Johnson and Johnson Extended Pain Drug (Opioid Analgesic) Nucynta ER Approved by FDA

This is the same drug, same old thing that has been working for years, come out with an extended release version and I am guessing the patent stretches out just a little further.  BD 

Approved with a risk evaluation and mitigation strategy (Follows alerts)

Aug 26 (Reuters) - Johnson and Johnson unit Janssen Pharmaceuticals got U.S. regulatory approval to market its oral pain drug Nucynta ER for moderate to severe chronic pain when an opioid analgesic is needed for extended use.

Nucynta ER is an extended-release version of the company's already approved pain drug Nucynta.

The drug has been approved along with a risk evaluation and mitigation strategy, also known as REMS, to educate prescribers about the potential for abuse, misuse, overdose and addiction from exposure to the drug.

http://www.reuters.com/article/2011/08/26/jnj-idUSL4E7JQ2KX20110826

Technorati Tags: FDA,Johnson and Johnson,drugs,pain relief,healthcare,prescription,Nucynta,Janssen

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So What’s Going on Over at the Heritage Health Prize Competition to Predict Who Ends Up Being Re-Admitted to the Hospital–A Lot of Mathematical Algorithms For One…

This is kind of interesting when you poke around over at the site and see the numbers almost like a gaming site on the web complete with a leaderboard with the number of players and entries.  This is where our former HHS Director gave his support to the project at the end of last year.  I guess science and the math there of is really changing as again this looks more like a gaming site with the way the information is included, but it’s not. 

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

From the Website:

“The winning team will create an algorithm that predicts how many days a patient will spend in a hospital in the next year. Once known, health care providers can develop new care plans and strategies to reach patients before emergencies occur, thereby reducing the number of unnecessary hospitalizations. This will result in increasing the health of patients while decreasing the cost of care. In short, a winning solution will change health care delivery as we know it – from an emphasis on caring for the individual after they get sick to a true health care system.

The Competition runs for two years and offers a US $3 million Grand Prize, as well as six Milestone Prizes totaling $230,000, which are awarded in varying amounts at three designated intervals during the Competition.”

The site is open for more to enroll and the grand prize is $3 Million so will there be an algorithm that will produce the “magic” here?  Kicking around the forum is kind of interesting which is open for anyone to read, but we now have teams merging, lot of rule clarifications and lots of talk about those algorithms.  Some are already contesting the numbers on the leaderboard.  Some are complaining about the data they received to work with.  I like the name of the one comment, “can I boost your score on my way out?”  We have questions on duplicate claims.  Then there’s a section on machine learning…hmmmmm…what kind of machine learning will this turn out…is it like anything that Kevin Slavin talks about with writing the unreadable…if you have not seen this yet, great video and learn about the algorithms that are out there in the financial district and how all the physicists are trying to unravel them too…hmmmm…healthcare, the unreadable…we need to see more on this before we end up with that one red stop button Kevin talks about.  I didn’t see any of the names algorithms in use so far like the Knife (referenced below) but that’s not the type of expedition in code this is anyway:)

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

Kevin Slavin–Algorithms

When this is all done, you might have some participants looking for a place like this <grin>>  What will all of this produce is the real question and will it be useful as true guidance and will the digital illiterate use it as standards, that is the big question.  BD 

Data Addiction and Abuse –The Up and Coming Next 12 Step Program Is On the Horizon–Side Effects Include Lack Of Data Quality, Integrity And Spasmodic Algorithms

http://www.heritagehealthprize.com/c/hhp

Technorati Tags: Data mining,healthcare,privacy,social networks,websites,patents,queries for money,algoirthims,Heritage

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FDA Approves Pfizer’s XALKORI® For Lung Cancer Patients Local or Metastatic Non-Small Therapy-Will It Affordable?

This is the first drug in 6 years to treat lung cancer but we seem to have a trend lately of the drugs being very expensive and not to mention the current shortage of generic drugs that treat cancer.  A quick search of the internet says the cost will be $9600 a month so again that runs into some money pretty quickly.   Now that we know the cost, please read the link below on how a new “scoring” algorithm has been developed to tell people how long they have to live…keep an eye out on this as we hope it will not be used to determine who gets care and who does not.  Actually the link below discusses how formulas are being used both constructively and the potential for abuse so read up as everyone is combining data from all different types of sources today and we have ethics issues forming rapidly.  BD 

Prognostic Scoring Analysis System Can Tell Doctors How Long Cancer Patients Have to Live; Danger Zone As Far as Misuse With Drug and Treatment Access for Patients

NEW YORK--(BUSINESS WIRE)--Pfizer Inc. announced today that the U.S. Food and Drug Administration (FDA) has approved XALKORI® (crizotinib) capsules, the first-ever therapy targeting anaplastic lymphoma kinase (ALK), for the treatment of patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) that is ALK-positive as detected by an FDA-approved test. The effectiveness of XALKORI is based on objective response rates (ORR) and, as XALKORI received accelerated approval from the FDA, Pfizer is conducting post-marketing clinical trials to further evaluate its clinical benefit.

“The development of XALKORI – from publication of the discovery of the ALK fusion gene in NSCLC to FDA approval in just four years - is a remarkable feat in the oncology world and reinforces the importance of collaboration among academic research, pharmaceutical, diagnostic and regulatory organizations.”

