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The Prescription Kiosk (ATM) Machine – A Visit with a Tele-Pharmacist

The machines have already been in use in Toronto, Canada for a few months, the green machines.  One comment I can’t let pass is if you are a physician and haven’t started e-prescribing yet, these machines only take e-prescribing, just something to think about as their existence  might push that envelope. 

The patient has a teleconference at the machine with a pharmacist.  Depending on what’s loaded in the machine, some might need an armed guard to watch over it, much like the pot vending machine in Los Angeles that has an armed guard watching over it.  There are 340 medications stored inside and the machine does the filling of the script and the tele-pharmacist verifies the machine's calculations before giving the ok.  So far the machine has not made any mistakes. 

It is an opportunity for hospitals to earn some money from having the kiosks in their facility.  With 340 drugs, it’s not going to be able to do all the imageprescriptive needs, but perhaps could handle many commonly prescribed generic medications.  As mentioned below, the page states they are in talks with negotiating with the US and the UK, so who knows where we go from there, encounters with a green drug kiosk may be in our future, talk about going green.  BD   

From the website:

“PharmaTrust is focused on improving communication between patients, physicians and pharmacists to enhance patient Care, Convenience and Choice. It can be deployed in hospitals, medical clinics, pharmacies and similar health care facilities.

PharmaTrust automation frees pharmacists from some routine tasks enabling them to maximize their time with patients, and supports physicians with medication data and health record information as they prescribe.”

Hundreds of Toronto patients have been picking up their prescription drugs in recent months much as they withdraw cash or buy a can of cola -- from special vending machines that some observers believe could transform the pharmacy business.

Customers insert their prescription into a slot in the device and a few minutes later, it spits out their medication.

Proponents say the Canadian-made drug kiosks, which feature a video link to a real pharmacist, offer convenience when there is no pharmacy open or close by. Skeptics, though, warn the machines will never duplicate the benefits of meeting in person with a druggist.

When customers insert their prescription, the ATM-like machine -- made by PCA Services Inc., -- snaps high-resolution photographs of both sides and transmits them to a pharmacist waiting in the firm's Oakville, Ont., call centre.

Meanwhile, PCA is on the verge of striking deals with major clients in the U.S. and U.K. In those cases, the company plans to partner with another organization, which would run the call centre, much as RIM works with cell-phone networks to provide BlackBerry service, Mr. Suma said.

Toronto vending machines dispense prescription drugs

NHS Calls the Fire Department to move Obese patients - UK

The fire fighters are not happy as they say it is an abuse of the services they do, and should be taking care of fires and other life and death situations, and not having to be at the call of the NHS for the multitude of calls. 

Fire crews in England have received at least 1,780 calls to help move obese patients in the last five years, 75% of them from the NHS, figures show.

"Obesity is a serious issue requiring serious analysis and policy. The big challenge is tackling the root causes and consequences of obesity such as heart disease and diabetes. Politicians, the NHS and industry need to work together to address it."

BBC NEWS | Health | Fire crews moving obese patients

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Kidney Removed via the Patient’s Belly Button - Spain

More news about minimally invasive surgery in the news.  It’s amazing how fast surgery procedures are moving with reference to new procedures made possible by new technologies.  By using the embryonic orifice as a point of entry, there is less scaring and a shorter recovery time and there are not as many nerves in this area as there are in other areas of the body, so that might suggest a little relief in the pain area with recovery.  The procedures is ok for both men and women and requires a surgical team specially trained on the surgical instruments used.  BD  image

The team of Dr. Antoni Alcaraz of Hospital Clínic de Barcelona has removed a kidney from a woman diagnosed with kidney cancer, through a single opening. This is the first operation of this type carried out in Spain and one of very few performed throughout the world. Recovery time is reduced by half and the surgical results are far better than those of conventional laparoscopy. The operation was carried out with material specially designed to be able to work from the navel, access that requires control and precision.

The single-port transumbilical nephrectomy (the technical name for this operation) was carried out using a single trocar made by the company Olympus. This laparoscopic instrument requires considerable control and precision to be used correctly, as the surgeon has to use 3 instruments through a single point in order to manipulate the organ remotely and extract it once it has been entrapped inside the body. Accessing the kidney via this route means no visible marks are left as the minimal incision made by the surgeons is hidden by the natural folds of the umbilical scar. Nevertheless, as with laparoscopic surgery or the NOTES approach, the transumbilical route is not completely risk-free and must always be performed by an experienced team of surgeons who are permanently trained in the use of the instruments.

Single, Safe Surgical Access Route For Kidney Extraction - The Navel

Doctor pleads guilty to hiding $3M from IRS and stole 6M from Charity Funds - Chicago

It’s no wonder how the former governor a few years ago was viewed as one of the most powerful people in healthcare!  6 million dollars taken from a charity for political fund raising and I might guess the IRS added up what was spent versus income.  BD 

CHICAGO (AP) — The business partner of a key witness in the federal investigation of corruption under former Illinois Gov.

has pleaded guilty to hiding $3 million in income from tax collectors.

Dr. Robert Weinstein of Northbrook, Ill., admitted Tuesday in a signed plea agreement that he and political fundraiser Stuart Levine siphoned $6 million out of a charity and that he didn't report the money to the Internal Revenue Service.

Levine was the government's star witness at the trial of political fixer Tony Rezko, and he's already admitted his part in the scheme.

