The videos are actually very good and the second video shows the actual procedure and nipping the polyp, so if you have never seen one, Dr. Oz shared his.  The videos walk you through the whole process, even the first video is drinking that awful tasting stuff to clean out for the next day.  Lot’s of flush noises in that video   The preparation is not fun by any means. 

Dr. Oz Has Colon Polyp (Pre-Cancerous Growth) Found During Routine Colonoscopy–He Follows His Own Advice and Is A Good Role Model for The Rest of Us (A Rare Find Today)

Just follow the links below to watch each episode.  When this article says it’s behind the scenes, it really is and very informative.  BD 

Dr. Oz takes you behind the scenes of his routine colonoscopy and the shocking outcome he never expected: the discovery of a precancerous polyp. Watch Dr. Oz as he deals with the reality of his diagnosis and emphasizes the need for preventive screenings. Learn more about the test that saved his life and what you can do to save your own.

Click here to watch Part 1: Dr. Oz at home as he prepares for his first colonoscopy.

Click here to watch Part 2: Witness the actual procedure and the moment when Dr. Oz’s physician discovers the precancerous polyp.

Click here to watch Part 3: Dr. Oz’s physician delivers the diagnosis: an adenomatous polyp, the kind that would have likely developed into cancer if left undetected and untreated.

Click here to watch Part 5:  Dr. Oz discusses how colonoscopy is a major preventive measure in protecting your health and explains the colon cancer risk factors.

Click here to watch Part 6: See how colon cancer grows and spreads through the body, and how a colonoscopy is performed.

Dr. Oz's Colonoscopy, Pt. 4 | The Dr. Oz Show

Technorati Tags: Dr.Oz,colonoscopy,screenings,50,advice,healthcare,colon cancer,polyp,Dr Oz Show,Oprah,role models

The article states a tool designed by McKesson is the software of choice that many hospitals use to guide the decision making process. As a patient if you are kept for observation, given a bed, meal, etc. that does not mean you have been “officially admitted as an inpatient”.

The software is known as InterQual and recent filings with the SEC called it a “trade secret” – and what do we call this?  The algorithms that are trade secrets. 

There are other companies that make software that does the same thing and they patent their algorithms too so we don’t know exactly how this works.  Again  depending on the descriptions here, patients are not always told if they have been officially ‘admitted as an inpatient”.  Medicare requires patients to be notified but again if they have bed and meal, they think they have been admitted. 

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

Medicare requires a 3 day inpatient stay, so when patients are not formally admitted, they don’t pay.  In this example here, the patient ended up in a nursing home and a big bill, because they went from being under observation without an official inpatient status, and then they get a huge bill that is not covered.  If the patient is there for observation, they get outpatient benefits. 

Now from the hospital billing side, this gets confusing too with a biller making errors with billing inpatients when in fact the patient was there for observation.  Later on audits come in and guess what, fraud it detected. 

Doctors are complaining that this locks up the system and when patients need to be kept for observation it creates problems and again there’s the bill the patient receives too.  This is one more area you might inquire about as a patient too, ask if you are there for observation or if you have been admitted so you can figure out what you might be exposed to for additional billing.  BD 

After Ann Callan, 85, fell and broke four ribs, she spent six days at Holy Cross Hospital in Silver Spring. Doctors and nurses examined her daily and gave her medications and oxygen to help her breathe. But when she was discharged in early January, her family got a surprise: Medicare would not pay for her follow-up nursing home care, because she did not have the prerequisite three days of inpatient care.

"Where was she?" asks her husband, Paul Callan, 85, a retired U.S. Army colonel. "I was with her all the time. I knew she was a patient there."

But Holy Cross had admitted her only for observation. Observation services include short-term treatment and tests to help doctors decide if the patient should be admitted for inpatient treatment. Medicare's guidance says it should take no more than 24 to 48 hours to make this determination.

And unless patients spend at least three consecutive days as an inpatient, Medicare will not cover follow-up nursing home expenses after discharge.

"Under a set of rather arbitrary definitions, which are very vague and difficult to understand and apply, we have to decide who's an inpatient and who's an outpatient when sometimes the distinction can be two or three points in their sodium level or the amount of IV fluids they are receiving," he told CMS officials at an information-gathering session Aug. 24.

If the distinction isn't always clear to doctors, it's even more elusive for patients.

Growing Number Of Patients Find A Hospital Stay Does Not Mean They’re Admitted - Kaiser Health News

Technorati Tags: hospital,Medicare,CMS,inpatient,outpatient,patient,confusion,billing,medical billing,nursing homes

Overall Dr. Berwick is a breath of fresh air with innovative thinking and I hope he gets a chance to work on some of these long seeded problems with Medicare as it has been years since CMS has had a director.  I get the feeling that we have folks in Congress that prefer to keep stirring the pot rather than see if someone can make some progress here.  These are times like we have never lived through before so you can’t compare past performances of others to what we are dealing with today. 

Senate GOP Demanding to Hear From Berwick – Perhaps They Would Learn More About Healthcare if They Asked Some Intelligent Questions….

