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Lawmakers Consider Adding Health IT to Stimulus Package – We Need some Congressional Algorithms

The one word here that somewhat scares me is “consider”, is this not a given to fund Health IT?  Algorithms rule the world and all decisions made so perhaps we can catch Congress up on the meaning and importance of Health IT.  Again, I sure wish we hand some “hands on” folks at the top of the helm here that didn’t have to rely on staff to recommend and translate.  Perhaps we could use some Congressional Algorithms. 

Just last week Bill Gates spoke on the same subject, and there’s a “hands on” man, and if he were speaking to a “hands on” group, perhaps things could move along a a better pace and we wouldn’t have government agencies such as the FDA having to play catch up.

Watch the video from last week about the AHIC recommendations to the new administration.  Most of it drags with thank you comments and a rolling of statistics, with a couple exceptions with Dr. Halamka who they call “the jet” as the video shows respect for him, but an ominous showing of “not understanding”, very clear in just everyone being themselves in the meeting.  We need a fleet of “jets” in Washington that understand technology first hand to get away from what we have now.   I wonder if those making decisions realize how important this is, other countries are dying for it and we keep thinking about it. 

In addition, there’s another article stating some of reservations here: 

Although direct financing of health IT is one way to raise levels of health IT adoption, he said, “I’m not sure that, by itself, it would lead to better care,” McClellan said.

I am not sure he understands algorithms.

Howard Dean, chairman of the Democratic National Committee and a medical internist, warned that standards and uses of systems underwritten by a stimulus would have to be widely tested and accepted before purchasing started.

How long do you think we have, the need is now and there are many standards that now exist, we can’t wait.

Dr. Jeffrey Kang, chief medical officer of CNA Healthcare and president of the eHealth Initiative, said he believed the health IT community was at an “inflection point” marking what the private sector could accomplish in setting up national health IT systems without greater involvement by the federal government.

I agree with private industry setting up a national health IT system, and the software for much of that is free and ready to be refined for the end user experience, called the Common User Interface, but the issue is getting the vendors to commit to the interface and make it easier to have a system that can communicate throughout, as the way it is set up now just due to the way electronic records have evolved, everyone wants to maintain being their own “island”.  Even GE was considering starting from scratch in a recent post in this effort.  Again, it just makes me think of how “hands on” knowledge would be so valuable with Congress.

Kang said one of his biggest worries was that consumer privacy concerns would bog down progress on health information streamlining in the coming year. “I’m worried that they won’t be able to figure it out in legislation,” he said.

Privacy issues, I just posted about PHRs with the Department of Defense working with Google Health and Microsoft HealthVault, I thought some of those issues were finally being put to bed. 

John Glaser, vice president and chief information officer of Partners HealthCare System, said the government might use the $50 billion to get its own health IT house in order, especially in streamlining how Medicare systems link to health care provider programs and systems.

This is not a bad idea for the government to get their IT House in order, which needs to be done anyway.

When you stop and think about it, who has their IT Houses in order, Pharma and the Health Insurance business, and I am talking their business intelligence software which allows for projecting with some pretty sophisticated algorithms.  What 2 large entities are controlling healthcare today in the US?  I rest my case. 

Anyway, as I mentioned above and referenced 2 of the smartest individuals around have been speaking up, but will they be heard and perhaps we can get some Congressional Algorithms in place, maybe?  We could easily use some funds in educating consumers on personal health records as they are available to all, but few, including many physicians even know they exist.  BD 

Senate Health, Education, Labor and Pensions Committee Chair Edward Kennedy (D-Mass.) and ranking member Mike Enzi (R-Wyo.) introduced the bill (S 1693) to create a national electronic health record system more than a year ago, but privacy issues and funding concerns prevented the legislation from reaching the floor. On Thursday, an aide to Enzi said the senator has not seen enough details of the economic proposal to know whether adding health IT to it would "blow the budget." A Kennedy spokesperson, who declined to comment on the proposed stimulus package, said that Kennedy supports "quick action on the investments in health IT that President-elect Obama has called for" (Noyes, CongressDaily, 12/4).

Lawmakers Consider Adding Health IT to Stimulus Package – iHealthBeat

Related Reading:

New federal study shows barriers to healthcare IT - All over the place

Malware attack - Department of Defense

Bill Gates Testifies before Congress - more technology education needed before the US falls behind....
Bill Gates granted first Einstein Award
'Natural Interface' will Become Affordable - Bill Gates
Senator Dr. Tom Coburn – Talks about Bloggers, Healthcare and Technology from the US Senate…

You Own Junk Bonds, Like it or Not – Opinion

Computer technology can cut into personalized patient care with complexity and complicated user interfaces

Personalized medicine will rely on IT – It’s all about Software

Desmond Tutu Presents e-Health Call to Action – Learn from the mistakes of the US

GE, Mayo Clinic, others to develop health record technology

EHRs need Standard Templates – So Let’s Look at the Common User Interface Project, a lot of the work is already in progress and partially completed

How electronic records reach your doctor – Integrated through the Hospitals

EHR Adoption Remains Off in the Distance – Getting way to complicated

Department of Defense Launches Personal Health Record Pilot – MiCare to Integrate with Google Health and HealthVault

I will say once more it looks like we are slowly getting over this privacy issue that has had everyone tied up in a knot for so long and with MiCare, the records can all be ported over into Google Health and Microsoft HealthVault, so if you don’t think PHRs are a hot ticket right now to getting better health care through documentation and being able to offer some credible data for medical and hospital visits, well you might want to think again, so that excuse is slowly going out the window for not taking a few minutes out to perhaps think about setting one up, not hard at all.

