FDA Scientist Complaints Are Not Allowed–2nd Time Rejection To Be Heard

There are some very good points here and the recent radiation news is the perfect example.  In their complains, scientists complained they were coerced and pushed to giving approval to many areas.  Software is coming into play more and more with medical devices and this has changed dramatically in the last few years, and ensuring software is going to work properly is a very big deal.  I can’t figure out in the news we read today as to why their complaints were not given at least an opportunity to be fully heard.  Having written my share of software that part of the process I understand well and you can’t be too careful and extra measures to ensure it works properly is not out of line. 

On some occasions, the decisions of the scientists were over ridden by documentation.  I think they should at least be heard and see what reservations they had as this makes no sense to not let them speak up, as we could stand to learn from this and perhaps even come up with some ideas for approvals.  I know the FDA is a busy place and is transitioning like crazy, but back as around 3 years ago, the agency had employees working where they did not even supply them a computer, with studies still being written in long hand.  I think in the last 2 years there has been a big fix in this area but still, as a consumer, I would like to hear what the scientists have to say.  BD 

Nine current and former scientists from the U.S. Food and Drug Administration's (FDA) medical device unit have filed complaints against the government agency related to the safety of medical devices. And for the second time these complaints have been thrown out by federal officials.

The scientists say they dealt with harassment and intimidation because they had concerns over FDA-approved medical devices. According to a Natural News story the scientists’ complaints were thrown out without any kind of investigation.
According to several reports, the FDA scientists went public with their concerns about the safety of new medical imaging devices that give a heavy load of dangerous radiation to patients.

They were very concerned with new computed tomography (CT) scanning machines that are being used on healthy individuals to screen for prostate cancer. The scientists say these new machines expose individuals to unnecessarily high levels of radiation.

These same devices are said to be the cause of hundreds of radiation overdoses from this past year.

And while all of this corruption is taking place the FDA sits there telling us that the new imaging machines are safe when used properly. What balls they have!

FDA won’t allow complaints from medical scientists | TG Daily

Technorati Tags: FDA,scientists,radiation,harrassment,medical devices,healthcare,software

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HealthNet in Connecticut to Lay Off 750 Employees as United Healthcare Takes Over Membership In the Northeast

This all happened back in September of 2009 and now as contracts expire and are not renewed with members moving over to United Healthcare, the jobs are going.

United HealthCare Purchase of HealthNet in the Northeast Did Not Include Transfer of Employees

The behemoth keeps growing.  The sale all happened pretty quickly while the Tri-Care contract bidding was going on and as soon as it was announced that Healthnet lost the northeast, then the sale took place but as it turns out the contract awards were not that simple either and as I last heard I think Healthnet kept it as they decided Aetna cheated with a conflict of interest.    United paid $500 million for the purchase. 

UnitedHealthCare Buys a Portion of Health Net in the Northeast

HealthNet Will Keep the Tri-Care North Contract – GOA Investigated the Original Award to Aetna

I still get confused at times with the United name on whether it is United Healthcare or United HealthGroup, where the care has disappeared.  Just today though Jeffries was a little concerned over all the acquisitions and the legal exposures of their subsidiary Ingenix though.

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

 

Healthnet Layoffs

Also in the news I read where United gets an award from Milliman, and that’s one of those companies, like their own, Ingenix that makes money selling your prescription data, so no wonder they think such achievers.  You can read the statement from Milliman about Intelliscript here.

Business is still slow for hospitals and even Mayo signed up with a national agreement with United recently so they can enjoy “in network” charges at their facilities.  This is not say whether or not this included “employer insurance” plans as we have St Joseph’s in Orange, California who won’t take that brand through employers but honors other United Plans. You won’t even be able to dodge these folks a geek events either as you can see they are a big sponsor now at CES. 

Going to CES This Year–Health Insurance Carrier United HealthGroup Enters Sponsorship Arena

Let’s also not forget their subsidiary acquisition in China to promote Chinese Medical Devices and Drugs globally and here in the US so we might have an idea what direction this might be going as they are known for driving down cost any which way they can, so perhaps drug companies in the US as well as us will feel the pinch, but maybe not too bad as many of them have companies or interest in China already, but doesn’t do much for our jobs I here I don’t’ think. 

UnitedHealth subsidiary (Ingenix Subsidiary I3) Acquires ChinaGate – Working to Sell Chinese Products Globally

From the China Gate website:

“We are familiar with the Chinese regulatory system and are well connected with most of the top urban class A  hospitals and clinical trial centers that are GCP certified by the China State Food and Drug Administration (SFDA). Moreover, since we worked many years in multi-national pharmaceutical companies ,we are well versed in ICH, European and United States Food and Drug Administration (FDA) requirements on Good Clinical Practice (GCP).

One more item of note, they also have a bank with over 1 billion on deposit through health savings accounts so the investment bankers even on Wall Street don’t get a lot of this action directly but it could be rolled on the market though. 

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

How did they do all of this, with those algorithms that Ingenix produces and has produced for years, all mathematics on how they made their money and we all remember too where the former CEO ended up with the SEC investigation; however he’s back out there now with a position at a private equity firm, keep your eyes open as these folks want to own everything it looks like and even through subsidiaries they get money from other health insurance carriers like the out of network settlement from the AMA where doctors where short paid on out of network charges – compliments of those algorithms. 

Perhaps now someone might comprehend why I think Congress better hire some Algo Men quickly as the Algo Men at United seem to outsmarting everyone along the line and making huge profits and taking them to the bank and it gets bigger every quarter.  Wendell Potter keeps telling use as he worked in the business for years and knows the Algo Game.

More Congressional Testimonies About Health IT–Members of Congress Could Entertain Getting an “Algo Man” on Staff As Wall Street and Health Insurers Have Them–Don’t Leave Home Without One

These are good links in this post if you want to read up on more history so until we get to be somewhat equal with technology, you and I go to battle with swords and daggers and United has the equivalent of machine gun technology and all the acquisitions and profits to prove it.  BD

Health Net of the Northeast will lay off 750 workers between January 2011 and March 2012 as it closes its Shelton office, a state filing shows.

