure Alive and Kicking

Intel Website

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8-Limbed Girl Recovering From Surgery

  Before and after pictures...BD 

It was only for a few moments, but it was enough: Little Lakshmi Tatma showed the world that she is doing OK.

The 2-year-old Indian girl who had extra arms and legs removed last week in a marathon surgery made her first public appearance since the operation at a news conference this afternoon at Sparsh Hospital in Bangalore.

ABC News: 8-Limbed Girl Recovering From Surgery

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A Health Plan for Wal-Mart: Less Stinginess

Costco still outdoing the big retailer with better benefits...BD

Now, the chain is even considering weight-loss clinics in its 4,000 stores and is toying with the idea of selling health insurance, hoping to finally bring coverage within reach of most Americans.

By 2000, as Wal-Mart became the largest retailer in the country, its health insurance drew heightened scrutinyThe evidence was compelling: Wal-Mart workers routinely showed up in large numbers on state Medicaid rolls from Georgia to Washington.The company eliminated onerous fees like $150 monthly for covering a spouse and cut out separate deductibles, like an additional $1,000 for a hospital stay.

And Wal-Mart’s insurance still pales in comparison to that offered by Costco, considered the gold standard in retailing because an employee pays just a few hundred dollars a year for generous individual coverage.

A Health Plan for Wal-Mart: Less Stinginess - New York Times

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Bush Vetoes Health and Education Bill

Don't understand the line of thought entirely...BD

WASHINGTON (AP) — President Bush on Tuesday signed a big increase in the Pentagon's non-war budget, and vetoed a spending measure for health and education programs prized by congressional Democrats. The $471 billion defense budget gives the Pentagon a 9 percent increase, roughly $40 billion.

The president's action was announced on Air Force One as Bush flew to Indiana for a speech expected to criticize the Democratic-led Congress on its budget priorities.The House fell three votes short of winning a veto-proof margin as it sent the measure to Bush.

The Associated Press: Bush Vetoes Health and Education Bill

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An Economy of Scales - Financial Health Incentives

One person's outlook on the use of employer weight loss incentives with his own personal twist...BD

Well, I am still fat. But now my wife, who is desperate, for some reason, to keep me around for a very long time, is turning the economics of obesity on its head, agreeing to provide me financial incentives to finally drop the pounds. It is a peculiar strategy, but it's not without merit: Economists have recently shown that if you pay people enough money, they will lose significant weight. Corporate America is starting to integrate cash incentives into wellness plans in hopes of reducing its health-care costs.

There are two ways to solve this problem. One: Lose weight. That would require exercise, which would take up time that I prefer using for less strenuous activities, like doing nothing. Or two: Take blood pressure medicine. My insurance company requires no co-payments for generic drugs, so I can theoretically mask the problem for free.

I chose the drugs and am thusly always on the prowl for beef. So, apparently, are millions of other Americans....We seem to be healthier fat people, but we're not cheap for the health-care system -- or our employers.

An Economy of Scales - washingtonpost.com

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Dr. Wes: Economic Implications of Medicare's Rule Change for EP's

Dr. Wes (cardiologist and internist) has done some homework..recommended reading for all...BD

I just got back from a meeting with our business manager and I'm depressed.
We did some homework regarding the implications of the new Medicare payment rules for our procedure codes no longer being exempt from the "51 modifier" as I mentioned before. 

Well, it's huge.

10:46 CST - Addendum: Oh, I forgot: this revenue cut does not include CMS's already-threatened 10.1% physician revenue cuts. Could this mean nearly 30% cut in EP's revenue? If so, the implications for our senior citizens could be profound.

Dr. Wes: Economic Implications of Medicare's Rule Change for EP's

Hat Tip:  Kevin, MD

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Consumers Should Review Their Current Medicare Private Drug Plans' Costs And Benefits And Compare All Their Drug Plan Options For 2008

Earlier we posted that in Orange County, CA, there is no option for higher premiums to cover the doughnut hole, so it's a good idea to check and see how your current plan stacks up this year.  BD

Medicare private drug plans have a gap in coverage known as the "doughnut hole," during which people must pay the full cost of their prescriptions. In 2008, the gap for many plans begins when total drug costs (what the consumer pays plus what the plan pays) reach $2,510. The coverage gap ends and catastrophic coverage begins after the consumer has spent $4,050 out of pocket. People with catastrophic coverage will then pay 5 percent of the cost of each drug or a copayment of $2.25 for covered generics and $5.60 for covered brand-name drugs, whichever is greater. There are plans in most states that offer some coverage through the gap, but they generally have higher monthly premiums and most cover only generic drugs in the gap.

