Practicing Rationale Medicine–Otis Brawley MD Keynote Address at the Association of Healthcare Journalists–Screenings, Treatments and More…

Dr. Otis Brawley, chief medical officer for the American Cancer Society spoke at the Association of Healthcare Journalists.  This is good thing and well worth listening to.  He explains tests, marketing and treatments especially with cancer as that is his field, an oncologist.  He says we need doctors who appreciate science and better informed patients.  He says people in the US may not always live longer but we sure do a great job of taking pictures (medical imaging).

He says we don’t get what we pay for.  The video is well worth watching as he brings in the pharma side of all of this and he attacks insurance companies as well.  He also talks about screenings that are not needed and some old laws on the books relative to treatment that maybe don’t need to be there. 

Otis Brawley, MD

How We Do Harm is the name of his book.  He also gives his opinion of the Warren Buffett prostate cancer screening and talks about expected life and age as a factor as to whether or not screening would be a good idea. 

As an encore here, another point of view but related on statistics and numbers, give it a listen and watch his video on the front page of this blog.  BD

“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

http://www.youtube.com/watch?v=LOdDS8rd4-8

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Allscripts CFO Resigns Along With A Few Other Key Individuals, Board Fires Chairman–1st Quarter Had Lower Sales And Net Earnings Down–Long Haul to Get Software Technologies Merged So They Work

The merger actually took place back in 2010 and both companies have a lot of EMR/EHR technologies.  Allscripts was already a bundle of merged technologies over the years.  So what does this say about the sales of electronic medical records, is it down all over or are folks buying other products?  All over the US IT expenditures are beginning to fall within and without Healthcare too.  How much can one afford to sell and use.

Allscripts and Eclipsys Merger Complete–New Name Allscripts

The company was even buddying up with Humana to give incentives for the purchase of their systems too.  Maybe that was it with getting too close to insurers?  I said a while back that would be the next collaboration and some insurers like UnitedHealthcare via owned subsidiaries already market 3 branded medical record systems.  The Allscripts deal used a company that had a big proud spot on their website with a Newt Gingrich endorsement to aggregate data:)

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

Back on track here it seems that most of folks that left were from the Eclipsys side of the table.  The CEO said delayed commitments were part of the reason for the drop, and that happens when doctors and hospitals are tight or running out of money.  Being I worked and integrated desktop software that was much simpler in nature a few years ago, this is becoming a big task and required tons of programmers to merge all of this.  Time will tell if the CEO stays in place and if their new dynamic “merged” program will fit the bill and oh yes, still be affordable as someone has to pay those programmers for this massive project:)   BD

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Electronic health record vendor Allscripts surprised Wall Street today by announcing that net earnings for the first quarter were down by half to $5.8 million on revenues of $364.7 million—a 9% increase. Allscripts’ stock fell 45% as a result. Chief executive officer Glen Tullman blamed the drop on “delayed commitments from them [clients] as they wait for us to introduce new releases and demonstrate more robust integration.”

The bigger surprise, however, was the firing of chairman Phil Pead, the resignation of CFO Bill Davis for another job, and the resignation of three board members who didn’t agree with the decision to terminate Pead. The now ex-chairman was CEO of Eclipsys, when it merged two years ago with Allscripts which wanted to gain entry into the hospital market.

Those who had adopted a wait-and-see attitude over the new product might decide to drop Allscripts altogether from consideration. Competitors, such as Cerner and Epic would also no doubt be ready to swoop in, and offer themselves as solid alternatives.

http://www.forbes.com/sites/zinamoukheiber/2012/04/26/with-allscripts-in-turmoil-ceo-glen-tullman-should-resign/?feed=rss_home

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Aetna First Quarter Results for 2012 Down 13% As Medical Claims Rise And Retail Marketing Efforts Continue With More Algorithm and Extensive Parameters Set for Qualification and Risk Assessments

So far the only one who’s profits in the major insurance business that keep rising are United as Blue Cross also experienced a drop in profits.  United has so many subsidiaries in their daisy chain that they get a cut of money it seems in almost every area today.  As a matter of fact it’s almost scary when you sit down and look at all the United subsidiaries as there are many and most have no clue and don’t even know they have a bank with a billion ore more on deposit.  Back with Aetna with what’s the news of late, they seem to be having some IT issues with client relations as well.  They did cut loose a number of doctors upcoming in Texas and yet in California sent out letters to patients stating doctors were no longer in network by error and had to fix that. 

