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Scribes in Healthcare Continue to Grow At Major Hospitals–Proof that Medical Records Systems are Still Not User Friendly Enough And Can Disrupt Physician Time With the Patient

9/04/2010 05:39:00 PM  , , ,  

I am foremost and upfront all about having medical records and if you have read this blog long enough you know that I developed and wrote one years back, thus my comments tend to be realistic and I comprehend the fact that we can’t just jump on every new piece of software or algorithm that appears.  In every business today the formulas and algorithms are more complicated and the programming is work in progress.  When the tech folks (like me) who have to support all the various forms of software that are out there, begin to complain, you there’s a problem.  image

Hospital Relies on High-tech 'Scribes' To Follow the Doctors and Enter Data to be Paperless

When you have spent time working with doctors first hand and as a partner to develop a system that will help them you learn to eat your own dog food right off the start and it is team work.  I started talking about the Common User Interface a couple of years ago and I still this is a good idea.  One young doctor told me he had to learn 5 different medical records system to get through his internship.

Medicine information is getting more complicated today too with all the information that has to be reviewed.  These doctors that like scribes may not at all be tech luddites, is just the amount of information and work flow needed and something have to give.  Of course the physician has to review what the scribe has entered to ensure this is correct.  image

Using Scribes at the Hospital – Some Doctors Really Like This Idea

The good side about scribes is that many are med students working for not much more than minimum wage and it is a learning process for them as they go through school.  Here’s an interesting quote from this article:

T”he companies that develop and sell electronic medical records systems are "in total denial" about how complicated they are for doctors to use, Strumpf said. "They know these systems need scribes," he said. "They work with us to train our scribes on their systems, but they don't want to be public about it."

Again I mentioned the open source Common User Interface that could be adopted by any medical record company and this is the screens only and

the rest of their system could stay in place as is for other functions.

Microsoft Common User Interface for Health Applications- Silverlight...and Windows Presentation Foundation

Here I am using and and doing a walk through back in 2008, so you can see this is not brand new.

Competition and who can build the best input algorithms are at the heart imageof all of this.  Back when I was writing if someone has something easier for clinicians to use, heck I was all over it as my ego was not that big, and this is a bit of a territory battle here. 

Here’s a doctor/developer in New Zealand that I know who is working imagewith it in format and he’s not even using Microsoft code to do it, so enough about the complaint that you have to spend a lot of money to use format.

Common User Interface – EHR Development Work in Progress

Back at HIMMMS 2008 I was there helping promote Tablet PCs and I used from one of my MSDN meetings, a prototype that had

been around before the Common User Interface.  It was kind of funny as I wanted to be not promoting any system to be impartial and all the other EMR vendors I met with at the time showing off the tablet were asking “who’s system is that”, in other words it got attention.  Here’s a short video I did after HIMMS with the prototype.  I had already hung up my coding shoes at this point.

Electronic Medical Records of the Futureimage

Back in 2006 I was already adjusting my program to work on Tablets too and if you are curious the link below has a few screenshots.  Keep in mind this was back before we had a lot of the new innovative code and system we see today so not bad though and it even changed colors for the user’s preference.

What Does an Antiquated EMR (Electronic Record System) Look Like

“More scribes are on the way. Ronald Reagan UCLA Medical Center, Emory University Hospital in Atlanta and Beth Israel Medical Center in New York City said they are exploring the idea. Physicians in other specialties, including urology and family practice, also are starting to adopt scribes.”

Again we all want electronic medical records and more importantly they need to address the needs and formats of the end users, doctors, nurses, etc. and time for programmers and businesses to eat a little dog food along this path.image

Again, I like all of this and see the value but again I can’t jump on and promote every single program whether it’s for the consumer or for the clinician, as what seems to be practiced today with some jumping on every thing that shows up. I interface with people from all walks of life but I remember the physician side and the creation process and thus so, consumers would be wise to keep this in mind before going into attack mode with doctors who are not quite readily ripping their way through  medical records with expeditious input,   

Consumers also need to remember that their doctor is creating the equivalent of an income tax 1040 form for every visit and that can be 20-3- a day, so think of it this way, as a consumer how would you like to be filing your incomes tax forms 20-30 times a day, I think I made the the point. 

Remember some get the short form, some have to be itemized and some get audited (denied), so just think of the administrative time that goes into those 3 functions above and you have a pretty good idea of how complicated and detailed the record/billing side of healthcare is.  I’m not trying to give Scribes a big line of promotion here, just looking at things realistically and how they have evolved.  That coding in my background and working hand in hand with doctors writing an EMR a few years ago really helps me include what I feel is a realistic spin on all of this, nothing like first hand experience rather than listening to magpies.

(This is the Medical Quack and not the Medical Magpie) <grin>

Even UCLA is looking into scribes and they are one of the most connected and wireless capable facilities in California, so this has nothing to do with how wired a place is and how fancy the software is – it’s all about having a system that doctors and nurses can use without immense disruptions with patient care and if it takes a scribe to help them weather all of this, then so be it.  BDimage

Melissa Genove has dreamed of becoming a physician since childhood. To help her prepare, she spends as many as 35 hours each week shadowing emergency room doctors at Loma Linda University Medical Center. The 23-year-old listens intently as they examine patients, records their treatment plans in a laptop computer, and follows up on prescriptions, lab tests, consultations with specialists and anything else the doctors order.
Genove is not an intern, or even a medical student. She is the chief medical scribe in the hospital's emergency department — and one of several thousand young people pioneering a new healthcare field.

