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Healthcare Reform Omission of Public Option Having a Big Effect in California With Medicaid Budget Cuts And Things Just Not Working With The Passing of a Fragmented Law

When you stop and look back on how the reform law was created with the give and takes, every day you can see in the news that the omission of a public option would have truly completed the framework for the US law and now everyone blames the President, but how can you do that when you end up passing a law that was fragmented due to lobbyist efforts and as you can see things have changed a lot in 2 years.  Insurance companies have gone on huge buying sprees for Health IT companies to make money in those area outside of just selling premiums.  You see it all over today with Untied Health and Aetna and I call it “subsidiary watch”.  We have the GOP I guess to thank for this with continued digital illiteracy in their stands and just basically what we hear today coming out of their mouths with all the OMG stories in the press.  They still live in the old days and keep trying to force old methodologies our way and they just don’t work. 

Now back California, it’s already hard enough to find doctors who will see patients covered by Medicaid and this will make it worse with what the projected cuts are of 10% less reimbursement for doctors and co-pay and visit charges. 

Digital Illiteracy Still Plaguing Lawmakers With Not Using High Powered Technology to Model and Simulate Healthcare Laws–Ryan Hasn’t Figured Out He’s No White Hope Yet (Video)

With all the health insurer mergers and acquisitions we are entertained today by headlines about the folks in Health IT marching on Washington, for what, bigger insurer profits?  All of Health IT is not owned by insurers so at this blog I try to point those out who are not and can also offer good services, etc. without being owned by a corporate conglomerate and the key is to not any them get too big as that’s the insurers come knocking to buy them up. 

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

If we had approved a public option, things would have been different by now and there could have been some who can afford, paying premiums in but it didn’t work out that way and some folks couldn’t use high tech to model and project this and I kind of guess the White House knew some of this, but hands are tied.  It’s more important to see side shows about abortions these days rather than tackling the real issues out there. Things changed too over the last couple of years and lawmakers don’t get that and today you can’t hardly wonder through the world of healthcare without somewhere along the line dropping some money into the United Healthcare till as they are everywhere, imaging, medical records, banks, medical claims, wellness, behavioral analytics, HIE, and more with partnering with drug stores, the YMCA and more.  Even the VA, through acquisitions they made is in business with United so again they a drop in the till all over the place and some may be small contributions but they all add up for shareholder profits. 

We don’t even have judges that can figure this out as they get caught in their own conflicts of interest with not keeping up with acquisitions in healthcare and wit the amount of data and items to look at, each ruling is like another box of Forest Gump chocolate, we just don’t what we are going to get:)

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

You have Dr. Berwick over there at Medicare trying to do the right thing and he’s actually participating in Medicare personally himself now with his last birthday, but how’s he supposed to impact all of this?   He doesn’t have control over all this outside his area of Medicare. 

So again we are back to the missing public option that insurers thought was going to take all of their business and in hind their fears I think are pretty unfounded as if this keeps going the way it is and with bad economic conditions, why not have the President come in and do a Roosevelt and take them all over?  It’s been a while since something like this has occurred in the US but it’s not getting any better and laws are not keeping up with the hi-tech algorithms running the insurance business either, they just keep adjusting and bringing out new business models they can construct in as little as 48 hours. That’s one way to get your hands on new technology when companies are so corrupted that they can no longer serve the public interest.

If California doesn’t work, there goes the whole system and again, with a fragmented law passed that took out some of the very need cores, we have what’s out there today, a mess and insurers just making record profits and moving into more and more areas of healthcare with algorithms to control cost and sadly some of the care we get.  It may not be to late to consider a public option either but again if California falls, so goes the rest.  BD 

Reporting from Washington -- For more than a year, as conservative states have battled President Obama's sweeping healthcare law, California was supposed to be a model that showed the law's promise.
But the state is emerging as one of the biggest headaches for the White House in its bid to help states bring millions of Americans into the healthcare system starting in 2014.
Though still outpacing much of the nation, cash-strapped California is cutting its healthcare safety net more aggressively than almost any other state, despite billions of dollars in special aid from Washington.
And state leaders are pressing the Obama administration for permission to place some of the toughest limits in the nation on government-subsidized healthcare, including a cap on how often people with Medicaid — the healthcare program for the poorest Americans — can go to the doctor.
A decision on some of California's requests is expected this month. If approved, the limits could open the door to deep cutbacks nationwide.

California already spends less per beneficiary than any state. It is now seeking waivers from the federal government to impose copays of $5 for office visits and prescriptions, $50 for emergency room visits and $100 for hospital stays. Few other states come close to charging Medicaid recipients that much.
Cost sharing in Medicaid is tightly restricted under federal law because it can discourage people from seeking needed care. A family of three at the federal poverty line makes just $356 a week.
The state plans to limit Medicaid beneficiaries to seven doctor visits a year, with exceptions for essential care. No state has imposed such stringent limits.

Many doctors have already closed their doors to Medicaid patients. Other providers are following suit. In June, Sharp Coronado Hospital in San Diego County stopped taking new patients at its facility providing long-term life support.
"I'm afraid no one is going to take these people," said Chief Executive Marcia Hall.

