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Update: Dr. Don Berwick Will Be Nominated as CMS Administrator – Featured Expert From “Money Driven Medicine” – The Book and Movie (Videos)

3/27/2010 10:11:00 PM  ,  

I was reading through my news and Maggie Mahar has updated her blog and states the rumor of the nomination is now true. 

Also in her update, here’s a clip from her imagenotes:  why can’t the Kaiser Permanente model work everywhere?

“In part 2 of this profile, I’ll talk about what Berwick has to say about fragmentation–and variations in care in different parts of the country. Why can’t the Kaiser Permanente model work everywhere. What does he mean when he says that we haven’t even tried “transparency”? What will Medicare ask of U.S. hospitals? Just how much waste does the think there is in the system? How quickly can Medicare move to eliminate that waste?”

Kaiser Permanente is innovative alright and here’s a link to an interview I did with Chris McCarthy a few months ago that’s worth reading.  Kaiser has an innovation department and Chris also heads up the ICN group for healthcare as well.  I said he has a great job to be able to reach out and predict and project issues sometimes even before they arrive. 

Innovation and Learning at Kaiser Permanente – Interview With Chris McCarthy

At the link below you can also read up on the ILN, which was kind enough to feature my post above on their website as well. 

The Innovation Learning Network – Major Healthcare Organizations Working Together with “Design Thinking”

Dr. Berwick appears to be very high on the work flow put in place at Kaiser Permanente, thus the basis of his question.  Hopefully all will go well with confirmation of Dr. Berwick at the Senate as well.  Below is the original post from Saturday. 

Dr. Don Berwick Rumored to Become CMS Administrator – Featured Expert From “Money Driven Medicine” – The Book and Movie (Videos)

Patients make more frugal choices he states than the healthcare system when given the information, and they participate, satisfactions and outcomes improve.  He says what more could you want.   The patient are becoming victims of competition.  Most patients according to Dr. Berwick don’t realize how high some risks are with healthcare and it’s a trade off in some areas.

I watched the movie and Money Driven Medicine had quite a bit of press around this blog.   There were several opportunities to see the move in it’s entirety and you can also purchase the movie for educational use as well.

Money Driven Medicine The Documentary – Streaming During the Month of November So You Can Watch for Free

Money Driven Medicine – Taking Back Healthcare from the Bill Moyer Show

The movie also drove Dr. David Winn to comment and add some content to the blog here on his feelings, he’s the CEO and founder of E-MDs medical records and I posted his letter to President Obama which can be read at the link below.

Dr. David Winn Founder of e-MDs EHR Responds to “Money Driven Medicine” With Suggested Solutions for Healthcare Reform

I am including this information as the movie gave straight facts and has a huge impact on telling the story as to what is happening with healthcare in the US today and the information in the videos here give you some ideas of where Dr. Berwick is coming from.  His appointment would be someone in the “know” who has worked first hand in healthcare and has the wisdom to share with others, using fact and not politics.  If the rumors are true here, it looks like we could have someone who believes in change and straight issues in office and perhaps a few less politics.  Here is the first video as seen on Maggie Mahar’s site, www.healthbeatblog.org.  You can visit the website and hear and learn more about what Dr. Berwick is all about. 

Also at the end of the post is the trailer for Money Drive Medicine, if you have not seen what it is all about.

Again there are more videos at Maggie Mahar’s site so you can perhaps learn a bit more about Dr. Berwick.  From what I have read and seen, he seems to be a great choice to head up CMS – Center for Medicare. 

He’s right, it’s going to take a lot of courage and change and leadership that we have not had or seen yet, people needlessly afraid of change, which I talk about here all the time and call it “tech denial” for the most part here.  BD    

Thursday, Inside Health Policy’s Brett Coughlin and Amy Lotven were the first to report the rumor : “According to several Washington sources . . . the White House has picked Harvard professor and pediatrician Donald Berwick to serve as CMS Administrator. A K Street source said that Berwick agreed to take the job ‘some time ago’ but only on the condition that health reform pass first. Although administration officials did not confirm the chatter, sources said that the announcement could come as soon as next week.” (via Politico Pulse)

This makes sense. Not long ago, I wrote about the need for strong leadership at CMS: “For some time,  I have argued that I believe that White House health care policy-makers want to select someone strong enough to pursue a relatively radical agenda.  My guess is that the White House did not want to face a battle over Senate confirmation of such a candidate while fighting the larger war over healthcare reform.

Health Beat: Dr. Don Berwick to Become Medicare Director? If It’s True, This Is Wonderful News

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PrivaMed, Inc. Granted US Patent for Security Platform and Cards for Medical Records

3/27/2010 08:05:00 PM  ,  

In reading the press release and web site the patent appears to include multi platforms for security for anything from biometrics, a card, a PDA cell phone and a few other software configurations.  With all the issues we read about currently with security breaches, the solution field is bound to become pretty crowded quickly I am guessing too and we could start seeing full on security partners with EHR systems above and beyond what is already built into the medical records system.  BD 


From the website:

“Our solutions provide a wide range of systems and services for the health care industry. They include systems and services for implementations and operations of PrivaMed™ cards. We also provide system solutions and services for the HIPAA privacy and security compliance.”

“PrivaMedTM™ Personal Manager allows review and entry to the PrivaMedTM™ card information on personal computers and on PDAs (Personal Digital Assistants). This system application software has been designed to integrate with other applications on Microsoft Windows based systems and has interfaces to various medical applications for transfer and conversion of any data.”

(NEW YORK — March 22, 2010)— PrivaMed Inc., a New York-based healthcare electronic records and data security company, announces that it has beenimage granted a patent by the US Patent Office. The patent describes a secure, portable, electronic database, containing the patient’s full medical records. The method can be implemented on various portable devices that can be carried by patients, and presented to different providers.

This method can also be implemented through online host systems. 

