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California Sends 2,643 Families the Wrong Medi-Cal Cards–Flawed Data and Algorithm - Attack of the Killer Algorithms Chapter 51

 

Sometimes I go a few weeks without an update but just did one yesterday and here’s another today.  You can read the article below andimage see there’s a hot line set up for those who received the wrong cards.  With so many entities in data systems today this is happening more frequently so thus here was the case of “flawed data” that was caught after the fact.  It could be worse if it had not been caught.  Software, in the words of Bills Gates is nothing more than a bunch of algorithms working together and thus these algorithms has some flawed data inside when running their missions. 

I started the series over a year ago and this as you can see is Chapter 51 as mistakes and mismatched data costs people job opportunities and credit score errors as well.  The credit scoring goes way deeper than that though with agencies that combine credible data with non credible data and then score consumers with information they mine from the web that could be total fiction.  Something needs to be done about that and all who sell data should be licensed and should pay quarterly excise taxes.  Companies makes billion and billions each year selling data.  Some companies that could expand manufacturing have opened up factories oversees and their expansion in the US has been to mine and sell data, which does nothing for US jobs.  Also a lot of the data they sell is becoming flawed and as consumers we have to fix all the corporate errors on our dime.

Attack of the Killer Algorithms! Digest & Links for All Chapters–Read About Math and Crafty Formulas Running on Servers 24/7 Making Life Impacting Decisions About You– Updated


Here was Chapter 50 and see how the algorithms made a decision to up a consumer’s health insurance premium by $100 a month.

Woman Moves 10 Miles in California, Blue Cross Raises Premiums From $418 a Month to $524–Quantified “Crap Algorithm” For Geographic Risk, Killer Algorithms Chapter 50 That Sustain Inequality In The US


Here’s another another post which I guess could have been part of the Killer Algorithm series to where the Academy of Family Practice Physicians found the United Healthcare algorithms calculating and paying doctors in some parts of the country less than Medicare. 

The AAFP Confronts United Healthcare On Reimbursements, Some Are Below Medicare Rates In Parts of the US–Payment Algorithms/Formulas Calculated Deep Within IT Infrastructures Do the Job


What is also amazing though too is the speed at which some folks think all of this comes together today is pretty simple, it’s not as more data has to connect from various silos to make a complete record or transaction and if that information comes from outside your silo and there’s errors, well like a snowball it rolls downhill and that data with flaws will do the same thing with every other data base it gets queried with.  The fun part of all of this though doesn’t really begin until the errors are fixed. 

By that time the data more than likely has been probably used by many sources and the tentacles could be many.  When the data queries roll out and like in this example, they are running 100 miles and hour but when you have to back up, try going back to the speed of around 10 miles per hour.  It’s just like a car when you talk about forward and backward speeds.  You can’t have same speed going backwards as you do forwards and all the errors have to be fixed. 

Systems are so complex today as we built them that way as companies competed to have an “edge” and in the financial markets, that’s still going on to the point of one quant suggested that they could use drones on the Atlantic ocean to get the signals faster on stock markets between the US and the UK, imagine that, not.  I’m not holding my breath when it comes to insurance exchanges either as so much data grew in the last 2 years and insurers are setting up their own exchanges as well…question is..how will they work and will the government be able to set up as they were originally designed.  Many states handed it over to the feds as the exchanges require negotiating with insurers and nobody looks forward to their complexities either.  I think the old cherry picking days for profit are drawing to a close and when you have to insure a big population in the US, might as dump a bunch of them as they no longer will or should apply.  BD 


A computer programming error is being blamed for a mass mailing mixup — California's Department of Health Care Services (DHCS) reported Saturday that 2,643 Medi-Cal benefits identification cards were sent to the wrong families. 

According to a news release, the BIC cards were meant for some of the children making the Jan. 1 transition from the Healthy Families Program to Medi-Cal.

Families sent cards by mistake will receive a self-addressed stamped envelope to mail them back. Additionally, a helpline has been set up at 1-855-297-5064, Monday through Friday, between the hours of 8 a.m. and 5 p.m.

http://www.scpr.org/blogs/news/2012/12/22/11696/2643-medi-cal-benefits-cards-accidentally-mailed-w/

Dr. Oz Visits Stanford University Medical–Discussing Radial Artery Access, The Wrist And Not The Leg

I first wrote about this back in 2010 on how the stents are done on an outpatient basis and the stent travels via your wrist and not the groin area.  When you watch the videos, the “groin” area is called the “old fashioned way”.

A coronary stent is a tiny mesh tube that helps open up blood vessels clogged with cholesterol, fat and other stuff that leads to heart disease. Stenting is usually preceded by angioplasty, which involves expanding a balloon inside the artery to crush the plaque


At Stanford Hospital Coronary Stent Processes Are Done On As an Outpatient Procedure–Using the Radial Artery in the Wrist

Click on the image below to view the video at the Dr. Oz website.  The doctor states to be sure and ask if the procedure is available as not all hospitals are doing it via the wrist yet and you want to make sure you have a doctor who has experience with the procedure as well. 


image

In addition, they give you an Ipad to keep you busy while they work on your procedures. 

Stanford Hospital Gives Ipads To Patients in the Catheterization and Angiography Labs

image

The videos are interesting and helps get people out of the hospital faster and heal sooner. 

