Medical Quack: 05/01/2007

Flexicath gains FDA Approval

The FirmGrip™ combines a standard catheter enclosed in a polymer sleeve with a special silicone insertion unit to produce a self-contained sterile catheter insertion field.

FirmGrip.15
In this model, a soft midterm catheter (20 cm) encased in the compact sterile sleeve is inserted in a simple, efficient manner using Peel-away needle or standard IV canula as port of entry. Having the midterm catheter encased in the sterile sleeve reduces the chance of infection and the need for an external sterile environment. FirmGrip.15 provides physicians the flexibility to leave a soft catheter in place for midterm (up to 29 days) treatment periods.

First product will be available for sale on June 2007.

Source: Flexicath Ltd

Hat Tip: Medgdget

Patient told to cough up or ship out

The practice continues to work with needy patients as stated in the full article...BD

When a doctor's office prescribes timely payment for its services, a patient might be wise to comply -- even when the bill is for a relatively small amount of money.
A coastal Sussex County businesswoman, for instance, has been forced to find a new primary-care physician for herself and her children after allowing a $40 bill to linger for months. It wasn't that real estate agent Donna Atsidis didn't intend to pay the debt, she said recently, she simply hadn't gotten around to it.
"I didn't think it was real," Atsidis said, but she was shaken nonetheless. "I went in there and I was so embarrassed my voice was cracking when I tried to find out what it meant."
She paid off what she owed -- $40.20, to be exact -- but that didn't change her status. She and her daughters, ages 9 and 12, were eligible for emergency service in the short term, but would have to find a new provider for routine care. The decision was final.

The Daily Times - www.delmarvanow.com - Salisbury, Md.

Bill Gates and Steve Jobs Together

Nice interview and interaction and very well done. BD

ID cards for Medical Pot users to be issued

The application fee for county residents will be $153, or $76.50 for Medi-Cal recipients. Medical marijuana users must present a doctor's written recommendation to obtain the drug, and must apply to the Department of Public Health.

ID cards for medical pot users to be issued - Los Angeles Times

Medical lab automated at UCI

New automated process for securing lab results...results sent electronically to the physicians...be sure your PC or network is ready...BD

The specimens are all marked with bar codes that the automated lab reads to direct the samples along the line. The first read sends the sample into a centrifuge for spinning or to a device that pops off the cap.

At a testing station, a needle-like instrument rapidly dips into the sample to remove a dab for placement on a testing device, whether to measure cholesterol or potassium levels. A self-cleaning function sterilizes the needle before it dips again.

Lab workers don't have to handle open containers in the automated system.

"When you have the human element, I've seen spills happen," Congelliere said. "There's always that potential of hazard."

A computer spits out the results, alerting lab scientists of unusual or dangerous results. The process is also tailored to track an individual's changes since the last test.
"Most of the specimens that go through the lab are normal results," Berman said. "In a hospital, you're going to have a lot of criticals and you want to put your attention on those adverse results."
Results are also sent electronically to doctors.

Article - Money - Medical lab automated at UCI

Former San Jose Medical Group manager stole patients' information

The former manager at San Jose Medical Group entered a guilty plea to charges that he stole computer equipment containing sensitive personal information, the U.S. Attorney's office said Thursday.
U.S. Attorney Scott N. Schools said Joseph Nathaniel Harris, 44, who now lives in Riverside, admitted stealing equipment in March 2005 that included a DVD with information on almost 200,000 patients in the San Jose area.
FBI agents recovered the DVD.
Harris was branch manager at the San Jose Medical Group, a medical services organization that includes hundreds of affiliated physicians in the South Bay, but left in September 2004. In March 2005, employees discovered computer equipment missing from the group's administrative office, including information on patients' names, addresses, phone numbers, dates of birth, Social Security numbers, diagnoses, and medical procedures.

Former San Jose Medical Group manager stole patients' info - Silicon Valley / San Jose Business Journal:

FDA Approves Wyeth's Torisel For Treatment Of Advanced Kidney Cancer

The US Food and Drug Administration (FDA) yesterday approved Wyeth's new drug Torisel (chemical name temsirolimus) for the treatment of renal cell carcinoma, the most common form of advanced kidney cancer.
The FDA approval was based on the results of a clinical trial published today in the New England Journal of Medicine.
The trial showed that patients who were given Torisel alone showed a significant improvement in overall survival of about three and a half months compared with patients who were only on interferon.

Source: FDA Approves Wyeth's Torisel For Treatment Of Advanced Kidney Cancer

Wearable monitoring devices from BodyMedia

Working on a diet...products are available for both personal and professional use and the data is recorded and used with PC software. The article states the armband can be given to a patient for monitoring, the results are sent to the patient's PC whereby they can be emailed to the monitoring physician. I would anticipate seeing the personal versions showing up at gyms and with personal trainers in the new future. Sounds like a very simplistic way to really find out how many calories we burn and perhaps find some new areas for improvement as we continue the battle of the bulge. BD

bodybugg™ armband
The bodybugg™ armband monitors an individual's Total Energy Expenditure (TEE). This is the total number of calories their body burns during the day while exercising, driving a car, walking the dog, even sleeping. The armband is a comfortable device worn on the back of the upper arm that continuously and accurately measures calories burned throughout the day. The slim design of the armband minimizes interference with day-to-day activities and can be worn discreetly under clothing.
SenseWear® software applications
The SenseWear® software applications allow you to easily upload, annotate, analyze and share data recorded with the SenseWear® armband. SenseWear® Professional software includes advanced algorithms that accurately process your patients' continuous body data into information you can use. The software allows you to easily graph data and print reports. Advanced features let you customize the collection rate of each of the sensor channels as well as the METs levels that determine different levels of activity, from sedentary to very vigorous.

The bodybugg system enables individuals and healthcare providers (personal trainers, nutritionists, etc.) to accurately monitor calories burned and compare it to calories consumed. It's the perfect tool for anyone struggling to manage their weight effectively or helping someone else do the same.

For the health practitioner, we provide valuable tools that can be used to drive client/patient success and create new revenue streams.

Source: BodyMedia

Northrop Grumman Provides Patient Information Application to Centers for Medicare and Medicaid

CMS outsourcing efforts for improving health care...BD

MCLEAN, Va., May 30, 2007 (PRIME NEWSWIRE) -- Northrop Grumman Corporation (NYSE:NOC) has been awarded a task order from the Centers for Medicare and Medicaid Services (CMS) to develop and implement a Web-based application that will help Medicare providers develop comprehensive assessments of patients discharged from post-acute care.
Under the CMS Professional Information Technology (IT) Services indefinite-delivery/indefinite quantity contract, Northrop Grumman will create and deploy a patient assessment instrument that will allow Medicare providers to capture health and demographic information for complete, electronic patient profiles. The secure, Web-based environment will support CMS' post-acute care program, which is care provided to individuals who need additional help recuperating from an acute illness or serious medical procedure.
The post-acute care assessment instrument will be used for patient placement decision-making; enhanced safety and quality of information to a receiving provider; and comprehensive information for patient health follow-up and outcome. The data collected from the assessment instrument will also be used by CMS to improve Medicare's payment for post-acute care services and the coordination of these services.
Work on the contract will be conducted in Woodlawn, Md., over one year with three one-year options.

Source: Northrop Grumman Provides Patient Information Application to Centers for Medicare and Medicaid

United Health Group demonstration held at the annual meeting

MINNEAPOLIS - While United Health Group, Inc., tried to reassure shareholders that it's addressing a stock scandal that forced the ouster of CEO William McGuire, protesters outside the HMO's annual meeting called for universal health care.
The demonstrators, organized by the Universal Health Care Action Network-Minnesota, www.uhcan-mn.org, said United Health and other insurers continue to make massive profits while millions of Americans lack health coverage. They protested outside the Minneapolis Convention Center where United Health – the largest HMO in the country – held its annual meeting Tuesday morning.
"Right now, we have a market-based system that's been proven unsustainable," said UHCAN member Stefanie Levi. "People are dying as a result of our broken health care system."
At the annual meeting, United Health announced that in 2006, it increased earnings by 37 percent, revenue by 54 percent, and cash flow by 60 percent. Management also tried to reassure shareholders that the company was responding to concerns raised after McGuire was forced out last year in a scandal over the backdating of stock options. Before his ouster, McGuire was the highest-paid executive in Minnesota, receiving $124 million in stock options alone in 2006.