Aetna States Letters Mailed to Thousands of California Customers Were A Mistake–Their Doctors Are Still In Network–”Rogue Algorithms and Flawed Data”–Attack of the Killer Algorithms Chapter 25

 

If you read often enough then you kind of know I dig a little deeper with looking at what’s in the news as far as the “data” side of how insurers operate.  Aetna has tried some different things to include selling their software at Best Buy and now in several states they are going to begin selling insurance at Costco.  Below is the post from a short while back relating to the situation in Texas and mind you Aetna is not broke, just earnings are down.   

Aetna Notifies 130 Texas Doctors That It Will Terminate Their Contracts on July 1 – E & M Codes Primary Levels 4 and 5 Billing Analytics For Peer Comparison Used To Substantiate the Decision – Video

Again today we have to be aware of all the massive amounts of data out there and frankly as a country we are trying to run our economy on algorithms and it’s kind of starting to bottom out a bit as we still need companies who “make” products and not just collect and sell consumers as products.  Maybe we are finally reaching that tipping point to where we need to step back and stop commoditizing humans as the algorithms and parameters are getting harder to meet as corporate USA keeps drilling them down.  BD 

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Aetna Inc.'s first-quarter profit fell 13 percent as expenses rose and the health insurer faced a tough comparison to year-ago earnings that included a one-time gain.

The Hartford, Conn., company's adjusted earnings missed Wall Street expectations, and its shares tumbled more than 7 percent in premarket trading.

The amount Aetna paid in medical claims, its largest expense, climbed more than 9 percent to $5.86 billion in the first quarter. An Aetna spokeswoman said the big jump was partially due to the relatively low total from last year's quarter.

http://insurancenewsnet.com/article.aspx?id=340001&type=lifehealth

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Watson Pharma Buys Swiss Company Actavis for Just Under $6 Billion

Generic Lipitor has been the big blockbuster that has helped Watson and Actavis is also a generic drug company, mainly in Europe and Watson is looking for a bigger footprint there.  Watson also has some of their own brand name products they market as well and they have partnered with Amgen with creating/marketing “biosimilar” drugs for cancer.  Actavis also has more employees than does Watson. 

One product though that has been a little controversial is the generic version of Yaz.  BD

Watson Pharma Gets FDA Approval for Generic Version of Contraceptive Yaz–A Drug That Has Suffered Recalls & Other Issues

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Watson Pharmaceuticals Inc. (WPI) agreed to acquire Swiss rival Actavis in a widely expected deal potentially valued at roughly EUR4.5 billion ($5.94 billion), which will give the U.S.-based group a boost in the global rankings of generic drug makers to No. 3.

Watson has received a bump from sales of no-name drugs like the generic version of Pfizer Inc.'s (PFE) blockbuster anticholesterol drug Lipitor. But like a lot of generic drug makers, Watson has been trying to diversify ahead of the anticipated dropoff in branded drug patent expirations over the next few years.

Actavis was taken private in 2007 by the private-equity firm Novator in a roughly $5 billion deal. Actavis then went on an acquisition spree, snapping up generic-drug companies all over the world and building a big debt load in the process. But that gave the company a strong presence in fast-growing emerging markets such as Eastern Europe, which could help explain Watson's interest in doing the deal.

http://online.wsj.com/article/BT-CO-20120425-723706.html

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Another Study that Shows Pay for Performance is Not Bringing About Better Patient Outcomes…Why Do They Keep Doing It? What’s CMS Going to Do?

