A new chapter in the continuing story of antibiotic resistance is being written in doctors' offices across the country, as a group of common bacteria rapidly becomes resistant to the antibiotics that have been used to treat them for decades. The bacteria are called Staphylococcus aureus, or staph for short. Staph are the most common cause of skin infections like boils and can also cause lung infections, bloodstream infections and abscesses in the body's internal organs. In hospitalized patients, infections caused by antibiotic-resistant staph have been common for years. Among healthy people, though, antibiotic resistance in staph has not been a big problem. Since the 1970's, doctors have routinely, and successfully, treated staph infections in healthy patients with penicillin-like drugs. Not anymore. Office doctors who follow this practice now may find their patients getting sicker instead of better.

Through Gaps in System, Nurse Left Trail of Grief
The New York Times, 2/29/2004

He tried suicide at least three times, did four stints at mental hospitals, broke into a colleague's house and wanted a doctor prosecuted just for drawing his blood. He was once found wearing surgical scrubs at the missile controls of a nuclear submarine, and he was known in his neighborhood for his nighttime chasing of cats. And even before the deaths that led to his arrest in December, at least four times in his career as a nurse, people claimed Charles Cullen might have killed patients in New Jersey and Pennsylvania.

The chore busters: New concierge service keeps
University Hospital staff sane
Cincinnati Business Courier, 2/27/2004

Kathy Moller works longer hours as a registered nurse at University Hospital now that concierges Melissa Gunning and Tina Napier run her errands. That's exactly what Karen Bankston, vice president for external relations at the Health Alliance (University Hospital's parent agency) hoped for when she decided to try out the services provided by Best Upon Request.

Ailing hospitals losing revenue to suburban medical offices
Business First of Buffalo (NY), 2/27.2004

Colonoscopies are the newest among diagnostic tests and surgical procedures that are leaving Western New York hospitals and finding homes in medical centers that are right in patients' neighborhoods in many cases. Colonoscopies join MRI scans, cataract surgery and other tests and procedures that are able to be performed in community-based medical offices, usually in populous suburbs, where it is more convenient for doctors and patients. It also less expensive – estimated to be about $300 less per colonoscopy – because there are fewer fixed costs in a small office than a big hospital.

Hospitals see growth in outpatient services
Dallas Business Journal, 2/27/2004

Under pressure to create revenue to offset slim margins from inpatient care, hospitals nationwide are focusing on ambulatory care service lines. And, according to new research, those with clearly defined organizational goals and substantial research of their markets are most successful. Ambulatory care, defined as medical care delivered on an outpatient basis, plays a significant role in the United States, accounting for 4.4 billion visits in 2002 alone.

Patients' Rx: fast food?
Dallas Business Journal, 2/27/2004

Craving a juicy hamburger? Can't live another second without a cup of gourmet coffee? Don't let a minor inconvenience like being in the hospital get in your way. More and more Dallas-Fort Worth hospitals are resembling shopping-mall food courts, with retail kiosks and counters offering everything from Subway sandwiches and McDonald's fries to Starbucks coffee.

Physician-investors may learn hospital
privileges have a price
The Business Journal of Kansas City, 2/27/2004

Throughout the country, community hospitals have started kicking entrepreneurial doctors out, revoking admitting privileges if a physician invests in a competing hospital or outpatient facility.

Robots Assist Heart Surgeons
The Wall Street Journal, 2/26/2004

A four-armed surgical robot costing $1.2 million is becoming a fixture in a growing number of hospital operating rooms. But is it the next wave in minimally invasive surgery, or technological overkill at an exorbitant price?

Specialty hospitals growing fast
The Dallas Morning News, 2/26/2004

For much of last year, executives at Texas Health Resources brainstormed with architects and lawyers to build a project that would ward off a looming competitive threat. But in December, President Bush helped dash the company's plans for a specialty hospital in Garland that would perform mostly lucrative surgical procedures. Buried in the new Medicare legislation he signed was a little-noticed moratorium halting construction of such hospitals for 18 months. THR's scramble highlights the pressures large hospitals face from a new brand of rivals – small hospitals, often with 20 or fewer beds, which specialize only in a few profitable kinds of operations. Rather than see these facilities steal away their revenue, some companies such as THR are getting into the business themselves.

Bar Codes Favored to Cut Hospitals' Drug Errors
Washington Post, 2/26/2004

Many of the plastic identity bracelets that hospital patients wear will soon have an added bit of information embossed on them -- a bar code containing information designed to make sure patients do not get the wrong drug or dosage by mistake.

FDA Will Require Bar Codes On Hospital-Dispensed Drugs
The Wall Street Journal, 2/26/2004

Prescription and over-the-counter drugs given to patients in hospitals will require bar codes as a safeguard against medical errors, the U.S. government announced. Bar codes also will be required for vaccines, as well as machine-readable information on blood and blood products.

J&J and Guidant Form Alliance
Before Launch of a Rival's Stent
The Wall Street Journal, 2/25/2004

Johnson & Johnson and Guidant Corp. roiled the $4 billion market for coronary stents by announcing they are joining forces to market J&J's drug-coated device in advance of the expected launch of a competitor.

PREVENTING MEDICAL ERRORS: U-M hospital's goal:
Safest in the nation
Detroit Free Press, 2/24/2004

Kati Bauer was concerned. The incision on her husband's neck "looked yucky." But when she told several young physicians caring for him in June 2002 at the University of Michigan Medical Center, they dismissed her concerns, she says. The medicine they had prescribed would protect him, she says they told her. Jim Bauer, a builder hospitalized with serious injuries from a fall at work, then developed an infection that added weeks to his hospital stay and threatened his life.

Hospitals embracing information technology
Milwaukee Journal Sentinel, 2/22/2004

It's not like hospitals are strangers to high technology. They are crammed with information-age machines capable of amazing tasks. Some peer into a patient's insides and capture video of beating hearts. Others zap tumors with precise bolts of radiation. Yet, when it comes to how a doctor informs colleagues of a patient's diagnosis or a nurse about a care plan, the technology often is little more advanced than hand-scrawled notes or mumbled dictation into a tape recorder.

Rival wants a piece of Cypher
The Miami Herald, 2/20/2004

In what's shaping up as a multibillion-dollar global battle, Boston Scientific is expected to receive federal approval soon for a drug-coated stent that could provide massive competition to the Cypher manufactured by Cordis, based in Miami Lakes. The stakes are huge. In just the 10 months since its introduction in the United States, the Cypher has enjoyed unprecedented success for a medical device, having been inserted in 500,000 patients worldwide and having earned Cordis' parent company, Johnson & Johnson, about $1.5 billion in revenue.

Hospitals take high-tech, low-tech roads to curb medical mishaps
Baltimore Business Journal, 2/20/2004

Maryland hospitals have redoubled efforts to make patient safety their No. 1 priority. There's much at stake. Businesses and the public increasingly choose hospitals based on the quality of care they deliver. Maryland has been a pioneer in patient safety. It's been nearly 20 years since the Maryland Hospital Association started its "Quality Indicator Project" so hospitals could measure and assess their clinical performance in order to improve the quality of their care. This has proved so successful that hospitals in all 50 states and 12 foreign countries now participate.

