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Judge States NYC Public Hospitals Can’t Lay Off 150 Labor Employees-A Sound Methodology Was Not Submitted

I am guessing the case for the layoffs and replacements were not substantiated and the employees stated it would put patients at risk.  This is the first I have read something of this sort but the article did not state what percentage of the entire force the 150 employees represents.  BDimage

New York City's public hospitals have been barred from laying off about 150 electricians, carpenters and laborers -- at least for now.

A Manhattan judge ruled Wednesday that the city Health and Hospitals Corp. "failed to employ a sound methodology" in deciding to let go about half its laborers and one-third of its electricians and carpenters. The ruling sends the matter back to the hospital agency for further evaluation.

The carpenters' lawyer, Robert Stulberg, calls the decision a victory for the tradespeople and patients. The workers said the layoffs could jeopardize patients because the employees' work involves fire and other safety measures.

Judge blocks layoffs of NYC hospital tradespeople - BusinessWeek

Forte Research Systems Unveils the Allegro™ Research Cloud-Based Product

Clinical trial and research goes into the cloud.  With the system being web based, there’s not software to install and the press release states it has an easier format to imageuse.  PercipEnz Technologies is now Forte Research Systems with a name change.  Not too long ago I remembered reading about resources being tied up with a lack of bandwidth and one pharma company was not able to have researchers query large amounts of data without interruption.  BD

MADISON, Wis., Nov. 18, 2010 /PRNewswire/ -- Forte Research Systems, makers of OnCore® , the most widely adopted clinical research platform among academic research organizations and cancer centers in the United States, unveiled a new product line today, the Allegro™ Research on Demand, cloud-based clinical research management solution. The first product in the new line is Allegro CTMS@Site™, the clinical trials management system built exclusively for investigational sites.

Pharmaceutical companies conducting clinical trials on new drugs are spreading the work among more sites as a way to increase the probability of success and to reach more potential patient participants. In turn, this trend has led individual sites to take on more trials. At the same time, while sites are grappling with more trials, the trials are becoming much more complex with a proliferation of procedures and subject eligibility criteria.

Forte Research Systems Unveils the Allegro™ Research on Demand Cloud-Based Product Line -- MADISON, Wis., Nov. 18, 2010 /PRNewswire/ --

Doctor Charged With Inside Trading Relating to Clinical Drug Trial Has Bail Set at 3 Million

The doctor has been charged with 2 counts of securities fraud and is still being held until bail is met.  The charges stated he provided inside information to a hedge fund which supposedly allowed the group to voice millions in losses.  It appears the doctor who is based in France is located here in the US.  This week there has been a flurry of investigations and arrests with inside trading violations.image

The violation was said to have taken place in last 2007 and 2008.  The hedge fund connected here is FrontPoint Partners which the Wall Street Journal states is being spun off from Morgan Stanley.  The suit states they were trading shares of Human Genome Sciences.You can view the pipeline here of the company.  There are no additional details and I assume we will hear more about how the entire case came about as it moves along.  What is insider trading?  I think we are all beginning to find out and how the laws are interpreted as they can be gray in areas and I am thinking a case would need to have to show substantial documentation that inside trading took place.  What is public knowledge and what is insider trading is sounds like we are going to hear a lot about it.  The US has some of the toughest laws in the world.  Here’s a video that discusses insider trading from the Wall Street Journal.  BD

NEW YORK—Bail was set at $3 million Wednesday for a French doctor who allegedly tipped a hedge-fund manager with confidential information in an insider-trading scheme.

At a detention hearing, U.S. Magistrate Judge Frank Maas in Manhattan set bail for Yves M. Benhamou, a 50-year-old Paris-based doctor specializing in liver diseases, at $3 million. He can be released from custody once he posts the bail, which is also to be secured by $1 million in property. Bail conditions include home incarceration in the New York area and electronic monitoring while charges are pending.

Bail Set For Doctor in Insider-Trading Case - WSJ.com

Stem Cells from Bone Marrow Can Be Used To Regenerate Bladders

If you follow along this blog, then you may already know there are women and children walking around with bladders that have been grown in labs, amazing technology.  Below is a link with a couple videos that explains the process and now we have a new revelation where bone marrow cells can be used instead of animal cells to grow bladders.  Regenerative medicine’s goal is to help the thousands waiting for organ transplants and the hundreds of veterans who return from Iraq and Afghanistan horribly maimed.  So far, researchers have created beating hearts, ears and bladders by manipulating cells in the human body into regrowing tissue.

Regenerative Medicine – Growing Human Body Parts

In addition, I spent some time last year speaking with Cook Medical about their regenerative processes with healing hernias and other issues with their platform of tissue used to re-grow body tissue.

Regenerative Medicine and How it Works – Interview with Cook Biotech (Medical)

In the news a couple weeks ago, Spain has created the first world’s laboratory to work with growing organs.  The laboratory will "empty" human hearts or other human organs unsuitable for transplantation and recolonize their cell content with the patient's stem cells, allowing the organs to grow a new, ready for transplant back into the new body.  When body parts and this science further matures we will have less of a reliance on transplants which is easier on the patient too as you do not have to deal with the potential of the body rejecting. 

First Human Organ Transplant Laboratory Opens in Spain–Regenerative Medicine

The next goal with organs is the liver and a couple weeks ago, a small liver, not ready for prime time was grown and this if course is very much at the beginning stage.  With being able to grow a bladder with the patient’s own stem cells, this is one more step on perfecting the model and a science that truly saves live.  BD 

Northwestern University researchers have created a model that is capable of using stem cells from a patient's bone marrow to regenerate their bladder. 