The Associated Press: Doctor pleads guilty to hiding $3M from IRS

National Library of Health Sciences in Helsinki Follows the Medical Quack

Sometimes you don’t realize how far the web actually stretches at times.  I found the Medical Quack among the listings at the National Library of Health Sciences Feed listings in Finland.  I’m not sure how I got here, but it is appreciated and I am in good company with Medgadget who is also on the feed site.   Many thanks to all the readers in Helsinki!  BD 

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http://www.terkko.helsinki.fi/feednavigator/?c2=Latest

Microsoft Buy Dell – PC Pro Thinks so and Offers Discussion

I have no clue as to whether or not this is true, but the writer discusses why he believes this will happen.  You can read for yourself and form your imageown opinion here, and the media will let us all know if and when something monumental as such occurs.  From the retail store portion of the business plan it would make sense to compete heads up with Apple and have branded hardware available for purchase when the stores open.  It would also allow for “ready to go” packages with hardware and software loaded and ready to carry out the door or order on the web.

We all know hardware in the computer business has not been doing very well, so there could be something to all of this.   There are also many other hardware manufacturers out there as well that run Windows too, so if and how all this would take place would be interesting to say the least.  Microsoft has been in the hardware business a little with mice, keyboards, cameras, in other words accessories but not the full computer.  BD 

The news that Microsoft is to buy Dell, which should become official at the beginning of April, comes as no big surprise. Dell hasn't been doing that well recently, and the global economic downturn is certainly contributing to its woes. image

Few companies are prepared to splash out on new hardware when money is tight, especially without a clear indication that it really will run the latest version of Windows in a satisfactory way. Until now, this has been an ongoing guessing game with each new release - will the months of hardware R&D pay off and bring true synergy to the platform paradigm? Even the best have been getting it wrong - remember the outrage at HP when it discovered that the graphics hardware requirements had changed a few months before the release of Vista? You might think Vista simply sucked, but deeper analysis shows this is an over-simplistic analysis of the situation. It was a lack of synergy that made all the difference.

PC Pro: Blogs & Analysis: Columns: Epilog:

Grants.Gov website is getting overloaded with traffic – Move to the “Cloud”?

The next question, who’s cloud?  With the new grants and money available perhaps the rush of applicants and users of the site was not anticipated to the level it has reached and the economy of course adds fuel to the fire here.  image

So does the answer lie in Software as a Service?  The group was given until March 13th to come up with a plan, well let’s see, that’s tomorrow.  One more area of the government in need of a technology overhaul and there will be more coming as old dynasty software and servers start to lag and choke.  BD 

Wall Street and Healthcare – Was it the Mob or have the rest of us been operating like a PC with no anti-virus protection?

The federal government's new "pro cloud" attitude is about to get its first test. Office of Management and Budget director Peter Orszag is warning that a government portal used for competitive grants is at "significant risk of failure" due to system overload. Can cloud computing save the day?

The OMB has identified the Grants.gov site, where citizens can go to apply for more than a thousand grant programs, as being particularly vulnerable to a spike in traffic as people rush to file applications tied to the recently signed Recovery Act. According to a memo issued March 9 by Orszag, Grants.gov has experienced traffic over the past few months that "far exceeded" its anticipated workload, resulting in performance degradation. What's more, Grants.gov could be in for a 60% increase in application traffic in the months ahead.

At-Risk Government IT Systems Require Immediate Action - Plug Into The Cloud – InformationWeek

Microsoft Security Strategist Named Cybersecurity Leader – Finally shopping at the “Smart Store”

This is good news with getting some of the experts on board with the Department of Homeland Security and also important:

"Phil Reitinger is a recognized expert on computer security and understands the importance of working with the private sector," TechAmerica president Phil Bond said in a statement.”

Open Source is not a cure all, just as the private sector is not a cure all either, a combination of both usually wins, so when it comes to privacy and security we have someone who has been on both sides here, DOD and Microsoft, finally getting to the “hands on” folks and perhaps a few less magpies.  BD 

Reitinger has "Phil Reitinger is a recognized expert on computer security and understands the importance of working with the private sector," TechAmerica president Phil Bond said in a statement. been responsible for improving and protecting the security of information and infrastructure at Microsoft (NSDQ: MSFT), where he has served as chief trustworthy infrastructure strategist. In that role, he worked closely with government agencies and other private companies on cybersecurity programs. He is a member of the Federal Emergency Management Agency's National Advisory Committee and considered an expert on computer crime and policy.

He has also served as the Department of Defense's executive director of the cybercrime center and he was deputy chief of the Department of Justice's computer crime and intellectual property division. Reitinger has a law degree from Yale Law School and a bachelor's in electrical engineering and computer science from Vanderbilt University.

Microsoft Security Strategist Named Cybersecurity Leader -- Cybersecurity -- InformationWeek

FBI Raids Former Office Of Obama's Pick For CTO, Kundra

The articles state that Kundra is not the target, co-workers and the D.C. Chief Security Officer was arrested, with potential bribery being the point of the FBI raid.  One more chapter in the nomination game, but I’m sure he paid his taxes, what next, and there will be more as transparency begins to unfold all around us.  BD 

The FBI has raided the former offices of Washington, D.C.'s chief technology officer Vivek Kundra.

The U.S. Attorney's Office confirmed that the FBI was searching the offices where Kundra and nearly 300 other employees worked. Two individuals were arrested in connection with a bribery probe investigation, District of Columbia Mayor's Office spokeswoman Mafara Hobson told InformationWeek.

