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HHS Study on HIPAA and Medical Record Privacy is 18 Months Late–Complex Issue But There’s Time For A Big Facebook Contest Speaking of Privacy?

8/12/2011 11:36:00 PM  , , ,  

Why did I mention Facebook?  It has to do with privacy as well.  Certainly what is being discussed here are the privacy standards and procedures for personal health records for the most part and nobody’s doing much about it.  That’s what people, businesses and government does when things get too complicated – NOTHING.  image

Now with all the talk about privacy and what we see on the web all the time with privacy issues with Facebook and the platform opting people in with having to opt out of many of their privacy issues, why are we promoting a contest?  To me right now the 2 don’t seem to match with the same idea, right?  I’m not saying Facebook doesn’t have use as it does and just spoke to doctors on how to use it to build their practice, but with caution so as not to make mistakes on what gets posted. 

HHS Seems To Be Confused on Social Networks–Facebook for Disaster Support Contest, Give Me a Break Use Twitter Like Everyone Else Does

We all know so many sites are selling our personal data and making huge profits from it and as a good example Walgreens themselves said their data selling business is valued at just under $800 million, so again why are we promoting a platform that is maybe not ready for prime time full on privacy and security?  If I have missed something here, let me know. 

Now when it comes to personal health records, we all know that Google has opted out due to lack of participation and use.  Maybe that fact and having to work with privacy policies that have never been defined may have lead to their decision?  So many think that all medical information is covered via HIPAA but it’s not and when consumers find out their prescription records are sold for example they go nuts as they think HIPAA covers this.  Maybe this is why nobody can make a decision and come up with standards that everyone can live with.  If we were not constantly risk assessed on every street corner today perhaps this would not be such a big issue, but that’s not the way it works in the US. 

We also have 3rd parties on the web with medical devices that sell out data in addition to all the marketers out there and more than ever this is in the limelight as we all don’t like it.  Social networking sites exploit information for commercial purposes too.  So again I ask are we going to have privacy or not?  Again I understand the complexity of coming to an agreement on all of this but it is confusing to the consumer when HIPAA is spoken at one fork in the road and Facebook at the other.  Why does something like this have to be an opt out with facial recognition? 

Prevent Facebook From Suggesting Your Friends Tag You in Their Photos Using Facial Recognition

Social networking does not always get it right either, from MIT.  They also say some type of privacy laws are needed soon.  Again I think at this point we may have figured out we all need to be adults with what we put on the web but when it goes beyond our control and we get matched with data that someone else puts on the web, i.e. a group picture that runs out to identify us, we need to give this some serious thought. 

When Social Media Mining Gets It Wrong–Facebook Profile is Hardly a Reliable Source For Making Critical Decisions

An associate professor of information technology and public policy at the Heinz College at Carnegie Mellon University, showed how a photograph of a person can imagebe used to find his or her date of birth, social security number, and other information by using facial recognition technology to match the image to a profile on Facebook and other websites.  Social Security numbers are all a big part of healthcare with medical claims even though they are no longer supposed to be used as an ID number, they are. 

I can understand the complexity and the need for several federal agencies to provide input and the fact that nobody wants this big project as there’s a lot to it but for goodness sakes if we are going to talk privacy can we at least stay with the same theme?  To make matters even more complicated we have a credit agency now that thinks they can take data from the web and use it with risk assessment based on your credit scores to create algorithms that can tell if you will take your prescriptions…please this is the biggest fleece and selling of mis matched algorithms out there. 

FICO Analytics Press Release Marketing Credit Scoring Algorithms to Predict Medication Adherence–Update (Opinion)

I see very mixed messages being sent out from HHS and again can be all be on the same theme of privacy without conflicting software and web sites?  Either go one way or the other and remain consistent.  I think when it is the responsibility of HHS to promote privacy and then run this web contest with to promote Facebook which is still working on their privacy issues is totally out of place and doesn’t show enough thinking ahead here and thus I come back to everyone is a consumer and a participant.  Facebook is fine for an information page, asking for feedback, a presentation or whatever in that respect but to have a government program that runs on there with the facial recognition being used to mine data is a bit irresponsible. 

How many at the ONC or HHS are using Facebook and want their own personal data exploited and worse yet, how many new users won’t understand. My goal here in part is to educate and let people know when and where their data is being sold as best I can and where certain websites and services exploit or sell it as so many are not aware and I don’t want to see anyone denied any healthcare services due to a marketing for profit scheme.     

For 15 years, the Health Insurance Portability and Accountability Act (HIPAA) has given patients a variety of privacy protections for personal health information obtained by medical providers. Unbeknownst to many, though, the same protections do not apply to records controlled by consumers. Privacy advocates say it’s time that stricter standards apply to those records — but efforts to do just that have gone nowhere in Washington, and Congressionally mandated recommendations on how to make it happen are already 18 months late.

But the HHS Office of National Coordinator (ONC) for Health Information Technology, the agency responsible for overseeing the details of the law, has still not filed the report. A spokesman for HHS told iWatch News the department was working on it, but could provide no target date for release.  

An ONC spokesperson said the agency has had ongoing discussions with the FTC, the Department of Commerce and HHS Office for Civil Rights, and said the delay in issuing the report “reflects the complexity of the issues at hand and our commitment to thoroughly evaluate these issues with our federal partners to develop strong, fair and consistent recommendations.”  

Deven McGraw, director of the Health Privacy Project at CDT, pointed out that HIPAA laws have always only applied to specific health care entities. “HIPAA is not the right set of rules [for personal health records] because it’s all geared toward how traditional health organizations have used data,” she said.

There is one regulation for personal health records in the 2009 HIPAA legislation. If a digital medical records provider transmits protected health information to an organization or business partner that is covered by HIPAA, such as a hospital or clinic, then they are considered a “business associate” under the law and therefore subject to the same privacy rules as those they contract with.