Consumers Should Review Their Current Medicare Private Drug Plans' Costs And Benefits And Compare All Their Drug Plan Options For 2008

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Medicare Part D changes include no coverage for `doughnut hole' gap - Orange County, CA

The "doughnut" hole is still there...and no plans to cover the gap and there are 57 prescription drug plans to choose from...BD

Ah, now is the time when everyone on Medicare gets to make choices about prescription drug coverage.

Beginning Thursday until the end of the year, Orange County Medicare Part A and B recipients may choose from among 57 prescription drug plans offered by 23 organizations.

If you are part of a Medicare Advantage Plan or HMO plan for your medical coverage, chances are you already have prescription coverage through these plans. That accounts for just under 50 percent of Orange County's Medicare recipients.

The average this year in Orange County is a $20 premium, a deductible of $275, and prescription drug coverage of 25 percent of Medicare costs up to $2,510. But for the first time, there is no coverage after you reach that limit in drug costs.  For the first two years of Medicare Part D, there were plans covering the gap. None are available this year.

There's a gap – called the doughnut hole – for drug costs from $2,511 to $5,726. In other words, if you're in the gap, you pay out of pocket – with no reimbursement – $3,215. After you pay that out, 5 percent of your costs are then covered.

Life: Medicare Part D changes include no coverage for `doughnut hole' gap | medicare, coverage, drug, plan, prescription - OCRegister.com

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Pill makes endoscopy easy to swallow

You could almost make a full length picture..that is if you don't mind looking at your intestines as being the leading actors and actresses...just one pill to swallow...and according to reports does a better job than X-Rays.  BD 

Studying and treating disorders of the digestive system might not be the most glamorous job.

But you'd never know it from talking with Dr. Fawaz Hakki, a gastroenterologist. These days, he's feeling like a movie director.  

The feature presentation? It's a full-color video of the tight, twisted tunnels of a patient's small intestine.Capsule endoscopy is a breakthrough technology, originally developed in Israel, Hakki said. The capsule has been in use in the United States for about five years.After about eight hours - the time it takes for the capsule to move through the small intestine - the patient returns to the doctor's office, the recorder is removed from the patient and the information it contains is downloaded onto a computer for examination.  Hakki said the procedure costs between $800 and $900, which includes the capsule, facility fee and doctor's fee.

Pill makes endoscopy easy to swallow - Herald-Mail News for Hagerstown, Washington County Maryland, Pennsylvania and West Virginia

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Medicine in Second Life: virtual doctors, hospitals

This is a little off beat, but if you have not heard of Second Life, take a look at the link below.  The reason for this post is that along with many other big corporations such as Intel and CNN, there are now some virtual medical worlds popping up on 2nd life and some are being considered to be a good place to learn.  The virtual world is full of avatars whereby you can perhaps pursue and inquire about things that may not be possible in the real world, but just don't forget to come back.  The one location states it is the real world location of a physician in the UK, but remember this is virtual and best to trust your own physician and not the virtual MD.  This could prove to be quite educational according to the article.  BD

There are just a few hospitals, most of them are totally empty as there are just some places where you can get injured. And if you die, then you register again and get a new resident. But I’ve found a virtual doctor and his hospital, Lundquist Hospital whose note says:

This hospital is the base of Dr. Jude Lundquist, a real-life doctor based in the United Kingdom. He offers free and confidential advice in the following areas…What do you think? The question of reliability is raised again. Would you trust a virtual doctor? Even if his real-life doctor statement is true. I asked him to answer some of my questions, I’m still waiting for his answers.

According to the National Review of Medicine, the American Cancer Society and US Centers for Disease Control are early adopters. They consider Second Life as an educational opportunity they just couldn’t pass up.

Medicine in Second Life: virtual doctors, hospitals, and of course, sperm donation « ScienceRoll

What is second life, website.

