Everybody else is speculating so maybe I should do the same and add one more possibility to the till.

A server fall over possibly could have started all of this on Wall Street, then of course panic sets in and it got worse  - those algorithms.  

If this was by chance happening at the same time as all the high volumes of trading occurring  interruption in the fail over procedure could have caused a delay in the data getting over the mirrored secondary server and with the speed that stocks are traded today it got mucky but from what I have read it appears once everything loaded back into memory, stocks ended up back where they were.  The automated trades that had been configured just worked with what was in memory at the time too, so a mathematical mess.    

I would not think it could have been the trading software but rather a data transfer once server fail over kicked in.  You see it now and then on the web if you know what you are looking at with an occasional blink on a web site which may be a server fail over has taken place.  Darn servers go down all the time (grin). 

Again it just looks like there was something interrupting in getting the cache memory over who knows how many clusters were involved here. 

I keep reading where they are looking at their trading software and I don’t think that’s where the answer lies and the fat finger thing sounds kind of silly.  This was what was said on the Wall Street Journal yesterday.

http://online.wsj.com/article/SB10001424052748704370704575228664083620340.html?mod=rss_Today%27s_Most_Popular

Recently in the news was the upgrade to some new processors too, the Xeon 7500 series which unleashes some real awesome power.  As you can see from the clips below – hosting of additional algorithms can be done.  Intel is putting out really great computing power these days! 

http://www.wallstreetandtech.com/technology-risk-management/showArticle.jhtml?articleID=224201032

“The Intel Xeon 5600 processor is the successor to the Intel Xeon processor 5500 series introduced in early 2009, and can deliver up to 60% performance improvement over the Xeon 5500. The extra speed comes mainly thanks to Intel's industry-leading manufacturing technology which enables smaller (32 nanometres in length), faster and more energy-efficient transistors (the building blocks of processors) thus improving performance and reducing energy consumption of the chip overall. This makes them ideal for deployment in trading environments as the faster processing speeds will feed directly into the demands of latency sensitive trading activities.

“The technology is already being applied to the market, and early adopters are seeing immediately the relevance to and the immediate benefits in today's trading conditions. “

Anthony Warden, ED Global Head of Algorithmic Trading and Quant Prime Broker Technology, Nomura, said: "Handling bursts in trade traffic is a key factor in DMA and low latency, high throughput trading platforms. By enabling us to spread processing over more cores, the Intel Xeon processor 7500 series will allow us to handle larger peaks more efficiently without any increase in response times. The increased core count of the 7500 series also allows us to host more trading algorithms on a single box which can communicate through local memory, thereby reducing latency."

Those clients who have quickly utilized the features of these technologies are gaining immediate commercial benefits in trading and the high data processing capability over multicore feeds through to improved risk management and analytics at the enterprise level which, as a result of greater supervisory scrutiny, will see increasing focus across the market in the coming years."

Fall over is used on servers like RAID is on PCs for mirroring and back up, so when one goes down, the other steps in without missing a step.

“Automatic fall-over is a term associated with content management and contingency planning for system disaster and recovery. It is an automated process where in case of a system or server failure, the control of data and applications will "automatically fall over" to a secondary system or server. Automatic fall over procedures results in less costly downtime while eliminating the possibility of inducing system failure during recovery, and usually require very little user input.”

In short is the trading speed outdoing what can be accomplished when a server fall over needs to take place and with new Xeons in place did we have a little competition for processor threads here if all were not using the same processor power?  If all were not running same processors (the new Xeons) we may have had a perfect storm potential, although the processors are to improve latency, but when combined with existing technology and design nobody knows sometimes what could happen.  We know what is supposed to happen and what is not supposed to happen but computer science is not 100%, although we want it to be. 

Data house design is definitely getting more complex everywhere today and specs on hardware/software configurations can be detailed and tedium.  So there’s my feeble 2 cent speculation and hopefully the forensics tech folks on Wall Street will iron it all out for us soon and if nothing else I got some traffic to the blog today (grin).  BD

Technorati Tags: MedicalQuack, Wall Street, opinion, speculation, algoirthms, high speed trading, flash trading, Intel, processors, Server fail over, Xeon, data glitch

I don’t know how this happened but I appreciate the vote of confidence.  I did some screenshots and I am indeed some very good company here with others who also provide some very valuable information and I read and subscribe to almost everyone else on the list too so be sure and check them out too on Twitter and their blogs as well.  

I just somewhat consider myself to be a “forensic dot connector” for the most part and try to bring both sides of conversations to the table with how medical devices are evolving and what potential impact it may have; and who’s either using them now or who may be implementing in the future; and maybe how they will do it; and what to be aware of or what to prepare for. 

Thank you again and I’ll keep plugging away at it here.  BD 

 

OrganizedWisdom features thousands of trusted doctors, health professionals, and health groups, actively organizing, curating, and recommending quality online health and wellness resources.

Top Medical_Device Experts on OrganizedWisdom Health

Technorati Tags: Medical Quack, medical devices, Organized Wisdom Health, healthcare, bloggers, awareness, information, health information, healthcare websites

Those in southern California may already be aware of the plan from HealthNet that is similar and allows patients to cross the border with their plan. 

