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Microsoft's Ballmer on Yahoo and the Future

Mr. Ballmer also sees an end to paper.  I talk quite a bit about medical records and in this interview, Mr. Ballmer agrees that media is set to be turned upside down. In other words, magazines, newspapers, etc. in 10 years will no longer exist in paper format.  Perhaps we can say the same for medical records.  Video at the site.  BD 

In an animated discussion with Washington Post editors and reporters yesterday, Microsoft chief executive Steve Ballmer offered his far-ranging views of upcoming changes in technology and the media.

Microsoft's Ballmer on Yahoo and the Future - washingtonpost.com

NY Medicaid to deny payment for hospital errors

New York Medicaid following the Medicare example with not paying for avoidable mistakes.  Last year 20 procedures were on the wrong patient or wrong body part  and 127 cases involved leaving foreign objects in the body after surgery.  BD 

ALBANY, N.Y. - New York hospitals soon won't be able to bill Medicaid for mistakes during surgery, medication errors and other deadly complications caused by preventable hospital blunders. The state Department of Health tracks these as "never events," or mistakes that should never happen. In October, Medicaid will stop paying for things like wrong-site surgery, wrong patient procedures, disability associated with treatment, medication errors and other problems.

NY Medicaid to deny payment for hospital errors - Forbes.com

Tight Rein on Blood Sugar Has No Heart Benefits

Controlling your diabetes is necessary, but the studies show it does not reduce your chances of heart disease, and in this study of those working to maintain their sugar levels, the death rate was higher, go figure on this one.  Cholesterol and blood pressure treatments are still the best methodologies…along with exercise and losing weight if needed.  

The studies were middle aged people who had been diagnosed quite a while back, so they were not dealing with a brand new diagnosed group of people.  So much for the Cardio-diabetes 2 relationship, at least for now.  BD 

The results provide more details and bolster findings reported in February, when one of the studies, by the National Institutes of Health, ended prematurely. At that time, researchers surprised diabetes experts with the announcement that study participants who were rigorously controlling their blood sugar actually had a higher death rate than those whose blood sugar control was less stringent.

Tight Rein on Blood Sugar Has No Heart Benefits - NYTimes.com

11 Deaths In Medical Devices Tied To Heparin

The heparin saga continues with contaminated devices, the FDA still has to investigate, even though in April a warning letter was sent.  81 deaths and many allergic reactions had been traced back to the contaminated heparin without devices. 

Medical device manufacturers may be on the hot seat as this investigation continues, as most of the cases were reported by families.  The whole scenario here with the contamination is a shame that it even happened, and the fact that it was stated to be an economical decision, less expensive.  BD

WASHINGTON -(Dow Jones)- The U.S. Food and Drug Administration has received reports of 11 deaths and other adverse events associated with medical devices that contain heparin, a widely used blood thinner that has sparked Congressional inquiries about the agency's oversight of drug manufacturing. The FDA, in documents posted on its Web site Thursday, said it can't determine at this time whether the devices cited in the reports contain contaminated heparin.

UPDATE: FDA: 11 Deaths In Medical Devices Tied To Heparin

DARPA Wants 'Fracture Putty' To Fix Broken Bones

 Darpa is reaching out for proposals in the healthcare area…putty to provide assistance to soldiers in the battlefield.  The putty needs to bond with the bone and degrade in the imagebody over time.  It needs to be able to adapt to biochemical signals as does real bone.  Responses are due by July 29th, so if you are in the biotech, adhesives, etc. fields, this might be a good opportunity. 

With many limbs being amputated, this could serve to help reconstruct the bone and possibly avoid some instances, and if nothing else, the rate of infection with this method could be less.   The full press release (pdf) can be viewed here.  BD  

Darpa, the Defense Advanced Research Projects Agency, wants help developing "fracture putty," a substance that it hopes will be able to make broken limbs functional again in a matter of hours. "DARPA seeks to develop a dynamic putty which, when packed in/around a compound bone fracture, provides full load-bearing capabilities within hours, creates an osteoconductive bone-like internal structure, and degrades over time to harmless resorbable by-products as normal bone regenerates," the agency said in its request for proposals (RFP)  .If you have the right stuff, or if you think you can invent it, Darpa awaits your proposal.

DARPA Wants 'Fracture Putty' To Fix Broken Bones -- DARPA -- InformationWeek

Cuba approves sex change operations

In addition to owning computers, one other right has been granted..BD 

HAVANA (Reuters) - Cuba, in the latest change since President Raul Castro took office in February, has allowed doctors to perform sex change operations, a specialist at the National Center for Sex Education said on Friday. Center director Mariela Castro, the president's daughter, has pushed for the operations and said that at least 28 people in the country of 11 million want the surgery.

Cuba approves sex change operations - Yahoo! News

How to Use a Gene Gun

Science Roll always has some of the most interesting articles…video at the website.  Video is fascinating on how the entire process works.  BD 

If you dream of creating genetically modified plants or animals, watch this short film: It makes preparing DNA-laden gold bullets for a gene image gun, and shooting them into rat brain cells, look easy. Although the video is meant for neuroscience research, it showcases tools and techniques that are also used in synthetic biology -- the branch of science that deals with creating new forms of life.The video, which was produced by the Journal of Visualized Experiments, allows you to look over the shoulder of Georgia Woods, a graduate student at the University of California Davis. image

She narrates while decorating tiny gold particles with DNA, coating the inside of a plastic tube with those bullets, and firing them into rat neurons. At one point, she even demonstrates a simple mod for her Bio-Rad Helios gene gun.

Video: How to Use a Gene Gun | Wired Science from Wired.com

Hat Tip and great find:  Science Roll

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Two thirds of office staff suffer from repetitive strain injury

Get yourself a good comfortable chair and start using some alternative methods of input, like dictation for starters…BD 

More than two thirds of workers now suffer from repetitive strain injury, costing £300million in lost working hours, a new study has found. The research from Microsoft revealed cases soared by more than 30 per cent last year because more staff than ever work on the move. imageOffice-based employees work on the move using laptops and mobiles for an hour more per day on average than they did two years ago.

One of the main factors behind the high number of injuries is because not enough companies are replacing their existing office equipment with ergonomic hardware that can reduce the risk of RSI.  These include an ergonomic articulating keyboard, monitor arms, footrests, copy holders, ergonomic mice, laptop holders and chairs.

