Kenta Biotech relocates to Zurich

BERN, SWITZERLAND – Kenta Biotech announced that it is relocating from Bern, Switzerland to Bio-Technopark in Zurich-Schlieren. In its new headquarters, Kenta Biotech will rent state-of-the-art laboratories, allowing it to boost research efforts and development of treatments for hospital-acquired infections.

Among the site’s advantages are its proximity to academic research centers in Zurich and the support provided by local authorities.

“This is definitely a strategic move for the company and we are now located at the best possible place for a young and innovative biotech company in Switzerland,” said Franco Merckling, CEO of Kenta Biotech.

Kenta Biotech has for six years developed technologies and products to fight hospital-acquired infections. With its relocation, officials say the company hopes to send a positive message to current and future investors and partners.
 

Organization sends health info via mobile phones

The Mobile Alliance for Maternal Action (MAMA) celebrates one year of working with local organizations to send timely and culturally sensitive health and wellness information to new and expectant mothers in 22 countries via mobile phones.

MAMA is a $10 million three-year partnership that addresses the 360,000 maternal deaths and 3.1 million newborn deaths that occur each year. It is a collaboration between the U.S. Agency for International Development (USAID), Johnson & Johnson, the United Nations Foundation and BabyCenter. It operates through a secretariat hosted by the mHealth Alliance.

The organization is due to launch nationally in Bangladesh in July, and South Africa will preview its services in May at the GSMA-mHealth Alliance Mobile Health Summit in Cape Town.

Subscribers to the service register by indicating the expected due date or birthday of their recently born child and receive weekly health messages and reminders during the pregnancy and up to the child’s first birthday. Messages include everything from proper nutrition, breastfeeding, vaccinations and referrals to local health resources.

Maternal and infant death rates remain high, and 99 percent of them occur in developing nations. Most of these deaths are preventable with relevant information and care.

“By using available technology and credible health information, the world has the knowledge and the opportunity to stop millions of deaths to moms and babies each year,” said Kirsten Gagnaire, Global Partnership Director at MAMA.

More than one billion women in low- and middle-income countries own mobile phones. Mobile health messages can inform, dispel myths, highlight warning signs and connect pregnant women and new moms with local health services.

Louisa-Care: Making Health Insurance More Affordable for Small Businesses

Louisa McQueeney is general manager and chief financial officer of Palm Beach Groves, a small, family-owned Florida gift and food shipping company. She believes it�s important for a small business to provide health insurance for its employees: �It creates a long-term relationship with your employees,� she says.

The health care law, Louisa says, is helping Palm Beach Groves continue to provide health coverage its employees by funding a health care tax credit for targeted small businesses. For Palm Beach Groves, that tax credit amounted to a $7,400 savings that could be used to offset health insurance costs. �

�It�s the first time in 12 years that I�ve actually seen a reduction in [health coverage] cost for the business,� Louisa says. �The decrease in our cost is directly tied to the tax credit. If it wasn�t for the Affordable Care Act, we would not be talking about a tax credit.�

Do you know what you pay for health insurance?

A disturbing survey reveals that most Californians � and likely most Americans � are unwilling to focus on the details of their health coverage. Those who are focused on the details are finding their coverage is increasingly riddled with holes.

Health care consumers say their medical costs are going up and expect them to continue to rise. But people are unlikely to ask about cost before getting care. And many don't even know how much they pay for coverage or what their deductible is.

That's according to a recent survey of Californians, and likely applies to most Americans. It's an odd disconnect that people are aware that costs are going up and likely to continue (73 percent thought so), but that many folks are unwilling to focus on the details of their coverage.

Maybe that's understandable, given how difficult it can be to sort out premiums from deductibles from copays, and how often those change from year to year.

Most Americans still get their insurance coverage from an employer, and we like to think that we're taken care of � that if we have a job and a health plan we're all set. What increasing numbers of people are learning is that there are holes in the system even if we have coverage. In this survey from the California HealthCare Foundation, 39 percent of those whose costs went up in the past year said their benefits got worse at the same time.

Those trends are not news for people buying insurance for themselves on the individual market, where high deductibles and Swiss-cheese coverage are the norm. Of those whose costs had risen, 61 percent were in the individual market.

So, the likelihood that your health plan is getting more expensive and/or less comprehensive is fairly decent, and would seem to provide plenty of incentive to educate yourself about your coverage. And yet just 26 percent of those surveyed tried to get information about the cost of a test, treatment or other type of health service before receiving it. Doing research was more likely among those with a high deductible (the amount of money you pay before insurance kicks in).

More evidence that American consumers are practicing avoidance: Among the half of survey respondents who knew they had a deductible, nearly half didn't know the amount. A third didn't know what their premium was or wouldn't answer the question.

These are troubling statistics given the brave new world of insurance coverage we're living in, one that assumes consumers are shopping for health coverage and medical services just like they do other big-ticket items like cars. But there aren't many people who don't know how much their car payment is.

Catholic Groups Sue Obama Administration Over Birth Control Rule

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In a compromise, President Obama proposed to allow religious universities and charities offer birth control coverage through their own health insurers.

iStockphoto.com

In a compromise, President Obama proposed to allow religious universities and charities offer birth control coverage through their own health insurers.

So much for compromise.

A total of 43 Catholic educational, charitable and other entities filed a dozen lawsuits in federal court around the nation Monday, charging that the Obama Administration's rule requiring coverage of birth control in most health insurance plans violates their religious freedom.

Among the plaintiffs in the suits are the University of Notre Dame and the Catholic University of America, as well as the Archdioceses of New York, Washington, Dallas, St. Louis and Pittsburgh.

They join several other, mostly smaller entities that have sued over the requirements for no-cost coverage of regular birth control, sterilization and so-called morning after emergency contraceptives. Because one of the ways those drugs may work is by preventing the implantation of a fertilized egg into a woman's uterus, Catholics believe they can cause a very early abortion, even though they are classified by the Food and Drug Administration as contraceptives.

 

President Obama tried to defuse the controversy over the requirement back in February, after religious groups complained that the exemption from the requirement, which applied effectively only to actual houses of worship and groups that employ only members of a specific faith, was too narrow.

The president's proposal was not to expand the exemption, but to allow religious universities and charities to have their health insurers offer the coverage instead.

"The result will be that religious organizations won't have to pay for these services, and no religious institution will have to provide these services directly," Obama said. "But women who work at these institutions will have access to free contraceptive services, just like other women, and they'll no longer have to pay hundreds of dollars a year that could go towards paying the rent or buying groceries."

The president's Catholic allies were pleased, as were some of those who had been complaining. Even the president of Notre Dame, Father John Jenkins, called the announcement "a welcome step toward recognizing the freedom of religious institutions to abide by the principles that define their respective missions."

But over time, discussions over how to make it work appear to have broken down.

Even taking the actual benefits out of the hands of the religious organization "does not solve our moral dilemma," said Catholic University President John Garvey in a statement. Garvey noted that, "The only change the 'accommodation' offers is that the insurance company, rather than the University, would notify subscribers that the policy covers the mandated services." But the students and employees would still have to pay for "objectionable" prescriptions and services.

The Obama Administration declined comment on the suits, citing a policy of silence with regard to ongoing litigation.

But Cecile Richards, president of Planned Parenthood, which is among the groups most strongly backing the requirement for contraceptive coverage, said, "It is unbelievable that in the year 2012 we have to fight for access to birth control."

N.Y. man defrauds Medicare of $70,000 in medical device reimbursements

BOSTON – Michael McKay, 32, of Saratoga Springs, N.Y.. pleaded guilty in district court on May 11 for forging physician’s chart notes to make Medicare or private carrier claims qualify for reimbursements for bone growth stimulator medical devices.

According to the Office of the Inspector General (OIG), between 2008 and 2010, McKay collected $70,000 in false Medicare claims.

District Judge Denise Casper has scheduled McKay’s sentencing for Sept. 6, 2012. McKay faces up to 10 years in prison, to be followed by three years of supervised release; a $250,000 fine; asset forfeiture and restitution.

Had the case proceeded to trial the government’s evidence would have proven that between 2008 and 2009 McKay was a territory manager for a company that manufactured and distributed bone growth stimulator medical devices, according to the OIG. McKay’s territory included New York, Pennsylvania and Ohio.

The device that McKay sold was intended to assist patients with bone fractures that did not heal properly, according to the OIG. Medicare has specific guidelines describing when it will pay for this device for one of its beneficiaries. Many private insurance carriers follow these guidelines as well. McKay often received orders for patients that did not satisfy these guidelines. When this happened, McKay forged the patients’ medical records to make it appear as though the order met Medicare or private payer guidelines.

