TabletKiosk will show at CES two new devices

Stay tuned to CES for the announcements this week.  Brand new UMPC and a rugged tablet, as you can see from the pictures from the Mobility Site...nice job on the inking on this post too...here's a link from Microsoft to keep up to date on what's happening this week as well as a link to TabletPCReview for updates....the rugged tablet will be a nice new addition especially with health care use in the hospitals and a physician's office for that matter....BD

http://www.microsoft.com/ces/

http://www.tabletpcreview.com/default.asp?newsID=1057

Tabletkiosk has refreshed its web page with a new banner that clearly indicates that they will be showing two devices at CES. After carefully analyzing the banner it seems to me that one of them is a rugged Tablet PC with a screen size between 8 to 10 inches.

TabletKiosk will show at CES two new devices | Mobility Site

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Patients left to starve on NHS wards

If it isn't bad enough with the super bugs in the hospitals, a new study shows that some patients are not being fed properly while in the hospital...are the nurses that busy tending to the large number of patients...anyway one more issue facing the NHS in the UK....BD 

The number of NHS patients suffering from malnourishment as they leave hospital has nearly doubled, new figures show.  Around 140,000 patients were discharged after being inadequately fed on NHS wards last year, statistics obtained by the Conservatives reveal.

The number released from hospital suffering from malnutrition, nutritional anaemia, or other nutritional deficiencies has risen by 84 per cent in the decade since Labour came to power, from 74,431 in 1997 to 139,127.  The shadow health minister Stephen O'Brien, who obtained the statistics, described them as a "scandal".

Last year, the health minister Ivan Lewis admitted patients were being starved on wards, with some elderly people given little more than a scoop of mashed potato for lunch.  "Nurses are so rushed off their feet that it is no surprise that patients end up malnourished.

"We have heard stories of elderly people who haven't had a meal all day because they have just been overlooked. The food is just taken away when the patient hasn't been able to eat any of it.

"It is a scandal in the 21st century - it ought never to happen."

Patients left to starve on NHS wards - Telegraph

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The Truth About Mandatory Health Insurance

How do you break it down to get everyone to pay what would be called their fair share...complicated..BD

In the most recent Census report, the lion's share of the increase in the uninsured occurred in five border states: Arizona, California, Florida, New Mexico and Texas. In San Francisco, public health authorities estimate that 61% of the city's uninsured are not citizens.

Despite national findings about who is in the emergency room, uninsured immigrants and their children are putting stress on emergency rooms in the border states. Newly arrived immigrants without coverage are less apt to use the emergency room than U.S. citizens, according to a Rand study published two years ago by Health Affairs. However, the sheer number of Hispanic newcomers who seek care and are unable to pay is overwhelming many hospitals.

According to the Census Bureau, of the 47 million uninsured, nearly 10 million have household incomes of at least $75,000. They probably can afford coverage but have chosen not to buy it. Another 14 million of the uninsured are already eligible for government programs such as Medicaid (for low income adults) and the State Children's Health Insurance Program (for children) and simply need to sign up.

That leaves about 23.7 million people -- some citizens, others newcomers -- who cannot afford coverage. It's up to the nation to decide what to do about that. One thing is clear: Mandating that everyone, including young adults, buy insurance, and then hiding a hefty, cost sharing tax inside their premium, is an unfair solution.

The Truth About Mandatory Health Insurance - WSJ.com

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Health Benefits and Retirees

New law that will allow employers to shift employees 65 and older to Medicare...BD

A new federal regulation allows employers to reduce or eliminate health benefits for retirees when they turn 65 and become eligible for Medicare. Although that will cause distress for some, it is a welcome step that could help slow the deterioration of employment-based health insurance. It seems likely that the new rule will help far more people than it hurts.  It has been denounced as discriminatory by AARP, the main lobby for elderly Americans.

In late December, acting in accord with a favorable appeals court decision, the Equal Employment Opportunity Commission ruled that employers could drop coverage of older retirees or offer them plans that would supplement Medicare or comparable state insurance programs while providing better benefits to younger retirees.

Health Benefits and Retirees - New York Times

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Sears puts customers' buying histories on the Web

Potential security breach story of the week, but apparently Sears has responded...according to the article all you needed was a name and address and you were able to locate anyone's purchases...all the way back to 1978..they violated their own security policy...sometimes in a rush I wonder if some of the services are deployed without a full security check in order to meet competition and gain additional marketing and sales...happens in every industry including health care.  BD

San Francisco - Sears Holdings has come under fire from privacy advocates for making the purchase history of its customers publicly available on its Managemyhome.com Web site. This is a violation of Sears' own online privacy policy, which does not allow the company to share users' purchase history with the general public, Edelman said.

In fact, Sears has noticed the problem. "We take our customers' privacy concerns very seriously," the company said in an e-mailed statement. "As a result, we have turned off the ability to view a customer's purchase history on Manage My Home until we can implement a validation process that will restrict access by unauthorized third parties."

Sears puts customers' buying histories on the Web - Yahoo! News

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‘Wombs for Rent’ - the next outsource frontier in India - Surrogate Mothers

For infertile couples this is another alternative to have a surrogate mother in India, and everyone seems to win from this as the surrogates make a substantial amount of money by India's standards and raises their standard of living as well...BD

ANAND, India — Every night in this quiet western India city, 15 pregnant women prepare for sleep in the spacious house they share, ascending the stairs in a procession of ballooned bellies.

A team of maids, cooks and doctors looks after the women, whose pregnancies would be unusual anywhere else but are common here. The young mothers of Anand, a place famous for its milk, are pregnant with the children of infertile couples from around the world.

The small clinic at Kaival Hospital matches infertile couples with local women, cares for the women during pregnancy and delivery and counsels them afterward. Anand’s surrogate mothers, pioneers in the growing field of outsourced pregnancies, have given birth to roughly 40 babies.

Ritu Sodhi, a furniture importer from Los Angeles who was born in India, spent $200,000 trying to get pregnant through in-vitro fertilization, and was considering spending another $80,000 to hire a surrogate mother in the United States.

“We were so desperate,” she said. “It was emotionally and financially exhausting.”