But while the conversion is underway, doctors estimate that their productivity plummets by about 30% as they learn to cope with a complicated new system. That's where scribes come in.
Like Genove, they are typically young, tech-savvy and undaunted by computers. They are willing to work for $8 to $10 an hour with no benefits. Most do the job part-time as college students and plan to go on to full-time careers in medicine or nursing. They say the experience gives them a valuable head start.

Leaders of the three biggest companies providing scribes estimate that about 200 emergency departments in community hospitals and academic medical centers currently use them. More scribes are on the way. Ronald Reagan UCLA Medical Center, Emory University Hospital in Atlanta and Beth Israel Medical Center in New York City said they are exploring the idea. Physicians in other specialties, including urology and family practice, also are starting to adopt scribes.

Scribes let doctors focus on patients - latimes.com

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New York Public Hospitals Yanking Doctor’s Contracts Stating It Is Leading To the Creation of an Accountable Care Organization

9/04/2010 12:08:00 AM  ,  

Accountable Care Organizations require a close alignment of physicians and their groups with doctors so it appears this is what the goal here is, along with negotiated new contract provisions while they are at it.  Something along this line is being tried in California and has ended up in court.  image

City of Hope Files Lawsuit Against Their Own Doctors – Wants MDs Join For Profit Medical Group & Terminating Nearly All Physician Research Current Contracts

The whole idea here is to lower costs and rewards will be given for those who keep the cost down and focus on preventive medicine.  Also keeping down inpatient admissions figure n here too.  Some doctors in the entire process stand to be laid off as well.  BD

New York City's public hospital system is bracing for federal health reform by changing how it contracts with the doctors that work at its hospitals. The new contracting strategy is part of a broad restructuring announced in May to save the New York City Health and Hospitals Corp. millions of dollars, and to position the agency in a post-health care reform world.

At stake are some $857 million in contracts in HHC's 2011 fiscal year. HHC said in May it would restructure its affiliation agreements; the contract consolidation is part of that strategy. The system is also cutting 6%, or $51.5 million, from its affiliation costs by laying off doctors and taking other steps.

The system currently secures physician services through eight contracts with medical schools or large group practices. That volume complicates HHC's ability to function as an integrated delivery system and deliver more coordinated care-management in the reform era.

The change in affiliation contracts is one step HHC is taking toward becoming what is called an accountable care organization, a new type of arrangement under the federal health care reform law that requires close alignment of a physician work force with hospitals.

These accountable care organizations, large collectives of doctors, hospitals and outpatient facilities, will play a greater role in lowering costs and improving the quality of care for their Medicare patients. In exchange, they get higher Medicare reimbursement. The organizations are intended to reward providers that shift their focus to preventive care and lessen the need for expensive inpatient procedures.

Public hospital system yanks doctor contracts - Crain's New York Business

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Lenovo ThinkCentre M90z All In One Desktop Discussion

9/04/2010 12:05:00 AM  ,  

This is a nice computer and along with a couple other bloggers you may see Multi-touch supporton the web with a few other discussing so this is a plus if as you get more than one perspective from a blog you follow.   I’m participating in evaluating and commenting on the Lenovo Think Centre M90z. . It has been supplied by Lenovo for my use in evaluating.  I’ll be adding some posts here and there on things that I find useful and what I am doing with the unit.

First thing I like is the fact that it is an all in one unit and I don’t have a tower to deal with as this was what lead me to buy my IMAC a couple years ago.

I have included a couple images here so you can see what I am talking about.  It has touch screen capabilities which I have been used to using with my tablet so have the desktop that does this too is great.  Being a tablet person since they came out, the first thing I tried out with the TIP input panel, the handwriting recognition.  It works great and recognition is fine with Windows 7.  I will be working eventually on the speech recognition too as those are some of the tools I use personally all the Easy to replace HD and Ramtime.  I can easily use my fingernail to write! 

The unit has 4 mg of ram, but being it is a 32 bit system, just a shade under 3 can be accessed and that is true of any 32 bit computer.  I’ll be doing additional testing and one item I added was blue tooth on one of the USB ports as I use both a blue tooth mouse and keyboard with the unit.  I’m into wireless where ever I can be.  Connecting to my wireless network was very easy and nice to have that capability built in.

I also attached a USB TV Tuner to work with the Media Center to try it out as well.  A few years ago I did some demos for Microsoft and Intel on Media Centers Greenerso it was right up on top of my list. 

The television reception is good and the Media Center works well and the Windows 7 version has a few new little extras on the interface.  The computer is also a power saver and has “green” technology with power savers, etc.  Moving the unit around is easy enough with the handle on the top back side and it’s easy enough to pull the stand out and set it down, ready to use. 

This is the first of a few posts I will add here and this is more or less a simple introduction and stay tuned for more information later and a chance to win one of these units too.  BD 

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Stolen Adderall XR Found in Expired Returns to Shire Pharma–Bar Codes Could Have Been Helpful with Immediate Identification

9/03/2010 11:27:00 PM  ,  

Most pharma companies will offer refunds on expired drugs that are returned in their original bottles.  This is a big problem with thefts and I guess if a criminal imagedoesn’t mind waiting to collect, assuming they are the ones doing the returns, it eventually gets caught as the drug now expired was stolen back in 2008.

Some thieves set up reseller companies and sell the stolen drugs to pharmacies too and that is yet another angle on theft to look out for.  These are the lots included and will NOT be eligible for any refund.  If anyone finds themselves in possession of imagethese lots, do not use as they could be subject to tampering or not stored at the proper temperatures, etc.   