Health Net of California Expands Salud HMO to Southern California

Now we have one more insurer allowing consumers with the selection of the plan through employer options to have an option to be covered for medical care with the approved HMO Vitalidad in Mexico which operates in the border cities.  As the article states consumers would select a primary care physician either here in the US or one in Mexico.  As I have mentioned before, Mexico is ripe and anxious to cash in on US Healthcare revenue.  Last year when I attended the Tourism Conference in Los Angeles there were several organizations present and they are building big new hospitals in Mexico, both on the border and further down in the country.  BD 

Mexico President is Motivated With US Healthcare Reform to Attract Residents and Medical Tourism With Joint Commission Accredited Hospitals

WALNUT CREEK, Calif., May 06, 2010 (BUSINESS WIRE) -- Aetna announced today that is has introduced a new health plan that allows members and their families to access health care in California or in the Mexican cities of Mexicali, Tecate and Tijuana, through an agreement with Mexico's premiere HMO program, Sistemas Medicos Nacionales, S.A. de C.V. (SIMNSA).

"Aetna recognizes that it is important for our members to be able to receive health care in a language and cultural setting they understand and feel comfortable with," said Beth Andersen, president of Aetna's West Region. "Vitalidad Plus(SM) offers employers an affordable health option that lets their employees receive care in whichever setting they prefer."

Vitalidad Plus(SM) California con Aetna is an HMO plan that features 100 percent coverage for qualified preventative care, including immunizations and child and adult wellness exams. Employers can select four different copayment levels for employees. Members and their family members will select a primary care physician in California or one of the SIMNSA physicians in Mexico.

Plan documents and customer service are available in both Spanish and English. In addition, members can visit Aetna's Spanish language web site to search for participating doctors and hospitals, and obtain information on a variety of Aetna health programs and products.

Aetna Introduces New Cross-Border Health Plan That Lets Workers Decide Where to Access Care - MarketWatch

Technorati Tags: Aetna, medical, health insurance, medical tourism, healthcare reform, Mexico, employers, HMO, preventive medicine, Vitalidad, California

First of all great kudos to Jim Edwards at BNET for some great investigative reporting here.  Being a female and I’m sure other women will appreciate this knowledge as well.  If not for his article, which you can read in full at the link at the bottom of this post, nobody would have ever been aware of the recall.

Look at the link to where the notice was placed, again good investigative skills here in finding this he goes on to say relative to the lawsuits that even the attorneys who are presently suing Bayer had not a clue that the recall existed but I’m sure they may add some additional information here to the case based on the recall information.   Being we are all consumed with the over the counter recall that took place last weekend from J and J, I thought this was definitely worth the mention, especially to all my female readers here. 

Now while all this is going on Bayer gets another birth control pill, Natazia approved by the FDA. 

“The use of Natazia is associated with increased risks of several serious conditions including venous and arterial thrombotic and thromboembolic events (such as myocardial infarction, thromboembolism, stroke), hepatic neoplasia, gallbladder disease, hypertension, ruptured ovarian cyst and uterine leiomyoma.  The excess risk of thromboembolic events is highest during the first year of use of COC.”

Also I might add that last year Dr. Erika Schwartz and I had a discussion on hormone replacement therapy and she warned about some of the new contraceptives on the market and that a good treatment plan with bioidentical hormone therapy is all that is needed, and we are still waiting for some studies comparing the Premarin products, made with pregnant female horses as compared to bio identical therapy which has been stated to be safer and less risk for being at the root of causing breast and ovarian cancer.  We don’t know for sure and we would really like some additional information to pick up where the Women’s Health Initiative left off as they did not distinguish and grouped Premarin and bioidenticals all in the same group when warning women of the cancer associated risk. 

Bioidentical Hormone Replacement Therapy– Interview with Dr. Erika Schwartz

“Dr. Schwartz stated that with some of the new drugs and side effects shown, they tend to possibly be “messing with your system” too much with chemically interfering with ovulation, when all that is necessary is a good hormone treatment plan, exercise, a good diet and some supplements or vitamins to keep you on the right path.”

One more note as I do on every recall post, I reference the Microsoft Tags so we could use our cell phones and easily identify any recalled products or at least get information and a link to the website easily enough.  As Jim pointed out, this is a perfect example of a recall that went unnoticed and was important, or should I say it’s important to all the women out here.

Microsoft Tags on CBS Early Show – Wake Up FDA, Pharma and Medical Device Companies –Scan Those Drugs, Medical Devices and Synchronize with an FDA Tag Data Base – Recalls, Theft Tracking and More….

If you want to see how this technology works, download the free software on your Android, BlackBerry, IPhone or Smart Phone and check out TV Guide magazine, just shoot and aim with the phone all the information is at your fingertips.  Some General Mills food products in the grocery store also have Tags and you can create your own tags too, I have a couple here on the site that I made.  

While searching on the page I also found this, a Prempro recall underneath the Yaz notice.  It’s not as large as the Yaz recall but still substantial with several thousands of cartons of dispensers.  BD

Bayer (BAY) is being sued in 1,100 lawsuits alleging its best-selling product, the contraceptive Yaz, carries a higher risk of blood clots, so you’d think that when the pill was recalled, it might have generated some headlines. But it didn’t.

In fact, the FDA did issue a recall for Yaz back in November 2009 (scroll about halfway down to see it). The reason: Bayer had reported the product was “within specification” when in fact it wasn’t — the company had taken a number of measures and averaged them together to get the number it needed. And no one noticed.

The recall is significant for a number of reasons: First, it involved specifications for the dosage of drospirenone in the pill, which is the new ingredient that the lawsuits allege is more dangerous than the traditional recipe.

Second, the recall wasn’t small. It involved 32,856 boxes of Yaz, at three packs per box, and 122,208 boxes of Ocella, an identical product.

Third, and perhaps most significant, although the recall was dated Nov. 25, the FDA inspected Bayer on this same issue in March 2009  — and warned the company about its averaging practice in August 2009. The unanswered question here is, How many out-of-spec pills did women take before the product was recalled?

