Patient upset that drug use was on his medical record

Tough and touchy question posed by this internist..worth reading the entire article...the last line says it all....BD

I am an internist. A life-insurance company rejected a patient of mine when it saw on his medical records, read with his consent, that he has used drugs recreationally. He angrily told me he didn't know this would be in his records (although he saw me taking notes during his visits). Should I include such things in patients' records and emphasize that I'm doing so, even if it leads my patients to withhold important information?

It is also different when considering not life but health insurance. Everyone has a moral right to health care. Current public policy, built around private insurers, can thwart that access by denying coverage or making it prohibitively expensive for those who have a serious medical condition like HIV, for example, or engage in risky conduct. Under this system, it is difficult to imagine a really good course of action for a physician. Only a change in public policy can truly solve your problem.

Everday ethics: Patient upset that drug use was on his medical record - Salt Lake Tribune

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LinkedIn Tools: Outlook Toolbar

Like many others, I have joined the network, but I am slow to add folks as of yet...but the best part of this whole LinkedIn site is the add on for Outlook...even if you have not used the features of connecting with others, the toolbar has one great feature, copy and paste text from any email and create a contact....if nothing else is used here, this one feature along makes it worth while.  It sure beats the heck out of typing each individual contact in Outlook.  Very simple, highlight the text and use the "grab" button on the toolbar. You can also link your Outlook contacts but that is one more feature I have not used. 

And the other feature I like is the dashboard...it helps keep me up to date on my emails and tasks.  The names have been erased here to protect the innocent...but this is definitely helping me stay on top of my emails and correspondence.  Again, I have yet to add anyone to the network but I am sure enjoying the toolbar features.  If you live in Outlook like I do, give this one some serious thought...I read recently where Bill Gates is now on Linked In...BD 

Build your network from frequent contacts

Manage your LinkedIn contacts in Outlook

Stay connected to your network

LinkedIn: LinkedIn Tools: Outlook Toolbar

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McCain's Positions Put Him at Odds with Physician Readers

 Whoops....he's not winning any votes from the physicians...and what the physicians said in the their response makes sense...BD 

In discussing how McCain would fairly reimburse physicians while controlling healthcare costs, Holtz-Eakin said McCain believes physicians should be paid based on patient outcomes, not fee-for-service, which "pays based on volume alone."

On the basis of that comment, MedPage Today surveyed readers about how physicians should be paid, asking "Is outcomes-based payment realistic?" To date, an overwhelming majority (81%) of the more than 1,200 respondents have voted "No."

Another physician carried that argument one step further: "Relying on health outcomes as a criterion for paying physicians is unrealistic," she said, "given the volatile nature of certain disease, patient compliance, and environmental factors that affect the patient's ability to comply."Do all these comments hold a message for Sen. McCain's candidacy? None of the respondents who focused on the election indicated a favorable opinion of McCain.

Medical News: Campaign '08: McCain's Positions Put Him at Odds with Physician Readers - in Public Health & Policy, Campaign '08 from MedPage Today

Hat Tip:  Kevin, MD

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CureHunter - Evidence Based Medicine in Real Clinical Time

 CureHunter search engine goes beyond regular dictionaries by ... CureHunter can read the entire US National Library of Medicine Medline Archive and automatically extract and qualify the evidence for successful clinical outcomes of all known drugs for human disease...the mobile version is free for licensed physicians to reference from a PDA....CureHunter evidence data can be directly integrated into your EMR systems such as Epic, GE Centricity, and VA CPRS. Universities and research organizations can take advantage of data export with powerful tools from the SAS Institute, Mathematica, Salford and original data modeling systems.  BD

Quantified evidence for drug efficacy made accessible during the patient visit...
Evidence-Based Medicine is now possible in Real Clinical Time.

Drug Re-targeting and Purposing Analysis: CureHunter can compute optimal off-label applications for existing drugs in your portfolio in as little as 90 days, reduce time to market by many years, and drive development costs down by well over 50%.

Formulary Optimization for HMOs, and Payer-Providers: CureHunter Medication Effectiveness Evidence can be mapped to drug pricing data to optimize return on drug investment by showing which medications produce the best rates of patient recovery while minimizing the adverse events that force recurring visits.

Company | CureHunter

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Helping Around the House Gets Men Sex

Ok, couldn't resist this one....the male gender might want to listen up here...what do you have to lose...so what if you are a big corporate executive...somebody still needs to take the garbage out at home...things have changed since the 60s...BD 

American men still don't pull their weight when it comes to housework and child care, but collectively they're not the slackers they used to be. The average dad has gradually been getting better about picking himself up off the sofa and pitching in, according to a new report in which a psychologist suggests the payoff for doing more chores could be more sex.

"If a guy does housework, it looks to the woman like he really cares about her — he's not treating her like a servant," said Coleman, who is affiliated with the Council on Contemporary Families. "And if a woman feels stressed out because the house is a mess and the guy's sitting on the couch while she's vacuuming, that's not going to put her in the mood."

ABC News: Helping Around the House Gets Men Sex

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Old Habits Die hard....Windows Mobile and Paper Business cards

Last week I attended the HIMMS convention in Orlando and used my tablet PC to maximize my coverage and information at hand, but one other item to note was the fact that so many folks were still handing out "business cards".  How many carry a device that is capable of "beaming" contact information?  Many of us in the business world have them...Blackberries, Windows Mobile devices, etc. but it's amazing how we still rely on "paper" for the exchange of information instead of beaming a contact with our devices. Now this is not new technology by any means and has been around for quite a while as we all remember the Palm commercials with 2 folks beaming their information on the train...I too collected business cards as I was not sure of the comfort level of others using the technology...but again, this makes light of the fact of another area of how old habits die hard...with a paper card you have to either scan with OCR software or type all the information into a "contact file"; however when the information is beamed, the information is in the phone and synchronizes with Outlook...and ready to be utilized...phone calls, email, or just a general reference for all the information.  There is also a V-Card format that can be used to import the information in to Email clients outside of Outlook as well.  You can also beam other files with a Windows Mobile unit. 

