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The Poor Are Turned Away For Cancer Screenings – But Let’s Be Sure to Pay Those Dividends

I just posted about the 3 big companies in New York stating they “have to stand by” and pay their investors.  What kind of investors are they?  Greedy ones and what kind of insurance companies are these? image

Just even a portion of the millions they claim they have to pay would take care of a multitude of pap smears and mammograms.  This also puts the American Cancer Society in a bad spot as well.  I keep saying there’s no way anyone is going to get their arms completely around projecting the cost of healthcare as technology raises the bar and cost every day, something we have to live with.  When you hear stories like this an then hear about the need for dividends, this really makes one big case for insurers to get off the stock market and return to being non-profits as its only going to grow worse as the algorithmic calculations continue to grow more complex they find new and innovative ways to create formulas to generate profits from areas that should be left alone.  BD 

What Comes First Dividends or Healthcare – 3 Health Insurance Companies Defend Payouts of Dividends

Once back to a non profit status, there goes the dividend problem.  BD 

ALBANY, N.Y. – As the economy falters and more people go without health insurance, low-income women in at least 20 states are being turned away or put on long waiting lists for free cancer screenings, according to the American Cancer Society's Cancer Action Network.

New York used to screen women of all ages, but this year the budget crunch has forced them to focus on those considered at highest risk and exclude women under 50.

In the unofficial survey of programs for July 2008 through April 2009, the organization found that state budget strains are forcing some programs to reject people who would otherwise qualify for free mammograms and Pap smears. Just how many are turned away isn't known; in some cases, the women are screened through other programs or referred to different providers.

The Cancer Society has no way to count how many women are being turned away, and many providers don't keep track of how many are denied screening, or whether those women find another alternative. The cost of screening varies, but the average mammogram is about $100, while a Pap screen can range between $75 and $200, according to the society.

"It's pretty painful" to turn women away, said Shari House, owner of the Pearl Health Center in Portland.

"They get angry, they get depressed, they get hopeless," she said. "It's like having a door slammed in your face."

Poor being turned away from free cancer screenings - Yahoo! News

What Comes First Dividends or Healthcare – 3 Health Insurance Companies Defend Payouts of Dividends

All this comes at a time where hospitals are just “getting by”.  This is just one more reason where healthcare for profit is failing as they dividends come from premium money that is paid for coverage.  If this were a non profit business we wouldn’t be dealing with this factor and many more dollars would appear to be available to take care of health problems.  image
Last estimate was around 55% of the hospitals in the US were operating in the red, so does this make sense?  Without hospitals we don’t get cured and don’t have the necessary surgical procedures to save lives.  Health Insurance started many years ago as being non profit and maybe it’s a good idea to give that some thought once more. With today’s current business models we are doing way more than spreading the cost over a large group of insured, we are increasing overhead and additional profits for those with creative algorithms who have found a way to get a piece of the pie, thus diluting the dollars paid.  BD 
ALBANY -- Three for-profit insurance companies want to pay more than $1.2 billion in dividends from premiums collected during 2008 in New York state to their out-of-state corporate parents, drawing the ire of Gov. David Paterson and other officials.
The amount is up from $948 million the year before, and comes at a time when many consumers are facing double-digit percentage increases in health care costs.
"The fact that health insurers take such large amounts of money out of the health care system while individual New Yorkers and small businesses struggle with skyrocketing health insurance premiums is deeply troubling," the governor said Thursday. "State law allows them to issue these dividends to their out-of-state corporate parents, and there is nothing New York State regulators can do about it; they need the authority to protect consumers."
On Friday, the insurance companies, United Healthcare, parent of Oxford Health Plans HMO; Aetna; and Wellpoint Holding Corp., parent of Empire BlueCross BlueShield, defended the payouts.
The companies cited by the governor's office and their proposed dividend payouts were Oxford Health Plans (NY) HMO, $800 million; Aetna Health HMO, $134 million; Empire Healthchoice Assurance, $200 million, and United Healthcare of NY Inc., HMO, $75 million.
"While insurers seek to distribute $1.2 billion in dividends to out-of-state corporate parents -- a staggering 25 percent increase over last year -- hospitals on the frontline of patient care are struggling just to break even," said Kenneth E. Raske, president of Greater New York Hospital Association. "That disparity should outrage all New Yorkers."


Health firms defend payouts -- Page 1 -- Times Union - Albany NY

Regenerative Medicine – A Visit to Wake Forest Where They Grow Body Parts With Stem Cells

Not too long ago I posted about Dr. Oz taking a visit to Wake Forest where most of this is taking place and now this Sunday 60 Minutes will be providing an update.  I have included the trailer for the show below. 

Dr. Oz Visits a regenerative medicine lab in Wake Forest

Dr. Oz talked about the bladders that were grown and there are 15 women and children walking around with bladders that were created with stem cells.

Within the last couple months, there were a couple of other stem cell regenerative news items, one being the clinical trial in Australia where breast tissue is grown back by implanting stem cells, and the other is still a bit experimental, but you can probably get the idea where this is going.

Regenerative Medicine: Clinical Trial To Begin with Women in Australia Using Stem Cells To ReGrow Breasts – Has Been Successful with Pigs

Regenerative Medicine News – Fully Functional Rabbit Penis Created That Works

When I attended the World Tourism Conference with Healthcare I learned quite a bit about speaking with a gentleman from China on some of their efforts and where they are going as well. 

