Medical Quack

Medicare HMOs fend off oversight

WASHINGTON, May 16 (UPI) -- Facing down the threat of greater regulation, health insurers unveiled a plan to curb shady marketing practices to seniors at a congressional hearing Wednesday, but their efforts may come too late. <blockquote> "Get on top of this and get on top of it fast," said Sen. Gordon Smith, R-Ore., at a Senate Special Committee on Aging investigation of unscrupulous sales tactics being used by insurers in the Medicare Advantage program. At the hearing, senior advocates, state insurance commissioners and several members of Congress called for the elimination of limits on state oversight of the plans. People with Medicare are being locked into costly and ineffective health and drug plans with no oversight from the Bush Administration, while at the same time states are barred from protecting them," said Robert Hayes, president of the Medicare Rights Center, a New York City based beneficiary assistance group. Brock Slabach, a board member of the National Rural Health Association, told lawmakers that seniors enrolling in a plan often don't know that physicians are not required by Medicare to accept the plans. "When beneficiaries actually need the services is when they discover the gaps," he said. </blockquote> Source: <a href="http://www.sciencedaily.com/upi/index.php?feed=Science&article=UPI-1-20070516-20331700-bc-us-medicareadvantage-analysis.xml">ScienceDaily: Analysis: Medicare HMOs fend off oversight</a>

Medicare HMOs fend off oversight

WASHINGTON, May 16 (UPI) -- Facing down the threat of greater regulation, health insurers unveiled a plan to curb shady marketing practic...

Wednesday, May 23, 2007

Powerful MDs from the blog, "Running a Hospital"

This post is from the blog of Beth Israel Hospital CEO, Paul Levy giving recognition to the powerful MDs as ranked by Modern Healthcare magazine.  Earlier I had posted an article on Dr. Halamka, their CIO, being recognized too in an overall IT arena.  Good to see healthcare represented and as you can see from the listing below, when narrowed down to healthcare only, he's right up there, and the hospital has Mr. Levy who blogs too!  It certainly appears to be a good partnership all the way around for sharing knowledge and information in the pursuit of better healthcare for all.  BD <blockquote> <h5>Powerful MDs </h5> Modern Health Care <a href="http://www.modernphysician.com/page.cms?pageId=278">presents</a> its list of the 5o most powerful MDs in America. Four come from our little corner of the world. #2, Jim Mongan, CEO of Partners Healthcare System #3, Don Berwick, CEO of the Institute for Healthcare Improvement #13, John Halamka, our CIO #42, Gary Gottlieb, CEO of Brigham and Women's Hospital Related post:  <a href="http://ducknetweb.blogspot.com/2007/05/hospital-cio-makes-top-100-list-for-it.html">E-Week Award</a></blockquote> Source: <a href="http://runningahospital.blogspot.com/2007/05/powerful-mds.html">Running a hospital: Powerful MDs</a>

Powerful MDs from the blog, "Running a Hospital"

This post is from the blog of Beth Israel Hospital CEO, Paul Levy giving recognition to the powerful MDs as ranked by Modern Healthcare maga...

Wednesday, May 23, 2007

Hospital Mortality Rates To Go Online Beginning in June

<blockquote> CMS in June will post the first broad comparison of hospital mortality rates for heart attack and heart failure in Medicare beneficiaries on the <a href="http://www.hospitalcompare.hhs.gov/Hospital/Home2.asp?version=alternate&browser=IE%7C6%7CWinXP&language=English&defaultstatus=0&pagelist=Home">Hospital Compare</a> Web site, <a href="http://www.usatoday.com/news/health/2007-05-22-death-rates_N.htm"><cite>USA Today</cite></a> reports. Hospital mortality rates currently "are among the best-kept secrets in American medicine" and remain "closely guarded," according to <cite>USA Today</cite>. The Web site will include information on whether the 30-day mortality rates for the conditions at more than 4,000 hospitals nationwide are higher than, lower than or equal to the national average. Steven Nissen, a cardiologist at the Cleveland Clinic, said, "I feel strongly that the public has a right to see how hospitals and physicians perform," adding, "It's got to be done carefully. If not, it can backfire, and the whole system can fall down."</blockquote> Source: <a href="http://www.californiahealthline.org/articles/2007/5/23/Hospital-Mortality-Rates-To-Go-Online-Beginning-in-June.aspx">Hospital Mortality Rates To Go Online Beginning in June - California Healthline</a> (nay require subscription)

Hospital Mortality Rates To Go Online Beginning in June

CMS in June will post the first broad comparison of hospital mortality rates for heart attack and heart failure in Medicare beneficiarie...