Department of Defense and VA to migrate health records

With the Department of Defense and the VA now migrating records too, this should perhaps down the road even lead to more information availability.

Interoperability Advice for the New Administration – AHIC

Are electronic and personal health records inevitable? – Sure they are but we need education and mentors to make it work!

Dr. Crounse from Microsoft had recently written about his trip to Japan whereby everyone was inquiring as to when HealthVault and Google Health PHRs would be available there as they were anxious to get them, unlike what we are seeing here in the US.

Personal Health Records – Who’s in the Know and Who has one?

Why Use a PHR – Because It is there and it stands to help decrease medical errors

The only issue I have with PHRs though is the lack of outreach programs to help consumers get started and that is something needed all over the US. As each post I do on PHRs, they all are working with either Google Health, HealthVault or both, and the benefit is having the various vendors populate your records for you. ER doctors would love to have credible information too instead of having to shoot from the hip. Perhaps we will see all ER departments equipped with Kiosks someday too that connect to PHRs for adding information as needed. BD

Press Release:

Falls Church, Va. — The Department of Defense (DoD) is pleased to announce the successful launch of MiCare, the Military Health System’s prototype personal health record (PHR) at Madigan Army Medical Center (MAMC) in Tacoma, Wa. MiCare is designed to help members of the military and their families more easily and effectively manage their health and wellness, regardless of their location and as they seek care inside and beyond the Military Health System. MiCare developed as a pilot project in partnership with Microsoft Corp. and Google. The project which began in March 2008, focused on incorporating the services and features offered by commercial vendors as a way to expedite the development and expand the capabilities of the military’s PHR.

Dr. S. Ward Casscells, assistant secretary of defense for health affairs, praised the hard work and spirit of the partnership which made the development and launch of MiCare a success. He said, "I am a strong advocate for the adoption and use of PHRs. They allow patients to take more responsibility for their healthcare needs and make patients and providers interactive partners in the healthcare encounter. I believe MiCare will empower our beneficiaries and significantly enhance both the quality and continuity of healthcare we provide."

Both Microsoft® HealthVault™ and Google Health™ serve as protected patient-controlled repositories for health information that is needed to support PHR functions. Regardless which platform the beneficiary chooses, both provide a secure place to store, manage, and distribute their own personal health information.

Beneficiaries who choose to enroll in MiCare at MAMC will have access to their demographic information, active medication lists, their allergy data, lab results, radiology results, personal problem list, past visits, upcoming appointments and inpatient/outpatient documentation from AHLTA, the military electronic health record.

Using Microsoft HealthVault or Google Health, the beneficiary will also have the ability to store health records obtained from civilian providers, plans and pharmacies. HealthVault also allows uploading of data from health and fitness devices, such as pedometers, blood pressure monitors, blood glucose monitors and peak flow meters. The beneficiary can choose to share this data with healthcare providers and a wide range of health and wellness applications and services connected on the HealthVault or Google Health platform.

Beneficiaries’ health information will be protected under the new "Connecting for Health" guidelines developed by the Markle Foundation with the aid of Microsoft, Google and other vendors to establish the standards for keeping sensitive information private. The beneficiary has complete control over who looks at the data and what information they see.

Both Microsoft and Google expressed enthusiasm about the project and indicated that they were pleased to be providing services which will benefit military families.

"Providing one location to store and manage health data can make a significant impact on military families on the move, for retirees seeking care, and for family health managers left behind as a parent is called to duty," said Peter Neupert, corporate vice president for Microsoft’s Health Solutions Group. "We look forward to demonstrating the value of this pilot."

Likewise, Sameer Samat, Director of Product Management for Google Health said, "Google is pleased to be working on the MiCare pilot with the DoD. Helping military service members organize all their personal health information in one secure and central location will ultimately help them better coordinate their care as they move locations."

Plans for deployment of MiCare beyond the initial MAMC pilot location are under consideration and new features including secure provider/patient messaging and a provider portal will be considered for development and addition to subsequent versions.

Ultimately, MiCare will serve as a patient-centric health record, aggregating documentation and information from all sources of healthcare in a location accessible to the beneficiary and under their complete control.

The importance of the MiCare initiative was summed up by Mr. Charles Campbell, the Military Health System’s chief information officer. He said, "Micare will not only meet the needs of our Service members and beneficiaries and improve the continuity of their care, it also supports the national goal to develop the foundation for secure, health information exchange between patients and providers."

http://www.health.mil/Press/Release.aspx?ID=456

Related Reading:

Study Predicts Big Savings from PHRs (Personal Health Records) – Best Kept Secret in Healthcare?
CMS names four PHR vendors for Medicare pilot program and includes Google Health
The Health Cloud – Personal Health Records
Clinical Trials in the US – Begin involving the physicians and patients at the point of care to achieve greater success and participation with Personal Health Records
How electronic records reach your doctor – Integrated through the Hospitals
Healthcare leaders favor personal networks (Personal Health Records) to RHIOs for data exchange
Social Security likes PHRs too – wanting to work with EMR and PHR software with pilot program
The Economy – One more Reason to think about a Free PHR
Google Health Online Services – Connections Beyond Medications – Personal Health Records
Why Use a PHR – Because It is there and it stands to help decrease medical errors
The Health Cloud – Personal Health Records
Getting Organized With Online Medical Records – Personal Health Records
Healthline – Interview with the CEO – Health 2.0
Healthcare leaders favor personal networks (Personal Health Records) to RHIOs for data exchange

eClinicalWorks Users Annual Meeting – Integration and the Future of EHRS and PHRs

