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Gamification–You Have Won and Now We Know All About You - It Didn’t Cost One Cent-Insurance Companies Have Games To Find Out More About You Too– “Attack of Killer Algorithms” Chapter 11 | The Medical Quack

Sat, 04 Feb 2012 17:37:42 -0500

This is a good article and if you like privacy well worth the read here to find out what goes on behind the scenes with data mining and giving out all kinds of information about yourself to those that mine and sell data. This article in the New York Times kind of reiterates what I talk about here from time to time. Now we know what the health insurance companies have “games”. I have said it before and it comes from a higher resource than me now. Here’s a couple examples and again I don’t know how popular they are since I don’t do games and don’t use coupons.

Aetna To Offer Online Game Social Game For Personal Wellness- Joins Humana As They Have An Online Game Called FamScape

Health Insurer Humana Introduces a New Game Called FamScape–Making It Fun to Get And Maybe Mine Your Data?

The article further discusses how it used to require a bigger pay back to get folks enticed to play but not any more, egos and being #1 on on social jag is all it takes:) Who wins? I think you can figure that out when it comes to the data and what you gave away, but they have the ultimate at the other end, “the data'”. So did you win or lose? Healthcare is not alone though as the financial area has some games out there too where you can be a virtual investor and there’s a pretty good chance they have some data to sell. This is big business as even the retail chain Walgreens said their data selling business is worth just under $800 million and that was last year so maybe it’s growing? So what’s in a reward today? Actually the use of data for sale with high frequency traders and Hedge Funds is growing at a rate faster than Facebook

High Frequency Traders Using Social Networks and Growing Rapidly With Algorithms That Find, Sort and Leverage-Growing At A Rate Faster Than Facebook

A new type of analytics the article says…I would agree with that comment and it makes billions for Corporate USA from “free data” that you contribute. Along that topic there’s also the free data gained from mining state government servers and it has gotten so bad that some states have added software to block the bots. In North Carolina they threw out CoreLogic and revoked their license to mine and some of these folks that mine are too cheap to pay a few hundred dollars every quarter to update information. Do wonder why it is so hard at times to get something that is erroneous off your record? That’s the story on that end.

Once again this brings me back around to my case of the “Killer Algorithms” that are out there and how they suck you in one way or another and then some work against you later. If you want to dig deeper on how you get sucked in, the link below has a great video that will explain a lot of this and how it is designed to do just that, suck you in.

Context is Everything–More About the Dark Arts of Mathematical Deception–Professor Siefe Lecture Given at Google’s New York Office–Big Healthcare Focus

So in essence just one more set of crafted algorithms that get you to participate for nothing and your data gets sold. I would think many would be tired of this by now but until the education as to what happens on the other side sinks in I suppose it will thrive. How do you stop it, answer is you don’t as it’s almost impossible but what I think we should do is license and tax those folks that do this and require a disclosure site so anyone wanting to “play the game” knows what happens on the back side and call it the Alternative Millionaire’s Tax as that’s who would be getting taxed, companies making millions for zero output and take free taxpayer data and make billions off consumer’s backs while they entertain themselves with these very crafty algorithms online.

The Alternative Millionaire’s Tax–License and Tax Big Corporations Who Mine and Sell Taxpayer Data They Get for Free From the Internet-Phase One to Restore Middle Class With Transparency, Disclosure and Money

We don’t know or have a clue as to exactly what is collected and how much the value is on the data, but the billions made sure makes a huge statement and you know we are all still stuck paying federal excise taxes on tires we need for our cars, so this doesn’t make a bit of sense to me.

You Are the Product–Privacy Anonymity and Net Neutrality On the Internet - Excellent Stanford University Lecture (Video)

This leads me to one final link here and actually it is post I made back in August of 2009, “Do we need a department of algorithms” or something along that line? I made the post about the time the Madoff case hit the news…SEC certainly needs some new efficient algorithms as it looked like the Facebook IPO filing shut down their site this week too, so see the power that big corporate USA has with their data and algorithms in knowing how to game you and the system? There was also a comment in the Times article too about how we are headed for a real backlash with all of this and in my opinion the sooner the better as that will indicate a much smarter consumer crowd out there. BD

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

FOR the last few weeks, Kenneth Brown has reigned over Samsung Nation, an online loyalty program that offers virtual rewards to consumers who talk up Samsung, the electronics giant.

In the three months since the program was introduced, Mr. Brown, owner of Atlantic Detail Service, a steel detailing business in Athol, Mass., has racked up more than 4.5 million points, often placing him atop the site’s leader board.

Along the way, he has earned a virtual “Twitterati” badge — a turquoise circle — for posting dozens of links to

Samsung.com on his Twitter account. He’s nabbed a virtual “Connoisseur” award for his frequent comments on the Samsung site. And, while newcomers who register for the program might attain mere “Novice” status, Mr. Brown has joined the ranks of the elite “Cognoscenti” by answering many questions from site users.

Game techniques, Mr. Duggan says, prompt consumers to spend more time on company Web sites, contribute more content and share more product information with Facebook and Twitter adherents. One of his clients, he says, uses a gamification program to collect information about 300 actions — like posting comments or sharing with a social network — performed by several million people.

Ian Bogost, a professor of digital media at the Georgia Institute of Technology, for example, refers to the programs as “exploitationware.” Consumers might be less eager to sign up, he argues, if they understood that some programs have less in common with real games than with, say, spyware.

“Why not call it a new kind of analytics?” says Professor Bogost, a founding partner at Persuasive Games, a firm that designs video games for education and activism. “Companies could say, ‘Well, we are offering you a new program in which we watch your every move and make decisions about our advertising based on the things we see you do.’ ”

“There is probably a backlash coming,” Ms. Robertson says. Pretty soon, she predicts, companies may differentiate themselves with anti-gamification promotions like “No points. No annoying missions. Just clean services.”

http://www.nytimes.com/2012/02/05/business/employers-and-brands-use-gaming-to-gauge-engagement.html?_r=1&smid=tw-nytimesbusiness&seid=auto

Technorati Tags: marketing,healthcare,devices,advertising,doctors,Humana,games,compliance,data mining,health insurance,Aetna,gamification,Samsung

Monday Morning Update 2/6/12 | HISTalk

Sat, 04 Feb 2012 16:38:13 -0500

From Kit Carson: “Re: Fletcher Flora. I’m interested in knowing what’s going on with shareholders. The final distribution statement was supposed to go out in November 2011.” We broke the news in November 2010 that Merge Healthcare had acquired the LIS vendor (I forget how I found out, but it must have been sneaky since I worded it as “HIStalk has learned,” which means I was snooping.) I don’t know anything about its shares, but I’ll run an update if anybody has one.

From Adele: “Re: HIStalk. As a sponsor, thanks for all of your hard work toward making HIMSS as productive as possible for your subscribers and for your sponsors. We are grateful that you all actually make the time to track our news and offer your suggestions to us when there are so many larger ‘fish to fry’ in your universe. HIStalk is one of the only places that provides for an equal voice for all of its sponsors, regardless of size, revenues, or politics. As a smaller company, we just can’t write a fat check simply to pay to play in some other channels. Moreover, we wouldn’t. For us, that is just not responsible stewardship of our clients’ resources.” Sometimes Inga and I need a little boost and this gave us one. Thanks.

From Vendor_Neutral: “Re: Epic. Wondering if you came across the online discussion spurred by the NYT piece?” I did see it, but like a lot of Internet discussion, I found it to be mostly hot air pontificating by industry sideliners and self-referencing, self-appointed experts who have never used Epic, aren’t clinicians, and don’t even work in healthcare IT (if you’re going to criticize a restaurant, at least eat there a couple of times.) Some of the least-informed comments drone on about Epic’s outdated technology, a clear signal that the authors have no experience in a business software environment, where customers value applications that are solid, scalable, and expertly managed over the latest iPad app or cool Web site. To dismiss the business and software savvy of hospitals that are buying Epic in droves is ludicrous, even if you (as I) doubt that most of them have the organizational fortitude to get the rosy ROI and patient benefits they expect when they fork over mega-millions. Somehow I doubt that Judy is losing sleep worrying that all the armchair quarterbacks will redirect their expertise into building a better mousetrap that will renders hers as obsolete as the company’s persistent detractors claim it already is.

From CDS Observer: “Re: FDA regulation of clinical decision support. This could be serious since it could involve a wider range of systems to be regulated, such as EMRs and simple apps. This would be a big blow to many smaller companies. Our company has joined CDS Coalition to make our voice heard and to keep members informed in case their product ends up getting included in the regulatory net.” I found the CDS Coalition’s Web page here. Companies pay $1,200 to $30,000 per year to join.

From Ambergris: “Re: KLAS scores of publicly traded companies. Didn’t you post something at one time?” That was actually Evan Steele of SRS, who made the point in October that five of the six top-rated EHR products are offered by privately held vendors, while eight of the nine lowest-ranked products are offered by publicly traded companies. To be fair, he’s only looking at customer support rankings of a specific ambulatory EHR category. However, I will add from experience, having had a few incumbent vendors go public or be acquired by publicly traded companies, that every one of them got worse afterward (I’ve written many times on the KLAS “first to worst” product phenomenon.) Investors replaced me as the company’s most important customer. I’d like to say it doesn’t have to be that way, but I can’t think of many exceptions. On the other hand, if you buy from the company after they’re public, at least you know what you’re getting and have less reason to be disappointed compared to the folks who knew them before.

From Jess: “Re: fast track clinic model for expediting medical services to patients coming to the hospital. I was hoping I could tap into your vast knowledge base to see what you know about this model.” I think you are overestimating the vastness of my knowledge base since it’s coming up empty on this topic (although come to think of it, “vast” usually means big but empty.) I will call in the assistance of expert readers to fill my void.

From The PACS Designer: “Re: Jobs biography. The biography Steve Jobs by Walter Isaacson has some interesting comments. Jobs said of Microsoft’s Bill Gates, ‘Bill is basically unimaginative and has never invented anything, which is why I think he’s more comfortable now in philanthropy than technology.’ Isaacson said this about Steve: ‘He was not the world’s greatest manager. In fact, he could have been one of the world’s worst managers. He could be very, very mean to people at times.’" I think that’s what I enjoyed most about the book – trying to figure out how someone so narcissistic, uncaring, and downright nasty could not only create arguably the world’s greatest company, but run it as a publicly traded company CEO almost until the day he died despite seemingly lacking all the important skills for the job. The only other example I could think of was Neal Patterson of Cerner. And Bill Gates. I guess the bottom line is that if you’re a visionary who started the company (see: Mark Zuckerberg), you can mold it to your bizarre personality, unlike the typical gunslinger, committee-vetted musical chair CEO that big corporations love who are loaded with MBA school bean-counting competency but short on anything resembling risk-taking, innovation, and vision.

The good news about offshore programming is that half of responding readers don’t automatically assume it means shoddy work. The bad news is that the other half do. New poll to your right, and this should be fun: who is most responsible for the glut of clinically useless EMR information?

Inga and I forget ever year just how busy we get in January and February in the HIMSS build-up period: interviewing, plowing through increasing numbers of pointless press releases to find the occasional newsworthy tidbit, adding new sponsors, and planning HIStalkapalooza. If we’re slow to respond, that’s why. I came home from a nine-hour day at the hospital Friday, chowed down the Wendy’s salad and baked potato helpfully provided by Mrs. HIStalk on her way home from work since she knew I was overwhelmed and had approximately 15 minutes of free time to eat, and worked eight straight hours on HIStalk stuff without even leaving my chair. Six hours later, I was back up and at it for another long day Saturday, where emerged like Punxsutawney Phil only long enough to see my own shadow during a brief lunch with Mrs. H, then get back to work. That grind won’t end for us until the conference is over. I will need (and am taking) a vacation afterward, assuming I survive until then, and Inga will be away the week after. The worst thing is that, like a crack user, I enjoy it and can’t see cutting back even though it’s probably unhealthy. While I’m away, I’ll plan my self-improvement for the rest of the year, so if you have ideas of books I should read, conferences I should attend, or things I should do, let me know.

Speaking of HIStalkapalooza, thanks again to ESD for putting together an outstanding event. It’s a big effort to have planners visit potential sites, work out food and entertainment details, handle logistics like registration and decorations, and of course write a huge check when it’s all over. They have been outstanding to work with, and since they get what HIStalk is about, they suggested some fun surprises that I heartily approved. If you need consulting help with your clinical systems projects (training, implementation, support, optimization, Meaningful Use, etc.) I’m sure they wouldn’t be opposed to taking your call. If you got an HIStalkapalooza invitation, please thank them when you get there. I wasn’t even sure I wanted to do another event this year, but I think it’s going to be cool.

Also fun: Medsphere is bringing over its 1971 VW open source bus, which Chairman Mike Doyle tells me will be available “to shuttle HIStalk groupies to your event on Tuesday.” I don’t know what they’ve planned for routes and all that, so maybe just flag it down if you see it if you need a ride to the Palazzo.

I’ll put in just a brief placeholder for our Booth Crawl, which will offer provider attendees of HIMSS what I would guess is their best chance to impress the fam by bringing home an iPad 2. Think of it as a scavenger hunt where you visit the designated booths to get the answers to secret questions (you’re visiting booths anyway, so you might as well hit these and get in the running for a swell prize.) You enter those answers online by Wednesday evening and watch HIStalk to see if you are one of the randomly drawn winners. You don’t have to get stickers or stamps on a card, you don’t have to drop your entry into a hopper, and you don’t have to be present to win. We have 55 iPads to give away, so the odds should be pretty good, plus you’re supporting our sponsors just by playing (not to mention that I noticed that a couple of sponsors have added prizes of their own.) I’ll be posting the form shortly. Nobody’s making money off this since we’re doing the work on our end for free and the sponsors happily donated the prizes, so for everybody involved it’s all about putting iPads into the hands of readers.

One last HIMSS note: if you aren’t attending, we will try our best not to make you feel left behind even though we have to write a lot about it. I think I speak for most readers in saying that the more years you go, the less you enjoy it and the more it becomes work instead of fun. I stay up until all hours each night at the conference writing everything up so you won’t miss anything important. The educational sessions are always iffy if you don’t research the presenter’s credentials in advance – I should hire someone to help me put on independent Webinars that would provide similar education without the travel and time off expense, which I’ve been talking about doing for years.

I verified that RelWare has closed its office and let half the staff go, having lost the client for which it developed its EXR EHR, Henry Ford Health System. HFHS went live on the $100 million system, then decided less than a year later to have a $350 million fling with Epic instead (note to self: don’t ask HFHS for long-term IT strategic planning help.) RelWare is sitting on a certified EHR (Inpatient and Modular Ambulatory) that is running in six hospitals and 100 clinics that will soon be homeless, so they’ll consider licensing arrangements or outright sale of the source code to interested organizations. My RelWare contact is somewhat informal, so I guess you can e-mail me if you’re interested and I’ll forward.

Travis has been writing some really good stuff on HIStalk Mobile lately. The fun mixture of pieces includes, in the three most recent posts, (a) a hands-on review of the Zeo Sleep Manager; (b) a new post that contains a lot of items that I hadn’t seen elsewhere; and (c) his take on mobile strategies for pharma. He’s a doctor and an mHealth startup guy, so while I’ve seen splashier sites covering similar ground, I haven’t seen any doing it better.

Thanks to the following new and renewing sponsors that supported HIStalk, HIStalk Practice, and HIStalk Mobile in January (click a logo for more information). You have to admire them for mailing off a check to a post office box to an anonymous, smart mouth blogger without so much as a phone call to sooth any concerns they might have. They either sign up after reading the information sheet or they don’t, and we appreciate those who do.

Epocrates earns Ambulatory Complete EHR certification for its EHR v2. I had forgotten they had one, to be honest. They acquired the iChart mobile app a couple of years ago and rebuilt it into a full product, announcing GA in July 2011.

TrustHCS names Dianne Haas PhD, RN as executive director of its consulting services division.

Morton Meyerson joins the board of Encore Health Resources. He’s the former CEO of Perot Systems and runs Dallas investment firm 2M Companies, Inc.

Office for Civil Rights has cranked up their HITECH-mandated spot-check HIPAA audits, with the first 20 lucky organizations being notified in December that they had been chosen (with 130 more planned for 2012.) CynergisTek and ZixCorp are running a free Webinar next week featuring former HHS HIPAA enforcer and attorney Adam Greene and some folks who participated in those first 20 audits. If anybody has time to sit in, let me know the gist.

Vince’s HIS-tory lesson this week gets a bit more personal, honoring former SMS VP Jim Carter. Vince’s stuff isn’t just for the long-timers – whippersnappers can learn from the HIT history books, too.

McKesson acquires the oncology clinical decision support tools of Proventys.

Lawson announces that its Cloverleaf integration technologies have met the highest industry standards at the IHE Connecthon.

Joint Commission investigates a complaint against University of Michigan Health System that says it waited six months before telling police that child pornography had been found on a medical resident’s flash drive in the ED. Joint Commission is considering whether the delay qualifies as a sentinel event.

Revenue cycle vendor Accretive Health, already being sued by the State of Minnesota over a lost laptop, has its debt collections license suspended by the state until it provides information about how it was using patient information for collections and how its collectors interacted with patients.

Apple CEO Tim Cook, showing more support for charitable activities than his predecessor, says the company has donated $50 million to Stanford’s hospital, most of it for new building construction. Maybe he should have looked for charities that don’t run a hugely successful business already given that Stanford Hospitals and Clinics reported a profit of $186 million in its most recent government reports, paying its president almost $2 million and the CIO $680K. I’ll say this: when I donate to charity, it’s never to a hospital, including the several I’ve worked for. They are making plenty of money already, wasting significant amounts of it, and not really helping improve health as much as just providing more episodic healthcare encounters. I’d rather support public health causes that keep people from becoming their customers, such as those addressing obesity, disease management, and preventive care.

HIE vendor Sandlot Solutions names Joseph Casper, formerly of MedPlus, as CEO.

