Saturday, June 30, 2012

ONC targets Rx drug abuse with new data initiative

WASHINGTON – The Office of the National Coordinator for Health IT has launched a pilot program to make existing prescription drug use data available to healthcare providers and pharmacists when they treat patients during office visits and in emergency departments.

The test projects in Indiana and Ohio will measure the effectiveness of expanding and improving access to prescription drug monitoring programs (PDMPs) as part of the administration’s efforts to reduce prescription drug abuse.

The monitoring programs are statewide electronic databases, which are designed as a tool for providers to identify and intervene in cases of potential prescription drug abuse. The databases collect, monitor and analyze electronically transmitted prescribing and dispensing data submitted by pharmacies and dispensing practitioners.

The idea is that by improving real-time access to the information it will encourage providers to use the program more than it is now. So far, 49 states have legislation authorizing prescription drug monitoring programs or have active programs.

“The PDMP pilot projects will help hospital staff identify a patient’s controlled substance history at the point of care to enable better targeting of appropriate treatments and reduce the potential of an overdose or even death,” said Farzad Mostashari, MD, national coordinator for health IT. “We are not creating new systems; we are adding value to those that exist,” he added.

In Indiana, emergency department staff will be able to receive a patient’s controlled substance prescription history directly through the Regenstrief Medical Record System (RMRS), a care management system used by Wishard Health Services, a community health system in Indianapolis, and other hospitals.

The project is a collaboration of ONC, Regenstrief, Wishard, the National Association of Boards of Pharmacy, Appriss Inc., and the State of Indiana. In some states, Emergency departments are responsible for almost 25 percent of all controlled substance prescriptions.

The Ohio pilot will test having a drug risk indicator in the electronic health record (EHR) and how that affects clinical decision making. The Ohio project is a collaboration with the Springfield Center for Family Medicine, Eagle Software Corporation’s NARxCHECK, the State of Ohio, and MITRE.

The hope is that the pilots will improve real-time data sharing among providers, increase interoperability of data among states, and expand the number of people using these tools, according to Gil Kerlikowske, director of National Drug Control Policy.

The Enhancing Access to PDMPs Project stems from joint efforts of public sector and private industry experts that participated in the White House Roundtable on Health IT and Prescription Drug Abuse last year and the subsequent action plan (PDF).

The Centers for Disease Control and Prevention has said that the United States is in the midst of an epidemic of prescription drug overdose deaths, which outnumber deaths from heroin and cocaine combined.

Wednesday, June 27, 2012

American Medical Assoc.: Require obesity education for kids

CHICAGO(AP)�The American Medical Association on Wednesday put its weight behind requiring yearly instruction aimed at preventing obesity for public schoolchildren and teens.

The nation's largest physicians group agreed to support legislation that would require classes in causes, consequences and prevention of obesity for first through 12th graders. Doctors will be encouraged to volunteer their time to help with that under the new policy adopted on the final day of the AMA's annual policymaking meeting.

Another new policy adopted Wednesday says the AMA supports the idea of using revenue from taxes on sugar-sweetened sodas as one way to help pay for obesity-fighting programs. But the group stopped short of fully endorsing such taxes.

Some doctors think soda taxes would disproportionately hurt the poor and disadvantaged. Others said taxes shouldn't be used to force people to make healthful decisions they should be making on their own.

Doctors at the meeting shared sobering statistics and personal stories in urging the AMA to sharpen its focus on obesity prevention.

"I can't tell you the number of 40-pound 1-year-olds I see every day," Dr. Melissa Garretson, a Stephensville, Texas pediatrician, told the delegates before Wednesday's vote. She said requiring obesity education "is a great idea."

The measure was drafted by the AMA's Pennsylvania delegation. It cited data showing that more than 300 million people worldwide are obese and said requiring nutrition education to prevent obesity has never been proposed.

Obesity affects more than one-third of U.S. adults and almost one in five children, or more than 12 million kids. Recent evidence suggests those numbers may have stabilized, but doctors say that's small consolation when so many people are still too fat.

Excess weight is strongly linked with diabetes, heart disease and some cancers, and weight loss of just 5 percent can help improve health, the Pennsylvania doctors' measure said.

Dr. Bruce Wilder, a delegation member, said he will ask Pennsylvania legislators to introduce legislation to enact that requirement in schools.

In other action at the meeting, the AMA voted to:

�urge online social networks to adopt bans on cyber-bullying, or "electronic aggression," on their sites.

�work to reduce suicide among gay, lesbian, bisexual and transgender teens by partnering with public health and policy groups addressing the problem.

�encourage state and local drug courts as an alternative to incarceration for nonviolent criminals.

Tuesday, June 26, 2012

Greenway integrates patient data with Microsoft HealthVault

CARROLLTON, GA – With an eye toward driving patient engagement, Greenway Medical Technologies is piloting a project by which its EHR and practice management technology, PrimeSUITE, will link with Microsoft's personal health record.

Through PrimeSUITE's secure online portal, PrimePATIENT, patients can create and access a HealthVault account to gather, store and manage centralized and sharable health information.

The integration will provide patients with digital health history forms to establish the HealthVault clinical record. Following each patient visit, entire clinical summaries or chosen elements can be sent from PrimeSUITE into HealthVault through standards-based continuity-of-care document (CCD) transport. Patients can merge the discrete data with compatible medical device, home healthcare and mobile application data to create a broader or tailored clinical picture, officials say.

"Mobile, accessible and liquid data are prerequisites for today's care coordination," said Greenway President and CEO Tee Green, who noted that "it's time to recognize patients as consumers of healthcare best practices. They are demanding it, and payers are increasingly linking patient engagement and empowerment into quality reporting and data exchange criteria in meaningful use and accountable care programs. We are committed to providing these innovations, and are proud to announce this collaboration with Microsoft."

Greenway officials say the combined data is sharable with other providers regardless of which EHR system they use if HealthVault integration is also present, or through permissible PrimeSUITE data exchange directly into EHRs and health information exchanges.

"With more than three hundred live applications across the Web and mobile devices, HealthVault can be a truly transformational tool to create more informed and engaged patients, but it only works when people have access to their clinical information," said Sean Nolan, Microsoft HealthVault distinguished engineer. "Greenway has made it easy for their providers to deliver exactly that."

Monday, June 25, 2012

Many chain stores now add a toy aisle for adults

Store shelves at supermarkets, pharmacies and supercenters across the USA are making room for sex toys once reserved for adults-only eyes.

CVS, Walgreens, Kroger, Safeway, Target and Walmart are among major national chains that now include vibrators on store shelves. These devices (also known as personal massagers or vibes) have been around a long time, but their availability on the mass market is relatively new. Condom makers Trojan and Durex are among brands that have expanded product lines to include vibrators, starting with small vibrating rings. Durex launched its first handheld vibrator in 2008, Trojan in 2010.

"We're talking about the Walgreens and CVSes of the world � not the dot-coms and sex shops and things of that nature," says Durex senior brand manager Alan Cheung of the U.S. headquarters in Parsippany, N.J.

So why isn't anyone blushing?

With the erotic Fifty Shades trilogy still topping best-selling book lists and a movie (Hysteria) about the invention of the vibrator opening across the USA this week, the summer is starting out steamy. Sexperts cite a combination of factors, including marketing that targets average women. They also trace societal changes to 1998, when a Sex and the City episode broached the subject of vibrators. And in the early 2000s, Tupperware parties gave way to parties selling vibrators and sex toys.

"People are more comfortable than ever talking about vibrators and the idea of having one," says Bruce Weiss, vice president of marketing for Trojan, based in Princeton, N.J.

Even the fact that vibrators are the focus of a feature film illustrates how times have changed. Hysteria is a period comedy set in 1880s London.

"Couples are less willing to tolerate lousy sex," says sex therapist and clinical psychologist David Schnarch of Evergreen, Colo. "People have much higher expectations."

Websites that sell an array of paraphernalia designed to enhance the sexual experience include Liberator Bedroom Adventure Gear, which looks rather like a sexual Bed, Bath and Beyond. The Fifty Shades books prominently feature a sex playroom with whips, handcuffs and other sex toys, and now websites including Pure Romance and Babeland sell Fifty Shades-inspired wares.

Vibrator sales are increasing, show exclusive data provided to USA TODAY by Trojan. The research is by Nielsen, which tracks UPC-coded items scanned at food, drug and mass retailers, including vibrator rings and handheld devices. First-quarter numbers for 2012 count 318,840 vibrators (all brands) sold at retail outlets, excluding Walmart. That's $4.4 million worth of vibrators sold, up about 14% over the first quarter last year, Nielsen says.

Vibrator makers say they are responding to customer demand. About 53% of women and 45% of men have ever used a vibrator, suggests a 2008 online survey of 2,056 women and 1,047 men, ages 18-60, by the Center for Sexual Health Promotion at Indiana University in Bloomington. Funded by Trojan, it has resulted in a handful of academic papers in peer-reviewed journals, including two 2010 papers in the Journal of Sex & Marital Therapy, on vibrator use in relationships.

"Introducing a vibrator into a sexual relationship is now much more common in the U.S. and much less fraught with protecting a man's precious ego than it might have been 15 or 20 years ago," Schnarch says.