FBI Investigates Former Office Of Obama's Pick For CIO -- Federal ID – InformationWeek

Even though the Washington, D.C. mayor's office and federal authorities say federal CIO Vivek Kundra isn't a target of an FBI raid of Kundra's former offices at the D.C. IT department this morning, this is one distraction I'd bet he didn’t want to have to deal with.

In this case, a spokesman at the offices of D.C. mayor Adrian Fenty confirms that the FBI raided the Washington, D.C., Office of the Chief Technology Officer -- Kundra's last job -- and arrested D.C.'s chief security officer, Yusuf Acar. Reports say it was a bribery sting. Though sources say Kundra is not a target of the ongoing investigation that ensnared Acar, Acar is likely a direct report of Kundra, and commenters on other sites are already saying Kundra should have known what was going on in his offices or is somehow responsible by association.

FBI Raid Of D.C. IT Offices Is A Federal Headache - Government IT Blog – InformationWeek

Medical Humor With A Purpose: Placebo Television #16 – Dr. Doug

Dr. Doug is once more speaking out, one of the best and be sure and take heed of the warning, this is a disruptive video from the disruptive doctor, funny!  The website has an entire history of all the Placebo Television videos.  BD  

  • A look at the study between masturbation and the risk of prostate cancer
  • Anyone want a peanut butter and salmonella sandwich?
  • Godasil Vaccine

This video is not for those under age 16, those with weak stomachs or those without a sophomoric sense of humor. Lighten up people.

Placebo Journal Blog: Medical Humor With A Purpose: Placebo Television #16

FDA Approves Salmonella – (Spoof from the Onion)

This is funny and when you can’t get rid of it, do you approve it?   A bit of humor from the other side.  BD 

WASHINGTON—Calling it "perfectly safe for the most part," and "not nearly as destructive or fatal as previously thought," the Food and Drug Administration approved the enterobacteria salmonella for human consumption this week.image

The federal agency, which has struggled in recent years to contain the food-borne pathogen, and repeatedly failed to prevent tainted products from reaching store shelves, announced Monday that salmonella was now completely okay for all Americans to enjoy.

"Rigorous testing has shown that salmonella is...fine," FDA director of food safety Stephen Sundlof said. "In fact, our research indicates that there's no need to pull any more foodstuffs from the market. Not raw chicken. Not contaminated spinach. Not thousands of jars of harmful peanut butter. Not anything."

“It's approved," Sundlof continued."Healthy, delicious salmonella is finally approved."

FDA Approves Salmonella | The Onion - America's Finest News Source

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Sam’s Club and the eClinicalWorks EMR Bundle – Additional Information from eClinicalWorks

I ran across this interview from HIS Talk, an interview on the run with Girish Kumar discussing the Wal-Mart/Sam’s Club program.  Also,as posted earlier eClinicalWorks connects with Microsoft HealthVault, but check with the version of software installed with your physician’s office if needed, but it appears the new software as a service option looks like a go.  BD 

eClinicalWorks Interview below: 

UPDATE: notes from speaking with Girish Kumar Wednesday afternoon. Sorry that they are terse and a little raw, but I had 15 minutes between meetings at work and Girish was in the car on the way to the airport.

If a physician buys from Sam’s, will it be the same product, implementation services, and support that eCW offers directly?

Absolutely. We’re trying to make it simple. Everybody says EMRs are hard and implementing change is hard. We realize that. We’ve been doing SaaS since 2003 and have invested a ton on a data center. We wanted system that is ready out of the box, configured, with content, although it will still require on-site implementation and services. It’s the same in terms of product, services, training, but faster and easier to deploy.

Why would a customer buy from Sam’s? Do they save any money? Can they choose a no-services option?

Wal-Mart used its Sam’s Club division because it has a lot of small business customers as corporate members. They buy ongoing stuff every month, not just simple things like gloves and bandages, but have a corporate account and buy copiers, payroll software, etc. They don’t have to go into Sam’s. You call a corporate number, get an assigned representative, talk to them about what you need, and the item is shipped. eCW salespeople will still show the product and talk to the customer. There are packages we want to give them that are pre-configured. The customer will not pick blindly - they will still consult with an eCW person.

Will Wal-Mart do its own advertising and marketing?

There will definitely be a significant campaign. They have 200,000 healthcare professionals today as members, mostly as doctors.

Any projections on volumes?

I have to keep that confidential, but there was a lot of planning on the eCW side. Investments have increased, made the company even more ready. This can have a significant impact on how physicians look at, evaluate, and purchase EMRs. We would like to see taking it away from being a niche sales process, where sometimes we confuse the customer, to make it a very streamlined process so that a customer can make an educated decision. They know how many days to go live, how many days training, cost, etc. eCW does 30 Webinars every week that every customer has access to with a live attendant and all Sam’s members will be able to avail themselves of that.

We believe we are the largest SaaS EMR in the country with 4,000 physicians. If we include hospital customers hosting affiliated physicians and RHIOs, that’s another 4,000. That’s 8,000 today of our 25,000 physicians. We’re trying to leverage that scale to make it easier and cheaper to deploy.

Do you anticipate any product changes?

For primary care, we spent two years working with New York City. We put into the product all the content needed to run a primary care practice - templates, order sets, clinical decision support. That is years of content that we jointly developed. That is all pre-packaged with the product - it’s not just the software any more. On the specialty care, we have about 50 specialty databases. All of that will be available pre-configured when they sign up. When the trainer shows up, all the content will be there and if we want to change it, we can change it together. We will go live with a comprehensive data repository with clinical decision support at no extra cost for the content.