FDA Looks to Chips to Thwart Drug Counterfeiters
Washington Post, 2/19/2004

To protect against the threat of counterfeit drugs, the Food and Drug Administration wants drugmakers, distributors and pharmacists to adopt new technologies – including embedded computer chips that would transmit identifying information – by 2007.

FDA Plans Bogus-Drug Crackdown
The Wall Street Journal, 2/19/2004

The Food and Drug Administration unveiled its plan to crack down on counterfeit prescription drugs, with a focus on pushing new technologies that would help track and protect medicines. But the initiative, which will combine with efforts by state regulators, doesn't include an immediate solution to a problem that investigators have identified as one of the most pressing: tracing and documenting the origins of drugs, which can sometimes change hands multiple times on the route from factories to drug-store shelves.

Hotel or hospital?

Washington Business Journal, 4/5/2004

Industry code alters drug firm, physician interaction

St. Louis Business Journal, 4/2/2004

Hotel food services managers used to light up when pharmaceutical companies scheduled events. But not any more. The change came in July 2002 when the pharmaceutical industry adopted standards developed by the Pharmaceutical Research and Manufacturers of America, known as the PhRMA Code. The code offers guidelines for how sales representatives and others involved in marketing pharmaceuticals should interact with health-care professionals. For companies that choose to follow the code, it eliminates entertainment of doctors and other health-care professionals as an acceptable form of interaction. Gone, too, are most meetings at golf resorts, since the code calls for meetings to take place at "a venue conducive to providing scientific or educational information. Specifically, this means no 'dine and dash,' no entertainment and recreational events (for example, sporting events or spa visits)," according to the association's code.

Finding a cure for what ails them: Hospitals
search for balance in correcting errors

Baltimore Business Journal, 4/2/2004

Mistakes happen. That is a fact of life. But when mistakes happen at a hospital, they could mean life, death or serious injury.

3M’s Rising Star

BusinessWeek Online, 4/2/2004

Jim McNerney was one of those boys: up early in the morning climbing trees while everybody else in the family was in bed, rousing his three younger brothers to play two-on-two hockey in their basement, running his high school's boys club, and pitching on the varsity baseball team. And he grew up to be one of those men: For three decades, Walter James McNerney Jr. has climbed the corporate ladder without a pause, uprooting his family every two to three years since earning his master's degree from Harvard Business School in 1975. He job-hopped from Procter & Gamble to McKinsey & Co. and then up through General Electric. On Jan. 1, 2001, after losing a three-way race to succeed John F. Welch as chief executive, he moved on yet again to become chairman and CEO of 3M, the first outsider to head the Saint Paul (Minn.) company in its century-long history. It has been a remarkably seamless transition. In many ways, 3M is a mini General Electric Co. Both are industrial conglomerates that seek to balance slowdowns in one industry with upturns elsewhere, and both have strong traditions of discipline, quality, and an intense focus on measuring and rewarding performance.

Many Hospitals Resist Computerized Patient Care

The New York Times, 4/6/2004

For years, technology has been held out as an important way to curb the scourge of medical errors. President Bush and Senator John Kerry have each called for a bigger commitment to computerization to reduce the 98,000 avoidable deaths a year that an eye-opening federal report in 1999 said might be caused by mistakes of doctors, nurses and other hospital personnel. Yet even now, despite pressure from large employers, unions and health care advocacy groups - and aggressive marketing by vendors - only a few dozen medical centers across the country are making full use of the latest computerized patient safety systems.

Bronx Hospital Embraces Online Technology
That Others Avoid

The New York Times, 4/6/2004

T o prescribe drugs for a hospital patient he visited recently, Dr. Matt Berger did not whip out a pen and paper. In fact, there was not a chart or prescription pad in sight on the ward. Instead, he sat down at a computer. Dr. Berger, chief of the medical service at Weiler Hospital of Montefiore Medical Center in the Bronx, wanted to order a blood thinner for the patient. The computer checked whether the patient was already taking the medication, whether he was allergic to it, whether there might be a negative interaction with another drug he was taking, whether any of his lab tests indicated a danger in taking the new one, whether the dosage was correct for someone his size and age, and whether there was a cheaper alternative. In a blink, the computer warned of a potentially dangerous interaction with two antibiotics the patient was on, suggested a much lower dose of the blood thinner, proposed a less expensive drug and calculated the appropriate dose.

12 Simple Rules for Complex IT Projects

HealthLeaders Magazine, 4/7/2004

How do you begin to manage an IT implementation overhaul involving a landmark Chicago hospital? Mike Sommers, CIO of Cook County Bureau of Health Services, offers some simple rules that apply to project success big and small.

With New Chief, GE Healthcare Breaks Tradition

The Wall Street Journal, 4/8/2004

When Sir William Castell, the incoming chief executive and president of General Electric Co.'s medical unit, addressed his team earlier this year, he quickly demonstrated a management style considered quite apart from the GE mold.

For one thing, unlike most GE managers, he spoke without using a Power Point presentation. And rather than focus on the numbers he wanted to achieve, he asked managers and technicians to take part in a "dreaming session."

Hospitals 'think lean' to fight rising costs

The Business Journal (Minneapolis/St. Paul), 4/9/2004

Area hospitals and clinics are adopting "lean thinking" programs to cut the fat from their operations. The fight is not against obese patients, but rather against the escalating costs of health care. St. Louis Park-based Park Nicollet Health Services, Bloomington-based HealthPartners and Minneapolis-based Allina Hospitals and Clinics are all employing efficiency techniques created by the automobile industry.

To Fix Health Care, Hospitals Take Tips From Factory Floor

The Wall Street Journal, 4/9/2004

In the factories of Toyota Motor Corp., any worker who spots a serious problem can pull a cord and stop the assembly line. Richard Shannon, chairman of medicine at Allegheny General Hospital, is applying the Toyota technique to an intensive-care unit here. Just the other day, a nurse brought the medical "production line" to a halt. Candice Bena thought a 76-year-old patient needed a new intravenous line but couldn't get the radiology department to install one immediately. Fearing the patient would develop an infection, the nurse phoned Dr. Shannon. That was the equivalent of pulling "the 'andon' cord," says Dr. Shannon, using the Japanese word for "lantern." He immediately called the hospital's chairman of radiology, who within two hours installed the new IV line himself.

Hospital bills spin out of control

USA Today, 4/12/2004

Hospital sticker shock is hitting the USA. It isn't just $5-a-pill aspirin. Daily room charges exceed $5,000 in some New Jersey hospitals. An appendectomy in California, including about two days in the hospital, has an average list charge of $18,000. Nationally, federal data show the median charge for treating a heart attack is more than $20,000. Rapidly rising hospital charges have placed hospitals in the spotlight. Critics say hospitals are unfairly using their growing clout in many markets and charging far more than it costs to provide services.

As Obesity Surgeries Soar, So Do Safety, Cost Concerns

The Washington Post, 4/11/2004

The number of overweight Americans resorting to stomach-shrinking surgery is rising so rapidly that health experts and insurance companies are increasingly becoming alarmed about the safety, effectiveness and mounting costs of the operations. While the operations can produce dramatic benefits for very obese people, some hospitals and surgeons may be rushing too quickly to satisfy the surging demand, offering the lucrative procedures without adequate training, experience and support, experts say.

