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Outgoing Federal CIO Says to Focus on Execution-Literal Translation Might Be The “Lawmakers Just Don’t Get It”–Congressional Digital Illiteracy Just Sucks

This is a nice article written and saying everything politically correct which anyone would do if they were in his shoes.  So now I’ll take the opportunity to translate in imagehow the Quack sees all of this:)  On a tiny scale by comparison, I run into the same stuff and it all comes back to digital literacy and working together to make progress.  I already said I felt he was frustrated in a post when he announced he was leaving and that’s what frustrated IT folks do, they leave when they have had enough and can’t make progress.  It’s the old throw in the towel routine and this is not due to the actions on their end, it’s due to the non ability to have intelligent conversations and get funding from the other side that doesn’t get it.  You burn CIOs up when you don’t work with them and make an attempt to elevate the level of comprehension of technology in the world today. 

Vivek Kundra-US CIO To Resign And Take Fellowship at Harvard-Was He OverTaxed And Burnt Out, If So That is Allowed Today As This A True Reality for CIOs All Over the US

Sure there’s a lot of projects unfinished but when you are bumping your head against a brick wall that’s what occurs.  Will anyone want to step in and face the same thing, I guess time will tell if they can somehow communicate with some of the digital illiterates and get funding and attitudes to change.  There are many companies and technologies to choose from out there today and a good CIO that knows how to combine them is worth their weight in gold but unfortunately it’s a thankless job due to digital illiteracy among lawmakers.  Sure this is favorite rant here but it is oh so true and disappointing with what is happening today.  Below are a couple of my favorite posts on this topic that basically say “they just don’t get it” and can’t see technology tools that will help them even when it’s staring them in the face.  They seem to think that consumer digital literacy is “for those guys over there”. 

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

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

He mentions funding and how that is a problem and I have referenced here a post about how the Senate cut funds for cloud services, so it doesn’t get much worse than that with digital illiteracy.  Last year myself and a bunch of other tech folks just scratched our heads over that one, and look where Cloud technology is today, duh?  He also states there is no congressional committee for Federal IT spending, well again we don’t have enough digital literate elected officials to do that either, as they seem to think that talk about abortions is king.  See what I mean with digital literacy lacking here and minds that live in the 70s. 

US Federal CIO Vivek Kundra to Review 30 High Risk IT Projects – Federal IT Dashboard Used to Identify Rating Concerns

He also mentioned the fact that the companies who obtain contracts are limited too, not because they may or may not be the best companies for the job, but they know the federal procurement procedures and too few new imagecomers get the chance, so I think that about sums it up. We are burning out CIOs at every level to include many in healthcare and public CIOs largely due to digital illiterate lawmakers.  It’s like the big white elephant that nobody wants to talk about, but it holds the entire country back and progress is not made in the fashion it should be.  It is sad when we have creative technologies that have the ability to be substantial leaders and their talents and expertise get put aside for lame lawmaking sessions talking about abortions instead of moving the US further ahead.  So who will be the next “technology sacrifice”?  I guess we have to wait and see if anyone wants to jump into the digital illiterate hornet’s nest and see how much they can tolerate.  BD   

If given the chance, outgoing federal CIO Vivek Kundra, who will leave his post next month for a stint at Harvard University, would advise his successor place a "huge focus" on execution of the IT agenda that's already been laid out during Kundra's two-year tenure.

"The blueprint has been laid out, but if you look at federal IT, it's not immune to the law of entropy--everything will move toward disorder," Kundra told the President's Council of Advisors on Science and Technology on Friday. "My advice would be to be aware of entropy and make sure that you're really, really focused on execution, not just on policies. You need to roll up your sleeves and get some work done."

In his remarks, he cautioned that too often, officials come into the White House with a belief that they're only going to focus on policy, and while that might lead to good ideas, it doesn't necessarily lead to accomplishments. "Every single day, I would sit down with agency CIOs and push them in that direction," Kundra said.

Funding problems also factor in the failure of the federal government to take full advantage of a common data architecture, common IT platforms and unified fiber networks, Kundra said in response to a question from Google executive chairman Eric Schmidt. "The biggest problem, I always say, is how we fund IT," Kundra said. "That's a pretty serious issue."

Outgoing Federal CIO: Focus On Execution -- InformationWeekOutgoing Federal CIO: Focus On Execution - government Blog

Gang of Six Might As Well Hang It Up-Not Using the Right Super Powered Computing to Simulate and Query So Just A Stab In the Dark And No Real “Algo Men” In Sight to Help

Yup this one more of my infamous posts on the lack of the right technology and digital literacy among lawmakers.  Big companies use very sophisticated software and servers today, i.e. insurance companies and Wall Street, so how in the world imagedo they think that they are going to be able to come up with solutions here?  It’s as bad ad the Ryan deal and you know why?  They are not using the right technology to simulate and query as there’s a lot of stuff out there today, perhaps even triple fold of what had to be considered even 2 years ago, and these folks just don’t get it. 

I am not saying this the right technology is a miracle worker and will present a 100% magic formula but it will sure put them closer to the marker and avoid truckloads of unintentional circumstances.  Stop and think, this is what pharma does to create new drugs today, all on the computer until they reach the final stages to set up a wet lab when the computerized research is ready to move beyond the data.  Do you want to read a story about an insurance company that uses such system and really figured out how to maximize the system and get $50 to $80 from a money stricken state on top of everything else, check out the link below, it’s all math.