Peter Rost for FDA Commissioner – Read up and see what you think

Well, this goes back to a post I made a while back about the two hottest trends in health care, in this case we can focus on the whistleblower side of things, but not lose sight of the fact that the algorithms control everything, data, Congress, the pills we take, you name it.  Pfizer might be a bit worried if he were designated, but with transparency today, there’s no hiding anything so by today’s rules you have to play fair, those algorithms make it so.  

The 2 New Hot Words in Healthcare: Algorithms and Whistleblowers

Nothing can be worse than the lack of transparency we have had for the last number of years and the FDA sitting on their hands when it came to technology, but perhaps not their fault entirely as the leader was not a technical person and for that matter neither are the folks who sit in Congress for the most part, so how was anything going to get done?   Well what you see is what we got. 

The Boston Globe also has an article about the need for a strong FDA leader.  You can visit his website for additional information about his background and see what you think. 

The big thing needed now and the FDA is taking action is to increase their Business Intelligence, and this last year has been more than one big embarrassment in this area, but it all falls under the leader of the ship and if you have a technologically challenged person at the top of the helm without some first hand technology experience, then every one else suffers. I have posted numerous times on this subject and the FDA as well as other government agencies, as well as Congress are now caught up in the nasty but needed game of catch up and you can’t help but notice it, I just write about it, the only difference here.  Some studies as reported earlier this year were still be written up in longhand, on paper, so that just goes to show how a strong technical leader is needed and drug companies invest heavily in technology.  The folks with the technology, data bases and tools to mine it have the power, as we have all seen of late.

Here’s a screenshot from the poll conducted at his website, looks good in the popularity department, but we will all just have to wait and see, in the meantime you can visit the site and read up.  Again, I just hope to see some tech people in high offices as we need to have officials that have some “hands on” experience instead of having to rely on the costly time it takes for staff to educate and bring them up to par on what’s happening, and then hope that our leaders understand it and can make decisions, just nice to have folks who get it first hand and have the “hands on “ approach and knowledge, and also not have to worry about what gets lost in the translation, we have had a full blown number of years of that with both Pharma and Health insurance added to that pot, as they and Wall Street have been the kings of algorithms that rule all economic and monetary decisions that either give or take away the quality of life we would all like to enjoy and see once more in this country.  BD 

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If Pfizer Inc. were to describe its worst nightmare, it might very well be seeing former company whistleblower Peter Rost imagebecome commissioner of the U.S. Food and Drug Administration. So guess who is actively seeking the FDA's top post? Peter  Rost, a former Pfizer vice president who turned whistleblower after he alleged that a subsidiary of the company started promoting off-label uses of various drugs, not only is in the running for FDA commissioner, but he has at least two congressmen in his corner.

Pfizer fired Rost in 2005 after it became known that the marketing executive's allegations about off-label promotion of drugs had led to a criminal investigation against the company.
Rost went on to write a bestseller about his experiences, titled “The Whistleblower: Confessions of a Healthcare Hitman,” which detailed payouts to doctors, marketing drugs to children and various illegal and unethical activities he said he witnessed.

PharmaGossip: Go Peter Go!

Related Reading:

FDA May Need Major Restructuring – Catch up with Technology

Study Calling For Medical Device Information To Better Serve Patients And Doctors from the FDA

First US FDA office unveiled in Beijing

Business Intelligence for the FDA on the way
A Broken Agency – China and the FDA
Medicine is a Low Tech Business - Clinical Studies still done on paper too!
Sentinel Initiative Boosts FDA Safety Oversight
FDA, Military Health System tighten data sharing pact
Will Greed lead to Meltdown of the Health System?
“Beware of Geeks Bearing Formulas”…Warren Buffett
The 2 New Hot Words in Healthcare: Algorithms and Whistleblowers

The Melamine Nightmare Needs to be Fixed – Business Intelligence Could Help

FDA Reform Planned
FDA Head: We're Boosting I.T.

FDA to detain food shipments from China – Why not add some technology to the inspection processes?

Did you work for a Company that went bankrupt? You may not have any insurance, including Cobra coverage

Bankruptcy can mean cancelling all insurance coverage, including chapter 11, so employees can take their place in line for money owed when it comes to health care claims.  This is scary but happening more and more today.  I was speaking a physician’s office recently and this same topic came up in conversation.  A former employee of one of the bankrupt firms on Wall Street was caught in the same predicament,image no Cobra, and yet the employee was told they would have Cobra coverage. 

So if one is unlucky enough to be caught up in this scheme, well just be prepared for the worst when it comes to health care claims and be sure to ask questions and investigate to perhaps find out ahead of the game if possible.  One woman even had her labor induced early for fear she would not be covered upon hearing the news and still have to pay over 20k in hospital bills when she got the word. 