Saturday, June 23, 2012

Dartmouth Board garners $26M innovation grant

With a $26 million government Health Care Innovation Award in hand, the Dartmouth Board of Trustees will hire Patient Family Activators (PFAs), who will assume roles of patient advocate, assisting the patient with care choices and engaging them in a shared decision-making process.

The project will support and connect 15 High Value Healthcare Collaborative (HVHC) member healthcare systems throughout 16 states, and over the course of three years, will train 5,775 healthcare workers and create 48 new PFA positions.

A portion of the funding will also be used to improve patient data collection via health information technology, as William Weeks, MD, co-creator of the Dartmouth Institute for Health Policy and Clinical Practice, explained.

“Some funds will be used to both facilitate learning and deployment across the HVHC members as well as collecting data (through grant funded tablets that will be integrated into local EHRs), feeding back reports on results, and expanding current IT infrastructure to supplement current HVHC reporting abilities and better integrate such reporting into HVHC member IT systems.”

Health and Human Services (HHS) Secretary Kathleen Sebelius announced on June 15 the second round of recipients for the Health Care Innovation Awards, funded through the Affordable Care Act. The  Dartmouth Board of Trustees was among 81 groups nationwide that walked away with a win.

Three-year cost savings from the Dartmouth project are estimated to be more than $63.7 million, and Weeks explained the majority of savings would result from the overall reduction in Medicare costs of each patient.

Weeks said, “Savings are therefore derived from both improving the efficiency and reducing the costs of each episode of care and using patient shared decision making to help patients make informed decisions, decisions which – according to the literature – are more conservative and less costly than the care that their providers would recommend.”

He continued, “By engaging providers in improving the efficiency and safety of care processes, and by engaging patients in the decision-making process regarding their healthcare choices, we believe that we can reduce this variation and waste, reduce the unrestrained growth in healthcare costs, and concurrently improve patient satisfaction and health outcomes.”

The Dartmouth Board of Trustees-sponsored program was one of 107 total projects nationwide that garnered an Innovation Award out of more than 3,000 applicants nationwide.

The Centers for Medicare & Medicaid Services (CMS) created the Center for Medicare & Medicaid Innovation to improve the health of Medicaid, Medicare and CHIP patients - and by extension all Americans - while combating escalating costs. The $1 Billion Health Care Innovation - carries a triple aim: better health, better healthcare and reduced costs. The Innovation Challenge provides three-year grants of $1 million to $30 million to healthcare providers, payers, local government entities, and public-private partnerships, including collaborative efforts among multiple payers.
 

Thursday, June 21, 2012

BancTec acquires GTESS claims processing business

IRVING, TX – BancTec, which specializes in financial business process outsourcing, transaction automation and document management, has acquired certain assets of Richardson, Texas-based GTESS, a provider of claims pre-adjudication technology and services for the healthcare industry.

GTESS has served a client base including more than 40 healthcare payers nationwide. BancTec officials say the acquisition – financial terms of which were not disclosed – will enable the firm to strengthen and expand its healthcare claims processing services.

“In this era of healthcare consolidation and reform, health plans and related organizations are under increasing pressure to improve efficiency – but too often are held back by complex, manual pre-adjudication processes,” said Maria L. Allen, senior vice president and president of the Americas at BancTec. “With this addition, BancTec will be able to effectively address this pain point as part of an integrated claims processing offering.”

Founded in 1990, GTESS specializes in automation technologies that drive cost and process improvements in the front-end, or pre-adjudication, portion of healthcare claims processing. This includes the automation of costly, labor-intensive pre-adjudication processes such as provider and member matching and paper claim handling, keying and processing. GTESS has enabled clients to achieve their goals for increased automation, speed and lower costs of claims processing.

“BancTec and GTESS have shared a commitment to superior service and client satisfaction that have stood the test of time,” said Mark King, chairman of GTESS.  “Like GTESS, BancTec provides flexible, focused automation and outsourcing solutions that serve the healthcare industry well. This strategic move gives clients the opportunity to significantly reduce annual expenses by lowering the cost per claim and dramatically improving accuracy, consistency and customer response.”

Wednesday, June 20, 2012

Suffering and Dying for Healthcare in Las Vegas

By Donna Smith–

Happy Easter everyone. Happy season of new life and blooming flowers. It�s the season of rebirth and regeneration. So, if that�s the case, then what the hell is up with letting thousands of people wait and suffer and die because we do not have the money to treat their illnesses anymore? In Las Vegas. It�s Vegas, baby. But it could be Sioux City or Boston or even Missoula. It is the reality of our national healthcare disgrace in America.

If you watched CBS�s �60 Minutes� on Sunday, April 4, then you saw the same horrifying story I did. Budget cuts had to be made at the county hospital in the recession, the hospital CEO said. Outpatient chemotherapy clinic is closed. Letters go out to the patients. Treatment ends. People suffer with growing tumors, broken bones from metastasized cancers; people suffer to breathe. The budget is cut. It�s horrifying stuff this national disgrace. (If you didn�t see it, you can watch it here.)

Want a chocolate Easter egg? How about some jelly beans in a basket?

Meanwhile, a young mom and cancer patient in Las Vegas goes untreated� she worked and had insurance until she got too sick. Then, well, you know the drill by now. She�s dying. She�s suffering. She even had her hospital bed repossessed. She�s one of us. She is me. She is you. She is your child. And she is just one of thousands who got the letters telling them their treatments were ending. Done. No more care.

And now there is no bail-out for her or for any of us if we�re in her shoes. Where�s her bail-out? No one is even talking that way or thinking that way. Healthcare reform is on their radar, they say. We�ll get it done this year, they proudly exclaim. Meanwhile, this woman suffers. Another person dies. What is there to be proud of?

Could this Congress act now on our behalf, please? There is a war against humanity going on in these United States. My Congress and my President are to be keeping me safe and secure in my home. But so long as they know of these lethal abuses within the healthcare system, they are not honoring their commitments to me. Or to you.

This isn�t Iraq or Afghanistan. It�s Las Vegas.

We could see swift action, if we had lawmakers who saw this as an attack on our citizens. For instance, there could be a moratorium on any patient having cancer treatment discontinued due to budget cuts or insurance company bottom lines. Clean and clear. No more letters cutting off treatment. While they dance their political dances on the long-term policy, could they please act as if we�re under attack? Because we are. People are being put to death through budget cuts and profit-margins, and many are getting less care than is guaranteed a prisoner under our set of laws protecting those who are incarcerated.

Yet we sit in calm meetings in Washington, DC, — and we argue about who sits in the White House forums and who does not — and in other venues around the nation trying to decide if the political impact of health reform plans will harm re-election chances for our favorite elected friends or make the insurance or big corporate hospital interests upset with our lawmakers. Blah, blah, blah� while another dozen or score or more die. Cancer doesn�t wait for anyone to decide who is in and who is out.

Happy Easter. The season celebrating the risen prince of peace isn�t so damn peaceful for people on the wrong side of the recession. Especially people with cancer.

I just want that young woman and the thousands of others in her same inexcusable situation in these United States to know we�re fighting for what is just� healthcare is indeed a human right. Health insurance will not get us there � it can be lost, it can be changed, it can be inadequate, it can be denied and it can be dishonored.

But healthcare is a human right. It is not a political football. I pray we have the strength to do what is right and just, publicly funded and privately delivered healthcare � and do it now � because doing less would not be what we are all about as people. We are better than this.

During Easter and every season, we are better people than this. I know we are because we still have the ability to be horrified when a young mother in Las Vegas suffers needlessly. I hope she takes her place in heaven knowing we cared. Happy Easter, Yolanda Coleman. May God somehow make your pain a little less severe today. I am sorry you have hurt so badly during this time. You deserved better.

Donna Smith is a community organizer for the California Nurses Association and National Co-Chair for the Progressive Democrats of America Healthcare Not Warfare campaign.

Sunday, June 17, 2012

The Reward for Donating a Kidney: No Insurance

From the New York Times –

When Erika Royer�s lupus led to kidney failure four years ago, her father, Radburn, was able to give her an extraordinary gift: a kidney.

Ms. Royer, now 31, regained her kidney function, no longer needs dialysis and has been able to return to work. But because of his donation, her father, a physically active 53-year-old, has been unable to obtain private health insurance.

Like most other kidney donors, Mr. Royer, a retired teacher in Eveleth, Minn., was carefully screened and is in good health. But Blue Cross and Blue Shield of Minnesota rejected his application for coverage last year, as well as his appeals, on the grounds that he has chronic kidney disease, even though many people live with one kidney and his nephrologist testified that his kidney is healthy. Mr. Royer was also unable to purchase life insurance.

Officials with Blue Cross and Blue Shield of Minnesota refused to discuss Mr. Royer�s case because of privacy laws, but said in a statement that Minnesota residents who are rejected by private insurers can buy coverage through the Minnesota Comprehensive Health Association high-risk pool, which is what Mr. Royer said he did, though he is paying more for less comprehensive insurance.