Dr. Arun Sharma and Dr. Earl Cheng, both from the Feinberg School of Medicine at Northwestern University, have developed a medical model for regenerating the human bladder using mesenchymal stem cells (MSCs) from the patient's own bone marrow.

DailyTech - Primate-based Model/Bone Stem Cells Used to Regenerate Bladders

The Complicated Algorithms Used by Medicare to Establish Hospital Compensation

This is a great article and in the New York Times today and it has been broken down to show the overall mathematics that are used to determine payments.  We are again, back to the “A” word that you see plastered in the center of this blog, an algorithm.  I just finished watching a PBS documentary called “Facing Death” and clearly up front too in this video the doctor states that to make life saving decisions, they are relying on the algorithms to help them make decisions as it is complicated, as we have so many more alternatives and things that can be done to save a life and when to use which methodologies to have an improved outcome is complicated. We are all still humans and we can predict everything as miracles still exist today and to deprive one of a potential miracle is something nobody wants to live with when making decisions as such.

As far as what hospitals get paid, this is a huge topic and it is discussed on the web almost every day and payments do vary from one hospital to the next in the same area and in different states.  You almost have to read up on being a bit of an economist to completely comprehend the calculated formulas, aka algorithms.  Some state legislatures are coming of age with wanting accountability with private insurance algorithms, like in New Jersey.

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

The article further goes on to say that the pricing too does not seem to indicate better quality but is rather driven by market value, in other words the contracts that are negotiated today.  The payment systems are supposed to be transparent, which in essence they are to a degree, that is if you are an economist and understand the algorithmic formulas, but most of us don’t unless you sit down to fully study the entire situation and the author here has done a good summary of explaining in layman’s terms what this means.  All the medical coding that everyone complains about enters into this arena for the government to make their assessments.  How else do you think they know how many cases of pneumonia for example are diagnosed every year.  Those codes, known as an ICD9 are the key to compiling those statistics. 

image

Labor charges are calculated and they are summarized to a degree as they vary from one facility to another.  If you go back to a case of pneumonia that is complicated with diabetes, then the outcome and projection will change as now you have 2 health situations to formulate.  Hospitals that see uninsured patients get a higher level to help compensate and then there is also the break they receive on taxes if they are non profit.  Again without a full study time on your part, it takes a while to get to the absolute understanding.

Further more the author makes a comparison here to private health care insurance and the fact that it is not transparent, in other words we do not get to see their algorithms and how they calculate which is something I make a point of here quite frequently.  Also worth noting too is the fact that the algorithms calculated by Medicare are largely created by information that is provided by health insurance companies who are Medicare contractors, so the relationship of Medicare data and private insurance is tight, in other words they have the data.  This leads to stories in the news of people being turned down for care when private insurers use their algorithms to project and determine eligibility and claim payments. Unlike Medicare they run algorithms to determine what money they will need to pay under a risk category and as Wendell Potter has explained to us many times, Wall Street sees any claim payment made as loss when you look at profit and investor standpoints, and it does make one wonder why do we support such a system?  There reaches a time when the algorithms used do not support ethics and outcome.  Two years ago I started suggesting that we need a Department of Algorithms or something along this line.

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

We all currently hate the complicated systems we work with today for profit and it’s not getting any better with contracts, so if a system were created with private insurers that set pricing standards, it would certainly make life easier all the way around and we can all certainly deal with a little less marketing.  Have you had a conversation with either a hospitalist or ER doctor lately to hear about the decision making algorithms they use for payment in order to first of all get the best care, and secondly adhere to their goals of keeping the price down?  If not, ask one and you might get an earful if they like talking.  Many may not want to talk about it and I can’t blame them as they are stretched out beyond ethics at times and again there’s the constant pressure of the hospital to keep costs down from the administrative side as doctors as a whole are going to do what they do best to save a life.  Private insurers are up to their ears in lawsuits with the use of cost cutting formulas.

Insurance Companies Under Attack with Lawsuits – Generated by Their Algorithms

So in summary a simpler system with algorithms that are less complicated would certainly be something that would be welcome I feel as again when care is needed with so many differentiations of treatments available and the pricing that is added every day due to new technologies and treatments available, it would certainly stand to reduce some stress all the way around when it comes down to who is going to pay what and to who.  BD 

In a previous post, I described how Medicare came to adopt price schedules for hospitals and physicians that are now derided as Soviet in origin. Actually, as I noted, this was a home-grown American idea that Presidents Ronald Reagan and George H.W. Bush embraced and introduced to Medicare.

In this and the next post I would like to describe how this system works, starting with inpatient hospital services. I will draw on the excellent literature provided by Medpac, the independent Medicare Payment Advisory Commission established in 1997 by Congress to advise it on issues affecting the Medicare program.

Medicare’s payment system does have an underlying rationale that can be explained to market participants. It is fully transparent. And it does strive for horizontal equity, meaning that it pays hospitals in similar situations the same price for the same service.

Although this system can and does accommodate adjustments for local market conditions and sometimes even rewards what policy makers value – extra payments for services provided to underserved areas – it is primarily cost-based rather than value-based, which I and other policy analysts would prefer.