Health Net announced last year that it planned to stop offering health insurance in the Northeast, and it sold its membership rolls and licenses to UnitedHealthcare.

But the affect on employment in Connecticut wasn't entirely clear until the health insurer filed figures under federal law with the state Department of Labor.

"We have actually hired some Health Net employees already since the transaction was first approved," said UnitedHealthcare spokesman Daryl Richard, noting that the company employs about 4,000 in Connecticut.

The company's departure from the Connecticut market leaves five major health insurers: Aetna, Anthem Blue Cross and Blue Shield in Connecticut, CIGNA, ConnectiCare and UnitedHealthcare.

Health Net To Lay Off 750 - Hartford Courant

Technorati Tags: algorithms,data,hospitals,health insurance,state laws,government,United Healthcare,Ingenix,healthcare reform,patients Not Profit,Healthnet

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Capitalism Problems with Research and Poverty–Bill Gates at mHealth Convention

In a prior interview Bill Gates said we are spending money insanely and you almost have to agree with this as with this blog I see money being thrown so many different directions.  He delivered the key not at the International Healthcare Wireless convention.  The needs of the poor are not being addressed and he mentions the “human” element that sometimes gets missed with capitalism.  He fears cuts will be eminent with government this year. 

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

Mr. Gates know where technology is going and gets the concept of modeling with software for creating drugs before jumping to the expense of creating actual labs.  This is a good perspective here on how this works.  He also gives credit to the UK for their staying power with money dedicated to research. 

Bill Gates has also invested in technology to keep the cost of research affordable.  BD

Bill Gates Invests In Software Company That Predicts and Helps Generate Creating New Drugs

Bill Gates on Tuesday said capitalism has "systemic" problems when it comes to research, science and poverty, and that's where governments and charities must step in.

The Microsoft co-founder and chairman spoke at the mHealth Summit in Washington, D.C. As is the norm these days, he was speaking as co-chair of the Bill & Melinda Gates Foundation.

"Capitalism does amazing things," Gates said, "but it has one systemic problem in therms of research, in that it doesn't do enough. It has another systemic problem in that the needs of the poorest will not be prioritized the way they would if you put a more human-values-driven system in.

Gates: Capitalism has 'systemic' problems with research, poverty

Technorati Tags: Bill Gates,Healthcare,disease,marlaia,Technomy,busienss models,tools,software,design,data,information,predictions,innovation,education,Microsoft,mHealth

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Problems with Using Accounting Statistics Without Projective Algorithmic Process Modeling-Cut Spending Without Viewing Alternative Models- IT Literacy In DC?

Yes I read everything that was in the news like everyone else did yesterday and this is my take on this situation.  I keep saying these folks on Congress need some “brains” or what I call Algo Men to help them before taking an immediate stance and coming out in public with items as such which is not what the American public wants to hear, me neither. 

Granted everyone might want to hear what new plans and alternatives are but my question here is did they take time to explore any of this?  I think this is a big question too and I base my reserves here on the fact that the GOP mission was created in a pdf format where the producers of the document were not savvy enough to remove their names, staff members that were former lobbyists for big corporations.  Rachel Maddow had the big story on this one with images and names.  Again, how in the world can effective laws be created and intelligent stands be taken without this today.  Wall Street certainly doesn’t function this way at all, and they have all the money, so what’s up with this?    How can you regulate a business you don’t understand?  The link below has the entire details and video and below are a couple paragraphs from the original post from a few months ago.  Wall Street hires the best Algo Men around. 

The Properties of an Adobe pdf Document -Rachel Maddow Rips the GOP on Lack of General Consumer IT Knowledge And Exposes the Input and Authors of the Content–Lobbyists

“She talks about the GOP Pledge and the pdf format that was used for the original presentation.  We all deal with pdf documents all the time and she of course brings something forward we all probably use, “right click’ properties.  The properties show the some of the folks who created input here to include AIG, Pfizer, some oil companies and others so it appears they all had input and this is the Republican pledge that came from a staffer who was formerly a big time lobbyist.  Do lobbyists have influence, sort of looks that way when the properties of his document show the sources here. 

It doesn’t matter much what you say today if you don’t have the appropriate algorithms in place to back you up, read it every day in the news with the OMG stories.  I wrote my own analogy about some of this and flat out we have lawmakers trying to create laws that govern technology that they have no clue on how it works, dangerous.  I see this rhetoric of going back to the 70s and I guess it appears to be a time when folks seem to find a subject they feel qualified to talk about, best I can figure.  In another video you can listen to Rachel talk about the GOP talk about those wanting to privatize Medicare, Social Security and the VA.  This one will get your blood pumping.”

Just for the sake of convenience and to emphasize the importance of IT Literacy for our leaders today, here’s the video for another look:

I am truly afraid of a Congress that just seems to be grasping at accounting numbers and just doing a straight cut routine without projecting some additional models that could offer more solutions, but that’s the world of what I generally call the “non participants” in this area.  We want a smart Congress and not more antics and soap opera type of news.  We can all certainly stand today to do without the opera kings and queens in Washington and want some intelligent solutions and at least know they have some Algo Men helping them out. 

When you realize that everything today with laws and policies requires an IT infrastructure these things bother me as we can’t ignore this fact as technology throws us a new left curve every day and denial is not a river in Egypt as someone said.  Walgreens CEO and CFO are entirely in the loop here and spoke out 2 days after the election on the stand of repeal, for goodness sakes IT infrastructure does not grow on trees, it costs a ton of money and time. 