 

http://www.doctoroz.com/videos/breakthrough-treatment-heart-disease-pt-2

Wrist Sensors That Can Tell You How Stressed Out You Are–Neumitra Device Start Up at MIT

MIT had this write up on the bandu device.  I looked over at indiegogo, the crowd sourcing page and the goal was $250,000 and see where $7,189 was raised.  Will a device as such find a place in the consumer world?  I read through the material and you can watch the video below on how it will work with sending the stress level information back toimage an IPhone.  What is interesting is the healthcare claims it makes as there could be some use that has value if in fact they device functions to help patients with PTSD and help with some diagnostic areas.  Would I myself wear one just as a consumer with no known issues with stress other than occasionally being stressed out, probably not.  I could dig out my old “mood ring” for that <grin>.  Furthermore would I want this information sent to someone else, not at all.  As you can see I’m not messing with that mood ring anymore either:)

Time will tell what the “watch” technology will do with the sensors and again if it remains more on the clinical side and gets developed with some additional technology sensors, who knows what we might see down the road there.  Again I know when I am stressed and I might miss knowing when I am minimally stressed but I don’t want to “stress” out knowing that I missed some analytics that can tell me I had a few minimal stress episodes:)  BD 




Amid rising concerns over post-traumatic stress disorder (PTSD) and other mental illnesses, two MIT startups are developing wrist-worn sensors that can detect physiological changes—including perspiration and elevated temperature—that may signal the onset of events like anxiety attacks.

The data collected by these devices can be fed into an algorithm that aims to learn what triggers anxiety, or when people may be about to engage in a risky behavior. One goal is to head off destructive behavior, from drug abuse to suicide and violent outbursts, and to help with treatment.

The newest of these startups, Boston-based Neumitra, emergedimage from stealth mode earlier this year with a device that can measure proxies for excitement or stress, including increased motion, increased skin conductance from perspiration, and elevated skin temperature. The device, called bandu, sends readings to the wearer’s smartphone, which records them for later analysis. The device also includes a display that can be customized to suggest, say, that you take your medication, call a loved one, or listen to a song.


http://www.technologyreview.com/news/508716/wrist-sensor-tells-you-how-stressed-out-you-are/

FDA Put Out Warning on Fatal Rash Originating from the Use of Incivek for Hepatitis C, Deaths Reported

imageApparently the rash is occurring when the drug Incivek is taken in combination with the drugs peginterferon alfa and ribavirin.  The patients who were taking the drug combination developed rashes and then continued without any clinical consult and the fact that the rash kept getting worse, and that’s not a good idea.  A box warning will now be included about the potential development of the rash.   It seems that this is a rare occurrence and that those who notice it and are treated recover.  More can be read at the website for Incivek. BD
 

Dec. 19, 2012 -- The FDA warned people taking the hepatitis C drug Incivek (telaprevir) that it has received reports of a serious skin rash from the medication, which has led to several deaths.

The deaths occurred in people taking Incivek combination treatment.

This antiviral treatment includes the drug Incivek in combination with the drugs peginterferon alfa and ribavirin.

This combination treatment is most commonly used for genotype 1 chronic hepatitis C in adults with compensated liver disease (meaning the liver has some damage but still works), including those who have cirrhosis (scarring of the liver) or those who have previously received interferon-based treatment.

The FDA says some people had developed a serious skin rash while on the combination drug treatment, yet they continued to take the three medications despite the rash worsening and leading to life-threatening symptoms

http://www.webmd.com/hepatitis/news/20121219/fatal-rash-hep-c-incivek

FDA Approves New Anthrax Drug From Glaxo -Raxibacumab

This is a little humorous in stating clinical trials are not possibleimage for humans, of course not for a drug like this.  There were over 300 volunteers who took the drug that did not have Anthrax exposure to test the safety of the drug with side effects, etc.  BD



For the first time, the agency has approved a monoclonal antibody to treat an infection under the FDA's Animal Efficacy Rule. A monoclonal antibody is a protein that resembles a human antibody that identifies and neutralizes foreign bodies like bacteria and viruses.

The approval came after controlled studies were conducted on animals. This is because anthrax is a rare, lethal disease and it is not possible to conduct drug trials on human test subjects.

http://www.medicaldaily.com/articles/13532/20121215/fda-approves-new-anthrax-drug.htm#XosebSXO6AwehbRM.99

The AAFP Confronts United Healthcare On Reimbursements, Some Are Below Medicare Rates In Parts of the US–Payment Algorithms/Formulas Calculated Deep Within IT Infrastructures Do the Job

The burden was on the AAFP to present the findings here but the article states that United was surprised that they were paying less than Medicare.  I guess they don’t compare here and there?  United said they were going to do something about it but what remains a mystery as of yet.  When will the move from fee for service take place?  I think all insurers would like to move to that one but in the complex world today, it’s the IT infrastructure that has to be built to carry it before any changes are made.  The article continues on with suggestions on for doctors on how to negotiate better contracts.  If you read the comments, the doctors writing in on comments say it’s a waste of time as they don’t get that opportunity.

One doctor commented and stated that in south Florida they are paying 75% of what Medicare pays using a 2001 Medicare fee schedule.  Right now we have the annual issue with the SGR Medicare cuts on the table for doctors and just a couple weeks ago United posted this on where they look for saving…if those folks in Florida are only getting 75% of Medicare and have more cuts to look forward to?  They hired from HHS, Steve Larsen who was primarily responsible for writing the healthcare law, so now he sits as a VP at United. 
 

UnitedHealthCare Looks at Doctor’s Pay for Savings, Nothing New There Been Doing It for Years But Keep In Mind We Have the Annual Medicare Cut Fix on the Floor Again with Congress–Timing?

You tell me where the trust is after the 15 years of short paying doctors and hospitals was settled by the AMA, a real use of technology used against those who did not have it at the time.  Sounds like these folks are just like Jamie Dimon and Jon Corzine…”I don’t know” when you ask about money and business models. 

