I can only imagine what the patient is going through after specifically waiting for this device to become available as a safe method of treating her breast cancer.  This happened at Hoag Hospital in Orange County and luckily enough the particles were found on a check up and now she may need to have her breast removed as a result of the malfunction.  As you can read below the treatment was new in the fact that it does no require isotopes, which are used commonly with most radiation treatments.  The device was being used in clinical trials being conducted at Hoag. 

From the website about the device:

“The Axxent® Electronic Brachytherapy System® is a leading-edge technology that utilizes a proprietary miniaturized X-ray source to apply radiation directly to a tumor bed within the body. The Axxent® X-ray Source delivers high-dose rate, low energy radiation treatment without the use of radioactive isotopes. Axxent does not use radioactive isotopes, so it can be used without the need for a lead-shielded room. This enables veterinarians and therapists to remain with their patients during treatment, ensuring their safety and the treatment's accurate delivery.”

Below is what was recommended from the manufacturer and Hoag Hospital immediately reported to the FDA.  This goes to further substantiate a national registry of incidents with medical devices, especially those treating patients for cancer.  The toxicity of the tungsten in her breasts is stated to be low but it appears from what I am reading here that the only way to be sure the particles are gone is to remove her breasts.  As you can see now from the recommendations below MRIs will now be required as a follow up.  The patient was the first to undergo the new treatment and there’s no mention of any other patients in the article and hopefully there won’t be more.  BD 

iCAD recently acquired Xoft, Inc., developer of the Axxent brachytherapy system Axxent uses non-radioactive miniaturized X-ray tube technology and is FDA-cleared for treatment of early stage breast cancer, skin cancer and endometrial cancer, so you can see device might face some scrutiny in other areas of treatment.  At any rate you can almost be assured that additional inquiries and reports may follow.  BD  

A woman treated for cancer at Hoag Hospital in Newport Beach may end up losing her breasts because of a flaw in a new radiation system, which has been recalled, according to a lawsuit.

The 58-year-old “Jane Doe” was the first person at Hoag to undergo the treatment on her left breast and had specifically waited for the system to become available.

Now doctors want to remove her breasts after a shield used with the system shed tiny particles of tungsten throughout her chest, said her attorney, Jeff Milman of Irvine. The tungsten was found as part of her six-month checkup.

“There are no definitive studies that talk about long-term risk,” Milman said.

Jane Doe, a clinical psychologist, filed suit in February, targeting the manufacturer, Xoft Inc. and Hoag Hospital.

The device in question is the XOFT/iCAD Axxent Flexishield Mini, which protects parts of the body from unwanted radiation during use of the Axxent Brachytherapy System. After conducting an investigation, the company recalled the flexishield device in February.  Patients are advised to follow up with their physicians to help them monitor for side-effects.

“We believe this issue has no impact on the safety and efficacy of the radiation therapy delivered by the Axxent system,” said the recall notice. To see the full notice click here Xoft_recall_02-04-11.

Flawed therapy endangers woman’s breasts - OC Watchdog - The Orange County Register

Technorati Tags: breast cancer,radiation,shield,Axxent Brachytherapy System,Hoag Hospital,healthcare,recall,FDA treatment,Xoft,iCAD,cancer

The SRI was founded 1946 as part of Stanford University.  This is fascinating place to work I would guess.  Robert Scoble recently took a tour and provided videos that cover some of what they do there.  They have everything from contract with the FDA to figure out why devices (stents) and drugs don’t work all the way up to robotics.  I’m going to focus on the the healthcare end of things even though they have a lot more than healthcare going on. 

When you visit the “spinoff” pages you can see both Intuitive Industries (daVinci robot) and Nuance listed.  This is where they had their beginnings at SRI.  SRI is also the birthplace of the “computer mouse”.  At the end of this post I have included the SRI documentary so you can see how it evolved over the years.  SRI has worked with the NIH to develop drugs and clinical trials since the 1950s. 

SRI Biosciences from the Website:

“SRI Biosciences has all of the resources necessary to advance R&D programs from Idea to IND® — from initial discovery to investigational new drug applications that enable human clinical trials. We team with academia, biotech and pharma companies, foundations, and government agencies to solve important health problems around the globe. We carry out basic research, drug discovery, and drug development, including contract services. SRI's drug pipeline has yielded several marketed drugs, several additional drugs currently in human testing, and more than 10 programs in preclinical stages or early discovery. In our CRO business, we have advanced well over 100 drugs to clinical trials. We also work at the interfaces of science and technology to create novel platforms for the next generation of tools in diagnostics, drug delivery, medical devices, and systems biology.”

