This week, all the materials on the application for leave to appeal in Cuthbertson v. Rasouli have been submitted to the judges of the Supreme Court of Canada. I hope they take this case.&nb...
Delaware MOLST
This morning, I made a presentation on advance directives and MOLST with these slides at the Delaware VA Medical Center. I hope that I raised awareness and introduced providers to the rationale, benefits, and operation of MOLST. But it was humbling to discover the wide range of detailed questions for which we do not have prepared answers. Education, training, and policy-writing will be a long process. As the excellent AARP Public Policy Institute report advises: "Advocates should expect a multiyear implementation proces...
Jesus Cornelio v. Banner Health
Earlier this week, I posted some video news reports on the Phoenix, Arizona case of Jesus Cornelio. As the case is not in litigation and neither the family nor the hospital has released detailed facts, it is difficult to make informed comments. It is unclear if this is a medical futility case, a medical deportation case, or what. According the ABC News and other independent news sources, at least the following facts appear to be true:The patient's brain was without oxygen for more than 10 minutes, which doctors say caused severe damage to his brain.The patient is not a U.S. citizen.The patient does not have health insurance.The patient does not qualify for Arizona Medicaid.The patient's medical expenses to date total about $120,000.The hospital has apparently told the family...
Arizona Health Information Network Chooses OptumInsight (United HealthCare Company) for Their HIE Exchange–Subsidiary Watch
It seems everywhere you turn today with Health IT investments there’s a chunk of changed headed toward United. The company was an acquisition made by the large behemoth in August of 2010. If they can’t buy the exchange I guess the next best thing here is to get your subsidiary in action. We heard that a few days ago with Blue Cross buying an exchange. In addition to the medical records that Ingenix (OptumInsight) has owned and sold for years, the acquisition of Axolotl gives them a second EHR to sell along with HIE capabilities. Ingenix Acquires Health Information Exchange Services/EHR Provider Axolotl-United Health...
Bad Science and Bad Analytics That Misleads–TED Video Takes on Advertising on Steroids and Danger of Mis-Matched Analytics And Distortion of Clinical Trials (Video)
This is great and goes along with some of my recent posts with analytics on steroids for marketing only and also makes a point about what gets put in journals today too. Dr. Ben Goldacre, talks fast so listen up carefully, but he gets it. Fish Oil pills is one he takes on as well as coffee and cancer, yes it does and no it doesn’t. On the pills they calculate and project how the children would have done without the pills..bunk. I am so glad this is finally getting attention so consumers may start asking questions if posed with something you know is weird and yet it persists in the papers every day, day in and day...
SEC Sues Quant–Undisclosed Error in Trading Algorithm- Miscalculating “Risk”-Healthcare Software Evaluates This Factor Too
How often do we hear “risk” assessment in healthcare? If you are in the payable and IT side of it, all the time. It comes back again to the algorithms. In Health IT this is why we have the certification processes for medical records, but when it comes to the payment side and risk management done by insurance companies, there’s not checking and balancing as we are at the mercy of their algorithms for risk assessment. With steroid marketing today in healthcare, we have some situations too where such algorithms are overstated and oversold, but nobody does anything sadly. It’s just the same old factor of fleecing those...
Oracle Announces Insurance Exchange Platform - Purchasing Health Insurance Platform–Available for State Governments
Not too long ago Microsoft announced their platform availability for state governments as well. The Oracle suite will connect with Siebel for CRM capabilities. With both big company offerings this leaves a couple options besides have to buddy with an insurance company offering. Actually this is better I think with actual technology companies as it will defer any conflicts of interest and keep things cleaner as subsidiaries with insurers today have all types of business models out there and with technology provided by companies who don’t sell insurance I think it’s a cleaner operation for sure. In other Oracle news, they...
Blue Cross and AllScripts Going to Pick Up the Tab for Doctors Electronic Medical Records In North Carolina
This is interesting as Blue Cross doesn’t have a medical record program and I have said in the past the next move will be insurers buying up the EHR folks. NCPath is the name of the program and 85% of the tab will be picked up, except the free clinics will not have to pay at all. So it sounds like with the certified records system in place they will all be able to attest for stimulus money too. Right on websites it seems like we used to see more about better patient outcomes but like most on healthcare anymore, well you can see the image below to where profitability is the focus. Some carriers, such as United have...
FDA Approval Given for Face Mask Designed for Children and Awards Pediatric R and D Device Grants
The mask is to be used in hospitals to reduce the spread of airborne bacteria and viruses and is designed for ages 5 to 12. In other FDA pediatric news the agency has given out grants for Orphan Product Development. We are starting to hear a lot about orphan diseases and the need for more research and many Children’s hospitals are a deep dive into it with R and D efforts. The full story can be read here. BD James Geiger, MD and Andre Muelenaer, MD, at the University of Michigan Pediatric Device Consortium (M-PED) & Pediatric Medical Device Institute (PMDI) Pediatric Medical Device Consortium, $1,100,000/per year...