Anyway, this was just something that struck me as unusual as the show was all about technology...there were the card readers set up to scan the information while at the booth to make this easy to import in to Outlook for follow up emails, but what about the times when meetings occurred outside the designated booth areas and the device to scan was not available..those are the times when I still noticed the dependency on the old paper business cards alive and well.

The link below will take you to a Windows Mobile page that explains the process...BD

In the Calendar, Contacts, Notes, Tasks, and Pictures programs, you can beam files and information to other devices using Bluetooth or infrared. From the program, select the item you want to beam. In Calendar, first open the appointment in Agenda view.

Windows Mobile powered Smartphone Help & How Tos (Microsoft Windows Mobile, Windows CE, Mobile Computing, Mobile device)

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Will your plumber and repair technician soon be carrying Tablet PCs?

When I read this story I couldn't help but think back to the post from Dr. Crounse at Microsoft about the plumber who showed up with a tablet, ready to take care of business...quotes from the article below....if the plumber can be mobile, why not the physician?  I can't tell you how much I appreciated the tablet at the HIMMS convention...as well as myself, the tablet went to work allowing me to take notes and identify potential clients and relative information almost instantly, thus getting right to the point and not wasting any time for the exhibitors as well...BD 

In fact, I also show a photo that was sent to me not long ago by a colleague who needed his  toilet fixed.  He said the plumber arrived at his home in a GPS enabled van and carried a Tablet PC into his home.  He used the PC to order parts, document his work and present an electronic invoice.  My colleague who sent me the picture asked, "Why isn't healthcare more like this?" 

When these folks come to your home and office, you don’t currently see many of them carrying computing devices. Sure, nearly all of them carry cell phones — sometimes multiple cell phones — but when they’re done most of them still whip out a clipboard and a three-ply form that you have to press really hard to sign so that your signature comes clear on all three sheets.

Will your plumber and repair technician soon be carrying Tablet PCs? | Tech Sanity Check | TechRepublic.com

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Microsoft partners cozy up on interoperability

The Microsoft HealthVault comes right to mind here....good spot for developers to check out...and Office Live Workspaces....BD 

Microsoft on Thursday announced  an alliance with vendors as the first step towards its brave new world of interoperable software.

The company said existing partners DataViz, Quickoffice and Novell were all working on the new "Document Interoperability Initiative" to test incompatibilities and to make it easier to shift information between different formats.

The software giant also said it has released a translator between ISO-approved standard ODF (Open Document Format), the file format used by rivals including Sun and IBM, and Office Open XML (OOXML) for Microsoft's Excel and PowerPoint apps.

ENN - Microsoft partners cosy up on interoperability

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Pilots complain of laser attacks

A little off topic here...but this could be the Stealth aircraft doing a nice little light show up there as they are invisible until they want to be seen...they have long missions to fly and sometimes a pilot could get bored...opinion only here..BD 

OTTAWA (Reuters) - At least 33 pilots in Canada, including some flying large commercial airliners, have complained about being flashed in the eyes by bright lights that could be lasers, officials said on Thursday.

Canada's transport ministry said it is probing the complaints, which started in 2005, and had handed most of them over to the police. "All we know is that a bright light was shone into the cockpit. We don't know if it is in fact a laser and that's why when these reports happen, an investigation is started," said ministry spokeswoman Kirsten Goodnough

Pilots complain of laser attacks | Oddly Enough | Reuters

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California's Department of Managed Health Care..

A small department continues to grow...and enforce...where does the fine money go and are the fines having a positive effect for better healthcare    BD 

The Department of Managed Health Care collected record fines of $4.8 million from the industry in 2007, but the department only budgets for a 5 percent reserve. If high fines are collected, and the department's budget reserve swells, the department lowers other fees that it collects from the industry to bring its reserve back under 5 percent.

The department is supported primarily by an annual assessment on each HMO. That fee is determined in part by other sources of income for the department, including money from fines. So, in effect, the more money the department collects in fines, the lower the annual assessments. Critics of the system contend the money is simply being returned to the same insurance providers who are being punished by the department."If we're still seeing violations of this magnitude, obviously not," Padilla said referring to the million-dollar levy. "For all the attention the record fines have been receiving, when you hold that up against the record profits from the industry, you have to ask yourself, ‘Is this enough?' Clearly, they are not the deterrent we thought they'd be."

Capitol Weekly: The Newspaper of California State Government and Politics

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Telling patients you dropped their health plan

Good advice from Medical Economics...don't wait until the denied claim arise...and forwarding records is a whole lot easier with electronic records...BD 

I declined to renew my provider contract with an insurer whose reimbursements are too low. Who should notify the affected patients—the health plan or me? If it's up to me, what should I say?

You should be the one to tell them. Say that you'll no longer be a provider for their insurer as of a certain date. It's not necessary to explain why you left the plan. Thank them for the privilege of having been their physician and assure them that you'll be happy to continue seeing them out-of-network. List the other plans you belong to, just in case that's an option for someone.

To assist those patients who'll need to find a new physician, suggest that they contact their plan for names of other providers in the area who are accepting patients. Also give the number of the local medical society for help in locating a new doctor. Let them know you'll promptly forward copies of their records to the doctor of their choice, upon their written request.

