RememberItNow! Web Based Program and PHR – Text Messages and Emails Sent for Medication Reminders

We have one more new entry into the PHR business and this service will send messages to your cell phone to remind you when to take your pills.  We are talking about “compliance” once more.  Again, you can share this information with whom you delegate.  Caregivers and family members can be included in for sharing.  I like the video showing grandpa with his cell phone here.  

The service is not free and offers a 30 day trial.  I would expect this type of service at some point in time to be rolled into a full service PHR instead of a stand alone product.   BD  

Orinda, CA (PRWEB) March 11, 2010 -- RememberItNow! LLC announced the launch today of the first eHealth service which helps people take medications correctly by sending reminders to their cell phone. RememberItNow! also makes it simple to maintain a personal health record and create an interactive private care community.

RememberItNow! Launches Mobile Medication Reminder and eHealth Service

Technorati Tags: PHR, drugs, heatlhcare, software, medications, personal health records, text messages, cell phones, Health IT, RememberItNow

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FDA Gives Plavix New Box Warning Relating to Metabolization in the Body – Step One Toward Personalized Medicine

As mentioned in prior posts, is Plavix a good candidate for personalized medicine, since it is a blood thinner.  Right now with the new warning, it is basically telling you that it might not work for you so with a test perhaps the guess work someday could be eliminated. 

FDA To look at benefits of Plavix in certain patients

Will Plavix be the next drug up for a genetic test?  There are not many alternative drugs either that could easily replace the functionality of Plavix, it is a blood thinner.   One idea would be to monitor patients with poor liver or kidney metabolization. as suggested here, a blog written by Steve Murphy, MD of New York who has a personalized medicine practice, and thus electronic records would help the cause here tremendously as manually if a practice has a substantial amount of patients, it would be a nightmare.  BD

Plavix – What’s the next step for doctors and patients – possible genetic testing in the near future?

SILVER SPRING, Md., March 12 /PRNewswire-USNewswire/ -- The U.S. Food and Drug Administration today added a boxed warning to the anti-blood clotting drug Plavix (clopidogrel), alerting patients and health care professionals that the drug can be less effective in people who cannot metabolize the drug to convert it to its active form. 

Plavix reduces the risk of heart attack, unstable angina, stroke, and cardiovascular death in patients with cardiovascular disease by making platelets less likely to form blood clots. Plavix does not have its anti-platelet effects until it is metabolized into its active form by the liver enzyme, CYP2C19.

n May 2009, the FDA added this warning to the drug's label. After reviewing more data, the agency felt it was important to highlight this risk in a boxed warning.

It is estimated that 2 percent to 14 percent of the U.S. population are poor metabolizers. The FDA recommends that health care professionals consider alternative dosing of Plavix for these patients, or consider using other anti-platelet medications. Tests are available to assess CYP2C19 genotype to determine if a patient is a poor metabolizer.

Patients should not stop taking Plavix unless told to do so by their health care professional. They should talk with their health care professional if they have any concerns about Plavix.

Plavix is made under a Bristol-Myers Squibb - Sanofi Pharmaceuticals partnership.

FDA Announces New Boxed Warning on Plavix -- SILVER SPRING, Md., March 12 /PRNewswire-USNewswire/ --

Technorati Tags: genomics, personalized medicine, DNA, healthcare, sequencing, technology, Health IT, Biotech, pharmacogenomics, Plavix, cardiology, physician, FDA, FDA warnings, Information overload

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GOP Trying to Scare the Democrats? I Think They are Scaring Everyone As Non Participants

Does the average person care about how many seats one party or the other has, I don’t really think so as that does not impact their day to day life very much but does the average American think about healthcare reform, you bet.  If you think it makes a difference on whether or not you “like” a Congress person, it doesn’t.  What is really coming forward through all of this is the transparency of seeing what type of individuals we elect through the healthcare reform bill. It’s becoming obvious to see with news reports and the internet on who is willing to work and collaborate and those who choose not too, and there’ some of those from each party, but the GOP seems to be taking the spotlight.  

We have reached an age whereby technology influences the way we make laws and budget financing and projections and those who do not understand this process and are non-participants themselves are certainly coming out in the news day with others gawking and understanding the fallacies of what is being said.  If you do any type of reading on what is happening, you can’t help but notice all of this.  We have 34 members that have now announced retirement, it’s getting a little too difficult to take stands and promote ideas and philosophies in areas where one does not understand nor participate and we end up with rather “stupid” stuff in the news.   There are a lot of folks at the World Economic Forum who seem to get it, but they are not the ones who make the laws. 

Davos: World Economic Forum – Banking Reform And Other Important Issues Were On The Agenda This Year

Earlier today I posted about 2 big hospitals in Florida ready to close up due to lack of money.  Do you think any of those folks are concerned about political parties?  I think they just want healthcare and the soap operate that prevails means nothing in Washington DC. 

Jackson Health System Announces the Closure of 2 Hospitals in the Miami-Dade Area – Not Enough Money To Keep the Doors Open

These strategic games are becoming more useless as each day goes on and it’s sad that we are seeing so many individuals on the forefront who don’t know how or refuse to work by collaborating as we all suffer in the US due to this side show and the crummy stuff that makes the news.  It’s fine for entertainment purposes, just as Limbaugh is, but the frightening fact is that it is not entertainment and I think some members might have this confused with the purpose of creating laws.  It certainly looks that way to me.  We don’t want entertainment from Washington, we want individuals that can work together and collaborate, both sides.  BD 

With a final vote drawing near on President Barack Obama's health-care overhaul, Republicans' latest strategy can be neatly summarized: try to scare the daylights out of House Democrats.

If the overhaul passes, Mr. Alexander said he believes there will be a movement to repeal the health-care law. The GOP has also highlighted deals Democrats offered senators to secure votes.

For months Republicans have been telling the public that the Democrats' plan is a government takeover of health care. Now they are ramping up their warnings to Democratic lawmakers themselves, saying a "yes" vote puts their political careers at risk.

Democrats ridicule the notion that Republican leaders are concerned they could lose seats, and also contend that voters have been pelted with misinformation about the bill. If it passes and the public sees its benefits, support for the plan and those who enacted it will rise, they say.

"I'm ready for that battle," said Rep. Sander Levin (D., Mich.), whose district includes many conservative Democrats. "I have confidence the people will decide that responsible reform was better than deadlock and better than the status quo."