The officials refused several requests for an interview, saying in an e-mailed statement that �healthy individuals who happen to have one kidney can and do receive coverage� through Blue Cross and Blue Shield as long as their test results are within medically accepted normal ranges.

Mr. Royer said he is baffled by the denial. �From my perspective, I�d be a good risk,� he said. �I�d just be putting in premiums and helping balance the system out.�

There is little data on how often kidney donors have trouble obtaining insurance, but advocates say the fear of being uninsurable may be a powerful deterrent to donation. A 2006 study done by an advocacy organization for transplant professionals found that 39 percent of transplant centers reported that they had had eligible donors who declined to donate because they feared having future insurance problems.

The health of living donors is seldom at issue: Though some research suggests that kidney donors may be slightly more prone to develop high blood pressure as they age, long-term studies have found donors live as long as other healthy people. One study reported that donors live even longer.

Most insurers maintain that prior kidney donation does not affect coverage decisions or premiums, but while transplant cases like Mr. Royer�s are rare, advocates and social workers who work closely with donors say the problem may be more common than is recognized. A review study published in 2007 by Canadian researchers found that as many as 11 percent of them have encountered problems with life and health insurance coverage.

It�s a problem with implications for thousands of people. In 2008, the last year for which figures were available from the National Institute of Diabetes and Digestive and Kidney Diseases, 17,413 kidney transplants were performed, most of them (11,382) from cadavers. But there were 87,820 people awaiting a kidney transplant as of February 2011, and another 2,249 waiting for both a kidney and a pancreas.

Continue reading…

Congress passes stimulus package with $19B for healthcare IT

WASHINGTON – Congress passed the final version of the $787 billion economic stimulus bill Feb. 13, with $19 billion slated for healthcare IT. President Obama is slated to sign it today in Denver.

The American Recovery and Reinvestment Act (H.R. 1), is also loaded with more than $100 billion for other healthcare measures including funding to help beef up state Medicaid coffers and subsidies to help unemployed workers afford healthcare coverage through COBRA.

American Hospital Association President and CEO Richard Umbdenstock said the bill "is a step in the right direction," and AHA looks forward to working with Congress and the Administration to further refine some of the provisions.

Umbdenstock said provisions in the bill contain key items that are important to the patients and communities served by the nation's hospitals, ranging from ensuring the availability of healthcare coverage for the unemployed and providing increased support for the Medicaid program to making a down-payment on investments to improve the quality and efficiency of care through health information technology; investing in the training of more healthcare professionals, and blocking several Medicare and Medicaid regulations proposed by the previous Administration that would have created barriers to serving our most vulnerable patient populations.

Carl Buising, MD, executive director of healthcare, U.S. Public Sector Health at Microsoft said the bill, with its emphasis on key healthcare IT priorities will improve information-sharing and availability, which will in turn drive quality, efficiency, and patient-centric services for the 21st Century.

"With substantial funding for adoption and expansion of health IT at the provider, facility, regional, and national levels, we can make real progress," Buising said. "It will be important in the execution to include sufficient flexibility in the decisions and deployments undertaken such that today's various data and information formats can all be managed, as well as the forthcoming standards to be developed."

"During the execution phase, we must also maintain a continued emphasis on technical progress that connects the legacy and siloed systems of today and advances information sharing, rather than simply creating more siloes," he said. "This is an unusual and exciting opportunity to advance healthcare and healthcare IT in the nation.  The stimulus provides the opportunity to fundamentally alter the way we capture, store, use, and share information in the healthcare process, which will then enable improvements in efficiency, quality, and condition management to a degree simply not possible today."

"The economic stimulus package represents a significant step forward for the advancement of healthcare in the United States," said Harry Greenspun, chief medical officer for Perot Systems. "These funds should significantly advance patient safety and care while creating good paying jobs in the health IT sector, especially if we can achieve the goal of developing an electronic health record of every American."

The Pharmaceutical Care Management Association (PCMA) said the bill is an important first step. "Our industry is committed to working with all stakeholders to ensure broad adoption of health information technology so that patients and physicians have access to full and complete electronic medical records that include basic safety and savings tools like e-prescribing," PCMA officials said in a statement. "We are encouraged that the legislation specifically includes e-prescribing as an integral component of a fully-functional HIT system."
 
In addition to the healthcare IT provisions in the economic stimulus bill, PCMA said it supports the inclusion of comparative effectiveness research in the law, which will improve clinical decision-making, enhance quality of care, and discourage wasteful spending.

Saturday, June 16, 2012

Healthcare petition urges: Everybody In, Nobody Out

For more than five years, medical students from the University of Kansas Medical Center have put in long hours serving uninsured patients at their Jay Doc Free Clinic.

Last year, a number of students and physicians involved in such efforts started a new group, Heartland Healthcare for All. Their aim is to push universal health care beyond the walls of their free clinics and into federal legislation that would leave no patient behind.

With a new president preparing to take office, they’re not wasting any time sending their ideas to Washington, D.C.

Elizabeth Stephens, a medical student at KU Med and a member of Heartland Healthcare for All, says the organization started with a viewing of Michael Moore’s 2007 documentary, Sicko, which criticizes the current model of private health care as ineffective and unjust.

“They left the movie outraged by what they had seen,” Stephens says of a group of students and professionals at the screening. “They started talking in the lobby and decided to form a group of concerned citizens.”

Since then, the HHFA has organized vigils and protests to advance a more equitable system. They’ve thrown their weight behind a publicly financed, single-payer system, like the one proposed by Michigan Congressman John Conyers and co-sponsored by Missouri U.S. Rep. Emanuel Cleaver. “We really believe the most equitable and most cost-effective way to truly have a system where everybody’s in and nobody’s left out is a single-payer system,” Stephens says.

Now the group is trying to get more citizens on board.

After Barack Obama became the Democratic nominee for president, his campaign called for citizens to hold meetings in their homes and to discuss the changes they’d like to see in Washington, D.C. About 40 people showed up to an HHFA-sponsored gathering to talk about health care, Stephens says. The group came up with a unanimous vision. They put that wording down on paper. Now they’ve turned that session into an online petition that demands: “Everybody In, Nobody Out.”

In the two weeks since it went live, the effort has gained more than 100 signatures. Stephens says the hope is to get as many names as possible and then send the message to the new president once he takes office.

“He’s asked for input from the people who elected him,” Stephens says of Obama. “We thought this would be a great time to show the president-elect and local representatives and senators there is strong support for this and people want it. Politicians aren’t ever going to go out on their own and do something radical. They have to know the people who voted for them want that change first. We want to demonstrate wide support for this so they can get behind it, as well.”

This weekend, the Obama camp is once again calling on citizens to throw house parties to jump-start political discussions. Before then, though, the members of HHFA will gather at the same free clinic that hosts the Jay Docs tonight to keep pushing for a system that’s open to everyone.

This article is from pitch.com.

Learn all you can about health care alternatives

The following editorial is from www.Courier-Journal.com.

The challenge is for citizens to get involved. the public must do its part by educating itself about the various alternatives, and letting their representatives in Washington know what they conclude.

How broken is our current system?

Some 47 million Americans are uninsured; another 50 million are underinsured (not fully covered).

About 8.7 million children are uninsured.

Most bankruptcies have a health reason as a major cause, and 68 percent of those people who have gone belly up do have health insurance policies.

The World Health Organization ranks the level of U.S. health care at 37th in the world.

Private health insurance companies, which have doubled the premiums since 2000, have a bureaucratic overhead of 28-31 percent while Medicare operates at 3 percent efficiency. Therein lies a large part of the problem. These companies have an incentive to reduce benefits to patients.

The most persistent solution on the grassroots level is a single-payer system, the single payer being the federal government. This program involves a Medicare-type approach for everyone, but it would be expanded to include dental care, vision care and preventive programs. Overall, it would cost about the same — maybe a little more, maybe a little less — as the present 15 percent of the Gross National Product (GNP). All other industrialized nations with full coverage for all citizens average about half the costs in total medical care.

A single-payer system is best outlined in congressional bill HR676, which would set up the National Health Insurance (NHI) program. What it is not is “socialized medicine.” England and Spain have socialized medicine, wherein the doctors and hospitals are all employees of the federal government. Under HR676 the present system would stay; doctors would remain private vendors and would submit their bills to one payer, the U.S. government, not to the 1,500 private health insurance companies. Patients would still choose their doctors. (More about HR676 later)

Is a single-payer system just the blue-sky proposal of some Washington, D.C., think tank? Not by a long shot. It is the work product of Rep. John Conyers and has 90 other congressmen as co-sponsors. This is about one in five House members. Also endorsing HR676 are the U.S. Conference of Mayors (a nonpartisan group of 1,100 members), Physicians for National Health Care Program (more than 10,000 doctors), League of Independent Voters, the United Church of Christ and the United Methodist Board of Church and Society, 32 city councils (including Louisville, Indianapolis, Baltimore, Detroit and Boston), 14 national and international labor organizations, the American Medical Students’ Association, the National Family Farm Coalition and more.