“Overall, lung cancer is responsible for more deaths each year worldwide than any other type of cancer. XALKORI is an advance in the treatment of this devastating illness, providing a new therapeutic option for a subset of patients with the disease,” said Ian Read, president and chief executive officer of Pfizer. “The acceleration, collaboration and critical focus of the XALKORI clinical development program reflect Pfizer’s Precision Medicine approach to advancing our pipeline and strengthening our innovative core to deliver medicines that matter most.”

http://www.businesswire.com/news/home/20110826005815/en/U.S.-Food-Drug-Administration-Approves-Pfizer%E2%80%99s-XALKORI%C2%AE

Technorati Tags: XALKORI,cancer,lung cancer,Pfizer,drugs,insurance,clinical trials,healthcare,FDA,oncology

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Humana to Buy Arcadian Management Services HMO With 64,000 Members–Subsidiary Watch

Arcadian Health offered Medicare Part D policies and we kind of know what’s in the future for their business as far as rates, etc. with the Healthcare law. 

From the website:

“Our Health Plan organization is a community-based local network, providing coordinated care to our members in small to medium-sized communities across the United States. We offer a variety of value-oriented Medicare Advantage health plans and we exercise the utmost standards of dignity, compassion, understanding and respect for our members. “

In addition Humana has been collaborating on several revenue cycle/medical record issues of late, when they are not battling for the Tri-Care military contract which I believe is still theirs but may be in court with United battling for the contract last I read.  United may not be at a total loss as there’s the possibility of subsidiary business with the Health IT business today, but not as big perhaps as the over all contract for services. 

Allscripts And Humana Collaborate to Provide Decision Support Software for MDs Along With Financial Assistance and Incentives For Adopting Allscripts EHR System

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

I keep reporting on more of this type of activity of late with insurers scooping up the HMOS and the IPAs of late, so this look to be some kind of a trend and again, pay attention these days to who owns who if you care to know where your money goes as far as corporate profits to bottom line conglomerates.  If that is of no interest they can entertain you with their “FamScape” game where again who knows where the data goes and what level of consumer interest is really here, but some developer probably made a ton of money creating it and there another insurance carrier doing the same thing out there as well, but to me the games just really insult one's intelligence but I’m not everyone though.  What’s more exciting playing World of Warcraft or FamScape?  BD  

Health Insurer Humana Introduces a New Game Called FamScape–Making It Fun to Get And Maybe Mine Your Data?

LOUISVILLE, KY – Humana Inc. announced Thursday that it has signed an agreement to acquire Arcadian Management Services, an Oakland, Calif.-based Medicare Advantage HMO with approximately 64,000 members in 15 states. Terms of the agreement were not disclosed.

Louisville, Ky.-based health insurer Humana Inc. said most of Arcadians members reside in small or medium-sized communities across the U.S. It had close to $33.9 billion in revenue in 2010.

Founded in 1996, Arcadian Health Plan provides Medicare Advantage coverage through its affiliates in 15 states: Arizona, Arkansas, California, Georgia, Louisiana, Maine, Missouri, New Hampshire, New York, North Carolina, Oklahoma, South Carolina, Texas, Virginia and Washington. Its 2010 revenue was $622 million.

http://www.healthcarefinancenews.com/news/humana-acquire-arcadian-management-services

Technorati Tags: Arcadian Management Services,Humana,heatlh insurance,healthcare,HMOs,managed care,contracts,patietns

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Prognostic Scoring Analysis System Can Tell Doctors How Long Cancer Patients Have to Live; Danger Zone As Far as Misuse With Drug and Treatment Access for Patients

This is kind of an interesting topic and not a pleasant one by any means, but now there’s a software tool that can give the predictions based on analytics on how long a cancer patient has to live.  This is news nobody wants to tell a patient and never easy, and we do have quite a few cases of patients beating the odds of what they are told.  One very prominent person who is well known throughout the healthcare web industry is e-PatientDave who is speaks all over the world about getting involved in your own care as it just may save your life like it did his. 

Dave deBronkart -e-Patient Dave On Letting Patients Help Sort Out the Health Data

Now the danger area here with analytics come in as far as treatment and will the “digital illiterates” or those who are flat out trying to cut costs use such analytics to deny care?  You know someone will do a study to justify such and thus again ethics must enter the picture here as again there are many the beat the odds and you never know when that might happen.  You can read below the opinion of one doctor as well and he recommends the same with using the information wisely for sure.  Here’s where the danger zone comes in with program such as FICO coming back with numbers and let’s say a patient was scored using their “flawed” system of using credit scores and one ranked low, so would they deny care?  I mention this as chemo drugs are in such short supply today, so again what affect would this have?  Even though it’s chemo-therapy delivered, analytics folks usually wouldn't even see that as they are numbers folks and not doctors. 

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

Heck all FICO wants to do is make a buck selling software and algorithms that they profess to be helpful and again I say mis-matched for the sake of marketing and making a buck.  It is what it is.  With the data worlds today you can see where such an analytics algorithm sold to an insurance company, mixed with the results of the predictive results would end up almost being in the category of the “unreadable data” and the computer would perhaps kick out devastating and statistics that would deny care and treatment.  You head it here first as it may not be these two instances, but there’s out there doing similar analytics with data today, and it seems to be easier when the analytics folks are owned by big conglomerates as they could potentially have access to many different shapes and forms of data and we don’t know how they are using it. 

So folks go lightly on your “scoring” of the human bodies with cancer and use such information wisely and don’t let the analytics fall over into areas where this would deny care.  We have already seen how the “digital illiterates” in Arizona were cold and heartless with implants and so if it happened once, it will happen again and until someone questions the data, nobody has to account for how their decisions were made and the roots of their data. Another related article below talks about “IT data profiling” and this is different from what you are hearing in the news today and has to do with making sure the data entered is correct, and love the example given on the data entry clerks paid by how many forms they do an hour and when they don’t know what the accurate data is if missing, they just out guess and then you as a consumer have the flawed data in yours files, which could be spread out to more sources than you could even imagine today with all data being aggregated and summarized for analytics. 

