We live in the world of integrated software and employee participation is an option with a device such as an iPhone to monitor activity, along with being connected to a Wellness Coach that could send you emails and text messages, some could be a nice warning telling you that you are not moving enough today, in other words, you are not exhibiting enough physician activity today.  There are devices that one can wear that does this wireless reporting and you can read in the related reading below about a couple, who specifically target insurance and risk management companies to promote their sales, as shown on their websites.

If you want to check it out and have an iPhone, you can download this program and see how it works.  The iPhone has a built in accelerometer to sense motion that makes this possible.  This software is free but could easily be built upon for use in a proprietary system. 

Walk n Play iPhone Application – Tracks Every Move You Make and Creates A Report

“Redbrick’s methods for tracking employees’ commitment to these health plans are surprisingly detailed (though they may smack a bit of Big Brother). For example, it offers an iPhone application that records progress on a person’s walking exercises and beams the data back to Redbrick’s system. Pedometers and watches that do the same are also in the works, VentureWire reports. This might sound a tad invasive, but the company says that employers have the choice whether or not to make employees prove that they are following their custom health maps.”

Target Corporation Partners with Red Brick Wellness Program

From prior articles it states the use of devices are optional, but with the use of a device that is your human audit trail that beams information back to server another carrot dangled to give cheaper rates to employees that participate and if so, at what level, does the monitoring take place only during working hours or is this a 24/7 situation?  Something to give some thought to if you still value a level of privacy.

Devices and the data they report are getting smarter and this is an area where one needs to know exactly where the data goes and how and when it will be evaluated, and if it could be used against you should a few days of insufficient activity enter into a situation where a medical claim is involved. For this reason alone, I believe that a personal health record should be the focus point to gather the information, and thus should a patient decide to share the information, they are in control and could shut it off if desired by stopping the sharing process.  I could easily see where employees could possibly offered big discounts too for using an iPhone with participation with electronic proof that you are following the road map set forth by a coach. 

Once again it’s in the algorithms that are created to collect and report data and will it evolve to the point of having to carry a device to have insurance?  As costs go up, so do the requirements for additional data, we are seeing that now and the legal cases in some areas surrounding the use of some of the algorithms used to calculate payments for out of network charges.

Are we ever going to have some Algorithmic Centric laws to protect privacy?   The other day I posted about the human hedge funds being proposed on Wall Street, where investors take part in life insurance policies and stand to lose money if the participating group ends up living too long.  After reading such, I have a very strong distrust as do most who have read that article I would guess.  Again as data aggregation continues and more information is made available, would some of this be intertwined at some point?  These are questions, and good ones, as it is possible today, but again laws are needed to protect “personal electronic privacy” that are algorithmic centric and spell out the exact process, and we don’t have any such laws now as this is an emerging technology just getting started. 

Personal Electronic Privacy should be addressed at some point, just as other privacy issues have, except it’s a bit more complicated and needs algorithmic centric laws and rules in order to protect citizens.   BD

WellPoint Inc., the parent of Anthem Blue Cross and Blue Shield of Wisconsin, said it has entered a partnership with health and wellness company RedBrick Health to create a new, behavior-based wellness and incentive program for WellPoint's affiliated health plans' large employers and health plan customers.

Minneapolis-based RedBrick contracts with employers to provide workers’ health assessment and screening tools, health coaching programs over the telephone and Internet, and other health and wellness services. Workers get financial awards for participating, and employers are able to reduce health insurance costs.

WellPoint enters wellness program partnership - The Business Journal of Milwaukee:

Related Reading:

The Health Coach/Insurance Company – Employer plan to uses devices and phones for employees to prove their physical activity

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

The Human Audit Trail to automatically track your fitness and sleep and a few other things…

If You Think The “So Called Death Panels” are Something To Worry About – Read This and Get Educated

Goldman Stolen Code – Has Algorithmic Fraud Become A Business Model in HealthCare Too?

Health Care Insurers Suggest Algorithms and Business Intelligence solutions to provide health insurance solution

Technorati Tags: Health Insurance,Healthcare,Wellness Programs,fitness monitoring,Big Brother,premiums,incentives,employer insurance,intrusive technology,weight Loss,iPhone,Blue Cross,Red Brick,Privacy

Steve Ballmer adds his words relative to healthcare and the focus at Microsoft in providing the software platforms to help make this happen.  The video is in Silverlight, so you do need the browser add on.  If you haven’t seen it yet, I have Twitter in Silverlight on the right hand side too, works pretty good. 

As more devices connect and go Blue Tooth, the connection to send and gather information with HealthVault is going to continue to grow.  Here’s a couple good recent examples of devices moving to Blue Tooth. 

Bluetooth stethoscope Available from 3M HealthCare – Wireless Heartbeats

Blue Tooth Wireless Fingertip Pulse Oximeter – Taking Your Pulse Gone Wireless

In the past I have been fortunate enough to speak with Steve Shihadeh, vice president, Microsoft Health Solutions Group, and Michael Naimoli, Industry Solutions Director for Microsoft’s U.S. Health & Life Sciences Group and a former biopharmaceutical scientist directly with interview chats and there’s additional information at the links below as to where Microsoft is going, both in healthcare and life sciences.   Also, not too long ago Peter Neupert, Corporate vice President at Microsoft Healthcare solutions had a “bloggers” telephone conference including several bloggers and myself you may want to read up on as well.   BD

I have an entire section related to Personal Health Records for more information and there’s quite a bit about HealthVault. 

