“Numbers Don’t Lie, But People Do”–Radio Interview from Charles Siefe–Journalists Take Note, He Addresses How Marketing And Bogus Statistics Are Sources of Problems That Mislead the Public & Government

*******There’s a ton of healthcare addressed here*****

In doing this blog I really have to evaluate what goes up here as with marketing and advertising on steroids today, I want to have good information and not someone just looking for a pitch, I get lots of those.  There’s a few other folks talking about this book too, like Scientific American.  Who coined the word “proofiness”, none other than Stephen Colbert; and and Jon Stewart are some very smart people.  I talk a lot about the math and how it gets used in healthcare and have made note of this book many times and today here’s a radio interview so you can hear more of it yourself.  The professor makes total sense and again if you read here often enough you hear me question some of the “marketing” analytics time and time again. 

You have to ask questions as there are “dirty” algorithms out there and how dirty they are varies.  Some are just stupid mistakes while others are very finely crafted to maximize profits and sometimes at the expense of those “who do not ask questions even when they know something is not right”.  Don’t be one of those as it never hurts to inquire.   Listen to the radio show from Charles Siefe and it’s in several formats as the radio station in New Zealand didn’t seem to be online at all times, so choose one and go for it.  Also, Google has a book preview here. 

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

Politicians, marketing gurus and even medical experts manipulate math to make even the most outrageous claims seem entirely plausible. In his book 'Proofinesss: The Dark Arts of Mathematical Deception' journalism professor Charles Seife reveals the many ways we are blinded by numbers.

Play Interview Via QuickTime                                Download: Ogg Vorbis MP3

Now if you have listened and tuned in think back to last year with Jon Steward and Steven Colbert, this was pretty much what this was all about as mathematical deception is creating disruption. 

Rally To Restore Sanity–A Big Success With Some Real Straight Talk About The Disruption and Distraction We Live With Today

The news media picks up numbers like they are the gospel truth and drive everyone nuts.  Not to fault the writers all the way around as they have this item called “ratings” to meet and thus news gets skewed and I think we saw a bit of that last week with Dr. Oz.  Now I like Dr. Oz, but again I’m smart enough to see the ratings games that are played as the news came out the next day how his show blew Anderson Cooper out of the water, and that was our media top stories, ratings.  Back in August of 2009, I made the post below so algorithmic formulas could be audited and validated for accuracy.

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

He addresses the credit card debt story and how distorted the news was in reporting the “non scientific” data and feels journalists should do more to correlate.  Scientists too are making big mistakes too.  The alcohol benefits discussion too is discussed well and how the crunching of numbers is impossible.  Below is one huge mis match that is nothing but full out marketing with relating a credit score to prescription adherence and I hope they are called on this one soon. 

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

If you look at data in the wrong way, your can prove just about anything you want says Professor Siefe.  The need to be seen and academics with medical research is lousy he continues with statistics.  He states the British Journal “Nature” is notorious for publishing more junk these days he continues.  I wrote about all the horrendous marketing in healthcare a while back that skews reality. 

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

He says it gets really dangerous with medical research with statistical games to get certain drugs on the market and nobody finds out how poor the drug is until it starts killing people. If you have not heard enough then read below on the dangers of machine learning when such stats become non questioned and they end up with machine learning technologies…..this is a huge danger is nobody questions the “dirty” algorithms and code. 

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

People take round numbers less seriously he continues as far as believing, however when numbers are spoken for a specific dollar amount, people think that the numbers are correct and marketers know this, and we see this in the press too.  So now you can move on to the next chapter here and see the danger of such statistics that may be wrong and not related, gets into the heart of machine learning like what WellPoint is doing.  By the way if you read here often enough there’s a few stories on how they have missed on their algorithms on a number of times and now they want to use machine learning for some of their data? 

How Algorithms Shape Our World

One last item that bothers me too is research and take a look at this post here on how formulas are being approached like a game with Heritage and there are gamers working at it and again how much of what Professor Siefe said will apply here? 

Will the Heritage results contain a lot of mixed numbers that a ton of coders are trying to relate?  I can almost tell you there will be some in there, not all, but some will exist, so we an wait and see if I hit the mark on that one as we seem to have forgotten how to treat research like science and think just any old coder will do to stretch the imagination to correlate.  Check back here and let’s see how I do with this one:)  So far I’m right on with the Department of Algorithms from August of 2009 and had quite a few agree with me on that one.  Again this method is less than impressive and will have unrelated items connected for sure as the $3 million dollar carrot endorsed by our former HHS Director is hanging out there and someone will connect to get the cash for sure and work every tiny angle to support the relevance when in truth it may not be there but they will fight to the end to support it for the money, not for saving lives. 

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…

He doesn’t say all studies are bad or that all news reported is bad but he says try to put things in context and see if studies stick out and go against the grain?  Are you being forced to change you view on the world based on the results of just one study.  I think Professor Siefe is going to have some questions for a lot of folks as he announced on Twitter this week that he intends to file suit against the NIH, relating to spinning numbers and again I don’t know any more than that but will keep you updated as I hear more.  BD

http://www.radionz.co.nz/national/programmes/afternoons/audio/2497824/numbers-don%27t-lie,-but-sometimes-people-do

Technorati Tags: Proofiness,algoirthms,mathmatics,12 step addictions,healthcare,desired results,rogue algorithm,Charles Seife,books,numbers,analytics,journalism

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Maggots Back in the News Again Helping Heal Diabetic Wounds in Hawaii

The doctors in Hawaii stated that that using maggots give the wound a jump start with healing.  Maggot debridement treatment is the actual name of the treatment.  The FDA approved the use of maggots a while back in 2004 for use with diabetics to help heal wounds.  These are maggots grown in a lab and not those found in the wild and they are encased in a something similar to a nylon so they stay put for a couple days.  There were even clinical trials in the UK at a children’s hospital that proved successful.

Maggot News – Clinical Trials, Wound Care and Surgical Theatre Closings in the UK

ZooBiotic now produces 600,000 maggots, and 1,500 dressings per month from its pharmaceutical production unit, supplying a client base of more than 4,000.

Is there a CPT Code for Maggots Yet?