Walgreens CEO And CFO First to Speak Out -Repeal of Healthcare Law Would Wreck Their Business Models (aka their Algorithms)

With complex data systems and information sharing, you can’t merely just take a stand and then go back and ask technologists to “make it work for you” as those days are long gone and big expenses and consequences are at stake.

Talk of Repealing Healthcare Law–How About the Expense of the IT Infrastructure Algorithm Resets And Costs That Would Be Required?

I guess they just don’t get it and again someday soon we may be looking at digital laws being algorithmically centric, otherwise they don’t have enough teeth.  The New Jersey legislature is getting wise with their new bill and it talks specifically about health insurance algorithms and the need to be responsible. 

New Jersey Legislature Getting Smart– Bill to Modify Claim Procedures to Include Asking For Insurance Company Algorithms-Bill A3334

About a year ago I made this post about needing a Department of Algorithms and if not that than something along this line soon otherwise we are sunk. 

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

Insurance companies sure live and die by them too and get into trouble when they set the parameters to high too, and the formulas can be adjusted too and they get sued over the ending results the come out with denied coverage, claims, etc.  Earlier this year we had the “breast cancer algorithm” that found patients with the disease and scored them and it was claimed they were denied care or coverage, again base on the algorithms. 

Insurance Companies Under Attack with Lawsuits – Generated by Their Algorithms

In view of what I heard with just straight cutting I’m disappointed as intelligence might offer some better solutions, that is if we can convince those in Congress to use some modeling here and not just rely on accounting.  Google uses it and even invested in a company that uses predictive algorithms too.  Can we learn something here?

Yup I’m scared of what I hear without substantiation and understanding of IT infrastructure costing. New drugs are even being created this way with algorithmic modeling that does the work on the computer until the late stages to when a lab is set up and that way if the research is not deemed to be a success, money is saved without setting up actual labs and science moves in another direction with new modeling. Bill Gates has invested in this and believes in it too. 

It’s not Superman, Spiderman or even Wonder Woman that creates solutions and become our heroes, it’s the “Algo Men” with all the data, algorithms and wisdom for innovation.  BD

Republicans who took over the House on pledges to reduce federal spending and get the nation’s budget in order are running into the third rail of U.S. politics.

A draft proposal from the co-chairman of President Obama’s fiscal commission this week put Social Security on the front burner, leading some Democrats to draw a line in the sand. The proposal would raise the retirement age, slightly reduce benefits and raise the cap on income subject to payroll taxes.

While the proposal was drawn up to keep Social Security solvent and not to deal specifically with reducing the nation’s record deficit, Democratic strategists say it will be difficult for Republicans to duck an issue that has caused them political pain in the past.

“It does put them in a tough position,” Mike Lux, a strategist who works with liberal advocacy groups, said of the GOP. “These kinds of proposals, raising the retirement age and cutting benefits, are overwhelmingly unpopular with the American people."

Social Security reforms could be bombshell for House GOP - TheHill.com

Technorati Tags: Social Security,VA,Veterans Administration,healthcare reform,Pledge to America,GOP,politics,non participants,Medicare

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City of Hope Uses Stem Cells Injected Into Woman’s Brain To Fight Cancerous Tumor

This poor woman was told she had about 2 months left to live and then found out about the research at the City of Hope and was ready to go.  She is the very first recipient in this area to try using stem cells to help cure and/or treat her brain tumor.

In addition to the stem cells an enzyme is injected directly into the brain and the hope is the stem cells will seek out and attach themselves to the tumor.  The drug also administered  is to react with the stem cells and the enzyme and get the chemotherapy drug activated at the tumor target, and hopefully the healthy brain tissue will be left untouched.  With a woman give a diagnosis of 2 months to live, she has nothing to risk at this point and perhaps everything to gain and has traveled from Seattle for the procedure.  The chemotherapy should be easier on her body too without having the chemotherapy go through here entire body.  BD   

(CBS) Doctors injected stem cells into a woman's brain, hoping they'll fight her cancer. Close to 23,000 Americans are diagnosed with brain cancer each year and more than half that number die. Some pioneering research may be changing that.
In California Wednesday that woman made medical history, the first human being to have stem cells injected into her brain to try to cure cancer. CBS News correspondent Ben Tracy met this pioneer patient and has an exclusive look at this ground-breaking procedure.

Dr. Karen Aboody has been working on a revolutionary new cancer treatment for the very worst brain tumors called glioblastomas, the same kind Vonckx has.

"The chemotherapy is never going toxic all over the body. It's just being made where the tumor cells are, so in that case we should have a lot less side effect," says Aboody.

Stem Cells Used to Fight Woman's Brain Tumor - CBS Evening News - CBS News

Technorati Tags: Brain cancer,stem cells,City of Hope,tumor,cancer,research and development,target,trial

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Study Shows Recovery From Autism Possible With Intensive 3 Year Behavioral Therapy

The Center for Autism and Related Disorders released results from three-year study that recovery from autism is possible.  The study involved 14 children and used behavioral modification  and 43 percent no long displayed symptoms of autism so this is not a 100% cure but a little less than half is certainly well worth the effort.   Some might say the study was a small group, but any improvement for Autism is worth talking about for sure.  Those who were not declared without symptoms showed improvement as well. 

This was a joint effort in which the State of Arizona funded and CARD has several locations in the US and around the world, which you can find at the website and listed at the bottom of the press release.  BD 

Press Release:

Phoenix (November 12, 2010) – A landmark study proves that children are capable of recovery from autism, or of making substantial gains in cognitive and adaptive functioning, as well as language skills, according to results released last night by Dr. Doreen Granpeesheh, founder of the Center for Autism and Related Disorders, Inc. (CARD).

The three-year study, which the State of Arizona funded and CARD, the world’s largest provider of early intensive behavioral intervention for children with autism, conducted, evaluated the effects of behavioral intervention for 14 young children with autism using a version of Applied Behavior Analysis (ABA) that blends structured teaching with play-based behavioral intervention. Today, 43 percent of the study’s participants no longer display clinical symptoms of autism and most of the participants demonstrate significant improvements in functioning.