With bankruptcies growing both personal and business wise, this scenario will continue to grow unfortunately and on top of all, the government doesn’t even track these individuals to add to the list of the uninsured.  BD 

When Archway & Mother's Cookie Co. told employees in an October letter it would "go out of business immediately," some workers frantically sought medical care while they believed their insurance would still cover the costs. In Ashland, Ohio, a pregnant employee had labor induced before her due date. Another worker bought a $6,000 insulin pump for her diabetic daughter. "I called my doctor at home and said, 'I need to have my gallbladder removed this weekend,'" recalls Janet Esbenshade, a 37-year-old mother of two who lost her job packing cookies.

Those employees and many others ended up saddled with huge medical bills anyway. Archway was self-insured -- and when it filed for bankruptcy on Oct. 6, there wasn't enough money in its coffers to cover hundreds of thousands of dollars worth of outstanding health-care claims along with all its other debts.

Workers weren't eligible for Cobra, a federal act that gives certain laid-off employees the right to temporarily continue health-care coverage at group rates. That's because Cobra doesn't apply when a company terminates its insurance plan.  Some are abruptly eliminating insurance and leaving laid-off workers with bills for medical expenses incurred before the shutdowns, a trend that is exacerbating health and money problems for tens of thousands of people nationwide.

The government doesn't track how many people wind up uninsured. When companies file for reorganization under bankruptcy rules, they often continue their insurance coverage. Companies that liquidate usually terminate these benefits.

Similarly, Nadine Deck says she was out on disability with a chronic breathing disorder. When Archway shut down, she stopped receiving disability checks. So she turned to unemployment and received checks over four weeks. But the government stopped paying, saying she couldn't collect while on disability. The government now wants its $900 back, she says.

The Human Toll of the Credit Crunch - WSJ.com

Zinc Zipper' Plays Key Role In Hospital-Acquired Infections - MRSA

What is interesting is that the FDA has approved IV injections only for those who have radio isotope poisoning, perhaps from isotopes used in nuclear medicine an diagnostics, but if the process of removing zinc can help in the prevention of MRSA with coating devices in the future, this could be one big boost on the war with hospital acquired infections.  BD 

"We've shown that if you remove the zinc, you prevent the biofilm from forming, and if you add zinc back, the biofilm can grow," says Herr. "So we're hopeful that we can use this sort of approach to prevent these biofilms from ever taking hold in the first place." The most practical applications, Herr says, might involve coatings for implanted medical devices, or rinses that a surgeon could use to clear the area around the implant.

Systemic removal of zinc, such as through an intravenous injection, is impractical for now because DTPA is approved by the U.S. Food and Drug Administration only for people with radio isotope poisoning. In addition, zinc is known to activate immune cells and play many other important roles in the body, so a proper balance would need to be developed.

Zinc Zipper' Plays Key Role In Hospital-Acquired Infections

Related Reading: 

Medical Isotopes - Will there be enough, treatment delays through October possible at US Hospitals

Canada set to order restart of isotope reactor

Docs trained with IT say without it they feel vulnerable when using a paper based system

This could very well be a step backwards to having everything that is electronic and up to date and then going to a facility where paper as an example still rules and old methodologies have to be learned, just the opposite of what is going on in other offices and hospitals.

This study was done at Vanderbilt where they have developed some real state of the art software and procedures, such as this one to alert physicians to the onset of Sepsis with the use of Windows Server 2008, good read if you haven’t caught up with what they are doing. 

Vanderbilt University Medical Center - Server 2008 and Sepsis Detection

Leadership Strategy for the Prevention of Line Sepsis – 10th Leading Cause of Death Worldwide

The study also states that students are looking for hospitals that are using HIT technology when they graduate as well, so this can have an effect on the recruiting for those hospitals who are not up to date yet and still rely on paper systems for record keeping and other hospital functions.  BD

NASHVILLE, TN - A new study has found that physicians who receive training in a technology-rich environment but go on to work in a less modern facility feel they can't provide safe, efficient care as they could have with information technology. The study, ""Performing Without a Net: Transitioning Away From a Health Information Technology-Rich Training Environment," was conducted by Vanderbilt University Medical Center.

About 80 percent of the 328 Vanderbilt graduates who participated in the study were working in an environment with less IT. According to the study, they reported  "feeling less able to practice safe patient care, to utilize evidence at the point of care, to work efficiently, to share and communicate information and to work effectively within the local system."

Docs trained with IT say without it they feel vulnerable

Older Men Dating Younger Women Gets A Science Study

Well no big revolution here, reminds me of song by Steely Dan, “Hey Nineteen”…give that one a listen (grin), perhaps much less to talk about at times, a simpler woman?   BD 

Middle-aged men want younger women and don't mind talking about their own positive qualities to get them, according to research at Gothenburg University and Oxford University that studied 400 matchmaking ads to see how men and women choose partners.

Older Men Dating Younger Women Gets A Science Study - And We Get To Make Fun Of It

NIH Updates Timeline for New Peer Review Systems

After a review of this article it appears that some new software for business intelligence is entering the picture, either that or some major update to bring in new features. By May 2009, the new guidelines are to be in place.  If you are looking for grants this might be worth reading to be updated.  There will be restructured applications and the bar has risen over the last couple years and it appears now the system will be further automated to deal and work with the growing number of applications and R and D projects approved, which makes sense to keep on top and timely review potential candidates for funding.  Just recently announced the second amended grant submission process is being phased out as well.  BD 

NEW YORK (GenomeWeb News) – The National Institutes of Health this week provided an update on several aspects of its new peer-review policy.

