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Remote Area Medical Holds Free Clinic in Nashville-1000 or More Patients Expected

2/19/2011 10:14:00 PM  ,  

Remote Area Medical is making it’s first visit to Nashville.  We still have issues all through out the US with healthcare.  If you remember back the last couple of years imagethey have come to the Los Angeles area twice.  The clinic is anticipating seeing over 1000 patients.  At 3:30 am people were already lining up in the cold weather to be seen.  Here’s the last schedule posted from their website and you can see where later this year, in April there are 2 Free Clinics returning to California, this time the northern portion of the state in Sacramento and Oakland.  In many states getting enough volunteers is difficult as doctors cannot cross state lines to participate, an item Stan Brock would like to see addressed.  BD

Stan Brock From Remote Area Medical Speaks Out Asking Laws To Allow Doctors To Be Able to Cross State Lines

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In today’s hard times it’s really great to have RAM here to help out and get medical care to those who need it at no charge, for the non insured and under insured.  BD 

NASHVILLE, Tenn. - The halls and gymnasiums of McGavock High imageSchool will become a free health clinic this weekend.Medical, dental and vision services will be offered to an estimated 2,000 people on Saturday and Sunday.

The clinic is being held by the Remote ACcess Medical Volunteer Corps, a non profit group that helps provide healthcare to those in need around the world.
The school's gymnasium will be transformed into 50 complete dental stations Feb. 19-20. Down the hall, doctors will treat patients and vision exams will be given. Outside, a mobile optical lab will make eyeglasses.

"We'll offer extractions cleaning, eye exam check for eye disease make a pair of glasses," said Ron Brewer, the director of Remote Access Medical.

Free Health Care Clinic In Nashville This Weekend - NewsChannel5.com | Nashville News, Weather & Sports

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Meaningful Use-Time To Investigate Beyond Proof of Concept and Half Baked Technologies, A Security Reality Check

2/18/2011 11:10:00 AM  , ,  

Half baked is a lot of what we are getting out there today.  Everyone in different aspects of Health IT has their own special interest and some of these areas are not playing very well with other technologies.  Take a look and think about why in the world do we have so many electronic medical record systems.  Sure imagethere’s room for open competition but everyone thinks they have the best mouse trap out there.

On the other side of the coin you have the folks chasing the ACO and they can’t understand why everyone is not just jumping all over this.  Certainly it’s a good concept but again with a reality check they all have a ton of other issues on their plates, some of which are day to day data operations that can’t be back burnered either, so the ACO folks better sit back and wait a while until your efforts can be addressed and worked into the entire scheme.  There are a ton of vendors with software applications to help you there and they too are all “marketing their asses off” to make a buck, it is what it is today. 

Many of those outside the Health IT business have no clue of the work and data structures entailed to make this work, and the same can be said for most consumers as they see something on the web they want it today.  Hold on to your hats folks as all of this is not going to happen. Keep in mind those CIOs having a big stake in this too are also consumers and patients so they are looking after your best interest after all, so don’t feel that you are neglected.  When it comes to healthcare, we are all consumers. 

I can easily reflect back to when I was writing code and the days that I thought I had designed the best and what I thought was the most efficient and easy to use screens for data entry and viewing.  So I compiled and created the update only to find out that for the doctor’s, it sucked.  That would lead to another level of conversation as perhaps they did like part of the design and thus I would go back to the drawing board and create a compromise and sometimes this doesn’t happen just once, it may occur many times over before the desired solution occurs. 

Sure everyone wants to be on the wagon for their stimulus money and if I were a doctor I would be right in there too, but again, when you look at this huge moving target today in healthcare, you can’t push too much out there too fast.  Stop and think about what’s happening at the FDA?  Does this impact care, sure it does and they are working on major IT infrastructure upgrades as fast as they can.  Is this having an impact on over all medical records, clinical trials and other data systems?  It sure does, so again ACO guys hang on and wait a while until this element gets structured in there as the Docs want their stimulus money first, I would. 

Let’s talk about cloud data functionality.  Does this impact medical records?  It sure does and even gets more complicated when you have lawmakers that don’t understand it and don’t fund it in the Senate which I call a big “duh” moment from last year.  You know these luddites at times that we elect make the laws and we have to deal with their “non participant” statures and soap operas at times in Washington so we sit back and see what in the world they do next.  It’s who we elected and what we have to deal with as far as laws and regulations.  We all wish they would educate themselves up a few levels, but what power do we have if they don’t?  We can vote them out or recall, but do we have another luddite waiting in the reins? 

Senate Cuts Cloud Services From Budget That Would Allow for Data Center and IT Infrastructure Consolidation–Back to the 8 Track Tapes Next?

Consumers get beat up right and left in the news about digital literacy and this just doesn’t seem fair when there’s luddites at the top and at the bottom. 

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

Back in December I attended this convention to just chat and gather information for my own knowledge and it was an eye opener as various panels came together and answered questions, asked questions and so on.  I asked a few questions, and some a bit complicated to see what the answers would be and I did this not to put anyone on on the spot but to more or less see where folks were coming from and how they were dealing with this big moving target.  I got my answers and it was about what I expected.  I did not get “bad” answers at all but most were pretty much information offered based on a “work in progress” knowledge base, which is about the best you can expect and there’s a lot of good things happening. 