McKay altered physician’s chart notes, changing the dates of patient visits and inserting false diagnoses, officials from the OIG said. McKay also created phony medical chart notes, describing patient visits that did not occur.

The medical device company fired McKay after it discovered his fraud, OIG officials said. After that, McKay’s supervisor and another territory manager, Derrick Field, concocted a scheme in which McKay continued to submit orders from doctors in his former territory, but he submitted them through Field.

Field, who was also convicted for healthcare fraud in a similar scheme, submitted the orders to the device company and split the commissions with McKay. McKay continued to forge patients’ medical records even after he was fired by the company for this conduct, according to the OIG.

5 novel uses for RTLS technology

Recent reports have touted the effectiveness of RTLS technology on a company's bottom line. An even better ROI can be had with a little creativity, says Merrie Wallace, executive vice president of product solutions at real-time awareness solutions company Awarepoint.

"Quite frankly, most customers start with some location finding," said Wallace. "That's their goal – finding a piece of equipment, finding a staff member. We look for not just where the items are, but what's the history and what's the outcome. That's what we're trying to drive."

Wallace outlines five novel uses for RTLS technology. 

1.For asset tracking. From a maintenance perspective, said Wallace, organizations want to have the right volume of equipment. "What we find is most hospitals have double or triple the amount of equipment they need because they can never find them or locate them," she said. Also, from a capital perspective, RTLS technology aids in lowering expenses, whether it's purchasing to replace lost equipment or renting from a third-party vendor. "So that expense comes up dramatically, but what we find is, once we deploy tags on equipment like ventilators and compression devices, we find 10 percent of the time, those items are in the wrong direction from a healthcare delivery process." What tends to happen, Wallace said, is equipment travels from patient room to patient room, without undergoing a decontamination process. "So we track that and we alert to that, if there are breaches in those processes. We make sure we have the right flows going on."

[See also: RTLS sets the stage for savings at NC Medical Center.]

2.In surgery. When it comes to using RTLS in the operating room, said Wallace, organizations have opted to deploy the technology on their instrumentation pans to ensure instruments go through a decontamination process. And once again, RTLS technology is used to keep track of equipment. "It's about reducing the cost of your equipment across your facility," said Wallace. "Let's drive toward an outcome, and it's really an outcome that's non-reimbursable, which is a hospital acquired infection. We know if this equipment isn't being decontaminated, it can lead to those infections."

3.For temperature monitoring. Wallace said she's seen RTLS technology deployed in similar quality initiatives, like when it comes to temperature monitoring in refrigerators. "Institutions have [medical-grade] refrigerators that maintain tissue, blood product, medications, etc., and it needs to be maintained at the appropriate temperature," she said. Nurses typically manage the refrigerators, Wallace continued, which often contain large volumes of specimens, and they're responsible for looking out for variations in temperature. "We put temperature probes in those devices, and it allows an institution to centralize and get the task off your professional staff," she said. "It allows it to be centralized and then [send out an] alert if there are any variations that would compromise the contents of that refrigeration unit, as well as keep [the organization] compliant."

[See also: Real-time top trend in claims.]

4.For the protection of PHI. Recently, Wallace saw an organization deploy RTLS technology on any device containing personal health information (PHI). "So, most IT departments today really manage the security into those devices and password protect and auto log-out these devices in an effort to maintain the HIPAA and privacy protection of PHI," she said. The organization she spoke with "creatively, and rightly so, looked to tag all the devices that contained PHI information." With the help of this technology,  an organization can not only track where, for example, a laptop is, but can also be alerted if it somehow makes its way to the trash, she said. "So they would know where those devices are if they contain PHI. I understand the challenges healthcare institutions have as far as maintaining PHI, but tagging devices that contain it and knowing at all times where they're located is a very innovative strategy."

5. To drive efficiency and improve workflows. Wallace referenced a hospital in Oregon, which is "actually tagging a complex workflow environment and high-acuity areas in surgery," she said. This includes not only their equipment, but also everyone on their staff, including physicians, anesthesiologists, and patients. "[This] can help predict and make sure the next steps occur in a care delivery process," said Wallace. For example, a series of communication occurs when a pre-op patient first meets with an anesthesiologist. "It creates a chain, and the workflow allows us to say this interaction will happen because the anesthesiologist met with the patient and had their interaction. We know they’ll be doing that downstream notification to the next constituents in terms of care delivery to let them know the patient is ready." Employing RTLS technology, Wallace added, helps reduce the communication required in this chain – such as phone calls – while increasing the capacity in these institutions. It's about "the capacity and access to care for patients, and the efficiency of care for the patient," she said. "We want the most streamlined process as possible." 

Embattled Hospital Debt Collector Taps Politicians For Defense

Jim Mone/AP

Minnesota Attorney General Lori Swanson announces a lawsuit against Accretive Health in Jan., saying the company failed to protect the confidentiality of health care records for thousands of Minnesota residents. The charges have widened to include the company's tactics in collecting debts.

So what do you do when you're accused of hitting up sick patients in the hospital to pay their bills � sometimes even before they get treatment?

Well, if you're Chicago-based Accretive Health, under fire by not only the Minnesota Attorney General but key members of Congress and possibly the Obama Administration, you fight fire with fire. You line up your own set of political defenders.

To back up a bit, this story began last year with a stolen laptop, which led to a January lawsuit filed by Minnesota Attorney General Lori Swanson charging Accretive with privacy violations.

The resulting investigation led, in turn, to an April story in The New York Times, that chronicled how Accretive workers allegedly posed as employees in Minnesota hospitals, and included "embedding debt collectors as employees in emergency rooms and demanding that patients pay before receiving treatment."

 

Accretive struck back, charging that that Attorney General Swanson's report contained "inaccuracies, innuendo and unfounded speculation." The company also enlisted a formidable political ally � Chicago Mayor and former Obama Chief of Staff Rahm Emanuel. He personally asked Swanson to back off, noting in a letter that the company "does important work for hospitals and good things for our City, particularly for our neediest citizens."

Swanson, however, declined Emanuel's entreaty. "We will continue to interview witnesses and perform our law enforcement responsibilities over charitable hospitals in Minnesota," she said in a statement.

So now Accretive is upping the ante. It has enlisted a veritable who's who in health policy to come up with "national standards for how hospitals and other providers interact with patients regarding their financial obligations." In other words, how aggressive can debt collectors be without running afoul of federal law, various or regulation or good public relations.

The group includes some well-connected heavy-hitters, including former Bush administration Health and Human Services Secretary Mike Leavitt and Medicare chief Mark McClellan, former Senate GOP leader Bill Frist,. There some prominent Democrats too, including former Clinton Administration HHS Secretary Donna Shalala and former Senate Democratic leader Tom Daschle.

For all of Accretive's alleged misdeeds, however, the collection of outstanding bills is a serious one for hospitals, particularly as they await the Supreme Court's decision about the 2010 health law. Hospitals agreed to take significant reductions in Medicare payments with the expectation they would make that money back when currently uninsured patients whose care now goes unpaid would gain coverage.

Should the high court strike down the requirement for most people to obtain insurance, however, that could leave hospitals in a financially difficult spot.

Web First: Q&A with Allscripts CEO Glen Tullman

CHICAGO – In real estate, it’s all about location, location, location, they say. In healthcare IT, you might say it’s about integration, integration, integration. Allscripts CEO Glen Tullman is keenly aware of how critical product integration is, he says, and he’s working on it. It’s the difficulties with integration that seem to have led to the EHR company’s recent troubles – at least it’s what Allscripts customers and analysts mention most often. Then came April 25 and the ousting of Allscripts’ board chairman, which triggered three board members to quit in protest, the departure of its CFO (for reasons unrelated, according to the company) and a dismal quarterly report, all of which led to stock price plunging 44 percent.

Allscripts CEO Glen Tullman discusses the challenges that face the company, plans for recovery and its future in the market.

[See also: Allscripts in skid mode as shares plunge, chairman ousted]

Q. Can you make Allscripts whole and thriving again? How? How long will it take? What’s your vision?
A. Yes, I believe we can. Many companies would love to have our positioning, our products, our marketshare and our earnings and cash flow. But to be clear, we can execute better than we have, and we will. We have the right leadership team in place and have made the investments to enable us to lead the industry. And we have the best client base in the industry. Relative to timeline, we are making improvements right now. 
 