Telling patients you dropped their health plan - Practice Management Q&A - Medical Economics

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Use marketing to draw in more patients

Good article from Medical Economics on how to market a practice to draw the patients you want to provide services for....there are many avenues and this article gives some simple and sound suggestions....marketing needed above and beyond the IPA level for managed care MDs...BD 

Like successful theatrical presentations, effective advertising entails good timing and knowing your audience, in addition to having a good product. To attract athletes to his practice, John Pagliano, a podiatrist in Long Beach , CA, sponsors 5-and 10-kilometer races, so that his practice is advertised via each event's T-shirts and programs. He also holds running clinics after the races, in which participants discuss their running-related problems. The local press has taken notice: In August 2007, the Daily Breeze ran an article about Pagliano in which he was referred to as "Doctor Distance."

Use marketing to draw in more patients - Newspaper ads? The Internet? Public speaking? Here's how to choose the most effective business-builders—and avoid those that don't work. - Medical

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Why my cash-only practice failed - The author and her partner bet that patients would pay out of pocket for extra service. They were wrong....

Undercoding and trying to help the patient save money..BD

After 40 months of working without an income or benefits, my partner came to her senses and called it quits. Who could blame her?

Our policy of trying to save patients money—combined with our patients' reluctance to file claims because of the hassle—had backfired. And so, while we had more than a thousand patients, with many new ones coming in every day, few came for follow-up visits. And with receipts stagnant, the prospect that the business would somehow grow in the future was unlikely. I held on a little longer, but, five years after opening my cash-only practice, I finally sold it—lock, stock, and barrel—to our local hospital system. I'm now an employed physician, seeing many of the same patients I saw as a private practitioner. When I ask, they tell me they preferred the level of care they were getting before.

Why my cash-only practice failed - The author and her partner bet that patients would pay out of pocket for extra service. They were wrong. - Medical Economics

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Physicians' Prescription: Scrap Medicare Private Insurance Plans

Once more we are back to "who's going to pay the bill"....Newt Gingrich was correct several years ago when he commented about Medicare being a mess, but look at what we have today...by today's standards Medicare certainly could use some improvement, but look at the mess we have with private industry infiltrating...and making huge profits while they are at it...almost gives Medicare a more angelic disposition...and one thing to think about is that we as voters have no say in what private industry says and does...but we do when it comes to the ability to put petitions on the ballot for the public to vote on government propositions.......BD 

Instead, the physicians of the Texas Medical Association (TMA) prescribe another remedy that would tap into what some in Washington, D.C. view as a "sacred cow": Get the money from overpaid Medicare Advantage plans.
Physicians lose money every time they care for a Medicare patient. Medicare uses a flawed payment formula that pays doctors less than it costs them to provide the care. As Congress considers cutting physician payments more, many doctors say they will be forced to limit or stop seeing Medicare patients.

Dr. Taber, an El Paso urologist, calls Medicare Advantage "a billion dollar rip. It's wasteful spending on the part of Medicare, and a frivolous and costly adventure."

Physicians' Prescription: Scrap Medicare Private Insurance Plans

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Lack Of Public Toilets Devastating Lives, UK

Why is this happening?  Lack of personnel to attend and clean...an effort to save money? Will the future be "bring your own toilet"?  The provisioning of public toilets....BD  

'This report is good as far as it goes - outlining what councils can do to improve access using their current powers. But actions speak louder than words. Over the past decade, more than 40 per cent of all public toilets have closed, as local councils have increasingly decided that the cost of provision was too great. This policy decision has had a devastating impact on the lives of older people across the UK. Research for Help the Aged ** has shown that more than half of older people find that a lack of public toilets prevents them from going out as often as they like. The effect of this is to keep many older people on a "bladder leash" - with shrinking social involvement and increased isolation an inevitable and dangerous effect.

Lack Of Public Toilets Devastating Lives, UK

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'Iceman' Continues to Baffle Doctors

Interesting story...he doesn't have frostbite and runs in the snow in a pair of shorts...BD 

It's a bitterly cold winter day and students on the University of Minnesota campus are bundled up, hurrying to their next class. Wim Hof, dressed in shorts, sandals and nothing else, appeared from the doorway of a school building.

He's known as 'The Ice Man." When he didn't experience frostbite or hypothermia, the body's usual reactions to extreme cold, his extraordinary ability started to get the attention of doctors who specialize in extreme medicine.One answer might lie in an ancient Himalayan meditation called "Tummo," which is thought to generate heat. Hof began practicing the ritual years ago.

ABC News: 'Iceman' Continues to Baffle Doctors

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AjaxWindows- A Web Based Operating System

New development in operating systems...one that is totally web based and by use of virtual technology...choose your operating system...I use virtual technology quite frequently on my tablet as it natively runs Vista, but if I need XP for a demonstration or any other purpose, I simply boot up XP right in the middle of Vista...however, the web based operating system is taking this one step further with needing an Internet connection only...BD 

Now that technology is growing beyond our wildest imagination, we can test operating systems without having to make permanent changes to our existing ones.

This comes in handy if you are doubtful about the benefits of switching and would like to test it first. Virtual desktops are useful tools when you must test numerous software applications. Instead of having to leave endless traces of uninstalled software on your computer system, just install it on a virtual desktop. Not only will this let you test the application fully, but it can be fun as well.

The only difference between a regular operating system and this one is that it is completely done from an online web browser. This feature alone makes it great because you do not have to install it to make it work.

