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Med Solutions and Blue Cross Caught On the Stress Test Denial Algorithm (video)

4/15/2011 07:08:00 PM  ,  

Ok we are now starting to see some of the 3rd party risk companies used by insurers being questioned.  When they make their sales pitch to insurers they of imagecourse tell them how much money they can save them, a percentage usually.  The video talks about approval for tests and what is allowed and what is not allowed.

What controls these cost evaluations – those algorithms! 

In this case a nuclear stress test was ordered by his doctor and it was denied by Blue Cross 3 times and the doctors had to go to work and interesting how this video shows a web conversation with him and his doctor too.  After 3 times the doctor sent the patient to the hospital where a big blockage was found and if he had not received treatment he would dead said the doctor at the hospital.  He had an emergency quadruple bypass. 

Visit msnbc.com for breaking news, world news, and news about the economy

Med solutions is the 3rd party who worked for Blue Cross promising 25-30% savings, they run algorithms to do this based on data input into the system and the patient records they have on file.  Med Solutions ended up with a Senate investigation and found that sure there were some denied appropriately but how about the ones inappropriately denied, like in this case.  If your life is on the line it’s one huge difference and imagesomeone better fix that algorithm.  Med Solutions fees were to be cut if it didn’t save Blue Cross 20% with their auditing, so you can think about what may have gone on here.  Back in 2007 I found an old post here with a doctor complaining about Aetna and Med Solutions getting grilled in a peer to peer meeting as it did not meet the criteria set forth.

“Because the test I ordered did not fit Aetna’s or Medsolution’s “protocol”, quite possibly created by businessmen without much medical background, my patient must suffer. I should not need to provide justification for preferring to perform one study over another as long as each is appropriately ordered.”

Who’s playing doctor here?  Their argument was that they want to guarantee that patients get the care they need, well maybe if you not looking at having your rates cut.  Interesting too is that I tried to visit the Med Solutions website today and it is down, which could be coincidental but maybe not.  Blue Cross changed their imageprocedures and said they no longer require approval for nuclear stress tests.  This was good case that made it to the news for an awareness for all and perhaps they will look closer at the algorithms run by the 3rd party software folks they used in the future. 

Now do you see where our lawmakers are having issues here with quick changes in algorithms like this when patients are denied care.  The link below is a long post and covers a lot of territory about digital illiteracy in lawmaking and why some processes should change and I included a video from Harry Markopolos to remind us of the fact that we can’t take dull knives to gun battles. 

Healthcare Reform Law– Is Any Judge Fully Capable of A Decision on a Law That is Challenged By Constantly Changing Algorithms?

We certify software from medical record vendors, so why do we not certify that he algorithms run by insurers and their agents are also performing correctly? 

We need some digital algorithms on file to save time and patients like this the anguish.  I wrote this back in 2009 by the way on the Department of Algorithms.  BD

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

msnbc video: Health insurers putting squeeze on tests

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Vanguard Health IPO In the Works But Will Remain a Controlled Company With Private Equity Investors

4/15/2011 05:27:00 PM  ,  

Private equity firm Blackstone Group owns 66.1% of the company and as the article states below it will remain a “controlled” company. At the end of last year the imagecompany bought the Detroit Medical Center so it is now a for profit center.  If you have not heard of Blackstone, they are a very large private equity firm. 

Vanguard's Purchase of the Detroit Medical Center Receives Approval from Michigan Attorney General

A few years ago Vanguard sold some of their hospitals to Prime Healthcare here in Orange County.  La Palma and Huntington Beach hospitals were two of the medical centers sold.  Since selling to Prime, who will not negotiate with insurance companies for contracts, the hospitals are not like they used to be, not busy at all with inpatients, but rather run Cadillac ER rooms, as that’s where the money is at with billing customary charges.  Vanguard typically buys bankrupt or near-bankrupt facilities, then invests in capital improvements to help upgrade service and Prime is kind of in the same business.  Right now though you can roll bowling balls through their parking lots, at least the 2 mentioned above compared to how they used to operate.  BD 

Vanguard Health Systems, Nashville, filed a prospectus with the U.S. Securities and Exchange Commission for Vanguard's initial public offering of stock.

The company plans to sell stock worth $600 million in the IPO, with the shares to be traded under the symbol “VHS” on the New York Stock exchange, according to the filing. Vanguard intends to use the proceeds to pay off senior discount notes that are due in February 2016, according to the filing. The prospectus does not specify what price range it expects for the initial offering of shares or how many shares will be sold.
The filing also does not state the specific ownership interests of its three main shareholding groups after the sale of the public shares, but does state that after the IPO, Vanguard still will be considered a “controlled company” under New York Stock Exchange rules because the three groups will still control a majority of the voting power of the company. Private equity firm Blackstone Group owns a 66.1% interest in the company currently. Morgan Stanley Capital Partners, which was the company's original equity investor when it was founded in 1997, owns an 18% stake. The company's management team owns 15.9% collectively, including 7.4% by Chairman and CEO Charlie Martin.