In accordance with previous research, CARD found that many of the children made substantial gains in cognitive and adaptive functioning, as well as language skills. Most of the children also demonstrated significant improvements in executive functioning. After treatment, the average T-score for the group on the BRIEF, a measure of overall executive functioning, was 61, well below the cut-off for clinically significant impairment. Parent stress was also decreased dramatically, with a mean post-treatment percentile score of 68, also well below the cut-off for clinical significance. In addition, 8 out of 14 children were functioning in the average range on the Vineland ABC, a measure of overall adaptive functioning, whereas only 2 of 14 were in the average range before treatment began.

“Years ago, some doctors would tell parents that they should institutionalize their children after an autism diagnosis,” said Dr. Granpeesheh. “Today, we know that autism is treatable and recovery is possible with the right services. Every child deserves a chance to learn and grow, and we hope that these results provide hope to families of newly diagnosed children.

“My daughter is now recovered from autism,” said Elizabeth Howell, parent of a study participant. “When people meet her and interact with her, they cannot believe that she ever had an autism diagnosis. My daughter is an outstanding student in an elementary classroom with typical peers without any aides or support. Our family now does things that we previously only dreamed of doing – we are like every other family on the block.”

Among the study’s major findings is that children who developed language skills early in therapy made greater gains over time. In addition to the children who recovered from autism, the other half of the program participants made substantial gains in their ability to communicate and live independently. Even the children whose progress was the slowest experienced significant decreases in challenging behaviors and increases in independent communication and leisure skills, thereby resulting in improved self-reliance and quality of life.

“The behavioral intervention was intensive, comprehensive and high-quality,” said Dr. Amy Kenzer, CARD research manager. “These factors play a major role in the outcomes observed.”

“This project provides further proof that autism is treatable and that behavioral intervention is effective, when done properly,” says Dr. Jonathan Tarbox, CARD director of research and development.

What makes this study unique is the successful partnership between the state of Arizona, CARD (a private agency), and families affected by autism.

In 2007, the state of Arizona allocated funds for a three-year program that evaluated the effects of behavioral intervention for 14 young children with autism. All children received 25 or more hours per week of one-on-one teaching and therapy with trained professionals. Their therapy consisted of intensive teaching based on the principles and procedures of Applied Behavior Analysis (ABA), a scientifically proven treatment for autism. The CARD Model of ABA, which focuses on blending intensive, structured teaching with less structured, play-based behavioral intervention techniques, was implemented in the study. Treatment plans were based on identifying what motivates the children and treatment activities were based on the desires and interests of children involved. As part of the study, the CARD treatment integrated a careful assessment of each child’s strengths and deficits and directly addressed each area of need through targeted teaching programs.

“I have followed the progress of these children over the past three years and the results are spectacular,” said Russell Pearce, president-elect of the Arizona State Senate.

The program is now a model for the implementation of effective, comprehensive, intensive behavioral intervention for children with autism.

“We want to particularly thank the incredible families we worked with,” said Dr. Granpeesheh. “One of the most important factors that impact the effectiveness of treatment is the involvement and dedication of a child’s parents, and we could not ask for better parents than we have the privilege of working with in Arizona.”

Autism is a pervasive developmental disorder that is marked by the presence of impaired social interaction and communication and a restricted repertoire of activities and interests. Autism is currently estimated to affect as many as 1 in 110 children in America and is four times more common in boys than in girls.

For questions regarding this study, contact Dr. Jonathan Tarbox at j.tarbox@centerforautism.com.

For more information about the CARD curriculum, visit: www.centerforautism.com and www.skillsglobal.com or www.skillselearning.com.

About the Center for Autism and Related Disorders, Inc.:

The Center for Autism and Related Disorders, Inc. (CARD) is the world's largest and most experienced organizations effectively treating children with autism and related disorders. Following the principles of Applied Behavior Analysis, a behavioral treatment approach that has been thoroughly and empirically validated by the scientific community, CARD develops individualized treatment plans that focus on teaching vital skills.

CARD’s extensive curriculum consists of programs to teach language and communication, social skills, self-help skills, fine and gross motor skills, play skills, social cognitive skills and executive functioning skills. Programming in each of these areas follows a hierarchical advancement that utilizes combinations of errorless teaching, discrete trial training, fluency and natural environment training. The CARD program supports biomedical interventions for autism and promotes the use of these interventions to stabilize the child’s medical condition prior to and during behavioral intervention. CARD is committed to science as the most objective and reliable approach to evaluating treatment for autism. CARD’s mission is to conduct empirical research on the assessment and treatment of autism and to disseminate research findings and derived technology through publication and education of professionals and the public. While the primary focus of CARD’s research is ABA-based methods of assessment and treatment, CARD’s overall approach to research includes any topic which may hold promise for producing information that could improve the lives of individuals with autism.

CARD provides both regional and remote services around the globe through its 20 satellite sites in Arizona, Australia, California (12), Illinois, New York (2), New Zealand, Texas, Virginia, and its affiliate sites in the United Arab Emirates and South Africa. With a mission to increase access to the most effective treatments, CARD has developed strong working relationships with parent organizations, schools, government agencies all over the world and across six continents. CARD was founded by Executive Director Doreen Granpeesheh, PhD, BCBA-D, in 1990.

For more information about the Center for Autism and Related Disorders, visit: www.centerforautism.com.

Technorati Tags: Autism. technology,healthcare,Arizona,CARD,treatment,children,behavior,assessment

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Extormity EHR Launches Medicare Fraud Module (Humor) Up Coding Made Simple

Ok these folks are reading the Medical Quack no doubt as I have talked a lot about fraud, false positives, algorithms set up to detect fraud with false positives, Medicare contractors owned by insurance companies and so on….and they had to all the way to Croatia to get their algorithm. <grin>.  This is humor all right, but underneath it all these guys get it.  You may remember some of their earlier strategy plans. 