"We want to honor the flexibility that the states need and want," said Dr. Donald Berwick, who heads the federal Medicaid and Medicare programs. "But beneficiaries are also having a tough time, and we want make sure their interests and access are being protected."

http://www.latimes.com/business/la-na-california-healthcare-20110915,0,1214204.story?track=rss&dlvrit=52116

Rite-Aid and OptumHealth (Subsidiary of UnitedHealthcare) Offering Face to Face Virtual Clinic Consults with Optum Doctors and Nurses Inside Stores in Michigan–Cost $45.00

The service is provided via American Well, which has been around for quite a while and their efforts were first used in connection with Blue Cross in Hawaii a couple imageyears ago.  When using the service you get to see an OptumHealth (UnitedHealth care) doctor or nurse for your consultation.  There’s a disclaimer on the Rite-Aid page that states they are “independent providers”.  The nurses and doctors will also be able to refill prescriptions and give out educational information, along with of course grabbing that data and adding it to a data base somewhere in the data bases maintained by the company.  It’s not all a bad thing for care, but as we know prescription data is sold on the market like crazy so you get this at any pharmacy any more as a consumer.  I don’t know what value it holds for Rite-Aid but Walgreens said their data selling business is worth just under $800 million, lot of money.  Prescription costs are not included in the visit and are separate. 

The website says during the promotion period with getting started you get a nurse consult for free and the doctor charge is $45 for a 10 minute visit, so when you log on, clock’s running so be prepared as you can pay more if the visit takes more time. 

Now Clinic

You will need to submit your own claims as that part is not connected but I can guess it kicks out the summary you need to submit your claims and have your credit card ready to pay or an ATM card.  BD

“Services provided via NowClinic online care are not submitted by NowClinic or the provider to your health coverage plan, Medicare, or any state Medicaid program for reimbursement or any other third-party payor. When you use NowClinic online care, you are responsible for all fees for services provided.

CAMP HILL, Pa., Sep 15, 2011 (BUSINESS WIRE) -- --Rite Aid and OptumHealth First to Provide "Virtual" Clinics in a Retail Pharmacy Setting

Rite Aid and OptumHealth are bringing the latest in quality, convenient online health care to Rite Aid customers in the greater Detroit area with the introduction of NowClinic(SM) Online Care services, now available inside select Rite Aid pharmacies. NowClinic offers Rite Aid customers real-time access to convenient medical care, information and resources from doctors and OptumHealth nurses. Rite Aid and OptumHealth are the first to provide a virtual clinic in a retail pharmacy setting.

Through private, face-to-face consultations using the Internet, Rite Aid customers can see and speak directly to doctors who are able to discuss symptoms, provide guidance, diagnose and prescribe certain medications when appropriate. Customers can also interact with OptumHealth nurses, who are able to address a range of health care needs such as basic health care education, information on common acute issues and assistance in identifying appropriate provider options for care. A customer record is automatically captured at the end of each interaction and is available for immediate sharing with a customer's primary care provider, maintaining continuity of care.

image

Customers can also access NowClinic Online Care 24/7 by visiting www.myNowClinic.com/RiteAid , which is especially convenient when customers are not able to visit a doctor's office or for when offices or their local Rite Aid are not open. Currently, conversations with nurses are complementary and a 10-minute consultation with a doctor is $45.

http://www.marketwatch.com/story/rite-aid-and-optumhealth-introduce-nowclinicsm-online-care-services-in-detroit-2011-09-15

Eel Removed From Man’s Bladder–Entered Via His Penis While He Was At A Beauty Spa for an Exotic Dry Skin Treatment With Fish

Ok if you have not seen this on the web already today, here it is and this happened in China where the spa let’s the eels nibble away at your dry skin.  Next time wear underwear is what I would say, a nice pair of speedos would keep the eels away.  The surgery took 3 hours and to remove from the 56 year old man’s bladder.

It didn’t live though, it died in the bladder, no air.  The eel being a slippery character allowed it to swim right up through the man’s penis.  I guess from the story the man tried to stop it when it was about half way in, but again was too slippery and it got away from him.  BD 

Zhang Nan was bathing with live eels to cleanse his skiimagen when one rogue serpent took a liking to his manhood.

Foreign object: The dead eel is placed next to the surgical tool used to remove it from Zhang Nan's bladder (Picture: CEN)

The eel treatment in question is a similar concept to the popular London spas that offer fish pedicures.

Thinking that the eels would make him look ten years younger, Nan dived into the water and let them feast upon layers of dead skin.

But after laying in the spa bath, Nan felt a sharp pain and realized a small eel was working its way up his urethra and into his bladder

http://www.metro.co.uk/weird/875317-eel-removed-from-mans-bladder-after-entering-penis-during-beauty-spa

Dr Oz and the FDA Differ on Apple Juice Arsenic Content–Show Ratings Did Not Disappoint

Whatever!  Has anyone died from this yet?  I don’t think so and again the news said it buried Anderson Cooper today in ratings.  I like his show and he’s very good at entertaining and bringing good news to light and also I might venture to say that ratings are very much in here to keep the show up at the top.  He’s done a little bit of everything including talking to the dead:)  Last week he gave one of our Los Angeles Newscasters a stress test so he must never rest.  The FDA does describe the difference between natural arsenic and that which is poison and says it is safe, stay tuned as I’m sure there will be more on this one.  BD 