A primary care doctor can go live with the system as it is, with rich content.

What does this to do the competitive landscape?

We’ve always taken tremendous pride on our leadership on price and functionality. 97% of eCW customers surveyed said their total costs met their expectations when they bought and implemented eCW. 93% of physicians said the EMR met or exceeded expectations. I still have to worry about the 7% and I lose sleep about it more than I take advantage of the 93%, but if a package with those numbers is readily available, people will ask the question: if I’m able to get a comprehensive product that people are happy with at this price point with content and support, why should I spend more? Price visibility will be black and white. No longer will you see those quotes saying an EMR will cost $300,000. You will see more informed questions, pricing pressure, and frankly, higher expectations if content is provided. I don’t want to take six months to implement PM and another six months for an EMR. This is a unified product we’re offering, by the way, both EMR and PM. We’re offering five days of implementation on site with the Sam’s Club package and they can buy more for $750 a day plus travel, but our track record is that we can do it in five days.

What are the benefits to eClinicalWorks?

There are many benefits. We want to be a company with 100,000 physicians using our product and 100 million patients whose lives are positively affected by it. There’s a lot more work to be done, but this platform gives us more opportunity.

Sam’s Club to Sell eClinicalWorks EMR Bundle

Related Reading:

HealthVault Connects with eClinicalWorks EHR, NextGen EHR/EMR Systems and more…Shop Wal-Mart (Sam’s Club) in the Spring

eClinicalWorks Electronic Medical Records Scores with 2 new large installations

Obama's Healthcare Economic Plan – Leaders with “Hands On” Technology Experience and Algorithms Needed

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

Tufts Medical Center In Boston to Subsidize EHRs

Hoag Hospital Selects eClinicalWorks for Its EHR Subsidy Program- Newport Beach, CA

Agencies have problems collecting Recovery.gov data – Reporting on Stimulus Money Spent

Many government agencies need some IT upgrades to report back where the money is spent and grants released, HHS might be able to help here since it is already a shared provider of information.  This somewhat speaks out again for the need for standards as some of the back end data bases will need upgrades, revisions, etc. to be able to communicate.  We all want to know where the money goes, so upgrades it appears are on the way for some old and even perhaps new systems so our government reporting can work and generate the desired information on where the money from the stimulus bill goes.  BD 

Agencies must implement new computer systems or modify existing ones to collect and transmit the data required to show where and how they have spent the money authorized by the economic stimulus law, federal information technology officials have said.

Agencies must post information that accounts for how they have used the funds on federal programs or distributed as grants to states and local governments on the White House’s Recovery.gov Web site. Agencies have also established their own Recovery.gov sites.

To collect the financial, performance and control data that is required for posting on Recovery.gov, agencies must re-engineer their back-end systems, said Michael Carleton, CIO at the Health and Human Services Department.

“At present, we’re not organized that way because we didn’t have such a system,” he said.

However, HHS may be able to assist some other agencies with gathering data related to grants that agencies distribute to states. HHS is a shared services provider for a number of agencies for OMB's Grants Management Line of Business consolidation effort.

Agencies have problems collecting Recovery.gov data -- Federal Computer Week

Kroger uses technology to help identify and inform consumers of recalled products

This is a great example of using technology with tainted products, first of all, the recalled products wouldn’t scan at check out, and if you were identified by use of your Kroger card, you would get a message on your receipt that you had purchased a product that had in fact been recalled and an automated phone call from the computerized system.

I have always wondered how much information retailers have on my purchasing habits, well from what I have read here, it appears to be quite a bit and hopefully with interconnecting data bases, this information will be kept in house and not shared with those I would not want to know about my weekly purchases of candy, potato chips, etc. (grin), otherwise somewhere along the line somebody in risk management is going to have the capability to scrutinize this too, something to think about when we talk about privacy, as companies are already looking at prescription lists to qualify or enable information of this sort with claims and qualifications for health insurance.  How far could this go?  On the other side of the coin though, this is a good warning for consumers on the recalled products.  BD 

Supermarkets across the country cleared the shelves of more than 2,600 items recalled after salmonella contamination was found in some products made by the Peanut Corp. of America.

The chain then made sure that mis-shelved products picked up elsewhere in the store couldn't be scanned by cashiers or at self-checkout counters.

"At an Irving store, I witnessed a customer in line ahead of me trying to buy protein bars," King said. "But the screen said: 'Item under recall. Do not sell.'"

Then someone in Kroger's consumer-safety department came up with the idea of using the chain's technology in two more ways: Shoppers holding the Kroger Plus card who had previously purchased any of the recalled items would receive a personalized message on their cash register receipt tape telling them to dispose of those products. The warning is repeated on their next visit.

The customer also receives an interactive voice response call from an automatic dialing system, informing them to dispose of items they purchased because of the salmonella list, King said.

Kroger uses technology to stop flow of recalled items

Related Reading:

Prescriptions risk score used to deny health insurance

FDA Peanut Recall Widget Added to the Medical Quack

Obama’s Proposed Budget Includes Billions to Bolster FDA — About Time

Peanut Corp. of America files for bankruptcy – Chapter 7

Obama Wants a complete review of the FDA – Add some Technology with Business Intelligence
Government Accuses Georgia Plant of Knowingly Shipping Bad Peanut Butter – How about some FDA electronic audit trails on consumables?

