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70,000 More Patients Join the the Free Credit Protection Club in Philadelphia–Stolen Flash Drive Storage Device Again…

I don’t know when VPNs might take a stronger hold.  According to the article below the employee has an extensive criminal record, but so far there’s no evidence of any of the patient information being used.  There were other items reported missing as well.  There’s no mention of encryption and usually when this is not mentioned there’s a pretty good chance it was not protected as IT individuals are usually quick to note any additional information as such as it does make a difference on the odds of the data being accessed.  A couple years ago this story made the news, the data was encrypted but the login and password were taped on the device.  BD  

If You Take the Time to Encrypt Medical Information – Don’t Tape the Passwords on the Container or Flash Drive – NHS Security Breach

The Family Planning Council in Philadelphia made public Friday that a computer storage device containing the personal and medical records of about 70,000 patients was stolen in December and remains missing.

The theft was blamed on a former worker whose employment ended Dec. 28, the day the theft was discovered and reported to police.

The former employee, Kelly Stanton, 40, has an extensive criminal record, and has been in and out of prison for the last two decades on multiple convictions of theft and other offenses, court records show.

The health-care providers affected by the data breach include Children's Hospital of Philadelphia, Planned Parenthood Southeastern Pennsylvania, Planned Parenthood Association of Bucks County, Spectrum Health Services Inc., and Public Health Management Corp.

Patient data stolen from Philadelphia's Family Planning Council | Philadelphia Inquirer | 04/09/2011

Blue Cross Rate Increases Spread Between 2 Regulatory Agencies in California-Consumer Watchdog Calls on Governor to Merge Insurance Commissioner & Managed Care Office As HMO Side Rates Go up 16%

Now this is a mess, those who are under the area governed by the the state insurance commissioner were granted a smaller increase; however the HMO policy holders are not that lucky and will get a larger increase and see larger co-pays and higher deductibles.  So now it appears to be tied up with bureaucracy on what type of plan one has.  It was in the news of late that the increase would be smaller for the group under the regulatory jurisdiction of the insurance commissioner.  There’s also the imagepending DOJ investigation about contracts made directly with hospitals but California was not named here. 

Department of Justice Investigating Blue Cross Blue Shield Insurance Plan Contracts Made Directly With Hospitals

The consumer watchdog has called upon Governor Jerry Brown to intervene for some type of decision and merge the two regulatory agencies together.  Anthem states they lost money on their HMO business and thus the reason for higher increases for premiums in that area.  This is confusing to say the least and it comes down to those algorithmic reports to substantiate where they need money I guess.  The whole idea of insurance is to spread the cost over a large group and by having the HMO consumers separated from the PPO group under the insurance commissioner doesn’t make sense as the cost does not get spread over a larger group. 

By using business intelligence software (algorithms) they isolate their money losing areas and pass along the higher increases to that group only.  The company also has some big Medicare contracts where they process claims where lawmakers are finally looking at this process as with all the mergers and acquisitions that have occurred in the last couple of years, there’s some joint efforts with subsidiaries working together for more profits, in other words Health IT contracts that conflict with other areas of claim settlements with no incentives to fight fraud as if too many are removed as fraud, the transaction numbers may drop.  BD 

Lawmakers Finally Asking About Medicare Contractor Conflict of Interests-Subsidiary Watch and Inquiries-Mergers and Acquisitions

Nearly 151,000 Anthem Blue Cross individual policyholders face rate hikes of as much as 26% on May 1, even though far more Anthem individual customers are getting a break this year.

The difference is a result of California's two-headed health insurance bureaucracy.

About 600,000 people with Anthem policies under the supervision of state Insurance Commissioner Dave Jones will see smaller-than-expected increases July 1.

Anthem agreed to cut those rate hikes to 9.1% on average, from 16.4%, amid pressure from Jones and consumers. The Woodland Hills insurer also postponed plans to raise deductibles and co-pays for medical care until January.

Left out were 150,983 customers with individual plans overseen by the Department of Managed Health Care, an agency under California Gov. Jerry Brown. Anthem, the state's largest for-profit health insurer, said it would raise rates an average of 16% for these subscribers May 1, in addition to hiking deductibles and co-pays.

Kay said she faces a 17% hike as well as an increase in her deductible from $2,500 to $2,950, even though she already met the lower deductible in January.

Anthem member Denis Robinson said he tried unsuccessfully to figure it out so he could complain about his May 1 rate hike of 26% and an impending increase in his deductible to $2,950 from $2,500. "It is a maze," he said.

Consumer advocates also are puzzled. On Thursday, the group Consumer Watchdog called on the governor to merge the two regulators under Jones' Department of Insurance, which has a large staff of actuaries devoted to analyzing insurance filings.

Cuts To Anthem's Rate Hikes Are Not For Everyone | Consumer Watchdog

Remote Area Medical Seeing Over 1000 Patients a Day At the Free Medical Clinic Held At the Oakland Coliseum

The wonderful folks at Remote Area Medical continue their mission in Oakland after just finishing a free clinic in Sacramento.  These are all volunteers donating their time.  People are camping out overnight and the clinic is being held at the Oakland coliseum. 

Remote Area Medical Wraps Up Free Medical Care Clinic in Sacramento and Moves to Oakland For Another 4 Days of Free Care

You can visit the website for more information and here’s a quick snapshot below of their next stops in the US.  BD 

image

Their next stop is Haiti.  Last year in Los Angeles, they came twice and helped thousands and many are employed individuals with either no insurances nor not enough insurance.  The dental and eye exams were highlighted in the video from the new station in San Francisco.  Stan Brock, founder of RAM has publicly spoken out many times about doctors being able to cross state lines to donate their time for his clinics and thus far that has fallen on deaf ears.  The link below goes back a couple years to a great interview with Larry King talking to Stan Brock the founder of RAM.  BD 

OAKLAND, Calif. (KGO) -- Thousands of Bay Area residents waited in line for hours for something most of us do without giving it a second thought -- a teeth cleaning and an eye exam. But with health insurance rates at record highs and many people unemployed, it's nearly impossible for many.