The only company I hear talk about pay for performance all the time is United Healthcare and it certainly must help their profits.  Pay for performance has it’s place in sales but with steroid marketing of late and naïve consumers believing every report they hear, I think we are a little heavy on this incentive practice, especially in medicine.  What about all these incentives that need to be met?  I agree goals are good but when money get pinned on some of this, especially with the way Health IT is going how do you do this so it fair for all?


Pay For Performance Is Not All That It Has Cracked Up to Be-Time to Rethink As Money Is Not Creating Better Health Outcomes

Insurance companies jump in on this game too, make it tough for hospitals and that means they need to buy more analytics and UnitedHealthCare and Aetna are right at their door with subsidiaries to sell software to hospitals.  Is this not a little strange you think that the same companies that pay incentives have subsidiaries ready to jump in and get more money from the hospitals for more analytics?   Doctors also have reviews and sometimes they are told they have not met their admitting quotas.  Yes that has been said to MDs and heard it from a few doctors.  BD

Performance Reviews at the Hospital Means Pay for Performance for the Facility – Are the Quotas Being Met

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(Reuters) - A program to pay hospitals bonuses for hitting key performance measures, or dock them if they miss, failed to improve the health outcomes of patients, according to a large, long-term study.

The study could lead to a re-examination of financial incentives in healthcare, as policymakers seek ways to reward results rather than paying doctors and other providers for each service they provide, such as a diagnostic test.

Such an incentive program for hospitals is a key provision of the U.S. healthcare overhaul law that is being challenged this week before the Supreme Court.

The study looked at pay-for-performance incentives similar to those in the law and found no evidence that the program helped more patients live longer. It was published on Wednesday in the New England Journal of Medicine.

http://www.reuters.com/article/2012/03/28/us-usa-healthcare-compensation-idUSBRE82R1F720120328?feedType=RSS&feedName=healthNews&utm_source=dlvr.it&utm_medium=twitter&dlvrit=309303

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Sandbox VC Firm that Manages Blue Cross/Blue Shield VC Funds Is Moving to San Francisco–An Incubator for Some New Coders To Write Algorithms for Profit?

What else would you think?  Why would they not stay in Chicago?  When you see those orange tablets sitting in doctors offices, those are funded by the Blues Venture Capital arm.  Who would have ever thought health insurance companies would turn into VC.  Look what happened here as Wellpoint buys a company from their own Venture Capital company. 

WellPoint & Partners Buy Bloom Private Health Insurance Exchange From Their Own Venture Capital Company (Sandbox) –Subsidiary Watch

The only reason I see health insurance companies wanting an incubator is to make money and by the way Blue Cross was down a little the first quarter and membership too as United Healthcare seems to beating them over the head with their aggressive marketing efforts and in some states Blue Cross and United are at odds right now over government insurance administration contracts.  BD

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Sandbox Industries, with its internally focused startup incubator, is opening its doors in San Francisco.

The Chicago-based venture firm that manages an $18.8 million vintage 2008 seed fund will unveil on Tuesday plans for a West Coast “startup foundry” in the trendy South of Market neighborhood of the city.

http://www.pehub.com/146820/sandbox-industries-to-open-its-doors-and-an-incubator-in-san-francisco/?utm_source=dlvr.it&utm_medium=twitter&utm_campaign=sandbox-industries-to-open-its-doors-and-an-incubator-in-san-francisco

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Accretive Medical Collections and Analytics Cited by Minnesota by Attorney General For Collecting from Patients At Bedside and Worse–Employees on Pay for Performance Too? Killer Algorithms Chapter 28

Ok we all know collection folks put employees on pay for performance or they get a bonus but this went a little too far.  We already know they were in trouble for their past practice of showing actual patient records to investors on Wall Street and that was uncovered over due to a lost notebook.  This is where the Killer Algorithms come in to play as they sell hospitals on what kind of return they can have in revenue by using their services.  Business analytics on steroids violating humans ethics is what we have here. 

Accretive Health Debt Collector Employee Has Laptop Stolen With Non Encrypted Patient Data from 2 Hospitals And Had Access to All the Data Via Revenue Cycling - Patient Information Was Shared With Wall Street Investors – Algorithms For Profit Again?
 