The State | 01/05/2008 | A fertile industry | In India, ‘wombs for rent’

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How doctors lie on death certificates to hide the true scale of the toll from hospital infections - UK

Continuing issues with C diff and MRSA in the UK - are the numbers higher than anticipated?  According to this article, physicians are not always listing the correct cause of death so the numbers could be even higher...BD

Joan Horne once worked for the National Health Service. In her day the wards were scrubbed with bleach, while nurses washed their hands with soap and water before caring for a patient. If not, a strict matron wanted to know why. Only this week, a worried doctor told me that MRSA and C. diff is rife in London's major teaching hospitals. He said that of 16 patients in a single ward at one hospital 'four have C. diff and three have MRSA, and that is typical of the situation in every ward'.

She has never forgotten the golden era of the NHS. So when 78-year-old Joan watched Edwin, her husband of 37 years, die after catching a deadly superbug at her local hospital, she began a fight for justice.

In 2005, the latest year that death statistics for C. diff were available, 3,807 hospital patients died, a rise of almost 70 per cent over the previous 12 months. But the truth is that this figure may be utterly meaningless because many people, including Joan, believe there is a cover-up over the figures.

Just before Christmas, a tape recorder in her hand, she marched off to Barnsley Hospital in Yorkshire and forced managers to admit that not only had Edwin contracted a lethal infection called Clostridium difficile (C. diff) as a patient, but that doctors failed to declare the truth on his death certificate.

How doctors lie on death certificates to hide the true scale of the toll from hospital infections | the Daily Mail

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DH watch-ban ‘potentially dangerous’

The debate over whether or not a physician can wear a watch in the UK...is one needed?  If they ban the watches, then a bed side clock will need to be present at each bed...go figure...BD 

Doctors have difficulty carrying out simple clinical tasks without a wristwatch, according to two clinicians.

Trusts were asked to implement a ‘bare below the elbows’ infection control policy at the beginning of January 2008 by Health Secretary Alan Johnson. Yet medics have approached the British Medical Journal with concerns that the lack of wristwatches could affect patient care.
James Henderson, a specialist registrar in plastic surgery at the Norfolk and Norwich University Hospital NHS Trust, and Sarah McCracken, a specialist registrar in geriatric medicine at Ipswich Hospital, revealed the results of a survey of 20 people to carry out simple medical observations without the use of a “second hand” to show their dependence on wristwatches. The medics claim that, “only one participant gave values for each reading that would not have been potentially dangerous in a clinical setting”.
In his letter to the British Medical Journal, Dr James Henderson said:
“Little account has been made of the clinical benefits of a wristwatch. The majority of beds and examination couches in hospitals do not currently allow sight of a clock.

DH watch-ban ‘potentially dangerous’

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Korean Boxer's Death Gives Life to Six

Sad story...victorious but only to fall to his death due to continuous blows to the head area with boxing...but wonderful that his organs were able to help others....BD

South Koreans are mourning the death of former world champion boxer Choi Yo-Sam, but lauded his family's decision to donate Choi's organs to save lives. 

The 33-year-old boxer fell into a coma minutes after winning the WBO intercontinental flyweight match against Indonesian Heri Amol Christmas Day.  Korean boxing analysts are now discussing ways to prevent further fatal and serious injuries.

"He suffered intracranial bleeding in his brain. It was caused by not just one blow, but by repeatedly accumulated hits Immediately after the winner was announced, Choi collapsed at his corner of the ring.on his head," said Dr. Lee Sung-Gyu, in charge of organ transplant at Asan Medical Center in Seoul.

ABC News: Korean Boxer's Death Gives Life to Six

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'Sleepworking' Helps Make Business and Tech Decisions

First there was sleep walking...and now we have sleep working....this has my name all over it...and the article says some good stuff comes out it too...BD

"Sleep on it" is not just an admonition, but useful advice for small-business owners and managers struggling to sort out how to better run their businesses, including the use of new technology, according to a survey released Thursday by Staples.

Some 85% of the 300-plus small-business people interviewed for the survey indicated they were grappling with decisions on whether to incorporate new media such as blogs, podcasts, and virtual meeting software and services in their business activities. The Internet survey found that 51% "sleepwork," or dream about their work, and nearly 70% of those who do sleepwork put their "work dreams" into action when they wake up.

The Second Annual Staples National Small Business Survey also found that nearly 40% of the survey respondents said their best business ideas occurred while they were driving. In addition, the survey produced information that indicated that business managers were working too hard: Nearly 40% said they couldn't remember when they last took a vacation.

Managers Use 'Sleepworking' To Make Business, Tech Decisions - Yahoo! News

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California data-breach law now covers medical information

This has pretty much been policy by many, but now it is the law...BD

California residents must now be notified when their electronic medical information or health insurance information has been exposed.

AB1298, which took effect Tuesday, expands California's data-breach notification law to include unencrypted medical histories, information on mental or physical conditions, and medical treatments and diagnoses. Also covered under the law are unencrypted insurance policy or subscriber numbers, any applications for insurance, claims histories and appeals.

"I think a lot of organizations will end up being surprised by this law," Dixon said.

The law also prevents any company that holds electronic personal health records from disclosing that information without consent.

California data-breach law now covers medical information

www.oispp.ca.gov

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‘Miraculous’ Recovery for Man Who Fell 47 Floors - New York

Very lucky man and this is a true miracle that he will be pretty much back to normal in time.  BD

But they predicted that his recovery would be complete in about a year.  Alcides Moreno plunged 47 stories that morning last month, clinging to his 3-foot-wide window washer’s platform as it shot down the dark glass face of an Upper East Side apartment building. His brother Edgar, who had been working with him on the platform, was killed.

Asked at the press conference whether Mr. Moreno would walk again, Dr. Barie said, “We believe so, yes.” He noted that Mr. Moreno’s pelvis had not been injured in the fall. Dr. Barie also said that all the injuries to Mr. Moreno’s legs — some 10 fractures — had been “repaired” except one.

“Our goal is not just survival, but functional survival,” he said.

‘Miraculous’ Recovery for Man Who Fell 47 Floors - New York Times

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2008 the Year of Information Overload...

Ok you may have already seen this, Stress with Overload......but here it is again...and guess what, your doctor might be just as stressed and overloaded...just look at the paperwork he has to contend with for health care insurers for one...

