BlueCross Blue Shield Office in Tennessee Received Bomb Threats – Nothing Found

All employees were evacuated and later returned to work, and with 5 buildings this sounds like a substantial amount of employees to get out of the buildings.  Nothing was found and all returned back to work.  The University of Tennessee had also received bomb threats this week.  BD 

Oct 24, 2009 (Chattanooga Times Free Press - McClatchy-Tribune Information Services via COMTEX) -- A second telephoned bomb threat in Chattanooga in three days forced the evacuation of BlueCross BlueShield's downtown location early Friday afternoon.

BlueCross' Cameron Hill location was evacuated about 12:15 p.m. after the company received a call that bombs had been placed in the campus' five buildings.
Chattanooga police conducted sweeps of the buildings and found nothing, said Capt. Terri Whiteside, spokeswoman for the Chattanooga Fire Department.

Officials set up a call station in the main lobby that allowed employees to report any suspicious or unusual behavior on Friday, Capt. Whiteside said.

BlueCross allowed employees to return after the situation was assessed, said BlueCross spokeswoman Mary Thompson in an e-mailed statement.

BlueCross cleared after bomb threat

Technorati Tags: BlueCross,BlueShield,bomb threats,health insuance,Tennessee

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Windows 7 Will be an Asset and Improvement for Healthcare Software Applications – Touchscreen PCs

I have used a Tablet PC with touchscreen and now I don’t know how to live without it, so with touch screen being supported in Windows 7, interacting with computers is going to become much easier even if you don’t have a tablet.   I still love my slate tablet and it works great for presentations all over without having to pull out the digitizer.  With Windows 7 all you need is a computer that has the hardware support for touch and who knows, this could lead to fewer cases of carpel tunnel.

Software will learn the scribbling habits, which before was pretty much only on the Tablet PC, so with Windows 7, we can look forward to interacting in a much more natural fashion, just have to remind ourselves that it is there and pull ourselves away from the mouse when not needed.  BD

Thanks to its full support of multi-touch touch screens, Windows 7 is perfect for a tablet PC any doctor can use to record, update, and analyze your health records.

The big phrase you will hear this year is All In One. It means instead of choosing among a notebook, a tablet and a touchscreen, they are all one thing. As the standard PC becomes an All In One, the price drops toward the $500/unit level seen in standard laptops

But wait, there’s more. Because the touchscreen is now supported within the operating system, applications will also get that support. This will also drop the price of solutions dramatically.

But a virtual page is being turned here. There are no longer any excuses for doctors to have tablet PCs equipped with a pen-like stylus, an interface just as good as the clipboard and, over time, better.

Windows 7 will shine in medicine | ZDNet Healthcare | ZDNet.com

Technorati Tags: Windows 7,healthcare,Windows,Microsoft,touchscreen,Tablet PC,data input,cliboards,PC

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Staying Alive – Dr. Craig Freied Co-Founder of (Azyxxi) Microsoft Amalga And Hospital Safety (ABC 20/20)

To bring you up to date if you are not familiar with Amalga, it is currently one of the Healthcare Solutions from Microsoft, the brains. Below is an excerpt from an archive in the Washington Post about the beginnings before Microsoft, when the project was called Azyxxi.  Dr. Freied thinks hospitals should be designed more like airports and in the video he explains why.   Some of his statistics were interesting, like female doctors have overall better results on keeping patients alive over male counterparts. 
What I like is the description of the doctor:  “Data Junkie” being a bit of one myself in having written an EMR, but this man knows 25 computer languages, genius in my eyes just speaking for that one item alone.   He and his partner knew how algorithms would work to give information and save lives, well enough that Microsoft bought it and and has continued to develop the system that took 8 years to build for Dr. Feied and his partner.  You can read more of the history of Amalga here at Wikipedia.  In the early days, before being acquired by Microsoft, the software was named Azyxxi.
“Mark Smith and Craig Feied quickly discovered that the main reason for the frustration and wait times was the delay in getting test results and other information to ER doctors and nurses. For Smith, who came to medicine from a PhD program in computer science at Stanford, and Feied, who started his career as a biophysicist and knows 25 computer languages, the obvious answer was to write a computer program that could eliminate the bottlenecks.
Sixteen months later, they installed the first terminal in the middle of the ER with a handwritten sign taped on it: "Beta Test. Do Not Use." But as they had hoped, people began using it anyway -- and were astounded by what they could do. And before long, doctors were coming from other departments to retrieve information on patients who had come to them through the emergency room. 
Over the next eight years, Azyxxi spread through the hospital as more people used and demanded it, and more information was fed into its database. By 2002, the IT department threw in the towel and canceled a contract with an outside vendor to develop a hospital-wide electronics record system, having already spent $8 million. By the end of last year, with the help of a handful of in-house programmers, Azyxxi had been rolled out in all six sister hospitals in the MedStar system, at maybe a third of the cost of what an outside supplier would have charged, according to hospital officials.”
Earlier this year I had the chance to speak with Steve Shihadeh and Mike Naimoli from Microsoft and you can read the interviews below where he discussed where Amalga and Life Sciences are today and the future growth.  You can also do a search on the blog under Amalga and find a number of additional posts as well. 

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

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

Amalga has grown and is being used as a solution all over the world and in the US, El Camino hospital, New York Presbyterian, St. Josephs to name a few and Amalga also played a part in the Microsoft H1N1 tool that was announced a couple weeks ago. 
Dr. Oz speaks about the importance of electronic medical records at New York Presbyterian too. 