Providers have different levels of access to the data on the database, depending on their credentials and the data added by each provider is digitally signed and is “trusted”.

With the successful granting of this patent, PrivaMed began working on different implementations of the method for smart cards, USB memory drives and mobile phones.

Because , the stored data is encrypted and can be accessed only by authorized parties, this method can be implemented for storage of patient data records online as well as on a variety of mobile devices. In all cases, the method meets all HIPPA security requirements.

“The approval of the patent validates our vision of how to securely store, access, and present health data records on a variety of different devices and host based systems.” said David Asay, CEO of PrivaMed Inc. “We believe that this patent will bring tremendous efficiencies to the patient information transaction processes and great savings to the entire healthcare system”.

M. Aaron Karimzadeh, PrivaMed’s President, said, “While the US health care system is going through major changes, our solutions utilizing this technology, will remain effective for a wide range of implementations.

The technology gives patients wider flexibility of choice to visit different Health care providers; and allows each provider to see the patient’s complete and up to date medical records, instantly. The information available to provider can include every large radiological images”.

Providers can securely upload patient data records to regional servers that will act, not only as a safe and secure backup for the patient’s ;data but also as a platform for remote accessing data records by provider personnel with the appropriate credentials. The system will also produce a remarkably suitable platform for managing, handling, and processing providers’ transactions, including patient/provider authentications and HIPAA transactions.

PrivaMed is a medical technologies development company, located in Carle Place, New York.

Its team members include technology specialists, medical scientists security experts, and business managers, while its Advisory Board is made up of high ranking subject matter experts, and Medical experts

For all investment and partnership opportunities please contact the company President, M. Aaron Karimzadeh: info@privamedinc.com or call 516-338-8880.

Patent granted for Portable Electronic Medical infromation

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Senate Majority Leader Harry Reid Calls Out “No” By Mistake on Healthcare Vote – Second Time He Did This

3/26/2010 05:54:00 PM  ,  

The senator supports reform and has worked hard to gain supporters.  I guess he may have been distracted and changed his vote, and this has been done twice now.  What’s his level of distraction?

Is Distraction Getting in the Way of HealthCare Reform?

I think I am right when I say we live in a world of constant disruption and this proves that point.  Can you imagine if our Senators and Representatives had to participate with a biometric monitoring too!  They all thought Twitter was a big evil, but what if the game was for real and all your statistics started being recorded like they think should be good for us?  Could they stand it?  Congress is in better position than us though as they have no restrictions and on how they are “scored” like we are for cost. 

Distraction and Disruption – A Way of Life Today with Technology - Do Our Leaders Understand What Is Happening?

“We make laws” and don’t have time to participate, we know what is best for the country?  Is this what we are hearing today?  I kind of seems that way.  I would love to see a session of Congress with members getting text messages to get up and move around, having to answer the messages and so on with wearing a device like a Fitbit or Muve Gruve.   Could they function this way and create laws at the same time?  Looks like they are easily confused without biometrics, but they know they are good for us, right????  The words of the non participants.  

They certainly think it is ok for us, but that’s the world of the non participants that subscribe to the philosophy of “its for those guys over there”.  BD 

 

Washington (CNN) -- Senate Majority Leader Harry Reid mistakenly called out "no" Thursday when asked for his vote on the health care reconciliation bill, setting the chamber howling with laughter.

Reid voted the wrong way when the clerk called for his vote, realized his error and quickly changed his vote to "yes."

"He did it again," someone said amid laughter.

Reid casts wrong vote on health care for second time - CNN.com

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Congressional Death Threats Are Bi-Partisan – Please Stop the Political Show And Get In Touch With Reality

3/26/2010 11:28:00 AM  , , ,  

I say it can’t get much worse, but it does.  Death threats are to be taken seriously by all means and there’s anger on both sides. Blaming each other and the other party accomplishes nothing.  I tell people all the time to watch what you put on the Internet about yourself, well the same applies here too plus there’s additional media coverage as in this video from CNN. 

Perhaps all politicians are still living in a world of “tech denial” and don’t get this.  In the meantime it certainly makes for some real “stupid” and disgusting news.  Our leaders are out of touch and this certainly makes the case.  Blame shifting should not be a part of government – collaboration makes more sense.  Why do you think the American public trust is at its all time low?  Again, threats are to be taken seriously by all means, but for the 99.9999999% of us peaceful citizens in this country there’s a few other emotions we experience from all of this and those are disgust, laughter and a lack of trust and confidence in our leadership. 

This is distraction at one of the highest peaks that I have ever seen, disruptive enough to prevent any real progress and the fish in the tank are totally incoherent.  BD

Anderson Cooper 360: Blog Archive - Video: Security threat gets political « - Blogs from CNN.com

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Desperate Hospitals Returns For 2010

3/26/2010 10:10:00 AM  , , ,  

I did a series last year called “Desperate Hospitals” and now it seems it’s time once again, unfortunately re-open the series again.  Hospitals have fixed costs and have pretty much cut down the the bone where they can.  Some hospitals have been lucky with philanthropy kicking in and helping out with money and others have not.  Sometimes this is the big difference along with how they operate.   I stopped with my last update in March of 2009 and here it is a year later almost exactly and here we go again unfortunately.

Hospital Lay Offs Will Hit an All Time High for 2009 – AMA

I brought back my “poster child” hospital picture here as well, which was Century City Hospital that closed due to lack of funds, which sits right on the outskirts of Beverly Hills and is across the street from many big Fortune 500 companies located in Century City, where the money’s at.   This somewhat relates to a bit of greed I think when it comes to healthcare versus making a buck.  In addition if you do a search you will find many hospitals in Canada also laying off workers.  Please feel free to add more in the comments as I know I didn’t catch all of them.