Did You Know the FDA Recalled Bayer's Yaz Contraceptive? Neither Did Anyone Else | BNET Pharma Blog | BNET

Technorati Tags: Yaz, Recalls, FDA, contraceptives, Prempro, Wyeth, Microsoft Tags, healthcare, lawsuits, consumers, patients, Women's Health Initiative, Bayer, BNET

First off I want to say thank you for the plug here and he might be right, I see all others talking about personal health records but I have not seen other bloggers and others putting a link on their site to make it easy to find Google Health or HealthVault, after all if you read about something and you want to enter the world of being a “participant” you don’t want to have to go looking for the sites so maybe some other bloggers might add the links to their sites too.

Last year I spoke with Steve Shihadeh, VP of Microsoft Health Solutions and we talked about HealthVault a bit and he shared with me that a friend or member of the family wasn’t sure why they needed a PHR. 

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

Here’s a short note about the project at Scripps and it involves information about genomics and analysis for generic risks.  This could very well be a trend here.

“Co-sponsors of the study include Navigenics Inc. of Redwood Shores, Calif.; Affymetrix of Santa Clara, Calif.; and Microsoft Corp. of Redmond, Wash. Study participants age 18 and older can receive a scan of their genome and a detailed analysis of their genetic risk for more than 20 health conditions that may be changed by lifestyle, including diabetes, obesity, heart attack and some forms of cancer.”

“HealthVault is working together with Scripps and Navigenics on a project that allows individuals to sign up for the pilot program and have their entire human genome sequenced. The results of the 20 year study will all be contained in HealthVault, and every participant in the program now has a HealthVault account established as part of the process.”

Well it just so happens that the same individual enrolled in a clinical trial at Scripps in San Diego and guess what, they now have a HealthVault PHR as the trial uses HealthVault to store all the information, so this goes right along here with what Dan is saying in his video, get one.  Some of the information from the trial can be shared with your doctor and vice versa.  As he states, why waste any lab results and tests that were done in the process of the trial, makes good sense to me.

 

Also, don’t forget to look at TrialX because if you have done your homework and put all your data together, drill down and get the trials that you are qualified for and save time in finding them.   The site has a link for TrialX right on the widget and I also have an entire section of over 300 posts with many details and “how to’s” relative to using both HealthVault and Google Health which are free.  You can also use the 2nd search box and find them specifically by looking by keyword, i.e. Quest, Labcorp and the related articles will appear almost instantly.  In many of the posts I go through step by step with images on how to get everything connected so it auto populates without you having to manually enter all the data.  This is a good way to also check for any errors too as some information could have been entered erroneously with years of data brought together here. 

Last year speaking of Quest I interviewed Rohit Nayak from MedPlus/Quest Labs and you can read more at the link below as we talked about Quest Diagnostics labs and the PHR connections to both Google Health and HealthVault.  BD 

Quest Diagnostics and Health IT – Interview with Rohit Nayak, Vice President of Sales, Clinical Information Solutions Group, MedPlus

One other short item worth mentioning here is that I also have a widget that shows recent Clinical trial information while you are at the Medical Quack and it is located right under the image/links to HealthVault and Google Health.  You can find more videos at Dan’s blog about helpful clinical trial information here. 

 

There’s also one other “free” PHR that comes to mind that I have posted about on the Medical Quack and that is Patient Ally from Office Ally so there’s one other alternative to check out as well.  I did a walk through and they also aggregate your data and if you are a member of an IPA or HMO you could be hearing about it via the organization too, thus I thought I should include here as they are working with Blue Shield with a contract on PHRs.  BD

“For more information on Personal Health Records, I would check a good blog called The Medical Quack. So far its the only blog I know with links to GHealth and Hvault where you can store your Personal Health Records. Check it out!”

Keeping Your Personal Health Records From A Clinical Trial, Or To Get In a Clinical Trial « The Clinical Trials Guru

Technorati Tags: PHR, clinical trials, HealthVault, Google Health, TrialX, personal health records, data, results, doctor, patient, information, connections, EHR, Health IT, Patient Ally

I remember after the stock market crash reading articles on the web about how 2-3 days afterwards that people were puzzled by Microsoft and others selling their new servers to a market that just crashed, well they know their markets and realized that rebuilding was the first thing to do.  Did they buy, of course they did an rapidly on Wall Street to have the fastest, most efficient and high powered data and software available.  I don’t know if Main Street realized or understood this process as there was enough other distractions going on at that time.  Why do you think Goldman sits where they do today financially?  They outsmarted everyone with knowing how to used technology and business intelligence, it is what it is. 

Traders Profit With High Speed Computers and Servers…Health Insurers Use Them Too

Also in the news today it came out that Verizon and several other big employers “considered” dropping employer sponsored health insurance.  They ran the algorithms to calculate the cost on do or don’t do.  It’s great that this was on the web today, but it’s part of what business does today, the analyze and use those algorithms for decision making processes but it does make for a good OMG story.  Senator Waxman wanted to see their decision making processes so he got it, the algorithms of risk management.  The companies printed up 1100 pages as there may have been issues delivering in digital format so the companies did bend over backwards a bit to compensate for non participant levels in dealing with technology here so it could be read.

For some reason or another folks seem to have a hard time understanding what really happened here and this is where tech denial and lack of reading leaves a lot of folks wondering, not knowing and above all frustrated and angry.  So far it turns out that the companies determined which was the better dollar route to go and it looks as if most are keeping employer provided insurance.  The minute new laws and regulations are signed into place, immediately the risk management algorithms go to work to give data for decision making processes. 