Two thirds of office staff suffer from repetitive strain injury | Mail Online 

Via:  http://www.switched.com/2008/06/06/repetitive-stress-injury-on-the-rise/

Safeway Kicks Off Month of Events and Fundraising for Prostate Cancer Research

  Watch for the events a local stores.  The money raised is donated directly to charities , which provides grants to teaching hospitals and cancer centers doing leading edge research. A related story shows the recipients of this years awards.  The affiliated hospitals included Massachusetts General, Harvard and MIT, Beth Israel Deaconess Medical Center, University of Washington, University of California San Diego, UCLA, and more.  BD 

image Safeway Inc. (NYSE:SWY) kicks off its annual prostate cancer fundraising and awareness campaign this week. This marks the eighth consecutive year that Safeway has been raising awareness and funds for prostate cancer research. Since the effort began, the company has raised nearly $30 million for prostate cancer research at some of North America's top cancer centers. The company has teamed up with the Prostate Cancer Foundation (PCF), the world's largest philanthropic supporter of prostate cancer research, to distribute the funds. This year's campaign will focus on early detection and screening as a way to reduce mortality rates.

Safeway will reach consumers through a series of radio,print and in-store advertisements that will run during June. Thecompany will hold media events to raise awareness, particularlysurrounding Father's Day celebrations, in a number of theirgeographies throughout North America.

Safeway Kicks Off Month of Events and Fundraising for Prostate Cancer Research and... | Reuters

Cancer Concerns Fuel FDA Inquiry and European study delays another approval

This inquiry revolves around the pediatric use of the drugs to investigate any relationship to the development of cancer.  In a related story, another pharma company is working with the FDA on a safety study produced in Europe with adverse effect reported, so the approval in Europe with additional statistics may delay the some of the future action of the FDA here as well.  Warning labels may be the ultimate outcome once all the relative information can be evaluated.  BD  image

Sometimes rare safety issues with one or two drugs can sink the fortunes of other drugs in the same class of therapies. Yesterday, the FDA issued a communication that it was looking into possible safety issues with some of the best-selling biopharmaceuticals on the market.

TNF-inhibitor-based drugs on the market include Amgen (Nasdaq: AMGN) and Wyeth's (NYSE: WYE) more-than-$3 billion-a-year Enbrel, Johnson & Johnson (NYSE: JNJ) and Schering Plough's (NYSE: SGP) more-than-$3 billion-a-year Remicade, and Abbott Labs' (NYSE: ABT) Humira, which is expected to bring in around $4 billion in sales this year. Needless to say, any reluctance by doctors to prescribe the drugs, or a tightening of FDA restrictions on these compounds' use, could have a very negative impact on some of big pharma's top lines.

Cancer Concerns Fuel FDA Inquiry

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J&J Aims to Sell Contact Lenses for Kids

New products for Johnson and Johnson, but will children be able to work with using contact lenses?  BD 

With stents and anemia drugs under pressure, Johnson & Johnson is looking for growth wherever it can find it. Are your kids ready for contact lenses? J&J’s Vistakon division sure thinks so.  The company has been talking up the contact-lens study with eye doctors in hopes of making them more comfortable with prescribing contacts to youngsters. No further approval from FDA is necessary, and J&J already makes the right sizes.

http://blogs.wsj.com/health/2008/06/06/jj-aims-to-sell-contact-lenses-for-kids/

GE to Integrate Cardiac Data into Electronic Health Records

This is good news for the physicians already using one of the Electronic Medical Records programs mentioned below.  With having an ECG available in the medical record, this will certainly not only make it more convenient, but will also result in better health care and treatments for the patients.  At present the Cardio devices can send information to the GE Centricity system.  BD image

GE Healthcare will integrate its diagnostic cardiology products with electronic health records systems from several other vendors. The integration is designed to enable electrocardiogram data to flow from GE Healthcare's cardiology devices to the patient's record in the various EHRs so physicians can access it more quickly, vendor executives say.

The company's Diagnostic Cardiology business unit, which is based in Wauwatosa, Wis., is working with e-MDs Inc., eClinicalworks, GEMMS, McKesson Provider Technologies, Medinotes Corp., and Medtuity Inc. for the initiative. The devices already can send data to GE Healthcare's own Centricity EHR system.

GE to Integrate Cardiac Data into EHRs

Your private health details may already be online

How much information is on the web?  Chances are there’s a lot more online that what you might think about.  There are advantages and disadvantages.  One advantage is that they are accessible anywhere with computer access.  Privacy issues are still in the main stay though as we hear story after story about security breaches.  In many cases imageyou may be able to opt out of participation, but the procedures may vary from plan to plan.  Chances are if you have not opted out, you are opted in.  The records of course are under secure access and all the required information and permissions need to be entered for access.  For personal health records, you can use services such as Google Health and Microsoft Health Vault for your own files, and even import information from other available participating software companies who partner with them.  BD 

ATLANTA, Georgia -- Imagine my surprise when, in the course of doing research for this story, I stumbled upon my own personal health information online.  There it was in black, white, and hypertext blue. My annual mammograms; the visits to the podiatrist for the splinter in my foot; the kind of birth control I use -- it was all on my health insurance company's Web site. And that's not all: The prescriptions drugs I use were listed on the Web site where I get my prescription drug insurance.

Yes, indeed. Every diagnosis, treatment, and doctor's appointment I'd had since 2003 was on the Internet. All I needed to get them was a phone call to my insurance company and information other people might know, such as my Social Security number, date of birth and address.

Your private health details may already be online - CNN.com

Delta Dental Signs Up For Open Source Business Intelligence Software

 More news for Linux emerging into the Health Care business with an open source solution for Business Intelligence.  One note here is that Microsoft also licenses Suse Linux as well, so the future brings a combination of both commercial and open source software working together.  In a related story, Smartphones are also entering the mobile Linux world and again the future look to software will include various combinations and technologies, and this is happening in healthcare today.  BD 

Pentaho, a startup that develops open source business intelligence software, said Thursday it had signed up Delta Dental of Virginia as a customer, winning the business from SAP's Business Objects. It's the latest add to a growing list of midsize to large businesses trying out Pentaho's open source BI product.