I have conducted a few interviews with Cook Medical who has a very active regenerative medicine department and they were kind enough to go into detail on how some of their procedures work.  They fix hernias and create knee scaffolds.  At any rate I will have to watch myself for the latest chapter on where this technology is, as it is all moving so fast and many things we think are science fiction are no long that at all.  Below in the related links I put some of the posts I have recently covered in reference to stem cells.  BD 

Biologic Graft Technology Online Resources from Cook Medical – Regenerative Medicine


(CBS) Only a few years ago it would have been regarded as science fiction, but regenerative medicine - the growing of body parts - is becoming a reality.
60 Minutes correspondent Morley Safer reports on how researchers like Dr. Anthony Atala at the Wake Forest Institute of Regenerative Medicine can grow ears and bladders from patients' own cells.
"Every single cell in your body has all the genetic information to create a whole new you," says Atala. "So if you place that cell in the right environment, it'll be programmed to do what it's supposed to do."

Growing Body Parts - 60 Minutes - CBS News

Related Reading for Stem Cells

FDA OKs First Human Trials of Embryonic Stem Cells – Geron Biotech
Heartbeat of a new industry – Stem Cell Storage Banks
Doctors transplant windpipe with stem cells
Prostate Gland grown from stem cell - But Who Would Want One?
Testicles Could Be New Source Of Stem Cells – Stem Cells for Males only
Stem Cells and Breast Surgery
I have stem cells in my belly…harvesting fat..
Footballer's Wives Breasts Made Using Stem Cells – The Evolving World of Plastic Surgery…
Pre-clinical Data Demonstrate Ability To Regenerate An Entire Bladder
Menstrual blood -- a valuable source of multipotential stem cells?
Tapping Into the Code of Life With Science - Some of this is here today...not science fiction...medical technology is on the rise...
Cloned cells bring hope of therapy for Parkinson’s disease
British scientist grow human heart valve from stem cells

Office Ally and Blue Shield of California Collaborate to Provide Online Secure Communications Between Patients and Physicians

imageOffice Ally and Blue Shield are now working together to supply the electronic road map that will allow patients to communicate securely with their physicians on the internet.  Patient Ally, the PHR web based personal health records system is the vehicle from Office Ally that supplies the secured connections and the link. 
You can read the information below in the communication set to go out to all current participants who have been using Relay Health from McKesson for this purpose.  Patients will still be able to use Relay Health without change, but the visit will not be covered under an “E-Health”visit.   We are starting to hear more and more about compensating physicians for their time spent with following up and consults using technology today.  Not too imagelong ago I posted about Office Ally receiving their accreditation for privacy and HIPAA compliance.

Office Ally Receives Electronic Health Network Accreditation – Privacy and HIPPA Compliance

Back in November Office Ally introduced “Patient Ally’ the PHR (personal health records) website for patients.  All of Office Ally’s web based  modules coordinate and talk with each other, thus allowing a full stream of information to be shared.  With Patient Ally, all medical records are stored with Office Ally on their servers, something you need to inquire about today, know where your records are stored.  I have used the PHR myself to set up records as when speaking about software, you need to experience it yourself and it is pretty straight forward.

Office Ally Adds More Connectivity for Physicians and Patients – EHR and PHR Web Based Services

The big reason of course here too is too look at what the new contract with Blue Shield entails here both for the patients and physicians with the clarification of “E-Visits” being covered.  One thing I do have to say from personal experience is that they still provide real people to help you out.  I do some billing and use their Practice Mate billing software and have had to call on a couple issues with claim related questions and the help is right there and is free.  image
You can follow Office_Ally on Twitter for additional updates. 
Under "Physician’s Resources” column on the right hand side of this site for the main site you can read up on the free clearinghouse services they offer for MDs and hospitals across the US. 
Below is the notification being sent this week to notify patient of the change.  Again, anyone can sign up at a patient though and you don’t have to be with Blue Shield to set up your PHR.  Will stay on top of any more news for future developments here.  The E-Visits are on the way.  BD 
The following is an advertisement for Blue Shield of California
  image

Thank you for entrusting us with providing you access to quality coverage. Our records indicate that you are registered to use RelayHealth for communicating with your Personal Physicians online.
In an effort to expand this service to more members and physicians, we are changing our vendor for this service from RelayHealth to Office Ally effective January 1, 2010. Like RelayHealth, Office Ally offers online communications services for physicians and patients.
You may continue to use most of the features available to you via RelayHealth, including making appointments and getting prescriptions through a participating physician. However, to receive coverage for an E-Visit (Internet-based consultations) please register with Office Ally's patient website, Patient Ally. Your Personal Physician must also register with Office Ally. E-Visits through RelayHealth will no longer be covered effective January 1, 2010.
You can register and learn more about the Office Ally service by visiting www.patientally.com or calling (888) 747-4255.
If you have any questions about the change, or about your benefits for this service, please call a Member Services representative at the phone number listed on your Blue Shield ID card. We apologize for any inconvenience this change causes you or your Personal Physician.
Thank you for being a Blue Shield member.


If you no longer wish to receive emails from Blue Shield of California, you can unsubscribe by sending a blank email - no need to fill in the subject line.
Blue Shield of California, 50 Beale St., San Francisco, CA 94105.
Blue Shield of California is an independent member of the Blue Shield Association. Blue Shield® and the Shield Symbol are registered marks of the BlueCross BlueShield Association, an Association of Independent Blue Cross and Blue Shield Plans.
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Hospitals Need To Replace The Steris System Endoscope Sterilizer in 6 Months – FDA Mandate

Just a few days ago I made the comment relative to budgets and said ask a hospital CEO what it is like to budget for things are exist tomorrow that imageare not here today, well this is pretty close, as an unexpected expense.  The safety and effectiveness of the sterilizer can’t be verified, so out they go and hospitals buy new ones. 

Cost of Healthcare – Nobody Will Get This Right ...

Anyway, this is a bit of a boom for competitor Johnson and Johnson as the agency has begun recommending the purchase of their product for a replacement.  BD 

As mentioned below, FDA provides no financial assistance, the hospitals eat it.  In the last year, the VA has been in the news about sterilization a few times with people being tested for hepatitis and HIV exposure, so there’s no choice here at all. 