Our main areas of focus are product delivery and client experience. We are investing $190 million in 2012 in improving performance, integration and innovation with a number of major releases and improvements in motion. Relative to improving product performance, we have established test labs to eliminate past integration challenges, especially third-party products and the new apps being built for our open platform.

Additionally, Wand, our native iPad app for our Enterprise and Professional EHRs, was recently launched and has been positively received in the market. Our iPad application for our Sunrise Acute offering is already on the market. Wand is another example of the innovation that Allscripts is known for.
 
Over the course of the year, we have added more than 400 frontline support personnel to our team, many of whom are now just coming on line. And, we continue to upgrade our hosting capabilities through a new data center as well as improved monitoring capabilities to better serve our current customers and future prospects. Additionally, at the beginning of the first quarter we launched a major reorganization, bringing together our sales and services teams into a single organization. This is absolutely the right move for our clients, providing them a single point of contact and a team that is not just accountable for selling, but delivering.

Q. Why the so-called poison pill, or shareholders rights approach?
A. This is a common approach when companies believe their stock is undervalued. We are committed to act in the best interests of our stockholders and our clients, which is why we increased the size of our current plan from $200 million to $400 million. We adopted the shareholder rights plan to protect against efforts to obtain control of Allscripts that are inconsistent with the best interests of the company, our clients and our stockholders. As described in a recent article in The Street, “The decision to enact a poison pill by Allscripts, though, also places the company in the camp of target market properties that are deciding to gut it out rather than sell out…”

[See also: Allscripts: Debacle or silver lining?]

More of the interview on the next pages.

Popular antibiotic linked with rare but deadly heart risk

CHICAGO(AP)�An antibiotic widely used for bronchitis and other common infections seems to increase chances for sudden deadly heart problems, a rare but surprising risk found in a 14-year study.

Zithromax, or azithromycin, is more expensive than other antibiotics, but it's popular because it often can be taken for fewer days. But the results suggest doctors should prescribe other options for people already prone to heart problems, the researchers and other experts said.

Vanderbilt University researchers analyzed health records and data on millions of prescriptions for several antibiotics given to about 540,000 Tennessee Medicaid patients from 1992 to 2006. There were 29 heart-related deaths among those who took Zithromax during five days of treatment. Their risk of death while taking the drug was more than double that of patients on another antibiotic, amoxicillin, or those who took none.

To compare risks, the researchers calculated that the number of deaths per 1 million courses of antibiotics would be about 85 among Zithromax patients versus 32 among amoxicillin patients and 30 among those on no antibiotics. The highest risks were in Zithromax patients with existing heart problems.

Patients in each group started out with comparable risks for heart trouble, the researchers said.

The results suggest there would be 47 extra heart-related deaths per 1 million courses of treatment with Zithromax, compared with amoxicillin. A usual treatment course for Zithromax is about five days, versus about 10 days for amoxicillin and other antibiotics. Zithromax is at least twice as expensive as generic amoxicillin; online prescription drug sellers charge a few dollars per pill for Zithromax.

"People need to recognize that the overall risk is low," said Dr. Harlan Krumholz, a Yale University health outcomes specialist who was not involved in the study. More research is needed to confirm the findings, but still, he said patients with heart disease "should probably be steered away" from Zithromax for now.

The study appears in Thursday's New England Journal of Medicine. The National Heart, Lung and Blood Institute helped pay for the research.

Zithromax, marketed by Pfizer Inc., has been available in the United States for two decades. It's often used to treat bronchitis, sinus infections and pneumonia. Wayne Ray, a Vanderbilt professor of medicine, decided to study the drug's risks because of evidence linking it with potential heart rhythm problems. Also, antibiotics in the same class as Zithromax have been linked with sudden cardiac death.

Zithromax is among top-selling antibiotics. U.S. sales last year totaled $464 million, according to IMS Health, a health care information and services company.

Pfizer issued a statement saying it would thoroughly review the study. "Patient safety is of the utmost importance to Pfizer and we continuously monitor the safety and efficacy of our products to ensure that the benefits and risks are accurately described," the company said.

Patients studied were age 50 on average and not hospitalized. Most had common ailments, including sinus infections and bronchitis. Those on Zithromax were about as healthy as those on other antibiotics, making it unlikely that an underlying condition might explain the increased death risk.

Medicaid patients generally have more disability and lower incomes than other patients, so whether the same results would be found in the general population is uncertain, Ray said.

Dr. Bruce Psaty, a professor of medicine at the University of Washington, said doctors and patients need to know about the potential risks. He said the results also raise concerns about long-term use of Zithromax, which other research suggests could benefit people with severe lung disease. Additional research is needed to determine if that kind of use could be dangerous, he said.

���

AP Medical Writer Lindsey tanner can be reached at http://www.twitter.com/LindseyTanner

A Critic's Advice For Doctors In Search Of Industry Work

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Over in the U.K. there's a set of principles being floated in support of collaboration between the drug industry and doctors.

A sample of the dos and don'ts for doctors reads a little like dating advice:

"Don't establish blanket policies denying interaction with industry or regard it merely as a source of funding.

Do look for opportunities to get involved: in clinical trials, in joint working and/or with opportunities provided by industry for medical education."

Yes, there have been problems in the past. But the document suggests not letting those issues scare doctors off:

 

"Opportunities may be missed or even rejected because of misconceptions stemming from historical practices that are no longer acceptable, or the actions of a few individuals that are not typical of the working relationship between healthcare professionals and the industry."

Go ahead and see sales reps, the document counsels, and help drugmakers by serving on their advisory boards. And look for ways to take advantage of industry-sponsored education.

I'd overlooked the guidelines until today, when Australian journalist Ray Moynihan, a frequent critic of financial conflicts in medicine, made me take notice with a piece in BMJ, the British Medical Journal.

He makes quick (and footnoted) work of them. In his own tongue-in-cheek way, he advises would-be collaborators with some more dos and don'ts. A sample:

Don't read a review that found no evidence that doctors who saw drug reps were any better off when it came to prescribing medicines well. Don't read an analysis that found doctors who had positive views of the controversial diabetes drug Avandia were more likely to have financial conflicts involving drug companies. Don't read a proposal to control conflicts of interest in medicine by reducing the sway industry has on continuing medical education.

Moynihan takes a hard line. But it's not that hard to see why. Recent history provides plenty of cautionary tales.

Like The U.S., Europe Wrestles With Health Care

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A patient is treated at the Nord Hospital in Marseille, France, in February. European countries have also been engaged in intense debates on the future of their health care systems, where universal coverage is the norm.

Anne-Chrisine Poujoulat/AFP/Getty Images

A patient is treated at the Nord Hospital in Marseille, France, in February. European countries have also been engaged in intense debates on the future of their health care systems, where universal coverage is the norm.

The U.S. has been absorbed by the Supreme Court case this week on the future of health care. But Americans are not alone.

Several European nations, where universal health care has been the norm for decades, have been waging their own intense debates as they also deal with aging populations and rising costs.

Britain passed a new health care measure earlier this month, after more than a year of rancorous debate. Can the European experience cast some light on the American debate over health care?

"There are some common problems," says British analyst Chris Ham, "but we're coming to this debate from very different starting points. In the States, it's about how to extend coverage to more people, whereas [in Britain], it's about how to get more bang for the buck out of our current system."

 

Ham is the chief executive of The King's Fund, an independent health policy think tank in London.

The British Debate

Britain's debate is still going on, with critics charging that the Conservative-led government is trying to privatize the more than 60-year-old system in an effort to cut the nation's budget deficit.

The government says the reforms will trim a bloated health care bureaucracy and give doctors more control over health care management.

All health systems face the same challenges. You have new technologies, aging populations and more chronic disease. More and more treatments are possible. You have rising demands from consumers and patients to try everything. The question is � when you have universal coverage, is that sustainable?

- Victor Rodwin, professor of health policy at the Wagner School of Public Service at New York University

Just before the measure finally passed this month, Richard Horton, the editor of the prestigious British medical journal The Lancet, said, "People will die thanks to the government's decision to focus on competition, rather than quality."

Britain's health care system is funded through general taxes, and it provides free health services to residents of the United Kingdom.

As in most countries, the issue is cost. The National Health Service currently costs the U.K. more than $158 billion a year.

Ham says his group agrees that reforms are needed, but believes the process should have been "more evolutionary, not so radical."

He fears that implementing the new regulations will destabilize the system and distract health care administrators from the real goal of improving health care.

Still, Ham says, most Britons generally like their system, especially as compared with the United States.