Female Condom gets FDA Approval

The company has produced a new and less expensive version, which was the problem initially with the product costing too much.  BD

The Food and Drug Administration has approved a new version of the female condom, allowing it to be sold in the U.S. and distributed imagemore widely across the world.

The agency’s decision was expected after an FDA advisory panel endorsed the product late last year. The condom is manufactured by the Female Health Company, based in Chicago.

The new version, made of synthetic rubber instead of polyurethane, is cheaper than the original female condom -- a long lubricated sheath anchored at either end by a flexible ring. When inserted, the closed end of the sheath is positioned high in the vaginal canal. 

Though the material is different in the updated version, the design is not.  Both products are equally effective.

FDA approves new female condom | Triage

CVS Closes 90 MinuteClinics For The Season…

Even the Minute Clinics are not escaping the effects of today’s economy.   The article does mention they are continuing to open clinics in the Massachusetts area, which might lend some truth to the fact that we hear how difficult or how it is a long wait to find a primary care physician in that state.  The doors are not closing, just shorter hours and some facilities closed until a next season, well we have 4 options there and the economy will be an indicator as to which season they re-open I would guess.  Last time when I stopped by the one close to me, a good bit of the business was administering flu shots.  BD 

CVS Caremark Corp. (CVS) has placed about 16% of its retail MinuteClinic locations on a seasonal schedule, closing their doors for the time being, while keeping other drugstore clinics open in those markets, a company spokeswoman said Monday.

MinuteClinic, the largest operator of retail clinics in the U.S., is making the move "to align with consumer demand," said CVS Caremark spokeswoman Carolyn Castel. The company now has about 460 clinics in operation, excluding those now closed for the season, she said.

The move has implications for the retail clinic industry, which enters a slow season in the spring, and may be a sign of increased pressure wrought by the economic recession.

CVS Shuts 90 MinuteClinics For The Season, Citing Demand

Related Reading:

CVS Drug Stores – CEO Talks about Recession Plans

CVS to Offer Records Via HealthVault
Cleveland Clinic and Selected Minute Clinics to Share Medical Records
CVS/Caremark join the Generic Discount Club – Connect information to Personal Health Record Accounts
Minute Clinic Visit - Huntington Beach, CA

Microsoft Word Ontology Add in for Word 2007 – Free and Open Source Download for Scientific Research

You need to have a current version of Office 2007 or Word 2007 to use the add in, prior versions do not work.  If you are doing quite a bit of scientific research, this might be worth looking at to link to vocabularies and areas of study.  If you are not involved in scientific research, skip this post and move on the the next one.  BD

REDMOND, Wash., and SAN JOSE, Calif. — March 11, 2009 — The nuggets of information necessary for simagecience to progress are often hard to find, submerged deep within the Web, or within databases that can’t be easily accessed or integrated. As a result, many scientists today work in relative isolation, follow blind alleys and unnecessarily duplicate existing research.

Addressing this critical challenge for researchers, Microsoft Corp. and Creative Commons announced today, before an industry panel at the O’Reilly Emerging Technology Conference (ETech 2009, http://en.oreilly.com/et2009), the release of the Ontology Add-in for Microsoft Office Word 2007 that will enable authors to easily add scientific hyperlinks as semantic annotations, drawn from ontologies, to their documents and research papers. Ontologies are shared vocabularies created and maintained by different academic domains to model their fields of study.

This Add-in will make it easier for scientists to link their documents to the Web in a meaningful way. Deployed on a wide scale, ontology-enabled scientific publishing will provide a Web boost to scientific discovery.

Science Commons, a division of Creative Commons, is incubating the adoption of semantic scientific publishing through creation of a robust database of ontologies (http://neurocommons.org) and development of supporting technical standards and code. Microsoft Research has built a technology bridge to enable the link between Microsoft Office Word 2007 and these ontologies.

“The Web is broken for scientific researchers — full of hyperlinks of scholarly articles, but it is nearly impossible for us to find what we need,” said John Wilbanks, vice president for Science at Creative Commons. “The semantic Web tool will help bridge the gap between basic research and meaningful discovery, unlocking the value of research so more people can benefit from the work scientists are doing.”

Microsoft Releases Open Tools to Enhance Scientific Research Efforts Building on Science Commons Ontologies: Breakthrough collaboration helps researchers make easier connections on the Web.

Robots at Work in Orange County Hospitals - California

This robot is not new to the blog here as I have done several posts about how it works, and Fountain Valley Regional hospital a Tenet facility, where I have a few surgeries done in the past, now has one to make rounds.  The robot is leased at $6500.00 a month.  Also by adding the robot, the hospital was able to to apply for certification as a specialized stroke center by the Joint Commission, approval is still pending.  The robot comes complete with a stethoscope and can print out orders on paper that runs like a cash register tape.image

This is paid for by the hospital as insurance companies only cover a robot when in service in a rural area.  Wonder if we might see this change some day too as it used to be shortages were found mostly in rural areas for finding a doctor, but now it’s all over.  Below is a video from UCLA that shows the robot in action and explains a bit more about how it functions and the other end, the control center where the doctor is located.  These guys need to be plugged in and charged up too, just like any other computer. 

The second video below highlights what Children’s Hospital of Orange County is doing in the pharmacy to cut down on medical errors.  The video is a couple years old so I am guessing there are updates and new services that may be available with the RIVA pharmacy robot as well. 