CIO Confidence In Meaningful Use Drops-The New Left Curve of Technology That Arrives Daily Contributes-Don’t Burn These Folks Out

Bottom line is it took years to create all the complicated systems we have out there today and it’s going to take a few more years to help everyone communicate.  You simply can’t jump on every band wagon that rolls along, but it’s wise to take a look and see what’s in there and then base an evaluation or opinion.  Again, remember too there’s getting to be a pretty fine line today between marketing and education and that gets really blurred at times. 

Institute for Health Technology Transformation Convention–Fall 2010 Convention - Insights From The Medical Quack

We can move over to the social networking side of healthcare next.  There are many good tools to be used and use them wisely so you benefit.  I do have to just laugh at times though when I see these screaming rhetorics  on who’s not using it well and what they should be doing. I think when folks run out of things to chat about we get a load of those types of posts on blogs, etc. and what’s even funnier at times is when you see everyone repeating them, enough of the judgmental stuff and get back to basics and use social networks to enhance your education and skills and quit telling everyone else what they should do and focus on your own back yard.  Try to figure out who’s offering education and who’s just flat out marketing you and that’s not always simple these days. 

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

Last but not least, go visit a practice, a hospital and ask questions and learn up and see how they are functioning with adding new technologies into the every day business of running their business.  I think the folks at CHIME are making a pretty good point here about holding off on the “proof of concept” part of Meaningful Use as we have not made it past part one yet that is now in play.  When you are in an office studying and looking at systems, they all look great, but don’t forget the implementation part of this and how much time the CIO and clinicians have to dedicate, as they still do have to care for patients and can’t devote the same amount of time to software that you do. 

With all the complicated data systems today it doesn’t seem that we are making it any easier for the clinicians any time soon although some places do a lot better at this than others.  No wonder Dr. Blumenthal wants to go back to Harvard <grin>.  I say this in jest because the pressure is phenomenal and I understand this and the same holds true when I wrote about burning out the CIOS to people at these levels too. 

In doing this blog I certainly get tired of looking at what I call half baked technologies out there and think everyone is nuts when they keep using the word innovation, as we have nothing but innovative people out there with stuff emerging every day.  What we don’t do very well is collaborate.  As I said a few months ago it’s fouling up our systems and I have a lot of folks agree with that.

 Innovation brings us half baked technologies, collaboration finishes the task.

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

So back on track when you think about phase two of meaningful use think about all the other “proof of concepts” laying around out there since Meaningful Use was created and look for some real collaborative efforts instead of the half baked innovation stuff that fills the news today.  Give the CIOs and others in healthcare a break and understand this takes time to evolve.  This evolution holds true in other industries outside of healthcare too but nowhere else is is more critical. 

You think you can have it all today with accurate data and high performing systems, think again as every concept and innovation is not the great white hope today.  Security in my book has to come before a lot of other Health IT technologies and thus some feature functionalities will have to take a back seat until more emphasis is given to secure what we have.  Check out this well done video below on what can happen and has happened with security and even though is this is not healthcare, you will get the picture.  BD

Health IT Security and Why It Matters-What Is a SQL Injection Flaw and It Still Keeps Happening Today (Video/Fictional Story)

ANN ARBOR, MI – The College of Healthcare Information Management Executives (CHIME), with 1,400 CIO members, is urging the government to allow hospitals and physician practices more time to assess Stage 1 progress and to better prepare for Stage 2 meaningful use objectives.

CHIME submitted its comments on Stage 2 meaningful use objectives Thursday.

Meaningful use measures and objectives for Stage 2 should reflect the capabilities and experiences of hospitals and physicians to handle the scope of Stage 1 before any measures for the second stage are codified, CHIME contends

"Although most CIOs take the lead in deploying and encouraging optimization of information systems, our primary goal is to help introduce and manage change in our organizations," said David Muntz, chair of CHIME's Advocacy Leadership Team (pictured at right). "The change management implications of our current environment have never been greater, hence, our interest in finding certainty and practicality whenever possible. Even well-intended efforts must recognize that the staff and physicians need a clear vision of the future and time to absorb and adjust to the changes."

CIOs call for delaying move to Stage 2 meaningful use | Healthcare IT News

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First-Year Resident Wanted for Alleged Sexual Assault of Patients at Christiana Hospital in Delaware-Warrants Issued

2/18/2011 09:01:00 AM  ,  

The incidents were reported between October 1st and November 15th.  All were female patients between the ages of 20 and 32.  Computerized records were imageaudited that lead to identifying the resident.  See electronic records are good for unfortunate occurrences such as this in nailing down the history.  He was in the charts digging around of the six victims and performed physical exams, didn’t document in the charts. 

Three of the victims were not under his area of jurisdiction, being “non teaching” patients so he had no reason to be in the charts.  The Attorney General and the Healthcare system are looking for him and there’s information at the bottom of the post on how to report any tips.  I hope they find him and again when accessing sophisticated medical record systems today, there’s usually always an audit trail and hopefully the medical records are leading authorities in the right direction here to capture this former resident.  Taking off and being on the run doesn’t seem to be a very good indicator here.  BD   

NEWARK, Del. - Delaware State Police are trying to find a former first-year resident at Christiana Hospital who they have identified as a suspect in the alleged sexual assaults of six patients.

According to state police, Shyamkrishnan Ramdas, 27, of Newark, has been charged with six counts each of third-degree unlawful sexual contact and abuse, mistreatment or neglect of a patient or resident of a facility.

Ramdas is a former first-year post-graduate internal medicine resident with the Christiana Care Health System.

Warrants have been issued for Ramdas, but his whereabouts are unknown at this time, as he is no longer employed by health system, police said.