LA-ABC News Anchor Gets a Stress Test from Dr. Oz–And As the Show Moves to Channel 7

Apple Juice Arsenic
Apple Juice

WEDNESDAY – SEPTEMBER 14, 2011  Dr. Oz Investigative report on arsenic in apple juice reveals high levels in the juice you drink. Aging too fast on the inside. The 6 super foods to slow aging and prevent disease. Marjorie Johnson puts Dr. Oz's super foods to the test.

http://calgary.ctv.ca/servlet/an/local/CTVNews/20110914/fda-apple-juice-oz-110914/20110914/?hub=CalgaryHome

Joint Commission Grades Prime HealthCare Hospitals at Top Performers-Cadillac ER Rooms

If you read in the news, the hospital chain has had their other issues outside of the JACO standards in California in the last couple of years. I live and drive by one in Huntington Beach and the parking lot usually has no more than about a half a dozen cars in the lot, unlike how it used to be before the acquisition.  On the other side of the coin if Prime has not bought it, the hospital may not have been there today.  Kaiser and Prime went around and around on billing too for a number of years for patients seen out of network for balance due billing, but I guess JACO focuses only on the facility and patient care itself.  It’s kind of strange that way as you don’t maybe get the full picture from all aspects. 

Prime Healthcare Billing Processes Under Question as 25% of Medicare Patients are Showing Malnutrition- Profit Algorithms?

Prime Healthcare Under Investigation for High Infection Rates in California in Four Hospitals

Perhaps if I had these above issues along with a lawsuit from the state of California I too would probably want to focus on something done right.  As I understand they are beginning to negotiate with insurance carriers which was something they did not do for a number of years and thus the ER room hospitals were created.  No doubt though it would not be as easy to meet the same standards for a big busier facility though.  BD

ONTARIO, Calif., Sept. 14, 2011 /PRNewswire/ -- The Joint Commission on Wednesday Recognized Nine Hospitals Either Owned or Operated by Prime Healthcare Services as Top National Performers on Key Quality Measures

Out of more than 3,000 hospitals across the country, these hospitals – Garden Grove Hospital Medical Center, Huntington Beach Hospital, La Palma Intercommunity Hospital, Paradise Valley Medical Center, San Dimas Community Hospital, Shasta Regional Medical Center, West Anaheim Medical Center, Encino Hospital Medical Center and Montclair Hospital Medical Center – were recognized based on data reported about evidence-based clinical processes that are shown to improve care for certain conditions, including heart attack, heart failure, pneumonia, surgical care and children's asthma.

"Today the public expects transparency in the reporting of performance at the hospitals where they receive care, and the Joint Commission is shining a light on the top-performing hospitals that have achieved excellence on a number of vital measures of quality of care," said Mark R. Chassin, M.D., FACP, M.P.P., M.P.H., president, The Joint Commission.

http://ca.finance.yahoo.com/news/Prime-Healthcare-Services-prnews-1285618136.html

Machine Learning Software Working Behind the Scenes Should Move With Caution in Healthcare-Writing the Unreadable With Rogue Algorithms With No Human Intervention

We are hearing more and more about the use of machine learning and this week we have WellPoint banking their bucks on reducing costs with it’s use.  The computing power is phenomenal and if you are not already aware, there are other industries that are using machine learning too.  You will get more benefits by a landslide; however a lot of this is brand new territory and we have seen some oddities that have occurred, one being called a Flash Crash and we all know that one.  You imagehave some algorithms that are programmed to hide and others that are programmed to go find them. 

The Quiet Rise of Machine Learning-Like IBM Watson Offers With Speed and Learned Analytics-Congress Needs Technology This To Make Better Laws & Collaborate

The reason for caution is that there are going to be some odd happenings with data here and there and thus the awareness to question if something does not appear to be correct.  We have so many digital illiterates today that don’t do that and never question and other people who are at the end of their decision process get hurt or fleeced.  Again, the data being input has a huge impact as well as the old saying of garbage in and garbage out has not changed and I don’t that part will ever change but we are getting better.  Microsoft has a tool kit for writing “machine learning” applications too so everyone’s into it and it works of course with the cloud. 

Microsoft Research Launches Free Tool Kit to Assist Big-Data Scientists-More Ways to Use the Azure Cloud With Large Scale Data Sets And Algorithms For Analytics

Wait until le load up those ICD10 codes in there to decipher imagewhether or not that bite on the patient was from an Orca or a McCaw.  There’s a ton of processing power with IBMWatson 70 servers…as I said lawmakers could really make good use of this and they need it more than Wellpoint but you do have to pay for it and lawmakers could behave like real humans again and collaborate if everyone starts with the same numbers. 

WellPoint Hiring IBM Watson Technologies–Congress Needs to Wrap Their Heads Around Using Technology That Processes 200 Million Pages of Info in 3 Seconds to Make Laws

This is a great presentation by Kevin Slavin who tells us about the affects of algorithms in the world today and worth a listen.  3 years ago when I put the word center stage on my blog, it was for a reason to educate and bring the word and it’s meaning into every day use in healthcare.  I had people telling me I was nuts and nobody’s going to get that,…hmmm, but where are we today and yes we are writing the “unreadable” as we have known it for years with software development.  You have to love his example of 2 algorithms on Amazon that with no human intervention but just reacting with each other, ran the price of a book for sale up to $12 million, just out bidding each other and stuck in motionThis is why I say caution with healthcare and to question something that may not look right as we will need to live with those infrequent algo mashes that go bonkers, like a Flash Crash with those algos.  The video is below but use the link for even more information I included on the original post, lots of it there.