AMA Announces Doctors And Patients Can Expect To See the UnitedHealthCare/Ingenix Class Action Settlement Checks In the Mail Soon - Out of Network Short Payments–Attack of the Killer Algorithms Chapter 19

With all the analytics they sell and develop I would imagine their “quant” payroll has to be good sized when you bring in all their subsidiaries and their “quants” too as more money is coming from that end of the business than selling policies last I read.  Perhaps this reimbursement issue was one of those non linear calculations to match where there are relatively no matches or relationships in data?  By the way if you would like to see the credentials that your doctor has to meet with united to gain premium recognition or if you are a doctor and have not seen this, here’s the link to their pdf.  BD


 
A little more than a year ago, AAFP leaders and staff members met with representatives of UnitedHealthcare at our headquarters in Leawood, Kan. During that meeting, the Academy spelled out for the large private payer that its policy of paying fee-for-service rates that are below Medicare rates creates distressed practice environments and jeopardizes patients' access to care. 

At the time, United's leaders expressed surprise that the insurer was paying less -- in some cases far less -- than Medicare in some markets.

So where does that leave America's family physicians? Those of us who contract with UnitedHealthcare should be aware that when our contracts are up for renewal, there is an opportunity for re-negotiation, especially for those who practice in areas where the company has been paying less than Medicare rates.

United has said that it ultimately intends to move away from a strict fee-for-service system to a "value-based contracting model" that will offer physicians rewards based on quality of care. The health plan hopes to have up to 70 percent of the patients it covers affected by this approach within the next three years.

http://blogs.aafp.org/cfr/leadervoices/entry/united_healthcare_acknowledges_payment_shortcomings?sf7967619=1

Woman Moves 10 Miles in California, Blue Cross Raises Premiums From $418 a Month to $524–Quantified “Crap Algorithm” For Geographic Risk, Killer Algorithms Chapter 50 That Sustain Inequality In The US

Yes we are having issues with algorithms all over the place today and here’s another example.  The woman moves 10 miles and her premiums increase over $100 a month.  These are some very complicated formulas used by insurers today.  As a matter of fact some of the calculations today just might be a little “too” complex.  She’s seeing the same doctors and getting the same care, just living in a new place 10 miles down the road.  Consumers are getting the brunt of all of the analytics used today and of course doctors get this type of evaluation too.  Here’s something to look at from United for a comparison and all of them are using complex formulas to evaluate doctors and patients and this means there’s a ton of room for errors with one small parameter being incomplete or if it falls into a another category.  Take a look at this link and see if you can figure out if a doctor meets what United wants them to meet in credentialed areas.  It’s a mess.  Doctors get something along this line from all the insurers they work with.  It’s now just moving into the consumer area with analytics on steroids.  If that doesn’t get you we have the auto refill pharmacy Algorithm which gives consumers headaches.

The Automatic Prescription Refill Algorithm Causing Havoc at CVS When Not Personally Authorized By the Patient–Attack of the Killer Algorithms Chapter 40


Over in the car insurance world I had my own rogue algorithm attack with data mining and the new owners of my house, six months after the sale, get added to my car insurance policy. Obviously is was data mining looking for information they thought I had omitted?  My local office had everything correct and said it was that “other division” that was having problems getting some of their data corrected.  The other division, guess that was the data miner group running queries through public records and anywhere else they can go.

Insurance Company Data Mining With Automated Transactions? What Is Being Done With Consumer Data–My Flawed Corporate America Data Shows Up -Attack of the Killer Algorithms Chapter 45


One think I can say for sure for insurance analytics, they are going into the crapper when it comes to accuracy.  It has to do with this addition with selling data and the automated algorithms that run the processes and it’s getting worse.  I’m guessing that this woman in her appeal to Blue Cross is waiting for someone to modify the parameters of this algorithm that caused her monthly premiums to raise.  One other area the insurers use today and that is MIB and fat chance of getting things fixed there is they have errors.  It can take years as their focus right now is making money selling data.  Their operation of being just a holding place for consumer data has changed and they have become pretty aggressive in marketing. 

The MIB – Health Insurance Bureau Business Intelligence Mining May Go Beyond Just Healthcare Information

In addition to an individual’s credit history, data collected by the Medical Information Bureau (MIB) may include medical conditions, driving records, criminal activity, drug use, participation in hazardous sports, and personal or family genetic history, among other facts.   Here’s more on that topic as they also sit around and calculate how long you may or may not live.  Who knows when insurance carriers pull some of these analytics to add to your risk assessment?  It’s out there.  It’s all about data for sale and the heck with the consumer.  Everything is not transparent and we have no clue what data they used to evaluate risk.  So perhaps they added some of this information as well to her file when she moved? 

MIB Solutions and Hooper Holmes Working Together to Assess Morality Risk – Analytics and Consumer Files Used for Underwriting And To Estimate How Long You May Live And What Your Body Will Cost Over Time

We need to license and tax the data sellers and have a federal page of disclosures from all who sell data and with violations then law enforcement has a leg to stand on to fine or retract licensees to sell data.

Start Licensing and Taxing the Data Sellers of the Internet Making Billions of Profit Dollars Mining “Free Taxpayer Data”–Attack of the Killer Algorithms Chapter 17 - “Occupy Algorithms”– Help Stop Inequality in the US

Watch this video from Christopher Steiner who wrote the book “Automate This” and get in touch with what is really being done with math and algorithms…who gets to be the kingpin of the algorithms that move the money he asks.  The Blue Cross Algorithm took over and made this decision with the consumer with no other recourse than to appeal and see if Blue Cross will adjust any parameter that made this change take place.  If you need more, watch the videos on the left had side of this blog and you will get educated very quickly.  When are these processes with algorithms a utility and when do they become a menace he says.  The woman’s husband is on Medicare and says he’s glad he no problems like this!    She also had pre-existing conditions to she’s stuck with not being able to change either.  BD 





This kind of arbitrary rate increase is legal, according to the Times, because insurance companies have divided the state into rate zones based on the average cost of local doctors and hospitals. Move into another rate zone, and your premiums can go up. This just looks like another way to gouge citizens in their time of need, and stuff corporate pockets with more of people’s hard-earned money. It has absolutely nothing to do with providing good health care. If California could implement a universal, publicly-financed health system, you would never have to worry about how your premiums will be affected if you relocated. Because your premiums would be $0.

http://californiaonecare.org/palm-desert-woman-gets-socked-with-106-rate-hike-for-10-mile-move/?utm_source=rss&utm_medium=rss&utm_campaign=palm-desert-woman-gets-socked-with-106-rate-hike-for-10-mile-move&utm_source=twitterfeed&utm_medium=twitter&utm_campaign=365+Ad+Campaign

Allscripts Ousts CEO Glen Tullman and Lee Shapiro, President, Appoints Board Member To Take Over

Allscripts has had a rocky year no doubt and again in my opinion it all began with not having enough time to write all the integration code needed when Eclipsys was purchased.  I am giving a technology view from what I have read like everyone else.  Paul Black has bee appointed as the new CEO and has a background in the medical records business having been a COO at Cerner in the past.  In August the company went back to Microsoft for some help to expand Allscripts' application developer program.