Link to the ABC Video
Other areas of the report discussed keeping things clean and safe around the hospital.  Actually when you watch the ABC Video, these items were featured first. 
They discuss the “killer tie”, describing it as a big “germ slob” that goes around collecting bacteria all day long.  We want to go to the hospital to NOT die, in other words we don’t want to die of something else you catch at the hospital, we want to get well.
  
Hand washing is discussed at great length.  At Cedar Sinai they put a screensaver on all the computers in the hospital as a constant reminder for doctors to wash their hands.  Repetition works everywhere.  They did a culture of the bacterial and their hands.
In addition to a screensaver, I like this technology solution I wrote about a while back, as it is simple to use and appears to be non intrusive or disruptive.

Real Time Monitoring of When you Washed your Hands – Don’t Touch that Patient Until You Have Washed Your Hands

This is the result of a culture, big mass there is bacteria and certainly looks pretty ugly.  Cedars also posted pictures like this all around the hospital too as a reminder. 

They followed a nurse for 10 minutes and in that amount of time she had to wash her hands 20 times, something you wouldn’t think about I guess until you see the person working in action.  Cedars has even added disposable stethoscopes to work on cleanliness. 
It’s a good watch and worth the 20 minutes and will bring you up to date on how many thinking outside or not even near a box, are creating solutions.  BD 
Watch '20/20' Friday Nights at 10 p.m. - ABC News
Related Reading:

Microsoft Research: Research & Programs for Healthcare

Genomics and Silverlight from Microsoft working together for Great Visual Enhancement– BioMashUps

Scripps, Navigenics, Affymetrix and Microsoft team on groundbreaking health study – Personalized Medicine

Two More Hospitals Sign for Amalga from Microsoft

Wisconsin Health Information Exchange RHIO connected with Amalga from Microsoft

Microsoft Introduces Groundbreaking Technology – Amalga Life Sciences Software

Technorati Tags: Azyxxi,Amalga,healthcare,Microsoft,washiing hands,HAI,hospital acquired infections,cleanliness,software,data bases

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Take Healthcare Out of the Hospital States Internist From Non Profit Exploring Disruptive Innovations

He makes some very good points on some disruptive technologies that have entered healthcare, like Minute Clinics and about how the venue of job descriptions is changing, duties shifting to other areas such as physician’s assistants performing tasks provided by doctors.  He speaks about devices and yes we are accustomed to using present day devices, but most are not any where near ready to move to the next level whereby data is being reported from the devices which requires additional interaction and participation in one’s healthcare.  Shoot there are doctors who don’t even know what those are as well.  Also important is the muddy waters out there with devices as well, where’s your data going? Ask questions and be disruptive here yourself. 

The next level of disruptive technology is going to need one heck of a training effort, otherwise it will be just that – a disruption that nobody understands or wants to deal with, folks will give up if overwhelmed.  In following along with the title of this article, taking healthcare out of the hospital, we are talking a lot of devices and data reporting, so again not to be overlooked and considered. 

One other item not mentioned is insurance carriers and they disrupt everybody every day with new business models, new plans, new scoring procedures for claims, and not to mention new algorithms that will affect somebody and the care they receive.  So again all of this is fine and dandy with a little push, but we don’t want to over look the entire picture and need balance from all areas and not just decide to be disruptive because we can. (grin).  BD

Jason Hwang, an internist and director of healthcare for the Innosight Institute, told attendees at the 2009 Connected Health Symposium in Boston that the best way to reform healthcare is to let disruptive, "bottom-up" technologies de-centralize the system.

Jason Hwang's prescription for healthcare reform can be boiled down to a simple axiom: Take healthcare out of the hospital.

The internist and executive director of healthcare at the Innosight Institute told attendees at the 2009 Connected Health Symposium that healthcare is too expensive and inaccessible for too many people, because the system's hospital-centric business model isn't sustainable.

Instead, Hwang called for a new model that recognizes the increasing role technology plays in our society.

"The story we often tell is about diabetics being empowered by technology to do more and more care for themselves. Obviously, outcomes tend to be better when [diabetics] are more engaged with their health," Hwang told MassDevice after his speech. "So we've armed them with glucose meters, insulin dosages that they're allowed to adjust on their own and an easy ability to get syringes in pharmacies. All of that goes to de-centralizing care.

"As you change the care-giving venue, you also usually change the profession of the person providing the care," Hwang observed. "Specialists have become generalists and more care is being given on an outpatient basis. Duties once performed by physicians are now the domain of physicians-assistants and nurses."

Hwang: Take healthcare out of the hospital | MassDevice - Medical Device Industry News

Technorati Tags: disruption,Innosight,think tanks,non profits,healthcare reform,medical devices reporting data,medical devices,hospital

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Sad Economic Times for Seniors - 70 Year Old Man with Oxygen Tank Robs Bank and Gets Away

This happened in San Diego and is on the FBI list.  This is sad as more thank likely are trying to survive.  This also says something for us as humans I think as how could not not catch up with a man with an oxygen tank, and where was security?  If things were not so bad we would not have seniors robbing banks!   Video of the report.

Again, another sign of the sad times we are going through now.  I am guessing the employees and others may not have even had the heart to go after him.  They did not disclose the amount of money he actually obtained, but it stated he wanted $10,000, not a huge amount by today’s standards and perhaps he needed it to pay for his healthcare if he was carrying an oxygen tank.  BD

 

SAN DIEGO - A man in his 70's or 80's is on the loose after he robbed a bank Friday. It is the third time in two months that banks have been hit by elderly robbers. The robber got away with an undisclosed amount of money.