Wednesday, May 23, 2007

Medicare changes coverage for Esophageal Doppler monitoring

<blockquote> CMS was asked to reconsider our current national coverage determination (NCD) on ultrasound diagnostic procedures. CMS has determined that there is sufficient evidence to conclude that esophageal Doppler monitoring of cardiac output for ventilated patients in the ICU and operative patients with a need for intra-operative fluid optimization is reasonable and necessary under Section 1862(a)(1)(A) of the Social Security Act, and therefore, we are removing the past national non-coverage of cardiac output Doppler monitoring. <img src="http://www.deltexmedical.com/img/pht1.jpg"> CMS will amend the NCD Ultrasound Diagnostic Procedures at section 220.5 of the NCD manual by adding “Monitoring of cardiac output (Esophageal Doppler) for ventilated patients in the ICU and operative patients with a need for intra-operative fluid optimization” to Category I, and deleting “Monitoring of cardiac output (Doppler)” from Category II. Private insurers often follow Medicare's lead when deciding which procedures and devices to cover.</blockquote> Source: <a href="https://www.cms.hhs.gov/mcd/viewdecisionmemo.asp?id=196">Centers for Medicare & Medicaid Services</a> Related Story:  <a href="http://www.reuters.com/article/health-SP/idUSN2245823820070522">http://www.reuters.com/article/health-SP/idUSN2245823820070522</a>

Medicare changes coverage for Esophageal Doppler monitoring

CMS was asked to reconsider our current national coverage determination (NCD) on ultrasound diagnostic procedures. CMS has determined th...

Wednesday, May 23, 2007

HMO News - Prospect Medical Holdings to Acquire ProMed Healthcare for $48.0 Million

<blockquote> <h3> Company to Assume Care of 81,000 HMO-Covered Lives, Including Almost 10,000 Seniors</h3> CULVER CITY, Calif.--(BUSINESS WIRE)--Prospect Medical Holdings, Inc. (AMEX: PZZ) (“Prospect”), which manages the medical care of HMO enrollees in Southern California, today announced that it has signed a definitive agreement to acquire ProMed Health Care, which is comprised of two Independent Physician Associations (“IPAs”) -- Pomona Valley Medical Group and Upland Medical Group – and ProMed Health Care Administrators, the management services organization (“MSO”) that serves these IPAs. The acquisition, which is expected to be immediately accretive to earnings, is expected to close on June 1, 2007. The Boards of Directors of both companies have approved the transaction.</blockquote> Source: <a href="http://home.businesswire.com/portal/site/google/index.jsp?ndmViewId=news_view&newsId=20070522006405&newsLang=en">Prospect Medical Holdings to Acquire ProMed Healthcare for $48.0 Million</a>

HMO News - Prospect Medical Holdings to Acquire ProMed Healthcare for $48.0 Million

Company to Assume Care of 81,000 HMO-Covered Lives, Including Almost 10,000 Seniors CULVER CITY, Calif.--(BUSINESS WIRE)-- Prospect Me...

Wednesday, May 23, 2007

Judge Orders Medical Records in Legal Suit

Medical records...coming to a court near you soon?  BD <blockquote> BRENTWOOD, N.H. - A judge has ordered a former top official with the state medical examiner's office to submit to a physical exam and sign over medical records to settle a debate between prosecutors and her lawyer over whether she's too sick to face trial. Judge Tina Nadeau handed down the order following a meeting last week when prosecutors called for a more detailed account of Kathrine Wieder's physical and mental well-being, according to a decision made public yesterday. Wieder, who worked as the state's chief forensic investigator, faces 44 charges alleging she abused her position at the medical examiner's office to increase her wages by signing cremation certificates. Adams has already interviewed Wieder once and has asked for a detailed list of her medications, as well as details of her medical and health records. </blockquote> Source: <a href="http://www.newburyportnews.com/punews/local_story_142115906">NewburyportNews.com, Newburyport, MA - Judge orders defendant to share records, submit to exam</a>

Judge Orders Medical Records in Legal Suit

Medical records...coming to a court near you soon? BD BRENTWOOD, N.H. - A judge has ordered a former top official with the state medical...

Wednesday, May 23, 2007

A Woman’s Knee Replacement That Fits Their Shape and Size

While on the page I did a quick check by zip code to see how many surgeons offer this procedure and found 6 available from a zip code in Huntington Beach, CA providing listings within 25 miles.  BD <blockquote> The Zimmer Gender Solutions Knee is contoured to fit the unique shape and size of women's knees. It does this by matching a woman's shape and size with its 3 distinct differences: The Zimmer Gender Knee has a thinner profile than traditional knee replacements, it allows for more natural movement of the kneecap, and it has a shape specially contoured for women. <img src="http://www.zimmer.com/web/images/products/joints/knees/Gender_thinner_D1.jpg"> <img align="left" src="http://www.zimmer.com/web/images/products/joints/knees/Gender_Healthyknee_Callout.gif"> The Zimmer Gender Knee has a contoured shape proportioned to fit women's anatomies. This helps the implant from overhanging the bone and potentially pressing on or damaging surrounding ligaments and tendons.  </blockquote>              Source: <a href="http://www.genderknee.com/micro/ctl?template=mn&op=global&action=1&id=9520&global=1">Zimmer Gender Knee, A Woman’s Knee Replacement That Fits Their Shape and Size</a> Hat Tip:  <a href="http://www.medlaunches.com/gadgets/the_new_knee_replacement_for_women_introduced.php">Medlaunches.com</a>

A Woman’s Knee Replacement That Fits Their Shape and Size

While on the page I did a quick check by zip code to see how many surgeons offer this procedure and found 6 available from a zip code in Hun...