In this report out of 37 all but 5 were helped and they even got rid of MRSA infections in 5 wounds that were resisting antibiotic treatment.  BD 

(Reuters Health) - Researchers from Hawaii have a suggestion for how to jump-start the healing of difficult diabetic wounds: let maggots do the work.
To allow such wounds to heal, doctors remove infected or dead tissue with scalpels or enzymes, a process they call debridement.

But these tools often fail, said Dr. Lawrence Eron from Kaiser Hospital and the University of Hawaii in Honolulu.
"These problem patients with diabetes really need better treatments in order to salvage their limbs," he told Reuters Health.
"Maggot debridement treatment is overwhelmingly effective," he added. "After just one treatment these wounds start looking better."

Eron's team treated 37 diabetics with maggots. The patients all suffered from a type of artery disease that causes poor circulation in the limbs, and they all had stubborn wounds -- some up to five years old.

Five wounds were infected with the antibiotic-mocking "superbug" MRSA, but they healed successfully with the maggot therapy. Nine wounds were infected with another bacterium called MSSA, and six of those healed up. All 10 cases with infection due to group B streptococci were successfully treated, Eron said.

Maggots secrete substances into the wounds that liquefy dead tissue and then they ingest the material to further degrade it in their gut. The wounds are cleaned, and other substances contained in the maggot secretions allow the development of granulation tissue, a type of connective tissue that forms during wound healing.

http://www.latimes.com/health/sns-rt-us-diabetes-woundstre78m6sd-20110923,0,1152119.story?track=rss&utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+latimes%2Ffeatures%2Fhealth+%28L.A.+Times+-+Health%29

Technorati Tags: Maggots,diabetes,Kaiser,Hawaii,healthcare,therapy,MRSA,wound care,hospitals,circulation,tissue

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24 Massachusetts Hospitals Facing Penalties for Exceeding Preventable Re-Admissions State Wide Average Parameters–As Calculated With Complex Algorithms

I think this is just the first of a ton of chapters on these types of stories as every where you look, re-admissions is in the news and how to keep this from happening.  Granted it is a good thing to draw attention and work on it by all means and there are all kinds of collaborated solutions but in this case many feel the software was faulty to a degree.  That can happen by all means. 

Last time I checked in on the $3 million dollar carrot here in California in search for the perfect algorithms to predict who would be re-admitted, the site looks more like it designed for gaming, so there’s one more area where instead of looking for guidance someone believes there is an ultimate formula that can be broadcasted and used al the definitive rule…wrong.   This one at Heritage has the blessing of former HHS director Leavitt too so maybe he thinks this is true too?

Data and analytics make us smarter and we gain a ton of knowledge, but the digital illiterates who have never written a stick of code seem the only ones who think there’s an ultimate formula for all of this.  The word is guidance and education and not a secret sauce formula.  I had to laugh when I heard a Senator ask Google the other day if they had cooked up some secret sauce, hilarious! 

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…

To continue on here, the Massachusetts Hospital Association was not very happy with it either and further went on to say the 3M PPR system was not appropriate and that the state’s own experts had already rejected it as the “secret sauce” and there were more items that go into the judging process other than the 3M algorithms.  One hospital was put on the list in error and I removed it and didn’t include on the list from the original article, so see how accurate they are.

This is what happens again when someone or a groups of folks who again have written a stick of code get blind sided and think some algorithms can give them the ultimate accurate results to judge other with, instead of being smart and using the results to encourage and educate and perhaps look for other areas to improve upon.  In the meantime though, keep selling those algos to those who think all have the “secret sauce” cooked in as there’s a ton of takers out there that need learn up and use statistics wisely and constructively.  Along with improved digital literacy we have this on the horizon too <grin>.  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

Twenty-four hospitals across the state are facing financial penalties because their so-called “potentially preventable readmissions rates,” are too high, according to MassHealth administrators.

The penalties, slated to take effect Oct. 1, are part of the new, 2012 rate contracts between the state and the 65 hospitals who care for MassHealth patients. Hospitals deemed by the state to have too many re-admitted patients will be hit with a 2.2 percent reduction in their standard payment amount per discharge, or SPAD.

Here’s the list (from the state) of hospitals facing the financial penalty:

–NASHOBA VALLEY MEDICAL CENTER
–NOBLE HOSPITAL
–MILTON MEDICAL CENTER
–MARLBOROUGH HOSPITAL
–NORTH ADAMS REGIONAL HOSPITAL
–HEYWOOD HOSPITAL
–ANNA JAQUES HOSPITAL
–STURDY MEMORIAL HOSPITAL
–QUINCY MEDICAL CENTER
–MORTON HOSPITAL INC
–ST ANNES HOSPITAL
–CARITAS NORWOOD HOSPITAL
–SAINT VINCENT HOSPITAL
–ST ELIZABETH HOSPITAL
–SOUTH SHORE HOSPITAL
–CARITAS GOOD SAMARITAN MEDICAL
–METROWEST MEDICAL CENTER
–BROCKTON_HOSPITAL
–CAMBRIDGE HEALTH ALLIANCE
–SOUTHCOAST TOBEY HOSPITAL
–TUFTS NEW ENGLAND MEDICAL
–BRIGHAM & WOMEN’S HOSPITAL
–BOSTON MEDICAL CENTER

http://commonhealth.wbur.org/2011/09/hospitals-face-financial-penalties-for-preventable-readmissions/

Technorati Tags: algorithms,fines,hospitals,heatlhcare,HealthIT,patients,doctors,healthcare,Massachusetts,formulas,re-admissions

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Humana to Acquire MD Care HMO in Southern California–HMO/IPA Purchases Continue With Insurers

There has been a lot of news of late with insurance carriers buying out IPAs and HIMOs in southern California and today we have one more.  Recently you had United Health buying up Monarch in Orange County and Blue Cross buying up CareMore for 2 giant purchases and both have very large memberships of both doctors and patients. 
You have to read through this press release though will the long “cautionary advisory” to investors/SEC information where they talk about a number of issues to include the lawsuit that is on going with the legal suit with United Healthcare challenging the awarding of the Tri-Care contract back to Humana.  If you have not kept up with that legal mess, check out the link below for a little history.  United was the new award, but problems were found so the contract went back to Humana.