What’s at the base of a lot of this:  Wall Street Algorithms that smashed economy with “programmed desired financial numbers” shown as justification for trading and investments, while the whole time worked on the back side to create profit centers in areas where they should not have existed. If you read this blog enough you might just come to hating the word algorithm by now, as it is the crux of the matter as that is what displays all the decision making data on the screen that everybody uses and hardly anybody questions as the data is the machine gun and we are still running around with swords.  “Tech denial” and lack of education and the ability to fight back takes your money in a flash and I sure hope we have a Congress that soon will come to terms with this.  BD  

Here’s what is on the web today:

In New York City

NEW YORK—The nation’s largest public hospital system plans to slash its work force—including doctors and nurses—by about 10% over two years as government aid drops and the number of uninsured patients jumps.

With its budget deficit set to top $1 billion, New York City’s Health and Hospitals Corp. plans to eliminate 2,600 jobs in the fiscal year that begins July 1. That comes on top of 1,300 positions to be eliminated this year.

“No hospital system in the country is exempt from the crushing economics facing the health-care industry,” said New York Mayor Michael Bloomberg. He noted that New York had been early to adopt electronic medical records but said that state budget cuts were hitting the system hard.

In Boston, MA

With the announcement of healthcare reform, it might appear that the private equity firm sees potential here with the promise of new patients coming in the doors soon at Caritas Health Care.  Even though purchased by Cerberus and being non profit status, the six hospitals will retain their Catholic affiliation.  The hospital chain has had to recover from bankruptcy recently and has been on the path of rebuilding.

In Oakland, CA

After running up more than $80 million in losses over the last four years, including $26 million in 2009, Children’s Hospital & Research Center Oakland said Thursday it must restructure its outpatient services, develop new business opportunities, and negotiate higher private insurance and government reimbursements to cover patient care costs.

The losses have been mounting “at an unsustainable rate,” acknowledged President and CEO Bert Lubin, M.D., who took office last August.

In Rockport, ME

ROCKPORT, Maine — Pen Bay Healthcare laid off 15 more people and eliminated several positions to try to meet the expected $3 million revenue drop for the next fiscal year, starting in April.

A laundry list of departments is affected, including but not limited to surgical practice, urology, neurology, pediatrics, family medicine, human resources, billing and information technology.

In Springfield, MO

A hospital in Springfield is cutting nearly 60 jobs. St John's Hospital told 48 of its employees in the Springfield area that those positions are being eliminated. As further streamlining, nine spots that are currently vacant will not be filled. A spokesperson says these jobs are mostly administrative so no patient-care positions will be affected. They say a regional business office will open in Springfield next month and bring 66 jobs back to the area.

In West Houston, TX

HOUSTON (KTRK) -- Hundreds of people are now set to be laid off from a medical center in west Houston. Its operators say they've seen fewer and fewer patients, so they're looking for ways to remain open.

We told you last week that Spring Branch Medical Center was stopping its in-patient services. Now, its operators are taking another step, and we're learning details about the hundreds of layoffs.  The hospital has been on shaky financial footing for years, according to employees with whom we spoke. Officials say the facility has 299 beds and typically only about 80 are filled.

In Chesterfield, MO

Sisters of Mercy Health System this morning announced the elimination of 226 positions across the four-state region it serves as part of a system-wide restructuring.

The layoffs affect 89 leadership positions and 137 "co-worker roles," which represent less than 1% of Mercy's 36,000 employees, said the Chesterfield, MO-based health system, in a media release.

In Scranton, PA

Mercy Tyler Hospital in Tunkhannock announced Thursday it will lay off 18 employees as part of a reorganization plan.

The affected employees, full- and part-time from infection control, pharmacy, laboratory, imaging, EKG, and physician services departments, were notified Thursday morning, said Denise Gieski, hospital president and CEO. The layoffs were expected to be completed by the week’s end.

This is the first time in more than 10 years for layoffs at Tyler, Gieski said.

In Phoenix, AZ

The state's budget cuts also could mean a smaller pool of medical-school graduates likely to practice in Arizona. Arizona has slashed more than $20 million from programs that reimburse hospitals for providing indigent care and training student doctors. Combined with a loss of matching federal dollars, hospitals will lose out on more than $37 million for medical education. Without the money, hospitals may reduce the number of student doctors they teach.

Hospitals also say the Medicaid cuts will result in more expensive premiums for those with private insurance. That's because hospitals will negotiate higher reimbursement rates from private insurers, who in turn will charge their customers more.

In Oconomowoc, WI

OCONOMOWOC, Wis. -- New competition is forcing an Oconomowoc hospital to lay off some workers. ProHealth Care employs 586 people in Oconomowoc.

ProHealth Care said it has cut the jobs of fewer than 3 percent of its workforce at Oconomowoc Memorial Hospital.

Spokeswoman Sandra Peterson said they are experiencing a drop in business following the opening of Aurora Health Care’s new medical center in nearby Summit.

In Miami, FL (The Haiti Heroes)

After two weeks of emergency meetings between hospital, union, and County officials, an agreement was reached on a temporary “stabilization” plan that will cut 655 positions, delay debt payments and exact $30 million in concessions from Jackson Health System workers in Miami-Dade County.

Rolden’s plans turned out to be far more draconian than what she initially reported to the press. Originally, she announced layoffs ranging from 900 to 2,000. The most drastic cut in services, she claimed then, would be the closure of a single emergency room.

In Amarillo, TX

Northwest Texas Healthcare System laid off nine employees and is freezing certain nonvital positions.

Spokeswoman Caytie Martin couldn't specify what positions were affected by the layoffs and hiring freeze. image

"We froze some positions that are not necessary at this time," Martin said.

The hospital system, which announced the changes in a memo to workers last week, employs about 1,900.

In Marshall, MN

MARSHALL - Avera Marshall Regional Medical Center will be closing its Home Health Care service line and laying off 16 employees, hospital officials said Monday. The decision was a financial one, and had nothing to do with the quality or importance of the services provided, said Avera Marshall community relations director Deann Holland.