2011/08/12/5732/privacy-advocates-want-stricter-rules-online-patient-controlled-health-records/page/0/1

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New Rules Help in Preventing Another Flash Crash But How About the Disruptor Algo Encountering the Boston Shuffler, The Knife, Carnival or Other Named Algorithms That Lurk

8/12/2011 07:38:00 PM  , ,  

On the Street and in Healthcare, it’s all about those algorithms.  This is an interesting video that discusses some of the algorithms put in place on the markets to stop other algorithms when certain parameters occur.  The 2000 physicists work on this all the time also known as Quants in some circles.  Investors are wary of how high frequency trading works with taking very small elements and working the odds, but that’s it works today.  We have some machine learning going on here with algorithms no human is calling.  The programmers and Quants develop the algorithms that can stop other algorithms.  They are talking a small glitch with Exxon below.  Watch this video and then continue on after the break. 

I made this post with this excellent video from Kevin Slavin on how algorithms affect our lives and he’s talking flash crash and algorithms that no humans are talking too so this is worth embedding once again.  It’s been going like gangbusters on the blog with being read.  The folks in the video above have probably never written a stick of code so now see the difference from a speaker who has and get the full story.

Kevin Slavin–How Algorithms Shape our World

Your pension, your mortgage, etc might be at the mercy of these algorithms.  Nobody ordered and had any control over the flash crash.  We are writing code that we can not longer read and lost some of the sense here.  In the image below look at the fiber optic laid between Chicago and New York all for running trading algorithms.

image

He mentions the company Nanex that reached into the exchanges and they actually find some of these rogue algorithms and pulls them out and pins them to walls like butterflies.  He points out how some of these algorithms make their way on to Amazon with a little tiny book selling for over a million (which is not worth that, it’s the algo).  These are algorithms locked in loops with each other with no human oversight.  image

Want to read some of what they find, take a look at the Flash Crash Analysis page they have on the web and you can dig in further if you like.  I like the one comment there stating “it’s Whac-A-Mole again”…an algorithm.  The company sells data feed software and their product helps of course with their research arm.

image

Good example in the video too is comparing two different vacuum systems, with 2 different algorithms programmed for cleaning up. 

Nanex reported that on August 5,2011 1 trillion bytes of data were processed and a year ago the level was half of that amount, so more exposure and more chances for some rogue algos out there. 

The SEC should stay close to these folks for sure as they noted one other proposal fro the SEC on 803 would have made the crash worse.  With all the activity this week, the folks at Nanex are back in action.  So if you watched the 1st video and then the second, you might have a better idea as to what’s going out there.  BD 

New rules put in place since the May 2010 Flash Crash have helped the markets sidestep another flash crash. Despite a few minor glitches, the markets not seen any major trading glitches, Brendan Conway reports.

Video - Markets Hub: New Rules Prevent a New Flash Crash in Face of Ongoing Volatility - WSJ.com

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Thomson Reuters Launches More Cost Management Software for Hospitals–Getting Ready for the Sale At the End of the Year?

8/12/2011 05:54:00 PM  ,  

It was only a couple of months ago that Thomson Reuters announced their plans to sell the Healthcare Division by the end of the year so question here is this new software going to add value to the sale price when asked?  The report said the division was profitable but they wanted to stay with their core business of reporting so I guess if they have any unreleased software not out there, get  it out there now to drive an asking price up and beef up that software portfolio. 

Thomson Reuters Plans to Sell Healthcare Unit By the End of the Year

I am guessing this comes under the Healthcare division they plan to sell since it’s all about business intelligence at the hospital and how to contain costs and there’s a ton of that kind of software on the market already.  Of course there’s risk based assessments and we are all into that today as even getting up in the morning we seem to have someone wanting to assess and make some determination on whether or not we are going to have a productive day, you know based on what side of the bed you get out of <grin>. 

There’s something that might be a little different in the package with algorithms to design bundled payments but it just may not be called that in other software programs.  The new offing is called “Payment Reform Solutions” and that pretty much spells it out for the focus here and again very much like so many other offerings out there today.  BD 

ANN ARBOR, MI – Thomson Reuters has launched a suite of new payment reform tools designed to help U.S. hospitals manage risk and seize opportunities as new healthcare payment models go into effect.

"Healthcare providers face a mixture of reimbursement methods including fee-for service, bundled payments, value-based purchasing penalties and population-based payments integral to medical homes and accountable care organizations," said Doug Shaw, executive vice president at Thomson Reuters. "Our new services help providers adapt in this rapidly evolving environment by leveraging information and analytic capabilities we traditionally deliver to governmental and commercial healthcare payers."

Thomson Reuters helps hospitals navigate new reimbursement models | Healthcare IT News

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Kaiser Permanente Union Vote With 2 Competing Labor Groups Will be Rerun for Another Vote As Ordered By National Labor Relations Board

8/12/2011 04:27:00 PM  , ,  

We have one more sign of employee unrest and the National Labor Relations Board has ordered the vote to be taken again. There are 2 unions here vying for the position to represent thousands of Kaiser Permanente employees.  As mentioned there’s a big cost here and Kaiser has agreed to a new vote as well.  A few months ago nurses struck at a Los Angeles facility to bring attention to patient safety and that cost money too.  Nurses want to be heard and who better imagewhenever it comes to patient safety as they are the front line in any hospital.