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

Kevin Slavin–Algorithms

Now how monumental and important is this, well if you have seen the latest Ipad commercial, there’s Kevin Slavin’s talk right at the beginning focused.  Check it out below.  Truth of the matter is we don’t have the luxury any more to say “I don’t do math”, not my doing just bringing around the awareness. 

IPAD Commercial

And speaking of books, I’ll note this one as a must read again as I have so many times on this blog…maybe I’ll get royalties <grin>, just kidding there.  I have folks on Twitter telling me they are reading now, folks in healthcare.  Deceptive, mismatched data and algorithms created for marketing versus actual accuracy lurk out there today sadly and we are actually seeing some of them become unraveled as people ask questions, “show us your code. “ 

This is absolutely huge in the financial side of things right now with FINRA and the SEC asking high frequency traders for their code. In the High Frequency World of trading the battle of hardware is just about coming to a close, in other words there’s not a lot more they can do to make servers go faster, so the next move, are more “creative machine learning algorithms” for the coders to write and believe me, they are on this already. 

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

Back on target, yes IBM Watson will give us some huge abilities to sort and analyze data quickly, but we will need to be aware of those rogue algos as they will pop up here and there and there and we’ll study them just the quants do on Wall Street that pull those algos out of the exchanges to do the same thing.  It is critical too in healthcare as we are now talking a human life and thus the words of caution to ask if something looks strange and don’t let your common sense get buried with results on the screen if they don’t look right.  Here’s some other folks with some predictive machine learning to market. 

An Algorithm Can Predict Cardiac Arrest 24 Hours Before it Happens With “Machine Learning Technologies”

With involving the intricate and confusing coding of healthcare and if and when this develops beyond just guidelines and individuals and doctors are “required” to use this information, we could very well be in the “land of no return” when it would come back to tracing a claim and how the diagnosis and CPT payment codes are entered.  Some of course, the obvious would be there, but  what if? 

What if those algorithms with claims numbers, diagnosis numbers, and other related information went haywire…would one end up with a medical bill that got inflated just like the example in the TED video of $12 million for the book on sale at Amazon?

Could happen but we don’t know yet so again and awareness and the fact that there will be issued to live with when machine learning becomes larger in healthcare just as it is in the financial market and we can get some Quants in there to work on them, just just like Wall Street does.

We can start naming our own healthcare algorithms, like theICD shuffler, the surgeon’s knife or maybe CPT Chaos”, and so on <grin>. 

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"

The algorithms have teeth with contemporary math.  So again, let the doctors test and try and test again and from the consumer side, guidelines only and don’t tie in in pay for performance by all means with the use of machine learning or it will be abused and mis interpreted for profit.  BD 

IBM demonstrated how doctors can use its Watson supercomputer to diagnose and treat patients at the National Press Club on Tuesday.

Dr. Herbert Chase, a professor of clinical medicine at Columbia University, entered a hypothetical patient's symptoms, and Watson was able to correctly diagnose the patient with Lyme disease.

Watson even suggested a drug to treat the condition. Dr. Chase then told the computer the patient was pregnant and allergic to penicillin. This new information led Watson to change its suggestion to a more appropriate drug.

Pfizer Sales Department To Employ Software as a Service Contract for More Analytics Use to Up Production–Gonna Learn Math

Who is not using some kind of analytics today.  I was tweeting earlier that I had 4 press releases today talking about their second to none, outstanding, cost effective imageand cost effective solutions.  They all sound the same to me anymore, and maybe that’s because a few years back I used to write that kind of stuff, so all in nature and what they do are very similar.  Pharma reps will now be able to be equipped with that stats that they need to drive home how many patients are suffering from the conditions that the drug they are selling will fix or treat.  I might have to change the name of this blog soon to correspond with the news that comes out to the Analytical Quack:)

Boy I really do have to say that so many press releases anymore are such “cookie cutters” and those 5 or 6 templates used really make the round today.  The company with the software slates themselves as the leading provider of “sales enablement solutions”…wait a minute you mean you can sell unless you have software that can “enable” you <grin>.  I also spent 25 years in sales with Fortune 500 companies so a little bit of my sarcasm here as I remember well how the big corporate machines work very well, one area down in revenue, it gets a focus, you sell deals and benefits (used to be pens and lunches) and somehow in a coupe months that area of the company is back on line.  Pfizer has been tablet friendly with their reps for years and has a ton of resources and services already used by their employees to include SharePoint for all and so now they have one more tool to “enable” sales.  BD

Callidus Software Inc. (NASDAQ: CALD), the leader in Sales Performance Management (SPM), announced today that Pfizer Inc, the world's largest research-based biopharmaceutical company, has selected the iCentera Sales Enablement SaaS platform to drive the effectiveness of its sales team in the U.S., including internal sales, contract sales, and channel partners. The agreement was signed in the third quarter of 2011.