"We often cite the fact that you have about 50 million Americans who have no insurance or are under-insured. The biggest cause of bankruptcy [in the U.S.] is health care costs, and we find that very shocking," Ham says.

France Experienced Bitter Fight

France consistently rates among the best health care systems in the world, and yet it, too, underwent a bitter fight when it adopted revisions in 2009.

The French system is financed by income and payroll taxes, and health insurance is compulsory.

The national insurance plan covers about 70 percent of health care costs, and most people use private insurance, obtained through their jobs, to pay the rest.

Residents of France can choose any doctor or specialist they wish.

As in Britain, the French changes were driven by rising costs.

"All health systems face the same challenges," say Victor Rodwin, an expert on the French system and a professor of health policy at the Wagner School of Public Service at New York University. "You have new technologies, aging populations and more chronic disease. More and more treatments are possible. You have rising demands from consumers and patients to try everything. The question is � when you have universal coverage, is that sustainable?"

Despite the passions that were ignited when the French reforms were first passed, he points out that health issues haven't been a factor in France's current presidential campaign.

He says most people in France perceive their coverage as better than both the British and American systems.

"They don't like the British system because they believe it involves waiting in queues for health care," Rodwin says. "And when they look at the U.S., they don't like the idea of 16 percent of the population not being covered. They think that's socially irresponsible."

Germany Has Had Multiple Changes

In Germany, Chancellor Angela Merkel's center-right coalition faced a slump in popularity during the fight that ended with the passage of health care changes in November 2010.

We often cite the fact that you have about 50 million Americans who have no insurance or are under-insured. The biggest cause of bankruptcy [in the U.S.] is health care costs, and we find that very shocking.

- Chris Ham of The King's Fund, a health policy think tank in London

"Health care is an area where no country seems to think they have it right," says Arthur Daemmrich, a professor at the Harvard Business School. He points out that Germany has had a series of major health care revisions in the past decade.

Daemmrich says some reforms in various countries may be converging toward shared solutions. "More and more countries are putting rules on pharmaceutical pricing," he says.

"The second area of convergence is to set up formal bodies like [Britain's] National Institute for Health and Clinical Excellence, or NICE, to set policies for reimbursement," Daemmrich adds.

"In Britain, for example, a new bio-tech drug that extends a person's life on average one or two months, but costs $25,000, would not be reimbursed," he says, adding that Germany put a similar measure in place.

Mark McClellan, a former commissioner at the U.S. Food and Drug Administration, says, "The British system and ours are moving in the direction of being focused on the results patients get, and not just on the costs."

We're starting from very different points, but moving toward systems that will give physicians more flexibility, but also make them more accountable for costs," says McClellan, who now heads the Engelberg Center for Health Care Reform at the Brookings Institution.

New program for diabetes patients puts text messaging to work

WASHINGTON – Chartered Health Plan, the oldest Medicaid managed care organization in the District of Columbia, is launching a new text messaging program for 50 of its members to help them better manage diabetes, which requires regular care to avoid costly complications.

The program enables participants to receive brief tips about living with diabetes, as part of a case management program that also includes face-to-face support.

[See also: Diabetes texting program gets a boost]

Research shows that people who actively participate in their care can more effectively manage chronic diseases such as diabetes. In many cases, however, particularly in the neighborhoods Chartered serves, people with diabetes find it difficult to understand and manage the disease, Chartered executives say.
 
"Mobile health is the wave of the future for improved management of chronic disease," said Richard Katz, MD, director of the division of cardiology at the George Washington University Hospital, which previously partnered with Chartered Health Plan on a similar program. "It can be extremely popular with diabetes patients and result in reduced emergency room visits and hospitalizations."

Diabetes affects D.C. residents at substantially higher rates than in other areas of the country. In 2010, 10.9 percent of D.C. adults received a diabetes diagnosis, compared with 8.7 percent nationwide, and death rates associated with the disease are also disproportionately higher. Poorly managed diabetes can lead to complications such as blindness and foot problems, often leading to costly emergency room visits that could be avoided.

"This program connects our diabetic members to the real-time support they need," said Karen Dale, an executive at Chartered Health Plan. "Through this and other innovations, we're opening doors to good health for those who need it most in our community."

[See also: HHS Text4Health, mHealth initiatives focus on smoking cessation]

Bridging the gap
For years, Chartered has sought to keep members with diabetes engaged in their care through regular telephone calls and mailings, as well as face-to-face interaction with members. By adding a text-messaging element, Chartered executives say, the plan is expanding the impact of this effort and enabling members to play a more active role in the management of their disease.

The program encourages members to avoid unnecessary emergency room visits and instead to schedule annual appointments with their primary care providers as well as get annual eye and foot exams. It also helps people take their diabetes medicines appropriately and make lifestyle changes to better support their health.

Participants receive tips and messages on various topics, including when to contact a doctor, nutrition tips and diabetes-related information. The text messages also include interactive quizzes and announce community events to keep participants involved.

Future plans
The program will be evaluated later this year with an eye toward potential expansion. It is part of Chartered's commitment to transform healthcare in the District, officials say. Building on its secure cell phone technology platform, Chartered ultimately hopes to create support groups for various diseases and send other disease-specific messages and personalized messages, such as appointment reminders, to its members.

"Our goal is to leverage mobile technologies and smart networks to improve the well-being of our community," said Dale. "We've been committed to improving the quality of care, reducing costs and creating a healthier community for the past 25 years, and will continue to take advantage of new opportunities to solve Washington's most critical health and social challenges."

4 tips for start-up health IT companies

Start-up health IT companies have made quite a splash this past year – with some even claiming they have the ability to change the healthcare industry as we know it. Programs have been launched to help fledgling companies grow, and now the focus has shifted onto how these organizations can increase innovation and improve health and wellness. 

Lisa Suennen, managing member at venture capital firm Psilos Group and author of the blog Venture Valkyrie, outlines four basic tips for start-up health IT companies.

1.Have a business model. It sounds basic, said Suennen, but you'd be surprised how many companies fail to complete this step. "I have so many companies [who don't do that], it blows my mind," she said. "I ask how they're going to get paid, and they go, 'We're going to figure that out after the pilot.' Our reaction is 'No, that's not so good.'" She added when creating a business model, it's essential to identify who the customer is, "because you can't build a proper product without knowing your customer, and the customer is who pays you." On her blog, Suennen writes that many companies will find themselves revising their business model – something that's completely normal during their early years. "Truth of the matter is that the average start-up company typically goes through more than one attempt at the brass ring," she wrote. "Early business models often fail and entrepreneurs go back to the drawing board and reinvent their original vision."

[See also: StartUp Health Initiative launched to spur innovation.]

2.Don't depend on the consumer for your revenue. According to Suennen, during the early years of a company, the consumer shouldn't be depended on for significant revenue. "It's not yet time to depend on the consumer for your revenue model," she said. "They're just not ready, and they won't deliver the revenue to you yet. Consumer-directed health IT products are struggling and people aren't ready to pay."

3.Recognize a start-up's role in job creation. On her blog, Suennen writes that start-up companies are playing a critical role in job creation. In fact, she wrote, firms less than five years old have created about 40 million American jobs over the past three decades, accounting for almost all of the net new jobs during that period. "That's a pretty stunning fact," she wrote. "In a world where there is no way out of the healthcare crisis except through the generation of new ideas to solve our healthcare problems, young companies are the golden ticket to new employment."

[See also: Start-up to help healthcare sector leverage social media.]

4. Know the path to success isn't always straight and narrow. "To be honest, I haven't yet seen a company that had a straight, upward and to the right pointing line from start to finish," Suennen wrote. Instead, based on her experiences, Suennen said most companies leaving her firm have seen rather unconventional paths to success. "The line looks more like the path taken by a blindfolded cat chasing after a highly uncoordinated mouse – the roundabout, back and forth and a little bit spastic," she wrote. "Start-up companies are a little bit like that story about the six blind guys and the elephant: you get a different story about it, depending on when you touch it." She concluded by pointing almost all successful start-ups have seen their fair share of trying times. "I don't think I could point to a single example of a company that we count among our success and claim that it didn't try to commit suicide at least once along the way."

Follow Michelle McNickle on Twitter, @Michelle_writes

Vanessa-Care: Health Coverage Without Lifetime Limits

Vanessa Mishkit, a nurse in Tampa, knows firsthand what it�s like to go up against insurance companies on behalf of her child.