The Food & Drug Administration flexes its new muscles, forcing hospitals to stop using Steris Corp.'s endoscope sterilizer within six months. image

The Food & Drug Administration told hospital administrators across the country to stop using a popular endoscope sterilizer made by Steris Corp. (NYSE:STE) within six months, after the watchdog agency could not verify the safety of the product.

The Steris System 1 processor is typically used in surgical and endoscope suites for sterilizing and disinfecting medical devices.

The edict could mean significant and unexpected costs for healthcare facilities, as they scramble to comply. Jerry Berger, the director of media relations for Beth Israel Deaconess Medical Center in Boston, told MassDevice that it's impossible to speculate on the exact cost. Berger confirmed that BIDMC has begun making plans to replace their entire cache of the sterilizers, which retail for around $5,000 each. The FDA has said it will not provide any financial assistance to hospitals replacing the machines.

But the FDA said Steris continued to assure customers the units were safe and continued to sell new units, prompting the agency to act more aggressively and actively advise hospitals to switch to competing devices, a potentially huge boon for competitors like Advanced Sterilization Products, the Johnson & Johnson (NYSE:JNJ) division that makes the Sterrad sterilization system.

FDA gives hospitals six months to ditch Steris System 1 | MassDevice - Medical Device Industry News

Is Arco Gas Leak In Seal Beach Linked to Cancer – Prime Real Estate in Southern California

This is not too far from where I live and as mentioned is prime real estate territory here.  I’m not in that general area though and far enough away, but I was surprised in reading the story as the tanks ruptured back in 1986, quite a number of years ago.image  I have filled up there. 

The cleaning began just this July, a while since the breaks at the gas station. 

SEAL BEACH – The Orange County Health Care Agency will study whether there is a possible correlation between an old gas leak and certain types of cancer reported in the Bridgeport neighborhood, city officials said.

ARCO is looking to clean up contaminated soil vapors from a gas leak at the station on Pacific Coast Highway and 5th Street and the health-care agency is concerned about the possible link of benzene, a known carcinogen, to a type of leukemia.

Underground storage tanks at the station ruptured in 1986, and ARCO and the Orange County Health Care Agency have worked since then to clean up the site. ARCO in January discovered the station was expelling contaminated vapors and the company started cleaning the site in July, said company spokesman Tom Mueller.  Soil vapor contamination can make its way through cracks in the foundation and creep into the inside air, according to Mueller. The vapors are odorless and can be harmful to breathe.

ARCO has been using an extraction system at the station that has been successful so far, Mueller added.  If testing shows there is a health risk in the neighborhood, ARCO will pay for resident relocation, living expenses and property damage. The company will also compensate residents who sell their homes below appraised market value because of the contamination problem, Mueller said.

Health officials: Is gas leak linked to cancer? | arco, city, health - News - The Orange County Register

Nurses Are The Most Honest and Ethical Professionals – Gallup Pole

Nurses beat out physicians and pharmacists and have been on the top of this pole for the last 10 years.  BD

The majority of Americans believe nurses are the most honest and ethical professionals in the country, according to the results of the imageannual Gallup Honesty and Ethics of Professionals Poll released Tuesday.

A total 83% of respondents viewed nurses as having either “high or very high” ethical standards, according to Gallup. Two other medical professionals, pharmacists and physicians, took the number two and three spots, though they didn't engender as much trust from the public. Some 66% and 65% of Americans, respectively, considered them to have the highest ethical standards. Nurses have topped the list for all but one of the 10 years they have been included in the poll. In 2001, firefighters edged out nurses with a 90% approval rating.

Whom do you trust? Most Americans say nurses - McKnight's Long Term Care News

Cardiologist Writes to His Congressman Regarding Medicare Cuts – The Impact

Recently I have posted a couple of times about the impact the proposed cuts in Cardiology will have if they go through.  One of my clients was kind enough to send me a copy of his letter to his representative in Congress.  Not too long ago I did a short presentation for doctors at his hospital on imagesocial networking and you can go to the QIK widget, click menu and see who’s talking here and he helped the hospital enroll in the Siemens program last year on trying to win an MRI. 

Is Your Cardiologist Now Going to be Your Hospitalist? Many Will Close Offices If Reductions Are Made

CMS plans cuts to Medicare Cardiology Provider Fees Close to 40%

Perhaps if all get involved here and write and support Cardiology and wave off the proposed budget cuts, we could make a difference.  He spells out his own impact as well as expanding on how cardiology will be impacted throughout the US.  BD
This is the email I received from Dr. “Mike” with his preface on the letter to his person in Congress.
“I am embarrassed and humbled as I send this letter to you. It is a letter I sent to my congresswoman regarding the budget cuts solely directed to cardiologists come January 1st. It is self-explanatory. I am literally scared about my survival as well as the impact these changes will have on my patients and for healthcare in general.
In the next few days there will be a vote in Congress about this and the possibility of freezing the pay cuts to Cardiology. Though I don't know if you agree with me or if you even care I would deeply appreciate your help. If you can send a letter or even copy my letter and send it to your representative or to other cardiologists you know it will make a difference. Time is of the essence.”