In three separate announcements, the agency updated its timeline for implementing a set of changes to its peer review system, described upcoming changes to its scoring system, and announced enhancements to its review criteria for judging applications.

The NIH began developing potential changes for the peer-review systems in 2007, and in September 2008 it announced when the new policies will take effect.

In January 2010, NIH will implement shorter applications for R01 grants for 2011 funding, and restructured applications that will align with review criteria. The new system will use a nine-point rating scale, with one being best and nine poorest, in order to create a scale with sufficient range.

Reviewers will consider the significance of a project, how the investigators are suited for the project, how the project challenges current research or clinical paradigms, the overall strategy, methodology and approach, and how the scientific environment may contribute to the project’s success.

Some of the other criteria reviewers will consider include protections for human subjects; the inclusion of women, minorities, and children; the involvement of live vertebrate animals; and if applications are resubmissions, renewals, or revised applications.

http://www.genomeweb.com/issues/news/151130-1.html?CMP=OTC-RSS

Related Reading:

NIH to Phase Out Second Amended Grant Submissions

NIH Suspends Emory Grant Amid Questions Over Pharma Payments

FDA and NIH Using Twitter for Updates – The Government Twitter Battle has been won

National Institutes Of Health Launches ClinicalTrials Results Database

Forensic Breakthrough Stirs NIH to Close GWAS Data from Public View

Free Cancer Research Tools Available for Clinical Researchers

Obsolete computers – I Still See a few of these in use in some medical offices

We all talk about how healthcare is sometimes behind the times, well this page is very interesting and yes I do see some of these in officesimage still in use, like the old IBM Selectric typewriter (not a computer but included here as being obsolete)  in medical offices with no computer in sight.  Even found the old Newton in this collection.  Interesting site to take a look at some of the dinosaurs of the past and compare to where we are today.  BD 

image 

The Obsolete Technology Website has a gallery of 100+ obsolete computers.

Gallery of obsolete  computers - Boing Boing

Medical Devices and Biotech – Many are still securing Venture Capital Funding

Amidst all we are hearing today about funding being tight and harder to secure, many are still securing financing to continue.  There are also imagereports on some that are closing and running out of money too, such as this recent article about Orexigen Therapeutics who is scrapping 2 investigational drugs to begin focusing on a combination of bupropion and naltrexone (Contrave) for obesity, as well as another weight-loss drug called zonisamide sustained release and bupropion SR (Empatic). Results from a final-stage clinical trial of Contrave are expected in January.  As of now, the company has no money making products on the market which makes it tough at times.  

Their focus will be on solutions for the number one health issue in the US, obesity.  Meanwhile below are a few recent funding announcements from VentureBeat that shows the capital is still there and the bar has been raised significantly, especially in the last few months with the state of the economy to secure funds.   If you take notice though, it appears the device business seems to be capturing a lion’s share from the recent listings below.  BD 

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Broncus inhales $38M to treat lung disease, eyes IPO

December 5th, 2008

Broncus Technologies, developer of devices to treat emphysema and other lung ailments, may make a second run at going public after bringing in $38 million in seventh-round funding to break even, reports VentureWire. The Mountain View, Calif. company first filed for a $75 million IPO last November, but withdrew in June due to the flagging lifescience market.

ViOptix snags $7.4M to measure tissue oxygen

December 5th, 2008

Biotech firm ViOptix just tacked $4.4 million onto an already $12.2 million fourth round of funding and landed $3 million in debt financing to break even, reports VentureWire. The Fremont, Calif. company says this will be its last round of venture capital.

Around since 1999, ViOptix has pioneered a device that allows doctors to detect how much oxygen exists in human tissues through a non-invasive procedure. No plans for the new money, beyond self-sufficiency, have been disclosed. All told, the company has brought in about $33 million to date.

Pelikan scoops up $12.5M for diabetes diagnostics

December 4th, 2008

Pelikan Technologies, maker of diagnostic and health-monitoring devices that can be used by regular people, nabbed a $12.5 million tranche of an expected $25 million seventh round of funding, according to VentureWire. Its flagship product, the handheld diabetes tester Pelikan Sun, is already on the market and is even being targeted for children.

Catalyst lands $40M to combat disease-causing proteins

December 4th, 2008

Catalyst Biosciences has raked in $40.4 million in third-round funding to continue engineering an enzyme called protease to fight disease-causing proteins. The technology has the potential to affect many different diseases, including cancer and hemophilia. It has R&D agreements with Wyeth Pharmaceuticals and Centocor Research & Development.

Endoscopic Tech nabs $11M for heart surgery tools

December 2nd, 2008

Medical device maker Endoscopic Technologies brought in an $11 million tranche of second-round funding from Boston Scientific, Telegraph Hill Partners and Saints Capital. The money will be used to further develop the San Ramon, Calif. company’s line of devices that aid in cardiothoracic surgeries like bypasses and valve repairs, reports VentureWire.

http://venturebeat.com/category/wire/

Eyelash enhancement Drug Discussion continues

In a time whereby we are looking at cures for cancer and other related drugs, items such as this I guess still need consideration too for the imagesafe use of a drug for those long lustrous eye lashes.  I guess the old standby product called “mascara” that does the same thing with applying to one’s eyelashes could maybe be replaced some day?  The concern here is for the off label use and perhaps overdose of the drug if someone were to perhaps assume that if one dose a day works well, what would 4 doses do?  The jury at the FDA is still blinking over this one and are there any side effects found yet as being researched with pretty much all drugs on the market today?  BD  

Reporting from Washington -- A panel of government experts said Friday that a glaucoma drug from Allergan Inc. appeared to be a safe and effective way to make eyelashes longer and fuller. Irvine-based Allergan, which makes Botox anti-wrinkle injections, has asked the Food and Drug Administration to approve its Lumigan formula to enhance eyelashes for patients 18 and older.