Delta Dental of Virginia, a provider of employee dental benefits programs with $320 million in annual revenue, says it's using Pentaho's extract, transform, and load, or ETL, and reporting tools. The software provides its clients with historical reports to facilitate their access to such things as claims information and enrollment data. Systems used for the effort include an Oracle Linux server, a JBoss Application Server, and an Oracle 10g database.

Delta Dental Signs Up For Open Source Business Intelligence Software - Yahoo! News

Coding Cues: The difference between billing for skilled nursing facility vs. custodial care

Good article to review, what is the difference here as recent changes might lead to some confusion…BD 

We're about to take on nursing home patients and have the following billing questions: Is billing different for patients in a nursing home versus a skilled nursing home, and what's the difference between the two? Do we bill the nursing home or the insurer?

Coding Cues: The difference between billing for skilled nursing facility vs. custodial care - - Medical Economics

Helping patients shouldn't hurt me! - extra effort to get low-cost drugs for her patients works to her detriment under P4P

How does the physician come out a winner here?  We all like those $4.00 medications offered by retailers, and there’s a link on this blog that goes directly to the listings for anyone to read.  Patients access this information too.  The sad thing about this entire story is the fact that the physician is going the extra mile to help patients, but in the long run the performance of how the physician prescribes is being jolted.  image

The insurance companies rank the pay for performance on the amount of generic prescriptions, but when using one of the retailers offering the great deals, the insurance companies are not included on that data as it is a “cash” business of sorts…so how does an MD win and yet the insurers believe they can rank and provide incentives for physicians going the extra mile, what’s wrong with this picture?  I would want to see this physician any day over one who is not making the effort, and besides this, it makes a difference on whether or not a patient will take their medication if it is not within what is considered affordable, thus when it comes to wellness, all efforts are down the drain if the patient does not take the medication prescribed for the treatment plan.  Can’t the insurers come up with a better plan for the physicians so they don’t get penalized for helping their patients?   Perhaps the new data base that is due to come out soon with everyone’s prescriptions listed may help the scenario, so at least the physicians will be able to see and counter back with the information to justify their pay for performance.  BD 

Wal-Mart's $4 generic drugs, as well as free antibiotics offered by a local pharmacy, help a lot of my patients. Whenever possible, I prescribe medicine available for $4 for patients who have a $10 copay for generics; for those on multiple meds, that $6 difference can really add up. And I send patients who have trouble paying for antibiotics to the pharmacy where they're free.

“To top it off, his new plan is big on pay for performance. So not only are his clinical indicators rotten, but all the work I'm doing to try to fix them will count against me.  The local P4P programs grade and pay doctors partly based on our percentage of generic prescribing. But when patients take advantage of great deals on generics offered by giant retailers, the insurance companies are left out of the loop. Consequently, they're clueless as to the actual number of generic scripts I write. So my percentage of generic prescriptions, always very high, has dropped, according to the health plan, and my second-level prescribing has increased. That means I'm going to get dinged when it comes time to dole out P4P rewards.”

The Way I See It: Helping patients shouldn't hurt me! - The author's extra effort to get low-cost drugs for her patients works to her detriment under P4P. - Medical Economics

Albertsons Health and Nutrition Grants Available

Potential opportunity for tax exempt nonprofit organizations to apply for grants.  Grants are available in the Health and Nutrition area as well as hunger relief and other areas of education.  If you are a nonprofit, it’s worth taking a look.  BD 

image Albertsons Health and Nutrition Grants Albertsons is accepting grant applications in the following areas: hunger relief, youth and education, health and nutrition, and environmental stewardship. Award amounts vary. Eligible applicants are 501(c)3 nonprofit organizations and schools in areas where Albertsons grocery stores operate. HOW TO APPLY FOR A DONATION: Albertsons is committed to being a good neighbor. We wish to improve our communities by giving back to our neighborhoods where we live and work. Criteria Our donations provide funding in the following areas: * Hunger Relief * Youth & Education * Health & Nutrition * Environmental Stewardship
http://www.albertsons.com/abs_inthecommunity/community_support/how_to_grant.asp

Albertsons Health and Nutrition Grants

DuoFertility USB Skin Patch Helps Couples Plan A Baby

More do it at home technology, this time a patch that can help when the time is right to conceive, to be priced at $1000.00.  All one has to do is wear the patch under your arm and check results on the hand held reader and it’s up to you to do the rest, ovulation monitoring at the click of a button.  If you are interested in participating in a trial, visit the website for additional information…BD 

After the launch of the USB pregnancy test, it was only a matter of time before the image technology was used in more birth-related gizmos. Joining the ranks of numerous DIY home medical tests is DuoFertility, a heat-sensing skin patch that records temperature of the woman wearing it to establish the baseline of her body’s basal temperature (BBT) which imageindicates the time of ovulation. Created by a company founded by Cambridge University PhD students, the patch records over 20,000 more temperature readings than other fertility temperatures and records them through the included reader or via a USB download on any compute helping couples plan conception. Co sting around $1,000, DuoFertility is expected to hit European markets later this year.

http://www.gizmowatch.com/entry/duofertility-usb-skin-patch-helps-couples-plan-a-baby/#comments

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Medicare Updates Its List Of Recognized Sources To Help Make Coverage Decisions For Anti-Cancer Chemotherapy Drugs

Help to make sure the contractors for Medicare payments and physicians have the latest information on what will be compensated, which changes almost daily.  The burden for payment is on the contractor to check for FDA approval, and then further to see if there is any scientific evidence that supports using a drug to treat a disease in case the FDA approval does not include any of this information, so in other words, payment could be possible if clinical studies go beyond what has been recommended by the FDA. Sounds confusing by all means and in the end who really knows what could be compensated at any given time when it comes to drugs for cancer.  BD 

A compendium is a comprehensive listing of FDA-approved drugs and biologics. In some cases, compendia specialize in a particular subset of drugs, such as those used for anti-cancer treatment. Compendia include a summary of how each drug works in the body, as well as information for health care practitioners about proper dosing and whether the drug is recommended or endorsed for use in treating a specific disease. The Medicare local contractors, who process and pay Medicare claims and approve coverage for drugs under Medicare Part B, use compendia as one of several tools to determine whether an anti-cancer drug should be covered under Medicare Part B.

Medicare Updates Its List Of Recognized Sources To Help Make Coverage Decisions For Anti-Cancer Chemotherapy Drugs

CMS Proposes P4P I.T. Test – Physicians burned out on IT?