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

That’s’ not the end of this though as in June of 2011 United filed case against the DOD for the Tri-Care contract because basically they feel they just want it and the money of course.

Update: UnitedHealthcare Sues Department of Defense Over Tri-Care Contracts–They Said They Would Do This – Is This A Case Of My Algorithms Are Better Than Yours?

So I assume this is why all the cautionary information for investors in case Humana loses the case and the multi million dollar military contract would go back to United.  Stay tuned on that one and there are a number of other smaller disclosures stated within the press release and I don’t know what the financial status of MD Care was at the time of purchase as some are profitable entities and some are either borderline or are operating in the red today.  BD 
Press Release:
LOUISVILLE, Ky.--(BUSINESS WIRE)--Humana Inc. (NYSE: HUM) announced today that it has signed an agreement to acquire MD Care, a California-based Medicare Advantage HMO with approximately 15,000 members in Southern California. Terms were not disclosed.
MD Care was founded in 2007 and offers Medicare beneficiaries a choice of plans with comprehensive and value-added alternatives to traditional Fee-for-Service Medicare, including Medicare Advantage medical plans; Medicare Advantage - prescription drug plans (include medical and drug coverage); and Medicare Advantage special needs plans. MD Care’s members reside in four Southern California counties: Los Angeles County, Orange County, San Bernardino County and Riverside County.
“As Humana continues growing its Medicare business in the western U.S., MD Care offers an opportunity to expand our Medicare footprint and the suite of products and services we offer in California,” said Thomas J. Liston, senior vice president of senior products for Humana. “As one of the nation’s leading Medicare companies, with more than 4.3 million Medicare members nationwide and more than 200,000 Medicare members in California, Humana is committed to continued growth in California.”
MD Care’s 2010 revenue was $155 million. The transaction is subject to both federal and state regulatory approvals and is expected to close in late 2011. Humana’s acquisition of MD Care is not expected to materially impact its financial earnings guidance for the year ending December 31, 2011.
About MD Care
MD Care has contracted with primary-care and specialty physicians, as well as hospitals and other medical providers who are some of the most respected in the communities they serve. At MD Care, doctors are encouraged to be involved in their patient-care decisions. MD Care offers Medicare beneficiaries a choice of plans with comprehensive and value-added alternatives to traditional Fee-for-Service Medicare. MD Care focuses on meeting members’ needs, from enrollment through the entire continuum of care.
MD Care’s medical-delivery model focuses on preventive care, health maintenance, and access to health services which are safe, evidence-based (supported by published medical evidence) and quality driven. MD Care’s mission is to serve the Medicare population with outstanding medical care, wellness programs, and superior member service.
For more information about MD Care, visit www.mdcarehealthplan.com.
Cautionary Statement
This news release includes forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. When used in investor presentations, press releases, Securities and Exchange Commission (SEC) filings, and in oral statements made by or with the approval of one of Humana’s executive officers, the words or phrases like “expects,” “anticipates,” “intends,” “likely will result,” “estimates,” “projects” or variations of such words and similar expressions are intended to identify such forward-looking statements. These forward-looking statements are not guarantees of future performance and are subject to risks, uncertainties, and assumptions, including, among other things, information set forth in the “Risk Factors” section of the company’s SEC filings, a summary of which includes but is not limited to the following:

• Health insurance reform legislation, including The Patient Protection and Affordable Care Act and The Health Care and Education Reconciliation Act of 2010, could have a material adverse effect on Humana’s results of operations, including restricting revenue, enrollment and premium growth in certain products and market segments, increasing the company's medical and administrative costs by, among other things, requiring a minimum benefit ratio, lowering the company’s Medicare payment rates and increasing the company’s expenses associated with a non-deductible federal premium tax; financial position, including the company's ability to maintain the value of its goodwill; and cash flows. In addition, if the new non-deductible federal premium tax is imposed as enacted, and if Humana is unable to adjust its business model to address this new tax, there can be no assurance that the non-deductible federal premium tax would not have a material adverse effect on the company’s results of operations, financial position, and cash flows.
• If Humana does not design and price its products properly and competitively, if the premiums Humana charges are insufficient to cover the cost of health care services delivered to its members, or if its estimates of benefit expenses are inadequate, Humana’s profitability could be materially adversely affected. Humana estimates the costs of its benefit expense payments, and designs and prices its products accordingly, using actuarial methods and assumptions based upon, among other relevant factors, claim payment patterns, medical cost inflation, and historical developments such as claim inventory levels and claim receipt patterns. These estimates, however, involve extensive judgment, and have considerable inherent variability that is extremely sensitive to payment patterns and medical cost trends.
• If Humana fails to effectively implement its operational and strategic initiatives, including its Medicare initiatives, the company’s business may be materially adversely affected, which is of particular importance given the concentration of the company’s revenues in the Medicare business.
• If Humana fails to properly maintain the integrity of its data, to strategically implement new information systems, or to protect Humana’s proprietary rights to its systems, the company’s business may be materially adversely affected.
• Humana is involved in various legal actions and governmental and internal investigations, including without limitation, an ongoing internal investigation related to certain aspects of its Florida subsidiary operations, the outcome of any of which could result in substantial monetary damages, penalties, fines or other sanctions. Increased litigation or regulatory action and any related negative publicity could increase the company’s cost of doing business.
• Humana’s business activities are subject to substantial government regulation and related audits for compliance, including, among others, existing audits regarding Medicare risk adjustment data. New laws or regulations, or changes in existing laws or regulations or their manner of application, including the methodology that may be used by the government in implementing results of risk adjustment audits, could increase the company’s cost of doing business and may adversely affect the company’s business, profitability and financial condition. In addition, as a government contractor, Humana is exposed to additional risks that may adversely affect the company’s business or the company’s willingness to participate in government health care programs.
• On February 25, 2011, the Department of Defense TRICARE Management Activity, or TMA, awarded the TRICARE South Region contract to Humana. On March 7, 2011, the competing bidder filed a protest of the award with the Government Accountability Office. Also on March 7, 2011, as provided in the Federal Acquisition Regulations, TMA issued a stop work order to Humana in connection with the award. On June 14, 2011, the GAO upheld the award of the contract to Humana and TMA subsequently lifted the stop work order. On June 21, 2011, the competing bidder filed a complaint in the United States Court of Federal Claims objecting to the award of the contract to Humana. That case is currently pending before the Court. As a result of the award of the TRICARE South Region contract to the company, Humana no longer expects a goodwill impairment to occur during the second half of 2011. Ultimate disposition of the contract award is, however, subject to the resolution of the complaint filed by the unsuccessful bidder.
• Any failure to manage administrative costs could hamper Humana’s profitability.
• Any failure by Humana to manage acquisitions and other significant transactions successfully may have a material adverse effect on its results of operations, financial position, and cash flows.
• If Humana fails to develop and maintain satisfactory relationships with the providers of care to its members, the company’s business may be adversely affected.
• Humana’s home-delivery pharmacy business is highly competitive and subjects it to regulations in addition to those the company faces with its core health benefits businesses.
• Changes in the prescription drug industry pricing benchmarks may adversely affect Humana’s financial performance.
• If Humana does not continue to earn and retain purchase discounts and volume rebates from pharmaceutical manufacturers at current levels, Humana’s gross margins may decline.
• Humana’s ability to obtain funds from its subsidiaries is restricted by state insurance regulations.
• Downgrades in Humana’s debt ratings, should they occur, may adversely affect its business, results of operations, and financial condition.
• Federal government contracts account for a substantial portion of Humana’s revenue and earnings. A delay by Congress in raising the federal government’s debt ceiling, should it occur, could lead to a reduction, suspension or cancellation of federal government spending that could, in turn, have a material adverse effect on Humana’s business and profitability.
• Changes in economic conditions could adversely affect Humana’s business and results of operations.
• The securities and credit markets may experience volatility and disruption, which may adversely affect Humana’s business.
• Given the current economic climate, Humana’s stock and the stock of other companies in the insurance industry may be increasingly subject to stock price and trading volume volatility.