"At Pfizer, we need to effectively drive a targeted, relevant value proposition across a large portfolio of products," said Jeffrey LiPira, Director, Team Leader Sales Operations, Pfizer. "With the iCentera Sales Enablement solution, we can deliver targeted product information in real-time across our broad-based, distributed sales network and increase our sales force productivity through more knowledgeable sales people."

http://r.einnews.com/dH7ks+

Thief Steals Woman’s Diamond-Captured by Police and Sent to Have X-Ray & Was Found in the Stomach

With modern day technology, swallowing something you stole just doesn’t work anymore.  This happened in Spain and lucky that one officer notices the motions of the man putting his hand up to his mouth.  Now the fun part, recovery of the jewelry.  BD  image

A thief in Spain who stole a diamond from a British woman -- and then swallowed it -- was caught when police stopped him at a checkpoint and forced him to undergo an X-ray.

The theft occurred when two British women entered a restaurant in the luxury southern resort of Marbella and one of them left her handbag on the floor by her chair, police said in a statement.

"Two well-dressed men came in, one sitting at the bar and the other next to the woman," it said.

"This gesture and the fact that they had found the pendant without the diamond made the police think he may have swallowed it.

"To find the stone, those arrested were taken to a medical center where they underwent X-rays, and the diamond was located inside the stomach of one of them, who admitted swallowing it."

http://news.yahoo.com/thief-swallowed-diamond-caught-x-ray-114841934.html

Ohio Valley Hospitals Currently Millions In Debt to Pay $3.8 Million to Settle Fraud Allegations for Billing False Claims to Medicare and Medicaid

In reading the article it also states that the government is actually going to pursue imagethe physicians as well, simply due to the nature of the fraudulent billing.  In addition the former CEO of the Ohio Valley hospital was sued for draining endowment funds and hid information from the board while also making illegal payments to the doctors so it sounds like he was right in all of this.  BD 

Ohio Valley Medical Center, East Ohio Regional Hospital and the parent corporation of both will pay $3.8 million to settle allegations of health care fraud, U.S. Attorney William Ihlenfeld said Monday.

The deal ends an investigation into allegations that the hospitals submitted false claims to Medicaid and Medicare from January 2005 to August 2010. Both hospitals are owned by Ohio Valley Health Education & Services Corporation. OVMC is in Wheeling, and East Ohio is in Martins Ferry, Ohio.

Ihlenfeld said the penalty is severe because the compensation agreements the hospitals had with local physicians were improper under federal law and involved significant amounts of money.

Together, the two Ohio Valley hospitals have 340 beds and more than 1,800 employees.

The company also said it will work with the U.S. Attorney and the Office of Inspector General in the U.S. Department of Health and Human Services on a compliance program that ensures the hospitals exceed federal guidelines and expectations.

The administration has publicly said it's tens of millions of dollars in debt.

http://www.businessweek.com/ap/financialnews/D9PN5LBO1.htm

American Academy of Pediatrics Steps in to Correct False Statements Made During GOP Debate that Stated HPV Vaccine Causes Mental Retardation

Well let’s not put any politicians in charge of healthcare issues is what I say.  imageWhether or not the vaccine is deemed safe is another issue if one wants to dispute the Academy and there are all kinds of discussions and opinions, but it does not cause mental retardation.  BD 

The American Academy of Pediatrics would like to correct false statements made in the Republican presidential campaign that HPV vaccine is dangerous and can cause mental retardation. There is absolutely no scientific validity to this statement. Since the vaccine has been introduced, more than 35 million doses have been administered, and it has an excellent safety record.

The American Academy of Pediatrics, the Centers for Disease Control and Prevention, and the American Academy of Family Physicians all recommend that girls receive HPV vaccine around age 11 or 12. That's because this is the age at which the vaccine produces the best immune response in the body, and because it's important to protect girls well before the onset of sexual activity. In the U.S., about 6 million people, including teens, become infected with HPV each year, and 4,000 women die from cervical cancer. This is a life-saving vaccine that can protect girls from cervical cancer.

http://www.npr.org/blogs/health/2011/09/13/140445104/pediatricians-fact-check-bachmanns-bashing-of-hpv-vaccine

Former FDA Chemist Charged by SEC With Insider Trading, Case Gets Another Charge of Child Pornography Against His Son Who Was a Co-conspirator

I guess the son didn’t think twice about combining inside trading efforts and child pornography on the same computer as that’s when it was found by authorities who confiscated his MAC.  Child pornography doesn’t mix with any kind of business for sure, so as the article states he will also have to register as a sex offender if proven guilty.  BD 

SEC Files Lawsuit Against FDA Chemist for Insider Trading Violations

Liang was charged today in federal court in Maryland with one count of possessing child pornography. The government asked that Liang forfeit a MacBook laptop computer seized at his Gaithersburg, Maryland home during raids by the Federal Bureau of Investigation in March and April.

Prosecutors charged the Liangs in March with conspiracy, wire fraud and securities fraud. The maximum penalty for the fraud charges is 20 years in prison.