Wednesday, May 23, 2007

Google doubles Gmail attachment limit

Thanks for the folks at JKOnTheRun for bringing this new fact to our attention!  One other small item worth mentioning too about GMail, it uses SSH, an encrypted connection to send and receive email.  If you are a physician using a service that does not encrypt, perhaps Yahoo or any other web based email system, think about Google for sending any sensitive patient information.  GMail can also be configured to work with Outlook once you allow POP3 in the overall settings.  They also offer a couple other web based suggestions for sending large attachments below.  BD  <blockquote> <a href="http://jkontherun.blogs.com/.shared/image.html?/photos/uncategorized/2007/05/23/gmail_logo.jpg"><img alt="Gmail_logo" border="0" height="62" src="http://jkontherun.blogs.com/jkontherun/images/2007/05/23/gmail_logo.jpg" title="Gmail_logo" width="83"></a> Please try not to send me any 20 MB attachments, but if you do, you can now use Gmail. The (unofficial) <a href="http://googlesystem.blogspot.com/2007/05/gmail-doubles-maximum-attachment-size.html">Google Operating System blog says that Google's Gmail service just increased the attachment limit from 10 MB to 20 MB</a>, which ought to make most e-mail clients choke twice as fast now. While it's nice for Google to raise limits at the e-mail poker table, here's an alternative to sending those large attachments: try either the <a href="http://www.senduit.com/">senduit</a> or <a href="http://www.mailbigfile.com">MailBigFile</a> services. These freebies allow you to upload and store a large file for a pre-determined length of time up to a week. You get a URL for the file which you can then e-mail to a bud in lieu of the large attachment. This gives your mobile pal time to get to a faster or wired connection for the quicker transfer. ;)</blockquote> Source: <a href="http://jkontherun.blogs.com/jkontherun/2007/05/google_doubles_.html">jkOnTheRun: Google doubles Gmail attachment limit; try these alternatives</a>

Google doubles Gmail attachment limit

Thanks for the folks at JKOnTheRun for bringing this new fact to our attention! One other small item worth mentioning too about GMail, it u...

Wednesday, May 23, 2007

The Catch 22 of Health Insurance

Many families make too much money to qualify for assistance, but on the other hand paying for individual policies breaks the bank as well.  BD <blockquote> LOS ANGELES (Reuters) - Volunteer firefighter Cindy Holland has no medical insurance, and her husband's health benefits as a full-time paramedic do not extend to family members, so she and their three children go without. The hard-working Northern California family makes too much money to qualify for public health insurance but too little to afford a private policy, caught in a Catch 22 that puts many U.S. workers at risk of financial ruin. "It would kill us financially to do the insurance -- if we want to keep a roof over our head and food in my kids. You end up rolling the dice," said Cindy, a California native who works a pair of part-time jobs on top of firefighting. <h5> <a href="javascript:void(window.open('/news/pictures/slideshow?collectionId=464','slideshowWin','top=50,left=100,height=580,resizable=yes,width=733,scrollbars=yes'))"></a>That number is widely believed to be higher today as healthcare costs skyrocket, employers slash worker benefits and insurers gut coverage and cherry-pick the healthiest customers.</h5></blockquote> Source: <a href="http://www.reuters.com/article/healthNews/idUSN4P41784820070523?src=052307_1227_DOUBLEFEATURE_&pageNumber=1">Health care crisis squeezes working families | Health | Reuters</a>

The Catch 22 of Health Insurance

Many families make too much money to qualify for assistance, but on the other hand paying for individual policies breaks the bank as well. ...

Wednesday, May 23, 2007

Electronic Records put some MDs on Edge

I haven't run across any MDs yet that needed professional help yet over using Electronic Medical Records, but I have seen the frustration, mostly from offices that do not get enough training or don't take training seriously.  I think the one line below says it all, "change".  This could be something new, Disruptive Physician Syndrome...and from the full article, the cure doesn't appear to be inexpensive.  I also comment on a forum called EMR Update where we discuss EMR topics all the time and most of the physicians on the forum pretty much agree hands down too that training makes all the difference in the world on a successful implementation and they advise all to be sure and take all offers from the vendors when it comes to training...BD <img src="http://modernhealthcare.com/graphics/mh_spacer.gif" width="9"> But there's another downside that not many people are talking about: disruptive physicians. That's according to physician Alexis Polles, medical director of the professional enhancement program at Pine Grove Behavioral Health & Addiction Services in Hattiesburg, Miss. Polles and the program's clinical director, Phillip Hemphill, gave a presentation on disruptive physicians at the American College of Physician Executives' Spring Institute May 5-10 in Orlando, Fla. I covered the conference for the first time and sat in on the disruptive-physician session looking for some news. According to Polles and to several physician-executives I spoke with after the session, some practicing physicians are getting so frustrated trying to figure out how to use EHRs that they're lashing out at their peers, co-workers and staff—so much so that they need to seek professional help at places like Pine Grove. Said one physician-executive sitting at my table, "They just don't see why they have to change, and they take it out on everyone else." And off they go for some expensive behavioral modification. <blockquote> Source: <a href="http://modernhealthcare.com/apps/pbcs.dll/article?AID=/20070516/FREE/70515009&SearchID=73281736988100">Modern Healthcare Online</a></blockquote>

Electronic Records put some MDs on Edge

I haven't run across any MDs yet that needed professional help yet over using Electronic Medical Records, but I have seen the frustratio...