Interesting this comes at a time when Congress is looking at the 10% cut to physicians…pay for performance is probably not #1 on the list today, rather seeing whether or not they can profitably continue to operate an office is foremost. We all know IT benefits healthcare with additional information, the problem is the fragmentation and how it is used and mined.  The average HMO doctor has but 10 minutes average for a visit, so he needs to see the patient, examine, and have access to real time clinical information, write a prescription, educate the patient all within that time.  Put yourself in the physician’s shoes, could you do all of that in 10 minutes and be subject to Internet rankings at the same time by the insurers?    It’s what the family practice physician faces every day with a workflow of 20 to up to 40 patients every day.  BD 

The agency's Medicare Care Management Performance Demonstration would be a three-year project to evaluate the use of I.T. in four physician practices to help care for Medicare beneficiaries with congestive heart failure, coronary heart disease and diabetes. The demonstration would target practices with at least 50 Medicare beneficiaries with the conditions in Arkansas, California, Massachusetts and Utah. The goals would be to improve continuity of care, help stabilize the conditions, prevent or minimize acute exacerbations of chronic conditions and reduce adverse health outcomes.

CMS Proposes P4P I.T. Test

Feds Back Wyeth in Supreme Court Case

This case also might have an impact on future cases brought against drug companies…and brings the FDA into a touch situation as well.  No 2 cases are the same and every detail of each case has to be evaluated.  On the other hand it calls for the utmost scrutiny by the FDA to grant approvals as well…BD 

The case, Wyeth v. Levine, asks whether a patient who has been harmed by a drug can sue under state law if the drug was produced and marketed under terms approved by the FDA. The broader legal question here is called “preemption,” and refers to the question of whether federal law preempts state law.

http://blogs.wsj.com/health/2008/06/06/feds-back-wyeth-in-supreme-court-case/

Crystal clear savings for Drug Companies – Developing Technology

Interesting new development for protection of drug patents, which is still in the working stage and could be developed to work at the factory level.  Monitoring crystal structures could be a valuable tool in the protection of patents and intellectual property. Drug crystals can be viewed while they are forming, something new that has not been done before.  The company states they are interested with pursuing conversations with drug companies.  BD 

Drug companies could save millions thanks to a new technology to monitor crystals as they form. The technique, developed by University of Leeds engineers, is a potentially invaluable tool in drug manufacture, where controlling crystal forms is crucial both to cost and product safety. Most drug compounds are crystalline and their structure can affect both their physical attributes and their performance. Changes to these structures are often caused by undetected fluctuations in the process.

Crystal clear savings for drug giants

Hospitals Closing…ER Rooms Crowded?

There are many reports out over the over crowding of the ER rooms at hospitals, yet hospital closures continue.  Some are due to debt and insolvency and there are reasons for other closures, such as consolidation.  It does make one wonder, where is health care going when it comes to having adequate facilities.  

There are links to 2 separate articles below on 2 more closures, one in Ohio and the image other in the Chicago area.  One is due to consolidation and the other is due party to debt and to make room to make way to allow the parcel to build for the 2016 Olympics.  The lease is up and planning is still in progress with worried employees speaking out over the potential job losses up and coming. 

With all the current articles about over crowded ER rooms, it does make you wonder where do we go from here.  If the ER rooms are already over crowded and hospitals continue to be closed, what’s going to be the future?  Will one be able to get in to an ER room in the future?  Much depends on where you live, but most of the closures are appearing to be in metropolitan areas. Many hospitals have also opted to putting their debt out to auction to try to catch up, the bidder obtains the contract to collect unpaid bills from both patients and insurers.  BD 

“The closing of Reese's facility at 2929 S. Ellis Ave. has been in the works for months, as the storied hospital has been deteriorating for years amid tens of millions of dollars in losses and a series of challenges that include ownership changes, competition from rival medical centers and a rising number of uninsured patients who cannot pay their bills.”

Affinity Medical Center announced Thursday that it will close the former Doctors Hospital and consolidate all hospital services at the former Massillon Community Hospital by Sept. 1.

http://www.ohio.com/lifestyle/health/19592884.html

http://www.chicagotribune.com/business/chi-fri-michael-reese-hospital-cjun06,0,5393887.story

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UCI students victims of health insurer leak – United Healthcare

After several students had issued filing tax returns, the investigation is now pointed towards United HealthCare.  After not being able to file tax returns and finding out someone else had used their information to file fake returns, the criminal investigation continued.  So far, all the victims were covered by United Health Care after running a series of data queries to find what they all had in common.

As it appears now, the campus systems did not have a leak, and the jury is still out until finalized.  It makes you wonder how safe is all your personal data and information and what are the full efforts that can be taken.  When it comes to personal health records, I don’t think I am willing to trust an insurer at this time and would prefer either a Microsoft or Google account, or perhaps even a usb stick to carry with me.  BD 

IRVINE – A computer security breach at a health insurance company was responsible for an identity theft at UC Irvine that affected 1,132 students, and led to fake tax returns filed for at least 155 of them, officials said Thursday.

A criminal investigation is still underway in the case, which came from a leak at Minnesota-based UnitedHealthcare, the insurance provider for UCI graduate students.

http://www.ocregister.com/articles/students-uci-tax-2061061-insurance-campus

Three Calif. health care centers cited after patient deaths

3 hospitals in Northern California..the State of California continues to assign fines, these occurring after deaths at each facility. Fines ranged from $60 to 100k.  Not too long ago, there were several citations issued in southern California.  Technology can stand to help some of these situations with adequate monitoring of patients when a human can’t be present at all times and issue alerts.  With electronic monitoring systems issuing alerts that need to be addressed, perhaps down the road incidents like these will become a thing of the past.  BD 

One woman died of dehydration, one patient fell 14 times, and the last was due to properly help a comatose patient breath after replacing his tracheostomy tube. 