We asked readers to let us know if they were presenting at HIMSS after one expressed concern that as a first-time presenter, she might be standing in a nearly empty room. Here are those who submitted their information.

Session # 55: Tale of Two Health Systems: Implementing an Enterprise Data Warehouse

Two major health systems (Orlando Health and Essentia Health) present their lessons learned and benefits achieved via an enterprise data warehouse initiative.
Rick Schooler, Orlando Health Ken Gilles, Essentia Health
Tuesday, February 21, 12:15 PM – 1:15 PM

Session #31: Marketing the Healthcare IT Project

Effective marketing is a crucial part of any IT project- We will discuss innovative ways you can market to end-users and provide real examples from premier health systems to amp up the marketing initiatives within your organization.
Chuck Christian, CIO Good Samaritan Hospital Steve Bennett, VP Kirby Partners
Tuesday, February 21 @ 11:00-12:00 Murano 3303

Session # 42: EHRs: The New Drug Safety, Liability and Efficacy Battleground

The rapid adoption of EHRs by U.S. providers creates a new and powerful platform to improve patient safety, professional liability protection, drug efficacy and regulatory compliance.
Edward Fotsch, MD, Chief Executive Officer, PDR Network David Troxel, MD, Medical Director, The Doctors Company
Tuesday, February 21, 12:15 PM-1:15 PM (Marco Polo 803)

Session # 110: A Community HIE that Makes Cents while Improving Health Location

MyHealth Access Network, a Beacon Community in Tulsa, is focused on improving health with a community-wide infrastructure for healthcare IT learn their approach and associated ROI evaluations.
David Kendrick MD, MPH, CEO MyHealth Access Network, a Beacon Community
Wednesday, February 22, 1:00 PM – 2:00 PM

Session# 211: Increasing Nurse Leaders’ Informatics Skills: Building from the TIGER Competencies

Provides a discussion of the application of TIGER competencies to create institutional education programs to increase nurse leaders’ informatics skills.
Melissa Barthold, MSN, RN-BC, CPHIMS, FHIMSS IT Senior Clinical Solutions Consultant University of Mississippi Medical Center Jackson, Mississippi
Friday, Feb. 24th, 2012 10-11 AM

Session #66: Extreme Makeover – ICD-10 Code Edition: Demystifying the Conversion Toolkit

ICD-10 translation engine tools, code mapping tools, crosswalks, GEMs, code simulation tools, medical language/content management tools, computer-assisted coding software, and more — what’s a healthcare organization to use?
Deborah Kohn, MPH, RHIA, FACHE, CPHIMS Principal Dak Systems Consulting
Wednesday, February 22; 8:30 – 9:30 am

Session #153: How to Create a Care Coordination Team Using Spare Parts

Learn about a primary care group’s innovative model of care coordination which combines standard EMR functionality + clinical checklists + low cost staff to make life easier for physicians and patients, while improving quality and saving time and money for everyone!
Lyle Berkowitz, MD, FACP, FHIMSS Medical Director of IT & Innovation, Northwestern Memorial Physicians Group (NMPG) Associate Professor of Clinical Medicine, Feinberg School of Medicine at Northwestern University.
Thursday, Feb 23: 9:45 AM – 10:45 AM (Marcello 4502)

Session #32: The New Millennium of Enterprise Patient Centric Care across the Revenue Cycle

This presentation will review how the Cleveland Clinic is transforming traditional revenue cycle management by implementing an enterprise patient administrative management system, aligned to their Patients First Initiative.
Lyman Sornberger, Executive Director Revenue Cycle Management, at Cleveland Clinic Health System, and Dawn Mitchell, Principal, Aspen Advisors
Tuesday, 2/21 – 11:00am – 12:00pm

Session #406: IT Governance for Hospitals and Health Systems

Learn how to create an IT governance process that increases the number of projects that support your organizational strategy and are completed on-time and on-budget.
Roger Kropf, PhD, Professor at New York University, Wagner Graduate School, and Guy Scalzi, Principal at Aspen Advisors
1 of only 12 HIMSS eSessions

Session #9: The People of Clinical Decision Support

I’ll present results of a qualitative study I conducted along with OHSU’s POET research team at seven hospitals and health systems across the US focused on the types of people needed to carry out a clinical decision support program.
Adam Wright from Brigham and Women’s Hospital in Boston
Tuesday, February 21 @ 9:45 AM in Veronese 2503

Session #163: Applying Lean Principles to Ensure Clinician Productivity while Securing PHI

In this session we will explore the process and results of applying Lean principles at Mahaska Health Partnership to measure clinician productivity and minimize waste when implementing security technologies.
Kristi R. Roose Information Technology Director, Mahaska Health Partnership Dan Nikkel Continuous Improvement Director, Mahaska Health Partnership
Thursday, February 23, 1:00 PM – 2:00 PM in Lido 3103

E-mail Mr. H.

Tracking Boobs–Implantable RFID Chip to Identify Breast Implants | The Medical Quack

Sat, 04 Feb 2012 16:20:11 -0500

Well let’s place some serial numbers on those implants, and of course this idea came to light after the situation in Europe with the questionable breast implants and the arrest of the creator. The chip has been around in many forms and has evolved as I covered it for a few years here myself and owners have changed a bit too. You can soon have a chip off the old boob.

VeriTeQ Acquisition Corporation Buys VeriChip Implanted Chip and Health Link Personal Health Record Technology from Positive ID–Implantable RFID and Sensors

The company was the first to announce the chip that talked back to a scanner and even connected with HealthVault but I don’t think it was widespread in use. We go back to the conversation of “do I want to be chipped”. I don’t think most of us have issues with chipping our pets but the jury is still out on us having chips.

PositiveID Corporation's Health Link Personal Health Record – First PHR to Communicate Real-Time Blood Sugar Readings for Diabetics and Their Caregivers/Physicians

“VeriTeQ will focus on three main areas: patient identification and personal health record (PHR) access through the VeriChip implantable microchip and Health Link web-based PHR; implantable sensor applications; and identification of medical devices within the body. VeriTeQ will also focus on identification and sensor applications for animals.”

Siemens like the idea and the back track below tells about their investment.

PositiveID The “Chip” People are Back-an Agreement with Siemens To Expand Wireless Body Monitoring With A Chip Implant

If you are a diabetic, there’s also work being done for an implanted chip to read your glucose numbers and automatically send it to their software which can connect to other software, called GlucoChip. I don’t know they might hit on something to sell that chip but time will tell. They are also working in Israel on Inhaled insulin too, so inhale and let the chip do the reporting someday? In the meantime we have boob chips on the way and I wonder if the boobs will do text and email? Don’t laugh as there are devices out there that do that and the cardio vascular area has some trials in that part of the body.

Will there be any charities donating to this cause in the case of reconstruction for breast cancer? Sorry I just had to add that and a tiny bit of demented humor here. BD

(RTTNews.com) - VeriTeQ Acquisition Corporation Friday said it will offer its FDA-cleared VeriChip microchip, a rice grain-sized, passive RFID microchip, for the identification of breast implants and other medical devices.

Following the international breast implant scare involving breast implants from French company Poly Implant Prothese (PIP), which used industrial silicone for its breast implants to decrease costs, it was announced yesterday that the European Union is contemplating a manufacturer requirement to embed microchips in breast implants to provide for accurate and immediate traceability of these and potentially other medical devices. It is estimated that approximately 400,000 PIP implants were sold around the world.

Scott Silverman, chairman and CEO of VeriTeQ, said, "The current system for identifying surgically implanted medical devices is archaic and flawed. Once a device is in a person's body, there is no way to know for certain which company manufactured the device or what the specific device is. Embedding our VeriChip within a medical device prior to insertion enables a healthcare professional to scan the area of the patient's body where the device is implanted and receive immediate and accurate confirmation of what the device in question is and its manufacturer."

http://www.nasdaq.com/article/veriteq-to-offer-implantable-rfid-microchip-for-traceability-of-breast-implants-20120203-00781

Technorati Tags: PositiveID,glucose,breathing,health insurance,devices that report data,medical devices,PHR,personal health records,technology,IGlucose,FIS,HealthVault,Google Health,diabetes,VeriTeQ

LSU Announces $34 Million in Cuts to the Public Hospital System–Closing Beds in the ER and Mental Health Areas–Layoff Plans To be Announced Later | The Medical Quack

Sat, 04 Feb 2012 15:38:30 -0500

As you can read below, the full plans remain to be seen yet when it gets down to the actual nitty gritty here. LSU has been the temporary replacement for patients who formerly were seen at Charity Hospital which we all remember was destroyed with hurricane Katrina. Last week I made a post about healthcare IPOs and I think it also fits here with the dog and pony shows we still see on Wall Street with the financial side and the fact that hospitals are still struggling.

Greenway Medical Records IPO–Videos and Pictures at NYSE Getting Old as Hospitals and Doctors Struggle for Income And Close

Actually I don’t know why the NYSE still has this big building as all the action takes place over in New Jersey on servers and trading is pretty much all electronic these days and perhaps it would be better suited as a museum since it is part of our heritage and any money collected for tours could be donated to charities, you think? This comes to mind after the recent Komen stories and how it was all lit up in “pink” for the big shindig that was held there.

A new hospital is being built and it appears there’s still money from that after reading this article. I wonder why Senator Vitter is not more pro-active here with his state or is he? The Vitter Problem…..Of late he seems more pre-occupied with abortions and the silliness that has occurred with wasting everyone’s time. LSU hospitals have lost $100 million over the last 3 years and have reduced employees by over 400.

There are seven hospitals in the system to be affected and other hospitals are considering their own cuts. Again, strange times we live in today when we have a lawmaking body that is so out of touch. BD

Louisiana State University authorities announced $34 million in cuts to its public hospital system Friday, with a $15 million hit to Interim LSU Public Hospital in New Orleans that will mean eliminating the chemical detox unit and closing beds in the emergency department, mental health emergency extension and psychiatric inpatient unit at the DePaul campus. LSU administrators will submit a detailed layoff plan to the state Civil Service Commission on Tuesday, the same day that individual workers will get their layoff notices.

A drop in state tax revenues necessitated the midyear budget reductions, which where ordered by Gov. Bobby Jindal's administration. The cuts affect the seven-hospital system anchored in New Orleans. The system and its $780 million budget also include facilities in Baton Rouge, Bogalusa, Houma, Independence, Lafayette and Lake Charles. Separately, LSU hospitals in Shreveport, Monroe and Pineville must consider their own cuts.

The Jindal administration maintains that LSU effectively brought the cuts on themselves by budgeting based on money that was never actually appropriated.

At the New Orleans hospital, the big-ticket cuts include:

Eliminating the 20-bed chemical detox unit: $841,632.

Closing nine inpatient psychiatric beds on the DePaul Hospital campus, leaving 29 open: $663,007.

Closing 10 mental health beds in the emergency department, leaving 10 open: $853,673.

Closing four general emergency department beds, leaving 40: $1.43 million.

Closing 24 medical/surgical beds: $1 million.

Cutting additional personnel across all departments: $4.94 million.

Scaling back treatment for state prisoners: $2 million.

Cutting professional services contracts with Tulane physicians/professors: $2.29 million.

According to the LSU Health Care Division's most recent annual report, Interim LSU Public Hospital had 283 staffed adult and pediatric beds, along with 38 staffed psychiatric beds, with almost 15,000 annual inpatient admissions. Nineteen nursery and neonatal ICU beds have since closed. The hospital had 2,284 full-time employees.

The hospital, the temporary successor to Charity Hospital, is expected to remain in operation until early 2015, the promised launch for the $1.1 billion University Medical Center project under way in Mid-City, across Tulane Avenue from LSU's existing medical campus.

http://www.nola.com/politics/index.ssf/2012/02/lsu_making_15_million_in_cuts.html

Technorati Tags: LSU,budget cuts,Charity Hospital,healthcare,HealthIT,emergency room,hospital,contracts,doctors,inequality

EHR Incentive ROI – Your Milage May Vary | Candid CIO

Sat, 04 Feb 2012 13:31:18 -0500

Our first hospital to attest for EHR Incentives is expected to receive $3,173,094 for Stage 1. To qualify for that incentive we spent $381,133. This includes the cost for 5,219 hours of IT time to complete the work.

So, it surprised me when I was listening to a CIO discuss Meaningful Use on one of the hscio.com podcasts. He stated that Meaningful Use was an underfunded mandate. That is far from our early experience at Ministry.

I don’t think either of us are incorrect. We just appeared to be starting from different positions and we took different paths to attest for Stage 1.

In our pursuit of the EHR incentives provided under the stimulus bill we piloted one hospital to create a standard approach for the remaining 14. Our pilot site was our most technically sophisticated hospital, so the work to be done was less than typical. In fact, this hospital (Ministry Saint Clare’s Hospital in Weston, Wi) is an all digital hospital that has had virtually all orders entered by physicians since 2006. We have invested over $100M in IT at this hospital, it is rewarding to know that we made decisions that positioned us well to achieve Meaningful Use. This incentive money offsets a small portion of that investment.

I believe that the effort to get this hospital positioned to attest for Stage 1 was as close to minimal as any hospital in the country. In my mind this is a best case for return on investment. Our remaining hospitals will be closer to break-even.

One thing that is not significantly different between my experience and the CIO on the podcast is the software. We both use GE Centricity Enterprise as our core HIS system. However, we did self-certify Centricity (and a collection of other EHR technologies) rather than upgrade to GE’s certified version. This also saved us money and allowed us to move quickly.

CFP: Intl Sym on Network Enabled Health Informatics, Bio-Medicine and Bioinformatics(HI-BI-BI 2012) - Istanbul, Turkey 27 -28 August | Forum Discussions - Health Informatics Forum

Sat, 04 Feb 2012 09:58:09 -0500

Call for Papers

Full Papers, Position Papers and Posters International Symposium on Network Enabled Health Informatics, Bio-Medicine and Bioinformatics

HI-BI-BI 2012

http://hibibi2012.cpsc.ucalgary.ca

In conjunction with ASONAM 2012

Istanbul, Turkey

27 - 28 August 2012

For paper submission:…

Physician billing towards balanced work | ecare India Blog

Sat, 04 Feb 2012 08:28:27 -0500

After the chaos that the HIPAA 5010 implementation has created in the industry, there are multiple unanswered questions before us. It all revolves around two factors – Healthcare implementations and the day to day billing operations. Are we striking proper balance between the two? Are we taking the medical billing and coding implementations seriously? A genuine answer to the questions would be a big ‘no’ from most of us. We all try to cross the bridge as it comes, without analyzing the depth of impact it may have on the day to day operations and vice versa. We try to keep pace with the regular activities until we dodge them aside only to run behind any implementation, while it nears deadline.

Keeping pace with healthcare implementations while sustaining billing productivity:

Starting from HIPAA 5010, we have many other implementations like ICD10 and EHR on Queue that need be worked out before 2013 & 2015 respectively. Every day, it’s becoming tough for the healthcare professionals to adapt to the rapidly changing industry, with ‘uncertainty’ spreading across like an epidemic. Now, it’s high time we streamline the work flow and make room for advancements in our daily schedule.

Here are a few suggestions for physicians and medical billing companies to keep pace with implementations/projects:

Allot specific time for gathering industry updates
Enroll for daily email alerts from reliable healthcare organizations
Discuss with colleagues, social networking peers about the latest developments in healthcare billing on a regular basis
Attend important events and meets that discusses on medical billing issues and developments
Set up project plan & conduct weekly reviews for any implementation like ICD10
Provide training to staff on a daily basis
Testing is an important phase before any project goes live. Test every system before it goes live, find and fix the flaws in the system
During the post implementation phase, monitor and maintain system. Analyze & measure user experience & efficiency with people involved. Document the observations which will provide input for future enhancements

When you are planned and well informed, you can easily manage the medical billing and coding operations and the implementations simultaneously without having to sacrifice the other.

Weekly Overseas Health IT Links - 4th February, 2012. | Australian Health Information Technology

Sat, 04 Feb 2012 01:00:02 -0500

Here are a few I have come across last week. Note: Each link is followed by a title and few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment. ----- http://online.wsj.com/article/SB10001424052970204124204577154661814932978.html JANUARY 23, 2012 Should Every Patient Have a Unique ID Number for All Medical Records? The WSJ Debate Yes: It means better care, says Michael F. Collins. No: Privacy would suffer, says Deborah C. Peel. As the U.S. invests billions of dollars to convert from paper-based medical records to electronic ones, has the time come to offer everyone a unique health-care identification number? Proponents say universal patient identifiers, or UPIs, deserve a serious look because they are the most efficient way to connect patients to their medical data. They say UPIs not only facilitate information sharing among doctors and...

This is the initial part of the post - read more by clicking on the title of the article. David.

Is computerized medical records a benefit or are they a detriment | Forum Discussions - Health Informatics Forum

Fri, 03 Feb 2012 23:02:56 -0500

Computers have come along way in the past two decades. Health care facilities are switching from paper to computerized medical records every year. Computerized medical records are very convenient. I realize that they are very beneficial because they Allow All of patient’s info such as allergies, medical conditions, current medications, insurance details is easily compacted into a file on computer, The patient’s information can be easily transmitted to other health care professionals,…

MMR Global PHR Law Suits and Patents–Company That Drew Attention With the Russell Armstrong Suicide in Hollywood | The Medical Quack

Fri, 03 Feb 2012 22:50:36 -0500

The money keeps disappearing in one way or another and now there’s another question here with this settlement between of a balance of $25 million owed. We remember the sad suicide and the real housewife star Taylor Armstrong as that was all over the news.

MMR (MyMedicalRecords) Lawsuit Looking for Shareholder Answers With Taylor and Russell Armstrong–The PHR and Hollywood Suicide Connection, Where’s the Money?

Surgery Center Management, LLC issued a payment of $5 million and then took it back after they said MMR refused further negotiations. This back link explains their biotech interest outside of the Health IT portion of the business.