Vanguard Health plans IPO - Healthcare business news, research, information and opinions | Modern Healthcare

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Man Bites Police Dog After Attack Then Sues Over Dog Violating His Civil Rights-Dog Injured From Bite-Man Suffers Diabetic Seizure

4/15/2011 04:00:00 PM  ,  

Did you get all of this?  The suspect was being chased by a police dog and when imagethe dog was in range, he bit the dog.  In addition, the man is claiming he was denied his insulin while being held which caused a seizure.  The man who bit the dog is serving 8 years for the burglary crime for which he was being chased for.  BD

PHOENIX (AP) — A 33-year-old man who bit back after he was caught by a Phoenix police dog is suing police.Erin Sullivan alleges the dog violated his civil rights and used excessive force to capture him after he ran from officers in Glendale during a burglary investigation last year.

Man bites dog _ then sues over police canine's act - seattlepi.com

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FDA Approve New Treatment for Brain Tumors from NovoCure

4/15/2011 03:50:00 PM  ,  

Back in October of 2009 both Pfizer and J and J had invested in NovoCure.  The electrodes tackle the cancer cells only and healthy cells are left alone.  Compared to imagechemotherapy it offers a better quality of life with brain tumors but you need to be connected almost all the time and carry around the 7 pound battery pack.  The system is completely non invasive. 

Pfizer Along With Johnson and Johnson Invest in Cancer Medical Device - Novo-Cure Stopping Growth of Tumor and Potential Reversal

Perhaps as time moves forward the device and battery pack will get smaller.  BD 

NovoCure

A new treatment for a deadly form of brain cancer has been approved by the FDA and is cleared for sale in the U.S. market.

The NovoTTF-100A System (NovoTTF) made by NovoCure is a "non-invasive device consisting of four sets of insulated electrodes attached to an electronic box," according to the privately-held Israeli company.

The FDA's neurological devices panel last month voted 7-to-3, with 2 abstentions, that there is reasonable assurance that the benefits of the device outweigh its risks when "administered as a monotherapy in place of standard medical therapy" for treatment of for treating the brain cancer glioblastoma multiforme (GBM), according to a prepared release from the company

Cancer treatment: FDA approves new brain tumor treatment | MassDevice - Medical Device Industry News

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Community Health Systems Receives Subpoena–Bring in Your Algorithms Used By Pro-MED 3rd Party Software for the ER

4/15/2011 03:29:00 PM  ,  

The plot gets thicker it seems with a hostile take over in place with Tenet and and their lawsuit filed.  It is not known yet as to whether or not this is related but it adds to the plot maybe?  The Texas attorney general’s office filed a similar request in November.  Both hospital chains have paid healthy fines in the past. 

Tenet Files Suit Accusing Community Health Of Inflating Hospital Admissions

Tenet Tells Community Health Thanks But No Thanks in Response to Their Submission of 10 Nominees for Tenet’s Board of Directors

Let’s take another look at the video made by the Texas Medical Association on what happens with strained relationships when money and funds are at the root of profits and what can and did happen in 2009 at a hospital in Texas. 

TMA video–When Hospitals Play Doctor

Just as a side note, the Inspector General is also monitoring the upgrade of CMS and their computer systems and if you are interested in some of the auditing software they use, the link below will tell you more and it’s a free download.  BD

Office of Inspector General to Monitor Upgrade of CMS Computer and Data Systems and Stimulus Incentives for EHRs

Community Health Systems, Franklin, Tenn., received a subpoena from HHS' inspector general's office seeking documents related to emergency department processes and procedures at all of the company's hospitals, according to a securities filing.

The subpoena was dated April 8 and was issued by the inspector general's Chicago office for an investigation into possible improper Medicare and Medicaid claims, according to the filing. The subpoena requests documents related to Community's use of the Pro-MED clinical information system, a third-party software system used to manage and track emergency department operations, and its relationships with emergency department physicians, including financial arrangements, according to the filing.

Community Health Systems receives subpoena - Healthcare business news, research, information and opinions | Modern Healthcare

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Staph Bacteria Living in Much of the US Meat We Buy at the Store-Research and Development of Antibiotics Also At a Low

4/15/2011 11:03:00 AM  , ,  

The statistics reported by TGEN in Arizona are a bit of an awakening.  So what happens when we eat the meat, do we have bacteria living from within that the body needs to fight off?  Chickens and cattle have been given antibiotics for yeas before slaughter and this is recycling back.  When meat is cooked that reduces imageconsumption of the bacteria but the over all effect questioned here is that is this leading to our bodies become more resistant to antibiotic treatments, are they less effective.

This is a big issue as we have far fewer drug companies than ever doing research and development with antibiotics as the profits have not been there, so add that to the scenario and it doesn’t look to add up to a lot of good odds for the future.  Below is an example where J and J bailed on a drug being developed for MRSA after it was not given approval.  You wonder in a case like this though if further development in a different direction could be worthwhile pursuing since there’s already a lot of ground work laid. 

Johnson and Johnson Drops Investment for MRSA Drug Development After Failing to Meet European CE Mark & FDA Approvals

As hospitals continue to work hard against the spread of MRSA is this a contributing factor with exposure at some point, that I don’t know but MRSA shows up at the gyms and many other places in life too.    This clinical trial is ongoing in Irvine California too with a treatment process. 