Even Madoff used “dirty algorithms” for all his money making schemes that nobody questioned for years, nobody was interested in how it took place but rather just took the money and ran and when it all shuffled out, unfortunately so many lost, but it pays to ask questions and try to understand how some of this comes around.  BD

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

Maybe a Department of Algorithms is getting closer to becoming a reality someday with digital formatted technology making big strides and rapidly every day is entering into our every day lifestyles.   

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

Anywhere technology can take the place of humans today, it seems like it is being done and rapidly as it comes back to saving money so how do we fight this on the job end of things, and is there more falling out the bottom than we can put in at the top?  BD 

Data-integration spending in the financial sector will grow approximately 5 percent over the next two years, fueled primarily by data issues brought to light during the recent financial crisis, according to a recent report by The Aite Group, a Boston-based research firm.

This year alone, financial firms will spend $1.76 billion on costs related to data integration (personnel, hardware and software), according to the report commissioned by Asset Control, a data-management software firm. That's actually slightly less than financial firms spent in 2007, but more than the approximately $1.68 billion they've spent over the past two years.

The credit crisis and ensuing lack of industry transparency brought the need for effective data management to the forefront. The industry’s collective inability to understand and report on risk exposure quickly and correctly is tied to a lack of data, and not simply a failure of the systems themselves.

The announcements greatly annoyed Representative Henry Waxman, who accused the companies of using the big numbers to exaggerate health care reform's burden on employers. Waxman, chairman of the House Energy and Commerce Committee, demanded that they turn over their confidential memos, and summoned their top executives for hearings.

But Waxman didn't simply request documents related to the write down issue. He wanted every document the companies created that discussed what the bill would do to their most uncontrollable expense: healthcare costs.

AT&T revealed that it spends $2.4 billion a year on coverage for its almost 300,000 active employees, a number that would fall to $600 million if AT&T stopped providing health care coverage and paid the penalty option instead. AT&T declined comment.

Financial Crisis Prompts More Data-Integration Spending | Blogs | ITBusinessEdge.com

Technorati Tags: Banking, Congress, Economics, Investments, Wall Street, Goldman, Health Insurance, Cray computers, Hi powered PCs, Servers, algorithms

Everybody is using algorithmic formulas today to help them do their job better with less wasted efforts and drug reps can benefit too from the same formulas of evaluation.  Let’s face it today in any industry, being in sales is getting to be tough job as everyone wants to absolutely define the direction for the ultimate positive response of getting a positive answer and sales of course.  One thing that can’t be replaced here is the personal relationship that we all value in sales and I spent enough years in sales to know this is a fact. 

I had a physician make a comment recently too that if all is equal, in other words what he felt was the the drug treatment, the cost, and add in the knowledge of the representative too, the one who brings donuts wins, in other words the relationship as donuts are not going to break a sale simply on the fact that people like to eat.

With this powerful information in hand now, drug reps can avoid those physicians who have a reputation or statistical representation of “being unavailable”.  If Dr. Brown doesn’t see reps then mosey on over to Dr. Smith for effective in face selling time:)  In time I can guess that sales managers will be seeing the call reports and will be equipped with their algorithms to evaluate those sales reps who are constantly trying to see those who are not really available and discussing alternative methods of contact such as email.  When your time in sales is also being algorithmically calculated on where the company is getting the best bang for the buck, well here comes those algorithms once more. 

According to the press release, strategies in sales save money, just like everything else out there today so here come the numbers.  In 2008 Merck started using “contracted” sales people and there may be others who do the same, so you could in fact have one representative for more than one drug company and you can bet the folks will be trained and given tools such as the offering mentioned in the press release.

Merck Outsourcing - Brings in Contract Sales Force

Where does this information come from?  It’s the old standing pharmacy benefit management information that is collected by drug stores and pharmacy benefit managers and there’s a ton load of money made off of selling your prescription medication records.  Drug reps needs to know where to focus and this information has been around a long time.  As a provider there you can opt out of being included.  Many are starting to do this.  In the meantime, as patients your medication records do not fall under HIPAA and there’s a ton of money made here by companies who provide this like Milliman and Ingenix (a division of United Healthcare).  Those are the 2 big ones but I’m sure there’s a few more business intelligence services who provide the same or similar offerings. 

These 2 companies make a ton of money from selling and marketing our medication information.  They sell it back to underwriters.  You can click on the images to find out more.  Again, after reading this post about the lawsuit and the diligent effort being used for the number of years it covers, the company must figure the information is going to be goldmine to riches, like the selling of our medication files goes.  

This has become a hot issue with Congress too as this information does not fall under HIPAA and HHS would like a little more control and say so here too.  It is a bit confusing as they are trying to regulate the “marketing” but it appears the sale of medication information on patients is not being thoroughly addressed.

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

Anyway, just something to give some thought too as a provider and you can make your own opinion here.  By opting out these days there’s a bit less patient information to go around and market us, but on the other hand if you want the pharma industry to target you better with other means of spending quality time with you then maybe you might want to stay in.  Either way though, the data gets sold for profit and is part of the problem with the high cost of healthcare today even if Pharma access is not given as the health insurance companies use it for calculating premiums and underwriting costs.  United, with their subsidiary of Ingenix is making money from both sides here with data analysis and selling policies. 

We already have “behavioral underwriting” being pursued with health insurance so is this maybe a move for “behavioral drug sales” coming to play?

Once more I’ll end this again and say “it’s all about those algos” with business intelligence software analysis in every corner of healthcare.  BD  

EVANSTON, Ill., May 6 /PRNewswire/ -- Obtaining access to busy physicians grew still more difficult for pharmaceutical representatives in 2009, as the number of physicians willing to see most reps fell nearly 20 percent, the number of prescribers refusing to see most reps increased by half and the number of management-planned sales calls that were nearly impossible to complete topped 8 million.