Uwe Reinhardt: Medicare and Hospital Payments - NYTimes.com

General Accounting Office Questions Nursing Homes Owned By Private Equity Firms–Lack of Data To Evaluate Care and Safety

The AGO prepared one report already and is working on a second report to ensure safety and care for seniors and they were overly concerned over the lack of data imageand information provided to make a full evaluation.  We had one case in California that turned pretty ugly with patients not getting adequate care and their liability insurance was exhausted. 

Skilled Healthcare Group Gets Court Verdict of Not Meeting Minimum Nursing Home Standards in California And May Not Be Able to Appeal– Skilled Healthcare’s Liability Insurance Has Been Exhausted For This Year So Now What?

In view of the fact that the 3 largest nursing home chains are owned by private equity firms the GAO determined it was worth reporting on.  We are facing some similar questions too with hospitals now being acquired by private equity firms.  In California we have one chain of hospitals that have been purchased when they are out of money and they all turn into Cadillac ER rooms and all services found not profitable are pretty much shut down. 

Medicare cuts to nursing homes are also making them look less lucrative and now some of the chains are focusing on caring for patients recovering from surgical procedures, as if they are not quite ready to leave the hospital, patients are sent to nursing homes for recovery.  Of course this entails additional data work to transfer all the patient records from the hospital to the nursing home and of course physically moving patients around too.  As stated in this article, investors in private equity may not be seeing the profits they anticipated a couple years ago as healthcare reform and technology continue to change the shape and methodologies provided to take care of both seniors and those recovering from surgery.  We can’t have care suffer for the sake of only making a profit only.  BD   

THEY are best known for eyeing glittery targets such as swanky retailers and landmark buildings. But private-equity firms have also recently shown interest in a much less glamorous business: nursing homes. Since 2005 there have been at least 46 buy-outs of nursing-home operators worldwide, according to Dealogic, a research firm. Private-equity firms now own three of the five largest chains of homes in the United States, including the biggest, HCR ManorCare, which was bought by Carlyle for more than $6 billion in 2007.

The takeovers of nursing homes by the sort of hard-headed financiers widely regarded as being capable of selling their own grandmothers have attracted scrutiny from Congress’s investigative arm, the Government Accountability Office (GAO). In October it released a report expressing worries about its lack of data on investment firms’ ownership of nursing homes, which it said hampered its ability to monitor standards of care. The GAO is now working on another report, in which it will evaluate the adequacy of the care provided in homes bought by private equity.

Private equity buys into care homes: Wall Street goes long on grannies | The Economist

Lenovo M90Z Promotion–Receive a Free Wireless Keyboard and Mouse With Purchase

As many of you may have read here at the Medical Quack I am working with M90z_12(camera)Lenovo to test drive and determine where healthcare applications can be supported with the use of the computer and the use of a touch screen computer.  As I stated prior, this is a disclaimer in the fact they Lenovo has provided me a unit to work with and provide some useful feedback.  

In addition to supplying feedback, Lenovo has also enabled me to pass along the following offer when ordering one of their computers online with a code that you enter when ordering on line and at check out time.  You can review my original post below and there are also several other healthcare bloggers who are participants too so you may see this offer more than once if you are reading other blogs, so at any rate when purchasing a unit take advantage of the free offer. 

Lenovo ThinkCentre M90z All In One Desktop Discussion

I still need to do some further testing with speech recognition on the unit myself and will add more later. 

Stay tuned as there will be more news and opportunities to win a unit like this forthcoming. 

shop_M90z

Get a free Ultra slim Wireless Keyboard & Mouse when purchasing an M90z

Enter the eCoupon code during the checkout process: M90ZMEDQUACK

UCLA Cancer Researchers Uncover Drug Resistance Mechanisms in Common Forms of Melanoma–Clinical Trial Results

Fighting skin cancer and finding the targets for drug development is not an easy task and UCLA released their recent findings on how they are working to find imagesolutions for cancers that become resistant after a period of time.  As you can read further in the press release, one experimental drug offered results but they were not long lasting and additional targets are being sought as the cancer became resistant after a period of several months.  BD 

Press Release:

Researchers with UCLA’s Jonsson Comprehensive Cancer Center have found that melanoma patients whose cancers are caused by mutation of the BRAF gene become resistant to a promising targeted treatment through another genetic mutation or the overexpression of a cell surface protein, both driving survival of the cancer and accounting for relapse.image

The study, published Nov. 24, 2010, in the early online edition of the peer-reviewed journal Nature, could result in the development of new targeted therapies to fight resistance once the patient stops responding and the cancer begins to grow again, said Dr. Roger Lo, senior author of the study.

In a clinical trial at UCLA’s Jonsson Cancer Center and other locations, patients with BRAF-mutated metastatic melanoma have been responding very well to an experimental drug, PLX4032. However, the responses are short lived, averaging seven to nine months in duration, because the cancer gets around the blockade put up by PLX4032, which targets the BRAF mutation found in 50 to 60 percent of melanoma patients.

Lo and his team spent two years studying tissue taken from patients enrolled in the Jonsson Cancer Center study to try to determine the mechanism of resistance. They also developed drug resistant cell lines to study, in collaboration with another team at UCLA’s Jonsson Cancer Center led by Dr. Antoni Ribas, an associate professor of hematology/oncology

It had been theorized that BRAF was finding a way around the experimental drug by developing a secondary mutation. However, Lo determined that was not the case, an important finding because it means that second generation drugs targeting BRAF would not work and therefore should not be developed, saving precious time.

Lo said that while his team was studying resistance, they expected to find secondary mutations in BRAF.