The Republican warnings focus in part on Democrats' two-step legislative strategy. Under this plan, House members would first approve a Senate bill many of them dislike. Then both chambers would vote to "fix" the first bill, in part by expanding insurance subsidies for lower earners. To pass this second bill, the Senate would rely on a procedure called "reconciliation," which requires a simple majority of 51 votes instead to the 60 needed to overcome a promised filibuster.

Republicans say there is no guarantee the Senate will approve the "fixes" bill, because reconciliation gives them other ways to block it.

GOP's New Tactic: Alarm Rivals - WSJ.com

Technorati Tags: GOP, Democrats, collaboration, Washington DC, politics, healthcare reform, non participants, Congress, filibuster, healthcare, ignorance, entertainment, technology

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Sex Is Over at 70 According to a Report Published in the British Medical Journal Funded In Part by the NIH

This is where some of your tax dollars go, and maybe we might have already been keyed into some of this, well depending on your age zone (grin).  The focus here too is to let individuals know what if you are healthier to begin with and work at healthy lifestyles, then your sex life could be longer.  I don’t know for a fact or not, but I don’t think this report is going to subdue or discourage the ones who are not living healthy lifestyles either.   Again, the big hint here appears to be lead a healthier lifestyle and I guess you could work at beating the odds.  BD  

(Bloomberg) — The average person's sex life ends by the age of 70, according to a report published today in the British Medical Journal.

Men age 30 have an average of 35 years of sexually active life remaining, compared with 31 years for women, researchers at the University of Chicago's department of obstetrics and gynecology estimated after reviewing a survey of 3,000 people. A separate survey of older people showed that by 55, men have an average sexual life expectancy of 15 years and women can expect 10 more years, the researchers found.

People in very good or excellent health were almost twice as likely to be interested in sex as people in poorer health, according to the study. Men lost more years of sexual activity as a result of poor health than women, the researchers said. That may motivate men to pursue healthier lifestyles, they said.

The gap was largest among 75- to 85-year-olds. About 40 percent of men in that group were sexually active, compared with 17 percent of women, the researchers found.

The study was funded by the University of Chicago and the U.S. National Institutes of Health.

Sex Life Ends at 70 as Health Declines, Study Says - BusinessWeek

Technorati Tags: Sex Life, study, British Medical Journal, NIH, healthcare, preventive medicine, Sex, lifestyles

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CMS Extends Medicare-Tricare PHR Pilot Test MyPHRSC – Personal Health Records

I first posted about the project back in September of 2008 and CMS is now extending the pilot program.   You can view the demo pages here that show the various screens available for the patients.  What is nice is to be able to search Medicare claims to see what is being processed and what is on file. 

According to this update, participation has exceeded the expectations for South Carolina Medicare beneficiaries that has 660,000 eligible participants.  It is noted that due to the level that have signed up and are participating, this reinforces the fact that Medicare beneficiaries do have an interest in having a PHR.  The pilot program has now been extended until September 2010.  A few quotes from the website below: 
“In order to provide additional information for your record, MyPHRSC launched a new partnership with TRICARE for LIFE to populate 24 months of pharmacy data for individuals who have both Medicare and TRICARE for Life Coverage. Initially, pharmacy data will be provided. However, additional data may be provided as the pilot continues. You may authorize TRICARE for LIFE pharmacy and additional data to be populated into your record by clicking on the TRICARE for LIFE logo on the MyPHRSC Welcome Page. If you do not want this information to appear in your record, you do not need to do anything at this time.

Although the information contained in MyPHRSC comes from Medicare claims data, Medicare will not have access to your information through MyPHRSC. Only you and the people you authorize will be able to view your record.

For questions about your TRICARE for Life coverage, please call 1-800-444-5445. If you have questions about your pharmacy data, please call 1-866-363-8779. For more information on TRICARE for Life, go to TRICARE for LIFE.”

The Confusing Issue of the PHR – Personal Health Record

The PHR is powered by HealthTrio, LLC, which is a web based software program developed by the company to aggregate and bring all the information together through the PHR.  In addition, CMS also has the ongoing PHR project for Medicare recipients in Arizona and Utah and that program is lacking training and education all the way around for participants.  Here’s one link below and there are several others on the blog relative to that project.  BD 

Medicare's Updates Pilot Personal Health Record Program – Medicare PHR Choice

 

A personal health record pilot in South Carolina, which incorporates both Medicare and military Tricare claims data, has been extended through Sept. 30, 2010.

The Internet-based My Personal Health Record-South Carolina (MyPHRSC), a Medicare project, provides its 4,500 participants 24 months of Medicare A and B claims history and 24 months of Tricare pharmacy data upon request.

http://www.govhealthit.com/newsitem.aspx?nid=73290

Technorati Tags: personal health records, PHR, medical records, DOD, CMS, Tricare, pilot, MyPHRSC, Medicare, healthcare, HealthIT, Medicare PHR Choice

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Hospitalist Requests Records from Walter Reed Hospital Response: "You Can Expect Your Medical Records in 21 Days"

The Happy Hospitalist blog tells of his own experience in getting records from Walter Reed Hospital, and as you can see, it’s a long time.  He’s treating a patient who had surgery there 3 years ago and needs the information to provide a treatment plan for the hospital.  This is very good work on his part as he can see what has been done and potentially avoid additional costs, and furthermore provide better care for the patient!  We talk a lot about additional tests and other medical costs that can be avoided and here’s the perfect example with the patient suffering acute renal failure, this is a big thing!  

I don’t think any treatment plans here can wait upon 21 days, so “Happy” has to do what he has to do, regardless of whether or not records are available.  Later down the road should the analysts backtrack and inquire to check out his treatment plans they should see a big red flag here – 21 days to get patient records.  It’s nice that we have doctors like Happy who take time out to tell us what goes on in the “real” world.   This certainly speaks very loud for electronic medical records and aggregation needs, so the information can be available when needed. 

I might add one other thought here from the patient side of things and that is a PHR (personal health record) populated with information from Walter Reed Hospital could have allowed some of this information for Happy to be available.  If you haven’t given much thought to getting one started, this is a good example of how it could be of help, and I’m sure Happy would have appreciated having the information available too, as the patient could have “shared” the information with him.  You can find the “Happy Hospitalist” in my blogroll listing. 