SACRAMENTO—The state has cited and fined health care centers in Contra Costa, Sacramento and San Mateo counties after patient deaths.

http://www.mercurynews.com/breakingnews/ci_9493583

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Hospital system to try in-store clinics - Washington

The hospital chain is going to try it’s hand at retail clinics…with nurse practitioners.  Medical records will be integrated with the hospital. 

image Electronic medical record for a patients will connect the retail clinics to the hospitals, emergency rooms, and thus the retail clinics will have a connection to the primary care physicians and specialists as well.  The hospital may have a good idea going here with the integration process, something that healthcare is struggling with throughout.  The records will have full alerts via the charts for previous lab tests, medications, and allergies.  In case additional care is needed beyond the office, the connection will be there.  BD

MultiCare, which runs the hospitals Tacoma General, Mary Bridge Children's, Allenmore and Good Samaritan in Puyallup, plans to open two clinics in Rite Aid stores, in Tacoma and Lakewood, the first week of August. The clinics will be staffed with nurse practitioners and offer diagnosis and treatment for common illnesses, including strep throat, earaches, flu, bladder infections, bronchitis and allergies, and will provide such services as lab tests and immunizations.

Hospital system to try in-store clinics

Personalized UV protection arrives in Canada

The product is not available here in the US, yet and there are plans to roll out later this year.  The process involves a cheek swab and a sample of nose skin for the evaluation process.  Once the lab results are obtained, a personalized skin care plan is created using the products from Dermglow that is best suited for the individual.  There is no claim regarding an individual’s potential of developing cancer though.  The plan will help to prevent and promote repair of DNA damage from the sun.  image

This method replaces using hair. Mitochondrial DNA is used to test for UV-induced damage as it cannot repair damage and therefore provides a diary of sun exposure" explained Birch-Machin.”  BD

05-Jun-2008 - DermaDNA, a system that measures an individual's DNA damage resulting from UV radiation and recommends a skin care regime accordingly, is launched in Canada. The skincare system results from a collaboration between Genesis Genomics, a manufacturer of genetic tests for cancer and other diseases, and Dermaglow, a Canadian based skin care company.

Personalised UV protection arrives in Canada

Medical Quack Posts Syndicated with Professional Journalism Sites

Just as information, you may begin seeing additional coverage, like the 2 examples below.  I don’t have any say or what content is chosen, but hopefully this will work to drive more readers for both the Medical Quack blog and the news publications as well. 

Thanks to everyone for their continued readership!image

Along the side and also at the bottom of the page if you do any ordering from Amazon, you can easily use either link to place an order.   The sections are set by default to medical equipment and devices, but you can easily change the search and locate any product or information desired on Amazon.  There are quite a few listings under Amazon as well for medically related items and books.  BD 

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http://www.reuters.com/article/blogBurst/health?bbPostId=BAfMYODD5A1mB4i22hiR9pHlB98ftY6Ilr6rCz5IEhdAijeTv

Do Medical Devices get recalled – Yes they do…

Something to be aware of, hip replacements, heart defibrillators, and more.  This may not be something one would want to think about right after having a hip replacement.  There has been a big difference on the way the FDA clears devices versus drugs.  As devices are getting smaller and smarter, it’s a challenge to keep up with the latest technology for all.  300,000 deaths are associated with devices each year.  Medtronic just recently had their recall.  Once you have a device it is there for life, a bit different from taking a drug.  Be sure to read up on the latest with medical devices before making a decision if possible.  Last but not least, how does one’s health insurance handle this…something to ponder when a device is recalled….BD 

For someone prone to dangerous heart rhythms, implanted defibrillators deliver a shock that restores a normal heartbeat, often saving a life. Unfortunately, when the electrode wires to the heart fail, they may not deliver the critical shock, or deliver shocks when they aren't needed, sometimes taking a life. When concerns about the device arose, it was unclear despite years of use and thousands of patients if there was truly a performance problem. The company finally studied 25,000 patients and eventually recalled the defective electrode. Similar recalls have affected hundreds of thousands of defibrillators and pacemakers (without defibrillators) in recent years.

Opinion | Don't be too eager to try the latest medical gadgets | Seattle Times Newspaper

North Oakland Medical Center – Physician’s Group to purchase after Chapter 11 Bankruptcy

This is one hospital who got lucky…in a sense…as the article states, this was not the ideal situation but it beats the alternative of an empty building of service to nobody.  The council had to eat the 19.3 billion owed by the hospital, not to mention the city itself has a 6.2 million deficit at the same time.  In 2007 there were cuts of up to 24 million, still not enough to bring solvency.  Around half of the hospitals in the US are balancing on not becoming insolvent.  Things could also stand to change quite a bit when the facility becomes a “for profit” organization.  If not for the concessions, the hospital would not be able to be sold…BD 

The vote paves the way for a very complicated process involving Chapter 11 reorganization bankruptcy and sale to a private group of physicians who would operate the facility as a for-profit hospital. Oakland Physicians Medical Center LLC is a collection of 72 physicians and would operate the 178-bed hospital, which employs more than 800, as a for-profit venture. They have said they would invest $20 million in the facility. There's also the question of $38 million in bonds, and a deal will have to be struck with bondholders as well.

Gary Gosselin: Sale right Rx for North Oakland Medical Center -

TripSync and Microsoft Outlook for Travel

For anyone  who travels and lives in Outlook for their schedule and email, this is a “must have”.  It integrates with Outlook and will synchronize with your calendar!  One less step in having to add all the information manually.  You can also use it on a Windows Mobile phone.   It can also work from the browser, but there’s nothing that beats having it in Outlook!  The book and hold feature is great and will hold your reservations for 24 hours.  There are folks in healthcare that travel and use Outlook, thus I thought this could end up being very useful.  I like the format and having the itinerary right in the calendar.  BD  image

Book travel directly from your Outlook calendar or web interface. There is no need to access the TripSync site once you've installed the plug-ins. imageChoose your favorite application: Microsoft Outlook, IE or Firefox and download the corresponding plug-in to connect to TripSync. The Firefox Plug-in runs on both Windows and Macintosh.

TripSync eliminates the added hassle, time and confusion of other online booking tools by uniquely catering to your specific travel management needs. Whether you are a travel arranger, business traveler or road-warrior, Tripsync makes booking travel more simplified, organized, and synchronized.

TripSync | Customer Support | Download TripSync Connectors

Misys Seeks Resellers for MyWay

One of the larger ambulatory EMR/EHR retailers has created a program to attract additional resellers….BD 

Misys Healthcare Systems has launched a reseller program for its Misys MyWay integrated practice management and electronic health records software for physician practices. Raleigh, N.C.-based Misys last year targeted smaller practices by licensing and re-branding as Misys MyWay the software products of iMedica Corp., Carrollton, Texas.