In summary this occurs when the integrity of the data is never checked, just collected and sold to another party.  It does cost extra money for the data to be checked and those that are selling collected data just may not take the extra time and money to do this.  BD 

IT Data Profiling That is Not Happening Before the Invasion of the “Data Snatchers”That Sell our Profiles & Information–Polluting the Water (Data) For Profit

ScienceDaily (Aug. 25, 2011) — A new scoring system can more reliably predict whether patients with advanced cancer are likely to survive for "days," "weeks" or "months" finds a study published online in the British Medical Journal.

Patients with advanced cancer and their carers often wish to know how long they have left to live. This information is also important for clinicians to help them plan appropriate care. Clinician predictions of survival are the mainstay of current practice, but are unreliable, over-optimistic and subjective.

So a team of researchers, led by Dr Paddy Stone at St George's, University of London, set out to develop a scoring system for use in patients with advanced cancer in different care settings that was as good, or better, than clinicians' best predictions.

Using a combination of clinical and laboratory variables known to predict survival, the team created two prognostic scores (PiPS-A and PiPS-B) to predict whether patients were likely to survive for "days" (0-13 days), "weeks" (14-55 days) or "months" (more than 55 days) compared with actual survival and clinicians' predictions.

In an accompanying editorial, Paul Glare from the Memorial Sloan-Kettering Cancer Center in New York believes that prognosis "needs to be restored as a core clinical skill, to optimize the patient's treatment and planning."

He says that prognostic tools can help, but should not be applied blindly, and he points out that "communicating the prediction to the patient is as important as forecasting it."

http://www.sciencedaily.com/releases/2011/08/110825193101.htm

Technorati Tags: cancer,scoring,analytics,healthcare,HealthIT,doctors,patients,treatment,ethics,software,data

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Dan And Don, The Clinical Trial Guys and the Medical Quack Have a Chat…

Yesterday Dan and Don invited me to an open discussion as part of their weekly interviews they post on their website with someone in healthcare and yesterday we talked about clinical trials and some additional areas in healthcare and some very general.  Be ready for a lot chat here, it runs around 45 minutes. 

We had some fun and it allowed me to do a bit of story telling from some past experiences, something I don’t ever seem to get around to doing much.  In addition I explain how I used my past experience with having written an EMR into how my blog posts appear today and the influence it had.  We are in the world of “algorithms” today and using them wisely for guidance and not having the “digital illiterate” declare some of the analytics as gospel is sometimes becoming a dangerous mix with intelligence claims that are not there and created more for marketing than anything else.  It becoming a challenge to tell the difference at times too by all means, depending on how good the marketing efforts some put forth.

The Clinical Trial Guys…

Here’s where you can find the Clinical Trial guys and again it was fun and I thank Dan and Don for the time and we just let it roll. 

http://www.TheClinicalTrialsGuru.com

Analytics make us much smarter, but again merging the worlds of those who do not write code and the “geeks” can be a very delicate issue, one that I try not to lose face with as it’s a reality and in some area with combined algorithmic formulas, we are in fact “writing the unreadable” in some areas with even some of the social medical profiles used, as is happening in the financial world with algorithms reacting with each other with no human intervention.  I mention all of this as my efforts to create an awareness hopefully to generate the interest with asking questions and encouraging research if you think something perhaps doesn’t sound right, as a good decision with all the “real” facts you can get your hands on is priceless.  BD  

How Algorithms Shape Our World–TED Talks Kevin Slavin–Writing the Unreadable And A Good Reason to Get Into the Math

http://www.youtube.com/watch?v=TfYs8bz9Mh8&feature=share

Technorati Tags: clinical trials,heatlhcare,medical devices,drugs,pharma,HealthIT,Medical Quack,technology,medicine,chat,consumers,doctors

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Stem Cells Extracted from Fat Created New Bone and Saved Patient from Amputation–Regenerative Medicine

This is some pretty amazing technology with what they were able to do with stem cells here and save the woman who was in a wheelchair from amputation, and on top of that, she’s walking again.  There are so many amazing areas in regenerative medicine that are evolving and this is one of them.  BD

WBAL - Researchers in Maryland are using stem cells from fat to grow new bone.

In January 2009, 53-year-old Susan Cossabone was in a terrible head-on collision. Her injuries made her fear that she'd never walk again, much less ride her beloved horses at her horse farm in New Jersey.

"I thought I would lose the leg. If you could have seen it when they cut off my favorite jeans -- you could just see bones sticking and flesh. You couldn't see much of a leg," she said.

For a while, it looked as though her leg would require amputation, doctors said.

http://www.ksdk.com/news/article/273723/9/Doctors-use-stem-cells-extracted-from-fat-to-create-new-bone-tissue

Technorati Tags: stem cells,regenerative medicine,healthcare,science,legs,bones,tissue,fat cells

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GAO Report on For-Profit Nursing Homes: Deficiencies Swell, Direct Care Staffing Declines, Profit Margins Soar For Investors

This is probably no surprise to anyone as it is happening all over in healthcare when the for profits move in and cut down to bare bones sometimes.  Back in November of 2010 the GAO stated that they could not get enough data from the homes owned by private equity firms, although I could bet there might be plenty of “revenue cycling” data laying around perhaps.  That is what seems to take priority today, revenue cycling over care. 

General Accounting Office Questions Nursing Homes Owned By Private Equity Firms–Lack of Data To Evaluate Care and Safety

We had one situation here in California that got so bad with the financial side that they exhausted their insurance coverage for legal cases and fines so according to this latest report things are not moving along much better.  Medicare cuts to nursing homes don’t help either. 