  • Adderall XR 15mg; Lot No. A38146A; Expiration Date: 02/29/2012
  • Carbatrol 200mg; Lot No. A40918A; Expiration Date: 04/30/2010
  • Carbatrol 200mg; Lot No. A40919A; Expiration Date: 04/30/2010
  • Carbatrol 200mg; Lot No. A41575A; Expiration Date: 05/31/2010

If the bottles would have contained 2D bar codes any cell phone would have enabled immediate identification before they even hit the return department at Shire, making work a little easier for the DEA to perhaps find some stolen drugs too.  BD

Microsoft Tags – Microsoft MSDN Posts Ideas from the Medical Quack About Use in Healthcare!

Shire Pharmaceuticals has warned that some of its medicines stolen whilst in transit in 2008 are now reappearing on the market as expired returns.

The company suffered a theft of a shipment containing its attention-deficit hyperactivity disorder drug Adderall XR (mixed amphetamine salts) and epilepsy medication Carbatrol (carbamazepine) in October 2008. The load was en route from its manufacturing facility in North Carolina to a distribution center in Kentucky.

SecuringPharma - Stolen Shire medicines found in expired returns

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Medical Marijuana News in California–First TV Ad Airs in California And Workers At Marijuana Factory Join the Teamsters

9/03/2010 10:58:00 PM  ,  

The commercial has been getting mixed reactions on whether or not the advertising should be allowed on TV.  There were no pictures of the product or anything showing use, just the commercial of 30 seconds talking about it. 

In another news story, workers that grow and maintain the gardens have joined the teamsters union. 

The company will pay for the workers' health care costs, which is pretty much what the contract was all about.  image

“The workers are employed by Marjyn Investments LLC in Oakland, a management company retained by multiple lawful cooperatives organized under California laws for the purpose of providing patient access to medical marijuana.

The workers are trimmers, gardeners and cloners. Cloners clone different strains of marijuana, depending on its medical needs, said Lou Marchetti, the business agent for Local 70, which organized the workers and negotiated the contract. Marjyn Investments provides medical marijuana used by patients suffering from cancer, HIV and other life threatening illnesses.”

Who would have ever though marijuana providers would be organized?  The agreement was negotiated and signed quickly without much ado and all parties seem happy and satisfied too.  BD 

 

No one seemed out of joint earlier this week when a California TV station broadcast what is believed to be the first-ever paid spot for medical weed. Or were they just keeping a lid on their feelings?

First Medical Marijuana Ad Airs in California: Is it Wrong? - Health Blog - CBS News

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Accentus Medical Partners With Accentus Medical–Orthopedic Implants With a Unique Surfacing Process To Ward Off Post Orthopedic Surgical Infections

9/03/2010 10:15:00 PM  ,  

This is an electrochemical process that involves high voltage anodisation.   Devices imagethat have been treated will have a shiny violet color.  You can see from the image below how small reservoirs are created. 

Back in 2008 I did a post on another type of process used for coating devices again looking for the same outcome, less post operation infections. 

Healionics Gets Angel Group Funding – Coatings for Implanted Medical Devices

Many of the new products from Zimmer may be sporting that light purple color soon.  BD 

image

OXFORD, England, Sep 03, 2010 (BUSINESS WIRE) -- Accentus Medical, a leading UK medical technology company that supplies advanced coatings and surface treatments to the medical device industry, announced today that it has signed a License and Services Agreement with Zimmer Holdings, Inc., a global market leader in musculoskeletal care. This agreement will enable the use of Accentus Medical's Agluna(R) anti-infective technology on a potentially broad range of Zimmer products.

Under the terms of the agreement, Zimmer will acquire exclusive global rights to utilize Agluna(R) for joint reconstruction and trauma products. In addition, the company will have an 18-month option to acquire additional exclusive rights for spinal devices, dental implants and sports medicineimage products. As part of the agreement, there will be an initial period of further development of Agluna(R). Accentus and Zimmer will collaborate to secure regulatory approval for products treated with the Agluna(R) technology in both the E.U. and U.S. Financial details of the agreement were not disclosed.

Agluna(R) is a novel, patented surface modification technology applied to medical devices manufactured from titanium and its various alloys. The goal of the technology is to reduce infection rates following surgical procedures

Accentus Medical Signs Global Licence Agreement with Zimmer - MarketWatch

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3 BILLION AND COUNTING Documentary About The Needless Ban of DDT–Decision of One Scientist and The Reason for the Huge Outbreak of Malaria and Why Bed Bugs are Back

9/03/2010 08:51:00 PM  , ,  

This looks like a movie that need to go on my list to see.  Bed bugs were eradicated imageby the use of DDT.  Howard Stern is on the case to back up the doctor who made the film to bring DDT back as well.  On the topic of Malaria, we also have the Gates Foundation working diligently on a cure too. We might all remember the jar of mosquitos he let loose at his talk last year at the TED convention, video at the link. 

Bill Gates from the TED Presentation this week – Malaria and Educationimage

According to what I am reading here the mistake goes back to one person at the EPA making this decision and now it turns out it was wrong.  If this is the case and so many are dying when we had a real good handle on malaria, it might be time to bring it back. 

With the bed bugs, the Ohio governor is trying to get a waiver from the EPA to use pesticides such as Malathion and Propoxur to get rid of the infestations.  We are lucky here it’s bed bugs and not malaria.  What I found also interesting was the cocktail from the 40s and 50s that had a splash of DDT in it, so for a short while I guess a few drank it. 

From the Website:

“This film follows the journey of Dr. Rutledge (a preventive-medicine doctor who grew up on a farm in Mississippi) as he travels the globe in 40 days to discover why so many women and children are still dying needlessly from malaria — one death every 12 seconds.

He eventually finds himself in Washington DC where it all “went down” during the Nixon ERROR. He discovers that our very own US government, ONE MAN in imageparticular, SCAMMED the American people with lies and deceit causing the death of untold millions.