United Health shareholders rejected proposals put forth by investor groups, including the California public pension system, to tighten controls on executive compensation and open up board elections. Instead, shareholders approved company-backed proposals that make modest changes in the board election process.
The number of uninsured Americans is approaching 50 million and millions more are under-insured.

Source: Welcome to Workday Minnesota, your leading source for labor news!

Blue Cross to lose 350 jobs after Medicare contract expires

TOPEKA - Blue Cross and Blue Shield of Kansas will lose 350 jobs in the state after a bid for a five-year Medicare contract was rejected.
The company was told that a bid by one of its subsidiaries, Wheatlands Administrative Services, was rejected by the Centers for Medicare and Medicaid Services, company spokesman Graham Bailey said.
After the current contract expires, Topeka is expected to lose 335 jobs and Salina 15 jobs.

Source: Kansas.com | 05/30/2007 | Insurer to lose 350 jobs after Medicare contract expires

Microsoft unveils new Surface computer

This may totally change the way radiology reports and images are viewed or just accessing a patient chart. Last year I remembered viewing the "play anywhere" video from Microsoft and this appears to be the next phase of the technology emerging. Get your cellphones and wireless equipped tablets ready for some interaction....BD

The machines, which Microsoft planned to debut Wednesday at a technology conference in Carlsbad, Calif., are set to arrive in November in T-Mobile USA stores and properties owned by Starwood Hotels & Resorts Worldwide Inc. and Harrah's Entertainment Inc.
Surface is essentially a Windows Vista PC tucked inside a shiny black table base, topped with a 30-inch touchscreen in a clear acrylic frame. Five cameras that can sense nearby objects are mounted beneath the screen. Users can interact with the machine by touching or dragging their fingertips and objects such as paintbrushes across the screen, or by setting real-world items tagged with special bar-code labels on top of it.

Unlike most touchscreens, Surface can respond to more than one touch at a time. During a demonstration with a reporter last week, Mark Bolger, the Surface Computing group's marketing director, "dipped" his finger in an on-screen paint palette, then dragged it across the screen to draw a smiley face. Then he used all 10 fingers at once to give the face a full head of hair.

Popular Mechanics also provides a nice video preview from their website.

Source: Microsoft unveils new Surface computer - Yahoo! News

Surface Page Presentation from Microsoft: http://www.microsoft.com/surface/

Additional information here: http://on10.net/Blogs/larry/first-look-microsoft-surfacing-computing/

Visits to Doctors Who Are Not in, Ever

This story breaks down the generations in the search for information, "Dr. Google" in particular here provides the basic information and the article continues on to talk about how different generations locate and find information today with technology. BD

“I’m contagious,” my 9-year-old said, looking up from the laptop on which she had just typed her symptoms one morning last week. “I shouldn’t go to school with strip throat.”
“It’s strep throat,” I said, not looking up from my breakfast. “And you don’t have it. So go get dressed.
Patients should not skip going to the doctor in favor of sleuthing online, though. “I encourage my patients to get more medical information to be a better patient,” Dr. Rohack said. “But I also think you need help wading through all that information, and that continues to be the higher role of doctors.”
As today’s children age, they will increasingly rely on collaborating online with peers as a tool to weed out erroneous information, Mr. Prensky predicted.
“Our generation holds information that might be useful one day close to the chest, but kids share it like crazy,” he said, adding that in the future, “Kids will look at a situation and say, ‘This is a problem for 20 people to figure out,’ or ‘This is a problem that will take 10 people,’ and they’ll break it down and share it.”
Until then? The next time my daughter comes down with a case of strip throat, I may suggest to her that Dr. Google’s treatment of choice is a shot.

Source: Visits to Doctors Who Are Not in, Ever - New York Times

Bloodless Prostate Cancer Surgery Performed

More about robotic surgery. As this field continues to grow and procedures are added, it really can help speed up recovery times and in most instances is far less invasive. The picture below shows the surgeon in the operating room, viewing everything from the da vinci console. BD

Even if traditionally invasive open surgery had been an option, Reginald's relatively young age at 55 allowed for a less traumatic, nerve-sparing prostate cancer treatment called a da Vinci Robotic Prostatectomy. Taking advantage of the da Vinci robot's improved operative dexterity and superior magnification, a surgeon makes five keyhole incisions rather than the six-inch invasive incision required for open prostatectomy. Smaller incisions mean less nerve damage, less pain, a shorter hospital stay and faster catheter removal. Most importantly, in Reginald's case, the da Vinci Robotic Prostatectomy could be performed with less than 100CCs of blood loss, which is insignificant, and would not challenge his religious beliefs.

Source: Bloodless Prostate Cancer Surgery Performed On Jehovah's Witness Patient

ICU Nurse Working Conditions Linked To Increase In Patient Infections

"Nurses are the hospitals' safety officers"....BD

A review of outcomes data for more than 15,000 patients in 51 U.S. hospital ICUs showed that those with high nurse staffing levels (the average was 17 registered nurse hours per patient day) had a lower incidence of infections. Higher levels of overtime hours were associated with increased rates of infection and skin ulcers. On average nurses worked overtime 5.6 percent of the time. These findings, reported in the June issue of Medical Care, one of the leading health care administration journals, support the notion that a systematic approach aimed at improving nurse working conditions will improve patient safety.
"Nurses are the hospitals' safety officers," said Patricia W. Stone, Ph.D., M.P.H., R.N., assistant professor of nursing at Columbia University Medical Center and the study's first author. "However, nursing units that are understaffed and that have overworked nurses are shown to have poor patient outcomes. Improvements in nurse working conditions are necessary for the safety of our nation's sickest patients. With the looming nursing shortage, hospitals direly need to address working conditions in order to help retain current staff now and recruit people into nursing in the future.

Source: ICU Nurse Working Conditions Linked To Increase In Patient Infections

AMA wants doctors to swap idea online

I think this is already taking place in many circles on the web...goes under the name of "blogging" BD

The AMA on Wednesday plans to announce a partnership with a company called Sermo Inc., which seeks to use the Web to tap into the collective wisdom of the service's growing network of 15,000 U.S. doctors.

Some doctors are skeptical the nine-month-old service can advance medical safety, and a pharmaceutical industry group worries the service could spread as much rumor as fact.
But the 160-year-old AMA hopes its collaboration with Cambridge, Mass.-based Sermo will open a new line of communication, allowing members to quickly share everything from advice about treating an individual patient's unique symptoms to opinions on whether regulators should approve an experimental drug.
Other doctors rank postings based on whether the information appears credible — a "wisdom of the crowd" approach that Sermo says assigns low rankings to spurious claims that should be read with skepticism. Doctors can challenge or corroborate others' postings.

Source: AMA wants doctors to swap idea online - Yahoo! News

Hospitalist Model May Reduce Costs without adversely Affecting Outcomes

(from Medscape, may require subscription

May 25, 2007 (Dallas) — For patients with common inpatient diagnoses, the hospitalist model reduces length of stay and costs without adversely affecting mortality or readmission, according to a presentation by Peter K. Lindenauer, MD, MSc, medical director of clinical and quality informatics at Baystate Health and associate professor of medicine at Tufts University School of Medicine, in Springfield, Massachusetts, at Hospital Medicine 2007, the Society for Hospital Medicine annual meeting.
"The improved efficiency was observed at both teaching and nonteaching institutions," said Dr. Lindenauer. "These efficiency gains were only partially explained by the higher inpatient volumes of hospitalists compared with the 2 other physician groups. This suggests that the other aspects of the hospitalist model — such as their on-site and often 24-hour presence and the alignment of their incentives with those of the hospital — can result in greater efficiency."