Nurses Hold One Day Strike at Kaiser's Sunset Boulevard Medical Center (Los Angeles) To Bring Attention To Patient Safety

From what I am reading here it did get sticky with Kaiser having to repay some employees some wages that were withheld for joining one union.  All unions are not the same and have different representation of course so too when changing to a new union with contracts, well that costs money too.  I think just the battle itself here shows the huge unrest in the US as far as working conditions and employees being more outspoken.  I think Kaiser is in a position financially to withstand any battle costs though as Wendell Potter pointed out a couple months ago that their profits have grown to over $ 5 billion since 2009, but wait they are a non profit, right?  The profits and money all goes to sit reserves according to his article and he also let on that the CEO is making $8 million a year.  We don’t normally get much insight into the financials of the non profits. 

Anyway with the union dispute it doesn’t seem like there’s any financial hardship here unlike other union situations across the US by comparison.  What is also interesting too is that the 500 IT professionals rushed in to join the Service Employees International Union, United Healthcare Workers – West (SEIU-UHW) on Thurs., June 30. 

500 Kaiser Permanente IT Professionals Join the Service Employees International Union–SEIU-UHW

The rerun will be interesting to see if any of the outcomes change here.  This is one group who seems to be lucky with the money available to pay them.  BD 

While millions of Americans work jobs with stagnating wages, poor job security and no union representation, two labor unions are waging a turf war over a group of unionized California hospital workers, leading critics to question whether the saga best serves the interests of ordinary American workers.

In the latest chapter of one of the nastiest union battles in recent memory, the National Labor Relations Board has ordered a do-over of one of the largest union elections in U.S. history. The board's ruling is a blow to Service Employees International Union -- one of the most powerful and fastest growing American labor unions -- which won the October election when employees at California health care giant Kaiser Permanente chose not to join the rival National Union of Healthcare Workers by a vote 18,290 to 11,364.

"The rerun of this Kaiser election will involve a huge amount of money, resources and attention ... at a time when unions are in such trouble," Freeman said. "It seems a great shame to me that such energy is going to be devoted to an internal squabble. No matter who wins this fight, workers at Kaiser will be represented by a union -- not so for thousands of U.S. workers who would be benefited by representation."

"The real question for Kaiser employees is: So why is it that Kaiser so wants this union? Its because the SEIU is a company union; it's a sellout union; its not about workers rights," said NUHW vice president John Borsos. Borsos added that in order for the election re-run to be fair, there would have to be extensive efforts made to insure that every employee understood that Kaiser and SEIU lied in the previous run up to the election.

SEIU, meanwhile, says that while they don't agree with the NLRB's recommendation for an election do-over, union leadership at Kaiser has already voted to support a speedy reelection.

Union Turf War Distracts From Decline Of Organized Labor In U.S.

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One More “Forest Gump” Judicial Ruling on Healthcare Law-Insurer Business Models and Algorithms Have Changed So What’s Wrong With A Law That Can Adjust to Accommodate

8/12/2011 02:04:00 PM  , ,  

Here' we go again and I say “Forest Gump” as its like that box of chocolate anymore with not knowing what you are going to get.  When you imagelook at the types of companies the insurers were a couple of years ago compared to today, they have done a lot of changing and added tons of subsidiary companies and for some reason everyone overlooks this, but you should not as subsidiaries put profit right down to the corporate bottom line.  I really am doubting a proper interpretation can be made and it all depends what political side of the fence they live on and the news tells us that.  They need better technology to thoroughly sort the data and even the President has come out and said he’s not adverse to modifications but to strip the law from the books entirely could be worse than one thinks. 

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

I try my best here to inform and many of my posts contain the key words “Subsidiary Watch” as that’s what it is.  Harvard is supposed to be doing a study on the affects of mergers and acquisitions in healthcare and I would suggest they might want to hurry it up a little bit as it will get more widespread attention than this little Medical Quack blog:)  In the meantime, the information is here for the finding if you want to educate yourself and see the huge changes that have been made and ultimately don’t forget about how they aggregate and sell data for profit too, that’s in there alive and well. 

Walgreens said not too long ago that their data selling business was worth just under $800 million…hint hint folks…take that hint study up.  Here’s a great example of what is taking place all over today when doctors get cuts from insurers and then they send a subsidiary company in to sell them software to help them analyze and keep what they do have, it’s a vicious game and United and Aetna are playing it out there as well as others.  Think about this, was all this going on when the Healthcare law was passed to the huge degree it is today?  Sure there was some but not to the extent it is today so again folks here’s the change and the reason we might need some digital laws soon to keep up.  A recent study says it costs doctors $83k a year to keep up with all the insurer red tape.

Subsidiary Watch-Corporate Conglomerate Insurers Reduce Compensation Contracts Using One Subsidiary Then Market Same MDs With Another Subsidiary in Health IT

Again I don’t know for the life of me how the judges and our Congressional bodies intend to keep working the way they are as even the public can shoot holes all around some of these interpretations we see today.  Look at these judges who did not keep up on mergers and acquisition and the hot water they go into.

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 Acquisitions

Then you have this ruling on selling mined data that I say we should tax as with technology today you need to give law enforcement a leg to stand on so selling data without the right credentials, license, etc. can give them teeth and slow all of this down. 

Vermont Judicial Ruling on Selling Data Mined Information Certainly Haunts of Huge Undertones of Digital Illiteracy & Tech Denial–There’s A Better Solution–Tax It!

We suffer as a country so badly from leaders who are plagued with digital illiteracy and anyone who thinks the Healthcare law doesn’t need modifications is digital illiterate too as insurers can use their algorithms and knock out a new business plan and put it in motion in 48 hours and listen up, laws need the flexibility to work with that today, or we sink just like what we are seeing. 

We are in a technological battle here to where the regulators have no clue how far advanced the financial world is and we should wake up soon. 