In making forward-looking statements, Humana is not undertaking to address or update them in future filings or communications regarding its business or results. In light of these risks, uncertainties, and assumptions, the forward-looking events discussed herein may or may not occur. There also may be other risks that the company is unable to predict at this time. Any of these risks and uncertainties may cause actual results to differ materially from the results discussed in the forward-looking statements.
Humana advises investors to read the following documents as filed by the company with the SEC for further discussion both of the risks it faces and its historical performance:

• Form 10-K for the year ended December 31, 2010;
• Form 10-Qs for the quarters ended March 31, 2011 and June 30, 2011;
• Form 8-Ks filed during 2011.

About Humana
Humana Inc., headquartered in Louisville, Kentucky, is a leading health care company that offers a wide range of insurance products and health and wellness services that incorporate an integrated approach to lifelong well-being. By leveraging the strengths of its core businesses, Humana believes it can better explore opportunities for existing and emerging adjacencies in health care that can further enhance wellness opportunities for the millions of people across the nation with whom the company has relationships.
More information regarding Humana is available to investors via the Investor Relations page of the company’s web site at www.humana.com, including copies of:

• Annual reports to stockholders
• Securities and Exchange Commission filings
• Most recent investor conference presentations
• Quarterly earnings news releases
• Replays of most recent earnings release conference calls
• Calendar of events (including upcoming earnings conference call dates and times, as well as planned interaction with research analysts and institutional investors)
• Corporate Governance information

http://www.businesswire.com/news/home/20110923005117/en/Humana-Announces-Agreement-Acquire-MD-Care

Technorati Tags: Humana,TriCare,health insurance,Health Net,Pentagon,Tri-Care,United Healthcare,GAO,MD Care,mergers and acquisitions,patients,doctors

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Vista Private Equity Partners Buys Sage Healthcare Medical Records System for $30 Million From UK Software Conglomerate

Sage is located in the UK and has grown with the purchase of many acquisitions over the years to include the healthcare division with a north American operation providing a Certified medical records system that qualifies doctors for stimulus incentives. 

Vista Equity Partners has 3 locations in the US and already has a few managed healthcare companies in their portfolio.  Sage has been around selling medical records in the US for quite a while.  BD

Sept. 22 (Bloomberg) -- Vista Equity Partners, a private- equity firm focused on enterprise software and technology businesses, agreed to buy Sage Group Plc’s U.S. healthcare division.

The sale of Sage Software Healthcare, which offers practice management and electronic health-record offerings, is expected to be completed in November, the U.K. company said in a statement. Sage will make a loss of up to 70 million pounds ($108.4 million) through the sale and redistribute cash proceeds of $320 million to shareholders by buying back shares.

http://www.businessweek.com/news/2011-09-22/vista-equity-buys-sage-software-healthcare-for-320-million.html

Technorati Tags: mergers and acquistions,healthcare,Sage,software,medical records,EHR,Heatlh IT,Vista Equity,Private Equity

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Embryonic Stem Cell Treatment in Europe Begins to Improve, Halt or Reverse Blindness From Macular Dystrophy

The replacement retinal cells are from embryonic stem cells and we all know what controversy that creates but good the trial has the go ahead to pursue and see if eye sight can be improved and slow down and halt the disease.

ACT focuses on ophthalmology treatments in a couple other areas and has a couple other clinical trials in progress including one for dry eye.  BD

British surgeons are to take part in the first trial in patients of a human embryonic stem cell therapy to gain approval from regulators in Europe.

Surgeons at Moorfields Eye Hospital in London will inject cells into the eyes of 12 patients with an incurable eye disease called Stargardt's macular dystrophy, one of the main causes of blindness in young people.

The clinical trial, designed to investigate the safety and tolerance of the groundbreaking therapy, is due to begin in December having received approval from the UK's Medicines and Healthcare products Regulatory Agency on Thursday. It is the first trial in people of a stem cell therapy to receive the go ahead from regulators in any European country.