“Steve Ballmer, CEO of Microsoft, discusses the importance of healthcare as an industry to Microsoft, Microsoft HealthVault and Microsoft Amalga, and the impact of connected medical records.”

http://www.microsoft.com/video/en/us/details/e8c6d820-0692-4afd-a8af-0e1fa3e095b4

Related Reading:

Discussion with Peter Neupert – Corporate Vice President, Microsoft Health Solutions Group

A Deep Dive into Microsoft Life Sciences Today and in the Future – Interview with Michael Naimoli

Steve Shihadeh, VP Microsoft Health Solutions Group – The Amalga Software Solution for Aggregating Hospital Information (Interview)

Technorati Tags: Microsoft,Microsoft Life Sciences,Healthcare,CodePlex,Clinical Trials,Supply Chain Management,information management,Amalga,Steve Ballmer,HealthVault,Health IT

The website is up and going, complete with a link to follow on Twitter.  What makes Dr. Oz unique I think is passion.  When someone has passion for what they do, it shows, and if you have ever seen him on Oprah, well one show is all it takes to see that. 

I have quite a few of his videos and appearances here at the blog and the most fascinating of all is the one where he explains regenerative medicine.  I have done some interviews too with Cook Medical on the same subject, the guy who grew his finger back with pixie dust for example and you can search and find more information and use the link below to read up.  The related reading below has some of the former posts relative to Dr. Oz below.  BD 

Regenerative Medicine and How it Works – Interview with Cook Biotech (Medical)

Dr. Oz, host of “The Dr. Oz Show” launching Monday, September 14, 2009, is Vice-Chair and Professor of Surgery at Columbia University.  He directs the Cardiovascular Institute and Complementary Medicine Program at New York Presbyterian Hospital. His research interests include heart replacement surgery, minimally invasive cardiac surgery, complementary medicine and health care policy.  He has authored over 400 original publications, book chapters, and medical books and has received several patents. He performs 250 heart operations annually.
Follow Oz on Twitter

Dr. Oz was born in Cleveland, Ohio and received his undergraduate degree from Harvard University (1982) and obtained a joint MD and MBA (1986) from the University of Pennsylvania School of Medicine and Wharton Business School.  He was awarded the Captain’s Athletic Award for leadership in college and was Class President followed by President of the Student Body during medical school.  He lives in northern New Jersey with his wife Lisa of 23 years and their four children, Daphne, Arabella, Zoe, and Oliver.

Meet Dr. Oz | The Dr. Oz Show

Related Reading:

Dr. Mehmet Oz – Does Not Care Which Plan We Pick – Says They all Won’t Work and the True Answer is Lifestyle

Dr. Oz Talks About Healthcare Reform with a “Clinical” and “Smart Patient” View

Oprah Says Farewell to Dr. Oz and Launches the Winfrey Produced Dr. Oz Show – Healthcare Education in the Making

Dr. Oz (as seen on Oprah) Discusses How Electronic Medical Records Improve Care – New York Presbyterian moves forward from pilot program

Medical Quack on the Chicago Sun Times - Oprah Says Goodbye to Dr.Oz

The Oprah Show – Dr. Oz Explores and Explains Regenerative Medicine

Dr. Oz (as seen on Oprah) Discusses How Electronic Medical Records Improve Care – New York Presbyterian moves forward from pilot program

Swine Flu: Dr. Oz Speaks Out and Gives Some Advice and Information

Michael J. Fox on Parkinson’s Disease and Stem Cells – Oprah and the Daily Show

Technorati Tags: New York-Presbyterian hospital,Dr. Oz,Oprah,electronic medical records,healthcare,EHR,PHR,Microsoft,personal health records,Healthcare Reform,Obesity,smart patient,regenerative medicine,Cook Medical

While you are on the site, you can head on over to the Twitter feed on “#healthcare” and see what is being talked about using the Twitter Hash mark for the topic and feeds where the word healthcare is used.   The feed will update about every minute as well.  It is a busy feed with a lot going on so as soon as there are five new updates, it somewhat does the “twist” and gives more real time updates, pretty interesting.  BD 

Technorati Tags: Twitter,healthcare,blog,MedicalQuack,resources,blogging

Things have changed so much since I was a child, what happened to nice little stuffed doggies, cats, dolls, etc.  Well it appears now the trend is to hug a virus.  Is this the new way of creating an awareness?  Could be I guess.  Recently I had posted about the Toy Uterus from another company being recalled though as the ovaries could cause a child to choke if they were pulled from the toy.  The recall only affects those bought in the year 2008 it appears so if you have one from 2009 it appears you are ok. 

The CDC even sells the toy at their gift shop too.  In addition to H1N1, there’s a a few more viruses for sale too.  Giant Microbes is the company that created and sells the nice little fuzzy creatures. 

Notice this is not a “pig” and I am adhering to the request of the meat council to not mention the “S” word at all here so I do not affect the sale of pork.

There’s also an adult section where you can buy some reason serious huggables.  You can now hug herpes and chlamydia if you want.  All four of the monsters will set you back around $30.00.  Healthcare marketing is certainly changing, and I don’t know it’s just a strange picture to me to see a child running around hugging herpes (grin).  I can hear Mom calling now, “would you please take that stomach out of your mouth”.