So in the meantime until such occurs we seem to live in a “Forest Gump Digital Illiterate World” waiting around for someone to open a box of chocolates instead of using some high tech methodologies and intelligence to create better laws, and nothing is left but digital illiterate politics, just watch the news it’s there every night.  We need technology and knowledge for better decision making today and Congress can’t seem to get that and still mess around with taking stands on abortions half the time, and then they wonder why everyone has such a low opinion of the folks that live in the 70s.  When technology allows companies to use their business algorithms to adjust for profit and we have thick heads sitting around talking nonsense in Congress, well you get the picture.  It is the sad reality of what we have elected today.  I said that stuck out like sore thumb a few months ago and there are more posts just like it here at the Quack, nobody want to do the math with the exception of Wall Street today.  BD

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…

White House officials say today's appeals court ruling against the requirement that all Americans buy health insurance -- the key part of President Obama's health care law -- will not stand.

"Individuals who choose to go without health insurance are making an economic decision that affects all of us -- when people without insurance obtain health care they cannot pay for, those with insurance and taxpayers are often left to pick up the tab," writes health care aide Stephanie Cutter on the White House blog.

Obama aide: Health care ruling won't stand

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Prevent Facebook From Suggesting Your Friends Tag You in Their Photos Using Facial Recognition

8/12/2011 01:08:00 PM  ,  

Ok here we go again with yet one more Facebook feature enabled by default.  This is an article written by Kurt, who I know from Microsoft that is the leader of the Windows Mobile User Group in Los Angeles and that I have know for a number of years and he’s a smart guy and engineer.  We used to learn a lot in those meetings imagewith some of his expertise so when Kurt takes time out to inform I listen as the guy’s never wrong;)  Take that from many years of sitting in his meetings.  His disclosure clearly states too that these are his own opinions and again he knows his stuff. 

He also mentions the study done by Carnegie Mellon about how this can potentially end any kind of anonymity we have left.  You can use the link to his blog on how to disable this newest feature that they seem to think is good for us.  I don’t know about you but I’m tired of all of this and I shut my Facebook account off about 3 months ago and doing fine without it and worrying about this stuff.  Again, those are my thoughts but in other areas outside of what I do it may have some use.  I just flat out got tired of all the time it was taking and couldn’t work with the constant interruptions and way too much communication for me as folks used those tags to include me in way too many conversations and I couldn’t get out of them and now tags for images are on the horizon here.   We are all so busy today and I do miss those meetings as I learned a lot but perhaps they will come around again soon and thank Kurt for the heads up.  BD

Well, well, well.  It turns out that Facebook will, by default, recognize your photo in other people’s photos and suggest that they tag you with your real name.

In other words:  If a friend has a photo with your picture in it, Facebook will automatically identify you by placing a square around your face based on other places you’ve been tagged, using facial recognition, and autosuggest that your friend tag you in the photo.  And as you get tagged more and more, the richer the photo recognition gets.  It’s self-perpetuating.

HOWTO: Prevent Facebook from suggesting your friends tag you in their photos using facial recognition « Kurt Shintaku's Blog

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ONC Working On Another Consumer Health IT Awareness Program–Magpie Healthcare Again With No Role Models in Sight?

8/12/2011 12:15:00 PM  , , ,  

Ok so the title here is bound to get some attention and the individual listed in this post is the “only” one at the ONC that has publicly admitted she uses what they proclaim is good for everyone else..  Where’s the rest of the folks at the ONC, do they use a PHR or do they just repeat what is in the news and what they “believe” is good for everyone else?  If you read at the Medical Quack you know I am an advocate of personal health records and “good” consumer health IT applications, not those that just do “one” thing. 

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

I have an entire section devoted to all types of information on PHRs and probably one of the largest on the web, so thus I feel the need to speak out a little bit as I do my best to be a “hands on”person and not repeat like magpie as the web is full of that today so hopefully when I can share in that fashion it makes a difference. Who do you want to teach you how to drive a car, a person that drives a car or one who read a book about how to drive but doesn’t drive one…case closed there if you will.  Back in September of 2010 I wrote this post to indicate how a new avenue of showing value needs to come along. 

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

About the same time I wrote this about HHS, does they participate?  We don’t now as we still have this paradigm of reliance on experts that truly may not exist with lack of participation or at least we never hear about it.  I’m not making this stuff up either as go to your average doctors office and talk about PHRs, good chance they have never heard of them and odds for that even get better when talking with consumers.  This is not the web, this is real time face to face discussions, in other words the “real world” which sometimes gets lost with discussions on the web and we have all done that to a degree, self included. 

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

I would think that perhaps some of the REC centers could use a little follow up as this one in Orange County, where we have a ton of tech companies and information available is non existent compared to great efforts in other parts of the US.

Orange County California REC Center For Doctor Assistance with Medical Records Appears to be a Bust So Far…

Aren’t the folks at the ONC every going to get out of the box and maybe try being role models?  We need those.   What do those experts do for themselves that could have value to share and inspire others?  This is not an easy task to get the attention of the consumer too I realize that because I have been doing it myself for about 3 years on PHRs, but role models and participating and sharing the value is one big missing element here, so get over yourselves and jump on the consume bandwagon here and participate to inspire others. 

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

I don’t see Microsoft wasting any time with pushing HeatlhVault as they are in the news all the time with new developments and I cover them here.  I have interviewed imagehealthcare executives from Microsoft who “do use Healthvault” themselves and they are not afraid to talk about it, called the internal sell here but value still needs to be seen there for participation as well.  As a matter of fact, Sean over at the Family Health Guy blog (HealthVault) asked you guys to take a break, right?  So while you are taking a break maybe think about showing some value for consumers and share the wealth?  You kind of bore me and maybe others with the current efforts and I’ll still stand strong with the FDA recalls/cellphones as being huge vehicle that would drive this and yes it means big time collaboration but the consumers are worth it, right as we all today seem to end up on the short end of the stick so much, and this would be a great area to make a difference.   