Medical teams hope to slow, halt or even reverse the effects of the disease by injecting healthy retinal cells into the eye. The trial is controversial because the replacement retinal cells – known as RPE, or retinal pigment epithelial cells – are derived from human embryonic stem cells.The Massachusetts-based company Advanced Cell Technology (ACT) announced the trial on Thursday. It will run alongside a similar study that began in July at the Jules Stein Eye Institute at the University of California, Los Angeles.

Technorati Tags: Clinical Trials,Europe,Eyesight,mascular Dystrophy,stem cells Inc,retina,Embryonic cells,eye,blindness,regenerative medicine,ACT

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Tunstall Healthcare Buys AMAC, American Medical Alert Company–Both Are Remote Monitoring Companies

Tunstall is also a member of the Continua Wireless Alliance and they are located in the UK with several locations around the world.  AMAC is a publicly traded compnay in the US sold on the NASDAQ exchange.  It looks like remote healthcare companies are going through consolidation like many others in healthcare.  AMAC has several wireless monitoring products they market to include the Intel Health Guide which I have written about here a couple of times.  BD

“Established in the UK in 1957, Tunstall Healthcare Group is the world's leading provider of telehealthcare solutions. Operating in more than 30 countries and employing over 1000 people, Tunstall supports 2.5m people around the world.”

“American Medical Alert Corp. (NASDAQ:AMAC) is a leading provider of remote health monitoring devices and 24/7 communication services to facilitate stronger, more positive relationships between patients, providers and payers. With our innovative dashboard of connectivity solutions, AMAC adds a new dimension to the healthcare landscape to enhance care, accelerate response time, improve operational effectiveness and help create a sustainable competitive advantage for your organization.”

LONG ISLAND CITY, N.Y.--(BUSINESS WIRE)--American Medical Alert Corp (Nasdaq: AMAC), a leading provider of remote health monitoring and 24/7 communication services that enhances care, accelerates response times, improves operational effectiveness and delivers sustainable patient services, has announced today that it has entered into a definitive agreement to be acquired by Tunstall Healthcare Group Limited, a leading telehealth and telecare provider. Tunstall will acquire all of the outstanding common shares of AMAC for $8.55 per share in cash without interest, representing a premium of approximately 50% over AMAC’s closing share price on September 22, 2011, plus one Contingent Payment Right (CPR) per share providing a contingent cash payment for the holder of such common share in the event of a sale of AMAC’s interests in the Lifecomm joint venture or prior sale of Tunstall under certain conditions. The transaction is expected to close at the end of the fourth quarter of 2011.

Based in New York, AMAC has two business divisions. The first is Health and Safety Monitoring Systems (HSMS) which includes a rich portfolio of remote patient monitoring devices and services including personal emergency response systems (PERS), mobile PERS, medication management and telehealth. The second division is Telephony Based Communication Services (TBCS), AMAC’s contact center services group, which provides concierge level communication services to all types of healthcare entities, including physician groups, hospitals, homecare and the pharmaceutical industry.

http://www.businesswire.com/news/home/20110922006855/en/Tunstall-Healthcare-Group-Limited-Acquire-AMAC-American

Technorati Tags: mergers and acquisitions,home monitoring,wireless,healthIT,seniors,telehealth,call centers,emergency alerts,hospitals,doctors,patients Tunstall,AMAC

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Next Data Seller Up to Bat–General Motors With OnStar, Changes Privacy Policy and Wants Permission to Sell Your Data

Are we not already sick of this.  We all know that drugs store chains are almost at the point of making more money by selling data any more for one.  Walgreens publicly admitted a few months ago that their “data selling” business was worth just under $800 million so perhaps that may be part of the reason here for more jumping in and gee we can’t even imagine the millions that Facebook makes off of selling data profiles as there are apps, games and so for the embedded in their platform all over the place. I think the secondary purpose of a drug store is to provide drugs in order to get that big profitable data to sell, but problem is we are out of balance and our economy can’t live on algorithms alone. 

Let’s make this a good rant while I’m at it and throw a few more items out here like Target that will scan your driver’s license if you want to buy a bottle of wine.  They have a pharmacy so we know they are selling prescription data already.  I’ll never buy another bottle there again and I will make my purchase from the small independent business man with a convenience store near me.  He needs it worse than Target does and he won’t scan my driver’s license. 

Are Target Stores Now Selling Data Too? California Store Scanned My Driver’s License When I Bought One Bottle of Wine–How Much Business in the US Is Living Off of Data and Algorithms, Partly Why We Have Job Issues

Now recently in the news they talked about cars checking your glucose levels and so forth maybe one day so is the plan to have OnStar be the collector of that data too?  You know we can’t stop all of this but there is a suggestion I have and it’s a good one.  Require a resellers license and make it a steep price.  Next require a public disclosure filing on the web updated as needed to all the the companies data is sold to.  Last but not least, put a heavy tax on it.  Let’s generate some money for the middle class who are now becoming the poor. 

Privacy Wanted–So Let’s Require Those Who Sell Web Data to Register and Tax the Transactions and Publicly Disclose Who They Sell To With a Federal Registry

Even HHS gets confused with some of this stuff with talking privacy and Facebook in the same sentence too and that’s what you get without executives at the top without a little bit of IT background today, they get confused.  How about riots as a disaster?  With recent events maybe someone might want to rethink this one out.

HHS Seems To Be Confused on Social Networks–Facebook for Disaster Support Contest, Give Me a Break

Here’s more good news on data selling…the country can’t base the economy on Algos only we need balance and to start producing more tangibles and jobs will appear that way too. 

"Banks plan to compete with Groupon and LivingSocial by targeting coupons and deals at credit card holders based on their shopping habits. They found a way to do it without violating financial privacy laws: 'They're "selling" shopping habits the same way Facebook "sells" personal data about its users: in-network. It's a clever privacy work-around. Just as Facebook allows advertisers to specifically target certain kinds of users based on their profile information (without actually providing that profile information to the advertisers), banks plan to allow advertisers to send deals and coupons to their customers based on what they've bought before. That way, no user data actually leaves the network — instead, deals just enter the network. Each time a customer cashes in on one of those deals, the bank gets a commission.'"

Let’s not forget these folks in the credit business too that are over selling their capabilities with mis-matched data…to pharma and insurance companies that take information from the web and combine it with your credit score and score you again to determine if you will be a patient who will take their meds. 