He leaves no stone unturned in this heart felt fact finding mission that is chock full of shocking findings that are sure to open up a virtual BLIZZARD of long overdue debate.”

Did you know?

The Mickey Slim was a drink that had short-lived popularity in the United States in the 1940s and 1950s. According to the The Dedalus Book of Absinthe by Phil Baker, it was made by combining gin with a pinch of DDT (also known as dichlorodiphenyltrichloroethane), an insecticide that would later be banned in most countries; consumers of this concoction claimed that its effects were similar to absinthe.

You can also follow along on their Facebook Page.  William Ruckelshaus, who was the head of the EPA now is a strategic director for a venture capital firm, Madrona.  Information from their website below:

“He is currently a director of TVW, Isilon Systems, Inc., and has recently retired from the boards of Weyerhaeuser Company, Nordstrom, Inc., Cummins Engine Company, Solutia, Pharmacia Corporation, and Monsanto. Bill is also on the Board and former Chairman of World Resources Institute in Washington, D.C., Chairman of the Salmon Recovery Funding Board for the State of Washington, Chair of the Seattle Aquarium Society, former member of the U.S. Commission on Ocean Policy. In 2004 he was appointed Chairman of The William D. Ruckelshaus Center, a collaborative problem solving institution of the University of Washington and Washington State University. In 2003 he was appointed to serve on the National Oceanic and Atmospheric Administration, Science Advisory Board. And in 2005, he was appointed by Governor Gregoire to co-chair the Puget Sound Partnership to organize the cleanup of Puget Sound.”

PCBs are the problem according to what I have read here and not the DDT and there was confusion and mix ups on the interpretation.  William Ruckelshaus had never attended a session in the seven months of EPA hearings, and admittedly had not read the transcript of the hearings overturned the ruling of an EPA administrative law Judge.  Another website, Junk Science called DDA “A Weapon of Mass Survival”, not destruction in this case. 

I would certainly like to see both Malaria and of smaller importance the Bed Bugs by comparison go away if this is all it takes, and again the movie is on my list and the trailer is below.  BD 

NEW YORK, Sept. 3 /PRNewswire-USNewswire/ -- The QUAD Cinema, one of New York City's leading art houses, presents the New York premiere of the provocative new documentary, 3 BILLION AND COUNTING (102 minutes), directed and produced by Dr. D. Rutledge Taylor.

Sure to spark outrage, Dr. Rutledge, a California physician specializing in preventative medicine, chronicles the effects of the world-wide ban on the pesticide DDT in 1972, a ban inspired by the first enviro-bestseller, Rachel Carson's Silent Spring (1962). Rutledge's five-year-long effort is driven by his revulsion at millions of deaths, mostly of women and young children, in Africa and South East Asia, by the mosquito-borne disease, Malaria. According to a recent World Health Organization report, Malaria kills one million people annually, a disease, Rutledge confirms, that is wholly and immediately preventable.

3 Billion and Counting Trailer

A naturalist and a die-hard advocate of preventative medicine, Dr. Rutledge, in the long tradition of American debunkers, wanted to see first hand the extent of Malaria's worldwide impact, and to discover why policies are still in place that exacerbate the epidemic. 

Further, the film adds clarity to the record by showing that the effects of DDT were confused in the public's mind with the undeniably devastating effects on the environment and water ways of PCBs. Because both chemicals were in the news at the same time, the effects of DDT became linked with the harmful effects of PCBs. Environmental activists, medical experts, and advocates of its ban did nothing to eliminate this confusion.

In his dissection of the rise of the environmental movement and the fall of science, he drops one bomb after another -- a reputable scientist is caught manipulating test outcomes to prove the adverse effects of DDT; the man who started it all, William Ruckelshaus, the Administrator of the EPA in Richard Nixon's presidency, reverses his position on the harmlessness of DDT to appease the membership of The Environmental Defense Fund.

The documentary raises fundamental questions: whom can we trust; what do we have to know in order to trust them; and finally, will we make the effort to know it? The film begs us to educate ourselves. 3 BILLION AND COUNTING is instructive well beyond the outrage it inspires.

3 BILLION AND COUNTING Opens in New York at The QUAD Cinema -- NEW YORK, Sept. 3 /PRNewswire-USNewswire/ --

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Walgreens and Omnicare Swap Businesses–Giving Long Term Pharmacy Care to Omni and They Get Omni’s Home Infusion Business

9/03/2010 07:27:00 PM  ,  

Walgreen said  it has also agreed to acquire ApothecaryRx pharmacies from Graymark Healthcare systems as Graymark wants to focus on their sleep apnea business.  Omnicare has not been quiet this week either with buying Continuing imageCare RX which serves 40,000 beds of long term care facilities so it looks like Omnicare is trying to grow the business they have been in for years and Walgreens is trying to do the same without each one competing as a one stop shop.  Omnicare has not been without challenges and issues too over the last number of years.  The Chicago Tribune also has a current article on the kick backs in the Chicago area lawsuit. 

Omnicare, Johnson & Johnson, Risperdal, Whistleblowers and Legal Woes Back in the News Againimage

Basically with long term senior care Walgreen’s is opting out of that business but providing home IV services such as antibiotics will allow for that area to expand.  I am guessing too there’s more money perhaps in that side of the business too. 

With changing business models, the pharmacists now at Walgreens can earn pay for performance dollars for signing up consumers in the YMCA and others where their Ingenix division has calculated the consumer “might” be at risk of developing diabetes, not diabetic consumers. BD

UnitedHealthCare To Use Data Mining Algorithms On Claim Data To Look For Those At “Risk” of Developing Diabetes – Walgreens and the YMCA Benefit With Pay for Performance Dollars to Promote and Supply The Tools

Walgreen Co., the biggest U.S. drugstore chain, said Friday it will acquire the home infusion business of Omnicare Inc. in exchange for its long-term care pharmacy business.