If he does not get confirmed by the Senate at sometime, his job runs out at the end of the year 2011 so what a pressure cooker situation with less than 2 years to jump in here.  Keeping the Senators happy and working on creating solutions to this big problem all at once is a big task, especially when the Senate is full of “non participants”.   I think he’s smart enough to realize we need some human touches in all of this and not just running a bunch of new software out there – we are up to our ears in hearing that and self included with too many scatterings with “innovation”.  A little more collaboration and working together in technology solutions would be a welcome change at this point.  Right now with role models this is about as good as we get, doctors texting while driving, congressmen using cell phones while driving and doing a radio show.   

Surgeon Frank Ryan Dies in Car Crash–Lost Control While Texting and Tweeting–Plastic Surgeon for Many Celebrities

At least we see Dr. Berwick with some technology in hand at times, which is more than I can say for others in administration and HHS, so perhaps there’s hope on the horizon with a good role model here.  BD 

WASHINGTON — Newly installed Medicare chief Donald Berwick, keeping a low public profile after encountering controversy over his appointment, is moving quickly behind the scenes to seed the US health care system with 100 to 300 sites to test new models of caring for patients.

In Massachusetts, private insurers such as Blue Cross and Blue Shield have begun expanding the use of global payments for the care of diabetes, high-blood pressure, and cardiovascular disease. Bay State political leaders, seeking ways to control costs in the Commonwealth’s pioneering health care initiative, are considering whether to expand the adoption of such systems.

Unless he can win over some GOP senators, who voted uniformly against the health care law, Berwick won’t be able to win a 60-vote confirmation in the Senate and will be forced to leave office when his recess appointment expires at the end of 2011

Medicare head pushes health care test sites - The Boston Globe

Technorati Tags: Berwick,healthcare,GOP,NHS,government,politics,Senate,Finance,Baucus,CMS

This program is for affordable healthcare for children.  Most of the counties affected here are in northern California or Mid-state.  I wonder if is is part of the effect of our California budget cuts being able to pay?  BD

Blue Shield of California recently announced it will no longer provide coverage for 15,000 Healthy Families patients in 15 counties. Effective October 1, the insurer is pulling its Healthy Families HMO product out of nine counties (Alameda, Marin, Placer, San Joaquin, Santa Clara, Santa Cruz, Solano, Sonoma, and Yolo) and its EPO product out of six counties (Butte, Kings, Madera, Merced, San Luis Obispo and Stanislaus counties).

Patients were notified of these changes in July and were given the opportunity to select a new plan. If they did not select a plan by the August 31 deadline, they were automatically transferred to the default "community provider plan" (CPP) for their county. Patients will have until October 31 to switch to another plan if they are dissatisfied with the CPP. For a list of available plans by county, visit the Healthy Families website.

Blue Shield pulls out of Healthy Families in 15 counties

Technorati Tags: Blue Shield,California,State Government,healthcare,budgets,Healthy Families

First of all if you are the biggest Medicaid prescriber I would expect more than 3 employees on staff.  In addition, they were not doctors and many charges were billed with patients not seen and when they were see, they were not physicians.  BD

Medicare Fraud – Criminals Do a Better Job With Filing Claims And Coding Than Providers

The problem with catching some of these folks is that they study the billing processes and bill better than real doctors, they know the data routine unfortunately.  BD

Sept. 7 (Bloomberg) -- The biggest prescriber of drugs for Medicaid patients in New Jersey ran a medical practice that used phony physicians to see patients, according to a Federal Bureau of Investigation arrest complaint.

Yousuf Masood, 46, billed Medicaid, the government insurance program for the poor and disabled, for thousands of visits by patients who either got no services or were seen by three employees who had no medical license and posed as doctors, according to the FBI complaint.

New Jersey Medicaid Doctor Used Non-MDs, FBI Says - BusinessWeek

Technorati Tags: FBI,New Jersey,fraud,Medicaid,CMS,medical billing

This is the 3rd year for this event and Michael Douglas has announced he will be there via a taped segment.  Other attendees will include Dr. Oz, Christina Applegate and more.  I have included some posts here and there on the Quack that give updates on where the money raised is going.  You can also visit the website to find out more and donate.

Stand Up to Cancer Grants Go to 2 Arizona Doctors and Their Teams to Turn Science Into Cures for Cancer

Unless you have missed the news he has been under radiation treatment therapy for throat cancer.  Ironically this month, his new movie, “Wall Street, Money Never Sleeps” is due out later this month. 

"Wall Street: “Money Never Sleeps"- “Greed is Good- Now It’s Legal – Its About the Game – Everybody’s Drinking the Same Kool-Aid” – The Move Trailer

We wish him the best on his recovery and will see him this Friday as the fund raiser will be broadcast simultaneously on all networks..  BD

In addition to the bevy of stars already signed up for this week’s “Stand Up to Cancer” telethon, actor Michael Douglas will also participate in the event, which will raise funds for cancer research.

The 65-year-old star of the upcoming movie “Wall Street: Money Never Sleeps” was recently diagnosed with a tumor in his throat, and is currently enduring a bout of radiation and chemotherapy. “It’s a fight,” he told People magazine of his treatment. “It knocks you out.”