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

I know I have posted this a couple of times with the lecture from Stanford University on how data is collected, but this is a good place for it to appear once again with “you are the product”.  BD 

You are the product…

Now according to this article if you say it is ok, and cancel your OnStar contract they can still continue to collect data, so saying OK and cancelling later doesn’t stop the process either. 

If you sell your car, you are selling a vehicle that still collects data so you have to manually go through and disconnect it, just like you would a computer.  Again, time to get those resellers licenses going and start taxing these folks making millions as the middle class deserves a bit of the money too and the only way I can think of to get it is by taxing and licensing.  BD 

OnStar Corp., the General Motors communication service for drivers, may soon start selling customer data to other companies.

In emails sent to customers, OnStar detailed changes to its privacy statement that go into effect in December. Under the revised policy, the company may start collecting data from any vehicle equipped with an OnStar device and could share that information with credit card processors, law enforcement and others.

"We may share or sell anonymized data (including location, speed, and safety belt usage) with third parties for any purpose, which may prove useful for such things as research relating to public safety or traffic services," the privacy statement said.

"I canceled the OnStar subscription on my new GMC vehicle today after receiving an email from the company about their new terms and conditions," wrote scientist and blogger Jonathan Zdziarski in a post. "Anonymized GPS data? There's no such thing!"

http://latimesblogs.latimes.com/technology/2011/09/onstar-privacy-policy.html

Technorati Tags: security,privacy,advertising,license,data,browsers,algorithms,registry,government,internet,healthcare,Target,drivers license,wine,marketing,OnStar,GMail,General Motors

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HHS Sends Out $109 Million in Grants to Help States and DC Figure Out the Insurer Premium Rate Algorithms and Requests–Help With the Math & A Few Other Efforts

As the President said this week, it’s all about doing the math and when it comes to insurer rate increases, well that’s math and business intelligence algorithmic formulas are used by the carriers to go forward with their requests for rate hikes and by law anything over 10% needs to be approved.  Last year HHS told WellPoint to bring their algorithms for rate increases to Washington over the proposed increases in California. 

HHS to California Blue Cross – Bring Your Algorithms to Washington And Explain

Some carriers such as Blue Cross also uses behavioral analytics to work with wellness programs and where and who has access with some of those we don’t know at times and some like Red Brick are smack a bit of big brother with some of their devices and discounts given to employees who participate to save money. 

WellPoint enters wellness program partnership With Red Brick – Behavior Based Health Insurance

In some states though, some governments are “getting smart” and realize this is the “Algo Game” and are asking carriers for their formulas. 

New Jersey Legislature Getting Smart– Bill to Modify Claim Procedures to Include Asking For Insurance Company Algorithms-Bill A3334

I think we are going to see a lot of explaining here as transparency moves through and hopefully some of the grant money will help that along with deciphering the Algorithms used for calculations as they have been wrong.   We can hardly forget the AIG algorithms that were in fact pretty dirty and there will be more.  These algos helped create credit ratings…..and this goes back to 1987 and the process has been building since with too many trusting individuals on the consumer side being fleeced.  BD   

AIG: You Bring the Nerds and the Algorithms and I’ll give you a AAA Rating…a little history from 1987

WASHINGTON – The Department of Health and Human Services (HHS) granted $109 million Tuesday for states and the District of Columbia to fund reviews of health insurance rate hikes.

“We’re committed to fighting unreasonable premium increases and we know rate review works,” said Kathleen Sebelius, HHS secretary, in a statement. “States continue to have the primary responsibility for reviewing insurance rates and these grants give them more resources to hold insurance companies accountable.”

As of September 1, 2011, the Affordable Care Act requires health insurers seeking to increase their rates by 10 percent or more in the individual and small group market to submit their request to experts to determine whether the rates are unreasonable. The ACA also requires insurance companies to publicly justify unreasonable premium rate increases. The goal of these provisions is to bring greater transparency and accountability to the process.

HHS also released a new report Tuesday entitled "Rate Review Works," detailing how previous rate review grants are fighting premium hikes and helping make the health insurance marketplace more transparent.

Improve transparency and consumer interfaces: Twenty-eight states and the District of Columbia are proposing to use grant funds to improve consumer interfaces, such as developing a rate review home page at the Department of Insurance website and providing opportunities for consumers to comment on proposed rate hikes via the website.

http://healthcarefinancenews.com/news/hhs-grants-109m-help-keep-insurance-premium-hikes-reasonable

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Swedish Hospital System in Seattle To Implement Microsoft Amalga for a Unified Health Intelligence Solution

.Nobody really paid attention to Swedish Hospital System until they had this minor event back in January and I say minor because it was but when you read the news it went to an OMG status, problem with some of the news reporting today. 

Software Audit System Shuts Down Swedish Medical Center Medical Records for 4 Hours

Back on target the hospital uses Epic for their medical records so Amalga will be aggregating information from the medical records system for all types of reporting and access via dashboards as this is what Amalga does with many brands of medical record vendors.  Amalga has several different modules and working parts to include analytics for decision making processes to help with unnecessary hospital re-admissions. 

Microsoft Readmissions Manager For Amalga-Behavioral Analytics For Clinical Decision Processes (Video)

You may have heard all about the machine learning techniques of IBM Watson, well Microsoft is right up there too with bridging the gaps in healthcare where they can with machine learning as well.  BD 

Press Release:

SEATTLE and REDMOND, Wash. — Sept. 21, 2011 — Swedish, the largest health system in the Greater Seattle area, plans to implement Microsoft Amalga, a health intelligence platform, to improve care coordination across organizational boundaries and help manage population health as patients move among care settings. The adoption of Amalga is designed to strengthen the health system’s relationships with patients and providers across the community, help improve patient transitions and care quality, and position Swedish for growth in the era of accountable care.

“Healthcare reform requires health systems to do more with less,” said Swedish President and CEO Rod Hochman, M.D. “Amalga is a key technology enabler that will allow us to efficiently combine data stored in disparate IT systems across multiple facilities and use it to uncover opportunities to improve performance and the quality of patient care across the care continuum.”