Every time you think it can’t get worse, it does as people were getting turned away as they wanted money up front before treatment.  Doctors complained about it.  When you read the one employee’s comment about more money out there, well here speaks pay for performance.  There’s a time and place for incentives and this at bedside and harassing patients is not the place.  One employee sounded scared they would get fired too so it sounds like we had some negative threats here too.   

I keep telling all to look at the math and the formulas and you have the whole story and how far will some go.  These folks were brutal.  Last year we had these folks running some bad algorithms…wake up folks..algorithms have teeth and grade and rate you and sadly you treated badly if those numbers are low. We don’t’ have enough trained people that know “how” to work with analytics and employees sometimes think one little glitch on a screen is bad, well heck we have so many analytics running, everyone at least one glitch. Med Solutions shut their site down over their analytics activities when caught. 

Med Solutions and Blue Cross Caught On the Stress Test Denial Algorithm (video)

 

If you need some additional real life examples see the 20 some links I have compiled below with every day events with bad math and formulas that deny and create flawed data.  BD

Attack of the Killer Algorithms–Digest & Links for All Chapters–How Math and Crafty Formulas Today Running on Servers 24/7 Make Life Impacting Decisions About You–Updated 3-11-2012

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ST. PAUL, Minn.—An Illinois medical debt collection company routinely pressured patients in Minnesota hospitals to pay for services before treatment was given, going so far as to collect at a patient's bedside and in some cases leading patients to decide to skip treatment, according to a report from the Minnesota attorney general.

The allegations are detailed in a six-volume report released by Minnesota Attorney General Lori Swanson as part of a lawsuit she filed in January against Chicago-based Accretive Health Inc., which has contracts with two Minnesota hospital operations. The report accuses Accretive of misusing private patient information and creating "high-pressure, boiler room-style sales atmospheres" in which employees were coached to aggressively collect debt

http://www.boston.com/news/nation/articles/2012/04/25/minn_ag_cites_accretive_for_debt_tactics/

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Look No Further Than Wisconsin To See the Connection Between “Digital Illiterate Lawmakers” With New Law “No Web Cams During a Non Surgical Abortion Procedure” - This Says It All!

I talk a lot about digital illiteracy with many lawmakers, why?  Because it’s true and all you have to do is read the news.  It’s amazing that in the rapidly developing world of technology we have today that you still see these throw backs to the 70s.  They haven’t quite figured it out yet that technology in healthcare is here and is developing and changing rapidly.  Those of us in technology literally “laugh” at laws as such as we see right to the point here and scratch our heads as to “why” laws as such are created.  Even those who are not big techs scratch their heads too as web cams are like part of every part of life.  One wonders if these folks use smart phones too?  Outside the US when news of such is read I kind of wonder what other countries have to say about some of this too? 

We all know the governor is not too smart if you go back to the phone call to where a radio personality sucked him in to a “fake” call from one of the Koch brothers, which was really hysterical, but in another way very sad as that’s’ the level of intelligence sitting in that office, scary.  These folks that put so much effort into controlling abortions could really re-direct themselves to work on some very serious issues by all means. Back in 2011, about a year ago I wrote on this topic and it was bringing to the forefront how digital illiteracy was leading back to this “default” topic of abortions and as far as I can tell, it’s about all they can muster up to control and talk about as laws dealing with technology certainly seem to be over their heads.  So even a year ago the connection I made between digital literacy and lawmakers was pretty much on target. 

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

 

I just wonder if they even think about how they look to the rest of the world, and seriously it’s like a bunch of “loose cannons” running around and of course a “digital formatted law” would probably even be a bigger crime <grin>.

In a time when everyone else is looking at big data and have the ability to better sort large amounts of data, do you think lawmakers have thought this could be a good idea to help them?  So far I have not seen any evidence in that direction either, and on a federal level too.

