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May 25, 2016   Download print version

Healthcare supply chain leaders and visionaries honored at 16th Annual GHXcellence Awards

Just 5% of terminally-ill cancer patients fully understand prognosis, study finds

25 million Americans will struggle with vision problems by 2050

U.S. smoking rate does something it hasn't in years

Why the USDA is putting a new warning label on beef, starting this week

Anthem, Cigna merger squabbles could delay antitrust approval: WSJ

Shoulder surgery is the new testing ground for painkiller alternatives

Jump Technologies, Inc. and BIG Inventory announce partnership


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June 2016

Reprocessing in the ambulatory surgery center setting
by Susan Klacik

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Healthcare supply chain leaders and visionaries honored at 16th Annual GHXcellence Awards

Global Healthcare Exchange, LLC (GHX) announced the GHXcellence Award winners at the 2016 GHX Healthcare Supply Chain Summit awards banquet in Austin, TX. The awards, presented to provider and supplier organizations for the past 16 years, recognize the leaders and visionaries that are leveraging supply chain automation to remove waste, cut costs and improve patient care.  

This year GHX added the new Millennium Club award (announced April 20, 2016) for provider and supplier organizations that generate over one million automated transactions annually through the GHX Exchange, as well as eight new provider awards to the 2016 GHXcellence program, which blend quantitative and qualitative criteria to honor true healthcare supply chain leaders and innovation. Additionally, the GHX Provider Best 50 will also be recognized at the awards luncheon.

“This is a highlight of the Summit each year, an opportunity for GHX to recognize the professionals and organizations that are paving the way for true supply chain excellence in healthcare,” said Scott Kelley, vice president, North America Sales and Marketing, GHX. “These GHXcellence winners represent the best and the brightest in healthcare supply chain innovation and success. I am honored to recognize them as they facilitate transformation within the supply chain.”

GHX selected the winners based on quantifiable performance metrics around success in automating business processes, including increases in POs and number of trading partners. This year’s winners include:

·         Supply Chain Leadership (Provider): Bill Mosser, Franciscan Missionaries of Our Lady Health System

·         Supply Chain Leadership (Supplier): Carol Stone, C.R. Bard, Inc.

·         Provider of the Year (Large): Hackensack University Medical Center

·         Provider of the Year (Small to Medium): Seattle Children’s Hospital

·         Supplier of the Year (Large Volume): St. Jude Medical

·         Supplier of the Year (Small Volume): Merit Medical

·         Canadian Healthcare Supplier of the Year: Medtronic of Canada

·         Canadian Healthcare Provider of the Year: Transform Shared Service Organization

·         European Union Healthcare Supplier of the Year: Smiths Medical International Ltd.

·         Trading Partner Pair of the Year: Montefiore Health System and Zimmer Biomet

·         Excellence in Content Management: Integris Health

·         Excellence in Contract Management: Lane Regional Medical Center

·         Excellence in eProcurement: Berkshire Health Systems

·         Excellence in ePayables: Phoebe Putney Health System

·         Excellence in Vendor Credentialing: Sharp Healthcare  

·         Impact Industry Supplier for Credentialing: Teva Pharmaceuticals USA

·         Most Improved Provider: Henry Ford Health System

·         Rookie of the Year: Health Sciences North

For more details on award criteria, visit GHX.


Just 5% of terminally-ill cancer patients fully understand prognosis, study finds

Just a fraction of terminally-ill cancer patients fully understood their prognosis according to a new small study published in the Journal of Clinical Oncology.

Researchers from Memorial Sloan Kettering Cancer Center, Cornell University and Weill Cornell Medicine followed 178 cancer patients who were determined to be terminally ill. They interviewed each patient to see if they understood the gravity of their disease and their future prognosis.

Patients were asked what stage cancer they had, their current health status, how long they expected to live and if they had recently had a life-expectancy discussion with their doctor. Just 5 percent of the patients accurately answered all four questions about their disease and prognosis correctly. Additionally 23 percent of patients had a both recent and previous discussion about their life-expectancy with their doctor, according to the study.

Holly Prigerson, co-author and Director of the Center for Research on End of Life Care at Weill Cornell Medical Center, said it was a "shock" to see how few of the patients fully understood their prognoses. Prigerson said in some cases patients may not "hear" a terminal diagnosis if their physician avoids being blunt about their life expectancy or lack of treatment options.