These are among the findings of the latest AccessMonitor™, a report from global consulting firm ZS Associates that examines how often physicians and other prescribers will meet with sales representatives from pharmaceutical manufacturers.

According to the spring 2010 report of AccessMonitor™, only slightly more than half (58 percent) of prescribers in 2009 were "rep-accessible;" that is, they met with at least 70 percent of the sales representatives who called on them.  This is down 18 percent from the spring 2009 study that showed 71 percent of physicians met with at least 70 percent of pharmaceutical representatives.  At the same time, the number of "rep-inaccessible" prescribers — those who saw fewer than 30 percent of the reps who called on them — increased to 9 percent from 6 percent.  The report classified 33 percent of physicians as "rep-neutral;" they'll see 31 percent to 69 percent of the pharmaceutical salesmen who call on them.

The Doctor Won't See You (Mr. Pharma Rep), Now -- EVANSTON, Ill., May 6 /PRNewswire/ --

Technorati Tags: HHS, marketing, health insurance, Department of Justice, Legal Suit, privacy, Medicare claims, physicians, greed, drug reps, algorithms

I did a post about the site a couple years ago and it looked like a good time to add some additional information, since everyone today is busy checking to see if patient coverage is applicable.  In the first post I have had quite a few comments on the fact that users feel this should be free, and many use a billing service, clearinghouse, etc. where this type of service is provided as well.  If you just want to check and confirm without ties to another process or other software, this is a free standing website.  You will need to enroll and the service is purchased in lots of $25.00 with each check costing a quarter.  In other words you pay up front and charge against your payments, like a prepaid credit card would function until you have exhausted your balance. 

The service connects directly to CMS to supply the information.  If you are not party to electronic submissions, this site can help out as well.  Once your account is established you can log on to check for coverage.  Your NPI registration letter and a recent Medicare EOB for each provider that will use the service will be required as proof to enroll at www.checkmedicare.com.  BD

This service can save you time and money! Here's how:

• Verify patient information and eligibility!
• Receive deductible amount remaining for the year!
• Receive Primary Insurance information if Medicare is the Secondary Payor
• Receive Managed Care Organization Information(MCO/HMO) if patient is enrolled.
• 25 cents per check! No minimum monthly fee!
• No Time Limit! Transactions never expire!
• Available Nationwide, 24 Hrs a day, 7 days a week!¹
• Uses Most Web Browsers, No Additional Software Required!²
• Optional Direct Interfaces Available for Sammy USA, Simple Sam Plus, & Simple Sam (Medisoft Coming Soon!)
• 100% HIPAA Compliant!

“We at CheckMedicare.com specialize in offering software solutions for businesses in the healthcare field. Many offices wish to computerize and take advantage of the technological revolution that is going on around us. To you we offer CheckMedicare.com, a webservice that gives providers a quick and easy way to determine eligibility, deductible, and benefits status for Medicare patients. This service serves Medicare patients nationwide, regardless of the plan or carrier company (GHI Medicare, BC Medicare, etc..)”

Check Medicare Eligibility at www.CheckMedicare.com.

Technorati Tags: Medicare, eligibility, healthcare, CMS, claims, deductibles subscription, web services, software

This is something that we hope gets a second look here before the time runs out as the small and rural hospitals more than likely will not be able to afford the cost of having to credential twice.  The approval processes of the Joint Commission have become a popular discussion area on the web.  You can read the link about lab decisions here to get a little more insight.

Joint Commission Accreditation: Lab Decisions Will No Longer Affect Hospital Decisions

Back in 2008 the Joint Commission came under the review of Congress and were granted re-certification. 

Joint Commission for Hospitals under review from Congress and a request to re-apply for certification has been made

The next upcoming area according to this article has to do with telemedicine provisions being at risk with Medicare and their laws and provisions as relates to Medicare.  Now it appears the “bug” in the process is going to require double the work and more than likely double the amount paid to do the credential process twice.  Initially the Joint Commission was established to ensure quality and standards in the US and now if you read about some of the medical tourism articles, you can see where those outside the US use the credentials to attract patients to facilities outside the US with the stamp of approval and I am thinking this “privilege by proxy” is going weigh in there in the future if Medicare funds eventually are provided for payment for procedures outside the US. 

At any rate, this is a battle here between the Joint Commission, Congress and CMS that might need some attention soon if telemedicine is going to continue to grow and be provided for Medicare participants.  BD 

Health I.T. is marching forward on many fronts. But July 15 might be the day, barring Congressional intervention, that telemedicine moves in the opposite direction. On that day the Joint Commission’s “privilege by proxy” program bites the dust, which could have serious ramifications for the industry.

Privilege by proxy permitted hospitals to credential telemedicine practitioners from a distant site based on the credentialing/privileging decisions at that distant site. In a nutshell, it allowed physicians from large hospitals to provide telemedicine services to small or rural facilities without having to go through the credentialing process twice (as long as both hospitals were Joint Commission-accredited).

In July 2008 the Joint Commission lost its statutory deeming authority for accrediting hospitals. In order to get that authority back the commission had to reapply to CMS and brings its accreditation standards in line with Medicare’s conditions of participation for hospitals.

I brought these issues up with a couple of Medicare officials during a background call. They contended that the privilege by proxy program was eliminated not by any change in Medicare policy or subjective interpretation by agency officials, but as the result of the Joint Commission having to comply with straightforward, long-standing Medicare conditions of participation for hospitals.

Fingers can be pointed at a lot of the actors in this drama, but the bottom line is telemedicine in the United States will suffer a setback this summer. So much attention is being directed at health care reform and HITECH that many that spend their lives in telemedicine are worried that these and other blockades to expanding telemedicine services aren’t receiving the attention they deserve.