About 1,000 people each day are coming to the Oakland Coliseum to wait in line for hours, some even camping out overnight to meet with a doctor or a dentist. An appointment that could cost up to a few hundred dollars is completely free. There is no co-pay, no insurance needed, and every single doctor, dentist, assistant you see is here on their own time.

"Everyone here is a volunteer. Nobody here is getting paid to do this. It's a great commentary on the spirit of the American public," Remote Area Medical Founder Stan Brock said.

Free medical clinic helps Oakland's neediest | abc7news.com

Where is Venture Capital Investing With Healthcare Today-Can Be Risky Business With Long Time Big Commitments

This is an interesting feature from Forbes talking about mostly Health IT investments, and a little about drugs and devices.  You can watch the video and listen to what Venrock has to say.  One of the companies mentioned is Athenahealth which we imageare all probably very familiar with being a web based medical record/practice management solution that has done very well.  One moment things can be moving along fine and then regulation changes hit.  It was just a couple weeks ago I read somewhere that Athena was potentially looking at some big infrastructure upgrades to be compatible with more than one browser and that is not uncommon as there are others in that boat too.  Is that cheap to do, not really.  So we have some vendors who are looking big investments down the nose to keep the company running. 
On the other side of the coin we have the ONC created REC offices which are there to help the physicians get started with medical records along with support and so on.  I don’t really think it was a part of the original plan, but now you have contracts between vendors and the centers for cheaper licensing, so a doctor purchasing via a REC center could see maybe 1/3 off the price they could be offered directly and competition is fierce so everyone is inline to get a contract.  This is good of course for the doctors with affordability and advice for systems that have been certified, and for vendors that’s another 25k they have to pay for that accreditation.  It’s just the way it works.  So when investing in the records of the business those are a couple things to be aware of. 
I particularly liked the part in here where they discussed social networks and trying to apply this to healthcare and every time I read about this topic I have to laugh.  Consumers are not totally in the dark and with all the privacy issues looming, model something around Farmville, give me a break. Just because someone is addicted to games on Facebook doesn’t mean they will have any type of similar enthusiasm for medical information or help on Facebook, why?  Because it’s not fun.  I have seen and researched so many efforts that have tried to make that connection but it doesn’t happen.  Just my own personal opinion, I think it’s silly.  Healthcare is not a game and consumer know that. During the big healthcare campaign we had some funny stuff on Facebook happen too, this is a good one. Coupons and healthcare really don’t mix well either.  You can have virtual games and money on Facebook but virtual health doesn’t fit here.

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

Technology in healthcare is exploding in every direction and I don’t have a problem with someone trying to make a profit, but I find it disturbing when products that are marketed and sold don’t either show transparency, accuracy and are spun only for profits and forget the “care” part of it.  I get solicited all the time just because I do this blog and every day I have to look at what I put out there for readers and there’s a lot that doesn’t make it as again I try to include credible information about products, science breakthroughs, science and so forth that is geared to where the average layman can get something out of it. 

Sure as an investor the potential of a game, website or some other social entity will show it’s potential much faster than a lot of healthcare investments by far.  There’s a lot of glut with healthcare software with folks writing code just because they can to just see what sticks.  That is somewhat annoying as you can’t just go crazy over every little application that is written, especially consumer apps that nobody uses. 
I think the companies that do better are the ones who at least make some effort to collaborate with other partners too as there’s no great white hope in healthcare going to show up any time soon, although the lust is still there, but might as well cool your heels and look sensibly at what you see out there.  Also included in this article was a short mention of Phreesia, which is also funded by Blue Cross Venture Capital.  Most of  the health insurance companies have set up their own venture funds anymore too.  The Phreesia products are little tablets to where patients can enter information and it is sent either to a text file or integrated into a medical record and they are supported by advertising.  So far it looks to be ok, but if the advertising takes over the functional purpose at any time, then it joins the rest of the rank and file with potentially mining and marketing data in essence. 

Blue Cross Venture Capital Investment in Phreesia Tablets Appears to be Paying Off

Red Brick is another company here that goes into behavioral analytics and they are somewhat tied in with United with software analytics and they offer companies biometric monitoring devices to use and wellness analytics up the the you know what.  Behavioral analytics and predictions are on steroids today and if not implemented correctly, they could fail.  Personally I think they are a bit over the head and have seen employees functioning with it at Target and so wrapped up in reporting they didn’t even see me as a customer, so with biometrics something else to think about.  One other item to think about is whether or not the company would or does use their software or devices.  If not, I would stay clear as it doesn’t speak very highly of their own commitment and belief in their own product. 
I would probably not like what they sell as like so many other “innovations” make the users feel bad, so with mobile applications forget the game as consumers know that one.  Perhaps one day someone can develop an application that doesn’t make the consumer feel bad or feel this essence of big brother software breathing down their neck.  Novelty wears short on many of those types of reporting devices and they fall by the wayside in time. 

WellPoint enters wellness program partnership With Red Brick – Behavior Based Health Insurance

AirStrip has a good product and I have talked about it on the blog a few times with their mobile application for doctors.

Airstrip Gets FDA Approval for Critical Care and Cardiology – Remote Patient Monitoring

Last but not least you have the mountains of folks into the financial side of all of this and they work with insurers and always have some new latest and greatest algorithm that is guaranteed to get more money for hospitals and doctors.  Sure we need some of those out there but the marketing of all of their analytics is over whelming.  Many are betting on connecting health records but be wary as health insurers are buying their way into that market and may move right into the heath records for their next area of mergers and acquisitions.  The cost of the market with connecting and getting data is expensive for the buyer and I would also look for those owned by insurance companies to begin leaning on the medical record business to contribute to bump up their over all profits too, as that’s the kind of business it is.  As the video says, it’s not simple to figure it out sometimes and it’s not cheap or for the weak at heart.  BD
While social media hogs the spotlight, health information technology companies are slowly making their way into VC portfolios. Most venture capitalists (77%) expect investments in health IT to increase in 2011, according to a survey by the National Venture Capital Association and Dow Jones VentureSource. VCs invested $460 million in health IT companies in 2010—a 19% increase over 2009. The sector is being energized thanks in large part to government subsidies which reward doctors and hospitals for buying electronic health records (EHRs), provided they follow certain rules. 
Of the 100 VCs on the Forbes Midas List, the most active in Health IT investing is Bryan Roberts (#16) of Venrock. His early investments include Athenahealth and RelayHealth (now part of McKesson). Both are benefiting from EHR adoption. A more recent investment is hot start-up Castlight Health, which has raised more than $80 million since its inception in 2008—one of the biggest investments in a health IT company. Castlight allows consumers to find out how much medical procedures cost. Roberts co-founded it with Giovanni Colella, the founder of RelayHealth, and Todd Park, now CTO of the Department of Health and Human Services. Park is a co-founder of Athenahealth.
Which VCs On The Forbes Midas List Are Investing In Health IT? - Zina Moukheiber - Healthworks - Forbes