There was a time when the doctors would (and did) kill any national health care plan in the womb. Today a solid 59 percent of U.S. physicians now support national health insurance. Particularly strong on the issue are psychiatrists (83 percent), pediatric sub-specialists (71 percent), emergency medicine physicians (69 percent), general internists (64 percent) and family physicians (60 percent). Doctors and hospitals have to employ huge staffs just to process insurance claims from a multiplicity of insurance firms. About 20 percent of private doctors’ income goes to pay for this staff.

Businesses are now leaning toward a national program. The Business Coalition for Single Payer Healthcare in New York (www.BusinessCoalition.net) poses this scenario: “If you own a small business with a $100,000-per-month payroll, your health care costs can be reduced from typically $15,000 per month to just $3,300 — from 15 percent to 3.3 percent of wages, a savings of $140,400 per year.”

General Motors, which says health care adds at least $1,500 to each car, is paying people to leave their jobs so they can hire replacements at 50 cents on the dollar with reduced health benefits. This may help the bottom line and the company can compete better, but it is a sad commentary on the state of American health care, especially for the newest of workers.

Neither of the two major presidential candidates favored a single-payer program. Democrat Barack Obama comes up with a halfway reform that includes the insurance companies in the mix. His plan would offer help to nearly half of the uninsured people and would cover all children. Republican John McCain’s plan was only a small reform that features a tax credit plan of $5,000 for a family. This wouldn’t come close to paying a normal $12,000 premium for family health care. And the McCain plan, from some analysts’ viewpoint, would offer help to only about 4 to 5 million uninsured people.

Neither Republican nor Democrat solutions take advantage of the tremendous savings realized from eliminating the waste in the private health insurance industry. This waste alone, by the estimates of several studies, would pay for health coverage for all of the uninsured. More than several states have tried systems of mandating and subsidizing policies from insurance companies. Minnesota, Tennessee, Vermont, Washington and Massachusetts have learned the hard way in failing to fix the system by including the health insurance industry.

Where else would the money come from to support a national program? HR676 calls for a modest payroll tax on all employers and employees of 3.3 percent each, in addition to a 1.45 percent tax that they are already paying for a total of 4.75 percent each. Also there would be a 5 percent health tax on the top 5 percent of income earners and a 10 percent tax on the richest 1 percent . A small tax on stock and bond transfers is also envisioned along with the closing of corporate tax loopholes and repealing the Bush tax cut for the highest 1 percent of income earners.

When you subtract the cost of insurance premiums, the deductibles and the co-pays, most businesses and most people would pay less for national health care than they do today. Even if the cost did go up some, the coverage would be much broader and medical needs would be met much more easily.

What we are learning is that the United States is all alone among its peers in the whole world. This is the only country that treats health care as a commodity distributed according to ability to pay, rather than as a social service distributed according to medical need.

The challenge is to get fully informed citizens involved in changing things for the better.

DAVID ROSS STEVENS
Borden, Ind.

Mr. Stevens is a member of the Southern Indiana branch of Hoosiers for a Commonsense Health Plan (whose Kentucky counterpart can be reached at www.kyhealthcare.org).

Massachusetts Voters Say YES to Single-Payer Healthcare, and NO to Mandates

From MassCare.org:

Dear Single Payer Supporters –

In an election that has brought out the highest voter turnout in Massachusetts probably since 1928, local ballot initiatives supporting single payer and opposing individual mandates passed by landslide margins in all ten legislative districts where they appeared. With almost all precincts tallied, roughly 73 percent of 181,000 voters in the ten districts voted YES to the following:

“Should the representative from this district be instructed to support legislation creating a cost-effective single payer health insurance system that is available to all residents, and oppose laws penalizing those who fail to obtain health insurance?”

The measure passed with margins ranging from 65 percent in the Fifth Middlesex to 82 percent in the Third Hampshire. A table of results, along with other local non-binding referendum outcomes, is available at the Boston Globe website.

Thanks to everyone in these ten districts for your hard work, and congratulations!

Friday, June 15, 2012

Learn all you can about health care alternatives

The following editorial is from www.Courier-Journal.com.

The challenge is for citizens to get involved. the public must do its part by educating itself about the various alternatives, and letting their representatives in Washington know what they conclude.

How broken is our current system?

Some 47 million Americans are uninsured; another 50 million are underinsured (not fully covered).

About 8.7 million children are uninsured.

Most bankruptcies have a health reason as a major cause, and 68 percent of those people who have gone belly up do have health insurance policies.

The World Health Organization ranks the level of U.S. health care at 37th in the world.

Private health insurance companies, which have doubled the premiums since 2000, have a bureaucratic overhead of 28-31 percent while Medicare operates at 3 percent efficiency. Therein lies a large part of the problem. These companies have an incentive to reduce benefits to patients.

The most persistent solution on the grassroots level is a single-payer system, the single payer being the federal government. This program involves a Medicare-type approach for everyone, but it would be expanded to include dental care, vision care and preventive programs. Overall, it would cost about the same — maybe a little more, maybe a little less — as the present 15 percent of the Gross National Product (GNP). All other industrialized nations with full coverage for all citizens average about half the costs in total medical care.

A single-payer system is best outlined in congressional bill HR676, which would set up the National Health Insurance (NHI) program. What it is not is “socialized medicine.” England and Spain have socialized medicine, wherein the doctors and hospitals are all employees of the federal government. Under HR676 the present system would stay; doctors would remain private vendors and would submit their bills to one payer, the U.S. government, not to the 1,500 private health insurance companies. Patients would still choose their doctors. (More about HR676 later)

Is a single-payer system just the blue-sky proposal of some Washington, D.C., think tank? Not by a long shot. It is the work product of Rep. John Conyers and has 90 other congressmen as co-sponsors. This is about one in five House members. Also endorsing HR676 are the U.S. Conference of Mayors (a nonpartisan group of 1,100 members), Physicians for National Health Care Program (more than 10,000 doctors), League of Independent Voters, the United Church of Christ and the United Methodist Board of Church and Society, 32 city councils (including Louisville, Indianapolis, Baltimore, Detroit and Boston), 14 national and international labor organizations, the American Medical Students’ Association, the National Family Farm Coalition and more.

There was a time when the doctors would (and did) kill any national health care plan in the womb. Today a solid 59 percent of U.S. physicians now support national health insurance. Particularly strong on the issue are psychiatrists (83 percent), pediatric sub-specialists (71 percent), emergency medicine physicians (69 percent), general internists (64 percent) and family physicians (60 percent). Doctors and hospitals have to employ huge staffs just to process insurance claims from a multiplicity of insurance firms. About 20 percent of private doctors’ income goes to pay for this staff.

Businesses are now leaning toward a national program. The Business Coalition for Single Payer Healthcare in New York (www.BusinessCoalition.net) poses this scenario: “If you own a small business with a $100,000-per-month payroll, your health care costs can be reduced from typically $15,000 per month to just $3,300 — from 15 percent to 3.3 percent of wages, a savings of $140,400 per year.”

General Motors, which says health care adds at least $1,500 to each car, is paying people to leave their jobs so they can hire replacements at 50 cents on the dollar with reduced health benefits. This may help the bottom line and the company can compete better, but it is a sad commentary on the state of American health care, especially for the newest of workers.

Neither of the two major presidential candidates favored a single-payer program. Democrat Barack Obama comes up with a halfway reform that includes the insurance companies in the mix. His plan would offer help to nearly half of the uninsured people and would cover all children. Republican John McCain’s plan was only a small reform that features a tax credit plan of $5,000 for a family. This wouldn’t come close to paying a normal $12,000 premium for family health care. And the McCain plan, from some analysts’ viewpoint, would offer help to only about 4 to 5 million uninsured people.

Neither Republican nor Democrat solutions take advantage of the tremendous savings realized from eliminating the waste in the private health insurance industry. This waste alone, by the estimates of several studies, would pay for health coverage for all of the uninsured. More than several states have tried systems of mandating and subsidizing policies from insurance companies. Minnesota, Tennessee, Vermont, Washington and Massachusetts have learned the hard way in failing to fix the system by including the health insurance industry.

Where else would the money come from to support a national program? HR676 calls for a modest payroll tax on all employers and employees of 3.3 percent each, in addition to a 1.45 percent tax that they are already paying for a total of 4.75 percent each. Also there would be a 5 percent health tax on the top 5 percent of income earners and a 10 percent tax on the richest 1 percent . A small tax on stock and bond transfers is also envisioned along with the closing of corporate tax loopholes and repealing the Bush tax cut for the highest 1 percent of income earners.

When you subtract the cost of insurance premiums, the deductibles and the co-pays, most businesses and most people would pay less for national health care than they do today. Even if the cost did go up some, the coverage would be much broader and medical needs would be met much more easily.

What we are learning is that the United States is all alone among its peers in the whole world. This is the only country that treats health care as a commodity distributed according to ability to pay, rather than as a social service distributed according to medical need.

The challenge is to get fully informed citizens involved in changing things for the better.

DAVID ROSS STEVENS
Borden, Ind.

Mr. Stevens is a member of the Southern Indiana branch of Hoosiers for a Commonsense Health Plan (whose Kentucky counterpart can be reached at www.kyhealthcare.org).