First of all I have included Robert’s interviews relative to the Intuitive Robotic Surgery Unit.  In the first video as he states you get an explanation and inside look into how the robot works today and then part 2 shows the future, robotic surgery over the web and with “no” doctor at the controls, yikes.  I don’t know if I would ever be ready for that one.  Some of their work is in conjunction with DARPA.  These take a while to watch so be prepared.  Robert even was able to sit down and try his hand at the daVinci.  The future of “surgical pods” for the military is something that is work in progress. 

daVinci Robotic Technology

Beyond daVinci–Trauma Pods

if you want to see more on the “trauma pod” SRI has an in depth video here which is using a “dummy’ and with no doctor present doing surgery.  In addition you can listen to a doctor speak about the robotics unit.  The animated video at the end shows a soldier injured, transferred to the pod and surgery is done and up he goes to the helicopter, almost spooky.

The third video here talks about how they work with various medical device companies trying to find out why “stents” fail, something we all want to know about!  We don’t want one of those by any means.  In addition there’s discussion of other industries too and how the “failure team” carries out their projects. 

SRI International

Now if you have some time, the last video is from the website which goes through the history of SRI.  SRI touts over 50,000 projects they have worked on and completed.  Most of this post involves really watching both Robert’s videos and the one included from the site to get the full impact and history of what goes on at SRI.

With all the recalls we have today, it’s good to see someone is on the job. If you want to see more outside of the healthcare area, TechCrunch has a few more of Robert’s videos where he posted as a guest and they are all very interesting by all means, I watched all of them.  Anyway, automated surgery looks like it’s the way of the future and some parts I like and some I’m not so sure about yet.  BD  

“This is a small part of an exclusive tour I had of SRI International, the innovative place that invented the mouse, among other things. Here we meet the team that studies failure of materials.”

YouTube - SRI International Tour: the failure team

Technorati Tags: SRI,medical devices,engineering,healthcare,stents,mouse,science,FDA,Stanford,Stanford Research Institute,Communicaiton

Being in California I always think of the company’s presence here since this is where they began but they also have been expanding into several other regions of the country and Georgia is one where they are expanding to serve more of the community.  BD

In an effort to provide lower cost, seamless health care closer to where patients live, Kaiser Permanente of Georgia is undergoing a major expansion – adding 11 new neighborhood medical offices in metro Atlanta over the past 16 months.

Medicare is beginning to bundle payments, so hospitals may get paid less if a pneumonia patient is re-admitted within 30 days for example, said Ken Thorpe, a health policy expert at Emory University. “That means you really have to integrate what’s going on between inpatient and outpatient care.”

The facilities are a one-stop shop for basic care with multiple services such as primary care, pediatrics and a pharmacy under one roof, said Dr. Rob Schreiner, executive medical director for Kaiser in Georgia. The nonprofit health plan’s latest addition, a 6,400-square-foot, $2.3 million facility in Fayetteville, opened Tuesday, and another in downtown Atlanta is slated to open in the spring.

The marketplace is “demanding lower health care costs, or at least flat health care costs, and more value for the dollar that is spent,” Schreiner said.

Kaiser expansion fueled by push toward integrated care  | ajc.com

Technorati Tags: Kaiser Permanente,Georgia,physicians,medical offices,integrated care,bundled payments,Medicare

Catholic ownership of hospitals is renewing in the US in some areas.  Trinity updates 48 acute care hospitals and is the 4th largest non profit Catholic Healthcare system in the US.  In other recent news Ascension Health has announced a joint venture for money with a private equity firm.  Loyola has had several layoffs and had tough financial times.  BD   

Ascension Health and Private Equity Firm Oak Hill Capital Form Joint Venture To Buy Catholic Hospitals and Health Systems

Amid the rapidly changing health care landscape, Loyola University Chicago on Friday said it will get out of the hospital business by selling its medical center complex to a large national Catholic hospital operator.

The market is demanding more from hospital operators to stay competitive. By merging, they can pool capital to buy new computer systems, electronic record-keeping systems and the latest medical technology.

The sale to Michigan-based Trinity Health ends decades of management led by the Jesuits at Loyola University Health System, parent of Loyola University Medical Center in west suburban Maywood.

Amid the economic downturn, Loyola's health system has cut scores of jobs and "taken $100 million out of (its) cost structure," said Dr. Paul Whelton, CEO of the Loyola health system.

The health system has about 6,800 employees, and Whelton would not rule out additional job cuts. But he said Loyola plans to expand in the Chicago area. "We are in growth mode," Whelton said.

Loyola University Chicago selling medical center to Trinity Health - chicagotribune.com

Technorati Tags: Loyola University,hospital,Catholic Health care,Trinity Heatlh Care,Michigan,budgets,job cuts

Individual plan members have been sent letters advising of the increase.  Anthem Blue Cross still states they have not made any profits on individual policies and thus we have another increase coming.  Last year rates increased by 14% after a debate and retraction of the original higher proposed increases. 