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FDA Approves New SPRYCEL® (Dasatinib) Product Labeling For Patients With Chronic-Phase CML

Bristol-Myers Squibb Company (NYSE: BMY) announced that the U.S. Food and Drug Administration (FDA) has approved new labeling for SPRYCEL to include a lower recommended starting dose of 100 mg once daily and safety and efficacy data in a greater number of patients with chronic-phase chronic myeloid leukemia (CML) resistant or intolerant to prior therapy including Gleevec.

FDA Approves New SPRYCEL® (Dasatinib) Product Labeling For Patients With Chronic-Phase CML

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CVS sues Walgreen over pharmacy pact

More lawsuits...we reported earlier this year on hospitals suing hospitals and now we have drug stores suing drug stores..BD 

CHICAGO - A unit of CVS Caremark Corp., the largest US drugstore chain by number of stores, sued rival Walgreen Co., claiming it prematurely canceled contracts to fill prescriptions for 70,000 people. more stories like this * Today's Globe: home healthcare workers; coffee, fish oil and Alzheimer's; pharmacy suit; shot for smokers * Walgreen October same-store sales rise * CVS Caremark 3Q profit soars * Walgreen sees movie-burning DVD kiosks at stores * September results at drug store chains * Caremark PCS Health LP claims Walgreen will disrupt prescription drug plans Caremark operates for employees of four companies unless it's barred by a judge's order, according to a complaint filed in Chicago federal court.

Walgreen spokesman Michael Polzin said yesterday that CVS Caremark had unilaterally reduced the amount of payments it made to Walgreen for drugs covered by certain employer-sponsored plans "to a level that impacts our ability to provide a high level of pharmacy service to those plan members."

CVS sues rival over pharmacy pact - The Boston Globe

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Most People With Chronic Kidney Disease Remain Unaware Of Their Condition

Chronic care conditions are part of a leading factor that contribute...BD

A growing number of Americans have chronic kidney disease, but most remain unaware of it, hampering efforts to prevent irreversible kidney failure requiring dialysis or a transplant, according to a study funded by the National Institutes of Health and published in the Journal of the American Medical Association.

"Increases in diabetes, hypertension, obesity, and the aging U.S. population explain at least some of the increase," says co-author Paul W. Eggers, Ph.D., director of kidney disease epidemiology at the National Institute of Diabetes and Digestive and Kidney Diseases, part of the NIH. "We don't know what may be responsible for the rest."

Most People With Chronic Kidney Disease Remain Unaware Of Their Condition

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Physicians predict veterans' healthcare costs will top $650 bill

Veterans are losing their health insurance benefits and coverage when returning from war...even though federal laws are supposed to protect them with the issuing of penalties?  Is anyone enforcing this, or are penalties being paid and insurance benefits continuing to be dropped?  BD

WASHINGTON - A group of noted physicians predicted yesterday that healthcare for Iraq veterans could top $650 billion, another warning of a looming social crisis as thousands of veterans struggle with mental and physical disabilities and other disruptions to family life. more stories like this * House planning veto showdown over Iraq * Bush's father comes to his defense on Iraq war * Dems to tie Iraq funds to withdrawal * House to debate Iraq troop withdrawals * Combat missions? Clinton, Edwards spar * The study by Physicians for Social Responsibility, titled "Shock and Awe Hits Home," marked the first attempt to isolate the financial costs of "the wide-ranging traumatic mental and social effects of the Iraq war.

New Defense Department data released yesterday show that thousands of members of the National Guard and Reserve who have returned from deployment have lost their jobs, health insurance, pensions, and other benefits;  nearly 11,000 soldiers have been denied prompt reemployment after leaving civilian jobs for military deployments; more than 22,000 lost seniority and pay; nearly 20,000 had their pensions cut; and nearly 11,000 were denied their previous health insurance benefits despite federal laws protecting them from being penalized for leaving civilian employment for wartime service. 

Physicians predict veterans' healthcare costs will top $650 billion - The Boston Globe

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New laser treatment aids pain management

New relief for arthritis joint pain, spasms, and stiffness..increases local blood circulation..BD

November 12, 2007 Statistics from the International Association for the Study of Pain indicate that one in five people suffer from moderate to severe chronic pain making it is one of the most costly health problems in the US. Traditional treatments have often included ongoing use of medications but much research is being done into alternative therapies such as laser treatment, with new offerings now on the market to assist with the reduction in pain from arthritis, injury or long term soreness.