Allscripts Turns to Microsoft To Expand Their Application Development

If you go back to 2010 you can read about the Eclipsys and Microsoft Amalga integration which is part of the new integrated systems to go into the Allscripts system, so I am guessing too that the integrated system is going to have components of Amalga in there as well for the intelligence type reporting.  Before the merger with Allscripts, Eclipsys and Microsoft were already working together with Amalga, which is now no longer under the Microsoft umbrella but rather moved over to the new company formed by GE and Microsoft, Caradigm so I thought perhaps looking at technologies only there could be a home there. 

Eclipsys and Microsoft To Integrate Sunrise Enterprise Suite With Amalga Unified Intelligence System

Caradigm–New Name for New Microsoft GE Healthcare Company

 

Recent activities have not looked good with filing the lawsuit over the lost business in New York other than it being an action to show they are doing “something”, but what if anything will it accomplish.  Truly I just think this all became bad news when sales projections were put out there and the code work was not done yet.  You can’t rush programming. 

If you read here enough I try cover the mechanics of some of this as best I can to bring an awareness and education around. “The short order code kitchen burned down years ago and there was no fire sale”  is what I keep telling all.  The whole campaign on Medicare with the idea of changing their IT infrastructure to vouchers was also just a farce that the media kept going as to work on a project so large, the budget would have been out of this world for the IT work, not to mention the fact that the US would have probably had to outsource it to both India and China to find enough qualified engineers.  Again folks in technology knew the voucher idea was a farce a long a time as as the money and time was not feasible and all the talk was vapor. 

Again that is what I see happened to a degree with Allscripts here too and that work combining two huge architectures like that is big, takes money and time so the days of CEOs romping out there making promises and expecting IT folks to deliver within “their” time frames are gone.  I think with sales pressure that is what occurred here and you just can’t serve up “raw” code and expect it to work.  This is exactly why people stall off beta programs too as it’s better to have it done correctly than to put out a half baked product that will result with a lot of unhappy clients.  Again get a  CEO this time who has some computer science or IT in their background is what I would say, it helps. 

Allscripts Sues NYC Health and Hospital System Over Contract Award to Epic - EHR Vendor Playing the Same Game as Health Insurance Companies With Lawsuits

Their executive vice president of culture and talent is also due to leave in 30 days and perhaps a little IT knowledge there too would not be bad.  With their efforts to get Microsoft to help them with apps for Windows 8 for one, again it still tells me they need more code written. BD



More recently, the company said speculation about a potential deal had hurt its third-quarter results by causing customers to delay decisions. Mr. Tullman in November said the company would have a "clean, unencumbered selling environment" once it decided whether or not to go forward with a strategic move.


http://online.wsj.com/article/SB10001424127887323777204578189951583494808.html?mod=googlenews_wsj


New Dissolving Female Condom That Helps Fight HIV, STDs, Powerful and Discreet

The research at the University of Washington was funded by the imageGates Foundation and if this comes around, condoms will never be the same.  This is definitely tech condom in design for sure.  It has to do with the fibers used to create it and one fabrics dissolves within a few minutes while another fabric dissolves slowly over a few days.  The secondary dissolve process is part of the HIV protection.  Electrospun fibers deliver the drug agents when it dissolves.  This is a pretty fascinating concept and a complex condom and this combines the best of both worlds it sounds like with drugs and a device.  BD 




A new, more discreet condom protects from pregnancy and sexually transmitted diseases (STDs) and dissolves after use.

The micro fibers allow for a more appealing family planning and STD prevention option. This modern condom, which dissolves during use, also delivers viral and pregnancy preventative drugs. According to the study, "We show that electrospun fibers deliver agents that inhibit both HIV and sperm in vitro in addition to physically preventing sperm penetration.

"

The hope is that this more powerful condom is, at the same time, more discreet. It doesn’t really matter how effective a condom is if people don’t use it. CDC estimates a reported 49 percent of pregnancies in the United States were unintended in 2006, a slight increase from 48 percent in 2001.

The dissolving condom could also have an impact on STDs, especially HIV. In the U.S., approximately 50,000 people are newly infected with HIV each year.

http://blogs.discovery.com/dfh-sara-novak/2012/12/dissolving-condom-releases-preventative-drugs-after-use.html#mkcpgn=twdh1

First U.S. Patient Treated Following FDA Approval of Cook Medical’s Zilver® PTX® Drug-Eluting Peripheral Stent

This is the first patient to receive the leg stent as it was only approved by the FDA in November of 2012.  This one took a long time to come to market and being a stent that goes in your leg, there’s a lot more work into securing it as your legs move physically where your heart does not.  At the link below there’s some additional information from a prior post.  A while back I interviewed Rob Lyles from Cook as well.  BD

 

Cook Medical Gets FDA Approval for Zilver PTX Drug Eluting Stent for the Treatment of Peripheral Arterial Disease (PAD)

Press Release…

BLOOMINGTON, Ind.--(BUSINESS WIRE)--Just weeks after the Food and Drug Administration (FDA) approved Cook Medical’s Zilver® PTX® Drug-Eluting Peripheral Stent, Riverside Methodist Hospital in Columbus, Ohio, has treated the first patient with the device as part of Cook’s U.S. commercial launch.