  “We were surprised that we couldn’t find a single case where a secondary mutation in BRAF was driving drug resistance,” said Lo, an assistant professor of dermatology. “In a big portion of cases where cancers acquire resistance to targeted drugs, the oncogene being targeted finds a way to get around the drug by developing other additional mutations.”

Cancers, Lo said, are very adept at finding ways around the drugs being used to fight them.

  “You hit it with an axe, but the cancer soon finds a way to mitigate the effects of the axe,” he said.

Lo and his team found that these mutually exclusive mechanisms of acquired drug resistance account for about 40 percent of the patients who were treated with PLX4032 and later acquired resistance to it. In some cases, Lo found that the cancer cells began overexpressing a cell surface protein that created an alternate survival pathway for the cancer while the BRAF survival pathway was being blocked by PLX4032. In other cases, a second oncogene, NRAS, became mutated, allowing the cancer to short circuit the PLX4032-inhibited BRAF mutation and reactivate the BRAF survival pathway. PLX4032 does not target the NRAS mutation, so the cancer can begin to regrow.

Lo said he expects to find other mechanisms of resistance in the remaining 60 percent of relapsing patients where neither of the two new mechanisms were found.

  “It’s important to find all the mechanisms of acquired drug resistance in this type of melanoma and figure out how to target them using drugs designed to hit those specific mechanisms,” he said. “We’ve found two mechanisms in two subsets of melanoma and we’ll need different drugs to treat those two subsets.”

Going forward, Lo and his team will study the resistance mechanisms of the two subsets discovered and any others uncovered later to perhaps find better targets for therapy. For example, targeting the cell surface protein overexpression may prove more difficult than finding what causes the overexpression further upstream and homing in on that.

“How does the cell surface receptor get turned on in the first place?” Lo said. “We need to trace it back to its origin, find out what machinery is turning it on and shut that down.”

Lo’s study is an example of the translational research focus at the Jonsson Cancer Center. The tissues from the patients in the clinic were studied in the lab, where Lo and his team found what was causing resistance in some cases. That information will be used to find drugs to target those mechanisms that will then be brought back into the clinic to be tested in clinical trials.

“Working with the patients and then working in the lab gives me a different perspective,” Lo said. “When patients ask what will happen to them if the experimental drug stops working, we can tell them that we’re working 24/7 in our laboratory to figure out why that happens and discover a way to stop it.”

About 68,000 cases of melanoma will be diagnosed in Americans this year alone. Of those, more than 8,700 people will die. For patients with metastatic melanoma, like those in the Jonsson Cancer Center study, there are few effective treatments, so it’s vital to come up with alternative therapies, Lo said.

The study was funded by the Dermatology Foundation, Burroughs Wellcome Fund, STOP CANCER Foundation, Margaret E. Early Medical Trust, Ian Copeland Memorial Melanoma Fund, V Foundation for Cancer Research, Melanoma Research Foundation, American Skin Association, Caltech-UCLA Joint Center for Translational Medicine and the Wesley Coyle Memorial Fund.

UCLA's Jonsson Comprehensive Cancer Center has more than 240 researchers and clinicians engaged in disease research, prevention, detection, control, treatment and education. One of the nation's largest comprehensive cancer centers, the Jonsson center is dedicated to promoting research and translating basic science into leading-edge clinical studies. In July 2010, the Jonsson Cancer Center was named among the top 10 cancer centers nationwide by U.S. News & World Report, a ranking it has held for 10 of the last 11 years. For more information on the Jonsson Cancer Center, visit our website at http://www.cancer.ucla.edu.

Kinect Hacked and Can Track Boobs (Video)

Kinect is certainly popular and and recently I wrote about how it could work with electronic medical records and I’m sure we might see more on that level, but this individual had some fun and figured out how to create some virtual bras.  It’s a fun video and like the music and these are male boobs <grin>.  There’s another video at the link below to show how Kinect works without the bra.  His motions even control the music too. 

Leveraging Gesture Power of Kinect With Windows 7–Future Interfaces/Interactions With Electronic Medical Records (Video)

Not even a month ago Microsoft bought another 3D chip company that also uses imagegestures and you can see their video at the link below, and now we have another company working with the Kinect technology, who also worked with Surface, and it really looks hot too.  I like the gesture handwriting.  You can read more at the Evoluce website and at the blog.  BD

Yes the Kinect from Microsoft can officially track the movements of your head, your hands, and your knees (and fingers, though rumored to be removed by Microsoft). But all thanks to the open source driver, we can now get all sorts of funky concept onto the Kinect. It is now able to detect boobs.

Well, almost. Dan Wilcox, the person how hacked it stated that “the computer searches for my manboobs and draws a bra or pasties on top, and music is played when titties are detected”.

Kinect hacked to track boobs, covers them up with a bra | Tech Life

Stolen Bristol-Myers Squibb Products–Truck Heist–When Are We Going to Bar Code Drugs and Medica Devices–Scan With Cell Phone

It keeps happening along with recalls, but nobody has done a thing and yet the technology is here to help.

Eli Lilly Pill Heist in Connecticut – Worth a Few Million on the Black Market And Should Have Been “Tagged” for Identification To Help Identify Reselling By the Thieves

Anyone who reads the blog regularly knows about my 6 month plus campaign where I have been advocating 3D and2D barcodes, also known as Microsoft Tags.  If you imagehave a chance enter your vote before you leave this page and let me know if you would value being able to use your cell phone as a scanner to find recalled products, drugs, devices etc. right on the shelves. 