Multi Radiance Medical has developed breakthrough technology in the field of therapeutic laser devices. Known as TerraQuant, the clinically proven, FDA approved device offers relief to chronic and acute pain sufferers. Combining 25,000 milliwatts of peak power with the worlds fastest super pulsed laser, TerraQuant delivers pulses at billionths of a second, producing a high-energy density that is absorbed deep into the tissue, accelerating pain relief.

New laser treatment aids pain management - gizmag Article

Right now there is a modality available that may relieve acute and chronic pain in as little as 1 to 3 days and it is cleared by the FDA.

Web Site and Product Information

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National ePrescribing Patient Safety Initiative

Revisit...this site has a permanent link on the right hand side for any physician to enroll for free e-prescribing...it works well on both a Tablet PC and on a Windows Mobile PDA...did I mention this is free?  If you do not have an EMR that it set up with e-prescribing, this is a good place to start...BD

The National ePrescribing Patient Safety Initiative (NEPSI) is a joint project of dedicated organizations that each play a unique role in resolving the current crisis in preventable medication errors.
Electronic prescribing (eRx¹) is a viable solution to counter shortcomings of the current paper-based prescribing processes that are in large part responsible for these errors. However, accessibility and cost barriers have slowed adoption of eRx by providers.
Until now.
The goal of NEPSI is to increase patient safety by making eRx accessible—and desirable—to all physicians and medication prescribers by providing it free of charge.
The eRx software provided by NEPSI is
Simple – Online prescribing is easier than a script pad
Safe – Instant checks on drug interactions, dosage levels and patient-specific factors including prior adverse reactions
Secure – Patient information protected by privacy and security measures including prescriber authentication
Free – Provided without cost by Allscripts and the members of NEPSI. 

 

National ePrescribing Patient Safety Initiative

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Better get bigger - Hospitals invest in equipment designed to handle larger and heavier patients...

From larger wheelchairs, blood pressure machines with larger cuffs...etc..."The market is growing for anything extra-large - wheelchairs, MRI machines, scales, even toilets."...BD

Before Medtronic started U.S. sales of an emergency medical device that automatically delivers chest compressions, the product was tailored with American patients in mind. The Fridley-based manufacturer made it bigger.

The initial version of the Lucas Chest Compression System, sold in Europe, accommodated patients with a sternum height of about 7 to 11 inches. But when Medtronic launched it here in April, the product was sized for patients with sternums measuring about 8 to 12 inches, said Anne Devine, a company spokeswoman.

Zoom motorized stretchers, from Michigan-based Stryker Corp., eliminate the pushing effort, making it ideal for use with heavier patients. The largest model has a weight capacity of 660 pounds. The stretchers are among many medical products suited for use with a growing number of obese patients in the U.S. (Courtesy of Stryker Corp.)

"We wanted to find something that could accommodate the larger patient, the claustrophobic patient and give us the quality and the speed," said Dr. Aaron Binstock, the oncology imaging director of Suburban Imaging in Coon Rapids. This year, his center purchased an MRI machine with a bore opening about 4 inches bigger than other MRIs.

The seat on a standard Invacare wheelchair is 18 inches wide. That compares with the 30-inch seat on the company's Topaz wheelchair, designed for patients who weigh up to 700 pounds.

The bigger seat carries a bigger price tag. The Topaz model starts at $1,842, about five times the approximately $370 list price of the standard version. 

"The obese patient is not well served by open technology," Sheehan said, adding that obesity trends made it a "no-brainer" for Siemens to introduce a machine with a larger bore.

TwinCities.com - Better get bigger

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Doctor reopening clinic despite investigation

Drastic action here...perhaps an audit could have accomplished the same?  BD

Dr. Dora Crandall’s north New Braunfels clinic is set to re-open just 12 days after being raided by state and federal authorities. The After Hours Clinic on the 1200 block of Hillcrest was searched Oct. 31 by The Drug Enforcement Agency, The Texas Attorney General’s Medicaid Fraud Control Unit and the New Braunfels Police Department. The search was part of an ongoing investigation that began nearly two years ago into allegations that Crandall was handing out prescriptions for “huge amounts” of drugs for cash payments and over billing Medicaid patients.