FDA panel backs Allergan's Lumigan for eyelash enhancement - Los Angeles Times

Anaheim General Hospital loses accreditation – Orange County, CA

image Anaheim General in Orange County has been in the news of late and this is one last blow to the facility.  Others were trying to purchase the facility, including Prime Health Care, who has been in the news of late over the balance billing situation in California.

Financially, there’s the same struggle going on here as faced by many other hospitals, the mix of funds between commercial payments and charity care and without contracts that pay enough from insurers and additional charity care piling up, the numbers just don’t make it.

The owner of the hospital, Pacific Health is also under investigation for fraud, although not related specifically to Anaheim General.  The Joint Commission themselves was also recently under the eye of Congress.  There are several hospitals overseas through medical tourism that have been accredited by the Joint Commission and in one of the wealthiest counties in the US, we still have hospitals here on the home front that have been deemed to pose a danger to patients, something to think about.

In my opinion one of the most glaring issues where citations were issued was failing to ensure that medical devices were safe and functioning within manufacturer's guidelines.  This could indicate some areas of education and procedures that perhaps were not initiated or administered properly.  As we continue to grow in the area of medical devices and their use, so does the education process become vital and important to make sure they are used according to the manufacturer's guidelines as approved by the FDA. 

Anyway, add all of these conditions together and here’s another hospital struggling for it’s continued existence.  You can read up here about the recent series on the blog called “Desperate Hospitals”, as was featured on Reuters and the Fox News of late.  BD 

Anaheim General Hospital, which cares for a large share of Orange County's poor, has lost its national quality accreditation in the wake of scores of safety citations by three sets of regulators. The 143-bed hospital has been struggling financially and the loss in standing could make matters worse by jeopardizing its ability to attract privately insured patients.

The commission ultimately withdrew Anaheim General's accreditation after concluding that conditions found during a March inspection posed a threat to patients.

Anaheim General Hospital loses accreditation - Los Angeles Times

Related Reading:

Desperate Hospitals – Updated November 21, 2008

Homeless patient spent hospital money on crack

Pacific Health to buy Anaheim Memorial

Memorial Health Services Announces Sale of Anaheim Memorial Medical Center

Prime Healthcare renews bid for Anaheim hospital

Cal. nonprofit hospitals take center stage as Brown vetoes sale of Anaheim Medical Center to Prime Healthcare Services

Joint Commission for Hospitals under review from Congress and a request to re-apply for certification has been made

Balance Billing Ban Upheld, but Who’s Going to Enforce the Policy?

Doctors and hospitals can’t balance bill, but the Department of Managed Care doesn’t have the authority yet to enforce?  This brings about a very good question of who will enforce this.  Is this a provision with no teeth?  Obviously this is good for patients as you come out with a bill of so many unknowns being added to the tab at times, but on the other hand, when items that are not anticipated enter the picture and are added, who will pick up the tab, or if one is seen by a physician out of network and potential higher charges apply.

Prime Healthcare in California has been in the spotlight here and is probably responsible for bringing this entire issue to the forefront.  Without anyone at the helm enforcing the ban, is it business as usual?  Last I looked, patients are still receiving bills for the balances and the battle is still alive and well, so it would be nice to have an entire cohesion here and have laws with some teeth that set the rules of the game up front. The situation is still not complete as the CMA and other parties have 60 days to file an appeal, so in the meantime one big lot of gray remains.  BD 

A Sacramento Superior Court judge issued a ruling Wednesday upholding state regulations that prevent doctors and hospitals from billing patients when their health plan doesn’t pay enough to cover their bills, state regulatory officials announced.

Drafted by the state Department of Managed Health Care, the regulations define balanced billing as an unfair billing practice prohibited by state law. The rules took effect Oct. 15.

The court explicitly chose not to address whether the DMHC has the authority to enforce that definition against providers, leaving that issue for another day.”“The California Association of Health plans is pleased to see the courts agree that consumers need to be protected from the predatory practice of balanced billing. Insured patients who are playing by the rules should not be used as leverage in billing disputes between health care providers and insurers,” Chris Ohman, chief executive officer at the California Association of Health Plans, said in a prepared statement.

http://www.bizjournals.com/sanfrancisco/stories/2008/12/01/daily72.html

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Ultrasound-Activated Microbubbles Fight Cancer with targeted therapy

This is not ready for prime time yet, but a new technique under development from Phillips to help with chemotherapy in targeting the cancer cells directing, thus less of the drug going through the rest of the healthy tissue of the body where it is not needed. 