Witnesses says the senior approached the teller at a US Bank inside a Vons on Carmel Mountain Road Friday afternoon. He claimed he had a gun and would shoot one of the tellers if he did not receive $10,000.

Have Tough Times Turned the Elderly to Crime? - San Diego 6

Technorati Tags: Seniors,oxygen tank,healthcare,healthcare reform,bank robberies,money,Senior healthcare,economy,human morals

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Health Insurance Business Intelligence “Scoring” Algorithms Interfering with Human Morals

We keep hearing these outrageous stories on the news all the time.  The first is a woman who is told to get sterilized in order to get insurance coverage.  In this family, her husband and children were accepted for coverage but she was denied as she had a C-section.  Are C-sections now flagged as as a reason to deny coverage?  What if she had not had a C-section, would she have been covered.  Many women over the years have had C-sections so why now are we considering this to be a “scoring” procedure when determining if someone can be covered?   In her case it was United Healthcare giving her the news.  If you think back to Sicko, remember we saw many examples of this times over, it has not stopped and as the algorithms get more defined and complicated, this will only continue to grow. 

They are the king of the algorithms and make more money from this end of their business today than they do from insuring people.  They live by those algorithms as just recently too in the news was the story of a 2 year old denied care as the algorithms showed she was too skinny.  Recently too in the news a kidney donor was also “scored” to be a risk for health insurance as well. 

Wellness Programs Get Thrown a Left Hook From GINA – No Family Medical History Allowed on a Health Risk Assessment

Scoring algorithms on claims are powerful too, if you read about several dermatology offices that within 5 days were cut off from ALL the insurance policies from paying, they related it back to the Ingenix scoring procedures used for detecting “potential” fraud.  This destroyed patient/doctor relationships and a couple offices had to close.  When you stop and think of not just one carrier, but all stopping payment within 5 days with no notice, this is scary.  Court and legal cases against Ingenix in the process as the other carriers subscribe to their business intelligence algorithms used.

It’s all in the risk management HRAs algorithms that determine this, set by a programmer under someone’s direction to do so.  Recently this week I posted about the GINA law and health risk assessments in question and waiting for the ultimate decision on whether or not family history can be used.  Again, the complicated algorithms run to assess whether or not someone can be covered is getting pretty complicated, so you somewhat wonder what will be the next item of criteria used to make these analogies.  As she states in the video, she’s not alone.

Want insurance? Get sterilized. – Feministing

In a somewhat related story, a couple has to get divorced in order to provide healthcare for their daughter.  The couple had to legally get a divorce so their daughter could get the assistance she needed by showing that her mother did not make enough money on her own to qualify.  How much is all of this interfering with our lives and “doing the right thing”.  The couple plans to re-marry when their daughter turns 18.  They obviously can’t afford the huge bills and perhaps too were denied coverage. 

Our current healthcare plan and the algorithmic formulas that are supposed to be used to improve healthcare are appear to have profits at the top of the priority list and then if some folks happen to get healthier along the way while others suffer, well you know it’s all in those algorithms they taunt at Congressional meetings on improvement, which if it is you or someone in your family having problems, it means nothing when you need and are denied care.  These are some real prime examples here as to why our current system does not work and is in fact working to destroy the “good” human instincts to help others that we all are born with by nature, and yet our leaders keep telling us to reach out and help others, but having this algorithmic penalty situation hanging over all our heads is forcing people to make decisions and take on attitudes we would not normally see. 

When we start seeing stories of 70 year old seniors robbing banks, you have to ask what is wrong?  This particular story happened in San Diego and they are still looking for the man, who by the way was also carrying an oxygen tank.  BD 

http://www.firstcoastnews.com/news/strange/news-article.aspx?storyid=147095&catid=82

Technorati Tags: health insurance,healthcare,algorithms,scoring health claims,Ingenix,United Healthcare,underwriting,morals,profits,healthcare reform

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Metro Health Village Using Thin Clients for Hospital Health IT – Epic Records System

They have 6 individuals maintaining about 4000 back end sessions.  If you are not familiar with thin clients, all the functionality is done at the back end, in other words, the IT staff is not being required to handle a full PC, so all the problems with operating systems and so on that go with having a PC are gone, all the software runs from the server.  Thin clients also used less electricity, so additional savings are seen there as well.

The thin clients are offered from a company named Wyse, who has been around for quite a while with this technology.  I also think Tablet PCs that could run on a thin client as such would also add a ton of value as now you have a tablet that can do inking.  There is software too now that can run inking from a server, Rite Pen.  I don’t know how far it is in development, but a while back spoke with them on some testing they were doing with Citrix.  I use it on my regular touch screen/inking tablet today as it enables me to write anywhere.  The next plateau I would guess would be to allow applications with touch capabilities to do the same from the server end on a thin client. 

The doctors wear a device around their neck so communication is simple and fast from Vocera Badge.  They are using “My Chart” integrated with their Epic record system to better engage doctors and patients, along with Outpatient facilities being connected.  You can view more at the website.  Patients can get online, schedule appointments, get prescription refills and communicate with their doctors, and again many of the off premise offices are connected to the hospital.  BD

Wyse Technology, the global leader in thin computing and client virtualization, today announced another successful customer implementation. Metro Health Village, located near Grand Rapids, Michigan, is one of the most comprehensive health care providers in west Michigan. Its staff of approximately 1,000 doctors and nurses provide care to nearly 11,000 inpatients each year, handle nearly 50,000 emergency room visits, and 320,000 visits to the outpatient centers each year. In all cases, patient records are accessed, updated and managed via thin clients from Wyse Technology. 