Her son was born with birth defects: developmentally delayed, legally blind, and near deaf. And even though Vanessa had health insurance through work at Tampa General Hospital, she was constantly fighting for her son�s coverage: He was born with a pre-existing condition.

YouTube embedded video: http://www.youtube-nocookie.com/embed/qUuvkixlbQY

�I had what I thought was excellent health insurance, and then after David was born we received notification that he had met his million-dollar limit and he wouldn�t be eligible for coverage,� Vanessa says.�

�There are thousands and thousands of families� who are in similar situations, she says. �They can�t advocate for themselves at this time because they�re caught up in day-to-day survival.� Vanessa points out that the Affordable Care Act now prevents insurance companies from denying coverage to children with pre-existing conditions. �We fought a huge battle and now with health care reform� other families won�t have to fight just to keep their keep their children well, she says.

In 2014, insurance companies will be barred from discriminating against anyone with pre-existing conditions. Additionally, the health reform law bars low annual and lifetime caps on claims, a way that insurance companies have used to avoid paying claims.

David �has a heart of gold and now I�m looking at him and he�s 23 years old. He is learning how to take as well care of himself as he possibly can within his limitations. I�m very proud of him,� Vanessa says.

The Affordable Care Act is designed to give hard working families the peace of mind they deserve in meeting their health care needs.

See all MyCare stories ?

Fridsma highlights doubling of digital docs

BALTIMORE – The number of physicians using electronic health records has doubled over the past two years, Doug Fridsma, MD, told an audience at AHIMA's ICD-10 Summit Monday.

“We are making real progress on EHR adoption and we are developing a workforce that is beginning to be trained to support this progress,” said Fridsma, director of the Office of Standards and Interoperability, part of the Office of the National Coordinator for Health Information Technology (ONC).
 
The number of primary care physicians using EHRs has doubled from 20 percent to 40 percent in two years, according to ONC statistics. Also since 2009, the number of hospitals adopting the technology has more than doubled from 16 percent to 35 percent, Fridsma said. More than 50 percent of doctors are indicating they intend to take advantage of EHRs to get meaningful use incentives.
 
At the same time, ONC is working with a community of stakeholders to create a portfolio of standards and specifications to address different needs and challenges through the Standards & Interoperability Framework, Fridsma said.
 
As he sees it, developing the foundation of interoperable health information exchange will be an “evolving journey.”

[See also: The 7 Deadly Sins of EMR implementation]

“We have to take an incremental approach and ask ourselves as each piece is developed: ‘Is this solution the best we have so far? Is it the logical next step in an incremental approach?’ Fridsma said, "and not let the perfect be the enemy of the good. When it comes to interoperability, one size will not fit all.”
 
Still, benefits are already becoming apparent. Fridsma pointed to the providers participating in the Nationwide Health Information Network Exchange, a group of federal agencies and private sector organizations that have implemented the portfolio of standards, service and policies that allow information to be exchanged securely over the Internet, are achieving measurable success. 

For example, the Social Security Administration is able to process disability claims 45 percent faster when querying for and receiving medical records through the exchange. Developing ways to exchange information electronically is critical, because as of now, even with EHR use, most doctors and health systems still rely on printers and faxes to exchange patient health information.
 
Fridsma thanked AHIMA for its leadership and support of global standards development efforts in creating standards for the international community.
 
“AHIMA is leading the way both in the U.S. and internationally as standards are developed to make health information exchange possible,” said AHIMA CEO Lynne Thomas Gordon. “Our members are on the forefront of implementing these changes that will lead to better health information and ultimately better patient care.”

'Seclusion rooms' for autistic students raise questions

Andrew St. Vincent's parents pose questions around the coffee table as the middle-schooler with autism builds a Lego city.

They want to know about the room.

"So you were in there by yourself?" his mother asks.

"When would you be in that room?" his father wants to know.

Michael and Elizabeth St. Vincent have never seen the room. Andrew told them about it months after they took him out of the Williamson County School District. He went into the room when he threw tantrums, he said.

Teachers put special-education students in "seclusion rooms" when the students exhibit aggression and let them go to "calming rooms" to pre-empt that behavior. The St. Vincents say their son spent too much time isolated in those rooms when he was supposed to have been mainstreamed with other fifth-graders at Scales Elementary School.

Critics call the seclusion spaces "scream rooms." Autism advocacy organizations are pushing for national legislation to outlaw them or restrict their use.

Tennessee already has set rules for how students can be restrained and isolated. Last year, the state mandated that seclusion rooms had to be at least 40 square feet. The Williamson County School District goes beyond the minimum, requiring theirs to be 100 square feet.

"I believe that this district tries to do what's right for students," said Carol Hendlmyer, director of student support services for Williamson County, stressing that teachers seek to follow federal and state guidelines for special-education students and work with their parents to set up individual education plans.

She could not discuss the St. Vincents' complaints, citing school district privacy policies. Federal law does require that parents of special-needs children be informed about behavior modification plans, she said.

Last autumn, the St. Vincents took their son out of the school district after he did poorly on his Tennessee Comprehensive Assessment Program test even though he had been making A's and B's in the sixth grade at Brentwood Middle School.

Andrew, who is almost 13 and now attends a private Christian school, told his mother about going to the room when she was talking about a national news report earlier this year on "scream rooms" in Connecticut.

"I would cry because I was being put in a room and I couldn't even have my voice heard," he said.

Holly Lu Conant Rees, who chairs the Disability Coalition in Education for Tennessee, said her organization and others pushed for a state law to set restraint and isolation rules. The legislature passed the initial law in 2009 and revised it last year.

"It is now crystal clear that restraints and isolation are to be used only in emergency situations, regardless of whether or not it is written into a child's individualized education program," Conant Rees said.

"And we tightened up the definition of 'emergency situation.' Previously, it had pretty subjective language about there being a risk of violence, which I sometimes called the 'fixin'-to' clause."

Calming rooms also used

The state law forbids the rooms from being locked. It also does not allow mechanical or chemical restraints. Specially trained educators are allowed to physically restrain a student to keep him or her or fellow students from harm.A seclusion room may or may not be padded because that depends upon the needs of a student, Hendlmyer said. The law requires that visual contact with the student be maintained.

"I will tell you not every school has one," she said. "But when you need one in a school, you need one. Sometimes, the school creates a space that they've confiscated. They have checked all the books out and converted it into this room for a specific need. When that need goes away, they convert it back into a storage room again or an office."

She stressed that very few students ever end up in a seclusion room.

The other separate space provided for special-needs students is a calming room."A calming room is used for a very specific purpose," Hendlmyer said. "It is used in general to prevent a child from being overstimulated or overly aggravated about something so that we try to prevent a serious behavior with a calming room."

Elizabeth St. Vincent saw her son's separation when she brought cupcakes to the school on his birthday and he had no classmates with whom to share them. Instead of the classroom, she found him in a smaller, partitioned space with a couple of desks. She thought this was the resource room where he was supposed to go for one-on-one attention for specified subjects. He was playing with a puzzle on the floor.

"Tell you what," she said to her son. "Why don't we go over to the lunchroom with everyone else and you can share cupcakes?"

Once all the cupcakes were gone, Andrew went back to his puzzle.

Like The U.S., Europe Wrestles With Health Care

Enlarge Anne-Chrisine Poujoulat/AFP/Getty Images

A patient is treated at the Nord Hospital in Marseille, France, in February. European countries have also been engaged in intense debates on the future of their health care systems, where universal coverage is the norm.

Anne-Chrisine Poujoulat/AFP/Getty Images

A patient is treated at the Nord Hospital in Marseille, France, in February. European countries have also been engaged in intense debates on the future of their health care systems, where universal coverage is the norm.

The U.S. has been absorbed by the Supreme Court case this week on the future of health care. But Americans are not alone.

Several European nations, where universal health care has been the norm for decades, have been waging their own intense debates as they also deal with aging populations and rising costs.

Britain passed a new health care measure earlier this month, after more than a year of rancorous debate. Can the European experience cast some light on the American debate over health care?

"There are some common problems," says British analyst Chris Ham, "but we're coming to this debate from very different starting points. In the States, it's about how to extend coverage to more people, whereas [in Britain], it's about how to get more bang for the buck out of our current system."

 

Ham is the chief executive of The King's Fund, an independent health policy think tank in London.

The British Debate

Britain's debate is still going on, with critics charging that the Conservative-led government is trying to privatize the more than 60-year-old system in an effort to cut the nation's budget deficit.

The government says the reforms will trim a bloated health care bureaucracy and give doctors more control over health care management.