Douglas, who will participate via a taped segment, will join previously announced stars Reese Witherspoon, Sofia Vergara, Christina Applegate, Michael C. Hall, Jim Parsons, Gabrielle Union, Seth MacFarlane, David Boreanaz and Mandy Moore for the hour-long program.

Michael Douglas will ‘Stand Up to Cancer’ – The Marquee Blog - CNN.com Blogs

Technorati Tags: Stand Up to Cancer,cancer,R and D,AACR,healthcare,grants,TGEN,Michael Douglas

Back in July of 2009 a judge ordered the unsealing of documents relating to how the drug was marketed, etc.  Pfizer who now owns Wyeth and all the related issues is disputing the report. DesignWrite, a medical communications company in Princeton, N.J., proposed to Wyeth a two-year plan that would include the preparation of about 30 articles for publication in medical journals.

Wyeth Used Ghostwriters - Video of the Premarin Horses

One of the biggest issues with the Women’s Health Initiative was the fact that the study rolled bio identical and the Wyeth drugs that are made from pregnant horse urine all into one category.  On this blog and in other places in the news we have all questioned the fact that there have not been any numbers comparing the two and perhaps Wyeth/Pfizer didn’t want this either?  Sales of Premarin and Prempro continue to decline.  Below you can see some of the discussions and links I had with Dr. Erika Schwartz about bioidentical hormones.

Hormone Therapy Said to Increase Risk of Ovarian Cancer – Were Bio Identicals Considered?

This is a good opportunity to mention a new documentary that is coming out soon and is available for screenings, Hot Flash Havoc, all about menopause and giving women the information they need to make decisions.  The Trailer for the movie is below and once I see the entire movie I’ll be writing more.

From the website:

“Hot Flash Havoc has brought together the leading experts in women's health across the United States to help unravel the confusion surrounding menopause and the controversial Women's Health Initiative (WHI). Our experts include doctors, clinicians, researchers, journalists, and women's health foundations. They are some of the leaders in the fields of Women's Sexual Health, Heart Health, Bone Health, Mental Health, and Physical Health. Since perimenopause begins in a woman’s mid 30’s it is vitally important for women to get educated sooner than later, thus empowering them to become their own health care advocates for the "Second Act" of their lives.”

The website also has a few other videos to see as well.  Again, more later when I have seen the entire movie and am looking forward to it.  BD

Hot Flash Havoc

(Reuters) - Drugmaker Wyeth used ghostwriters to play up the benefits and downplay the harm of hormone replacement therapy in articles published in medical journals, U.S. researchers said on Tuesday.

Dr. Adriane Fugh-Berman of Georgetown University Medical Center in Washington and colleagues analyzed dozens of ghostwritten reviews and commentaries published in medical journals and journal supplements, many of them using documents from judicial trials.

They said Wyeth, now owned by Pfizer, paid a medical communication company called DesignWrite $25,000 to ghostwrite articles on clinical studies, including four testing low-dose Prempro, the company's combination estrogen-progestin therapy.

Wyeth paid writers to promote hormone therapy: study | Reuters

Technorati Tags: bio identical hormones,Wyeth,Dr. Erika,healthcare,FDA,diet,wellness,Premarin,Estrogen,HRT,hormone replacement therapy,Woman's Heatlh,Women's Health Initiative,cancer,Hot Flashes

The product is safe for humans but deadly for these snakes who are taking over the island and this way they can catch up with the snakes when they munch.

The snakes are wiping out bird populations on the island is not a native of the island but more than likely was brought here on ships or planes.  It has no natural predators so the population just grows. 

The dead mice also have radio transmitters so they can track the dead snakes to see if this method of attack works.  BD

Guam–Snakes

Dead mice packed with acetaminophen, strapped to pieces of cardboard and dropped from helicopters may help control one of the big headaches for the Pacific island of Guam – the brown tree snake.

The U.S. Department of Agriculture last week began dropping the expired rodents packed with 80 mg of the generic equivalent of Tylenol on the forests of Naval Base Guam.

Since scientists discovered that the household pain reliever was deadly to the brown tree snakes, they’ve been trying to figure out how to get it to where many of the serpents live in the canopies of the island’s forests, according to a report in Stars & Stripes. The Tylenol-loaded mice are attached to two pieces of cardboard joined by paper streamers that snake exterminators hope will catch on tree branches, providing deadly snacks for snakes at those heights, according to the Stripes report.

Tylenol-loaded mice dropped from air to control snakes – This Just In - CNN.com Blogs

Technorati Tags: Guam,acetaminophen,mice,radio,brown snake,Tylenol,Brown Tree Snake

This is a large number of violations stacked up here by the State, 992,936 with a fine of 10k for each violation.  This could stand to be the largest fine in US history against a health insurance company.  United Health Group is appealing the process of course. 

When United took over Pacificare they stated they would maintain PacifiCare's workforce and relationships with providers.  Providers soon complained after the take over as claims were not paid timely, customer service suffered big time. I heard those complaints personally from office where I was consulting.  Seriously offices could not get answers and I over heard offices on the phone with their offices all the time.  United even came out and said they were going to get to be more user friendly. In Orange County, many employers are looking for new HMO contracts for their employees as the rate went up when converting over to a United policy from the old Pacificare and some hospitals won’t take Pacificare/United employer plans. 