Tuesday, May 22, 2007

How Many Patients Can One Doctor Manage?

This article from Medscape gives some food for thought with the idea of creating a "panel".  Might be helpful with P4P considerations.  BD  (may require a subscription) <blockquote> <h3></h3> Practices and individual providers should not take on more work than they can manage. If a panel is too large, the excess demand results in a never-ending and ever-expanding delay in services in addition to constant deflections to other providers, resulting in discontinuity. On the other hand, if a panel is too small, demand may not be adequate to support the practice. The demand for appointments must equal the supply of appointments if timely service is desired. A simple equation can be used to express this: Panel size × visits per patient per year (demand) = provider visits per day × provider days per year (supply). <ol> <li>It makes patients happy. Patient surveys clearly demonstrate that patients want the opportunity to choose a primary care provider; they want access to that provider when they choose; and they want a quality health care experience. Establishing a panel links each patient with a provider with whom they have a health care relationship. <li>It defines the workload. Establishing a panel helps divide and define workload within a practice and helps ensure that each provider is carrying his or her fair share. <li>It predicts patient demand. Panels are the source of demand not only for visits but also for non-visit work (paperwork, e-mail, etc.), tests, procedures and hospitalizations. Understanding the panel helps a practice anticipate that demand both. <li>It reveals provider performance issues. Understanding the panel allows groups to see the effects of provider variability. For example, if two providers have the same panel size but one provider has more demand than the other, then the practice can explore why this difference exists (e.g., one physician uses shorter return-visit intervals) and whether it is justified. <li>It helps improve outcomes. Identifying individual panels enables providers to make a commitment to continuity (that is, to taking care of their own patients for all their visits), which results in improved clinical outcomes,[17,18,28-30] reduced costs and enhanced revenue per visit.[13,16,19,31]</li></ol></blockquote> Source: <a href="http://www.medscape.com/viewarticle/556028_1">Panel Size: How Many Patients Can One Doctor Manage?</a>

How Many Patients Can One Doctor Manage?

This article from Medscape gives some food for thought with the idea of creating a "panel". Might be helpful with P4P considerati...

Tuesday, May 22, 2007

Doctors, Legislators Resist Drugmakers' Prying Eyes

There are 2 sides to every story, but the one comment included below puzzles me to a degree...was the pressure to increase sales high enough for job security perhaps to create this type of a comment to reflect upon the judgement of the physician?  What happened to "Doctor knows best."  BD Seattle pediatrician Rupin Thakkar's first inkling that the pharmaceutical industry was peering over his shoulder and into his prescription pad came in a letter from a drug representative about the generic drops Thakkar prescribes to treat infectious pinkeye. In the letter, the salesperson wrote that Thakkar was causing his patients to miss more days of school than they would if he put them on Vigamox, a more expensive brand-name medicine made by Alcon Laboratories. "My initial thought was 'How does she know what I'm prescribing?' " Thakkar said. "It feels intrusive. . . . I just feel strongly that medical encounters need to be private." Source: <a href="http://www.washingtonpost.com/wp-dyn/content/article/2007/05/21/AR2007052101701.html">Doctors, Legislators Resist Drugmakers' Prying Eyes - washingtonpost.com</a> Hat Tip:  <a href="http://www.kevinmd.com/blog/2007/05/big-pharma-data-mining-and-ama.html">Kevin, MD</a>

Doctors, Legislators Resist Drugmakers' Prying Eyes

There are 2 sides to every story, but the one comment included below puzzles me to a degree...was the pressure to increase sales high enough...

Tuesday, May 22, 2007

Chapter 4, "Are you still just using your cell phone for phone calls?"

Nice way of connecting those with asthma to the professionals who can help.  Interesting as well how the prompts could be set up for either a parent or child to enter information.  BD <blockquote> A remarkable story of success fighting asthma exists at the San Mateo Medical Center, San Mateo County's hospital. The cell phone prompts the child/parent at various times during the day through eight questions. The child/parent responds to the prompts. For example, did the child take his/her medicine? Is breathing more difficult? After the child measures her/her lung capacity, the cell phone prompts the child to put the measurements into the cell phone. Adverse indicators are relayed, via the phone, to a case manager and then, if needed, to physicians assigned to monitoring the children. If problems are indicated, the phone rings. A case manager seeks more information. The cell phone also offers encouraging messages if the indicators are themselves encouraging, for example, "Doing great! You go girl!" Over this past year, none of these children has experienced symptoms so severe as to require a visit to the hospital emergency room. Not one. Through intensive patient support and communication, medications are taken on time. Exposure to allergens is reduced. Bottom line: These children are gradually learning how to take better care of themselves. Their health has improved. </blockquote> Source: <a href="http://www.insidebayarea.com/opinions/letterstotheeditor/sanmateocountytimes/ci_5816434">Inside Bay Area - Cell phones, support make strong asthma medicine</a>

Chapter 4, "Are you still just using your cell phone for phone calls?"