Digital Illiteracy Is Killing Us With New Bill Wanting MD Medicare Compensation Put Online-No Clue on the Cost, Time and Truckloads of Errors to Audit and Correct

I commented the same thoughts on this when Dow Jones filed their lawsuit and folks that don’t wrote code or work with data bases have no clue on the work and expense this involves, and just cop out to “we want transparency”.  I say get a little digital literacy to go along with transparency you want.  In the time of budget cuts and other issues what in the world will this accomplish?  Do just put a bill like this out there because you can?  Grassley and the rest of them have never seen the complexity of medical billing, a shame, other wise they wouldn’t open mouth and insert foot.  Most consumers have never seen it either, so nobody has a clue of what they are wanting and talking about…this is hilarious. 

Medicare Data Base–It Is Not Ready for Prime Time To Expose to the Web Due to Errors Factors and Consumer Credibility In It’s Present State Relating to Physician Records

They think this is such a simple easy job, well look at the MD rating sites, heck they are riddled with dead doctors, retired doctors, doctors affiliated with hospitals they have never set foot in.  Where there is money to be saved in “cloud” services, the digital illiterate denied funding for that so what gives here and again no offense, but digital illiteracy is at the heart of understanding needs and how to create laws and funding. 

HealthGrades And Other MD Rating and Referral Sites List “Dead Doctors” on Their MD Information Pages And Even Include the Insurance Plans the “Dead Doctors” Honor

I researched that one and talked with doctors and we looked and I thank the ones who gave me even more feedback via email too.  The article below has a lot of information too on what insurance companies own and how they function with processing claims so if you learn up, give it a read.  Read the next few paragraphs from a post I made in January.

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

This is the biggest filing to create nothing more than a huge distraction and source of disruption that I have seen this year.  Again, like so many other items we see in the news today, with the general consumer having no idea how data and mathematics works, this is yet just one more exploit.  I read the articles from the Wall Street Journal that were published and even commented on a couple of them I believe.  Dow Jones is the owner of the Wall Street Journal which I enjoy reading and they do a good job; however, this to me is going one step too far. 

In order to appreciate the bizarre nature of this lawsuit we need a little bit of history here as this should be seen as a witch hunt, which is pretty much what we have here with throwing stones.  This is not the first time the Medicare data base has come under question and for the last 30 years the AMA has blocked the attempts to make such information public.  The Journal found some good examples of a couple of situations to where fraud was found by running algorithmic formulas to find items that were in fact suspicious and with additional follow up, yes there was a lot to question with those 2 doctors.  The Journal as I remember asked for some data to analyze and HHS gave them some sample data to look at. 

So what is this going to accomplish here?  This bill wants HHS to foot all the cost for this, but wait a minute are not not talking cutting funds…some thing IT grows on trees and this no finer example.  I am beginning to think that Congressmen just grown on trees <grin>.  Yeah, let HHS start to work on it and then you can expect the digital illiterate Spanish Inquisition on their IT projects to arise next <grin>.

Do Some Think That Health IT Costs and Systems Grow On Trees-Certainly Starting To Give That Impression of Late

Let’s just shake down some more doctors and consumers with this, that is what this amounts too as we have already seen MD rating sites don’t get it right and any outside agency or HHS is going to have a huge work pile with this and it will be full of errors.  Doctors will look bad as if they had a few bad billers this will show and many will look like crooks when they are not.  Consumers will be mad and this will serve to be a huge distraction and disruption and how many consumers will really use it probably not many as they are too busy just trying to live these days. 

I have been pro-active and suggesting the IBM Watson type of technology for Congress too to help them with getting the information they need as with speech recognition, it takes the lowest common denominator in Congress with digital literacy and let’s them participate easily so nobody gets left out and can query the information they want. Now what’s wrong with a more intelligent processing Congress?   Nothing I think, but luddites don’t change fast and they can’t see value, otherwise this post would not exist about this bill and waste of time and money. 

It is too bad that Medicare years ago didn’t get the same IT Infrastructure as Social Security did as they are self contained cheap to run and very efficient and it run on COBOL.  The image below is kind of interesting in the fact that if one has a Congressional issue with Medicare, you can get a response from a Wellpoint email address <grin>.  It’s not that bad and upgrades will done, but the check go out, and everyone is happy.  Actually Social Security exchanges medical records too with disability claims.  Again it runs cheap and efficient. 

Unfortunately the politics got involved years ago and that is why Medicare has a skeleton IT infrastructure as the insurance companies (as contractors) built an IT system to run all of it and it’s all under their umbrellas.  Maybe not a smart move years ago by politicians but we are stuck in the “pay me later mode” for those decisions now.  In the meantime, those on Wall Street, hedge funds and others see the value in business intelligence and it appears IBM is making their way to a sale in that area since they couldn’t find anyone in Washington that saw the value of being intelligent and having the ability to have instant information with everyone in discussion seeing the same queried information, from the FDA, GAO or whatever.  They still seem to like snail mail and this gives hedge funds one more advantage to the battle to where we keep taking knives to gun wars sadly, all based on digital illiteracy and non participation with technology.

Sad they just saw the whole IBM presentation as a game from what I have read on the web and couldn’t find a sole in Congress to see the value.  BD 

IBM Watson Capabilities Being Pitched to Financial Industry-Congress Must Not Have Felt They Needed This So Further Behind We Fall With Effective Intelligent Lawmaking

On Thursday, Sens. Chuck Grassley (R-Iowa) and Ron Wyden (D-Ore.) introduced the Medicare Data Access for Transparency and Accountability Act (S 756), which would overturn a 1979 court injunction that bars the government from revealing the amount individual physicians are paid by Medicare, the Wall Street Journal reports.