This move by CMS threatens the years of work and millions of dollars the providers have invested in telemedicine programs.”

Will July 15 be a Dark Day for Telemedicine?

Technorati Tags: Hospitals, Joint Commission, Accredited, Inspections, Hospital Safety, Congress, Investigation, Hospital Grades, telemedicine, CMS, hospital, previlege by proxy, heatlhcare

This has been the week for Johnson and Johnson, first the recalls and now the FDA questioning the combination of drugs offering relief and helping people fall asleep with getting pain relief from the acetaminophen.  This is not the first inquiry with consumer products as last year the FDA called Cheerios a “drug” due to their advertising and Bayer was sued over claiming it helped prevent prostate cancer.   Novartis is also in on this question with Excedrin PM. 

Bayer Is Sued Over Labeling Stating It Helps Prevent Prostate Cancer – One A Day

One comment of my own here is that as a blogger I get a lot of emails and information and sometimes I have to really look and evaluate the credibility of some of what I put on the blog to make sure it is credible information and not just marketing material, as I have advertising spots available for those who want that coverage and this way reader know it is advertised too.  BD 

Patients taking the drugs, most commonly sold as Johnson & Johnson's (JNJ.N) Tylenol PM and Novartis AG's (NOVN.VX) (NOVN.VX) (NVS.N) Excedrin PM, did not fall asleep significantly faster than those who took only acetaminophen or the sedative, known as diphenhydramine citrate, the FDA said in a letter to the industry earlier this year.

"There is an insufficient basis to support the combination of acetaminophen and diphenhydramine as a nighttime sleep aid for relief of occasional sleeplessness when associated with minor aches and pains," Dr. Charles Ganley, head of the FDA's Office of Nonprescription Products, wrote in a February 16 letter to the Consumer Healthcare Products Association, or CHPA, which represents makers of nonprescription medicines.

In March, J&J's McNeil Consumer Healthcare unit, which makes Tylenol PM, submitted additional data that it said showed the combination has "significantly more benefit for the relief of pain and sleeplessness than either ingredient alone."

U.S. rejects nighttime Tylenol, Excedrin study | Reuters

Technorati Tags: Excedrin PM, Tylenol PM, pain relief, FDA, study, reports, advertising, marketing, consumer products, Novartis

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 10%  with nursing uniforms by using the code “savescrubs_l2” 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

If you are a provider and are not enrolled, the time slot appears to have been pushed up 6 months, so only 60 days to register unless public comments predicate any changes being made.  NPI numbers must be included on all claims by providers for durable medical equipment supplied and prescribed for patients.  Thanks to Pat Whaley for giving us this heads up.  BD

Physicians and “eligible” providers received a jolt today in the May 5, 2010 Federal Register as the date for enrollment in PECOS (Provider Enrollment Chain and Ownership System) was moved up (pending the comment period and any changes resulting from the comment period) six months for providers that order or supply durable medical equipment (DME) for Medicare patients.  Instead of the January 3, 2011 date previously announced by CMS, the Patient Protection and Affordable Care Act (Affordable Care Act or PPACA) has provisions to move the go-date to July 6, 2010, just 60 days away.

Providers of medical items/other items/services and suppliers that qualify for a National Provider Identifier (NPI) must include their NPI on all applications to enroll in the Medicare and Medicaid programs AND on all claims for payment submitted under the Medicare and Medicaid programs.

“ Providers and suppliers furnishing services must comply with theMedicare requirements stipulated in the Act and in our regulations. These requirements are meant to ensure compliance with applicable statutes, as well as to promote the furnishing of high quality care. As Medicare program expenditures have grown, we have increased our efforts to ensure that only qualified individuals and organizations are allowed to enroll or maintain their Medicare billing privileges.”

You can read the rule in its entirety here.

Forget January 3, 2010! PECOS Date Moved 6 Months Closer – Referring & Supplying Providers New Date is July 6, 2010 | Manage My Practice.com

Technorati Tags: Medicare, Medicaid, PECOS, DME, medical claims, healthcare, NPI, enrollment, providers

Here’s a little history on this situation and now it appears after appealing the bid process, HealthNet will remain in place with Tri-Care for the northern contract.  Aetna it appears was disqualified with some conflict of interest and the General Accounting Office investigated the matter and here’s the new results.  No word yet on the appeal from Humana for the southern Tri-Care contract. 

Tri-Care Contracts Still Not Defined – Aetna and United Bids Still in Limbo From the GOA

“You think getting a claim paid today is difficult, well let’s step back a little further on the the Tri-Care bids and these 2 situations are still up in the air.  Healthnet and Humana protested the bids and thus far the GAO is still looking into the matter.   Aetna supposedly cheated with hiring a former Tri-Care official to prepare it’s bid.” 

Aetna and United HealthCare Secure Military Contracts with Tri-Care

After the original contracts were announced HealthNet sold it’s northeast business to United Healthcare.  I am guessing that was predicated on the potential loss with the original announcements.  The sale to United was announced a few days after HeatlhNet lost the Tri-Care contract in that area to Aetna with United gaining the Tri-Care agreement in the southeast.  Complaints of unfairness have been filed on the award of the Tri-Care business as well.  Profits last year for United were over 3 billion.

UnitedHealthCare Buys a Portion of Health Net in the Northeast

Anyway, it’s good to see at least part of the process being solved so the insured will know where their insurance contracts lie and where to go.  BD

SACRAMENTO, Calif., May 05, 2010 (BUSINESS WIRE) -- Health Net Federal Services, LLC (Health Net), a subsidiary of Health Net, announced that today the Department of Defense (DoD) notified the company that the DoD intends to award Health Net the new TRICARE North Region contract. Health Net currently is the managed care contractor for the TRICARE North Region.