Nice way of connecting those with asthma to the professionals who can help. Interesting as well how the prompts could be set up for either ...

Tuesday, May 22, 2007

Aetna Awards $275,000 To Chicagoland Nonprofits

Aetna Awards $275,000 To Chicagoland Nonprofits

Organizations invited to apply for 2007 grants addressing obesity, depression, the nursing shortage, and diversity and cultural competen...

Tuesday, May 22, 2007

People Feed Up With Long Doctor’s Office Visits Find a New Alternative Online

People Feed Up With Long Doctor’s Office Visits Find a New Alternative Online

Relief awaits those who hate waiting at the doctor’s office or simply don’t have medical insurance. The new wave has become free online...

Tuesday, May 22, 2007

CalPERS workers lose health option with Blue Shield

<blockquote> LAKE COUNTY -- With the gargantuan CalPERS Blue Shield health care benefit provider planning to quit Lake County to cut costs, county employees will be digging deeper into their pockets. A cost-cutting plan voted on last week by the pension fund's board of directors will allow Blue Shield to pull out of four rural counties, citing rising costs of providing service. Lake County, along with Napa, Plumas and El Dorado counties, will take the hit within the next year. "It's going to cost employees more out of pocket for the same health coverage they're getting now because of the deductible," Ferguson said. "The Blue Shield EPO option will no longer be available as of January 2008. "This is disappointing but not unexpected because we had a benefit without the network to support it," added Ferguson. "We hope that CalPERS is going to be working to develop an HMO in Lake County so they can bring HMO products back." Ferguson noted that the agency created an HMO in Humboldt County last year that became effective in March of this year.</blockquote> Source: <a href="http://www.record-bee.com/local/ci_5953532">www.record-bee.com - CalPERS workers lose health option</a>

CalPERS workers lose health option with Blue Shield

LAKE COUNTY -- With the gargantuan CalPERS Blue Shield health care benefit provider planning to quit Lake County to cut costs, county em...

Tuesday, May 22, 2007

Personal Health Records - physicians speak out on both the benefits and issues created from Modern Health care

I asked an employee this week at Verizon if they had begun using their electronic records from Verizon, but this employee was not aware of the new offering yet, so it appears to be in the works at this point. BD    <blockquote> Like a recurring dream about having to take a test they didn't study for, some physicians view the idea of patients with electronic personal-health records as their own personal nightmare. Visions of patients handing over a computer disk containing years' worth of blood-pressure readings taken every four hours along with random recollections of rashes and muscle strains that physicians are required to somehow make sense of and memorize are followed by thoughts of being sued because there was a kernel of important information missed in the deluge. Peter Basch, medical director for e-health at MedStar Health in Washington, says "physicians love a (hospital) discharge summary" that gives one to two pages of key points. What they may get from a PHR, however, could be something that has no resemblance to a discharge summary at all. Nevertheless, he says that PHRs could be an important tool in developing a partnership with patients, so he "gently forces" them to use the spreadsheets—either paper or electronic—that he has developed.</blockquote> Source: <a href="http://www.modernhealthcare.com/apps/pbcs.dll/article?AID=/20070521/FREE/70521005/0/FRONTPAGE">Modern Healthcare Online</a>

Personal Health Records - physicians speak out on both the benefits and issues created from Modern Health care

I asked an employee this week at Verizon if they had begun using their electronic records from Verizon, but this employee was not aware of t...

Tuesday, May 22, 2007

Who Killed HealthCare

New book written about the healthcare system in the US.  BD <blockquote> <a href="http://www.amazon.com/exec/obidos/ASIN/0071487808/theamericansp-20">Who Killed Health Care?</a>: America's $2 Trillion Medical Problem -- and the Consumer-Driven Cure (McGraw-Hill, 240 pages, $24.95) Try to imagine health care as a police lineup, with the patient behind the one-way mirror, trying to pick out the suspect. The lineup includes big hospitals, employers, big insurance companies, health care academics and government. When asked which of the suspects killed health care, the patient points to all of them. Indeed, the only ones to not make out on managed care were patients and doctors. Patients loathed the restrictive nature of HMOs, to the point that eventually HMOs were replaced by managed care organizations like Preferred Provider Organizations that put fewer restrictions on patient access and choice. Under managed care, doctors are pressured to conform to managed care organizations' disease management advice. Academics frequently complain of doctors' low compliance with such advice. However, it may be that the doctors, and not the academics, know what they are doing. As Herzlinger notes, "There is no accepted evidence of the cost effectiveness of disease management." Who Killed Health Care? points out that they actually came to prominence due to the HMO Act of 1973. With an economy facing rising health care costs in the early 1970s, President Richard Nixon turned to HMOs to hold costs down. His HMO Act required employers who offered insurance to offer at least one managed care product. It also offered subsidies to companies that opened HMOs. </blockquote> Source: <a href="http://www.spectator.org/dsp_article.asp?art_id=11472">The American Spectator</a>

Who Killed HealthCare

New book written about the healthcare system in the US. BD Who Killed Health Care? : America's $2 Trillion Medical Problem -- and the...