"The staff has done an excellent job," Dodie Derynck, Avera Marshall vice president, said of home services. "That's part of what makes this so disheartening."

In Honolulu, HI

Some of the hospitals went bankrupt and are now trying to recover.  Hawaii has been a focus of telemedicine more so perhaps than other states and it also stands to represent some potential savings.  The report states in the long run for next year, things are not going to get much better with current economic conditions and people losing their health insurance.

In Bakersfield, CA

San Joaquin General Hospital in Bakersfield is looking at some serious cuts, as noted here in the article, the hospital has been operating in the “red” for many years.  Now they are looking at possibly discontinue their residency program, sad.  I hope I don’t need to revive the “Desperate Hospitals” series again.  We keep hearing about record profits from insurance companies, record profits from pharmacy benefit managers, big profits from drug companies, and big profits from medical device manufacturers, and yet at the level of service, the hospitals and doctors offices the money gets tighter and less are receiving care.

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A Case of “Dirty” Algorithms – 2 Madoff Computer Administrators are Indicted – Illegal Coding and Networking for Big Profits

3/26/2010 08:58:00 AM  , ,  

This is worth mentioning as this is not by far the only case where illegal IT operations are happening.  With writing code and algorithms, programmers can adjust to reflect some “desired” numbers.  This is the base to where it all begins and takes place and illusions are created.  We need to have our government IT structure and talent up to this level in order to find and catch the wrong doers.  This did not happen for years as we were living in a world of “bliss” to where politicians lived in a world of “tech denial” and the coders just kept on working as they had a huge envelope here for fraud as they knew they had the machine guns and everyone kept running around with swords.  

All coding and networking is not created equal and like any other area of life, this needs to be audited, but again we didn’t have enough individuals who embraced that this was happening and kept living in a world of bliss and using outdated methods of tracking crime, which as well all know didn’t work.  Here’s an example below where an insurance company was running “HIV” algorithms to find affected patients.  When such code is run the screen presents data and then it’s up to the minds of those who queried the information as to what choice of action they will take.  These folks were caught, but I am guessing there’s much more going on.

Health Insurance Company Ran an “HIV” Algorithm To Cancel Consumer’s Policy –An Automatic Fraud Investigation Revealing “False Positives” Or “Unhealthy Patients”

We are really behind here with members of Congress coming to this conclusion and live in denial and still try to use old methodologies for laws and rules.  A good example is this link below, it has taken them all this time to come up with a law to monitor peer to peer use by government employees?  Shoot every business has long been all over this for years. 

Breaking News: House Passed a Bill to Prevent Government Employees From Using Peer to Peer File Sharing!

So when our government leaders talk about monitoring health insurance companies, they need to have the infrastructure and technology to do so and not just make a law that is not enforceable.  This is not to say that our leaders need to learn code, but they need to understand how this drives the economy and the laws we live by today.

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

If we don’t wise and read up at leadership levels, we are basically screwed and with transparency being what it is today, more “stupid” and “ignorant” schemes for political and monetary gain will keep appearing in the news.  We have a full on leadership of “non participants” and that will sink all of us faster than what we can shake a stick at.  Look at the Madoff example and see how long “bliss” and “ignorance” prevailed here, and we all know that story now.  In healthcare, we give anti fraud contracts to the same entities that used code to generate profits that were upheld in court as being “illegal”.  Again, this tells me there’s nobody home when it comes to auditing and ensuring our safety as citizens.  I urge everyone to take a few minutes every day to read up and learn something and read the news. 

Technology works behind the scenes and if you are not aware of what is happening, bliss and ignorance takes all your money in time.  In reading this post I see where it is noted that the SEC reviewed the books 5 times, and nothing came of it, programmers doing their hired job and wrote some pretty good deceptive code to keep the wolves away.  Hopefully now justice will be done.  Everything is not as it seems today with the layers of technology and intelligence we have available and with leaders who live in the world of bliss it scares me that this is eventually going to do us in and we will no longer be the world leader as other countries are moving quickly above our current status today.  BD 

A statement released yesterday by the U.S. Attorney's office for the Southern District of New York said the two men started working for Bernard L. Madoff Investment Securities, LLC (BLMIS) in the early 1990s. Both O'Hara and Perez were responsible for maintaining computer programs that supported Madoff's investment advisory business.

Between 2003 and 2008, Madoff's company's books were reviewed five times by the U.S. Securities and Exchange Commission and a European accounting firm that was conducting a review of the company on behalf of a European client.

DiPascali, who pleaded guilty to helping Madoff in the scheme, is awaiting sentencing. He faces up to 125 years in prison.

http://www.cio.com/article/586213

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Public Option Possibility Is Not Completely Dead – It’s the Missing Piece of the Puzzle We Still Need

3/25/2010 08:12:00 PM  ,  

As I understand this would bring on a second reconciliation effort.  Without the public option we are really stuck as citizens as we have no say over what privateimage industry does, but we do with government programs.  It’s 3 years away before adults with pre-existing conditions can be added to the roles, that is if they can afford it. 

In some areas of the country there’s no option for having health insurance with companies that are non-profit, thus some states are stuck with having to enforce that citizens pay a for profit company that is actively traded and sold on Wall Street.  That I feel is wrong as we have bailed out enough banks and businesses and it is not fair to impose any more profits, especially with healthcare on the citizens of the US.   

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

The mandatory law of requiring citizens to have insurance will fail without a Public Option and we could see more arguments, bankruptcies and less than honest use of “algorithms” to “score” and cherry pick claims.  This is already happening and we do not know what the controls will be on premiums yet either.  The past record with insurers when they have been caught is to dump out some fine money and keep going with a promise not to do the same thing again, sometimes it works and sometimes it does not and some issues continue on behind closed doors or under the carpet when technology is used to hide and carve algorithmic data to substantiate that they appear to be following the rules.