Extormity EHR Urges ONC to Keep Stalling….

From the website:

“The Extormity EMR software suite requires wholesale, revolutionary workflow change that dramatically impacts practice patterns. Our slow and painful change process significantly interrupts patient volumes and revenues, and this cumbersome transformation can only be appreciated in hindsight and with the aid of prescription medication (which can be prescribed via the Extormity EMRX Upgrade Module and Pharmacy Interface Pack).”

They are also “Seedie” certified so they are right on top of “meaningless use” too.  They just announced this new module to get their fair share since the getting seems to be so good out there today.  BD

---

Electronic health record vendor Extormity announced the launch of its new Extormicare® Medicare Fraud Module at a press conference in Washington, D.C. today.

“As recent investigative reports have made clear, Medicare fraud and abuse is costing taxpayers billions of dollars annually,” said CEO Brantley Whittington. “We simply want our generous slice of this very tasty and expensive pie.”

“We conducted market research which reveals that most of the fictional care reported to Medicare for reimbursement was not documented in an EHR — making those perpetrating the fraud far less efficient than they could be,” added Whittington. “Armed with this insight, we developed an EHR module that automatically documents falsified encounters and generates the highest possible level of E&M coding. These codes give the impression of meeting medical necessity criteria, while helping Extormity achieve profit targets.”

“A review of court documents also indicated that most of those who are apprehended were flagged based on the repetitive nature of their claims submissions,” according to Extormity CIO Oliver Brindle. “We found an algorithm savant in Croatia who wrote some code that optimizes these fake encounters — moving deftly from a garden variety UTI to pancreatitis. We paid him in goat skins and brandy and expect to profit handsomely on our meager investment.”

About Extormity
Extormity is an electronic health records mega-corporation dedicated to offering highly proprietary, difficult to customize and prohibitively expensive healthcare IT solutions. Our flagship product, the Extormity EMR Software Suite, was recently voted “Most Complex” by readers of a leading healthcare industry publication. Learn more at www.extormity.com

Technorati Tags: EHR,Extormity,humor,ONC,medical records,spoof,meaningful use,Seedie,Upcoding,billing

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Gov Schwarzenegger Announces Launch of Veteran Service Projects (Healthcare) For California In Honor of Veterans Day

California has a special obligation to serve the military as the state has more citizens in service than any other state.  He talks about the legislation that he has signed to help veterans when they return home. 

The governor reflects on his own childhood and growing up in fear in Austria and how good the US has been to him.  Joint Chiefs of Staff Admiral Mike Mullen also joins in and speaks about invisible wounds, PST and recommends the HMO film about the topic.  He states the film does a good job documenting what Post Traumatic Stress is.  Focusing on healthcare is mentioned as one of the big issues that needs to be addressed.  Happy Veterans day to all that have been there for us!  BD 

In the news this week some additional contributions and programs for veterans. 

Microsoft Awards Up to $8 Million in Cash and Software to Help Veterans Get Jobs And Care

The Governor joined Chairman of the Joint Chiefs of Staff Admiral Mike Mullen, Los Angeles Mayor Antonio Villaraigosa and government officials to deliver remarks at the launch of a service project in honor of Veterans Day.

http://tweetcast.in/1399

Technorati Tags: Schwarzenegger,Veterans Day,Governor,California,miltary forces,entertainment,thank you,government

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Medicare Chief Berwick Scheduled to Testify Before Senate Finance Committee Next Week- A Witch Hunt or Collaboration?

The good doctor has hardly been in office long enough to make a dent yet, but hopefully the Senate Finance Committee will be open ears rather than continuing to venture on what we have seen in the news with the “witch-hunt” tactics that have been reported.  I really get spooked and fearful as to whether or not there are listeners here and think we are in for some additional “press entertainment” instead of working together. I relate back to the stimulus testimonies for healthcare back in 2009 and my memories of watching their own video was not good.  I see since that time it has been removed, and this was the Finance committee’s own video. 

None of them knew what a personal health record was and you could see by the testimonies of Microsoft and Kaiser Permanente and the level of questions asked that they were just not read up and up to date at all, and PHRs are for everyone as this part was healthcare consumer IT knowledge and use.  So much for being a participant I said as I saw jus the opposite.  You can read my short review at the link below on what I saw then and I certainly hope we have grown a bit since then.

Investing in Health IT: US Senate Testimonies

We have never learned as a whole how to really collaborate well and sure there’s room for competition but when you look at costs today and so many similar IT projects competing in health we could benefit from collaboration here. 

Innovation Without Collaboration Is Fouling Up The US Healthcare IT System–We Need Both As We Can’t Stand on Innovation Alone

I think if we can give him a chance and listen perhaps there might be something to gain here, again the Senate should not expect miracles in a short amount of time and hopefully can get over their hurt feelings or whatever it is prohibiting them from listening. 

Head of CMS, Don Berwick Urges Health Insurance Companies to Cooperate to Reinstate “Trust”–Role Models Needed At All Levels of Leadership With Engaging Health IT

I worry about this being a witch hunt when I see items like Grassley investigating his background on items that have already been disclosed and that are public knowledge and have a tendency to waste everyone’s time, he should get an Algo Man on staff.     

Dr. Berwick Gets a Letter Today From Senator Grassley – Healthcare and Health IT Literacy Out Shadowed Again with 8 Track Tapes?

I also hope that the Senator realizes that Medicare is contracted out so heavily to WellPoint to provide functionality for Medicare via contracts that this is where some of the issues lie too when questioning CMS on issues, we don’t have all out own IT infrastructure there and we are back to the insurers once more in many areas.