Microsoft Tags in Healthcare – Comments and Demonstration at “Microsoft Connected Conference” with Surface

Now with this data base they are creating, why not put a Tag on each page and have the device and drug companies synchronize their updates with the FDA?  This also gives the FDA an answer to monitoring compliance with checking to see if the “tags” have been updated, what a novel idea use imagesome technology here, right?  This is not much different than faxes were in the early days as we had people skeptical about those too and now look where we are. 

image

I went in to a Best Buy store this week end to scan some Cannon products which use Tags from Microsoft, works well.  On the counters though Best Buy was using QR codes and I couldn’t get my reader to work and read those.  Also what is cool too is using the heat map of Bing and then you can even find the IP location of where the product was scanned.  A consumer who buys a product could check for authenticity this way, no scan information, don’t take it and this way stolen drugs can be identified this way as the messages that appear on stolen lots could be changed to indicate they are stolen or recalled.  BD

Bristol-Myers Squibb (BMS) is working with the U.S. Food and Drug Administration’s Office of Criminal Investigations (FDA), and other law enforcement officials, to recover cases of specified lots of recently stolen pharmaceutical products.  The specified lots were being transported in a tractor-trailer stolen in Florence, Kentucky, on Interstate 75 North at around 10 p.m. on Wednesday, November 10, 2010.  The trailer contained the products, lots and quantities listed below.

The specified lot numbers are designated solely for the Canadian market and are unique to that market.  The lot numbers in question are complete batches; no product with the same lot number had previously been distributed from BMS to any market.   The product packaging is in both English and French, as required by Canadian law. 

FDA Alert: Notification of Stolen Bristol-Myers Squibb Products

Orbitz Travel and Walgreens Launch Partnership to Keep Travelers Healthy

Have you had enough marketing yet?  Orbitz Travel service and Walgreens are going to work together to give Walgreen customers discounts and Walgreens is going to imagehelp those Orbitz traveler, travel healthy.  This could be helpful if traveling outside the US to find inoculation information as shots are needed before visiting some parts of the world. 

The first thing that pops into mind is how the data might be shared to facilitate additional marketing.  BD 

Under the partnership, Orbitz and Walgreens will also work together on cross-promotional marketing programs, offering exclusive travel discounts and deals to Walgreens customers, and will highlight consumer research and educational campaigns focused on being a healthy traveler. image
“This partnership will help improve the holistic travel experience for individuals and families, first focusing on raising awareness for our customers about preventive health care measures that can help make for a happy holiday,” said Jeanenne Tornatore, senior travel editor of Orbitz.com. “A major underlying goal is to further educate and inform travelers and encourage them to be proactive about seeking advice from health care experts about how they can maintain a healthy lifestyle during the holidays.”

Under the partnership, Orbitz and Walgreens will also work together on cross-promotional marketing programs, offering exclusive travel discounts and deals to Walgreens customers, and will highlight consumer research and educational campaigns focused on being a healthy traveler.

Moving forward, Orbitz and Walgreens will continue to work together on quarterly initiatives to promote healthy travel lifestyles such as the recent holiday travel survey. Additionally, Walgreens customers will receive exclusive hotel and travel deals available through Orbitz.com. In turn, Orbitz customers will benefit from special offers on products and services at Walgreens 7,600 locations. Both companies will support the program with cross-promotional brand visibility, educational outreach to customers and ongoing publicity efforts throughout 2011.

Walgreens Newsroom: Orbitz Worldwide and Walgreens Launch Partnership to Keep Travelers Healthy

Anti Sleep Device To Monitor Your State of Being While Driving Includes Accelerometer

We have one more device and this is actually being marketed toward companies to buy and provide for their employees who drive.  image

We live in the world of sensors today and this is one more that could be helpful, as long as it works by attraction with people wanting to use it as a tool and not one more device that creates full data trails for every second recorded.  BD 

  • Accelerometer – registers the movements of the car which are used to calculate driving times and break recommendations

  • High-precision clock – measures driving and reaction times and keeps track of the various risk intervals for the day; these are all factors used to calculate the driving fatigue levelimage

  • Light sensor – automatically adapts the display backlight to suit the light levels in the cockpit

  • Sound sensor – automatically adapts the audible signals to suit the noise levels in the cockpit

  • Touch sensor – ensures easy interaction while you drive

  • Intelligent on/off button – the magnetic base acts as an on/off button so you can save the battery when your Anti Sleep Pilot is not in use

  • Battery-operated – the Anti Sleep Pilot uses a standard AAA battery, so it is easy to install and does not rely on an in-car charger while you drive.

  • Anti Sleep Pilot » Product » Design

    Medtronic Acquires Hypertension Device Used to Deaden Nerves In the Kidney Area to Control Blood Pressure-Acquisitions Seen As Path Way For Growth

    Back in December of 2009 I covered the clinical trial process that is ongoing through this procedure to basically create a cure for high blood pressure with some imagepatients, thus eliminating the need for medications.  Medtronic has now purchased this company.

    Minimally Invasive Surgical Procedure In Clinical Trials to Regulate Blood Pressure and Reduce Risks of Heart Attacks

    RDN is the name of the procedure that is done with a catheter and they delivery treatments to nerves of the renal system.  A proprietary algorithm adjusts the imageprocedure to be customized for each patient and there is no implant with this procedure.  The procedure is already being performed in Europe.  As mentioned below Medtronic and other companies are looking for growth via acquisitions as some device markets are falling flat or with little increase.  BD 

    Ardian Catheter

    On Monday night, Medtronic Inc. announced it was spending $800 million to acquire a California company that's working on a unique treatment for high blood pressure. Rivals Boston Scientific Corp. and St. Jude Medical Inc. have recently brokered big-ticket deals, too.