Another good example of PHR mentality was all the huge press that Google Health being discontinued received?  Why?  It was being image[14]discontinued due to lack of interest so why all the press?  How many are going to miss it for goodness sakes but many took the opportunity to use it as subject matter for writing articles and again most of those who did that have never touched a PHR so what an oxymoron with public views and the press as well on this topic.  The folks in the press could tune up a little her too as again this is consumer health IT. 

Everything today is not at it seems <grin>, so let’s get some reality back in the picture ok?  In the meantime I am guessing that most will continue to choose playing World of Warcraft versus working on their PHR, you need a new game folks and “tag”  you are it.  Does the Surgeon General use the Surgeon General’s PHR….inquiring mind may just want to know.  BD 

WASHINGTON – The Office of the National Coordinator for Health IT will widen its efforts in mid-September to bring consumers into its orbit of tools and outreach with a campaign to get the public more involved in their health and health care.

ONC will develop activities to explain the value of health IT tools, such as electronic health records (EHRs), personal health records (PHRs) and mobile phone applications.

ONC plans to include a variety of organizations that touch consumers to participate in the effort and to seek their ideas for how to involve patients, according to Lygeia Ricciardi, ONC’s senior policy advisor for consumer e-health, at an Aug. 9 meeting of the Consumer Consortium on eHealth.

ONC plans consumer health IT campaign | Government Health IT

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Florida Governor Rick Scott Pays $360 a Year for State Health Insurance

8/12/2011 10:16:00 AM  , ,  

I would gather to say this news probably even makes people in Florida less happy with their current governor.  As you can read below on what he spent to win the election, does he feel it’s justified to get a break on his health insurance too?  The imagetaxpayers are paying for his insurance as they do for many top ranking VIPs in the state as they come as part of the perks of the job.  State legislators pay $8.34 a month for their health insurance.  Some retired government employees pay as much as $1200 a month with no subsidies and it amounts to over $15k a year. 

What does not seem to be fair is the premium amounts that state workers pay by comparison, an administrative assistant as quoted here pays $2.160 for their health insurance.  As a refresher Rick Scott signed the state budget that cut Medicaid reimbursements by 12%. 

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

In 1997 Scott was forced to resign as the CEO of Columbia/HCA, then the country’s largest hospital chain, while it was being investigated for massive Medicare and Medicaid fraud.  It doesn’t appear that with all his wealth that perhaps setting an example of bowing out of a taxpayer health insurance plan has much consideration here.  With the cost of healthcare for all in the US it seems lawmakers everywhere might be getting a second look by consumers as it certainly doesn’t seem fair with the laws that are being passed and budget cuts occurring.  BD 

Last year, political neophyte Rick Scott spent $73 million of his own money to bring the tea party's anti-government, pro-privatization agenda to the Florida governor's office. Today, the former executive pays just $30 a month for health care—and lets taxpayers cover the rest.

The governor, a proud bearer of the Republican Party's deregulation standard, has spent his first half-year in office decrying government waste: He's laid off thousands of Sunshine State employees, slashed their benefits, turned down (most of) the federal government's health care dollars, and put extra financial pressure on Florida retirees and Medicaid recipients. But Scott and his dependents pay one-fifth what a janitor in the state Capitol pays for health insurance…and less than 3 percent of what a retired state trooper pays for life-saving coverage.

Rick Scott Pays $360 a Year for State Health Insurance | Mother Jones

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County Run Stroger Hospital Launches Advertising Campaign to Lure Patients From Other Hospitals

8/12/2011 12:18:00 AM  ,  

This is the first I have heard of a county hospital anywhere in the US launching an advertising campaign. When you watch the video they are focused on delivering babies and I don’t know if Illinois is like California, but when it comes to Medicaid, this is the “one” area where doctors are compensated pretty well compared to the rest so perhaps there are some similarities.  I found this out from an MD client here in California and all he did was delivery babies.  BD 

August 11, 2011 (CHICAGO) (WLS) -- Stroger Hospital is doing something it has never done before. The county-run hospital has launched an advertising campaign to try to lure patients away from other health care facilities.

Little Jaylin is just 1-day-old. His mom, Sierra Grier, had a choice of hospitals, and she chose Stroger Hospital, reluctantly at first.

"Visiting every two weeks as it got closer, it wasn't as bad as I thought it would be. They took really good care of me," said Grier.

Stroger Hospital launches first advertising campaign | abc7chicago.com

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US Post Office Considering Closing Several Office and Withdrawing Employee Health and Retirement Plans–Money Issues

8/11/2011 06:04:00 PM  ,  

This debate has been going on for a long time and stopping Saturday deliveries was one that was also frequently discussed too.  The current contract does not permit layoffs and that’s a tough one but it hasn’t stopped any body else of late it seems.  The bad part is losing health and retirement benefits.  I occasionally chat with my postman and they have already done some of that and changed when Pacificare no longer offered the current contract here in California and they had to change.  I’m guessing like the rest of us a new option or options will appear for some kind of insurance but it would be no doubt not what they may have now.  On the other side of the coin relative to drugs,  CVS is worried about prescription deliveries.  BD

CVS Says Please Don’t Cut the Post Office Back to 5 Days – Our Mail Order Pharmacy Business Could Suffer

In an attempt to stem its financial hemorrhaging, the U.S. Postal Service is seeking to reduce its workforce by 20 percent, including through layoffs now prohibited by union contracts. USPS also wants to withdraw its employees from the health and retirement plans that cover federal staffers and create its own benefit programs for postal employees.

This major restructuring of the Postal Service’s relationship with its workforce would need congressional approval and would face fierce opposition from postal unions. But if approved, eliminating contract provisions that prevent layoffs and quitting the federal employee health and retirement programs could have ramifications for workers across the government and throughout the national’s labor movement.