Skilled Healthcare Group Gets Court Verdict of Not Meeting Minimum Nursing Home Standards in California And May Not Be Able to Appeal– Skilled Healthcare’s Liability Insurance Has Been Exhausted For This Year So Now What?

So what do we do, put all the residents on Facebook to talk about the conditions with an HHS Facebook program?  I say this in jest as we have some nutty folks out there that think giving away any privacy you have left and developing an app is going to save the world, when in fact folks are more likely to use it the wrong way but denial keeps this possibility from surfacing.  Again, lack of executives in how data is used and evaluated is a huge problem today and thus we get the somewhat digital illiterates making whacked out decision like this, a contest so maybe HHS can work and get some Facebook pills?  This is is so ridiculous and again shows “non participation” with executives in general consumer Health IT, otherwise they would know better.  Facebook is not the one and only cure all with some new algorithms for goodness sakes, but non participants can’t tell the difference. 

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

I don’t see any Facebook pills or Twitter clinics coming to the rescue here with reality. Hospice isn’t looking much better for that matter, so what do we do there, get the patients in the nursing homes a scribe for their Facebook application use??  It was stated yesterday that the new privacy on Facebook doesn’t apply for apps so your bare bottom is still somewhat hanging out there. 

For Profit Hospices Versus Non Profit Painting a Picture of Potential Cherry Picking-Could Happen With Data Created From Risk Assessment Analytics Algorithms-Study

So instead of seeing what the reality is we just look at aggregated numbers and ask “how’s that happening”…analytics are good and make us smarter but they are not the answer when action is need but rather should direct us into the areas that need to be addressed, like the GAO is trying to do here.  Anyway, if we could all get on the same path and use analytics a bit better and stop with some of the nonsense, perhaps progress would be made.  BD 

WASHINGTON--(BUSINESS WIRE)--Today, Brian Lee, Executive Director of Families for Better Care, called the Government Accountability Office’s (GAO) findings related to the quality of care in for-profit nursing homes acquired by private investment firms “predictably appalling.”

“It is troubling to learn that even with the preponderance of quality improvement initiatives, ombudsman advocacy work and government inspections (which providers often claim as ‘burdensome’ and ‘overregulating’) deficiencies continue to spike in these homes”

Findings showed that overall deficiencies swelled, direct care staffing declined and profit margins ticked higher.

“It is troubling to learn that even with the preponderance of quality improvement initiatives, ombudsman advocacy work and government inspections (which providers often claim as ‘burdensome’ and ‘overregulating’) deficiencies continue to spike in these homes,” said Lee. “It seems everyone knows that nursing home quality hinges on a high number of well-trained, direct care staff…everyone that is, but the nursing home industry.”

The report (GAO-11-571) is the second government report that stems from a 2007 New York Times critique of the management of care and services conducted by private investment (PI) firms of massive nursing home conglomerates. The Times reported that resident care suffered in part from cutbacks on nurse staffing to increase profitability.

The new report also revealed that serious deficiencies went down and registered nursing hours went up. “It is encouraging to learn that serious deficiencies are declining in some of these nursing homes. This translates into fewer residents experiencing the agony of improperly treated bed sores, fewer medication errors and fewer resident elopements,” said Lee.

But Lee and his group remain cautious about the mixed results, calling them “illusory.

http://www.businesswire.com/news/home/20110825005883/en/GAO-Report-For-Profit-Nursing-Homes-Deficiencies-Swell

Technorati Tags: General Accounting Office,nursing homes,private equity,investing,seniors,surgery,patients,Medicare,budgets,Hospice,for profit,non profit

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Cook Medical Introduces Endoscope With an HD Camera Attached- Portable Imaging System for Urologists

 Envisionier Medical Technology, Inc. is the manufacturer of the viewer.  The endogo HD easily attaches to an endoscope to capture, store, and share high definition endoscopic images and video instantly with patients, their families and physicians following a procedure.  This device could also potentially reduce costs by eliminating the need for additional procedures.  Not only do we get to see inside of everything today, but now it’s also in HD. 

In addition the information can also be send to an EHR program from the web storage services of eGoWorks™ in the cloud, and it is touch screen enabled too.  What is pretty funny is they have a game where you can use the endoscope animated image and shoot down the old technology.  BD 

Press Release:

Bloomington, Ind., August 22, 2011 – Cook Medical recently launched the endogo^® HD Portable Endoscopic Imaging System by Envisionier Medical Technology, Inc. The endogo HD has the ability to capture, store and share endoscopic images, making it possible for doctors to share information with patients instantly, simplify collaboration between colleagues and potentially reduce costs by eliminating the need for repeat procedures.[1]

With high definition video and still-image capture capabilities in a compact, portable setup, endogo HD allows a physician to share and review exam findings with the patient or family immediately following the exam, at the patient’s bedside or in a waiting room. A resident can also share captures with the attending physician, which may reduce the need for repeat procedures. With the endogo HD, OR imaging capabilities can now be available throughout the facility, wherever a procedure is performed. The combination of data acquisition, storage, management and the synchronization of patient folders in an easy-to-use Web application makes it possible to send an image or video over a secured connection to a referring doctor outside the facility.

Equally beneficial is the compatibility of the endogo HD with EMR systems. eGoWorks™, the online data storage and collaborative software that is compatible with the endogo HD, allows the data acquired with the portable camera to be used within EMR systems. 

 

“We are excited about endogo HD because it truly underscores Cook’s commitment to physicians and their patients,” said Jean-Marc Creissel, global leader of Cook’s Urology business unit. “The technology simplifies the process of storing and sharing medical images. The benefits around care, ease of use and potential cost savings are significant because this technology streamlines how physicians interact with each other, their patients and external facilities.”