In addition some policies will have higher co-pay amounts and deductibles.  Some consumers will be paying over $1000 a month for coverage of husband and wife.  BD 

It’s déjà vu all over again—almost a year ago exactly Anthem, the California division of Blue Cross health insurers, proposed raising rates on individual policy holders by as much as 39%.

That rate increase was stalled and eventually scaled back due to mathematical inaccuracies in Anthem’s rate filings, as pointed out by the California Insurance Commissioners office.

This time around Anthem has notified its individual plan holders that rates will be going up effective May 1, creating a cumulative rise in rates in excess of 40% for some consumers in less than a year.

Anthem Blue Cross, again, seeks dramatic rate increases on individual policies – Healthcare-NOW!

Technorati Tags: Blue Cross,Health Insurance,rate increase,California,healthcare,policies,premiums,co-pays

He has submitted his resignation and will effective at the end of March. I can guarantee this is not a fun job right now with the recalls and all the issues the DePuy division has faced.  He’s an executive in charge of running a failing implant division, and personally he did not create the units, nor did he implant any of them but it’s his bowl of wax, well at least until the end of the month.  Sometimes when in positions as such with recalls and failures, you might wonder does anyone really want that job?  I wouldn’t as you are not going to be able to please very many people and opinions at all. In the meantime if one company can’t make an implant that works, maybe go buy another, at least that is what it looks like with recent news. 

Johnson and Johnson Set to Make Another Offer To Smith & Nephew-Going After One More Orthopedic Acquisition in the UK Meanwhile Consumer Confidence Is Limited

This one was already announced as a buy out.

Johnson and Johnson Company, DePuy Orthopedics Acquires Finsbury Orthopaedics from the UK

The reason for leaving is cited as pursuing interests outside the company and again if I were in that pressure cooker it would sound like good reasoning to me.  BD 

Johnson & Johnson said Friday that the worldwide president of its DePuy Orthopaedics division, a maker of artificial hips and knees that has struggled with product recalls and lawsuits over faulty implants, is leaving the company. The executive, David Floyd, submitted his resignation last week and will leave at the end of March, a spokeswoman said.

Johnson & Johnson Implant Unit Executive Resigns - NYTimes.com

Technorati Tags: Johnson and Johnson,Depuy,knee,hip,orthopedics,surgery,implants,FDA,Smith & Nephew,mergers and acquisitions

Bill Gales was the curator this year for the Long Beach Convention and when it was his turn to talk he addressed budgets and the need for better education.

Bill Gates Serving as “Guest” Curator for the Annual TED Conference In March 2011

Also one of my favorites is returning Juan Enriquez who speaks about regenerative medicine and I’ll be looking for his talk as well as the videos from Wake Forest where they grow body parts, and there’s lots here already on that topic.  Back on track with today’s talk, Bill Gates said the accounting tricks were so bad that the folks at Enron wouldn’t have even tried this.  We have folks that don’t know mathematics, I think.  He stated many states are playing tricks with borrowing and using proceeds from tobacco sales to fund education.  He also mentioned that selling off state buildings is not going to get it.

We are not getting the brain power for the money spent.  Every year Mr. Gates addresses the dead ears at Congress on this topic and for the last 3 years I have covered each annual event at the Medical Quack.   He called for more transparency in accounting, which is a good thing.  Last year he also spoke to students at Berkeley on education and how to learn as much as you can, use the web to supplement and become people with a focus and education in more than one area, become the hybrids as those are the folks companies will be looking for. 

Bill Gates speaks at UC Berkeley Global Health, Education and Thoughts on Philanthropy

He has the funds but not enough to help all but the frustration I think is clearly heard here when he stated “isn’t anyone paying attention”, and I can agree with that as compared to other countries eating our lunch, we look lazy and maybe we are.  When I grew up the internet was not around but students today have it right at home and learning and reading is available at libraries too.  He uses California as an example. 

The sad truth I think is that nobody is really paying attention and in order to have money for schools, we need to alter some methodologies, just like what’s happening in healthcare but that’s also a horse of a different color and he states healthcare will grow in expense due to technology offerings. 

Bill Gates outlined that we need the following 3 items now.  We can figure #3 on our own pretty well. 

Tools to educate ourselves-the internet.

Clear and honest accounting –Accurate Algorithms not Those Driven for Desired Results as They May Not be the Same or Accurate

ABC also offered their coverage from yesterday.