The Letter below:
Dear Honorable Ms Richardson:
We met a few weeks ago at the Long Beach Community Hospital Condit dinner at the Hyatt Hotel.
I was impressed by your kindness and sincerity and I thank you for giving me your email address.
Long Beach has amongst the best heart specialists and programs in southern California.  We have developed a reputation however we are about to lose all this if current budget cuts go into effect by CMS (Medicare).
Outside of Health Care Reform which is being debated or the slated 21% pay cut coming for all physicians as per CMS on January 1st, there is an additional 20% being cut to one medical specialty and no other..........Cardiology. What adds to the significance and scariness of this is that whatever Medicare does all other insurance companies follow with similar cuts.
In an effort to try to entice more medical students to go into primary care they are increasing payments to primary care physicians and making up for this by taking it away from Cardiology. I can give you one reason why there are less primary care physicians nowadays.  It is because the gender demographics of medical students has changed and now roughly 50% of the medical students are women. 
They are electing to work in less time-demanding specialties (like Dermatology, non-interventional radiology, etc) so that they do not need to take call and thus compromise their desire to have children and a family. I can understand this but it is not because of the pay. In fact primary care physicians in some ways get paid more as they jump right into the workforce after residency whereas the rest of us who spend an extra 3-4 years specializing have to defer our income.
With the anticipated 21% pay cut for all physicians and the additional 20% cut for cardiologists this results in a roughly 40%  overall pay cut to cardiologists. The average cardiologist has at least a 60% overhead. This translates into zero income. To reduce our income by 100% is fiscally irresponsible let alone insane. We are still expected to work 11-14 hours per day including weekend work, receive calls any time of the day or night and respond to emergencies.  We are interrupted at every sacred moment of our lives. 
We go thru hell trying to balance seeing patients in the office during the day, running to several hospitals to see patients during the day and night, squeeze in performing surgeries (stents, pacemakers, etc) and be available at any time every day and night.  The demands are incredible and perhaps more so than any other medical specialty................and all this now for free! 
We live in constant fear that a simple error in judgment (whether it be because of lack of sleep or dealing with the stresses of simultaneous emergencies, etc) or a miscommunication will result in serious consequences for patients let alone to us and our families. We are aware there are attorneys and medical boards, confidentiality organizations, etc hovering over us to catch us off guard. We don't need these additional stressors. We are nowadays seeing more and more patients in the hospital who have no insurance and we are taking care of them for free (pro bono).
Cardiology perhaps more than any other specialty has made great strides in healthcare.  Cardiology has raised the prestige of the United States in the world of medicine. People rich and famous all over the world want their advanced cardiology care in the United States. Now that cardiologists will be reduced in effect to slaves the prestige of Cardiology in this country will dissipate and there will no longer be money or incentive to create new innovations and better care.
To compound this there is an expected shortfall of 15,000 cardiologists in this country in the next 10-15 years. Do you think any medical student will want to be a cardiologist when they have to work for free?
Rep Charlie Gonzalez (D-Tex) is introducing legislation to do away with these singular cuts to Cardiology. We would deeply appreciate if you can take the lead and help co-sponsor this bill. The government has lots to lose by allowing these cuts to take place yet will have much to save by not making these cuts. Remember that cardiologists have not had a raise in over 10 years yet our expenses grow. In lieu of raises please do not cut us any further.
Finally, these cuts to healthcare will come with serious repercussions. I know I will need to lay off 2 employees and other physicians will be doing the same. However more than just this, the adverse effect on physicians will spill over to other healthcare workers (nurses, technicians, administrators, etc). 
We will all be forced to cut back and there will be less discretionary income. The health care industry does its share and usually much more than its share in spending and supporting the local economies (stores, vendors, other professionals, philanthropic institutions, etc). With many businesses marginally holding on, cutting back on healthcare will result in our inability to continue to financially support these businesses and thus further compromise their ability to stay afloat. The quickest way to turn a bad recession into an all-out depression is proceeding with the current budget cuts. Mark my word on this.
Thank you so much for your understanding and help
My best wishes to you,
E. Mike Vasilomanolakis M.D.
Assistant Clinical Professor
Western University of Health Sciences
Director, Cardiac Services and
Heart Catheterization Laboratory
Community Hospital of Long Beach
1760 Termino Avenue    Suite 314
Long Beach,  California  90804

HIMSS’ Conference Held In Conjunction With Medical Banking – Business Intelligence and Algorithms

This is an added offer for attendees this year, as I posted in November, Medical Banking is now part of HIMMS. There’s nothing new here as far as the imagefocus on money as this is everywhere today.

HIMSS acquires Medical Banking Project – Business Intelligence and Banking Algorithms?

Who Should Join? (from the website)
”Bankers, healthcare organizations, large employers, IT executives, attorneys, accountants, CFOs, compliance officers, federal and state regulators, lobbyists, treasury and cash management executives, private banking executives, patient accounting managers, health data clearinghouses, financial clearinghouses and others.”

Medical Banking – If you Have Not Started Online Banking here’s A New Curve to Absorb

What do the banks base their intelligence and projections on, algorithms so if you have hung around this blog long enough and have seen the word in the middle of the page with a link to Wikipedia, get ready to hear about “the algos” as they are called on Wall Street.  This is somewhat a transition from the big focus in the past being inside the clinical area primarily although that portion is still part of the main convention. 

You may get an earful here as the press release states part of the financial section of the meeting is to learn about where banks invest with business intelligence and the algorithmic formulas that lead them to their decision making processes.  You can read the paragraph above where they are pretty much encouraging everyone to join, even lobbyists. 

Small tidbit of information here relating back to the stock market crash, remember the articles n the press about how Microsoft was pushing their new high powered server 2 days afterwards and everyone couldn’t figure that out, well look at Goldman Sachs, they were spending money 2 days later to update their technologies and it is a mix of their investments and prudent programmers that wrote the code to allow investors to work with their proprietary code and created trading software that is highly robotic for investors to use.

One more time it’s the algorithms that control the flow of funds and money today and this effort is being bridged into healthcare at a pretty rapid pace and thus we have Medical Banking to learn about.  I call it “high frequency healthcare” modeled after one of the the same methodologies used on Wall Street which is “high frequency trading” where 1/30th of a second makes or breaks a transaction with super powered computers sporting 4 Xeon Intel processors and the right formulas enabling the speed to capture a transaction before others have the same opportunity.  Is this the future of clearinghouses with claims, who knows?  BD 

Press Release:

CHICAGO – (December 10, 2009) –  Designing the Healthcare Financial Network of the Future, a centerpiece program that seeks to support overall health improvements by leveraging banking systems, will be offered on March 1-2, 2010 at the Omni Hotel in Atlanta, Ga. The program is held in conjunction with the Healthcare Information and Management Systems Society (HIMSS) Annual Conference & Exhibition at the Georgia World Congress Center from March 1-4, 2010.