Swedish also plans to use Amalga for population management, bringing together inpatient, outpatient and payer payment data to provide a unified view of a patient population to caregivers, allowing them to specify personalized or group care plans, track progress of cohorts over time, and report on outcomes via dashboards.

“We’re excited to collaborate with Swedish and demonstrate the power of connected data to build insight and transform healthcare,” said Peter Neupert, corporate vice president, Microsoft Health Solutions Group at Microsoft. “The ability to easily find and access health data across the enterprise is critical to enabling every participant in the health system to make timely and informed decisions and to continually improving the quality and efficiency of care.”

Amalga addresses a common and critical challenge of healthcare providers — integrating vast amounts of clinical, administrative and financial information that flows in and out of disparate information systems, and tailoring that information for use by physicians, analysts, laboratory technicians, nurses and administrators. Amalga takes advantage of health enterprises’ investments in existing health IT solutions, making it possible for the entire organization to gain quick access to data and turn that information into critical knowledge that facilitates better decision-making and improved patient outcomes.

Microsoft Amalga is used at other renowned healthcare institutions in the United States including New York-Presbyterian Hospital, Johns Hopkins Health System, Norton Healthcare, Providence Health & Services and St. Joseph Health System.

About Swedish

Swedish has grown over the last 101 years to become the largest, most comprehensive non-profit health provider in the Greater Seattle area with 8,500 employees, 3,000-physicians and 1,200-volunteers. It is comprised of four hospital campuses (First Hill, Cherry Hill, Ballard, Edmonds and Issaquah); freestanding emergency departments and ambulatory care centers in Redmond and Mill Creek; Swedish Visiting Nurse Services; and Swedish Medical Group – a network of more than 70 primary-care and specialty clinics located throughout the Greater Puget Sound area. Swedish opened a new emergency department and medical office building (MOB) on its Ballard campus in November 2010 and a new MOB and hospital in the Issaquah Highlands in July 2011. In addition to general medical and surgical care, Swedish is known as a regional referral center, providing specialized treatment in areas such as cardiovascular care, cancer care, neuroscience, orthopedics, high-risk obstetrics, pediatric specialties, organ transplantation and clinical research. For more information, visit www.swedish.org, www.swedishcares.org, www.facebook.com/swedishmedicalcenter or www.twitter.com/swedish.

About Microsoft in Health

Microsoft is committed to improving health around the world through software innovation. Over the past 14 years, Microsoft has steadily increased its investments in health, with a focus on addressing the challenges of health providers, health and social services organizations, payers, consumers, and life sciences companies worldwide. Microsoft closely collaborates with a broad ecosystem of partners and develops its own powerful health solutions, such as Amalga and HealthVault. Together, Microsoft and its industry partners are working to deliver health solutions for the way people aspire to work and live.

About Microsoft

Founded in 1975, Microsoft (Nasdaq “MSFT”) is the worldwide leader in software, services and solutions that help people and businesses realize their full potential

Technorati Tags: Microsoft,Amalga,Swedish Medical Center,medical records,Epic,back up,cloud,hospital,data,corruption,data base,Health IT

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Officials In Israel Blame Themselves for Allowing Private Care and the Selling Supplementary Insurance For Degrading Their Public Healthcare System

It’s always interesting to see what’s happening occasionally in other countries with healthcare and in this case there have bee months of doctors striking for better working conditions who work at government hospitals.  In addition, most of them moonlight with private care to make ends meet.  It sounds like they have the same ailment that we have in the US with insurance to a degree.

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

As I understand from reading the content here, the private practice money made ended up shorting what would have normally flowed to the government facilities and thus a short fall there.  The country has 4 HMOs and all are required to join one of the four and there’s always the option to pay for private care.  Some of the same doctors working in the government facilities have referred patients to their private practice or those of other doctors.  The government pays $59% of the cost for the citizens, the lowest compensation percentage for a country with socialized medicine.  BD 

JERUSALEM (JTA) -- Thousands of Israeli doctors spent the last four months engaged in a nationwide strike, using work stoppages, YouTube videos and a final hunger strike by disgruntled medical residents to protest their wages and working hours. Now that the doctors’ strike is over, Israelis are debating whether a raise in wages and shorter workdays can offset the deeper problems plaguing their country’s socialized health system.

Israel’s health system is “an old horse,” and the strikes exposed severe structural deficiencies in the health system, said Dov Chernichovsky, a professor of health policy and economics at Ben-Gurion University of the Negev. Chernichovsky also chairs the health policy program at the Taub Center for Social Policy Studies in Israel.

“We have an excellent system with a lot of good manpower, but we’re losing ground in its funding and organization,” he said. “It’s a system afflicted with narrow interests that undermine the public nature of the system.”

Most doctors remained at the public hospitals and HMOs, but many began moonlighting, seeing patients privately and scheduling procedures outside the confines of the public health system. In 1995, a health care reform law allowed HMOs to begin creating optional supplementary medical insurance that Israelis could purchase and which allowed them greater access to affordable private care.

“Everyone’s running to private medicine, especially since the strike,” said Yisrael Barel, a regional manager for HMO Leumit in Netanya. “The senior doctors don’t like to operate in the public system and push customers to do it privately. I recently called a friend, a top surgeon, to ask him to take care of a patient, and he said, ‘You expect me to do private medicine in a public hospital?’ ”

Guverman blames the situation on the Health Ministry’s acceptance 16 years ago of the legal provision allowing the HMOs to sell supplementary health insurance.

The country’s shift toward private medical care is “our fault, and it’s something that we failed to reorganize,” he said. “It’s created a significant impairment of the health care system, and I don’t see any immediate solutions for that.”

For now, it's clear that the strike raised questions and doctors are still demanding answers. The Health Ministry blames much of the crisis on their own acquiescence to the supplementary health insurance, which led to the growth of private medical care.