Two members of Congress who have introduced separate postal reform bills were non-committal on the USPS plan.

A spokeswoman for Sen. Thomas R. Carper (D-Del.) said “he is particularly interested in learning whether these proposals would be fair to employees and effective in reducing the Postal Service’s costs.”

Rep. Darrell Issa (R-Calif.), chairman of the House Oversight and Government Reform Committee, said: “These new ideas from the Postal Service are worth exploring. Options for reform and cost savings that will protect taxpayers from paying for a bailout, now or in the future, need to be on the table.”

USPS proposes cutting 120,000 jobs, pulling out of health-care plan - The Washington Post

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Digitally Fatigued Having a Hard Time Adding More Social Tools-We Have Enough Already And Let’s Make Those More Secure

8/10/2011 09:22:00 PM  , , ,  

I can agree with this article from the New York Times and in consumer mHeatlh applications I have been saying the same thing for the last 6 months, slow down and get the security tight and make apps that do more than “one thing”.  I get fatigued just reviewing them for others and if fatigue is setting in we need to take deep breath here and there.  The users depicted in this article too are Twitter fans and I have said for quite a while that Twitter gives me time while other social networks take my time.  Twitter is my news and it’s fast and efficient and I hope it stays that way.  Everyone though is certainly entitled to their own opinion for sure as everything is not for everybody in the world today.  I look and see the government pushing yet another contest with a Cancer application and then we have HHS pushing a Facebook contest.  Stop or should I say start indulging yourself and get a taste before you know what is good for everyone else.  image

Government Launches $80K Contest For Best Cancer Prevention Mobile App–Hope It Does More Than “One Thing” As We Have Too Many of Those Types of Applications

I could do without a new social network knowing the ones I use are in fact secure and would rather take that as a trade off.  In another article in the Business Insider today the discussion was held about start ups and what makes it and what doesn’t.  A few quotes from the article below…..1 of 100 start ups make it for the odds that are commonly quoted.  image

Social networks, video distributors, and clean tech businesses are the types of companies being shut down now. The firm is also shutting down an online retailer -- retail looks easy from the outside, but maintaining the proper amount of inventory is really complicated and can easily kill you if you get it wrong.

Series B seems to be the "safe zone." Sherwood shuts down a lot of companies that have closed angel funding and Series A rounds, but when companies get to Series B there seems to be a real push to go big and get to the next round. But by the time companies get to Series C or later, they often run into competitors who've gotten to scale first or can't raise enough capital to make the huge push necessary for a successful exit.”

Sure we need technology development all the time, not arguing that at all but can we collaborate a bit better and stop throwing stuff up to the wall to see what sticks for millions of dollars?  I know some healthcare folks that would love to continue to do their jobs and take care of the developers and technologists when they get sick too if there’s enough money left to pay them as hospitals and doctor incomes keep going down unlike the Silicon Valley. 

As a matter of fact I made about this in October of 2010 and it is still read quite heavily here, collaborate to innovate would really be nice as in healthcare we are just flooded with applications that are seldom used and bunches of frustrated developers and the think people who are also frustrated who try push all of this without hitting the consumer “value” button. 

The web peanut gallery is also very prevalent too with tons of articles pitching how great the algorithms are and how everyone should use it, but they never touch it themselves, so go figure….what does this accomplish?  BD

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

WHEN Jessica H. Lawrence left her job with the Girl Scouts of San Gorgonio Council in Redlands, Calif., to pursue a new life in New York City, she arrived in late January without a job, an apartment or someone to keep her warm through the winter nights.

But in less than six months, she found all three — and all because of Twitter.

The job came after a friend’s tweet inspired her to attend NY Tech Meetup, where she applied for a job and became the managing director.

She found her apartment after sending a Twitter message to the founder of the Midnight Brunch supper club. That scored her an invitation and — after meeting the owners of the brownstone where the meal was held — the cellar apartment, too.

“Value is in the eye of the beholder,” said Mr. Solis, adding that a small percentage of readers of his networking sites said they were suffering from social network fatigue. Then again, they usually get a second wind.

Digitally Fatigued, Networkers Try New Sites, but Strategize to Avoid Burnout - NYTimes.com

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UPMC and Nuance Partner to Transform the Way Patient Information is Captured, Understood and Used

8/10/2011 08:50:00 PM  , ,  

The 2 will work to define best practices for the use of speech and understanding technologies in today’s clinical setting, which is a big job for sure.  Nuance healthcare IT solutions will be standardized throughout 20 hospitals and more than 400 outpatient sites and doctor offices.  Hey I’m all for speech recognition to make the job easier and if this picks up ICD10 terminology too then all the better, but as you can see it doesn’t come cheap with the price tag of $9 billion over time.  All we need now is a little gesture technology added in and soon it may be “look Mom no keyboard”.  BD 

Press Release:

BURLINGTON, MA, August 10, 2011 — UPMC and Nuance imageCommunications, Inc., (NASDAQ: NUAN) today announced a multi-year, multi-million-dollar innovation collaboration, in which the two industry leaders will develop Medical Intelligence solutions as a means to transform the way patient information is captured, understood and used by caregivers.  The goal is to improve the quality and efficiency of care by creating a more complete and accurate electronic medical record (EMR), first across UPMC and then more broadly across the healthcare industry. 

Nuance and UPMC have signed a 10-year joint development agreement under which they will create speech and clinical language imageunderstanding (CLU)-enabled technologies.  Representing a new class of innovation in the world of health information technology and natural language processing, Medical Intelligence solutions from Nuance and UPMC will transform clinical data into actionable information that can be used to drive smarter clinical, business and compliance decisions.  Currently, most medical data is captured as unstructured free text and cannot be easily analyzed.  