"No one knows exactly what shape healthcare reform will take," according to Bill Lewkowski, Executive VP and CIO at Metro Health, "but what is clear to me is that the path to healthcare IT reform is through virtualization. From Electronic Medical Records (EMRs) to physician collaboration to HIPAA compliance to IT costs, there are too many benefits to virtualization to ignore."

Metro Health currently has Wyse thin clients deployed throughout Metro Health Village. Approximately 4,000 employee sessions are always running in Metro Health's data centers. Employees—clinicians, pharmacists, receptionists—simply go up to any of the approximately 1,250 Wyse V90 Windows XP Embedded thin client workstations in the hospital, enter their login information, and immediately see the same screen they had up when they logged out of their last session. It takes fewer than 15 seconds for a doctor to access a patient's information rather than the several minutes it would take to log in to a PC, open up the applications, and call up the data.

Metro Health Village implements Wyse Technology's healthcare IT solutions

Technorati Tags: Metro Health Village,technology,Rite Pen,heatlhcare,Health IT,Wyse,thin clients,computers,healthcare,Epic Medical Records

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Overcrowding Continues at County USC Hospital – Los Angeles

This is the brand new, state of the art facility that opened earlier this year.  The hospital has 600 beds and when in the planning stage many had argued for 750, but 600 was the number decided  upon.  Some patients are waiting as long as 23 hours to be seen, although average times are ranging from 3 to 16 hours.   Fears of the H1N1 virus are also having an impact on the over crowding. 

Patients are also being diverted to other private hospitals who take Medi-Cal.  One recently used is Downey Community which is in the stage of re-structuring after filing bankruptcy so that ER room is currently not on the list for referrals.  In case H1N1 cases pick up in a hurry, the hospital is ready to go with tents. 

The hospital also has some mobile units as we saw with RAM Remote area medical care with mobile dentists who setup to help out.

USC Mobile School of Dentistry Joins Remote Area Medical at the Forum in Los Angeles

I did a post a while back about all the new state of the art equipment, robots and more at the link below before the hospital opened.  They have robots and all the latest diagnostic equipment available too at bedside.  BD

LAC+USC Hospital – New Facility to Open Soon - Los Angeles

Los Angeles County-USC Medical Center has become too overcrowded to handle the expected surge of H1N1 flu patients in coming months, county leaders said this week as they forced hospital officials to reduce wait times by transferring patients more quickly.

The crowd waiting for emergency room beds at County-USC often swells to 100, with some people waiting up to 24 hours, Supervisor Gloria Molina said. 

Recent county reports show that 30% to 40% of the time the hospital is operating at “severely” and “dangerously” overcrowded levels.

County-USC already contracts with St. Vincent Medical Center in Los Angeles and several other private hospitals that honor Medi-Cal, and is negotiating contracts so it can transfer patients to more hospitals, according to Carol Meyer, chief network officer of the Los Angeles County Department of Health Services.

Overcrowding at County-USC hospital heightens swine flu fears | L.A. NOW | Los Angeles Times

Technorati Tags: LAC+USC Medical Center,Los Angeles,Hosptials,LA General Hospital,Healthcare,Historical Buildings,Keck School of Medicine of USC,USC Medical School,H1N1

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AssureRx Test Now Available – Genomic Information For Prescribing Psychiatric Medicine

The results are completely private and use a web-based program to locate.  This somewhat a first move of it’s type to be able to get a psychiatric genetic footprint before prescribing medications to treat various mental diseases/conditions to include medications for anti-depression.  Anti-depression drugs have had some high failure rates and the test now offers doctors a new tool to aide in prescribing a medication that could be more suited to work, as there’s a lot of choices out there today. 

The test must be ordered by a physician and the article states it takes around 48 hours for the results.  BD 

CINCINNATI, Oct. 22 /PRNewswire/ -- AssureRx, a personalized medicine company, announced today that it has begun a full launch of its first product, GeneSightRx(TM) This lab-developed, pharmacogenetic test had previously been commercially available only on a limited basis. The test combines state-of-the-art genetic testing technology with a multi-variate, algorithmic, interpretive report to help guide physicians during their decision-making process before prescribing psychiatric medications.

Al Lucas, VP Sales and Marketing, stated, "There is a significant challenge in psychiatric medicine to quickly find the most appropriate medication for each individual patient, which may bring relief from symptoms, reduce or prevent hospitalization, and avoid severe side-effects. Until recently, doctors had no way of identifying patients who may have genetic variations that would affect how medications might work in each patient."

The company was founded in June 2006 to commercialize industry-leading personalized medicine technology. Cincinnati Children's Hospital Medical Center and Mayo Clinic are equity holders and technology collaborators. More information on AssureRx visit: www.assurerxhealth.com.