Clinical Trial on Fighting MRSA Infections in Southern California To Begin With 10 Million Dollar Grant

Meat in the U.S. may be widely contaminated with strains of drug-resistant bacteria, researchers reported Friday.
Nearly half of all meat and poultry sampled in a new study contained drug-resistant strains of Staphylococcus aureus, the type of bacteria that most commonly causes staph infections. Such infections can take many forms, from a minor rash to pneumonia or sepsis. But the findings are less about direct threats to humans than they are about the risks of using antibiotics in agriculture.

Antibiotics are routinely given to livestock to promote growth and prevent disease in crowded pens. Last summer, the Food and Drug Administration urged the meat industry to cut back on antibiotics use over concerns that the bacterial resistance bred in stockyards makes antibiotics less effective in humans.

Meat contaminated: US meat contaminated with staph bacteria - latimes.com

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NIH Announces Plan to Develop Medical Image Sharing for PHRs-Role Models Would Help Stamp Out “Magpie Healthcare”

4/15/2011 09:33:00 AM  , , , ,  

I have said this a few times but where in the world are these experts with using a PHR?  Does anyone at the NIH even use one themselves?  Does anyone at imageHHS use a PHR, silence is deafening and we never hear about it.  How about the experts at the ONC, what value do they see in a PHR as they work with and communicate with medical record systems"? 

Where are these folks in reference to being any type of a role model?  Is this more of the experts telling us that their efforts are “for those guys over there” again.  How come nobody talks about the Surgeon General’s personal health record, do government employees use it, and come to think of it, does the Surgeon General use it? 

We have a lot of that out there today with those who promote and tell everyone else what they should be doing, don’t participate themselves and thus we have the emergence of additional assays of “Magpie Healthcare”.  If you promote consumer products are an an expert, it’s a good idea to use the technology yourself, you think?  It builds credibility in what you write as an expert.  Microsoft HealthVault already has their imaging sharing set and ready to go so perhaps a model here to view as well, it’s all free. 

HealthVault Begins Storing Medical Images (Dicom) Using Windows Azure Cloud Services With Full Encryption

Thank goodness we have a few out there who do use the technology and take time to explain to the rest of us, Dr. John Halamka at Harvard is by far the best and most knowledgeable expert here.  When you look at his blog when he talks about technologies, consumer programs too, you see screenshot examples of his PHR, so he explores it and thus so his opinions, instructions and so forth contain real credibility unlike the Magpies that lurk all over the web. 

I use HealthVault as a PHR for both myself and my 86 year old mother and truthfully her records are more in quantity than mine and simple age factors dictate that principle.  Do we have 100% of everything available stored, no.  Do we have the basics that we feel are important to share like allergies, medications, and and advanced directive in there, yes.

In short what I am saying here is that some important information stored here is a lot better than none.  We will be adding images shortly here too as we have recently been right in there with the image chasing game and have run images and had friends even help out taking them from one doctor to another.  We don’t live in the same state and are miles apart so we do what we have to do here so she gets the best care and everyone can have access.  Shoot even if you do not have anything else in there but images it’s a big step ahead with convenience for one and again not duplicating tests.  Think of it this way, as saving money and your time, see any value there?  You should. 

Yes we have all these ideas from HHS that we hear about with new programs and laws, but never a word on any value from those within who create all of this.  I can’t even find so much as an image on the web with HHS director Sebelius with so much as a cell phone in hand, so how visible is that with participation and showing an interest in Health IT…hint…hint..<grin>. I did pick on Joe Biden a while back but he now uses an Ipad himself so I can’t pick on him any longer, a good thing!

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

Anyway coming back around we have the wonderful studies and news that tell us how consumer literacy is pretty much non participatory in Health IT, well look what we have for role models and that will give you one big clue. 

So will Francis. Collins from the NIH be sharing his images or has he looked at HealthVault to get an idea how this might word or will we hear from any other executives there?  Is there anybody at these round table meetings using a PHR, I’m curious we never hear about it and again there’s nothing like hands on experience to give intellectual contributions. 

Personal Health Records – PHR Roundtable At the ONC-Hope All Experts and Attendees Actually Use a PHR-Hands On Experience Coupled with Other Knowledge Is The Best

The doctors fair better with medical record support but they have magpies out there lurking too with experts without any hands on experience telling them too what is good for them. 

Doctors Have Become One of the Largest Software Beta Testing Groups–”Magpie Healthcare” Unfortunately Still Thrives

Sometimes too we have this paradigm of relying on “experts that really don’t exist” but it’s been a way of life for many years and old habits are hard to break.  The TED video below makes some very good points about experts and what we perceive as an expert may really not be the full picture.  What is this addiction we have for experts and are they really in fact what we are visualizing.  When I don’t see any first hand experience discussed, anymore that’s the first thing that pops into my head.  When I read all these expert opinions on PHRs, well you get the picture there.  I have even gone the limit on a few occasions commending the authors on their great write up and then just out of curiosity ask which is their PHR of choice they are using. 

Disappointing to my ears, most are not using a PHR, so how in the world does one become an expert with a consumer product like a PHR if you have never tried one out or at least played with the software…here come the Magpies in force telling you what is good for you, kind of hypocritical you think?  Sad but that’s about mostly what we have out there.  