Employers in Orange County Looking for New HMO Contracts as St. Josephs and Some Others Begin Cancelling Agreements with Pacificare (UnitedHeatlhCare) – Employer Capitation Contracts

I think in all honesty their problems were data related in combining the systems which is really not an excuse but this happens and is still happening all over the place. As sick patients, we don’t get any exceptions.  We also had the Ingenix Inquisition too with United and most all other major carriers using the Ingenix data base to pay doctors and consumers short on out of network charges, and this is only one case there’s a lot more filed all over the US.  Pacificare was part of this before and under United. 

AMA Announced Settlement of Class Action Suit of $350 Million with Ingenix (United Healthcare)

During the last 15 years most of the major health insurance carriers paid Ingenix to license the data base used for out of network charges so United made money both from consumers and other health insurance companies with the data base that “low balled”

Ingenix Data Base Has Some Long Reaching Legal Tentacles with Aetna, Blue Cross, Blue Shield, Humana

Headlines from 2008:

State intervenes in PacifiCare coverage dispute

United/PacifiCare fined record $3.5 million

With all of this said, there’s room for some fines for not taking care of business how much and what is up to the courts. 

IT’S ALL ABOUT THOSE COST EFFICIENCY ALGOIRITHMS THAT MAKE DECISIONS TO DRIVE PROFITS. 

Health Care Insurers Suggest Algorithms and Business Intelligence solutions to provide health insurance solution

Insurers live and die by the algorithms and United owns Ingenix who can develop some whenever needed. 

I think the stuff that really works on public impressions too are what happens at board meetings with no holding a limit on what executives are paid and no concern over how much they want to spend on lobbying as the board says go for it. 

UnitedHealth Shareholders Say We Don’t Care What Executives Earn and What Is Spent on Lobbying – Go For It

It is important to pay attention to their subsidiary actions too as this is shaping many of the directions where the company is headed to ensure profits and expand upon if possible.  The link below summarizes some of this in a prior post.  BD

UnitedHealth Group 2nd Quarter Profits for 2010 Rose 31% – Expects Revenues of 93 Billion for the Year

The health insurer violated state law nearly 1 million times from 2006 to 2008 after it was bought by UnitedHealth Group, the Department of Insurance says.

California regulators are seeking fines of up to $10 billion from health insurer PacifiCare over allegations that it repeatedly mismanaged medical claims, lost thousands of patient documents, failed to pay doctors what they were owed and ignored calls to fix the problems.
In court filings and other documents, the California Department of Insurance says PacifiCare violated state law nearly 1 million times from 2006 to 2008 after it was purchased by UnitedHealth Group Inc., the nation's largest health insurance company by revenue.

The state's accusations are spelled out in documents filed with a state administrative law judge who has been hearing testimony intermittently since last December. At the conclusion of the Oakland hearing, the judge will decide whether to recommend penalties.

California regulators seek up to $10 billion in fines from PacifiCare - latimes.com

Technorati Tags: PacifiCare,United Healthcare,health insurance,branding,HMO,Orange County,rebranding,St. Josephs Hospitals,algorithms fraud,subsidiaryies,capitation,contracts

The advertisements say you never have to wear a bra again.  So far the FDA has not granted approval but in western Europe it seems to be taking off a preferred method for uplifts.  A woman needs to be beyond child bearing age.  The website has a full display of media to include videos and other newspaper articles.

The Breform is a permanent implant and can be removed and it uses a mesh scaffold for support. The article states there’s no loss of feeling.  BD 

From the website:

“The Breform™ Mastopexy
This operation is indicated for droopy breasts of normal size and can be performed under general anesthesia. The resulting scar in most patients is limited to the nipple (peri-areola) but in patients with poor skin quality or excessive skin, may also be underneath the nipple and in the fold beneath the breast (infa-mammary crease).
The Breform™ Reduction
The Breform™ breast reduction procedure was developed to assist the conventional reduction procedure as the breasts relied on the skin to maintain the shape and weight of the breast; as well as leaving the patient with dramatic scars. By introducing the Breform™ internal bra system, the surgeon is able to eliminate both these problems.

Polyester, a tried-and-tested, biocompatible synthetic material, is one of the oldest implant materials and has been used in cardiovascular and other surgery for over 40 years. More recently, it has found its place in cosmetic surgery as an excellent material for permanent soft-tissue augmentation. This non-absorbable material will remain within the patient’s breast for the rest of her lifetime, offering her a permanent internal support.

Polyester is not biodegradable and its surgical results are permanent. In addition, no allergic reactions have been reported.”

Breform, an invisible mesh bra, is a new breast lift procedure. American women looking to eliminate the sag that happens after many years of life and child bearing may consider going overseas to have this new procedure done.

A mammogram is needed before the procedure can be done, and age can play a factor of whether or not you are a candidate. Only six doctors are trained in the procedure in Great Britain.