AssureRx Launches First Personalized Medicine Product

Technorati Tags: pharmacogenetics,healthcare,labs,AssureRX,personalized medicine,mental health,patients,physicians,medications,FDA,anti-depressants

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New Tri-Care Contracts – I May Lose My Physician (Comment from a Reader)

This was actually a comment on one of my posts relating to the new Tri-Care contracts.  As you can see the reader is asking for any comments here so if anyone has anything to add, please feel free.  In reference to the physician losing their status with United, there could be a number of reasons and usually it comes down to contracted rates, although there could be other items as well involved.  The physician’s office may not be accepting the rates of compensation possibly with his current patient mix, thus would incur a loss, so perhaps negotiations are in the working.  Recently I had and MD tell me his compensation was reduced by 12% from the carrier and again that is a statement with no additional facts.

I would stay in touch with your physician and perhaps call the Tri-Care administrator for more information, I know frustrating and there may not be a definitive answer as of yet.  In the related reading below there is also a post about Tri-Care using telehealth which may or may not be in your area and perhaps this could be an option in his contract to provide this type of service.  Also in the news in the last day is a rebranding effort being done for current patients enrolled under Pacificare, which United bought about 4 years ago.  It sounds like there’s a lot going on at one time with a large number of changes taking place due to new contracts.  BD 

United HealthCare Rebranding PacifiCare Name

“We are Military Retired with TRICARE Prime insurance. We understand that United HealthCare now has the TRICARE contract which starts 01 April 2010. Our Physician relayed to us on Tuesday, 20 October that his office May lose their provider status under United and no longer be able to carry TRICARE insurance. He told us that they are fighting to stay as a provider but could lose the battle. We are more than 200 miles away from a MTC and don't understand how this could happen. It now appears that providers must have a huge population of military retirees before being allowed to have TRICARE as an insurance. Comments????? “

Related Reading:

Tri-Care Giving Telehealth Services a Try

Aetna and United Healthcare Secure Military Contracts

Unitedhealth receives $21.8b military health care contract with ...

Technorati Tags: Reader,Tri-Care,heatlh insurance,United Healthcare,physician,contracts,negotiations,military,healthcare,telehealth

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TriZetto Announces New Feature for Personal Health Records – Auto Populated for the Consumer But Payer Access for Eligibility Questions from Providers

I hope I am reading this correctly, you get the benefit of an auto populated PHR, but in essence it is not private as payers will have access?  This is slated to roll out by the year end.  Not too long ago I posted about HeatlhVault working with TriZetto.  TriZetto is business intelligence for risk management in healthcare. 

TriZetto Agreement with Microsoft HealthVault – Consumers Managing their Own Healthcare

Again, if I am reading this correctly, you get an automated PHR, populated for you so no leg work on your part, but you give up some privacy is appears along the way.  Health insurers will need to be using their proprietary business intelligence software to participate.  Earlier this year, TriZetto was purchased by Apax Partners, a London based private equity firm for 1.4 billion so somebody wants a return on their investment somewhere along this line.  They also have a large agreement in the Netherlands for processing claims and other financial interests.  Just a few days ago I posted about the Netherlands and problems they are having collecting from their insured as people are not paying, but under the law they can’t be cancelled there like we are here.

The company also has partnerships with Dallas based company TeleDoc. 

With the current HealthVault agreement and working with their PHR, this is interesting to see how this will all play out.  Do you get a PHR to use whether you want one or not?  If you do have to enroll it sounds like all your information is then available to payers?  Again, this is very confusing here and for me, I’ll stay with my HealthVault account where I feel I have control, since they are not in the insurance business. 

i did watch the video and the message to me was primarily “power to the payers” with the focus on algorithmic formulas that are proprietary and who knows how they calculate.  I still believe we need a “Department of Algorithms”.   When you stop and think of how far behind we are with some consumers barely even able to do email and the screens and so forth on the demo, we are in big trouble, intelligence taking advantage of ignorance once more.  I’m coming back to the “real” world and I can barely even think of many providers (many of whom do not even us an EHR yet) who could navigate all those screens and some hospital CEOs for that matter, life in the real world of humans that don’t scale.  BD

One Hell of a Training Program Needed

Press Release:

Auto-Populated, Portable PHR Includes Care Information From All of a Consumer's Providers

NEWPORT BEACH, Calif. - October 22, 2009 - The TriZetto Group, Inc. today announced additional features and functions of its new personal health record (PHR), which at year's end the healthcare IT firm will make available free of charge to health insurers that use its Facets® enterprise administration software and in early 2010 to payers using its QNXTTM application. The PHR will be free, as well, to the providers and consumers who use the electronic record.

When health plans deploy TriZetto's PHR, consumers will have immediate access to their pre-populated record and may designate family members who can access their record. When physician staffs request eligibility confirmation, payers will be able to provide a concise summary of relevant facts from the patient's PHR.

"Unlike hospital electronic medical records and physician office electronic health records, TriZetto's PHR will include information from all of the doctors and facilities that treat a patient over time," said Dave Pinkert, senior vice president of product management at TriZetto. "Further, only our PHR, populated by the rich repository of digital benefits and care information already in the systems of healthcare payers, are ready now for deployment to nearly half of the nation's insured."

Health plans that use TriZetto's enterprise administration systems provide medical benefits to 106 million Americans.

"The TriZetto PHR will automatically populate and update with clinical information that doctors and hospitals provide when they submit claims to healthcare payers," Pinkert explained. "This pre-population is completely unique in the market, especially when combined with the opportunity for consumers to add or supplement information to this PHR. It will help ensure consistent care and the most informed decisions between a patient and his or her multiple providers."