    The deal making frenzy is due, in part, to slowing core markets in med-tech. In Medtronic's case, sales of key spine surgery devices and heart defibrillators have flattened in the past year.

    image

    Given the trends, Wedbush Securities analyst Phillip Nalbone said large med-tech players like Medtronic "have no choice -- they better be out there buying things rapaciously because it's the only opportunity for growth. The harsh reality is that there is very little growth and maybe no growth left in all the big, traditional categories like pacemakers, defibrillators, drug-coated stents and spine [products]."

    Medtronic said Monday that its acquisition of Ardian Inc. gives it access to "one of the most exciting growth markets in medical devices." Ardian is selling its blood pressure device in Europe, but not yet in the United States.

    A time of challenges for Medtronic | StarTribune.com

    Giving Medical Record Access To An Employer and The “Employee Assistance” Program Lead to Woman Getting Fired

    According to the story the woman has been alcohol free for over 14 years and imageslipped back and informed her employer she was going to seek treatment.  We don’t know how bad the problem was or if she had been drinking on the job and/or had been warned as that content is not in the story here.

    What is stated is that she gave access to her medical records to her employer and their employee assistance program (perhaps a wellness program) and after she signed a second release that documented private therapy sessions she was fired after inquiring with human resources on the status of her therapy record release being added to the first set of records she released.  The doctors and hospital warned her NOT to release such items but obviously she felt the need to hopefully substantiate her issue and maintain here employment I might guess.  Doctors orders were correct here and think about this situation and I myself have been in doctors offices working to over hear employers call the office and ask for patient records, to which the answer is always no. 

    The woman has now filed a lawsuit and I am curious to know if this employee assistance program included “wellness” in their offerings too.  Again without all the details about her alcohol issue it’s hard to tell, but the one thing she could have stood solid on was giving the release to her health records as it appears somehow the information contained was used against her along the line.  This is what makes wellness programs a bit gray at times too as how much information does the employer and potentially the health insurance company connected actually getting imageand would they in fact admit to seeing information about an employee on the sly if not officially shown? 

    The odd part too about this is that the woman worked as a “risk manager”. 

    Follow doctor’s orders and don’t do it as data could be combined with other information on file and when analyzed with some algorithmic formulas, it could paint a deceptive picture with formulas looking for “desired” results.  BD 

    A little more than two years into her employment as a risk manager with a major construction firm, Lynne Kossow told her bosses in May 2009 that she had relapsed into alcoholism after 14 years of sobriety and would immediately seek treatment.

    Against the advice of hospital staff and her treating physician, Kossow said, she signed releases giving Michels Corporation's employee assistance program broad access to her medical records.

    Still, she was fired in June 2009, and now has sued Michels, claiming the company violated the Americans with Disabilities Act by terminating her on the basis of her condition.

    Woman sues in claim she was fired after starting alcoholism treatment - JSOnline

    HiRes 90K Cochlear Ear Implant Recalled By Advanced Bionics To Address Safety Concerns With FDA

    The first time I heard of the implant was in the movie “Sicko” where the insurance company would only pay for one cochlear implant for a baby losing its hearing and a lot has happened since that time with many being able to hear again so the recall imageis for devices that have NOT been implanted yet, so patients who have them are fine.  The company is working with the FDA to address 2 reported issues with pain and noise that was too loud with the device as well as shocking sensations so nobody is seriously hurt here.  You can read below how the University of Washington has worked with this technology too. 

    Ear Implant Device Using Technology from Cochlear Implants Being Tested for Balance Disorder–First Patient Receives Implant

    OR IMMEDIATE RELEASE – Valencia, CA, November 23, 2010 – Advanced Bionics (AB), a global leader in developing advanced cochlear implant systems, announced today that it has notified the US Food & Drug Administration (FDA) that it will voluntarily recall its HiRes 90K cochlear implant device and is retrieving all unimplanted devices in distribution. This action is being taken in response to two confirmed instances where the product experienced a malfunction requiring explanation. These recipients experienced severe pain, overly loud sounds and/or shocking sensations at 8-10 days after initial activation of their device.
    AB is continuing to evaluate the root cause(s) of the problem and is working closely with the FDA to address their questions and concerns, and institute changes to the product to ensure that the HiRes 90K has the highest quality for patients who use the device. This voluntary action is being taken to ensure continued patient safety and product quality.  The risk of any significant adverse medical events appears to be remote at present.

    Recalls, Market Withdrawals, & Safety Alerts > Advanced Bionics Announces Voluntary Recall Of The Hires 90k Cochlear Implant

    LA County Coroner’s Office Has A Gift Shop

    This is the last place one would look for a gift shop but there’s one here in Los Angeles.  They have shirts, bottles of body fluids, beach towels, etc.  I guess the shirts could say I was in the LA morgue and survived?  image

    This is perhaps one more way to keep budget losses down to a minimum by adding retail revenue if the store can start turning a profit as so far it’s not.  The article below says they need a marketing firm?  What will people not sell and market today or should I say what will people not buy.  BD 

    LOS ANGELES -- The morgue is about the last place you would think of to go shopping, so it's perhaps unsurprising that sales at Los Angeles County's coroner gift store are next to dead.