In short, we see a failure of communication here, and the importance of getting a PHR started, so that information can be shared with a physician who is caring for you, especially in this example with acute renal failure, a PHR with populated information could in fact be lifesaving. 

One short note, you can easily find all posts I have made referencing some of his great posts by using the second “instant” search box on the blog.  When the results come up (I searched for Happy Hospitalist) you can see the results in the screenshot below.  With the instant search of “blog roll” you can find posts from other bloggers easily right here on the Medical Quack and quickly read and link to their posts!  You can use the instant search to find articles from any of the bloggers I have listed in my blogroll.  We aggregate very well with blogs and we need hospitals and other healthcare facilities to do the same.  BD  

So I'm taking care of a pleasant 20 year old male admitted with acute renal failure and complications from a kidney surgery he obtained at the Walter Reed Military Hospital three years ago.  This guy was a former student at the Navel Academy when he was stricken with his unfortunate renal disease.  He told me his surgery was in 2007.

Nurse:  Dr Happy, we got in contact with the medical records at Walter Reed Military Hospital in Maryland.  They said the person in charge of getting records is gone today, but they will be back tomorrow (at 1pm in the afternoon EST).  But they also said that it could take up to 21 days to get the records.

Happy:  21 days?  Are you freakin' kidding me?

Nurse:  No.  They said they used to tell people it could be three days.  Then it was seven days.  Now they just tell everyone it could take up to 21 days to get medical records faxed.

What an embarrassment to our military men and women of this country.  You would think, after their incredible failures over the last several years, someone in command would make the appropriate changes. at Walter Reed Military Hospital.     Obama talks of ridding the waste and inefficiency from Medicare  National Bank.  Look in your backyard Mr Marlboro Man.   What an embarrassment to our Commander in Chief.

I can't imagine for even a second that Happy's hospital would tell anyone, let alone another acute care hospital, that it could take three weeks to get necessary records to make medical decision for patients.   I can't even imagine what it's like to be a hospitalist in that hospital.

Walter Reed Military Hospital: "You Can Expect Your Medical Records in 21 Days"

Technorati Tags: Happy Hospitalist, healthcare reform, EHR, medical records, hospitalist, treatment, military, Walter Reed Hospital, PHR, patient, aggregation, blogs, search, utilization

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Jackson Health System Announces the Closure of 2 Hospitals in the Miami-Dade Area – Not Enough Money To Keep the Doors Open

Jackson Health System  is in financial hurt as governing board of the Jackson Health System that acts on behalf of the Miami-Dade County Commission is in a stew for finding new and faster emergency revenue to keep the hospitals open.  After the hurricane in Haiti, the system provided a ton of charity relief for those brought to the Miami area and just within our own system provides charity care.  The CEO has announced the closure of 2 hospitals in the system and below is a quote from the hospital website on how one of the hospitals to be closed was in the process of renovating, so I guess all the building and improved services is either on hold or has gone down the tube. Its’ sad to see, but this seems to be the thanks one gets for providing healthcare services to those who are in desperate need. 

From the website:

“Jackson South is currently a 199-bed acute-care hospital located in south Miami-Dade County. Construction is underway to increase our size by 157,000 square feet and renovate an additional 72,000 square feet of existing space. This exciting project will expand our emergency room and surgical facilities and will add 57 new private patient rooms. It will also convert existing semi-private rooms to private rooms. Dining areas, and the diagnostic imaging and critical care units will be remodeled as well. “

The Miami-Dade hospital provided over 600 million in charity care, but was reimbursed 400 million, so there’s the 200 million outstanding.  In California we are looking at some of the same potential shortfalls and there’s some additional hospital closures happening in New York too.   The state legislators are “trying” to speed up the emergency recovery money from 30 to 15 days and is hoping the federal government makes the proposed Medicaid changes.  This is one big huge reason that healthcare reform is done, and done right, as the state has their own deficit of over 3 billion to deal with as well, so you get the picture here that not much is being done currently except a lot of talking about how “broke” everyone is and healthcare suffers. 

A year ago, this is what was on the blog here and for a short while there seemed to be some reprieves with layoffs and closures, it all seems to have bounced right back.  BD

Desperate Hospitals Update – April 2009

Hospital officials did not provide details, but CBS4 news partner The Miami Herald obtained the following email by a board member expressing frustration.

In an e-mail obtained by The Herald Friday to Jackson President & CEO Eneida Roldan, board member Martin Zilber said: ``I am very strongly in favor of a meeting with our fellow stakeholders. However, I am concerned about doing so as a full board and at such a public setting. Perhaps you and senior leadership should meet with leadership of our partner organizations first. I know you are pushing for transparency and board inclusion, however, I believe the next time our board meets, we need to know how our partners are willing to help and be presented with options so our board can take action and make an intelligent decision.''

And while legislators were sympathetic, they turned down her request saying the state faced its own budget crisis with a deficit of $3.2 billion.
Jackson receives $77 million in state money every 30 days and Miami legislators said they would work to try to get the money to the hospital sooner in 15-day increments rather than monthly. 
On March 6, Roldan announced plans to lay off 4,487 workers and close two of the system's hospitals – Jackson North and South -- in response to a $229 million dollar budget deficit.

Jackson Cancels Board Meeting To Discuss Plan - cbs4.com

Technorati Tags: hospitals, healthcare, Jackson Health System, budgets, Haiti, medical services, patients, emergency funds, healthcare reform, desperate hospitals

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Jewish Hospital & St. Mary's HealthCare Cutting 500 Jobs – Food and Environmental Services to be Contracted Out

Outsourcing is what is happening here with many of the employees having a new boss, and reason is to save money.  Over 50% of the US hospitals are now operating in the “red” and by shifting the cost over to a contract, benefits, health insurance, etc. are now going to a new source for the employee.  Chances are the benefits are not going to be as good as what the hospital offered, common sense may dictate this opinion. 