Tuesday, May 22, 2007

Is the new family doctor a nurse?

<blockquote> Cathy Giorgio wears a traditional white lab coat when she takes patient histories, performs physical exams, diagnoses health problems, reads lab reports and X-rays, writes prescriptions, and authorizes advanced medical tests. She performs almost every task a family doctor does, though she isn’t one. A growing number of healthcare experts believe nurse practitioners like Giorgio are the cure for an ailing U.S. health system faced with a growing number of patients and a looming shortage of general doctors, especially ones willing to treat poor patients. They cite statistics such as lower malpractice rates, lower care-related costs, and higher rates of patient compliance with treatment recommendations associated with these advanced-care nurses compared with their doctor cousins.</blockquote> Source: <a href="http://www.phillyburbs.com/pb-dyn/news/111-05222007-1350461.html">Is the new family doctor a nurse? (phillyBurbs.com) | Health, medical</a>

Is the new family doctor a nurse?

Cathy Giorgio wears a traditional white lab coat when she takes patient histories, performs physical exams, diagnoses health problems, r...

Tuesday, May 22, 2007

Mobile Medical Services - Dream Center

This is just a thought of my own, but many cities, Los Angeles included have mobile medical services for the homeless and hospital services through the Queen of Angels hospital. Just as an afterthought on the story on dumping the homeless who are still in need of further medical attention, is it an option? A couple years ago I was able to see the mobile medical office that helps take care of the homeless and it is a first class medical office on wheels and they do a great service in traveling to the homeless. The Dream Center is sponsored by gifts and donations. Is this something perhaps some other hospitals could perhaps entertain by donations and perhaps working with the homeless to get additional medical attention when needed. Here are a couple links that provide additional information. BD <a href="http://www.dreamcenter.org/donating_corporate.shtml">http://www.dreamcenter.org/donating_corporate.shtml</a> <a href="http://www.kathieleegifford.com/lamb04/charity/dc.php">http://www.kathieleegifford.com/lamb04/charity/dc.php</a>

Mobile Medical Services - Dream Center

This is just a thought of my own, but many cities, Los Angeles included have mobile medical services for the homeless and hospital services ...

Monday, May 21, 2007

Democrats prescribe bigger health levy - employer health insurance contributions could rise

Some employers are already beyond the 7.% proposed increase with their present offerings..BD <blockquote> SACRAMENTO — Escalating the already tense fight about what financial burden businesses should bear, the Democrats who control the Legislature proposed Tuesday that most California employers be required to spend the equivalent of at least 7.5% of their payrolls on healthcare — nearly twice the amount Gov. Arnold Schwarzenegger has proposed. The mandate on employers would raise more than $5 billion and — along with federal taxpayer money and worker contributions — allow California to extend insurance to about 69% of the 4.9 million people who lack it at any given moment. Among states, only Hawaii has a significant employer mandate. But the Democratic proposals in California would go further by including dependent coverage and more part-time workers. There are 233,000 firms that spend less than 7.5%; they employ 4.5 million workers. An additional 327,000 firms make no contribution; they employ 1.5 million workers.</blockquote> Source: <a href="http://www.latimes.com/news/local/la-me-health16may16,0,2097102.story?coll=la-home-local">Democrats prescribe bigger health levy - Los Angeles Times</a>

Democrats prescribe bigger health levy - employer health insurance contributions could rise

Some employers are already beyond the 7.% proposed increase with their present offerings..BD SACRAMENTO — Escalating the already tense fig...

Monday, May 21, 2007

Chapter 3, Are you still just using your cell phone for phone calls?

This concept not only involves Cell Phones, but also RFID (radio frequent ID technology) too. This could really be a life saver for post surgery and a new way to monitor cardiac and glucose readings as well.  A phone is a phone is a phone...????  Perhaps not by today's standards...BD <blockquote> <img src="http://www.gentag.com/images/General07.png"> Low cost disposable RFID sensors are now possible with Gentag’s proprietary reference technology. Since RFID-enabled <a href="http://www.rfidjournal.com/article/articleview/1020/1/1">cell phones</a> are currently either already available or under development with major cell phone manufacturers worldwide for both the 13.56 and UHF (Gen-2) frequencies and that market forecasts predict that up to 1 out of 2 phones in the future will be RFID-enabled, the global emergence of RFID sensor networks can be anticipated. By combining RFID cell phones and RFID sensors with cellular networks or the Internet, the consumer will be empowered to read any RFID sensor tag anywhere for almost any application. <blockquote> <img src="http://www.gentag.com/images/Asthma07.png"> </blockquote> Via:  <a href="http://www.gentag.com/technology.xml">Gentag</a> Hat Tip:  <a href="http://www.medgadget.com/archives/2007/05/diagnostic_sensors_read_by_rfidenabled_cell_phones.html">Medgadget</a></blockquote> Source: <a href="http://www.technovelgy.com/ct/Science-Fiction-News.asp?NewsNum=1048">RFID Diagnostic Sensors Read By RFID-Enabled Cell Phones: Science Fiction in the News</a>

Chapter 3, Are you still just using your cell phone for phone calls?