Younger folks don't appear to have this issue according to the study, but again they were brought up with computers and the baby boomers have some catching up to do...and look at Intel restructuring their work habits...if the big boys are making changes...it's something we all need to address and find solutions for...it can be done with a small learning curve and a bit of automation. Why do 3 separate spreadsheets when they could all be covered by one Share Point server with a portal....as a simple example....software systems such as CRM software and business intelligence will take some of the stress away by automating much of the manual processes being done in businesses today and create a much less stressful atmosphere when those manual reporting duties are automated and the search is taken down to a couple clicks of the mouse. Technology brings on information overload, but it can also be a cure with proper software implementation and use. BD

Basex, which researches knowledge economy issues, calls "information overload" its 2008 problem of the year. Constant interruptions reportedly cost America $650 billion in lost productivity each year.

That's according to research firm Basex, which chose "information overload" as its 2008 "Problem of the Year." Failure to solve the problem will lead to "reduced productivity and throttled innovation." The situation is dire enough that Intel's Nathan Zeldes estimates "the impact of information overload on each knowledge worker at up to eight hours a week." Intel, a company with 94,000 employees, views the problem as serious. At Intel we estimated the impact of information overload on each knowledge worker at up to eight hours a week," says Nathan Zeldes, a Principal Engineer focusing on computing productivity issues at Intel. "We are now looking at applying new work behaviors that can help reduce this impact".
But young people don't seem to have (yet, anyway) developed the same sense of aggravation toward technology that forces them to multitask. Many choose to do so, in fact. The Kaiser Family Foundation found in a study this year that most junior high and high school students train themselves early in the dark arts of multitasking, with most listening to music or watching TV while they read books or surf the Internet. 30 percent of students even multitask while doing their homework.

On the other hand, multitasking might well produce some benefits; answering queries quickly and jumping to urgent tasks may not be the best strategy for completing long-term work, but it might get breaking items out of the inbox faster. For companies that thrive on pumping out cutting-edge, timely information, information overload and its attendant multitasking requirements could prove to be a competitive necessity.

More Information and Story

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A new health care professional - the laborist?

Ten years from now, many babies could be delivered by doctors who are total strangers to the mothers. BD

Medical malpractice insurance for obstetricians and gynecologists could become so expensive that only hospitals — and the doctors under their insurance umbrellas — could afford coverage for birthings. Dr. David Herzog says insurance costs will affect care. According to the Web site of the American College of Obstetricians and Gynecologists, ob-gyn practitioners, on average, have nearly three claims filed against them during their careers.

For expectant moms it means their gynecologists, after shepherding them through nine months, would hand them over to a "laborist" — a hospital staff doctor specializing in delivering babies.

Increase in lawsuits discourages obstetricians from delivering babies

Hat Tip: Kevin, MD

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Microsoft Office Drops Support For Older File Formats

With Service Pack 3 for MS Office 2003...word to the warning...some of your older documents may not open..check with your administrator if the service pack has been applied and documents will not open...BD 

You might not have noticed it yet, but the recent service pack 3 release for Microsoft Office 2003 contains a hidden "feature" — it disables support for older Microsoft Office formats. If you've got any old Word, Excel, 1-2-3, Quattro, or Corel Draw documents hanging around your hard drive you'll need to delve into the Windows Registry to open them.

A note posted to the Microsoft Support Center says that “by default, these file formats are blocked because they are less secure,” and goes on to warn that “they may pose a risk to you.”

Microsoft Office Drops Support For Older File Formats | Compiler from Wired.com

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Lacking lawyers, justice is denied - California

With the malpractice caps in California...not enough money for an attorney to take the case...BD

Dave Stewart's 72-year-old mother went to Stanford University Medical Center for double knee-replacement surgery in April. Four days later, she was dead.
To Stewart, an anesthesiologist, it seemed a classic case of medical malpractice. After the operation, his mother developed sharp abdominal pain that she described as "10 on a scale of 1 to 10," according to her medical records.

The hospital failed to diagnose the cause of her pain and continued to treat her with narcotics. Her vital signs became unstable and she was moved to the intensive care unit, but she died of complications from an untreated bowel obstruction. State regulators cited the hospital in the case this fall.

Once an advocate of the California medical malpractice law, Dave Stewart, an anesthesiologist, now opposes it. His 72-year-old mother died after a double knee-replacement surgery last April, he and his sisters decided to sue. But no one would take the case, saying it wasn't worth the money.

Lacking lawyers, justice is denied - Los Angeles Times

Hat Tip:  Kevin, MD

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Hospital equipment on the auction block

Hospital supplies and equipment for sale in New Jersey after closure...BD

Are you in the market for a slightly used X-ray machine or a couple of hundred hospital beds? If so, you might want to look over the contents of the now-defunct Pascack Valley Hospital in Westwood, N.J.

The 280-bed hospital declared bankruptcy in September and closed its door for good Nov. 21 after struggling with nearly $100 million in debt.  The contents of the acute-care hospital — medical equipment, beds, filing cabinets, etc — will go on the auction block Feb. 4.

Interested bidders have to register by Jan. 28. For more information about the auction, contact the offices of Sills, Cummis, Epstein & Gross at 973-643-7000.

To Your Health » Blog Archive » Hospital on the auction block

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FDA clears first rapid blood test for MRSA

Good news on the MRSA battle front...BD

The U.S. Food and Drug Administration (FDA) has announced it has cleared for marketing the first rapid blood test for the drug-resistant staph bacterium known as MRSA (methicillin-resistant Staphylococcus aureus), which can cause potentially deadly infections.

Methicillin is an antibiotic that has been used successfully to treat infections from the Staphylococcus aureus bacterium. Over the years, the staph bacterium mutated and spawned MRSA, a strain of staph bacterium that is resistant to methicillin and which has a higher rate of being fatal. 

The BD GeneOhm StaphSR Assay uses molecular methods to identify whether a blood sample contains genetic material from the MRSA bacterium or the more common, less dangerous staph bacterium that can still be treated with methicillin.  In order to preserve the integrity of positive test results, this test should be used only in patients suspected of a staph infection. The test should not be used to monitor treatment for staph infections because it cannot quantify a patient's response to treatment. Test results should not be used as the sole basis for diagnosis as they may reflect the bacteria's presence in patients who have been successfully treated for staph infections. Also, the test will not rule out other complicating conditions or infections.