Now these guys don’t look quite as ominous, but these are more commonly found health issues.  I would much rather have a common cold in this version than the real thing that gets me if I had a choice. 

Here we have Staph and MRSA too, keep these out of the hospitals by all means! 

If viruses and ailments are not your thing, well there’s other plush alternatives to explore.  As mentioned above with the toy Uterus, there’s lots more where those came from here at I Love Guts.  How about a bladder or a heart or liver?

Know anyone who has had their gall bladder removed and want to send a personal message, well this could be the place for that too.  They have a few other organ specific cards too. 

This site also has some lapel pins too…a prostate pin, a uterus pin…and more…

I certainly had fun with this post.  We need a break here and there in healthcare and this was definitely the place at both sites exploring viruses and body parts in a most unusual fashion!   Must be good if CDC likes them too!  BD

H1N1 Swine Flu Available in Plush, Huggable Version

Related Reading:

The Toy Uterus Has Been Recalled..

Technorati Tags: Recalls,toys,uterus,safety,children,prostate,plush toys,viruses,H1N1 flu,humor,gallbladder,liver,CDC,Giant Microbes,I Heart Guts

About 2 years ago I told many that Healthcare in the US was going to reach a point of revolt and riots, and sad to say it appears we are knocking on that door today.  We are seeing more efforts with organizing labor groups as people are in fear and want representation of some sort.  Things we used to count on being a constant are no longer that, but and today the constant is “change”. 

As one  who works with code and data, and others will vouch for this as well, you do notice the complexities, strategies and intelligence growing rapidly, and whether or not we like to admit this fact, software is running most of the decision and things we do in life today.  You have an option to deny that too, but we all know that denial will catch up with you at some time.  We also have those who have not been afforded the opportunity to be educated in some of the areas that are running our lives today.  Recently I spoke with a pediatrician who like all other doctors today has a level of frustration.  Kids have had all the toys, internet, etc. and are accustomed to being “busy”, in other words there’s something to grab and do all the time.  The problem lies when they get to school, and how to capture their attention in a focused learning environment, good question, as they are conditioned to looking for all the devices and things they know of already in life that entertain and keep them busy.

Now if we can combine the 2, then perhaps we have a win-win, but this was something the doctor expressed to me and is seeing more and more of this with parents discussing how to handle this and not knowing exactly how, parents from another generation where this did not exist, thus there’s no memory available for references.  I think sometimes even some of the same applies to us too as adults as we are all struggling for balance, changing the way we think and live, and that’s a hard nut to crack as life has changed and there’s no going back at this point.

I see resistance to change, resistance to reading all the time.  Old habits die hard and there’s a big level of distrust with technology and adapting new methods.  I used to see that big time with a hospital CEO who would see me with my Tablet PC and it was like time to run for the hills and no curiosity at all at to what the device could offer or do.  If being able to somehow perk that level of curiosity was available, that’s about half the battle, but if that is dead, well the ship is pretty well sunk.

We’re getting nowhere in a hurry with all the bickering and arguing and around Twitter several have expressed concern too on the fact that those who are not educated and informed, could very well the the breaking point and the downfall, as when people do not understand and are not given truthful answers they revolt. 

Again, getting back to the technology side of this with watching more levels of code and aggregation being leveraged, we are smarter, well perhaps I should say those that take time to learn and participate, and those that do not, just still sit around and fight and argue as it is all they know.  There’s a big level of unbalance and it takes teamwork to get anything done.  Coders know it as it is inherent to work as a team and when someone writes a good piece of code, there’s no arguing and bickering, but rather appreciation and respect, as we all know how hard it is, and it might be a module I could use in one of my projects too so there’s an example of a good code of ethics.   If it’s really good code we can’t wait to share and show off a little too, but that’s normal with anything as overall it is an accomplishment.  When you give the code/program to an end user and they are saved hours and hours of time doing the same project manually that now takes 5 minutes, you really feel you have contributed to something positive and helped a fellow man/woman as you have given a huge gift these days, called time, time that can be spent with family and loved ones.  

It’s too bad that the ethics of most coders doesn’t flourish outside to others because it doesn’t appear to be much of this around today, sure there’s some but greed and control seem to be what drives all, sad to say.  We have new leadership in the country that is in fact trying to work in a more open environment and communicating, and at a very difficult time. We have made some real history with the new Executive branch, other Presidents didn’t have the problems in house today, the technology wasn’t there and wasn’t even explored to a high degree.  So instead of pointing fingers, it would be nice to have folks on a “real” team as the old scape goat routine is outdated.

Perception and paradigms are in ruins as the constants of the past are gone.  I hope our leaders can somehow maybe think like data/coders do, it would really help and we are all hands on folks that participate in whatever the project happens to be.  A little more of that would go a long way.  Again, as  mentioned above, I saw this battle coming 2 years ago as data and the complexity of the systems and software is what makes the world go around, and sadly to say when it comes to the human side of technology there are those who get caught up in it, and even Wendell Potter spoke about how it happens to you when working in such an environment without seeing the rest of what’s going on outside of it. 

You kind of look at philanthropy organizations like the Gates Foundation and might wonder why they pulled all their investments from pharma and biotech?  Mr. Gates himself has been beating that horse for many years about education, but again so many times his message falls on deaf ears too, know that feeling, when nobody listens and already has their minds preset and fears change instead of embracing it and hope our leaders don’t give up as we will suffer as a country for not educating and exploring new technologies and working at team players, the big white technology elephant in the living room doesn’t go away and is always there to maneuver around.  