The CEO of the hospital sums it up pretty good, it’s about the economy and hospitals can only cut so far as they have fixed costs.  Some hospitals around the country have been holding meetings, telling physicians that they “are not meeting quota”.  This means admitting quota.  Perhaps quota is not the best choice of words but that is what is being related to the doctors when the numbers show the hospital is not bringing in enough money to meet their bottom line costs.  To raise more money, admitting “insured” patients and even Medicare patients is a way of generating revenue, even though doctors of course do not want to admit patients who do not need to be there as well, but some are being put on the “hot seat” as if the bottom line revenue goals to keep the doors open are not met, well the hospital can fade away as well.  It’s really a very bad situation.  If physicians admit patients who do not need to be there, the utilization departments will track this down as this is their job and the doctor could get fired when those algorithms are run later, so a big catch 22. 

The doctor can feel pressured and perhaps admit borderline cases, but when the numbers are run later, he’s out the door at the hospital and he could also be replaced by other doctors who charge less, or perhaps I should say may be coerced into charging less.  BD 

LOUISVILLE, KY (WAVE) - Another major Louisville company is cutting jobs. On Wednesday, Jewish Hospital and St. Mary's HealthCare announced it would eliminate 500 of its more than 8,100 positions, about half through layoffs.

Interim CEO Janice James says it's "about as tough as you get in terms of management decisions."

James says about 250 employees now working for Jewish and St. Mary's won't have jobs at the end of the month.

"This isn't about the people's contributions individually," James said. "This is about a change in the economic reality that we live in."

The economy is finally hitting healthcare.

"Patients are deferring elective services," James explained. "A lot of the COBRA support that was there has come to an end for people who lost their jobs."

In addition, Jewish is contracting out its food and environmental services, meaning those employees will soon work for a new company.

"Those people will still be working here," James said. "They'll just be working in a different employment relationship."

Jewish Hospital & St. Mary's HealthCare to cut 500 positions - WAVE 3 TV Louisville, KY |

Technorati Tags: Jewish Hospital, layoffs, Desperate Hospitals, catch 22, labor, health insurance, benefits, economy, COBRA, budgets, healthcare reform, Jewish Hospital & St Mary's Healthcare

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Blue Shield in Washington Buys Wellness/Fitness Company – Venture Capital Investors Were Pleased With ROI

With the talk of reform and policy cost improving, there’s still a lot of money in the till for acquisitions it appears.  You can check out the website and again this is one more program focused at employers.  They have a gym in Seattle that goes along with the program. 

They also have a page on the website to sell you some nutritional products and devices. Is this the next move with wellness and fitness with insurance companies beginning to buy the gyms?  There are more than 2 million members in the northwest.  Regence Blue Shield had offered the plan to their own employees for the last year. 

From the website:

“ Kinetix offers a variety of programs to our corporate clients. These are customized programs that can be implemented effectively whether your employees sit in one location, are distributed in many locations, or a combination of both. Our product line has been designed to give our clients maximum flexibility and freedom while delivering consistent and measurable results.”

SEATTLE, Mar 10, 2010 (BUSINESS WIRE) -- Maveron LLC, a Seattle-based venture capital firm focused on helping exceptional entrepreneurs build great consumer businesses, announced the asset acquisition of portfolio company Kinetix Living Corp. by Regence BlueShield of Washington. Terms of the transaction were not disclosed. 

Kinetix, a Seattle-based company that helps people get and stay in the best shape of their lives, provides customized health and nutrition programs to corporate clients and individuals across the country. Kinetix has built a compelling, scalable and integrated business based on three pillars: fitness, nutrition and a supportive online community that promotes wellness at work and at home.

http://www.marketwatch.com/story/maveron-backed-health-and-wellness-company-kinetix-acquired-by-regence-blueshield-2010-03-10?reflink=MW_news_stmp

Technorati Tags: health insurance, wellness, fitness, healthcare, coaching, heatlhcare reform, Blue Shield, Kinetix

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Insurance Plans at This Employer Get a Little More Difficult to Decipher – More Confusing Algorithms That Lead to More Cost Out of Pocket for Big Expenditures

The focus here is for more money spent on preventive care, but when the big ones come, such as a knee or hip, or even cardiac care, it will be more out of pocket for the employees here.  It is lowering the cost on the preventive side, where we can usually afford, but passing along the bigger expense of surgery to the patient.  The prescription drugs for the preventive are not a huge plus as so many of those are generic in the deal, but we have discounted visits or free to the doctors. 

I might go on to guess that with negotiated contracts with the doctors and the visits sometimes being free, there goes less in the pockets of the doctors too.  It took some fancy formulas (algorithms) to come up with this one.  Actually it’s not the small routine expenses for preventive care that hurts everybody, it’s the large expenses and this is an option for employees, and yes, just one more way of crunching numbers with some new algorithms.  The plans are being underwritten by Blue Cross/Blue Shield.  It’s just one more way to shake out some numbers, and add to the confusion of getting good care.  As far as I have seen and heard from individuals I talk with, not much of this is really getting though as most patients don’t understand the entire analytics of the process.  

Workers at a Portland, Ore., steel mill soon will be able to pick a new type of insurance that offers free care for some illnesses, such as diabetes or depression, but requires hefty extra fees for treatments deemed overused, including knee replacements, hysterectomies and heart bypass surgery.

The insurance, which will be offered by five different insurers in Oregon, is the most far-reaching and potentially controversial step in an effort by employers nationally to rein in medical spending by redesigning health benefits.

"We're trying to make people better consumers," says John Worcester, head of benefits at Evraz Oregon Steel, the sole employer to sign up since the plans began coming on the market earlier this year.

Workers who choose the option over a more traditional plan next year could see their costs drop sharply if they have one of six chronic conditions but might pay hundreds more in deductibles and co-payments if they need a hip replacement or a heart stent.

At Evraz, Worcester expects only about 30 of the 450 workers at the plant will choose the new option over more conventional insurance — even though the company won't charge workers monthly premiums for the new type of policy. The policies, administered by Regence Blue Cross Blue Shield, will work like this:

Just as in more traditional insurance plans, workers would pay an annual deductible of about $250 before coverage kicks in. Doctor office visits would cost workers $10 to $20. Employees would pay 20% of the cost of hospital care, up to an annual maximum of $1,500 for individuals and $3,000 a year for family coverage.

But employees with certain conditions — asthma, congestive heart failure, diabetes, depression, heart disease, chronic bronchitis or emphysema — would get prescription drugs and visits with physicians free or at greatly reduced rates. High blood pressure, another common condition, would qualify for low-cost care if it was part of an overall diagnosis of heart disease.