She emphasized that doctors themselves have a hard time telling a patient there's nothing left that can save his or her life, but patients should be given all information so they can make better decisions.

Prigerson said previous studies have dispelled the idea that terminal patients who are told the truth fare worse than other patients who aren't given full information about their conditions.

Dr. Barbara Daly, director of our clinical ethics program, at University Hospitals Case Medical Center, explained that these end-of-life conversations are difficult since some patients find the information itself "threatening." Daly also said that some doctors speak in medical terms that can be confusing for a patient. "It takes a high level of skill to talk to people…to present it in a way where it’s understandable," said Daly. "Doctors...they literally forget how to talk like a normal person."

Daly said some medical centers are now using a designated person, such as a social worker or nurse practitioner, to talk to patients so that they fully understand their diagnosis and can get more time to talk about their disease.

Visit ABC News for the report.


25 million Americans will struggle with vision problems by 2050

As baby boomers age, the number of Americans with vision problems and blindness is expected to double over the next three decades, a new study suggests. In 2015, slightly more than 12 million Americans had a vision problem. But by 2050, that number will rise to 25 million, the researchers predicted.

"This study gives us a GPS for our nation's future eye health," said lead researcher Dr. Rohit Varma, a professor of ophthalmology at the University of Southern California Keck School of Medicine in Los Angeles.

"Our group and others have shown in previous studies that those who suffer from vision loss not only have a decreased quality of life but can also experience both physical and mental health decline, including an increased risk for chronic health conditions such as diabetes, depression and even death," he said.

The economic burden from vision loss and eye problems in the United States was estimated to be over $139 billion annually in 2013, Rohit said.

More education and screenings are critical for both younger and older Americans to prevent vision impairment that can dramatically affect quality of life, he added.

Regular eye exams, especially for those 40 and older, is an important tool for catching eye problems such as glaucoma, age-related macular degeneration and cataracts. Routine screening also ensures your eyeglass prescription is up-to-date.

"The earlier we can diagnose and treat potentially blinding eye diseases, the greater the likelihood that more people will have the chance to live longer lives without the physical limitations and emotional challenges of vision loss," Rohit said.

For the study, Rohit and colleagues analyzed data on men and women aged 40 and older from six studies on vision loss and blindness. Then they estimated the prevalence of these problems through 2050. U.S. Census data was used to project vision impairment and blindness by age, sex, race and ethnicity and state.

In 2015, whites, women and older adults had the highest prevalence of vision problems, and that will still be the case in 2050, the researchers predicted.

By 2050, the highest prevalence of visual impairment among minorities will shift from blacks -- 15 percent in 2015 to 16 percent in 2050 -- to Hispanics -- 10 percent in 2015 to 20 percent in 2050, according to the study.

The researchers also estimated that people in Florida and Hawaii will have the most vision problems, and people in Mississippi and Louisiana will have the highest prevalence of blindness.

Breaking it down by type of vision impairment, the researchers estimated that by 2050: 2 million Americans will struggle with blindness; 7 million will have glaucoma, which damages the optic nerve, or age-related macular degeneration, which destroys the retina; and 16 million will have the wrong eyeglasses.

Visit HealthDay for the study.


U.S. smoking rate does something it hasn't in years

The nation seems to be kicking its smoking habit faster than ever before. The rate of smoking among adults in the U.S. fell to 15 percent last year thanks to the biggest one-year decline in more than 20 years, according to a new government report.

The rate fell 2 percentage points from 2014, when about 17 percent of adults in a large national survey said they had recently smoked.

The smoking rate has been falling for decades, but it usually drops only 1 point or less in a year.

The last time there was a drop nearly as big was from 1992 to 1993, when the smoking rate fell 1.5 percentage points, according to Brian King of the Centers for Disease Control and Prevention.

The CDC reported the new statistic Tuesday. It's based on a large national survey that is the government's primary measuring stick for many health-related trends.

Smoking is the nation's leading cause of preventable illness, causing more than 480,000 deaths each year in the United States, the CDC estimates.

Why the smoking rate fell so much in 2015 - and whether it will fall as fast again - is not quite clear.

About 50 years ago, roughly 42 percent of U.S. adults smoked. It was common nearly everywhere - in office buildings, restaurants, airplanes and even hospitals. The smoking rate's gradual decline has coincided with an increased public understanding that smoking is a cause of cancer, heart disease and other lethal health problems.