In the last few years in the country, I have seen much less respect for laws and rules and thus when business intelligence software can be used to fool the rest, it is.  All you need to do is think back to the fall of Wall Street, generated with “trading algorithms” that produced the desired numbers.  Without a public option we have no real leg to stand on and not much will change dramatically for the average citizen and the frustration and anger will not dissipate. 

Feinstein Proposes “National Medical Insurance Rate Authority” Legislation To Allow HHS Secretary to Review – Hope HHS Can Wrap Their Heads Around the Algorithms And Not Get Lost in the Shuffle

The US government needs to build in infrastructure anyway that would support a better Medicare system as well, so that part is in desperate need too.  That’s part of how this entire mess began years ago with using private industry only and not investing in the government infrastructure, even as a back up system. 

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

I still say and believe as I have said for the last 2 years we need digital laws that are easier to work with and something along the line of a Department of Algorithms as algorithmic fraud is rampid throughout our business world today.  All formulas are not created equal and until such time they are filed and certified, we have no idea what we are going to get. 

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

Ask Harry Markopoulos on auditing and technology and I would be he would whole heartedly agree on the filing of algorithms, that’s what he has spent his life working with.  We are living in “high frequency” healthcare with no relief in site right now. 

Unfortunately we have a Congress that is a bit out of touch too with what is happening as just today the House passed a bill to prevent peer to peer software on government employees computers!  Get that!  Most have dealt with this long before now and it’s not that difficult a subject, but again I mention as it shows the lack of being in tune to how technology is changing the world. 

Breaking News: House Passed a Bill to Prevent Government Employees From Using Peer to Peer File Sharing!

I read that today and couldn’t believe what I was reading as this pertains to data and document security all the way around.   Congress scares me when they are this far out of touch and I hope they get the Public Plan right.  BD 

If Obama's advisers had any killer instinct, they would push him to zero in on an absolutely golden opportunity to include a public option in the historic HCR bill. There appears to me to be no downside to this move unless Obama and his peeps are worried about how the corporate world would react to doing something that could actually put right what is so very wrong with health care in our country.

The reason this jewel of an opportunity exists is that surprise surprise after the house passes the senate's HCR bill we have a real from the heart kumbaya moment where the love is flowing the tears are rolling and the polls are loving this HCR victory. Can anyone really see any of those 219 Democratic representatives being the one who once again drives HCR into the ditch. No way no how.

Tom Pappalardo: Obama Perfectly Posed to Push Public Option

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Kaiser Permanente Gets Positive Verdict in Neurontin Case By Using Evidence Based Medicine – Aetna Case Against Pfizer Failed in January

3/25/2010 06:02:00 PM  , ,  

From my prior post on this topic, the Department of Justice dismissed the Aetna case against Pfizer; however, Kaiser Permanente was able to document their imageeducation efforts and provide proof of their efforts and time spent with clinicians.  The charges revolved around off label marketing of the drug and Kaiser using evidence based medicine.  

“In looking at the 2 different business models here, I don’t think there’s any difficulty in seeing the very 2 different paths taken in this instance and the Kaiser suit so far still stands.  Aetna didn’t show an attempt to solve the problem  it appears, where I see Kaiser using education also having a staff of better informed clinicians when completed, anyone argue that one? “ BD

Pfizer 1 Aetna 0 – Score in Off Label Drug Legal Case – Kaiser Used Education to Change Prescribing Practices and Marketing And Their Case Still Stands

We are very pleased that justice has been achieved for our members and the physicians, pharmacists and staff who care for them.

Kaiser Permanente, along with the rest of the medical world, relied on the published science about Neurontin’s effectiveness, not knowing it had been wrongfully manipulated. As a result, we ultimately spent more than one hundred million dollars on a very expensive drug that we now know is no more effective than a placebo for pain, bipolar, and many other conditions it was promoted to relieve.

Kaiser Permanente Statement on Verdict in Neurontin Case | Kaiser Permanente News Center

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Almost 25% of Israelis Can’t Afford Healthcare – Survey

3/25/2010 05:47:00 PM  , ,  

Occasionally it is interesting to see how health insurance is viewed in other countries.  In this case the residents of Israel gave their thoughts on a survey done in 2009.  One thing that is similar though is appears is that those needing care and in lower income brackets indicated some form of issue, and mostly cost.  BD  image

A periodic survey on the level of performance of the health system in Israel suggests a rise in the number of Israelis who feel that health services are too costly.
According to the survey for 2009, carried out by the Myers-JDC-Brookdale Institute every two years, 24 percent of those asked said that health costs are a substantial burden compared to 22 percent in the 2007 report. 
This issue was particularly prominent among those with low income (36 percent), patients with chronic conditions (35 percent), and Arabic speakers (24 percent).

Ten percent of the respondents said they did not buy a prescription drug because of the cost, most of them, 27 percent, to treat chronic diseases, 24 percent for skin, eye or digestive system, and 13 percent for costly antibiotics. Moreover, 28 percent did not seek dental treatment because of the cost.
Respondents in the survey did express their satisfaction with the Health Maintenance Organizations, like they did two years ago. The leading HMO in rates of satisfaction was Kupat Holim Maccabi, with 93 percent. Kupat Holim Meuhedet, which held the number one spot since 2001, dropped to second place with a 92 percent approval rating. Kupat Holim Leumit, at 91 percent, and Kupat Holim Clalit with 88 percent followed.

Nearly one-quarter of Israelis can't afford health care - Haaretz - Israel News

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Breaking News: House Passed a Bill to Prevent Government Employees From Using Peer to Peer File Sharing!

3/25/2010 04:23:00 PM  , ,  

I say this is breaking news as almost everyone else in business has a policy and has had for quite some time!  I did put it on Twitter but felt later it deserved it’s imageown post.  I have gone into physician offices and hospitals and removed the peer to peer software where it was installed when coming in to consult.  One office had some really personal stuff from the doctor shared throughout the office!  That was embarrassing as most do not understand how to configure the software and it by default would share the document files.  