Source: Hospitalist Model May Reduce Costs

Despite advances, most hospitals are years away from fully computerized systems

Electronic records and accurate information do save lives; however, in the chase to provide the one central location cure all to locate medical records, we somehow left out some of the "baby steps" needed to get there. Having a practice or hospital using electronic records today is definitely a plus, but I agree on the span it's going to take to provide interoperability for all, and not to mention there are a lot of choices out there. One thing for sure that has come out of all of this is better health care and more patient involvement in taking a more active role in their own health care. It may be a while before we see a "one for all plan" but the "baby steps" taken in the meantime are definitely a plus anyway you look at it. There are a lot of folks in the healthcare industry making this change to a new way of operation and they need training and a little time to digest changes as they occur. The insurance industry has also provided a few stumbling blocks with consumer trust along the way too. You still have to know as a patient that "privacy" can and will still exist today with medical care. Health care is a personal issue and it seems in some areas that has been forgotten. We have the data today, but now the challenge is there to professionally manage the information in a way that will provide better health care for all. BD

Hospital records aren't what they used to be at Tri-City Medical Center.
Emergency room doctors record orders for lab tests, medications and treatments on wireless tablet computers. Nurses on the in-patient floors enter vital signs into rolling laptop computers.
And digital X-ray images are available on computer screens throughout the Oceanside, Calif., hospital moments after they are taken.
This kind of technology was a novelty just a few years ago, but now most hospitals across the country use some sort of electronic medical records system - a technological leap proven to reduce medical errors and one that many think is key to slowing runaway health care costs.
Several RAND Corp. researchers predicted that electronic health records could save hospitals and doctors $513 billion over the next 15 years, savings that could be passed along to insurers and patients, according to a 2005 article in the journal Health Affairs.
A trip to Tri-City suggests that the digital age has finally arrived in health care, but looks can be deceiving. Despite undeniable advances, most hospitals and doctors remain years away from full-scale electronic records and for those that do use electronic records, there is little, if any, way to share information.

Source: Greater Paramus News and Lifestyle Magazine - Despite advances, most hospitals are years away from fully computerized systems

Philanthropy's Struggle in Health Care: Nonprofit Hospitals in America

Study available - fee required. BD

Margins are falling, bond ratings are dropping, and competition for patients and reimbursement is sharp.
At the same time, the perceptions of the American public have changed. While a decade ago fewer than one in ten Americans saw no difference between nonprofit and for-profit hospitals, today more than half see nothing necessarily distinguishing about nonprofit providers of care. When public opinion erodes, philanthropic support may follow.
The study links these trends health care, economic, and philanthropic and suggests future implications. The report is important reading for all executives, directors, chairpersons, Board members and others affiliated with hospitals and healthcare in the United States. It’s also a vital read for major donors and foundation executives, healthcare companies, investors in the sector, government leaders and the media.

Source: onPhilanthropy: Articles: Philanthropy's Struggle in Health Care: Nonprofit Hospitals in America: Lives, Jobs and Philanthropy

Print to OneNote - Great Organizational tool

For anyone needing to keep their notes, emails, client information in one place, this is a killer application. I can literally take anything and include it in One Note for easy access and searching. Why spend all the time digging through the drive of a PC, when this makes the process so very simple and it is not hard to use at all. If you have a bunch of Word documents relative to a meeting, this makes it so simple. Need to find the information later, let One Note do the work for you and it will search by keyword. I use this all the time in my business and what a huge timeserver it can be. One Note can be used from a desktop as well as a tablet too. At the hospital making notes with a tablet can be a really simple task too and you have everything in one place. Need to share information with another MD, One Note can do by sharing a selected file. BD

You may not have noticed it, but when you installed OneNote 2007, you got a new printer: Send to OneNote 2007. If you need to add anything to your notes, you use File Print and select this printer. Short delay (how long depends on how big an item you are printing) and then the item appears in your notes.

What can you print to OneNote? Well, I haven’t found anything I can’t print to OneNote 2007 this way. Big documents take a long time, but they do get there.
Where? Oh - by default, the new notes will end up on a page in the Unfiled Notes section. You can change that by going to Tools–> Options and checking out the Send to OneNote options:

Once you print something to OneNote, it automatically becomes searchable. If the item is long or large, there may be a short delay before the content is searchable, but it will be indexed. In addition, once you print to OneNote, you can right click the object and “Copy the text” from the current page of the printout or the entire printout. What a great way to create copies of stuff, huh?

Source: Print to OneNote Hints ~ Vitamin CH - The cure for all computer ailments

Blues Plans Are Introducing More E-Prescribing Pilots, Initiatives

Is one of your health plans sponsoring NEPSI? We will always maintain a permanent link on this site for physicians to get started as it is free to anyone who decides to participate. There is a short webinar to attend before getting started that is an introduction on how to use the software, which is sent after the initial enrollment. BD

WellPoint, Inc. is joining other Blues plans in sponsoring e-prescribing for providers, partnering with General Motors Corp. (GM) in an Ohio-based e-prescribing pilot and co-sponsoring the National ePrescribing Patient Safety Initiative (NEPSI). Meanwhile, Blue Cross and Blue Shield of Florida (BCBSF) is initiating an effort with four major health plans in that state to promote e-prescribing to members. According to another plan, e-prescribing sponsorship has sped adoption of such tools, which are helping to reduce drug-related medical errors and improve cost savings for health plans, enrollees and payers.
They have a vested interest in improving patient safety and reducing health care costs," he says. NEPSI is "exciting as well, and there are health plans that are sponsoring it as well. It's a win win win," he asserts. "If the doctor uses [e-prescribing], studies show it improves efficiency and reduces medication errors," he explains.

Source: Blues Plans Are Introducing More E-Prescribing Pilots, Initiatives

BlueCross BlueShield Of South Carolina Launches Subsidiary To Facilitate Medical Tourism

This is the first type of service I have seen combining local health services and tourism in one package to speak...allowing 2 visits with local physicians...BD

BlueCross BlueShield of South Carolina recently launched a subsidiary, Companion Global Healthcare, to help U.S. patients plan trips to Thailand for lower-cost medical procedures, the Charleston Post and Courier reports. BCBS will cover patients' procedures organized through Companion Global if their BCBS plan allows the travel, according to spokesperson Elizabeth Hammond. Hammond said the insurer also will cover two follow-up visits with physicians at Doctors Care centers in the state.
While the subsidiary was created several months ago, no South Carolina resident has outsourced any procedures yet, the Post and Courier notes. The company is "one of the first efforts of its kind" in the nation and "reflects several trends," such as an increase in medical tourism, increasing health care costs and rising health standards in Asian countries, according to the Post and Courier.

Source: BlueCross BlueShield Of South Carolina Launches Subsidiary To Facilitate Medical Tourism

Heart congestion - share the revenue , better healthcare for the patients

This can certainly make the decision process much easier for the patient and hopefully ends up with fair compensation for all physicians involved. BD

To reduce patients' confusion, increase revenue, and improve care, the 50 Beth Israel Deaconess Medical Center doctors who work in the cardiology, cardiac surgery, and vascular surgery departments, along with senior hospital executives, have formed an independent corporation. For the first time, the doctors plan to share some of the revenue they generate. They say the new Cardiovascular Institute will increase cooperation, because they will be collectively responsible for the institute's success.

The most complicated aspect of the arrangement is how to share revenue. Traditionally, insurers make separate payments to a doctor and the hospital where a procedure is performed. Under the new setup , any growth in revenue paid to the hospital for cardiovascular procedures and testing will be shared with the Cardiovascular Institute. The institute also plans to use new formulas to share payments made to doctors. Until now, individual departments and their doctors have kept the fees they generate and decided how to distribute them.

A major stumbling block is pay disparity: Surgeons generally earn more money than other physicians, so sharing revenue equally could reduce their incomes. But the hospitals are testing the idea among smaller groups of doctors. At Brigham and Women's, radiologists and cardiologists who do cardiac imaging are pooling their professional fees, as are Mass. General specialists who do noninvasive procedures, such as ultrasound testing, in the vascular center.

"The best thing is to take the patient out of the middle and even the playing field in some way," said Dr. Andy Whittemore, the Brigham's chief medical officer.

Source: http://www.boston.com/business/globe/articles/2007/05/29/heart_congestion/

Hat Tip: Kevin MD

Partners TeleStroke Center

Using mobility to get the technology to hospitals that may not be able to afford this service otherwise and saving lives at the same time...BD

One form of treatment is to administer Tissue Plasminogen Activator (tPA), a clot busting drug that can greatly reduce the disability resulting from a stroke. tPA must be administered within 3 hours of symptom onset.
Unfortunately, some hospitals lack the resources to make this determination and cannot physically transfer the patient quickly enough to enable them to receive this therapy if warranted. This is where TeleStroke comes in. Subscribing hospitals can receive acute stroke care for patients without physically transferring the patient for an exam.
"I can examine someone very interactively with the help of a physician or a nurse on the other end and I can make a determination of the stroke severity and the type of stroke by looking at the patient and at the brain image," Dr. Schwamm said.
"It's almost like being in the room."