The insider-trading case has been postponed because “the parties are near resolution of this matter,” David Salem, assistant U.S. attorney, said in an Aug. 29 filing.

http://www.businessweek.com/news/2011-09-13/fda-insider-trading-defendant-charged-with-child-pornography.html

New ICD-10 Codes Get Very Specific–Was the Patient Bitten by an Orca or a Macaw–What’s the Big Rush for All of This (Video)

You have to love this video and the conversations between the 2 and anybody in medical billing will certainly jump on this one for sure.  I liked it and thought this is really good for the general public to know.  When I was writing my medical records program I had to import all these updates to the current system all the time, each quarter codes are added and codes are deleted.  When doctors create their super bills, this means change if any of them affect the most commonly used codes. Shoot years ago I had a doctor hit the ceiling when all the diabetes codes were expanded and this was 5-6 years ago.

140,000 codes will be there for the physician to choose from.  There are some that are insulting like “bizarre personal appearance” and gee what a code huh?  Let’s see what CPT code would unite with this one?  You can go all over the place with that one.  Granted new technologies needed to be added but listen up and hear about the 3 codes for walking into a lamppost too.  This is hilarious.  Heck what if the patient doesn’t know if they were bit by a turtle or tortoise?  Water skis on fire is yet one other great code!  October 1st on 2013 is the transition date and there’s a lot of companies just ready to cash in here for the big bucks.  India is ready to help us with our IT misery on this one.

Healthcare's ICD-10 Project Deadlines Could be a Jackpot for India’s IT Companies

There are also a lot of US companies who have produced the software to translate between the old and the new, again cha ching ching in Health IT expenditures and how long before that bubble bursts one day?  In addition there’s a lot of talk requesting that the process be delayed and Dr. Halamka up at Harvard has been one who has voiced his opinion on this simply due to the fact that it is too much on the plate for healthcare CIOs today.  You can read more about his recent interview on ICD10s and the over stressed CIOs of healthcare below and I have touching and blogging about that here on several posts for the last year myself. 

Dr. Halamka Speaks About Health IT–“CIOs are on Overload” and It Would be A Blessing to Stall Off ICD-10 to 2016 - The Straw Breaking the Camel’s Back

That is very true and the folks who make and set these timelines are usually those without any real “hands on” experience in this area and just project. 

Should ICD-10 Implementation Be Delayed With A SnoMed Adoption Focus Come First?

This has a snowball effect with rolling over to the public CIOs who have said they know more about health IT now than they ever expected to learn and absorb, not to mention be responsible for implementation.  WellPoint plans on having machine learning do some of this for you with IBMWatson technologies it seems with some machine learning techniques soon with maybe just jumping in a plucking those new codes out…time will tell how that will work:)  I used to work in logistics and the harmonized tariff for customs is not anywhere near this level, and that is from business that is highly automated too by comparison.  BD 

Healthcare Reform Putting Additional Pressure on Public and Medicaid CIOs-The Health IT Bubble Gets Closer As Money And Digital Literacy is Scarce

http://online.wsj.com/video/new-medical-billing-system-provides-precision/52CE9481-CE69-4F50-BA15-9DA789751728.html

Hoag Hospital Using daVinci Robot for Gynecologic Surgery Procedures

According to their website the hospital is using the latest version of the robot which includes dual consoles and 3D vision for the surgeons.  This is the first mention I have heard of the robot for women’s healthcare surgeries as we all know it has been used extensively for prostate and heart surgeries.  Now all we need is like Johns Hopkins has done with the $150 Kinect, hook it up and create some “no go” safety zones:)  Kinect might end up being daVinci ’s best one friend one day. 

Kinect And daVinci Surgical Robot Do Simulated Surgery imageSuturing Together (Video)

Back in January the University of Washington was working on this hack and now we have a video from Johns Hopkins where they have simulated a surgical procedure using gestures.  As the article states this is in the early stage here, but it’s been done and seems to be working pretty well during play time here.  BD

As the highest volume provider of robotic surgery in Orange County, and the first multidisciplinary program of its kind in Southern California, Hoag’s Gynecologic Robotic Surgery Program provides a patient-centered, integrated team approach to gynecologic surgical care using evidence-based medicine, progressive technology and innovative treatment options.

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At Hoag, robotic-assisted surgery is performed utilizing one of four state-of-the-art da Vinci® Surgical Systems. Each robotic unit consists of an ergonomically designed surgeon’s console, a patient-side cart with four interactive robotic arms, a high-performance vision system and proprietary EndoWrist® Instruments. Powered by state-of-the-art robotic technology, the surgeon’s hand movements are scaled, filtered and seamlessly translated into precise movements controlled exclusively by the surgeon. And in the case of the dual console da Vinci® Si HD Surgical System, two surgeons can work together simultaneously to perform highly complex minimally invasive surgery.

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Hoag is the first hospital in Southern California to acquire the newest robotic surgical device – the dual console da Vinci® Si HD Surgical System – and utilizes four state-of-the-art da Vinci® robots as part of its comprehensive robotic surgery program.

Conditions that may be appropriate for treatment with robotic surgery include:

Walgreens Sued for Firing 18 Year Loyal Employee Who Ate A Bag of Chips During Diabetic Attack

This is not good and the employee had worked for the company for 18 years and one has to wonder if this is a way of weeding out employees with chronic healthcare conditions as it costs them more to insure such employees?  This is pretty bad that if you are a diabetic and having an attack that you can’t reach for a bag of chips to keep yourself from going into a diabetic coma or something along imagethat line.  We hear of such tales and my own mother in her 80s has had some issues with Walgreens.