File Sharing Peer to Peer Programs Still Posing Risk to Exposing Patient Data – Think Twice About This

These folks are the same ones that are concerned about data security and just passed a huge Healthcare Reform package right?  This worries me.  What this says is that we have a bit of lack of education in software that almost every kid wants to use to get free music, videos and other items from connecting to another computer on the web, but yet we have leaders that have no clue what in the heck this is, been around for years and Napster was the beginning years ago. We have folks that don’t pay attention as to how technology is shaping our world.  Is there really a true understanding in Congress as to what HIPAA is all about?

Who lets this stuff get through the networks?  They must have some really good IT folks who firewall the network, either that or nobody is aware.  Look at this story that happened at a hospital with a worker infecting a computer. 

Man Accidentally Infects Ohio Hospital with Spyware – Was Meant for Girlfriend’s Home Computer and She Opened Her Yahoo Mail at Work Instead

At least somebody had the sense to use Tiversa, software that finds information on peer to peer networks that should not be on the web.  That’s the defense that has to be used for the dummies that share everything out there who can’t or don’t know how to configure the software.  

Peer to Peer Forensic Services – Enterprise solutions for Hospitals and other Health Agencies

Again, this just somewhat floors me that this is just now being looked at. The Senate wants alerts to notify individuals that peer to peer software is being used – not good enough.  Again when I read this it just makes me shudder at the thought of how little is know perhaps about security by those making the laws for this country.  There are business program now that use Peer to Peer, but network administrators set up security and firewalls for those ports to use used only, so here I am talking about recreational peer to peer sharing. 

Healthcare Workers Sharing Music and they could also be sharing Medical Records and Files

Again, you would have thought this would have been addressed way back when Napster was going strong.  Also one other note that I found interesting and posted about last year was the big ruckus over Representatives using Twitter?  Twitter is nothing with 140 text characters compared to this but it took an Act of Congress to allow and yet peer to peer lives on.  Go figure!!

In House, Tweets Fly Over Web Plan – Washington

Here’s a short excerpt from the Twitter/QIK incident, funny now when you think about Congress is just getting around to the real dangerous stuff with exposing confidential information.  Twitter by comparison is harmless. 

“I just learned the Dems are trying to censor Congressmen’s ability to use Twitter Qik YouTube Utterz etc — outrageous and I will fight them,” Representative John Culberson, Republican of Texas, wrote last Tuesday on his personal page on the online text-messaging site Twitter, where he posts a daily, rapid-fire log of his thoughts. Messages on Twitter are called tweets.  What started as a micro-protest on Mr. Culberson’s Twitter page became a macro-conflict on Capitol Hill with the two sides feuding on blogs, Blackberries and the old-fashioned way — face-to-face meetings in the halls of Congress. Even there technology has become a weapon in the debate.

This comes down to the same stuff that makes me nervous all over again, non participants that know what is good for everyone else but yet are ignorant without any first hand experience.  In December the House said they were going wireless and it would take about 3 years.  Is that the training or the installation?  I guess nobody has much time to do a web search on this hot topic either, it comes right up on how dangerous peer to peer sharing programs are. 

House of Representatives Going Wireless – Slated to Take 3 Years And Could Have Some Real Healthcare Management Benefits for Membersimage

Again, when I see things like this on the agenda, I get really scared and lose both trust and confidence in who we have running the ship as this is such common knowledge today and the fact that it is just now making news!  I thought part of the job was to keep up to date with current affairs? 

Maybe I’m off base here, and perhaps the peer to peer sharing was around to share that 3000 page plus healthcare bill (grin).  Ok enough of my sarcasm, but this does make me really wonder about what in the world they think about and how they see the world around them, anything like we do?  BD 

The House has passed a bill that would prevent government employees from using peer-to-peer file-sharing software either in the office

or when accessing government networks remotely from home.

The Secure Federal File Sharing Act, introduced by Rep. Edolphus Towns, D-N.Y., in November, calls for the Office of Management and Budget to ban the use of applications like BitTorrent or Limewire on government PCs and networks.

It also requires the OMB to set policies for federal employees who telecommute or access government networks remotely.

The bill passed by a vote of 408 to 13, according to a statement by Rep. Towns' office. Towns also is chairman of the House Oversight and Government Affairs Committee.

"We can no longer ignore the threat to sensitive government information, businesses, and consumers that insecure peer-to-peer networks pose," Towns said in the statement. "Securing federal computer files is critical to our national security."

The Senate is not currently considering a bill similar to the Secure Federal File Sharing Act, either. However, it is considering another bill, the P2P Cyber Protection and Informed User Act, which would require people sharing software to alert users when they encounter a P2P program.

House Bans File Sharing By Government Employees -- P2P Network Security -- InformationWeek

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Millions of People Rely on Library Computers for Employment, Health, and Education - Study

3/25/2010 12:19:00 PM  ,  

People are using technology and the internet when made available to find healthcare information.  Libraries have not died, just progressed with time.  BD  image

PORTLAND, Ore. -- Nearly one-third of Americans age 14 or older–roughly 77 million people–used a public library computer or wireless network to access the Internet in the past year, according to a national report released today. In 2009, as the nation struggled through a recession, people relied on library technology to find work, apply for college, secure government benefits, learn about critical medical treatments, and connect with their communities. 

The report, Opportunity for All: How the American Public Benefits from Internet Access at U.S. Libraries, is based on the first, large-scale study of who uses public computers and Internet access in public libraries, the ways library patrons use this free technology service, why they use it, and how it affects their lives. It was conducted by the University of Washington Information School and funded by the Bill & Melinda Gates Foundation and the Institute of Museum and Library Services.

37 percent focused on health issues. The vast majority of these users (82 percent) logged on to learn about a disease, illness, or medical condition. One-third of these users sought out doctors or health care providers. Of these, about half followed up by making appointments for care.