HHS to dig deeper for better decisions

WASHINGTON – For San Francisco-based Archimedes, a company named for a Greek mathematician of antiquity, it’s all about data, math, computing and healthcare modeling. The 20-year-old company deals in information – of the quantitative type. And now it will bring its high-powered analytics skills to bear for the Department of Health and Human Services.

Under a contract with HHS announced last month, Archimedes will dig into large quantities of data to provide several HHS agencies the ability to evaluate the effectiveness of specific health interventions more quickly and more accurately. HHS officials say it signals "a new era of medical decision-making."

The technology will enable the agencies to research, analyze and evaluate the effects of specific healthcare interventions more quickly and accurately, Archimedes executives say.

The company bills the Archimedes Model, developed initially with support from Kaiser Permanente, as “the most advanced mathematical modeling tool available to answer complex questions on health and healthcare.”

Under the contract, HHS will make a new Web-based interface called the Archimedes Healthcare Simulator (ARCHeS) available to its agencies, including the Centers for Medicare & Medicaid Services (CMS), the Centers for Disease Control and Prevention (CDC), the Agency for Healthcare Research and Quality (AHRQ), the National Heart, Lung & Blood Institute and the Food & Drug Administration (FDA).

A $15.6 million grant from the Robert Wood Johnson Foundation (RWJF) Pioneer Portfolio in 2007 supported the creation of ARCHeS, which makes the Archimedes Model more accessible and affordable for public policymakers and nonprofit users.

“When we initially made this grant, I said that the development of ARCHeS would usher in a new era in medical decision-making that we believe has the potential to transform health and healthcare,” said Risa Lavizzo-Mourey, MD, president and CEO of the Robert Wood Johnson Foundation. “By getting ARCHeS in the hands of HHS and all of its agencies, we’ve taken a very big step toward realizing that potential. Our goal has always been to create access to this innovation for the public policymakers and researchers best positioned to use it to inform decisions that will improve health and healthcare for all Americans. We now see that happening.”

“The quality and cost of healthcare are determined by decisions made by policymakers, physicians and others. To make those decisions wisely, decision makers need to know the consequences of the different options they face,” said David Eddy, MD, founder and chief medical officer of Archimedes. “For a high proportion of decisions, the only feasible way to get the needed information is to use mathematical models that integrate existing evidence, and are validated against evidence.

In his view, the contract with HHS will put the analytical power of advanced healthcare modeling on the desks of decision makers in the federal government.

“By combining this tool with their own insights and experience, decision makers will be able to understand much better the effects of different policies, and be able to design policies that achieve the twin goals of improving quality and controlling costs,” said Eddy.

In one of a number of analyses already performed by Archimedes, Kaiser Permanente used forecasts from the model as the impetus to launch a program to provide a bundle of aspirin, lovastatin (a cholesterol-lowering drug), and lisinopril (a blood pressure-reducing drug), to high-risk members. This analysis was used in informing the implementation of Kaiser Permanente’s ALL/PHASE program. The result was a more than 60 percent reduction in heart attacks and strokes over a two-year period.

As a result of HITECH Act and the Patient Protection and Affordable Care Act, the use of modeling and simulation platforms is in high demand for policymakers and researchers. Both of these laws include new requirements for use of data in the design of health benefits; comparative effectiveness of quality, cost, and outcomes; and evaluation of population health efforts.

In March, the federal government launched a research initiative in big data computing for a number of agencies, including the National Institutes of Health.

"The federal government sees a growing need across all of its agencies for innovative resources to aid in research, policy analysis and evaluation,” said U.S. Chief Technology Officer Todd Park. "We’re excited that ARCHeS will now be available to staff across the Department of Health and Human Services. It gives us an important new tool to analyze a wide variety of health policy questions and quickly compare different scenarios and outcomes.”

Tuesday, June 12, 2012

Meet Dr. Quentin Young

For those of you unfamiliar with Dr. Young, he has been a tireless advocate for single payer health care for over twenty years, but that is just one item on a CV that includes:
- Practicing medicine for over sixty years (he’s recently retired)
- President of the Medical Committee for Human Rights,(physicians who traveled to treat victims of racial violence)during the most tumultuous years of the civil rights movement, 1963-69
- Personal physician for Dr. King when he was in Chicago (Dr. Young was marching alongside Dr. King when attacked in Chicago. Can you think of a better guy to be next to you when you’re hit by a brick?)
- Chair of the Chicago Health Department under Mayor Harold Washington, and personal physician to Studs Terkel, and Mike Royko as well

Doc Young celebrated his 85th birthday this year, and his energy and enthusiasm puts us both to shame. Take it away, Doc!

Find the full article on the Daily Kos

mHealth: Embraced by developing world, resisted by developed countries

NEW YORK – A new study of the global mHealth market finds that consumers and developing countries are driving its growth, while physicians are reluctant to adapt.

Those are some of the conclusions drawn from “Emerging Health: Paths for Growth,” published by PricewaterhouseCoopers. The 48-page report, based on two separate surveys conducted by the Economist Intelligence Unit and analyzing 10 nations, indicates developing nations are quicker to accept and adopt telehealth because it’s seen as a way to increase access to healthcare, while developed nations like the United States are being dogged down by regulatory hurdles and a resistance to change among providers.

[See also: Doctor or patient? Who will drive mHealth?]

“Consumers are demanding and payers are willing to pay, but providers aren’t willing to provide,” said Christopher Wasden, PwC’s global healthcare innovation leader. “What we are going to need to do is get providers to think and act differently.”

“To what extent are physicians in their country willing to adapt?” he asked.

Wasden and David Levy, MD, also a global healthcare leader for PwC, said mHealth is more of a disruptive force in developed nations because it challenges the status quo and forces providers and payers to accept that patients have more control of their healthcare choices. Wasden said many doctors are wary of giving the patient more access to medical data and control because they fear – incorrectly – that they will lose business.

[See also: New report offers insight into fragmented mHealth market]

In developing countries, meanwhile, mHealth is seen as a new market with exciting possibilities. New startups and business models, with assistance from the telecommunications sector, Wasden said, are driving mHealth to unprecedented levels of growth. That, he said, is why the African nations and India are among the hotbeds for new innovation in mHealth.

In developed nations, meanwhile, providers – and to a lesser extent payers – say there are too many barriers to mHealth. More than one-quarter of those surveyed in both categories say the conservative culture in healthcare is a leading barrier; others include complex regulations and technology, lack of access to wireless services; and massive changes to the physician’s workload.

Nearly half of the patients surveyed, meanwhile, indicate that in the next three years, mHealth will improve the convenience (46 percent), cost (52 percent) and quality (48 percent) of their healthcare.

“Despite demand and the obvious potential benefits of mHealth, rapid adoption is not occurring,” Levy said. “The main barriers are not the technology but rather systemic to healthcare and inherent resistance to change. Though many people think mobile health will be ancillary or bolted on to the healthcare industry, we look at it differently: mHealth is the future of healthcare, deeply integrated into delivery that will be better, faster, less expensive and far more consumer-focused.”

While physicians are wary of the empowered patient (the report indicates 42 percent of doctors surveyed worry that mHealth will make their patients too independent), Wasden said they “completely miss” the benefits of instant access to healthcare data. He said healthcare costs can be brought down if patients change their behaviors, and that can be accomplished if they work with physicians and use real-time data to monitor and manage their lifestyles.

“We know what will really change patient outcomes … but physicians don’t believe they can change patient behaviors,” he said.

According to the report, only 27 percent of physicians encourage patients to use mHealth to become more active in managing their health, while 13 percent actually discourage it.

Wasden said the popular perception that payers are opposing mHealth in the United States is wrong. The report indicates 40 percent of payers surveyed encourage patients to let doctors monitor their health and activities and to use mHealth (compared to only 25 percent of physicians). Payers, he said, are feeling threatened by healthcare reform, and are adopting new technologies like mHealth in order to adapt to the changing healthcare landscape. They’re supporting measures that allow patients to be treated in their homes and in clinics – anywhere but the hospital, which he said is the “most expensive place to treat a patient.”

That doesn’t mean hospitals should fear mHealth. Wasden said America’s broken healthcare system – and the healthcare systems of many developed nations – are suffering because 30 percent to 50 percent of the patients in hospitals don’t need to be there, thus causing overcrowding and waste. Taking that percentage out of the hospitals, he said, reduces healthcare costs dramatically and frees up hospitals to treat only those who should be treated there.

Wasden said the PwC report points out that mHealth adoption will take time and effort. Eventually, he said, what’s called “mHealth” will evolve into “healthcare.”

“We need to be realistic that we are in the very early stages,” he said.

A full copy of the report is available for download here.

[See also: mHealth moving forward fast, experts say]

Monday, June 11, 2012

Top Ten Enemies of Single Payer

Most people, when they arrive in Washington, D.C., see it for what it is – a cesspool of corruption.

Two reasonable reactions to the cesspool.

One, run away screaming in fear.

Two, stay and fight back and bring to justice those who have corrupted our democracy.

Unfortunately, many choose a third way – stay and be transformed.

Instead of seeing a cesspool, they begin seeing a hot tub.

The result – profits and wealth for the corporate elite – death, disease and destruction for the American people.

Nowhere does this corrupt, calculating transformation do more damage than in the area of health care.