The program’s theme focuses on a new, multi-year global strategy tied to HIMSS’ acquisition of the Medical Banking Project earlier this year.  The Medical Banking Institute@HIMSS10 is open to all HIMSS attendees interested in the medical banking area.

“Demands on financial systems, both domestic and global, have created new roles for banks, said John Casillas, senior vice president, HIMSS MBProject, Business and Financial Systems. “There is a growing need for banking systems to improve fiscal processes for payers and providers.”

Industry leaders representing payers, providers and other stakeholders will convene in a neutral setting to identify and discuss critical path issues that currently impede cross-industry efficiency.  Topics include emerging functions in the new ‘health-wealth’ paradigm to standards and best practices that simplify and automate workflows.

          The Institute will feature sessions on health data privacy and security in banking channels as well as:

· Discussion that contextualizes general healthcare trends against medical banking metrics;

· A senior level banking panel that will help healthcare providers and payers to understand how banks are investing in revenue management technologies;

· Case studies that show the emergence of bank-driven community care platforms and more.

Preceding the Institute, the HIMSS Medical Banking Boot Camp will offer attendees an overview on the emerging role of banks and financial institutions in healthcare. The Boot Camp will meet from 1-5 p.m. on Feb. 28, 2010 at the Georgia World Congress Center.

     Registration for the Institute and Boot Camp is now open.  Hotel reservations can be made through Ambassadors.

     Visit the HIMSS Medical Banking Institute Web site for more information.

     Find out more about HIMSS10.

About HIMSS

The Healthcare Information and Management Systems Society (HIMSS) is a comprehensive healthcare-stakeholder membership organization exclusively focused on providing global leadership for the optimal use of information technology (IT) and management systems for the betterment of healthcare. Founded in 1961 with offices in Chicago, Washington D.C., Brussels, Singapore, and other locations across the United States, HIMSS represents more than 23,000 individual members, of which 73% work in patient care delivery settings. HIMSS also includes over 380 corporate members and nearly 30 not-for-profit organizations that share our mission of transforming healthcare through the effective use of information technology and management systems. HIMSS frames and leads healthcare public policy and industry practices through its educational, professional development, and advocacy initiatives designed to promote information and management systems’ contributions to ensuring quality patient care.  Visit www.himss.org for more information.

When Generic Drugs Are Good Enough

This is a guest post from Shannon Wills and I welcome her post to the Medical Quack today as she has some information to add regarding generic drugs.  Be sure to visit her links at the end of the post for more information.  BD  image

Their chemical compositions are similar and they are supposed to work just as well as the branded ones, but many people still hesitate to buy generic drugs even though they are much cheaper than the ones written on our prescriptions. For most of us, it is a conditioned response, one that has become ingrained in us through years of buying only prescription drugs and steering clear of the generic version because we perceive that something that is so much cheaper must be less efficient. And when it comes to medicine, we want only the best because it’s our health we’re putting on the line when we take a gamble on the kind of drugs we ingest. 

But if you knew the truth about generic drugs, you would realize that in spite of their low cost, some of them are as effective as the ones that your doctor has prescribed for you. So how do you know when generic drugs are enough? To answer this question, you first need to know what a generic drug is and why it is available at a lower price than other drugs of the same chemical composition.

Any prescription drug has to go through years of research and experimentation and must be proved effective and safe before it can hope to be approved by the US Food and Drug Administration (FDA) and allowed to be marketed under its brand name. The NDA (new drug approval) submitted to the FDA by the company is granted exclusive manufacturing rights that prevent other drug manufacturers from using the same formula and putting their brand name on the medicine. But they are allowed to come up with generic versions by submitting an ANDA (abbreviated new drug approval) request because the research has already been done and verified. This is why generic drugs are cheaper, because they don’t include the cost of the millions of dollars that go into the research and development process.

Although the generic drug is supposed to have the same chemical composition, it’s not always exactly similar to the branded version. The FDA has a rating system for the efficacy of generic drug, so if you want to go in for the cheaper version, look at the label for the AB rating. It is the code that lets you know that the generic drug is equivalent to the branded one and that one dosage of this drug is equivalent to one dosage of the branded one in blood concentration, elimination rate and efficacy.

A 2008 survey undertaken by the Kaiser Family Foundation states that generic drugs account for 65 percent of prescription sales and that this industry is growing at the rate of 7 percent. Moreover, with the enormous cost of healthcare, insurance companies are pushing patients to go for the generic versions of drugs.

So yes, generic drugs are good enough and more cost effective when they come with the AB certification.

By-line:

This post is contributed by Shannon Wills, who writes on the topic of x ray technician schools . She welcomes you comments at her email id: shannon1wills@radiffmail.com

Data Mining Marketing Amendment on Senate Health Bill – So Our Medication Records Can Still Be Sold Just not Marketed, Huh?

Well I guess better late than never, but maybe they have not noticed the number of drug reps calling on doctors is also decreasing, so there’s a few less feet on the street.  Most doctors are pretty busy today and I see it all over the place with signs taped on the door, “drug reps by appointment only”.  As a few more cutbacks come in to play though, this may not be as big of an issue as it was at one time but they are getting around to it.

Now what is an issue are middle people that still sell and make money from our medication records. 

Health Insurance Underwriting Practices With Prescription Data – How Does This Work

Here’s 2 companies making a ton of money selling our information, and makes the drug marketing reps who almost look innocent by comparison.  How about the costs and the algorithmic formulas that carve out money with selling our medication records.  If you get your drugs through a Pharmacy Benefit Manager, these folks can get and sell your information.  How profitable is Pharmacy Benefit managing, well Medco just made almost 15 Billion for the 3rd quarter and very people work there, it’s all automated, but there’s some big chunky algorithms that provide some big transaction fees for all the prescriptions run through. 