The bill also would require HHS to make the data, which would not include patient identities, available at no cost (Schoofs/Tamman, Wall Street Journal, 4/8).

Senators Introduce Bill To Open Up Access to Medicare Database - iHealthBeat

SEC Charges Johnson & Johnson With Foreign Bribery- $70 Million to be Paid In Fines But Again Nobody Did Anything Wrong

From the press release below at the SEC, this sounds like it took a bit of work to set up a company to pay bribes.  This sounds like it comes from the makers of financial algorithms on Wall Street, maybe not but sounds similar at minimum. 

“J&J chose profit margins over compliance with the law by acquiring a private company for the purpose of paying bribes, and using sham contracts, off-shore companies, and slush funds to cover its tracks.”  No wonder this guy quit so fast last month….

Johnson & Johnson DePuy Worldwide President Says “I’m Out of Here”

You know what gets me anymore is that nobody admits any wrong doing, apologies or anything else along that line and they just open their wallets and shell out money.  Is the the Bill Weldon way at J and J on this case.  Where that strong commitment, oh wait that was only for us in the United States and doesn’t apply here right as this happened over seas? <grin>.  The Isle of Man where the company was located sounds like it had a lot stuff going on.  The press release states the investigation is continuing so maybe more money later?  Stay tuned as criminal investigations continue but no punishment other than fines seems to result.  We also know they make a lot of money from “Stent Wars” too so as US citizens we can all be assured of quality “patented” stents that cost an arm and a leg. 

Where’s Some of the Focus for Johnson and Johnson Revenue Cycles – “Legally Patented Stent Wars”?

This is one good thing about technology though now with banks being connected, we have data trails and audit trails for evidence, well sometimes.  This is amazing as I keep reading about these big dollar fines, they have recalls coming out their ears and do think I can maybe convince them to do something for the consumer with bar code recalls…hmmmm….guess I have to keep waiting to get an idea across that would really help consumers.  Don’t imageworry if you get a counterfeit product, we have slush funds for that <grin>.  BD

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

FOR IMMEDIATE RELEASE

Washington, D.C., April 7, 2011 – The Securities and Exchange Commission today charged Johnson and Johnson (J&J) with violating the Foreign Corrupt Practices Act (FCPA) by bribing public doctors in several European countries and paying kickbacks to Iraq to illegally obtain business.

The SEC alleges that since at least 1998, subsidiaries of the New Brunswick, N.J.-based pharmaceutical, consumer product, and medical device company paid bribes to public doctors in Greece who selected J&J surgical implants, public doctors and hospital administrators in Poland who awarded contracts to J&J, and public doctors in Romania to prescribe J&J pharmaceutical products. J&J subsidiaries also paid kickbacks to Iraq to obtain 19 contracts under the United Nations Oil for Food Program.

J&J agreed to settle the SEC’s charges by paying more than $48.6 million in disgorgement and prejudgment interest. J&J also agreed to pay a $21.4 million fine to settle parallel criminal charges announced by the U.S. Department of Justice (DOJ) today. A resolution of a related investigation by the United Kingdom Serious Fraud Office is anticipated.

“The message in this and the SEC’s other FCPA cases is plain – any competitive advantage gained through corruption is a mirage,” said Robert Khuzami, Director of the SEC's Division of Enforcement. “J&J chose profit margins over compliance with the law by acquiring a private company for the purpose of paying bribes, and using sham contracts, off-shore companies, and slush funds to cover its tracks.”

Cheryl J. Scarboro, Chief of the SEC Enforcement Division’s Foreign Corrupt Practices Act Unit, added, “Bribes to public doctors can have a detrimental effect on the public health care systems that potentially pay more for products procured through greed and corruption.”

According to the SEC’s complaint filed in federal court in the District of Columbia, public doctors and administrators in Greece, Poland, and Romania who ordered or prescribed J&J products were rewarded in a variety of ways, including with cash and inappropriate travel. J&J subsidiaries, employees and agents used slush funds, sham civil contracts with doctors, and off-shore companies in the Isle of Man to carry out the bribery.

Without admitting or denying the SEC’s allegations, J&J has consented to the entry of a court order permanently enjoining it from future violations of Sections 30A, 13(b)(2)(A), and 13(b)(2)(B) of the Securities Exchange Act of 1934; ordering it to pay $38,227,826 in disgorgement and $10,438,490 in prejudgment interest; and ordering it to comply with certain undertakings regarding its FCPA compliance program. J&J voluntarily disclosed some of the violations by its employees and conducted a thorough internal investigation to determine the scope of the bribery and other violations, including proactive investigations in more than a dozen countries by both its internal auditors and outside counsel. J&J’s internal investigation and its ongoing compliance programs were essential in gathering facts regarding the full extent of J&J’s FCPA violations.

Kelly G. Kilroy and Tracy L. Price of the Enforcement Division’s FCPA Unit and Brent S. Mitchell and Reid A. Muoio conducted the SEC’s investigation. The SEC acknowledges the assistance of the U.S. Department of Justice, Fraud Section; Federal Bureau of Investigation; Serious Fraud Office in the United Kingdom; and 5th Investigation Department of the Regional Prosecutor’s Office in Radom, Poland. The SEC's investigation is continuing.

SEC Charges Johnson & Johnson With Foreign Bribery

What’s Going to Happen to Patients When in October of 2012 Medicare Will No Longer Reimburse for a Hospital Readmission Within 30 Days For Heart Attacks?

This is a very good question and explains too why we see all these big bounties hanging out there for coders to solve the problem with some algorithms.  Granted there’s tons of room for improvement, home monitoring and many other technology advances that can be used to keep re-admissions down.  But what if you are that patient that gets everything in the way of technology, home monitoring and the whole works, maybe several thousand dollars worth of technology and you end up getting sick again, and need to go back, due to no fault of yours or your medical care?  How is this hard core rule going to play out for those with heart failure and acute Myocardial infarctionIs the cardiologist going to be the dirty dog for a scape goat if your body decides to do otherwise? 