Relying on Experts When They May Not Exist–Many Intelligent and Smart People But Do We Have Misconceived Paradigms-TED

Well it will be interesting to see what the NIH comes up with by all means and hopefully they will have some internal consumer type of participation so we can look forward to hearing how it creates value…this is a lead hint if you didn’t catch this <grin>.  BD 

The National Institutes of Health plans to develop a medical image sharing system which patients can also access through their personal health records to see and control the exchange of their images with radiologists and other clinicians.

Healthcare providers widely use radiologic and other images for treatment and diagnosis, and a patient may have multiple images for the same problem across care settings, increasing cost and potential health risk to the patient.

NIH plans medical image sharing system | Government Health IT

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Shortage of Leukemia Drug Cytarabine Serious as Some Hospitals Turn Patients Away And They Will Die Without the Drug

4/15/2011 07:49:00 AM  ,  

There is no alternative treatment to be used for the drug.  Oncologists across the country are concerned and some of the hospitals that are turning patients away or having scarce supplies include the City of Hope, Cedars Sinai, Johns Hopkins and Massachusetts General Hospital.  There’s quite a number on the list. 

Injectable drugs seem to be the main target of shortages and even with generics they are expensive to produce and don’t yield any profit, so companies stop making them.  When you think of Propofol, the most heavily used drug for anesthesia with surgery, last year we went from 2 US manufacturers to none and it all comes from Germany now.  BD 

So far, oncologists in 30 states have reported a shortage of cytarabine, a drug that is key to treating certain types of leukemia. The situation, doctors say, is dire.

"If we can't get the drug, then the patients are going to die," said Dr. Hagop Kantarjian, chairman of the Department of Leukemia at the University of Texas M.D. Anderson Cancer Center in Houston.

For patients with AML who take cytarabine, the drug is the difference between a shot at life and certain death.

"Since its introduction, we can claim cures in 40 to 50 percent of patients," said Kantarjian. "Without the drug in the treatment regimen, the rate is zero."

Johns Hopkins Hospital in Baltimore said it only had a two-week supply. "We are really worried if we get a new patient with AML -- that will be very hard to keep up with."

Shortage of Leukemia Drug Cytarabine Forcing Hospitals to Turn Away Patients - ABC News

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Healthcare Reform Law– Is Any Judge Fully Capable of A Decision on a Law That is Challenged By Constantly Changing Algorithms?

4/15/2011 12:17:00 AM  , ,  

Just like everybody else I read the news and wonder where this is all going.  When the law was put into place a year ago there was a model and rules and regulations outlined with several time slots as to when the various provisions would take effect.  I have seen all the questions and have watched HHS work with this and give certain plans exceptions to the law.  So what do we have here? 

In the day and age we live in, business models of companies are changing rapidly as well as mergers and acquisitions and we have a lot unintended consequences arising.  As I said in another post, there’s not great white hope for a budget or a repeal of of what has already fragmented.  Certainly there are portions that are still pretty much in tact, but when the law was written and passed a year ago, things were different and the law was based on practices of insurers and budgets that were around then.  Time has passed and insurers have created even more complicated business models using algorithmic formulas and then some of this creates a new challenge to the law. 

So what gives? Could a court even really tear it apart and check for all legalities?  I doubt it as it’s just the times we live in.  Businesses have flex time and maybe that’s where we might be headed with “flex-laws” as nobody is winning this game and while it’s good for the OMG news stories with everyone playing out a role and all the speculation we see, in reality when we see budgets and plans made without any predictive studies included, it’s only as good as the day it’s written. Of late, some judges can’t even keep track of their own investments and get called on the carpet for conflicts of interest mostly because they don’t keep up with the business world today and many insurance companies are not only that today but have purchased a lot of other companies and are combining all data for super intelligence, to make a profit. 

This is the deal.  I don’t even think most judges have the ability to interpret the mass of information that is given to them without some extreme mining software and queries. 

3 Judges in Health-Care Lawsuits Caught Up In Potential Conflict of Interest-It’s Called Subsidiary Watch-Be Aware of Your Investments With Mergers and Acquisitionsimage

I do have to think that the President knows this and realizes the amount of constant change and disruption we have out there based on his talk this week and basically his overall behavior.  I think President Obama is aware of all of the changes and works with it the best he can with numbers and formulas and events that change the world every day.  If you stop and think about it, who has he been spending some time with, those who create algorithms, like Gates, Jobs, Ellison, Zuckerman and so on.   Here’s the one dinner list from a couple months ago. 

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

He also hired an Algo Man from Wall Street that is used to working with algorithms and formulas, so think about that.  If you watch behavior patterns we don’t see the foot in mouth syndrome we see over at Congress and more of a vote of confidence as I think he gets it, and understands that the current methodologies of lawmaking is going to have to change and somehow be modified as when you have businesses that keep trumping laws that are made, how do you make good laws?  It’s all about collaboration and in recent past talks he has also emphasized technology and keeping up to pace so the US doesn’t lose out, which is happening. 