Cigna to Relocate US Headquarters From Pennsylvania to Connecticut And State Will Pay Them $80 Million In Economic Benefits–”The Attack of the Killer Algorithms”

This is what they need, so everyone queries and get the number from the same starting place and put big white boards around so those who do not use mobile devices can see too.image

Use of IBMWatson Technology in Congress Would Allow For Smarter Laws and Decision Processes With Bonus Points For Lowering Over All Impact of Lobbyists

Example Congressman meets with lobbyists and listens, then returns back to the chambers and digs in.  If equipped with speech recognition, even the lowest common denominator with consumer IT skills would be able to participate, so nobody gets left out or picked on for not being up to date, although this could be a good reason to learn up though too at the same time.  By running queries and having the servers connected to the internet modeling could be accomplished to simulate let’s say the desires of the lobbyist and consequences and/or benefits would be revealed, simulation the key here. 

The least this group could do would be to truck on over to the DOE and rent some computing space, others have. 

1.7 Billion Super Computer Hours Awarded by the DOE–Biomedical Research Projects Included for Parkinson’s and Cancer

I just don’t want to have to go see a sequel to the movie “Inside Job” and that sadly seems like we are moving in that direction with digital illiteracy and lack of technology use as everyone else around the government is using machine learning and predictive algorithms, but our folks still crank out reports with old technologies and try to work with information overload and just don’t get tit.  BD 

“Inside Job”–A Learning Experience and Documentary About Financial Algorithms-And Some of Same Exists in Healthcare

The Senate’s Gang of Six, once viewed as the last-best chance for a bipartisan budget-cutting deal, may have finally hit the end of the road.

Sen. Tom Coburn (R-Okla.), who abandoned the talks this spring, is still sitting the negotiations out — a decision that has prevented the group from releasing its long-awaited budget-slashing proposal, according to sources involved in the negotiations. With Coburn out, the other two GOP senators in the gang, Idaho Sen. Mike Crapo and Georgia Sen. Saxby Chambliss, have declined to publicly endorse it, people familiar with the group say.

Gang of Six hits end of road - Manu Raju - POLITICO.com

Judges Act to Block Restrictive Abortion Rights in 3 States-The Default Topic of Discussion That Keeps Occurring With Digital Illiteracy that Plagues Lawmakers

Certainly we have by now heard enough of this but truly when you think about it and all the “real pressing” items we have to deal with today, this certainly make a huge case for digital illiteracy, otherwise they wouldn’t keep doing it.  That’s my opinion and the same for many, especially those who work in Health IT areas and we just shake our heads and say “why”.  It’s not that these are at the top of the ladder either as far as expense when cutting budgets either, it’s just something they think they can control and have enough knowledge to take a stand on. 

Again, I look at this a such a waste of time and those who keep brining this up for discussion truly keep dropping down the public confidence ladder as you don’t need to be brain surgeon to see this is all about control and the rights of women, it’s stupid and that’s how they are beginning to look with all of this.  Do you have to stoop to this level instead of learning up like many of us are doing to deal with “real crisis” areas? 

The time wasted here is saddening to think this is as far as the lawmaking knowledge goes sometimes?  How scary is this fact that we seem to have so many lawmakers that can’t get past this and seem to have some real issues with priorities.  Look at how ridiculous it gets with even attempting provisions to put doctors in jail?  Again, is this all they feel they can speak out about and control?  We better elect some better lawmakers next time if this is as good imageas it gets. 

Digital Illiteracy Still Plagues Law Makers–Severe Focus on Abortion Rights Proves It–Is This Where Our Lawmaking Knowledge Leaves Off or Even Begins? Scary…

We had the similar issues in Arizona to where those who needed transplants and again it’s a small area of the budget died due to “digital illiterate” interpretations of business modeled analytics.  This is why I keep saying that “figureheads” that lack any type of IT experience or even consumer digital literacy are such a real danger today as they distract and disrupt the normal flow of important business and lawmaking that needs to take place.  I would think that such lawmakers would perhaps want to take a step back and evaluate what they are doing and how they look to the rest of the country because it’s not good I can say that much and thank goodness we have some judges out there with some real common and legal sense too.  BD

In three new rulings, federal judges in different states have acted to block immediate enforcement of measures that restrict abortion rights and women’s access to affordable contraception, lifesaving cancer screenings and treatment for sexually transmitted diseases. These rulings are important victories for women’s health and reproductive rights.

While these rulings are preliminary, each is a determination that enforcing the law would cause irreparable harm and that the plaintiffs are likely to prevail at trial. They do not, however, address other threats to women’s health. Those include the slashing of state support for family-planning services by governors like Chris Christie of New Jersey, and attacks from Congress like the bill Republicans pushed through the House in May that would use the nation’s tax system as a weapon to end abortion insurance coverage in the private market.

The Courts Step In - NYTimes.com

Blue Shield Agrees to Pay for Autism Behavioral Therapies in California-Must Fall Under the Managed Care Regulation Division To be Eligible

We have 2 regulatory insurance agencies in California, the Department of Insurance and the Department of Managed Care.  The good news is at least one form of treatment for autism has been approved but the sticking point here is that it has to imagebe through the arm of Blue Shield that falls under the managed care agency and not the Department of Insurance.  This gets confusing at times and I do have to say this is at least one step in the right direction as autism treatment has been a no go for such a long time. 