AjaxWindows- A Web Based Operating System

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Fear About Expanded Department of Justice Probe Weighs on Orthopedists

Stryker, who we all know for the knee replacements testified last week before Congress...about their continued relationships with patients...and there could be potential indictments of physicians when it all boils out...and they are not alone as Wright Medical also received a subpoena late last year...definitely something that investors are looking at...BD 

SAN FRANCISCO (Reuters) Mar 06 - Fear about an expanding probe into orthopedic device companies' financial relationships with surgeons was enough to send chills down the spines of even the most honest doctors at the annual American Academy of Orthopaedic Surgeons (AAOS) meeting this week.

It is the first industry meeting since the top orthopedic device companies paid $311 million to settle with the government last September over financial relationships companies maintained with consulting physicians.

Fear About Expanded DOJ Probe Weighs on Orthopedists

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How Docs Tell Patients They're Dying

Recently released "The Bucket List" movie also addresses the issue...maybe not in the same arena as your average patient...but it does bring attention to the matter of how would one cope with the news...none the less something physicians deal with as part of what they do and something that never gets any easier for the physician or the patient especially.  BD 

Putting a time stamp on someone's life, several doctors told ABCNEWS.com, is something that few doctors are willing to do. Instead, they employ much more methodical and caring techniques of breaking the news to terminally ill patients.

Many patients fear abandonment, Grodin said, so doctors must be sure to take the time to remind their terminally ill patients that even though a cure might be out of the question, their health is still important to them.

ABC News: How Docs Tell Patients They're Dying

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MIView - Open Source (free) Medical Image Viewer

Worth a look, especially since it is free...you need a powerful enough processor(s) and at least 1 G of ram to use the software ...and a good graphics card...it also supports 64 bit computing...and if you are an Apple user, don't forget about Osirix...which is also open source and free....BD

MIview is an OpenGL based medical image viewer that contains useful tools such as a DICOM anonymizer and format conversion utility. MIView can read DICOM, Analyze/Nifti, and raster images, and can write Analyze/Nifti and raster images. It can also read and convert DICOM mosaic images. The main goal of MIView is to provide a platform to load any type of medical image and be able to view and manipulate the image. Volume rendering is the main type of advanced visualization that I'm trying to implement.

MIView - gbooksoft.com

Hat Tip:  Medgadget

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Physician House Calls Make Comeback

And the point here is for the insurance companies to make "house calls" profitable...Good mention of Dr. Parkinson, which you can find his site under the "blog roll" section here of how he uses the New York metro area to serve his patients....again part of his success is being innovative in a densely populated area and catering to a selected group of patients who would other wise find difficulty in getting medical care...he uses every bit of technology at his fingertips...but once again we have to wait and see what Medicare will do before medical services of such will be compensated...as private industry will usually follow the precedence of Medicare...Dr. Parkinson is doing his share to help relieve the congestion at the ER room...BD

The next time you see the doctor, you might not spend an hour in a waiting room, read eight-month-old magazines or be examined in a cold, antiseptic room. You might not do any of these things, because the next time you see the doctor, you might see him at your own home. In New York City, health care has joined Chinese food as a takeout option. The once common but now rare house call is making a comeback. Thanks to smaller, more portable tests, a lack of urgent care infrastructure and a willingness to ignore insurance companies, the last year has seen a boom in doctors who integrate house calls into their business to provide convenience and care for a wide range of patients.

From the demand side, Parkinson and Glatter have tapped into a client base fed up with the state of urgent care. This is a level of need below emergency but above a chronic problem, like a large cut that needs stitches or a bad case of the flu or strep. Most of those cases are routed to emergency rooms, where the patients will most likely sit for hours, triaged as a lower priority than gunshot wounds or labors.

House Calls Make Comeback | LiveScience

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Google is well positioned to enter the personal health record market

Good article about Google and personal health records and I agree, they are positioned well to make a huge entry in to this market, especially since the commitment was made to exclude advertising...Medgadget has done a good job in describing IBM's effort with Second Life to show their answer to personal health records as well...I still have some issues at times with second life as there's somewhat of a line between what is real and what is virtual, but we will know more as time evolves here with the acceptance and how it interfaces with the electronic records of today and the future....BD 

The market for personal health records is a product of consumers becoming more powerful within healthcare: easy access to healthcare information on the Internet means that patients can enter the physician's surgery more knowledgeable than ever before. Google's entrance into the market is particularly significant as it is one of the most powerful and well known consumer brands in existence today. While Google will not be able to depend solely upon its brand name to ensure the success of its personal health record (PHR) product, its history of successful past ventures stands the company in good stead. Furthermore, Google's significant consumer reach, both through its search engine and email, bodes well for the success of this new venture.
There are, however, other companies making their first foray into the PHR market. The most significant of these is Revolution Health, a company founded by Steve Case, the former CEO of AOL. Revolution Health demonstrates a breadth of offering and consumer appeal not unlike that of Google; however, as a start-up, it does not have the ready customer base or widely recognized brand of Google. In addition, Google is in a strong position for success in comparison with other companies, as it targets consumers in an advertisement-free environment.
Among the other companies developing PHRs are IBM, through Second Life, and Microsoft, through Health Vault. Overall, these companies are likely to achieve success by simply being involved in PHRs, and will benefit from any success that Google has within the PHR market as the trend seeps through the industry. Of the traditional IT vendors, IBM and Microsoft are demonstrating forward thinking by entering into this space and positioning themselves well for the future.
electronic healthcare record (EHR).
In addition, there is an opportunity for traditional vendors to offer their own PHRs within the market as an alternative to Google. While Google has been a great success, some consumers are suspicious of the company and its use of data. As a result, there will be opportunities within the market for multiple PHRs to exist alongside each other. Ultimately, however, because of its brand strength, consumer reach, and record of past successes, it is Google that is likely to have the greatest impact upon the industry, and bring PHRs into the living room of the population.

http://www.pharmaceutical-business-review.com/article_feature.asp?guid=92794139-74B3-4AFF-B802-3B96808B63E3

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Transgender Exec: From Michael to Megan at Microsoft

Gives a new meaning to Mother's day for the kids...but gosh he looked so much better before in my opinion...but folks do what the need to do...BD 

At Microsoft's Redmond, Wash., headquarters where male executives far outnumber their female counterparts, Megan is a standout, especially for one significant difference. Until few months ago, she was a he.