All health systems face the same challenges. You have new technologies, aging populations and more chronic disease. More and more treatments are possible. You have rising demands from consumers and patients to try everything. The question is � when you have universal coverage, is that sustainable?

- Victor Rodwin, professor of health policy at the Wagner School of Public Service at New York University

Just before the measure finally passed this month, Richard Horton, the editor of the prestigious British medical journal The Lancet, said, "People will die thanks to the government's decision to focus on competition, rather than quality."

Britain's health care system is funded through general taxes, and it provides free health services to residents of the United Kingdom.

As in most countries, the issue is cost. The National Health Service currently costs the U.K. more than $158 billion a year.

Ham says his group agrees that reforms are needed, but believes the process should have been "more evolutionary, not so radical."

He fears that implementing the new regulations will destabilize the system and distract health care administrators from the real goal of improving health care.

Still, Ham says, most Britons generally like their system, especially as compared with the United States.

"We often cite the fact that you have about 50 million Americans who have no insurance or are under-insured. The biggest cause of bankruptcy [in the U.S.] is health care costs, and we find that very shocking," Ham says.

France Experienced Bitter Fight

France consistently rates among the best health care systems in the world, and yet it, too, underwent a bitter fight when it adopted revisions in 2009.

The French system is financed by income and payroll taxes, and health insurance is compulsory.

The national insurance plan covers about 70 percent of health care costs, and most people use private insurance, obtained through their jobs, to pay the rest.

Residents of France can choose any doctor or specialist they wish.

As in Britain, the French changes were driven by rising costs.

"All health systems face the same challenges," say Victor Rodwin, an expert on the French system and a professor of health policy at the Wagner School of Public Service at New York University. "You have new technologies, aging populations and more chronic disease. More and more treatments are possible. You have rising demands from consumers and patients to try everything. The question is � when you have universal coverage, is that sustainable?"

Despite the passions that were ignited when the French reforms were first passed, he points out that health issues haven't been a factor in France's current presidential campaign.

He says most people in France perceive their coverage as better than both the British and American systems.

"They don't like the British system because they believe it involves waiting in queues for health care," Rodwin says. "And when they look at the U.S., they don't like the idea of 16 percent of the population not being covered. They think that's socially irresponsible."

Germany Has Had Multiple Changes

In Germany, Chancellor Angela Merkel's center-right coalition faced a slump in popularity during the fight that ended with the passage of health care changes in November 2010.

We often cite the fact that you have about 50 million Americans who have no insurance or are under-insured. The biggest cause of bankruptcy [in the U.S.] is health care costs, and we find that very shocking.

- Chris Ham of The King's Fund, a health policy think tank in London

"Health care is an area where no country seems to think they have it right," says Arthur Daemmrich, a professor at the Harvard Business School. He points out that Germany has had a series of major health care revisions in the past decade.

Daemmrich says some reforms in various countries may be converging toward shared solutions. "More and more countries are putting rules on pharmaceutical pricing," he says.

"The second area of convergence is to set up formal bodies like [Britain's] National Institute for Health and Clinical Excellence, or NICE, to set policies for reimbursement," Daemmrich adds.

"In Britain, for example, a new bio-tech drug that extends a person's life on average one or two months, but costs $25,000, would not be reimbursed," he says, adding that Germany put a similar measure in place.

Mark McClellan, a former commissioner at the U.S. Food and Drug Administration, says, "The British system and ours are moving in the direction of being focused on the results patients get, and not just on the costs."

We're starting from very different points, but moving toward systems that will give physicians more flexibility, but also make them more accountable for costs," says McClellan, who now heads the Engelberg Center for Health Care Reform at the Brookings Institution.

What the Health Law Means for the Latino Community

Across the country, more than 50 million Latinos are part of our communities, classrooms and workplaces. And thanks to the health care law, the Affordable Care Act, an estimated 5.4 million Latinos will gain insurance coverage by 2016 under the new law, according to an issue brief released by HHS today (go here to read it in Spanish). Just two years after it was passed, the health care law has already improved health outcomes and increased access to care for Latinos by:

Extending coverage to an estimated 736,000 Latino young adults under a provision that allows them to stay on their parents� health insurance until they turn 26,Expanding access to preventive services with no-cost sharing to an estimated 6.1 million Latino Americans with private insurance, andRequiring most health insurance plans to cover prevention and wellness services like cancer screenings, flu shots , and pap smears and mammograms for women, with no cost-sharing.

While 16.3 percent of Americans are currently uninsured, the percentage of Latinos without health insurance is even higher at 30.7 percent. As the law continues to be implemented:

Latinos of all income levels who would otherwise be uninsured will have access to health insurance through new Affordable Insurance Exchanges and as a result of expanded Medicaid coverage,Latino Americans suffering from a chronic disease�like the estimated 4.3 million Latino adults who are currently living with diabetes�will have access to new care innovations, like community health teams, that will help them manage their illness, andLatinos living in medically underserved areas will have access to new community health centers and preventive and primary care services.

To learn more about the impact of the Affordable Care Act on the health of the Latino community, join our Spanish-language Twitter chat today, April 10. You can join in the conversation starting at 2pm EST by following the #LaSaludLatina hashtag and at @HHSLatino.

You can read the issue brief in English here, and in Spanish here, For the fact sheet, visit this page.

FDA: Gulf seafood safe despite oil spill concerns

WASHINGTON�Photos of fish with sores may raise concern about long-term environmental effects of the massive BP oil spill � but federal health officials say the Gulf seafood that's on the market is safe to eat.

After all, diseased fish aren't allowed to be sold, said Dr. Robert W. Dickey, who heads the Food and Drug Administration's Gulf Coast Seafood Laboratory.

"It's important to emphasize that we're talking about a low percentage of fish," Dickey stressed. "It doesn't represent a seafood safety hazard."

Two years after the oil spill, scientists cite lesions and other deformities in some Gulf fish as a sign of lingering environmental damage. They can't say for sure what's causing the fish ailments or if there really are more sick fish today than in the past.

As marine biologists study the threats to the fish, here are some questions and answers about the safety of seafood:

Q: What keeps sick fish off the market?

A: Every wholesaler and seafood processor must follow longstanding FDA rules on what constitutes a safe and usable catch. Fish with lesions or signs of parasites or other disease aren't allowed, Dickey said.

Q: What about oil contamination that's not visible?

A: Federal and state laboratories tested more than 10,000 fish, shrimp and other animals for traces of certain chemicals in oil to be sure they were far below levels that could make anyone sick before commercial fishing ever was allowed to resume. Gulf Coast states are continuing that testing today as a precaution. Some species clear oil contaminants from their bodies more rapidly than others, the reason that fishing resumed before the oyster harvest. The FDA says that someone could eat 9 pounds of fish or 5 pounds of oyster meat a day for five years and still not reach the levels of concern for a key set of chemicals.

Q: But what about the oil compounds that scientists have reported finding in the bile of some fish?

A: Bile shows what a fish recently ate, but the fish's digestive system goes on to process and eliminate contaminants so they don't build up in edible tissue, Dickey said.

Q: Are there other reasons to pay attention to seafood safety?

A: Definitely. A California company recently recalled some yellowfin tuna used to make sushi because it was linked to an outbreak of salmonella food poisoning. And every year, health officials warn people with certain health conditions to avoid eating raw oysters � they may be contaminated with the Vibrio vulnificus bacteria that typically is found in warm coastal waters between April and October.

Annie-Care: Providing Preventive Services to Patients in Community Health Centers

Annie Neasman, a nurse and chief executive of the Jessie Trice Community Health Center in Miami, FL., recently shared with us her thoughts as she walks the hallways of the community health center and sees the people who are cared for there. Jessie Trice serves more than 30,000 people, who made more than 120,000 visits to the center last year. From pre-natal care to primary care for adults to special services for the elderly, the Jessie Trice Center provides care regardless of a person�s ability to pay.

Annie is proud of the health center�s efforts in keeping the residents of the community well. She says the Affordable Care Act, the health care reform law, has made it possible for so many more of them to get the preventive care they need to maintain their health and avoid worsening conditions.

�We have seen our Medicare population be able to go in and get preventive services without having to pay those co-payments and those deductibles,� she says. The Affordable Care Act �has impacted the lives of those individuals who now don�t have to wait because they don�t have the co-payment to get a mammogram � [or] those individuals who wait and say, �I�m not gonna go get that flu shot because it�s gonna cost me $20 up front.� And these have been real life stories � at the Jesse Trice Community Health Center.�

�The Affordable Care Act,� Annie says, �allows us to make sure that patients are treated early by being able to get preventive services and by treating patients early in a primary care setting and not going to the emergency room. In the long run that�s going to help all communities because the economic impact will be less.�

The community center is partly funded by grants in the Affordable Care Act.