"Smart technology is essential to the patient-centered, accountable care that we are committed to providing at UPMC.  Healthcare is rich in data that can be converted to intelligence and understanding.  By partnering with Nuance, we can enable smarter use of clinical data across the industry,” said Jeffrey A. Romoff, president and chief executive officer of UPMC.

UPMC, a $9 billion global health enterprise with more than 50,000 employees, is widely known and respected for its medical and technological expertise and its innovative partnerships with such industry leaders as Alcatel-Lucent, IBM and GE Healthcare.  UPMC is the only organization to be named one of the “most wired” hospitals for 13 consecutive years by Hospitals & Health Networks and ranked fifth last year in the InformationWeek500, a list of technology innovators across all industries.

“UPMC’s deep expertise in medicine and patient care combined with Nuance’s unmatched leadership in speech and language understanding technologies has the ability to change the face of healthcare delivery,” said Paul Ricci, chairman and CEO of Nuance.  “Together, we’ve entered into a unique and powerful collaboration that will accelerate the role healthcare IT plays in making clinical data more valuable.” 

The partnership between Nuance and UPMC also comprises an extensive technology and services license agreement in which UPMC will standardize on Nuance’s Best in KLAS healthcare IT solutions at more than 20 hospitals, 30 imaging centers and more than 400 outpatient sites.  After an extensive competitive evaluation process, UPMC selected Nuance as its enterprise-wide partner for speech and natural language processing solutions.

“By integrating speech and language understanding into the workflow of UPMC’s clinicians, we can save time, improve the accuracy and breadth of what is captured in the electronic record, and open the door to rich analytics that will help us to better understand what works and doesn’t work in medicine,” said Rasu Shrestha, M.D., vice president, medical information technology, at UPMC.

Under the terms of the joint development agreement, Nuance and UPMC will focus initially on CLU technology and decision-support tools that will help clinicians capture all relevant clinical details as they dictate notes for the medical record.  This is expected to improve quality reporting, coding and billing.  Other areas being explored by the partners include data mining specifically tied to the federal government’s “meaningful use” requirements for electronic records and creation of tools that will allow clinical document repositories to be easily searched and analyzed.  Solutions developed as part of the agreement will be commercially available through Nuance starting late this year.

Nuance’s work with UPMC reinforces the commitment and expands the resources that Nuance has directed to advance CLU, including strategic partnerships and development efforts with IBM and 3M.  Combined, these collaborations unite the industry’s foremost technological and clinical expertise to introduce the state-of-the-art in voice and language understanding technologies for healthcare. 

For more information on Nuance’s work with 3M visit: Nuance and 3M Team to Deliver Next Generation ICD-10 Ready Clinical Documentation Solutions and for more on Nuance and IBM, visit: IBM to collaborate with Nuance to Apply IBM’s Watson Analytics Technology to Healthcare.

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Government Launches $80K Contest For Best Cancer Prevention Mobile App–Hope It Does More Than “One Thing” As We Have Too Many of Those Types of Applications

8/10/2011 06:02:00 PM  , ,  

I do not mean to sound negative at all but we need apps that do more than one thing and show value to the consumer and if someone can create one, then I’m all for it but of late I have have not seen much in that area and too many apps doing the same thing are being created too.  Worst part of the whole deal-consumers don’t use them.  I’m glad I don’t have to hear about the mobile app that text’s pregnant women anymore as it’s time to move beyond that era as many apps do that for reasons other than healthcare and how many of us are pregnant <grin>.  In other words it had a focus of pregnant women who own a phone that could receive text messages.  I’m sure it’s still working well for those who use it too, but it’s time to move on to the next plateau. 

It sounds as if this is going to be more of a research type format for mobile use to get information to consumers and I see a ton of those applications already out there as I read so much when writing this blog so perhaps the magic format in an mHealth app will be created.  Again, I see the same old issue here with consumer interest and Cancer Control and behavior risk stuff is all over the web in any format that you want to include great stuff from the NIH too.  I have posted about their efforts here on this blog a few times. 

One word here, guys and gals, you are still missing the boat and lack a vehicle here to drive mHealth applications and getting the consumer to see value and again I come back around to FDA recalls. I don’t care what you see as value, its what the consumer sees that counts and will use.  I do realize all consumers are not geeks like me and I try and show and help people all the time and suggest that folks running contests of such do the same thing and then you will get it through the eyes of a consumer.  It’s not just for those guys over there and after an award is made I would like to hear some follow up from the folks at the ONC on how they are using the application too. 

It’s not just for those guys over there as we see all the time with the “experts’ who “think” they know what consumers want.  I agree there is value with mobile apps but everyone goes about this ass backwards all the time and then I see on Twitter folks never talking about the apps or worse yet, complaining, so get a hint folks and do something that shows value for the consumer and is not already duplicated 100 times over on the web.  Read the link below, that is a vehicle and value and got poll number and tweets to prove it from every day consumers and not geeks.  Again, will watch and see what rolls out of this contest here an maybe I’ll be proven wrong and a miracle will appear to get the already busy consumer who is learning all types of other apps, trying to live their lives, raise their kids etc. that will use this application. <grin>.  Heck even pharma has axed so many of their mobile apps too, sign of the times? 

Healthcare Bar Code Posts

You don’t have to take me too seriously though as I think HHS also has a bee in their bonnet too with promoting Facebook for a disaster support contest and this is why I really encourage all to be participants because half the folks that think this stuff up never use it themselves and we get too stuck on the reliance of what we may consider “experts” when they really are not in some very specific areas.  Everyone seems to know what is good for someone else and yet themselves they are some of the biggest “non participants” in consumer Health IT technologies.  BD

HHS Seems To Be Confused on Social Networks–Facebook for Disaster Support Contest, Give Me a Break Use Twitter Like Everyone Else Does

It was announced recently that the Office of the National Coordinator for Health IT (ONC) has launched a contest with an $80,000 cash prize to whoever can develop the best consumer mobile application to help prevent and control cancer.