Conversely, they'd pay much more if they have a treatment or test from a list of about 20 broad categories, including knee or hip replacement, cardiac bypass surgery, artery-opening stents, hysterectomies, high-tech-imaging exams or emergency room visits. In those cases, they'd pay double the annual deductible, double the amount they'd normally pay for an office visit and up to half the cost of hospital or ER visit, up to the $1,500/$3,000 maximums.

Insurers test health plans that stress patient choices - USATODAY.com

Technorati Tags: health insurance, algorithms, healthcare, formulas, preventive medicine, doctors, Blue Cross, Blue Shield, ER, healthcare reform

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Watch Glenn Beck Attack The Medical Quack At CNNBC (Video-Humor)

Video: Glenn Beck Attacks Barbara Duck

Oh the marvels of technology, just sign in to Facebook and you can have Glenn Beck attack you too.  The pictures are classic!   Be sure you have a Facebook picture on your profile that you like as this is how it shows up.

This is the safe way to have him attack you, Barbara the Duck Czar, learned something new today, Ducks can be czars:)  BD 

Fox host Glenn Beck spent much of the last week claiming that a normal, everyday progressive was linked to Stalin, Elvis, Joe Biden's cousin, and the guy who came up with the idea of taxes.

CNNBC | Breaking News, Weather, Sports, Tech, Opinions, and Multimedia | By You, For You, And About You

Technorati Tags: Humor, Facebook, CNNBC, Glenn Beck, politics, Medical Quack

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Anthem Blue Cross Marketing – Working Overtime to Sell that Expensive Insurance in California

I just received this in my email today and for the last month or so, I am getting weekly door hanger advertisements as well, similar to the image below.  With all the recent price increases coming out and talks in Washington, it appears they are on the move to find all the consumers with any ability to pay with somewhat aggressive marketing via the web and the door hangers.  I can’t remember other than this last month ever getting any health insurance advertisements like this, especially on such a regular basis. 

As a matter of fact, all the door hanging advertising seems to have picked up lately, but none weekly like Anthem.  One more note though, I am a bit older than the young woman in the picture so you can see just by the picture where the targeted audience lies here with young an healthy.  BD 

 

http://anthem4ca.com/email/CYB/17158/index.html

Technorati Tags: Blue Cross, Anthem, health insurance, advertising, marketing, mail, email, healthcare reform

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Payors Algorithms other Dubious Deals with the MedicalQuack - Blog Talk Radio 3-16-2010

Well somebody took the brave task of getting the Quack to talk “Algorithms”.  Actually I hope I have something intelligent to talk about:)  If you read the blog here then you know I try to take perhaps some confusing or complicated issues and make them simple and connect dots as far as the “other side” of healthcare goes, the business technology side of things that give us all headaches and it changes all the time.  So we are going to talk about data, data more data, and the algorithms.  I keep that word on the center of my blog as everything is revolving around the formulas and information created by computer code.  I hope you will join in and this is my first guest spot here to bear with me a bit.  I seem to cover many different areas at times and I need that 15-30 seconds at times to shift gears. 

Call-in Number: (347) 539-5527

Again I thank Gregg for the invitation here and look forward to the time.  6:00 pm worked great for me as I found out that Southern California Edison is also doing infrastructure updates that same day and said I should all be up at 4:00 pm, so no doing laundry that day!   The power company is getting close to putting chips in our meters so there goes another group of people unfortunately who are being replaced with some type of technology.  As much as I love technology and what it can do, I don’t like seeing the side where people lose jobs or where it is used against individuals for unjustified monetary gain.  That will be a topic next week.  I hope to see you logged on and tuned in.  You can use the phone or you can log in on the internet or do both!  I mention this for those who have never been on Blog Talk Radio.  BD 

“On the Tuesday, March 16th broadcast, at 6PM Pacific, and 9PM Eastern, I chat with Barbara Duck, aka the 'MedicalQuack', see: http://ducknetweb.blogspot.com/.

We'll talk about a range of topics in the health care 'transformation' space, and kick around the idea of 'who is really to blame' for the near imploding health care 'house of cards' we find ourselves in? Do health insurers really deserve the lion's share of the blame?

After all, there is plenty to go around. What about niche players like PBMs, or for profit hospital management companies, and their massive 'non profit' (aka tax exempt) brethren, have they really delivered on their (quality, cost, access, value) promises other than those made to Wall Street or via their ostensible community benefit claims? Join us for a lively and potentially controversial exchange.”

Payors Alogorithms other Dubious Deals with the MedicalQuack aka Barbara Duck 3/16/2010 - @2healthguru on Blog Talk Radio

Technorati Tags: Blog Talk Radio, Algorithms, healthcare, healthcare reform, MedicalQuack, @2healthguru, Twitter, Payors, Greg Masters

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ScrubsGallery.com – March Reader Discount

Again, I thank ScrubsGallery.com for advertising with the Medical Quack. 
This month they are offering a discount on General Nursing Scrubs with the special code below.  BD 

For a limited time, you can get a 15%  with nursing scrubs by using the code “savescrubs_r2"” on your order!
 
Next time you need to order scrubs or other healthcare apparel, please check out their website and compare. 
Thanks again to ScrubsGallery.Com for supporting the Medical Quack!!

Technorati Tags: MedicalQuack, ScrubsGallery.com, Advertising, lab coats, scrubs, healthcare, apparel, sponsored ads

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DePuy (Johnson and Johnson) Warning Doctors of High Failure Rates – Hip Product Being Phased Out

This is an interesting series of events here, and if the failure rate is high, why are the hips being “phased” out, in other words are they still being sold until the end of this year as the article states? 

Hip Replacement Study Released - Metal on Metal Devices Are Beginning to Fail Sooner than Expected

What is also interesting is the acquisition of another company who has had success with their hips and knees.  This occurred in December 2009, very recently, so it appears there’s a pretty quick replacement to not use the metal to metal hips.  

Johnson and Johnson Company, DePuy Orthopedics Acquires Finsbury Orthopaedics from the UK

One doctor in the Los Angeles area was paid over 3 million by Johnson and Johnson for the work he did with the ASR hip and stated that the “cups” were more of a challenge to implant than the competition.  A few other doctors chimed in with stating the design was bad as well.  Again, I’m just curious that if a warning went out and you know the product has big issues, why a phase out?  BD 

A unit of Johnson & Johnson, just months after saying it was phasing out an artificial hip implant because of slowing sales, has warned doctors that the device appears to have a high early failure rate in some patients.