Favrille Biotech and MyMedicalRecords.com, Inc. Announce Merger Agreement

In the meantime it appears business as usual with promoting their personal health record and have sold share overseas as well to internationally help market the PHR software and service. Are they ready to step in to where Google Health left off? BD

Health IT Company MMRGlobal (MyMedicalRecord.com) To Sell 4 Million Shares To Chinese Investment Partner

LOS ANGELES, CA, Feb 02, 2012 (MARKETWIRE via COMTEX) -- MMRGlobal, Inc. MMRF -2.56% ("MMR" or the "Company") today announced that pursuant to the terms of its December 9, 2011 Settlement and Patent License Agreement (the "Agreement") with Surgery Center Management, LLC ("SCM"), the Company has filed suit to collect the initial payment of $5 million, due on December 23, 2011, along with an application to the court for a Right To Attach Order and Order For Issuance of Writ of Attachment. Pursuant to the terms of the Agreement, the remaining $25 million is due in annual payments of $5 million each, starting November 15, 2012.

Notwithstanding the existence of the lawsuits, SCM and MMR are attempting to work on a settlement. Presuming the parties are able to successfully settle this matter, MMR may conclude additional transactions with affiliates of SCM on terms that are beneficial to the Company's stockholders. According to Robert H. Lorsch, MMRGlobal CEO, "Based on the review of outside accountants, a business transaction could represent substantial benefits and significant valuation to MMRF shareholders at the conclusion of a transaction which I believe that both sides would like to accomplish."

On December 29, 2011, SCM issued the $5 million to MyMedicalRecords, Inc. in the form of a cashier's check based on the terms of the Agreement. Despite SCM's delivery of the cashier's check to the Company, SCM then retook possession of the check after MMR refused to renegotiate certain terms and conditions, including the termination provisions surrounding the remaining $25,000,000 owed under the Agreement. SCM has also withheld the money in an attempt to leverage MMR into a transaction on terms that MMR believes are not in the best interest of its stockholders.

The Patents include any issued or pending U.S. and/or foreign patent applications and/or issued patents, including, but not limited to, Singapore, Hong Kong, Israel, South Korea, Mexico, New Zealand, Canada, Germany, Japan, the United Kingdom, and the United States. The Agreement includes the settlement of any potential claims by MMR against SCM and its affiliates for any past patent infringement.

Despite the dispute with SCM, MMR is continuing to operate its business in the normal course and is working to further exploit its Health IT patents and other biotech intellectual property.

http://www.marketwatch.com/story/30-million-due-to-mmrglobal-under-non-exclusive-patent-license-agreement-2012-02-02?reflink=MW_news_stmp

Technorati Tags: Russell Armstrong,Taylor Armstrong,shareholders,PHR,MyMedicalRecords,investors,MMR,television,suicide,medical records,SCM,stockholders

Timings And Cast For Public Hearings on the Senate Enquiry on The PCEHR. | Australian Health Information Technology

Fri, 03 Feb 2012 21:49:58 -0500

This has recently been announced: Personally Controlled Electronic Health Records Bill 2011 and one related bill Public hearing - Canberra, Monday 6 February 2012 Committee Room 2S3, Parliament House, Canberra 8:00am 8:40am Australian Medical Association (via teleconference) (Submission 43) Dr Steve Hambleton, President 8:40am 9:20am Services for Australian Rural and Remote Allied Health (Submission 8) together with Aboriginal Health Council of Western Australia (Submission 13) Mr Rod Wellington, Chief Executive Officer, SARRAH Dr Pendo Mwaiteleke, Principal Policy Officer, AHCWA 9:20am 10:00am Consumer Health Forum of Australia (Submission 7) Ms Carol Bennett, Chief Executive Officer 10:00am 10:10am Break 10:10am 10:50am Medical Software Industry Association (Submission 46) Ms Bridget Kirkham, Chief Executive Officer 10:50am 11:30am ...

This is the initial part of the post - read more by clicking on the title of the article. David.

Army’s New Standard Issue Individual First Aid Kit | Medgadget

Fri, 03 Feb 2012 19:02:05 -0500

The U.S. Army has been trying to improve first aid medical response of soldiers in the field, and has developed the latest Individual First Aid Kit, or IFAK, to meet the unique needs that presented themselves in Iraq and Afghanistan.

But the IFAK is bulky and gets in the way of other equipment, so developers at Natick Soldier Systems Center have completely redesigned the pack to store it in the small of the back while making it easily accessible from either side by the soldier injured or another trying to help him.

Army’s New Standard Issue Individual First Aid Kit | Medgadget

Fri, 03 Feb 2012 19:02:05 -0500

More Meaningful Use Stage 1 Numbers from 2011 | EMR and HIPAA

Fri, 03 Feb 2012 18:11:42 -0500

In a previous Meaningful Use Monday we wrote about a bunch of the Meaningful Use 2011 statistics that were put out by ONC and CMS. I know that my readers love statistics and information about Meaningful Use. Carl Bergman sent me a PDF file that contained some really interesting data on Meaningful Use stage 1 in 2011. The first pages we basically covered in the previous post, but starting on about page 10 or so there are some more detailed numbers.

Take a look at let us know which numbers you find interesting and/or unique.

Time Capsule: What Paul McCartney Can Teach Providers about Contract Penalties | HISTalk

Fri, 03 Feb 2012 17:24:10 -0500

I wrote weekly editorials for a boutique industry newsletter for several years, anxious for both audience and income. I learned a lot about coming up with ideas for the weekly grind, trying to be simultaneously opinionated and entertaining in a few hundred words, and not sleeping much because I was working all the time. They’re fun to read as a look back at what was important then (and often still important now).

I wrote this piece in February 2007.

What Paul McCartney Can Teach Providers about Contract Penalties
By Mr. HIStalk

This is top-secret provider stuff. If you work for a vendor, why not skip on down to the news items? I’m about to tell your prospects to take actions that you’ll dread.

As a hospital IT person, I would never sign a vendor’s software contract without including a variety of specific and severe performance penalties. From recent Inside Healthcare Computing articles, many or most hospitals will. I’m shocked. I like vendors, but money makes people (and companies) behave badly. Be friendly, but get everything in writing.

Vendors (software or otherwise) can say anything they want about their product’s performance and reliability. Those statements can have one of three possible outcomes:

If the company is both knowledgeable and honest, you will be pleasantly unsurprised when their product works as advertised, but at least you won’t be caught unaware by a major meltdown. That’s the best (but not necessarily the most common) outcome.
If the company is honest but doesn’t have broad enough experience with their product in a setting like yours, you’ll probably be miserable together, hoping they’re as responsive as they are honest. That’s bad. Sometimes you hit architecture or design flaws that can’t be fixed, in which case you’ll use resources to work around the problems.
If the company is lying or has wildly oversold their wares, nothing else matters because you’ve been suckered into a long-term, expensive, and contentious relationship with a vendor that has already demonstrated its willingness to take your money under false pretenses. That’s the worst case.

The biggest mistake hospitals make is uncovering problems with previous implementations, but then buying the product anyway. The most common rationalization: “We’re smarter than those rubes who couldn’t make it work, plus we really like the product and the salesperson.” That combination of naiveté and misplaced bravado has lined many a sales rep’s pocket. It often benefits an executive recruiter, too, since the CIO who ignores a product’s well-known, spotty history often has plenty of free time to reflect after he or she has been shown the door.

Vendors may not be thrilled to see the list of penalties you want, but they aren’t your best buddies. They have their bottom line price and terms. You’ve got yours. Negotiation is meeting somewhere in that middle ground, fighting for the bigger chunk of the unclaimed territory on the table. If the vendor doesn’t visibly hate you during negotiations, you’re not pushing hard enough. Nice guys and gals don’t get good deals.

Contracts without penalties are binding only to the customer. If the software fails to provide value, crashes constantly, or can’t be used like you were told, you still pay unless you were smart enough to write in penalties. Your want their skin in the game with yours.

The most important eventualities to cover with penalties:

If the software doesn’t do what you were promised in a way that makes it unusable.
If you have problems that will cause you the most harm: downtime, poor response time, or cancelled development plans.
If the software or vendor has weak areas that sound like trouble. If the salesperson’s teeth clench up when you lay out penalty terms for failing to deliver a richly functional ED package or a CPOE-to-pharmacy interface, maybe you haven’t heard the truth.

A hard-hitting, predefined penalty is your best hope for getting undivided attention when a problem arises. The cash won’t be much consolation, but it does create an automatic escalation path respected by all.

I know we all like to throw harmless little love words around like “partner” and “shared vision,” at least until you’ve signed the deal. Vendors pretend to be wounded when you sully the honeymoon bed with legal requirements. Take a lesson from Paul McCartney – maybe the vendor is a wonderful partner who loves you for something other than your money, but make them sign an air-tight prenuptial agreement just in case. Secretly, they’ll admire you for it.

HIStalk Interviews Brian Sherin, President, Besler Consulting | HISTalk

Fri, 03 Feb 2012 17:16:10 -0500

Brian Sherin is president of Besler Consulting of Princeton, NJ.

Tell me about yourself and about the company.

I got started in healthcare accidentally. I was doing an internship while I was in college, in an accounting department of a hospital. I can still see the face of the controller who I worked for at the time when I walked in, that look of, “I’m going to deal with this kid all summer?” But we got along well and I did that for two summers. I got involved in a lot of aspects of accounting, although my major was finance, not accounting per se.

When I came out of grad school, I ended up in a very a bad economy, pretty similar to now, and I didn’t have a job. One of the guys I worked with in the accounting staff there called me and said, “Are you interested?” and I said, “Well, sure.” So I did that, and then about eight months later the controller asked me if I wanted to take the business office manager position. I lost a lot of respect for them at that point [laughs] –I thought he had better judgment than that since after, all I had virtually no experience. But he told me he had confidence in me and I could do it, so away we went.

Over the next 11 years, I moved from patient accounting to managing the overall revenue cycle, worked closely with HIM and other clinical departments. I eventually I took over on more administrative responsibilities. To this day, I’m really grateful for the guy having confidence in me at the time. He gave me an opportunity to learn so much and to set me on my career path.

As you can tell by now, I’m not an IT expert in any way, but I think from the business perspective I am very much an advocate of using technology to every advantage possible. I guess I could stretch it and say that I’m an IT user expert, or maybe advocate is a better way to put it. As I look back at my career, some of the more positive and exciting experiences I had were overseeing several HIS system implementations for the hospital. I just found them really very rewarding once completed. I’d like to do some more of that, but I haven’t been involved with those for a while.

While still at the hospital, I talked to Phil Besler one day. He had founded the firm back in 1986 — this was probably the early ‘90s. I joined him. It was really a reimbursement firm back then. That’s all we did except some charge master work. We began to expand that and we moved into doing hospital revenue cycle consulting in the mid ‘90s. Those areas grew pretty quickly. Finally we established a coding accreditation compliance service line, which rounded out our service offerings.

Now I would define us as a financial and operational consulting firm. We have about 200 customers in 20 states and roughly 50 employees. Most of our clients are hospitals, though we count physician groups as well as other types of providers as clients. A majority of our business has been traditional consulting.

In 2002, we did a former company called Innovative Healthcare Solutions, which we began by taking the charge master review software we had developed in-house — which I believe was in FoxPro at the time — and we developed a Web-based tool that we marketed. It was pretty exciting. We’d never done anything like that. Eventually we developed other decision support products. IHS was eventually sold to Accuro in 2005, then Accuro became part of MedAssets, I believe in 2008.

In the last two years, we began to focus on software again. We launched our BVerified line of solutions last year. Our latest two products were launched early in January. The idea behind getting back into software and creating these solutions is that we want to be able to provide our customers these software products that allow them to receive the benefits of our expertise we’ve developed over the years, while at the same time creating the potential to drive additional benefits for our client through that software.

Between your consulting opportunities and now you’re more productized offerings, what revenue opportunities do you typically find that even pretty good hospitals and even your competitors might miss?

Most of what we’ve been doing is on the consulting basis with regard to some of our revenue recovery opportunities. We do the majority of our work as the primary vendor. However, we have found pretty significant opportunities going in either behind just solely internal processes on the part of hospitals or after other vendors. Depending on the particular issue, whether it’s on the DRG transfer rule or IME, very often we find up to 30% or so of additional revenue.

I think a lot of that has to do with just our approach. We’ve refined it very much over the years. We’ve identified some areas that we think are often overlooked either through internal processes or by other vendors. But at the same time, we’ve focused very, very heavily on the compliance aspects of it. We also have seen some processes that are not very compliant. We had a lot of input from our clients that they wanted something that they could be assured was entirely in compliance with all the rules and regs. We put a lot of effort and resource into that.

Is there a lot of concern out there about the RAC audits and all the other audits that the CMS is talking about doing?

I think there is, but my sense is it depends on what part of the country you’re in. Here in the Northeast, we haven’t seen a lot of RAC activity, but it’s almost like everyone’s waiting for the other shoe to drop. They know it’s coming — they just don’t know when. With their hands full with what they already have — with all the organizations out there doing audits and all the other demands they have on them, especially from the IT perspective — they’re very concerned, yes.

Do you think it will be like the IRS, where they will take a small sampling and make a high-profile example of any problems they find?

I don’t think that’s the way it’s necessarily going to go. Even on the RAC side, they’re still finding their way as well. I think some of it will come to that, where they’re going to realize that it’s so labor intensive to get through some of this. If you look at the recent demonstration project that CMS put out where if you want to join on, you’re essentially giving up your right to appeal short stays that are denied as inpatients, but they will allow you to bill them as outpatients. My guess is that one the reasons they’re going forward with that demonstration project is just because of the volume of appeals they’re experiencing.

I think it’s going to take some time for everything to settle out. Eventually, you may find more of the old style initial teaching hospital audits from way back in the ‘80s, when they looked at 30 claims or 100 claims and decided that they were due $18 million. I don’t think it’s going to be quite that bad, but I think there’ll be more of that practice as we go forward.

Describe the problem with hospital readmissions and what clients are asking you to do to prepare them for that.

CMS is going to begin looking at data with regards to readmissions. They’re going to essentially identify the top quartile in hospitals in terms of unnecessary readmits or related readmits. It’s going to reduce your overall Medicare-based payment. A lot of hospitals are looking at that. It’s fairly easy to look at the Medicare data that’s out there to determine where you fall yourself within the three categories of diagnosis they’re going to be looking at. It doesn’t really necessarily tell you where you fall in relation to what quartile you’re in.

It seems to us from talking to a lot of hospitals, those who have a problem know they have a problem. In a lot of ways, they feel like they’re in a situation where there’s not a whole lot they can do to effectuate any real change in those patterns quickly. Another factor is that a lot of people don’t realize is that the readmissions include if you discharge a patient and they get readmitted to another facility. You don’t even know that, but that counts towards your readmission number. And that data is not generally available to everybody.

I think it’s something that everyone is trying to do a better job of coordinating care. Once patients leave the hospital, they’re trying to do a better job of communicating with patients, making sure patients are following through on physician orders and seeing their physician within a specified timeframe and so on. But there’s limited resources to be able to do that, and there’s limited ability to really change people’s behavior in that way.

With the emphasis on making clinical care delivery less episodic, the billing stayed episodic and only now is moving toward billing for non-piecemeal work. Are hospitals going to be able to adjust quickly with the emphasis on ACOs?

I think that’s a real problem. Physicians have had that issue over the years too, where in some situations, they’re expected to manage care well beyond when they see the patient. It’s difficult. There’s really no reimbursement for that aspect of it. I think that ultimately hospitals understand that that’s the way it’s going. Whether you believe in ACOs or feel that they’re going to be the panacea some people think they’re going to be, nonetheless, that is the way things are going.

I don’t think anyone will argue the fact that a better process to manage patients once they leave the hospital — make sure they are following certain care plans, make sure they are seeing the right types of providers in the proper timeframe — is going to reduce readmissions, it’s going to reduce inappropriate admissions, it’s going to cut down on emergency room visits, and it’s going to overall have the great potential to lower the cost of healthcare. But we’re asking a lot of providers out there that are not going to be reimbursed in any way for a lot of those activities to take that on. I think that the funding for that is going to become a really critical issue.

There’s probably not much appetite to pay more for care, and not much ability since the government’s such a large payer. I guess it’s the equivalent of telling a steakhouse, “As of next week, you’re going to offer the same menu except as a one-price buffet.”

I agree. I don’t think there’s going to be much appetite at all for the government to put out any more money for this kind of thing. I think they feel that through some of these programs such as ACOs, with some of the incentives and whatnot, that’s going to effectuate some of this. And it may, for those who decide to become ACOs or maybe are positioned to do that.

The fact is that most providers are not really positioned to become ACOs and the incentives that are there for them. Even some of the premier facilities in the country have indicated that they don’t see the advantages to going to that ACO model and getting involved in that whole program. If they don’t see the value, it’s hard to believe that any inner city hospital is going to have the funds or the abilities to be able to put any kind of model like that in place unless they’re somehow funded for it.

Hospitals are imitative. If one does it, everybody does it. If a consultant starts recommending it or it shows up in a magazine, everybody jumps in line to do it. Do you think they’ll experiment with the ACO and either back out quickly or lose their shirts before they realize maybe it wasn’t as good as it sounded?

I don’t know. I’ve done some speaking engagements and have been in a number of meetings where someone would ask, “Who here from a provider side is going to plan for being an ACO?” Almost everyone raised their hands. I think that was just because it was early on — the rules weren’t defined.

As more and more comes out with regard to what’s expected from ACOs and what the cost is going to be and the type of infrastructure you had to have in place to effectively manage an ACO, I think you’re seeing more and more back away from it. My guess is there’s not going to be a whole lot of organizations that actually go all the way through and become an ACO and actively participate in that project. So we’ll see. My guess is that as providers dig through it, they’re going to realize that there’s really not a whole lot of advantage to them.

Do you have real-world examples of what you’ve found with your BVerified process?