Fully supporting industry interoperability and security standards, TriZetto's PHR will enable a patient to give a provider a fully digital record of his or her health history. The record will include the following information from the healthcare payer's claims system:

• Procedural history, including
  • Lab work
  • Exams
  • Surgeries and other treatments
• Diagnoses
• Healthcare providers who have treated the patient

"TriZetto's PHR will be portable," noted Pinkert. "So even as consumers change health plans, we'll make it easy for them to take their health record with them."

As a consolidated record of a patient's care by multiple providers and facilities, Pinkert added, TriZetto's PHR will support the "medical-home" approach to care. Under the medical-home approach, a personal physician takes the lead on coordinating integrated care for a patient by multiple providers who all share a complete record of the individual's health, medical conditions and treatment.

Members will be able to access their PHR on-line, with the ability to add or supplement information about:

• Family history (e.g., diseases and medical conditions of parents, siblings)
• Emergency contacts
• Medications and dosages
• Allergies
• Claims
• Immunizations
• Personal details, such as preferences and behaviors that can affect health status.

"Using TriZetto's PHR, consumers will be able to actively participate with their doctors in maintaining or improving their health," Pinkert said. "For instance, at a doctor's direction, a patient might regularly record his or her blood pressure in the PHR. Then, at the next office visit, the patient and doctor can evaluate the new data and discuss treatment options together."

TriZetto's PHR will be managed by consumers and populated by the large volume of digital benefits and care information in the systems of healthcare payers. "We have great expectations for this new solution," said Pinkert. "TriZetto's new PHR will bring a huge and immediate improvement to the efficiency and quality of the U.S. healthcare system."

About TriZetto

Founded in 1997, TriZetto is the leading privately held healthcare information technology company to the healthcare payer industry. With its technology touching half of the U.S. insured population, TriZetto is Powering Integrated Healthcare ManagementTM, the systematic application of processes and shared information to optimize the coordination of benefits and care for the healthcare consumer. The company's offerings include enterprise and component software, hosting, outsourcing services and consulting that help payers implement and optimize their operations and minimize the risk of bringing to market new products that drive competitive differentiation.

TriZetto Announces Features and Functions of Personal Health Record, on Track to Debut at Year`s End | Reuters

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CareMore Live On TriZetto's Clinical CareAdvance System Algorithms - Healthcare Business Intelligence

CareMore Health Plan Invests in Business Intelligence for Acute and Chronic Illness Management

Technorati Tags: Business Intelligence software,healthcare,Health,Trizetto,managed care,PHR,personal health records,health insurance,privacy

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Journal of Participatory Medicine – Website Launch

Ok so what is this all about, the word participatory comes from the work participation, so in short this is what it is all about, getting involved in your healthcare.  If you don’t get involved there’s nobody going to do it for you. 

We are very busy today as we have more information and decision making processes than mankind has ever faced and so goes the same for your doctor and their clinical staff.  I write about many new devices on this site and this is all part of the participatory medicine.  In one way or another in the upcoming future, there’s going to be a device or data report you are going to need to know about.  Telehealth is moving very quickly and devices are taking the place of “in office” communications as we have known in the past. 

There’s not a day that goes by where it seems I am not hearing of a “breakthrough” of some type, and yes that word is used loosely as it may be a breakthrough in an area that may not have an effect or be of interest to you, but would be of interest to someone else.  I try to break down articles that somewhat appeal to all and give a general list of posts.  Back on target here, read up, learn, and pay attention.  All devices and data are not created equal and we have literal explosions of technology and data coming from many different directions and it is easy to get lost.  The journal will also add some value with articles of interest to help keep you up to speed so you may want to bookmark the site for future reference too.  BD 

Why Participatory Medicine?

Summary: The job of the Journal of Participatory Medicine is to answer the question of "why participatory medicine"? It is our hypothesis that PM is good: It will lead to healthier, more empowered individuals, lower health care costs (through reduced need for health care) and a more productive, happier society overall. But that's just a hypothesis, and one we want to test rather than assert. To test it, we need both to cover news of the field and to encourage researchers and individuals to try things out and report on their efforts. So yes, we're a cheerleader and optimist..but in the end we must be a skeptical if loving critic.

Education

One aspect of education happens in schools. What's the proper curriculum for schoolchildren about healthy living? How can we teach kids that it is normal and expected that they maintain their own health records, check out a new doctor's performance, and research their treatment choices, much as they manage other parts of their lives? Those questions bear examining and we hope to become a resource whenever people need to find the answers.

For participatory medicine to flourish, consumers will also need tools and services to find and manage their own information. These will include everything from pedometers and monitoring devices, to easy-to-use software that will enable them to record their data, analyze it, and compare it with those of others. Many companies are jumping into this market; they will need to make sure their software interoperates with other tools and services on the market. We hope that this Journal will help the best to emerge and others to improve, and will highlight evidence on which ones make a difference to individuals.

Journal of Participatory Medicine Launch | Society for Participatory Medicine

Technorati Tags: participatory Medicine,healthcare,participatory Sensing,medical devices reporting data,heatlhcare,PHR,personal health records,physician,patient

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State of California Sending Out Face Masks in Orange County Until More H1N1 Vaccines Arrive

So far only 1.7 million doses of H1N1 have been sent to California, that is not many with the population we have here, and is barely enough to perhaps even begin to touch a portion of the community in southern California.  In the absence and until drug manufacturers can get more out, the State is sending out masks – 25 million masks. 

4.5 million doses of the nasal spray and about 18 million shots are what is budgeted and planned for California.  BD 

Hospitals, doctor’s offices and the county’s Health Care Agency are still waiting for an expected shipment of H1N1 vaccine shots from the state.