This concept not only involves Cell Phones, but also RFID (radio frequent ID technology) too. This could really be a life saver for post sur...

Monday, May 21, 2007

Tale of last 90 minutes- woman dies while nobody helps in the ER room

This is indeed a sad story and it was all captured on tape.  The hospital already has huge issues on it's doorsteps and this is not going to help<img align="right" alt="Inquiry" border="0" height="73" src="http://www.latimes.com/media/thumbnails/photo/2007-05/29920823.jpg" width="94"> matters.  Complacency?  Humanity?    BD <blockquote> County officials express dismay at the events surrounding the recent controversial death at King-Harbor hospital. One nurse has resigned.  <a href="http://www.latimes.com/news/local/la-me-king20may20_ji2dcnnc,0,457787.photo?coll=la-home-center"></a> In the emergency room at Martin Luther King Jr.-Harbor Hospital, Edith Isabel Rodriguez was seen as a complainer. Aside from one patient who briefly checked on her condition, no one helped her. A janitor cleaned the floor around her as if she were a piece of furniture. A closed-circuit camera captured everyone's apparent indifference. According to preliminary coroner's findings, the cause was a perforated large bowel, which caused an infection. Experts say the condition can bring about death fairly suddenly. "Where was their heart? Where was their humanity? … When Jose came in, everybody was just sitting, looking. Where were they?"</blockquote> Source: <a href="http://www.latimes.com/news/local/la-me-king20may20,0,6057993.story?page=1&coll=la-home-center">Tale of last 90 minutes of woman's life - Los Angeles Times</a> Hat Tip:  <a href="http://www.kevinmd.com/blog/2007/05/death-of-complainer.html">Kevin, MD</a>

Tale of last 90 minutes- woman dies while nobody helps in the ER room

This is indeed a sad story and it was all captured on tape. The hospital already has huge issues on it's doorsteps and this is not goin...

Sunday, May 20, 2007

Pharma Rep Interview from the Daily Show

Pharma Rep Interview from the Daily Show

This is a very funny interview from the Daily Show. We can't embed the video, but you can follow the link below to view. Comedy Centra...

Saturday, May 19, 2007

Medical Building set on fire

Medical Building set on fire

Was the intent to burn medical records? One more reason to ditch the paper files and back up your data...BD NORTH HOLLYWOOD, CA (AP) --...

Saturday, May 19, 2007

Medicare audits raise questions - claims rejected and classified "medically unnecessary"

<blockquote> The California Hospital Association raised concerns in November that PRG-Schultz was targeting rehabilitation hospitals that cared for Medicare patients after knee or hip replacement surgery. The hospital association said that PRG-Schultz had reviewed thousands of cases dating to 2002 and had rejected nearly all as medically unnecessary. Melinda Staveley, president of the 38-bed Rehabilitation Institute in Santa Barbara, Calif., said that more than 100 such cases from her nonprofit institution had been rejected. The facility could face repayment of more than $2 million. California’s U.S. House members will soon follow with a joint letter of their own asking for an investigation. The auditing program was set up as a demonstration project initially focusing on the three highest-cost Medicare states: California, New York and Florida. Separate contractors are used for each state. PRG-Schultz is the only for-profit contractor among them.</blockquote> Source: <a href="http://www.kansascity.com/news/politics/story/113746.html">www.kansascity.com | 05/18/2007 | Medicare audits raise questions</a>

Medicare audits raise questions - claims rejected and classified "medically unnecessary"

The California Hospital Association raised concerns in November that PRG-Schultz was targeting rehabilitation hospitals that cared for M...

Saturday, May 19, 2007

School officials at risk of firing - poor record keeping and student health records are part of the issue

In today's world of technology, it is almost a shame that paper folders are still being used.  If you read the comments below it states how they have to go through a "whole roomful of folders" to find the records.  The same thing happens with physicians and hospitals too who are still relying on the paper chart too.  From the article, it appears jobs are apparently on the line here for lack of organization and perhaps use of a little updated technology.  As a parent, this could send out a message to entertain some type of family personal health record so even if immunization records are not available from the school, a family health record file might help you keep this things in check.  BD  <blockquote> The Baltimore school system has threatened about 120 principals with disciplinary action, including termination, if their schools fail to provide a complete set of records for each student by the end of this month. Warning letters were sent to the principals recently after two state audits turned up evidence that missing and incomplete student records have become a widespread problem in city schools. Another audit conducted in April 2005 found, among other things, missing health records among the more than 1,300 general student records examined. Maryland education regulations require schools to have information on enrollment, attendance and promotion for all students. In April 2005, state officials pulled a random sample of student records at 43 city high schools and found missing standardized test scores, incomplete immunization requirements and outdated information on students' addresses. State officials say many systems require their schools to use a uniform recordkeeping system - with some using computers - but the city does not. "They just have a little manila folder, where they stick records in it and put it in filing room," said Carol Ann Baglin, assistant state superintendent for special education and early-intervention services. "So when we go out and ask for records, they have to go through a whole roomful of folders to dig them out."</blockquote> Source: <a href="http://www.baltimoresun.com/news/local/baltimore_city/bal-te.md.ci.principals19may19,0,679784.story?page=1&coll=bal-home-headlines">School officials at risk of firing - baltimoresun.com</a>

School officials at risk of firing - poor record keeping and student health records are part of the issue

In today's world of technology, it is almost a shame that paper folders are still being used. If you read the comments below it states ...