"Well, I'm me," Megan said. "And I think most people would perceive me as female these days. And that's the way I present myself to the outside world."  "I had two surgeries," she said, noting that all of her surgery was from the waist up.

"One was I had breast implants and the other one was I had what's called facial feminization surgery," she said. "My jaw is different, my ears got tucked back, my hairline got changed. I don't have a brow ridge anymore, my nose got done. My lip got changed and I don't have an Adam's apple anymore."

ABC News: Transgender Exec: From Michael to Megan

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Government Concedes Vaccine Case

Autism and vaccines...thimerosal, a mercury based preservative at the core of the discussion..BD

Government health officials have conceded that childhood vaccines worsened a rare, underlying disorder that ultimately led to autism-like symptoms in a Georgia girl, and that she should be paid from a federal vaccine-injury fund, the Associated Press reports.

Medical and legal experts say the narrow wording and circumstances probably make the case an exception, and not a precedent for thousands of other pending claims. The government “has not conceded that vaccines cause autism,” Linda Renzi, the lawyer representing federal officials, who have consistently maintained that childhood shots are safe, tells the AP.  Nearly 5,000 families are seeking compensation for autism or other developmental disabilities they blame on vaccines and a mercury-based preservative, thimerosal.

Pharmalot » Sticking Point: Government Concedes Vaccine Case

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Paradoxical Frog's Leap Forward For Diabetes

More research ongoing...perhaps the frog farms of the future...BD 

Skin secretions from South America's Paradoxical frog could be used to treat Type 2 diabetes, according to research announced this week at Diabetes UK's Annual Professional Conference in Glasgow.
Scientists from the University of Ulster and United Arab Emirates University have been studying the insulin-releasing capabilities of peptides found on the skin of the Pseudis paradoxal frog.
New class of drugs
The researchers found that Pseudin-2, a peptide which protects the frog from infection, stimulates insulin release. They have tested a synthetic version of the peptide and found it could be used to produce a drug that encourages the production of insulin in people with Type 2 diabetes. The treatment could be part of a new class of drugs called incretin mimetics.

Paradoxical Frog's Leap Forward For Diabetes

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Type 2 Diabetes May Be Caused By Intestinal Dysfunction

Scientific evidence that gastrointestinal bypass operations can cause some types of diabetes to go into remission...suggesting those even with BMI (body mass) less than 35 could be potential candidates for the surgery...BD 

Growing evidence shows that surgery may effectively cure Type 2 diabetes -- an approach that not only may change the way the disease is treated, but that introduces a new way of thinking about diabetes.
A new article -- published in a special supplement to the February issue of Diabetes Care by a leading expert in the emerging field of diabetes surgery -- points to the small bowel as the possible site of critical mechanisms for the development of diabetes.  Dr. Rubino was the first to provide scientific evidence that gastrointestinal bypass operations involving rerouting the gastrointestinal tract (i.e., gastric bypass) can cause diabetes remission independently of any weight loss, and even in subjects that are not obese.

Today, most patients with diabetes are not offered a surgical option, and bariatric surgery is recommended only for those with severe obesity (a body mass index, or BMI, of greater than 35kg).
"It has become clear, however, that BMI cut-offs can no longer be used to determine who is an ideal candidate for surgical treatment of diabetes," says Dr. Rubino.

Type 2 Diabetes May Be Caused By Intestinal Dysfunction

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Bar-coded surgical sponges to increase patient safety

At the end of surgery the system will let the surgeon know if there are any not accounted for each each sponge has their own code.....I like this technology a lot...especially if I was the patient...BD 

March 6, 2008 We’ve all seen a current affairs program with a victim who found out their doctor left a surgical sponge inside them - it’s a nightmare scenario for all concerned with doctors facing litigation and patients left with potentially life threatening infections ...and the scary thing is that it does actual happen. The Safety-Sponge System from SurgiCount Medical is designed to prevent these types of accidents using bar-code technology to account for all surgical sponges used during medical procedures.

Bar-coded surgical sponges to increase patient safety

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Last Chance To Change Medicare Health Plans Before Lock-In On April 1, USA

People with Medicare have one last chance to change their Medicare health plan before they are locked into their plans for the rest of the calendar year.
During the Open Enrollment Period, which began January 1 and lasts through March 31, people with Medicare are allowed to change their choice of Medicare health coverage once, but cannot add or drop the Medicare drug benefit. The new coverage will start the first of the month after they make their selection. Most Medicare recipients will not be able to change their plan again until 2009.

Last Chance To Change Medicare Health Plans Before Lock-In On April 1, USA

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Employers Pick Workers' Pockets on Health Insurance

According to the article, much of the premium money goes towards items not even related to health care, such as marketing and sales...BD

To those of you who have health insurance through your job, a bioethicist and an economist pose this question: Who do you think pays for your health coverage?

Most people who get insurance at work believe that it’s the boss. But the notion that employers really pay for insurance for their employees simply isn’t true.

That misunderstanding is called the “myth of shared responsibility” by Ezekiel Emanuel, the ethics guy, and Victor Fuchs, the money guy, in a commentary in JAMA. They explain that the cost of health insurance comes not from employers’ profits but from employee wages. Employers adjust for rising health care costs by essentially docking pay, and “the increasing cost of health care has resulted in relatively flat real wages for 30 years,” they write.