Barred as Rivals, Doctors See Some Hospitals in Court

The New York Times, 4/13/2004

For nearly 20 years, Dr. Bruce E. Murphy, a cardiologist and the son of a Baptist minister, has admitted patients to hospitals operated by Baptist Health, the dominant hospital system in Little Rock, Ark. Then in February, he received a letter from Baptist Health saying it might end his hospital privileges. Dr. Murphy recalls thinking, "It's not a very Christian thing to do, is it?" But religion, or health care for that matter, is not really the main issue. Dr. Murphy is one of the doctors with an ownership stake in a nearby competitor, the Arkansas Heart Hospital, where he also serves as medical director and where he sends many of his patients. And after seven years of watching Arkansas Heart vie for patients, Baptist Health, the largest health care organization in the state, is warning Little Rock's cardiologists that to invest in the competing hospital could mean no longer treating patients at a Baptist Health hospital.

Designing a Better Place to Die

The Wall Street Journal, 4/13/2004

Hospitals around the country are trying to make the ICU a better place to die. The intensive-care unit is a high-tech environment dedicated to saving lives. But the reality is that about 20% of all U.S. deaths occur there in the midst of its blinking monitors, ventilator tubes and busy white-coat clad staff. Hospitals are increasingly devoting more resources to making those who die there more comfortable. The goal is to achieve a peaceful death in which a person slips away surrounded by family and friends.

Hospitals put medical skills on display with live webcasts

Baltimore Sun, 4/13/2004

Hospitals are increasingly producing live streaming video of their surgeries and posting them on the Internet, where they're available to anyone - sort of ER meets reality TV. Such surgical webcasts are often a teaching tool. Doctors who watch them can generally take an exam for continuing education credit. But much of the impetus for the webcasts has come from hospital marketing departments, which believe this is a new way to build awareness of their services and attract patients.

With Tiny Brain Implants, Just Thinking May Make It So

The New York Times, 4/13/2004

Can a machine read a person's mind? A medical device company is about to find out. The company, Cyberkinetics Inc., plans to implant a tiny chip in the brains of five paralyzed people in an effort to enable them to operate a computer by thought alone.

Project uses computers to analyze nursing care

Milwaukee Journal Sentinel, 4/12/2004

Nurses at three Aurora Health Care hospitals are turning to technology to reduce costs and speed patient recovery. A new project involving Aurora; Cerner Corp., a Kansas City, Mo., health care information technology company; and the University of Wisconsin-Milwaukee will analyze how nurses care for patients and then suggest improvements.

As Tech Spreads, Hippocrates Dawdles

The Washington Post, 4/14/2004

One of the great anomalies of the U.S. health care system is that it is one of the most technically advanced industries and one of the most backward.

Virtual Colonoscopy Method Questioned

The Associated Press, 4/14/2004

The accuracy of virtual colonoscopy, which provides a computer-generated 3-D view of the colon, varies considerably, depending on the training and methods of the doctors performing it, researchers say. The cancer-detecting procedure is less reliable than previously thought and not ready for widespread use, according to a study of 600 patients at nine major clinics.

Rx by E-Mail May Save $29 Billion

The Wall Street Journal, 4/15/2004

A shift by physicians and pharmacies from handwritten to e-mail drug prescriptions could cut the nation's spiraling health-care costs by $29 billion a year, health researchers said in a new report. A nationwide "e-prescription" system could minimize confusion caused by hard-to-read handwritten prescriptions, preventing serious errors in doses and drug combinations, according to eHealth Initiative.

Making house calls, digitally

Charlotte News & Observer, 4/14/2004

The technology to remotely monitor patients' pulse, weight, blood pressure, blood-oxygen levels, general mobility and other indicators is already widely available. The declining costs and increasing use of high-speed Internet service should only accelerate acceptance of monitoring devices.

Hospitals refine tactics to retain profits
going to specialty centers

The Business Journal of Kansas City, 3/19/2004

Bruce Van Cleave works three miles from enemy territory. That would be Nall Avenue south of Interstate 435, home to Diagnostic Imaging Center, Eye Surgery of Kansas City, Pediatric Plastic Surgery and several dozen other outpatient health care providers. For Van Cleave's Carondelet Health, which operates Saint Joseph Health Center, and for other community hospital executives, a drive down Nall Avenue is like watching snipers pick off all the profitable parts of health care.

Appeals court clarifies rules for hospital joint ventures

Business First of Columbus, 3/26/2004

While there are highly publicized disagreements over the issue of physician ownership of specialty hospitals, such as the New Albany Surgical Hospital, such disputes are the exception, not the rule. In many cases, hospitals and physicians find ways to avoid such disputes and come together as partners, by forming joint ventures for the provision of various medical services.

These joint ventures can enable both hospitals and physicians to work together, in a mutually beneficial way, to enhance the quality and convenience of health-care services. However, when the hospital involved is a nonprofit, tax-exempt organization, it must be careful.

FBI raids California surgery clinics

The Wall Street Journal, 3/19/2004

The Federal Bureau of Investigation and other law-enforcement agencies raided three Southern California outpatient-surgery clinics as part of a 15-month investigation into what insurers call one of the biggest health-care frauds ever, an insurance-industry group said. Insurers and employers have been bilked out of somewhere between $300 million and $500 million in recent years by claims for unnecessary surgeries, health insurers say.

Drug dispensing goes high tech

The Atlanta Journal-Constitution, 3/27/2004

When an ob/gyn patient at Piedmont Hospital needs a medication, a nurse will deliver it, as always. But before that happens, the doctor will have ordered the drug on a computer, and a pharmacy robot likely will retrieve it and drop it into a bin marked for the patient. Later the nurse on the floor will use a bar-code scanner to double-check that the right patient is getting the right drug, the right dose, at the right time. This is health care catching up to the 21st century. With all the modern miracles it can produce, medicine has in some ways been stuck in old technology: prescriptions written in ballpoint, for example. But that's slowly changing, and the momentum is coming from sharper focus on medical errors and quality of care.

Wal-Mart hits snags
in push to use radio tags to track goods

The New York Times, 3/29/2004

When Wal-Mart Stores surprised its suppliers last summer by announcing an aggressive timetable for them to put radio frequency tags on their shipments, it put manufacturers of the most tightly controlled prescription drugs on the fastest track of all. They were supposed to send bulk shipments of such drugs in radio tag containers to a distribution center near the company's headquarters in Bentonville, Ark., by the end of March. With that deadline just days away, Wal-Mart is now admitting that it will not be met. A few companies have begun sending radio-tagged drugs, a Wal-Mart spokesman, Gus Whitcomb, said, although he declined to identify them. Mr. Whitcomb said that the company, which operates 3,000 pharmacies, had revised its goal and wanted all drug makers on board by the end of June.