Do you have a story like Annie�s? Share it at www.HealthCare.gov/MyCare.

Salmonella outbreak that sickened 90 people probed by FDA

WASHINGTON(AP)�Federal health officials are investigating an outbreak of salmonella that has sickened 90 people in 19 states and the District of Columbia, according to a Food and Drug Administration memo.

The outbreak may be linked to sushi and has caused at least seven hospitalizations, according to the memo distributed internally to FDA staff. No deaths have been reported to date.

Investigators are focusing on six clusters of restaurants in Texas, Wisconsin, Maryland, Rhode Island and Connecticut.

FDA spokesman Curtis Allen would not confirm or elaborate on the information, saying the memo "contains numbers of cases and hospitalizations that cannot be confirmed at this time."

Allen said the illness is linked to salmonella Bareilly, a bacteria strain previously associated with outbreaks in bean sprouts.

Tax Aid For Hearing Aids? Maybe

Marek Brzezinski/iStockphoto.com

Traditional Medicare doesn't pay for hearing aids, so some in Congress would like to give purchasers a tax break.

Hearing loss is all too common.

Some 35 million people have trouble hearing. After high blood pressure and arthritis, it's third on the list of chronic health issues for seniors.

Yet traditional Medicare coverage doesn't include the cost of hearing aids, and most private health plans follow suit. That leaves it to many people to scrape up the money on their own.

That's no small task, since hearing aids can cost a few thousand dollars and generally have to be replaced every four to six years.

Legislators in both houses of Congress over the past decade have repeatedly proposed a tax credit that could provide at least a modicum of financial help.

 

Bipartisan bills are pending again in both the House and Senate, but they're not moving ahead anytime soon. "We continue to gain support of the bill, but there has been no legislative activity," says Ingrida Lusis, director of federal and political advocacy at the American Speech-Language-Hearing Association. Both bills have been referred to committee, but no action has been taken.

The House bill would provide a tax credit of up to $500 per hearing aid every five years to people age 55 or older or to families who bought one for a dependent. People with incomes over $200,000 would be ineligible for the tax credit. It has been estimated to cost about $300 million.

The Senate bill provides for a similar tax credit but with no restriction on age or income.

One hearing aid user, Kathy Borzell, 62, of Sapphire, N.C., estimates she's spent $25,000 out of pocket over the past 20 years buying hearing aids for both ears.

Although $500 may only be a fraction of the cost most people spend on hearing aids, advocates say it would let policymakers send a message to those needing hearing aids that "We hear you."

VA to eliminate co-pays for telehealth consultations

WASHINGTON – The Department of Veterans’ Affairs has long been an advocate of using telehealth to reach veterans in their homes. Now it is working to make adoption easier and more appealing by  fast-tracking a proposal to eliminate patient co-pays for in-home video telehealth consultations in its Home-Based Primary Care (HBPC) program.

The VA had published a proposed rule in March to eliminate the co-pays, then added a direct final rule that would expedite the process if the proposed rule received no “significant” opposition. With the comment period ending on April 5, the rule could go into effect as early as May 7.

The HBPC program was created in 1972 to serve veterans with chronic conditions, focusing on a home-based approach to providing healthcare. According to a presentation at the 2011 National Health Policy Forum, the program has reduced hospital days by 62 percent and long-term-care days by 88 percent, thus reducing total healthcare costs by roughly 24 percent.

“Telehealth allows VA to provide certain medical care without requiring the veteran to be physically present with the examining or treating medical professional,” the direct final rule states. “Telehealth helps ensure that veterans are able to get their care in a timely and convenient manner by reducing burdens on the patient as well as appropriately reducing the utilization of VA resources without sacrificing the quality of care provided. The benefits of using this technology include increased access to specialist consultations, improved access to primary and ambulatory care, reduced waiting times and decreased veteran travel.

“Like clinical video telehealth, in-home video telehealth care is used to connect a veteran to a VA healthcare professional using real-time videoconferencing, and other equipment as necessary, as a means to replicate aspects of face-to-face assessment and care delivery that do not require the healthcare professional to make an examination requiring physical contact,” the rule continues. “However, in-home video telehealth care is provided in a veteran's home, eliminating the need for the veteran to travel to a clinical setting. Using telehealth capabilities, a VA clinician can assess elements of a patient's care, such as wound management, psychiatric or psychotherapeutic care, exercise plans and medication management. The clinician may also monitor patient self-care by reviewing vital signs and evaluating the patient's appearance on video.”

The Partnership for Quality Home Healthcare has come out in support of the action, saying it “would remove a barrier that may have previously discouraged veterans from choosing to use in-home video telehealth as a viable medical care option.”

“We applaud the VA for recognizing that co-payments can shift patients to more costly settings and increase healthcare costs,” said Billy Tauzin, chairman and senior counsel to the organization, in an April 5 press release. “By eliminating this counterproductive barrier, the VA is making it possible for more veterans to receive clinically advanced, cost-effective care in their own homes.”

In its ruling, the VA indicated it would not exempt co-pays for clinical video telehealth services, usually undertaken at community-based outpatient clinics, because they involve medical specialists, staff and technology outside the clinic, and because patient interaction plays an important part in these encounters.

The VA has seen a direct ROI in its telehealth program. According to officials, the Northwest Health Network, also known as the Veterans Integrated Service Network 20, which serves Alaska, Washington, Oregon, most of Idaho and a small part of Montana and California, saved roughly $742,000 in 2011 through the use of telehealth in more than 23,000 patient encounters, while one provider, the VA Roseburg Healthcare System in Oregon, saved more than $88,000 in travel costs by shifting more than 3,200 patient encounters to telehealth from in-person visits.

In addition, last November, the agency contracted with Boston-based telehealth provider American Well to make the company’s Online Care system more accessible to veterans. The contract, awarded after American Well earned the top prize in the VA Innovation Initiative (VAi2) industry innovation competition, allowed the company to establish three online practices to help veterans – a behavioral health practice in Minnesota and an oncology practice and perioperative practice in Nebraska and western Iowa.

Seniors are Saving Money Today and Tomorrow, Thanks to Health Care Law

Like thousands of Americans, Vero Beach, Florida resident William Morris is suffering from a rare, but treatable cancer. Compounding that difficult diagnosis is further bad news that, like many cancer drugs, the medicine he so desperately needs is very expensive.
�
But help with this cost came for William and his wife Suzanne from newly enhanced benefits under Medicare Part D � made possible by the health care reform law, the Affordable Care Act.� Thanks to the law, William saved $2,000 on the cost of his chemotherapy drugs.

Suzanne and William Morris are not alone. For years, seniors have watched their health care bills go up. The Affordable Care Act helps folks like the Morris family, and other seniors, by closing the gap in prescription drug benefits known as the �donut hole.��To assist those in the coverage gap, the law adds increased help for seniors and people with disabilities over time until the donut hole closes in 2020.� �William and Suzanne benefited from that help when they received big discounts on the medicine they needed.� People in the coverage gap also receive a 50% discount on expensive brand-name drugs covered by Part D and a 7% discount on generic medicines.

Today, we announced that in 2011 about 3.6 million people with Medicare benefited from donut hole discounts�saving a total of $2.1 billion, or an average of $604 per person.
�
And a new report released today finds that these discounts and other parts of the Affordable Care Act will lead to even bigger savings in the years ahead. According to the report, the average person with Medicare will save approximately $4,200 from 2011 to 2021, while those with high prescription drug costs will save much more � as much as $16,000 over the same period.� This is especially good news for people with chronic conditions such a diabetes and high blood pressure who must take their medication every day for many years.

For older Americans and people on disabilities who live on fixed incomes the value of this help cannot be overstated. Evidence indicates that as many as 25 percent of people with Medicare Part D stop taking their medicine when they are in the coverage gap. Thanks to the Affordable Care Act, they won�t have to.
�
For people like William who are fighting life-threatening or debilitating diseases, this benefit can help them heal, improve the quality of their lives and prevent the sometimes devastating results of leaving chronic conditions untreated.

World's oldest practicing doctor Leila Denmark dies at 114

ATLANTA�Dr. Leila Denmark, the world's oldest practicing physician when she retired at age 103, died Sunday in Athens, her family members said. She was 114.