    Tucked as unobtrusively as possible in a closed-door room off the coroner's lobby, the store is jam-packed with mortality-mocking merchandise: Water bottles marked "bodily fluids," boxer shorts dubbed "undertakers," toe tags, crime-scene tape and beach towels bearing the county coroner's trademarked symbol of a body outline.

    They recommend the coroner hire an outside firm with an eye to marketing the merchandise in high-traffic tourist areas, such as Hollywood Boulevard and Los Angeles International Airport.

    LA County coroner aims to revive gift shop sales

    FDA Approves Roll On Testosterone Axiron

    This took a while as of January of 2009 the phase 3 trials were closing on the imagedrug.  This was a combined effort of Eli Lilly and Acrux pharma to develop the drug. 

    Acrux – Roll on Testosterone Lotion Trial

    The usual warnings as we see with women’s hormones in this formula, don’t let it touch anyone else, unless your female partner wants a little extra perk.  I say this as testosterone is sometime prescribed for women so you can rub up a little now, but you have to get close to the arm pit, as that’s where it goes.  BD 

    INDIANAPOLIS, IN and MELBOURNE, AUSTRALIA (November 23, 2010) /PRNewswire/ — Eli Lilly and Company (NYSE:LLY) and Acrux (ASX: ACR) announced that the U.S. Food and Drug Administration (FDA) has approved Axiron® (testosterone) topical solution CIII for replacement therapy in men for certain conditions associated with a deficiency or absence of testosterone. Safety and efficacy of Axiron in males younger than 18 years of age have not been established.

    image

    Axiron is the first testosterone topical solution approved for application imagevia an armpit (underarm) applicator. Other forms of testosterone replacement therapy include: oral tablets, buccal tablets, subcutaneous pellets, transdermal patches, injections and topical gels applied by the hands.

    Lilly and Acrux Receive FDA Approval for Axiron(R) (testosterone) topical solution CIII

    Consumer Watch Dog Group Files Complaint with the FTC Regarding Data Mining, Profiling Algorithms–Privacy With Health Information At Risk With Insurer and Employer Usage

    This is always a great topic as you just don’t know what data mining algorithms could be mining your data. Yup, there’s that word again and it’s an algorithm that is written in code that does this.  Do you not think that algorithms are in control today or rather should I say some of those that create them in order to gain information?

    And Now A Word About Privacy – Digital Signs Using Hidden Facial Recognition Software To Market You and Store Data – Are They Playing in a Physician’s Office Near You?image

    Now this has you worried, walk with a mask in the future I guess and don’t look at digital signage boards as they may be marketing you from the face.    If nothing else this makes a statement on how health insurance companies dig and dig for any data they can get.  Here’s an example of what United is doing.

    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

    It’s those sneaky algorithms and wimpy disclosures that will get you.  We come back to the programmers and coders paid to do such things usually at the instruction of others wanting the data.  Nielsen decided it was a bad practice and said they were not doing this any longer, but again not doubting their word but only your programmer knows for sure. 

    Junk Insurance Lawsuit Filed Against Texas Firm Healthmarkets by LA City Attorney–More Algorithms for Profit Conflicting With Care

    Marketing and digging for data is pretty much destroying the very basis and value of what it was set up to do in healthcare as it is being seen as a “secret weapon” these days. Remember this story to where the folks were marketed.  I don’t know about you but I’m not putting my information on these sites or answering an quizzes, but have never been one to do that anyway. 

    Patients Like Me Experienced Data Mining Through a Data Mining Research Firm Break In –The Nielsen Company

    Now there are marketing companies that flat out buy your prescription data and sell it to insurers or companies doing clinical trials too and this you have no control over if you are on record at a pharmacy or PBM and the second company notes below is a wholly owned subsidiary of United Health Care and this has been going on for years and they make big dollars doing it. 

    You can read the statement from Milliman about Intelliscript here.

    image

    “Does this process make it more difficult for consumers to get insurance?
    No.  There is nothing new about consumers authorizing the release of their medical records, including prescriptions, to insurers.  This standard process has been in place for decades, helping insurers make good decisions about rates and insurability.”

    You can read more about Ingenix MedPoint here.

    There’s also a flash presentation where you can view the process here.

    image

    “By increasing understanding of potential disease conditions and relative risk, MedPoint enables underwriters to more accurately project future claims costs on a case-by-case basis.”

    Data mining is just another series of algorithms out there functioning on the web to find data.  Writing queries to match is not that hard once one finds a common denominator and again read below to where the one company wants a patent on their automated query system to match up your personal information with the likes of Twitter and Facebook

    Habits and Identities Revealed via Coupons – Facebook Fan Pages Can Make User ID Visible – Shopping Algorithms Reduce Privacy And Increase Visibility

    You don’t have to be on Facebook but it has happened there too and some of it gets sold.  During healthcare reform politics before the law was signed we had play money from a game on Facebook going to Blue Cross. 

    Have You Been Suckered In by FaceBook to Play Games To Support Employer and Insurance Company Reform Initiatives?

    Again, always read the “privacy statements” for each site and try your best to figure out exactly what it means.  This week, Humana came out with a game for people to play and connect devices to report data, where does that information go?  In the case of this game, I would rather connect and put the information into my PHR Healthvault so I know I have it and exactly who has access, me. 

    Health Insurer Humana Introduces a New Game Called FamScape–Making It Fun to Get And Maybe Mine Your Data?

    If all this information was not in some fashion used against us, there would probably be a lower resistance but when we have steroid algorithmic marketing out there and it’s only going to get worse, stay away from all of it would be my advice if you don’t agree with or understand the privacy statement. 