Also, below is a link on a post I did a while back about a futuristic day of visiting the doctor and some of the activity is a bit stretched, but everything you see in the post is technology that is either in use or available today, something to think about and there might be a few surprises with technology that you have not thought about, but is here today.  There are individual links to each post about each device or service included, so check out the links for more information.  BD 

The Future – A Day of Going to the Doctor

At Fountain Valley Regional Hospital

When 75-year-old stroke patient Joan Moullet arrived at Fountain Valley Regional Hospital, a neurologist didn't respond immediately to a page. So emergency room staff unplugged their backup from the wall.

A 5-foot-tall robot rolled to Moullet's bedside to connect her for a virtual face-to-face exam with a specialist in Los Angeles. Over his laptop, the doctor discussed her symptoms, reviewed her CAT scan and looked at her weakened hand through the robot's camera lens. Moullet could see the doctor's face on a screen that looks like the robot's head.

Fountain Valley's robot allows a doctor to do everything but shake a new patient's hand.

At Orange County Children’s Hospital – Robotic Pharmacy

At CHOC in Orange, pharmacists are dispensing intravenous medications with the $1 million precision of RIVA. The new robot works quickly in a sterile glass enclosure with some human help.

Rita Jew, executive director of the pharmacy, said the system reduces medication waste and errors and will free up pharmacists to work more closely with doctors and nurses on the patient floors.

Robots back up doctors at O.C. hospitals | robot, hospital, moullet, patient, doses - Life - OCRegister.com

Related Reading:

All Terrain Medical robot in development for the battlefield

Robodoc' coming to a hospital near you

Remote-Presence Robot Attends Patients at Ryder Trauma Center
Doctor monitoring via robot effective
Johns Hopkins demonstrates Robo Doc...

Remote-Presence Robot Attends Patients at Ryder Trauma Center

How technology is helping hospitals - UK

Doctor monitoring via robot effective

Johns Hopkins demonstrates Robo Doc...

Despicable Healthcare – Hope it doesn’t come to this…

A dramatization, or let’s say I hope so. 

With all the push on the dollar instead of better healthcare you can’t help but wonder where it is all going to end up, and again, hopefully not in the hands of risk management for all decision making processes as it already shows it is not making us any healthier.  BD 

Johnson and Johnson and the Schering Plough Deal with Merck – Could Things change here?

It’s all about who gets the money from Remicade, from Schering as J and J worked together with them on the development.  How complicated it gets with a new “Merck” legally created, in other words Schering gets to be the leader, then renamed, sounds complicated.   Read the article for the rest of the details.  This could complicate things all the way around or change, which ever way you want to look at it, especially when it gets in to the employment areas too. 

But as this article states, J and J could come in with an offer of their own, especially if there was any indication of any potential revenue loss anywhere along the line with contract loopholes that could appear out of the blue, as everyone figures out which legal legs they have to stand on.   BD 

In Merck’s conference call Monday morning announcing the $41 billion deal, several analysts questioned whether Merck would be able to pick up two drugs that Schering and J&J developed and marketed together over the years to treat rheumatoid arthritis. image

The questions arose because of the terms of a long-standing distribution agreement between Schering and J&J. The agreement specifies that if Schering-Plough were acquired, J&J would have the right to cancel the agreement and take full control of the drugs — and the billions of dollars they generate.

Side Deal with J&J Clouds Schering Sale - DealBook Blog - NYTimes.com

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Here Come the Bio Similar Drugs – Bill in Congress to allow Follow Me Provisions for the FDA

If you thought competition was tough with generic drugs, there’s a new kid on the street, biosimilar drugs.  The link below goes to a page on the Genentech website that explains the process in full detail.

“The terms "Biosimilar" or "Follow-on Biologic" refer to products that are marketed after expiration of patents, which are claimed to have similar properties to existing biologic products. Due to the complexity of biologics, a product can only be made that is similar, but not identical.”

Merck and Teva are 2 companies with a vested and growing interest in the follow on market.  Related reading has more below.  BD

Reps. Henry A. Waxman, Frank Pallone, Nathan Deal, and Jo Ann Emerson introduced H.R. 1427, the “Promoting Innovation and Access to Life-Saving Medicine Act,” a bipartisan bill to allow the Food and Drug Administration to approve affordable copies of biotech drugs. Biotech drugs, while often life-saving, are the fastest growing and most expensive components of the nation’s prescription drug bill. Many of them cost tens of thousands of dollars a year — prices that put them out of reach of patients and impose an unsustainable burden on employers, insurers, and the federal government. 

FDA currently lacks clear authority to approve generic versions of these products, allowing companies to charge monopoly prices even after all patents have expired. Introducing fair competition for biotech drugs is essential to keep these life-saving treatments affordable. Today’s bill gives FDA authority to ensure that any approved copy of a biotech drug is just as safe and effective as the original product, and provides the makers of new biotech drugs ample incentives for continued innovation. The Promoting Innovation and Access to Life-Saving Medicine Act is consistent with the legislation described in the President’s proposed budget.

Generic and brand name companies alike are now planting their seeds in the emerging follow-on biologic market and Congress should make every effort to support these efforts with the best interest of patients in mind. This sensible, consumer-focused legislation represents a dramatic first step in passing legislation to establish an approval and regulatory pathway for biologic products and I am pleased to join Chairman Waxman and Chairman Pallone in co-sponsoring the Promoting Innovation and Access to Life-Saving Medicine Act.”