"Health Net is honored to continue to serve our active duty, National Guard and Reserve members, and military retirees and their families in the North Region," said Jay Gellert, president and chief executive officer of Health Net, Inc. "I also want to take this opportunity to thank all of our associates who have continued to provide support for our TRICARE beneficiaries during the protest period."

Department of Defense Intends to Award Health Net the TRICARE North Contract - MarketWatch

Technorati Tags: Aetna, TriCare, health insurance, Humana, Health Net, Pentagon, Tri-Care, United Healthcare, GAO

We have been hearing about Kaiser Permanente going green and this is a bit more from our Governor on clean hydrogen power.  We are getting filling stations to get hydrogen here in California and Gov Arnold filled up at one. 

Kaiser Permanente Continues Green Movement – Purchasing Eco-friendly Medi cal Products

Fuel cells can be right next to the building and perhaps we can see this with health care buildings soon as well. 

I hope our next governor continues this methodology of updating us with valuable information – the value of Twitter with live broadcasts!    I love his talk about the luddites we have everywhere today too, got lots of those in healthcare too. Here’s a post where a person trying to help out had the same problem, getting attention and I agree that is so hard to do with “non participants” and I’m kind of used to being seen as somewhat of a “tech heathen”, been going on for years with those who don’t read, listen or use that area of curiosity to see what’s going on.  It sad the old paradigms like that still exist, but something I deal with all the time with technology being viewed as “evil” or I don’t have time to learn anything new.  You don’t know how many times I have heard that. 

Security Breach – US Treasury Department With 4 Public Sites Infected – It Pays To Read Blogs

The governor says to call the US government and urge them to talk a look at what California is doing.  Good stuff for sure.  BD 

Technorati Tags: Schwarzenegger, California, green technology, visions, participants, non participants, fuel, economy, US Government, hydrogen pump, Shell Station, cars, technology

We talk quite a bit about security in healthcare and when the US Treasury Department gets infected, people tend to listen up.  I found this of interest as the person who found the breach and/or infection reported it on a blog.  When you read the comments below he further went to the FBI as he states web administrators don’t usually believe such notices, but says when the FBI talks, people listen. 

Blogs are good filters and can really be helpful.  I somewhat think of myself in healthcare as a “forensic dot connector”, in other words the technology slant added here is different than what is found on many blogs as I try to bring in many aspects of a story.  This is where I feel bloggers are great companions to the journalists that bring us the news, but after the fact one may wonder, how does this potentially affect me, the bloggers will usually add the “personal” side quite often.

Communication is a 2 way street and just due to the fact that someone puts a blog out there looking for input doesn’t necessarily mean they will come to the mountain all the time either.  Last year on the healthcare side of things we had the conficker virus infecting MRI machines as an example.  This was due to some “old” provisions still in effect and party due to some “non participants” in technology maybe not catching this sooner. 

Hospital MRI and Other Medical Devices Infected with Conficker Virus – FDA Required 90 Day Notice before Windows Update Patch Could be Applied

This is just another example of how everyone needs to participate at some levels of technology to stay on top of all that is happening!  This is great that someone was watching out and caught the intrusion.  BD 

The Treasury Department has taken offline four public Web sites for the Bureau of Engraving and Printing after the discovery Monday of malicious code on a parent site.

The bureau began using a third-party cloud service provider to host the sites last year, it said Tuesday in a statement about the incident. “The hosting company used by BEP had an intrusion and as a result of that intrusion, numerous websites (BEP and non-BEP) were affected,” the statement said. The Treasury Government Security Operations Center was alerted to the problem and notified the bureau, which responded by taking the sites offline.

The infections first were reported by Roger Thompson, chief research officer for AVG Technologies, who discovered malicious code injected into the affected page Monday morning. He said the code appears to link with two attack servers in Ukraine.

The Bureau of Engraving and printing has four URLs pointing to one public Web site, which was infected with a malicious iFrame. The URLs are bep.gov, bep.treas.gov, moneyfactory.gov and moneyfactory.com. “BEP has since suspended the Web site,” the bureau said in its statement. “Through discussions with the provider, BEP is aware of the remediation steps required to restore the site and is currently working toward resolution.”

Thompson reported the breach to the FBI, which in turn apparently reported it to Treasury officials.

“I would gladly have reported it to Treasury, but it can be hard to find the right person,” he said. “Usually when I talk to a Web administrator they don’t believe me. When the FBI calls, they pay attention.”

Often, multiple exploits are available on the attack site. Such attacks commonly are used to compromise computers to steal sensitive information and for recruitment into botnets.

Thompson said he noticed the Treasury infections because they are in the .gov domain. “I think there are a jillion other sites being affected, but these were the only government sites, which is what we noticed.”

Treasury shuts down 4 cloud-hosted Web sites after infection -- Federal Computer Week

Technorati Tags: Security breach, Treasury Department, bot, websites, FBI, healthcare, MRI, conficker Virus, blogs, filters, non participants, Health IT, government

One of the products produced by the company has to do with “hand washing” and you may have seen or used it.  The issues the SEC is investigating has to do with inflating sales numbers, thus bilking investors in a scheme to falsely report numbers.  We are right back once more to the use of perhaps some “dirty” algorithms here in order to substantiate “desired” results for the purpose of greed and gain. 