The very first client we had for the screening verification tool, which was really the first BVerified product we put out there, we immediately found something which looked … I won’t get into the details, but it looked very questionable. We immediately called them and it was something that they were aware of. They were actually pretty impressed that we came up with it so quickly.

Everyone’s had some kind of finding. Sometimes as you go through those, you identify that there are things that were corrected or maybe it was incorrect information that was submitted to do the verification and whatnot. But our clients have been very happy with it thus far. To them, it’s a one-stop shop. They don’t have to have multiple screening tools in place. They’ve been happy with the product and the results they’re getting out of it.

It’s to check the HHS’s database for excluded parties, correct?

Yes. It goes through and checks both federal and state databases. We can adjust that, because with regard to some state databases, there are timeframes and “how often” rules in terms of how often you have to check. We built all of that into it. Essentially it’s looking for excluded individuals. It also has some additional functionality — it allows you to verify licensure and things like that as well.

You’ve done services related to point-of-service collections. Money is being left on the table by letting patients walk away without, but consumers are pushing back about being asked for a credit card before they’re seen. How do the hospital know that they’re ready to initiate that planning for point-of-service collections and what’s involved with transitioning to that?

The time is well past when those programs should be in place. In talking to our clients, I’ve always maintained – and this goes back quite a ways – you need to start this now, because it’s not like you just put someone with a cash register at the door. It doesn’t work that way. Most hospitals serve a pretty much a specified community, and it’s a matter of changing that community’s understanding of how you function. There’s a lot of communication that has to go on with both the patient population as well as the referring physician population. They need to understand what you’re doing and why you’re doing it.

Physicians have been doing this very effectively for a long, long time. Maybe it’s not some of the same dollars that are involved in terms of physicians who are merely collecting co-pays, but I defy you to find anyone who’s covered by any kind of a managed care or a PPO plan who’s gone to their physician who’s gotten to see that doc without paying their co-insurance first. They’ve done an effective job of that, so physicians understand the need for it.

The dollars are significantly more on the hospital side, but that can be worked through in terms of an arrangement with the patient. It takes a long time. It’s an educational process, it’s a community educational process. It’s not something you just turn the switch on overnight. What I’ve seen mostly is that hospitals have implemented it in maybe a few different areas within the hospital, but not universally. They do get pushback.

There has to be a commitment all the way up the management string, right up to the CEO and the board, that this is what we’re doing and this is how we’re going to do it. They’ve got to resist those calls that come in and say, “I was there the other day and I’ve been coming there for 30 years and now you’re asking for payment up front.” Everyone has to be on board, because as soon as you start making exceptions, it quickly loses its effectiveness.

What do you see as major areas of concern in the next five years and what should hospitals be doing now?

We’re addressing a lot of things on our end. With some of the other software tools we’ve developed, we’re trying to come up with ways that hospitals can take our expertise and our experience with a lot of things. We put them into a software tool so that the hospital can internalize them and gain greater control over some of those functions. Instead of doing it on a consulting basis, they have the ability to do it on their own. That works for some, doesn’t work for others.

We understand that a software solution isn’t automatically the solution for everybody. We’re trying to do that because what we’re hearing from some of our clients is that they need to bring some things internally and they want to reduce their costs a little bit. That’s why we’ve done those things with the transfer DRG tool and the Medicare advantage IME tool and our revenue integrity auditor.

At a higher level, my feeling is that over the next five years, hospitals have to begin to fully integrate their clinical and their financial operations. There’s still a separation there to a large degree with a lot of hospitals. While everyone’s moving in that direction, I think it needs to be looked at more as a business. There has to be a way to bring together those two aspects of the operation in one cohesive whole.

While obviously patient care is the business you’re in and you want the highest possible quality you can get, there needs to be some control over that, in terms of how you best do that. I think that’s the whole ACO concept, which is good. I’m not convinced on the ACO model, but I think the ACO concept is good in that it makes you bring it all together, operate more cost-efficiently, and coordinate care across the whole spectrum of the services the patient’s going to receive in their inpatient, outpatient, physician, physical therapy, specialists, whatever it may be.

The most important thing over the next five years is to start looking at healthcare delivery – and I don’t mean this in any kind of impersonal way — as a business, bringing together the financial delivery of care and the clinical delivery of care so that you’re getting the most sufficient product you can.

Any concluding thoughts?

We’re experiencing the most interesting and fast-paced changes we’ve ever seen in this industry. More so than ever, the changes we’re seeing now will dramatically alter the way healthcare is delivered and managed from this point onward. Everyone’s got to be ready for it, because I don’t think there’s any turning back. There may be some stumbling along the way, but everything that’s been started now is going to move forward. As Bob Dylan said, “You better start swimming or you’ll sink like a stone, because the times they are a-changing.”

We’re changing our approach and trying to meet the changing needs of our clients. We continue to focus on trying to find all the revenue we can for our clients. We won’t stop that. That’s the reason for developing some of these software tools — to give something to our clients that has a demonstrable, compelling ROI.

It’s pretty exciting times, but they’re also very challenging times. I think the pace is only going to pick up. We’re going to see incredible rate of change over the next few years.

Check-Cap X-ray Radar Pill Sliding Toward Commercial Introduction | Medgadget

Fri, 03 Feb 2012 15:42:43 -0500

GE has announced investing into an Israeli company called Check-Cap that’s developing swallowable endoscopic capsules for imaging the insides of the GI tract. Check-Cap seems to be a direct competitor of the better known Given Imaging, also an Israeli firm, that’s been producing its own PillCams for visualizing everything from the esophagus to the small intestine and beyond.

While PillCams use light in the visible spectrum and a traditional image sensor, the Check-Cap delivers low energy X-rays that provide a much different look at the internal anatomy. Because X-rays penetrate through soft material, food intake shouldn’t be a problem for the device, and all the typical preparation for a GI tract analysis may not have to apply.

Check-Cap X-ray Radar Pill Sliding Toward Commercial Introduction | Medgadget

Fri, 03 Feb 2012 15:42:43 -0500

Heart Stop Beating, a Film by Jeremiah Zagar | Medgadget

Fri, 03 Feb 2012 15:15:11 -0500

Drs. Billy Cohn and Bud Frazier at the Texas Heart Institute were faced with a patient last March who’s heart was about to succumb to the point that even a left ventricular assist device wouldn’t be sufficient to keep him alive. Described as a story of “two visionary doctors from the Texas Heart Institute who in March of 2011 successfully replaced a dying man’s heart with a ‘continuous flow’ rotor-driven device of their own design, proving that life was possible without a pulse or a heartbeat,” the film was directed by Jeremiah Zagar, whose feature-length documentary “In A Dream” was nominated for two Emmy’s in 2010.

Heart Stop Beating, a Film by Jeremiah Zagar | Medgadget

Fri, 03 Feb 2012 15:15:11 -0500

Next Generation LipiFlow for Evaporative Dry Eye Cleared in U.S. | Medgadget

Fri, 03 Feb 2012 14:33:24 -0500

TearScience of Morrisville, NC received FDA clearance for the new version of the LipiFlow Thermal Pulsation System for evaporative dry eye. The condition leaves patients with too few tears, making the remaining ones feel too salty. The system heats and massages the eyelids, helping unblock the flow of lipids from the meibomian glands found under the eyelids.

The new generation of LipiFlow provides the ability to two treat both eyes simultaneously, cutting treatment time in half, to about 12 minutes. It also sports a new interface that displays treatment temperature, pressure sequence and treatment time remaining, while recording all the data for easy sharing with the clinic’s electronic medical record system.

Next Generation LipiFlow for Evaporative Dry Eye Cleared in U.S. | Medgadget

Fri, 03 Feb 2012 14:33:24 -0500

Quest Diagnostics Offers Big Discount On Its EMR-Practice Management System | EMR and EHR

Fri, 03 Feb 2012 14:07:31 -0500

In the past, I’ve written volumes about hospital attempts to lock in doctors by offering them access to a free or deeply-discounted EMR. I haven’t heard much about this strategy of late — either the approach was dropped or it’s gone underground — but it seems that other players are still giving it a shot.

This time, in what seems to be a fairly logical step, Quest Diagnostics has kicked off a program offering medical practices a steep 85 percent discount off of the retail price of its Care360 EMR and practice management bundle. The announcement follows up on its 2011 regional giveaway program, which Quest says attracted thousands of physicians.

The deal, which reduces the physicians’ out of pocket cost to less than $100 per month, also includes training, hosting, maintenance and 24/7 support for Care360. The lab giant says physicians can get Care360 up and running in about 45 days.

I can’t think of a reason why this wouldn’t make great sense for Quest; if my contacts are to be believed, it has no better reputation than its key competitors when it comes to customer service and follow-through on clinical testing.

On the other hand, if I were a doctor I’d think long and hard before agreeing to a deal like this, even though the software is just about free. There’s simply too much at stake to plunge in.

Yes, Care360 is CCHIT certified and, intriguingly, has incorporated the Direct Project specs allowing doctors to share information with patients and hospitals. And yes, it seems to have made efforts to support EMR access via mobile devices. This is all good. And of course, the price is right.

On the other hand, I’m not sure I’d want to make this big of a commitment to any particular service provider, be it a reference lab, a radiology provider or the people who stock my vending machines with sodas.

I’d argue that the more important the service is, the less you want to be beholden to the vendor. After all,what if Care360 isn’t your cup of tea? Do you really want to disrupt your relationship with a critical provider like Quest?

Not only that, it’s risky to lock in an EMR just because it’s cheap. If Care360 takes 45 days to get installed, it’s not going to be possible to uninstall it in a day or two, and that could mean misery on wheels if the product doesn’t work for you.

Besides, it’s possible to get Web-based, easy to adopt or drop EMRs for only a couple hundred dollars a month more. It wouldn’t make sense to go for an EMR that might not work just to save that little. (If your margin is tight enough that a savings of $200 or $300 a month is critical, you have worse problems than finding the right EMR!)

I guess I’m saying that even if the EMR is nearly free, caveat emptor. You don’t want to get saddled with an albatross system just because the price was right.

Komen Reverses Decision With Planned Parenthood–Hard Lesson on How Business Analytics Are Misunderstood And/Or Abused–Attack of the Killer Algorithms Chapter 10 | The Medical Quack

Fri, 03 Feb 2012 13:33:15 -0500

The event truly did wake up the American public on how women’s health is understood today or rather should I say “misunderstood” as you read the news the last few days, it was pretty vicious and I read enough of it myself. We live in a world of business analytics today, algorithms that give us parameters to digest information and we make our decisions based on them. I watched the original video from Komen on why the decisions were made and that was exactly what I came away with. Again doing this blog I read so much of similar press releases and stories on the web and this was just one more but unfortunately politics jumped in here big time.

In essence this a big awakening to the American public on how we are attacked by some algorithms (software is nothing but a bunch of algorithms working together in the words of Bill Gates) that are defined for “desired” results perhaps instead of “accurate” results. It happens all the time in the business world and as long the two are the same we don’t have a problem but sadly it doesn’t work that way.

This was a rather big awakening to remind us that “ethics” need to play a big role today and you can’t use mathematical formulas to mow people over when the lines cross. You won’t read this anywhere else on the web as most don’t understand or make an attempt to understand coding and math, but this is how I see the long and short of it without putting a big OMG spin in here. They still have this issue I think under political discussion to maybe look at too as we all know this one won’t die either as it will continue to come up over and over.

Komen Has Also Stopped Funding for Embryonic Stem Cell Research–Politics and Some of Business Intelligence Algorithms At Work Here?

I also do hope they have stopped their activity from last year of suing smaller charities for using the word “cure” as this again is counter productive of what philanthropy is supposed to be and $1 million can certainly pay for a lot breast cancer screens rather than lawsuits.

We do have other advocates in Healthcare and Wendell Potter is one that has to come to mind as he was one that had been there and done in a prior occupation and speaks out about how people get sucked in to the corporate brain washing that occurs and in his own words he said he found that he to was looking at algorithms and reports as numbers and forgot they were people until his awakening day with finding some missing ethics. You can can read his material all over the web to find out more and I think this is a bit of what we had going on here, folks were lost in the algorithms and all of a sudden when the “teeth” came out and made those decisions, people woke up.

Our new consumer protection chief, Richard Cordray has his hands full to in unwinding and getting the bottom of how ethics and business intelligence algorithms need to work in harmony so as not to harm consumers. At the link below are some links to some the prior Attack posts I have here that are defined with all pubic information and give some real glaring examples of discrimination by the algorithm.

President Appoints Richard Cordray as New Consumer Financial Protection Chief - Hope He Knows And Understands Correcting Flawed Math and Formulas To Battle the “Financial Attack of Killer Algorithms” On Consumers With Banks and Corporate USA

In one final thought here too as I always do talk about this, we have this big sense of digital illiteracy in Congress today and whenever things get over their heads with comprehension levels, they all go back to this “default” topic of abortions and you see it in the news all the time so some smarter Congressmen would definitely be in order here as they accomplish nothing and basically lead up to this big issue here with lobbying and trying to control where they have none. BD

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

This was truly a sad state of affairs but maybe some of those who are stuck in their “default” rhetoric will have the chance to take a look at themselves and see how the rest of the educated digital world views them. Again, sad that this methodology was unbalanced and even the Komen organization was snowed under with the rationale with being blind sided on the ethics and unintentional consequences that occurred.

No doubt when you see the NYSE stock exchange lit up in pink it does make you wonder where the powers of influence like and how mathematics are marketed and spun to where reality is such a far sight away.

This is yet one more chapter in the Attack of the Killer Algorithms. BD

We want to apologize to the American public for recent decisions that cast doubt upon our commitment to our mission of saving women's lives.

The events of this week have been deeply unsettling for our supporters, partners and friends and all of us at Susan G. Komen. We have been distressed at the presumption that the changes made to our funding criteria were done for political reasons or to specifically penalize Planned Parenthood. They were not.

Our original desire was to fulfill our fiduciary duty to our donors by not funding grant applications made by organizations under investigation. We will amend the criteria to make clear that disqualifying investigations must be criminal and conclusive in nature and not political. That is what is right and fair.

Starting this afternoon, we will have calls with our network and key supporters to refocus our attention on our mission and get back to doing our work. We ask for the public's understanding and patience as we gather our Komen affiliates from around the country to determine how to move forward in the best interests of the women and people we serve.

We extend our deepest thanks for the outpouring of support we have received from so many in the past few days and we sincerely hope that these changes will be welcomed by those who have expressed their concern.

http://thescoopblog.dallasnews.com/archives/2012/02/komen-apologizes-for-recent-de.html

Technorati Tags: Breast Cancer,Breast Cancer Charities,Breast Cancer Research,Cancer,Cancer Prevention,Fundraising,Huffington Post Komen,Komen,Lawsuit,Lawsuits,Lung Cancer,Philanthropy,Susan G. Komen,Planned Parenthoodhood

Today's Best Exam History | Dalai's PACS Blog

Fri, 03 Feb 2012 13:28:00 -0500

Found on an order for an abdominal and pelvic CT:

28 yo s/p GSW to left thigh on Saturday Jan 28, 2012. Reports evaluation at (outside hospital) showing bullet lodged in muscle. States this morning, having BM and heard "clink", dug through stool and found bullet.

This is why I went to medical school, folks.

Continuous Near-Infrared Regional Cerebral Perfusion Monitoring Shows Promise in Stroke Patients | Medgadget

Fri, 03 Feb 2012 11:47:02 -0500

Researchers at Mayo Clinic in Florida have shown that cerebral optically-based near infra-red spectroscopic oximetry applied to patients who have suffered a stroke can help monitor regional cerebral perfusion in real time, and thus “may serve as a useful, noninvasive, bedside intensive care unit monitoring tool to assess brain oxygenation in a direct manner.” The study looked at the device called Fore-Sight from Casmed of Branford, CT, that measures blood oxygen, similar to a finger clip pulse oximeter. The Mayo study results have been published in Journal of Neurosurgery this month.

Regional cerebral blood flow monitoring devices such as Fore-Sight are already in wide deployment in cardiac surgery, where they are thought to prevent brain ischemia in patients undergoing major surgeries on bypass (valve replacements, aortic arch surgeries, etc.).

Continuous Near-Infrared Regional Cerebral Perfusion Monitoring Shows Promise in Stroke Patients | Medgadget

Fri, 03 Feb 2012 11:47:02 -0500

eCalcs – How to video | Galen Healthcare Solutions: Allscripts Consultants Enterprise EHR

Fri, 03 Feb 2012 11:00:24 -0500

We have received a warm response to eCalcs, Galen’s latest bolt on for the Allscripts Enterprise EHR. We have received a lot of compliments along the way – integrated health calculators are much needed, that Galen put out a thoughtfully crafted product, and even that we finally listened a built this type of add-on tool [...]

Highest Rate for Testicular Cancer and Mortality in Chile | Lab Soft News

Fri, 03 Feb 2012 09:36:26 -0500

Here's an interesting observation. Chile ranks first in the world for deaths from testicular cancer, according to the World Health Organization (WHO) and Chile’s Ministry of Health (see: Highest death rates for testicular cancer found in Chile). Read on, if you are interested, in the following excerpt from the article:

In 2009, 121 Chilean men died from the disease and 63 of those were 15 to 30 years old, the age group most at risk from the disease. In the U.K., however, where the population is three and a half times the size of Chile, there were only 70 deaths from testicular cancer in 2008, according to the Cancer Research U.K.’s figures. “Testicular cancer figures are low in Chile in relation to the other types of cancers found here, but yes, the figures are high in comparison with the rest of the world,” [said a cancer specialist ].....Testicular cancer has a 95 percent cure rate if caught and treated in time. Such treatments have been available in Chile for over two decades. Cancer experts in Chile recognize that the country has an unusually high rate of testicular cancer, but no one is sure why. “Less than 5 percent of cases can be explained by exclusively genetic or hereditary causes,” [according to a Chilean urologist] “Neighboring countries with the same ‘culture’ have much lower reported mortality rates from the disease than in Chile,” [according to a cancer expert]. [Another cancer expert offered]...a different theory altogether. “This is only a theory and I have no evidence to support this but there’s a lot of natural contamination of water in Chile, by various metals especially arsenic, and perhaps this could have something to do with the high numbers of cases,” he said. “Really, though, no one knows for sure.”