Medco Health Solutions $14.8 Billion 3rd Quarter Profit – Automation Is Part of Their Solution

If they were to address this part of the issue we might save some big buck on our prescriptions. If you go to one of the $4.00 retailers for most of your meds, they do not go through a Pharmacy Benefit Manager, nor are they recorded unless you sign up for one of the store’s prescription cards that creates a data trail, so pay cash and stay under the radar.  If you are not outside the radar your med records are accumulated and sold, sometimes to insurance companies before they underwrite you so if you take Lipitor for an example, well guess what, they already know you have issues and what they are. 

Again, the Senate is behind but hopefully this first step will draw more attention on making healthcare and the drugs we take affordable.  At the rate layoffs are going and with recent patterns to continue, the marketing will the least to worry about.  BD 

“HIPAA does not give the Department of Health and Human Services the ability to directly investigate or hold accountable entities, such as pharmacy benefit managers or companies such as Ingenix and Milliman, who are not covered by HIPAA.”

You can read the statement from Milliman about Intelliscript here.

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“Does this process make it more difficult for consumers to get insurance?
No.  There is nothing new about consumers authorizing the release of their medical records, including prescriptions, to insurers.  This standard process has been in place for decades, helping insurers make good decisions about rates and insurability.”

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From the Website:

Through a user-friendly interface, you can examine the relationships between various metrics to create revealing population profiles. Built-in filtering, grouping options, and custom report utilities help you to:

  • Identify and examine trends such as prescription volumes and shares over time, variations by prescriber specialties and/or sources, and competitors’ share gains that result from new patient starts and/or switches
  • Segment your market by prescribers or groups of prescribers
  • Track and compare the performance of health plans and custom provider groups, including their performance in relation to specific marketing initiatives
  • Detect and follow product-level switching patterns in your market

WASHINGTON - Drug companies would no longer be able to mine pharmacy records to track which doctors are prescribing their medications, under a proposal unveiled Thursday by two Senate Democrats.

The amendment to the Senate health care bill would effectively ban pharmaceutical data mining, the drug company practice of buying prescription records to target sales pitches to doctors.

However, the Senate amendment only bars the sale of prescribing records "for marketing purposes."

Consumer advocates say the Senate effort could raise the profile of data mining in Congress and among state lawmakers.

Lawmakers move to block mining of Rx data - Capitol Hill- msnbc.com

Uterus Pillows, Boob Scarves And Hug Pillows – Just What the Doctor Might Be Ordering

I thought the big story when I announced that the “toy uterus” had been recalled, but Happy found some larger and more interesting plush buddies to cuddle with. 

You can even buy a stuffed plush virus, but they are smaller plush toys, we’re talking big monster pillows here. 

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I’m not quite sure that the uterus pillow would fit my home decor and unlike the “toy uterus” it looks like the large pillow versions don’t have an issue with children pulling off the ovaries and choking. 

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A pillow that gives us hug is great, just watch where you place it. 

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I guess these are functional and do keep your neck warm.  These even come in green and you can check out Street Anatomy for more information here.  Happy has the run down on a couple of other items which you can view at his blog, he’s a hospitalist and can get by with more than I can (grin).  He states that he thinks that “pillow reps” might be taking over where the drug reps are leaving off.  BD 

Source:  The Happy Hospitalist

A Cozy Uterus at Street Anatomy

Craig Barrett (Intel) Talks About Dossia – Personal Health Records

Wal-Mart is the first to pilot the program.  I remember when the initial announcement first came out, I was actually doing some training work for Intel imageat that time.  Similar to HeatlhVault, Dossia is a platform that can integrate and work with other software.  Dossia is a non profit and thus Craig Barrett makes a comparison to Google Health and HealthVault being a retail type of service.

Wal-Mart Takes the PHR Plunge – Dossia Personal Health Records

This project has had it's issues getting off the ground amidst law suits, etc. The companies will pay a transaction fee for each employee and contribute 1.5 million each for the project. There are some pretty big names here.

I have to hand it to Mr. Barrett in going after the healthcare market again as this is not his first attempt here.  Back 2 years ago in December of 2007 I wrote about Dossia and wondered if it was going to make it.

A Utility Called Dossia- will it ever fly?

Since this time too, there have been many other newcomers enter the field of personal health records as well.  This program is “employer’ focused for participation where as with Google Health and HealthVault, anyone one can create their PHR and get started.  Time will tell where all of the personal health records end up going too.  We still have to figure on getting the patient involved first and educated to know how online healthcare records show value.  It wouldn’t be beyond me to say that at some point in time you could even see hospitals consider some type of administration fee for patients who do not present some type of records as the digital move in healthcare moves forward.  BD

http://video.forbes.com/fvn/intelligent-technology/craig-barrett-healthy-endeavor

Is Your Cardiologist Now Going to be Your Hospitalist? Many Will Close Offices If Reductions Are Made

This is actually not a maybe but a reality from what I have heard from cardiologists in the southern California area.  They are already thinking and putting mental and maybe other plans in place if this comes about.  As you see from below, the Medicare payment structure pays more for their services in the hospital versus being an outpatient.

CMS plans cuts to Medicare Cardiology Provider Fees Close to 40%

From a recent post Nov. 2009:

“As proposed in the draft rule in July, the new physician fee schedule also eliminates payment for consultation codes, which will reduce payments for cardiology consultation services.  If CMS is using the survey from the AMA and there was such a small return and this is the basis for the cut, I guess itimage would appear be sure and answer their surveys?   They may have had better luck on Sermo for a matter like this.