Wonder if there are any states that would allow him to take a look at their budgets?  He’s the match and algorithms genius so if I were in that position of having the opportunity I would sure entertain it as we are not moving at any rapid speed at present. Education belongs to everyone too and with generation gaps of “non participants” how to do we bring this together, everyone needs to participate and we need role models for the youth.  I have been saying that for 2 years here with healthcare as leaders don’t share any of their successes with consumer software, programs and devices and we are stuck on “its for those guys over there” once again. 

He also addressed the US governors in Washington this week and you can read more and listen to the audio cast at the Gates Foundation here.    Here’s one of the slides below and the reading and math value is way down there when spending is compared to how we are doing.  We have to enter this race soon before other countries bury us in the dirt. 

Send IBM Watson to Congress to help them out in this process.  BD

IBM Watson Did Get a Chance to Go To Congress-Should be a Permanent Home For Greater Intelligence for Creating Laws

Speaking at the 2011 TED Conference (Technology, Education, Design), Gates sharply criticized states for the waste in American education.

"The guys at Enron never would have done this! I mean this is so blatant, so extreme that, is anybody paying attention to what these guys do?" Gates said.

The 55-year-old multi-billionaire has made it a mission to find the money to make schools and teachers better.

"State budgets are a critical topic because here's where we make the real tradeoffs," he said. "If we make the wrong choice education won't be funded the right way."

Gates said many states, in their efforts to close their budget deficits, are making the wrong choices, cutting education.

"The bottom line is we need to care about state budgets because they're critical for our kids and our future."

Bill Gates on Education: Microsoft Founder Says Schools Not Teaching and Teachers Getting Pay Raises - ABC News

Technorati Tags: Bill Gates,TED,convention,Long Beach,Education,Healthcare,technology,budgets,states,teachers,transparency

I sat in on a webinar this week and as a healthcare blogger I was the lowest denominator attending but wanted to listen in and find out about what others, scientists, doctors and the Geron CEO had to say.  I do quite a few posts on the Quack here and thought this might be of interest since I have written a couple times about the Geron clinical trials at UCI relative to stem cell treatments for spinal cord damage.  You can read more at the links below on the trials.  The FDA cleared the trials back in 2009 for the use of embryonic stem cells to begin, then temporarily they stopped and now are back on. 

Stanford Joins Geron Spinal Cord Clinical Trials Program as the 3rd Location in the US

During the procedure, the neurosurgeon will apply about 2 million of the special cells (called GRNOPC1) directly into the injured area of the enrolled patient’s spinal cord.

Geron Gets FDA Approval To Resume Stem-Cell Study - Spinal Cord Injuries - Go UC Irvine!

First discussed were the past ethical debates with the NIH funding but he stated ut was a good thing that private investigation continued.  Dr. West elaborated a bit on this point and how the delay on funding from the NIH was a disappointment and became a political issue that added to the delay of research all across the US.  In addition, Geron has other stem cell programs as you can see from the screenshot below. 

In addition,Geron has granted exclusive and worldwide rights to the nutraceutical and cosmeceutical applications of TA-65 and I can perhaps explain more in a later post about their commercial product.  A pretty detailed explanation as to what is a stem cell was introduced and how they function. 

Later the difference between IPS stem cells and embryonic cells was defined.  I have covered this before but the big difference is that IPS cells can change characteristics, in other words skin stem cells can be reprogrammed to function as heart stem cells.  

Regenerative Medicine–Reprogramming Stem Cells Grow Heart Muscle Tissue Bypassing IPS Cell Creation–New Standard Set for Stem Cell Research

Also discussed was the stem cell trial at Cedar Sinai whereby stem cells are being injected directly into hearts and patients are becoming asymptomatic, in other words we can say cured but pretty close.  The link below has more information and a video of a man who had undergone the treatment. 

Heart Stem Cell Trial at Cedars Sinai – Patient’s Own Cells Injected to Reverse Heart Attack Damage

What I found very interesting as well with all the conversations we have and information we read about today relative to the cost of healthcare, stem cell treatments stand at the forefront as being a contributor to saving money.  As with any new technology it is expensive at first and then the prices lower.  When you stop and think about it, possibly not having to undergo a surgical invasive procedure, and with a stem cell treatment being given instead with a healing process this can save items such as hospital re-admissions, additional follow up visits and surgeries, etc.  The CEO of Geron was pretty specific about this and is making this case as one are to where the cost of healthcare should not be overlooked and thus the development of this technology is important. 

Of course as a patient, one’s health is a benefactor too and let’s face it if you had the choice between a device or having a stem cell procedure with the potential of better or same results, which would you choose?  In addition, the question was raised about cancer cells reproducing?  Thus far this had not occurred, which is good news as that is a big question for those who have been diagnosed with cancer and also in the news this week the same results were mentioned for breast cancer stem cell treatments from Cytori where the breast regrow.  So far there has been no return of any cancer cells.  Another company is also producing cosmetics with stem cell technology. 