Anyone who knows Ramdas' whereabouts or has any information about the incidents is asked to contact the Major Crimes Unit at Troop 2 by calling 302-834-2630. Or, call Delaware Crime Stoppers at 1-800-TIP-3333.

Information may also be provided online at www.tipsubmit.com , or send an anonymous tip by text to 274637 (CRIMES) using the keyword "DSP."

First-Year Resident Sought In 6 Sex Assaults On Hospital Patients

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Medicare Charges More than 100 Doctors, Nurses and Physical Therapists With Medicare Fraud In Multi State Round Up

2/17/2011 09:34:00 PM  ,  

This is good to see some progress being made.  Technology will eventually help recognize some of these patterns too with running reports and queries to look for items that fall outside the normal realms.  One example in this article shows one doctor making $6 million on hemorrhoid surgeries.  The article continues to go on to state that one case of removing 10 was impossible, so again technology will help guide law officials into the areas to where investigations should begin. 

Medicare Federal Investigators Getting Algorithms to Analyze And Find Fraud-Good Move as Contractors Efforts Are Weak With Risking Loss Of Transaction Revenue

In addition we now have the most wanted list to bring an awareness around with visuals. 

HHS Creates 'Most Wanted' List Website for Healthcare Fraud - Office of the Inspector General

One other area I think that can use some analysis too are the flawed listings on the web with doctors as crooks mine the web too.  When it comes to finding fraud the FBI and DOJ are pretty much on their own as there’s not much help coming from Medicare contractors as transaction fees apply on both good and fraudulent claims so one end of an insurance contractor makes money on the other end so why cut the amount of claims going through.  Anyway I suggest a major clean up here too so mining the web doesn’t lead to more crime with finding NPI numbers on dead doctors and so on.  BD

Dead Doctors and Inaccurate MD Listings On the Web Can Be a Real Hunting Ground of Information to Mine For Crooks Relative to Fraudulent Medical Billing

MIAMI – Federal authorities charged more than 100 doctors, nurses and physical therapists in nine cities with Medicare fraud Thursday, part of a massive nationwide bust that snared more suspects than any other in history.

More than 700 law enforcement agents fanned out to arrest dozens of people accused of illegally billing Medicare more than $225 million. The arrests are the latest in a string of major busts in the past two years as authorities have struggled to pare the fraud that's believed to cost the government between $60 billion and $90 billion each year. Stopping Medicare's budget from hemorrhaging that money will be key to paying for President Barack Obama's health care overhaul.

A Brooklyn, N.Y., proctologist was charged with billing $6.5 million for hemorrhoid removals, most of which he never performed. Dr. Boris Sachakov claimed he performed 10 hemorrhoid removals on one patient, which authorities said is not possible. An employee who answered at Sachakov's office declined comment Thursday.

Sachakov had been arrested last year on charges related to a separate scam. Sachokov denied the charges.

Authorities also busted three physical therapy clinics in Brooklyn, run by an organized network of Russian immigrants accused of paying recruiters to find elderly patients so they could bill for nearly $57 million in physical therapy that amounted to little more than back rubs, according to the indictment.

111 charged in Medicare scams worth $225 million - Yahoo! News

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Johnson and Johnson Files Complaint Against the FDA Regarding Sedasys Device Rejection Used for Propofol Delivery-But Wait We Still Have Shortages & No US Manufacturers?

2/17/2011 08:25:00 PM  ,  

Propofol requires by label that an anesthesiologist be present and the device would administer the drug for surgical procedures such as colonoscopies without an anesthesiologist present.  Doctors perform colonoscopies with a mild sedative without an anesthesiologist present, but use different drugs.  Perhaps all the recent recalls is not helping here.  There is a shortage of the drug that the device would use.  Maybe Johnson and Johnson needs to manufacture the drug since we have no US manufacturers left and rely on one company in Germany to supply the entire US.  The company in the US that distributes propofol set up hot lines to help hospitals with their orders a couple months ago. 

Anesthesia Drug Shortages, First It Was Propofol and now Pentothal–Choice #3 Is a Real Old Drug And Less Stable

Here’s a few more details from last year on the decision from the FDA with going from 2 US manufacturers to none within a few months. 

Teva To Stop Manufacturing Propofol – With No US Manufacturers Left FDA Approved Import From Europe

What makes this case also interesting is the division of J and looking for approval is the same division that issues recalls today. 

J&J Unit Recalls Wound-Sealing Adhesive And Hernia Treatment Product-Ethicon

Maybe this is bad timing?  Right now there’s almost a no win conversation going on between safety and getting products approved sooner and that includes both drugs and medical devices, but devices are getting most of the attention right now.  In addition, some members want to cut the FDA budget and I don’t see how that can be done and get the work load handled.  The only other alternative would be to start turning down some applications and that’s not really a good answer either as companies would go elsewhere.  Some US manufacturers have already done this and are kind of writing of the US market for selling their products and going for approval in Europe and other countries.   BD

FDA Medical Device Approval Process Under Review Due to Recalls With Numbers of Implanted Devices

The dispute stems from the FDA's rejection last year of a medical device made by J&J, despite endorsement by a panel of expert advisers who recommended approval. In response, J&J appealed directly to the commissioner, Margaret Hamburg—only the second such appeal in agency history.

While companies like J&J complain about the FDA, the agency is also feeling heat from some members of Congress and consumer groups to be tougher. They cite recalls of devices that were found to cause serious health problems, even deaths.