Heavy metal exposure as a possible etiology seems to be a stretch for me. It occurred to me, however, that an infectious etiology might be possible. There was not much current work on this idea but I did find one abstract that draws an epidemiological parallel between testicular cancer and Hodgkin's disease among young males (see: (see: Viral etiology of testicular tumors). Here is an excerpt from the abstract from this older article:

Testicular carcinoma and Hodgkin's disease are among the most frequent malignancies afflicting young men in the 15 to 39-year age group. These malignancies share other epidemiological characteristics as well, including multiple histological tumor types, higher rates of occurrence in white, urbanized populations and upper social classes, relative infrequency among black populations, low but definite familial occurrence and an early geographically acquired lifetime risk irrespective of later migration. Both diseases are increasing in this country. This epidemiological similarity suggests exposure to an infectious agent early in life. The Epstein-Barr virus is known to be oncogenic and neonatal exposure with early infection is believed to be associated with Burkitt's lymphoma in African children. High titers of antibodies to the Epstein-Barr virus capsid antigen also have been reported in a series of studies comparing patients with Hodgkin's disease and controls. Because testicular cancer is epidemiologically similar to Hodgkin's disease and, therefore, might be expected to manifest similar Epstein-Barr virus findings, we performed a viral screen (Epstein-Barr virus, cytomegalovirus, and hepatitis A and B viruses) on blood samples from 56 consecutive patients with clinical stage I germ cell tumors of the testis who had received no active therapy after orchiectomy. Our results show a high incidence (80 per cent) of previous exposure to Epstein-Barr virus and support the hypothesis of a possible infectious origin for testicular carcinoma.

The problem with this theory is that it doesn't explain the lower incidence for testicular cancer in culturally similar neighboring countries where the males would presumably be exposed to similar viruses. I suppose there is also the possibility of some sort of anomaly of cancer data collection or diagnosis in Chile.

I Wonder What NEHTA and DoHA Are Planning To Address This Problem. You May Only Notice The Problem Once A System Goes Live. | Australian Health Information Technology

Fri, 03 Feb 2012 00:00:06 -0500

This important wakeup call appeared from the UK a few days ago. It is clear there is a major requirement for care in system design and training to avoid problems. Bromley GPs redesign e-referral letters 24 January 2012 Rebecca Todd Bromley GPs have designed new templates for electronic referrals because of concerns about inappropriate patient information being included by “default”. The latest Bromley Local Medical Committee newsletter says Dr Mark Essop and Dr Hasib Rub have been working on a solution to the “problem of inappropriate information being sent inadvertently when using computer-generated referral letters." It uses the example of a parasuicide or abortion "from 30 years ago" being included in a referral for a frozen shoulder. Bromley LMC secretary Dr James Heathcote said the example was hypothetical. No cases had come to light in which inappropriate information had been sent, but the LMC wanted to be proactive in preventing any “disasters." In the past,...

This is the initial part of the post - read more by clicking on the title of the article. David.

MSIA voices concern over PCEHR legislation | Pulse+IT Magazine

Thu, 02 Feb 2012 23:32:31 -0500

The Medical Software Industry Association (MSIA) (http://www.msia.com.au) has strongly criticised aspects of the legislation underpinning the creation of the Personally Controlled Electronic Health Record (PCEHR). It has also attacked the National E-Health Transition Authority's (NEHTA) (http://www.nehta.gov.au) handling of the recent disruption to the roll out of work at Wave

Open Medicare Database, Good or Bad for Healthcare? | Clinical Integration for Quality Blog

Thu, 02 Feb 2012 23:02:20 -0500

On December 5, 2011 CMS finalized a regulation that will allow its extensive claims database to be used by employers, insurance companies and consumer groups to produce report cards on local doctors and hospitals.

Pursuant to section 10332 of the Affordable Care Act, the Social Security Act is amended requiring “standardized extracts of Medicare claims data under parts A, B, and D to be made available to “qualified entities” for the evaluation of the performance of providers and suppliers.” The intent is to share the information in order to generate public reports regarding quality performance, that is, to generate report cards.

Such research had been off-limits until now because of a decades-old court ruling that releasing the information would violate the privacy of doctors. Insurance companies tried to fill the gap using their own claims data, but their files were nowhere near as comprehensive as Medicare’s.

The result has led to allegations that due to limited claims volume, physician profiles from insurance companies have been prone to error.

The release of the CMS claims data presents a challenge to organized medicine. On the one hand, the database is vast, has more statistical validity than limited insurance company databases and should be more representative of comparable care across the US. For example, by analyzing a large volume of billing records, experts can glean critical information as to how often a doctor has performed a particular procedure and identify potential clinical problems such as preventable complications.

On the other hand, the AMA has challenged that the final rule failed to create the necessary safeguards to assure the accuracy of published information. CMS has asserted, in the final rule, that data will only be released to “qualified organizations,” which can demonstrate their experience in evaluating performance measures, analyzing claims data and protecting personal health information.

CMS currently expects about 25 qualified organizations to purchase the data at a cost of approximately $40,000. The rule also suggests a provision which would allow qualified organizations to purchase a national “benchmarking” dataset.

There has been considerable public support for “transparency” in healthcare. This rule assures the release of the vast CMS database which will result in a proliferation of physician “report cards.” The statistical challenge facing all physicians is that no matter the quality of care provided, 50% of physicians nationally can be characterized as “below average.” That is, in fact, the definition of average – the 50^th percentile. While most physicians provide high quality professional care, we are likely to see considerable conflict as the initial profiles are released.

RACGP raises governance, liability concerns over PCEHR | Pulse+IT Magazine

Thu, 02 Feb 2012 22:16:48 -0500

Problems with governance, the administrative burden on general practice, and professional and financial risk need to be resolved in order for general practitioners to have full confidence in the proposed PCEHR, the Royal Australian College of General Practitioners (RACGP) (http://www.racgp.org.au) says. In its submission (http://www.aph.gov.au/senate/committee/clac_ctte/pers_cont_elect_health_rec_11/submissions.htm) to the Senate Committee

ePrescriptions could save billions: US study | Pulse+IT Magazine

Thu, 02 Feb 2012 21:38:57 -0500

A US study has found ePrescribingcould save the healthcare system billions by reducing the rate of non-adherence. US ePrescription network Surescripts (http://www.surescripts.com) conducted a study from de-identified data that links ePrescribing to a significant increase in first-fill medication adherence. The World Health Organisation estimates that as many as 50 per cent

Greenway Medical (GWAY) IPO Suggests Big Opportunities For EMR Vendors | EMR and EHR

Thu, 02 Feb 2012 18:30:36 -0500

While there’s a number of large, publicly-traded EMR vendors out there — General Electric (NASDAQ: GE) and Cerner (NASDAQ: CERN) immediately come to mind — to date we haven’t seen many mid-sized or small companies kick off an initial public offering. But one medium-sized EMR/practice management vendor has broken the mold.

Today, Greenway Medical Technologies (NASDAQ: GWAY) took the plunge , pulling in $67 million to fund its operations. While the company had hoped to raise $100 million, its take is nothing to sneeze at. Health IT is a tricky investment, even for pros like yourselves, readers, and institutional investors in particular are a conservative bunch. The fact that they’re spending on a risky business means a lot.

Greenway, whose EMR is bundled with practice management software, had one heck of a ride today, with its stock climbing 30 percent during its first day of trading. The company sold 6.7 million shares at prices below its expected $11 to $13 range, diluting its intake somewhat, but the stock closed at a promising $13 per share.

The Carrollton, Ga.-based vendor has certainly done well in recent times. According to insider Wall Street blog Seeking Alpha, Greenway revenues shot up 55 percent, to $25.7 million, during the last quarter of operations. Operating margins went from negative to a positive 2 percent, which is at least a start. Its biggest cash generator during the quarter was licensing revenue, which climbed 49 percent.

What’s interesting about this IPO isn’t just the fact that it ended well for Greenway. After all, it did take in less than planned, and the Wall Street crowd justifiably wonders how it will fare in a mind-boggling competitive market. But it’s worth asking whether Greenway did better because it bundles both an EMR and practice management tools. Did the fact that Greenway wasn’t relying solely on EMR revenue contribute to its growth and financial success? It would be interesting to find out, as that might help predict whether the bundled model is especially popular with physicians.

As for those who’d seek to imitate Greenway, they may have a chance if they move soon. Seeking Alpha editors think HITECH will still pump enough money into the EMR market to make these companies a reasonable investment. And given how many doctors and hospitals are still struggling to put EMRs in place, I have to agree. In fact, given that an amazing number of hospitals and medical practices junk their first EMR, there may be a whole second wave of opportunity within three to five years.

All told, if the market’s response to a smallish IPO is any indication, you can expect a bunch of other EMR players to follow in its footsteps. I’m thinking it will be companies in the $100m to $200m range, as they’re small enough to need capital (much cheaper capital than banks offer these days!) and nimble enough to benefit from the cash influx. Stay tuned and in coming months, I’ll tell you which other EMR and HIT companies I’m betting will climb onto the launch pad.

Links to HIMSS12 Activities | HL7 Standards » HL7 Blog

Thu, 02 Feb 2012 18:17:41 -0500

[View the story "Topics For This Week’s #HITsm TweetChat, Feb. 3, 11 a.m. CT" on Storify]

Greenway Medical Records IPO–Videos and Pictures at NYSE Getting Old as Hospitals and Doctors Struggle for Income And Close | The Medical Quack

Thu, 02 Feb 2012 18:12:18 -0500

First of all nothing with the IPO but the pictures and videos announcing all of this are getting extremely old, so just take care of business and save some expense of the dog and pony show, please and the part with Gingrich in here was priceless as last year we had this. Again we don’t know how many will get rich, not as bad as the over valued social network IPOs, but again when many are struggling and doctors and hospitals go broke and close, not a big news item here for the middle class.

Newt Gingrich Scams Doctors With Fake Prize Awards That Costs $5000

You can listen to the interview and the “installed customer base” discussion here and again it’s a product used by healthcare today and there are many competitors and the stimulus was discussed with saying only half of the doctors will meet the qualifications and receive their money. This is yet just one more big corporate conglomerate pushing for revenue and profits. We have seen two big insurance companies too who are making record profits invest big in health IT so this tells you there’s again money in those algorithms. This picture though at the NYSE is no more impressive than seeing the Komen NYSE picture lit up in pink in my opinion and where was the part about being a partner with doctors? Did I miss it:) BD

http://www.thestreet.com/video/11397460/greenway-ipo-pops-on-opening.html#1429842201001

Technorati Tags: Greenway Medical Records,IPO,NYSE,stock exchange,Health IT,medical records,profits,algorithms

Global Health and GP2U partner for secure telehealth | Pulse+IT Magazine

Thu, 02 Feb 2012 18:00:00 -0500

Secure messaging provider Global Health (http://www.global-health.com) is partnering with video conferencing specialist GP21U Telehealth (http://www.gp2u.com.au target=) to provide a new interoperable telehealth solution aimed at GPs and specialists. Global Health runs the ReferralNet (http://www.referralnet.com.au) messaging service, a fully encrypted secure message delivery (SMD) system designed to meet the

Free February | Chilmark Research

Thu, 02 Feb 2012 17:45:05 -0500

Let you in on a little secret. February happens to be the month in which I was born. So to celebrate, I’m giving you dear readers a birthday gift. For the month of February you can get a free copy of the full report: iPHR Market Report Analysis & Trends. Be forewarned that this report is dated (yes, it does have a profile of Google Health), having been published in May 2008, but trust you’ll still find some worthy tidbits contained therein.

Happy reading!

Denmark Selects InterSystems HealthShare for Countrywide Health Information Exchange | eHealthNews.EU Portal / All News

Thu, 02 Feb 2012 17:00:01 -0500

InterSystems Corporation, a global leader in software for connected care, announced that InterSystems HealthShare™ has been chosen to support health information exchange (HIE) throughout Denmark.

Denmark Selects InterSystems HealthShare for Countrywide Health Information Exchange | eHealthNews.EU Portal / All News

Thu, 02 Feb 2012 17:00:01 -0500

InterSystems Corporation, a global leader in software for connected care, announced that InterSystems HealthShare™ has been chosen to support health information exchange (HIE) throughout Denmark.

Birmingham City Council Showcases City-Wide Telecare Programme at Telecare Service Launch | eHealthNews.EU Portal / All News

Thu, 02 Feb 2012 17:00:00 -0500

Birmingham City Council has launched its large-scale, city-wide telecare service in partnership with Tunstall. The service, which is believed to be the first of its kind in the UK, will benefit up to 25,000 people over the next three years

Birmingham City Council Showcases City-Wide Telecare Programme at Telecare Service Launch | eHealthNews.EU Portal / All News

Thu, 02 Feb 2012 17:00:00 -0500

News 2/3/12 | HISTalk

Thu, 02 Feb 2012 16:50:24 -0500

Top News

Shares of EHR vendor Greenway Medical Technologies rise 30% on its Thursday IPO, making GWAY the day’s biggest gainer on the New York Stock Exchange. Shares closed at $13, valuing the company at $358 million on revenue of $90 million. The company had revised its IPO price downward from $13 to $10 at the last minute, obviously leaving money on the table in hindsight.

Reader Comments

From Mr. Hospitality: “Re: HIMSS schedule. Do you know if there is a way to drop the HIMSS schedule into Outlook? Didn’t there used to be a way to do that?” I don’t use Outlook, but I couldn’t figure out an easy way to create a schedule in general from the HIMSS website. However, the HIMSS folks say an app is coming next week. I actually found it here, though it looks like it’s not quite complete since some sessions still lack specific details. The HIMSS12 Mobile Guide does allow you to select favorites and thus create a personalized schedule, though it’s not integrated with Outlook or other calendars.

From IT Guy: “Re: Reliance Software Systems. RelWare. the company that was developing the EMR for Henry Ford Health System, is no more. HFHS announced that it would implement Epic and sunset RelWare’s EXR product, leaving the company with no clients other than Ford. They have closed their doors and let their staff go.” Unverified. I e-mailed the company and received no response. Henry Ford went live less than a year ago on EXR.

From Randy Lugano: “Re: EMR character limit on assessments. Is this a common feature in popular EMRs?” A physician’s article in The New York Times in December bemoans her EMR’s 1,000-character limit as she tries to compose a usable assessment of a complicated patient.

I nip and tuck my descriptions of his diabetes, his hypertension, his aortic valve stenosis, trying to placate the demands of our nit-picky computer system. Nevertheless, I am still unable to fit a complete assessment into the box. In desperation, I call the help desk and voice my concerns. “Well, we can’t have the doctors rambling on forever,” the tech replies … Nobody, for example, leafs through a chart anymore, strolling back in time to see what has happened to the patient over many years. In the computer, all visits look the same from the outside, so it is impossible to tell which were thorough visits with extensive evaluation and which were only brief visits for medication refills. In practice, most doctors end up opening only the last two or three visits; everything before that is effectively consigned to the electronic dust heap. Most importantly, the electronic medical record affects how we think. The system encourages fragmented documentation, with different aspects of a patient’s condition secreted in unconnected fields, so it’s much harder to keep a global synthesis of the patient in mind. Now I’ve learned that file-size restrictions will limit the extent and depth of analysis. What will happen to the tradition of thorough clinical reasoning?

From CDMer: “Re: HIT testing. Another can of worms along the path of standardization.” NIST solicits bids for a Health Information Technology Testing Infrastructure that will “harmonize the efforts of healthcare standards test development and delivery to meet the demands for conformance and interoperability within the healthcare domain.”

From NYizMee: “Re: McKesson’s huge profits. I can’t understand how this company keeps making money. They do nearly everything so badly.” Healthcare has been very good to the company and its customers chose it willingly, so they must be doing something right.

From David Chou: “Re: Cleveland Clinic Abu Dhabi. Would love to share a Forbes piece on what we are doing.” David is the senior director of IT operations there. The 2.3 million square foot, 364-bed facility will open at the end of this year.

From Looking Out for the Little Man: “Re: CPSI. The little guy down in Mobile seems to be helping smaller hospitals meet MU, right behind Epic in the number of hospitals to attest.” The company’s fact sheet says 134 of its hospital clients have attested, giving it 22% of all attested hospitals, second only to Epic’s 164 hospitals.

HIStalk Announcements and Requests

Here’s a few things you might already know if you are a faithful HIStalk Practice reader: first-fill medication adherence improves when physicians e-prescribe. Doctors still prefer desktop PCs over other devices for accessing patient data in the office or at home. Some common problems causing 5010 rejections. CareCloud CEO Albert Santalo gives the low-down on his company in our interview. Dr. Gregg shares the inside scoop on the startup Health Care DataWorks. If you haven’t been a faithful HIStalk Practice reader, it’s not too late to change your ways and see the light of the ambulatory HIT work. Thanks for stopping by.

Listening: reader-recommended Rodrigo y Gabriela, a duo of former itinerant street musicians who play amazing guitar that includes everything from classics to heavy metal (one YouTube commenter called it “thrash metal flamenco.”) Check out Gabriela using her acoustic guitar like a drum kit.

Acquisitions, Funding, Business, and Stock

Clinical communications vendor PerfectServe closes on $10.9 million in Series C financing, led by PJC Capital.

Staff scheduling systems vendor OnShift closes on $3 million in Series B financing led by a client of West Capital Advisors.

TELUS Health Solutions announces the acquisition of Wolf Medical Systems, Canada’s largest cloud-based EMR vendor, and the creation of a new business line, TELUS Physician Solutions.

Trademark filings suggest that a possible name of the GE Healthcare-Microsoft joint venture is Caradigm. That trademark was held by Santa Barbara Regional Health Authority, but appears to have expired.