According to this article too, one commenter stated that there may not be a larger number of therapists who can provide the therapy.  This question would be much better fielded by a family who has a son or daughter who has autism.  There is a growing company too in the Los Angeles area that also offers help and assistance with autism information and other services.  I don’t know anything about them but below is a prior press release on the business.  BD 

Wellspring Opens Corporate Headquarters in Los Angeles – Autism Treatments and Services

Parents of children with autism are hopeful they have scored a victory this week after Blue Shield of California has agreed to pay for a form of therapy for the developmental disorder that it previously refused to cover.

The announcement that Blue Shield will pay for behavioral therapies for autism treatment - a step that other providers may soon follow - was made Wednesday during a hearing at the Capitol.

The hearing was focused on myriad problems parents faced in seeking coverage for behavioral therapies for their autistic children, but part of the way through, Maureen McKennan of the Department of Managed Health Care that regulates health maintenance organizations told members of a committee about the agreement.

Coverage of the treatment - known as applied behavior analysis or behavioral intervention therapies - has been denied by HMOs and health insurers who said it is not medical treatment. Medical professionals and advocates for those with autism have disagreed.

Meanwhile, Steinberg has introduced a bill, SB 166, that would mandate providers in California cover applied behavior analysis therapy.

Blue Shield to pay for autism behavioral therapy

Sermo and FiercePharma Partner to Allow Readers to Have Access to Sermo’s Online Information

This looks to be an interesting partnership and I am guessing the information being made available is actual information that can be helpful and I say this because imagethere’s a lot of stuff on Sermo that ends up being debates on other matters or some real rip roaring conversations that are opinionated in content, although those are very interesting and entertaining I must say having seen a few of them. 

The news release also did not say whether or not the doctor’s name or screen name will also be used, so I guess we shall see it when it appears over at Fierce.  Also in the news, Sermo announced their medical mobile application for MDs today.  BD 

image

Press Release:

CAMBRIDGE, Mass., July 13, 2011 /PRNewswire/ -- Sermo, Inc.image(www.sermo.com), the largest online physician community in the United States, and FiercePharma, the world's most widely read daily pharmaceutical industry news publication, today announced a partnership to publish exclusive content from Sermo's network through FiercePharma's media channels. 

"This partnership brings together insights from Sermo's community of over 120,000 physicians with the far reaching audience of the FiercePharma network," said Jon Michaeli, VP, Marketing of Sermo. "Working together, we will educate and inform a vast audience of physicians and pharmaceutical executives who stand to benefit from physician sentiment and insight."

Through weekly surveys conducted on Sermo, the partnership will reveal physician opinions on top issues and developments in medicine. Results and responses will be published on the FiercePharma website (www.fiercepharma.com) and announced via its newsletter and social media channels. FiercePharma readers will also have access to the Sermo Knowledge Center, holding whitepapers, research reports, case studies, and other relevant industry content.

"We're providing readers access to an influential, hard to reach group shaping the healthcare marketplace--physicians," said Arsalan Arif, Publisher, FiercePharma. "Our readers turn to us every day for fresh insight, and Sermo's research offers a unique perspective in that it is sourced directly from physicians whose patients and practices are affected by industry and regulatory changes."

About Sermo

Sermo is the largest online physician community in the United States, with more than 120,000 physicians spanning 68 specialties. All Sermo members are verified and credentialed physicians who collaborate on cases and exchange observations to improve patient care, discuss drugs and devices and share information on new therapies and innovations. Sermo also provides a way to target and engage physicians by providing access to its community for clients that need fast, actionable insights into treatments, medications and devices.  

About FiercePharma / FierceMarkets

FiercePharma is the world's most actively read pharmaceutical industry news publication with over 80,000 daily e-mail readers and thousands more on the web and Twitter. FiercePharma is published by FierceMarkets, a leader in digital B2B media with 39 publications spanning 7 vertical industries.

Sermo and FiercePharma Launch Content Partnership -- CAMBRIDGE, Mass., July 13, 2011 /PRNewswire/ --

Nuance Acquires Webmedx Transcription and Editing Services For Clinical Documentation -Nuance CEO Sells $9 Million of Stock

The number of speech recognition companies not owned by Nuance continues to get smaller.  There are still a few out there but most of the major players seem to imagehave been scooped up over the last couple of years. 

In addition in the news today someone became very rich, the CEO with sale of a lot of stock and he still owns over a couple million shares worth around $50 million.  Meanwhile the company debt is around $900 million.  I’m not an expert on what all that means, but the investor readers here can figure it out.  Below are a couple of other recent Nuance acquisitions.  I have covered most so if you want to see more just do a quick search using the Google custom search here.  BD   

Nuance Buys Noterize–A Top Selling Application for the Ipad

Nuance Acquires One More Speech Software Firm - SVOX In Zurich

(NUAN)Nuance Communications Inc. continues its latest acquisition spree, this time buying Atlanta company Webmedx Inc. for an undisclosed amount. Webmedx provides transcription and editing services and clinical documentation technology for hospitals and clinics.
According to a press release, Webmedx will strengthen Nuance Transcription Services by integrating Webmedx’s Quality Analytics application, based on natural language processing, with Nuance’s clinical language understanding systems.


Webmedx counts among its customers more than 100 hospitals including Bon Secours, and Catholic Healthcare West, according to officials. In addition to the transcription and documentation tech, Burlington-based Nuance (Nasdaq: NUAN) gets from Webmedx its Medical Technology Education Center (MTEC), an online speech recognition editing and medical transcription school.