Source: Partners TeleStroke Center : About TeleStroke

The Watch Phone is almost here....

For those of us that remember Dick Tracy and his phone...well many years later it has arrived or will arrive shortly...BD

Features:
Time/Date, Last Number Redial, Recent Calls, Missed Calls, File Manager, 199 Contacts, SMS Messages, Multi Languages, Flight Mode, Email.
Accessories:
USB Travel Adapter and Charger, Bluetooth Wireless Headset and Spare Battery .
Specification:
:: Model M500 Quad Mode, Touches, Java and WAP enabled
:: Weight: 60g
:: Color: Silver or Black with Leather Strap
:: Screen: TFT 1.5 - inch colour touchsreen 120 x 160
:: Frequency: GSM850/900/1800/1900Mhz (GPRS), SIM
:: SMS: Full SMS and MMS functionality
:: MP3: Support AAC/MP3 and
:: MP4: Support Video Playing
:: Touchscreen with Built-in Stylus
:: Memory: 128MB Built-in Memory
:: Battery: 400mAh, Talk Time 200 Minutes, Standby Time 80 Hours
:: USB: For Data Transfer and Recharging
:: Bluetooth 2.0

Source: SMS Technology Australia

Hat Tip: Engadget

When Health Coverage Doesn't Hold Up - Providers Can Deny Big Claims

CBS has a good storyline about medical insurance and this is just one of the stories featured. This so much reminds me of the recent Blue Cross settlement here in California where the carrier did settle. This is scary to think that when someone is in dire need of medical assistance that when it comes down to billing, the "bean counters" are put to work to scrub and research the data bases looking for any type of mere scan of a chance to deny paying services.

Why did this potential record take 3 years to surface? Why did the insurance company not question this 3 years ago? I'm sure they willingly collected his premium payments for the last 3 years as well. This could happen to anyone.

I am a programmer and create data bases and they are helpful and informative and lead to better healthcare, however, some tend to forget that this is still the "people" business and that human bodies are not the same as data and statistics and we do not all fit into "tables" and our ultimate healthcare is not just the matter of another "structured query" to determine whether or not our body justifies claim payments based on the criteria returned. People have afflictions and illnesses due to no fault of their own - they are born with many of them!

If we continue with the current system, then something has to be done to create an "assigned risk" category and pro-rate those folks and assign them to insurance companies for coverage. The car insurance business has assigned risks, so I ask, why can't something along this line be accomplished with medical insurance? Myself, I would much rather see pro-active direction with the insurers rather than the government make the decision for everyone as to what will occur, but if pro-activity is not taken, then the latter will more than likely be the ultimate decision for all.

When a member of the Los Angeles Insurance Commission is denied coverage, you have to ask, where does that leave the rest of us????? BD (see the related story below)

__________________________________________________________________________________

Walking along a stretch of road last summer, 54-year-old Tod Smith felt an intense burning in his chest and tightness in his arm — signs of a heart attack he never saw coming.
"I was in good health," Smith said. "No major health problems or conditions."
For Smith, an illustrator of children's books, his heart attack was the first shock. The second: more than $40,000 in medical bills his insurance company refused to cover — after he figured the company, Assurant, would pay.
"I certainly figured that a heart attack was a catastrophic event. So I figured I was covered," Smith said.
A two-month CBS News investigation of the individual insurance market found that Smith's experience was far from unique. Because it was expensive, his claim was investigated for fraud by Assurant Health, his insurance company.
After examining his medical records, the company refused to pay based on a 3-year old-reference to an "angina episode." Assurant said those words proved his condition was pre-existing, despite the fact that follow-up tests in the same file diagnose his "episode" as a case of acid reflux and ruled out a heart condition.

Assurant refused to discuss its denials of claims on camera, but it issued a statement saying it continually evaluates its claims process "to ensure it is fair, equitable and consistent with state laws and industry standards."

Source: When Health Coverage Doesn't Hold Up, CBS News Investigates How Individual Health Insurance Providers Can Deny Big Claims - CBS News

MEMBER OF CALIFORNIA INSURANCE COMMISSION DENIED COVERAGE

Scott Svonkin, an active 41-year-old, never thought he'd be one of them.
"Pacificare rejected me because I'm an expectant father. Blue Shield rejected me because I got a spider bite. And then this one rejected me because of asthma," Svonkin said.

Not for Svonkin. Ironically, he's a member of Los Angeles County's Insurance Commission.
"I never imagined it would be so hard to get health care," Svonkin said. "It's not a matter (that) I can't afford it. It's a matter that they won't give it to me at any price."

Insurers find all that information — and much more — in a massive, little-known data base called the MIB, or Medical Information Bureau. Insurers have even been known to question "friends and neighbors" about "morality and lifestyle" — using all of this information to decide who they will cover and who they won't.
"They can check your morals and your lifestyle?" asks Keteyian.
"Exactly," says Liang. "And they are going to judge you on this."

Doctors' list puts a price on care

I am guessing competition from the retail clinics may have some influence here with this decision and perhaps there will be more posted in time. BD

A lot of other providers don't want to compete on price because they think it cheapens the medical field.
Some critics, however, say the value of prices for consumers is limited because physicians treat conditions — and don't sell procedures. Without knowing the steps necessary to diagnose and treat a condition ahead of time, patients are unable to get a good estimate of probable charges.

"Before, if you had a $10 or $5 co-pay, it didn't hit your pocketbook," he said. "But if now you have to pay the first $2,000, the cost of an office visit matters to you a lot more."
Patients can go on the group's website and find that a chest X-ray runs $61 and that a physical examination for a middle-aged patient ranges from $140 to $160. Flu vaccinations are listed at $15,........HealthCare Partners' effort could prompt other physician groups to follow suit, given the competitive nature of Southern California's healthcare market, some experts said.
Still, the idea might take a while to catch on in markets where physicians don't have to compete for patients, said Maribeth Shannon, a California Healthcare Foundation program director.

Source: Doctors' list puts a price on care - Los Angeles Times

Link to the list (pdf) http://www.healthcarepartners.com/brochures/BasicFees_Web.pdf

Doctors sue hospital firm IHHI

Everybody seems to be suing everyone in this story...BD

Shareholder physicians want to boot key managers, saying the company that controls 12 percent of O.C.’s hospital beds could go out of business.

Doctors who own a majority of Integrated Healthcare Holdings Inc. have filed suit in an attempt to oust the company's top management, saying the executives are preventing the money-losing hospital owner from refinancing expensive loans.
The suit sheds light on a battle for control of a company that owns 12 percent of the hospital beds in Orange County. "The very survival of IHHI is in the balance, as well as its ability, to provide adequate healthcare to the community," the suit says.
Separately, IHHI has filed a suit against OCPIN, Anderson said. The suit was filed under court seal and can't be viewed by the public. It concerns a dispute over lease agreements on the hospitals' real estate, which is majority-owned by OCPIN and rented to IHHI, he said..

Source: Article - Money - Doctors sue hospital firm

The doctors remain upset about the treatment of Dr. Michael Fitzgibbons, a former chief of staff at Western Medical Center-Santa Ana. After the sale by Tenet, he sent e-mails to other doctors expressing doubts about IHHI's financial viability. The company sued him for defamation and lost.

Related Story: Orange County Register

Changes mean less care, more profits: HMO Business in Florida

Is it getting any better anywhere? BD

Before reform, about 95 percent of Florida doctors participated in Medicaid. Now a survey conducted by Georgetown University indicates that more doctors are dropping out of Medicaid and those that remain are seeing fewer patients. Most doctors stay in the system only out of loyalty to their patients with whom they've enjoyed an established relationship. Feeling overwhelmed by the harrowing challenges of just complying with arcane regulations and realizing that reimbursements are inadequate, many doctors are simply quitting. And there is little likelihood that things will get better since payment to doctors is down while paperwork is up.

While doctors are being paid less, the 15 HMOs and networks are being paid more. Prior to reform, HMO profit was a staggering 18.6 percent. Despite this, the Florida legislature is planning to increase their payments 11.7 percent! The securities firms CIBC World Markets and Goldman-Sachs reported that WellCare -- a major Florida Medicaid HMO -- has been shifting money to the Cayman Islands in the form of reinsurance premiums. Goldman-Sachs spokesman Carl McDonald stated that "Florida appears to be overpaying its Medicaid plans, and it would seem to be only a matter of time before the state figures this out." Florida's stated objective was to improve both access and care while saving money. Medicaid reform has accomplished little except enriching privately-held HMOs.