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

I think Congress also needs to change an collaborate better and more intelligently as the GAO is great and adds support but compared to business algorithms that change all the time, the GAO somewhat comes in after the fact and tells us what we have and right now we need to project a bit more on what we will get with simulations, and better collaboration.  Mathematical formulas can be written for both accurate and desired results, but unfortunately they are not always the same. 

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 are an average citizen and not heavy into how this works, you get fleeced, plain and simple and thus this is why the higher levels of technology and those on staff that are not lobbyists should be ones in demand. 

“Proofiness–The Dark Side of Mathematical Deception”–Created by Those Algorithms–New Book Coming Out Soon

Most laws today passed by lawmakers all seem to think they are for “those guys over there” and pass legislation that requires consumer digital literacy or the ability to get help and yet they don’t use what they are preaching themselves.  You can’t tear the law down and start over as some have suggested, and that comes from the less digitally aware I think.  I’ll go back one more time on my wish to have a Congress that can collaborate without chicken fights and soap operas and be able to use technology to sort all this stuff and data so everyone sees the same thing at the same time instead of groups of people scurrying around with their stacks of paper, the answers and techniques to generate more informed decision don’t lie in those papers.

We have doctors moving along with electronic medical records, which is a good thing but do we have a Congress that could put forth a similar effort?  I haven’t seen much of it, have you?  We get back around to that old paradigm of “its for those guys over there” again.  We have no role models to speak of with consumer literacy as very few even make that effort.  It’s always we know what is best for you and with those stack of papers running rampant, I shudder.  Here’s what the insurers suggest and all their algorithms are not accurate if you read the news often enough.

Health Care Insurers Suggest Algorithms and Business Intelligence solutions to provide health insurance solution

Is it time for that Department of Algorithms with digitally centric laws soon?  I think the time is just about here and if we don’t move in this direction, we sink.  Our poor human bodies are just flat out losing their liquidity with the power of mathematical formulas aka algorithms and the government just can’t keep up with Wall Street on that level. 

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

I will probably run this into the ground but still believe strongly that Congress needs IBMWatson to query and use the power of 70 servers with machine learning to enhance their lawmaking skills, and you can see the technology is going to Wall Street for use as they want rocket speed queries and the availability of information and the ability to predict models at hand.  Is it time for a sequel for Inside Job?  I hope not.

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

Today you just can’t make and properly interpret laws with algorithms in business that constantly change and have anything to really enforce equally, doesn’t work.  If we keep working the old method, we will sink as we need to think about where want to be as well, and the current show of events makes me both sad and worried that we don’t have the individuals in office that will take the time to collaborate and use technology to put them on top, and so we get left with soap operas where one guy has to be the bad guy and other the good guy.  Innovation without collaborate is what’s fouling up the US Healthcare system. 

I wrote back in August of 2009 asking if we needed a Department of Algorithms and that was inspired by listening to Harry Markopolos testify on how he gave normally formatted information to the SEC and they didn’t know what to do with it, i.e. what software formulas, etc. to audit.  BD

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

I wrapped it up and put in a box for you

U.S. District Court Judge Roger Vinson, in the U.S. District Court for the Northern District of Florida, became the first judge to strike down the entire health care reform act entitled the Patient Protection and Affordable Care Act.

Not surprisingly, the decision has left health care providers, governmental officials and insurers wondering where the law stands in light of this decision.  Also not surprisingly, there is widespread disagreement as to the answer to that question.

Healthcare Reform Law Will Be Determined By Supreme Court | Space Coast Medicine and Central Florida Medicine

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More Insider Trading Allegations in Healthcare Former Hedge Fund Manager Trading on Tips from A French Doctor

4/14/2011 10:57:00 PM  ,  

Who would think inside trading would be ramping up in healthcare and the case on the doctor/hedge fund manager seems like there’s quite a bit of information already imageout about the case. No matter what you do today with everything electronically tracked, someone will find that data trail, not a paper trail all the time anymore. 

FDA Chemist and Son Face Charges on Inside Trading–Data Trail Algorithms On The Computer Captured The Activity-Update

Feds Charge ex-Home Diagnostics CEO with Insider Trading Violations With Acquisition From Nipro Diagnostics

The hedge fund manager is also a doctor but it doesn’t appear that he was practicing any longer and the accusations were that both went “out of the network” for consulting.  Consulting as far as asking for drug progress, clinical trial updates are normal and what doctors/investors do but apparently this case stepped the rules with gratuities and insider trading tips where money was gained.  The discussion on the video below has some experts that explain what the ground rules are for information exchanges and where borders lie.  BD 

Insider trading analysis

A hedge fund manager who allegedly traded on tips from a French doctor thanked him with envelopes of cash and a hotel stay in Manhattan, and urged him to hide their dealings from investigators, according to a government complaint unveiled Wednesday.

The complaint confirmed that Joseph F. "Chip" Skowron III, formerly of FrontPoint Partners, is the previously unnamed portfolio manager who allegedly instructed his team to dump millions of dollars worth of shares in a biotechnology company about three years ago after the French doctor gave him an early window into bad news for the company's Hepatitis C drug.