“It was a great honor for my institution to be first to implant Cook Medical’s Zilver PTX as part of the stent’s commercial rimageoll-out,” said Gary Ansel, M.D., director for the Center for Critical Limb Care at Riverside Methodist Hospital. “This technology is so advanced and offers such prolonged patient benefit, I believe it will very quickly challenge older PAD treatments such as balloon angioplasty and bare metal stenting in the U.S. as the standard of PAD care.”

Zilver PTX, approved for use in the above-the-knee femoropopliteal artery, is the only drug-eluting stent approved for use in a peripheral artery in the U.S. The device has a proven drug effect1 that reduces by more than 50 percent the need for followup procedures to reopen the artery. These followup procedures can be expensive, which places extra burdens on patients, physicians and facilities.2

“The first commercial use of this stent represents what I think will be the start of a complete shift in the way physicians will treat PAD patients in this country,” said Rob Lyles, vice president and global leader of Cook Medical’s Peripheral Intervention division. “Zilver PTX, the only FDA-approved stent that brings the proven benefits of drug elution to the peripheral arteries, is an effective treatment option for patients who suffer with the painful and potentially debilitating consequences of PAD. We are extremely proud to bring this technology to American doctors and the patients they treat.”

This unique combination therapy device combines the mechanical support of stenting with the drug paclitaxel, which limits cell growth that can reclog the artery. The combination has been shown to maintain arterial blood flow to the superficial femoral artery (SFA) in seven out of ten patients through 24 months after implantation.3

The disease Zilver PTX targets, peripheral arterial disease (PAD), is one of the fastest-growing and most pervasive diseases of our time, affecting an estimated 8-12 million Americans each year.4 PAD is a disease in which plaque builds up in the arteries, which carry blood to the head, organs and limbs. While PAD typically affects arteries in the legs, it can also affect blood flow to the head, arms, kidneys and stomach.5 People aged 50 and over who have a history of diabetes, smoking and high blood pressure are at higher risk for PAD.6Other treatment modalities for PAD include medical management, lifestyle changes such as exercise, balloon angioplasty, bare metal stenting and surgical bypass of the blocked artery.

Zilver PTX is currently available in 54 markets, including the European Union, Brazil, Australia, Taiwan and Japan. Thousands of patients worldwide have been treated with Cook’s device.7

Dr. Gary Ansel is a principal investigator in the global Zilver PTX clinical trial. He is a paid consultant to Cook Medical with respect to its medical devices.

About Cook Medical

A global pioneer in medical breakthroughs, Cook Medical is committed to creating effective solutions that benefit millions of patients worldwide. Today, we combine medical devices, drugs, biologic grafts and cell therapies across more than 16,000 products serving more than 40 medical specialties. Founded in 1963 by a visionary who put patient needs and ethical business practices first, Cook is a family-owned company that has created more than 10,000 jobs worldwide. For more information, visit www.cookmedical.com. Follow Cook Medical on Twitter and LinkedIn.

Clear Guide Medical, Spun Off From Johns Hopkins Department of Computer Science and Johns Hopkins School of Medicine’s Radiology Department Getting Product Ready for Market

One thing you will notice is the expense on bringing a product to market.  This device will be used to guide ultrasounds.  There are only 5 employees so far and is filing for worldwide patents as well.  The advantage here is to make it simple for surgeons to learn how to use ultrasound and local physicians and clinics should be able to do a local biopsy.  Johns Hopkins is also paying for the patent filings which will run around 85k and Clear Guide will have to pay back on that one as most of their money has come grants.  BD

image

Clear Guide Medical LLC
is readying its first product, a medical device used in minimally invasive ultrasound surgeries that will be for sale in early 2014. Federal and state grants received this year aided the commercialization process for the Johns Hopkins spinoff, which hopes to receive another state grant early next year. 

The Baltimore life sciences company received a total of $550,000 from the federal National Institutes of Health and National Science Foundation, in 2011 and 2012, and $125,000 from the Maryland Technology Development Corp. in 2010 and 2012. It is waiting to hear about another grant from the latter, for $100,000.

Clear Guide Medical was founded in 2010, a spinoff from the Johns Hopkins Department of Computer Science and the Johns Hopkins School of Medicine’s radiology department. In 2012, it was the first company to move into the Johns Hopkins accelerator, located on the Homewood campus, Heisenberg says.
The company has five employees. It is in the midst of applying for a worldwide patent that covers the US, nations in Europe, Japan, Canada and Israel – countries that are most likely to develop competing devices. Johns Hopkins is paying the patent filing and application expenses, about $80,000, for which Clear Guidance will pay back in time.

http://bmoremedia.com/innovationnews/hopkinsspinoff121812.aspx

FTC to Investigate Data Brokers: Flawed Data Attacking Consumers-Need To Dig In To The Algorithmic Bots Slowing Down Government Servers to a Crawl & Stop Processes That Keep Inequality Alive in the US–Attack of the Killer Algorithms Chapter 49

This is good that it is getting attention but hopefully the right attention and those in key positions in government don’t get “Algo Duped” over all of this.  If you have read the Attack of the Killer Algorithm series then you know there are few chapters relating both to flawed data and the fact that “these algorithms” are denying people services, money, jobs, medical care, you name it.  Data brokers are more than just what was listed in this article, heck Walgreens made short of $800 million selling data only in 2010, so that’s why I say license all these folks and give law a leg to stand on, as a simple investigation without going in depth to understand all the algorithmic processes is futile.  If they need a license and anything is violated, then fine them or shut them down.  I’m going to copy and paste some of my material from some prior posts as I have tons of it to substantiate. 