The action by the company, DePuy Orthopaedics, follows more than two years of reports that the hip implant, which is known as the ASR, was failing in patients only a few years after implant, requiring costly and painful replacement operations.  The ASR, one of several hip models sold by DePuy, belongs to a category of devices known as metal-on-metal implants.

DePuy, of Warsaw, Ind., also announced late last year that it planned to phase out sales of the product worldwide by the end of 2010. 

Just last month, in an interview, DePuy officials defended the ASR’s track record, saying its performance equaled that of competing devices. Those officials also said that the company was phasing out sales of the ASR for commercial reasons, not because of any safety issues.

Some surgeons, including the ASR’s co-developer, Dr. Thomas P. Schmalzried, an orthopedic specialist in Los Angeles, said they had used the device successfully in their patients. But Dr. Schmalzried said in an interview last month that he and DePuy officials realized within the last two years that the ASR cup might be more of a challenge to implant properly than competing cups.

Several orthopedic specialists said that they believed that the design of the ASR cup, which is shallower than some similar devices, was at the heart of the implant’s problems. For example, Dr. Harlan C. Amstutz, an orthopedic surgeon in Los Angeles and an implant designer who is a consultant for Wright Medical Technology, a competing orthopedic company, said that he believed that the design was prone to problems.

Maker Drops Hip Device, Then Warns of Failures - NYTimes.com

Technorati Tags: medical devices, hip implant, surgery, replacement surgery, hip, metal to metal, ceramic, Journal of Athroplasty, pain, infection, orthopedic surgeon, DePuy, Johnson and Johnson

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Online Screener for Determining Mental Health Issues M-3 Symptom Checklist – Integrates with HeatlhVault

Ok I don’t think I am ready for this one, as the power of suggestion could be too strong for me here:)  I certainly would not want to self diagnose when it comes to mental illness and I think over all that this is a human to human area, but if you want to take a test, here it is. 

I get a little wigged out with what I report here, like insurance company behavioral underwriting and devices that report data.  Sometime as a human there’s some things I would rather not focus on if there’s not a problem apparent.  BD

Press Release:

 

CAMBRIDGE, Mass. [March 8, 2010] — A one-page online checklist that can be completed in a few minutes accurately indicates whether a patient may have any of four major mental health conditions, according to a study to be published in the March/April 2010 issue of the Annals of Family Medicine.

For the millions of Americans grappling with depression, anxiety, post-traumatic stress disorder or bipolar disorder, the documented accuracy of the M-3 Symptom Checklist (available on-line at www.mymoodmonitor.com) is a major breakthrough for mental health care, according to the researchers from the University of North Carolina, Weill Medical College at Cornell University and the Boston University School of Medicine who conducted the study.

"The M-3 offers a quick and accurate way to determine whether a person might have one of these four common psychiatric conditions. It also provides a clear and concise printed report detailing the results of the test, which can be shared and discussed with a person's family doctor or a mental health professional" says Larry Culpepper, MD, MPH, Chairman of the Department of Family Medicine at Boston University School of Medicine, and a co-author of the study.

“For the one-in-five Americans who have one of these diagnosable and treatable illnesses, the M-3 screener represents a major breakthrough by offering an easy-to-fillout questionnaire that allows people to identify what’s wrong with them, so they can get the help they need,” says the article’s lead author, Bradley N. Gaynes, MD, MPH, Associate Professor in the Department of Psychiatry at the University of North Carolina.

The M-3 also screens for suicide risk and substance abuse, warning users who might be at risk for these and other conditions and urging that follow-up steps be taken.

The M-3 Checklist is free, private and simple to use, and does not require any personal information to be divulged. It can be taken online, and soon will be available on mobile devices. After beginning treatment, patients can monitor their progress by retaking the test at regular intervals on Microsoft’s HealthVault, which ensures the results remain private.

And the M-3, which was independently funded and developed, is particularly timely: hospitals, doctors, and patients are preparing to use electronic medical records (EMR) systems to document all health care interactions and the M-3 is the first validated application to use EMR technology for mental health care. The recent Obama Administration economic stimulus package includes more than $20 billion in funding for the development of a nationwide electronic health records exchange over the next four years.

According to the most recent estimate from the National Institute of Mental Health, the annual economic impact of untreated mood disorders is more than $70 billion. For sufferers of depression and anxiety, lack of treatment can lead to reduced productivity or job loss, strain on personal relationships, and in some cases, can trigger drug use and/or suicide. Unlike other health issues, the very onset of depression and anxiety symptoms can hinder efforts to seek help, and many sufferers are held back by shame or lethargy.

According to the study: “The M-3 is a valid, efficient, and feasible tool for screening common psychiatric illnesses, including bipolar disorder and PTSD, in primary care. Its diagnostic accuracy equals that of presently used single-disorder screens but with the additional benefit of being combined into a one-page tool. The M-3 potentially can reduce missed psychiatric diagnoses and facilitate proper treatment of identified cases.”

The Annals study is based on the responses of 647 patients at the University of North Carolina Family Practice Medicine Clinic. Each subject filled out the 27-question M-3 checklist and then participated in a follow-up interview with a clinician who had no access to the results of the screener. The M-3 was effective in screening for any mood or anxiety disorder 83% of the time and for a specific disorder in 76% of cases.

The study was conducted by Bradley N. Gaynes, MD, MPH, Joanne De-Veaugh-Geiss, LPA, and Hongbin Gu, PhD, all of the University of North Carolina School of Medicine, Department of Psychiatry; David R. Rubinow, professor and chairman of psychiatry, University of North Carolina School of Medicine; Sam Weir, MD, University of North Carolina School of Medicine, Department of Family Medicine; Cora MacPherson, PhD, Social & Scientific Systems; Herbert C. Schulberg, PhD, M.S.Hyg., Weill Cornell Medical College; and Larry Culpepper, MD, MPH, professor and chairman of family medicine, Boston University and chief of family medicine, Boston Medical Center.