Outside the beltway cesspool/hot tub, the majority of doctors, nurses, small businesses, health economists, and the majority of the American people – according to recent polls – want a Canadian-style, single payer, everybody in, nobody out, free choice of doctor and hospital, national health insurance system.

Inside the beltway cesspool/hot tub, the corrupt elite will have none of it.

They won’t even put single payer on the table for discussion.

Why not?

Because it will bring a harsh justice – the death penalty – to their buddies in the multi-billion dollar private health insurance industry.

The will of the American people is being held up by a handful of organizations and individuals who profit off the suffering of the masses.

And the will of the American people will not be done until this criminal elite is confronted and defeated.

(Remember, virtually the entire industrialized world – save for us, the U.S. – makes it a crime to allow for-profit health insurance corporations to make money selling basic health insurance.)

Before we confront and defeat the inside the beltway cesspool/hot tub crowd, we must first know who they are.

To wit, we present the Top Ten Enemies of Single Payer (listed here in alphabetical order):

American Association of Retired Persons (AARP). AARP, one of DC’s most powerful lobbying groups, has worked inside the beltway for years to defeat single payer. Why? AARP makes about a quarter of its money selling insurance through its affiliate, United Healthcare Group, the nation’s largest for-profit insurance company. AARP must defeat single payer – which if enacted, would wipe out that revenue stream.

America’s Health Insurance Plans (AHIP). The private health insurance industry. Public enemy number one. The health insurance corporations must die so that the American people can live. Of course, facing the death penalty, AHIP is the most aggressive opponent to single payer. No compromise with AHIP.

American Medical Association. With a shrinking base of doctors (only 25 percent of doctors nationwide belong) – the AMA is the most conservative of the doctors’ organizations. I just returned from a health care policy forum at the Center for American Progress. As usual, not one of the panelists mentioned single payer. Only during the question period did a self-identified patient/citizen ask the single payer question. And a pit bull-like Nancy Nielsen, president of the AMA, ripped into the questioner. “Sounds more like a statement than a question,” Nielsen said. “And clearly you have a point of view about that. And I don’t happen to share that point of view.” Clearly she doesn’t. But just as clearly, the majority of doctors, probably even a majority of doctors who belong to the AMA, support single payer. Nielsen is in denial and must be defeated.

Barack Obama. He was for it when he was a state Senator in Illinois. Now, ensconced in the corporate prison that is the White House, he says single payer is off the table. To get off the list, Obama needs to put single payer back on the table.

Business Roundtable. Dr. David Himmelstein, co-founder of Physicians for a National Health Program (PNHP), was at a health care forum a couple of years ago sponsored by the Business Roundtable. And the moderator asked the audience – made up primarily of representatives of big business – to indicate their preference of health care reforms. And the majority came out in favor of single payer. Why then is the Business Roundtable opposed? Himmelstein put it this way: “In private, they support single payer, but they’re also thinking – if you can take away someone else’s business – the insurance companies’ business – you can take away mine. Also, if workers go on strike, I want them to lose their health insurance. And it’s also a cultural thing – we don’t do that kind of thing in this country.”

Families USA. A major inside the beltway liberal foundation and long-time foe of single payer. It’s chief executive, Ron Pollack, was once an advocate for single payer. But no more. In November 1991, Pollack was at a Washington hotel debating Yale University professor Ted Marmor in front of then Arkansas Governor Bill Clinton. Marmor was making the argument for single payer. Pollack against. A November 1994 article in the Washington Monthly, co-authored by Marmor, reported the result this way: “After the two advocates finished, Clinton looked thoughtful, pointed to Marmor and said, �Ted, you win the argument.’ But gesturing to Pollack, Marmor recalls, the governor quickly added, �But we’re going to do what he says.’ Even considering the Canadian system, everyone in the room agreed, would prompt GOP cries of �socialized medicine’ – cries that the press would faithfully report.”

Health Care for America Now. The largest coalition of liberal groups promoting a choice between a public plan and private insurance companies. “They are saying – we can’t do single payer because Americans don’t want it,” said Kip Sullivan of the Minnesota chapter of PNHP. “That’s based on junk research conducted by Celinda Lake for the Herndon Alliance. It is bad enough to say we can’t do single payer because the insurance industry is too powerful to beat. But it is just plain insidious to say we can’t do single payer because the American people don’t want it. In fact, polling data indicates that two-thirds of Americans support a single payer system. And that level of support exists despite the fact that there is little public discussion about it.”

Kaiser Family Foundation. One of the most prestigious liberal inside the beltway think tanks on health reform policy. Saul Friedman is a reporter for Newsday. In February, Friedman wrote an article for Newsday arguing that single payer is suffering from a conspiracy of silence. And he says Kaiser is the most culpable of the co-conpsirators. Kaiser, funded initially by insurance industry money, regularly keeps single payer off the table, Friedman says. When single payer advocates released a study in January asserting that Congressman John Conyers’ single payer bill (HR 676) could create 2.6 million new jobs and would cost far less than the private insurance currently paid for by individuals and employers, “the Kaiser Family Foundation’s daily online report on health care developments at kff.org didn’t mention it,” Friedman reported. “Nor has Kaiser, the most comprehensive online source of health care information, made any mention of single-payer or the Conyers bill since it was introduced in 2003, despite widespread support for such a plan according to Kaiser’s own polls.” After a number of insistent inquiries, Kaiser told Friedman that they would publish charts in March comparing the Stark and Conyers bills. They never did.

The Lewin Group. The go-to consulting firm for health reform studies. The most recent study, released last week and widely quoted in the press, of the public plan option, showed that the insurance industry would lose 32 million policy holders if a public plan is enacted. Lewin’s health reform policy guru, John Sheils, told the Associated Press: “The private insurance industry might just fizzle out altogether.” What the mainstream press didn’t report was that The Lewin Group is a wholly owned subsidiary of Ingenix, which is in turn owned by UnitedHealth Group, the nation’s largest health insurance corporation. Lewin Group has conducted studies on single payer at the state level – and their studies consistently show that single payer is the most efficient cost saving system. But Lewin Group has never done a study on HR 676 – which would create a single payer for the entire country and drive The Lewin Group’s parent – UnitedHealth Group- out of business. When asked why Lewin Group never has done a study on HR 676, Sheils said – “the President didn’t propose single payer, did he?” No, he didn’t. That’s why he too is on this list. (Sheils says The Lewin Group has studied national single payer. He points to a recent comparison of the different health reform proposals floating on Capitol Hill – including one by Congressman Pete Stark (D-California). Stark’s bill would give every American the option of opting into Medicare. But that’s not single payer, because it keeps the private insurance industry in the game. Sheils counters that he modeled the Stark bill as single-payer. “The employer coverage option under the Stark bill is made so unfavorable that no employer would do it. We have everyone in Medicare, with the resulting savings.” Sheils says that of all the plans studied, the Stark bill saves the most money.)

Pharmaceutical Research and Manufacturers Association of America (PHRMA). PHRMA chief executive Billy Tauzin says that under single payer, the government would become a “price fixer.” By which he means, the government, as a single payer, will have the power to negotiate drug prices downward, thus costing the drug corporations millions in excess profits. In recent years, PHRMA has infiltrated liberal sounding groups like America’s Agenda – Health Care for All. PHRMA’s Vice President for Government Affairs and Law, Jan Faiks, now sits on the board of America’s Agenda and PHRMA contributes money to the group – which has worked in recent years to undermine single payer at the state level. (America’s Agenda Mark Blum won’t say how much money PHRMA gives to his group.)

We have met the enemy.

And they ain’t us.

Russell Mokhiber is editor of the Washington, D.C.-based Corporate Crime Reporter. He is also founder of singlepayeraction.org.

Saturday, June 9, 2012

Orion Health to supply electronic record to Northern Ireland

Health and Social Care Northern Ireland (HSCNI) has tapped Orion Health Limited to provide a clinical portal-based electronic care record (ECR).

Covering a population of more than 1.8 million people, the ECR will facilitate the sharing of patient data taken from multiple existing information systems across acute, community, primary health and social care, officials say. The contract follows a successful Proof of Concept pilot of the ECR in Ulster Hospitals Dundonald, the Belfast City Hospital and two general practices in 2009 and 2010.

“The Electronic Care Record will improve the quality and safety of patient care as the system makes all of the relevant existing information available to doctors, nurses and other staff at the point of care,” said Carolyn Harper, MD, HSCNI project sponsor.

The Orion Health Clinical Portal will provide streamlined, secure, Web-based access to patient data from a single browser view, according to officials. The ECR will include vital patient information, including latest lab results, medications and clinical correspondence. Audit tools and patient privacy controls have been built into the ECR for greater security.

“The ECR will play a key role in delivering a patient centered service ensuring that the right information is available to health professionals where and when it is needed,” said Roy Harper, MD, consultant endocrinologist, Ulster Hospital.

As part of a seven-year contract the ECR will be deployed in 18 acute and community hospitals, all GP practices and community, mental health and social care facilities across the five regional trusts in Northern Ireland. Planned implementation will start in late 2012 with completion of the core elements anticipated early summer 2013.