She’s also a diabetic and has been for years and takes her blood sugar twice a day.  Well the pharmacist at Walgreens came along when it was time to refill her prescription one time and said that she was all wrong that she needed to do this 3 times a day.  The bottom line of this whole store is that she even checked with her insurers who said twice a day was fine and so did her doctor, but the pharmacists at Walgreens was almost relentless.  What’s the deal?  Mom didn’t want to have extra strips around going to waste and was doing the right thing, but perhaps Walgreens was more concerned about the sale numbers here?  Turns out they could not do the auto refill for a number that equates out to 2 times a day and were forcing the 3x a day number.  After a lot of hassle, even with her insurer calling and saying the smaller number was ok, they finally begged off.  You can read more about it at the link below.

Compliance Police Out In Force for Seniors–Health Plans and Drug Stores Making Phone Calls-Business Models & Caller Behavior Sucks -A Result of Pay for Performance Efforts?

At any rate this is pretty cold if all the facts line up correctly and the fact that 18 years of service go down the tube over trying to perhaps save costs on insurance benefits, which is what it is starting to look like.  It was probably some policy that she violated while having her attack as not paying for the chips first or something along that line as that’s what companies do today with legal interpretations and splitting fine hairs and making bad guys out of people with health conditions.  As  a side note, the company says it’s data selling business is worth just under $800 million so are we in to drugs or data?  BD   

The sacking of a Walgreens cashier who ate a $1.39 bag of chips during a diabetic attack in 2008 and paid for them later has drawn a lawsuit from the U.S. Equal Employment Opportunity Commission.

Josefina Hernandez of San Francisco had a clean record in nearly 18 years of service to the drugstore giant. Her supervisors knew she had diabetes, a disease that calls for careful monitoring and regulation of blood sugar levels.

“I almost always carry a piece of candy in my pocket for situations when I feel my blood sugar getting low, but I didn’t have anything on me this time,” Hernandez said in a statement on the EEOC website. “I knew I needed to do something quickly, so I reached for a bag of chips and paid for them as soon as I could. I worked for Walgreens with no problems almost two decades, so I am very upset to lose my job over this.”

http://abcnews.go.com/blogs/health/2011/09/12/walgreens-sued-for-firing-hungry-diabetic/

WellPoint Hiring IBM Watson Technologies–Congress Needs to Wrap Their Heads Around Using Technology That Processes 200 Million Pages of Info in 3 Seconds to Make Laws

Who does not think that processing 200 million pages of information in 3 seconds is not useful for making laws?  With using speech recognition even the lowest common denominator with tech skills in Congress can query and participate so every body gets covered. 

Yes if you read here often enough you will find a few of my posts that reflect thatimage sentiment and while it is nice to have super powered computing in healthcare, laws and budgets come first as the rest of healthcare comes after the money is allotted.  Here’s a couple examples below as I said this from day one. When companies such as Wellpoint can use such advanced 70 server technology with machine learning for healthcare, laws stand no chance as predictive modeling along with machine learning speed up the process and finding a loophole in any law becomes a much quicker task.  It’s been going on for years and it’s how the new algorithmic business models companies use work.  Look at this picture and I’m no fan of Goldman Sachs but it says it all, putting groves of paper in front of him to dig through…what a waste of time and effort when we have faster technologies available today. 

The Quiet Rise of Machine Learning-Like IBM Watson Offers With Speed and Learned Analytics-Congress Needs Technology This To Make Better Laws & Collaborate

IBM Watson Capabilities Being Pitched to Financial Industry-Congress Must Not Have Felt They Needed This So Further Behind We Fall With Effective Intelligent Lawmaking
IBM Watson Did Get a Chance to Go To Congress-Should be a Permanent Home For Greater Intelligence for Creating Laws

This technology and the time it takes to run queries when connected to the internet is phenomenal and time saving but we have some in DC that I think are still trying to pull rabbits out of hats and have not come to the understanding of how over loaded everyone is with information today and you need a system that can sort, predict unintentional consequences and create a model for laws.  This week on Tuesday there’s a presentation in Washington relative to the future in healthcare and I hope it’s on the research side and not all just for revenue cycling speed with Watson:)

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If you watch the video, the computing system is not connected to the internet, but can you imagine if it was?  It’s almost wasted not being connected to query the web.

IBM Watson

What I found interesting too was listening to the number of hours that one spent reading the words so the system would sound human and we have Nuance involved here with adding speech recognition technologies as well. 

Again, healthcare is nice as long as it’s not a revenue cycle focus only as we have enough of that out there today, but to use to create a smarter Congress and better lawmakers to me, is where such technologies would really help as again we need budgets and money to pay for all of it, no matter which way you shake it and having the speed of all the processor cores, would speed things up in Washington and add some real value for accuracy.

Back on target, oncologists said they would like to it out to see if it does in fact go through all the healthcare information available and come up with suitable treatment plans but are also fearful of the cost items being added that would skew actual better treatment plans and care.  Blue Cross/Wellpoint of course is in this for the money with reducing costs so I guess time will tell whether or not the algorithms prove useful in the course of everyday medicine. 

Watson can digest and process 200 million pages of content in less than 3 seconds, so again we have the “content” being processed as a real element of the success, being credible content. 

Imagine what that could do for lawmakers!  I rest my case. 