First-Ever National Study: Millions of People Rely on Library Computers for Employment, Health, and Education | Bill & Melinda Gates Foundation

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VA Testing Electronic System for Processing Disability Claims

3/25/2010 12:12:00 PM  ,  

Current paper files are scanned into the system instead of boxes of paper to be reviewed individually.  Reviewers will now be looking at the “virtual claims” on a imagecomputer screen, about time.  We have all read about the terrible backlog that veterans currently face with claims. 

Social Security To Start Sharing Electronic Records with VA and DOD in February 2010

As you can see above, Social Security is ready to begin sharing records with the VA too.  BD  

If the interminable backlog of veterans' disability claims has any chance of being eliminated, the system must go paperless.

But how to move to a fully electronic system is the quandary, and one Veterans Affairs Secretary Eric Shinseki wants resolved by 2012, when a modern system is to start rolling out.

At a Baltimore VA office, which Shinseki visited Wednesday, 30 claims processors have been rotated in to meticulously review virtual test pages. They are part of the conversation as VA officials address difficult questions: Should millions of veterans' files in storage be scanned? How is a veteran's privacy going to be protected? What questions should veterans be asked as they fill out an automated form to start the claims process?

VA tests system for electronic disability claims

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Biometric Monitoring to be Used by Florida HMO to Combat Healthcare Fraud – BioClaim Linking CMS 1500 To The Patient Visit

3/25/2010 11:45:00 AM  ,  

The Biometric log in device replaces the usual and standard paper sign in sheet we have all used for years.  The fingerprint is converted to a unique data code andimage not stored itself.  This is the same system being used at Disney in Florida.

75% of fraud is stated to be done by the provider as called “phantom billing”.  The 1500 claim form will link and provide the finger print to show that the patient actually showed up.  The software process will run before every claim is submitted. 

The first visit enrolls the finger print and given the unique ID number to include the date, time and location and the template is stored at the BioClaim central data base.  One item this adds is the fact that billing might be done faster.  No finger print, no claim is filed.  This will keep patients from trying to use another person’s insurance card.  A claim would be denied immediately if the correct person was not linked.  I would guess there might need to be some type of over ride added for an telehealth visit though as well if the practice is enrolled in one of those services, but individual software might have that taken care of to bypass.  Basically the software is identifying the patient correctly and not allowing for any items to be billed where a fingerprint for the visit is not available.  I have seen biometric log ins but this is somewhat the first I have seen combining check in with claim submissions.  BD 

From the website:

“Phantom Billing - This is billing for services that were not provided, billing for services to persons accompanying a patient who did not receive any medical imageservices, or billing for office visits that never occurred.

Card Swapping - This occurs when a patient receives treatments using another person's medical information.

Up-coding - This involves billing for more expensive treatments that services actually provided during a patient's visit.

Medical Identity Theft - This involves someone pretending to be someone else by using a person's name or other items such as an insurance card or number to obtain medical services. Medical identity theft can result in incorrect medical records being stored under the victim's name and insurance information.

Each of the above items are problems that result in a larger price tag for everyone; payer, provider and patient. Currently fraud detection is mostly done using computerized statistical analysis or by persons in the industry recognizing and reporting suspicious claims. This is a "pay and chase" methodology, pay the claim then, when fraud is detected, the fraudulent claims must be investigated further to provide proof that the claims are in fact fraudulent and then they can be pursued further. Each step of this process increases everyone's costs even further.

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BioClaim™ recognizes more than the problem that fraud in healthcare causes but also addresses the failures of other biometric/smart card solutions. Other biometric companies claim they eliminate fraud using a biometric device but rely on the receptionist/front desk personnel to stop a fraudulent transaction if the biometric validation does not match. There is no record of the biometric validation that occurred during the visit leaving the payer to continue to rely on the "pay and chase" method.”

CORAL GABLES, US: Simply Healthcare Plans, Inc. (SHP), a Florida based HMO, has entered into a collaboration agreement with Biometric Technologies, Inc. where Biometric Technologies will assist SHP with its efforts to reduce and prevent healthcare fraud in Florida. 

Biometric Technologies is a Florida based technology company that has developed BioClaim, a unique patented software product specifically developed for the detection of fraudulent healthcare claims. BioClaim uses biometrics to authenticate a patient at the point of service and interfaces the patient and claims information with the HMO claims system. SHP anticipates launching BioClaim with a select group of Medicaid providers in the next 90 days.

IT to treat healthcare fraud in Florida - CIOL News Reports

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Caritas Christi Health Care Sold to Private Equity Firm Cerberus For $830M - Massachusetts

3/25/2010 08:06:00 AM  ,  

With the announcement of healthcare reform, it might appear that the private equity firm sees potential here with the promise of new patients coming in the doors soon at Caritas Health Care.  Even though purchased by Cerberus and being non profit status, the six hospitals will retain their Catholic affiliation.  The hospital chain has had to recover from bankruptcy recently and has been on the path of rebuilding.  image

Caritas Christi Health Partners with Microsoft Amalga and HealthVault Technologies

Some of the other relief efforts have included selling the lab business to Quest Diagnostics. 

Quest Diagnostics buys Caritas Christi Hospitals Physician-Office Lab Business – Boston

From the Website:

“Cerberus Capital Management, L.P., along with its affiliates, is one of the world's leading private investment firms. Through its team of investment and operations professionals, Cerberus specializes in providing both financial resources and operational expertise to help transform undervalued companies into industry leaders for long-term success and value creation. Cerberus holds controlling or significant minority interests in companies around the world.
Cerberus is headquartered in New York City with affiliate and/or advisory offices in the United States, Europe, the Middle East and Asia.”image

In essence a non profit is no longer a non profit hospital system and the drive to make money by investing in healthcare is still alive and well with investors still calling the shots.  Cerberus invests in turning companies around but had one failure called Chrysler in recent years.  Once more we have a focus on profits taking the ring side seat.  BD 

Cerberus will provide approximately $830 million of capital support, including the assumption of all pension obligations for Caritas employees, the repayment of the system’s debt, a significant capital investment to fund operations and a commitment to approximately $400 million of capital projects, including six major construction projects that will provide immediate upgrades to each of the Caritas Christi hospitals, Caritas said.