Stem Cell Based Cosmetics Developed from International StemCell Corporation Announced

Below is a video presentation on what we age from Dr. Edward Park, M.D. in Orange County, California, who is treating patients with the commercial product TA-65.  In 2001, Geron Corporation, discovered the molecule, TA-65 ® which activates the fountain-of-youth enzyme called telomerase. 

Why We Age

The commercial product is not sold as a cure or antidote and has been covered by the major media on several occasions.  At any rate it is interesting to see both the clinical trial side and the commercial products here from the same company.  In closing I found all of this extremely fascinating and again the potential of stem cell technologies having an impact on the cost of healthcare and the needs to fund continued research seems to almost be imperative if we want to help cut down what is spent on healthcare and how it is contained.  As a side note, a patent is being applied for to grow teeth too. 

Dental Implants Using Body’s Own Stem Cells To Grow Them – Regenerative Dentistry In the Works

At the TED Long Beach convention this week the folks from Wake Forest printed out a kidney, that is the scaffold to grow a kidney and one person who received one of these kidneys several years ago is alive and doing well, so again the need for stem research is here and with growing organs, we do not have to face rejection from our bodies either.  You can read more about what’s happening at Wake Forest here and for additional posts just do a search, there’s a lot at the Medical Quack about what they do.  BD 

Scientists At Wake Forest Grow a Mini Liver From Human Cells–Regenerative Medicine

Technorati Tags: Geron Corporation,CEO Biotime,regenerative medicine,healthcare,stem cells,FDA,clinical trials,UCI,Wake Forest,TED

This is just too cute and funny and some talent put in to make the video.  Happy Hospitalist found quite a few videos and he has more at his site, a couple that have been here in the past and some other new ones, so if you want to view a few more use the link at the bottom of the post to visit his blog.  The name of the composer is also cracked me up, “ButtMeddler”.  BD 

Looking Up My Back Door

March is Colon Cancer Awareness Month.  Here are some colonoscopy video comedy and song and dance routines to encourage you to get off your  butt and get in to see your doctor for your free colonoscopy.

Funny Colonoscopy Videos For Colon Cancer Awareness Month (March)

Technorati Tags: colonoscopy,video,Happy Hospitalist,healthcare,screening,polyps,testing

We have a lot of choices today for devices for remote and home monitoring but one suggestion for those who create these products would be to go lightly on the payer benefits, as with rising health insurance costs, do consumers care if they benefit, not a chance.  I see this on almost all the web sites on how the “payers” will benefit and the message sent loud and clear is that there’s money to be made and saved and this is why you as a consumer should use one, not really that we care that much about your health and you as a person, it’s the buck and the payers we really want to benefit.  Now that is my opinion and vendors can view it as they choose but it’s something to think about as if I see it that way, chances are others are too.  Read the paragraph below from the website and see how excited you get as a consumer.   

“The benefits of the Intel Health Guide include patients who are more engaged to take a more active and positive role in their own care. For healthcare providers, it enables more informed and personalized care—which may lead to better patient satisfaction. And it helps healthcare organizations, including providers and payors, to face the challenges of chronic care, increase efficiency, and achieve organizational objectives. “

Again, I’m not saying the products are bad by any means but the whole marketing end of all of this just sucks for the consumer and does not appear to create any excitement or enthusiasm at all, and again this is not the only site playing to the ears of the insurers versus the consumers, it is viral all over the web.  Can we not think of a better way to work with consumers other than to focus on how they are helping insurance companies?  There’s nothing personal or anything to get a consumer excited at all and we wonder why mobile devices are so slow to catch on.  We have big business marketing to big business and the same ongoing attitude of “its for those guys over there”.  Would we ever stand a chance of anyone at HHS perhaps exploring the use?

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

When we talk about role models a good example is this Congressman from California using his cell phone while driving and he does not get a ticket and he is arrogant enough to be doing a radio show live interview at the same time, so this is what we clearly have as role models with cell phones and mobile devices to include those in healthcare.  Once again “its for those guys over there” not me, as “I am special” I would say from reading this article, but that’s what we have. 

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

How many employees or their family members at GE or Intel us this thing?  Just something to ponder as just because the FDA approves it doesn’t mean people are going to run out and buy it.  BD 

Intel-GE Care Innovations, a joint venture of Intel Corp. and GE Healthcare to enhance and market their respective home health and independent living applications, has received 510(k) market clearance from the Food and Drug Administration for the Intel Health Guide Express.

Intel Health Guide is a touch-screen home monitoring kiosk that links patients to caregivers. The Express version is software that enables the same functions via a personal computer rather than the kiosk. The software is scheduled for commercial availability in the second quarter of 2011.