***

About M-3: Sixty million Americans have a diagnosable mood or anxiety disorder every year while fewer than half of these individuals receive help for their condition. One reason for this shortfall has been the absence of a single, simple and reliable screen that can assess the presence of the mood and anxiety disorders, including obsessive-compulsive disorder, panic disorder and PTSD. The M-3 Screen is a symptom checklist that a patient can use to rate his or her mood in one easy review. It comprises a short series of questions that touch on indicators of mental health. M-3 was developed by a team of mental health practitioners and experts, including Robert M. Post, MD, head of the Bipolar Collaborative Network, Bernard M. Snyder, MD, assistant clinical professor of psychiatry at Georgetown University and a cognitive behavioral therapist, Michael L. Byer, director of M-3 Information, Larry Culpepper, MD, family practice program at Boston University, and Gerald Hurowitz, MD, assistant clinical professor of psychiatry at Columbia University and a clinical psychopharmacologist The free and private screener is independently funded without pharmaceutical support and is available at www.mymoodmonitor.com

About Annals of Family Medicine: Annals of Family Medicine is a peer-reviewed, indexed research journal that provides a cross-disciplinary forum for new, evidence-based information affecting the primary care disciplines. Launched in May 2003, Annals is sponsored by seven family medical organizations, including the American Academy of Family Physicians, the American Board of Family Medicine, the Society of Teachers of Family Medicine, the Association of Departments of Family Medicine, the Association of Family Medicine Residency Directors, the North American Primary Care Research Group, and the College of Family Physicians of Canada. Annals is published six times each year and contains original research from the clinical, biomedical, social and health services areas, as well as contributions on methodology and theory, selected reviews, essays and editorials. Complete editorial content and interactive discussion groups for each published article can be accessed free of charge on the journal’s Web site, www.annfammed.org.

Technorati Tags: HealthVault, MyMoodMonitor, healthcare, screening, mental illness

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FDA and NIH Working To Accelerate Development of Innovative Medical Technologies – It’s All In the Software

Personally from doing this blog it doesn’t appear to me that we have a shortage in the development area, but where the issues lie is in standards and bringing some of this to a better collaborative effort.  You do NOT want to rush the programmers of the software for the sake of having a product to sell that will jeopardize safety, but yet it happens all the time.  The development of new tools is software for evaluation and decision making.  On the drug side of the formula here, I’m not sure how this would work as I am not a chemist or scientist.   Earlier I posted this about Provenge, which is relying heavily on software, just due to the type of treatment plan it is. 

Dendreon “Intellivenge” Algorithmic Software Supporting Administration of Provenge – Seeking FDA Approval by May 1st

We also have the other side of the coin called “compliance” and there’s a lot going on in that area too with devices reporting data, which brings along security and privacy that we have to work with as well, and sometimes all those implications are not known up front, so I see this as “interesting” and secondary to healthcare reform.  We certainly need the research and development, but are we pricing ourselves out of the market in doing so?  BD 

The Food & Drug Administration and the National Institutes of Health are collaborating on an initiative to accelerate the development of innovative medical technologies.

and the National Institutes of Health launched a new program aimed at speeding innovative medical technologies to market.

The joint program involves translational science, "the shaping of basic scientific discoveries into treatments," and regulatory science, or "the development and use of new tools, standards and approaches to more efficiently develop products and to more effectively evaluate product safety, efficacy and quality," according to a press release.

FDA, NIH to fast-track med-tech innovation | MassDevice - Medical Device Industry News

Technorati Tags: FDA, NIH, software, drugs, fast track, innnovation, medical devices, technology, translational medicine, algorithm

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Biodesign® Advanced Tissue Repair – Cook Medical Regenerative Medicine Biodesign Website Expanded

If you check in here often enough you have probably seen information about Cook Medical and last year I had the opportunity to talk with a representative of Cook to find out more about how it works.  We discussed hernia repair for the most part and covered a few other areas. 

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

Cook Medical has expanded their site in this area to include more information for both patients and doctors.  You can visit the website links below to find out more.  The product is used and is more like natural material found in our bodies rather than plastic.  BD 

Bloomington, Ind., March 8, 2010 – In response to its first-ever microsite on advanced soft tissue repair, Cook Medical has expanded CookBiodesign.com with new features including Q&A physician videos on biologics and links to the latest peer-reviewed articles, research and data on its Biodesign® Advanced Tissue Repair Products. The expanded site now offers surgeons and patients more than 800 educational resources on Biodesign products, which have been used in one million procedures and more than 91 countries for the treatment of conditions such as hernia, fistula, incontinence, pelvic organ prolapse and Peyronie’s disease.

“CookBiodesign.com is becoming an invaluable resource for clinical information and procedural training in one of the most important technologies available for treating complex cases of soft tissue damage,” said Charles McIntosh, M.D., chief medical science and technology officer for Cook Medical. “It’s an asset for surgeons and patients alike who want to learn more about the advantages of biologic grafts.”

Launched in October, CookBiodesign.com is designed to inform the medical community and patients on the long-term evidence and benefits of Cook’s Biodesign products for a range of soft tissue repair procedures. The site has already drawn more than 160,000 page views and 70,000 unique visitors with its comprehensive resource library, containing procedural videos, procedural best practices and patient guides. The new features include eight video testimonials with medical and device experts explaining the differences between a biologic and synthetic healing response and the advantages of using biologics in complex cases. The site also features links to the latest peer-reviewed research and data on Biodesign, including citations and abstracts indexed through PubMed.

“We are thrilled with the site’s early popularity, and have received all-around positive feedback from the medical community thus far,” said Andy Cron, vice president of Cook Medical’s Surgery business unit. “Since the site’s inception, we have been committed to continuously adding new features to the site, ensuring that the resources and information provided to the physician and patient are the most accurate and up-to-date. Our goal is to make CookBiodesign.com a truly ‘one-stop shop’ for physicians and patients seeking thorough, reliable, current information on biologic grafts for soft tissue repair.”

Biodesign is a whole new category in the evolution of soft tissue repair, addressing physicians’ needs for an advanced biologic graft. Once implanted, Biodesign communicates with the body, signaling surrounding tissue to grow across the scaffold, allowing the body to restore itself. Biodesign completely remodels into fully vascularized tissue that becomes stronger over time, providing a permanent repair without a permanent material. Biodesign combines the best attributes of biologic grafts–resistant to infection and complete remodeling–with the added benefits of moderate price, ease of use and widespread availability. Introduced by Cook in 1995 and manufactured in the Cook Biotech facility in West Lafayette, Ind., the grafts have a proven track record in treating a range of conditions including hernias, fistulas, stress urinary incontinence, pelvic organ prolapse and Peyronie’s disease, as well as in staple-line reinforcement for bariatric surgery and plastic and reconstructive surgery. To date, nearly 850 peer-reviewed articles have been published on the technology behind Biodesign.