Gone are the days when a doctor just provided care. The doctor has become an uncompensated agent for the HMO............

Source: Changes mean less care, more profits: South Florida Sun-Sentinel

CMS to Stop Paying Hospitals for Medical Errors

I am not sure I totally agree with this methodology, but I can certainly add that in my travels, the "old school" hospital administrators do exist and I have experienced this first hand myself, even with walking in with a "Tablet PC". In today's world of evolving medical technology, I would think that administrators would at least 'look" at new developments and embrace at least some of the more simple techniques in their own daily use as this really helps IT administrators with bringing new technology to table.

Many IT managers rely on someone above their position to create budgets for this and if the folks at the top don't have at least an interest, many good and relatively inexpensive solutions are tabled with some of the reasons listed below. By far, one of the most common responses I have heard is "we can't afford it", and that sometimes stated even before even exploring new avenues and closes the door immediately to new technology. Perhaps as CMS expands their requirements, the "old school" administrators may someday take another view on what technology can do to save lives. Even "baby steps" in the right direction can prove beneficial and sometimes are not that expensive to deploy. On the flip side of the coin, there are the innovative hospitals that are taking big strides in this direction as well, taking time to share the knowledge with physicians on staff to ensure everyone is on the same team. Sharing knowledge today is one of the biggest tools we have to benefit all. BD

The proposed deadline is October 2008, so there's time left before new guidelines appear and perhaps some of the "Old School" administrators may have time to wake up to entertain revenue growth and place less emphasis on cost reduction to bring some real win-win solutions to the table for all and help saves lives at the same time. One of the best ways for an "old school" administrator to benefit is to begin adapting new technology in their personal lives, as this brings a whole new understanding to the table with familiarity and use.

Overall patient safety in hospitals is not improving. The latest HealthGrades report on patient safety in U.S. hospitals showed the PSI (AHRQ's patient safety index) rate increased 8% between 2003 and 2005 (more here). The lack of significant progress with patient safety has caused some to ask why payors reimburse hospitals for the additional care necessary after a patient suffers a preventable adverse event. It seems payors are starting to ask themselves this very question - according to this Indianapolis Star story:
Late next year Medicare plans to stop paying hospitals for costs incurred from some of the most common and preventable medical errors suffered by patients.
[...]
The federal Centers for Medicare and Medicaid Services, which operates Medicare, is taking public comment on the proposal through June. The changes are scheduled to take effect in October 2008.
Medical mistakes are deadly and expensive. Infections acquired in hospitals account for about 90,000 deaths and $4.5 billion in extra spending each year, according to the U.S. Centers for Disease Control and Prevention.
Unfortunately, most hospital administrators are more focused on cost reduction than revenue growth, and (if recent reports on patient safety "improvements" are to be believed) the stick - reduced reimbursement - will probably offer an incentive than the carrot.
CMS is starting with a subset of the list. Here are the 13 "never should happen" adverse events that CMS is considering for no reimbursement:

Catheter-associated urinary tract infections
Bed sores
Objects left in after surgery
Air embolism, or bubbles, in bloodstream from injection
Patients given incompatible blood type
Bloodstream staph infection
Ventilator-associated pneumonia
Vascular-catheter-associated infection
Clostridium difficile-associated disease (gastrointestinal infections)
Drug-resistant staph infection
Surgical site infections
Wrong surgery
Falls

Starting to withhold payment for adverse events will impact the health care industry as much as DRGs and capitation did years ago. Many "old school" hospital administration management techniques will fall from favor because doing things like increasing nurse to patient ratios have been repeatedly shown to result in more adverse events. This change will also eliminate the need to regulate nurse to patient ratios, like they have in California and a few other states - hospitals that operate at unsafe ratios this will go out of business (as they should).
Every hospital wants to make improvements that are easy and cost next to nothing. One of the frustrations of being a consultant is doing the needs assessment, the cost justification, and the implementation plan only to hear that, "that's really too much trouble - we don't want to do it." Of course it's even worse if you're employed by the hospital (or vendor) as part of a LEAN team or innovation workgroup.

Source: Medical Connectivity Consulting

Medicare pay-for-reporting: How to get your 1.5% ...

Get those registry modules up to date in any EMR to make this task easy. If you are currently using an EMR or EHR program that incorporates this, reporting will be as simple as creating a spreadsheet from the data entered while doing your daily charting. BD

Next month, Medicare will take a big step toward becoming a more active health care purchaser, by launching its first program-wide quality reporting initiative for physicians.
Not every physician will decide that participating in the Physician Quality Reporting Initiative is worth the money. Collecting data for the quality measures and passing it on to the government, for instance, will require extra work by doctors and their staff.
First, physicians must consult the CMS-approved list of 74 quality measures to decide how many to report and determine how many of their Medicare patients fit into those categories. To be eligible for the bonus, doctors must report on at least three measures and apply each one to at least 80% of the patients who fit that category.
Physicians who see a significant number of diabetic patients, for example, might decide to keep special tabs on whether these patients maintain their blood pressure control -- one of the CMS quality measures. To meet this requirement, a doctor would have to share with the government the individual blood pressure ranges of at least 8 out of 10 under-control diabetic patients during one or more of their follow-up office visits in the last half of the year.

Source: AMNews: June 4, 2007. Medicare pay-for-reporting: How to get your 1.5% ... American Medical News

Physicians say PPO network's fax masked 25% pay cut

Be sure to read any faxes these days from your neighborly PPO. BD

The AMA and several state medical societies are engaged in ongoing discussions with a PPO network that sent a fax to physicians that appeared to be a routine request for tax information -- but also bound physicians to having their reimbursement cut by 25%.
San Diego-based Three Rivers Provider Network sent the fax to physicians who had treated member patients, but who were not part of any TRPN network. TRPN not only has direct contracts with physicians, but also rents networks from other PPOs -- a practice which organized medicine has criticized as a "silent PPO" because physicians never negotiate rates with a plan, yet find themselves in it because they have signed a deal with a PPO that has rented out its network to someone else.
However, the TRPN fax also contained a paragraph stating that physicians would agree "payment of services will be 75% of provider's total billed charges for covered services." Physicians would sign one form; there was no opportunity to opt out of or negotiate the cut.
It's not uncommon for Howard H. Rosenblum, MD, an ophthalmologist in Nashville, Tenn., to receive a random fax from an insurance company asking him to fill out a W-9, so when Dr. Rosenblum received the TRPN form, he said he signed the document without much hesitation. Several months later, while conducting a spot check of his claims receipts, Dr. Rosenblum noticed he wasn't getting his normal fee from the insurance companies with which he contracts.

Source: AMNews: June 4, 2007. Physicians say PPO network's fax masked 25% pay cut ... American Medical News

Videoconferencing services for hospitals and clinics

Hospitals and clinics are exploring the alternative with non-English speaking patients, but experts say the cost must drop before it makes sense for private practices.

Translation services are pitching -- and some hospitals are buying -- videoconferencing technology as a way to improve communication with patients who don't speak English.
Emergency physician Michael Sayre, MD, who regularly uses a videoconferencing interpretation system at the Ohio State University Medical Center, said having the visual component makes "a huge difference." Because the system can be moved, translating can happen just about anywhere a patient might be

Source: AMNews: June 4, 2007. Videoconferencing services offer language translators ... American Medical News

Xiagara - over the hill, take the little blue pill

Cute animation and spoof on Viagara...

LSU jumps on the PHR bandwagon - online personal health records

By the time the 2008 hurricane season rolls around, the LSU Healthcare Network hopes its patients will be well on their way to having portable personal electronic health records they can access in case of a catastrophe.
LSU picked Medem’s™ iHealth to generate the free health records for patients, said Dr. Frank Opelka, CEO of the LSU Healthcare Network and associate dean for clinical affairs at LSU Health Sciences Center School of Medicine at New Orleans. The effort has only recently begun.
“The iHealth record is not the physician’s e-health record of his or her patient. It is the patient’s personal health record,” Opelka said. “It is a Web-based system that carries the patient’s complete medical history. It can be updated by each patient.”
If LSU’s patients evacuate the city or state and need healthcare, they can go to the Web and obtain their personal health records, Opelka said. Many of the LSU network’s patients don’t have computers or access to the Internet, so LSU will help them enter their information.