Heritage Providers Continues to Promote $3 Million Dollar Prize to Create An Algorithm To Predict and Prevent Hospitalizations

Sometimes the absolute best care can be given and the body says I’m having another attack 2 weeks or so later?  What happens then if the patient has already been there?  Do you start keeping patients for 30 days, of course not but on the other hand who’s going to be the one that says to the patient, you can’t come back as we don’t get paid.  Your heart attack is your fault.  Again, I see the room for improvement, more home monitoring, etc. but how this rule be cut and dry?  We know there’s a lot of money involved here as even former HHS director Leavitt has joined the board of a healthcare finance service, so everywhere you look you might be told good care is at the heart of all of this but dollars still seem to speak a different story.  He’s right in there promoting this code bounty too. 

Former HHS Secretary Mike Leavitt Joins Board of Healthcare Financial Services Company

I guess over the next year we may be hearing more about this as the time gets closer.  What business intelligence was used to make this decision? Could a patient be admitted to another hospital then?  So far we have seen pay for performance efforts not improving quality care either, so perhaps before this becomes law there could be some more questions to answer as again we delve deep into the area of “unintentional consequences” which happens a lot today without some type of business intelligence to at least model it before making decisions.  Second of all the algorithms will help, but wont completely solve re-admissions.  BD 

NEW ORLEANS—As the feds and payors focus on curbing readmission rates, hospitals and caregivers need to revisit management of the hospital-to-home transition. Philips Healthcare shared a new multi-vendor, multi-disciplinary model during the annual meeting of the American College of Cardiology (ACC).
“Patients leaving the hospital do not want to return anytime soon, yet many find themselves back in the hospital within 30 days. It has been shown that better patient outcomes are a result of not only the care received while in the hospital, but also the care at home,” said Henry A. Solomon, MD, chief medical officer at the ACC.

Post-discharge, Maria’s plan included home telehealth monitoring and remote cardiac monitoring managed by a centralized telehealth center. Physicians prescribed a Holter monitor, PT/INR meter and home defibrillator. She also used the automated dispensing service, which was programmed to alert providers if she missed a dose. Finally, Maria was enrolled in an ambulatory quality improvement registry.
Providers stressed that a comprehensive model that weds education, multidisciplinary management and consistency and standardization is key to addressing the readmission challenge.

ACC: Philips stresses hospital-to-home connections

FDA to Review Security Data Access After Insider Trading Charges Filed-Time to Update Group Policy on The Servers

Well group policy settings are the first thing that come to mind and if needed additional audit trails can be added to track access and log it.  I’m sure some type of Group Policy was in place at the time but maybe it was not tight enough.  Hospitals such as Long Beach Memorial who use Epic also have an algorithm called “break the glass” and employees are actually asked, just in case they are in there by a mouse click by mistake or whatever, before they get access so they have to allow it themselves and of course all this is tracked and audited.  image

SEC Files Lawsuit Against FDA Chemist for Insider Trading Violations

I’m sure the FDA has security access in place but perhaps adding more groups and restricting some access along with audit tables should do the trick.  Does the IT department like doing Group Policy, heck no as it gets complicated.  It is about as much fun as managing Outlook Exchange except it doesn’t need daily attention for the most part to the same extreme.  BD 

Food and Drug Administration Commissioner Margaret Hamburg, in a memo provided to Reuters, told employees she had taken steps to address "potential vulnerabilities" in the way the agency handles information electronically. The agency houses details about upcoming drug decisions that can make or break a pharmaceutical company's fortunes.

The steps include a new tracking system to "better monitor employee access of data," Hamburg said in a memo sent to FDA staff on Wednesday.

Exclusive: Trading charges spur FDA data protections | Reuters

Stem Cells Grow an Eye Retina

This is only the beginning but a good start for the eyes with stem cell treatments.  The retina was grown in a dish and later down the road who knows what stem cells will do for correcting sight problems.  Mouse embryonic stem cells were used for the study.  BD 

If the technique, published today in Nature, can be adapted to human imagecells and proved safe for transplantation -- which will take years -- it could offer an unlimited well of tissue to replace damaged retinas. More immediately, the synthetic retinal tissue could help scientists in the study of eye disease and in identifying therapies.

The work may also guide the assembly of other organs and tissues, says Bruce Conklin, a stem-cell biologist at the Gladstone Institute of Cardiovascular Disease in San Francisco, who was not involved in the work. "I think it really reveals a larger discovery that's coming upon all of us: that these cells have instructions that allow them to self-organize."

However, the eye structure created by Yoshiki Sasai at the RIKEN Center for Developmental Biology in Kobe and his team is much more complex.

The optic cup is brandy-snifter-shaped organ that has two distinct cell layers. The outer layer -- that nearest to the brain -- is made up of pigmented retinal cells that provide nutrients and support the retina. The inner layer is the retina itself, and contains several types of light-sensitive neuron, ganglion cells that conduct light information to the brain, and supporting glial cells.

To make this organ in a dish, Sasai's team grew mouse embryonic stem cells in a nutrient soup containing proteins that pushed stem cells to transform into retinal cells. The team also added a protein gel to support the cells. "It's a bandage to the tissue. Without that, cells tend to fall apart," Sasai says.

At first, the stem cells formed blobs of early retinal cells. Then, over the next week, the blobs grew and began to form a structure, seen early in eye development, called an optic vesicle. Just as it would in an embryo, the laboratory-made optic vesicle folded in on itself over the next two days to form an optic cup, with its characteristic brandy-snifter shape, double layer and the appropriate cells.

Robert Lanza, chief scientific officer of the biotechnology company Advanced Cell Technology, based in Santa Monica, California, says the paper has implications far beyond treating and modeling eye diseases. The research shows that embryonic stem cells, given the right physical and chemical surroundings, can spontaneously transform into intricate tissues. "Stem cells are smart," Lanza says. "This is just the tip of the iceberg. Hopefully it's the beginning of an important new phase of stem-cell research."