The J&J device that the FDA rejected, Sedasys, is used to mildly sedate patients about to undergo routine medical tests like colonoscopies, using the drug propofol. That sedative's label requires that it be administered by an anesthesiologist.

Typically, doctors who perform these procedures without an anesthesiologist give patients a sedative other than propofol, J&J says. Sedasys could make patients more comfortable and has safeguards protecting patients so an anesthesiologist wouldn't need to be present, according to the company.

The debate boiled at a House hearing Thursday. Financial backers of medical-device start-ups criticized the unpredictability of device reviews and said it is hurting hiring, while FDA officials countered that faster reviews might result in approvals of devices that, once they are on the market, harm patients.

J&J, FDA Differ on Medical Device Testing - WSJ.com

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J&J Unit Recalls Wound-Sealing Adhesive And Hernia Treatment Product-Ethicon

2/17/2011 07:34:00 PM  ,  

It seems like it’s never going to end with recalls and when J and J is finished with all imagetheir inspections, perhaps these will all but go away.  This company really need a coordinated recall system.  Even if the product doesn’t have any affect on consumers directly, the mounting items of items in the news certainly is not a very big help at all.  Earlier this week a re-organization was announced for the consumer products end of the business. 

Johnson and Johnson Restructures Consumer Products Group And Creates New Global Franchise Organization

Besides their own problems they have some counterfeiters to look out for as well.

Counterfeit Johnson & Johnson OneTouch Products Investigation – One More Good Reason to Start “Tagging” Products for Consumers So We Can Scan for Authenticity

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Again, Johnson and Johnson with all their products in so many different areas of healthcare could sure stand to build consumer, doctor and business confidence about now and it sure beats being the BP of imagethe pharmaceutical and medical devices industry and my bar coding idea still stands.  BD 

Johnson & Johnson's (JNJ) Ethicon unit recently recalled 700,000 vials of a liquid wound-sealing product amid reports of discoloration and a new hernia-treatment product due to concerns about non-sterile packaging, a spokeswoman confirmed Thursday.

Both voluntary events add to the list of product challenges for J&J, which has issued a series of recalls for various products since 2009 due to manufacturing-related problems.

Ethicon notified customers in a Feb. 2 letter that it was recalling certain lots of its Dermabond wound-sealing adhesive based on reports that some units contained discolored product and may also take longer than expected to set. The company, which notified the Food and Drug Administration, said it hasn't gotten any reports of adverse events related to the problem.

The company recalled 31 product lots--including 28 in the U.S.--that contained a total of 700,000 single-use vials, spokeswoman Barbara Montresor confirmed.

The Securestrap system involves a pistol-shaped tool used to deploy tiny, absorbable straps that hold mesh in place in hernia-repair procedures. Ethicon was just rolling the product out in late December when it launched a recall because it determined the sterile packaging barrier could be compromised, Montresor said.

J&J Unit Recalls Wound-Sealing Adhesive, Hernia Tool >JNJ - WSJ.com

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Department of Defense to Seed $500 Million For Companies to Develop Dual Use Technologies-“Collaboration Not Innovation” DOD Can’t Keep Pace With the Iphone

2/17/2011 04:30:00 PM  , ,  

Well here you have it, an admittance of not being up to speed with technology and again this goes back to the prior administration and their neglect of technology with the “non participants”.  The US Government is paying for this in almost every imagedepartment too with having to get their IT infrastructure up to date, healthcare included big time and HHS is finally working on it.  This was an address made up at the silicon valley basically saying we need tech help now!  HHS is barely keeping up with some areas and then they get this with the Dow Jones wanting to hone in…you can read up there on my thoughts on this as what they are proposing is not as simple as they think with providing accurate data. 

Dow Jones Files Lawsuit Against HHS To Overturn Ruling To Keep Medicare Physician Compensation Confidential In the False Name of Transparency-Distraction is More Like It

You can’t blame the current administration for this mess as it took years to get here and a bunch of luddites with 8 track tapes stored in their brains. 

Here’s a post from not long ago on what CMS is proposing and they need a lot of this to fight fraud.  This is also a big are for both the FDA and SEC too, they need IT infrastructure badly as this has become a game of cat and mouse with algorithmic formulas run by Wall Street that rearranged the money in this country and we can’t continue to take a knife to a machine gun battle much longer.  BD 

CMS Releases Plan for a Much Needed IT Infrastructure Upgrade With Computers, Data Systems And Those Updated Algorithms

Deputy Defense Secretary William J. Lynn’s heart was in the right place when he addressed the audience yesterday at RSA Security Conference (video) in San Francisco. But his own words belied the impossibility of the plan.

“It currently takes the Pentagon 81 months to field a new computer system. The iPhone was developed in just 24 months. That is less time than it takes us to prepare a budget and receive Congressional approval for it.

This means I get permission to start a project at the same time Steve Jobs is talking on his new iPhone. It’s not a fair trade. We have to close this gap.  Silicon Valley can help us.”

Eighty-one months — seven years — is far too long for an organization trying to work with an industry that evolves monthly to defend against attacks that spread in milliseconds.

The Pentagon must keep pace with the iPhone, but can't and won't | ZDNet

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Study: Leave Robotic Prostatectomy in the Hands of Experts

2/17/2011 04:00:00 PM  ,  

By now most of us know about the daVinci robot that is used for prostate surgeries imageand this new study suggests that it may not be advisable for every smaller community hospital to perform the procedure but rather rely on the high volume centers of excellence where surgeons are fully trained and familiar with the procedure.  In other words every hospital is not going to have the availability of the robot, some simply due to the cost of the unit itself.  BD 

Use of robotic prostatectomy has mushroomed in the United States, but new data suggest it is best left in the hands of expert surgeons.