Financial terms of the deal, which is expected to close before Nov. 15, were not disclosed.

Walgreen, based in Deerfield, Ill., said it decided to leave the long-term care pharmacy business because, on a stand-alone basis, it lacked the necessary scale "to effectively grow to a leading position in its sector without significant additional investment."

Pharmacy chain Walgreen, Omnicare trade businesses - BusinessWeek

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WellStar Hospital Board Fires CEO and Terminates VP and Executive Counsel–Georgia

9/03/2010 05:06:00 PM  ,  

This is a non profit group of 5 hospitals, clinics, outpatient centers, etc. As mentioned the VP was removed a imagecouple days prior and the board unanimously fired the CEO a day or so afterwards and there’s not much else available as far as information right now. 

In other related WellStar news, they are building a new hospital to replace an old facility that was built tin the 60s.  BD

WellStar Health System’s president and CEO Gregory Simone was fired by the system’s board on Thursday.

Board chairman and Marietta attorney Randall Bentley said the decision was a personnel matter and provided no information on the reason for Simone’s termination, which is effective immediately.image

Earlier this week Bonnie Wilson, WellStar’s executive vice president and general counsel, received notice that her contract would not be renewed.

Bentley did not say if the terminations were related.

WellStar CEO fired by hospital board  | ajc.com

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Smoking Baby and Mom Complete Rehab–Baby Has Quit Smoking and Mom Received Extensive Counseling

9/03/2010 03:43:00 PM  ,  

None of us can forget this story when it broke on the news in the Spring and talk show host Jimmy Kimmel has reminded us too with a bit of humor in various skits, imageso there’s just about no way one could have missed this story.  The good news is now that he has completed his 30 day rehab program which was provided by the government and luckily the smoking has not caused any health problems.

Fat Baby in Indonesia Has a 2 Pack A Day Smoking Habit – Company Offers Family A Car If He Quits

Now he does have a heart issue which the report says is due to the fact that he is obese.  He long longer throws fits and cries when he can’t get a cigarette.  I think Mom need the counseling here too to enable her to say no as I’m sure at 2 years old he doesn’t hop in the car or walk down the local convenience store to buy his next pack either. 

Mom watched him smoke his last cigarette and smashed his head on the floor at the hospital.  The doctor says that some children start at the age of a year old and he’s seen other cases.  I can’t imagine 3-4 packs a day for  baby to smoke.  The local government is responsible to monitor the child and make sure he doesn’t start again.  The next issue it looks like might be the diet for the tot.  Mom also learned parental skills too on how to give him something else besides a cigarette when he’s unhappy, common sense to most but I guess may not think in this manner, thus the 2 year old addiction problem.  BD

The tubby Indonesian toddler who caused a sensation last spring by enthusiastically puffing on cigarettes in a widely viewed video has quit smoking, according to media reports.

Two-year-old Ardi Rizal of South Sumatra, who reportedly smoked 40 cigarettes a day, has broken his nicotine addiction through a 30-day rehabilitation program, the Jakarta Globe reported Thursday.

"He has stopped smoking and doesn't ask for cigarettes anymore," Arist Merdeka Sirait, chairman of Indonesia's National Commission on Child Protection, said, according to another publication, Earth Times.According to earlier reports, the child was placed in state custody after the video emerged and the boy’s parents said he would cry and throw tantrums if he went too long without smoking a cigarette.

Smoking baby reportedly has quit – This Just In - CNN.com Blogs

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Memorial Hospital in Gulfport, Mississippi To Lay Off 47 Workers–Reminder This Area Was Also a Victim of Katrina

9/02/2010 10:39:00 AM  ,  

We always focus on New Orleans but there were other areas hard hit 5 years ago too and this is one of them.  The reasons slated here for the layoffs is back to the imagesame old story, money.  Reductions in Medicare and Medicaid are at the top of the list.  You can also visit the website and see they are also using some state of the art technology with robotic surgeries too with the daVinci device.

In addition to the layoffs, the hospice program will also end and employees will see an increase in their premiums and a wage freeze is in place for administrators.  This is not too far from where our Surgeon General practiced in Alabama and I’m sure she knows this area well too.  BD 

Forty-seven employees have been laid off at Memorial Hospital in Gulfport.

Gary Marchand, the hospitals president and CEO, says the layoffs came Friday and included 35 full-time employees. He says 10 nurses were laid off.

Marchand said Tuesday that Memorial Hospital is trying to offset an anticipated $11 million shortfall related to reimbursement reductions from Medicare and Medicaid.

Gulfport, Miss., hospital lays off 47 workers - BusinessWeek

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UnitedHealth Group Invests $10 Million in California Critical Access Hospitals-By Paying For A Bond Offering–A Loan

9/01/2010 06:24:00 PM  , ,  

Last month another California hospital in Petaluma received a lone somewhat along the same lines with the purchase of their tax exempt bonds.  The Capital Access Small imageIssuance Program division of United is paying the expenses for the loan which is stated to be at currently competitive rates.  The loan will be pooled for the rural hospitals needing access to funds for IT updates.  They are also giving a loan out to provide the money to do assessments to see what areas of IT are to be funded at each hospital and I am guessing teleheatlh is right up there since this is aimed at rural hospitals. 

From the website:

“The Capital Access Small Issuance Program offers tax-exempt bond financing at interest rates often lower than those of conventional loans, maturity and term structure design flexibility, and a dedicated team of underwriters and program investment professionals that help streamline the overall financing process. Issuance costs are subsidized by UnitedHealth Group and PacifiCare of California through the current Grant Program.”