FDA clears first rapid blood test for MRSA

WebSite

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Verizon Wireless Launches Mobile Banking

Did not see Wells Fargo and B of A, yet...but one more good reason to invest in a Smart Phone...not to mention having all your contacts, addresses handy and the use of Windows Mobile Live...Mobile Live allows me to get maps, directions, movie showings, etc. and it is all free...this is one service that I have not been able to live without and now is voice controlled...and besides I have all the mobile medical applications at my fingertips, check on insurance coverage for drugs and see which tiers apply...and the device can use blue tooth to send cardio and other statistics back to a physician too....are you still just using your cell phone for phone calls?   BD   

Verizon Wireless and mobile banking and payments enabler Firethorn Holdings, a Qualcomm company announced today that customers of major financial institutions, including Wachovia, SunTrust, FirstBank, and BancorpSouth, now have access to their accounts in the palms of their hands.

With Verizon Wireless’ mobile banking offering powered by Firethorn,
customers can now access and manage their financial relationships while
on-the-go for a seamless, real-time and secure user experience, including
checking bank account balances, transferring funds between accounts within the same bank, and reviewing and paying bills for those bills already set up through the financial institution’s online account servic

Verizon Wireless Launches Mobile Banking | Mobility Site

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Small firms may hold key to healthcare

With small companies passing more expenses of health care to employees...and in some areas making it non affordable for dependents, is this reducing the number of uninsured in the country?  It's not like the old days where it was "cheaper by the dozen"...BD

Jim Henderson, the second-generation proprietor of a seven-person construction supply business in St. Louis, prides himself on offering healthcare to his employees. But the premiums cost more than anything in his budget except the payroll. So benefits have been whittled down, and Henderson wonders how long he can keep covering his workers.

Even among the small companies that offer coverage, many protect just the worker, not a spouse or children. So in terms of policymaking, it will be almost impossible to reduce the number of uninsured substantially without involving those who work for small firms.

Small firms may hold key to healthcare - Los Angeles Times

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CPT codes: Get ready for 2008

Good article from Medical Economics summarizing the changes for this year...some of the key changes are outlined in this article...BD 

There are 242 new CPT codes and 54 deleted codes. But what's noteworthy for the coming year is that there are 305 revised codes—about four times as many as in 2007. Many of the revisions stem from changes in the list of codes that are exempt from modifier –51, which indicates that you did more than one non-E&M procedure during a single session. It's attached to the secondary, or lesser valued procedure, for which insurers typically reduce the fee.

Three new telephone codes (99441-99443) are for physicians to use to report E&M services provided by phone at the request of established patients. But they can't be used if the doctor sees the patient within 24 hours or the call refers to an E&M visit within the previous seven days. The new online E&M code (99444) is intended to report a physician's Internet response to an established patient's online inquiry. These services should be documented in the medical record.

CPT codes: Get ready for 2008 - Medical Economics

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Twelve Things IT Managers Should Resolve to Do

This relates ever so much to health care IT and CIO responsibilities for the upcoming year too.  Use the link to view the entire slide show...good words of wisdom...invest in at least one emerging technology...investigate managed services (something I have been advocating for a while now), demand time in front of the board, and make sure everyone on staff has a Smart Phone...those are the ones that stand out for me...the last one may not sound that important, but try to coordinate work projects with someone using just a regular cell phone and it will become very clear immediately how much more work this requires to work with staff members that still have to "dig" for their information...BD   

 

Twelve Things IT Managers Should Resolve to Do

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Electronic Passports Raise Privacy Issues

Using RFID technology...something we discuss here quite frequently as a huge tool for hospitals...coming this spring to a passport office near you.  BD

The federal government will soon offer passport cards equipped with electronic data chips to U.S. citizens who travel frequently between the United States and Canada, Mexico or the Caribbean. The cards can be read wirelessly from 20 feet, offering convenience to travelers but raising security and privacy concerns about the possibility of data being intercepted. 

The goal of the passport card, an alternative to the traditional passport, is to reduce the wait at land and sea border checkpoints by using an electronic device that can simultaneously read multiple cards' radio frequency identification (RFID) signals from a distance, checking travelers against terrorist and criminal watchlists while they wait.

Electronic Passports Raise Privacy Issues - washingtonpost.com

Source:  Engadget

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Microsoft adding postings to You Tube

There are several more, but this one I found to be useful for those folks who do not have Outlook, Windows Live Mail desktop is very similar in many ways and is an excellent email client to use with multiple email accounts...in other words go to one place for all your email accounts and not spend time on the web going from one to another.  BD

http://www.youtube.com/watch?v=Od88HVfz4t8

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Bush Vetoes Defense-Policy Bill including Veterans Health Funding

President Bush on Dec. 28, 2007, vetoed a $696 billion defense-policy bill (HR 1585) that included improvements to veterans' health care benefits and pay increases for servicemembers, the Wall Street Journal reports (Pullizi, Wall Street Journal, 12/29/07).
The bill would have included nearly $950 million for military health care in fiscal year 2008. The bill included four amendments, including one that would have barred most personality-disorder discharges from the military until the Pentagon submits a report on such discharges and another that would have ensured wounded veterans receive transitional care from the military for 180 days from the time the servicemember is separated from active duty. T

President Bush Vetoes Defense-Policy Bill That Had Veterans Health Funding

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U.S. Ruling Backs Benefit Cut at 65 in Retiree Plans

Something to be aware of if considering early retirement....employers have options to exercise with those who qualify for Medicare...BD

In general, the commission observed, employers are not required by federal law to provide health benefits to either active or retired workers.  . “This rule gives employers free rein to use age as a basis for reducing or eliminating health care benefits for retirees 65 and older,” said Christopher G. Mackaronis, a lawyer for AARP, which represents millions of people age 50 or above and which had sued in an effort to block issuance of the final regulation. “Ten million people could be affected — adversely affected — by the rule.”

Dianna B. Johnston, a lawyer for the commission, said many employers and labor unions had told it that “if they had to provide identical benefits for retirees under 65 and over 65, they would just drop retiree health benefits altogether for both groups.”  Under the new rule, employers may, if they choose, provide retiree health benefits “only to those retirees who are not yet eligible for Medicare.” Likewise, the rule says, retiree health benefits can be “altered, reduced or eliminated” when a retiree becomes eligible for Medicare.

In a preamble to the new regulation, published Wednesday in the Federal Register, the commission said, “The final rule is not intended to encourage employers to eliminate any retiree health benefits they may currently provide.”