CoreLogic was already kicked out of North Carolina for their bot activity in clogging servers and not paying timely and updating their data so do you wonder why it takes so long for you to get anything cleared with credit if these folks don’t update, they get you a second time with a wait after you spent your time and money fixing their mistakes. 

Excise Taxing the Data Sellers–Nobody’s Supporting the US IT Infrastructure, Especially In Times of Disaster-Companies Have Probably Made Money Off Selling Scraped Data of Those Hurt in the Wake of “Sandy”


Every time these folks screw us up with their flawed data, it’s on our dime as a consumer to fix it too and these folks just continue to rack in the millions.

It’s not fair and equitable to even dump more responsibility on the consumer for corporate America data flaws and to deny services and credit for one example.  Setting up a quarterly tax and license is not a difficult model as we can pretty much base it on the model used for sales tax and being it would be brand new and not have to be built from existing technologies, the up and running time could be pretty fast. You can’t help but think about this when you see the likes (and this is just one example, link below) of stingy little companies like this that have found a way to operate outside the regulation of the federal government and make millions.  As a consumer you can’t even see what they send out about you.  Is this fair..no.  These folks were Chapter 42 of my Attack of the Killer Algorithm series and there’s more like them out there. 

E-Scoring Credit Algorithms Invisible To Consumers Used to Market and Evaluate, Does Not Fall Under Federal Law And Such Are Used by Insurance Companies - How Will This Work With Exchanges –Attack of the Killer Algorithms Chapter 42

Start Licensing and Taxing the Data Sellers of the Internet Making Billions of Profit Dollars Mining “Free Taxpayer Data”–Attack of the Killer Algorithms Chapter 17 - “Occupy Algorithms”– Help Stop Inequality in the US


Behavioral analytics is huge area for abuse and that’s not to say it’s all bad because it’s not but people abuse it like anything else, they write some code, write a study to substantiate their math and off they go.  Do we know they are gaining any “real” value here?  So much of it is information from the web and people lie their asses off on this part of the data, so credible in this area..nope and in some areas you have been “duped” and it goes something like this…

”Hey dude let’s crunch some numbers and see if we can come up with some analytics to sell” 

   

Actually in this article they left out FICO and their claims to sell analytics using your credit rating and other information they won’t disclose to determine if you are going to be a medication compliant patient.  Yes that one is out there, overselling analytics and mismatching data to make a buck. Selling these analytics is one of the biggest abuses I have seen and is clearly a case to make money employing some “Algo Duping” along the line to sell this line of garbage with trying to sell some non linear data crap for lack of better words.


 

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

We all know by now that math is no longer the 100% methodology for determining accuracy in all cases when it is spun with algorithms and marketing today and that’s a fact.  In addition we have a lot of “flawed” data spun into some of the algorithms and this leads us to a point of insanity sometimes when we look and say “where did they get those numbers”.  You hear it all the time. If you don’t get this on how algorithms spin and flaw data use the link below and get educated from an NYU professor/journalist/mathematician.

“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


This could be a very useless investigation unless they dig in and understand the algorithms that do this and pull in everyone else that does it too as just because their main business is doing something else doesn’t mean that they don’t broker data on the side, a lot of that out there.  I do get a little worried when I see sessions of Congress looking like this, image below.


Here’s a classic post from the Medical Quack from 3 years ago…

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

Here’s the entire series of the Killer Algorithms and as I said many of them are data mining related.

Attack of the Killer Algorithms! Digest & Links for All Chapters–Read About Math and Crafty Formulas Running on Servers 24/7 Making Life Impacting Decisions About You– Updated

So FTC get  your “algorithm motors” running if you are really going to accomplish anything here….and get that excise tax in place for all and we could easily fund the FDA and NIH with it and finally have a leg for law enforcement to stand on to regulate.
 

Right now if nothing is done this is the biggest unfair attack on consumers that has ever existed, again mostly allowed to thrive as people don’t like math and don’t understand how algorithms move money! Big data is on it’s way and you can watch the video at the link below as there’s a big forum discussion with folks from NASA, T-Mobile and more about how it can be used wisely but in the meantime this other element of data brokers doesn’t care and they make billions harming consumers with loads of flawed data. BD


Big Data/Analytics If Used Out of Context and Without True Values Stand To Be A Huge Discriminatory Practice Against Consumers–More Honest Data Scientists Needed to Formulate Accuracy/Value To Keep Algo Duping For Profit Out of the Game




The Federal Trade Commission on Tuesday opened an investigation into data brokers, the companies that collect and sell information about consumers for marketing and other purposes.

The agency issued administrative subpoenas to nine different information resellers, requiring each company to provide extensive details about how it collects information about consumers; how it uses, stores, analyzes and shares that data; and whether the company allows consumers to access and correct the records the company holds about them. Some of the companies named in the inquiry do not directly sell information about consumers, but offer analytics services in which they categorize, score or evaluate consumer data.


http://www.nytimes.com/2012/12/19/technology/ftc-opens-an-inquiry-into-data-brokers.html?_r=0

Healthcare Holdings Group, Inc., Parent Company of Access My Records And ChartZoneMD Signs Patent Royalty Health IT License With MMRGlobal

This appears to be the second EHR/PHR company to sign a license agreement with MMRGlobal, parent company of MyMedicalRecords.com.  You can read some details below about the agreement or view the entire PR here, which states it is for 5 years and set to automatically renew after that period of time.  I posted back on the 10th of December about the agreement with 4Medica, another EHR vendor who also signed an agreement with MMRGlobal. 



4Medica Electronic Medical Records Company Signs Agreement With MMRGlobal (MyMedicalRecord) To License Health IT Patents

Bob and I talked about the patents on a prior blog post (link below) at the Medical Quack and you can also visit  Bob Lorsch’s Blog at MMRGlobal at the link below where he further elaborates beyond our discussion and interview with more details about the technologies and patents.  This is interesting to see companies without huge expensive lawsuits acknowledging the patents, which I guess is why you have them if one is the creator of such technologies. 