Breast Lift by Breform Invisible Bra - But not in US | Business & Finance News

Technorati Tags: Breform,Masopexy,breast reduction,breast lift,implant,procedure,Europen CE mark

This seems to be quite a long series of messages via text and phone calls.  The female patient told his wife and the patient had threatened suicide if he stopped.  The doctor is 65 and the patient is 26. 

Strangely enough the doctor treated patients for drug and alcohol addictions and the article also said he had stopped seeing the patient before the phone sex began.  Eventually they met in person but never did commit the the act but lot of petting and other items were mentioned here.  BD

ALBANY - A Long Island doctor who treated patients with drug addictions got hooked on having phone sex with one - and later told his wife, state health officials say.

A Health Department disciplinary committee found that Dr. Michael Eisenberg, 65, engaged in an "abusive," two-year relationship with a woman sent to him for treatment for alcohol abuse.

The panel declared him morally unfit to practice medicine and stripped him of his license.

"The overwhelming evidence in this case clearly establishes that Dr. Eisenberg engaged in a sexual relationship with a very ill patient and that this act did her harm," the panel said in a report.

Investigators said Eisenberg and the patient - who was 26 when she first saw Eisenberg - exchanged nearly 2,200 "personal and or sexual telephone calls" and approximately 12,000 text messages from January 2007 through September 2009.

Long Island doctor Michael Eisenberg loses medical license over phone sex with patient

Technorati Tags: doctors,addictions,medical license,patient,relationship,cell phone,text messages

I’m going to use some experiences that my 86 year old mother had this week with phone calls from both entities.  She’s a diabetic and has been for around 12 years and thus so is tuned in to taking her blood sugar readings every day and she does it like clockwork.  She also has a good record of getting in for her appointments for her annual physicals and breast screenings. 

A couple weeks ago she received a call from her Medicare Part D insurer reminding her that it is time for her annual physical.  She knew this already and we talked about it a couple weeks ago.  There’s nothing wrong with getting a reminder phone call and I understand where all of this is coming from, especially with healthcare reform and no co-pays required. What became a little less than tolerable though with the phone call was the insistence of the caller wanting to make a conference call and make her appointment for her.  The called asked if she would like to have her make the appointment for my mother.  When my mother said she preferred not and that she would call and make her own appointment, this is where the pressure cooker turned on.  Mom had one heck of a time convincing her that she would call and make the appointment and was brow beat over and over on how the caller from the health plan would do this for her, almost to the point of not accepting ‘no” for an answer. 

This is a bit heavy here to me as if the caller could see she is up to date on everything and does what she is supposed to do. This makes me wonder if the callers are on “pay for performance” for every appointment they make?  I know this stuff goes on with either a bonus or an evaluation on how successful they are with doing this job.  I spent over 25 years in sales and marketing and that is how some of this comes about.  Pay for performance is coming out our ears!

Tenet Signs National Agreement with Cigna – Hospitals To Receive Higher Compensation When Pay for Performance Quality Metrics Are Met

Shoot ask any MD about pay for performance in this area and they can tell you some of what they get too, i.e. they get drug over the carpet for patients not filling their prescriptions when in fact they have, but may have chosen a $4.00 generic source and have not used their “prescription” plan and by doing that actually saved money.  Insurers have some new algorithms and those spark new business model programs for compliance.  MDs also get bad nicks on their pay for performance for failure of dead patients who have not had their annual mammogram.

What are we doing with all the data we have?  We still need help and direction with many in knowing how to use it constructively  and productively. 

Health Net Creates Additional Performance Algorithms by Contracting With MedeAnalytics

This just rubbed me the wrong way for a caller to be so insistent and pushy.  Let’s move on to the next 2 compliance phone calls here.  She gets her diabetes strips from Walgreens who also called her.  Again as I mentioned above she’s been a diabetic for years and does her testing as she should, and does it twice a day, but the pharmacy said she needs to do it 3 times a day.  The pharmacy also said they had her next prescription ready for her too.  To this she said, hold off as I am getting too much and I don’t want to have too much on hand that might expire before I can use it.

Walgreens was basing their prescription refills and her needs on 3 times a day when in fact she does it twice a day.  They finally worked with her to let Mom get her own refills “when she needs them” but the caller on the phone was adamant about doing her readings 3 times a day.  

Translation: Mom is messing up the automated system her by doing it twice a day instead of 3 times a day I think <grin>.  They may or may not have a parameter that can be added for twice a day, either that or it requires someone in a supervisory position to make that change or a programmer to add it as a selected choice for the patient based on communications.   I realize working with data how automation is set into motion based on parameters.  if you miss your screening, Walgreens has buses running out there to help patients too.

AARP and Walgreens Sending Out a Fleet of Buses to Offer Free Screenings

Phone call number 3, which is also like 1 and 2 is unrelated.  This phone call comes from her healthcare provider again checking in with her medication requirements and they said twice a day is sufficient for her to take her readings and she told them about the pharmacy insisting she needed to do this 3 times a day. 