We created the complicated world we have today with data systems, information needed, processed, etc. and to not have everyone up to par on the understanding of how we need to function and worth within the algorithms created (and there not going away and many new ones are coming) is where the one of the biggest downfalls lies today.  People don’t need to be experts on computers and their technology, but they do need to know why things are happening the way they are and how they can participate in a constructive manner for themselves and everyone around.  Education….education…..education for all, hands on.  BD 

Democrats — and liberals in particular — want heroic measures and large scale intervention. They think the legislation needs big new ideas such as a public insurance plan that would have government offering coverage to middle-class workers and their families.

Republicans want a conservative treatment to relieve the worst symptoms of America's health care malaise. They're proposing help for small business owners and the self-employed, and some GOP lawmakers probably could go along with expanding current programs that cover the poorest of the poor. But no new government plan and no guarantees that everyone would be covered.

Analysis: More fighting could doom health care - Health care reform- msnbc.com

Technorati Tags: healthcare reform,technology,teamwork,leadership,education,perception,participation,government,opinion,algorithms

The first thing that sticks out is the cost, for over 2 weeks in the hospital and four operations at 10k, well we know that is not an option here in the US, but they were in a spot where they needed care and are just reporting in on the experience.  He compares this to his 2 hours as an outpatient for sinus surgery at 14k here.  What was also interesting was the fact that his wife’s records from 10 years ago at the hospital were available, so I wonder if they were digitized to be made available?  Anyway, an interesting read from Forbes on the comparison and what he had to say.  BD 

LONDON -- Timothy Stoltzfus Jost writes a lot about health care systems in Europe, but this year the Washington and Lee University Law School professor had the unenviable opportunity of comparing the U.S. and German systems first-hand. His conclusion: The German system, with its mix of public and private health care plans, may be less glitzy, but it delivers just as much bang for far fewer bucks.

Jost was in Goettingen, Germany, for a conference in April when his wife had a bad accident. She was jumping over a fence, trying to get into the botanic gardens, when a ring she was wearing got caught, ripping off her finger.

Several weeks ago, Jost, who has private insurance in the U.S., received the bill for his wife's two-week hospital stay in Germany, her four operations and the ambulatory services she received. He was floored by how cheap it was, especially when compared with an operation he had this summer in the U.S. The tab for his wife, Ruth, came to a little over $10,000.

By contrast, the hospital bill for Jost's two-hour or so outpatient surgery to open up his sinuses totaled $14,521. Jost has yet to receive the bill from the surgeon and anesthesiologist performing his sinus operation.

Jost says the accommodation and food in the German hospital was more basic than in a U.S. hospital and the facility was staffed with far fewer people. "When I had my minor surgery, there were people all over the place," he said. "In Germany, there was very competent staff and they were very responsive when we needed attention, but there were probably two people covering 10 rooms."

More importantly, Jost says, the hospital was just as technologically sophisticated as any U.S. hospital. And the German health care system appeared to be well organized. Doctors in Goettingen were able to retrieve medical records from a previous hospital stay his wife had had in Germany more than a decade earlier.

An American Checks Up On German Health Care - Forbes.com

Technorati Tags: healthcare,reporter,Germany,hospital,surgery,healthcare reform

This was a surprise early in the season with the number of cases being almost 25% of the university and many just stayed at home and some of those were possibly not reported.  As we all know the flu season usually starts when the weather changes, but except for the last week here in southern California, it has been a mild, cooler summer than normal.  There’s a lot students not in class this week.  BD 

SAN FRANCISCO, California (AFP) – Some 2,000 students at Washington State University have reported symptoms of swine flu, university officials said, in one of the largest reported outbreaks of the virus on a US college campus.

The west-coast school last week instituted a blog to help provide information to students about the sudden and dramatic spread of the A(H1N1) virus on campus just days into the new school term.

"We estimate that we have been in contact with about 2,000 students with influenza-like illness in the first 10 days of our fall semester," the latest online posting said.

"At this time of year, we would typically only see a handful of patients with influenza-like illness. Health care providers in the local community have also seen WSU students with influenza-like illness, but we have no way of knowing how man

2,000 students at US university report swine flu symptoms - Yahoo! News

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CVS Caremark to offer free Flu Shots for unemployed – Minute Clinics and Vouchers

It’s H1N1 – Advisory Email Received to Not use “Swine” with Future Media Posts

First Case of Pigs with Swine Flu Reported in Canada

Technorati Tags: Flu,H1N1 flu,Swine flu,healthcare,pandemic influenza,Washington,Flu shots

One more new feature added here that can make it easy to search while on the blog.  This is pretty neat and works well and will find related information quickly, both here and on the web too.  It pops up in a small window right where the post is located.

 

This is the search box to use for both.  Above the search is a box that only searches the Medical Quack and may give some different results and runs a bit slower. 

The first tab shows the results on this blog.  The second tab shows results on the web.  I searched for the word “duck” for an example here. 

 

Also, remember too you can double click on any word in a post to get further information or a definition of any word you may not understand or want more information! 