Denmark became the first resident physician at Henrietta Egleston Hospital for Children in Atlanta when it opened in 1928, said her grandson, Steven Hutcherson of Atlanta. She also admitted the first patient at the hospital, now part of Children's Healthcare of Atlanta.

She loved helping children, and it showed in the way she would turn to the next family waiting to see her, Hutcherson said.

"She would say, 'Who is the next little angel?," he said.

Denmark began her pediatrics practice in her home in Atlanta in 1931 and continued until her retirement in 2001. That year, she earned the distinction of being the world's oldest practicing physician, said Robert Young, senior consultant for gerontology for Guinness World Records. She was also the world's fourth-oldest living person when she died, Young said.

Throughout her career, she always kept her office in or near her home, where children and their parents would show up at all hours in need of care, family members said.

"The kids would come in and she would spend as much time as she needed with the parents to help fix that baby or that child," Hutcherson said. "What she would do is figure out how to help them stay well."

Helping children get well and stay well was challenging in Atlanta's soot-stained air that darkened the sky during the Depression era, relatives said.

She treated some of Atlanta's poorest children as a volunteer at the Central Presbyterian Baby Clinic near the state capitol in Atlanta, said her daughter, Mary Hutcherson of Athens. Mill workers and other poor people who had no other way to get medical care would bring their sick children to the clinic.

Denmark loved her volunteer work at the clinic, just as she loved seeing patients in her home, her daughter said.

That enduring love of her work was a key to her long life, along with eating right, family members said.

"She absolutely loved practicing medicine more than anything else in the world," said another grandson, Dr. James Hutcherson of Evergreen, Colo. "She never referred to practicing medicine as work."

Denmark also received several honors during her career, including the Fisher Award in 1935 for outstanding research in diagnosis, treatment, and immunization of whooping cough.

She received alumni awards from Tift College, Mercer University, Georgia Southern and the Medical College of Georgia; and honorary degrees from Tift, Mercer and Emory University.

Denmark's funeral is planned for 1 p.m. Thursday at First United Methodist Church in Athens.

"Everything about her was always trying to make a difference, first and foremost," Steven Hutcherson said.

Advisory panel cautious about federal HIE proposals

WASHINGTON – The Health IT Policy Committee has concerns over some of the health information exchange requirements contained in the meaningful use Stage 2 proposed rule.

At the committee’s April 4 meeting, the group hashed out some of the HIE requirements as part of their preparations for providing recommendations  to the Office of the National Coordinator for Health Information Technology by May 7.

The proposed regulation, released Feb. 24, calls for prescriptions and lab results to be shared electronically. It also calls for electronic communication among providers across care settings.

It is important to make the requirements clear and balanced so providers will have a better chance at accomplishing them, according to Micky Tripathi, chair of the committee’s information exchange panel at the April 4 meeting. He is also president and CEO of the Massachusetts eHealth Collaborative.

Health information exchange is a critical aspect of this next stage of meaningful use to start using data to coordinate care and improve patient outcomes.

Among the differences with the meaningful use proposed rule, the committee wants to restore its recommended requirement for hospitals to send structured lab data, Tripathi said. The Centers for Medicare and Medicaid Services did not follow that recommendation in its proposed rule released in February.

CMS noted that this might be a burden on hospitals, but Tripathi said in his conversations, many hospitals do not see this as a burden, and some might find it beneficial to have a standard rather than a lot of optionality that exists today both within the organization and in dealing with EHR vendors.

“We’re requiring that EHRs be certified to receive according to a set of standards. We’re also requiring that clinicians have a certain amount of their labs be structured labs. But we’re not requiring that the last piece of puzzle that is responsible for a large fraction of the results delivery meet that standard,” he said.

Hospitals sending lab information in standardized data format directly affects the ability of physicians to achieve their structured lab result requirement and will also affect clinical quality measure capabilities, Tripathi said.

The panel also recommended removing a cross-vendor requirement that 10 percent of electronic exchange of transition care summaries be transmitted to organizations that they are not affiliated with and that are on a different vendor platform.

While the panel agreed with the first part, it did not agree with cross-vendor exchange requirement. In many markets, there is often a single vendor that has high penetration.

“What we want to do is create an incentive for vendors to incorporate the national standards deeply into their products,” he said.

The cross-vendor exchange requirement instead provides an incentive to artificially create a two tier system by deeply integrating proprietary technology with the EHR product but then do this other tier with lower integration for the national standard.

Farzad Mostashari, the national health IT coordinator, said that the rationale for the cross-vendor requirement was to avoid a “walled garden” scenario where providers could meet the exchange requirement within their own vendor’s context yet never share data outside of it. 

“From a policy view, is there comfort that without the cross-vendor requirement we won’t end up in a situation where there is a significant number of providers not exchanging information outside of their vendor boundaries?” Mostashari asked.

Tripathi said that providers “are going to exchange with whom they need to exchange from a patient care and business perspective independent of what platform they are on. So you should create and enforce the standards for the platforms that they are on regardless of whom they are exchanging with in terms of vendors,” he added.

 

 

Vendor Notebook: NoMoreClipboard extends file formats for PHR data

NoMoreClipboard announced that its users can now download their personal health record information in five different file formats including ASCII, .pdf, CCD, CCR and PHR Extract. Officials say the move is aimed at supporting healthcare industry efforts to make consumer access to digital health data a top priority.   

EarthLink announced the launch of three new EarthLink Business IT Services packaged solutions. These packages are designed to simplify the cloud so businesses can leverage the benefits of virtualization services, say officials. The Cloud Launch Pad, the Cloud Entry Bundle, and the Secure Email Bundle enable customers to economically partner with EarthLink to complement their internal IT resources.

Lifepoint Informatics has launched CPOE Connect, an EHR plug-in solution, aimed at meeting the growing need for EHR vendors to deliver lab order entry functionality to their customers and offers. CPOE Connect allows EHR companies to offer superior lab order entry capability embedded seamlessly into any EHR or EMR product, officials say.

SRS announced that West Tennessee Bone & Joint Clinic has selected the SRS EHR for its 11 providers, 9 office locations, and surgery center. West Tennessee Bone & Joint Clinic offers comprehensive orthopaedic care and services throughout western Tennessee.

MED3OOO announced Olmsted Medical Center (OMC) in Rochester, Minn., has extended its partnership with MED3OOO through 2017. “Our physicians have embraced InteGreat EHR and value MED3OOO’s commitment to providing us with the functionality we require to meet the needs of clinicians and enhance the care we provide our patients,” said OMC’s Chief Medical Information Officer Linda Williams, MD.

The TriZetto Group announced that El Paso First Health Plans, Inc., a non-profit community healthcare organization serving 95,000 people in the El Paso, Texas, area, has used an integrated set of TriZetto’s software and services to improve efficiency and support compliance with complex federal healthcare regulations.

ProUroCare Medical announced it has received clearance from the U.S. Food & Drug Administration (FDA) for its ProUroScan prostate mechanical imaging (PMI) system. The approval paves the way for men and their families to receive high-resolution visual documentations as an aid in detecting prostate abnormalities that were previously detected by digital rectal examination (DRE), officials say.

BRIT Systems and Medic Vision Imaging Solutions jointly announced an agreement for BRIT Systems to support the U.S. installations of the SafeCT image enhancement system. SafeCT is a universal iterative image reconstruction add-on product manufactured by Medic Vision that delivers diagnostic image quality to studies acquired over a wide range of exposure parameters on any CT scanner.

dLife officially launched its Healthcare Solutions Group to work closely with health plans, providers, pharmaceutical and device manufacturers to provide engagement, behavior change, and self-management programs for people living with diabetes.
 
TigerText announced the addition of 30 new SMB healthcare enterprises in Q1 to its list of clients. Unlike traditional SMS text messaging, TigerText provides healthcare organizations with its own private and encrypted network which is HIPAA compliant and can be accessed via employees’ own smartphones, officials say. TigerText’s SMB subscribers include Albany Gastroenterology Consultants and Delaware Valley Plastic Surgery.  

MedAssets announced that Benefis Health System (Benefis), a 516-bed health system located in Great Falls, Mont., has signed an agreement to use MedAssets Spend and Clinical Resource Management Solutions to achieve cost savings across its supply chain operations. The agreement calls for Benefis to initiate use of the company’s group purchasing organization (GPO) and other cost containment services.

McKesson announced that Radiology Associates of Fox Valley (RAFV) in Neenah, Wisc., has selected McKesson Revenue Management Solutions (RMS) to help the group modernize its revenue cycle operations and navigate changes in the healthcare billing and coding environment.