Suppliers may miss tracking mandate set by Wal-Mart

The Wall Street Journal, 3/31/2004

Only 25% of suppliers will be able to meet Wal-Mart Stores Inc.'s January 2005 deadline to equip merchandise pallets and cases with radio-frequency identification tags because technologies are incompatible and the shift lacks immediate benefits for suppliers, according to a study by Forrester Research Inc. A supplier's average initial investment in radio-frequency-tag technology will be at least $9.1 million in equipment and added labor costs, Forrester said, but suppliers won't see projected benefits, such as reduced product damage, out-of-stocks or theft, for several years. At the same time, Wal-Mart has said it won't let suppliers add those costs to their wholesale prices.

Hospitals phase in bar-coded medication regimen

The Business Review (Albany), 3/26/2004

Local hospitals are preparing to spend a hefty amount of money to comply with a federal plan requiring step-by-step tracking of medication administration via bar-coded medicines.

Just the basics: Aurora launching Quick
Care sites in pharmacies, stores

The Business Journal of Milwaukee, 3/26/2004

Aurora Health Care is launching basic medical clinics known as Aurora Quick Care, which will test and diagnose patients for common medical problems in 10 to 15 minutes for $30 at retail pharmacies, grocery stores and other locations.

Improving Laparoscopic Surgery

The New York Times, 3/29/2004

Lester Cohen seems an unlikely candidate to revolutionize the field of surgery. A business major at New York University in the 1950's, he went on to help run a successful family business that produced, among other things, elastic straps for brassieres. Tomorrow, Mr. Cohen will receive his second patent for a device that he contends should make certain kinds of surgery safer and faster. Some experts in the surgical field think Mr. Cohen might be right. Mr. Cohen has developed a novel clamp that he says "takes the best of both worlds" - from traditional surgery and newer laparoscopic surgery - and combines these two approaches into a new hybrid type of surgery. It allows the surgeon a fuller view of the inside of the patient – as if there was a full surgical incision – but through the smaller incisions of laparoscopic procedures.

N.J. firm hopes to license talking pill bottles

The Philadelphia Inquirer, 3/29/2004

Frustrated by trouble reading the tiny instructions on a medicine bottle, entrepreneur Jerry Mahoney decided to help others who also struggle to make out the fine print. Now his five-year-old software company, iVoice Inc., of Matawan, is developing a miniature computer-chip-and-speaker system that fits on the bottom of a prescription bottle. When pressed, the device will say what is in the bottle, how to take it, and whether to watch out for side effects or interactions with other drugs or alcohol.

Advice from the top:
Climbing the ladder in the health industry

The Wall Street Journal, 3/31/2004

Dan Hilferty is president and CEO of Philadelphia-based AmeriHealth Mercy/Keystone Mercy Health Plan, a Medicaid managed-care plan that, along with its affiliates, provides services to more than one million members in six states. Mr. Hilferty, a finalist for Managed Healthcare Executive magazine's Reader's Choice Executive of the Year, has led AmeriHealth Mercy since 1996. Prior to his tenure there, he was the executive director of PennPorts, where he managed economic-development programs related to the ports of Philadelphia, Pittsburgh and Erie. The Online Journal talked with Mr. Hilferty about changes in the health-care industry and what it's going to take for people starting out to be successful.

Hospitals could pay price to mend Medicare
The Street.com, 3/25/2004

Medicare could pour salt on the wounded hospital industry. Seeking a cure for its own financial woes, Medicare may pull the knife on hospitals in an effort to save itself. Otherwise, the tax-funded health insurance program – forced to cover massive crowds of aging baby boomers – could wind up bankrupt in just 15 years.

Health-Care Industry Struggles With Keeping Patient Data Secure

The Wall Street Journal, 4/28/2004

As the health-care industry moves to switch to electronic medical records from archaic paper files, many organizations are woefully unprepared to safeguard the confidentiality of patient data and stop it from being leaked or stolen. Those are the conclusions of a new report from URAC, a nonprofit group that audits and accredits quality measures in health-care organizations, which says the U.S. health-care industry faces big stumbling blocks in its scramble to comply with the new security provisions of the privacy law, known as the Health Insurance Portability and Accountability Act.

Revenue Management: A Story in Three Acts

HealthLeaders, 4/28/2004

Hospitals too often limit their revenue cycle initiatives to collecting revenue that has been billed. Healthcare Delivery Design Group President Patrick Shumaker says that an effective revenue plan is built on capturing efficiencies at three-parts along the revenue cycle, not just one.

Maryland VA Center
Installs New Filmless Imaging Department

The Washington Post, 4/28/2004

The Baltimore Veterans Affairs Medical Center installed the nation's first filmless imaging department, and a paperless computerized system keeps track of every patient's medical data.

Malpractice lawsuit accuses hospital of mishandling X-ray

Baltimore Sun, 4/29/2004

A 19-year-old Baltimore woman is suing Harbor Hospital, charging that it lost, misfiled and failed to read a critical X-ray, delaying the diagnosis of what she says is now a terminal cancer.

A Glimpse at the Future of DNA:
M.D.'s Inside the Body

The New York Times, 4/29/2004

Scientists have developed what they say could become the world's smallest medical kit: a computer, made of DNA, that can diagnose disease and automatically dispense medicine to treat it. The computer, so small that one trillion would fit into a drop of water, now works only in a test tube, and it could be decades before something like it is ready for practical use. But it offers an intriguing glimpse of a future in which molecular machines operate inside people, spotting diseases and treating them before noticeable symptoms even appear.

United Makes a Move to the East

HealthLeaders, 4/30/2004

United Group's $5 billion bid to buy Oxford Health Plans is another large grab in a year of big health plan mergers. HealthLeaders Research market analyst Heather Wicks analyzes what the deal means to the companies, the region and the industry.

Doctors: 'E - Nose' Can Sniff Out Ailments

The Associated Press via The New York Times. 4/30/2004

Researchers at the University of Pennsylvania have completed several studies that they say demonstrate the promise of a hand-held “electronic nose” for diagnosing pneumonia and sinusitis by analyzing a patient's exhaled breath. The doctors, who presented their findings on Thursday at a conference in Phoenix, believe that the e-nose device could make it faster, easier and cheaper to spot some respiratory diseases and, as a result, reduce unnecessary prescription of antibiotics.

Sutter’s tech prescription: Take lots of cash

San Francisco Business Times, 4/30/2004

Sutter Health will spend $1.2 billion on information technology for its Northern California hospitals and medical groups, joining rivals Kaiser Permanente and Catholic Healthcare West in what is sure to become a high-stakes technology battle.

In battle against health-care inflation, online
access to patient info offers incremental savings

Business First of Columbus, 4/30/2004

Finding answers to key questions such as a patient's insurance eligibility or co-payment due has become a lot easier for health care providers, thanks to the increasing number of insurance companies that offer online access to patient information. Insurers have invested billions of dollars in increasing their electronic capabilities, according to the Washington, D.C.-based trade group Health Insurance Plans of America, including the development of physician portals, which allow doctor's offices or the billing services they hire to interact with insurance companies using secure Web sites, rather than contacting the company's customer service staff over the telephone. The portals should lower administrative costs for doctors by streamlining the claims process, insurance company officials say, in addition to speeding up payments to health-care providers.