U.S. Ruling Backs Benefit Cut at 65 in Retiree Plans - New York Times

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Free Rx samples go to wealthy, insured-US study

Some are still helping those in the poverty levels, but the study indicated that more above the poverty level benefited from RX samples...BD 

WASHINGTON, Jan 2 (Reuters) - Insured and wealthy Americans are more likely than needy patients to get the billions of dollars in free drug samples distributed by pharmaceutical companies to win patient and doctor loyalty, a study released on Wednesday said.
Free prescription samples are popular with doctors who want to try new drugs, and the pharmaceutical industry contends that such samples also help the low income and the uninsured.

But the study of prescription use of nearly 33,000 U.S. residents during 2003 found the neediest are least likely to get free samples.  Critics said the samples and representatives steer doctors and patients to the priciest drugs, and spur use of prescriptions for ailments not originally intended or tested. Similarly, of all sample recipients, 72 percent had income above 200 percent of the federal poverty line, while 28 percent had incomes below that level.

Free Rx samples go to wealthy, insured-US study | Reuters

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The Looming CIO Shortage

Good article addressing the future of the CIO....health care in particular is a challenging role for the CIO...a good idea to make sure the CIO is in to servers, virtualization, outsourcing and Web 2.0 to build a solid organized future....CIOs of today and tomorrow need leadership, communication and IT skills....it's an executive as well as a "hands on" position....BD 

The CIO also needs a strong set of relationship management capabilities to manage the increasingly larger network of relationships that define today's IT environment—internal staff, contractors, outsourcing partners, internal business partners, an external network of peers, and in some instances, an external network of clients. 

For example, in healthcare, with a growing number of regional health information organizations, CIOs have responsibility for providing data and interoperability not only to members of their own organization, but also other hospitals and healthcare entities. Here, careful management of relationships with entities where there is no formal reporting structure becomes critical.

The Looming CIO Shortage: 2010 CIO Capabilities

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Critical Shock Treatment Often Delayed in Cardiac Arrest

Good point about having automated defibrillators at the hospital...they are are airports and in other public areas today...so why not at the hospital for quick access when needed...like the old fire extinguisher in the wall...have a couple defibrillators ready if needed...BD

Just because you're in the hospital doesn't mean you'll quickly get treated if your heart stops beating. About one-third of patients don't get a potentially live-saving shock within the recommended two minutes, a new study found. 

Those who don't get prompt defibrillation are more likely to die or end up brain damaged or disabled, the study showed. For every minute of delay, the chances of survival worsens, researchers reported in Thursday's New England Journal of Medicine.  The research showed delays were more likely at smaller hospitals, after-hours or on weekends, and for patients who weren't constantly being monitored or were admitted for non-heart problems.

One potential way to speed up response times, Chan suggests, is to make automated external defibrillators, or AEDs, available throughout hospitals so that nurses could readily use them instead of waiting for doctors to deliver shocks.  "We have them outside the hospital setting already today. Is there any reason not to have these (in hospitals)?" Chan said.

ABC News: Critical Shock Treatment Often Delayed in Cardiac Arrest

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YouTube and similar sites have more doctors getting ready for their close-ups ...

Nice touch to add video...even if it is just a message to call the office as an attachment to an email...hearing and seeing is not available in regular email as we have to use "smileys" sometimes to identity or emphasize a point or words...there is a multitude of medically related and instructional videos on You Tube..everything from humor to "how to" on many procedures...BD 

Loring Jacobs. MD , an internist from Las Vegas, wanted to find a more personal way to tell patients their routine test results, otherwise relayed through a phone call, an automated system or a nurse. 

Capitalizing on the growth and popularity of Web videos, some physicians are now turning to the camera as an inexpensive tool for communicating with patients. Sometimes there's even a marketing impact.

So Dr. Jacobs began making video e-mails, giving patients the results himself, and explaining them in more detail. If the news is bad, Dr. Jacobs sends a video requesting that the patient make an That "how" question is one a small but growing number of physicians are trying to figure out, as they incorporate the use of Internet video into their practices.appointment. 

AMNews: Jan. 7, 2008. Click to play: YouTube and similar sites have more doctors getting ready for their close-ups ... American Medical News

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Payer Trend: 'Tiering' Physicians and 'Steering' Patients

Profiling is done via "grouper" software...no this is not the fish...everything relative to one diagnosis is grouped together...physicians argue that claim data does not reflect clinical outcomes as well....and what do you do as a physician when you are at the bottom of the list?  Those payers that do not have tiered plans will more than likely employ them down the road...when looking a profile for a physician, see who created the list...and realize that sometimes information can be skewed to reflect costs and not necessarily better care...BD 

Family physician Kevin B. Martin, MD, offers his patients top-tier medical care in Auburn, Wash. Or maybe he doesn't. Or maybe he didn't at one time, but he does now. It all depends on which health plan you ask - and when.

Martin is one of many doctors who have come away shaking their heads after payers have rated the efficiency and quality of their practices based only on claims data and then have shared the results with patients. The goal of the approach, which some call "tiering and steering," is to cut costs and encourage quality. Martin just calls it frustrating.  "I am the same doctor," Martin says. "I give the same care with the same instruments and the same hands in the same rooms regardless of the payer. I'm not a good doc one day on one plan and the dregs another day on another plan."

Aetna, CIGNA, Humana and United Healthcare all have tiered networks. They are called Aetna Aexcel, CIGNA Care Network, Humana Preferred and UnitedHealth Premium. Currently, the only payers that tier family physicians are United and Humana. United has stated that it will not allow employers to use benefit design incentives based on family physicians' tiers to steer their employees. United does exempt physicians in the highest tiers from its required notification program for radiology procedures. Aetna and CIGNA do not rate and tier family physicians but likely will at some point in the future.

Payer Trend: 'Tiering' Physicians and 'Steering' Patients

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Aquariums in the Doctor's Office - Attorney Chooses Sharks...

We have all seen them and they are nice to watch, and it appears this attorney is following what many physicians have done in their office....with one exception....he's putting a shark in his aquarium...true to form?    Also, the aquarium will have a live web cam, so you can check up on the "shark" at any time....not his owner, just the shark....will the shark have the same calming effect?  Tune in to the links above in a couple weeks and see how the shark is doing...a computer will monitor the aquarium and can be set up to email you if the ph levels and temperatures are out of tolerance...BD 

An aquarium adds to the aesthetic appeal of a hotel or Doctor’s Clinic lobby. The gentile movement of fish attracts the attention of visitors instantly. In children’’s hospitals they captivate the children’’s fantasy and help them heal faster. The waiting rooms and the lobbies become more inviting, welcoming and attractive.