Canon Europe acquires Netherlands-based PACS vendor Delft Diagnostic Imaging, saying it plans to focus on medical imaging for future growth.

Medical payment processor MediSwipe acquires the assets of ReachMeDaily.com, a private social media platform that connects senior citizens in residential centers with their families.

California startup TigerText, which offers HIPAA-compliant text messaging for hospitals, raises $8.2 million in a second round of funding.

Telehealth vendor InTouch Health, which claims 400 hospital customers of its FDA-approved remote presence devices, gets a $6 million investment from iRobot Corp., best known for its Roomba vacuum cleaner.

The Advisory Board Company reports Q3 results: revenue up 33%, EPS $0.46 vs. $0.24.

Sales

MedLabs Diagnostics (NJ) chooses the Ignis Systems EMR-Link lab outreach solution to provide area practices with lab ordering and reporting capabilities.

The Danish health system selects InterSystems to develop and support its national HIE.

Upper Chesapeake Health (MD) picks Forerun’s FlexChart physician documentation software for its emergency departments.

Rush-Copley Medical Center (IL) selects Medicity’s HIE technology to facilitate affiliated physicians’ access to clinical results and reports.

NorthCrest Medical Center (TN) chooses Allscripts Sunrise Clinical Manager, adding to its previous deployments of the company’s ED and ambulatory EHR solutions.

Merge Healthcare signs 10 new Merge RIS customers, raising to 30 the number of radiology practices using it as a Complete EHR.

Scripps Health (CA) selects MEDSEEK’s enterprise software suite.

St. Mark’s Medical Center (TX) selects McKesson Horizon Medical Imaging for use with its Paragon HIS.

The Nebraska Medical Center expands its use of products from Streamline Health Solutions, adding its Epic integration suite to the content management and HIM workflow solutions it was already using.

People

Greater Houston HIE changes its name to Greater Houston Healthconnect and names James Langabeer PhD, formerly of the University of Texas Health Science Center, as president and CEO. He replaces Kay Carr, who became CEO last March.

API Healthcare appoints Peter Goepfrich (Vital Images, PwC) as CFO.

Brad Swenson rejoins technology financing company Winthrop Resources Corporation as SVP, chief product strategy and business development officer. He was previously with Surescripts. We interviewed him in May 2011.

Announcements and Implementations

Awarepoint signs 191 contracts for its aware360Suite in 2011, increasing its client base to 123 healthcare systems and 186 hospital sites.

Telehealth and remote monitoring solution provider Cardiocom and Delta Health Technologies, a provider of IT systems for homecare and hospice agencies, announce completion of a bi-directional telehealth interface between their systems.

St. Joseph’s Hospital and Medical Center (AZ) announces its deployment of MobileMD for the exchange and communication of clinical information.

Government and Politics

MGMA sends a letter to HHS Secretary Kathleen Sebelius outlining problems that practices are having with the 5010 transition and urging an additional delay in enforcing the change. MGMA warns that unless the government takes the necessary steps to resolve issues, many practices will face significant cash flow disruptions for practices and operational difficulties, a reduced ability to treat patients, staff layoffs, and even practice closure.

Other

Anthelio partners with Healthland to provide migration and implementation services for Healthland clients migrating to Healthland Centriq EHR.

The defunct St. Vincent’s Hospital – Manhattan (NY), obligated by state law to maintain medical records for six years after discharge, petitions the bankruptcy court to force Allscripts to help the hospital transfer its data from its own servers to a less-expensive system. The former hospital says Sunrise Clinical Manager is costing it $17K per month and another company offered to extract its store it for $1,200 per month, but Allscripts won’t help unless the hospital keeps paying the monthly tab.

UMass Memorial Healthcare announces plans to lay off 700 to 900 employees, under the gun to trim $50 million from its budget to avoid a loss for the year.

Sponsor Updates

Billian’s HealthDATA reports that 35-45% of doctors are affiliated with hospitals in 10 states, with internal medicine ranked as the top specialty.
CapSite’s SVP and GM Gino Johnson will present an overview of the HIE market at this month’s ZirMed’s Thrive User Conference.
T-System announces that 42 hospitals have attested to Stage 1 MU using its T SystemEV emergency department information system.
GE Healthcare introduces the latest version of its Centricity Patient Online portal.

EPtalk by Dr. Jayne

CMIO magazine publishes its 2012 Compensation Survey. No surprise: 87% of CMIOs are men, although women are increasing in the field – up from 8% to 13% this year. Apparently I fall into their target demographic since the majority of those surveyed work at multi-hospital organizations in the south.

For those of you who may be just a teensy bit behind in your ICD-10 implementations, my favorite Geek Doctor John Halamka offers the request for consulting assistance that his organization used. Also included is a letter to stakeholders to identify which applications use ICD-9 and need to use ICD-10. He promises to share as much as he can as their project plans and timelines unfold, so stay tuned.

I wonder if ICD-10 has a code for this? Physicians report an increase in cyberchondria. Patients reading online information are increasingly displaying unfounded anxiety about their health. To combat the increased worry, physicians report spending more time in office visits to discuss why patients think they have particular diseases and convincing them that it may be unlikely.

Some websites have recently caught my eye. AdverseEvents has gathered information from the FDA’s database. Users can search over 4,500 medication records. Clarimed is similar, but has information on medical devices as well as drugs and procedures. I’m sure the cyberchondriacs found them long before I did.

I just have to laugh. Earlier this month, the Department of Health and Human Services published new standards for electronic funds transfers (EFT) in healthcare as required by the Affordable Care Act. This is supposed to result in billions of dollars of administrative savings for physicians, hospitals, insurers, and states over the next decade. HHS Secretary Kathleen Sibelius is quoted as saying, “Thanks to the Affordable Care Act, healthcare professionals will spend less time filling out paperwork and more time focusing on delivering the best care for patients.” Unfortunately, the recent federal initiatives have actually increased burdensome busywork for me, as I am forced to review mind-bogglingly annoying reports about how many times I’m checking or not checking a particular box required for Meaningful Use calculations. Additionally, any reduction in paperwork due to EFT changes will likely be offset with increased mounds of insurer paperwork trying to deny care for sick patients.

A new study reports that “the majority of U.S. physicians are moderately to severely stressed or burned out on an average day.” That’s not good news for the people caring for you and your loved ones. Only 15% of physicians feel their organizations are helping them deal with the situation. Burnout has been shown to increase the risk of medical errors. Physicians cite their top stressors as the economy, healthcare reform, Medicare/Medicaid policies, and unemployed and uninsured patients. No surprises there. Executives, take note: show your docs some love and get those severely impacted staffers some help before it’s too late.

Medical Economics publishes its must-have gadget guide. One of my favorites is the MobiUS SP1 hand-held ultrasound unit which can transmit images via cell phone or Wi-Fi. Another favorite is the SleepView Monitor, which allows home testing for sleep apnea. If I would have had one in my little black doctor bag during a recent trip, I’d have slapped it on the gentleman near me on the plane. I seriously thought I was going to have to resuscitate him.

Hints on the Microsoft/GE venture’s name from Weird News Andy: “So, a portal-like product that allows information to flow between logical entities. Drawbridge is a little too intimidating. Hatch is too nautical. Aperture is too esoteric. Gates. That’s the ticket.”

Speaking of little black doctor bags, I’m still looking for the perfect little black dress to go with mine (and with the shoes!) for HIStalkapalooza. I thought I had my date squared away, but in a surprise last-minute showing, one of my secret crushes has agreed to attend (sorry, Farzad, I waited as long as I could – but if you decide to attend, I’m sure we’d be accommodating.)

Have a question about home monitoring devices, Las Vegas bail bondsmen, or why the soles of Christian Louboutin shoes are red? E-mail me.

Contacts

Mr. H, Inga, Dr. Jayne, Dr. Gregg.

More news: HIStalk Practice, HIStalk Mobile.

Boston Sci’s PROMUS Element Plus PtCr Stent Debuts in Europe | Medgadget

Thu, 02 Feb 2012 16:45:34 -0500

Bostton Scientific has announced the European market launch of the PROMUS Element Plus everolimus-eluting platinum chromium coronary stent. Professor Antonio Colombo, MD, director of the cardiac catheterization lab at Columbus Hospital and San Raffaele Hospital in Milan, recently implanted the first patient in Europe with the device. The stent incorporates platinum chromium (PtCr) alloy and features a catheter delivery system designed to facilitate deliverability in treating patients with coronary artery disease. Boston Scientific plans on marketing the stent in select European and other CE Mark countries immediately. A full market launch will follow in the second quarter of 2012.

“The PtCr alloy and stent architecture used in the Element platform offer significant advantages in conformability and radiopacity compared to other stent platforms,” explained Dr. Colombo in a press release. “I believe the improved deliverability of the PROMUS Element Plus Stent System will add another significant benefit, especially when accessing challenging lesions. This innovative stent is also supported by strong clinical outcomes from the PLATINUM trials, which demonstrated very low rates of revascularization and stent thrombosis at one year.”

Boston Sci’s PROMUS Element Plus PtCr Stent Debuts in Europe | Medgadget

Thu, 02 Feb 2012 16:45:34 -0500

Next Generation DentalVibe Pain Relieving Device Unveiled | Medgadget

Thu, 02 Feb 2012 16:26:26 -0500

A new generation of the DentalVibe dental injection pain relieving device has recently been released.

The new version of the device, which vibrates the gums to drive the brain’s attention away from the pain caused by the injection needle, sports more power, deeper penetration, and a couple other features to make it a more effective tool in the dental office.

Next Generation DentalVibe Pain Relieving Device Unveiled | Medgadget

Thu, 02 Feb 2012 16:26:26 -0500

A new generation of the DentalVibe dental injection pain relieving device has recently been released.

E-Prescribing Shown to Improve Outcomes and Save Billions | Medicine and Technology [part of HCPLive]

Thu, 02 Feb 2012 16:13:00 -0500

More physicians are adopting e-prescribing because of the "meaningful use" requirements mandated by the HITECH Act. Some love it and others seem to really hate it. Eventually, we're all going to get accustomed to it and we'll look back on the stone-age days when prescriptions were written by hand. Here's some interesting news regarding the benefits of e-prescribing:

E-Prescribing Shown to Improve Outcomes and Save U.S. Healthcare System Billions of Dollars

ARLINGTON, VA -- (MARKET WIRE) -- 02/01/12 -- Surescripts, the nation's e-prescription network, today announced study findings from de-identified data that link e-prescribing to a significant increase in first-fill medication adherence. Poor adherence to medication therapy is a large and costly problem in the U.S. The World Health Organization estimates that as many as 50 percent of patients do not adhere fully to their medication treatment(1), leading to 125,000 premature deaths and billions in preventable health care costs(2). The Surescripts analysis suggests that the increase in first-fill medication adherence combined with other e-prescribing benefits could, over the next 10 years, lead to between $140 billion and $240 billion in health care savings and improved health outcomes.

Read more »

Komen Has Also Stopped Funding for Embryonic Stem Cell Research–Politics and Some of Business Intelligence Algorithms At Work Here? | The Medical Quack

Thu, 02 Feb 2012 15:52:51 -0500

This is not an attack on Komen from this blog but basically just putting facts out there as I see them on the web and gosh knows the last couple of days has spring a ton of information and opinions. I did remove them from my public service area with this being a second controversial area as even with last year with the reporting of spending $1 million suing other charities was not tops in my opinion I still had their link. This is kind of like strike 2 if you will and now is this strike 3 to have other funding removed? You tell me.

I did watch the video and basically the message I received was the fact that they want to spend their money, which they have the right to do, where they thought it would be in the best interest; however you can’t control the public perception and the video was just like so much of what I hear today, the algorithms of business intelligence. I guess as I blog a lot about health insurance algorithms I tune in there as have heard the same repetitively for so long so to me, one more dishing out of some Killer Algorithms for those who have benefited from their charity in the past.

It’s all about the math folks and the algorithms that help in these decision making processes. We have a lot of good algorithms out there but like anything in the world today there’s the dark side that creeps in. No doubt that analytics make us smarter today but the levels of ethics and forgiveness will always play it’s role, especially when something gets big notoriety such as this. I take what I see and curate with my own editorials for readers and hopefully educate folks on what goes on behind the scenes today with technology that creates a lot of the decision making processes today and that’s what was done here. If you look at the video of Steven Colbert, there are opinions that are more pointed than what you may see here and all have their perspective.

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

The bottom line here for me is the sad effect that politics is having on philanthropy and how the abortion issue worked it’s way into this situation that is now not funding breast cancer screening. Those poor women who rely on Planned Parenthood, are they the bad guys or gals? Of course not.

It’s stupid and we have a bunch of self serving members of Congress that appear to be more digitally illiterate than we ever dreamed of.

Now I base this on what they say and what is reported as I am not friends or in contact directly with any of them. When things get over their head and decisions require a level of expertise they don’t have either due to non participation in technology or egos or whatever it is, the digital illiteracy shows up like the white elephant in the living room. They all seem to be non participating experts on “what’s good for those guys over there”. You can dig around this blog and find quite a few posts that relate back to the same thing, so nothing new from this blogger in that respect. These are big problems sitting in those chairs in Washington that let personal interests and controls factors get in the way.

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

Once again I’ll go back to a very related topic here on how our new consumer protection chief, Richard Cordray has his hands full with corporate USA and their definite big advantage with writing algorithms and code that take a couple days to adjust after a new law is passed, it is what it is and if you know what to look for you see day in and day out but nobody wants to seem to go point blank on it and maybe that is what I do here in trying to educate readers on the behind scenes part of how technology operates these days. Right now those same folks can’t seem to come to an agreement as to whether or not they want to cut off their profiting from insider trading but somehow feel so compelled to stick their noses into a healthcare situation where it does not belong. The link below also has the “Vitter Problem” identified by MSNBC with a very good storyline from day one, since he seems to have his nose in here too.

Insider Trading Not Illegal for Congress and Their Staff–STOCK Act Introduced to Stop Trading on The Congressional Knowledge Act

If you want to save lives, it requires stem cells, both kinds so if the IFS don’t work or can’t be programmed to work without the embryo then so be it and folks should get over that. The US has to be the world laughing stock when it comes to abortions at this point so do we let science to their thing and create solutions or do we continue to stay stuck in the 70s.

I have full respect for religion and respect that of other but come on with all of this and allow science to improve our standards of living and once and for all find cures. In summary, it’s a crying shame that philanthropy which is a good thing was drawn into the so called “expert opinion” area here, of which there is none but we all need to learn to get along and respect the rights and views of others and again work for scientific cures and I hope it was ok that I used that word but I’m not a charity so I think I am safe:)

When it comes to decision making we are all under the Attack of the Killer Algorithms if ethics and a level of forgiveness is not used when making decisions today, discrimination by the algorithm.

The link below has links that go into several areas of the Attacks of the Killer Algorithms if you want to read up, all public information and just curated here.

President Appoints Richard Cordray as New Consumer Financial Protection Chief - Hope He Knows And Understands Correcting Flawed Math and Formulas To Battle the “Financial Attack of Killer Algorithms” On Consumers With Banks and Corporate USA

Welcome to the world of discrimination by the algorithm….

We live in a distracted society today where social algorithms even supersede the value of human lives, just read the news yesterday and social networks are good, I use them and the are here to stay, but at what over inflated value…I read yesterday that in words of value we are worth less than $5 on Facebook, but look at what they are doing on Wall Street with valuating the intangible algorithms they are selling..time for new thinking here when social algorithms dollars supersede the value of human lives as the chase for the perfect social algorithm seems to be commanding more money than this country producing tangibles, and that is crazy. BD

In addition to stopping funding for the Planned Parenthood abortion business, Komen for the Cure has also quietly stopped funding embryonic stem cell research centers, another concern for pro-life advocates.

As LifeNews reported last July, Karen Malec of the Coalition on Abortion/Breast Cancer spent time examining Komen’s 990 Forms for the IRS for 2010 and she found that Komen has active relationships with at least five research groups or educational facilities that engage in embryonic stem cell research, which requires the destruction of unborn children in their earliest days for stem cells that have yet to help any patients.

The return showed donations from Komen totaling $3.75 million to Johns Hopkins University School of Medicine, $4.5 million to the University of Kansas Medical Center, $1 million to the U.S. National Cancer Institute, $1 million to the Society for Women’s Health Research, and $600,000 to Yale University. All of them have embryonic stem cell research programs.

On November 30, 2011, Komen quietly added a new statement to its web site stating that it does not support embryonic stem cell research but supports the kinds that do not involve the destruction of human life.

“I oppose embryonic stem cell research, which creates life solely for the purpose of destroying it. I do, however, strongly support adult stem cell research, which has produced numerous scientific achievements without terminating innocent lives in the process,” Handel said in 2010 as a candidate for the U.S. Senate.

http://www.lifenews.com/2012/02/01/komen-also-stops-funding-embryonic-stem-cell-research-centers/

Op Ed: Emanuel NYT Editorial is Irresponsible and Naive | e-CareManagement Blog

Thu, 02 Feb 2012 14:36:21 -0500

Zeke Emanuel’s editorial in the New York Times — The End of Health Insurance Companies — really got my blood boiling. It’s irresponsible and naive. Former Obama advisor Emanuel “predicts”:

By 2020, the American health insurance industry will be extinct. Insurance companies will be replaced by accountable care organizations — groups of doctors, hospitals and other health care providers who come together to provide the full range of medical care for patients.

Irresponsible

Provoking and demonizing health plans might have had populist appeal and political value in 2009, but in 2012 it’s an unnecessary attack on a constituency that has potential to be one of the administration’s best allies in advancing accountable care.

Prior to ACA reform legislation, health plans had the wrong economic incentives — the rules of the game were not consistent with good public policy:

Health plans had incentives to AVOID risk, not manage risk. They were economically incentivized to avoid high risk patients (with preexisting conditions) and to get rid of patients that became sick
Health plans had minimal incentives to CONTROL systemic costs — they could pass them on in the form of premium increases.