Health Blog : Employers Pick Workers' Pockets on Health Insurance

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More FBI privacy violations confirmed

Why is this story here...some of this information is relative to health care data bases...but on the other side of the coin they forgot to pay the phone bill, so some wire taps were on phone lines that were disconnected for non payment...below are 2 of the health care related data bases...BD

"_A health care fraud system that looks at billing records in government and private insurance claims databases to identify fraud or over-billing by health care providers. It also has been running since 2003.  _A database created in 2005 that looks at consumer complaints to the Food and Drug Administration to identify larger trends about fraud by Internet pharmacies."

WASHINGTON - The FBI acknowledged Wednesday it improperly accessed Americans' telephone records, credit reports and Internet traffic in 2006, the fourth straight year of privacy abuses resulting from investigations aimed at tracking terrorists and spies.

The breach occurred before the FBI enacted broad new reforms in March 2007 to prevent future lapses, FBI Director Robert Mueller said. And it was caused, in part, by banks, telecommunication companies and other private businesses giving the FBI more personal client data than was requested.  The credibility factor shows there needs to be outside oversight," said former FBI agent Michael German, now a national security adviser for the American Civil Liberties Union. He also cast doubt on the FBI's reforms.

More FBI privacy violations confirmed - Yahoo! News

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What's Being read at the "Medical Quack" Today

Among the resource column on the right hand side, there's also a map tool whereby you can select and see what topics are being read today, and some of the most popular topics posted...just click on the map to get started ...you can move the map around and view the flags...click on a flag to see which pose is being read..the link in the pop up will take you directly to the story....there are other links that will give a text page on what everyone is reading today as well. 

This has been on the blog for a while now, but I have never taken the time to tell anyone it is here...so here it is....BD 

http://feedjit.com/stats/ducknetweb.blogspot.com/map/?x=70&y=25&w=160&h=94

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No More Clipboard unveils medical-records compiler

A new partner for the Microsoft Health Vault...and plans to partner with Google...I can see this being of value to a physician to import medical information to the EMR chart...again it would be the decision of the physician on whether or not to import the information after a comparison...there may be information that would not be relative in the EMR Chart...and then again, additional information provided by the patient could really be helpful...interesting too in the fact that the service will be free of charge to work with EMR/EHR software companies...one big potential advance in getting a complete chart for each patient...if a patient were seeing more than one physician this could really be helpful in keeping things up to date at all ends....and again the patient has the overall control as to what they include in the PHR (personal health record)....BD

A Fort Wayne company Monday launched a Web-based tool designed to ease the flow of medical information between different electronic records and health-information-exchange networks. NoMoreClipboard.com is partnering with Microsoft HealthVault – a Web site for managing personal health and medical information. And it plans to partner with Google Health, a platform still in its pilot phase where users can manage their own health records.

NoMoreClipboard.com , an online personal health records company, developed FroozHIE as a tool to compare information, such as medications, from different sources side-by-side. Patient information sent remotely from a personal health record can be compared alongside data in an electronic medical record at the doctor’s office, company officials said. FroozHIE does this without overwriting or duplicating data, said Michael Mirro, a Fort Wayne-based cardiologist and chairman of the IT Committee for the American College of Cardiology. “With the FroozHIE tool, I see the information I have next to similar information from the patient, and I can click on one button to selectively incorporate data I don’t have into my (electronic medical record).”

The product is being offered free of charge, including to other health care IT vendors, something Donnell believes will help raise the company’s profile.

Local firm unveils medical-records compiler | The Journal Gazette

Video here: http://www.healthvault.com/hospitals/NoMoreClipboard/default.html

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Retiree couple needs $225K for medical - $102k for an Individual

Thinking about retiring...new study shows how much you may need as a nest egg to afford health care and maintain a similar standard of living....does retiring mean lowering your standard of living?  BD 

NEW YORK - A couple retiring this year will need about $225,000 in savings to cover medical costs in retirement, according to a study released Wednesday by Fidelity Investments.  The figure, calculated for a couple age 65, is up 4.7 percent from the $215,000 estimate for 2007, the Boston-based financial services company said. And it is similar to other projections for health care costs in retirement — daunting figures given that longer life spans also are requiring workers to increase retirement nest eggs.

A separate study released last month by the Center for Retirement Research at Boston College estimated that an individual needs to go into retirement with some $102,000 earmarked just for health care coverage, while a couple needs about $206,000.

Given current levels of retirement savings, the center said, six in 10 older workers are "at risk" of being unable to maintain their standard of living in retirement.

Retiree couple needs $225K for medical - Yahoo! News

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Heroes are Born Series...Get to know your IT Support folks...they really are not the folks ready for the "funny farm"....

This comic strip drew my attention here as is relates to IT technology and some of the misunderstandings in today's world...It drives home a point about how sometimes those outside the world of IT may not understand the inner workings, and sometimes there's a lack of interest and lack of knowledge as the one individual here states "anyone couldn't print up one of these"...instead of getting to the facts as to the why and how...some old methodologies of simply finding a "quick scapegoat" are still alive and well unfortunately...until substantiated by a higher level of IT support....as shown here...BD 

http://blogs.technet.com/blogfiles/hhh_comic/WindowsLiveWriter/HHHComicSeriesWeek62_5CC0/ITDC_6.2_letters_200dpi.png

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Breath Test for Diabetes

Still 5-10 years away, but hope for diabetics in checking their blood sugar levels without the painful needles...BD 

Fourteen-year-old Robbie Mansfield pricks his finger seven times a day. That means this young baseball fan tests his blood sugar 2,555 times a year. But now, there may be a painless way to collect those numbers.