Experts attribute recent declines decline to the mounting impact of anti-smoking advertising campaigns, cigarette taxes and smoking bans.

The increased marketing of electronic cigarettes and their growing popularity has also likely played a role. But it is not yet clear whether this will help further propel the decline in smoking, or contribute to an increase in smoking in years to come.

Visit CBS News for the report.


Why the USDA is putting a new warning label on beef, starting this week

A new USDA-mandated label will start appearing on cuts of beef this week, noting whether the meat was run through a machine that uses blades or needles to pierce and break down the muscle fibers and make it easier to chew. But it also means the meat has a greater chance of being contaminated and making you sick.

The process, which has been used for years, increases the chances of pathogens such as E. coli or salmonella from being passes from one piece of meat to the next. Plus, because the machine digs into the meat, the bacteria can be pushed further inside the meat — meaning it has to be cooked to a higher internal temperature, 145 degrees, to kill it.

“Blade tenderized,” that label might read, followed by safe cooking instructions: “Cook until steak reaches an internal temperature of 145 degrees Fahrenheit as measured by a food thermometer and allow to rest for 3 minutes.”

If pathogens like E. coli or salmonella happen to be on the surface of the steak, tenderizing transfers those bacteria from the surface to the inside. Since the inside takes longer to cook and is more likely to be undercooked, bacteria have a higher chance for survival there. And without a label, you can’t tell if you need to be especially careful with your steak.

Mechanical tenderizing is not an unusual occurrence. FSIS estimates that 2.7 billion pounds, or about 11 percent, of the beef labeled for sale has been mechanically tenderized. The new labels will affect an estimated 6.2 billion servings of steaks and roasts every year, according to FSIS.

The U.S. Centers for Disease Control and Prevention has tracked six outbreaks of foodborne illness since 2000 that were attributable to mechanically tenderized beef products prepared in restaurants and consumers’ homes.

In 2009, 21 people in 16 states were infected with the most common strain of dangerous E. coli called O157. Nine had to be hospitalized, and one victim developed hemolytic uremic syndrome, a potentially fatal kidney disease. USDA food safety officials connected the illnesses to blade-tenderized steaks from National Steak and Poultry, and the company recalled 248,000 pounds of beef products.

Before the label became a requirement, Costco had been voluntarily labeling its meat. According to Consumer Reports, the grocery giant began labeling its mechanically tenderized beef in 2012 after an E. coli outbreak in Canada was linked to their blade-tenderized steaks.

Visit Sacramento Bee for the article.


Anthem, Cigna merger squabbles could delay antitrust approval: WSJ

Quarrels have broken out behind the scenes of Anthem's proposed acquisition of Cigna, as the health insurers seek regulatory approval for their landmark deal, The Wall Street Journal reported this week.

The newspaper said the squabbles could delay or derail antitrust approvals, though the deal does not appear to be in danger of imminent collapse.

Sources familiar with the matter confirmed the citations in the Journal story.

In a series of letters between top officials including their chief executives, the Journal said Anthem and Cigna accuse each other of violating the July merger agreement and fumbling submissions to regulators. A key point of contention is Anthem's lawsuit against Express Scripts, a middleman for prescription drugs, according to the newspaper. The suit accuses Express Scripts of overcharging Anthem for drugs.

Cigna Chairman Isaiah Harris Jr., in an April 9 letter to Anthem's board, said the suit could hurt the prospects for regulatory approval and the combined company's value, the Journal said. Anthem responded to Cigna's board that it had alerted Cigna to the possibility of a lawsuit early in their merger talks, and that getting better prices from Express Scripts could only be beneficial, the newspaper reported.

In a filing with the Securities and Exchange Commission Cigna said that the deal may close in 2017, rather than in 2016 due to the complexity of the regulatory process.

Anthem, meanwhile, said it had not changed its expectations on timing.

Visit CNBC for the article.


Shoulder surgery is the new testing ground for painkiller alternatives

A common shoulder surgery has become a testing ground for some novel painkilling techniques as doctors seek to reduce the use of prescription narcotics known as opioids.

Rotator-cuff surgery, which aims to repair a shoulder tendon that can get torn from sports, a bad fall or simple wear and tear, is among the most painful for patients to recover from. If nonaddictive painkilling techniques can be shown effective with this surgery, doctors hope they will be more widely adopted especially by orthopedic surgeons, who are among the most frequent prescribers of opioids.