Stem Cells Make 'Retina in a Dish': Scientific American

FDA Moves in on Triad and Seizes $6 Million Dollars of Product-The Medicated Wipe Recalls Issues Continue - Triad is an Outsource for Several Fortune 25 Companies

What a mess this has been and gee if consumers, doctors, hospitals and so on imagewould have been able to use a smart phone to find recalls products lots, how much easier this could have been.  One thing with this recall from Triad we found out they private label for tons of companies, and thus they too also had to put out recall alerts for their products, after they figured out if they were affected.  This is huge snowball effect going here.  You should see the lists…huge!  If you shopped at Walgreens and bought over the counter medicated wipes, well check those huge number of recalled lots!!  Is this not fun or what!  No it is not.  We still have no system.  Here’s part of the original post I made back on January 7, 2011 when it started. 

FDA Announces Recall of Alcohol Prep Pads, Swabs, Swabsticks From Triad–FDA and Manufacturers Should Ashamed-Campaign for Bar Codes Still Stands Stronger Than Ever!

This is by far the biggest neglect of both the FDA and drug/medical device and over the counter healthcare products!!  Have you ever tried to return a product to a retail drug store and be told “no” because it’s not on their authorized list!!  Now some of their products are used by healthcare professionals too and I looked all over the web site and as close as I could come was to find wipes or products that remove adhesive tape so I think this is what the product recall is all about that could be contaminated.  A cell phone to scan the box would soooooo simple.  image

This is another good sized recall and granted the products are not expensive but for goodness sakes we have private label stuff in here now too.  If in fact the products are not sanitary we need to have an easier way to find them on the shelves.  Look what a mess they make for the retail stores too. 

CVS and Walgreens should join my cause here as this is just simply “tech denial” and nobody wanting to do a thing about it.  I have sent this to drug companies, the FDA, the DEA and several other deaf ears. This is costing the retail stores money too!  Again, a good reason for them to join the cause here.

This isn’t just a J and J deal anymore and see what was on twitter about this not too long ago, everyone liked it! 

I keep seeing all these notices that the FDA wants public input, but you can read the post below and see what happens when you try to contribute, its not good.

FDA Looking for Public Input on How They Communicate With the Public-In My Case They Don’t Relative to Using Bar Codes for Device, Drug and OTC Products Recalls

I guess the stuff was still shipping and being distributed, thus US Marshalls as directed by the FDA had to show up and close up shop.  BD

The Food and Drug Administration said Wednesday that antiseptic products made by Triad Group and H&P Industries were seized to prevent the distribution of products that might be contaminated and pose a health risk.

At the FDA's request, U.S. Marshals have seized more than $6 million worth of products from Triad's facility in Hartland, Wis. The products included antiseptic products, cough and cold products, nasal sprays, suppositories, medicated wipes, antifungal creams, hemorrhoidal wipes, raw materials among other items. The Triad products were widely used in medical facilities around the country, and were also available for sale to the public under a variety of product names at Safeway, City Market and Walgreen's chain stores.

Triad Group and H&P Industries are owned and managed by the same parties. Triad confirmed that the seizure began on Monday and that it has halted production.

FDA seizes $6 million in products from Triad - Forbes.com

UCSF Going to Try Their Hand at the Killer Healthcare App with mHealth-Problem So Far Is that Nobody Has Created Desirable Value for Consumers With Any of It

This runs along the same lines as personal health records and let’s get down to basics here as every application says you are not perfect and you need to fix something, who wants that!  Most of the folks that talk and develop I lot of the applications would not use it themselves, but kind of know what is good “for those guys over there”.  This strikes me as funny as nobody gets why the consumers are not just thrilled to use all these applications that are going to tell them something negative about themselves, Duh?  Right now there’s more than enough in the nightly news to feel like we are being blamed for all the budget problems in the US just because we exist for goodness sakes. 

I like technology and what it can do and pretty advocate good stuff and I get tired of the “Junker” software created out there too that nobody uses.  I happen happen to like what I am pitching and that is the FDA bar code recalls.  First of all, guess what it gets that smartphone into the consumer’s hand and they are using it to find recalls, finally someone gives the consumer something that’s not going to tell them how bad they are, and does the just the opposite if we were able to use phones this way.  Fat chance getting folks like the FDA and pharma companies to get off their luddite behinds and get on to this so far. 

Microsoft Tags – Microsoft MSDN Posts Ideas from the Medical Quack About Use in Healthcare!

Heck even the White House could warm up to this idea with the same technology to keep uninvited guests out…we remember that one, right?

White House Security Breach – Next Time Send Out Invitations Imprinted with Microsoft Tags and Scan with 2D Bar Codes on Arrival

Next up we see the press articles that talk about government leaders talking about how health IT illiterate consumers are and they are just as illiterate.  No role models there and I have yet to hear anyone from HHS talk about how the Surgeon General’s PHR has shown value for them and we are living in the social world today.  That tells me they really are not that social and we sill have the paradigm of “its for those guys over there” along with big echoes of “Magpie Healthcare”. 

What’s On the Agenda Tonight–World of Warcraft or Work on My Personal Health Record

All these endeavors are not bad but we all know more will fail or fade than get used.  This article says the University is a good position to create apps, well who isn’t and that is not a statement to discount any of their efforts but more of what’s reality out there today, who isn’t?   Now on the other hand, why do people flock to games on their phones, because it is fun and the game is not going to make them feel bad.  Some try to make healthcare games, but the underlying object of telling you that you are not doing something right is still there.  The VA the other day is talking about Vista their medical record system and about having a custodian for the open source.  There’s also a company who did work with the source and created a commercial installation, so will these 2 talk?  I don’t know but thought it was a good idea since there’s a lot of code written here?

VA Issues Draft for a Vista EHR Open Source Custodial Agent-Have They Spoken to Medsphere to Perhaps Collaborate-Is There Anyone Really Going To Do That?

It’s an interesting world as everybody seems to talk a big show with declaring such expertise and yet it never gets there most of the time.  Perhaps the University here will come up with something as that’s what mobile apps seem to be mostly today, create and see if it sticks on the wall.  You know, come to think of it, Harvard has a mobile platform and I just wonder if UCSF will talk with them….collaboration again knocking at the door maybe or are we still the on the best mouse trap campaign. 