“I find it interesting that with all the allegations in the affidavit, no action has been taken by the medical board,” he said. “Absolutely no adverse action has been taken or even threatened against her.”

The Herald-Zeitung

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Doctors' offices try to ward off medical identity theft

Your medical records have more value on the black market than your social security number...technology can certainly help with query based software that can immediately alert activity outside the normal realm of business...information can be both text and pictorial based with charts that analyze information in real time..if you wait for paper methodologies these days, it's too late..and as the article states once fraudulent information is added to a legitimate medical record, it's just something else one needs to battle with insurance coverage...as it appears the burden of responsibility is on the patient with seeking out advocacy help in many instances, which will also usually come at a cost to the consumer...BD 

Dixon said there is a black market for medical records, with the police reporting that a person's medical records can sell for about $50 on the street, compared with a dollar or two for Social Security numbers.

The records are used by fake clinics to file fraudulent claims so that they can bilk insurance companies out of millions of dollars. 

Kenneth Faustine, director of special investigations at Cigna, said he is seeing more of these types of schemes. Criminals typically buy 1,000 medical records and set up a post office box to collect checks, he said.  They hit quick, and by the time anyone realizes it, they [have] shut down," he said.

Faustine said Cigna developed a computerized system that helps detect such fraud. For example, if a certain doctor typically sends in 100 claims a month, the system will prompt an investigation if that doctor suddenly submits 500 claims.

It's difficult to remove erroneous information from medical records, Dixon said, because some health-care providers are reluctant to change records out of fear of violating federal health and privacy laws.

newsobserver.com | Doctors' offices try to ward off medical identity theft

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Medical Records Found Dumped In Dallas Trash Bin

Security breach story of the week..paper this time...BD

A Dallas doctor admits he made a mistake when he threw the documents away. A neighbor found the information in an alley in an Oak Cliff neighborhood. The tall blue recycling bin was filled to nearly overflowing.
The medical records, clinical diagnoses, insurance statements were all tied to Dr. Andrew Campbell.
The more than 300 files were old. The patient's elderly, perhaps even dead, but their social security numbers were on display, a potential treasure troll for potential identity thieves.

cbs11tv.com - Medical Records Found Dumped In Dallas Trash Bin

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Dangerous prescription: the US approach to health care

Some good points in the article...do we go for the affordable and available cures or is there a lack if evidence based treatment sometimes...BD

We didn't need Michael Moore to tell us that the American health-care system is broken; it's been front-page news for so long, we're getting - well - sick of hearing about it. Yes, Americans pay too much for care that is anything but caring, for technology that does little more than prolong our agony, for hospitals from which we emerge sicker than we entered

Her point that we overuse certain medical services simply because they are offered to us is a critically important one, as is her call for medicine to become more evidence-based.

Dangerous prescription: the US approach to health care - The Boston Globe

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'Superbug's' killer cousin - USA 300

Additional information on MRSA....it lives among us it appears everywhere..and the USA 300 can appear anywhere when people are sharing razors, etc., personal items...BD 

But here's the conundrum: Another kind of staph infection, this one acquired out in the community, is much more "virulent" -- by which I mean invasive and quick to replicate in the host -- than hospital-acquired staph. This is the notorious "USA 300" strain, the one that has been dubbed the "superbug." This is the one that has been causing panic in the community at large, closing schools and killing a number (but not a terribly large number) of people.

USA 300, and a few other community-acquired strains, contain in their genetic makeup many more virulence factors than hospital strains have. These traits make them more invasive and better at causing infection in healthy people. But even though they're more virulent, they lack many of the resistance genes that characterize MRSA in hospitals. That means they're more treatable.  Fortunately, even community MRSA strains, including USA 300, are still sensitive to many antibiotics.

What's more, hospital strains don't need to jump directly from person to person. They have help. Physicians, nurses and orderlies spread the strains among patients. A touch of a hand or the brush of a hospital gown against a bed can spread staph infection. Any break in hygiene, no matter how slight, may propel germs from patient to patient.

'Superbug's' killer cousin - Los Angeles Times

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