New Jersey Hospital Where 13 Were
Killed Prepares to Face Lawsuits

The New York Times, 4/30/2004

It was the hospital that finally stopped Charles Cullen, but now Somerset Medical Center is in the eye of a legal storm. Mr. Cullen, one of the worst mass murderers in New Jersey's history, confessed that he had murdered 13 patients at the hospital, and had attempted to murder two more. Five of those murders and one of the attempted murders occurred after the hospital was first warned that someone there might be intentionally poisoning patients. In the wake of the deaths, the hospital for one of New Jersey's richest counties is hunkering down for a storm of civil negligence and wrongful death suits headed its way.

Baptist halts its costly IT upgrade

Birmingham Business Journal, 4/30/2004

Debt-ridden Baptist Health System Inc. is pulling the plug on its multimillion-dollar effort to install Siemens Medical Solutions Health Services Corp.'s Soarian software throughout its hospitals. Soarian is Siemens' latest generation of information technology software for hospital systems and helps with electronic record-keeping, communications, patient care and safety and with the storage and retrieval of digital images such as X-rays and MRIs.

Kapiolani’s telesurgery will reach doctors worldwide

Pacific Business News (Honolulu), 4/30/2004

Kapiolani Medical Center for Women & Children will begin broadcasting live surgeries to physicians from around the world next week. The hospital, which unveiled two $800,000 surgical suites this month, will be the first local facility to use telesurgery. A subset of telemedicine, it uses high-bandwidth video conferencing to connect with doctors outside the hospital.

$35 million settlement announced in UW billing case

The Seattle Times, 5/1/2004

The University of Washington destroyed and sanitized reports on billing fraud at its medical centers, according to a whistle-blower lawsuit that led to a criminal investigation and a $35 million settlement announced today — the largest against a U.S. teaching hospital. The lawsuit, which has been under seal for almost five years, also details how the university changed its policies to allow doctors to bill the government for more expensive services than they had performed.

Hospitals Turn Off the Pagers and Find the Doctor Faster

The New York Times, 5/4/2004

Big plans for using wireless devices to streamline business practices — by tracking things like an individual yogurt container from the factory floor to the grocery store door — keep slipping into the future. But when Brian Horton, the director of the emergency department at Mercy Medical Center in Roseburg, Ore., needs to talk to somebody right this minute, he no longer has to have the nurse or doctor paged. He presses a button on a palm-size device, speaks the person's name and, in most cases, gets an immediate reply. So far, hospitals are the front line in the integration of wireless into the workplace.

Hospitals Administer Antidote for Bad Debt

The Wall Street Journal, 5/4/2004

As bad debt from uncollected patient bills piles up at the nation's hospitals, some of them are defending themselves with an ancient but perfectly legal accounting tool: the eraser. The maneuver could shrink reported bad-debt expenses, but it won't boost earnings – or relieve the pressure on hospital share prices.

Docs find shift to paperless isn’t painless

The Business Journal of Kansas City, 4/16/2004

Want to see your doctor break out in hives? Whisper the term "electronic medical record." The federal government wants to improve health care by eliminating paper, that oft-disparaged source of mistakes, misfilings and misreadings that contribute to medical errors. Kevin Walker, a consultant to physician practices with Century Business Services Inc., said doctors generally agree with the idea. Implementation is what makes their hands start trembling.

7 Tips for Creating the New American Hospital

HealthLeaders, 4/19/2004

The model for the typical American hospital has survived for decades. But former hospital CEO and current consultant Gary Campbell says the new healthcare landscape requires an improved model that embraces concepts of teamwork and ownership.

The End of Primary Care

The New York Times, 4/18/2004

The patient shivered as she waited for the doctor to climb the stairs to the second floor. She was 6 years old, and a fever had kept her home for the past few days. Her mother, half of a working couple with four other children, called the doctor that afternoon. The child listened as her mother's voice grew closer, punctuated by an occasional low-pitched question. Fear overcame malaise, and the girl slipped quietly under the bed. The doctor, a tall, thin man with reddish-blond hair and freckles, glanced around the room and then somewhat awkwardly lowered himself onto the floor. He smiled at the girl. ''Hello, Lisa,'' he said to me. And then we talked – right there, underneath the bed, as if it were the most natural thing in the world. I don't remember what we talked about or how long the conversation lasted. But that morning and for years after, I trusted the man with the freckled face to care for me – whenever care was needed. It's that bond that drew me and others to the practice of medicine.

In a High-Tech World, Pacemaker Risks Rise

The New York Times, 4/20/2004

As high-tech gadgets and devices proliferate, people who use pacemakers are finding themselves in a world that is increasingly difficult to navigate. Once concentrated in the workplace, devices that can disrupt pacemaker function are now much harder to avoid. Metal detectors hidden in store entrances and exits, for example, can be impossible to spot. Magnetic resonance imaging techniques, often considered a danger to those with pacemakers or implanted defibrillators, have become a common diagnostic procedure. But sometimes, doctors have found, the culprit can even be something that appears relatively innocuous.

Sensors Seeking ‘Dirty Bombs’
Often Pinpoint Patients Instead

The Wall Street Journal, 4/21/2004

In this era of terror alerts, one of the risks preoccupying the nation's law-enforcement agencies is radioactive "dirty bombs." To detect the devices – which consist of radioactive materials wrapped around a conventional explosive – law-enforcement officials around the country have been armed with radiation-detection equipment, often small pager-like devices that vibrate when they detect radiation. So far, no radioactive bombs have been reported. But the sensitive devices regularly pick out patients who have been injected with a radioactive substance for cardiac-stress tests or other diagnostic procedures.

Report Card to Rank Hospitals on Safety

The Wall Street Journal, 4/22/2004

After soaring costs, improving the quality of care is one of the most critical issues in medicine today. Now, there is an ambitious new effort to evaluate safety practices at the nation's hospitals. It's part of a growing trend by various groups to survey and assess the quality of American health care. The goal is to provide detailed evaluations that will both motivate the performance of doctors and hospitals and give patients criteria to make smarter choices.

Beyond the EKG, to a Hypersensitive Heart Monitor

The New York Times, 4/22/2004

The familiar electrocardiograms of yearly medical checkups are the routine way to record electrical activity of the heart and detect disorders in its rhythms. But the test is relatively insensitive at pinpointing small areas where there may be problems, since a standard EKG machine samples electrical potential only at a handful of points on the body's surface. But a new computer-based method developed by a researcher seeks to deliver far more detailed information about the electrical activity of the heart. Instead of a dozen or so electrodes, the technique uses 224 of them, all woven into a chain mail-like vest worn by the patient. The electrode-based recordings are then combined with computerized X-rays taken at the same time.

New law to change reimbursement rate

Dayton Business Journal, 4/16/2004

Rural and small-town hospitals should start to see some financial relief as a result of several provisions from the Medicare Prescription Drug, Improvement and Modernization Act of 2003 that was signed into law by President Bush in December. According to the Centers for Medicare and Medicaid Services, two provisions that took effect on April 1 will increase payments to hospitals outside of large urban areas by nearly $12 billion during the next 10 years.