Health Guide to measure such vital signs as blood pressure, pulse and weight, and respond to questions specific to their condition. Health Guide also enables videoconferencing so clinicians can assess patients for signs and symptoms suggesting deterioration in their condition.

FDA Approves Home Health App

Technorati Tags: Intel,GE,monitoring devices,computer,software,healthcare,wireless,patients,vital signs,video conferencing

Talk about drama when getting a lay off notice, an instant message to meet in the lobby and then taken to a hotel for the official word.  Drama king tactics seem to exist with layoffs today.   It sounds almost like people are being round up like a herd of cattle for goodness sakes.  The layoffs were part of a reorganization effort and realignment of sales and sales support.  Also in the news this week the company found out they did not get the Tri-Care business after all as the GAO said their bid was not valid, but this was in the south part of the country and I don’t think it had anything to do with the layoffs in California from what I read. 

Humana Keeps Tricare In The South And Back in May of 2010 HealthNet Was Able to Keep the Northeast-Both Companies Filed Appeals

Let’s not forget this was another record year for profits for the company. 

The “algorithm” side of their business, Ingenix and subsidiaries increased 10% and if you watched the news this year there were more then plenty acquisitions made at the tech level of the company, subsidiary watch.  When you look at the sector of business below on the chart, prescription and health revenue units were down but the algorithm revenue was up!  There’s money in those Algos.

Full Year Revenues of $94.2 Billion Increased 8% Year-Over-Year, and Include a 10% Increase in Fourth Quarter Revenues to $24 Billion.  BD

UnitedHealth Group Reports Record Profits for 2010 of $1.80 Billion-Algorithm Revenues Up with Subsidiary Groups Too

UnitedHealthcare Medicare & Retirement laid off 180 workers in Santa Ana today as part of a company consolidation, a company spokesman confirmed.

“UnitedHealthcare Medicare & Retirement is realigning parts of our sales and sales support functions,” the spokesman said. “Unfortunately, as part of the shift, some positions are being eliminated in California.”

The spokesman said the health insurer wanted to streamline activities that are being done in multiple places. The Santa Ana work will be shifted to other business locations, including Minnesota, Wisconsin and Virginia, said the spokesman.

One UnitedHealthcare worker said those affected got an instant message to meet in the lobby. They were then taken to hotel where they were notified they were being laid off.

UnitedHealthcare lays off 180 in O.C. - Handling Hard Times - The Orange County Register

Technorati Tags: UnitedHealthcare,revenue,profits,layoffs,Orange County,Medicare,health insurance

I know that parking structure in Long Beach but last time I was there no Google car.  If I am not mistaken, the Google car is the forward workings of Stanford who built the autonomous car, Junior that competed in the last Darpa Urban Challenge and came in second place.  The Intel car and I’m sure the Google car is the same or similar runs off of 4 servers in the trunk, just like ones you buy off the shelf.  it looks like there’s a model upgrade on the car since the “Junior” days and all the sensors are now hidden and contained versus the earlier days.  The car really moves. 

Google Car

Intel The Car Company – Could Happen and Perhaps a Good Idea as there’s a lot more to this story and technology

Here’s some history on the car before the Darpa challenge that tells a bit more about it.  BD

Junior Self Driving car

Google gave folks a brief glimpse at its super secret self-driving cars last fall, but nothing like what it's just showed off at the TED conference that's happening this week in Long Beach, California. The company is not only actually letting attendees inside the autonomous car for a first-hand demonstration, but it's intentionally stepped things up to an "aggressive" level to show just how capable the car really is -- we're talking squealing tires and really tight cornering (all on a closed course, naturally).

Google's self-driving cars take TED attendees for a wild ride -- Engadget

Technorati Tags: TED,Google,autonomous car,Long Beach,self driving car

Here we go again, back to the soap operas and and attention getting commentaries.  I am guessing once more, based on what I read here that we have a return of the 70s folks with 8 track tape values.  Dr. Berwick has not even had enough time in the job to get started, so what in the world do these folks think you get with a nomination-immediate gratification?  If that’s the case we voted some questionable personalities into office as that’s a pie in the sky, especially by today’s world that we live in.  Again, what’s up with this?  Of course there’s no other person suggested either I am guessing so more disruptive soap opera antics in store. 

The reasons given here are weak, with the reasoning of lack of dealing with insurance companies to, it’s all about technology and thus this is where the 8 track mentality comes back into play.  That’s the answer area with algorithms that are utilized today for all major decision making processes and 8 tracks can’t see or acknowledge that.  I meant what I said about bringing in IBM Watson here to bring some intelligence into the decision and law making processes. 

IBM Watson Did Get a Chance to Go To Congress-Should be a Permanent Home For Greater Intelligence for Creating Laws

the President hired his Algo Man, so what’s taking these folks so long?  It’s all about those algos today.