Petaluma Health Center Get Loan From United Health Group (Capital Access) Who Purchased Their Tax Exempt Bonds

I guess we hope everyone survives and makes the payments otherwise United imagecould end up owning hospitals too.  United also has a bank with over 1billion in deposits on premiums they collect from Health Savings Accounts.

UnitedHealth Group Owns a Bank With Deposits Surpassing a Billion – OptumHealth Bank FDIC Insured

From July of 2009 we had the hundred of millions United stated they would invest with Cisco for a national telehealth network.  BD 

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

The investments come from UnitedHealth Group's 20-year, $200 million California Health Care Investment Program, which helps health care organizations in California access capital

UnitedHealth Group has announced it will invest $10 million to help California's Critical Access Hospitals improve their health information technology (IT) systems and adopt electronic health records.

California's Critical Access Hospitals are health care facilities with a maximum of 25 beds and located in a rural area at least 35 miles from another hospital, or a rural hospital that is 15 miles from another hospital in mountainous terrain or areas with only secondary roads.

The funds will be made available from UnitedHealth Group's California Health Care Investment Program, a 20-year, $200 million commitment to health care organizations that provide services to underserved, low-income and underinsured communities and populations throughout California.

UnitedHealth Group is also providing $200,000 in grants to the California State Rural Health Association (CSRHA) to assess IT needs at California's 31 Critical Access Hospitals. Once the assessments are completed, UnitedHealth Group, with input from CSRHA, will select the Critical Access Hospitals that will receive a total of $10 million in capital from UnitedHealth Group for health IT projects.

UnitedHealth Group to Invest $10 Million to Help Improve Health Care Information Technology Systems at California's Critical Access Hospitals - MarketWatch

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Aneesh Chopra US CTO Discusses The Future of US Technology and Infrastructure Innovation (Video)

9/01/2010 05:22:00 PM  , ,  

Mr. Chopra is definitely a cheer leader and has the ideas going in the right direction and offers some good ideas and examples of where they are going and how the challenge programs are working to bring those to the table for the challenge.

He mentions Epocrates and says he doesn’t know a doctor today that doesn’t have this available on their phone or on their computer – well that’s good for him but back to the real world here where I also promote this and try to persuade doctors to use it, I find quite a few that are not using it, so everything in who’s talking I guess on certain topics.  Yes, it would be nice to have all doctors using Epocrates imageas I have it on my phone for look up as a patient, but the point I’m making here is that we have folks, both patients and doctors not up to this level yet. 

VA Can Now Use the “Blue Button” to Download Their Data from Their PHR (Personal Health Record)

Reference is made to the new Telehealth network launched in California, see the link below. 

Nation’s Largest Telehealth Network Launches-California Telehealth Network With Governor Schwarzenegger & Aneesh Chopraimage

I share in his enthusiasm and understand where the focus is and where it all needs to go and what the results will be.  I still think we need better collaboration as we have a lot of duplication coming out along with innovation, so the key is to get folks together that are working on the same goals with software.  He does mention that the payment system is a big hurdle.  Who’s going to write the Killer King algorithm? 

Aneesh Chopra: Build Database of Business Rules For States to Use To Determine Eligibility–Is This A First Step Towards a “Department of Algorithms”?

You can read more about the NHIN he references at the link below.  I added some related information at that post.

Office of the National Coordinator Awards Lockheed Martin $9 Million to Create Real World Model of Nationwide Health Information Network (NHIN)

Now we have one side of the picture and Mr Chopra does a good job and has the imageenthusiasm, but as I mention in my off the wall post below, we have a lot of other areas of life touching on all of this, implementation is a big one. It has to be useable and acceptable and there are folks addicted to the chase too.  Balance and working with private industry is also needed upfront.  Again, I like all of this but also realize that when we have too much on our plate at once we may end up with nothing.  Visions are great but we need to get there and bring the clinical aspect into the mix.  As he says, he’s the tech guy and we need the whole picture 

I learned this when writing code too as sometimes I thought I had the killer application but the doctor didn’t like it, or it needed modification.  Sometimes we were in complete agreement and enthusiasm on both sides, but then after a while he didn’t use part of it anymore that I thought really showed value.  That stuff happens in the best of cases. 

Data Addiction and Abuse –The Up and Coming Next 12 Step Program Is On the Horizon–Side Effects Include Lack Of Data Quality, Integrity And Spasmodic Algorithms

When you listen to Bill Gates, who is also an optimist we get a lot of the same, but imagehe’s also a businessman and kind of fades in that direction to combine with a little different perspective and shows a bit  more of human are of caring/concern when speaking versus the hard core data value talk.  There’s nothing wrong with this when the crowd is data people as they understand and I have even caught myself at times speaking too hard core data requirements at maybe the wrong times, but today more than ever with losing a lot of human values out there, ethics counts big time and should not be forgotten, otherwise people will start shooting servers, like this guy did this week.  Don’t laugh as this could be the way folks retaliate without digital literacy. 

Worker Gets Drunk and Shoots Server With 45 Magnum–Server Was Packing a Full Artillery of Blades To Defend Itself

Yes I get excited too when I see what value data brings but I try not to forget the human element of all of this and the real need to bring about Health IT literacy from our Congress on down, as they don’t have it either and thus we have no role models and just a bunch of politicians.  Bill Gates was funny too in how he described this recently too.  If you want his perspective use the link below, and it’s another quite lengthy video, but again well worth watching.  BD 

Bill Gates on Reinventing Capitalism–Building A Better Disease Model - Biased Individuals (Politicians) are Depressing and Kill Innovation-Techonomy Conference 2010

FORA.tv - Aneesh Chopra: The Future of US Tech Innovation

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California Doctor In Bakersfield Gets Stuck in the Chimney and Died–Was Said to be Breaking In To Boyfriends Home

9/01/2010 01:13:00 PM    

This is a strange one and I’m sure the news will pick up more on this as it develops.  The story is strange in the fact that the boyfriend left and house and escaped while the break in was happening, but did he not return?  image

A house sitter discovered her body in the chimney a couple days later.  An autopsy will be conducted and investigators say it sounds suspicious.  BD

BAKERSFIELD, Calif. — A doctor involved in an "on-again, off-again" relationship apparently tried to force her way into her boyfriend's home by sliding down the chimney, police said Tuesday. Her decomposing body was found there three days later.