ACA changed incentives and disrupted the payer business model:

Health plans will longer be allowed to avoid high risk patients; they must accept all comers
Health plans must MANAGE, not avoid costs. Health plans are abandoning their old business models.

What are we seeing in the marketplace? Almost all health plans are embracing the vision of accountable care and need to shift the system from Volume to Value. Health plans could be administration’s biggest friend in revamping the health care delivery non-system.

Naive (more…)

No tag for this post.

Informatics evolution | Forum Discussions - Health Informatics Forum

Thu, 02 Feb 2012 14:28:23 -0500

Hi,

I was just wondering how flexible or fluid your current informatics system is. Were you able to give input either before implementation or after? Does your site many modifications?

HIMSS 12 New Media Meetup – Sponsored by simplifyMD | EMR and HIPAA

Thu, 02 Feb 2012 14:20:31 -0500

REGISTER NOW!!

I’m really excited to announce the 3rd annual New Media Meetup at HIMSS 2012. Last year’s event had an amazing turnout in Orlando and I expect this year’s will be even better with a whole bunch of interesting new and old faces. It’s quite frankly my favorite part of HIMSS thanks to the amazing people who are there.

Everyone is welcome at the event. Maybe you participate in New Media (Blogger, Tweeter, LinkedIn, Facebook, etc) or maybe you just enjoy consuming other people’s media (like this blog) or maybe you’re interested in using New Media for yourself or your company. Everyone is welcome to attend and network with others interested in New Media. I’m excited this year to welcome the #HITsm and #hcsm crowd that will be out in full force I’m sure.

If that isn’t enough reason to attend, I’m really happy to have teamed up with simplifyMD to sponsor the New Media Meetup at HIMSS Las Vegas. The event will be on Wednesday 2/22 7:00-9:00 PM at the awesome BB King’s Blues Club in the Mirage Hotel (A short walk across the street from the Venetian/Sands). That’s right: an open bar, Live Music with a dance floor, and amazing people.

REGISTER NOW!!

Please register for the event so we know how many to expect. I expect we’ll max out registrations for the event like we did last year, so register now before it’s too late.

Be sure to tell all your Blogger, Twitter and other new media friends about the event so we have the best and brightest in the healthcare IT social media world at the event.

About Our Sponsors

simplifyMD – Founded in 2006 and headquartered in Atlanta, thousands of end-users benefit from simplifyMD every day as they manage millions of electronic health records for physicians in 27 specialties and on two continents. simplifyMD was created specifically to lower operating costs, increase revenue, and provide relief to overworked physicians and administrators. Offering a cloud-optimized SaaS solution for one low monthly price, that costs less than traditional paper folders, makes simplifyMD’s EHR software as easy to buy and implement as it is to learn and use. At simplifyMD we believe the EHR experience does not have to be so complicated. All EHR companies promise efficiency, simplifyMD guarantees it.

HealthcareScene.com – The premiere healthcare IT and EMR network of websites. HealthcareScene.com consists of 14 different EMR, EHR and Healthcare IT websites having generated over 7+ million pageviews and includes over 3500 article and 9000 comments. HealthcareScene.com works to promote the interesting independent voices in healthcare.

Influential Networks – Influential Networks is one of the largest networks of healthcare IT influencers combined with a premium healthcare IT ad network. Through the Influential Network, we help both marketers and publishers reach their goals within this powerful niche market. Influential Networks goal is to connect influencers with publishers beyond just advertising.

If you have any questions about the event, feel free to drop us a line on our Contact Us page. See you in Las Vegas!

Heathcare Informatics Providers | Forum Discussions - Health Informatics Forum

Thu, 02 Feb 2012 14:16:37 -0500

I am a sophomore nursing student in a Healthcare Informatics class. I am curious what some of the major differnces (positive and negative) are in the different healthcare informatics providers and how do hospitals decide which healthcare informatics provider to use?

cost vs benefits of healthcare informatics? | Forum Discussions - Health Informatics Forum

Thu, 02 Feb 2012 14:15:36 -0500

Im a sophomore nursing student and im taking a class on healthcare informatics. There are ovbiously a lot of positive aspects to the field, but I was wondering what the negatives or downfalls were to healthcare informatics? Also, is privacy a big issue for the clients when talking about healthcare informatics?

Cardinal Health Releases Smart-Seal Surgical Mask | Medgadget

Thu, 02 Feb 2012 14:11:23 -0500

Cardinal Health has made available its Smart-Seal surgical mask that improves both its fit and reduces interior fogging while providing a high level of filtration and resistance to liquids.

From the announcement:

Cardinal Health Releases Smart-Seal Surgical Mask | Medgadget

Thu, 02 Feb 2012 14:11:23 -0500

Cardinal Health has made available its Smart-Seal surgical mask that improves both its fit and reduces interior fogging while providing a high level of filtration and resistance to liquids.

From the announcement:

NASA’s Smartphone Attachment Smells, Identifies Chemical Compounds | Medgadget

Thu, 02 Feb 2012 13:02:41 -0500

Gizmodo is profiling work being done at NASA Ames Research Center to develop a mobile phone powered sensor that could be used for a variety of applications from detecting chemical attacks in future military conflicts to testing blood glucose indirectly by measuring acetone in exhaled breath.

The device takes advantage of the same kind of nanosensors that are already in use on the International Space Station detecting chemicals that are effectively dangerous pollutants in the orbiting enclosed space. It works as an attachment to a smarphone (looks like an iPhone), and we are excited to hopefully one day see this technology built right into the body of the phone to provide basic diagnostic capabilities.

NASA’s Smartphone Attachment Smells, Identifies Chemical Compounds | Medgadget

Thu, 02 Feb 2012 13:02:41 -0500

Universal Health Records | Forum Discussions - Health Informatics Forum

Thu, 02 Feb 2012 12:51:56 -0500

Hello,

I am a Junior nursing student in a BSN program. I was curious to the restrictions/limitations that inhibit a universal electronic record system that allows someones medical record to be shared around the world. If someone goes in to their primary physician, then goes to a hospital while on vacation, why can't tha hospital pull up the person's electronic record to see their entire history and current medications? Especially if this person is unconscious, it would be useful to…

Mini Crab-Like Robot Removes Stomach Cancer | Medgadget

Thu, 02 Feb 2012 12:47:05 -0500

Researchers from Singapore have developed a small robot designed to remove stomach cancer in its early stages. The mini robot resembles a crab, because it incorporates a pincer and a hook to do the job. The robot is mounted on an endoscope which reaches the stomach via the patient’s mouth. Next to its size, another advantage of the robot is that it doesn’t leave an external scar.

The crab-like robot has a pincer to grab the tissue to be removed, and the hook can cut the tissue and cauterize it to stop the bleeding. The operating surgeon can see what’s happening through the little camera in the endoscope and control the robot’s movements. These movements are very precise and accurate compared to movements made directly with human hands.

Mini Crab-Like Robot Removes Stomach Cancer | Medgadget

Thu, 02 Feb 2012 12:47:05 -0500

Three Cool New Features in 11.2.3 | Galen Healthcare Solutions: Allscripts Consultants Enterprise EHR

Thu, 02 Feb 2012 11:20:56 -0500

While reviewing 11.2.3 release notes there are some enhancements I thought are worth pointing out. These particular enhancements did not fall under the distinction of “Major Enhancements”, but nonetheless, some of these are going to make Providers and Users very happy. The font size in the Clinical Desktop: The font size for the worklist and [...]

Hospital Website Smackdown: Mayo Clinic versus Cleveland Clinic | Lab Soft News

Thu, 02 Feb 2012 11:14:41 -0500

I knew that this time would ultimately arrive but we appear to be there now. Two prestigious hospitals are being compared on the basis of the quality of their web sites. A recent article posits a web site smackdown between Mayo Clinic and Cleveland Clinic (see: Website Smackdown: Mayo Clinic vs. Cleveland Clinic). Following is an excerpt of the article:

In this week's Website Smackdown, I’m taking a look at the websites for two of the biggest hospital complexes in the world, the Mayo Clinic and the Cleveland Clinic....The Mayo Clinic and Cleveland Clinic rank neck and neck (third and fourth respectively) on US News & World Report’s Honor Roll of Best Hospitals, but there’s a huge difference in the quality of their websites.

(1) Most people coming to the website for a major hospital have health-related questions, require immediate need for a doctor, or need information about visiting (directions, visiting hours, etc.). Just as hospitals are in the business of patient care, their websites should reflect that same level of care for site visitors....(2) Now take a look how each site handles the critical area of “Health Information.”....(3) Finally, let’s look at one more service provided by both websites: Find a Doctor....

So what can you learn from these hospital websites?

Know your target audience and know why they are coming to your site.

Prioritize your navigation to serve the biggest needs of your visitors.

Make sure you have powerful calls to action and prominent contact information.

Emphasize customer service!

In order not to keep you in suspense if you have not read the original article, the Cleveland Clinic has won this particular competition in the three stated categories. The author of the note supports his conclusion with screen-cap images of the web pages for the two hospitals. The secret of the quality of the Cleveland Clinic web site does not involve any magic and is based on the bulleted points listed at the end of the excerpt above: (1) understand the mind of the patient; (2) prioritize web site navigation; and (3) emphasize contact information and customer service.

Hmmm. Trying to understand the mind of the patient browsing a hospital web site. Sounds simple enough, doesn't it? However, I suspect that this might be a difficult task for some hospital executives and healthcare professionals such as nurses and doctors. The reason for this: many of us are so immersed in our professional disciplines and the complexities of healthcare delivery that it's hard to think as patients do.

Let me give you one practical example of this. Many years ago, I discovered that a prestigious hospital had located its neurology clinic next to its neurosurgery clinic and its cardiology clinic next to its cardiac surgery clinic. Wait a minute! That makes no sense. The specialties of cardiology and neurology are part of internal medicine -- they belong on the internal medicine floor of the clinic building, don't they. This clinic design approach makes sense to patients who tend to think more about organ systems and not the way that medical disciplines have evolved and are organized.

HCIT: Don’t Underestimate the Power of CMS’ Carrots and Sticks | EMR Straight Talk

Thu, 02 Feb 2012 09:51:05 -0500

Anyone who knows even a little bit about behavior modification theory intuitively understands that offering rewards and/or punishments is an effective way to encourage people to do what you want them to do. The government clearly understands this principle and has been using incentives and penalties to motivate physicians to participate in its programs—PQRS, ePrescribing, and, most recently, the EHR incentives.

The EHR incentives have already prompted a great deal of EHR activity, but the program is too new to quantify cause and effect yet. A direct correlation between government policy and provider behavior, however, is evidenced by the history of my company’s ePrescribing license purchases, so I thought EMR Straight Talk readers would find the analysis of my company’s experience interesting.

As illustrated above, ePrescribing sales tracked the MIPPA legislation as follows:

2009 was the first year of ePrescribing bonuses, and the requirements (a 50% threshold) made it important to start ePrescribing early in the year. As you can see, this created a huge demand for ePrescribing licenses during the first half of 2009.
Sales continued in late 2009 and early 2010—although at a more moderate rate—as later adopters decided to take advantage of the last year of 2% bonuses and as the easier-to-meet threshold of 25 ePrescribing encounters was introduced.
Imminent penalties caused a spike in sales in the beginning of 2011, when providers first learned that 2012 penalties would be based on ePrescribing activity—or lack thereof—in the first 6 months of 2011.

Another interesting observation that can be made is that, for some providers, penalties are a much more effective behavior modification tool than incentives, regardless of the relative amounts of money at stake. My experience with ePrescribing—illustrated by the 2011 surge in licenses—was that many physicians who had not been persuaded by the 2% bonuses in 2009 and 2010 felt compelled to move ahead when faced with a 1% penalty for 2012. Regardless of whether a particular physician attributes more weight to the carrot or to the stick, the data above—although not unexpected—confirms the effectiveness of the government’s strategy.

ePrescribing 2011: The Irony and the Ecstasy
The number of different government programs, and the length of...
Meaningful Use, ePrescribing, and PQRS: Need for Harmonization
While physicians are working feverishly to understand the complexities of...
Stage 2 Meaningful Use Delayed to 2014: What’s It Really About?
HHS has made it official—Stage 2 of meaningful use will...

HCIT: Don’t Underestimate the Power of CMS’ Carrots and Sticks | EMR Straight Talk

Thu, 02 Feb 2012 09:51:05 -0500

As illustrated above, ePrescribing sales tracked the MIPPA legislation as follows:

2009 was the first year of ePrescribing bonuses, and the requirements (a 50% threshold) made it important to start ePrescribing early in the year. As you can see, this created a huge demand for ePrescribing licenses during the first half of 2009.
Sales continued in late 2009 and early 2010—although at a more moderate rate—as later adopters decided to take advantage of the last year of 2% bonuses and as the easier-to-meet threshold of 25 ePrescribing encounters was introduced.
Imminent penalties caused a spike in sales in the beginning of 2011, when providers first learned that 2012 penalties would be based on ePrescribing activity—or lack thereof—in the first 6 months of 2011.

ePrescribing 2011: The Irony and the Ecstasy
The number of different government programs, and the length of...
Meaningful Use, ePrescribing, and PQRS: Need for Harmonization
While physicians are working feverishly to understand the complexities of...
Stage 2 Meaningful Use Delayed to 2014: What’s It Really About?
HHS has made it official—Stage 2 of meaningful use will...

Pioneer ACO Update: Q&A With Health IT Leaders from Eastern Maine Healthcare System | HL7 Standards » HL7 Blog

Thu, 02 Feb 2012 09:12:18 -0500

In December 2011, the U.S. Department of Health and Human Services (HHS) released the names of 32 health organizations selected to participate in their Pioneer Accountable Care Organization (ACO) model, which launched just over one month ago on Jan. 1. Chosen from 80 applicants, these 32 Pioneer ACOs are testing several new payment arrangements, which [...]

Social Media and its Continuing Impact on Healthcare | The Ozmosis Blog

Thu, 02 Feb 2012 06:01:00 -0500

Join Ozmosis & Ogilvy Public Relations Wednesday, February 15th for a star studded discussion on the continuing role social media plays in healthcare as part of Social Media Week in Washington, DC. As we look back on the impact social media has had on the healthcare industry over the past year, we see dramatic growth in social media adoption by health care consumers, providers, and all the various organizations engaged in the healthcare ecosystem. While the industry has taken a giant leap forward into the world of social tools and collaborative models, we’ve only scratched the surface of what is yet to come.

I Wonder Who Has The Correct Story Here? Can They Both Be True? | Australian Health Information Technology

Thu, 02 Feb 2012 04:00:02 -0500

In the NEHTA release on the Clinical Software ‘glitch’ which was made public last week we read the following. NEHTA pauses implementation in pilot sites 24 January 2012. National E-Health Transition Authority CEO, Mr Peter Fleming has announced that following a detailed internal review and analysis, NEHTA is temporarily pausing implementation of Primary Care desktop software development around its specifications for the eHealth pilot sites. "Our specifications are subject to rigorous assessment processes and this has highlighted some technical incompatibilities across versions. We have identified problems with the specifications and have made the decision in order to avoid any risks," Mr Fleming said. The pilot sites were established to test and deploy software and eHealth capability in real world healthcare settings prior to the introduction of the personally controlled electronic health record system. While the pilot site and national infrastructure projects have operated in...

This is the initial part of the post - read more by clicking on the title of the article. David.

UMass Memorial Health Care Will Cut 700 to 900 Jobs And Will Sell Off Home Health Services–Pressure From Insurers Who Are Seeing Bigger Profits to Reduce Costs | The Medical Quack

Thu, 02 Feb 2012 02:10:25 -0500

The title about says it all here so while the fantasy world of the 1% are chasing social algorithms, hospitals continue to struggle and insurers are seeing even bigger profits than before but continue to hammer down on the hospitals. If you read through below there are a couple of hospital closures also in store in Massachusetts.

UMass Memorial will seek a potential buyer for Worcester-based Home Health and Hospice (HH&H). In addition they are looking to sell their lab services as insurers are directing patients and doctors to use other labs with lower costs. The hospital system is the largest employer in the center of Massachusetts.

Good Science, Investments and The Chase for Social Algorithms Has Become a Dangerous Mix-Healthcare and The Creation of Jobs Continue to Suffer

“There is already “a mini-gold rush” of companies trying to market tests based on the new techniques, at a time when good science has not caught up with the financial push..
Social networks are great and I use them but when sick do I go take a “Facebook pill”, or get some “Twitter therapy”, or get admitted to a “LinkedIn hospital”? Don’t laugh as something along this line might be tossed your way when there’s not enough hospitals to care for all. BD

UMass Memorial Health Care, which lost money in the last three months of 2011 amid shrinking patient volume, told its employees yesterday that it will shed 700 to 900 jobs, about 6 percent of its workforce, through a combination of layoffs at its flagship hospital and the sale of divisions that provide services such as home health care.

The health care system, which operates UMass Memorial Medical Center in Worcester and four community hospitals, is the largest employer in Central Massachusetts, with about 13,500 workers. But its profitability has been eroding for several years as it faces increasing pressure from businesses and commercial insurers to reduce costs.

Patient discharges fell 6 percent in the most recent quarter from the same period a year earlier, while imaging tests dropped by more than 7 percent, said John G. O’Brien, chief executive of the Worcester-based system. He said the numbers are declining as the system prepares to shift from a fee-for-service model to so-called global payments, under which insurers give hospitals and doctors a budget to provide patient care.

Hospital groups ranging from Boston Medical Center to Cambridge Health Alliance to Northeast Hospital Corp. of Beverly have slashed hundreds of jobs over the past two years.