The goal of the contest is to foster mobile innovation in terms of addressing the priorities of the National Cancer Institute’s Division of Cancer Control and Population Sciences (DCCPS).  These include “behavior risk reduction for prevention, survivorship (e.g., nutrition, physical activity, smoking cessation), early detection and screening, informed decision-making, and adherence to treatment regimens.”

mHealth: Government Launches $80K Contest For Best Cancer Prevention Mobile App | Mobile Marketing Watch

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Microsoft Tags (Barcodes) Used with LifeSaver Mobile Application-Paramedics Scan a Printed Card to Access Your Records

8/10/2011 04:46:00 PM  , ,  

Ok I like bar codes as everyone who visits here knows and this is yet one more way the Tags from Microsoft can be used.  I have written about Razcode encrypted imageMicrosoft Tags here before and how they work with HeatlhVault and even Google Health as well as many devices such as the Withings Scale.  As a matter of fact I have a Microsoft Tag on this site in the right hand corner so go ahead and scan and read the blog on your smart phone too.  Here’s a couple links from the Duck archives below and there’s lots more like this if you do a search on the Medical Quack. 

RazCode/Windows Tags – Bar Coding to Add Information to PHRs, EHRs, and More…
Connecting HealthVault/Google Health and More to RazCode Encrypted Microsoft Tags – Automate Data Inputimage
RAZCODE (Microsoft Tags) Using Smart Phones to authenticate MDs When e-Prescribing Controlled Substances

“Auth Tag” – Mobile Microsoft Bar Code Tags Using a Smartphone To Scan for Two Factor Authentication Giving Users Digital Tokens

Microsoft Receives Patent-Techniques to Create Counterfeit and Tamper Resistant Labels Using Fiber Optic Strands-Bar Codes Getting Closer for Drug/Device Recalls?

I have 2 links at the top of the blog and I have been campaigning for their use with FDA recalls, and when everyone talks about consumer use of mHealth, this is the ticket and it kills many birds with a half of a stone. 

Life saver App

A while back the folks over at Microsoft were kind enough to add my recommendations to the list too.image

Tag Could Boost Safety in Medical Industry

“Microsoft Tag has had an exciting impact on the medical profession lately. The quarterly magazine Micro-Cap Review has recently featured one Ms. Barbara Duck, author of the Medical Quack blog, on the subject of Tag in the medical industry.

Micro-Cap Review is at the fingertips of all the movers and shakers of the medical industry, with approximately 35,000 subscribers and distribution in New York's financial district and conventions worldwide. The publication recently featured Duck and Tag in an article titled “Bar Code Solutions for those Pharmaceutical and Medical Device Recalls That Never End.”

Barcodes are where it’s happening and this also has use for in case of an emergency.  I am guessing your emergency information would be what you want on here, like medications, allergies, etc. enough to save your life and prevent mistakes made by clinicians that could occur without having the information ahead of time.  It is HL7 compatible. Again, bar codes and their use save lives whether it is medical information or finding recalls…FDA…hint..hint…as well as the drug and device companies.  I was also recently featured in the Milwaukee Journal newspaper with my thoughts on the recall issue too regarding the big Triad mess and the factory is still closed.  So all you frustrated folks out there trying to entice consumers into using mobile medical applications, get the vehicle that shows immediate value to the consumer and get behind this, otherwise we just keep having one more seldom used app after another showing up, which are of no value unless people want to use them and again “see value”.  BD

Recalled Wipes From Triad Still Out There in Consumer Medicine Cabinets and Possibly At Some Retail Locations-Manufacturers and FDA Need To Do A Better Job-Bar Codes

Scan any newspaper’s recent headlines and it becomes obvious: the world has been experiencing a rash of natural disasters, from the earthquake and tsunami in Japan, to the horrific tornadoes in Joplin, Missouri and the southeastern United States. And that’s just in the past few months. Sadly, each of these disasters has claimed many victims. One thing that could have helped was a technology that keeps track of the unique medical histories of every person affected. Now, thanks in part to Microsoft Tag, there is just such a technology: the LifeSaver App.

The next phase of the App, coming in about 30 days, will allow for the uploading of x-rays, EKG’s, EEG’s or any other file stored in PDF format. It will also have the ability to store a living will or a do-not-resuscitate (DNR) order for a patient.

Tag to the Rescue | Success Story | Microsoft Tag

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Anesthesiologist Charged With Sexually Assaulting 7 Women While Sedated in Oregon

8/10/2011 11:33:00 AM  ,  

The state board has suspended his license and he has admitted abuse with one patient.  This is scary for women to know that someone like this exists out there as when one is sedated, what control or ability do you have to fight back.  The man is married and has 2 children.  He has been charged with rape and felony sexual abuse.  BD 

Court documents show that the anesthesiologist accused of the sexual imageabuse and rape of seven women has admitted sexually touching at least one woman after he medically sedated her.

The admission came during a recorded conversation Doctor Frederick George Field had with one of his alleged victims, according to court documents.

Five more women, bringing the total to seven, have also come forward and accused Field, 45, of abusing them while they were incapacitated.

Field, of The Dalles, Oregon, was charged with rape and felony sexual abuse yesterday in an arraignment.

Field was arrested July 28 after two victims came forward alleging he'd sexually assaulted them.

One of them says she was victimized in February, another in 2007. The five additional victims say they were abused from 2008 to as recently as last month.

Married doctor charged with sexually assaulting SEVEN women under medical sedation admits abusing one | Mail Online

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