Nuance buys Atlanta's Webmedx - Mass High Tech Business News

MultiCare In Tacoma To Lay Off 350 Due to Declining Revenues in the Tacoma Area

This is the largest lay off of its kind since 2004.  We are back to the same old imagesituation and story, money once again.  Back in 2008 the hospital/clinic chain has tried their hand at retail clinics as well and I don’t know if that is still alive and well today.  BD 

Hospital system to try in-store clinics - Washington

Tacoma-based MultiCare Health System, Pierce County’s largest private employer, announced Tuesday that it would eliminate by early autumn up to 350 positions from its work force of 9,400.

In the first round of selecting which positions will be lost – and before mandatory layoffs – MultiCare employees will be offered the opportunity to retire or leave voluntarily.

said MultiCare will receive $37.6 million less reimbursement for the 2011-2013 biennium than offered by the state in the most recent biennium. The figure includes a $10 million reduction that began July 1. The health system also has faced $14.8 million in additional expenses from charity care and bad debt through May, compared with the same period last year.

MultiCare operates more than 100 facilities in Pierce and King counties, including four hospitals, 84 clinics and 22 program-outreach offices.

Tacoma-based MultiCare to lay off up to 350 employees by fall | Business - The News Tribune

Free Clinics Turning Away Patients As They are Not Able to Keep Up with Demand as Rise in Patient Visits Increases

Clinics are over whelmed with the number of patients as well as the increasing number of returned visits.  This is certainly a sign of the times of our current healthcare system getting tighter and more difficult to have access.  BD image

STAMFORD, Conn., July 13, 2011 /PRNewswire-USNewswire/ -- A new AmeriCares report has found health care clinics providing free services to the needy are experiencing such a dramatic increase in patient visits that many have been forced for the first time to turn away eligible patients because they cannot keep up with demand. More than 300 free clinics were surveyed for the report, "Addressing Resource Gaps in the U.S. Health Care Safety Net: An Assessment of the Free Clinic Network."

According to the AmeriCares findings, 89 percent of free clinics nationally have seen a rise in patient visits within the past three years, and more than half (56 percent) have been forced to turn away eligible patients due to resource constraints such as limited medical and support staff, expensive lab tests and medications, inadequate facility space, and declining financial support.

Nation's Free Clinics Turning Away Patients -- STAMFORD, Conn., July 13, 2011 /PRNewswire-USNewswire/ --

Aetna International Buys 100% Stake in India Health Maintenance and Care Organization

I don’t know if this is good news or not as the rest of the world reads what we have here in the US but as I read here the company is a start up and 80,000 members are currently enrolled along with 3000 doctors, dentists and labs.  Members pay an annual fee for a card that offers services at a discounted rate. BD

US-based Aetna International has acquired 100 per cent stake in Indian Health Organization Pvt Ltd, an Indian start-up for an undisclosed amount, the company said.image

With this acquisition Aetna will gain entry into Indian market and get access to 80,000 members enlisted as IHO customers, network of 3,000 doctors, dentists, clinics and labs, as well as preventative care and wellness programs and opportunity for Aetna to diversify into a new geography, the company added.

IHO was founded in 2008 by Visham Sikand and Sunando Sen with 2,500 doctors, 800 pharmacies, 300 laboratories and 500 dentists in their network. It provides health card for an annual fee that offers card holders diagnostic tests and medical consultations at discounted rates. The card can also be used at a network of doctors, dentists and pharmacies for further discounts.

Aetna International Acquires 100% Stake In Indian Health Start-up IHO | VCCircle

B. Braun Acquires Patent for Wireless Communication Between Medical Devices And Hospital Information Systems

The patent relates to the company’s Smart Pumps and DoseTrac Infusion systems whereby the software can be read at a nursing station or anywhere else where a computer is available as well as on the pump itself.  The system includes bar coding and wireless communication to the computers monitoring the units at the patient bedside.  BD 

BETHLEHEM, Pa., July 12, 2011 /PRNewswire/ -- B. Braun Medical Inc. (B. Braun) announced today that it has acquired US patent 7,933,780, imagewhich was issued April 26, 2011, and two pending applications, providing the Company patent rights related to enhanced communication between medical devices and hospital information management systems through wireless communication.

image

"The addition of this patent further broadens our existing patent portfolio, which includes barcoding and wireless communication between IV imagepumps and hospital information management systems," said Gale White, Vice President of Infusion Systems Division for B. Braun Medical Inc. "This patent adds additional ownership rights protecting the B. Braun technology available to our infusion pump customers." 

The technology covered by the patent is related to bedside point-of-care (BPOC) applications, which allows for seamless communication between medical devices and hospital information management systems, and ultimately makes the clinician's job easier.

B. Braun Acquires Patent for Enhanced Wireless Communication Between Medical Devices and... -- BETHLEHEM, Pa., July 12, 2011 /PRNewswire/ --

Puerto Rico Doctors Threaten to Stop Serving Close to a Million Patients Over Insurance Company Non Reimbursements

Doctors in Puerto Rico stated they are owed over $60 million and are on the brink of not seeing Medicaid patients until they start getting paid.  The IPA in Puerto Rico represents 38 medical groups.  The government stated that it would be terminating imageit’s agreement with MCS, the largest insurance provider under the Medicaid program.  Hospitals stated they are owed around $91 million.  The insurance carrier blames the government saying it owes they $243 million for services provided.

One thing for sure here is that everyone seems to not be getting paid.  Two other smaller insurance companies are not experiencing any issues by comparison with providing the Medicaid services and paying providers.  The doctors, labs and pharmacies all want to be in on the negotiations for the next contract when it begins so MCS can be eliminated. 