Experts these days in software are getting harder to find and that is partly because such a glut of it out there so anymore, and again I like software and used to write it, I don’t get very excited and with nobody doing anything for the consumer other than telling how bad they are with an application, it’s hard to get behind most of it.  Who do you want to teach you how to drive a car, a person who read a book about it and has never driven or an individual who has driven a car for years and has lots of hands on experience?  I think we all know that answer but yet in software we keep getting the “book” guys out there and they can’t show value for the consumer, no matter what they do or say. 

So all in all its just another app in the wall <grin>.  BD

At the University of California, San Francisco, Jeff Jorgenson and his mHealth development team are building next-generation patient apps. Those apps will be highly personal, getting smarter as they learn more about the user. The phone might, for example, urge you to walk by the bar you are approaching because it knows you are stressed out – from the mood information you have inputted – and having a few drinks might make you relapse into smoking.

As an organization, UCSF is in a good position to create future apps. It has the medical knowledge, physicians who are interested in mHealth, the technical support from information services and patients who would use the apps. But it is not easy to coordinate all this, especially when nobody has the money to make it happen. Until now, funding for mHealth projects has come from the information services unit budget and various grants.

The problem with grants is that applicants need to show what they are going to do, and it takes money to create a demo. This is where wStack, an app engine created by Suarez, helps. It provides one engine to create demos and many kinds of applications. It also works in smartphones like iPhones and Android devices as well as in simpler phones.

The race is on for the killer health app at UCSF | SF Public Press

First Ever Insect Born (Mosquito) STD Discovered When Researcher Passed the Disease On To His Wife

After reading the title of this post does anyone have a problem with the Gates Foundation working to vaccine against malaria, hope not.  This was not malaria that was passed on at a STD but rather a somewhat rare infection called Zika.  The scientists were studying Malaria at the time and were bit several times.  The link below has a video of Bill Gates’s presentation at TED from a couple years ago.

Bill Gates from the TED Presentation this week – Malaria and Education

Actually there’s a clinical trial slated to begin this year with an experimental vaccine.  You can read down further and see how the CDC was also stumped on how this occurred and all sources together determined it was transferred to the scientists wife as an STD.  This is kind of scary to say the least. 

Clinical Trials to Begin for Malaria Vaccine Later This Year

As mentioned in the article with some climates warming and becoming breeding grounds it’s some thing to be aware of and I feel sorry for the wife of the scientist to have contracted this of course but it was also nice that she shared so the story on this being sexually transmitted was made possible.  In 2007 an island was hit with an explosive outbreak of the infection that infected 70% of the population so it has been isolated to a degree, but what would happen if it were to spread?  It’s not as deadly as malaria right now but being STD capable is pretty unnerving.  Come to think of it, do we need mosquitos?  At this point it’s just something that comes to mind if the lack of would destroy our ecosystem?  Of course we can’t get rid of them but wonder about limited numbers?  BD 

Passing on an STD to your wife is not necessarily the kind of thing you want made public. For that matter, have the CDC make public. But when you're the first documented case of an insect-borne disease transmitted through sexual intercourse, you hardly have a choice.

Outside of this guy and his wife seriously taking one for the team, it's fascinating (and scary) how our planet's changing climate forces more and more of these diseases into our lives. For example, rising temperatures are already bringing malaria to new altitudes like Mount Kenya.

It not only stumped the two scientists, but many laboratories including the U.S. Centers for Disease Control and Prevention (CDC), whose lab for insect-borne diseases which is near where Foy lives in Fort Collins. A year later the mystery pathogen was deduced over a few rounds of beers--which usually leads to STDs--on a return trip to Senegalr. Both researchers had become infected with Zika.

Not much is known about Zika. Up until 2007, there were only 14 known cases. That year Yap Island was hit with an explosive outbreak that infected over 70% of the island's inhabitants. In comparison to malaria where a child dies in Africa every 43 seconds from the disease. It has gotten so out of hand that some of the solutions border on ridiculous, like this mosquito-zapping laser from TED.

http://www.treehugger.com/files/2011/04/guy-contracts-first-ever-insect-borne-std-gives-it-to-wife.php

NIH to Ax 20% of Electronic Grant Contractors Due to Budget Cuts

30 of 160 contractors will get the word and this means a longer wait for grants and imagefewer will be processed.  The agency does not have a 2011 budget and is operating at last year’s levels. 

The required cut is $2 million in the $36 Million dollar budget so research and development kind of moves backwards I guess is the best way to put it.  BD 

In a sign of grim budget times, the National Institutes of Health (NIH) is cutting 20% of the contractors who help run its electronic grants system.

In a message today to extramural staff, NIH Deputy Director for Extramural Research Sally Rockey explains that "in the strained budget climate," the agency's Electronic Research Administration (eRA) "has been dealt a major reduction in its budget." To make matters worse, the cut is coming in the middle of the fiscal year (which runs from October to September). About 20% of eRA contract staff members are being "released," which will result in "a significant impact" on eRA's services, Rockey's note says. NIH staff and grantees will wait longer for eRA staff to respond to questions and fix system problems, and many eRA projects will be curtailed.

Like other federal agencies, NIH doesn't yet have a 2011 budget, and the agency is operating at last year's level under a temporary spending measure. Rockey says "competing priorities" required a $2 million cut in eRA's $36 million budget. That will mean shedding about 30 of the 160 eRA contractors, including some on the help desk. "We're going to try to find as many efficiencies as we can," she said.

Budget Freeze Forces NIH to Slash Electronic Grants Staff - ScienceInsider

CA Insurance Commissioner Sues Bristol-Myers-Squibb Accusing of Bribes and Kickbacks Involving Doctors

The suit revolves around benefits for high prescribers for all types of items like concert tickets, liquor and so on.  The article from the AMA says drug reps told low imageprescribers that they would not receive free samples or other invites.  The sales plan was called “Rounding Up the Doctors” that began back in 2001. 