For critics like Chernichovsky, it's a question of leadership, and the solution involves finding a way to change the policy debate and direction of the health care system.

http://www.jta.org/news/article/2011/09/18/3089437/after-doctors-strike-israelis-take-stock-of-health-care-systems-woes

Technorati Tags: Israel,doctors,students,medical school,healthcare,conditions,residencies,Tel Aviv,HMOs,overseas,private care,health insurance

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Insurance Companies to Fund and Establish Non Profit Analytics Group to Research Anonymized Medical Claim Data In Search of Identifying Trends and Costing in Healthcare

This is actually a good idea as depending on what type of reporting one wants to gather you could analyze and find both good and bad results here and that’s the purpose of the project.  The fact that insurers and the public will not have access is a good thing as this is the stuff that basically they already have.  With pooling information in large sectors like this it may uncover some areas to where costing can be identified and problem areas as well.

We just don’t want it to be used like the old out of network Ingenix data base where it was accessible and rates were lowballed for payment, and it appears with the research restrictions this should not be be the case.  In addition, it should not be sold either to substantiate the research and the insurers have enough money for that and besides this could sneak into being classified as patient care with ratios for patient care, but time will tell if it ends up encroaching over on the medical loss ratios for being compliant. 

We might see a bigger costs in one side of the country for certain procedures than let’s say on the other side of the US for a real simple example.  Again, what we don’t want is for the research efforts to level out a low balled rate and then passed on to the rest of the providers as it just doesn’t quite work that way.  The fact that doctors and hospitals are not being identified is good also as we are just looking at straight claim data, no matter what doctor saw the patient or what hospital they were in.  The fact that numbers can be compared to Medicare is also good so a real comparison factor can be seen on large data sets.

Again as long as it stays in a non commercial use and not for sale, then we might get some very good input here and address some areas for improvement and again whatever numbers and reports are produced, it should open up for some solution discussions and not algorithms to score patients for their care.  BD 

Several major health insurers have agreed to provide their claims data on a regular basis to academic researchers, in an unusual agreement that they say will open a window onto the rising costs of health care.

Aetna, Humana, Kaiser Permanente and the UnitedHealth Group plan to supply information on more than five billion medical claims, representing more than $1 trillion in spending, to a newly created nonprofit group, the Health Care Cost Institute.

About $2.6 trillion is spent each year in the United States on health care, an amount that is expected to increase by about 80 percent in the next decade.

While Medicare has made its data available to researchers, with certain confidentiality restrictions like prohibiting identification of individual doctors, information from private insurers has been largely piecemeal.

“Our perspective is that the nation needs greater transparency about what is driving health care costs,” said Simon Stevens, an executive vice president for the UnitedHealth Group.

The insurers say they will not have access to the aggregated pool of private data and the data will not be accessible to the public. The new institute will provide claims information to qualified researchers seeking to analyze the data, and it will make public twice-a-year summaries that identify changes in health care prices and use of medical services. These summaries might examine specific areas like maternity care or orthopedic claims, according to Martin Gaynor, a health economist at Carnegie Mellon University who will be chairman of the new institute’s governing board.

One of the critical differences between Medicare and private health plans is the variation in price that the commercial insurers pay to different hospitals and doctors for the same medical services. While Medicare generally pays a fixed price, with some adjustments for where a hospital or doctor is located and the like, private insurers may pay very different rates, depending on the characteristics of the individual market and hospital or doctor. “There’s huge variation across geographic markets,” said Mark Duggan, an economist at the Wharton School at the University of Pennsylvania. “It does not line up with Medicare.”

http://www.nytimes.com/2011/09/20/health/policy/20health.html

Technorati Tags: reserach and development,insurance,health insurance,analytics,cost,doctors,hospitals,non profits,procedures,drugs,healthcare,HealthIT

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Thousands of Nurses To Strike on Thursday In California to Include Sutter, Kaiser Permanente, Berkeley Hospitals and More

Strikes from nurses in California seem to be taking place a bit more frequently although nurses are going on strike all over the US.  Back in March of this year in Southern California nurses held a one day strike in the Los Angels area wanting better working conditions. 

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

If that wasn’t big enough we all have read this week about the folks protesting on Wall Street but they were not the first as back in June of this year thousands of nurses also walked on Wall Street. 

Nurses Demonstrate on Wall Street Discussing Wages, Working Conditions - Addressing the Sad State of Healthcare Created by Financial Greed (Video)

To be more specific the nurses were calling for a half-cent tax on stock and bond sales and other financial transactions and is called "The Main Street Contract for the American People".  The nurses address that people are suffering but the news isn’t covering it and the loss of home nursing services that are disappearing all over the country due to budget cuts.

The Kaiser contract was settled but the union has asked for their “sympathy” support.  Sutter Healthcare seems to be the big healthcare system in focus as they are the most profitable and are seeking concessions from the nurses.  One of the controversial items is the elimination of sick leave and I do have to say that would be big in my book too if nurses are working sick and it would come down to patient safety issues there.  BD

Nurses from Berkeley hospitals will participate Thursday in a massive strike along with thousands of nurses across the state.

Nearly 23,000 nurses from the California Nurses Association — a sector of the nation’s largest nurses’ union, National Nurses United — are planning to walk off the job at Sutter Health affiliate hospitals and Kaiser Permanente hospitals across Central and Northern California, including two Alta Bates Summit Medical Center campuses in Berkeley, according to a press release from National Nurses United.

The strike addresses what the national union calls “200 sweeping demands for concessions,” and comes in the midst of contract negotiations between union nurses and Alta Bates administrators, according to Carolyn Kemp, director of public relations at Alta Bates. In a Monday press release from the national union, the union expressed concern over proposed cuts to workers’ healthcare coverage and the elimination of paid sick leave, which it said could force sick nurses to work and put patients at risk. Contract negotiations have been ongoing since May.

Nurses from the Children’s Hospital and Research Center in Oakland will also strike Thursday as a result of their own failed contract negotiations.

In addition, 17,000 Kaiser Permanente nurses — also members of the union — in Central and Northern California have been called upon by the union to join with National Union of Healthcare Workers in a sympathy strike against proposed cuts to National Union of Healthcare Workers’ healthcare and retirement benefits.

http://www.dailycal.org/2011/09/20/area-nurses-to-join-thousands-of-other-nurses-in-statwide-strike/

Technorati Tags: Wall Street,nurses healthcare,profits,economy,wages,retiremente,taxes,transactions,Sutter Health,Kaiser Permanente

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