Delivery is expected this week, said spokeswoman Deanne Thompson of the Health Care Agency.

But  no one can say exactly when. Hoag Hospital’s medical director of infection control and epidemiology called state and county officials Wednesday, but couldn’t get answer on when the shots will arrive, said hospital spokeswoman Andrea Winter.

Doses of the nasal spray began trickling in two weeks ago, but those are reserved for children 2 to 18 and parents of infants.  Thompson said most shots will be shipped directly to private health care providers.

Orange County has received about 29,000 doses of the nasal spray.

http://healthyliving.freedomblogging.com/2009/10/22/state-delivering-25-million-face-masks-for-swine-flu/11803/

Technorati Tags: H1N1,Orange County,California,vaccines,Swine flu,pandemic influenza,flu,viruses

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A Case for a New Syringe – TED Presentation

This is a real eye opener here to see how many of these are laying around all over the world and how syringes are infecting more people today than mosquitoes are with malaria.  

Mr. Koska has come up with a new syringe that can only be used once, when you try for a second time, it breaks.  The cost is the same as what we pay today for the traditional syringe.  This is certainly a winner to me. 

  

When you watch the children that work picking these up so they can be resold, it’s sad and they too get infected from the syringe.  In the video you can clearly see a syringe being dropped back into the tray for re-use.  We about choke when it happens here and usually in the US it is some type of criminal action when this occurs, as we have seen recently in the news with a couple nurses re-using the syringes, one having a drug problem and passing on hepatitis to patients due to re-use.  I think the new syringe would be welcome anywhere.  BD 

Reuse of syringes, all too common in under-funded clinics, kills 1.3 million each year. Marc Koska clues us in to this devastating global problem with facts, photos and hidden-camera footage. He shares his solution: a low-cost syringe that can't be used twice. (Recorded at TEDGlobal 2009, July 2009, Long Beach, CA. Duration: 4:46)

TED Blog: 1.3 million reasons to re-invent the syringe: Marc Koska on TED.com

Technorati Tags: syringe,disease,TED,healthcare,infection,HIV,hepatitis,R and D

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Bill & Melinda Gates Foundation Fund 76 Research Projects – Healthcare

In the US, the Foundation focuses on education.  I can’t remember how many times I have posted videos of Mr. Gates in front of Congress asking for a call to arms for education of US citizens, and we still lack and are far behind.  In July, Bill Gates spoke in India stating the US got off to a bad start with computers.  In May this year he was the leader of the “billionaires” meeting.  The Foundation doesn’t wait for donated time on television, they buy it. 

Gates Foundation and Viacom Team Up for “Get Schooled”

You can read more about the US focused programs at the website.  These are not huge grants, but sometimes a great project doesn’t need huge amounts of money to get started before it can stand on it’s own.  The examples shown below, and several in the US all relate to healthcare, disease, and vaccines.  Also worth mentioning, the Foundation no longer plays around with Pharma and Biotech stocks with the exception of one biotech company, somewhat makes a statement I think.  BD

Gates foundation sold off almost all of their pharma, biotech stocks

“In this audio slideshow, Bill Gates talks about what the foundation's past nine years of focus on education have taught him about creating a “culture of achievement” in schools.”

ARUSHA, Tanzania -- The Bill & Melinda Gates Foundation today announced 76 grants of US$100,000 each to pursue bold ideas for transforming health in developing countries. The grants support researchers in 16 countries with ideas as diverse as a developing an electronic nose to diagnose tuberculosis and using chocolate to help prevent malaria. 

“Some of the biggest stumbling blocks in global health are now being overcome with promising new vaccines and treatments,” said Dr. Tachi Yamada, president of the Gates Foundation’s Global Health Program. “Grand Challenges Explorations will continue to fill the pipeline with possibilities and hopefully produce a breakthrough idea that could save untold numbers of lives.”

In three rounds of the foundation’s Grand Challenges Explorations initiative, 262 researchers representing 30 countries have been awarded grants.

Grantees from round 3 were selected from almost 3,000 proposals. All levels of scientists are represented – from young post-graduate investigators to veteran researchers – as are a wide range of disciplines, such as chemistry, bioengineering, electronics, mechanical engineering, infectious disease, and epidemiology. They are based at universities, research institutes, nonprofit organizations, and private companies around the world. Examples include:

• Innovative ways to diagnose infectious diseases:
  • Andrew Fung of University of California, Los Angeles aims to develop chewing gum that can detect malaria biomarkers in saliva;
  • Ranjan Nanda of the International Centre for Genetic Engineering & Biotechnology in India will attempt to create a handheld “electronic nose” that gathers and analyzes breath samples to diagnose tuberculosis;
  • Udantha Abeyratne of the University of Queensland in Australia will equip mobile phones and mp3 players with microphones to record cough and sleep sounds, which could then be screened to diagnose pneumonia.
• New strategies to fight malaria and mosquitoes:
  • Steven Maranz of Weill Cornell Medical College in New York will test the ability of a compound found in chocolate to keep malaria at bay;
  • Annette Habluetzel of the University of Camerino in Italy will create a micropellet food which, when activated by the sun, could generate toxins that kill mosquito larvae;
  • Peter Lubega Yiga of AdhocWorks Foundation in South Africa will test the efficacy of a fermentation-based household mosquito repellant.
• More effective vaccines:
  • Cecil Czerkinsky of the International Vaccine Institute in Korea will explore whether vaccines administered under the tongue can produce strong immune responses in distant organs such as the lungs and reproductive tract;
  • Margaret Njoroge of Med Biotech Laboratories in Uganda will develop an intranasal vaccine for mothers, designed to induce antibodies against malaria in breast milk and confer immunity on their babies;
  • Kate Edwards, at the University of San Diego will study how a brief bout of exercise may enhance the efficiency of pneumococcal vaccine.