The numbers of stories like this I am guessing will continue as the SEC moves on their way to find out who’s been telling the truth and who is not.  Even the Madoff Scheme had some algorithms used to pull the wool over everyone’s eyes.  It’s sad today but everything you see out there may not truly be what it really is and thus we need to get educated and understand some of the algorithmic formulas uses today as we have seen this healthcare too, it’s like one side has the technology of machine gun algorithms and the other side has sword and dagger technology and when it comes to desired results, we all know what that is all about.  

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

The company had way over stated their sales via reports generated with algorithmic formulas according to the article so who else out there is bending some algorithms?  We have a few in healthcare too that folks are looking at.  BD

 

NEW YORK (Dow Jones)--The top executives of Spongetech Delivery Systems Inc. (SPNG) were arrested and charged Wednesday in an alleged scheme to defraud investors by reporting falsely and grossly overstated sales figures.

According to a criminal complaint filed Wednesday, Michael Metter, Spongetech's chief executive and president, and Steven Moskowitz, the cleaning-products maker's chief operating officer and chief financial officer, were charged with conspiracy to commit securities fraud and obstruction of justice. They each face up to five years in prison on the conspiracy charge.

Metter, 58 years old, of Greenwich, Conn., and Moskowitz, 45, of Flushing, N.Y., are expected to appear before a U.S. magistrate judge in federal court in Brooklyn later Wednesday.

"The defendants in this case--Spongetech's highest corporate officers--are charged with executing a bold scheme to portray Spongetech as a company that was performing at a level far above reality," U.S. Attorney Loretta Lynch said in a statement. "As detailed in the complaint, the audacity of their scheme was matched only by their obstructive efforts during the course of the SEC's investigation."

UPDATE: Spongetech Execs Accused In Alleged Fraud Scheme - WSJ.com

Technorati Tags: SEC, Spongetech, heatlhcare reform, algorithms, investors, hands, sponges, washing hands, fraud

This is good news here as San Diego is somewhat of an area that focuses on wireless and devices that report data.  I have said before and I still think that this rapidly emerging area of healthcare is growing faster and far beyond what anyone initially anticipated.  Devices are reporting data that humans used to do pretty much exclusively. 

In the group you see Scripps, who has several on going projects and uses Microsoft HealthVault to store genetic data, so we have the PHR element included here too for sharing patient data.  If you follow the link below you can get some good input here from a TED video on how Eric Topol views some of the devices and their value in healthcare today, especially when he discusses how disruptive some can be, while others may have additional benefits. 

The Wireless Future of Medicine – The Forgotten Element of Meaningful Use -Eric Topol –TED 2010 (Video)

The FDA is now approving many such devices for use such as the HealthPal listed below.  If you are looking to get into crowded clinical trials as an example, having a PHR will tend to move you up the ladder for consideration too. 

FDA approves HealthPal – Bluetooth Device that Collects from Other Reporting Devices and Sends Information to PHR – HealthVault or Google Health

The entire listing of “Beacons” from HHS can be viewed here for those who received grants under the program.  BD

A consortium of hospitals and community clinics in the county has won a $15.3 million federal grant to link its electronic medical records systems so basic patient information can be shared among doctors.

Studies have shown that digital records help reduce errors, enable physicians to better emphasize preventive care and cut down on certain health costs.

The consortium was among 15 groups nationwide — and the only one in California — that received a total of $220 million from the Beacon Community program, which is part of $100 billion in funding for science, innovation and technology through the 2009 federal economic stimulus law.

UCSD Medical Center will function as the lead facility for the local initiative. Other consortium members include Scripps Health, Sharp HealthCare, the San Diego VA Healthcare System, San Diego Naval Medical Center, Rady Children’s Hospital, the San Diego Council of Community Clinics, the county office of Emergency Medical Services and the San Diego County Medical Society.

Medical groups get grant to link patient records - SignOnSanDiego.com

Technorati Tags: HHS, grants, beacons, healthcare, wireless, PHR, healthcare reform, Health IT, bluetooth, medical records, EHR, EMR, hospitals, technology, devices that report data

Not too long ago we heard about the solar panels being installed and used at Kaiser facilities and now the process continues to medical products that are environmentally friendly and recyclable.  Last year I had a tour and interview with the CFO of a hospital in Long Beach, not a Kaiser facility, but one that had the same reaching goals and I was amazed at some of the recycled projects that went into building the hospital.  There are items that you would not even think of off hand as being “green” or “recyclable” so this was an education indeed for me.  They recycled some of the old linoleum floor for one and has a nice new artsy looking surface when redone which was really very attractive.  

Miller Children’s Hospital Long Beach – Brand New Pavilion Carries Focus on Patients and “Green”

There is a company in Texas that takes needles and other items and makes pellets that are used to create cement?  Who would have ever thought, but another “green” technology emerging.

Medical Waste Being Recycled Into Building Materials and More – Pella-DRX Pellets

Using “green” products also saves money.  BD 

Kaiser Permanente, one of the largest U.S. providers of health care, today announced that it will start buying medical products based partly on eco-friendly criteria.

Kaiser Permanente, which today announced an effort to buy only eco-friendly medical products, has solar panels on the parking garages of its Santa Clara Medical Center in California.

To guide $1 billion in annual purchases, it's launching a "sustainability scorecard" that rates suppliers on their use of potentially harmful chemicals and environmental practices such as recycling.

It's also good business. Kaiser Permanente says it saved $20 million annually by switching to greener products in 2009.

Gerwig says the scorecard was developed in October but is now being applied as contracts come up for review. She says Broadlane, its group purchasing organization, will also begin using it this year with other clients, whose purchases total $9 billion annually.

Kaiser Permanente moves to green medical purchases - Green House - USATODAY.com

Technorati Tags: Kaiser Permanente, Green, Eco-friendly, purchasing, hospital, healthcare, hospitals