HealthSouth again seeks partner in digital hospital

The Birmingham News, 4/22/2004

HealthSouth Corp. is again looking for a partner in the Birmingham hospital market to share ownership of its hospital under construction on U.S. 280, the company's chief restructuring officer confirmed. HealthSouth doesn't need money from the partner to complete the hospital, and the company will open it alone if need be, Bryan Marsal said. But the U.S. 280 hospital would be stronger if HealthSouth aligned itself with a local hospital system for which running acute care hospitals is its main line of business, he said. HealthSouth's main business is outpatient surgery and rehabilitation centers, and it owns only two acute care hospitals.

JCAHO Proposal
Would Mandate Bar Code Technology by 2007

iHealthBeat, 4/22/2004

A proposal that would require accredited hospitals and other health care providers to have bar code scanning systems in place by 2007 has drawn praise from some in the health care community, who say the move is a bold step for patient care, but worry that the deadline could be too ambitious for providers to meet.

The Hospital Growth Imperative

HealthLeaders, 5/5/2004

Many hospital leaders have already met the challenge of cost reduction. Bob Edmondson, principal at Endeavor Health Group, says their focus must now shift to generate growth in volume, capacity and revenue.

Building A Better Bacteria Killer

Forbes.com, 5/5/2004

Under a microscope, the bacteria Staphylococcus aureus looks like a harmless pile of gold coins. But when it manages to sneak beneath the skin of an already sick patient, it wreaks havoc, infecting first the skin and then other organs, including the brain, heart and lungs. To make matters worse, it has now outsmarted most of the drugs used to treat it.

Boston Scientific to modify Taxus

The Boston Globe, 5/7/2004

Boston Scientific Corp. will modify the way it makes parts of its new Taxus coronary stent system, a spokesman said, to address medical complications that have cropped up for its hot-selling device.

Knowing What Nurses Want

HealthLeaders, 5/12/2004

Hospital leaders are often faced with what may seem like contradictory indicators when they assess nurse satisfaction. But Sabina Gesell, Ph.D., senior research associate with Press Ganey Associates Inc., says a recent study of nurse satisfaction indicators may help sort out what nurses want and how hospital leaders can give it to them.

Newt Gingrich: Getting Healthcare Online

HealthLeaders, 5/10/2004

Over the last few years, Newt Gingrich, the former U.S. Speaker of the House, has refashioned himself as a healthcare expert, becoming a vocal proponent of information technology in the healthcare setting. Gingrich now divides his time between healthcare and national security issues. He is founder of the Washington, D.C.-based Center for Health Transformation, a think tank devoted to reforming the nation's healthcare system through outcomes-based research. The author of "Saving Lives and Saving Money: Transforming Health and Healthcare," Gingrich is also a senior fellow at the American Enterprise Institute. He recently spoke with HealthLeaders about his ideas on healthcare reform, technology, and the future of the industry.

Artificial Spinal Disc Offers Cure Touted as Improvement Over Fusion

The Wall Street Journal, 5/12/2004

It might be one of the few times that an artificial replacement is better than the real thing. The artificial spinal disc is expected to be available in the U.S. in the next 12 months, and many in the medical community are excited about the potential improvements from the current procedure that uses bone grafts and metal.

An open operation

Cincinnati Business Courier, 5/14/2004

By inviting family members to view surgeries, a doctor hopes to fend off malpractice suits.

U.S. picking up pace of device inquiries

The Boston Globe, 5/19/2004

The U.S. Department of Health and Human Services plans to accelerate its investigations of alleged fraud and abuse by medical device companies, a senior official said. The inquiries will likely center on kickbacks and other improper sales and marketing deals between doctors and companies in the fast-growing industry, Lewis Morris, chief counsel to the department's inspector general, said in a phone interview.

The Four Cs of Physician EMR Adoption

HealthLeaders, 5/19/2004

Mark Leavitt, M.D., Ph.D., is medical director and ambulatory care director for the Healthcare Information and Management Systems Society. In previous careers, he has been an electrical engineer, a practicing internist, founder of MedicaLogic, and a member of the senior management team of GE Medical Systems Information Technologies. Leavitt spoke with Richard L. Reece, M.D., a pathologist, writer and newsletter editor, on the progress of electronic medical record adoption by doctors.

Doctors' New Tool To Fight Lawsuits: Saying 'I'm Sorry'

The Wall Street Journal, 5/18/2004

When a medical mishap turned Linda Kenney's routine ankle surgery into a chilling brush with death, the family quickly paid a visit to a lawyer's office. A jury, the family suspected, would likely show little mercy to the anesthesiologist, Frederick van Pelt, who inadvertently injected a painkilling drug in the wrong place, causing Ms. Kenney's heart to stop. To restart it, doctors at the Brigham and Women's Hospital sliced into her chest and cracked open her rib cage. Ms. Kenney's husband, Kevin, "wanted to kill the anesthesiologist, flatten him," says the 41-year-old mother of three. But then, Dr. van Pelt broke with convention. Against the hospital's advice, he wrote Ms. Kenney a personal letter saying he was "deeply saddened" by her suffering. Later, over coffee at a suburban diner, he apologized for the terrible accident.

The Silicon Guinea Pig

The Wall Street Journal, 5/21/2004

Can silicon microchips mimic living organisms? Some researchers believe they can provide a fast, cheap way to screen thousands of drugs for toxic side effects.

New X-ray equipment sits idle at S.F. General

San Francisco Chronicle, 5/24/2004

As patients wait and technicians fume, San Francisco General Hospital is hobbling along with X-ray machines that are nearly three-decades-old – while down the hall, more than $1 million in new equipment sits in unopened boxes.

Lockheed to Design Medical Software

The Washington Post, 5/24/2004

Bethesda-based Lockheed Martin Corp. won a contract worth up to $48 million from the Pentagon to develop software to link computer systems that contain military-patient records, medical-supply orders, blood-supply information and patient-evacuation and transfer data. The software will eventually allow doctors and nurses to access updated patient records from a central database, whether they are working near the battlefield or at a U.S. military hospital. The system would transmit patient histories and descriptions of previous appointments or treatments but will not send images such as X-rays, said Edward Humphrey, the Lockheed program manager overseeing the contract.

Doctors' ties harbour disease-causing germs

New Scientist, 5/24/2004

Doctors may be harbouring disease-causing bugs in their ties that could potentially be transmitted to patients, a new study has found. Nearly half the neckties worn by 42 doctors at the New York Hospital Medical Center of Queen's (NYHMCQ) contained bacteria, which can cause dangerous conditions like pneumonia and blood infections, the researchers found.

Some Insurers Say Pharmacy Costs Could Help Drive Medical Cost Growth in 2004

Managed Care Week, 5/24/2004

In their reviews of first-quarter 2004 financial results, several publicly traded health insurers said more rapidly rising pharmacy expenses were likely to join inpatient hospital costs as a major driver of overall hikes in 2004 medical costs for commercial enrollees. Five insurers – Anthem Inc., CIGNA Corp., Coventry Health Care Inc., WellChoice Inc. and Oxford Health Plans Inc. – said pharmacy costs were rising faster than in years past, driven by both unit-cost and utilization increases.