A good aquarium works great for lowering blood pressure. Since, it has life in it; it will definitely gain more attention than any plasma TV or expensive art in your living room. After all, an aquarium is natural living art that brings alive a piece of the coral reef or any other live aquatic environment in your home.  Cardiologists have been recommending heart patients to have aquariums in their office as well as home because they are associated with health benefits like lowered blood pressure, reduced stress, and controlled pulse rate.

Welcome to Crystal Clear Aquariums - Montana - Health Benefits

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Wee Target zeros-in on toilet training

New technology for helping parents "potty" train the boys...and affordable...BD 

January 3, 2007 Desperate parents resort to any number of incentives to encourage their kid to “use the potty”- special underpants, reward charts and for parents of boys, even floating toys in the toilet bowl for target practice! Inventor Joanna Haymes, a mother of three boys, took the latter idea further and developed the “Wee Target”. Inspired by heat sensitive ink on a packet of batteries and driven to help her boys aim in the right direction, she designed a “target”- a black circle made of heat sensitive ink which is fixed temporarily inside the toilet bowl. When the target is hit by urine, the circle fades and a surprise picture appears.

For about AUD$10.00 (USD$8.50) you get a target which lasts up to 6 weeks. It is attached by plastic suction cup, can be removed for cleaning and sits 2.5cm (about 1 inch) above water level so splashing is kept to a minimum. Each time the toilet is flushed, the target is cleaned and the picture disappears. So the "game" begins again on the next trip to the toilet.

But hey, it’s not just the kids who get to have all the fun, urinal targets for men are not a new idea. The urinal at Schiphol Airport in Amsterdam sports a “fake-fly” target and thanks to Marcel Neundorfer you can play an interactive game next time you go to the toilet!

Source:  Wee Target zeros-in on toilet training - gizmag Article

Web Site:  http://www.weetarget.com.au/

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California Court Overturns Cancellation Case, Sends to Trial

Blue Shield considering an appeal...BD

A unanimous ruling by a California appeals court backs individuals' cases against health insurers that terminated policies after substantial medical claims were filed, the Los Angeles Times reports.
Insurers in California cannot cancel individual health insurance policies without establishing that members intentionally mislead the company and showing that the insurer pursued an investigation before issuing the policy, according to the ruling by a panel of the 4th District Court of Appeals in Santa Ana.

California Appeals Court Overturns Cancellation Case, Sends to Trial - California Healthline

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The Cost of Information Technology

Good article on hospital IS services...even though it seems like it's a lot of money, with IT/IS technology there's never enough...as this high tech hospital CIO points out....BD    

This year's $169.4m BIDMC capital includes $57.8m for our new Center for Life Sciences Research building and $23m for backfilling vacated space as researchers move into the new building. The $15.4m IS capital budget also includes $3.4m for the Center for Life Sciences build out of telecom and network services. If you remove these for both BIDMC and IS, we are 13.5% of the total. The remainder is $8.5m for infrastructure, $.5m for Peoplesoft, and $3m for Disaster Recovery......We also provide Media Services/Telemedicine, Library Services, Telecommunications and Health Information management services (medical records).
At present, I believe that the capital and operating budgets I've provided here will result in more than 99.9% reliability, under 2 second transactions speeds in all applications, reasonable progress on our effort to be 85% electronic in all our care areas, and high customer satisfaction. As I often say, providing Information Systems is a continuous journey, so we will continue to seek additional budgets to support ever evolving user requirements.

Life as a Healthcare CIO: The Cost of Information Technology

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What the hell is that?

Urologist gets caught off guard here with something very unusual...something the cleaning crew found...humorous story about what happens in the ER...male chastity belt?  Worth the read and good chuckle from his blog..BD

So I had entirely forgotten about the most recent sexual device removal until I got a phone call from a very confused urologist today. A few weeks ago, a fellow presented requesting removal of a "male chastity device" which was, um, stuck. I didn't even know such things existed.  

The patient did not wish the device returned to him, and so after the entire staff had gazed at it in wonderment it was placed in the dirty utility room for disposal.

Movin' Meat: What the hell is that?

Hat Tip:  Kevin, MD

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Anonymous Kidney Donors Use Internet To Find Recipients

One more health care item has turned to the web to run queries to find a match...service is not free for those listing but could be lifesaving if needed for one who needs a transplant...BD 

A number of Web sites have launched to help match anonymous kidney donors and strangers in need, but some hospitals are reluctant to perform the surgeries because they fear that these donors might be psychologically unstable, more likely to back out of the transplant or secretly paid for the kidney, the Wall Street Journal reports.
Matching donors with needy patients online also can give advantages to the kidney recipients who create the most emotional plea, and in some cases, those who pay a Web site's fee.  For example, MatchingDonors.com charges people $295 to post their appeals for a kidney for 30 days, or $595 for a lifetime posting. Would-be donors can search the online database of profiles and select who they want to donate to, a process that allows patients to circumvent the national waiting list for transplants.

Anonymous Kidney Donors Use Internet To Find Recipients - iHealthBeat

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Pentagon, VA Take Next Step To Interoperable EHR System

Department of Defense and VA team up on health records...Clinical Data Repository/Health Data Repository, has been operating on a limited basis, but new configuration enhancements have enabled all sites to view shared patient data.  BD

Last week, the Departments of Defense and Veterans Affairs announced enhancements to software that will allow the agencies to share information on clinical events, medical procedures and problems experienced by patients who receive care from both agencies, Healthcare IT News reports (Monegain, Healthcare IT News, 12/28/07).

The software improvements on the agencies' Bidirectional Health Information Exchange are the third enhancement of 2007. Earlier upgrades let health care providers at DOD and VA share records on:

• Chemistry/hematology;
• In-theater medical treatment;
• Microbiology;
• Patient allergies;
• Pharmacy; and
• Radiology (Buxbaum, Government Health IT, 12/28/07).

Pentagon, VA Take Next Step To Interoperable EHR System - iHealthBeat

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First-Time Generic Approvals: Combunox, Dilantin, Antizol

Pain killers, seizure treatments, and emergency poison care and treatment...BD 

December 28, 2007 — The US Food and Drug Administration (FDA) has approved first-time generic formulations for oxycodone hydrochloride and ibuprofen tablets in 5 mg/400 mg strength for the short-term (no more than 7 days) management of acute, moderate to severe pain; extended phenytoin sodium capsules in 30-mg strength for control of generalized tonic-clonic and complex partial seizures and for prevention and treatment of seizures occurring during or following neurosurgery; and fomepizole injectable in 1 g/mL strength for treatment of poisoning with ethylene glycol or methanol.