On Wednesday, federal authorities in Manhattan disclosed that Dr. Skowron, 41 years old, faces civil and criminal charges for allegedly trading on insider information and trying to cover it up. They also disclosed that the French doctor, Yves Benhamou, this week pleaded guilty to four counts, including conspiracy to obstruct justice and making false statements. He faces up to 35 years in prison.

Dr. Skowron, who earned medical degree from Yale University and later moved into the investing business, was introduced to Dr. Benhamou in 2006 through an expert-network firm, the complaint says. The complaint says the hedge fund paid $900,000 annually to the firm for access to consultants, including Dr. Benhamou.

Ex-Hedge-Fund Manager Faces Insider Charges, Surrenders to FBI - WSJ.com

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Stem Cell Treatment Doing Wonders For Autistic Boy (Video)

4/14/2011 09:49:00 PM  ,  

This is pretty neat and one of the most positive treatments I have run across for treatment.  Stem treatments are on fire and basically are pretty safe.  The boy is now reading and is doing much he was not able to do before. School teachers also verified major improvement.  The family is going to make another trip for a second treatment soon.  BD 

Stem Cells Autism
A year ago, 9-year-old Kenneth Kelley couldn’t read. Prior to the age of 7, Kenneth couldn’t even talk. He was diagnosed with autism at an early age

» Stem Cell Treatment Doing Wonders For Autistic Boy Immortality Medicine

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Johnson and Johnson Recalls Stinky Topamax Drug Used for Epilepsy-The Cold Weather Stench That Stole Topamax

4/14/2011 09:00:00 PM  , ,  

Here we go again, the stench that stole Topamax.  Again I worked in logistics for over 20 years and the pallets do need to be treated but here in southern imageCalifornia, weather permits for this activity to moved outside most of the time or if it rains, it get put off until the weather is nice again, and that’s usually on a day or so.  The pallets are not going to make the pill stink, it’s the fact that they are treated to close to manufacturing. 

If we don’t want stinky meds, pray for good weather so the chemicals and the guys who treat pallets can do this outside!

Recall of Tylenol Expands on Adult Products – Smelly Chemical Issue – Bar Coding with Tags Really Needed To Alleviate Confusion and Problems Finding Products

Sure they have pallets from other companies, everybody has everybody else's pallets so let’s try a new story here.  Pallet wars and exchanges are some of the biggest battles you will ever seen in distribution. Once the pallet is treated and dried, you can use it, like what you are supposed to do with pallets, duh?  Ok so we can go to another scenario here to where they were not completely dry maybe.  I can tell you that chemical stinks!  Some companies also outsource the treatment of pallets too. I used to do business with one of their warehouses and heck any pallet that worked was used, not short of falling apart.  Actually on that end of the stick they were picky about their pallets so product imagewould not fall off and they were all shrink wrapped for security and not get contaminated.  I’m surprised at this point that none of the drugs have smelled of forklift gas, but it apparently doesn’t get captured like the chemical does in the bottles.  The first stench was in January of 2010 so we are over a year into stinky drugs. 

Does Your Tylenol Stink? Maybe It Has Been Recalled As The List Has Grown Today

Move the pallet treating business outside is the cure and wait until they dry or get one of the small companies that provide pallets to do it for you is another alternative.  These little businesses run around and pick up trashed pallets all the time, fix them up and sell them.  It’s a big business in the LA area and has been for years.  Depending on your distribution patterns, the factory or warehouse is either one that “collects” pallets and has tons of them, or is one that can’t get enough to ship with and those folks buy them from the “pallet businesses”. 

As a sales person I always used to loath those calls, being J and J was my account where I had a boss that sent me out to inspect and help out, and try to convince them to recover the pills that were falling off the pallet as forklift blades miss the pallets at times and ram right through the merchandise.  There’s just a little floor dust and pallet grease on them, can’t we get credit for recovered pills he would say…no! You think we have problems with mistakes in healthcare at times, why does someone miss with fork lift blades, I don’t know but it happens all the time.  I always had to explain to a boss that we could not sweep up pills off the warehouse floor for cargo claim credit <grin>. 

Get some bar codes would you J and J, this is getting ridiculous!  Can’t Bill Weldon earn that big compensation package soon?  Pallet sniffers for quality assurance? 

Microsoft Tags on CBS Early Show – Wake Up FDA, Pharma and Medical Device Companies –Scan Those Drugs, Medical Devices and Synchronize with an FDA Tag Data Base – Recalls, Theft Tracking and More….

In other Topamax news we had this today too Topamax and the generic topiramate have been linked to an increased risk of cleft palates and cleft lips in children born to women taking the drug. I will say one thing, I did laugh at drama given over “launching a full investigation” in the news of what happened, again take pallets outside and this will eliminate some of our recalls.  BD 

TRENTON, N.J. -- Johnson & Johnson issued yet another recall Thursday, this one for about 57,000 bottles of a widely used epilepsy pill, due to complaints of a chemical odor.

The health care giant said it is recalling two lots of 100-milligram tablets of Topamax, sold between Oct. 19 and Dec. 28, 2010. The lot numbers are OKG110 and OLG222. J&J said fewer than 6,000 of the bottles are believed to still be on the market.