MMRGlobal Patent Portfolio, Bob Lorsch, CEO Answers Questions Relative to Patented Technologies


Also in the news with a separate Press Release, MMR Platinum imageservices was announced to replace the MedicAlertGold services with MyMedicalRecords..  All current members using the current “Gold” service will be able to transition to the new upgraded services.  The company offers 24/7 help availability for customers.  Both licensing agreements signed are with EMR vendors supporting meaningful use and I realize this is only 2 vendors so far but is it setting pace for the rest in the PHR/EHR  industry…a very interesting patent case to say the least.  BD 


MMRGlobal Inks Royalty-Based License Agreement With Electronic Health Record Provider Healthcare Holdings Group and PHR Competitor imageAccess My Records

Dec 18, 2012 (Marketwire via COMTEX) --MMRGlobal, Inc. (OTCQB: MMRF) today announced it has filed a Form 8-K regarding the signing of another royalty-based licensing agreement. On December 17, 2012, MyMedicalRecords, Inc. ("MMR") signed a Non-Exclusive Patent License Agreement with Healthcare Holdings Group, Inc. ("HCH"), the parent of Access My Records, Inc., to license the U.S. rights for the health IT patents owned by MyMedicalRecords, Inc. These include but are not limited to U.S. Patent Numbers 8,321,240; 8,301,466; 8,117,045; 8,117,646; and 8,121,855, as well as any other health IT patents to be issued pursuant to pending applications filed by MyMedicalRecords in the United States and all divisions, continuations, reissues, and extensions (the "MMR Patents").

The initial term of the Agreement is five years and automatically renews to the expiration date of the last licensed patent to expire, which currently in the U.S. is twenty years from the date of filing. MMRGlobal is a leading provider of Personal Health Records (PHRs) including its MyMedicalRecords.com PHR and MMRPro document management and imaging systems for healthcare professionals.

Healthcare Holdings Group, Inc. is a comprehensive Electronic Health Record systems provider. HCH's solutions are designed for General Practice and Chiropractic disciplines. The company's software systems include ChartZoneMD, an EHR cloud-based software solution, and SmartFormsMD, a Voice Recognition Medical Dictionary module. HCH, through its wholly-owned operating subsidiary, Access My Records, Inc., provides the AccessMyRecords.com Personal Health Record and a free-standing Patient Portal designed to seamlessly connect to any EHR system. 

http://phx.corporate-ir.net/phoenix.zhtml?c=178404&p=irol-newsArticle&ID=1768142&highlight=

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Dental Assistant and Receptionist Ran After Hours Dental Care at Clinic in Pennsylvania Performing Root Canals and More For the Uninsured Arrested

Well I guess this could go one of two ways but either way it comes imageback to money.  Were the employees trying to somehow help the uninsured who could not pay or were they making additional pocket money?  I must say if they were fitting braces and doing root canals it was pretty sophisticated and they took x-rays and more.  BD



Authorities say a pair of crooked Pennsylvania dental office employees ran an after-hours, word-of-mouth operation where they performed root canals, pulled teeth and installed braces without proper training.

  Montgomery County prosecutors say they've identified three patients who received treatment from the impostors, but X-rays indicate there could be dozens more.

http://www.nbcphiladelphia.com/news/local/Fake-Dentists-Perform-Root-Canals-Without-Training-DA-183959281.html?dr

CCHIT To Develop Framework for ACOs As Interpretations and Implementation Differ And Many Still Question What It Is

I do have to say that ACOs have been a lively topic of discussion, no so much as to what they are to accomplish but the models or methodologies imageto do so have been varied.  One might ask will ACO models take the course of electronic medical records with hundreds of variations?  So this probably a good idea here to create some standards and a model to follow to somewhat keep all on a common path as far as the IT mechanics go and what components of Health IT are either required or best practice modules. 

The necessary players are pretty much defined, but other incidentals could use a little descriptive work as far as who’s the main leader and of course the coordinated information of what’s available with IT resources from all sides.  There’s a lot of work to involving the patients as well and that comes along with education and looks to be a lengthy process with conveying the understanding of what their care looks like as part of an ACO, as bottom lines with patients right now for a big part of it is what is my deductible and what am I going to have to pay out of pocket.  Needless to say this will be interesting to follow to see what is constructed here as a framework as I’m sure once this process gets started there will come a time when new technologies as they do all throughout healthcare today that were perhaps not in an original plan will probably need to be rolled in too, the way the world seems to work today.  BD



The Certification Commission for Health Information Technology (CCHIT) plans to develop an IT framework for accountable care organizations (ACOs). The framework will identify the health IT infrastructure components necessary for a provider organization to function effectively as an ACO and help identify any gaps that would prevent them from meeting their goals as an ACO.

“CCHIT has been the leader in developing criteria, and testing and certifying EHRs, for the past six years.

We also recently became the compliance testing body for a consortium of health information exchanges representing more than half of the U.S. population,” said William Jessee, MD, chair of the CCHIT Board of Trustees. “Building on that, and our successful CCHIT Certified and Office of the National Coordinator (ONC) authorized EHR certification programs, we are looking at other opportunities that will complement our work, and we believe expanding into the ACO environment is one way to do that.”

http://www.govhealthit.com/news/cchit-working-health-it-framework-acos

AngelMed Guardian System Implants Reach 600 With US Clinical Trials and Company Raises $27M

I first wrote about the implantable device back in 2011 and today it has the European CE approval and working closer with the US for FDA approval.  The funding will pay for the rest of the clinical trial process.  The device uses vibrating or other alerts to get the attention of the patient and it stores ECG traces as well.  From the website you can read more about the “ALERTS” study…

image

“The ALERTS study design provides a clinical environment to test the efficacy of a device that may significantly reduce time to imagetreatment and thus may decrease heart muscle damage and improve survival rates related to major cardiac events. After completing a Phase One study in the US, the AngelMed Guardian System is presently being tested in the ALERTS pivotal study. The ALERTS study is a prospective, randomized multicenter study with FDA approval for 100 centers and 1020 subjects with a high-risk of having a heart attack. All subjects have data collection and analysis enabled from the onset, however, subjects are randomized 1:1 for patient alerting ON or OFF for the first 6 months. After the initial 6 month period, patient alerting is enabled for the control group. All subjects will be followed until study closure.”