The last comment here rings in with what we here on the mainland too, maybe eliminating the role of the insurance companies is the key.  BD 

Physicians are threatening to stop serving nearly a million Puerto Ricans as a result of a dispute between the island's government and an insurance company over reimbursements for treating poor people.

Gov. Luis Fortuno on Wednesday appealed to the doctors to avoid cutting off patients, saying it would be illegal. In an interview with WAPA, a local TV station, he also said the government would withhold two months of payments to the insurance company unless it settled with doctors, hospitals, laboratories and others.

Just hours after Fortuno spoke, the island's health secretary announced the government paid $57 million of the $87 million it owed Medical Card System Inc. for June. Secretary Lorenzo Gonzalez initially said the remainder would be paid only when MCS settled its bills with medical providers, but he later said it would be paid in upcoming days.

Nolasco said eliminating the role of health insurance companies might be the solution.

Doctors Threaten Medicaid Cutoff in Puerto Rico - ABC News

Cigna to Relocate US Headquarters From Pennsylvania to Connecticut And State Will Pay Them $80 Million In Economic Benefits–”The Attack of the Killer Algorithms”

For sure there’s some interesting happenings going on at Cigna today and they are getting a lot of money from the State to create those 200 jobs.  What’s going to happen in Philadelphia though, how about those jobs? In addition the former CEO of Cigna who retired now works for these folks in the medical tourism business and the City of Hartford employees will now be able to travel to Puerto Rico for some of their procedures with being the first City to jump on the medical tourism bandwagon. 

City of Hartford First Major US City to Offer Medical Travel Benefits to Employees With Approximately 6% in Total Budget Savings

Now if that isn’t enough they are definitely working those business intelligence ALGORITHMS to figure out how to maintain those record level profits they keep reporting every quarter. If you read the article below, those algos tell them that they can keep additional revenues and profits if they exclude expatriate US citizens from the Medical Loss Ratios?

Cigna Wants Expatriate Plans Exempt from Medical Loss Ratios-Threatening to Dump 500 Employees in Delaware From Payroll

When you look at the potential of dumping 500 employees in Delaware, and let’s say they follow through with this for argumentive purposes, then we have 200 jobs to be added in Connecticut with some employees traveling to Puerto Rico for cheaper surgeries (which saves money) and then we still end up with a 300 net job loss, so how does this work overall as a corporation and net them $80 Million and from the State of Connecticut?  Anybody looked at the over all bottom line here? Are the 2 states talking about this over all effect since they are both involved?image

IT’S ALL ABOUT THOSE PROFIT ALGORITHMS ONCE AGAIN.  As stated if they yank 500 jobs and if we end up with a net loss of 300, and that’s only using these 2 locations, how does a loss of 300 jobs = $80 million, is there something wrong with this math?

It just flat out comes back to this same statement I have made over and over, the financial markets and their algorithms are outpacing the rest of us with mathematics and we get fleeced in the long rung, and of course it’s hard to see it as an average consumer as we only get the end results. 

“It is a technological arms race in financial markets and the regulators are a bit caught unaware of how quickly the technology has evolved”

It just looks like Connecticut seems to be the next area to where the tourism business and other interests can create additional revenues for Cigna, you think?  This is what I call “subsidiary watch” as they bought this company last year that ins the tourism and expatriate insurance business, so every subsidiary has to throw money down to the bottom line.  I said 3 years ago that the company you knew for years is not the same today as with data and sophisticated IT infrastructures, and selling a hog lode of profile and data on us, risk management assessments are not as clear and the algos created can tend to hide a true reality. 

CIGNA Acquires Vanbreda International–To Service Expatriate Customers With Health Insurance Outside the US And Employer Benefit Packages–Medical Tourism

I said 3 years ago that the company you knew for years is not the same today as with data and sophisticated IT infrastructures, and selling a hog lode of profile and data on us, risk management assessments are not as clear and the algos created can tend to hide a true reality. I can imagine what the insurer data business is worth today as Walgreens as a comparison valued theirs at $800 million.  This is some really laid off employees to jump in and get $80 million out of their cash stricken coffers. 

Somebody start doing some math in this country, please so we don’t all die from the “attack of the killer algorithms” . 

Those 200 jobs added will cost the state more in other areas as well I feel and perhaps too they will be traveling to Puerto Rico just like the City of Hartford for their medical needs before this is all said and done.  BD

Cigna Corp. said it now will be calling Bloomfield, Conn., home to its new U.S. headquarters.

The headquarters designation is part of the global health service and financial company's move to add at least 200 jobs and upgrade operations in Connecticut within the next two years.

Cigna, which has been headquartered in Philadelphia since 1982, also said it will receive up to $80 million in economic benefits from Connecticut's new "First Five" program. The program, designed as a new job creation tool, permits the Connecticut Department of Economic and Community Development to provide tax credits for the first five companies that add at least 200 jobs in the state by July 1, 2013, or the first five to increase their Connecticut presence by at least 200 jobs within five years while spending at least $25 million in the state.

Insurance News - Cigna to Relocate US Headquarters From Pennsylvania to Connecticut

Cook Medical Receives FDA Approval for Iliac Leg Graft For Use With Patients With Abdominal Aortic Aneurysms

It is designed for flexibility in the iliac arteries during endovascular aneurysm repair image(EVAR) and is kink resistant.  As you can read below the device already has the European CE Mark.  We seen to be seeing quite a few of these of late with Europe ahead of the FDA with many devices and drugs.  BD 

Press Release:

Bloomington, Ind., July 12, 2011 Cook Medical has received premarket approval (PMA) from the U.S. Food and Drug Administration (FDA) for its Zenith® Spiral-Z™ AAA Iliac Leg Graft. The device is indicated for use in patients with abdominal aortic aneurysms (AAA) that require graft support in the iliac artery.