Misys Seeks Resellers for MyWay

Prostate Cancer Foundation Awards for the 2008 Challenge -funding of continued research to find a cure…

Prostate cancer award recipients with high potential for solving problems with advanced prostate cancer.  In addition, another outcome is the process of better treatments for patients.  The awards range between $500,000 and 1 million for each program and hopefully one day will lead to a cure and a greater awareness.  Clinical studies are part of the process and in a related story a new procedure was announced today.  image

There were a total of 8 categories in which awards were awarded.  The affiliated hospitals included Massachusetts General, Harvard and MIT, Beth Israel Deaconess Medical Center, University of Washington, University of California San Diego, UCLA, and more.  The full list and details can be read here.  The website has additional information for patient, families, researchers, etc. and you can sign up for email alerts and updates.  BD image

The Prostate Cancer Foundation (PCF) has committed  more than $19 million in new research funding for scientific investigations focused on discovering new treatments for recurrent prostate cancer. A total of eight programs representing 18 leading research institutions and 36 researchers were selected as part of the foundation's 2008 Challenge Awards."We are very pleased to announce this year's recipients and believe their proposed projects will deliver critical contributions to the rapidly growing base of scientific knowledge on prostate cancer," commented Dr. Howard Soule, executive vice president of discovery and translation for the PCF. "These awards are aimed at accelerating breakthrough discoveries that can potentially end death and suffering from prostate cancer. That is our single focus and goal.

2008 Challenge Award Recipients - Prostate Cancer Foundation

Democrats Seek Support From Moderate Republicans Medicare Package – Physician Pay Cuts and e-Prescribing

This gets a little confusing as both the Medicare Physician pay cuts and e-Prescribing have been rolled together of late.  What is staring physicians right in the face is the 10% Medicare pay cut on July 1st, that’s right, less than a month away.  The patients will be the ultimate losers here, as more physicians will not take any new Medicare patients or perhaps some might not continue and refer patients to other physicians who will continue to see them.  Again, the Bush administration once again is threatening to veto. 

The e-Prescribing tie in would not take place until the year 2011, which gives evimage eryone adequate time to prepare and begin.  There’s a service available for free-Prescribing and the link is found permanently on this page.  This is a good move as everyone can make their adjustments and purchases if necessary. 

On another blog, one physician provides this statement after a visit to Washington: 

“This year I'm afraid it might be different.  I went to Washington and met with Senators and Representatives two weeks ago.  Everyone was really nice and helpful, but the response was, "We'd like to help you doc, but how are we gonna pay for reversing your cuts?"  The problem is known as "offsets."  Funny how that isn't an issue when it comes to Iraq, or Economic Stimulus packages.”

Sounds like they wanted the physicians to come up with a suggestion as to where Congress could find the funds.  Will there come a time when our leaders might consider a pro-active instead of a defensive approach?  The last program created by the government I believe was Medicare, so it’s time for a new plan.  Create a revenue source that would be large enough for all to contribute and have the revenue to cover all, like perhaps a national sale tax of a few pennies.  If a new source of revenue is not created, then it continues in the same path with health care and the people who serve us getting less and less, and when it gets to the point of not enough to pay the bills, then like any other individual, they look for other ways to provide for their living and families as well. 

Of recent, there have been several articles on the web that state exactly this.  What is sad to see and say, it appears this drawing to an end of the small practice that many of us have depended on for years, and to continue to practice medicine, many will have to take a 9 to 5 position with a large managed care company and subject to what ever contract they may offer.  BD 

Baucus' bill would halt a scheduled 10.6% cut to Medicare physician payments and institute a 0.5% increase in the payments for next year, among several other provisions. On Thursday, Baucus is scheduled to meet with physician groups to discuss the legislation.

Democrats Seek Support From Moderate Republicans On Sen. Baucus' Medicare Package

Online Prescription drug database coming to California

One of the most difficult trails to trace has been to find out what medications a patient is using.  In many instances, without having the records tied imagetogether, a patient can literally be seeing 4-5 doctors to get the same drugs, mostly pain killers or drugs that have an addictive tendency.  This will be the largest of it’s kind to allow physicians to query and find a history of a patients prescriptions in real time.  Right now is has been hit and miss with the physicians, perhaps using a drug test, or knowing other physicians the patient could be consulting.  

Having the information available will definitely help in the chase.  This also makes a case for ePrescribing as well.  Hopefully this will include all the 4 part written prescriptions as well.  Once those can be e-Prescribed, it will give a true audit trail.  Right now the pharmacy is doing the entry with all paper based prescriptions to add to the data bases.  BD 

Brown is to announce Wednesday that his office plans to place the state's prescription-tracking database on a secure Web site that health-care providers can log onto to obtain the information instantly. The move is intended to make it tougher for patients to go from doctor to doctor and fill multiple prescriptions.

SignOnSanDiego.com > News > State -- AG's office announces online drug database

A City Where Hospitals Are as Ill as the Patients – Los Angeles

Sine the closing of Martin Luther King Hospital, things have been a little bit crazy in trying to cover the residents who depended on the hospital. When a 911 call goes out, patients don’t know where they will end up, St. Francis, Kaiser, or Long Beach. Most residents are on Medicaid, in California known as Medical.  Budgets are tight and another 10% cut is proposed, and emergency rooms are already over crowded. 

image There have been more recent hospital closures in the Los Angeles area in the last couple of years and perhaps a private operator might re-open the Martin Luther King facility some day.  With many hospitals bordering on insolvency, the additional patient loads are making it difficult to handle as well.  The overcrowding of emergency rooms continues in the Los Angeles area and it doesn’t appear to be getting any better any time soon.  BD 

For thousands of residents of South Los Angeles who had depended on the large county-run King-Harbor hospital, the past 10 months have been a grueling exercise in cobbling together medical care. When King-Harbor was shut by federal officials, it became the 15th general acute care hospital to close in Los Angeles County since 2000, about half of which served residents in South Los Angeles.