Dr. Jacquelyn Kotarac, 49, first tried to get into the house with a shovel, then climbed a ladder to the roof last Wednesday night, removed the chimney cap and slid feet first down the flue, Bakersfield police Sgt. Mary DeGeare said.

DeGeare said the two were in an "on-again, off-again" relationship.

The man's identity was not revealed by police, but the man who resides in the home is William Moodie, 58.

Kotarac apparently died in the chimney, but her body was not discovered until a house-sitter noticed a stench and fluids coming from the fireplace Saturday, according to a police statement. The house-sitter and her son investigated with a flashlight and found Kotarac dead, wedged about two feet above the top of the interior fireplace opening.

The Associated Press: Cops: Calif doctor gets stuck in chimney, dies

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How Dependent Are We On Technology–Nike Has Filed for a Patent That Will Tie Our Shoes for Us

9/01/2010 12:57:00 PM  ,  

This is an old saying we have probably all used about not knowing how to tie our shoes, well it appears Nike is taking this to heart.  About 2-3 years ago I was sitting around with some of the top geek folks I know, including a few from Microsoft and we were talking about this exact same thing as we all realized the pace that technology all of a sudden was taking and how fast.  The geeks and the coders get this and sometimes the average consumer may not see it until later.  image

So the word here is that if you forget how to tie your shoes, its sounds like there’s hope on the way even for that with a USB mini port.!  One more in the barrel for digital literacy and the need to keep up I think!.  BD

We don’t usually cover shoe tech here on SmartPlanet, but if there’s one thing that we’ve learned, it’s that innovation comes in many forms.

American athletic apparel giant Nike has filed a patent for what appears to be a self-lacing shoe.

Officially referred to as an “automatic lacing system,” the innovation seems destined for the company’s iconic, tech-filled Air Jordan line of basketball sneakers.

Nike files patent application for self-lacing shoes - SmartPlanet

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Allscripts and Eclipsys Merger Complete–New Name Allscripts

9/01/2010 12:13:00 PM  , ,  

For identification purposes Allscripts is the leading name here and the products from Eclipsys have been added to the suite of available software. 

Misys Sells Allscripts Shares to Enable Eclipsys Merger – imageMedical Records

For a little more history, Allscripts is what is used for e-prescribing at the CVS Minute Clinics.  BD

CVS and AllScripts Collaborating on E-Prescribing – Minute Clinics Get Joint Commission Accreditation Award

Allscripts today will announce in a ceremony at the NASDAQ MarketSite in Times Square the completion of the merger of Allscripts-Misys Healthcare Solutions, Inc. with Eclipsys Corporation. The combined company, Allscripts Healthcare Solutions, Inc. (Allscripts), launches with a focus on helping healthcare providers nationwide collaborate through connected healthcare communities, enabling improved patient care at lower cost.

Allscripts is one of the largest companies focused exclusively on healthcare information technology, with over 5,500 employees and combined 2009 pro forma revenues of approximately $1.2 billion. It brings to market a complete portfolio of clinical, financial, analytics and connectivity solutions, and a client base of 180,000 physicians, 1,500 hospitals and 10,000 nursing homes, homecare agencies and other post-acute organizations – the largest network in healthcare.

Allscripts and Eclipsys Merge

f the business is going to continue with their financial interests.  The link below was from March of 2008 with the Misys-Allscripts merge. 

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Former FDA Commissioner, Dr. Andrew von Eschenbach Finds a Home on the Board of HistoSonics

9/01/2010 11:25:00 AM  ,  

This is an interesting technology as it uses sound waves to help fight the battle with treating urological cancer.  Last year it was announced that he also joined the “think tank” of Newt Gingrich.  image

Von Eschenbach Joins Newt Gingrich’s Think Tank – Add a Tiny Bit of Old Knowledge to a Lot of New Methodologies?

I thought some of the values over there we a little off base in a recent commentary.  BD

Newt Gingrich Gets Healthcare Value Bass Ackwards–It’s All About Those Algorithms

HistoSonics Inc. brought former Food & Drug Administration commissioner Dr. Andrew von Eschenbach onto its board yesterday.

The ex-commissioner's experience as a surgeon, urological oncologist and healthcare administrator made him a good fit, said the Ann Arbor, Mich.-based company, which is developing a treatment for urological cancer.

CEO Tom Davison said "[Dr. von Eschenbach's] commitment to safe and effective healthcare and especially cancer therapy aligns precisely with HistoSonics’ vision and long term strategy," in a prepared statement.

Ex-FDA commissioner joins board of Michigan cancer treatment firm | MassDevice - Medical Device Industry News

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Former Hospital CFO Charged With Fraud–Stealing from Danbury Health Systems

9/01/2010 11:15:00 AM  ,  

William Roe had been employed for 17 months for the health care system and apparently created his own consulting agency, Cycle Software, made out checks to the company and cashed them himself.  An audit revealed where the money was coming from and where it was going to.  I guess his salary of $300k a year was not enough?  BD  image

BRIDGEPORT, CN – A former chief financial officer for three different hospital networks is facing federal fraud charges for allegedly stealing more than $200,000 from health systems in Connecticut and Ohio.