Saturday, May 19, 2007

Hospital CIO makes the top 100 List for IT Innovation and Development

This is an online publication called E-Week who just recently published their top influential CIOs for the last year. If you keep up on recent medical articles on the web, you do find Beth Israel frequently in the news! Congratulations to Dr. Halamka! #57 John Halamka M.D., Beth Israel Deaconess Medical Center As a physician turned CIO, Halamka has been a prominent pioneer in electronic medical records and other health care IT initiatives <a href="http://1.bp.blogspot.com/_v3zjJigoAPE/Rk8yAhv52dI/AAAAAAAAAEI/AvCQAHa5z_0/s1600-h/cio.jpg" onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}"><img alt="" border="0" id="BLOGGER_PHOTO_ID_5066323090455779794" src="http://1.bp.blogspot.com/_v3zjJigoAPE/Rk8yAhv52dI/AAAAAAAAAEI/AvCQAHa5z_0/s200/cio.jpg" style="margin: 0pt 10px 10px 0pt; float: left; cursor: pointer; width: 259px; height: 198px;" /></a> <a href="http://www.eweek.com/">http://www.eweek.com/</a>

Hospital CIO makes the top 100 List for IT Innovation and Development

This is an online publication called E-Week who just recently published their top influential CIOs for the last year. If you keep up on rec...

Saturday, May 19, 2007

Chapter 2 - Are you still just using your Cell Phone for phone calls - Paramedics and Cardiologists work with wireless technology -saving lives

<a href="http://www.microsoft.com/windowsmobile/_assets/images/devices/deviceimages/small/254.jpg" onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}"><img alt="" border="0" src="http://www.microsoft.com/windowsmobile/_assets/images/devices/deviceimages/small/254.jpg" style="margin: 0pt 10px 10px 0pt; float: left; cursor: pointer; width: 81px; height: 175px;" /></a> This article surely has to tweak the interest of any Cardiologist! It is amazing once you give this some thought as the once categorized potential enemy of diagnostic equipment in the medical area is now saving lives. Mayo Clinic has also substantiated this a while back with their findings too. Amazing too is that this system has been in place since June in 2006! Again, this says a lot for professionals jumping outside the box and finding a mobile solution that can in fact save lives and improve the quality of health care. Being able to view an EKG on the cellphone ahead of the patient arriving can truly be a lifesaving technique and it has cut the time in half to begin treatment! BD Imagine paramedics mobilizing a team of cardiologists and nurses within minutes of arriving at the home of a person who is having a heart attack, simply by pressing a button that sends an electrocardiogram (ECG) over a wireless network. That's exactly what's being done at a Newark, NJ, medical center, and it's dramatically improving the quality of care, according to a study honored as the best abstract presented at the 30th Annual Scientific Sessions of the Society for Cardiovascular Angiography and Interventions (SCAI), May 9-12, 2007. At UMDNJ, for example, it took an average of 61 minutes in 2005 just to notify a cardiologist that a patient with a heart attack had arrived at the emergency room. Coupled with the assignment of on-call cardiologists to more than one hospital and the catheterization laboratory's 5 PM closing time, it was virtually impossible to begin catheter-based treatment within 90 minutes. In fact, the average door-to-intervention time-an alternative term used in this study to reflect the full range of catheter techniques available to interventional cardiologists-was nearly 146 minutes in 2005. Under the guidance of Marc Klapholz, M.D., director of the Division of Cardiology at UMDNJ, the wireless system went live in June 2006. It enables paramedics to use Bluetooth technology to send an ECG not just to the emergency room but also to a receiving station in the cath lab. From there the electrocardiogram is automatically converted to a PDF file and forwarded via the hospital intranet to several e-mail addresses set up just for that purpose. The on-call cardiologist receives a text message with instructions to download the electrocardiogram for viewing on a smart phone. The file also includes the phone number of the paramedic who initiated transmission of the electrocardiogram, so the cardiologist can immediately be in contact with the ambulance crew. Patients who are clearly having a heart attack are whisked directly to the cath lab. Source: <a href="http://www.medicalnewstoday.com/medicalnews.php?newsid=71286&nfid=rssfeeds">Transmitting ECGs To Cardiologists By Smart Phone Cuts Treatment Time In Half</a>

Chapter 2 - Are you still just using your Cell Phone for phone calls - Paramedics and Cardiologists work with wireless technology -saving lives

This article surely has to tweak the interest of any Cardiologist! It is amazing once you give this some thought as the once categorized po...