Localizing chemotherapy without the entire body having to go through the entire process in the blood stream could bring some relief in the treatment of some cancers.  We are seeing more and more of this type of targeted technology being developed to zero in on the areas that are directly affected instead of treating a large area. BD 

Microbubbles are miniature gas bubbles, mostly containing oxygen or air, which can be uniformly suspended in a liquid such as blood. Due to their size, they can pass through even the smallest of blood vessels, and therefore are commonly used together with medical ultrasound imaging. Microbubbles reflect ultrasound better than blood or soft tissues, thus allowing them to be used for highlighting blood in ultrasound images. Until now, their common use was only as contrast agents.image

When the tumor is located, the system shatters the shells of the microbubbles by means of a focused, high-energy ultrasound pulse. Once the shells are destroyed, the contents of the microbubbles spill into the surrounding area and the drugs reach the tumor directly instead of going through the whole bloodstream. This localized release technique prevents the drugs from influencing other systems in the body, thus preventing grueling side-effects and improving the quality of life of the patient undergoing chemotherapy.

Ultrasound-Activated Microbubbles Fight Cancer

Patients still rely on Word of Mouth for Information when choosing a physician

This makes perfect sense as we are still humans, looking for a human to care for us when we are sick.  Sure websites are helpful in looking up office locations, phone numbers, etc. and to get the basic information, as we used to do with phone books, so there’s not a total loss at hand.

If I am using the web, chances are I have already done my “word of mouth” expedition, so what ever I find on the web, and according to this report it is pretty flimsy, is not going to have a huge effect. It seems that folks turn to the web though if they have had an undesirable experience though, then you really go digging.  Also, even if you find a physician on the web, there’s still that desire to also somehow find some additional “human” information too, after all we are not looking for a “text box doc” to take care of us.image

Now as far as technology and follow up, I would not have a problem using the web for a telemedicine visit, again, I would feel ok after having met the physician in person beforehand, so I know who I am dealing with.  This report also goes to show how rankings, etc. can be tweaked and when insurance companies a while back began ranking doctors, it was not a full picture at all a well, as physicians who perhaps saw more patients who are in a critical state showed a higher death rate, so it was like comparing oranges to apples. 

Be sure and visit the link from the Slate where a physician did his own study and see what he has to say in detail.  I found his comments under the “Suggestadoctor” site quite amusing, but he is telling us exactly what happened.  BD 

“With my unceasing selfishness campaign, I was able to hike my scores to levels that would make my mother and even my mother-in-law proud. I also peddled my influence upon one other site, Suggestadoctor, where my electioneering was particularly productive. The next day, I received an e-certificate in a gold frame announcing that patient Kent S. had rated me so favorably—he was particularly impressed by my "superhuman ability"—that I was now a "Suggested Doctor" though I didn't make it into the site's elite "Most Recommended Doctors" circle.”

Despite all the hype about consumer-directed care and the ability of financially motivated patients to make good health-care buying decisions, it’s long been known that most consumers don’t pay attention to the increasing amount of web-based information about doctors and hospitals. A new study by the Center for Studying Health System Change (CSHSC) shows that none of the “transparency” efforts by health plans, the government, and assorted vendors have moved the needle in the past several years. Most people still rely on word of mouth and health-plan directories when choosing a primary-care physician, and they tend to depend on their primary-care doctors to select a specialist or a hospital.

But even if they were interested in going online—and they weren’t among the 90 million Americans with low health literacy—they’d find very little on the web to illuminate them. In an amusing Slate article, Dr. Kent Sepkowitz relates his arduous journey through a batch of sites that provide information on and patient ratings of doctors. “Here’s what I found: zilch,” he writes. “The online doctor rating system has a shocking lack of useful information.” It’s also easily manipulated, he discovered when he posed as a patient and posted enthusiastic comments about his own medical skills and affability.

http://industry.bnet.com/healthcare/1000253/consumer-directed-cares-achilles-heel/

Integrated Healthcare Holdings, Inc. has a new CEO

This has been a bit a story here over the last few years, Mr. Mogel is leaving to pursue other business interests and might have some pending legal issues to tend to as well (related reading).  BD 

SANTA ANA, Calif., Dec. 4 /PRNewswire-FirstCall/ -- Kenneth K. Westbrook, a leading executive in Southern California's health care industry, has been named President and Chief Executive Officer of Integrated Healthcare Holdings, Inc., effective image immediately. IHHI owns and operates four acute care hospitals in Orange County, California: Western Medical Center -- Santa Ana, Western Medical Center -- Anaheim, Chapman Medical Center and Coastal Communities Hospital. Though a newcomer to IHHI, Mr. Westbrook brings an insider's sensibility to his new post. Previously he ran 16 acute care hospitals in Southern California as senior vice president for Tenet Healthcare. When IHHI acquired four of those hospitals in northern Orange County several years ago, Mr. Westbrook helped managed the ownership change from Tenet to IHHI.

Mr. Westbrook succeeds Bruce Mogel, who is leaving the company after several years as CEO to pursue other business opportunities. Mr. Mogel will remain with the company as a consultant for several months to ensure a smooth transition for the new CEO.

Integrated Healthcare Holdings, Inc. Announces New Chief Executi... ( SANTA ANA Calif. Dec. 4 /- Kenneth K....)

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Blue Tooth Chip in a Pill – Network connection required before swallowing

image All you have to do is pair it and add it to your network!  Not too long ago we had the IPill, so here comes Raisin, still in clinical trials at present.  The information is time stamped and sent to the internet where it can be viewed by a physician, this is almost like outer space but as I always say, look around this blog long enough and you will find a lot of medical devices and the likes that might shock you that they do exist.   I never thought about Bluetooth being consumable before.  It will send back your heartbeat and even whether you are sitting down or standing! 