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

If you haven’t noticed we have some high frequency algorithms working their way into healthcare.  There are algorithms that create accurate data and some that create desired results and they are not always the same and sometimes hard to tell apart.  That’s how we all got soaked by Wall Street. 

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

At least before entering into emotional driven movements as such, get some Algo Men on board that can help with the analysis process and can we cut out the OMG and soap operas?  Wall Street and the President have their Algo Men, so what’s taking these GOP folks so long?  Again if they had IBM Watson in there to query and look at real numbers and analysis information we wouldn’t have this emotionally drive power play stuff going on.  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

If you look at Dr. Berwick’s record and where he has been and what he had done via business intelligence analysis processes with ethics that had lead to better healthcare, I think we might not be seeing this on the agenda and a full opportunity given to the doctor to do his job, again there’s no immediate gratification here no matter who you place in there so get your facts and Algo Men together and let them deal with lobbyists.  In case you never saw the trailer for Money Driven Medicine documentary from 2009, take a look below and you can see some input and insight from Dr. Berwick and with that I’ll end this post.  BD  

Money Driven Medicine

Obama slid Berwick into the position last summer via a recess appointment, causing consternation among his Republican opponents champing at the bit to grill Berwick in a nomination hearing. Obama re-nominated Berwick in January, setting the stage for a confrontation over who should have the job of implementing Obama's signature healthcare reform law. Berwick faced a grilling last month on the other side of the Capitol from Republican representatives on the House Ways & Means Committee. That experience will likely pale in comparison to his reception before the Senate during a confirmation hearing, judging by the tone of the letter sent out today.

The senators wrote that Berwick's lack of experience in the insurance arena and years-old statements about the British healthcare system make him an unsuitable pick for the job.

GOP to Obama: Ditch Medicare chief Donald Berwick | MassDevice - Medical Device Industry News

Technorati Tags: Berwick,CMS,Senators,digital illiteracy,business intelligence,IBM Watson,Obama,technology,Medicare,Health IT. Donald Berwick

Back in October of 2010 I wrote about Skinput and thought it was the solution for input and that was before Kinect came along and it still could be a mobile solution with using one’s arm for both control and data.   Kinect of course allows gesture control.  We are not to the point of carrying around a portable Kinect unit yet and this technology uses blue tooth wireless to input data so there’s still a lot of room here for mobility for sure. 

Microsoft's Skinput – Data Input for Medical Records Solved (Video)

Just imagine having your arm ready to receive data input that goes to your phone?  Pretty interesting concept and actually focuses in on input rather than just interactive screens, so it is different than Kinect.  The use of gestures is here with having the screen show up on your arm from your phone.  The amount of tan you have on your skin might affect visibility and viewable real estate might improve with larger arms. <grin>.  Just beam that medical record to my arm please.  BD 

Skinput, a Bluetooth-enabled device, allows you to use your own skin as an input device for devices like MP3 players, cell phones, or gaming consoles.

The device works via an armband that contains a small projector, which beams a screen onto your hand or forearm.

Bluetooth then transmits the corresponding signal to the appropriate device; if you’ve just dialed a phone number, for example, it sends the info to your phone and dials the number, or just hit your arm and choose a song from your MP3 playlist.

Whose idea: Chris Harrison, a Carnegie Mellon Ph.D student, and researchers Desney Tan and Dan Morris -- both from Microsoft Research.

MILLION DOLLAR IDEA: Your Bare Arm Becomes A Touchscreen That Controls Your Phone Or Game Console

Technorati Tags: Microsoft,technology,medical records,computers,data inpt,healthcare,mouse,keyboards,Carnegie Mellon,projector,gaming

The software company has been around in the UK for a number of years and when you go to the website you can see where last year they were the winner of the Public Sector contest for Microsoft Partner of the Year for 2010.  McKesson uses Microsoft technologies as well so perhaps a way to expand into markets outside the US.  McKesson like many others in Health IT are expanding via acquisitions.  Recently we had this announcement with the government systems and I’m not quite sure what route is being taken here since both entities already have Health IT systems, but I suppose we will hear more in time. 

General Dynamics And McKesson Receive Contracts to Assist Department of Defense Health Systems to Include AHLTA and Vista-How Many Hands are In this Contract Pot?

Also late last year we had the purchase of US Oncology technologies here in the US.  BD 

McKesson Acquires US Oncology–To Include Pay for Performance EHR Oncology Solutions

McKesson Corp. will acquire British hospital software vendor System C Healthcare for about $141.5 million in U.S. dollars.