First-Time Generic Approvals: Combunox, Dilantin, Antizol

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Research Suggests New Treatment Suitable For All Brain Tumor Patients

Combination could also apply to breast, pancreas and prostate cancers as well...BD

New research at Wake Forest University Baptist Medical Center suggests that a three-drug cocktail may one day improve outcomes in patients with glioblastoma multiforme (GBM), a type of brain tumor with a dismal prognosis. Two of the drug candidates have been developed, and the team is working on the third all targeted to kill or impair cancer cells and spare healthy brain.
Waldemar Debinski, M.D., Ph.D., senior researcher and director of the Wake Forest Brain Tumor Center of Excellence, predicts that the cocktail could be tested in patients within five years.

Research Suggests New Treatment Suitable For All Brain Tumor Patients

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Turning Anthrax Toxin Into A Cancer Killer

Mutated toxin...someday could hold some answers and help...BD

Most people wouldn't consider anthrax toxin to be beneficial, but this bacterial poison may someday be an effective cancer therapy. Anthrax toxin has actually been shown to be fairly selective in targeting melanoma cells, although the risk of non-cancer toxicity prevents any clinical use.

These encouraging mouse results suggest that modified anthrax toxin could be clinically viable, and this potent killer might someday be put to good use.

Turning Anthrax Toxin Into A Cancer Killer

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Cocaine Vaccine May Provide Addiction Cure

A request has been sent to the FDA to approve a trial...BD

Two Baylor College of Medicine researchers in Houston are working on a cocaine vaccine they hope will become the first-ever medication to treat people hooked on the drug. "For people who have a desire to stop using, the vaccine should be very useful," said Dr. Tom Kosten, a psychiatry professor who is being assisted in the research by his wife, Therese, a psychologist and neuroscientist. "At some point, most users will give in to temptation and relapse, but those for whom the vaccine is effective won't get high and will lose interest." 

The vaccine, currently in clinical trials, stimulates the immune system to attack the real thing when it's taken.  Kosten asked the Food and Drug Administration in December to green-light a multi-institutional trial to begin in the spring and is awaiting a response.

ABC News: Cocaine Vaccine May Provide Addiction Cure

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Celestron to debut new LCD digital microscope at CES

Microscope technology changing...nice LCD screen....BD

It looks like those in need of something a little more serious than a DIY microscope will soon have a new option to consider from Celestron, which is set to debut its new LCD digital microscope at CES. Up front and center on this one, as you can see, is a relatively large 3.5-inch LCD, which gets paired with a 2 megapixel digital camera and, of course, a microscope that'll let you take a peek at things at  magnification levels up to 40x.

You'll also get 128MB of internal memory to store those extreme close-ups for posterity and, thankfully, an SD card slot for further expansion. No word on a price just yet, but you'll apparently be able to get your hands on one sometime in February.

Celestron to debut new LCD digital microscope at CES - Engadget

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FDA Approvals: Kuvan, Protonix, Kaletra

December 27, 2007 — The US Food and Drug Administration (FDA) has approved sapropterin dihydrochloride tablets for the adjunctive treatment of phenylketonuria, pantoprazole sodium delayed-release oral suspension for patients with gastroesophageal reflux disease unable to swallow tablets, and low-dose lopinavir/ritonavir 100-mg/25-mg tablets for use with other antiretroviral agents in the treatment of children with HIV infection.

FDA Approvals: Kuvan, Protonix, Kaletra

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Advertising spots are located in either the right hand column or at the bottom of the site. Also, if there is something of public interest you feel I should include, please let me know as well. I try to bring articles of both current interest and perhaps items you may not find easily relative to healthcare on the web, to keep it interesting.
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Advertising spots are located in either the right hand column or at the bottom of the site. Also, if there is something of public interest you feel I should include, please let me know as well. I try to bring articles of both current interest and perhaps items you may not find easily relative to healthcare on the web, to keep it interesting.
Recently I have posted a few interviews and if you are interested in such, again, just drop me an email. Lately some of the posts have been included and featured on some major publications, such as Reuters, the Wall Street Journal, Computer Shopper, Ziff Davis, Fox News, the Chicago Times and more.
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New equipment 'best for patient' - cardiac arrest response

It has blue tooth technology to transmit data to various locations as well....as the plan evolves and grows, the patient could bypass the ER room and go directly to the cath lab...and there's a built in GPS clock...synchronize the data and time stamp...BD

The Council Bluffs Fire Department received new machines Friday and a dozen other towns are slated to receive them this month.  "Every transport unit is going to get one," Jolene Henning with Alegent Health said.

"They are buying the Zoll E series sensors and a package that goes with it," Brad Sauser with Carson EMS said. "It's going to give us the ability to do what is called '12 lead.'"  "As this program develops and evolves, we would bypass the ER altogether and go directly to the cath lab," Treynor EMS officer Tony Eblen said.

According to Henning, all cardiac cath lab technicians are on call after hours and it can take up to 30 minutes for them to respond. With the new equipment, those technicians could be on site and set up by the time the patient arrives.

SW Iowa News - New equipment 'best for patient'

Web Site:  http://www.zoll.com/product.aspx?id=390

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Hospital files lawsuits for payments...UVA Medical Center

If you don't pay or return calls...this hospital will send it off to the courts...BD 

"The hospital invests significant staff time and resources to determine if patients qualify for the state authorized indigent care program," writes hospital spokesperson Peter Jump. "The state of Virginia, not the hospital, sets the guidelines for which patients are considered to be indigent."
In Virginia, someone is considered indigent if they fall within 0 to 100 percent of the federal poverty guidelines, which are just over $20,000 for a family of four. Those patients who qualify owe the hospital nothing. Those who earn 100 to 200 percent of the federal poverty guidelines pay on a sliding scale from 5 to 70 percent of their bill. For the year July 2006 to June 2007, the medical center wrote off indigent care charges totaling $142.1 million.

The UVA Medical Center has a huge file full of lawsuits filed in Albemarle County Circuit Court in order to receive payment for unpaid medical bills.