William Roe, 54, of Wilton, Conn., has been charged with fraud and interstate transport of stolen funds in the misappropriation of $166,166 from Danbury Health Systems in Danbury, Conn., and $33,500 from Catholic Health Partners in Lima, Ohio. He had been employed by each health system at the time the fraud was alleged to have occurred.

Prior to joining Danbury Hospital in March 2009, Roe had been chief operating officer and CFO for the Moses Taylor Health Care System in Scranton, Pa., from 1998 to 2006 and CFO of the west central Ohio region of Catholic Healthcare Partners from 2006 to 2009.

According to the FBI, Roe also faces charges of defrauding Danbury Hospital out of $46,166 by altering the appraisal of his former home in Lima, Ohio, where he had lived before moving to Wilton to take the Danbury Hospital position. Danbury Hospital officials had agreed to pay Roe the difference between the appraised value of Roe’s house and what it sold for, officials said, so he allegedly boosted the value of the appraisal by about $70,000.

Former CFO in Connecticut, Ohio, charged with fraud | Healthcare Finance News

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Pfizer Buys FoldRx–Company Focused on Treatments for Parkinson’s disease, Huntington’s Disease, And Cystic fibrosis,

9/01/2010 11:04:00 AM  ,  

The bigger pharma companies continue with acquisitions and FoldRX focuses on imageniche disease cures in the neurological area.  Next year is when the patent expires for Lipitor and the company is looking for ways to replace lost revenue that will occur when generics become available.  BD 

Pfizer Inc.. agreed to buy closely held FoldRx Pharmaceuticals Inc. as it looks to expand into medicines for rare disorders.

FoldRx, based in Cambridge, Massachusetts, is focused on developing treatments for conditions caused by the improper folding of proteins, Pfizer said today in a statement. Financial terms of the deal weren’t disclosed.

The deal fits with Pfizer’s strategy of focusing on medicines for niche imagediseases, Geno Germano, head of Pfizer’s specialty care unit, said in a telephone interview. Pfizer set up a research division in June focused on developing medicines for orphan diseases, classified as conditions affecting less than 200,000 people. More than 30 million Americas have one of 6,000 orphan diseases, according to the National Organization for Rare Disorders.

Pfizer Agrees To Buy FoldRx in Rare-Disease Treatment Expansion Effort - Bloomberg

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Thomson Reuters Buys Healthcare Data Management–Acquiring Some Data Mining Algorithms for Employer Self Insured Plans

9/01/2010 10:10:00 AM  , , ,  

You know all these press releases are all looking the same today with the pre-imagefabricated marketing built in. I wonder sometimes if the writers of some of these think about the consumer and their care as the last thing that holds any interest here is “cutting edge data mining”  and “exciting developments” as an example.  What does that do for you as a consumer, does it mean anything?  We are in a world now where the reading material of today is not separated like it used to be and both investors and consumers are reading the same stuff.  If you read my blog often enough I try to bring awareness around about privacy factors and data mining so again the wording on some of these releases leaves a bit to be desired.  On a related topic was it “cutting edge technology’ that enabled Coke to cut off healthcare benefits to striking employees by using business intelligence to find the verbiage to give that a legal leg to stand on?

It just continues to show that the ethics and human side (i.e. patient) still gets left out in the cold but the big conglomerates want you to some how know that they care, do we believe this when we see “cutting edge data mining”?  I’m rambling here a bit about “common sense” what gets put out there today as if an employee of one of those firms read this jargon, does it mean anything?  The average consumer thinks more along the lines of what data do they have on me when it comes time to claims and insurance care. We certainly need auditing services today but on the same hand some of the same organizations that provide this service also make money from transactions so how many transactions that could be designated as potential fraud will actually be brought to light.  I wrote an opinion piece a few days ago pondering what is reality with analysis and what is addiction, trying to explain some roots with some help from reader comments. 

Data Addiction and Abuse –The Up and Coming Next 12 Step Program Is On the Horizon–Side Effects Include Lack Of Data Quality, Integrity And Spasmodic Algorithms

Reuters itself is a pretty large conglomerate with everything from reporting news to imageanalytics too.  The auditing and billing is by far one of the biggest areas to realize savings today, simply because we have built such a complicated system.  BD

From the website:

“Healthcare Data Management, Inc. (HDM) is the number one independent, provider of health benefits auditing and expense management reporting solutions for the self-insured employer. Our proven auditing solutions, paired with our cutting-edge data mining and industry-celebrated benchmarks, provide immediate and long-term savings to many of America’s leading employer groups. HDM works with corporations such as Ford, Harley Davidson, BMW, Kodak, Raytheon, Textron, Cingular, Royal Caribbean, and more to identify control issues, overcharges, and future savings. We collect, organize, analyze and monetize health plan data.”

We are pleased to announce that on August 31, 2010, Thomson Reuters, the world's leading source of intelligent information for businesses and professionals, acquired Healthcare Data Management, Inc., which is now part of the company's Healthcare & Science business.

This is an exciting development for Healthcare Data Management and one that will result in exceptional new value to your organization.

Both BenefitsWatch and BenefitsAudit will continue to be maintained as stand-alone, differentiated products, and we encourage you to learn more about them here. image

We welcome your continued patronage and invite you to discover the Healthcare & Science business of Thomson Reuters by visiting thomsonreuters.com. For a limited time, you may continue to access the existing Web site at hdminc.com or benefitswatch.com.

Existing customers with additional questions are welcome to contact your current account representative.

Employee Health Benefit Plan Audit Company | Healthcare Data Management, Inc.

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