New Feature on the Medical Quack – Answers.Com - Double Click on any Word within a Post

The Medical Quack

Technorati Tags: MedicalQuack,Answers.com,healthcare,blog,medical blog,Google,Google search,Blogger

We are all waiting for the premiere at the Venice Film Festival.  We have seen the trailer but won’t really know the impact until the move is unveiled.  We will have it here in a few weeks in Los Angeles.  The one comment below about the insurance loopholes is interesting too as I just posted something in that area yesterday.    Algorithms determine and create credit ratings too, give that some thought. 

If You Think The “So Called Death Panels” are Something To Worry About – Read This and Get Educated**

Healthcare and Wall Street are all tied in together.  Perhaps for his next movie we could see something titled like “I Want Your Code” as a focus, or “Open Source Algorithms Needed”.  Certainly this is my “geek” twist on this, but folks we down to “it is what it is”, so for those who don’t read and quite get a grip on how this is all being manipulated, please read up, it’s the only power we have, “education”, so please use this wonderful tool called “the internet’ and school up.  I do my best here with even keeping a link to help folks learn what an “algorithm” is, so I hope it gets read. 

The 3 words for HealthCare Reform in my opinion should be as follows:  Education, Education, Education, what do you think?   In his new movie it appears that by using entertainment, Michael Moore is into exploring the use of algorithms and his methods do it on the big screen.

“Capitalism A Love Story” has a new Trailer Released – Where’s Our Congressional Algorithms?

We need a new department in the government to help the SEC who has already shown they need help, these government departments don’t have the geeks and coders to go up against private industry who does have the geeks and who also get paid well. 

“Department of Algorithms – Do We Need One of These to Regulate Upcoming Laws? 

Vice President Biden wants videos too, why, so we can study and see how those algorithms are creating all of this, inquiring minds want to know. 

“In mathematics, computing, linguistics, and related subjects, an algorithm is an effective method for solving a problem using a finite sequence of instructions. Algorithms are used for calculation, data processing, and many other fields.”

In so many words, Warren Buffet makes a profound statement here too:  Beware of Geeks Bearing Formulas  Beware of the companies that direct the geeks to write and manipulate the formulas and algorithms.

The direct theme of the movie from what I read is not healthcare directly, but you would have to be living under a rock not to connect the fact that healthcare and Wall Street are joined at the hip and now that mortgages have rocked out, are they looking towards the Human Hedge Fund as their next frontier?   There’s nothing wrong with investing money in companies and hoping for a return on their growth, like the stock market was designed to do, but with technology we are venturing so far from where the purposes of the financial world began and now look more like one big gambling casino instead, with some pretty cold calculated algorithms running the bets.  BD

"Banking establishments are more dangerous than standing armies." So wrote Thomas Jefferson to a friend in 1816. Now Michael Moore, whose Fahrenheit 9/11 took on the U.S. Army, and the entire military-executive-industrial establishment, brings his latest documentary, Capitalism: A Love Story, to the Venice Film Festival. The land of Macchiavelli and the Medici is the perfect setting for Moore's nonfiction tragicomedy of greed and chicanery on Wall Street, in Washington, D.C., and through the entire economic apparatus. The movie will have its world premiere here tonight, before playing the Toronto Film Festival next week, opening Sept. 23 in New York and Los Angeles and achieving wide release Oct. 2

**Moore eagerly counts the ways. He lays out the "Dead Peasants" insurance loophole by which a corporation can take out policies on their rank-and-file workers and, when they die, reap millions in tax-free payouts.

At the end Moore says, "I refuse to live in a country like this — and I'm not leaving." But this call to arms demands more than a ringleader; it requires a ring, an engaged citizenry who are mad enough not to take it any more.

Michael Moore Goes for Broke With Capitalism - TIME

Related Reading:

Promising new startup of 2009 - Executive branch of the US federal Government

The 2 New Hot Words in Healthcare: Algorithms and Whistleblowers

Ex-Goldman programmer Inquisition Continues – Did He Really Steal the Algorithms or Just Worked on Code from Home?

Senate Testimony – Insurers Confuse Consumers and Dump Those Who are Sick, a Wall Street Run System

Technorati Tags: healthcare reform,algorithms,Michael Moore,healthcare,eduation,Congress,politics,Los Angeles Times,formulas,Wikipedia,Technology,Capitalism A Love Story,greed

You may or may not have read about the “tea parties” in the news, if not, check out the link below.  Good interaction from Al Franken here on handling their questions, unexpectedly.  I do agree with his comments too on allowing Medicare to negotiate directly with the drug companies as that is a good example of money coming right out for administration of pharmacy benefit.  Things have changed since Part D was implemented with most Pharma companies being out of that business now and selling their PBMs. 

Medicare just needs the data capabilities to administer and work directly with Pharmacy Benefit Managers is about the only hold up I can really see to delay this.  Insurance companies make big profits from this side of the business and one more contributing reason to the rising cost of both healthcare and health insurance.  BD 

The Medical Quack: The United HealthCare “Tea Parties” – Enlisting ...

“About a dozen tea party activists had staked out Sen. Al Franken's booth, and confronted him loudly when he arrived. But within minutes, he'd turned an unruly crowd into a productive conversation on health care. The discussion went from insurance reform, to the public option, to veterans benefits, to cap and trade. He made a few laugh and even told a touching story that moved a few to tears. A whole lot of common ground was found.”