“Zenith Spiral-Z provides imagephysicians with Cook’s most kink-resistant and trackable iliac leg graft to date,” said Phil Nowell, vice president of Cook Medical's Aortic Intervention division.

Zenith Spiral-Z features enhanced flexibility and kink resistance due to a continuous nitinol spiral stent. It also offers increased radial force at the proximal sealing site with Cook Medical’s latest technology in sealing stent design. The Zenith device’s Z-Trak® Introduction System features a PTFE-coated lumen to reduce surface friction and facilitate precise device delivery.

As part of Cook Medical’s Zenith Flex® AAA Endovascular Graft product line, Zenith Spiral-Z was launched in Europe following CE Mark approval in April 2011.

About Cook Medical

Founded in 1963, Cook Medical pioneered many of the medical devices now commonly used to perform minimally invasive medical procedures throughout the body. Today, the company integrates medical devices, drugs, cell therapy and biologic grafts to enhance patient safety and improve clinical outcomes. Since its inception, Cook has operated as a family-held private corporation. For more information, visit www.cookmedical.com <http://www.cookmedical.com/>.

Sequana Medical Receives CE Mark Approval for the ALFApump–Medical Device For Managing Recurrent Ascites-Abdominal Fluid Accumulation Expelled Via the Bladder

This device is very interesting and definitely stands to improve the quality of life forimage those who are afflicted with body fluids the accumulate in the abdomen due to liver cirrhosis or other related conditions.  The device is a battery-powered pump with catheters attached and one to the bladder as well.  The ALFApump collects the fluids and move it to the bladder to be expelled.  When you stop and think of how this is done now, I think anyone wouldimage want to try this alternative methods versus the big needle and invasive procedure of draining abdominal fluids. 

Hepatitis- and obesity-related liver diseases are escalating the number of patients who suffer from the condition and the repeated visits to drain are not something to look forward to as well so if this pump implanted does the work and sends the fluid to the bladder, then everyone wins here.  Hopefully the FDA will grant approval for use in the US before too long as well.  This is probably one of the most interesting engineered medical devices I have read about in quite a while and they are also working on something similar for the lung area. 

image

It also has a hand held charging unit that pumps through the skin and collect all the data on the pump activity and can be transferred to a doctor via a computer connection at the next office visit. 

Sequana Medical announced today that it has received CE Mark approval for the commercial sale of its ALFApump™ System. Over the coming months, the company will launch the product in selected hepatology and liver transplant hospitals across Europe. The ALFApump System is indicated for the management of refractory and recurrent ascites due to liver cirrhosis, a condition where massive and imageuncontrolled fluid accumulation occurs in the abdominal cavity.

"This is a major milestone both for our company and for patients with refractory ascites," stated Dr. Noel L. Johnson, CEO of Sequana Medical. "For patients, the treatment options for refractory ascites have been very limited and carried significant risks and side effects. The ALFApump System offers a new treatment tool which can improve patient quality of life while also reducing hospitalizations. It is a cost-effective solution and we believe over time it will become the preferred option for patients, physicians and payers. We are eager to begin our commercial launch in Europe."

Sequana Medical Receives CE Mark Approval for the ALFApump™ System and Adds... -- ZURICH, Switzerland, July 13, 2011 /PRNewswire/ --

Wife In the OC Under Arrest for Cutting Off Husband's Penis And Tossing It In the Garbage Disposal–Another Bobbitt Crime

This sounds like a rerun of Lorena Bobbitt but in this case the garbage disposal is a new twist and this time down in the OC area of southern California.  The couple was going through a divorce and you can hear the police state she said “he imagedeserved it”.  For some reason or other her picture looks familiar like someone I have come across in my work and I may be off base but she just looks like someone I had a couple words with at one time in a place of business.  I could be off base but there’s something familiar and I can’t put my finger on it as this is not far from where I live and work and in the past I had business dealings in the north end of the county. 

When you read through here she had also put something in his food to make him either sick or drowsy and then tied him to the bed.  The paramedics gathered up what they could from the disposal and the man is in the hospital in serious condition as she did at least call after her deed and he was rushed to the hospital.  From what the article says a prosthetic can be built but his plumbing should still be in tact. 

If that doesn’t work there’s always the rabbit study at at Wake Forest that may get to the human level one day to where they are growing them.  Back in 2009 one was grown for a rabbit and it worked and he produced offspring too.  Regenerative medicine has come a long way. 

Regenerative Medicine News – Fully Functional Rabbit Penis Created That Works

The man was taken to UCI Irvine which in the OC being a county facility is really tops for care as it is the best cardiac arrest facility in the OC with 24/7 interventional cardiologists who advise and assist other hospitals and is actually the place to go for heart attacks in the OC, as they have a brand new facility that was opened about a year ago as well.  BD 

Catherine Kieu Becker, 48, is under arrest for chopping off her husband's penis and tossing it in the garbage disposal.

After she laced her husband's food with an unknown drug or poison, he lay down, believing something was wrong with the food, according to police reports. Her husband then woke up tied to the bed as Becker cut off his penis with a knife. She then threw the genitalia in the garbage disposal and turned the disposal on, Lt. Jeff Nightengale of Garden Grove, Calif. police, said.