This product though is around 2 years from being on the market, even if the FDA approves next year, which is what they are hoping for.  Is is a device or a drug or both?  This product could open up a whole new category at the FDA, a product that is both a drug and a device.  The targets are chronic disease treatment and once you’re on this pill, there will be no fudging as far as when and what time you took your pill as others will be watching.  The pill talks to the patch, and the patch talks to a Bluetooth cell phone or computer to finish the reporting process.  No mention on how much the cost will be for the big brother Bluetooth pills yet.  Must be attractive to investors as they have raised over 90 million already.  BD  

Over the next few years popping a pill could be more than just taking a drug and hoping it works. A biomedical company has imagecreated a system to embed tiny computers and sensors into drugs and link them to a cellphone or the internet in a bid to make the monitoring of drug efficacy foolproof.

When swallowed the chips send a signal to the patch. The patch has accelerometers and amplifiers to track heart rate, respiratory rate, temperature and body angle to determine if the patient is lying down or standing up.

 That information is transmitted via Bluetooth to an online repository and can show how the body is responding to the drug, says Savage.

The networked pill product, branded Raisin, is still in clinical trials, but it shows how technology and medicine are being melded in ways that are likely to change how we take drugs. More broadly, they could be part of a suite of technologies that enable personalized medicine, the long-promoted ideal of tailoring drug treatments to an individual's physiological and genetic profile. imageProteus executives have compared their system to the electronics that help mechanics diagnose problems in cars.

Proteus’s Raisin™ System offers the potential to transform the way heart failure and other chronic diseases are managed. The initial application of the Raisin System is for the treatment of patients with heart failure. The system senses and records the precise time a patient takes one or more microchip-enabled drugs, providing physiologic feedback and decision-support to the patient, caregivers and clinicians, thus facilitating a cost-effective pathway to improved patient outcomes through personalized medicine.

Edible Electronics Monitor Drugs in Your Body | Wired Science from Wired.com

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Is It Time to Cut the Cord with Wireless and Tablet PCs in the hospital and office?

  Have you ever sat in an office with a physician typing in to a notebook?  Well it just loses something in the translation when a tablet pc is much more like the old paper chart if you will.  This is a good post about how many facilities are seeing the value of a Tablet PC.  Do I use one, of course and have a full section devoted to the one I use here. 

One thing I am really heavily relying on a lot is the speech recognition of late, since the Sahara Tablet has dual array microphones, so no headset required here!  Yes, I still use inking as well, and try to use all different ways of interacting with a Tablet PC these days, and anyone who sits in meetings can certainly benefit if they only use it for notes. Check out the section on all the posts on tablet pcs here.  The one I use can be seen on CSI-NY quite often. 

Myself, I am very comfortable with a slate tablet pc as I really got tired of “flipping a lid” on the convertibles, plus it’s lighter and performs very well.   The Sahara also has touch screen capabilities too so I don’t always need the stylus out, depending on what I want to do. 

I don’t know sometimes I still see folks knocking themselves out with battling carrying a notebook around when there are easier and better ways to get a handle on some of this.  A tablet is a great way to work a convention too.  Been there and done that with Microsoft One Note, so much better than my poor human memory.  You can always get a small folding usb or blue tooth keyboard if you need one and the Sahara goes in a big purse easily too so no having to carry that big ugly notebook bag that everyone seems to have.  Those are ugly anyway.  

I have even given presentations for seniors who were curios about the tablets and wanted to learn how to use speech recognition too.  Here’s a few past posts and more information is located under the related reading section.  BD  

Use and abuse your Tablet PC for Note Taking

Easy to Swallow - The Tablet PC

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abletFactory Handwriting Recognition EMR Electronic Medical Record Tablet

Great tool for e-prescribing too I might add and of course One Note is the ultimate MS Office Tool.  BD 

 

Some physician group practices that are reinventing their workflows as they adopt electronic health records are concluding that wireless networks fit in well with their new approaches. At Springfield (Ill.) Clinic, for example, doctors concluded that tablet computers were the most convenient option. "Physicians now don't see a patient unless they have their tablet; it's just like their stethoscope," says James Hewitt, CIO at the 195-physician practice.

Because physicians implementing EHRs will want easy access to clinical data from any location, wireless networks will be commonplace at clinics within five years, predicts Rosemarie Nelson, principal at MGMA Healthcare Consulting Group, Syracuse, N.Y. "A very large percentage of doctors' offices know that this is going to be in their future," adds Margret Amatayakul, president of MargretA Consulting in Schaumburg. Ill. "It's now more a matter of when they can afford it and how easy it will be for them to make the change."

Is It Time to Cut the Cord?

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Man-powered laptop charger prototype complete

Some things do get re-invented, this reminds me of the first sewing machine I used, with the old pumping foot pedals, and now we might just have one of these for our computers, and a little exercise while we are at it for out feet maybe?  BD  image

Charging your laptop could start to feel a lot more like work in the near future, if the folks at Easy Energy have it their way. They've just completed a protoype for the Yogen Max laptop charger, and though details are particularly spartan about the actual workings of the device, as you can see from the mock-up, it's going to involve a human foot pumping juice directly into your laptop.

Easy Energy Yogen Max foldable, man-powered laptop charger prototype complete - Engadget

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