Source: LSU Launches E-health Records for Patients on Louisiana Medical News

10 Educational Hours at the ER

May 25, 2007 - Having spent a sleepless night with a bit too much pain in my abdomen, I informed my wife I was suffering from another bout with diverticulitis. I was also forced to admit I had consumed a bag of microwave popcorn, a definite no-no for someone with no intestinal fortitude.
We asked the doctor how to avoid spending a day in the ER just to get antibiotics. She explained that had I arrived in an ambulance, I would have received immediate treatment; ambulances were handled immediately. After 10 hours at the hospital, I left with a prescription and a first-class education in the ER crisis.

Source: My Turn: 10 Educational Hours at the ER - To Your Health - MSNBC.com

Hat Tip: Kevin, MD

Hospitals taking a cue from retailers to reduce on meds errors

Virtually the same kind of technology used to ring up merchandise at the checkout counter is being put to a new use by some hospitals to help prevent medication mistakes for patients.
You already know how it works in stores: A clerk runs the bar codes on your merchandise across a scanner, and the price rings up on the cash register.
Now nurses in hospitals are scanning new bar code labels on medications, then scanning the bar codes being placed on patients' wristbands to make sure the right drugs are going to the right people.
"It's amazing that this technology has been in the grocery stores for 20 years, but it's just now getting into health care," said Jerry Esker, director of pharmacy for Sarah Bush Lincoln Health Center in Mattoon.
Hospitals aren't required to use bar code scanning equipment. But the FDA points out those that do stand to reduce their medication errors and liability insurance costs.
Provena United Samaritans Medical Center in Danville plans to roll it out this fall, and Provena's five other hospitals, including Covenant Medical Center in Urbana, will add the technology later, one hospital at a time, according to Jim Witt, Provena vice president for clinical integration.

Source: The News-Gazette.com:Hospitals taking a cue from retailers to reduce on meds errors

Chapter 8, "Are you still just using your cell phone for phone calls?"

Cell Phones made simple for seniors...good idea..BD

There's a reason Jitterbug has just won
recognition as the best new company in
the cell phone industry. Before we spoke,
we listened. We listened to the kind of
simple cell phone experience you wanted for
yourself and those you care about. The result
is Jitterbug. The best cell phone experience
you've ever had. Wouldn't you or someone you
love enjoy a comfortable, easy to use cell
phone to stay in touch with friends and family?

Source: Jitterbug Phones: Easy Emergency Cell Phones

Hat Tip: http://www.goldagers.com/2006/11/14/cellphones-for-older-adults/

UC Davis Medical Adds SmartPill GI Monitoring System

Check out the link below for the full story. The site is still working on a "find a physician" list at this time wh uses the SmartPill. BD

SmartPill aids in the evaluation of GI motility disorders, which can affect up to 50 percent of all diabetics
Buffalo, N.Y. and Sacramento, Calif. — Thursday, May 10, 2007 – Dr. Juan Carlos Garcia, M.D. and Dr. Amar Al-Juburi, gastroenterologists with UC Davis Medical Center, will offer the SmartPill GI Monitoring System to patients, introducing an innovative technology to the region. The SmartPill pH.p Capsule is the first medical device capable of providing segmented transit times for gastric emptying, combined small and large bowel, and total gastrointestinal (GI) tract transit.

The SmartPill pH.p Capsule
The SmartPill pH.p Capsule transits the intestines by peristalsis, or the normal rhythmic contraction of the intestinal muscles, and is capable of transmitting data continuously for greater than 72 hours. The single-use capsule is excreted naturally from the body, usually within a day or two.
Will the SmartPill Capsule replace current invasive procedures?
A logical compliment to Endoscopy, the SmartPill pH.p Capsule has the potential to replace gastric emptying scintigraphy.

Source: SmartPill | Press Releases

Mylan Laboratories To Acquire Generics Business Of Merck KGaA For 4.9 Billion Euros

Mylan Laboratories Inc. (NYSE: MYL) and Merck KGaA today announced the signing of a definitive agreement under which Mylan will acquire Merck's generics business ("Merck Generics") for EUR 4.9 billion ($6.7 billion) in an all-cash transaction. The combination of Mylan and Merck Generics will create a vertically and horizontally integrated generics and specialty pharmaceuticals leader with a diversified revenue base and a global footprint. On a pro forma basis, for calendar 2006, the combined company would have had revenues of approximately 4.2 billion dollars, EBITDA of approximately 1.0 billion dollars and approximately 10,000 employees, immediately making it among the top tier of global generic companies, with a significant presence in all of the top five global generics markets.
In addition to retaining Hank Klakurka, currently President and CEO of Merck Generics, Mylan has executed long-term employment agreements with members of Merck Generics' senior management team, ensuring that senior leadership remains intact. Mylan views the existing management and employees of Merck Generics as key to the success of the combined company.

Source: Mylan Laboratories To Acquire Generics Business Of Merck KGaA For 4.9 Billion Euros

Medicare Plans to Deny Coverage of Artificial Disks

Government regulators said yesterday that Medicare, the federal insurance program, planned to deny coverage for artificial disks implanted in the lower spines of older patients.
The preliminary decision, which is expected to become final in August, extends to the ProDisc-L made by Synthes a national coverage ban imposed a year ago on the Charité lumbar disk made by Johnson & Johnson; the Food and Drug Administration cleared the Pro Disc-L for sale last summer. It also signaled that Medicare will not cover Medtronic’s Maverick lumbar disk when that device reaches the market.
Yesterday’s decision applies to patients over 60, which is most of the 43 million people Medicare covers. Local administrators of Medicare benefits will continue to be able to pay for the devices in younger disabled patients on case by case.

Source: Medicare Plans to Deny Coverage of Artificial Disks - New York Times

Blue Cross Earmarks $2 Million To Fight Health Reform Plans

Blue Cross of California on Thursday launched an advertising campaign to oppose health insurance market reforms that are being proposed by Gov. Arnold Schwarzenegger (R) and Democratic lawmakers as part of their plans to overhaul California's health care system, the AP/San Jose Mercury News reports.
Blue Cross, the state's largest health insurer, in Thursday's Sacramento Bee ran an ad that compared the health care reform proposals to the energy deregulation in 1996 that led to blackouts and other problems in the energy market. The insurer has committed $2 million to the campaign.
Blue Cross opposes provisions in proposals by the governor, Assembly Speaker Fabian Núñez (D-Los Angeles) and Senate President Pro Tempore Don Perata (D-Oakland) that would require insurers to sell policies to everyone, regardless of pre-existing medical conditions.
Ann-Louise Kuhns, vice president of Blue Cross of California, said, "We've got more than one million members who could face very significant [premium] increases under some of these proposals." Kuhns said the insurer supports expanding public subsidies to provide health coverage to more residents but opposes any changes to the insurance market.
Support for Health Care Reform
Blue Cross is the lone insurer in California that publicly opposes Schwarzenegger's and the Democrats' reform proposals. The insurer formed a political committee called The Coalition for Responsible Healthcare Reform, but so far it is the committee's only member.

Source: Blue Cross Earmarks $2 Million To Fight Health Reform Plans - California Healthline

EHRs and Physician Training..Update

From Modern Health Care...this is a response to an earlier post with physician involvement with implementation of electronic medical records. I can agree in one area myself, "begged" as I have done a bit of that myself and it has been a real challenge sometimes to get the physician to "buy in" with training. If you read most of the articles on a successful implementation, most tend to agree that training is the key, it's all teamwork. BD

I have spent countless hours in the middle of the night, on weekends and during extended "go live" support working with physicians who never showed up for scheduled training. They were presented with the same material that was presented in the classes scheduled for physicians prior to going live. But they couldn't be bothered with showing up for the class they themselves had signed up to take.
Poor EHR design doesn't wash either. The physician groups are asked and in many cases begged to get involved in system design from the beginning and no one ever shows up or one physician is designated as the representative for all services, physician levels and programs. How many conference sessions and articles have been written about techniques to involve physicians in implementing EHR systems? Then the system goes live and physicians who never thought about participating complain because no one met their needs.
Healthcare facilities have catered to physicians for decades and implementing information technology is no different. It's time to stop treating physicians differently than the rest of healthcare professionals. If physicians want to be properly trained and supported then they need to take responsibility, as a group, for their own learning and to make their wants and needs known just as every other discipline does. Until a plurality of physicians decide to get involved in the design and implementation of EHR systems and become partners in creating solutions, they will continue to need someone to pick up the tab for their mental health.