Doctor Pietro Galassetti thinks he's found it. Dr. Galassetti collected breath samples from diabetic children while blood sugar levels were high and as levels fell in response to insulin. Using a technique developed to test air pollution, chemists detected high concentrations of methyl nitrate -- a byproduct of the damage to body tissue -- when blood sugar levels are too high.

Ivanhoe's Medical Breakthroughs - Breath Test for Diabetes

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Shackles and Skulls Reveal Sinister Past

A horrible story about a children's care center being the source of child abuse...BD

Until last month, the British Channel Island of Jersey was known mostly for its tourism, its status as an offshore tax shelter, and for the quality of its milk, courtesy of the famous Jersey cattle.

But now, something more sinister has clouded the island's reputation – a child-abuse scandal that threatens to destroy the reputations of some of Jersey's most well-known politicians and business leaders.

It began with the discovery – in February – of skull fragments at a former children's home called Haut de la Garenne.

ABC News: Shackles and Skulls Reveal Sinister Past

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Home Remedies for Head-to-Toe Health

 Doctor-approved Home remedies...headaches, back pain, and more...some of these might be worth a look....bad breath is one that caught my eye...BD 

Home remedies are a staple of natural medicine. They are cheap and fast, often work just as well as a drugstore fix, and may be as near as your spice cabinet, refrigerator or laundry room. To update your arsenal, we asked seven experts to share their latest discoveries, from headache panaceas to simple solutions for stiff backs, indigestion, charley horses and more. Here are their surprising, patient-tested contributions.

Drink up to 1/4 cup pure aloe vera gel dissolved in about half a cup of water or apple juice. Aloe vera contains an anti-inflammatory compound called B-sitosterol that soothes acid indigestion, a common cause of bad breath

ABC News: Home Remedies for Head-to-Toe Health

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Military health IT execs cite progress, caveats

Interesting comments from the Department of Defense, who had a large booth at the HIMMS conference this year.  Just from my own point of view, I visited the booth and fielded many specific questions and that is exactly what they were looking for, more than just a "sales" presentation and information specific relative to their IT needs and requirements...BD 

ORLANDO, Fla. — A painfully slow contracting process is hampering progress on military health information technology, and the system warrants closer oversight by the Defense Department, said Dr. Ward Casscells, DOD’s assistant secretary of health affairs.
In remarks at the Health Information Management Systems Society's annual meeting here this week, Casscells said he wants the Government Accountability Office and DOD’s inspector general to keep a close watch on delays in the fulfillment of health IT contracts. “Once contracts are let, they are not always carefully managed,” he said. Casscells also challenged health IT vendors to devote the same enthusiasm for producing systems that they give to winning contracts. “Don’t send us your varsity sales team, then your JV implementation team,” he said. “Our service members deserve better than that.”

Tibbits said military health IT planners are working on the second phase of a study to evaluate alternatives for a joint VA/DOD inpatient electronic health record. The study should be completed in six months, he said.

Military health IT execs cite progress, caveats

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Survey Of Physicians Finds That They Need More Sleep

Patients are not the only ones who need more sleep...BD 

In a new survey, physicians report they are not getting the sleep they need to function at their best and current work schedules may contribute to their inadequate sleep. The survey, issued by the American College of Chest Physicians Sleep Institute (ACCP-SI), found that most physicians sleep fewer hours than needed for peak performance and nearly half of physicians believe their work schedules do not allow for adequate sleep. Results further indicated that, when compared to the general population, physicians reported more caffeine use but better overall health.

Survey Of Physicians Finds That They Need More Sleep

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UMPC Tablets from TabletKiosk - EO Sale

I use and carry this exact unit....performs well and this might be a good opportunity to begin exploring mobility with the EO...a while back I covered a story about a physician in the Los Angeles area who uses the EO for mobility...he has the ability to refer to the charts on his EMR when on call during weekends and off hours.  Many physicians are going to the "2-Tablet" concept...one large unit for the office and another to carry with them when they are not physically at the office...the bonus with the EO is the portability and size...BD 

 

 

Price: $799.00
List Price: $1,048.95 (Includes 6-cell Extended Life battery)

SKU: EO-V7110-1-W (White)

• Create your own Custom Configuration
• 1.0GHz VIA C7®-M ULV Processor
• 1x SODIMM DDR2 slot with configurations from 512MB to 1GB
• Ultra Slim 7 " TFT-LCD Resistive Touch
• 802.11B/G and Bluetooth 2.0+EDR
• Microsoft® Windows® XP Tablet PC Edition 2005

Details on the EO Special Purchase

TabletKiosk Website:  http://www.tabletkiosk.com/

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Bristol-Myers CFO Leaves

It's getting tougher these days to be a CEO or CFO in health care...BD

Andy Bonfield is leaving the drugmaker to seek unspecified ‘new career opportunities’ at the end of the month, according to a statement. A Bristol spokeswoman says his departure is “completely unrelated” to an eye-opening $275 million charge for investing in sub-prime securities, which contributed to a loss in the fourth quarter.

That blunder did lead to the departure of the controller and two of his staffers. At the time, Bristol ceo Jim Cornelius stood before a Merrill Lynch conference in New York and declared “I’m a big believer in accountability, and we’re looking for a new corporate treasurer and a couple of people under him.” However, the turn of events prompted some to speculate that Bonfield should have been the one to be let go.