Wife Cuts Off Husband's Penis, Throws in Garbage Disposal - ABC News

Combining Random Events to Solve IT Problems and Finding the Blind Spots

Boy these are some genuine good points to follow and “not controlling variables” is a big one here. Dr. Halamka wrote in his blog about a scenario he dealt with and sometimes how information, issues and so forth come in from many areas and it can be a challenge sometimes to get all issues into one area to solve, but that’s kind of the way things work at times and every CIO around probably has this issue.

You can read the entire article at his post but the big message I got out of the post is the one that mentions “the blind spots”.  We like to think we are on top of everything but sometimes software installs or other issues are done without being on top of imagewhat actually occurs.  Last year I attended this conference and heard a lot about the “blind side” discussions mostly from big organizations and how the CIOs dealt with it.  It happens with nobody at fault as Dr. Halamka mentions above as there’s no control on a lot of how it happens, but then again, having coordinated plan to put it all together and solve is yet one more challenge today.  Sometimes others outside of IT expect the department to be 100% on top of everything but it’s just not so.     

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

With all the varied software solutions out there today sometimes it really is an effort to get all the other departments to keep the IT folks up to date as non tech folks may not always understand the complete planning and coordination that goes into everything today.  You miss one spot and it will eventually show up if not right away.  BD

As CIOs we have significant responsibility but limited authority.   We're accountable for stability, reliability, and security but cannot always control all the variables.
Here's an example of random events coming together to create a problem, which is now well on its way to resolution.   However, there are many lessons learned that I'd like to share with you.

1.  Policy and Technology need to be developed together.   No amount of hardware technology will satisfy customer needs unless there is some policy as to how the technology is used.    I should have focused on demand management in parallel with supply management, enforcing rigorous quotas and providing useful self-service reports while the chargeback model was being revised.
2.  Governance is essential to IT success.   Although no one in the user community relayed any storage plans or issues to me, there should have been appropriate committees or workgroups established to coordinate efforts among research labs.    In administrative and educational areas, it's common for groups to coordinate efforts with enterprise initiatives.  In research areas, it's more common for local efforts to occur without broad coordination.    Establishing governance that includes all research lab administrators would help improve this.
3.  Approval processes for purchases need to include IT planning.   When grants are used to purchase equipment there is no specific oversight of the infrastructure implications of adding such equipment on firewalls, networks, servers and storage.   Purchases that generate data should require additional approvals to align infrastructure supply and demand.
4.  Be wary of "Big Bang" go lives.  Our high performance computing upgrade was a single event - 1000 cores to 4000 cores.   This should have been phased to better assess the impact of the expansion on application use, other elements of infrastructure,  and customer expectation.

5. Know your own blind spots.  As with the CareGroup Network Outage, there are aspects of emerging technology which are so new that I do not know what I do not know.    When storage demand increases by 70% and throughput accelerates by a factor of 4, what happens to an advanced storage infrastructure?   Bringing in a third party storage consultant would have filled in knowledge gaps.
In the world of healthcare quality, there's an analogy that error is like slices of Swiss cheese.  If a stack of individual slices is lined up precisely, you can get a hole all the way through the stack.   In this case, a series of unrelated events lined up to create a problem.   I hope that IT professionals can use this episode to realign their "slices" and prevent infinite demand from impacting a limited supply.

Life as a Healthcare CIO: The Demand for a Free Service is Infinite

Solantic Urgent Care Chain Sold to Private Equity Firm–Owned by Florida Governor Rick Scott–Formerly Employed Doctor Discusses What It Was Like to Work There

The governor is now pretty much out of the health care management/investment side of the business with this sale.  We all may remember that he spent a record image$73 million on his campaign to become governor.  It’s interesting to see how the value of Solantic fell over the last couple of years as well.  Right now he’s not that popular in the state with the recently signed budget. 

Florida Governor Rick Scott Signs State Budget That Cuts Medicaid Reimbursements in the Sate by 12% While Florida HMO Profits Were Up 16%

You can read the entire article at the link but basically the doctor talks about the working conditions at the office where he worked and the day to day evaluations and how those at the bottom as far as not meeting standards were clipped off.  14 hour shifts were expected and everything evolved around the bottom line.  Clinic management turnover was frequent and it was not unusual to see 70 to 90 patents a day, that’s a huge workload in anyone’s books and was the bottom line focus putting patient safety in danger?  According to the doctor’s comments, getting revenue built was the big focus. 

Incentives are supposed to be good but in this case were they set too high?  Cameras were in all office but we kind of expect that today but the staff was expected to suggest extras for patients to buy as well, so with 70 patients a day how much care time did they get versus marketing time to buy vitamins and so forth?  BD 

When family practice physician Randy Prokes joined Solantic Urgent Care in 2004, he told state investigators, his Neptune Beach clinic brought in just $2,000 a day.

By the time he was fired from that job nearly six years later, Prokes said, that same clinic had quadrupled revenues to about $8,000 a day, reaping profit margins unheard of at most doctors' offices.

To achieve the urgent care chain's aggressive financial goals, doctors and nurse practitioners were expected to stand through 14-hour shifts, Prokes told state investigators in a Florida Department of Law Enforcement file obtained by The Palm Beach Post.

The sale of the Solantic urgent care chain to a New York private equity group this month marks Florida Gov. Rick Scott's exit from health industry management.