Source: Modern Healthcare Online

Many Small Physician Offices No Longer Provide Injected Medications Because of Medicare Reimbursement Issues

If you are a Medicare participant, this is worth checking out as many of the injection compensations are being changed by Medicare. Many small offices too may not be able to absorb the cost associated with maintaining a supply on hand if they cannot purchase in bulk quantity. BD

Thousands of small physician offices are "getting out of the business of administering drugs for conditions ranging from anemia and cancer to arthritis and infections," the Wall Street Journal reports. The shift is "an unintended consequence of a change in the way Medicare reimburses doctors" to administer medications that are injected or infused, according to the Journal.
Companies that manufacture the medications, such as Amgen and Johnson & Johnson, offer large rebates or discounts for bulk purchases, but many smaller physician offices do not purchase such treatments in bulk. In addition, because Medicare determines the reimbursements for such medications based on the average price paid, the discounts reduce reimbursements for all physicians, regardless of whether they receive discounts.

Source: Coverage & Access | Many Small Physician Offices No Longer Provide Injected Medications Because of Medicare Reimbursement Issues - Kaisernetwork.org

Demonstrators to target United Health Shareholders meeting

United Health Care issues in the news once more...BD

MINNEAPOLIS - To dramatize the need for health care reform, several organizations will demonstrate Tuesday outside the annual shareholders meeting of United Health Group.

The demonstration will start at 9 a.m. Tuesday, May 29, at the Minneapolis Convention Center, 1301 Second Ave. S., Minneapolis.
The event will "decry the gap between need and greed as United Health Group CEO William McGuire, his replacement Stephen Helmsley, and other Minnesota HMO executives bilk billions in stock options derived from denying health insurance to half a million Minnesotans," organizers said.
United Health Care is the largest HMO in the United States and McGuire was the highest-paid CEO in Minnesota history, with stock options totaling $2 billion. Helmsley, who replaced McGuire, has stock options in excess of $750 million. In contrast, the chief of Medicare, a single-payer system with the largest enrollment in the United States, makes $150,000 a year.

Source: Welcome to Workday Minnesota, your leading source for labor news!

Google declares war on $2 trillion health care industry

Interesting perspective on medical record technology. Will we someday "Google" our medical records? BD

The Google health care die has been cast, it is a $2 trillion declaration of medical intent.
Adam Bosworth, Google Vice preisdent Engineering, is no longer content with “touch-feely” consumer reach-out campaigns to “learn” what the “health care consumer” wants, he is now doing what Google does best: Telling the world how it will be.
It WILL be Google’s “vision for the future of health care.”
Those on the winning medical team will go the Googley way, or it’s the Google medical information highway.
Google scary now? Personal Health Records, sponsored by Google, next I warned one month ago. That day is nearing.
In Google’s medical push I present Bosworth’s health care (pay for the right to perform) IT road show underway over the past six months. Bosworth’s most recent stop was the American Medical Association of Informatics, and it was a big one, a $2 trillion one.

Source: » Google declares war on $2 trillion health care industry | Digital Markets | ZDNet.com

Pharma Marketing Blog: Dumb Blonde Reps vs. Slovenly Genius Reps

John Mack creates some good questions here on the Pharma Marketing Blog...the Pharma companies do cater good lunches though, as many of the offices I visit invite me to partake if I happen to be there on business, but most of the time it tends to be much better than pizza. BD

Ed Silverman over at Pharmalot posted a fun little item about a poll that Cafe Pharma is currently running.
Ed asked "Do Good-Looking Reps Do Better?" or rather that was the gist of the poll.
The devil is in the details. Here's what the poll asked:
Which type of rep gets the best results? An average looking rep that knows their products and can sell? or A super attractive rep that is an idiot and can't sell?
Only 16% of respondents chose the super attractive rep option.
Unfortunately, this survey can't possibly yield any meaningful insights.
To sell (ie, "do better" or "get best results"), you first have to get in the door. So, a better question would have been: Do attractive reps get better access to physicians than do slovenly, but knowledgeable, enthusiastic piglets?
I think a lot more than 16% would answer "Yes" to that!
Another, more meaningful question would have been: Do reps -- attractive, plain, or sloven -- who bear gifts -- pizza, sandwiches, cupcakes -- get better access than those who come empty-handed?
Again, I think the pizza-delivery rep would have no problem getting in the door to most doctor's offices.
Good looks and pizza are very visible attributes, in plain sight. You see the cleavage, you open the door. You see the pizza, you open the door. It's Pavlovian!

Source: Pharma Marketing Blog: Dumb Blonde Reps vs. Slovenly Genius Reps

Hat Tip: Kevin MD

FDA Approves Tigris System for testing donated blood

SAN DIEGO, May 24 /PRNewswire-FirstCall/ -- Gen-Probe Incorporated (Nasdaq: GPRO) announced today that the U.S. Food and Drug Administration (FDA) has approved the Company's PROCLEIX(R) TIGRIS(R) system, the first fully automated molecular diagnostics instrument, for use with the PROCLEIX ULTRIO(R) assay.
The PROCLEIX TIGRIS system was approved with the PROCLEIX ULTRIO assay to screen donated blood, plasma, organs and tissue for HIV-1 and hepatitis C virus (HCV) in individual blood donations or in pools of up to 16 blood samples. The system and assay also detect hepatitis B virus (HBV) in blood donations that are HBV-positive based on traditional serology tests for HBV surface antigen and core antibodies. As expected, the system and assay have not been approved at this time to screen donated blood for HBV, as the initial clinical studies were not designed to, and did not, demonstrate HBV "yield." Yield is defined as HBV-infected blood donations that were intercepted by the PROCLEIX ULTRIO assay, but that were initially negative based on the serology tests. Gen-Probe and Chiron have initiated a post-marketing study to demonstrate HBV yield and gain the associated donor screening claim.
The fully automated, high-throughput PROCLEIX TIGRIS system can process 1,000 blood samples in about 14 hours, a level of productivity that facilitates testing in smaller pool sizes, which in turn can increase assay sensitivity and blood safety.

Source: Gen-Probe: News: Press Releases

Insurers Promote Use Of Generic Anticholesterol Drugs

The Syracuse Post-Standard on Monday examined how many health insurers have begun to encourage members to use generic versions of the anticholesterol medication Zocor, which reached the U.S. market last June, rather than Lipitor, manufactured by Pfizer, to reduce costs.
For example, Excellus BlueCross BlueShield of New York has begun to provide members with a one-month supply of simvastatin, the generic version of Zocor, at no cost and has reduced the cost of simvastatin for members to about $7.50 monthly, compared with about $135 monthly for Lipitor. Joel Owerbach, chief pharmacy officer for Excellus, said, "Lipitor is a great drug, but the reality is, for the vast majority of people who are taking Lipitor, you can get to the same place by taking a drug that's going to cost a lot less."

Source: Insurers Promote Use Of Generic Anticholesterol Drugs

Chapter 7, "Are you still just using your Cell Phone for phone calls?"

Windows Live Search for your cell phone can be a huge tool. In this example we did some live lookups on the phone. It has a very simple interface and will not only help you with a map, but can also help you locate a business, i.e. a restaurant, a medical office, hospital, you name it. The examples are fairly simple, but you can see we have driving instructions, traffic conditions, a map, and an option to search for other nearby businesses. I can also save the location to a contact file or forward to someone else. Now that has some huge potential with the medical business in the case of an emergency call, making a house call, finding a hospital, for a few examples.
If you are mobile and have left the "safe harbor" of your desktop PC, give this some real thought as it can be a huge time saver and just might be a life saver too. An ambulance company could easily send the emergency location to an MD, hospital, etc. or the MD could also forward the location in the case of an emergency too.
Shoot, if you just want to find a nice place to eat, it's not bad either. BD

Source: http://mobile.search.live.com/about/

California Grants Provide Funds for Nurse Training

Gov. Arnold Schwarzenegger (R) on Wednesday announced more than $1.6 million in grants to help fund six nurse training programs statewide.
The grants are intended to help California residents find jobs that pay at least the average state hourly wage of $22.51 while also boosting California's supply of health care workers.
Funds to train registered nurses and licensed vocational nurses will go to these five Los Angeles area hospitals:

Brotman Medical Center;
Century City Doctors Hospital;
East Los Angeles Doctors Hospital;
Olympia Medical Center; and
USC University Hospital.