The endogo HD easily couples with both flexible and rigid endoscopes, transforming the captured images and video from analog to digital. The camera also has built-in light source optimization for high-quality imaging and a 3.5 inch removable LCD touch-screen (eGo™) for multimedia playback.

¹ Lemonnier LA, Treadway CK, Lin HS, et al. The feasibility of telemedicine in fiberoptic laryngoscopy. Laryngoscope. 2010;120(suppl S3):S10.

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 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. Follow Cook Medical on Twitter @cookmedicalpr and @CookUro.

 

Technorati Tags: endogo HD,Cool Medical,medical devices,HD,medical records DOD,data storage,healthcare,Health IT,urology

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CMS Created Four Bundled Plans for Payment and Is Looking for Hospitals and Physicians to Participate

Overall this is a good thing, if the process is kept simple enough to where it doesn’t work out to be another Health IT situation to where it takes more time to get started.  Just the other day I posted about the amount of money a physician spends on the insurance side of things and it was a pretty large number.

Health Insurance Paper Work Costs Doctors an Average of $83k a Year

In addition many doctors and hospitals are not even ready to move into the ICD10 world so just looking at how much one can handle on the plate at one time.  Hospitals might be able to work a bit easier from their end.  BD 

The initiative will bundle payment across provider sites for multiple services given during an episode of care, which is a single hospital stay and/or recovery from the stay. The idea behind bundled payments is to give providers a greater incentive to coordinate care across settings, which would require advanced use of health information technologies.

The initiative follows a Medicare bundled payment demonstration program for heart bypass surgery that saved Medicare $42.3 million--about 10 percent of expected costs--and saved patients $7.9 million in co-insurance costs, and lowered mortality rates, according to CMS.

The four payment models in the Bundled Payments for Care Improvement Initiative are:

* Model 1: An acute care hospital stay only,

* Model 2: The acute care stay plus associated post-acute care,

* Model 3: Just the post-acute care following discharge, and

* Model 4: A single prospective bundled payment that would encompass all services during an inpatient stay by the hospital, physicians and other providers

Final applications for Model 1 are due by Oct. 21, 2012, with applications for other models due by March 15, 2012. More information is available here.

http://www.healthdatamanagement.com/news/medicare-bundled-payments-revenue-cms-43050-1.html?ET=healthdatamanagement:e1948:120588a:&st=email&utm_source=editorial&utm_medium=email&utm_campaign=HDM_Daily_082411

Technorati Tags: CMS,bundled payments,healthcare,Health IT,Medicare,surgery,programs,applications

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Allergan Gets FDA Approval for Using Botox To Treat Overactive Bladders

Botox seems to be a shining star for relief in many areas of late and last year another type of botox was approved to treat cervical dystonia. In March of last year the FDA also approved the use for muscle spasms in the hand and wrist area.  BD

FDA Approves Xeomin® A Botulinum Toxin Type A (Botox)To Treat Cervical Dystonia

FDA Gives the Ok for Botox To Be Used for Muscle Spasms In the Wrist and Finger Areas of the Hand

Botox gives grandmother her voice back

Allergan Inc. won U.S. clearance to market the wrinkle smoother Botox as a treatment for urinary incontinence.

The Food and Drug Administration approved the drug for people with overactive bladders who have neurologic conditions such as multiple sclerosis and spinal cord injuries, the agency said today in a statement. The medicine is injected into the bladder to increase its capacity by relaxing muscles.

Botox, also used to reduce facial wrinkles and treat neurological disorders, is the Irvine, California-based company’s top product with $1.4 billion in revenue last year. Sales of the drug for incontinence in people with MS and spinal cord injuries may reach $40 million in 2017, Seamus Fernandez, a Boston-based analyst at Leerink Swann & Co., said today in a note to investors.

Technorati Tags: FDA,Botox,Allergan,spams,muscles,flexor,injections,pain,wrinq,sweating,drugs,overactive bladder

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Microsoft Announces New Leadership for U.S. Health & Life Sciences Group

Microsoft adds some new leadership to their healthcare services division.  Additional information can be found at the MSDN Microsoft in Health site with a little additional history on both individuals.  BD 

Press Release:

Washington, D.C. — August 24, 2011 — Microsoft Corp. announced today two new leadership positions within the company’s U.S. health organization. Michael Robinson is Microsoft’s new General Manager of U.S. Health & Life Sciences and Dennis Schmuland has been promoted to a newly-created role, that of Chief Health Strategy Officer.

Robinson previously served as the General Manager, Public Sector for Middle East & Africa where he was responsible for managing the growth and strategy for Microsoft’s Public Sector business in over 70 countries. With more than 35 years of sales, technology and management experience, Robinson has helped grow the Microsoft business since joining the company in 2002.

“With the opportunities and challenges we face as a nation, there is no more important time to be part of the health industry in this country,” said Robinson. “Microsoft is uniquely positioned to help health organizations deliver impactful solutions and strategies that improve care delivery, empower consumers to manage their own health, and ultimately drive down costs in the industry.”

Reporting to Robinson, Dennis Schmuland has been promoted to Chief Health Strategy Officer and will help to drive the company’s engagement with key constituencies, including consumers, providers, health plans, life sciences organizations and federal, state and local health and human services organizations. Schmuland previously served as Microsoft’s National Director of Health Plan Industry Solutions and has been with Microsoft for 10 years. He holds a doctorate in medicine from the University of Washington School of Medicine and is a Fellow of the American Academy of Family Physicians. Schmuland also serves on the editorial advisory board for Managed Healthcare Executive and on the board of US Healthiest. 