This is hard to believe and all it will do is create a shortage in cardiology.  If you have ever had heart problems and need help, you don’t want these folks to go away and only be available only at the hospital as the care will not be the same.  As the article states, those on Medicare will have to check into the hospital to be seen, where they have coverage.  Perhaps things will change around here as they did this week for radiation oncologists, which were also facing a big cut, and that has now been reversed to a small cut of 1% a year for a total of 5%.  Also, the respondents of the survey had a large number of are already hospital based.” 

This is indeed interesting to see how many ways they want to cut the pie and also we need to keep in mind that technology will be adding cost here too, so it goes with the territory of needing reform and getting it funded.  Nobody is going to hit the nail on the head.  Cardiologists need to keep up with technology too and that is another cost factor.  BD 

Since the Centers for Medicare & Medicaid Services (CMS) issued its 2010 physician fee final rule last week with cuts to cardiology practices averaging 27 percent, the American College of Cardiology (ACC) has expressed adamant opposition, and its CEO, Jack Lewin, MD, said that this will cause the shuttering of practices. However, former CMS Administrator Thomas A. Scully explained how the agency is limited by finite funding and growing pressures to fund other areas of healthcare.
The first area of contention is how CMS arrived at this final rule. The ACC strongly disagrees with the data that CMS used to calculate practice expenses and justify its cuts.

CMS is under “tremendous pressure” both from Congress and the public to re-allocate funds to primary care physicians and basic preventive services, Scully said. “As a result, all the specialties are going to get trimmed back. The general problem is the increasing volume, so the payment per service is going to continue to decrease, especially under the current system where the government sets prices," he said.
“When spending goes up, the RB/RVS system makes cuts, because the budget is finite. The sandbox is not getting any bigger,” Scully said.
Lewin concurred that CMS is “stuck with the current formulas” and noted that this is another reason that healthcare reform is needed.

This lack of practice sustainability will lead cardiologists, according to Lewin, to become “employees of hospitals, causing the closure of individual and group cardiology practices.” Acknowledging that cardiologists have already begun to move in that direction due to previous cuts, he explained that cardiologists receive better reimbursements, and Medicare pays two to four times more for the same tests in a hospital setting.
He cautioned, however, that hospitals will not be able to accommodate this shift, especially as costs increase two to four times.

Feature: CMS cuts could make hospitalists out of cardiologists

UnitedHealthcare Creates an Application for the iPhone – Find Doctors and Hospitals And Stay In Our Network

Well at least you don’t have to pay for it.  They want to be sure you can find those doctors and hospital “in network” before chancing a costly visit with a facility or doctor out of network.  We hear about that lately don’t we.  When that ambulance comes to pick you up take out iPhone and do imageeverything you can to be sure you get to an “in network” facility (grin).

With the recent expansion of mobile clinics or buses, you might need to know where that bus is parked in rural areas once they are parked around the country.  BD   

UnitedHealth To Spend Tens of Million of Dollars with Cisco to Build Nationwide Telehealth Network

UnitedHealthcare rolled out a free app for Apple’s iPhone Wednesday that allows members to find a doctor, hospital or other medical service via cell phone.

The new DocGPS can search for 23 kinds of health care facilities and 58 types of doctor specialists within the company’s national network.

Free and available at the iPhone App Store or itunes.com/appstore, DocGPS allows users to locate a doctor or hospital, find the office on a map, get directions and call the doctor or facility with a single tap.  “We are putting a powerful tool in the hands of consumers so they can make more informed health care decisions whether they are at home, at work or on the run,” Dawn Owens, chief executive officer at OptumHealth, a UnitedHealth Group company and lead developer of the new technology for UnitedHealthcare members, said in a press release.

UnitedHealthcare helps members find docs with new app - The Business Journal of the Greater Triad Area:

Tech Puppets – Just out There Dealing with Technology

It has been a while since I contributed to the humor section, well here’s a few for today…Apple/Windows Puppet Battle, The Best Buy Puppets, and Windows Apocalypse 7.  There are are few more at the You Tube site and I could not quite post the one about cell phones here.  You can visit the main site on You Tube.   Hoggworks Studios is the creator of these 2 funny guys.  BD 

Retail Wars…

The Geek Squad…

Windows 7 Apocalypse….

YouTube - Mac vs PC: Retail Wars!

Medicare Advantage Plans Waste Billions of Dollars - Study

This should come as no surprise as we see it all over the web, advertising and explanations on how to select a plan.  It rolls over into the government even putting time and effort into a guide and websites too.   One example is the money that goes out for Pharmacy Benefit Managers, posted here yesterday.  The plans all come with one of these for the most part.  Check out and see the behind the scenes expenses and compensations.

Pharmacy Benefit Administrators – Algorithms That Carve Out Profits From What We and the Government Pay for Medicationsimage

By not having the ability to negotiate directly the government puts out a ton of money with medications.  Would be nice if some of this overhead money went directly to paying healthcare claims, perhaps we could stand to enable a few more folks to get well.  BD

Health insurance companies that offer private alternative Medicare plans, called Medicare Advantage, put billions of dollars toward profits and marketing rather than patient care, according to a report released Wednesday by House Democrats.

Reuters: "From 2005 to 2008, Medicare Advantage insurers reported $27 billion in expenses unrelated to care, according to the report released by [the House Energy and Commerce Committee], which looked at 34 such insurers. It also pointed to millions spent on executive compensation and company retreats in Hawaii, Cancun, Mexico and other exotic locales."

Medicare Advantage plans waste billions, report finds

New Approach With Bone Marrow Transplants Cures Sickle Cell Disease

Patients need donor but with the new process not all of the patient’s bone marrow is killed, just part by using radiation.  The new process imageeliminates much of the chemotherapy and is targeted for children.  The regenerated bone marrow end up being a combination of both the donor and the patient.  The earlier it can be done, the potential less damage the disease can contribute to the patient’s organs.  BD

BOSTON (Reuters) - Bone marrow transplants, already used to treat some children with sickle cell disease, also may cure some adults with this deadly genetic defect that causes red blood cells to contort, U.S. scientists said on Wednesday.