J&J said only that the pills were sold in the U.S. and Puerto Rico.

The New Brunswick, N.J., company has now issued 22 product recalls, involving well over 300 million bottles of medicines, since September 2009.

J&J Issues Another Recall, For Epilepsy Pills - Oklahoma City News Story - KOCO Oklahoma City

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HealthVault Begins Storing Medical Images (Dicom) Using Windows Azure Cloud Services With Full Encryption

4/14/2011 06:15:00 AM  , , ,  

This is cool and makes me think of what my mother as a senior has gone through imagewith 2nd opinions and so on.  She has literally had to enlist the help of friends to pick up images and take them in hand to various doctor’s offices.  Yes that is a pain and having HealthVault at a storage point is great.  Dicom images are big files so that is where the cloud comes in.  If you have images already in your possession there’s an interface to upload them to HealthVault. 

If you share with a provider they can download and keep the images in your record so again this is a big timesaver.  Imaging centers can automatically send your imageimages to your personal health record with HealthVault. 

The one vendor mentioned has a “drop box” for files and if you have used any of those types of sharing programs, it’s works well and is pretty simple to use.  There’s always a link on this site under resources if you want to get started on the right hand side. 

It has been a while since I mentioned this, you can track your prescriptions from Walgreens and CVS too and have them all in one place.  Also at CVS Minute Clinic they work with HealthVault and pretty much anymore from conversations I have had with a few locations, they ask you right up front if you want to connect with HealthVault or Google Health any more too. 

I have uploaded documents to my file but again imaging files are huge this using the cloud takes care of the “size” issues.  What is also nice is having the Dicom viewer and not needing another piece of software to view the images.   I can use one less image viewer on my computer too.  BD 

I'm always talking about how lame the health IT landscape is --- and with good reason. But there is one domain in which advances have been consistent and amazing and clearly impactful to care: medical imaging. Our ability to look inside a body and see with incredible detail what's going on inside is just staggering. image

Well, today there is no way I could be more over-the-top excited to say --- medical imaging is now a core part of the HealthVault platform. We're talking full diagnostic quality DICOM images, with an integration that makes it immediately useful to consumers and their providers:

  • A new release of HealthVault Connection Center that imagemakes it super-easy to upload images from a CD or DVD , and enables users to burn new discs to share with providers --- complete with a viewer and "autoplay" behavior that providers expect.
  • Full platform support for HealthVault applications to store and retrieve images themselves, enabling seamless integration with radiology centers and clinical systems.

Of course, we have to ensure that we keep the data secure and private as well --- we do this with a really cool piece of code that creates unique encryption keys for every image, stores those keys in our core HealthVault data center, and only sends encrypted, chunked data to Azure. This effectively lets us use Azure as an infinitely-sized disk --- warms this geek's heart to see it all come together.

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It’s all about the pictures: medical imaging arrives at HealthVault! - Family Health Guy - Site Home - MSDN Blogs

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Tenet Healthcare And Many Others Join Obama Administration Safety Panel-Partnership for Patients

4/13/2011 11:39:00 PM  ,  

This is a new group established by HHS to work towards better patient care.  This imageis a good move in view of what else is going on between Tenet and HCA, it can’t hurt.  This looks like a good common ground where everyone comes together despite their business differences.  Part of the safety problems we have today are a result of the fast emerging technology that we have as it takes time to digest all of this and granted systems are making it safer but they also offer areas of disruption at the same time. 

Tenet Files Suit Accusing Community Health Of Inflating Hospital Admissions

There are pretty much all the major hospitals listed and of course all the insurance folks are there.  The map shows where they are and you can filter and see who’s in so far.

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Below is a little general information from the website: 

“Achieving the goals of the Partnership for Patients will reflect the combined effort of many key stakeholders within the health care system – from physicians, nurses, hospitals, health plans, employers and unions, patients and their advocates, as well as the Federal and State governments. Major stakeholders – including more than 500 hospitals – have already pledged to join with Medicare in a shared effort to save thousands of lives, stop millions of injuries and take important steps toward a more dependable and affordable health care system.”

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Tenet Healthcare Corp. has joined an Obama administration partnership designed to improve patient safety within hospitals, the Dallas-based company announced today.

The administration's Partnership for Patients is a public-private partnership launched this week by U.S. Department of Health and Human Services Secretary Kathleen Sebelius.

"We are pleased to be a part of this partnership to improve patient safety," said Dr. Kelvin A. Baggett, Tenet's chief medical officer. "This partnership is consistent with our ongoing commitment to improve the care we provide to our patients and with our goal of becoming the safest provider of care in the communities we serve."

Tenet joins Obama patient safety panel | Dallas Business Journal

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Medical Marijuana Dispensary HopeNet Increases Hours of Operation and Remodels To Create Better Patient Experience

4/13/2011 07:05:00 PM  ,  

Gee when I looked at the website at first I didn’t realize this was a dispensary as it is very well done.  In addition, food products are on the menu so individuals who imageuse medical marijuana don’t have to smoke a joint.  The store is located in San Francisco.  You need to have a California Medical Pot card as those are the only individuals who can legally purchase cannabis with a prescription.  They also deliver as advertised.  I have never been inside one of the stores so just checking out the website is a bit of an education for me.  At any rate the hope is to create an atmosphere of being both safe and relaxing for patrons.  Dispensaries look to be moving upscale to best serve patients.