    My next question here, what is the FTC going to do with all these questionable algorithms?  Hmmmm….we are too late to the party once again as I suggested a couple years ago some type of regulations are needed here since it costs consumers money and potential identify issues.  Is the FTC going to get some code hackers in to see what’s behind the scenes here? 

    Only your algorithm knows for sure.

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

    There’s a bit more here on a prior post I wrote on the topic below.  As a consumer if you want to get even on some of these sites, just lie with some exaggerated numbers and perhaps we can all create such inflated data bases that are filled to the brim with data that is so far beyond belief they might throw it away <grin>. 

    Why Is Almost Everyone In Healthcare Marketing Their “Ass” Off

    Don’t let the wrong algorithms hit you in the back on your way out the door as Algorithmic marketing has arrived.  BD

    QualityHealth is one of a number of companies cited in the complaint to the F.T.C. filed by four nonprofit privacy and consumer advocacy groups. In the complaint, the Center for Digital Democracy, U.S. PIRG, Consumer Watchdog and the World Privacy Forum charged that online marketing of medications, products and medical services posed fundamental new risks to consumer privacy and health because of sophisticated data collection and patient-profiling techniques.

    Some sites, the complaint said, were not transparent enough about how they tracked people through users’ online heath searches and discussions or how they categorized and marketed to their conditions. Other sites may not be entirely open about how they create and use data profiles about users or blur the line between independent and sponsored content, the complaint said.

    The concern, said Ed Mierzwinski, the consumer program director at U.S. PIRG, is not just about data mining and marketing that could influence patients to seek drugs they do not need or to spend more money on branded drugs rather than generics. More broadly, employers or health insurers could gain access to the consumers’ data profiles, leading to potential problems or penalties against the consumer, he said.

    A notice at the bottom of QualityHealth’s member registration form, for example, provides a link to the site’s privacy policy. The policy explains that information that may or may not identify someone may be used for ads aimed at consumers.

    Mr. Vladeck offered a hypothetical example of a core privacy question. “Suppose someone goes online to read about depression, should that person get targeted with ads for antidepressants, for counseling services or books about depression?”

    Online Health Sites Share Personal Data, Privacy Groups Say - NYTimes.com

    Head of FDA Criminal Office Retires After WhistleBlower Reported Misconduct

    The Office of Criminal investigation at the FDA finds counterfeit and adulterated medicines, and helped bring federal cases to court.  The budget for the office has grown, which is a good thing and the FDA also stated that they would have liked to have a bit more transparency and reports from the criminal office, which reportedly was known for a lot of secrecy.  image

    The problem was “outsourcing” is work to a contractor from what the article stated and a letter from a whistleblower was sent to Grassley and as soon as he inquired, here forth came the retirement notice.  BD

    WASHINGTON—The Food and Drug Administration's top criminal investigator is stepping down after a whistleblower made allegations about the alteration of internal agency reports and other misconduct.

    Terry Vermillion set up the FDA's Office of Criminal Investigations in 1992 after retiring as a Secret Service agent. The office has been at the center of the current probe into alleged doping by cyclist Lance Armstrong. The anonymous whistleblower complaint, sent to Sen. Chuck Grassley (R., Iowa), doesn't involve the Armstrong case.

    Mr. Vermillion has declined to comment since the letter was first reported last month, and didn't respond Tuesday to an email and a call to his office. The FDA didn't make him available for comment.

    Head of FDA Criminal Office Steps Down After Whistleblower Complaint - WSJ.com

    Government Accounting Office Releases Earth Shattering Report - EHR Systems Can Save Money–What Took Them So Long

    As noted at the bottom of this article we all know this but now it is official since imagemembers of Congress rely on reports and information from the GAO.  This is good for Health IT to have this fact documented, no matter it took so every person in Congress can come to terms with this fact and hopefully used the numbers and information the GAO reported.

    Now on a similar note, I wonder how many members of Congress actually use any type of a personal health record?  I think that is a good question as using one will stand t increase their digital consumer literacy and awareness and don’t the staff pick up this area of responsibility as it is your life and not theirs as they can get their own PHR as this is a consumer product, and it’s free from many.  How about that anesthesiologist that wants his US government health insurance, there’s a good place to start with one who should know the value of a PHR – wonder if he has one?

    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

    Good work on those algorithms that created this report from the GAO so there’s hopefully one less thing to argue about in Congress and again maybe this will spur some real Health IT participation at those levels, just like they want us to to.  BD

    In a new report, the Government Accountability Office (GAO) took a look at electronic health records (EHRs) as they relate to improving health care and cutting costs. It examines the stories of 15 health care providers that have formed integrated delivery systems (IDSs).

    These particular IDSs were of interest to the GAO because their patient rolls include what the government defines as “underserved populations,” that is, people facing economic, geographic, cultural or linguistic barriers to care, including Medicaid enrollees and rural populations. The government provides a safety net for many such patients — and legislators have to find room in the budget to fund it.

    To health care providers who are advanced EHR users, the contents of the report might sound like a long-winded, taxpayer-funded waste of stating the obvious. Legislators, however, rely on GAO findings to help guide them in their craft. With a divided Congress convening, it’s nice that health IT leaders will have a positive report from a source they know speak legislators’ language. It could come in handy for future reference when the hyperbole ratchets up in Capitol Hill debates.

    EHR systems can cut health care costs, GAO reports - Health IT Pulse