MelaFind Device Finally Given FDA Approval For Detecting Melanoma –It Took 7 Years
This has been a long haul for Melafind as back in November of 2010 the FDA panel approved the device, and here we are in September of 2011 with now jut getting approval. Below is a video from the Wall Street Journal that depicts some of the history on Melafind. New Melanoma Identification Device Gets FDA Panel Approval–Questions About How Human Intervention Works with Melafind Algorithm Arise From Discussion In August 27, 2009 I reported that the device company was waiting approval so here with even my blog you have a bit of history. MelaFind Medical Device for Detecting Melanoma Skin Cancer Awaiting FDA Decision ...
Baby Joseph Maraachli Dies
The CBC reports: "Joseph Maraachli, the terminally ill baby at the centre of a legal and ethical battle, has died at his Windsor, Ont., home. Baby Joseph, as he affectionately became known, suffered from a degenerative brain disease. He was 20 months old when he died late Tuesday afternoon." As a father, I am pleased that the parents were able to get so much time with their son since the Ontario courts first ruled against them in January. Still, it concerns me that two levels of court review determined that Joseph’s parents were not making appropriate decisions for him. The parents were not criminally...
Larry Ellison Announced As Distinguished Medical Informatics Awardee for His Contributions to Health IT and the Ellison Foundation From the Friends of the National Library of Medicine (NIH)
There are some other known recipients but this is Larry’s day in my book:) Dr. Oz is also in here for an award as well as other research and development individuals at the Howard Hughes Institute. Dr. Oz gets enough publicity and most of the time is on key. Larry Ellison is always in the press with nobody understanding him at times, but he’s brilliant and started out writing code. For all his life he has had to live with being upstaged less than 24 hours of having the largest IPO by Microsoft so it was short ordeal. Oracle does quite a bit in healthcare and has grown with several acquisitions. When Windows...
Miami-Dade County Fires Deloitte Consulting–Couldn’t Get A Straight Answer, Those Algorithms and Complicated Legal Text Once Again Making It Tough For Mere Humans
This goes to an item the County needed clarification on and the Deloitte and their attorneys just couldn’t give them a straight answer, so they got fired. In reading this Deloitte asked the County if they had been properly following federal tax rules while making a 5 percent pre-tax deduction. Deloitte had to subcontract with a law firm and they declined to comment, don’t you just love this, that kettle is too hot for me to jump into. Sometimes its even damn hard to get a judge who’s up to date with all their investments as they don’t seem to pay enough attention sometimes and find themselves in a conflict of interest and wonder...
Massachusetts Governor and Israel Chief Scientist Form Massachusetts-Israel Innovation Partnership (MIP)–Applications Being Taken For Funding Biotech, Pharma, Medical Devices And More In Life Sciences
Full information on the project is at the link at the bottom of the post. This is an interesting relationship as Israel is known for their technology both in high tech and in life sciences. When you think of that Intel processor in your computer, think Israel because that’s where a lot of the silicon technology for chips is developed, big R and D. “The projects must aim to develop a new or significantly improved product or process for commercialization in global markets but also be beneficial to Massachusetts in terms of additional jobs and income.” Israel is also going through some stressful times and some of it is kind...
Cancer - Do Not Overdiagnose, Overtreat, Overpromise
"Dying cancer patients should not be given 'futile' drugs" - That is the title of Martin Beckford's article in the Telegraph reporting on this Lancet Oncology Commission report, “Delivering Affordable Cancer Care in High-Income Countries.” Similar to an ASCO report from this spring, the LOC finds that “in developed countries, cancer treatment is becoming a culture of excess. We overdiagnose, overtreat, and overpromise." Among other factors driving “overutilization,” the Report notes:It is “quicker and easier” to order treatment or a scan than to tell a patient it may not be necessary or worthwhileThe fear of being sued if clinicians fail to take every possible course of actionDemand from patients who do not personally pay the billsBoth doctors and patients need to be educated about...
Supreme Court Likely to Rule on Healthcare Law Early Next Year–This Gives The Justices Time to Rent Some Computing Space from the DOE As They Will Need It
Well after this amount of time and different interpretations we want to make sure that all data and information is included so we get it right. Why the DOE? They have the third fastest computer in the world and they do rent out space. HHS and the NIH have research running on it now so when it comes to something this big, get the right tech power to handle the details and put everything into a format that they can work with. It makes sense and is exactly how business functions today so there’s not reason to go by the seat of our pants on this. Here’s a little history on the Super Computer’s power and computing space....
Hoag Hospital Lays Off 175 Staff Members- St. Joseph Cutting 144–Layoffs Occurring Even Within the Affluent Areas of Country–All Comes Back to Reimbursement
Even in Newport Beach, California hospitals are feeling the pinch and you can read below it all comes back around to reimbursements. Hoag hospital works with Aetna Insurance’s IT subsidiaries (Medcity) to connect doctors and health data. In Health IT areas it’s getting down to the linking and competiveness of the insurance IT infrastructures going way beyond just processing medical claims with all the various subsidiaries that are out there today and sometimes hard to recognize as some have some pretty long daisy chains. Aetna to Acquire Medcity-Health IT Connectivity Vendor-Former CEO Takes Position on Board at Boeing They are...