C-VILLE Charlottesville's news & arts weekly | Charlottesville VA news music culture dining

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Technology connects family - Redlands, CA with Iraq

Great use of the free technology from the hospital to allow the US soldier to see and talk with his wife who had just given birth...Voice over IP and webcam technology....the couple was already connected but this made it exceptionally nice in the fact that he was able to see his new born daughter...many miles away...BD 

REDLANDS - Dixee Rogers, who was born Friday night, slept while her father had his first chance to see her.  "Look Dixee, wake up, it's Daddy," mother Larissa Rogers, 21, said Monday while dad looked on from a computer screen, thousands of miles away.

Dixee's father, U.S. Marine Cpl. Andy Rogers, 22, is on his second tour of duty in Iraq. Rogers was able to see his newborn daughter via a technological hookup thanks to the Freedom Calls Foundation, a nonprofit that maintains satellite connections so overseas military personnel can contact family members.  

Larissa said she first started communicating with Andy via the popular MySpace social networking Web site while he was serving his first tour of duty.

San Bernardino County Sun - Technology connects family

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Brain mapping technology

Helpful for tumors and stroke victims...having a picture ahead of time via use of and MRI and software...BD

CINCINNATI, Ohio -- In brain surgery, accuracy is crucial. Surgeons typically use electrical stimulation while patients are awake to identify important areas in the brain during surgery. Now, doctors are using a new technology to map the brain.

Scott Engle spends his spare time making ice cream cones and setting up a neighborhood café for teens. That’s because a hard, bony mass beneath his skull causes severe pain.  These images are merged from a functional MRI and special software. Patients perform activities during the scan, so neuroradiologists can map key areas to avoid during surgery.

Leach says the brain mapping software may also be helpful to surgeons performing brain stimulation procedures on stroke patients.

News 14 | 24 Hour Local News | HEADLINES | Brain mapping technology

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Hospitals' action stops spread of infection - California

In the one example cited here, data mining was a big help as patterns were identified with urinary tract infections...and traced to the catheters and their use....good example of a hospital taking advantage of data mining for a positive result...BD 

As the public's alarm mounts over methicillin-resistant Staphylococcus aureus, or MRSA, and other antibiotic-resistant bacteria, a few hospitals in California and across the country are finding that aggressive action to detect and avert infections pays off. 
During a recently concluded 18-month pilot project, nine California hospitals were able to prevent an estimated 600 healthcare-associated infections by using a data-mining program to comb through computerized records, flagging infections quickly enough to thwart their spread.
The hospitals avoided $9 million in treatment costs, said Deborah Schwab, director of health and technology for the Blue Shield of California Foundation, the healthcare philanthropy that sponsored the million-dollar experiment.

"If you asked most hospitals if they had a problem, they'd probably say no," said Schwab, a former nurse. "When I entered healthcare in the 1970s, everyone assumed that hospital-acquired infections were just tough luck."

Mission Hospital in Mission Viejo, one of the participating hospitals, uncovered a pattern of urinary tract infections, many of them traced to the use of urinary catheters, said Debbie Mulligan, the hospital's infection prevention manager. By limiting the amount of time a patient used a catheter and substituting high-quality diapers, the hospital has been able to reduce its infection rate by 20%, Mulligan said.

Hospitals' action stops spread of infection - Los Angeles Times

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New Course Provides Refresher And Certification For Surgeons Performing Laparoscopic Surgery at Beth Israel in Boston

Beth Israel Deaconess Medical Center is the official hospital of the Boston Red Sox and will now require certification for laparoscopic surgeries raising the bar to a new level.  The CEO also blogs to keep all updated and you can find a link to the site in the right hand reference side of this page.  BD

Attending general surgeons at Beth Israel Deaconess Medical Center (BIDMC) will be required to prove basic motor skills outside an operating room before performing laparoscopic surgery on patients.
CRICO/RMF, the Harvard medical community's professional liability insurer, will offer "Fundamentals in Laparoscopic Surgery" (FLS) as a refresher course in January 2008. As an incentive for this voluntary program, CRICO/RMF is providing a one-time patient safety incentive to attending general surgeons who demonstrate successful completion of the FLS exam.

In an unprecedented requirement, all BIDMC general surgeons will need FLS certification to obtain privileges in laparoscopy. This requirement for certification for privileging at BIDMC is the first time surgeons in the United States will be required to demonstrate motor skills, according to Daniel B. Jones, MD, FACS, BIDMC's Chief of Minimally Invasive Surgery.

New Course Provides Refresher And Certification For Surgeons Performing Laparoscopic Surgery

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FDA Approves Voluven To Treat Serious Blood Volume Loss During And After Surgery

Not for patients on dialysis....BD

The U.S. Food and Drug Administration today approved Voluven, an intravenous solution that prevents and treats a dangerous loss of blood volume, a condition that sometimes occurs during and after surgery.
Significant blood losses can cause a rapid drop in the volume of red blood cells and plasma circulating through the body. This can lead to shock, which is potentially fatal. Blood volume expanders are commonly administered to quickly restore some of the lost volume so that remaining red blood cells can continue to deliver needed oxygen to the body's tissues.

During orthopedic surgery, Voluven was as safe and effective in expanding blood volume as Hespan, an approved starch solution.

FDA Approves Voluven To Treat Serious Blood Volume Loss During And After Surgery

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Thrifty patients pay price with botched surgery

Something to think about before traveling over the border...especially if one has any chronic conditions such as diabetes, heart disease, etc. as these conditions may require special monitoring and sometimes at a reduced cost and availability of medical equipment as facilities, something could be missed or eliminated in the process...BD

In the border city of Tijuana, most patients in some hospitals are American. Most come from California for dental work and plastic surgery that isn’t covered by insurance. This month, Tijuana’s medical community announced an initiative to encourage even more patients to cross the border.

The U.S. Embassy warns that while elective surgery may be cheaper in Mexico, “facilities may lack access to sufficient emergency support.”

And when things go wrong, seeking redress can be next to impossible. Class-action lawsuits — a foundation of consumer protection in the United States — don’t exist in Mexico, and the judicial system remains plagued by corruption and bureaucratic inertia.  Operating on a patient with diabetes and hypertension requires careful testing and monitoring, even when the most qualified plastic surgeons are involved, according to Dr. James Wells of Long Beach, Calif., former president of the American Society of Plastic Surgeons.

Thrifty patients pay price with botched surgery - Health care- msnbc.com

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