Follow Biodesign updates on Twitter at twitter.com/cooksurgery.

About Cook Medical
Founded in 1963, Cook Medical pioneered many of the medical devices now commonly used to perform minimally invasive medical procedures throughout the body. Today, the company integrates medical devices, drugs and biologics to enhance patient safety and improve clinical outcomes. Since its inception, Cook has operated as a family-held private corporation. For more information, visit www.cookmedical.com. Follow Cook Medical on Twitter at twitter.com/cookmedicalpr.

Technorati Tags: Cook Medical, healthcare, minimally invasive surgery, Cook Biotech, Regenerational Medicine, Wound Care, Cook Bio, hernia repair, Biodesign

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Don’t Look for a Date at This Drug Store (Video – Humor)

The pharmacist was just doing his job, right?  BD

PharmaGossip: LOL - "Genital or oral?"

Technorati Tags: humor, herpes, oral, genital, prescription, medical humor, drug store, pharmacist

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Dendreon “Intellivenge” Algorithmic Software Supporting Administration of Provenge – Seeking FDA Approval by May 1st

This company has been in the news for a couple years now and if you haven’t followed this company as far as development, politics, the FDA and more, it has a little bit of everything.  Even with biotech drugs getting approved today, it’s all about the software that combines the efforts of the drug to bring reporting and other significant data together.  The biotech drug from Dendreon, Provenge is used to extend life for those suffering with terminal prostate cancer and is the the first of it’s kind treatment to stimulate the patient’s immune system to fight cancer cells and it has minimal side effects. 

The drug is under current review at the FDA after being turned down in 2007 as the data was not conclusive enough with trials and information submitted.  My 1st is the deadline this year for the FDA to make a decision.  The Intellivenge software system is part of that decision making process to support the efforts of the company.  The patient needs to be tested and blood drawn at the doctor’s office and sent to Dendreon for incubation for a couple days.  If you will, this is a classroom for the blood cells as they are matched with with a protein found on prostate cancer cells.  After this process takes place, the blood cells are sent back to the doctor to where they are reinjected back into the patient in 3 shots during a month.  This is not like taking a pill and forgetting about it, so this is why the software plays such an important role here, this is a brand new type of delivery system. 

For security, each one is bar coded and for some reason or another here I’m thinking Microsoft Tags again as they are much more thorough than straight bar codes, and they can be updated too.  When we have medicine personalized to this level we don’t want any mix ups.  Dendreon wrote the propriety software in house.   As we keep seeing the lines of both software and drugs/medical devices closely coming together, who knows we might need to merge the FDA with some Health IT portions of the government, as it’s complicated any more.  

Tags for Use in Healthcare – Medical Stents, Medications - One Scan Away From Safety Information in Real Time

You can watch the video here that explains the process.  You can see by watching the video the bar coding used, and not knowing what system is being used here and with any level of encryption it’s hard to comment further than the Microsoft Tags; however, there are encrypted Tags that can be used for PHRs, and that seems to me like a step in the right direction here.  I worked in logistics for years and understand the process easily, logistics was one of the earlier uses of the technology.  We need those tracking algorithms for sure!   

Connecting HealthVault/Google Health and More to RazCode Encrypted Microsoft Tags – Automate Data Input

From the website: (from the CIO)

“The planning required to support the transportation and processing of a patient’s cells must be accurate, timely and precise. To accommodate this, Dendreon has developed a highly sophisticated and innovative software program called Intellivenge™. This technology helps coordinate and plan logistics for the entire treatment cycle for sipuleucel-T, from the initial cell collection to the delivery and infusion of cells back to the patient.

Intellivenge was designed to be the information resource linking the physician’s office, the apheresis center (where the patient’s cells are collected), the Dendreon manufacturing facility and all of the transportation services required to ensure that the cells received from each patient are processed within the required window of time. Using proprietary technology,  Intellivenge coordinates the timing of all the resources each patient needs for the treatment cycle and tracks where a patient’s cells are at every stage of the processing cycle.  Intellivenge also assists patients, physicians and their office staff with follow up appointment timing and scheduling.”

“The dedication of our research and development team has resulted in our lead product candidate, sipuleucel-T, rapidly approaching commercialization.

“Sipuleucel-T, an active cellular immunotherapy, is in late-stage development for the treatment of metastatic, androgen-independent prostate cancer.

Lapuleucel-T, an active cellular immunotherapy, is in development for breast, ovarian and colon cancer.

CEA, an active cellular immunotherapy, is in preclinical development for breast, lung and colon cancer.

CA-9, an active cellular immunotherapy, is in preclinical development for kidney, colon and cervical cancer.

TRPM8 (also known as TRPP8), a small molecule, is in a Phase 1 clinical trial to evaluate it against multiple types of solid tumors.”

As you can see this is a whole new ball game for treatment, so with adding transportation and logistics into the picture due to the nature of how the therapy is generated, you need the software.  As you can see from above, there are 4 more in the pipeline too.  BD

If Dendreon makes any information technology screw-ups with its experimental treatment for prostate cancer, it could be a matter of life and death for patients. That’s why the Seattle-based biotech company has turned to a custom software vendor with a reputation for supporting the California 9-1-1 system for 12 years with zero downtime.

The Dendreon IT contract is held by Direct Technology, a Roseville, CA-based custom software developer with a 40-person office in Bellevue, WA. Direct Technology, formerly called DirectApps, has forged a close relationship with Dendreon over the past three years, under a contract that gives it full responsibility to support, operate, maintain, and enhance Intellivenge, the program that oversees administration of sipuleucel-T (Provenge). I heard about this from talking to Wud Pocinwong, a senior vice president with Direct Technology in Bellevue.

Dendreon Leans on California 9-1-1 Software Vendor to Keep Provenge Trains on Time | Xconomy

Technorati Tags: Dendreon, Provenge, prostate cancer, software, Intellivenge, biotech, FDA, technology, algorithms, Microsoft Tags, bar codes, active cellular immunitherapy

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