Pharmalot » Subprime Results? Bristol-Myers CFO Leaves

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CMS Estimates Medicare Physician Payment Cuts, Outlines Cost-Containment Steps

The debate continues and everyone is watching to see what Congress will do...BD

CMS estimates that Medicare payments to physicians will decline by 10.6% below current levels on July 1 and by 15.4% below current levels on Jan. 1, 2009, under the current payment formula, CQ HealthBeat reports. The estimates were released on Friday in a letter from Jeffrey Rich, director of the CMS Center for Medicare Management, to the Medicare Payment Advisory Commission. The cuts reflect an increase in the volume of services provided by physicians that exceeds growth targets. " Nielsen said that if the 10.6% cut goes into effect on July 1, about 60% of physicians say they will have to limit how many new Medicare beneficiaries they can treat, and more than half say they will have to reduce office staff.

CMS Estimates Medicare Physician Payment Cuts, Outlines Cost-Containment Steps

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Microsoft preps StartKey: A ‘Windows companion’ on a USB stick

Good move for Microsoft with the portable USB flash drive devices...I have used one for quite a while and to be able to carry my "Live" settings and documents with me would be a real plus...BD

Microsoft has some big plans for the small-sized storage devices. Microsoft is working on turning USB-based flash drives into a “Windows companion” — a new product known as “StartKey” — that will allow users to carry their Windows and Windows Live settings with them.

StartKey isn’t just for USB sticks; it also will work on other flash-storage devices, like SD memory cards. Microsoft is looking to turn these intelligent storage devices portable “computing companions” for users in both developed and emerging markets, with availability (at least in beta form) likely before the end of this year, according to sources who asked not to be named.

Microsoft’s goal is to build an end-to-end  StartKey environment — comprised of everything from system software on the flash devices, a software development kit to enable third-party developers to create products that can leverage StartKey, and accompany Microsoft applications and services, sources said.

Microsoft preps StartKey: A ‘Windows companion’ on a USB stick | All about Microsoft | ZDNet.com

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Baxter points to China in drug probe

Update...BD 

Baxter says that means the problems may have originated with Chinese suppliers of heparin's main ingredient, derived from pig intestines.  The Food and Drug Administration last week found quality-control problems at a Chinese supply factory.

Baxter points to China in drug probe - Yahoo! News

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Men have a harder time forgiving than women do

I knew this one all along...BD 

Men have a harder time forgiving than women do, according to Case Western Reserve University psychologist Julie Juola Exline. But that can change if men develop empathy toward an offender by seeing they may also be capable of similar actions. Then the gender gap closes, and men become less vengeful.

Exline is the lead author on the Journal of Personality and Social Psychology's article, "Not so Innocent: Does Seeing One's Own Capability for Wrongdoing Predict Forgiveness"" She collaborated with researchers Roy Baumeister and Anne Zell from Florida State University; Amy Kraft from Arizona State; and Charlotte Witvliet from Hope College.

Men have a harder time forgiving than women do

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Pricey pills work better even if they're fake

Gosh if the fake pain killers are this good, who needs the real thing...interesting study on pain killers and placebos...obviously the study was not for acute pain scenarios and should in no way have any relevance in that area...BD 

When it comes to painkillers, many people believe “you get what you pay for,” according to a new study that found patients are actually more likely to get relief if they think they’re taking high-priced pain pills.

Volunteers who were given a placebo said to cost $2.50 per pill and described as a “potent opioid-agonist that provides fast-acting, long lasting relief”  were much more likely to report pain relief than those given a placebo described as a discounted ten-cent version of the same pill. The study is published as a research letter in this week's Journal of the American Medical Association.

Pricey pills work better even if they're fake - Health care- msnbc.com

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Microsoft Offers Free Web-Based Office Extension - Software as a Service

I just have one word to describe this service....Awesome....worth checking out....so far the cloud is working well.....and I am still learning more as I go....why spend time emailing documents when you can share...something we have all done for quite a while, but why load up a co-workers email and your own for that matter when there are better ways to share documents! A couple weeks ago I also moved my website and domain over to Office Live Small Business and thus far have only had one issue with One Note Shared files, which I understand there is a fix in the works....and this is how it looks.

From here I can go to my Shared Workspace...and it looks like this...you can see the 2 shared documents in file....I chose to share one document with myself at another email address...

Now I am sharing another document with my other email address: 

I can view the document online....

I am notified in Outlook that I have shared this document....

Here's the sharing email send to me at my other email address: 

And here it is to view when I go to "click here to view"...I can also stop sharing at any time....

I have also downloaded the Office Live Add In so I can use my desktop version of Office to view the document...since many are still using Office 2003, I specifically used the 2003 version for this demo and it works much the same in Office 2007...

I sign in and it goes to Office On Line for me to locate the document.....

And here's the Word document, opened from Office Live Workspaces, using my Desktop Version of Microsoft Office....

Being this document is shared without any restrictions on permissions, I simply saved it to my desktop...nice....if the author had not left the options open and this was a "read only" file, that would not have been possible...I could also save it on the workspace as well! 

There are templated workspaces you can add as well....

I think I am going to like working with both Office Live and Office Live Workspace....I can also share this document live, but I'll leave that for another post.....BD 

Microsoft took another step Monday toward its goal of being a "Software plus Services" company, as it opened its beta version of a Web-extended Office suite. First previewed in the fall, Office Live Workspace beta is being made available free as a Web-based extension of the dominant Office productivity suite. It had previously been available as a private beta, and the final release is expected later this year. The software giant said this version will allow people to "access their documents online and share their work with others."

Michael Silver, an analyst with industry research firm Gartner, pointed out that Office Live Workspace does not provide the full Office capabilities online, but is an "add-on for collaboration and small business management" to provide storage, version control and other online features. It is not, he said, what Google Docs is.

Microsoft Offers Free Web-Based Office Extension - Yahoo! News

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