Committee on Energy and Commerce - Bipartisan Group of Members Introduces “Promoting Innovation and Access to Life-Saving Medicines Act”

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Pfizer Joins the Generic Club

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Some Doctors Don’t know which tests/procedures could be the best

This is not to say doctors are not in the know, they are, look a the journals they read, and more importantly than that, look at all the new developments, drug approvals, publications that come out on a daily basis, they too are in overload.  If you find something on the web, ask your doctor if you think it could be something to pursue with a treatment plan. 

This question, then brings up this question:  Should Doctors have to follow Treatment Rules?

“Advocates of linking pay to treatment guidelines, such as Snow, argue that too often doctors fail to keep up with the science and don’t end up doing what’s appropriate.”

Sure we are playing catch up in healthcare IT, but have any of the advocates that criticize lack of science knowledge, been a family practice doctor?  There’s no black and white to all of this, and science changes daily.  Now, based on the story today about the journal articles that were fake, well can they now trust all their journals?  This is a battle that’s never going to be won, sure we can get the doctors a little more tech savvy with electronic medical records, that’s a given and now that there’s money coming in to do so, but what do we do with the bean counters that want everything accountable and algorithms to explain everything?  That one we will never solve as long as we are all humans who fall prone to being sick. BD 

WASHINGTON - Think your doctor knows which drug — or surgery or even diagnostic test — works best? Think again.

Half the time, there's little if any good evidence comparing one to another. And one of medicine's little secrets is that brand-new drugs don't have to work any better than cheap old ones to be approved for sale.

Now the government has a $1.1 billion down payment to start unraveling that problem, money provided in the economic stimulus package to better determine which test or treatment works best, when and for whom so that patients don't waste time and money on poor choice.

Does arthroscopic surgery work any better than painkillers for knee arthritis? Of all the competing pills, which is best to start with in treating Type 2 diabetes or high blood pressure? Is there really any difference between Prevacid and Prilosec for heartburn, or between Fosamax and hormone treatments for bone-weakening osteoporosis?

The result: The nation has a scattershot method for determining best medicine. The little-known AHRQ spends about $30 million a year reviewing evidence of select tests and treatments. The National Institutes of Health occasionally compares contested therapies in expensive, years-long studies involving thousands of patients, like the stroke trial now under way.

Even docs often don’t know which test is best - Health care- msnbc.com

Want to Serve on Standards and Policy Panels for the HIT Standards Committee?

I hope the 2 new women with HHS have their business intelligence hats on, they will be needed.  We do need standards and the “smart” people at the helm, not politicians.  March 16th is the deadline to volunteer to be a committee member.  Dr. Halamka from Harvard, a current NeHC member has his thoughts at the link below.

Hopes and Expectations for the Next Year from a Healthcare CIO 

We do need an agency in place for standards, otherwise we become more fractured than we already are.  BD 

The Office of the National Coordinator for Health Information Technology is seeking nominations to the HIT Standards Committee and HIT Policy Committee, both created under the American Recovery and Reinvestment Act.

The HIT Policy Committee will advise the national coordinator on implementation of a national health information network. The HIT Standards Committee will advise the national coordinator on standards, implementation specifications and certification criteria to support the electronic exchange of health information.

The Act enables the Secretary of Health and Human Services to recognize the existing National eHealth Collaborative as either the policy or standards committee if the collaborative is modified to be consistent with the new law, according to the announcement of the accepting of nominations. "At this time, the Department of Health and Human Services is evaluating options regarding the National eHealth Collaborative and its role in relation to those committees."

Want to Serve on Standards, Policy Panels?

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Bringing Providers, Health Care Executives and Administrators into the 21st Century

Bill Gates' Dad Said Raise my Son’s Taxes

He also carries the same thought as many, spend on education, an area where we are running behind, and need to spend just a little of the time we spend entertaining ourselves on reading and learning perhaps.  We just don’t seem to read enough as a whole, and every where I turn these days on the web, this is the same thought being mentioned by all the “smart” people, please read.  Hopefully some of the PC manufacturers might get wind of this too and focus a bit more on educational software on new PCs instead of Gaming being the forefront and draw.  Games are fine too and a lot of fun, but some educational focus added in would be nice.  BD 

We already knew Bill Gates Sr, father of Microsoft (MSFT) founder Bill Gates Jr, was one heck of a toastmaster. But the old man also has some pretty strong opinions on tax policy too.

In an op-ed for the Seattle P-I the elder Gates co-authored, he says Washington State has "the most regressive tax regime in the country" and calls for a new state income tax targeting earners making over $200,000 a year.

Bill Gates' Dad: Raise Taxes On My Son!

Rosetta Genomics Publishes Data on Lung Cancer Test – Journal of Clinical Oncology

This is good news in finding cancer of the unknown with lung tumors.  Back in January I have the opportunity to interview Rosetta about the tests and here’s a brief portion of the interview, use the link to read the entire post with all the details.  The tests are 96% and thousand of patients now can have the answer as to where their cancer tumor originated, as even though a tumor is in the lung, it could have migrated from somewhere else and that would could the treatments plans to vary as well.  BD 

Rosetta Genomics Interview – microRNA for Diagnosing Lung Cancer Tumors

Rosetta Genomics – Today I had the opportunity to speak with and interview Ronen Tamir, Chief Commercialization Officer, at Rosetta to find out how imagemicroRNA is helping diagnose and treat cancer.  

If you have been keeping up with the news of late, Rosetta in the last couple of weeks has had 3 press releases announcing their new microRNA tests which they will begin offering to help doctors analyze and determine diagnosis of certain types of lung cancer and where cancer has it’s origins.  This is expected to help doctors decide what type of cancer is to be treated. The use of microRNAs will give accurate information about the cancer they are dealing with and aid doctors in guiding personalized treatment plans, specific to the type of cancer that is detected.