Now I know the three new words with medications is compliance, compliance, compliance, but when we have folks working in a pool of compliance phone call employees calling, let’s get on the same routine here if we can.  It’s things like this that make the whole system look stupid, and it is stupid.  So far, we have not heard from her mail order pharmacy but who knows they could be next.  At this point she is ok without having to hear from them too. 

On her physical, if they want to call back in a couple weeks if their data would not show an appointment being made with her doctor that is fine.  Knowing Mom though that will not be necessary, but I also understand everyone is not Mom and doesn’t follow the rules like she does. They actually made her feel bad and she resented the pounding and insistence of all this information all the way around from the drug store to the healthcare insurer.  Some pharmacies allow the pharmacists to collect pay for performance money too, but lucky Mom at this point United is not her carrier so hopefully this program will pass her by at 86 as she’s not physically able to be working out at the YMCA. 

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

Is there not a better way to do this I ask?  Can we all get on the same wave length and not badger the patients?  We have always worked through our doctors for all of this and I think that method is the best. 

By the way, at 86 years old Mom does her refills online and is right up to par on this as it is easier for her that way.  Seniors are into using the internet for convenience too so don’t think that doesn’t happen just due to age.  She also has a PHR with HealthVault too and granted I helped her out there but who cares she has it and knows how to pull it up if she needs the information.

I used Mom as an example but she is not alone in this as others will be getting the same so some courtesy and less pressure for compliance to meet their internal performance goals would be nice.  This is still the human business and it still pays to “listen” to the patient before jumping off a limb to be the “Shell Answer man” to dictate rather than advise with patient care. 

Shame on all these callers with lacking some common human sense and the ability to listen and shame on those directors who push these individuals to work and react in such a fashion – business model needs improvement.  BD

Technorati Tags: AARP,Walgreens,healthcare,bus,screenings,obesity,BMI,cholesterol,blood pressure,marketing,drug stores,heatlh,diabetes,insurance,Medicare Part D,Compliance

I talk a lot about our serious lack of role models today, not only in healthcare but in other areas of government and Dr. Oz certainly stands to defy what we get a daily dose of with the usual attitude and paradigm of “its for those guys over there’. 

He just recently turned 50 and went in for the suggested colonoscopy upon reaching that age. On September 7th, he’s slated to discuss more on his show.  He has a way with utilizing television and other medias to get his message across and sometimes it involved humor and is extremely funny, but we get the message. 

Dr. Oz Visits Jimmy Kimmel and Discusses Nutrition, Obesity, Size and Gives a Few Impromptu Exams (Videos)

So much of what we hear is critical and judgmental like this post below to where those who are making such statements are actually the pots calling the kettle black as we never hear about how they value healthcare technology and nothing about their own experiences, but that’s the world of self righteous politics where they have not learned how to share yet, just pass judgment on others.  Stuff like this in the news does little to help others and just continues to show what a bunch of non participants we have in Washington when it comes to healthcare technology too.

HHS National Plan to Improve Health Literacy – Not Going To Happen Until We Focus on Using Technology (The Tool for Literacy) Which Includes Role Models at HHS And Other Places in Government

This is pretty typical of what we hear and see in the news with this Congressman being a prime example of thinking that his radio show was so important he couldn’t even listen to what the rest of the world is saying about cell phone uses and gets pulled over while on a live radio show – big non participant and a real dog for a role model for sure. 

US Congressional Representative Gets Pulled Over for Using a Cell Phone While Driving And Was Live on the Air Doing Radio Interview

One of my favorite segments he covered was on the Oprah show with regenerative medicine where he walks us through Wake Forest and shows all what is going on there, and even to his own amazement he was astonished at how far this technology has come with people walking around with bladders grown in dishes from their own stem cells. 

The Oprah Show – Dr. Oz Explores and Explains Regenerative Medicine

This was great that Dr. Oz is taking the time out to share as he does everything right and he still was hit with the polyp, so it goes to show that nobody is exempt when it comes to healthcare and screening and again, hats off for taking the time to share, he gets social medial by all means, and too bad few in government get it. 

You can read and view more information at Dr. Oz’s Blog.  He stated it was an unexpected awakening and by sharing it’s a wake up call for all.  BD 

Dr. Mehmet Oz has always been outspoken about the importance of living a healthy lifestyle. So when the TV host, who boasts that he "always" takes his own advice, went in for a routine colonoscopy after his 50th birthday this year, he never imagined he'd have anything to worry about.

But during the examination, his doctor found an adenomatous polyp, or precancerous growth, inside his intestine, which if left behind, could have likely become colon cancer.
"This was a shakeup for me," Oz tells PEOPLE. "I have done everything right. I don't have any family history, and yet I'm high risk now."

Dr. Oz Has Colon Cancer Scare - Health, Dr. Oz : People.com

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The group has actually been conducting the FDA approved testing since 2004.  Other countries have studies doing about the same thing.  So far since 2004, 21 patients have been treated in the study.  The funding for the study comes from the Multidisciplinary Association of Psychedelic Studies. 

There will be a screening process for applicants to go through.  The group is also working to get the Department of Defense involved in the study as well.  BD 

A pair of psychiatric experts think they’ve got the answer to the soaring number of troops coming back from war with PTSD: have them undergo intensive psychotherapy — while they’re rolling on ecstasy.