Take Two Grass-Fed Steaks And Call Me in the Morning

The Wall Street Journal, 5/25/2004

As food companies look for ways to cash in on the nation's obsession with healthy eating, an increasing number are copying marketing tactics that long have been used by the pharmaceuticals industry: They are pitching their products directly to doctors. The hope is that doctors will start recommending specific foods – and even brand names – to patients.

Innovation in small doses

The San Diego Union-Tribune, 5/25/2004

Intravenous drug pumps are big business, as proven by the sale of San Diego-based Alaris Medical Systems last week for almost $2 billion. Yes, intravenous drug pumps. Those are the the little boxes on those shiny metal poles from which nurses hang bags of medicine or fluids. They are a critical part of patient care at hospitals around the world.

Conor Drug-Eluting Stent Shows Promise in Early Tests

The Wall Street Journal, 5/25/2004

Preliminary tests of a new type of drug-eluting stent, a device used to help prop open arteries after treatment to remove life-threatening plaque, suggest that the device might be less likely to clog up with scar tissue than stents currently on the market. The new stent, made by closely held Conor Medsystems Inc. of Menlo Park, Calif., differs from the newest stents now sold by companies such as Johnson & Johnson and Boston Scientific Inc., which are coated with drugs designed to prevent the buildup of scar tissue around the stent. That problem has plagued the bare-metal stents that have been in use for roughly a decade, since it often requires surgeons to retreat the affected artery.

Doctors utilizing new form of help

Richmond (VA) Times-Dispatch, 5/25/2004

At CJW Medical Center, Dr. Richard L. Bremer is one of about a dozen "hospitalists" who coordinate and oversee the care of patients from the time they are admitted to the time they leave. Bremer, an internist, works full time at the hospital and is chiefly concerned with inpatient care, unlike physicians in private practice who take care of patients primarily outside of hospitals but who also have to take care of established patients when those patients are hospitalized.

Virginia Mason fires three after check of 200 contract workers

Seattle Post-Intelligencer, 5/26/2004

After one worker was accused of raping a patient, Virginia Mason Medical Center has checked the backgrounds of roughly 200 contract employees and fired three of them, a hospital spokeswoman said yesterday. The hospital's review came after a patient reported being sexually assaulted by an outside-agency worker whose job was to transport patients from place to place inside the Seattle hospital.

Effort Is Widened To Reward Doctors For IT Investment

The Wall Street Journal, 5/26/2004

In a continuing effort to rein in health costs and improve the quality of care that their employees receive, a group of large corporations, including General Electric Co., Procter & Gamble Co. and Ford Motor Co., plans to expand a program that financially rewards physicians for implementing technology-based patient-management systems. The program, called Bridges to Excellence, is run in conjunction with the National Committee for Quality Assurance, a nonprofit organization that monitors health-care quality. The program is part of a growing "pay-for-performance" trend that rewards doctors for quality care. Other companies participating include Verizon Communications Inc. and United Parcel Service Inc.

The Six Action Steps of Reinvention

HealthLeaders, 5/26/2004

The final lifecycle stage of every healthcare organization is the time of reinvention, when the CEO must wrench the organization from patterns that may have worked for decades. Gary Campbell, a principal with Second Curve Healthcare and is former CEO of The Heart Center of Indiana, offers six steps to lead HCOs through to a new life.

Increases in Health Care Premiums Are Slowing

The New York Times, 5/27/2004

Health insurance premiums are expected to rise up to 10 percent this year, well below the annual increases of 14 to 18 percent in the last few years but still more than double the overall inflation rate. While the slowdown in the rate of increase will provide a bit of relief to employers and their insured workers, the rise in premiums means that the price of health care coverage will remain a burden.

Keeping one eye on the future of medicine

The Tennessean, 5/27/2004

Anesthesiologists at Vanderbilt University Medical Center feel like they have X-ray vision thanks to a wearable computer system developed earlier this year that has improved patient safety and caught the attention of the Department of Defense.

The doctor will e-mail you now

Seattle Post-Intelligencer, 5/27/2004

More and more patients are choosing to email their doctors. Rather than waiting on hold or playing phone tag with their physicians, patients can ask direct questions and receive speedier responses. E-mail can also mean fewer visits to the doctor's office. But for some doctors, the prospect of being inundated with complicated e-mails that raise multiple medical issues is daunting, especially when they're not paid for their time spent responding to those messages.

Medical makeover: Denver hospitals planning changes in way they do business
Denver Business Journal, 5/28/2004

As hospitals in metro Denver look to improve their bottom lines and rethink the way they do business, they are calling on corporate America for help. They say such companies as Ritz Carlton and United Airlines have important things to teach them about customer service, safety and streamlining operations.

High-tech gadgets monitor patients in new eICU
Puget Sound Business Journal (Seattle), 5/28/2004

If you've ever been at the bedside of a loved one in a hospital intensive care unit, you know that just when something happens, it seems the doctor is never around. Although the ICU is the most heavily staffed area in a hospital, there are times when the intensive care specialist is busy elsewhere or just unavailable. Sometimes this is merely an inconvenience. But at other times, when it takes precious minutes to bring in the all-call doctor, it can be life threatening.

No pain, no gain
Dallas Business Journal, 5/28/2004

The idea of changing to a paperless office is hard for many Metroplex physicians to swallow, but for those who already have implemented the necessary technology, the benefits are indisputable.

St. Vincent's is completing its digital integration
Birmingham Business Journal, 5/28/2004

In a bid to fully integrate its digital systems, St. Vincent's Hospital has contracted with McKesson Information Solutions LLC to bring its finance and supply chain software in-house. The Birmingham hospital had been contracting with parent company Ascension Health Inc. for those services. The new digital systems will go on-line July 1 - the beginning of the hospital's fiscal year - and will integrate the billing and supply services with McKesson's clinical software already being used at St. Vincent's.

Drawing Without a License: Phlebotomists Get Little Training, Regulation
The Washington Post, 6/1/2004

When you get your blood drawn, the person who tells you to roll up your sleeve and make a fist may have a professional manner and be dressed in medical scrubs. That doesn't mean he's been to medical school or nursing school . . . or any school at all. In most parts of the country, including the Washington area, phlebotomists -- workers who take blood in a medical setting -- are governed by few rules or none at all.

Executive's gamble pays off as Baptist nears profit
The Tennessean, 6/1/2004

A year after losing more than $32 million, Baptist Hospital in Nashville has turned a corner and should make a profit this year, said Tom Beeman, chief executive officer of Saint Thomas Health Services. He expects the 683-bed hospital at 2000 Church St. to report a profit of more than $2 million this year. If that happens, it would fulfill a promise, and justify a gamble, made by Beeman two and a half years ago when his employer, St. Louis-based Ascension Health, bought Baptist and pledged to stem the tide of red ink that nearly forced the 86-year-old hospital to close.

A hospital that's winning the battle against bacteria
Pittsburgh Post-Gazette, 6/1/2004

Bacteria that are resistant to antibiotics prey on hospital and nursing home patients across the country, but at least one of these nasty bugs has been eliminated from a surgical unit in Pittsburgh. No patient has contracted methicillin-resistant Staphylococcus aureus infection since October in the 36-bed unit on 4 West at the VA Pittsburgh Healthcare System. That's a significant improvement over 2002, when the same unit saw 12 patients infected with MRSA during the year, according to the U.S. Centers for Disease Control and Prevention. The efforts at the VA in Oakland are being held up as a model in infection control by both the CDC and the Pittsburgh Regional Healthcare Initiative, a Downtown nonprofit group that promotes quality improvement efforts.