The techniques might include injecting a nonaddictive anesthetic at the base of the neck to block pain signals, or sending a patient home with a catheter implanted under the skin to deliver doses of anesthetics for several days. Wearable icing devices and mechanical stimulation of the surgical site can reduce pain and swelling during physical therapy. And drug regimens seek to steer patients within a few days toward common medications such as Tylenol.

Some of the techniques to control pain have been around in some form for years. But their use in combination, known as multimodal management, is gaining popularity amid mounting concern about an epidemic of opioid addiction. A July 2015 study in Mayo Clinic Proceedings found one in four people who were prescribed a narcotic painkiller for the first time progressed to long-term prescriptions, putting them at risk for dependence and dangerous side effects.

“As a profession we prescribe too many narcotics for too many patients,” says Andrew Rokito, chief of the division of shoulder and elbow surgery at NYU Langone Medical Center’s Department of Orthopaedic Surgery in New York. “Barring unusual circumstances, we should be able to get a good handle on patients’ pain after surgery and minimize their opioid use.”

Catheters can be a problem for some patients, Dr. Rokito says. The devices don’t always stay in place and having a catheter protruding from the neck for several days can be “intimidating” for some people. Patients also must get used to having their arms numb and weak for several days.

More often, Dr. Rokito says he uses single-dose injections of nerve blocks that can last up to 24 hours. He advises patients to start on a short course of opioid medication before the block wears off to ease the transition. After three or four days, Tylenol is generally sufficient.

Risks from injections include nerve damage and complications from leakage of the anesthetic. Local anesthetic also can be toxic to cartilage. But Dr. Rokito says the blocks are safe because they are directed at the nerves that supply the shoulder region and aren’t placed directly in the surgical site.

In a study of 85 patients, published online in April in the journal Arthroscopy: The Journal of Arthroscopic & Related Surgery, researchers at the University of Chicago reported that a group sent home with a three-day continuous nerve block had better pain control, used fewer opioids and slept better than patients given a single injection at the time of surgery.

Tariq Malik, lead author of the study and assistant professor of anesthesia and critical care at University of Chicago Medicine, says the three-day block allows patients “to get over the hump of the worst pain so the inflammation subsides enough to make it more manageable.”

Operations to repair torn rotator cuffs, which attach the upper arm to the shoulder blade, have increased sharply over the last two decades, in part as the aging population seeks to maintain an active lifestyle. Nearly two million patients a year seek help for rotator-cuff injuries, and about a third of those require surgery, according to the American Academy of Orthopaedic Surgeons.

A study in January in the American Journal of Orthopedics estimated outpatient surgical costs for rotator-cuff repair at close to $6,000. Proponents of alternative-pain-control approaches say they would add minimally to the costs and could save in the long run due to the high costs related to narcotic overuse.

Visit the Wall Street Journal for the report.


Jump Technologies, Inc. and BIG Inventory announce partnership

Jump Technologies, Inc., a software company with solutions that improve supply management and BIG Inventory, an inventory service company that helps hospitals conduct physical inventory in all medical-surgical and clinical areas, announced a partnership to help health systems improve end-to-end inventory visibility and management, while increasing efficiency and cost reductions.

Supply chain costs represent the second largest and fastest growing area of expense for hospitals. With the ever-increasing need for greater cost reductions, improving the management of inventory presents a significant opportunity. As many hospitals continue to rely on par approaches to inventory replenishment, which grow less accurate over time due to ongoing estimation of supplies, conducting an expert, accurate physical inventory to understand supply levels, then managing supplies with accurate tracking and velocity reporting, can help healthcare systems reduce inventory levels by as much as 20 percent.

With this partnership, BIG Inventory and Jump Technologies are aligning their resources to help provider organizations improve the management of supplies, from the time they enter the health system until they are used in patient care.

BIG Inventory brings resources to plan and conduct an organization’s physical inventory throughout the hospital, including all medical-surgical and clinical areas. Working with BIG Inventory, hospital supply chain leaders can manage this labor-intensive task without tying up internal resources. Then with an accurate picture of on-hand inventory, hospitals more efficiently shoulder the ongoing management of supplies using JumpTech’s cloud-based solutions, which provide visibility from demand-to-use, increasing the accuracy of supply replenishment and helping eliminate overstocking and stock-outs.

Visit Jump for the release.