A City Where Hospitals Are as Ill as the Patients - NYTimes.com

Walgreens to pay $35 million to settle Medicaid prescription drug fraud allegations

This is the 3rd settlement with Walgreens…the cost of the tablets were a little bit more than capsules in this instance…and the charges could have been triple the amount and Medicaid was footing the bill, in other words, the taxpayers.  In addition, an agreement was signed with the department of Health and Human Services to insure this does not happen again for the next 5 yearsIn a related story, Walgreens is going for a new mode of advertising with a huge sing in New York Times Square of 17,000 square feet that will debut next fall.  Perhaps the advertising will help with keeping their name in front of the consumers to generate more revenue with a new focus here.  BD 

Walgreen Co. of Deerfield, Ill., has agreed to pay $35 million to settle claims that from 2001 to 2005, it improperly switched patients to different versions of the prescriptions drugs Ranitidine, Fluoxetine and Eldepryl in order to increase its reimbursement from Medicaid, the Justice Department announced today.

By switching the form of the drug dispensed to Medicaid patients, Walgreens substantially increased its reimbursement from Medicaid while providing no additional medical benefit to patients.

Walgreens to pay $35 million to settle Medicaid prescription drug fraud allegations

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Medical Device markets outperforms drug market growth

Medical devices are also converging on the world of pharma…G.E. Phillips, Siemens, and there are more with the diagnostic business.  Then we have the medical devices themselves, screws, nuts and bolts…many with wireless and other technology built in, pacemakers that report back to a mobile phone or computer as a simple example.  If you are regular reader of this blog, you may have already seen many of them featured as they become approved or are announced. 

Pharma and medical devices also come together with joint efforts, such as the medicated stents that have been in the news recently, and devices that release insulin into the body by use of technology related pumps.  Strategic partnerships for pharma makes sense today, not only for products, but to keep on top of the completive world of medicine today.  Not too far down the road, personalized medicine will also present it’s challenges for the drug companies as well, with DNA doing the story telling and having the potential to drive clinical studies either up or down, and even perhaps breaking studies down in to smaller definitive groups.  Big pharma is also right up there investing in their biotech futures as well.  BD  

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The medical imaging companies are not the only ones analyzing closely these convergence trends - Johnson & Johnson, Abbott Labs, Hoffman La Roche, and Baxter International represent four drug companies with strong business segments in medical devices.

Global medical device market outperforms drug market growth (WTN News)

Clinical Trials – Numerous Florida Community Hospitals participating

Most of the physicians involved in trials are single physicians often recruited by drug companies who are already familiar with their prescribing habits and approved medications of choice…it can bring potentially groundbreaking treatments to community hospitals.  Sarasota Memorial Hospital is the area’s largest hospital and also for trials with 19 current active files.  Dr. Kirk Voelker has taken over thimageis spring , as he has had quite extensive experience with clinical trials. 

One clinical device is a small stent to help keep passages open for the exhaling passageways for those with lung disease.  Sarasota is just one of a few community hospitals with dedicated clinical research centers.  Dr. Voelker states it has a lot to do with the motivated physicians and their backgrounds in research.  He decides which studies will be open for participation.  Patients are normally not compensated in a large dollar amount but are there more for the potential cure.  There are several cancer studies in progress as well.  One small footnote about Dr. Voelker, is that he was also the founder a few years ago of one of the most active and successful websites with physicians and others in the pursuit of electronic medical records, EMR Update, aka EMRUpdate.com. a forum where I participate and contribute as well.  BD 

About 32,000 such clinical trials are under way in the United States today, conducted by universities, private companies and the federal government.Almost 6,000 have some Florida presence, such as a hospital or doctor recruiting patients. While most trial sponsors focus on larger cities -- nearly 3,000 are in and around Miami -- more than 500 sites are in Sarasota and Bradenton alone.

HeraldTribune.com - Business - Business news stories about Sarasota, Manatee and Charlotte counties in Florida. - HeraldTribune.com

Increase in consultants makes heart surgery safer at night in the UK

During daytime hours heart surgery is more often performed by junior doctors and at night only 17 percent is carried out by junior physicians.  Still, the quality of care is still very closely related to a senior physician seeing the patient.  Also contributing is the fact that 1 in 10 patients were considered poorly assessed and private hospitals faired better than those of the NHS, with failing to provide written information to patients about their procedures. 

In the US, unless it is an emergency, most procedures are done during the day hours, so this is a turn about from how hospitals function here.  On one other note, the managers of failing hospitals also face being replaced with folks from private firms and the payoffs are starting to diminish.  Some will still continue to be promoted from the NHS, but employees of private industry are now being considered as well for replacements.  BD 

Operations are now safest when carried out at night, according to a major investigation into deaths following heart surgery.  After decades in which the NHS has fought to reduce risks outside normal working hours, heart patients now get better care after 6pm and before 8am.

Increase in consultants makes heart surgery safer at night - Health News, Health & Wellbeing - The Independent

Hospitals Put Patients' Debt Up for Auction

How much will debt pay?  With an auction, winning bidders may get to keep all of the money they collected as well.  There are a couple of websites set up to do this already, and most of the time the hospital has the final say over who is awarded the big, and it may not be the highest.  With around 50% of the hospitals in the country teetering on the brink of insolvency, there might be more of this to come.  The American Hospital Association estimated that 6% of all costs are either unpaid bills or charity, and this was based on a number of around 5,000 community hospitals.  Will there be more people losing houses?  image

Also in the news this week, Tenet sold 4 more hospitals…and one might guess they are more than likely not the top profit earners for the organization.  Where does it all end.  The country appears to not only be facing a shortage of doctors in the future, but perhaps hospitals as well.  There are also continuing legal battles between hospitals on collecting from each other over contracted rates paid when patients are seen “out of network”…something the state of California is looking in to at present…BD 

In a move that consumer groups say could increase pressure on people with unpaid medical bills, some hospitals are trying out a new tactic to recoup patients' debts: They're auctioning the debt online reported by the Wall Street Journal.  Hospitals have long relied on outside collection agencies to go after debtors. Under traditional arrangements, these agencies receive a percentage of any money they get from a debtor; the more they collect, the more they earn.

Hospitals Put Patients' Debt Up for Auction - WSJ.com

Kroger invests in The Little Clinics – Retail Health Facilities

Kroger sees a future in the small clinics located inside the stores.  Already there are several in place, now Kroger becomes an actual share holder.  Kroger also offers many generic drugs for $4.00 and there’s a link to their PDF file on this site for easy reference.  Kroger has over 2,000 stores in the US.  BD 

The Kroger Co. said Thursday that it has made a “significant investment” in Brentwood-based The Little Clinic LLC to help speed up a nationwide rollout of walk-in medical clinics in its supermarkets.
Already, The Little Clinic operates inside 26 Kroger stores, offering basic non-emergency medical care through a staff of registered nurse practitioners and physicians’ assistants. The clinics are open days, evenings and weekends.