Grassley Investigating Medicare Contractor Conflicts of Interest–Some Are Owned by Subsidiaries of Health Insurance Companies- Will That Do It? Get An “Algo Man” For Help

There are citizens out there perhaps like me that are looking at the entire picture here rather than just another political “chicken” fight for the news and one more OMG story in the news.  BD

Medicare Administrator Donald Berwick will face critics of President Barack Obama’s health- care overhaul next week, his first appearance before Congress since he was appointed in a process that bypassed the Senate.

Berwick will testify at a Senate Finance Committee hearing on Medicare, the health insurance program for the elderly and disabled, and the Medicaid program for the poor, the panel said today in a statement. Republicans such as the panel’s ranking member, Senator Charles Grassley of Iowa, for months have said they want to question Berwick on the health-care law.

Medicare Chief Berwick to Make First Appearance Before Congress Next Week - Bloomberg

Technorati Tags: Berwick,healthcare,GOP,NHS,government,politics,Senate,Finance,CMS,health insurance,role models,Algo Man,algorithms

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China May Surpass the U.S. As the World’s Strongest Economy within Two Years While We Still Focus On Entertaining Ourselves

This is a pretty scary statement to all of us living in the US, although this has been in the news for years and this is especially crucial in healthcare, where we can’t seem to get our act together here in the US.  While there are almost more speaking English in China than in the US, this kind of sends a real hard message, they are using the internet to gain knowledge while we tend to focus on the side of the web that entertains us instead. 

All those neat tablets that we like, well that technology came from China, going way back to the original Microsoft tablet pc technology, it came from their offices in China and now look where we are, everybody loves them and wants one and the IPad is made in China, so you kind of want to ask the question where are we and this is probably a real good indicator as to why our President is visiting Asia too.  American insurance companies are investing in China to get more Chinese drugs and devices here in the US and globally, and here’s one example if you have not seen this yet from earlier this year.  Take a serious hint as I keep saying company subsidiary actions matter today as they are not always here in the US.  I post this information sometimes and wonder if any one pays attention.  Sure you may not see all of this in the news but it’s happening with technology and data with superior business intelligence systems.

UnitedHealth subsidiary (Ingenix Subsidiary I3) Acquires ChinaGate – Working to Sell Chinese Products Globally

Many of the companies on the stock exchange are investing overseas and not just in US companies and they sit on all the money that has been redistributed in the US through the use of algorithmic mathematical formulas.  Our Congressional luddites can’t seem to wrap their heads around this and still live in the 70s while everyone is growing around us. 

Election Is Done-Future for Healthcare Needs Role Models And Hopefully Not A Return to the Era of 8 Track Tapes and Old Paradigms

While we have members sit around and fight with Google and are upset over privacy issues when they can’t lock down their own personal wireless units at home, we have a problem and they seem to stay stuck here and focus on small items by comparison that keep distraction alive from the real items at hand.  I’m sure at times we are providing some great entertainment in the news front as we did with this last election.  Myself, I don’t want entertainment anymore from Washington, but rather prefer leaders that can rise the occasion and “get it”.

Members of Congress Not Locking Down Their Home Wireless Networks with Passwords Now Angered At Google For Snooping with Street Views?

The banks get it and thus so are moving forward and use their intelligence, why do they have all the money you might ask and we have an SEC for example that was asleep at the wheel.  Banks like this as they can continue to use their intelligence gained through technology while the rest of us sit in lala land. 

More Congressional Testimonies About Health IT–Members of Congress Could Entertain Getting an “Algo Man” on Staff As Wall Street and Health Insurers Have Them–Don’t Leave Home Without One

I hope we are at the point to where we can elect officials that can focus on our economy from a professional and intellectual standpoint rather than being entertainment for us here in the US and the world to mock.  BD 

What's going on with China and why should we care?

Well, according to the Conference Board, a prestigious global, independent business membership and research association, within two years China will surpass the United States as the World's strongest economy as measured by Gross National Product or GDP and when taking purchasing power parity or PPP into account.

I know that's a lot of information to take in. But that's the way professional economists talk. How about this? Right now, the U.S.GDP is about $15 trillion and China's is about $5 trillion. Going by current expected growth figures where China's economy is anticipated to grow at ten times the rate of the U.S. it would take China's economy another decade to pass the U.S. economy.

Why does any of it matter to you? Consider this. China already has enormous power over our economy. Take Wednesday. A Chinese rating agency downgraded U.S. debt and in a separate move China ordered its major banks to park more cash at the central bank. The immediate reaction? Both the European and U.S. stock markets fell. The U.S. market recovered somewhat later following better than expected jobless claims but the point had been made. When China talks, American and European markets listen.

China Is Expected to Surpass the U.S. As the World’s Strongest Economy within Two Years

Technorati Tags: UnitedHealthcare,Ingenix,I3,ChinaGate,FDA,China,medical devices,drugs,heatlhcare,mergers and acquisitions

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Office of Inspector General Finds $40 Million by CMS With Less than Effective Drugs Prescribed–Medicare Part D Data Search

There were a large number rejected but there was also a large number that slipped through. Now when it comes to Medicare Part D, as we all know by now this is administered by insurance companies and their data so in essence, this is due to the lack of full data by those administering the plans and updating their algorithms to reject claims on “less than effective” drugs as the FDA classifies. 

I f a drug is not included on the list, then the mathematical formulas used to automate the screening process can’t find them, so we are back to data, data and more data here along with those algorithms that are supposed to pin point these items.  This is a “contractor” issue it sounds like here on the Part D portions as it is no secret out there that this is the part of the deal where insurers provide HMO type services to seniors. 

The less than effective drugs are mostly old ones that were in use before the FDA was around and have no official FDA status but are still used.  The companies can request a hearing with the FDA to gain approval but many don’t seem to want to do that as most are pretty much inexpensive items and it may not be worth their time and money to do so, and then there’s always the option of not gaining approval, even though the drug has been out there for years.  We saw some of that in the news lately with the FDA threatening to remove one of those drugs and changing their mind later as it is still used frequently and is affordable.   