Source: California Grants Provide Funds for Nurse Training - California Healthline

Centers for Medicare and Medicaid Services - Hospital Compare

I gave this a try this morning using several different search criteria and the results for each hospital selected were given on a bar graph for easy comparison. Some hospitals did not treat or supply enough data to show on every graph in a few categories. Good tool to get a basic idea of the services and quality results by comparing side by side. One nice small add on is the ability to use a larger font to view the pages too. BD

Hospital Compare - A quality tool for adults, including people with Medicare
This tool provides you with information on how well the hospitals in your area care for all their adult patients with certain medical conditions. This information will help you compare the quality of care hospitals provide. Hospital Compare was created through the efforts of the Centers for Medicare and Medicaid Services (CMS) and organizations that represent hospitals, doctors, employers, accrediting organizations, other Federal agencies and the public.
Talk to your doctor about this information to help you, your family and your friends make your best hospital care decisions.
By Name
I want to find a hospital by entering all/some of its name:
Hospital Name
By Proximity
I want to find all hospitals within a certain distance of:
City
ZIP Code
By Geography

Source: HHS - Hospital Compare

Why hedge fund managers outearn doctors - BloggingStocks

Interesting comparison on this blog, one person's opinion...BD

But there's really more to it than that -- society perceived that the pricing mechanism for doctors' services was broken. That is, if the free market set the price, many citizens would not be able to afford to pay. And society believes implicitly that health care should be widely available to citizens. (That doesn't mean everybody. 40 million Americans are not covered by health insurance but many of them can get care at hospital emergency rooms.)
But given the perception of a broken pricing system, government and managed care organizations intervened. Thus, if a doctor takes patients who do not directly pay their own bills -- but rely on Medicare, Medicaid, or an HMO -- then the price for that service is set by someone other than the doctor.
Most hedge fund managers let computers do much of the work -- something doctors can't do.
Meanwhile, a doctor's best chance to make big money is to go into investment banking -- where salaries and bonuses are in the millions and rising -- or to focus only on patients who have such deep pockets that they will write checks from their own bank accounts to hire the best talent.
Until these economic conditions change, Doctors will continue to earn the acclamation and hedge fund managers will get the money.

Source: Why hedge fund managers outearn doctors - BloggingStocks

Health Benefits Direct to Enter California Market With Addition of PacifiCare as Health Insurance Carrier

If you have not used one of these services, this is an online service built to help companies and individuals select and purchase various types of health care coverage. BD

RADNOR, PA -- (MARKET WIRE) -- May 24, 2007 -- Health Benefits Direct Corporation (OTCBB: HBDT), a leading innovator in the direct marketing and distribution of a wide range of health and life insurance products in the individual market, today announced that it has entered into an agreement with PacifiCare, a UnitedHealthcare company, to market a number of PacifiCare's health insurance plans for individuals and families in California.
"We are continuing to selectively and strategically expand our health insurance portal with leading providers like PacifiCare," said Alvin H. Clemens, Chairman and Chief Executive Officer. "As an advocate for individual insurance consumers, we want to line our customers up with the best, most reliable coverage offered by the most highly rated carriers. Adding PacifiCare enables us to enter the large California market with a premier offering of health insurance products."
In addition to PacifiCare, Health Benefits Direct's major medical insurance carriers include UnitedHealthcare's Golden Rule Insurance Company, Aetna, Humana, Time Insurance Company (marketed as Assurant Health), and UniCare (a Wellpoint company). The company offers life insurance through Fidelity Life and AIG American General (an AIG company). Indemnity, short-term major medical, and critical illness insurance is offered through various additional partners.

Source: PRESS RELEASE Health Benefits Direct to Enter California Market With Addition of PacifiCare as Health Insurance Carrier

Sometimes, Sightseeing Is a Look at Your X-Rays

Interesting article about both sides of medical tourism..and brings to light what type of medical attention the citizens of these countries receive...BD

But just as American travelers begin getting comfortable with the safety of foreign hospitals, they face a new question. With developing world hospitals focusing on medical tourists, some may take doctors away from understaffed public clinics in nations like India and Thailand, potentially leading to a public backlash against medical visitors. Already, the press in Thailand and India has warned that medical tourism, which can be more lucrative for physicians, is sucking doctors away from public clinics.
Only days after my luxury dengue treatment at Bumrungrad, I saw this other side. At a larger Thai hospital where I’d walked in after feeling my fever spiking, I sat on a hard bench in the middle of a waiting room littered with cigarette butts and empty plastic bottles. For over an hour, no one called me. When a nurse finally approached me, she warned there wouldn’t be any doctors around for hours, and then turned and walked away.
I got up and took a cab to Bumrungrad.

Source: Sometimes, Sightseeing Is a Look at Your X-Rays - New York Times

Advertising pharmaceuticals with Legos?

Does marketing need to go this far? BD

More new business opportunities for drugmakers - cross-promotional moments with toymakers. Here we have an item that's popular with children of many ages, particularly young boys.

Source: Pharmalot: Risperdal Legos: Building Blocks For Care

Hat Tip: Kevin, MD

Chapter 6, "Are you still just using your Cell Phone for Phone calls?"

In Japan a participant can simply snap a picture of the food and get expert advice back via the cell phone for nutrition information. BD

TOKYO, Japan (AP) -- Wondering how much of a diet-buster that banana cream pie on your plate is? Some Japanese have a novel way to find out: Photograph it with your cell phone and send the image to an expert.
With cell phones ubiquitous in Japan and rising concern over expanding waistlines, health care providers have put two and two together to allow the calorie-conscious to send photos of their meals to nutritionists for analysis and recommendations.
Osaka is using a system developed by Asahi Kasei Corp., a Tokyo-based chemical and medical equipment manufacturer. The system is operating at about 150 health care providers and local governments around the country, company official Naoki Yoshimura said.
Nutritionists can work with photos from one day's meals to several weeks' worth, he said. Results come back in three days. Participants also can log onto a Web site to get further dietary information and upload photos from digital cameras.
"Cell phones are everywhere here," Onishi said. "We're hoping they can now make it easier for people to get help improving their diet."

Source: Cell phone cameras help Japanese lose weight - CNN.com

Robotic Surgery May Improve Survival Rate For Prostate Cancer Patients

Performing less invasive laparoscopic surgery using robotic technology may improve survival rates for prostate cancer patients, according to a study by urologic oncologists at Thomas Jefferson University Hospital's multidisciplinary Genitourinary (GU) cancer center.
In a study presented May 21, 2007 at the annual American Urological Society meeting in Anaheim, Calif., the Jefferson urologists found that performing a laparoscopic radical prostatectomy (LRP) with robot technology can reduce positive surgical margins. Positive surgical margins refers to when cancer, seen under a microscope, goes to the edge of a specimen, meaning that cancerous cells likely remain in the patient. LRP is the surgical removal of the entire prostate gland and surrounding tissue including the seminal vessels through several tiny incisions.
The robotic system further refines laparoscopic prostatectomy by allowing a surgeon's hand movements to be scaled, filtered and translated into precise movements of micro-instruments within the operative field. The magnified, three-dimensional view the surgeon experiences enables him to perform precise surgery in complex procedures, such as radical prostatectomy, through small surgical incisions.

Source: Robotic Surgery May Improve Survival Rate For Prostate Cancer Patients

Patient Pain Medication - Self Dispensing pill medication at bedside

This is not a new concept as IV dispensers have been around for quite a while, but new technology allows for the same type of dispensing with pills by using RFID (radio frequency ID). BD

The MOD® is a Class I device approved for use by the FDA. Use of the device in the EQA Program is not considered experimental but rather, Institutions may collect data related to the use of the device for internal purposes as part of the device evaluation. Modules for data collection are included in the EQA Program Source Book to encourage a thorough evaluation. No data or internal information collected will be requested by the program sponsor.

The device is delivered to the patient’s bedside and locked onto an IV pole within easy reach of the patient. The patient wears a Radio Frequency Identification (RFID) wristband that has been programmed into the device. When the lock-out interval has passed, the patient sees the bright green ready light on the MOD®. To request a dose of medication the patient follows these three easy steps:

Touches the pain scale to record the pain level and activate the RFID reader within the device
Swipes the RFID wristband over the front of the device to turn the tray to the open position
Removes a single pill from the device and takes the medication

Source: AVANCEN, LLC - About the MOD®