System C serves about 40 hospitals in the National Health Service. Its Medway product line includes a core hospital and ambulatory clinical information system and multiple modules supporting emergency care, maternity, diabetic care, ambulance care, infection control, and data analytics, among other functions. The company also sells software to social services agencies

McKesson to Buy British HIT Firm

Technorati Tags: Microsoft,McKesson,Health IT,mergers and acquisitions,software,hospitals,NHS,medical records

When you stop and think about endorsements I feel this one is important, why?  Dr. Halamka is not only a doctor but also a computer science expert, so there’s a lot of knowledge rolled into one person, not to mention the ability he has to talk and share his knowledge and ideas with all.  Bill Gates said last year in a talk at Berkeley that the folks who are the “hybrids” in technology are going to be the most sought after individuals and he’s right and the good doctor is right up there.  In his blog he gets out there, hands on, as well as doctors and other staff members and puts it to the test.  This is good as what we get here is “real” information beyond a “proof of concept” and that’s what we want today. 

If you go back to read what happened in 2010, you can read about the one MD at the hospital who put it to the test back April.  The link is from Dr. Halamka’s blog which he keeps updated with “cool technologies”  A few months later, he adds more input from one of the hospitalists.  A couple weeks later, a nice question and answer post on the blog about the Ipad.  A couple weeks ago, yet one more post on how to secure an Ipad and Iphone was added.  Within only a couple days they had figured out how to use Log Me In for an immediate connection and it went upwards from there. 

You just don’t get this type of quality information anywhere else on the web, and I pretty much try to scour and find all the helpful information I can on the web to do this blog.  A while back when things were much simpler and still communicated on the desktop I wrote a medical records system and given that, I have a ton of appreciation for all the data work that goes into the pursuit of  medical records that can talk and communicate with each other and the amount of work and coding that enters into the picture. 

I don’t write code any longer, but it certainly serves to give me a huge appreciation and understanding of what goes into the processes and thus you see a little different focus here as I’ve been on both sides a bit with working with MDs as partners.  Sometimes the way I visualized a solution and the way it was used were two different perceptions and then came the meeting of the minds.  I was not always right and so back the code drawing board for the next revision, again with input from the doctors on how it would work for them and using what skills I had to try and make it happen.  This is where the good doctor has all of this rolled into one person, phenomenal and rare, but so valuable! 

Sometimes folks in IT make it look easier than it is at times and yes we are guilty there but there’s a good reason for that and it is due to the fact that we want the best and easiest user interfaces so everyone doesn’t have to become a high powered user to participate. 

You can watch the video below from Apple and about half way through you can hear the presentation from Dr. Halamka with real life experiences and his work to make it happen.  Again, this is what we want and not just proof of concept-we want the real stuff! 

Ipad 2 from Apple

In the changing world of technology we work in today, there’s not one company that has all the answers, especially true in Health IT, and knowing how to play in the sandbox and combine for ultimate solutions is where it’s at.  I use both Apple and Microsoft technologies (this post being done on an IMAC that happens to be running Windows right now).  I like both and they can all work together, collaboration at it’s best. 

I think the dual core processor, which was created in house by Apple is huge as with more cores to run programs we see more power and I do reflect back to when Intel introduced theirs as I was doing some training for them at the time and dual cores make a difference with more cache and memory disambiguation; ok enough tech talk on silicon.   Certainly Apple has their relationship with Intel as well but back to basics here we need to look at what makes a total solution.  When you stop and think that other than Apple, Microsoft is the #2 producer of software for Apple, well that brings to mind collaboration once more, so the 2 do work together and I like all of it.  I have been a tablet pc person since day one but I look for the best solutions as well and thus I hopefully create some honest opinions here too.  All geeks are consumers too. 

None of us know what’s going to show up tomorrow when it comes to technology but I think it’s important to keep an open mind and oh yes, be curious.  Once you have a high level of curiosity, then education flourishes. As the video mentions, Apple said they found people using the IPad in areas they had not even thought about, and I think the healthcare movement in how it has been adapted was a bit of a surprise element there too. In summary, hats off to Dr. Halamka  for keeping us informed and satisfying our “curious” minds and you can almost bet there will lots more to come as Ipad2 gets put to the task.  BD 

About 12 minutes in, after an establishing shot of the sign for the BIDMC’s West Campus, John says:

“Sometimes doctors are overwhelmed with data. What we’ve tried to do on the iPad is to give doctors at the point of care the tools they need at the exact moment the doctor can make the difference.”

“We’re finding with the iPad that doctors are spending more time with patients. In fact, doctors are engaging patients by showing them images, showing them data on the screen. So it’s empowered doctors to be more productive, and it’s also brought doctors and patients together.”

Harvard Med Alpha Geek John Halamka: iPad Will Change How Doctors Practice Medicine | CommonHealth

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