Ex-Solantic doctor tells of intense pressure on staff to reap revenue

Hat Tip:  Pharmagossip

Hospital Coalition, AHA and Others Campaign to Be Left Out of Medicare and Medicaid Cuts–Worried About Spending Reductions and Future Existence of Some Facilities

The coalition groups include the AHA, the Federation of American Hospitals, National Association of Public Hospitals, and HCA.  The collation states that with the healthcare law they held their end of the deal and are in a position to where additional cuts are going to put more hospitals in financial straights.  image

The entire idea here is to not be a target with budget cuts.  The posts I have put on this blog about the financial status of hospitals are many and it doesn’t stop.  Granted some are in better shape than others but once the spiral starts, it’s hard to come back.  Even when being bought by investors one bank last week had to file bankruptcy as the new owner would not assume their debt and the other choice was to close the hospital.  BD 

Hospital Ad Campaign

As Congress and the White House continue to struggle over reducing the deficit, a coalition of hospitals and hospital associations launched a second broadcast commercial warning lawmakers not to target them.

The Coalition to Protect America’s Health Care is spending $1 million this week on a broadcast campaign that asks Congress to leave hospitals out of any plans for cutting federal funding. Hospitals agreed to billions in Medicare cuts as part of the health law and are worried about facing further spending reductions. The hospitals ran an initial ad last month.

Hospital Spots Push Back Against Payment Cuts – Capsules - The KHN Blog

New CEO And Chairman of MedQuist Holdings Speech Recognition Technologies Is 28 Years Old–Health IT Guru And Former CEO of Mysis

They are getting younger all the time and this is why we get our butts kicked with imageexecutives that don’t have some IT knowledge in their background.  Granted this is a Health IT company with medical record technologies, but something to pay attention to.  He’s also a big lobbyist.  You can also read below where he orchestrated the merger of Mysis and Allscripts medical records.  More background below talks about the payer-provider solutions, in other words software and algorithms.  In short, they have hired a professional geek with tan IT background. 

Medquist also has speech recognition technologies that have not been purchased by Nuance so far:)  They are also looking at a merger with another speech recognition company M*Modal.  Their technologies integrate with most EHR systems and work with radiology system as well.  BD 

FRANKLIN, Tenn., Jul 11, 2011 (GlobeNewswire via COMTEX) -- MedQuist Holdings Inc. /quotes/zigman/3905460 MEDH -1.57% , a leading provider of integrated clinical documentation solutions for the U.S. healthcare industry, announced the Board of Directors has appointed Roger L. (Vern) Davenport as Chairman and Chief Executive Officer of the Company, effective immediately. Mr. Davenport assumes the positions held by Bob Aquilina, Chairman, and Peter Masanotti, Chief Executive Officer. image

An industry leader, spokesman and lobbyist, Vern Davenport has three decades of senior executive experience in building and transforming healthcare IT businesses in the United States and globally. He most recently served as special senior strategic advisor to the Chairman of Quintiles. Previously, Mr. Davenport was CEO of Misys Healthcare and led the strategic merger of Misys Healthcare Solutions and Allscripts, creating the U.S. market leader in acute and ambulatory clinical information systems. Davenport also handled the establishment of a Public and Payer Sector,image which focused on payer-provider integration and State Medicaid transformations. Davenport has a broad range of experience across the entire healthcare IT spectrum including radiology, modalities and software technology. He has served as an executive for companies such as IBM, Shared Medical Systems, Kodak and Siemens Medical Solutions. He earned a bachelor's degree and an MBA from East Carolina University in Greenville, N.C

MedQuist Holdings Hires 28-Year Healthcare IT Veteran as Chairman and CEO - MarketWatch

VA Awards $12 Billion In Contracts for Health IT Upgrades and Open Version Conversion of Vista Medical Records System

So that’s $12 Billion for 153 hospitals and 800 outpatient clinics for this massive project.  This is massive and something needed for upgrades, although the current Vista system works well and there has been a version created that is open source and I wonder if they will be using the company here in southern California who have already created a version.  It was just a couple months ago that the Vista Open source project was announced. 

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?

In addition there’s also the project to develop a web based version of Vista from last year.  If you read the news today, the hackers of the web broke into Booz Allen Hamilton today, one of the new contract holders. 

VA to develop prototype for VistA - Aviva Virtual A Web Enabled System

Also it was good to see companies owned by disabled veterans were included and some small businesses too.  $12 Billion is a lot of money so even when looking at the outside world, costs are similar.  BD 

The Department of Veterans Affairs (VA) has named 14 prime contractors for a sweeping $12 billion technology contract aimed at modernizing IT systems across the department.

Hewlett Packard Enterprise Services, Booz Allen Hamilton, and Harris Corp. are among the big-name companies that have won awards under the Transformation Twenty-One Total Technology (T4) program, a five-year program aimed at charting the agency's long-term technology course by transforming a range of IT operations across the department.

However, the VA also has awarded seven of the 14 contracts to service-disabled veteran small businesses and veteran-owned small businesses as a way to provide opportunities to the veterans it services, the department said in a statement.

The department also will name one additional company for T4 once it resolves a dispute with the Government Accountability Office (GAO), according to the VA.

Rounding out the awardees of T4 contracts are: Adams Communications & Engineering Technology, ASM Research, By Light, CACI-ISS, Creative Computing Solutions, Firstview Federal TS, Information Innovators, 7 Delta, SRA, Systems Made Simple, and Technatomy.

VA Awards $12 Billion For Tech Overhaul -- InformationWeekVA Awards $12 Billion For Tech Overhaul - government Blog