Kroger invests in The Little Clinics | www.tennessean.com | The Tennessean

Silverlight June Webcast Series

 Hard Hat Area:  Developers….If you haven’t seen the Common User Interface for the NHS in the UK, take a look at this prior post.  Electronic Medical Reimage cords continue to emerge and grow with new functionality and Silverlight is up there on the agenda.  For software companies looking for ideas and how to incorporate in to an EMR/EHR, here’s a list of some free developer webcasts that are up and coming.  Thanks to Sarah Perez for keeping everyone updated.  BD 

 Lindsay Rutter is going to be doing a series of webcasts on Silverlight 2 in June, starting on June 16th. The topics will include learning about deep zoom, learning the WPF UI framework, learning about adaptive streaming, and more. In total, there will be 6 webcasts in all. To register for any of these free webcasts, just click on its title in the list below below:

Silverlight 2 June Webcast Series | Sarah In Tampa | Channel 10

After Caesareans, Some See Higher Insurance Cost

The insurance companies continue to “cherry pick” patients.  This one caught my eye in the fact that much of this is out of one’s control.  C-sections are now a potential consideration for denial of coverage?  Does this make sense?  Some insurance companies have taken the high road here and are removing such provisions, but in this case, with this insurer, it’s not happening yet. 

There is no woman in her right mind that would choose a C-Section birth if a natural birth is considered safe and she is able to deliver, as with the incision the risk for infection rises.  This is one area where some re-thinking could apply if we are going to continue to raise families and women are having children at a later stage of life today.  BD 

She was turned down because she had given birth by Caesarean section. Having the operation once increases the odds that it will be performed again, and if she became pregnant and needed another Caesarean, Golden Rule did not want to pay for it. A letter from the company explained that if she had been sterilized after the Caesarean, or if she were over 40 and had given birth two or more years before applying, she might have qualified.

But in Colorado, such exclusions are considered discriminatory and are forbidden, so Golden Rule simply rejects women who have had the surgery, unless they have been sterilized or meet the company’s age requirements.  The company, based in Indianapolis, is owned by UnitedHealthcare, which collects more than $50 billion a year in premiums and has 26 million members, most with group coverage.

After Caesareans, Some See Higher Insurance Cost - NYTimes.com

YouTube and Medical Product Approval Videos…

This makes sense…promoting products via You Tube..why not, as we see everything else on the web.  This is actually a very smart marketing process.  After watching the video I walked away with a bit more knowledge that what I had before. 

With all the emerging technologies coming out so rapidly today, media is the way to go to quickly get the word out.  The cardiac assist device featured in this video has just cleared the FDA and stands to save lives.  We used to only have television for our news and media, but it’s up to us to take a look on the web today, and you might just learn something. 

Visit the post for additional information.  A well made point here indeed.  BD 

As Congress moves to consider many FDA and pharmaceutical marketing reforms, one of the areas that they will be looking at quite closely is Direct-to-Consumer (DTC) advertising.  The reform could take on many aspects from giving FDA more power to regulate to an out and out ban of DTC during the first years after approval.

Eye on FDA: Postscript to Yesterday's Posting - YouTube and Product Approval

Medicare Payments to Doctors May Hinge on Electronic Prescribing

This is actually quite a bit down the road, the year 2011 before any pinch is felt, which allows plenty of time for physicians to learn the process.  The one big hitch in all of this is the failure of the DEA to get with the program.  Most physicians that have already made the switch are very happy and satisfied, once the learning curve is over, it is a very efficient way to handle prescriptions.  image

As the process goes not, with a physician who is using e-Prescribing, he has to stop everything, put the computer aside, and drag out “paper”, yes, I said paper.  With today’s methodologies and audit trails inherent in every system, I have to ask, why does the DEA still want paper?  Is there internal system ready to handle the processes?  Audit trails and controls can pretty much efficiently handle most needs today, not only that, but it would provide them with a full audit trail to search.

Right now most physician practices get what are called “fax bots” from the pharmacies, in other words, the pharmacy connecting to the physician’s office to verify refills, and if you have not been in “paper” doctors office to see this in action, they just keep the machine rolling all day long.  With e-Prescribing, this can be controlled and get rid of burning those paper files all day long on the fax machine, plus save a few trees.  Not only that, but someone has to fetch the faxes, call the pharmacies, etc. when it can all be done with a data process, leaving staff and physicians more time to see patients face to face.

Last but not least, let’s address the handwriting…not much more needs to be said here as this goes on every day with pharmacies not being able to read the handwriting on the “paper”.  How long do we want to bypass the white elephant in the living room?  With e-Prescribing, alerts are also generated when a potential conflict arises. 

In today’s busy world, these can certainly be on huge help and have the potential to cut down prescribing errors.  Think of the physician who gets a late night call and has nothing to view about the patients’s medications, do we trust this to memory when there are systems in place to help avoid complications?  Unfortunately there’s still a lot of this in existence today, and the computer can do a much faster analysis than what the human brain can do in the same amount of time.  It’s time to start using the tools we have available today.

Now for the 10% looming Medicare cut looming to take place today, that is another issue all together and has nothing to do with e-Prescribing and needs to be stopped so patients will still be able to find a physician to see them.  Patients are the big loser here and their compensation needs to be maintained at a level where they will still continue to practice as many are finding it difficult to make ends meet.  Everything else in the practice budget is going up, so why are we trying to cut the funds that help the doors to the practice open.  BD

Congress is already bracing for an epic health-reform debate after a new president takes office. But lawmakers–and lobbyists–still have a big piece of unfinished health business for this year: paying doctors.

On July 1, doctors face a 10.6% cut in their fees from the federal Medicare program, a reduction legislators temporarily postponed last year. To avoid the dropoff, Congress is expected to pass a bill to restore the money, as it has repeatedly done in the past. And, true to form, the negotiations look like they’ll go down to the wire.

The hitch: Democrats and Republicans haven’t managed to agree on some key questions, in particular how to pay for making the doctors whole. The Bush Administration has already threatened to veto a bill that goes after Medicare Advantage plans, the private insurers’ versions of the elderly-insurance program.

Health Blog : Medicare Payments to Doctors May Hinge on Electronic Prescribing