Dr. Michael Mithoefer and Anne Mithoefer, a psychiatric nurse, are the South Carolina pair who’ve been spearheading research into ecstasy, known clinically as MDMA, since 2000. After one successful study on 21 PTSD patients between 2004 and 2008, they’ve now received the final okay from FDA and DEA officials to start a study entirely devoted to former military service members.

“My sense is that, especially after we published the results of the first study, these institutions are more open to the idea,” Dr. Michael Mithoefer tells Danger Room. “Obviously, this is still new and experimental, and it can take time to get through to big institutions.”

Vets Get Ecstasy to Treat Their PTSD | Danger Room | Wired.com

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This is something that is needed like now.  I also posted about a movie that is coming out that discusses DDT and the desire to bring the chemical back and discussed the potential dangers and non dangers associated along with the decision to stop DDT back in the Nixon administration.

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

Malaria and the cure has also been a big focus for the Bill and Melinda Gates Foundation.

Bill Gates - an optimist and a comedian – Fills the Room with Mosquitoes at TED

After some very extensive research  NITD609 was identified as a potential drug candidate. Plasmodium falciparum and Plasmodium vivax have been conquered the drug resistant strain of malaria we are seeing today.  Genomics research from the Scripps Research Institute played a major role in this investigation.

Scripps, Navigenics, Affymetrix and Microsoft team on groundbreaking health study – Personalized Medicine

A little information from the recent past above with Scripps using various technologies with genomics to include HealthVault personal health records to store a lot of their information derived from studies too.  BD 

An international team of scientists plans to begin clinical trials for a new malaria vaccine later this year.
Researchers from The Scripps Research Institute, the Swiss Tropical Institute, the Genomics Institute of the Novartis Research Foundation and the Novartis Institute for Tropical Diseases revealed their findings in the September 3 issue of the journal Science, according to HealthCanal.com.
Elizabeth Winzeler, a Scripps Research associate professor and member of the Genomics Institute of the Novartis Research Foundation, told HealthCanal.com that she was excited by the new compound.

After initially finding 275 potential candidates, Winzeler was able to narrow the field to just 17 that could be effective and safe for humans. After looking at the toxicity and pharmacokinetic profiles of those, one compound stood out as promising. It belonged to a chemical class of molecules known as spiroindolones. Spiroindolones had never before been associated with malaria.

Clinical trials to begin for new malaria vaccine | Vaccine News Daily

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The drug is just barely off and running and the treatment is not inexpensive by any means and according to this notice put out by the FDA, they want additional information at CMS on how stroke victims are affected that have received the drug so this appears to be further exploration into the world of immunotherapy treatment to determine what effects and benefits are potentially available with strokes being on the list.   

Dendreon Announces CMS Evaluation of Provenge for Late Stage Prostate Cancer Patients

As I wrote back in March before the approval process took place, part of the evaluation from the FDA included looking at their sophisticated tracking system called “Intellivenge”. 

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

Dendreon uses a sophisticated tracking system with bar coding to ensure the correct blood is returned to the right patient after the incubation process.  This is important as someone would not want the blood from another patient, although I read it would not be fatal, but rather not as effective but still no room for error here. 

This is a brand new class of drugs and It appears to be a good question to find out what other uses and benefits may be derived with measuring additional potential benefits.  BD 

The Centers for Medicare and Medicaid Services (CMS) has called this meeting to consider the currently available evidence regarding the impact of labeled and unlabeled use of autologous cellular immunotherapy treatment on health outcomes of patients with metastatic prostate cancer.

As described on the FDA website at http://www.fda.gov/BiologicsBloodVaccines/CellularGeneTherapyProducts/ApprovedProducts/ucm213559.htm, “PROVENGE® (Sipuleucel T, APC8015) is an autologous cellular immunotherapy product consisting of peripheral blood mononuclear cells (PBMCs) obtained from patients by leukapheresis and activated in vitro with a recombinant fusion protein (prostatic acid phosphatase fused with GM-CSF). FDA will require the sponsor to complete a post marketing study to evaluate the risk of stroke in patients who receive sipuleucel-T.”

Provenge® has FDA approved labeling for the treatment of asymptomatic or minimally symptomatic metastatic castrate resistant (hormone refractory) prostate cancer.

Centers for Medicare & Medicaid Services

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Hospitals are investing in robots and if you read this blog often enough, you have seen several posts on this topic and under the related reading below there’s a brief summary.  Their use though is also growing beyond just the hospital as this story in the New York Times shows how the CEO of Mozilla attends meetings via a Tele Presence Robot.  Over the last few years we keep hearing about how expensive it is for a person to physically travel to meetings and conventions.  Is your CEO thinking about this? 

Tele Presence Robots for Remote Workers – Invasion of the AnyBots

This hospital received accreditation from the Joint Commission to be a “stroke center” with using the robot and being able to tap into a facility like UCI or a number of other hospitals to have an interventional cardiologist available immediately.  They are using a robot from a company called “InTouch Health” and we have seen their robot at UCLA, Johns Hopkins and many additional places. 