So when all this boils down here, is this a huge crime or big deal, not really and if those drugs were not useful, doctors would not be prescribing them as again, they are affordable compared to some of the newer drugs that are out that may treat the same symptoms, but that are not affordable for many. Coming back around here, the health insurance companies are probably happy to see them being used as they save money, so this study just kind of opens up a can of worms with utilization of data overall.  BD 

The Centers for Medicare and Medicaid Services (CMS) is in hot water over illegal Medicare Part D payments. The Office of the Inspector General (OIG) found that the agency reimbursed plan sponsors $43.3 million for prescription drugs on the market that FDA classifies as less than effective. The OIG report covered calendar years 2006 and 2007 and a gross Part D drug expenditure of $115 billion.

"Less-than-effective drugs lack substantial evidence of effectiveness for all intended purposes," the OIG report said. "Although use of less-than-effective drugs may not cause direct physical harm to Part D beneficiaries, reliance on these drugs could be detrimental when they are used instead of drugs whose effectiveness has been verified ... Part D should not have covered these drugs."

OIG explained that CMS did identify and reject the vast majority of claims for less-than-effective products, some 5.3 million claims in all. But $43.3 million slipped through the system.

OIG found that CMS used an incomplete list of less-than-effective drugs to screen claims.  CMS relies primarily on First DataBank's National Drug File Data File Plus and Medi-Span's Master Drug Data Base.

OIG uncovers $40 million in illegal CMS payments for Medicare Part D - - Drug Topics

Technorati Tags: CMS,drugs,less than effective drugs,FDA,data,algorithms,pharma,Medicare Part D

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Germany Votes to Break Up Drug Company Pricing Monopolies

According to this Bloomberg article, the prices that are negotiated with German insurance companies also stand to set a guide for other countries as well.  Germany in essence is fighting the same thing we are here with higher priced drugs that are becoming non affordable.  Within the year’s time given, if no agreements are determined on price, the Health Ministry will do it for them.  This rule is for drugs that have not either been approved or are not for sale yet. 

German Government Healthcare Reform Law Signed–With Plenty of Critics And Includes Spending Cuts for Doctors

Germany has also recently increased health insurance premiums back in July as part of their overhaul for healthcare.  BD 

Drugmakers face more than 2 billion euros ($2.76 billion) in price cuts in Germany, their biggest market in Europe, after lawmakers in Berlin approved the first controls on the cost of innovative medicines.

The law, backed by the lower house today, gives companies a one-year window to negotiate prices with insurers after introducing new drugs, potentially affecting Novartis AG’s multiple sclerosis treatment Gilenya and AstraZeneca Plc’s blood thinner Brilinta among other medicines that haven’t been approved yet in Europe. If no agreement is reached, the Health Ministry would set a maximum price, and the drugs would undergo a cost-benefit analysis by a semi-state agency.

Drugmakers Face Pressure on Prices After Germany Votes to Break `Monopoly' - Bloomberg

Technorati Tags: health insurance,heatlhcare,patients,politics,Germany,insurance agent,drugs,Bayer

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Cleveland Clinic and Mayo Clinic Competing for US Domestic Medical Tourists With Company and Health Insurance Contracts

In the news this week Cleveland Clinic was reported laying off around 200 employees to restructure with current economic conditions, so this might add a little more reason to look for and solicit additional business.  Earlier this year the Cleveland Clinic signed a contract with Lowes for cardiac care to where patient care is covered by the company, along with travel and other items if they have their surgery at the Cleveland Clinic.  So far 19 employees have taken advantage of the option.  In addition the Cleveland Clinic is also focusing on attracting patients from the Middle East with a new website.

Lowe's And Cleveland Clinic Strike Up a Domestic Medical Tourism Contract – Heart Surgery for Employees and Dependents

Mayo Clinic has signed a national contract with United Healthcare to pay in network charges if they travel to their facilities.  Unlike the Lowes contract that Cleveland has it doesn’t mention any travel or other expenses covered.  As this article mentions Mayo barely broke even in 2008 and had only a small profit in 2009 so they too like all hospitals are looking for more patients.  There have even been some administrative fees added with associated clinics.

Cleveland Clinic “facility fee” or “hospital services fee” has Patients up in Arms

Big branded institutions like Mayo, Cleveland Clinic, Johns Hopkins, etc. get a revenue from over seas too with facilities set up in places like Dubai, so if you look at the entire picture here, the money needed to keep the leading facilities open and running is not all coming from here in the US, something to think about as one might wonder how the financials would look without the additional sources of income.  BD 

Mayo Clinic has joined the medical network of UnitedHealthcare, making it cheaper for 20 million of the insurers' commercial members around the country to seek care there. This is the first national contract Mayo has signed and is part of a move by Mayo to shed its aura of expensive exclusivity. UnitedHealth members will now pay in-network prices if they go to Mayo, which can offer significant savings over out-of-network prices. This national agreement with UnitedHealthcare covers all Mayo's group practices and hospitals in Rochester, Jacksonville, Phoenix and Scottsdale.
Mayo had smaller, specialized contracts with UnitedHealth in the past. Since 2004, it's been part of UnitedHealth's transplant network. It also has contracts with other national insurers, but those agreements only cover people in some regions of the country. Mayo has a reputation for being more expensive per procedure while UnitedHealth has a reputation for driving a hard bargain with providers. The promise of more commercial business is attractive to Mayo because after barely breaking even in 2008, it only managed a small profit in 2009. Mayo treated 528,000 patients last year. Currently, 20 to 30% of patients travel more than 500 miles for treatment.