A multicenter analysis of 3,794 cases of robotic-assisted laparoscopic radical prostatectomy (RALP) performed by three experienced surgeons found that at least 1,500-1,600 cases were needed to achieve a positive surgical margin (PSM) rate of less than 10%, which is widely accepted in the surgical literature as a sign of excellence.

"We recommend that this operation should not be done by all urologists in small community hospitals, but should be focused and concentrated into those high-volume centers of excellence where the operation can be done by surgeons doing a large number of cases, very frequently, in order that they can achieve the best possible cancer-control results for their patients," lead author Dr. Prasanna Sooriakumaran said during a Feb. 15 press briefing for a symposium on genitourinary cancers.

The study will be formally presented at the symposium, which is sponsored by the American Society of Clinical Oncology, American Society for Radiation Oncology, and Society of Urologic Oncology.

Analysis: Leave Robotic Prostatectomy in the Hands of Experts : Internal Medicine News

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HHS Opens New Website-Health Indicators Warehouse For Community Reported Data

2/17/2011 02:36:00 PM  ,  

If you want to look up community rankings on selected healthcare areas this may be the place for you.  I can see this being useful for students for one in having to write reports for school and other businesses looking for community health data that could be relative to their own business efforts.  If as a developer you might feel there’s a burning desire for a program to help interpret and work with community data, there’s an API for that too.  They did put a bit of extra information out there for developers too with SOAP methodologies and it looks like it has some dot net technologies in here without looking closer. 

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Be patient if you are looking up data as these are some big queries so allow time to search.  I looked up infectious disease and there are many subtitles to narrow it down.

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I looked up rabies and there was no national data yet, but I guess as time goes on there will as there’s an explanation page that tells how the data is or will be collected.  Again, the average consumer more than likely won’t be venturing over here very often and I see it as more for research for community information that may be needed.  BD   

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The Health Indicators Warehouse holds data to support researchers, policymakers and technology developers. Available data covers life expectancy, mortality, disease incidence or prevalence, health behaviors, health risk factors, physical environments, socioeconomic environments, and care access, cost, quality and use, among other factors. Indicators may be defined for a specific population, place, political jurisdiction or geographic area.

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In total, the warehouse holds nearly 1,200 downloadable indicators from 170 data sources. More information is available at http://healthindicators.gov.

http://www.healthdatamanagement.com/news/HHS-Releases-Health-Indicator-Data-41940-1.html

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Johnson and Johnson Restructures Consumer Products Group And Creates New Global Franchise Organization

2/17/2011 02:18:00 PM  ,  

Restoring the McNeil Consumer Healthcare brands is a big focus here as you would imagehave to be living under a rock today not to have been affected in one way or another when looking for products on shelves that either are no longer there or have been recalled.  The US sector of the restructuring gets it’s own division as probably a good thing as this is where so much of the recalls and negativity took place, just read the news. 
The Global Franchise Organization looks to be focusing on their research and development partners for quality assurance and technological advances as well as assuring the fact that franchises are properly equipped and up to date with everything the company makes available.  I always get confused in some of the big conglomerate explanations of who answers to who and where all the divisions areas of responsibilities lie but I think they key element here is the dividing of the consumer goods division into 4 regions for greater concentration and marketing.  We all know after all the recalls, some new methodologies/strategies were probably in order.  BD

The businesses will be organized regionally, with each of the regions (Asia-Pacific, Europe/Middle East/Africa, Latin America, and North America) led by a Company Group Chairman or International Vice President.  Customer Development will report to the Company Group Chairman, North America. 
In order to give focused attention to quality and compliance, and the critical task of restoring our McNeil Consumer Healthcare brands, the U.S. OTC business will be a separate organization. U.S. OTC will report to a Company Group Chairman, who also will be responsible for Worldwide McNeil Nutritionals, Wellness & Prevention, and the Johnson & Johnson–Merck Consumer Pharmaceuticals Company. Ortho Dermatologics will continue to report to the Vice President, Business Development.
This regional structure will enable quicker reaction to changing market conditions and more efficient execution of region-wide initiatives. It will help to accelerate growth in emerging markets and ensure healthy businesses in developed markets.  Regions will have responsibility for: regional and individual market P&Ls for all countries in the region; in-market execution; customer strategies and relationships; and local market research.
We are also developing the processes that will help the new organization run effectively and efficiently, such as strategic and business planning; annual goal and target setting; new product prioritization; succession and talent planning; performance and development planning; and Sales & Operations Planning. We also will begin work shortly on a Consumer Group Strategic Plan, to take full advantage of the opportunities afforded by our new organization.

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President Obama Meeting with Tech Industry Leaders–CEOs and Some of the Smartest CEOs (Algo Men) Who Write Code

2/17/2011 01:45:00 PM  , , ,  

If you have not seen the news the President is meeting with some of the brightest leaders in technology today.  I have been saying this for a couple years now at the Medical Quack that intelligence and decisions in healthcare are being derived from those algorithms and that’s what the talk here is all about. 

Of course a couple of the most impressive on this list are Steve Jobs and Larry Ellison, they wrote code and again as I always say, “there’s nothing like first hand experience” and as consumers we can all use some first hand experience in trying new software and technologies that are available to us, that’s how we learn.  Not too long ago the President hired his “hybrid” chief of staff that understands algorithms and their use today.