Robots at Work in Orange County Hospitals - California

When you think about bad weather, and other disruptions with multi tasking CEOs today, is this the next glimpse you get and how the future communication with officers of companies is going?  There are robots for home monitoring for seniors too and the article below has a robot video that really reminds you of the old Jetsons cartoons with “Rosie”. 

New CPT Codes - Billing Codes for Robot and Home Monitoring Services – Telemedicine

Now this is where things get real interesting as the use beyond doctors is growing.  As mentioned above the CEO of Mozilla uses the technology for his meetings.  The robots are smart enough to know when to return to their charging stations too so if you are looking to stay outside the radar, the battery packs are where the power lies. Chances are too that they are also smart enough to send an alert out if anyone is messing around where they should not be.  You do have to open doors for these guys too.

The big selling point here is that tele conferences need to be set up in advance and with the robots the officer just logs on and sets the robot in motion. 

This video is interesting as it shows all types of robots that are work in progress.  The robot for termite exploration is interesting. How we as humans adjust and react is something we don’t quite know and understand yet, self included here of course.

Robots

The folks over at the XPRIZE foundation did a video to show how people react when the the boss shows up remotely and shows what he sees at the other end via the camera.

XPRIZE

In a hospital this could really get interesting as we already have robo doctors floating around so add in some administrative tele presence here with the CEO or board members cruising through and you may never see them in the flesh again <grin>.  Someday it could be just a meeting of the robots while the humans stay at home, but again one human is needed to open the doors for them, but who knows that may be next.  A simple mouse or joy stick is all that is needed to control the robots remotely.  BD 

Dr. Shatzel, a neurologist, hustled not to the emergency room where the patient lay — 260 miles away, in Bakersfield — but to a darkened room at a hospital here. He took a seat in front of the latest tools of his trade: computer monitors, a keyboard and a joystick that control his assistant on the scene — a robot on wheels.

He guided the roughly five-foot-tall machine, which has a large monitor as its “head,” into the patient’s room in Bakersfield. Dr. Shatzel’s face appeared on screen, and his voice issued from a speaker.

Related Reading:

Military is Using Robotic Doctors too

Robots at Work in Orange County Hospitals – California

All Terrain Medical robot in development for the battlefield

Robodoc' coming to a hospital near you

Remote-Presence Robot Attends Patients at Ryder Trauma Center

Doctor monitoring via robot effective

Johns Hopkins demonstrates Robo Doc...

Remote-Presence Robot Attends Patients at Ryder Trauma Center

How technology is helping hospitals - UK

Doctor monitoring via robot effective

Johns Hopkins demonstrates Robo Doc...

Smarter Than You Think - The Boss Is Robotic, and Rolling Up Behind You - NYTimes.com

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15% off scrub tops with code "top_value"

One again I thank ScrubsGallery for their continued support of the Medical Quack Blog.  Each month they offer a discount for readers and you can use the link in the image above to take advantage of the discount offered this month.

Next time you need to order scrubs or other healthcare apparel, please check out their website and compare. 

 

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Well we are getting a lot closer to the brain with treatments for sure and this same treatment has been used for severe cases of epilepsy.  If it works well and is safe, it certainly would seem to be an improvement over a large dose of drugs on a daily diet. 

UCLA has an exclusive worldwide license for the TNS with NeuroSigma, a Los Angeles–based neuromodulation company.  In 1997 the FDA approved the process for epilepsy and now in trials for depression.  As you read through here there were 2 different options for patients, one was to sleep with a device for 8 hours and the other option was to have miniature subcutaneous electrodes implanted under the skin.  80 percent had positive results with their depression in the results published relative to the trial.  If the economy keeps going the way it is, there could more of us standing in line for this soon <grin>, but again if it works and gives an alternative to being somewhat zoned out on medications then we might see real growth in a few years.  BD

In a recently completed clinical trial at UCLA, trigeminal nerve stimulation (TNS) achieved an average of a 70 percent reduction in symptom severity over an eight-week study period. The study’s principal investigator, Dr. Ian A. Cook, the Miller Family Professor of Psychiatry at the Semel Institute for Neuroscience and Human Behavior at UCLA, presented the results at a recent National Institutes of Health conference on depression and other psychiatric disorders, noting that 80 percent of the subjects achieved remission, a highly significant result in this pilot study.

TNS is not new to UCLA. It was pioneered for treatment-resistant epilepsy in humans by Dr. Christopher M. DeGiorgio, a UCLA professor of neurology. The results of a positive 12-patient feasibility trial in epilepsy were reported last year in the journal Neurology. A larger, double-blind pilot epilepsy clinical trial is underway at UCLA and the University of Southern California.

The stimulator that was used in the depression clinical trial is about the size of a large cell phone. Two wires from the stimulator are passed under the clothing and connected to electrodes attached to the forehead by adhesive. The electrodes transmit an electrical current to the nerve. All the patients in the trial used the device for approximately eight hours every night while asleep. In contrast to antidepressants, no major side effects were noted.

Non-invasive therapy significantly improves depression, UCLA researchers say | BreakThrough Digest Medical News

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