Both Robinson and Schmuland will continue to collaborate with the worldwide Health Solutions Group led by Microsoft Corporate Vice President Peter Neupert. The Health Solutions Group is responsible for developing, selling and supporting Microsoft Amalga, a health intelligence platform for health enterprises, Microsoft HealthVault, a technology platform that puts people in control of their personal health information, and a suite of identity and access management solutions acquired from Sentillion in 2010.

For more information on Microsoft in Health, please visit: www.microsoft.com/health.

Technorati Tags: Microsoft,healthcare,Health solutions,Health IT,doctors,consumers,providers,software

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Predictive Modeling for Wound Care - Risk Assessment Software To Integrate with EHR Systems That Predicts and Analyzes Wounds–WoundVision iNSIGHT

This looks to be an interesting product with being able to assess a wound and determine what other areas it could affect and this could be a good application in the battle grounds perhaps too.  You can the wound completely analyzed on a flow sheet, graph, etc. and really dig in.  As mentioned, during admission this could be a valuable assessment for sure.  Bedsores looks like an area to where it would have some good use too. 

You can watch the video and what is also interesting is the fact that it says it can “predict” a wound?  Now what types of wounds would it predict?  The video below states it can find a wound before it is clinically visible?  If it could find staph aka MRSA that would be good by all means.  Every dermatologist around could have one to diagnose and graph bad cases of acne right?  Of course it’s about saving time and money too as the video emphasizes that as well with proper coding for reimbursement. 

It boasts a 92% accuracy rate.  The company is offering free trials right now according to the press release.  I talk predictive modeling all the time and how our lawmakers can’t see to get there, pretty amazing when we can use it for wound care and possibly predicting a wound, which I would again guess would be from a virus or as I mentioned above maybe a real bad case of acne <grin>.  As  a matter of fact maybe all our lawmakers should be scanned to see where all their wounds are or will develop for an education process:)  You know if they develop a home system for consumers could this maybe be of help for those with herpes or shingles?  I’m just maybe thinking out loud here.  BD 

Yes it’s an algorithm that does the diagnosing and analytics. 

Wound Vision

Press Release:

INDIANAPOLIS--(EON: Enhanced Online News)--WoundVision™, the healthcare industry pioneer in advanced wound detection technology, is announcing today the launch of WoundVision iNSIGHT. Designed to deliver critical patient information bedside, iNSIGHT is the company’s web-based risk assessment software program that assists in the prediction, prevention and early intervention of pressure ulcers and other complications of health. HIPAA-compliant and configured to integrate seamlessly with facilities’ EMR, WoundVision iNSIGHT serves as a base mechanism for patient assessment management across all levels of acuity. The technology provides multiple means for acquiring essential patient information bedside through an array of assessments, including a comprehensive assessment, a quick assessment, a skin and soft tissue assessment and a wound tracker assessment. Any time a patient’s information is entered or updated, iNSIGHT’s predictive models produce patient risk graphs, trend lines representing the patient’s series of health, wound probability graphs, wound healing graphs and wound differential graphs to ensure informed and accurate clinical decisions. The web-based solution is easy to use and saves clinicians time and resources by securing comprehensive patient data during admission. This critical data is then accessible from any internet-connected computer, providing a consistent and holistic view to the patient throughout their experience, whether in a hospital, long-term care facility or at home.

“By standardizing the risk assessment process, our latest innovation promotes the continuity of care at all acuity levels, thus eliminating variability and subjectivity throughout the entire process. With iNSIGHT, caregivers now have the opportunity to individualize and personalize the process, while complying with government and best practices regulations.”

“Today’s medical environment demands that risk assessment be at the forefront of clinical care, and WoundVision iNSIGHT does just that,” said James G. Spahn, MD, FACS, co-founder and CEO of WoundVision. “By standardizing the risk assessment process, our latest innovation promotes the continuity of care at all acuity levels, thus eliminating variability and subjectivity throughout the entire process. With iNSIGHT, caregivers now have the opportunity to individualize and personalize the process, while complying with government and best practices regulations.”

WoundVision is a predictive modeling and risk assessment solution – soon to be supported by thermal imaging – for early wound detection, which maximizes a facility's efficiency in patient care and outcomes. With WoundVision's technology, healthcare providers can objectively predict and track pressure ulcers, wounds and other health issues to optimize patient outcomes, comply with government regulations and preserve revenue. By cost-effectively bringing knowledge bedside, WoundVision allows staff to not only stay more informed about their patient's health but increase the quality of care they can provide.

WoundVision is currently offering cost-free trials of the iNSIGHT software. These trials will also include the soon-to-be-released WoundVision Thermal Imaging System (TIS) for early wound detection.

For sales inquiries regarding WoundVision iNSIGHT, please contact Jeff Paschen at 317-775-6089 or jeff@woundvision.com. More information can also be found at www.woundvision.com.