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

So now we have a “no web cam” consultation law…when the rest of the world is moving forward with telehealth, I swear others looking in too have to just be rolling over laughing at such a law as it saves money and gives people better access to care.  I guess they don’t read the news and are not too concerned over better healthcare because this is related to that “default topic of abortions for the digitally illiterates”.  Last year a federal judge blocked abortion rules in Kansas, so I mean what is up with these out of touch folks as there’s yet another bunch of digital illiterates in lawmaking. 

Kansas Health Abortion Rules Blocked by Federal Judge Who Put The “Digital Illiterate Whack Job” Lawmakers” In Their Place And Maybe That is the 70s

 

In a round about way even the Vatican is getting tired of the digital illiterates in office even though they have their beliefs regarding abortions, they are not out trying create laws and they too see a need for better digital literacy, especially in the financial world, so again these folks in Wisconsin and their “web cam” law are really looking pathetic and the link below fell into one of my posts about “The Attack of the Killer Algorithms”, which basically again talks about digital illiteracy of lawmakers and how banks and big business control all with servers running 24/7 making life impacting decisions about all of us, and the lawmakers in Wisconsin can’t see this and continue this battle on abortions with huge amounts of time and money spent on this.  This is really sad that this is what is in office today.

“Attack of the Killer Algorithms” Part 3–Vatican Doesn’t Like It Either–Occupy Wall Street Belongs in New York As They Don’t Do Code or Algorithms in Washington–Only Find time To Talk Abortions

 

The time and money spent here even made it’s way to Washington and a couple months ago there was a hearing on women’s health and no women were invited.  I have respect for all their views but please keep it out of lawmaking and respect the views of others.  Again the latest on no web cams has more than just me looking at the severe digital literacy and mental capacities of those in office for sure as how in the world can this be controlled? 

How is one going to determine that an “illegal web cam” consult was done?  These folks just don’t get technology at all and are looking “dumber” all the time as I would rather have them jump on the band wagon and get up to speed with where many already are.  I took my link for the Komen foundation off my page and replaced it with Planned Parenthood when the analytics of where to best spend their money became a big political issue for the “digital illiterates” as they don’t realize how analytics are moving the money around, see the picture below at the post on how this intertwines too with the big even on Wall Street as some of philanthropy today has gotten out of touch too.  The analytic folks though are smart and know the digital illiterates can be manipulated and they do that, get their money where they want it and I wonder if corporate US sits back and somewhat laughs at the fact that they can manipulate the digital illiterate lawmakers too?  Komen also last year got a little out of bounds for suing other charities for the use of the word “Cure”, so what’s that tell you, big business and business intelligence analytics at work. 

Komen Foundation Cuts of Funds to Planned Parenthood - Wall Street Was Lit up in “Pink” Last Week For Fund Raising from Hedge Funds and Other Financial Companies

 

Poor Planned Parenthood is once again in the middle of this battle so again who’s going to monitor those dastardly web cams in the potential case that one might be doing a consult for an abortion?  Clearly they have no clue what this would entail with data trails and so forth…hysterically sad on on the levels of digital literacy.  In addition physicians can face felonies if violating the law.  The web cam phrase really takes the cake though and shows how far behind these lawmakers are and how they need to somehow attach themselves to “real” world out there as they are looking “dumb” and “dumber” every day when the need for “control” forces them into a box to where they think they can control “web cams” and how they are used, while the rest of the world moves forward. I don’t know how else to say this but these folks just look plain stupid and in my opinion are the “whack jobs” that somehow work on the emotions of the public when we all know the math and the algorithms are controlling who gets what today.   BD

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MILWAUKEE (Reuters) - Planned Parenthood of Wisconsin has suspended non-surgical abortions in response to a new state law that makes it harder for women to have the procedure, a move that followed anti-abortion measures in several Republican-controlled states.

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he law, which took effect on Friday, requires women visit a doctor at least three times before having a drug-induced abortion, forces physicians to determine whether women are being coerced into having an abortion and prohibits women and doctors from using web cams during the procedure.

http://news.yahoo.com/wisconsins-planned-parenthood-suspends-non-surgical-abortions-175324214.html

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