Watson, the "Jeopardy!"-playing computer system, is getting a job.

WellPoint Inc. and International Business Machines Corp. are set to announce a deal on Monday for the health insurer to use the Watson technology, the first time the high-profile project will result in a commercial application.

http://online.wsj.com/article/SB10001424053111903532804576564600781798420.html?mod=rss_whats_news_us&utm_source=feedburner&utm_medium=feed&utm_campaign=Feed:+wsj/xml/rss/3_7011+%28WSJ.com:+What%27s+News+US%29&utm_content=Google+Reader&_nocache=1315792334665&mg=com-wsj#articleTabs%3Darticle

Cochlear Ear Recalls Latest Range of Implants Due to Unexplained Failures

This is kind of sad with this recall as many who wear them depend on the units.  In addition the Cochlear technology is also being used to test for balance disorders with new implant procedures at the University of Washington. 

Ear Implant Device Using Technology from Cochlear Implants imageBeing Tested for Balance Disorder–First Patient Receives Implant

Hopefully this will pass over soon and those who have already been implanted with the device don’t have to worry about the recall as it’s for those who have not been implanted yet.  Last year another company in California also had a recall of implanted hear devices. 

HiRes 90K Cochlear Ear Implant Recalled By Advanced Bionics To Address Safety Concerns With FDA

There is one other company I am aware of, Esteem who received FDA approval last year for their implanted product and so far no recalls there but the approval from the FDA just came in March of 2010. BD
MELBOURNE—Cochlear Ltd., the world's biggest maker of bionic ears, on Monday recalled its latest range of hearing implants after a recent unexplained increase in failures.
Cochlear shares plunged as much as 27% after Chief Executive Chris Roberts said the company has stopped manufacture of the Nucleus CI500 range, which in the 2011 fiscal year made up 70% of the company's sales of implant units.
Analysts said the recall could lead to prolonged market share gains for Cochlear's competitors such as the Austria-based Med-El. Cochlear has about 65% of the global hearing implant market.
"Reliability is very important," Mr. Roberts told analysts on a conference call. "If there's some things happening that we don't understand, we're far, far better to stop and understand it...rather than just battle ahead and hope it all works out."
http://online.wsj.com/article/SB10001424053111904265504576565540894094816.html

Doctors in India Go on Strike To Demand Better Security at Hospitals

Talks are scheduled to resume but in some instances, surgeries had to be rescheduled or postponed.  As I read here this involves government hospitals for the most part and with recent incidents in the news the doctors probably have very good reason to want better security.  I’m sure some of these sentiments could be shared by doctors in the US too as we seem to be seeing more incidents happening imageat our hospitals here in the US as well.  Doctors do need to be able to feel secure when treating patients for sure no matter where you are.  The NHS over the last number of years has also been busy recruiting doctors from India as well so does this leave the country short handed? 

India is not the only area where doctors are protesting as in July doctors were also protesting and striking in Israel with wanting better working conditions and signed petitions to wanting better working conditions. 

Medical Students and Doctors Protest in Israel Demanding Improvements in the Healthcare System

Back in 2009 doctors went on strike in India after being attacked by family members in some hospitals so it sounds like security issues still need attention with this recent strike.

Doctors attacked in India Hospital – Threatened to Go On Strike after violent attack by Patient family Members

Also worth a note is that if access is not available, many have had to rely on the unreliable services offered by roadside street doctors who may or may not be of help as they may suggest herbs and other types of home remedies when in fact that’s not what a patient needs when critically ill. 

Roadside Street Doctors Are A Thriving Business in India

Nobody loses greater than the patient having access but again it appears to be the point that this is the last resort on getting attention so action can be taken to provide secure environments for doctors to practice in India.  BD 

Mumbai: Medical services in Maharashtra were severely hit on Saturday as over 3,000 resident doctors in government hospitals across the state went on an indefinite strike to press for enhanced security at hospitals, even as talks with authorities proved unsuccessful, doctors said.
Patients at various hospitals were hard pressed to find a doctor. Department heads at various hospitals said that more than 50 percent of their scheduled surgeries had to be postponed.

"We had two meetings today - one with the Mumbai's Municipal Commissioner Subodh Kumar and the other with the director of DMER (Directorate of Medical Education and Research) Dr P.S. Shingare. While the municipal commissioner has agreed to most of our demands, Shingare has asked for some time to look into the matter," said Pankaj Nalawade of Maharashtra Association of Resident Doctors (MARD) from KEM Hospital.
Nalawade said three government hospitals in Mumbai that come under the municipal corporation have major security issues. He also identified 11 government hospitals across the state which do not have adequate security for doctors.

"We have scheduled a meeting with Shingare Sunday and are awaiting a positive outcome. Till then, we continue to strike work," Nalawade said.

Around 400 doctors from Nagpur's government hospitals also joined Saturday's strike. "Manhandling and assault of doctors should stop. Authorities have to see to it that doctors are provided with proper security," said Bhausaheb Munde of MARD, Nagpur.
This is the ninth such incident this year, Nalawade said, while reiterating MARD's demand for better CCTV surveillance and security in hospitals. "We keep voicing our concerns but they fall on deaf ears."

http://www.ndtv.com/article/india/doctors-strike-hits-maharashtra-talks-fail-132805