Also down below is another video from a Town Hall Meeting with Dr. Senator Coburn listening to a woman who’s child has severe health issues showing another side of Town Hall meetings.  

Related Reading:

The Medical Quack: Senator Dr. Tom Coburn – Talks about Bloggers ...

The Medical Quack: The Doctors Show from The US Senate – The 2 MDs

The Medical Quack: My Dud Telephone Town Hall Meeting from the 70s ...

Technorati Tags: Healthcare,healthcare reform,Franken,Coburn,Town Hall Meetings,Tea,Obama,Medicare,Part D,health insurance,pharma

I thought for the female readers of this blog, this needs to be mentioned.  Also, the product could have other uses, in a medical office restroom, perhaps even at the hospital when sitting down or bending due to a procedures, etc. would be difficult, and could spare use of some catheters too if there’s an alternative and the patient can move around. 

“Once you practice a time or two, using a GoGirl is going to feel like second nature. You won’t be like a man. You’ll just pee like one.”

  “GoGirl fits easily in your purse, pocket, or glove compartment. It’s a must for travel and sports. And it’s great for everyday––no more crouching over or trying to cover up an unsanitary public toilet.”

With all the concern of bacteria in public places today, especially a restroom, this could be a real asset.  BD 

http://www.cnn.com/video/data/2.0/video/tech/2009/09/03/dnt.mn.female.urinal.cnn.html

Technorati Tags: Go Girl,bacteria,urination,public restrooms,heatlhcare,women's heatlh

This is big and the red tape that goes along with it.  In another article a representative from the insurance industry stated many of these are clerical or paperwork errors, and there is some substance to that as I am sitting here right now looking at 10 that were denied, but paid on the same patient a month ago, nothing changed except the fact that the carrier needs to update their data integration to either put out a policy to not put dashes in the social security number or put that option in their processing software.  Let’s not over look the fact that that it took time for me me to re-submit to the clearinghouse too. 

Sure there are duplicates too, but I don’t think this is what we are talking about here with this focus, although it does make a point of how complicated and inefficient medical billing is, on some issues there’s no rhyme or reason and administrative time spent by medical practices to deal with this type of stuff too is maddening.  The big denials of course are the ones that make the news, as for each one of those, there are plenty more.  Again, they use scoring to keep fraud down and when scoring for fraud and greed cross the line for risk management, we have a problem, patients and doctors have problems.  What is also amazing to me is that on these highly publicized cases we hear the very cold hearted reasons for not covering the claim too.  Again, it’s down to business intelligence software that grades and makes those decisions, until a human steps in to make adjustments.  It’s all about those algorithms that run 24/7, humans need sleep and can’t function at that level.  Once more, this is what we need, paper doesn’t cut it.

Are We Ever Going to Get Some Algorithm Centric Laws Passed for Healthcare!

Again I wish our lawmakers could come to terms with this and read up.  They still don’t get it.  I’ll reference this once more as I have several times, but watch the video from the Senate in January with the healthcare IT stimulus initiative and see how much is not known.  It speaks for itself with none of the Senate committee having a clue on what electronic medical records look like and how they work, much less personal health records that are for everyone, they don’t read up on technology it appears. 

Health Fraud Scores Could Be a Contributing Factor to Medical Claims Being Denied

Just being better in touch would really help and again I hope they understand the magnitude of this investigation too.  I wrote about the “dud” Town Hall meeting I accidentally attended last week.  I say that as there was no announcement, but just the phone ringing that connected you to the meeting, all by phone. 

With the technology and resources we have today there’s a better way to communicate, notify constituents, and I felt it was somewhat like “Surf’s Up, Let’s Have a Town Hall” agenda. 

Nothing will be accomplished here until we have laws that spell out the rules and how to protect citizens and get away from the “Surf’s Up” spontaneous constituent meetings.  It’s also somewhat amazing too that with all the unrest we are seeing, that with the story of Goldman’s code being stolen that nobody has infiltrated on this code, so they must have their security locked up as it should be.  BD 

OAKLAND, Calif., Sept. 2 /PRNewswire/ -- More than one of every five requests for medical claims for insured patients, even when recommended by a patient's physician, are rejected by California's largest private insurers, amounting to very real death panels in practice daily in the nation's biggest state, according to data released today by the California Nurses Association/National Nurses Organizing Committee. CNA/NNOC researchers analyzed data reported by the insurers to the California Department of Managed Care. From 2002 through June 30, 2009, the six largest insurers operating in California rejected 31.2 million claims for care - 21 percent of all claims.

PacifiCare denied 40 percent of all California claims in the first six monthsof 2009. Cigna, which gained notoriety two years ago for denying a livertransplant to 17-year-old Nataline Sarkisyan of Northridge, Calif. and thenreversing itself, tragically too late to save her life, was still rejectingone-third of all claims for the first half of 2009.

Rejection of care is a very lucrative business for the insurance giants. Thetop 18 insurance giants racked up $15.9 billion in profits last year.

California's Real Death Panels: Insurers Deny 21% of Claims | U.S. | Reuters

Related Reading;

If You Think The “So Called Death Panels” are Something To Worry About – Read This and Get Educated

Goldman Stolen Code – Has Algorithmic Fraud Become A Business Model in HealthCare Too?

Health Insurance Premiums To Rise 29 Percent Letter Sent by Insurer – What Does Your Score Say?