Cleveland Clinic and Mayo Clinic compete for medical tourists

Technorati Tags: Lowes,healthcare,heart surgery,heatlh insurance,Cleveland clinic,cardiology,heart disease,Mayo Clinic,medical tourism,United Healthcare

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“mHealth Moving Faster than Expected”–Did Someone Just Wake Up–It’s Been Moving Fast For a Number of Years

Back in the middle of 2007 I was listening and talking about Craig Mundie from Microsoft and what they were doing in 3rd world countries with supplying cell phones that work and help those who can’t read.  Now we are trying to help and show value for those “who can read”.  The images here go back and allow one who cannot read to touch the screen and via images.  This was almost 4 years ago and the patient gets connected to a doctor who can help them, talking.

When we saw this, we all kind of chucked at the the little “barfy pac-man” guy picture but it makes the point and shows “instant value”.  This is where everyone is struggling today with mHealth.  There’s a lot of good stuff out there and perhaps this is part of the problem with not enough collaboration going on and everyone trying to build the better mouse trap.  I know in doing this blog and trying to relay helpful and beneficial information I get tired of all the new apps and unless I think it has wide appeal and will help many, and have a future, I don’t post it otherwise I would lose readers in a hurry as they would get bored too.

Now doing this blog and the amount of reading I do I’m probably a bit more up to date than most and I began using a PDA when they came out, Palm and Pocket PCs before they were phones so a bit of history with myself and mobility, been a part of me for quite a while and wrote a few ugly CE embedded visual basic things, but that’s all we had way back and ugly those programs were. 

When it came time to meaningful use, no mobile incentives added in to speak of and thus optional incentives I think would have done wonders here.  They probably didn’t think too much as people tend to think about what they do and use and thus perhaps some of this was missed, back to the non participant syndrome maybe?

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

Medical Device =  Algorithms  =  Medical Data  =  Data Reports  =  PHR  =  EHR  =  _____.

Do you want to talk exotic, let’s go there and look at this blue tooth inhaler, and has been around a couple of years already.  Watch the video as we now have wellness and 3rd party folks, some owned by subsidiaries of insurance companies that vowing to get all the health data they can get on you, and that’ is a big part of what makes the mHealth market difficult as who do you trust.  In the video below you see the example of the data trail of the device on when you inhaled, how much you inhaled, the time and so on going back to an insurance company.  We wouldn’t mind that if it was not potential held against a patient when it comes to compliance.

Blue Tooth Inhaler

So you end up in the ER Room and file claim for your expenses, and let’s say you had some personal issues come up on the same day for example.  Would a consumer be hit with something like this?  “We sent you 3 text messages, emailed you 2 times, sent off a vibrating alarm and you were 3 hours late with your prescribed medication, and thusly so we are denying your claim”…hmmmm..nasty potential stuff here, but when it comes to algorithms for risk with insurance companies they consider every payment a loss and we can thank Wendell Potter for that bit of knowledge.  Read his book as he can tell you how they work the algorithms on the other side that we do not get to see. 

Wendell Potter Tell All Book–Deadly Spin–One to Put On My List as “He Knows Algorithms and How they Create Profits”

So when you take all of this into consideration and the fact that we don’t have many laws with 3rd parties and mobile devices, who want to jump on it as the information with some devices can lead to problems with care or potential denial of care.  Would that one person who was late inhaling be considered “fraud”…we have a lot of algorithm nutcases out there who read and determine events as such and common sense would say not, but that’s not what’s being done today as we read these OMG stories in the news all the time. 

Anyway, I read a lot of the mHealth comments around the web and so many were saying the same thing, it’s a fragmented mess and nobody can develop any real business models.  Sure there are some not connected with 3rd parties who intend to profit so check them out and find them if you can. 

Innovation Without Collaboration Is Fouling Up The US Healthcare IT System–We Need Both As We Can’t Stand on Innovation Alone

This is I think one of the real issues as to why some of this doesn’t take off, especially the consumer side as the professional side seems to do a better job and doesn’t have as much data mining going on, otherwise the hospitals and doctors would drop a lot of it and they do pay for the software too.  So, developing faster than we thought, well open eyes here as it’s been on fire and then some for a while, but again fragmented and opportunistic in some areas for profit.   Stick one of these on every member of Congress and text the hell out of it and see what they think and bring them into the 21st century.  That would make a real interesting YouTube video watching a Congressional Session with members being constantly interrupted to inhale, walk around or what ever else can be built in as this stuff can be disruptive too. 

mHealth requires more than just innovation at this point, so add on some collaboration, aggregation and come up with stuff that shows the consumers immediate value, like my little campaign of finding FDA recalls with a cell phone and being able to scan.  If we can do this and get rid of the 3rd parties who sell and use your data against you for care and profit, we would see more mobile applications in use, but everyone needs to see the point of creating what is value for the consumer  and it’s just not working too well in a lot of areas. 

mHealth is not going to be able to sustain on Innovation alone and I think we are seeing some hints of this already so everyone wake up and let’s get rid of that impossible dream.  We know we live in the world of sensors today and just human nature is going to stop us from taking on more than we can handle and opt to give away too, common sense.  BD 

WASHINGTON – Marketplace innovation to move healthcare forward using mobile technology is advancing at speeds that only a short time ago could not be imagined, said Aneesh Chopra, U.S. Chief Technology Officer at the mHealth Summit on Tuesday.

This year's mHealth Summit, organized by the Foundation for the National Institutes of Health in partnership with the mHealth Alliance and the National Institutes of Health (NIH) is being held Nov. 8-10 in Washington, D.C., and has drawn more than 2,000 professionals from the U.S. and 30 countries to hear from experts on mobile health technology and policy.

At a luncheon keynote, Chopra told attendees that cloud computing and improved connectivity could help unlock progress and compress the cycle time from idea to operation. Already, examples can be seen across government and the marketplace, and the results "are astounding," Chopra said.

IT chief: mHealth moving forward faster than expected | Healthcare IT News

Technorati Tags: biometric monitoring,health insurance,heatlhcare,Fitbit,Muve,healthcare,wireless,blue tooth,cell phone,devices that report data,medical devices

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