About WoundVision™

WoundVision™ is the industry pioneer in advanced wound detection technology. The WoundVision imaging system enables healthcare providers to predict and track wounds by utilizing personalized patient health data and infrared thermographic images. Offering objective and unbiased health analysis based on comprehensive data and first-of-its-kind imaging, WoundVision allows healthcare providers to implement the optimal care plans for improved and cost-effective patient care. Please contact Ashley Eggert with media inquiries at 317.202.2280 x15 or ashley@dittoepr.com. For more information, visit www.woundvision.com.

http://eon.businesswire.com/news/eon/20110824006052/en/doctor/finance/government

Technorati Tags: WoundVision,software,risk assessment,medical devices,coding,skin,dermatology,emergency care,thermal imaging,healthcare,EHR

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Goldman Sachs-The Movie by Civil War Creator Ken Burns Leaked! (Video-Spoof)

This is so funny and I have an idea for the next sequel….how about this guy below over at United Healthcare, the highest paid CEO these days?   These folks are good over at Minyanville.com!  BD 

United Health CEO Compensation Grew 21 Percent–Pay For Performance/Salary Yielded 4.7 Million of An Almost $11 Million Pay Out

Goldman Sachs Leaked Movie–Spoof

Technorati Tags: Goldman Sachs,Ken Burns,money,spoof,video,healthcare,banking,insurance,humor,algoirthms,United Healthcare

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IT Data Profiling That is Not Happening Before the Invasion of the “Data Snatchers”That Sell our Profiles & Information–Polluting the Water (Data) For Profit

When you hear the word privacy today you also hear the word profile but the purpose of this article is not to discuss that profile, but rather what he companies do or do not do before selling and aggregating information from one area to another.  We get this a lot in medical records when one let’s say review of system is in the chart, and then every other doctor seeing the patient uses the same document or file, but what if it’s wrong?  Well you may have a dozen or so people with wrong information and then how do you get to the bottom of it?  This is a big issue today.

Unfortunately when data is not profiled and checked for errors, we have the folks out there that think because it’s in the data base it has to be correct…wrong.  I have proven that on this blog with the web based MD referral sites and that’s huge as the sites are not updated as they should be and why I found my former dead doctor still listed in the internet after life and still available to see patients.  There was no profiling done to check or accuracy there. 

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

Nobody at Health Grades or any of the other companies that do the same were checking and thus we had no company “data profiling”.  Most just want to use the data, sell it or what ever they do with it and run to first base.  In some cases information is just scraped from the web and it’s fat chance there’s any “business data profiling” to clean stuff up going on at all.  Social networks do not always get it right and yet people believe that what’s on there is 100% accurate and that comes back to digital literacy. 

Privacy-Beware of the Data Snatching Algorithms on the Web Some of This Relates to Healthcare and How You are Bought & Sold-Important Information for All (Video)

The example in this story is great and drives the point home and will give you something to think about when it comes to data entry.  There was a required field and when the data entry clerks were paid by how many forms they could fill in and the information was not there, they made it up…hmmmm…is this what is called “pay for performance”….sounds like it to me and shows how the carrot does not always lead to accuracy. Now in the example data profiling engines could be run to check and see why so many had the same birthday…in other words it looks for certain patterns, just like the software does that checks medical claims.  We have tons and tons of software there alright but when it comes to doing some data profiling before shipping our data out for sale, nope this does not happen as they can make a buck without it and later when things don’t jive, the consumers get fleeced and have to prove their innocence as again everyone thinks that what is on that screen is 100% accurate when it comes to business. 

This brings me back around to the FICO fleece to where they are selling information based on your credit scores with a lot of other information they obtain freely from the web stating it can predict whether as a patient you will take your medications. This is flat out marketing of data and you can bet it shoved together to make that sale to a pharmaceutical or insurer as that is their market with little or no profiling of the data, just queries only for “desired” results.  They don’t care if the data is accurate or not, they want a sale and we as consumers are fleeced. 

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

I made a post a while back which is still a good idea to require licenses and tax this money since we can’t really stop it and you can see the damage that the over use is creating with our economy based on algorithms only without enough companies actually producing a tangible product in the US. 

Why Is Almost Everyone In Healthcare Marketing Their “Ass” Off

Now with data systems being combined and re-analyzed, we are getting to the point with machine learning to where the computers don’t know the difference and we end up with no tracking back to see where the original information came from, again another good reason to license and tax so we have a point of origin. We should learn this from Wall Street so as not to repeat what they did, same thing with algorithms that react with each other with no human intervention.  In short there’s nobody minding the data store and it’s like a used car being sold from one party to another in very short period of time with nobody even bumping a tire because to analyze and do the company data profiling, it’s costs money to invest and that eats up the profits they make selling the data. 

We are now writing the unreadable and this will eventually be a huge mess with all types of corrupt and tainted data if there’s not a registry started soon so there’s an audit trail and again the corrupted and flawed data that will be held against you at some point in time that nobody will ever be able to trace. Watch this video below and see the algorithms of how 2 different computer run vacuum cleaners see your carpet and you’ll get the picture as all algorithms are not created equally.  We have a run-away train here with nobody minding the store and data will grow to be more unreliable and polluted just like the water, but also like the water we can take steps to avoid this and clean it up.  BD 

Algorithms Affecting our Lives

.Jim Harris, independent data quality consultant and writer, shared this real-life example from a data quality project at an insurance company to show the problems data profiling can find:

.. we were doing data profiling on some fields like date of birth. We were noticing some weird trends  – people tended to be born on Jan. 1, Feb. 2, March 3, April 4, May 5 – and we were like, “Okay, what’s going on? Why are those particular dates coming up?” We found out that the date of birth field was a required field on an insurance application that most people – like if they were applying for automobile insurance – didn’t feel the need to provide.

But the data entry clerks are being paid based on how many applications they can get in per hour, so when they came across a field that was required that didn’t have a value for, they just made a date up and they just basically picked their birth year, but used Jan. 1 or Feb. 2. So you had a bunch of bogus dates entered into the system. The data value was accurate. Jan. 1, 1970, is legitimately somebody’s birthday, but it’s not the birthday of the customer that was associated with the insurance transaction.

When developers write a new application for the input of some new data, it's normal for input fields to be 'validated' - a simple 'hard coded' form of profiling. ... Yet people have far fewer reservations about integrating data from here, there and everywhere - often not checking for even the most egregious data errors, and thereby polluting the organizational drinking water. Data profiling engines are a great technology for quickly improving the quality of data as it is integrated from one system into another.