Clinical Trials That Are Paying People to Smoke Marijuana

Back in December UCLA even had openings for clinical trials relative to medical marijuana so things are changing in the world today and in January in the OC, seniors were also able t attend a convention that was specific to address their needs for pain relief.  BD 

Orange County Conference Markets Medical Marijuana To Seniors at Laguna Woods

HopeNet, one of San Fransicso's oldest and most trusted dispensaries, is happy to announce two significant steps in their mission to alleviate suffering through medicinal marijuana. Facility upgrades mean HopeNet is a safer, more inviting place, and extended hours mean more patients will be able to use the facility.

"HopeNet members are excited about the extended hours from 10 A.M. to 9 P.M. in San Francisco's South of Market district (SOMA)," said Catherine Smith, spokesperson for HopeNet. "We really look forward to helping a large number of new people in our great new space and through our extended hours."

Finding HopeNet open in the past has proven difficult, as most patients have busy work-days that overlapped with rush-hour traffic and their office hours. Opening earlier and staying open later in the evening will help patients avoid the rush and stress of getting their medication in a timely fashion, and hopefully offer just that much more of a relief when walking through HopeNet's front door. A patient can now afford to spend 10-15 minutes and smoke a joint, relax, read or chat with others, and enjoy a cup of fresh water before heading back out onto 9th Street. Patients will also feel secure at night while inside and outside of HopeNet with improved lighting for extra security.

HopeNet Increases Hours of Operation, Remodels Facility to Benefit Medical Cannabis Patients

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Senator Harkin: Americans with Disabilities Leaving Labor Force at Alarming Rate And Makes an Appeal for Increasing In the Workforce

4/13/2011 06:28:00 PM  ,  

Below is a news release from the Senator’s office asking for business and anyone else to help address the lack of work for those with disabilities.  Sometimes one might wonder too if the current state of affairs with health insurance benefits might imagehave some impact in this area as well.  We all know jobs are in short supply, regardless of what some of the trending reports say.  I think on almost every job applications you fill out today, the question is there asking if you have any disabilities and again when employers are furnishing benefits, does this get skewed in the system?  The link at the bottom has the full address given by the Senator.  BD 

WASHINGTON, April 12 -- The office of Sen. Tom Harkin, D-Iowa, issued the following news release:

This morning, Senator Tom Harkin (D-IA) gave the keynote address at the U.S. Chamber of Commerce's Corporate Disability Employment Summit. A longtime champion for people with disabilities, Harkin sponsored the Americans with Disabilities Act, and as Chairman of the Senate Committee on Health, Education, Labor and Pensions, he recently held a hearing to identify barriers to employment for people with intellectual disabilities and strategies that have successfully improved employment opportunities. Today, he sounded the alarm on a disturbing trend: more than two thirds of Americans with disabilities are without a job, and adults with disabilities are leaving the labor force during this recession at more than 10 times the rate of adults without disabilities. Harkin called on the CEOs and business owners in the audience to join him in his goal of increasing the number of disabled Americans in the workforce from 4.9 million today to 6 million in 2015.

"As we enter into the third decade of implementation of the ADA, my central priority is improving employment opportunities and outcomes for people with disabilities. The ADA and the special education laws have combined to produce the best-educated population of people with disabilities in U.S. history. And yet, while the majority of them would like to be working, the shocking fact is that more than two thirds of Americans with disabilities are without a job. In fact, now that the Bureau of Labor Statistics is reporting regularly on the employment situation for people with disabilities, we have strong evidence that it has gotten disproportionately worse for workers with disabilities in the last two years. According to BLS data, between March of 2009 and March of this year, the size of the disability workforce shrunk by 395,000 workers to about 4.9 million workers," Harkin said in his remarks.

"When this drop is compared with broader labor force trends, you can see that more than one in three American adults who have left the labor force in the last two years have been people with disabilities. That means that, during this recession, adults with disabilities have been leaving the labor force at a rate more than 10 times the rate of adults without disabilities. This disturbing trend line has not received much attention from policymakers or the public. We need to recognize that it has a huge budgetary and social cost. For example, it has been accompanied by increases in applications for Social Security Disability Insurance benefits, which have grown from an average of 200,000 new applications per month at the beginning of 2008 to an average of close to 250,000 per month by the end of 2010.

"If we work together, I believe we can set a realistic goal of increasing the number of adults with disabilities participating in the labor force from 4.9 million, today, to 6 million by 2015. Expanding the disability workforce by more than one million workers in four years is achievable if we get serious about making it happen.I want your ideas and I am asking for your collaboration so that our policies are producing real results on the ground--real results that become jobs for people with disabilities and a strong, talented and loyal workforce for businesses. If there are federal policies that are getting in the way of your efforts, I want to hear about those too so we can do something about them. Making a real impact on disability employment numbers is one of my top priorities and will remain so as long as I am in the Senate."

Insurance News - Harkin: Americans with Disabilities Leaving Labor Force at Alarming Rate

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