President Obama Names a New “Hybrid” Chief of Staff That Can Bring Some “Algo Men” to the White House and Washington

The world has changed in 2 years, a lot.  In healthcare we have some hands on IT folks coming to the helm as well, and in reality that should have been done 2 years ago with the Director of HHS needing more Health IT background than negotiation skills as that’s just the world we live in today. Here’s a post from a couple months ago about algorithm methodologies below.  The same business intelligence processes use for investing/banking are making their way into healthcare and I don’t like all of it either as we have a tremendous lack of balance along with some very serious ethic problems.  Don’t shoot me, I’m just the piano player here trying to bring about an awareness and hopefully shine some light on how technology and the world is evolving. 

High Frequency Electronic Trading Methodologies And Algorithms Work Their Way Into Healthcare With Human Bodies Losing Liquidity With the “Data Game”

With healthcare it’s time we should be able to stop feeling like a “commodity” laying in a hospital bed, which is the way finance looks at it when it comes to money and we need a balance between saving money and treating people like humans.  Until we are able to balance some of this, new jobs are not going to show up, and those that do will not be what people are currently trained to do, so we come back around to education. Bill Gates has spent years testifying to deaf ears in Washington on this topic too as entertaining ourselves has seemed to trump learning in so many ways, and we need balance and a little bit of both.  Also of interest on the list is Genentech, new drugs are all designed by computers and algorithms before they reach their final stages, again not like it used to be.  One more interesting post about technology and our lawmakers, they need to tune up here soon and get those Algo Men who can help them with looking at reality and start ditching their 8 track tapes.  <grin>.  BD

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
  • John Doerr, partner, Kleiner Perkins Caufield & Byers
  • Carol Bartz, president and CEO, Yahoo!
  • John Chambers, CEO and chairman, Cisco Systems
  • Dick Costolo, CEO, Twitter
  • Larry Ellison, co-founder and CEO, Oracle
  • Reed Hastings, CEO, NetFlix
  • John Hennessy, president, Stanford University
  • Steve Jobs, chairman and CEO, Apple
  • Art Levinson, chairman and former CEO, Genentech
  • Eric Schmidt, chairman and CEO, Google
  • Steve Westly, managing partner and founder, Westly Group
  • Mark Zuckerberg, founder, president and CEO, Facebook

Official list of attendees at Obama tech meeting: CEOs of Twitter, Netflix, Oracle, Yahoo, others | Technology | Los Angeles Times

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IBM and Nuance to Work on “Watson” (The Distant Cousin of Dr. Watson) Perhaps Affordable Technology for Use In Healthcare If Private Equity Investors Stay Out Of It

2/17/2011 12:35:00 PM  , ,  

For those of you who might wonder why is the computer called “Watson”, here's little background that might lead to some interesting reading.  Dr. Watson has been imagearound a long time.  Actually the first Dr. Watson appeared with IBM as a program used with dos and and other networking platforms and was called DWTNDA.  In 1994 Dr. Watson was recognized as the product of the year.  If you want to read more about the history, follow this link.   In addition the founder of IBM was named Thomas J. Watson, so there’s a few cousins running around out there. 

This Watson also has another distant cousin on the Microsoft side and anyone who has perhaps encountered any major issues with Windows may have heard of this Dr. Watson who’s primary function is to debug.   Now this Windows Dr. Watson is names after Doctor Watson of the Sherlock Holmes fame so we know how brilliant he was and thus we have Dr. Watson in Windows since 1995, so as you can see the name Watson is pretty popular. 

What I found interesting too in reading about the Jeopardy game was the fact that they had to disconnect the Watson computer from the web, otherwise it would have even had a bigger advantage by searching the web too, so in staying with that thought if you added this capability to such a computer technology for use in healthcare, you can see what a wealth or maybe overload at other times could appear.

Actually Nuance and IBM integration is not new but perhaps the “Watson” imageintegration is as back in January of 2009 this announcement was made about how they were planning to incorporate IBM technology into Nuance’s speech solutions.  I remember the old IBM Via Voice program and used t have it on my cell phone a few years ago. 

Nuance and IBM to license and integrate speech technologies

One thing for sure speech recognition and how we interact with computers is certainly up for a lot of changes.  Over the years I doing this blog Nuance has just about about bought up and competition in this area and also has purchased some similar speech technologies. 

If you are in science, we already have Adam, who is the robotic scientist but he works mostly on his own without a lot of human intervention and chatter so who knows what would occur if imageWatson and Adam started talking to each other <grin>

Adam – The Robot Scientist Designing It’s own Experiments

I hope we do get a chance to try the technology out in healthcare if Wall Street doesn’t pay and scarf up the technology first for investor use.   Here’s what Jon Steward had to say for another view.  BD   

NEW YORK (GenomeWeb News) – IBM and Nuance Communications today announced a partnership to explore developing the analytical capabilities of IBM's super computer Watson for applications in the healthcare field and a potential role in personalized medicine.

The effort will combine IBM's Deep Question Answering, Natural Language Processing, and Machine Learning capabilities with Nuance's speech recognition and Clinical Language Understanding solutions. The partners believe the combined technologies can be used in the diagnosis and treatment of patients by providing hospitals, physicians, and payers access to critical and timely information.