In the long run, data profiling can be used both tactically and strategically. Tactically, it can serve as an integral part of data improvement programs. Strategically, it can help managers determine the appropriateness of different data source systems under consideration for deployment in a particular project.

http://www.itbusinessedge.com/cm/blogs/lawson/why-business-users-should-do-data-profiling/?cs=48413

Technorati Tags: privacy,data,data profiling,selling data,consumers,insurance,IT,HealthIT,forms,data entry

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FDA Approves Ellipse Technologies to Market Remote Control Leg Lengthening Device

This is not surgery to make your lets longer, that’s another topic and company but rather this is rather an orthopedic device to remotely control implants in your legs for bone lengthening.  If you want to read about surgery to be taller and all the pain and suffering and bone breaking, then check out the link below. 

Surgery to Become Taller – Cosmetic Limb Lengthening (CLL)

Spinal scoliosis in children is the first targeted market and that sounds like a very good place to begin.  The company is located in Irvine, California and the device already has the European CE mark of approval. 

“The pictures are pretty interesting though and it looks kind of sci-fi looking if you will or like a big hardware type of tool.  From the website below:

Our initial products are non-invasively adjustable implants used to restore proper anatomic position and alignment of the spine and long-bones. The key to Ellipse Technology is the non-invasive magnetic interaction between the implant and the External Remote Controller “ERC”, a portable, hand held unit that uses permanent rare earth magnets to automatically modify the length of the implant through the touch of a switch. The amount of lengthening or shortening of the MAGEC or PRECICE implant can be seen immediately on the ERC display module.”

This seems pretty wild as you use the device to automatically modify the length of the implant with a switch on the hand held unit and I can guess this is going to cost a few dollars too when available.  BD

Press Release:

IRVINE, Calif.--(BUSINESS WIRE)--Ellipse Technologies, Inc. (“Ellipse”) announced today that it has received FDA marketing clearance of the Company’s PRECICE^TM Limb Lengthening device in the United States. Limb Lengthening procedures are used to treat a number of medical conditions, including legs shortened due to congenital abnormalities, major fractures of one of the legs and shortened leg bones due to other medical diseases, such as cancer.

“Our remote control technology was a huge hit among attendees. The PRECICE System is easily recognized as a game-changer for patients suffering from limb deformities”

Ellipse has initiated clinical use of the PRECICE devices and plans an international product launch during the first half of 2012.

Commenting on the PRECICE technology, Stuart Green, M.D., Professor of Orthopedic Surgery, University of California, Irvine, said, “The PRECICE Technology will make it possible to use externally controllable implants for patients who require bone lengthening. In the future, this technology will likely be adapted to many other orthopedic applications.”

PRECICE^TM Remote Control Limb Lengthening System

The initial PRECICE devices will be used in leg limb lengthening procedures of the femur and tibia bones. Rather than using adjustable external fixation systems which are attached to the leg bone through long-term openings in the skin, the PRECICE REMOTE CONTROL TECHNOLOGY provides an internal implant adjusted to lengthen the leg bones via non-invasive methods from outside the body. Ellipse and its scientific advisors believe the PRECICE devices will not only provide a less-invasive approach to these procedures but also significantly reduce the potential for complications (e.g., infections) during the healing and recuperation period.

The PRECICE System was recently unveiled at the Limb Lengthening and Reconstruction Society (LLRS) Annual Meeting in Chicago. “Our remote control technology was a huge hit among attendees. The PRECICE System is easily recognized as a game-changer for patients suffering from limb deformities,” said Ed Roschak, Ellipse Chief Operating Officer.

Ellipse is continuing to develop the PRECICE technology for orthopedic fracture management and trauma applications.

MAGEC^TM Remote Control Spinal Deformity System

Ellipse has developed the MAGEC (MAGnetic Expansion Control) Technology for minimally invasive, and ultimately non-invasive, orthopedic deformity prevention and management. MAGEC Technology is a breakthrough medical device technology capable of non-invasively adjusting implants within the human body from outside the body via remote control. The adjustment of the device can also be reversed. The first application for this technology is for the treatment of spinal scoliosis in children.

With the MAGEC Technology, a single minimally invasive surgical procedure is completed. Then, during a series of routine outpatient visits, the physician will dynamically adjust the MAGEC Technology from outside the body via the MAGEC System’s External Remote Controller (“ERC”), thus eliminating the need for multiple highly invasive surgical procedures which are required with currently marketed, conventional products.

The MAGEC System is CE-Marked and Ellipse recently initiated a product launch at the International Meeting for Advanced Spine Therapies (IMAST) in Copenhagen, Denmark. Commenting on this launch, Mr. Roschak said, “The response to MAGEC from the international spine community at IMAST was profoundly positive. The vast majority of physicians told us the Ellipse breakthrough technology will be of great benefit to their patients with spinal deformity. Now, we can move forward with the international rollout of the MAGEC System.”

Ellipse Technologies, Inc. is a privately-held medical device company located in Irvine, California. The Company is focused on developing its implantable remote control technology platforms to include innovative and state-of-the-art treatments for a broad spectrum of spinal and orthopedic deformity applications, orthopedic trauma and fracture management.

The MAGEC^TM System is not currently available for distribution in U.S.

http://www.businesswire.com/news/home/20110823006435/en/Ellipse-Technologies-Announces-FDA-Clearance-Market-PRECICETM

Technorati Tags: MAGEC,Ellipse,FDA,orthopedic deformity,wireless,trauma,fractures,bones,medical devcies,rods,PRECISE

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