Nine of 10 adult patients given an experimental bone marrow transplant treatment were cured of sickle cell disease, researchers at the U.S. government's National Institutes of Health reported in the New England Journal of Medicine.

In conventional bone marrow transplants, doctors try to destroy all of a patient's own bone marrow. Using the new technique, adults are given a lower dose of radiation, only partially destroying the patient's bone marrow.

Tisdale and his team used about one quarter of the conventional dose of radiation, which was enough to wipe out part of the marrow. They also eliminated chemotherapy normally given to suppress the immune system.

Marrow transplant cures adult sickle cell disease | Reuters

Microsoft Acquires Sentillion – Single Sign On To Work With Amalga and More…

Back in June of this year Microsoft and Sentillion signed a licensing agreement and now as things move along they will become part of the Microsoft imageHealthcare group.  One of the notable case studies listed has been their work with Tenet hospitals.  

Single Sign on for Microsoft Amalga – Sentillion Signs License Agreement

Sentillion will be complimenting Microsoft Amalga solutions and allow for additional security software and identification for doctors and nurses for entering and reviewing data in medical charts.  You can learn a bit more about Amalga at the link below with an interview I conducted earlier this year.

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

The software has integrated with several medical record systems and below is a brief summary from the site.  BD 

From the Website:

“For over a decade Sentillion has addressed head-on the ever present challenge faced by healthcare organizations of how to quickly integrate clinical applications and add enhancements to clinical workflows.

Sentillion has integrated with over 600 clinical applications, including those from the leading HIT vendors, including Cerner, Eclipsys, Epic Systems, GE Healthcare/IDX, McKesson, MEDITECH, and Siemens. In the 10 years we have been doing this, we haven’t encountered an application we can’t integrate with.”

Press Releases

REDMOND, Wash. — Dec. 10, 2009 — Microsoft Corp. today announced that it intends to acquire Sentillion Inc., a privately held company specializing in software for the healthcare industry. Combining Sentillion’s products with Microsoft Amalga Unified Intelligence System (UIS) will make it easier for healthcare professionals to deliver better patient care by streamlining access to multiple IT applications and patient data.

Sentillion will continue to sell and support its products to new and existing customers while Microsoft invests in the long-term evolution of the combined portfolio of Sentillion and Microsoft health solutions. Sentillion will also continue to operate out of its corporate headquarters in Andover, Mass. The acquisition is expected to close in early calendar year 2010. Financial terms were not disclosed.

“Microsoft and Sentillion share a vision of a connected health system in which the free and rapid flow of information, coupled with streamlined access to a hospital’s myriad healthcare applications, empowers doctors and nurses to perform their roles with greater insight, speed and effectiveness,” said Peter Neupert, corporate vice president, Microsoft Health Solutions Group. “As a result, our products and strategies are a natural fit. Joining efforts with Sentillion will allow us to amplify and accelerate the impact we can make in health IT and health globally.”

“We’re excited to build on the powerful foundation we have built over the past decade in product development, sales and marketing, customer relationships, and execution excellence,” said Robert Seliger, CEO of Sentillion. “With its commitment to improving health and the global resources it brings to bear, Microsoft is the perfect partner to expand our efforts worldwide.”

By combining Sentillion’s context management and single sign-on technologies with Amalga UIS, a real-time data aggregation solution, Microsoft aims to give clinicians new insight about patients in real time and enable them to perform the appropriate task with unprecedented speed. At the same time, the workflow of clinicians will be simplified, allowing them to spend less time navigating different IT systems and more time with patients.

Microsoft Amalga UIS addresses a common and critical challenge of healthcare providers — integrating vast amounts of clinical, administrative and financial information that flow in and out of disparate information systems, and tailoring that information for use by physicians, analysts, laboratory technicians, nurses and administrators. Amalga UIS is in use at more than 115 hospitals in renowned U.S. health organizations, including the Johns Hopkins Health System, NewYork-Presbyterian Hospital, Novant Health and Seattle Children’s Hospital.

Sentillion’s technologies integrate all types of clinical, business and personal productivity applications, regardless of whether they are Web-based, Windows-based or legacy systems. More than 1,000 hospitals representing 160 healthcare organizations, ranging from single facilities to large, complex multistate health systems, use Sentillion’s solutions as a strategic part of their clinical IT infrastructure.

About Sentillion
Since 1998, Sentillion has been revolutionizing healthcare IT with award winning, industry recognized identity and access management technology. Sentillion has successfully combined patented technology with a deep understanding of the healthcare industry to deliver a comprehensive set of solutions for single sign-on, identity management, clinical workstations and desktop virtualization. Recognized as the number one single sign-on (SSO) vendor in the KLAS Top 20: 2008 Year-End Report, Sentillion is the only identity and access management company whose solutions are used daily by over 500,000 caregivers in leading healthcare organizations across North America and Europe. Sentillion is a privately held company headquartered in Andover, Mass. For more information, visit Sentillion at http://www.sentillion.com.

About Microsoft in Health
Microsoft is committed to improving health around the world through software innovation. Over the past 12 years Microsoft has steadily increased its investments in health, with a focus on addressing the challenges of health providers, health and social services organizations, payers, consumers, and life sciences companies worldwide. Microsoft closely collaborates with a broad ecosystem of partners and develops its own powerful health solutions, such as Amalga and HealthVault. Together, Microsoft and its industry partners are working to advance a vision of unifying health information and making it more readily available, ensuring the best quality of life and affordable care for everyone.

About Microsoft
Founded in 1975, Microsoft (Nasdaq “MSFT”) is the worldwide leader in software, services and solutions that help people and businesses realize their full potential.

Sentillion: Identity and Access Management for Healthcare