Funding 76 New Ideas to Improve Global Health - Bill & Melinda Gates Foundation

Technorati Tags: Bill & Melinda Gates Foundation,Philanthropy,healthcare,science,R and D,disease,technology,grants,education,Bill Gates

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The Rejected Windows Mobile Marketplace Applications - Humor

Windows Mobile has been getting a bit of flack lately, so why not add some inside humor to the scenario.  The rejected apps are funny.  BD

  

Today, Microsoft’s Windows Mobile Dev team released a humorous video giving a sneak peek inside the Microsoft Apps Lab. Here, you get a behind-the-scenes look at a few of the apps Microsoft dreamed up for its new Windows Marketplace, but were forced to reject for various reasons ranging from stupidity to lawsuits to physical pain.

Video: The Rejected Windows Marketplace Apps (Humor)

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Wellness Programs Get Thrown a Left Hook From GINA – No Family Medical History Allowed on a Health Risk Assessment

As I can interpret here, it appears that GINA will not allow any family history information to be collected by a Wellness Program, incentive or no incentive as it violates the provision of the law.  Also as it explains below, the use of a Health Risk Assessment cannot be used if family medical information is included.  This is getting more interesting by the moment.  I still say we need algorithmic centric laws or this is going to be the country’s pastime, interpreting laws 24/7. 

HHS Attempts to clarify GINA Laws

Here’s just one more example why today’s business models of using complicated algorithms to calculate risk on humans, and all of us by nature are not 100% predictable, but this is what the business models are trying to achieve, futile point.  Certainly there’s a bit that is predictable and lots of room for improvement, but are we not getting tired of these algorithms that make decisions that result in one more denial of service and an OMG story for the press? 

I guess some folks haven’t figured out yet how tight genomics, technology and healthcare have become and keep trying to treat each as a separate faction.  I would have to say those ideas too mainly come from those who are not participants and lack much hands on skills with working with any type of healthcare technology, even that of such designated for consumers, like PHRs, that they all say are good for us.  I agree they are good for us, but where’s the role models?  Are we ever going to see any of them stick their toe in the water or are we going to have to live with “Magpie Healthcare”? 

It appears now that including family history on a Health Risk Assessment is out the window, so stay tuned, or there could be new forms coming soon.  I really don’t know how much more they can literally botch up healthcare with all the underlying risk management algorithms, and in the meantime people are going without care.  Just this week a bad algorithm denied coverage to a 2 year old because she didn’t meet the parameters set by the algorithms, and does a human make an adjustment, no.  We have to play out the whole news story once again before it gets changed, so you can see how strong those algos are when they are on the screen, change them without an act of God and the employee may lose their job.

How much are the members in Congress participating in their own healthcare?  Would any of them entertain a device using an accelerometer to help them?  Do they know what an accelerometer is?  These are just some passing questions I thought about today.  Anyway, if you are asked to fill out a Health Risk Assessment (HRA) you might want to ask or check to see if there have been any updates made to what is and what is not allowed.  BD 

An organization of industry stakeholders that carry out and support chronic disease prevention and care is calling for a moratorium on new federal regulations to protect genetic information.
The Departments of Health and Human Services, Labor and Treasury in early October issued the interim final rule to implement provisions of the Genetic Information Nondiscrimination Act of 2008.

"Further, the interim final regulations state that a wellness program that provides rewards for completing an HRA that requests family medical history would violate the prohibition against requesting genetic information for underwriting purposes, even if the rewards or incentives are not based on the outcome of the assessment. The interim final regulations provide no exception to this rule, regardless of the amount of the reward or incentive or whether the HRA meets the HIPAA wellness plan requirements.

"Finally, and most troubling, the interim final regulations prohibit the use of an HRA to determine whether a participant is eligible for a disease management program if the HRA elicits family medical information. This prohibition holds even if the HRA does not otherwise contain a financial reward or incentive."

Groups: Genetic Data Rule Flawed

Technorati Tags: GINA,HHS,pharmacogenomics,genomics,healthcare,healthcare reform,health insurance,DNA,Lab tests. algorithms,Magpie Healthcare

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The H1N1 Robot Makes It’s Debut in Japan – The SwineBot Simulator

Japan is known for their love of robots, so now we have a new one, the Swinebot.  Yes, they did it correctly, it looks like a human and not a pig and they may not have issues there with people worrying about eating pork, which of course is ok as it is an airborne flu.

The poor robot sits around sick all day long with the Swine H1N1 flu.  If you don’t treat the robot correctly, I guess it dies on you, as it quits breathing.  Below is another video that shows a robot coughing.  BD 

Here’s one that coughs at you too.  This one is here in the US so we have a different bot. 

The robot is meant to be a diagnostic tool for physicians. The robot shows symptoms of someone having a severe outbreak of the flu including moaning, sweating and difficulty breathing. If the robot is not treated properly it will eventually stop breathing.

Flu Robot on Display at Tokyo Trade Fair

Technorati Tags: H1N1,robot,Japan,Swine flu,pandemic influenza,healthcare,simulation

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