“Cerberus is pleased to be making a long-term investment that will help ensure the viability and future success of the Caritas Christi health care system,” said W. Brett Ingersoll, co-director of private equity at Cerberus in a statement. “Caritas is the region’s largest community hospital network, and our investment will give physicians, nurses and other health professionals the additional tools they need to deliver world-class care to patients in the communities where they live.”

The agreement also stipulates that the six Caritas Christi hospitals will retain their Catholic identities, and their existing policies on charitable and pastoral care, community benefits, and approach to labor relations from a social justice perspective. The hospitals include St. Elizabeth’s Medical Center in Brighton, Carney Hospital in Dorchester, Norwood Hospital, Good Samaritan Medical Center in Brockton, St. Anne’s Hospital in Fall River and Holy Family Hospital in Methuen.

Private equity group to buy Caritas Christi for $830M - BostonHerald.com

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Cambridge Consultants Announces Consulting Services For Clinical Trials Using Bayesian Statistical Analysis To Help Expedite the Process and Help Negotiate with the FDA

3/25/2010 07:30:00 AM  , ,  

The title above is a mouthful, what is Bayesian.  If you have heard of email spam filters you may have heard the term Bayesian.  Here’s more at Wikipedia to perhaps explain a little more.  I have covered Cambridge before and they are the company that has created some exotic drug delivery inhaler systems, like the Blue Tooth image Inhaler.

The VenaHub Medical Device Hub Wirelessly Reports Health Data Compliance and the Blue Tooth Inhaler

Cambridge Consultants is pretty much a “think tank” for generating devices and technologies that are sold to other healthcare companies.  With adding consulting with the FDA preferred methodology, this will allow for viewing multiple treatment data and plans the process should flow more efficiently and give added value data for decision making processes with patient treatment plans.  In short they are going to help companies get their products through clinical trials and approved by the FDA sooner.  BD   

Press Release:

Cambridge Consultants, a leading technology product design and development firm, has announced it is to offer a new consultancy service for medical device clinical trials, saving clients both time and money through a more effective method of analyzing trial data. The news follows the announcement of the US Food and Drug Administration’s (FDA) finalized guidance, allowing the use of Bayesian statistical analysis in such trials. The new service is expected to benefit medical device companies looking to quickly comply with the new guidelines, but who do not have the in-house experience of designing and analyzing a Bayesian trial.

Already offering companies a wide range of support services in adopting Bayesian methods, Cambridge Consultants new consultancy service is predicted to deliver significant benefits to patients, doctors, trial sponsors and regulators. The new support service includes clinical trial planning and design, analysis of historical data, trial simulation, software development and verification. Support on negotiating with the FDA is also part of the new service, with advice offered on trial planning, developing submissions and creating responses to regulatory questions. Cambridge Consultants’ expertise is based on its long history of developing innovative medical devices and getting them to market quickly, as well as its own use of Bayesian statistical methods in its research and testing.

The FDA issued its guidance on the use of Bayesian statistics in clinical trials in February 2010, enabling companies to take full advantage of the statistical method. This method makes it possible for companies to combine data collected in previous studies with data collected in a current trial. By combining this data, researchers can justify running shorter or smaller clinical trials, ultimately delivering cost savings to the sponsors of the trial.

Moreover, both patients and doctors can also benefit from the use of the statistical analysis. For doctors, shorter and more efficient trials mean that they can design trials to look at multiple potential treatment combinations simultaneously and refine the treatments to treat each patient optimally. As a result, the trial participants are more likely to receive effective treatment; shorter trials also means that new treatments will reach patients, and the wider market, faster.

“The finalized guidance from the FDA has the potential to open the door to a wide ranging streamlining and improvement in clinical trials for medical devices,” commented Paula Gomes of Cambridge Consultants’ Global Medical Technology Practice. “With the wealth of experience Cambridge Consultants has in employing Bayesian methods we can help companies extract the maximum benefit from the technique and deliver smaller, shorter and more cost effective clinical trials.”

___________________

Cambridge Consultants develops breakthrough products, creates and licenses intellectual property, and provides business consultancy in technology critical issues for clients worldwide.  For 50 years, the company has been helping its clients turn business opportunities into commercial successes, whether they are launching first-to-market products, entering new markets or expanding existing markets through the introduction of new technologies.  With a team of over 300 engineers, designers, scientists and consultants, in offices in Cambridge (UK) and Boston (USA), Cambridge Consultants offers solutions across a diverse range of industries including medical technology, industrial and consumer products, transport, energy, cleantech and wireless communications.  

Throughout 2010, Cambridge Consultants celebrates its 50th year in business.  Created by three Cambridge graduates in 1960, the company has grown into a leading technology business, renowned worldwide for its ability to solve technical problems and provide innovative, practical solutions to commercial issues.  In 2009, the company was awarded the prestigious Queen’s Award for Enterprise in International Trade.  For more information visit: www.CambridgeConsultants.com

Cambridge Consultants is part of Altran, the European leader in innovation and high technology consulting.  The Group’s 17,500 consultants, operating worldwide, cover the entire range of engineering specialties, including electronics, information technology, quality and organization.  Altran offers its clients ongoing support throughout the innovation cycle, from technology watch, applied basic research and management consulting to industrial systems engineering and information systems.  The Group provides services to most industries, including the automotive, aeronautics, space, life sciences and telecommunications sectors.  Founded in 1982, Altran operates in 20 priority countries.  In 2008, it generated a turnover of €1,650 million.  For more information visit: www.altran.com

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