“I am confident that the electronic care record system will assist in developing a sustainable healthcare system that delivers now and will continue to deliver in the future for the good of everyone in Northern Ireland,” said Health Minister Edwin Poots.

Thursday, June 7, 2012

Leapfrog grades hospitals A to F on patient safety

WASHINGTON – A new report card from healthcare watchdog The Leapfrog Group ranks hospitals for patient safety – A through F. Infections, medication and medical error and injuries are still rampant, according to Leapfrog's survey. Massachusetts hospitals ranked high. Those in the nation's capitol had the lowest average scores.

Approximately 400 people die every day because of hospital errors – the equivalent of a jet crashing every day and killing all aboard, Leapfrog notes. In response to this silent epidemic, more than 2,600 U.S. hospitals will now receive an A, B, C, D or F Hospital Safety Score based on patient safety via a first-of-its-kind initiative.

[See also: Leapfrog Group names top hospitals for 2011]

A blue ribbon panel of the nation’s top patient safety experts provided guidance to the Leapfrog Group, an independent national nonprofit run by employers and other large purchasers of health benefits, to develop the Hospital Safety Score. The Hospital Safety Score is calculated using publicly available data on patient injuries, medical and medication errors, and infections.

Not all hospitals earned an A, and there are some surprises, including hospitals with outstanding reputations for quality appearing with Hospital Safety Scores of B, C or below.

"The Hospital Safety Score exclusively measures safety – meaning errors, accidents, and infections," said Ashish Jha, MD, of Harvard, a member of the blue ribbon expert panel. "Even hospitals with excellent programs for surgical and medical care, state-of-the-art diagnostic equipment, and dedicated physicians may still need this score as a reminder that patient safety should be a top priority."

[See also: Most hospitals fall short on safety measures, Leapfrog survey shows]

"The Leapfrog Group’s goal is to give patients the vital information they need and deserve before even entering a hospital," said Leah Binder, president and CEO of the Leapfrog Group. "We hope people will use this score to talk with their doctor, make informed decisions about where to seek care, and take the right precautions during a hospital stay."

For the first time, the Hospital Safety Score will highlight the country’s best hospitals and warn against the worst to save lives and bring attention to the nation’s silent safety epidemic. According to recent studies, one in four Medicare patients will leave a hospital with a potentially fatal issue they didn’t have prior to hospitalization. On average, one medication error per day occurs for each hospitalized patient, and more than 180,000 Americans die every year from hospital accidents, errors, and infections.

The Hospital Safety Score website allows visitors to search hospital scores for free, and also provides information on how the public can protect themselves and loved ones during a hospital stay.

"The Leapfrog Group board has been frustrated with the lack of progress in improving patient safety, despite significant industry efforts over the past decade," said David Knowlton, immediate past chair of the Leapfrog Group Board of Directors and chair of the Leapfrog Group’s Patient Safety Committee. "It is time for a game changer. It’s time to give American families the heads-up they need to protect themselves if they face the need for a hospital stay."

The Leapfrog Group’s membership of employers and other purchasers of health benefits, and business coalitions on health across the country, will be working to engage communities, employers, health plans, and hospitals in using the Hospital Safety Score to improve safety, Leapfrog executives said. The Hospital Safety Score will be reissued using updated data in November 2012, with an annual Hospital Safety Score to follow in 2013 and beyond.

Key findings:Of the 2,652 general hospitals issued a Hospital Safety Score, 729 earned an A, 679 earned a B, and 1243 earned a C or below.A wide range of hospitals earned A's with no one class of hospitals dominating among those showing the highest safety scores.Hospitals earning an A include academic medical centers Massachusetts General, NYU Langone Medical Center, and University of California San Francisco. Many rural hospitals earned an A, including Grinnell Regional Medical Center in Iowa and Baptist Health South Florida Homestead Hospital in Florida.Hospitals with myriad national accolades, such as Mayo Clinic, Virginia Mason Medical Center, and University of Michigan Medical Center, each earned an A.

Less predictable were the A scores earned by hospitals serving highly vulnerable, impoverished, and/or health-challenged populations, such as Bellevue Hospital, Montefiore Hospital, and Detroit Receiving Hospital.

"A" scores were awarded to for-profit hospitals including many in the HCA systems, as well as hundreds of not-for-profit and public hospitals.

Community hospitals showed excellence as well, such as OSF St. Joseph Medical Center in Illinois.

More on methodology and panel experts on next page.

Cerner revenues up 18 percent in 4th quarter

KANSAS CITY, MO – The economy may be in crisis, but Cerner Corp. has a rosy outlook. The Kansas City-based healthcare IT company posted a better-than-expected fourth quarter result on Tuesday, with revenues up 18 percent.

Executives credited the company's broad global client base for its success.

"The large size and geographic diversity of our client base and the deep strategic relationships with those clients contributed to our ability to deliver solid results in a difficult environment," said Cerner founder and CEO Neal Patterson.

"We are pleased with our fourth quarter and full-year 2008 results, which reflect good execution in a challenging economic environment," Patterson said. "We delivered solid bookings, revenue and earnings and record levels of cash flow."

"We are cautiously optimistic that we will continue to generate solid results," he said, adding that Cerner is well positioned to take advantage of the Obama administration's focus on healthcare IT as a necessary piece of healthcare reform.

Sean Weil, an analyst with Piper Jaffrey, concurs that Cerner is well positioned for the stimulus package making its way through Congress.

"Cerner is one of a handful of companies that can benefit from both the hospital and physician stimulus incentives," he said in an analysis issued Wednesday.

In addition, Weiland said Cerner's size and scale likely afford it the capital it needs to execute.

Cerner's bookings in the fourth quarter of 2008 were $404.9 million, near the record level of $406.6 million recorded in the fourth quarter of 2007. Fourth quarter revenue increased 18 percent, to $465.7 million, over the same period a year ago.

Net earnings were $71.5 million compared with fourth quarter 2007 net earnings of $41.3 million.

Other fourth-quarter highlights:

Cash collections of $441 million and record operating cash flow of $98 million.Days sales outstanding of 92 days compared to 93 days in the third quarter of 2008 and 90 days during the same quarter last year.Total revenue backlog of $3.5 billion, up 7 percent over the same quarter a year ago. This is composed of $2.9 billion of contract backlog and $0.6 billion of support and maintenance backlog.

Tuesday, June 5, 2012

Hearing loss technology wins global mHealth competition

CAPE TOWN, South Africa – Massachusetts Institute of Technology (MIT), in partnership with Brazil’s Federal University of Rio Grande Do Norte, won the Mobile Health University Challenge with software that screens for hearing impairment.

With an estimated 588 million people worldwide and 5.7 million Brazilians afflicted by some level of hearing loss, the technology – dubbed the Sana AudioPulse – aims to make testing easier for hearing-impaired populations in rural and poverty-stricken areas that may not have access to medical care. Laws in Brazil mandate that newborns be screened for hearing loss; however, the implementation process has been stymied by funding limitations and shortages of staff and proper equipment. This AudioPulse technology could help overcome these obstacles. 

As the winning team, MIT and the Federal University of Rio Grande Do Norte will be offered mentoring towards the future development of their innovation and the opportunity to exhibit at key industry events such as the GSMA's Connected Living Latin America Summit, which is being held in Brazil in June 2012.

The competition, held at the GSMA-mHealth Alliance Mobile Health Summit in Cape Town, asked university students worldwide to develop a mobile health concept that would address a specific healthcare need. From the initial group of entrants, the top 13 teams were invited to attend this week's finals at the GSMA-mHealth Alliance Mobile Health Summit to present their ideas to a judging panel comprised of venture capitalists and major players in the mobile and health industries. From these 13 teams, four were chosen to present to the judging panel in a final round, and from the final four, one overall winner was selected.

Besides MIT and Federal University of Rio Grande Do Norte, the finalists were:

Jordan University of Science and Technology (Jordan) - Snore Detector, a smartphone application used for detecting and monitoring Obstructive Sleep Apnea Syndrome (OSAS). UC Berkeley (US) – LifeCheck, a digital checklist technology for hospitals aimed at reducing redundancy and hospital errors.  University of Oxford (UK) – BabeeMon, a baby monitoring technology, specifically for preterm infants, that detects respiration, blood oxygen saturation and heart rhythm.

"The teams were challenged and encouraged to use their originality and creativity to create a compelling and viable mHealth solution, and we commend the enthusiasm and commitment shown by all those who took part in our inaugural competition," said Jeanine Vos, Executive Director, mHealth at the GSMA. "Our congratulations to the winning team, MIT and the Federal University of Rio Grande Do Norte and our thanks to all those who participated."

Suffering and Dying for Healthcare in Las Vegas

By Donna Smith–

Happy Easter everyone. Happy season of new life and blooming flowers. It�s the season of rebirth and regeneration. So, if that�s the case, then what the hell is up with letting thousands of people wait and suffer and die because we do not have the money to treat their illnesses anymore? In Las Vegas. It�s Vegas, baby. But it could be Sioux City or Boston or even Missoula. It is the reality of our national healthcare disgrace in America.