AngelMed Guardian System-Implanted Device to Alert Patients They Are Either Having or Are Close to a Heart Attack-Clinical Trials


Angel Medical Systems
, an innovator in today's cardiac medical device arena, recently celebrated the implant of the 600th patient with its AngelMed Guardian system. With the help of its manufacturing partner, Flextronics, Angel Medical Systems also achieved this milestone more than two months ahead of the company's estimate.

AngelMed Guardian is designed to detect and alert imagepatients of acute episodes of cardiac ischemia related to the progression of coronary artery disease and thrombotic coronary occlusion caused by vulnerable plaque ruptures.  Some of the external monitoring devices that are part of the Guardian's alerting system were built by Flextronics in Valencia, CA.

http://www.onlinetmd.com/angel-medical-systems-implants-cardiac-device-12312.aspx

Allscripts Sues NYC Health and Hospital System Over Contract Award to Epic - EHR Vendor Playing the Same Game as Health Insurance Companies With Lawsuits

I don’t funny understand how this is going to help as it’s not going to make them look any better in the eyes of the decision makers.  There’s more than just cost that comes into these contract awards by all means and this seems to be the card that is being played here.  We can all go back to the 1st quarter results that came in and again I said they didn’t have their code ready with the integration process with the Eclipses system they acquired.  I have seen this in healthcare and other industries were sales are projected on anticipated sales and you can’t hurry the coders either.  If the cake is not baked you can’t frost and serve it.

When you compare it to Epic, and again I’m looking at history here and technologies with no favorites to either side, but Epic has all their development of their system pretty much in house, where as Allscripts has grown by acquiring other companies and merging technologies.  When you have it all in house and can go back and reference anything from years back and have all the code, there’s something to be said for that.  Way back when I was writing I had to go back at times and what I did was very simple compared to today’s systems, but it was there.  When you have code written outside your concern that you bought, a little different story.  That doesn’t mean that the integration is not good but like I keep telling everyone…

”The short order code kitchen burned down years ago and there was no fire sale”

This not only applies here but all over in IT infrastructure.  Here’s a post from a couple days ago where I took the time to imagetranslate what was in the news to what had to happen with the mechanics…you don’t get that anywhere else but I’m just trying to help the layman understand what some of this means.  Sure people edit and find things to improve, but that process is a heck of a lot faster than the processes needed to fix it or develop new code.  Wake up.  At the link below, GAO has done its work and now CMS has to go back and do the extensive time consuming, dollar consuming code fixes.  It is what it is. 

GAO Tells CMS Pre-Pay Editing/Auditing on Claims Should Be Greater As Processes Not Catching Enough–Time To Start Cranking Out Some Additional Code and Algorithms For the IT Infrastructure

First of all we had the complaint filed and now it becomes a lawsuit. 

 

AllScripts Files Complaint With Review Board At Health and Hospitals Corporation Protesting Award of Contract to Epic Medical Records For New York City’s Public Hospital System

This somewhat parallels some of what I see with insurance carrier contracts and here United filed suit and sued the government as they wanted the Tri-Care contract in the west, so what gives here with Allscripts…same thing?  It makes for a lot of legal fees for one and makes some lawyers kind of rich.  This too is yet another battle of the algorithms (software) and price. 

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?


One other small difference here is that the CEO of Epic, and granted she has made a lot of money, wrote the original code for Epic and that is something that unless the other company has done the same has huge value.  Not only does the company have all the code from day one, the CEO has “hands on” experience here and there is so much to be said there as she has IT knowledge that any old CEO for hire won’t have. 

As a matter of fact most CEOs today get kind of get lost as they try to “run” companies with just using business tactics but lack the “hands on” experience to know the IT and code mechanics, and thus so Epic has an advantage there and those purchasing systems with IT backgrounds know it.  You do have to have 500 beds before Epic will talk with you as that is their market.  I don’t know how a lawsuit is going to change this opinion with the folks that chose Epic as it was more than money that went in to this decision as their necks are on the line to make the best decision. 

So I don’t know where this lawsuit will go but I said a while back the company would do well, technology wise to hook up with Caradigm as the company they bought (Eclipsys) already had technologies working with Amalga and Caradigm sells it today.  Caradigm is the new company that GE and Microsoft formed earlier this year and besides that they don’t have an EMR to sell either…so…think about it. 

Eclipsys and Microsoft To Integrate Sunrise Enterprise Suite With Amalga Unified Intelligence System


These are just my opinions here and again I don’t know how this lawsuit is going to make a big change as the technologies are different between the two companies and once you are kicked out doesn’t a little sugar do a little more than vinegar?  This is a wild one but again maybe seeing it be successful for big insurance companies doing lawsuits maybe they just decided to give a shot and see what sticks, lot of that out there today.  BD



Allscripts Healthcare Solutions Inc. (MDRX), a provider of electronic medical records, sued New York City Health and Hospitals Corp. over a $303 million contract given to another company.

The complaint was filed today in New York State Supreme Court in Manhattan over a contract for computer hardware and software awarded this year to Epic Systems Corp., a closely held medical-software provider based in Verona, Wisconsin.

The award is “arbitrary, capricious, an abuse of discretion and lacks a rational basis,” according to the complaint.

http://www.bloomberg.com/news/2012-12-13/allscripts-sues-nyc-health-hospital-over-contract-award.html