Sixteen hospitals, nearly a quarter of those in the state, have been losing money, according to a report last year. Last month, Taunton State Hospital, which houses 169 mentally ill patients, said it would close its doors, while long-term care provider Kindred Healthcare Inc. said it will shut its 45-bed Waltham hospital.

http://bostonglobe.com/business/2012/02/02/umass-memorial-health-care-shed-jobs-through-layoffs-and-sales-some-divisions/ot4SXNZz76gYMxo6aqVXwL/story.html

Technorati Tags: UMass Memorial,layoffs,doctors,nurses,Massachusetts,employees,patients,insurance,business

Study: E-Prescribing Boosts Medication Adherence, Slashes Spending | EHR Outlook

Thu, 02 Feb 2012 00:00:00 -0500

Add this one to the ledger tallying health IT's efficacy. A large study from Surescripts, which looked at more than 40 million prescription records from 2008 to 2010, found that e-prescribing resulted in a 10 percent boost to the rate of first-fill medication adherence -- an outcome that has significant...

ePrescribing reduces clinical errors | Pulse+IT Magazine

Thu, 02 Feb 2012 00:00:00 -0500

Commercial ePrescribing systems are able to reduce prescribing errors by up to 66 per cent, a University of NSW study (http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001164) has found. Researchers studied prescribing errors both before and after the introduction of iSoft's MedChart (http://www.isofthealth.com/en/Solutions/HospitalsandClinics/MedicationManagement.aspx) and Cerner's Millennium PowerOrders (https://store.cerner.com/items/201) ePrescribing systems in two Australian teaching

Aetna Reports 4th Quarter Profit 2011 Jumping 73 Percent | The Medical Quack

Wed, 01 Feb 2012 22:30:16 -0500

Profits were larger due to less use of medical services so bigger profits for insurance companies. The company is also selling software at retail Best Buy stores.

Best Buy Setting Up to Hawk Software from Aetna For Consumer Wellness–Companies Still Don’t Get the Consumer Involvement Yet With a Vehicle and Creating Value

In addition the company bought another HMO company in India. IHO was founded in 2008 by Visham Sikand and Sunando Sen with 2,500 doctors, 800 pharmacies, 300 laboratories and 500 dentists in their network

Aetna International Buys 100% Stake in India Health Maintenance and Care Organization

Also the restrictions from CMS were released this summer for enroll new patients in part D and the Aetna has also pulled out of providing individual policies in Colorado. With mergers and acquisitions the health insurance is a far cry from what it used to be. BD

CMS Lifts Aetna Restrictions on Medicare Part D Enrollment As of July 1, 2011

INDIANAPOLIS — Health insurer Aetna Inc.’s fourth-quarter net income jumped 73 percent, as it continued to benefit from low use of health care and some key expenses fell.

The Hartford, Conn., insurer’s earnings and revenue topped Wall Street expectations due in part to slower-than-expected growth in health care use, a trend that has helped insurers routinely outperform the past several quarters. Many analysts expect this trend to continue into 2012.

Aetna said Wednesday that it earned $372.6 million, or $1.02 per share, in the three months that ended Dec. 31. That’s up from $215.6 million, or 53 cents per share, in the 2010 quarter. Revenue climbed slightly to $8.57 billion.

Earnings excluding capital gains and other items were 97 cents per share.

http://www.washingtonpost.com/business/industries/health-insurer-aetna-reports-4th-quarter-profit-jumps-73-percent-helped-by-lower-medical-use/2012/02/01/gIQAvUKHhQ_story.html

Technorati Tags: Aetna,marketing,privacy,wellness,health insurance,commentaries,opinion,retail,consumers,profits

9th Annual The Best of San Antonio Breast Cancer | Medicine and Technology [part of HCPLive]

Wed, 01 Feb 2012 21:52:00 -0500

If you're near Chicago, don't miss this complimentary CME event this Saturday!

9th Annual The Best of San Antonio Breast Cancer

Saturday Feb 4, 2012
Chicago, IL

Program Director:

Kathy S. Albain, MD, FACP
Professor of Medicine
Division of Hematology/Oncology
Loyola University Chicago Stritch School of Medicine
Director, Breast Clinical Research Program
Director, Thoracic Oncology Program
Cardinal Bernardin Cancer Center
Loyola University Medical Center
Maywood, IL

This educational program is directed toward medical, surgical, and radiation oncologists interested in the treatment of patients with breast cancer. Fellows, nurse practitioners, nurses, physician assistants, pharmacists, researchers, and other health care professionals interested in the treatment of breast cancer are also invited to attend.

More information here.

There Was A Webinar On The Specification Problems With the PCEHR Today. Some Interesting Things Emerged. | Australian Health Information Technology

Wed, 01 Feb 2012 21:12:33 -0500

The webinar ran between 8:30 and about 9:30. If things follow the usual pattern there will be audio and slides available from this link in due course. http://www.nehta.gov.au/ehealth-implementation/pcehr-standards I will let people listen for themselves if they want to understand all the details. At a high level I came away with the following impressions from the reports I have heard. 1. The key issue is around 5 CDA Implementation Guides for such clinical documents as clinical letters, referrals and so on which are faulty and need to be revised and made ‘error free’. 2. There are some major issues between NEHTA and DoHA which are causing all sorts of problems and it is felt that unless things are got back on track fast there is an existential threat to the whole program. 3. Those who were building to the (old) specifications are pretty grumpy. 4. Astonishingly the CDA specifications were not tested via a ‘CDA Validation Program’ to ensure it was correct. Pretty basic stuff....

This is the initial part of the post - read more by clicking on the title of the article. David.

Pfizer Recalls 1 Million Birth Control Packs–Where’s the Bar Codes to Help Consumers Identify? Yet One More Big Example of the “Shitty Deal” American Consumers Get | The Medical Quack

Wed, 01 Feb 2012 20:37:00 -0500

That’s right folks you get nothing in terms of a disaster recovery plan and here’s yet one more example. It costs a little money but it will save lives and if you read about the Facebook IPO that’s worth billions, then you can see that someone calculated it out to your worth being just under 5 bucks and this is about the same I think with big Pharma. You know they are consumers too that would like to be able to find recalls, so what’s the problem with at least someone doing a pilot on this?

In the title I had to use a couple words to get attention as we all remember with testimonies in Congress the “shitty deal” is now part of history of course.

I sit and laugh my fanny off reading about 3 years of news about how consumers don’t embrace mobile health, well give us a good reason and incentive. It’s like the other side gets and collects all the data, well in the case of recalls do you not think consumers want some information. HHS is a joke when it comes to getting consumers motivated because they can’t find a “role model” in house that will speak to consumers as I guess they feel all of this knowledge is “for those guys over there’ and truth be known most of them are not participants so I assume this is why it is so hard to get a role model to break loose in government, but instead we tons of celebrities that tell us how good the drugs are? What’s up with this?

I don’t know where else to go with this as I have some pretty high ranking at the FDA who read this blog too and still nothing? I was important enough at one point to have a major newspaper talk to me about it regarding the wipes recalls.

Recalled Wipes From Triad Still Out There in Consumer Medicine Cabinets and Possibly At Some Retail Locations-Manufacturers and FDA Need To Do A Better Job-Bar Codes

Now we do have one feeble attempt with J and J trying them out on baby wipes with product information stored which could be changed to reflect recall information if needed.

Johnson and Johnson Puts Microsoft Tag Bar Codes on Baby Wipes But Can’t Do the Same to Give Consumers the Chance to Find Their FDA Recalls - BarCode Baby Steps?

You can read this article from a few months back about a man who died as he was implanted with a recalled device that was missed being pulled from the shelf, and I say this was a needless death, but go sock your money today on some intangible social algorithms that value you at less than $5 for your human life.

There are two links at the top of the site where you can read up and find out more. I think I have about 75 articles or so, every time there’s a substantial recall where the technology would have helped, I have been on it.

Tell me there’s not room for a bar codes on these drugs. They just don’t want to do it and actually its pretty stupid when you look not only at consumer convenience, but look the extra time and expense the companies and the FDA go through themselves! ‘Grab a little heat map and find the drugs once they have been scanned too. I did it just to see who was scanning my site with my bar code…geez…but let’s make it difficult and continue on with that sorry American tradition of the “shitty deal” right? BD

Microsoft Tag Bar Codes–Who’s Been Scanning the Medical Quack–The Bing Heat Map Tells All And Could Help Find Stolen or Expired Drugs and Devices With This Methodology

You can scan your Vodka, but not medicine!

Pfizer Inc. (PFE), the world’s biggest drugmaker, recalled 1 million birth-control packs after discovering that pills were mixed up inside the packages, possibly putting women at risk for unintended pregnancies.

The company recalled 14 lots of Lo/Ovral-28 tablets and 14 lots of a generic version of the medicine, New York-based Pfizer said yesterday in an e-mail. About 1 million packs of 28 tablets were withdrawn, Grace Ann Arnold, a Pfizer spokeswoman, said in a separate e-mail.

The pills, manufactured and packaged by Pfizer, were marketed by closely held Akrimax Rx Products of Cranford, New Jersey under the Akrimax Pharmaceuticals brand. The company hasn’t received any reports of adverse health consequences, Arnold said.

Each pack contains 21 white tablets that contain the synthetic hormones norgestrel and ethinyl estradiol and are taken for 21 consecutive days. The remaining seven tablets are inactive pink pills taken for a week.

http://www.bloomberg.com/news/2012-01-31/pfizer-recalls-1-million-birth-control-packs-after-mix-up-in-pill-dosages.html

Technorati Tags: Pfizer,FDA,recalls,birth control pills,drugs,healthcare,bar codes,tag,blister packs,mHealth

Large EHR Vendor Recommendation | EMR and HIPAA

Wed, 01 Feb 2012 19:23:01 -0500

One of the more interesting dynamics in the EMR and EHR world has to do with large versus small EHR companies. I guess we’ve always loved a big versus small story ever since David slew the Giant Goliath. Plus, there’s something American that causes most of us to really root for the underdog. I don’t know what it is, but unless my team is playing I’m most often hoping that the underdog spoils the party and does something surprising. Maybe this is why so many of us love to pit the big EHR vendors against the small EHR vendors.

Personally I don’t have any particular preference for or against larger or small EHR vendors. I care more about choosing the right EHR vendor for the right situation. In some cases those are small EHR vendors and in some cases those are large EHR vendors. I only discriminate against EHR vendors who don’t perform. Many of those that don’t perform I call Jabba the Hutt EHRs. If you haven’t read my Jabba the Hutt EHR posts, you should.

Although, what prompted this post was a comment I read recently from a doctor who uses a large EHR vendor. I won’t say which EHR or who made this comment since it doesn’t matter to learn from the comment. They basically made this suggestion:I recommended a large EHR so that it can connect everything. Then he said that the large EHR vendor decreased productivity.

Certainly I realize this is only one person discussing why doctors should go with a large EHR vendor, but if I’m a large EHR vendor I’d be really upset if this is my message. And while this is one example, I’ve certainly heard it other times before.

Think about this message from a physician’s perspective. I can either go with an EHR product that decreases my productivity (Translation: I make less money) or with an EHR product that can connect everything (Translation: That’s nice, but does it save me time or make me more money?)

All the connections in the world are great, but if you hurt a clinical processes business in the process then that’s going to be a real problem. I’m a huge EHR software advocate. I think every doctor should use EHR. However, if EHR vendors continue to do EHR implementations that have a long term negative impact on EHR productivity, then physicians will continue to resist EHR software in their offices.

The good news is that I’m seeing more and more EHR vendors focused on maintaining and improving the productivity of an office during and after an EHR implementation. I hope that trend continues and that all EHR vendors become fanatical at maximizing the efficiency of a practice during and post EHR implementation.

HCN updates MDref, fixes PracSoft bug | Pulse+IT Magazine

Wed, 01 Feb 2012 19:18:08 -0500

Health Communication Network (http://www.hcn.com.au) (HCN) has released its February 2012 update of the MDref Drug Database (http://www.hcn.com.au/Products/Medical+Director). It has also resolved a bug in its recent update of PracSoft (http://www.hcn.com.au/Products/PracSoft), which was compromising demographic data in the practice management system. A new version of the update is now available

The Best Part Of The Superbowl | Dalai's PACS Blog

Wed, 01 Feb 2012 19:11:00 -0500

I'm not the world's biggest football fan, but I generally do watch the Superbowl. While I don't really have much skin in the game, so to speak, I am very distantly acquainted with the family that owns one of the teams, so I guess I'll root for them.

But the real reason I watch is for the commercials. It has become a tradition for advertisers to put their best efforts into the VERY expensive Superbowl messages.

My all time favorite is still the FedEx Caveman Commercial from 2006:

Time and technology march on, and the offerings from this year are certain to be even more incredible. The productions from several automobile manufacturers have been posted a bit early to YouTube, perhaps to catch that portion of the audience that actually watches the game and goes to the bathroom during the breaks.

First, we have Ferris Honda's Day Off:

Next, a teaser from Acura, starring Jerry Seinfeld and Jay Leno:

Now, a frosty one from Suzuki:

And something a bit more blood-curdling from Audi:

And finally, let this farce from Volkswagen outwit you:

Lexus just barely got the ad out in time for the GS debut on Friday:

I wonder what the good folks at Bud Light will come up with this year....

CIO Unplugged 2/1/12 | HISTalk

Wed, 01 Feb 2012 18:09:08 -0500

The views and opinions expressed in this blog are mine personally and are not necessarily representative of current or former employers.

The Bad Boss

New town. New job. I was stoked over what was essentially a startup within an enterprise. As a visual learner and teacher, I asked the office manager for a whiteboard.

No go. The president wanted to keep corporate operating costs low. No worries. I went to Staples, and for the cost of a Starbucks Grande Red Eye, I bought myself a whiteboard.

Before I had a chance to hang my would-be art piece, my boss stopped in and frowned. “What’s this?” After I explained my reasoning, he said, “Take it out.” He wanted all the offices to have the same minimalist look and feel.

Well, my kids loved it. That whiteboard became central to their homeschool activities. I’ve used it over the years for meetings at home.

Little did I know, the rejected whiteboard was only an omen of the legalistic reign under which I was now employed. I was tempted to pack up and head back south. After all, I had a 90-day “get-out-of-jail-free” card from my former employer who would graciously welcome me back. Our old home had not yet sold.

Tempted as I was to escape, I knew running away was wrong. If I quit now, I would never learn perseverance. I had made a commitment and I would keep it, no matter how aggravating. I knew I would use this challenging experience to prepare for the future. Angry and disillusioned, I stuck it out.

Most of us have had a manager who’s aggravated the heck out of us. National employee engagement scores from Gallup suggest that many are presently in such situations. Web sites such as Really Bad Boss are extremely popular. Numerous best-sellers have been written on the subject. And did you ever ask yourself why The Office and Dilbert are such big hits? Because we can all relate on some level to bad bosses. I suspect all of us will have the opportunity to encounter one along the way. This was mine.

I make an effort to understand these concerns because I don’t want to be a bad boss. And I’m very aware of my potential to become what I hate. We’re all susceptible.

That said, I’ve been blessed to work with predominantly good bosses. So here is what I learned to make the best out of bad-boss situations:

Honor leadership. Part of my career plan is based on the premise of honoring those in authority over me. This can be tough. Clearly, you should never turn a blind eye to unethical behaviors or abuse. I am solely referencing a difficult and disagreeable boss. Actively give honor to them. It may not change them, but it will change you.
Make your boss famous. Another toughie. Why would you make a bad boss famous? Because if you can make them better, there’s a chance your situation will improve. Don’t talk up how wonderful your division outcomes are, but give the glory for good things to your boss and take your lumps when things are not so good. Leadership demands humility. “There’s no limit to the amount of good one can do as long has he doesn’t care who gets the credit.” Author unknown
Take the good. Most bosses are bosses because they have done something good and have the capacity for more. Seek out the good and apply it to your career. My anti-whiteboard boss taught me the importance of having a “kitchen cabinet,” developing key informal relationships that serve as a sounding board and advisory committee. Life is too short to not learn from all circumstances.
Check the mirror. Take inventory of the bad and look for signs of these traits in yourself. If you find one, pull it out. Guard against bad-boss behaviors creeping into your own style. If your boss is inclined to knee-jerk reactions, don’t start flailing your arms every time you are faced with a challenge. Recognize bad-boss behavior and never replicate.
Leading up. This might seem impossible, but keep faith that you can influence a change in your boss. Lead by example. Although your voice may not be heard, your actions will be noticed, subconsciously or otherwise.
Think long term. Look ahead and remind yourself that today’s actions dictate tomorrow’s decisions. If you quit when things are tough, you will become a quitter. Stick things out. Don’t tap out too quickly.
Speak no ill will. Avoid the trap of complaining about bad boss to other people. This will only exasperate the situation and make it worse than it is. Speak blessing instead.
Seek first to understand. Figure out the drivers for bad boss behavior. They are likely stress induced. Most bad bosses are well-intentioned leaders who’ve lost their way because of personal and/or professional pressures. Identify the sources of stress and you might help reduce or eliminate it. At the very least, you will sympathize and realize the behavior is not a vendetta against you, albeit it feels like it.
Avoid a bad boss. Forbes shares five tips to spot a bad boss in an interview. Gather your own references. Call the person who most recently held the position. Call on the other direct reports. If you are well networked, get the internal buzz on your potential boss. Many a bad-boss situation could be avoided if you research diligently and listen to what you hear. Don’t believe things will change because you believe you are better than your references. They won’t.
Joy in suffering. This is the toughest one for me, but the most important. “Suffering produces perseverance; perseverance builds character; and character produces hope.” It’s an upward, spiraling cycle throughout life.

So if you have a bad boss, you have a choice. Life is too short to be in a bad boss situation, but you owe it to yourself, your people, your boss, and your organization to make it work.

I persevered with the anti-whiteboard boss. I established a “kitchen cabinet” as I’d learned from him. I was promoted out of that division and into corporate, where I became CIO. Hope never disappointed me.

And then I purchased the biggest damned whiteboard ever made.

Ed Marx is a CIO currently working for a large integrated health system. Ed encourages your interaction through this blog. Add a comment by clicking the link at the bottom of this post. You can also connect with him directly through his profile pages on social networking sites LinkedIn and Facebook and you can follow him via Twitter — user name marxists.