If you watched CBS�s �60 Minutes� on Sunday, April 4, then you saw the same horrifying story I did. Budget cuts had to be made at the county hospital in the recession, the hospital CEO said. Outpatient chemotherapy clinic is closed. Letters go out to the patients. Treatment ends. People suffer with growing tumors, broken bones from metastasized cancers; people suffer to breathe. The budget is cut. It�s horrifying stuff this national disgrace. (If you didn�t see it, you can watch it here.)

Want a chocolate Easter egg? How about some jelly beans in a basket?

Meanwhile, a young mom and cancer patient in Las Vegas goes untreated� she worked and had insurance until she got too sick. Then, well, you know the drill by now. She�s dying. She�s suffering. She even had her hospital bed repossessed. She�s one of us. She is me. She is you. She is your child. And she is just one of thousands who got the letters telling them their treatments were ending. Done. No more care.

And now there is no bail-out for her or for any of us if we�re in her shoes. Where�s her bail-out? No one is even talking that way or thinking that way. Healthcare reform is on their radar, they say. We�ll get it done this year, they proudly exclaim. Meanwhile, this woman suffers. Another person dies. What is there to be proud of?

Could this Congress act now on our behalf, please? There is a war against humanity going on in these United States. My Congress and my President are to be keeping me safe and secure in my home. But so long as they know of these lethal abuses within the healthcare system, they are not honoring their commitments to me. Or to you.

This isn�t Iraq or Afghanistan. It�s Las Vegas.

We could see swift action, if we had lawmakers who saw this as an attack on our citizens. For instance, there could be a moratorium on any patient having cancer treatment discontinued due to budget cuts or insurance company bottom lines. Clean and clear. No more letters cutting off treatment. While they dance their political dances on the long-term policy, could they please act as if we�re under attack? Because we are. People are being put to death through budget cuts and profit-margins, and many are getting less care than is guaranteed a prisoner under our set of laws protecting those who are incarcerated.

Yet we sit in calm meetings in Washington, DC, — and we argue about who sits in the White House forums and who does not — and in other venues around the nation trying to decide if the political impact of health reform plans will harm re-election chances for our favorite elected friends or make the insurance or big corporate hospital interests upset with our lawmakers. Blah, blah, blah� while another dozen or score or more die. Cancer doesn�t wait for anyone to decide who is in and who is out.

Happy Easter. The season celebrating the risen prince of peace isn�t so damn peaceful for people on the wrong side of the recession. Especially people with cancer.

I just want that young woman and the thousands of others in her same inexcusable situation in these United States to know we�re fighting for what is just� healthcare is indeed a human right. Health insurance will not get us there � it can be lost, it can be changed, it can be inadequate, it can be denied and it can be dishonored.

But healthcare is a human right. It is not a political football. I pray we have the strength to do what is right and just, publicly funded and privately delivered healthcare � and do it now � because doing less would not be what we are all about as people. We are better than this.

During Easter and every season, we are better people than this. I know we are because we still have the ability to be horrified when a young mother in Las Vegas suffers needlessly. I hope she takes her place in heaven knowing we cared. Happy Easter, Yolanda Coleman. May God somehow make your pain a little less severe today. I am sorry you have hurt so badly during this time. You deserved better.

Donna Smith is a community organizer for the California Nurses Association and National Co-Chair for the Progressive Democrats of America Healthcare Not Warfare campaign.

Hearing loss technology wins global mHealth competition

CAPE TOWN, South Africa – Massachusetts Institute of Technology (MIT), in partnership with Brazil’s Federal University of Rio Grande Do Norte, won the Mobile Health University Challenge with software that screens for hearing impairment.

With an estimated 588 million people worldwide and 5.7 million Brazilians afflicted by some level of hearing loss, the technology – dubbed the Sana AudioPulse – aims to make testing easier for hearing-impaired populations in rural and poverty-stricken areas that may not have access to medical care. Laws in Brazil mandate that newborns be screened for hearing loss; however, the implementation process has been stymied by funding limitations and shortages of staff and proper equipment. This AudioPulse technology could help overcome these obstacles. 

As the winning team, MIT and the Federal University of Rio Grande Do Norte will be offered mentoring towards the future development of their innovation and the opportunity to exhibit at key industry events such as the GSMA's Connected Living Latin America Summit, which is being held in Brazil in June 2012.

The competition, held at the GSMA-mHealth Alliance Mobile Health Summit in Cape Town, asked university students worldwide to develop a mobile health concept that would address a specific healthcare need. From the initial group of entrants, the top 13 teams were invited to attend this week's finals at the GSMA-mHealth Alliance Mobile Health Summit to present their ideas to a judging panel comprised of venture capitalists and major players in the mobile and health industries. From these 13 teams, four were chosen to present to the judging panel in a final round, and from the final four, one overall winner was selected.

Besides MIT and Federal University of Rio Grande Do Norte, the finalists were:

Jordan University of Science and Technology (Jordan) - Snore Detector, a smartphone application used for detecting and monitoring Obstructive Sleep Apnea Syndrome (OSAS). UC Berkeley (US) – LifeCheck, a digital checklist technology for hospitals aimed at reducing redundancy and hospital errors.  University of Oxford (UK) – BabeeMon, a baby monitoring technology, specifically for preterm infants, that detects respiration, blood oxygen saturation and heart rhythm.

"The teams were challenged and encouraged to use their originality and creativity to create a compelling and viable mHealth solution, and we commend the enthusiasm and commitment shown by all those who took part in our inaugural competition," said Jeanine Vos, Executive Director, mHealth at the GSMA. "Our congratulations to the winning team, MIT and the Federal University of Rio Grande Do Norte and our thanks to all those who participated."

Monday, June 4, 2012

Employers Less Likely To Drop Coverage Than You Might Think

iStockphoto.com

Employers are bruised by health costs, but most aren't thinking about dropping coverage just yet.

When it comes to businesses providing health coverage for employees, there's a mad dash for the exits, right?

Maybe not, according to a recent survey of more than 1,300 U.S. employers of varying sizes. Consultants at Oliver Wyman's health practice wondered how employers are weighing the increasing costs of providing health insurance and the potential exit strategy paths available under the federal health law (if it survives the Supreme Court).

Bottom line: only 8 percent of the employers surveyed have plans to drop coverage altogether. But half of the companies surveyed do plan to make big changes to the coverage they offer.

"The most critical points are that they by and large have a very strong desire to take care of their employees," Oliver Wyman's Mindy Kairey tells Shots. Many employers have a strong belief that healthy employees are better employees.

 

And some employers worry that they'd be less able to attract the workers they want without offering health coverage. Companies that employ more highly paid workers are less likely to be thinking about dropping coverage.

So what's changing? Health costs continue to rise, putting pressure on employers to manage insurance expenses. The folks at Oliver Wyman asked about two relatively new approaches that are starting to get some traction.

One is private insurance exchanges, essentially beefed-up menus of coverage options that feature a wider variety of options than you might already be choosing from each year. In some cases, the employer might give you a fixed amount of money to make the decision about which one to pick. About 60 percent of companies would consider this approach if it save them at least 10 percent on health costs, the survey found.

Another option gets a new buzzword: value-based networks. In this approach, providers of health care get paid based on the quality bang for the buck they provide. About half of employers are interested in this option, if it save them at least 10 percent of costs.

As it is, the erosion of employer-based health coverage is well under way, as NPR reported as part of a series on what it's like to be sick in America. "In plain language, it's becoming skimpier and skimpier and less and less comprehensive," Drew Altman, president and CEO of the Kaiser Family Foundation, told us.

Sunday, June 3, 2012

IT pledge has market on pins and needles

WASHINGTON –  President Barack Obama’s pledge to inject $50 billion into the healthcare field over the next five years to develop and support technology has many in the industry wondering how and where that money might be spent.

On Jan. 22, 117 CEOs and business leaders sent a letter to House and Senate leaders supporting federal investment in healthcare information technology, broadband and energy smart grids, saying they “will provide our nation with a near-term stimulus and long-term comparative advantage.”

“Congress and the new Administration face a formidable task, restoring the nation’s confidence and encouraging the innovation, risk-taking and entrepreneurship needed to get our country moving again. The investments in a smarter energy grid, healthcare IT (such as electronic medical records) and accelerating broadband deployment recommended by President Obama will not only stimulate the economy, but will also accelerate long-term growth. They fund the future,” the letter read.

“I expect that the Obama Administration will strongly promote both electronic health records and electronic prescribing, and there is little doubt that this is good news for the country, for patients, for physicians and for Allscripts and other healthcare IT companies,” said Glen Tullman chief executive officer of Allscripts-Misys Healthcare Solutions. “I anticipate these new programs will include both carrots and sticks, similar to the successful CMS e-prescribing program that took effect this month. By encouraging physicians not only to buy the technology but just as importantly to provide incentives for its use, I think we’ll see a significant uptick in adoption and, as a result, better care for patients at lower cost.”

VirtualHealth Technologies, Inc., a Lexington, Ky.-based healthcare IT vendor, issued a press release the day after Obama’s entry into the White House announcing plans to develop new practice management, electronic medical records, secure messaging and patient portal technologies in the coming year.

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."