Ingenix Data Base Has Some Long Reaching Legal Tentacles with Aetna, Blue Cross, Blue Shield, Humana

Are We Ever Going to Get Some Algorithm Centric Laws Passed for Healthcare!

Goldman Stolen Code – Has Algorithmic Fraud Become A Business Model in HealthCare Too?

Health Care Insurers Suggest Algorithms and Business Intelligence solutions to provide health insurance solution

Technorati Tags: health insurance,insurance,healthcare reform,investors,claims,California,denials,algorithms,business intelligence

Banks are trying to create new products, but is the new product “Human Hedge” Funds? 

If you are worried about so called government death panels, then you need to read on here.  As I have mentioned many many times, Wall Street invests heavily in Business Intelligence software, they get their numbers and information this way to bring to the “think tank”, and this is exactly what we have going on here, one big scary think tank. 

Under this type of plan, you would have the opportunity to have investors buy in to your life insurance policy, thereby keeping the number of cancellations down, but we all know what happens when other people’s money comes into to play, they get involved in some aspect of your life, and in this case if you are perhaps living too long and they are not getting a fast enough return on their money, they will inquire, so what do we have here?  This is obscene to say the least. 

One of the focuses here is to allow an individual to cash out their policy at a higher rate of income than what the insurer would offer.  What happens if you are living too long, is there a death squad sent out to see why?  As we have heard many times from CEOs, the focus is the investors and not humans, sad to say of those with little or no morals.  

“In addition to fraud, there is another potential risk for investors: that some people could live far longer than expected.”

Even as an investor, how are you going to be assured the policies are legitimate?  Read on…quote below.

“The solution? A bond made up of life settlements would ideally have policies from people with a range of diseases — leukemia, lung cancer, heart disease, breast cancer, diabetes, Alzheimer’s. That is because if too many people with leukemia are in the securitization portfolio, and a cure is developed, the value of the bond would plummet.”

They are running algorithms to simulate what would happen if people live too long to try and get some projections on how this would work.  This may or may not be a good deal for the life insurance companies in the long run, but frees up operating money.  Now we also can’t over look the fact that companies talk to each other too, so where do the folks get this information, from both life and health insurance companies and perhaps even the government.  Again, this is projecting, but would health services be denied to individuals so they don’t have the potential to live as long, to keep investors happy and a potential collaboration taking place between investors/health insurance/life insurance companies. 

As I have so many times mentioned, we need laws that are “algorithmic centric” to spell out and see the exact formulas that are used to calculate the investing policies we use today.  Health Insurance way back started as “non profit” business to spread the expense of healthcare over a large number of individuals so everyone could afford healthcare and today we are so far from that concept it isn’t funny, as the dollar calls the shot and not healthcare. 

Are We Ever Going to Get Some Algorithm Centric Laws Passed for Healthcare!

Just think, you may have to be suffering from some major disease, breast cancer, diabetes, etc. before you could have the opportunity too as there will be a bunch of investors looking over your shoulder wondering how long it’s going to take for you to check out so they can see a return on their money.  I don’t care about other types of investments and the algorithms they run, but when it comes to healthcare and human lives it should be open source so we can all see how we are graded or scored and what parameters, data arrays, etc. are used.

Healthy people in this, well it appears there’s too much unknown here, they want “sick” people where they can hedge and bet on your demise.  In essence the healthy person might end up being discriminated against as there would not be enough information on if he/she has a disease that has the potential to shorten their life.  Applicants will be scored on their policies no doubt, as that is the way the world works today and you may need enough chronic illnesses to play in this so called “dead pool”.  If you are cured, then again, you don’t fit this business model. 

Goldman Stolen Code – Has Algorithmic Fraud Become A Business Model in HealthCare Too?

This could circle around indefinitely with all types of misuse too.  Gee if you want to purchase life insurance are you going to require medical records that show some type of health problem to qualify?  If you somehow collaborate with your doctor and find something and begin treatment, well you risk a higher score with qualifying for health insurance now and get your premiums raised, you take more drugs possibly, but hey now you qualify for life insurance that you may want to leave to your family.  In the long run though, you have done what investors want, you are now sick and have a disease that fits into the “candidate pool” and you need that life insurance so once again investors can make some money. 

Ok so if you cash out, you could stand to make some money over and above what the insurance company would pay according to this model and if you keep your policy and live too long, well I discussed that above and investors are going to get impatient for their money if you live too long! 

This is one big reason we need regulations on the insurance business all the way around.  We are now just integrating medical records, but insurance has had high levels of integration and data mining for some time now.  Please feel free to comment and add/or correct anything I may have missed here too.  BD 

After the mortgage business imploded last year, Wall Street investment banks began searching for another big idea to make money. They think they may have found one.

The earlier the policyholder dies, the bigger the return — though if people live longer than expected, investors could get poor returns or even lose money.

The bankers plan to buy “life settlements,” life insurance policies that ill and elderly people sell for cash — $400,000 for a $1 million policy, say, depending on the life expectancy of the insured person. Then they plan to “securitize” these policies, in Wall Street jargon, by packaging hundreds or thousands together into bonds. They will then resell those bonds to investors, like big pension funds, who will receive the payouts when people with the insurance die.

“We’re hoping to get a herd stampeding after the first offering,” said one investment banker not authorized to speak to the news media.

But if a policy is purchased and packaged into a security, investors will keep paying the premiums that might have been abandoned; as a result, more policies will stay in force, ensuring more payouts over time and less money for the insurance companies.