I am guessing this may have covered more than one drug as there is not one named in particular as this is what we usually see in the news.  The case goes back to 2007 and now is unsealed since the CA insurance commissioner has the suit.  BD

California's insurance commissioner is suing pharmaceutical giant Bristol-Myers Squibb Co., accusing the drug company of bribing physicians using an assortment of kickbacks to prescribe the company's drugs.

According to the lawsuit, physicians deemed "high prescribers" by Bristol-Myers received trips to basketball camps, free concert tickets, autographed basketball merchandise, liquor, golf outings and other rewards to boost prescriptions. Low-prescribing doctors were warned by drug reps that they would not receive free samples or event invitations, the suit said.

The suit was filed in 2007 by former Bristol-Myers employees in the Superior Court of the State of California for the County of Los Angeles. The suit was sealed until early March of this year, when California Insurance Commissioner Dave Jones joined the complaint and requested that it be made public.

Bristol-Myers was among 55 drug companies that signed on to an ethical interactions code established by the Pharmaceutical Research and Manufacturers of America, said PhRMA spokeswoman Kate Connors. Under part of the voluntary code, companies are prohibited from providing entertainment or recreational items such as theater tickets and vacations to any health care professional who is not part of the company.

amednews: California lawsuit accuses drug powerhouse of bribing doctors :: April 4, 2011 ... American Medical News

MidState Medical Center in Hartford Security Breach-Employee Downloaded Patient Files and Took Them Home

Hopefully one day stories like this will cease to exist.  A couple months ago a imagehacker faked out employees and they gave him everything he wanted.  So why is it that this employee could download all this information and if work needed to be done at home, have we ever heard of a VPN?  With today’s speed on the internet, there’s almost really no reason to be carrying around patient data in this manner any more or for employees to have access without out prior permission from someone in IT.  I’ve seen it done all the time in the past too with people taking information on portable drives with no password or encryption and today the consequences are just too high to be doing this. 

Hospital Security Breach–Hacker Fakes Out Employees and Asks for Their Email and Log In Information And They Gave It To Him

Sometimes though too the CIOs have a hard time getting funds for additional Health IT services, kind of what like happened a few years ago to retailer TJMaxx who didn’t think security was that important, but they do now. 

MERIDEN - The personal information of about 93,500 patients of MidState Medical Center may be compromised after a Hartford Hospital employee downloaded the information to an external hard drive and took it home.

MidState has not been able to recover the hard drive, which contains patients' names, addresses, marital status, Social Security numbers, medical record numbers and dates of birth. The information was downloaded to the hard drive on Feb. 15 at Hartford Hospital by a worker no longer employed by the hospital. Hospital officials would not name the former employee.

Hartford Hospital and MidState are both part of Hartford Healthcare and share information.

"The financial fraud aspect is huge but the medical fraud is the one that is most insidious to me," said Vincent J. Messina Jr., a Meriden salesman who deals in identity theft protection. "Imagine getting in a car accident and needing a blood transfusion but they can't do it because you have an incorrect medical condition listed on your medical records - or being denied treatment because of some bad information. Your records can get updated incorrectly without you even knowing."

MidState patient information may have been compromised - Local News from Myrecordjournal.com

e-MDs Selected as EHR Vendor by Medical Society of the State of New York (MSSNY)

Medical record vendors are probably under more review and scrutiny today than ever and being selected as well as being a certified ONC vendor is important as with so many choices today, we are comparing notes and experiences.  e-MDs is an advertiser at the Medical Quack and you can always find a link to their site for additional information under the resources column on the right hand side of this site.  MSSNY is a non profit organization that works with physicians to encourage the adaptation of medical records for their members.  BD 

AUSTIN, TX – e-MDs, a leading provider of electronic health records (EHRs), announced they have been selected as an EHR vendor partner imageby the Medical Society of the State of New York (MSSNY).  MSSNY is a non-profit organization committed to representing the medical profession as a whole and advocating health related rights, responsibilities and issues.  MSSNY will work with e-MDs to encourage and facilitate the adoption of EHR technology by the state’s healthcare providers.  As a selected vendor, e-MDs will help providers manage efficient implementation and achievement of Meaningful Use in a cost effective manner. 
e-MDs was one of six finalists to be chosen to participate in MSSNY’s rigorous evaluation process.  The vendors, who all service the one-to-ten provider group, were identified through their high KLAS ratings and asked to complete a 20-page functionality matrix answering detailed questions about their products.  The vendor responses were reviewed by MSSNY’s evaluation committee, consisting of five health information technology (HIT) and EHR proficient physicians, including the MSSNY HIT Chair, Dr. Salvatore Volpe, a leading HIT champion.  The thorough evaluation process was conducted to identify “the best systems for our physician members,” explained Dr. Volpe.  “We needed to flush out important processes, which if omitted by the vendor could result in medical errors and place the patient at risk by introducing adverse medical complications.”

e-MDs Continues Track Record of Employee and Revenue Growth

LabCorp Buys Orchid Cellmark International DNA Testing Services

LabCorp also provides the testing services for Google’s 123andme.  In addition there are have been a couple other purchases by LabCorp. Initially the Westcliff purchase was questioned but as I understand now it has moved forward. 

FTC Challenges Acquisition of Westcliff Labs by LabCorp In Southern California-Why?

When you view the Orchid website they are pretty much marketing in both the UK and Canada.  In the US some of the mail order DNA businesses are still under investigation from the FDA.  It’s pretty wild as the site is not just for medical testing but they offer forensic, paternity and several other types of tests.  In view of this business maturing, beware of the DNA snatchers.<grin>.  BD 

Beware of the DNA Snatchers of the Future

Laboratory Corporation of America® Holdings (LabCorp®) (NYSE: LH) and Orchid Cellmark Inc. (NASDAQ: ORCH), an international provider of DNA testing services primarily for forensic and family relationship imageapplications, today announced that they have entered into a definitive agreement and plan of merger under which LabCorp will acquire all of the outstanding shares of Orchid Cellmark in a cash tender offer for $2.80 per share for a total purchase price to stockholders and optionholders of approximately $85.4 million. Orchid Cellmark strengthens LabCorp's presence and strong brand name in identity testing in the US and establishes its presence in identity testing in the UK.

LabCorp to acquire Orchid Cellmark