NEW YORK (GenomeWeb News) – Rosetta Genomics and its research collaborators have published in the Journal of Clinical Oncology data from a study showing that the same biomarker used in the firm's miRNA-based test for squamous lung cancer provided 96 percent sensitivity.

The study, which was posted online Monday on the journal's website, included 262 patients and was conducted by Rehovot, Israel-based Rosetta and researchers from Columbia University, NYU Cancer Institute, and Sheba Medical Center.

Rosetta Genomics Publishes Data on Lung Cancer Test | GenomeWeb Daily News | DxPGx | GenomeWeb

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Top Pain Scientist Fabricated Data in Pain Killer Studies – Was Money a powerful motivator

When you ask the question, why would someone do this?  Money sure seems to be the first thing that pops into my mind, or maybe there’s some recognition attached as well.  Sad, in that in the times we live in today that people still find time to try and defeat honesty, especially when it comes to research related to the drugs we take.  In addition this somewhat makes one wonder how much more of this type of activity could be uncovered imageas the move for transparency continues to rapidly grow.  With technology and the new balance and checks, plus the need for teamwork versus individual research, I would also hope the future of this type of activity will begin to resolve itself as well. 

I will be looking forward to hearing more about this case as it evolves.  BD  

A prominent Massachusetts anesthesiologist allegedly fabricated 21 medical studies that claimed to show benefits from painkillers like Vioxx and Celebrex, according to the hospital where he worked.

Baystate Medical Center, Springfield, Mass., said that its former chief of acute pain, Scott S. Reuben, had faked data used in the studies, which were published in several anesthesiology journals between 1996 and 2008.

The hospital has asked the medical journals to retract the 21 studies, some of which reported favorable results from the use of painkillers like Pfizer Inc.'s Bextra and Merck & Co.'s Vioxx -- both since withdrawn -- as well as Pfizer's Celebrex and Lyrica. Dr. Reuben's research work also claimed positive findings for Wyeth's antidepressant Effexor XR as a pain killer. And he wrote to the Food and Drug Administration, urging the agency not to restrict the use of many of the painkillers he studied, citing his own data on their safety and effectiveness.

Dr. Reuben had been a paid speaker on behalf of Pfizer's medicines, and it paid for some of his research. "It is very disappointing to learn about Dr. Scott Reuben's alleged actions," Pfizer said in a statement. "When we decided to support Dr. Reuben's research, he worked for a credible academic medical center and appeared to be a reputable investigator."

Dr. Reuben is on an indefinite leave from his post at Baystate, the hospital said. He no longer holds an appointment as a professor at Tufts University's medical school, according to the university.

Top Pain Scientist Fabricated Data in Studies, Hospital Says - WSJ.com

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The Muve Gruve Device Measures your Inactivity – Intrusive Technology with a Human Audit Trail?

The Muve Gruve device sounds very similar to another device that I posted about a few months ago, check out the human audit trail related reading below. This one get on the intrusive technology list for one big reason, right from the company web page, it is targeted at risk management to help promote use through employers for employees to lose weight through lower premiums.  I would personally prefer to see an item as such marketed to the individual to encourage use and the ability to lose weight and not a big brother type of device with strings attached to have an employer breathing down your back and blame you for the higher insurance group rates paid if you did not meet your goals, think about it.  No that is not the way it is supposed to be, but how many things are the way they are supposed to be, in reality with all transparency and honestly if we all think about it, that is probably pretty close as to the scenario it will create.  Next thing, you will find yourself fired and the employer will justify as you were the cause of their higher premium rates.  image Not to mention, this devices buzzes and bugs you when you are inactive too. 

Or, there’s on other possibility of being given a Health Coach, who will encourage and show you how to lose weight, although some of the programs have been questioned of late as they may conflict with what your primary care doctor may be recommending, the Coach is there for the money, the doctor is there for your health. 

Read what these poor kids in the UK are having to deal with, heart monitors to help them deal with their anger, no time to be a kid with a human role model, get your learning from the device and learn to behave yourself?  Schoolchildren given heart-rate monitors to curb anti-social behavior.  BD

Intrusive Technology?

Dr. Jim Levine of the Mayo clinic discovered that if people are active throughout the day by being reminded to move or stop being inactive they could keep their metabolism from shutting down and therefore be able to lose unwanted weight. Through his research he strove to better understand the benefits of non-exercise activity thermogenesis (NEAT) and came up with the concept for a wearable device.

He determined the key was a system that could calculate an individual's metabolic pattern and measure calorie burn throughout a day's activity and then relay targeted caloric intake to the user. He needed a device that not only monitored and measured an individual's every movement in a 24-hour period but also prompt the individual to get up and initiate activity before their metabolism slows. The Pelegrin Partners licensed Dr. Levine's technology and founded the company to take this important weight management opportunity into commercial practice.

The clip on the Gruve was designed to integrate into the shape of the device and function on virtually any type of clothing or belt to be unobtrusive to the user. The Gruve uses vibration to notify the user it is time to get moving.

A targeted customer base is corporations looking to explore the possibility of reducing the cost of insurance premiums by improving peoples health through prevention rather that treatment and those who need that extra reminder to get up and at it to stay fit.

Worrell | Muve Gruve

Hat Tip:  Medgadget

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