New Exotic Investments Emerging on Wall Street - NYTimes.com

Technorati Tags: health insurance,life insurance,Wall Street,healthcare reform,investors,hedge funds,non profit,gambling,wagering,business intelligence,fraud

This report might help explain why companies, such as Outcome are in existence today.  You can read more at the link below and why the company has received stimulus funds to continue their work.  Once the trial is done, Outcome creates patient registries to report back on medications in how they are working in the real world, so if investigators change the reporting on the outcome, we have this to fall back on, although it does take time to gather, it is a big step towards transparency and finding out what is really happening. 

Goals are to have real time information to decision makers; the patients, physicians and insurers. The information is available and stored with “cloud technology”.   BD

Outcome Sciences – The Medical Information We Want – Evidenced Based Medicine

“This is a very informative article/interview to find out what Outcome Sciences does, clinical outcomes and using patient registries.  It is a public company and received stimulus funds.  Outcome was a spinout from Harvard a few years back.  Part of the work studies real world results and compares them to clinical trials/studies.  As we all know clinical trials are a small limited group, so once the medication is out in the real world they collect even more data as everyone wants to know if it works, what are the real or other side effects that may not have shown in a trial.

Safety, effectiveness and and quality are the three focuses with their studies.” 

Many researchers are ignoring a 2005 requirement that they register proposed clinical trials in a government database as a condition for publishing their results in medical journals. And the journals are publishing the papers anyway, a new study reveals.

The study, a review of 323 articles published last year in leading medical journals, found that only 147 of the clinical trials — 45.5 percent — were properly registered before the end of the trial in a way that clearly stated the main outcomes being assessed. Even among the articles that were registered, almost a third had discrepancies between the outcomes described in the registry and the ones ultimately reported.

Dr. Moher added that bias could easily be introduced when investigators changed the primary outcome they were measuring — moving the goalpost, so to speak. That might happen, for example, if a clinical trial is designed to determine whether a drug increases survival rates but investigators change the primary outcome to assessing if the drug improves quality of life.

Vital Signs - Awareness - Clinical Trial Rule Is Widely Ignored - NYTimes.com

Technorati Tags: Evidence Based Medicine,Obama,treatments,comparisons,heatlhcare,research,registries,Outcome Sciences,clincal Trials

  We all laugh to a degree about it, but there might be some level of addiction with all of us, just like coffee, etc, but for those who need help and the addition is real, there’s a center now that can help.  I do like the picture of the nice serene country side.  This link will take you right to a survey page where you can take a test/survey to see if you might have some of these tendencies with Internet Addiction.  Of course with blogging and the work I do, there’s probably a bit of addiction present with myself, but for now I’ll sit in denial (grin).  We need CPT codes next. 

Internet Addiction is a Clinical Disorder.....

I looked around the site a bit, and gee, I like the “tree house”, I could live there.  You can also follow the website on Twitter, that is unless you are addicted to Twitter.  Overall I think this is an effort to help get us back to “human” thinking again with all the time we spend with computers and technology to bring balance back, and learn how to live and work with technology as it’s a bit different in my opinion than perhaps alcohol or gambling where abstinence is the desired end result, as technology is all around us and achieving balance is probably something all of us would like to find out more about, even though maybe not addictive, but what’s the key to the balance of life.  I sure don’t have any big answers on that one myself. 

I found a link to another site with more information on the topic here:  http://www.netaddiction.com/   Some places like China were giving shock treatment for Internet Addict and now it looks like the government has banned it, “ouch”, One Flew Over the Internet!

China bans electro-shock Treatments at Mental Hospital for treating Internet addicts

The FDA approved something similar though here for Obsessive Compulsive Disorder, so would Internet Addiction fall into this category? 

FDA OKs deep brain stimulation for Obsessive Compulsive Disorder – Medtronic

Or there is this treatment where you could go get zapped on your lunch hour:

Brainsway gets FDA nod for device trial – Another Device for Transcranial Magnetic Stimulation

This site and program is not any of the above treatments, but rather an approach that focuses on a 12 step program, like we have all heard about for years and has some words of wisdom for everyone to use to guide them through life and is about humans helping humans, something that gets lost in the high paced world we live in today.  BD 

Alexander, 19, needed help to break an addiction he calls as destructive as alcohol or drugs. He found it in this suburb of high-tech Seattle, where what claims to be the first residential treatment center for Internet addiction in the United States just opened its doors.  Ben Alexander spent nearly every waking minute playing the video game "World of Warcraft." As a result, he flunked out of the University of Iowa.

The center, called ReSTART, is somewhat ironically located near Redmond, headquarters of Microsoft and a world center of the computer industry. It opened in July and for $14,000 offers a 45-day program intended to help people wean themselves from pathological computer use, which can include obsessive use of video games, texting, Facebook, eBay, Twitter and any other time-killers brought courtesy of technology.

The effects of addiction are no joke. They range from loss of a job or marriage to car accidents for those who can't stop texting while driving. Some people have died after playing video games for days without a break, generally stemming from a blood clot associated with being sedentary.

Internet addiction center opens in US by AP: Yahoo! Tech

Technorati Tags: Internet Addiction,healthcare,CPT,Twitter,Facebook,Gaming,ReStart,heatlhcare,mental health,e-Bay,time killers