IBM, Nuance Partner on Bringing 'Watson' into Healthcare | GenomeWeb Daily News | Informatics | GenomeWeb

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White House Proposes Medicare Doc Fix To The Payment Algorithm for 2 Years

2/17/2011 08:30:00 AM  , ,  

Yes that is what this is, yet one more algorithm that created the plans for budgets and agency funding for a number of years.  You have to step back and look at when the business model was created, years ago and then step back and look at where we are today.  This goes to show how fast things are moving today. Back when this algorithm was created for Medicare pay for doctors, it was based on current economic times, which we all know by now do not resemble where we are today. 

Now today let’s move forward to where we are today and the economic changes that have taken place, the statistics and projects created simply do not and cannot apply.  This is partially the reason that a 2 year fix is projected to again allow for changes and amendments as time progresses.  This also makes a point to why digital formatted laws would make sense. It may not be possible to create a permanent fix as when you look back, what was created years ago is now out of date.  We all know healthcare costs, budgeting, software, technology change by the minute so again, give some thought to the plan of sustaining 2 years versus a non realistic “permanent” fix as that just simply may not be possible, although it’s a great thought, we have to look at what we are working with. 

Even if a 2 year plan is created, it may not make it all the way through the 2 year time slot too, so again something to keep in mind but we do need to remove the soap opera and uncertainties for the doctors as when this appears for a vote to extend, it creates a ton of controversy not to mention the decision making processes of the doctors as to whether or not they can continue to afford to see Medicare patients. 

It’s the budget algorithms that needs to be adjusted and again, members of Congress and some federal judges for that matter would be wise to get some real Algo Men on board to help them understand current day processes. 

Florida Judge Rules Against Health Law– Need Some Judicial “Algo Men” to Influence Decisions on Costs With Methodology Entailment and IT Systems Functionality

The President hired his Algo Man and if you don’t have someone around to explain how all of this works, we are lost, just watch what appears in the news today and you can clearly see it with reports of foot in mouth almost daily. 

President Obama Names a New “Hybrid” Chief of Staff That Can Bring Some “Algo Men” to the White House and Washington

President Obama's top health official on Wednesday defended the White House's decision not to include a long-term fix of the Medicare doctors' payment system in its budget proposal.
The White House budget released Monday includes a two-year "doc fix" to the Sustainable Growth Rate formula, which determines Medicare reimbursements, but Republicans on the House Ways and Means Committee on Wednesday pressed Health and Human Services Secretary Kathleen Sebelius for details on a longer-term fix.
The budget proposed pay-fors to cover the $54 billion fix over two years, but it doesn't propose how to cover $315 billion of needed fixes over the following eight years.

Sebelius defends doc fix strategy - The Hill's Healthwatch

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Massachusetts Medical School Wins Contract to Design Health Insurance Exchanges

2/17/2011 07:56:00 AM  , ,  

Massachusetts was the model that was used to design some of the models that imagewere used to create the plan for insurance exchanges.  Now when you read this article you can see how fast technology is moving as you see the very model used is now outdated with how modern technology has evolved and it too needs a facelift.  “The Connector” as designed and created the state’s exchange service now needs to be updated.

From the website:

“Our online Commonwealth Choice marketplace is the only place where you can compare plans from the state's major insurers. We're an independent state agency, so you can shop with confidence.

Our Commonwealth Care program offers low-or-no-cost health insurance for people who qualify. It provides comprehensive benefits and a choice of health plans.”

This gives the state a front run position with some of the research and methodologies already in place, so the award here makes sense.  If you remember back to 2006 the entire country was watching to see how the Massachusetts plan would work.  BD   

The University of Massachusetts Medical School received a $35.6 million contract from the federal government yesterday to create an online system that would make it easier for consumers and small business owners to shop for insurance under the national health care overhaul.

Massachusetts, which passed its own health care overhaul in 2006, already has an online exchange, called the Connector. But a major upgrade will be needed to make it conform to the national law, even though the national legislation was modeled on the Massachusetts experience, said the professor who will be in charge of the Massachusetts contract, Dr. Jay Himmelstein, UMass director of public sector health information technology.

UMass wins US contract to design insurance exchange - The Boston Globe

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UCLA and VA Researchers Accidentally Discover Compound that Induces Hair Growth By Blocking Stress Related Hormone-They Filed for a Patent

2/16/2011 06:13:00 PM  ,  

What they found by accident was that astressin-B could also translate for use in imagehuman hair growth. It is known that the stress-hormone CRF, its receptors and other peptides that modulate these receptors are also found in human skin.  They were not looking for this but rather it happened along the way as they were studying stress related gastrointestinal functionality. 

Basically in a nutshell by treating stress hormone receptors, hair grows back and the article states it was all back in 3 months on the mice that had lost their hair due to stress.  Now if this goes further, this is a hot ticket for sure as you may in the process get a little stress relief and get hair at the same time.  The NIH was responsible for the funding of the research. 

So far all we have are hairy mice but I think there’s some real interest and possibilities here as the patent was filed.  BD

Now, a team led by researchers from UCLA and the Veterans Administration that was investigating how stress affects gastrointestinal function may have found a chemical compound that induces hair growth by blocking a stress-related hormone associated with hair loss -- entirely by accident.

The serendipitous discovery is described in an article published in the online journal PLoS One.

"Our findings show that a short-duration treatment with this compound causes an astounding long-term hair regrowth in chronically stressed mutant mice," said Million Mulugeta, an adjunct professor of medicine in the division of digestive diseases at the David Geffen School of Medicine at UCLA and a corresponding author of the research. "This could open new venues to treat hair loss in humans through the modulation of the stress hormone receptors, particularly hair loss related to chronic stress and aging."

UCLA and VA researchers injected the astressin-B into the bald mice to observe how its CRF-blocking ability affected gastrointestinal tract function. The initial single injection had no effect, so the investigators continued the injections over five days to give the peptide a better chance of blocking the CRF receptors. They measured the inhibitory effects of this regimen on the stress-induced response in the colons of the mice and placed the animals back in their cages with their hairy counterparts.

About three months later, the investigators returned to these mice to conduct further gastrointestinal studies and found they couldn't distinguish them from their unaltered brethren. They had regrown hair on their previously bald backs.

"When we analyzed the identification number of the mice that had grown hair we found that, indeed, the astressin-B peptide was responsible for the remarkable hair growth in the bald mice," Mulugeta said. "Subsequent studies confirmed this unequivocally."

Regrowing hair: Researchers may have accidentally discovered a solution

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Mylan’s President Recommends the FDA Should Update User Fees for Generic Drug Companies & Beef Up Inspection Efforts

2/16/2011 05:57:00 PM  ,  

She does make some very good points here with bringing in additional revenue to imageallow the FDA to inspect more over seas manufacturing facilities.  She also states that branded companies as well as generic drug companies both need need more attention with inspections.  Currently in the US factories are on a 2 year cycle and she stated the same should be done overseas.  BD

Bresch wants the agency to start inspecting drug facilities located overseas — for branded companies as well as generic makers — on the same two-year cycle is uses to review most plants in the U.S.

About half the drugs in America, both branded and generic, are imported, and many are coming in from foreign plants that may never have been inspected, Bresch says. “You’re giving those drugs to your children,” she says. “Don’t you want to know that they were made in safe conditions?”

Bresch is taking her campaign to the GPA’s meeting, which begins today, where members on various strategy committees are trying to hammer out a position on user fees in time for upcoming negotiations with the FDA.  Her plan isn’t the only one in play, but several association members said the group is coalescing around her general ideas.

Mylan’s President Talks About Her Wish List for the FDA - Health Blog - WSJ

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FDA Gives Approval for Lap-Band Use With Less Obese Patients

2/16/2011 05:36:00 PM  ,  

This means those who are borderline no longer have to put on weight to have the surgery, hey that does happen sometimes. In Europe the Lap Band is already considered an intervention device for “Diabesity” and we all know that diabetes 2 and weight carry a strong connection.  BD

LAP-BAND(TM) is First Obesity Intervention Device in Europe for Treatment of “Diabesity”

Lap-Band weight-loss surgery can be a good idea for millions more obese patients than previously were eligible for the stomach-constricting device, the Food and Drug Administration says.

The Lap-Band, made by Irvine-based Allergan Inc., previously was FDA-approved only for people with a body-mass index, or BMI, of 40 or higher, or 35 if they have associated problems like high blood pressure or diabetes.

Allergan announced Wednesday that the FDA voted to expand the Lap-Band cut-off to patients with a BMI of 30 with an obesity-related health problem, as an FDA advisory panel recommended in December. People with a BMI of 25-29.9 are considered overweight but not obese

FDA okays Lap-Band for less obese patients - In Your Face - The Orange County Register

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ZocDoc Opens for Business in Los Angeles To Include Covering the OC-Find Doctors and Make Online Doctor Appointments for Free

2/16/2011 11:56:00 AM  , , ,  

Once I saw the announcement, and being I live in the OC, time to go check it out and so far I like what I see.  The format is easy enough to use and the profiles of the imagedoctors are included.  I originally posted about the service back in 2010 when they made their debut in New York.  The technology is built around SQL Server and Dot net.  The service is free for patients and doctors pay a small monthly fee to be listed. 

ZocDoc Secures More Funding – Find Doctors and Make Appointments Online

Being the hands on person I try to be as much as I can I did a search and did some poking around.  The one item that is great is that the doctors create their own profiles!  Nice!  Read down further and I’ll tell you why this is important. 

image

Here’s what my zip code looks like and I just did a simple search for a primary care MD in my area.  There are doctors in Los Angeles and in Orange County.

image

One item to note is that the doctors are listed here because they want to be and in turn they are seeing value with getting appointments made to see patients.  Participatory Appointments and doctor enrollment with value, I like this and for those of you who are not in one of their areas you’ll still have to put up with one of those “other” services with flaws that run doctors up the flag pole and have MDs associated with hospitals where they have never set foot, dead doctors and so on.  You can read a summary of some of my past articles on how “the other guys” work at the link below and again, when ZocDoc comes around take a look at again we have participatory membership and consumer information here, along with value.  ZocDoc is not trying to rate the doctors either, just get you connected so you can go see one! 

Yahoo Search-Dead Doctor Listings and Flaws Alive and Well There too! Is Everybody on the Web Drinking the Flawed Data?

Those other services want the doctors to work on log on and correct what they create as a profile with no value for them and somewhat blame the doctors and health boards for their errors, this is much better as dead doctors don’t create profiles and don’t want appointments. 

ZocDoc

Also of interest, I posted yesterday about some hospitals in southern California allowing appointments for up to 2 hours in advance at the ER room and this could be a helpful resource too.  BD

Southern California Hospital Offers Appointments for the Emergency Room for $15.00 for Non Emergency Visits-InQuickER

Find Dentists or Doctors and Book Online Instantly - ZocDoc

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