Hospitals Start to Seek Payment Upfront
The Wall Street Journal, 6/2/2004

Hospitals across the country are starting to hit up patients for part of their bill before discharging them -- and sometimes even before treating them. The aggressive new push is part of a broad effort by hospitals to cut bad-debt expenses. These expenses, which amount to billions of dollars in losses for U.S. hospitals each year, have been soaring due to increasing numbers of uninsured patients and changes in health insurance that push more costs directly onto patients. Much of that debt is simply uncollectible because the patients are too poor to pay. But a growing portion is due to insured patients who fall behind on the deductibles and co-payments that their policies don't cover. As a result, hospital administrators are stepping up efforts to collect on the patient portion of the bill.

And in This Corner, Bush and Brailer
HealthLeaders, 6/3/2004

President Bush's newest goal of widespread adoption of electronic health records within the next decade is both noble and naïve. Noble, in that virtually everyone in the healthcare industry, patients included, would benefit. Naïve, in that the tangled and fragmented healthcare industry is not exactly good material for overhaul of any kind-particularly in the absence of an overlord who could simply change things by fiat.

Nurses offering advice on design of new hospitals, clinics
The Business Journal of Milwaukee, 6/4/2004

Increasingly, nurses are playing a crucial role in the design of hospitals, clinics and other health care centers. Their expertise is important because of their knowledge of patients' needs.

The digital unite: PACS helps doctors work better, faster
South Florida Business Journal, 6/4/2004

X-ray film is going the way of the 8-track, Betamax and manual typewriters. In health care, that means the code-writing is on the wall: Digitize all diagnostic imaging or risk patient safety, competitive impotence and unhappy doctors who want to practice elsewhere. At major hospitals across South Florida, the process of taking radiology and cardiology departments digital has been on the horizon for several years. But from Miami's Baptist Health to the JFK Hospital in West Palm Beach and the North and South Broward hospital districts in between, each has made a large investment in what is known as PACS - a picture archiving and communications system.

Trust, not technology, the root of managing health care
The Tennessean, 6/6/2004

Tom Cigarran started in the health-care business in New York while working at Dunn and Bradstreet. After coming to Nashville in the early days of the for-profit hospital industry, he founded his own company in 1981. It eventually became American Healthways. Today, Cigarran is chairman of this company and also chairman of AmSurg Corp., which owns specialty surgery centers and was spun off from the parent company. Disease management has become a center-stage discussion in delivering health care and reducing costs. Medicare plans to do a pilot project, and if all goes well, offer it to participants in 2007.

Small hospitals profit 'below the radar'
The Tennessean, 6/6/2004

Associated Healthcare Systems Inc. is the latest Nashville-area hospital company to acquire a new facility, but in the increasingly fast-paced business of rural hospital management, that distinction might not last long.

Infectious disease specialist: Butler VA center following rules now
Pittsburgh Post-Gazette, 6/10/2004

An infectious disease specialist said the Veterans Affairs Medical Center in Butler appeared to be following federal protocols related to infection control when he visited the facility following two deaths related to an antibiotic-resistant staph infection.

ViaHealth: From the Brink
HealthLeaders, 6/11/2004

Every business day, ViaHealth president and chief executive officer Samuel R. Huston and chief financial officer Richard Hogg receive an update from the financial department of how much cash the Rochester, N.Y., nonprofit, multihospital system has on-hand. "If we haven't heard a report by 3 p.m., then phone calls begin going out," Hogg says. Going a step further to instill in the company a clear focus on business basics, system leaders have reduced the language of all matters financial to one simple statement: Cash is king. Using that central philosophy, team members say, helps bring all of the potentially mind-boggling angles of healthcare finance down to a common denominator understood by all. And while the daily monitoring of the financial outlook may appear to some as excessive, ViaHealth's leaders see a clear focus on financial health and a solid grasp on the basics of business as necessary to avoid a relapse.

Medical-malpractice battle gets personal – Some doctors refuse to treat attorneys
USA Today, 6/14/2004

Some doctors are refusing medical treatment to lawyers, their families and their employees except in emergencies. Professional medical societies are trying to silence their peers by discouraging doctors from testifying as expert witnesses on behalf of plaintiffs. And a New Jersey doctor who supported malpractice legislation that his colleagues opposed was ousted from his hospital post.

In push to limit health costs,
device makers farming out work
Boston Globe, 6/14/2004

The makers of medical devices spend millions of dollars to distinguish their products, but much of their inventory is becoming more alike. That's because device makers are sending more of their work to a growing industry of contract manufacturers. The trend is driven by the push to control medical costs, and has major implications for 450 Massachusetts and New Hampshire employees of one major contractor that's in the process of being acquired.

AMA turns down proposal to ease guideline on gifts
The Associated Press via Chicago Tribune, 6/15/2004

The American Medical Association rejected a proposal Monday that would have softened the group's stance against drug industry "freebies," including paying for doctors' trips to industry-sponsored educational conferences.

Payment Obstacles to Hospital, Physician and Patient Telecommunication
HealthLeaders, 6/17/2004

Despite exhortations by President Bush, Newt Gingrich, Sen. Hillary Clinton (D-NY), and others on IT adoption in every hospital and physician's office as part of the solution to health system problems, progress is slow because the jury remains out on certain fundamental questions: Will government agencies, health plans, and patients pay hospitals and doctors for IT solutions that reduce costs, improve quality and enhance outcomes? Should IT services simply be considered as the cost of doing business? The details, in short, are in the money. Health plans and patients are reluctant to pay hospitals and physicians extra for IT services outside customary coverage.

Virus Risk at L.I. Hospital Underscores Wider Problem
The New York Times, 6/21/2004

When a Long Island hospital revealed last week that it might have inadvertently exposed 177 patients to H.I.V. and hepatitis during routine endoscopies, hospital officials said the lapse was an embarrassing aberration. But some scientists, health officials and patients said the problems at the hospital, North Shore University Hospital in Manhasset, are typical of the flaws throughout the murky world of endoscopies, where state regulations are spotty and arguments smolder over cleaning procedures and safety standards.

Health Care, Hamptons Style
The New York Times, 6/20/2004

THE latest status symbol on the East End of Long Island is as revealing as it is outrageous: priority medical treatment at Southampton Hospital for 50 wealthy families in return for a "membership" fee. The 95-year-old financially ailing Southampton Hospital - the only serious medical emergency center on the South Fork - is offering a plan aimed at wealthy summer visitors whose primary doctors are back in Manhattan and out of reach, presumably along with the hospital's sense of propriety. For $6,000 per family, or $3,800 for individuals, not including doctors' fees, cardholders in the Southampton PLUS plan are entitled to "priority access" to medical care at the hospital from May 28 to Sept. 26. A brochure about the plan was mailed to several thousand summer homeowners from a mailing list the hospital purchased from a source it declined to identify.

Justices Limit Suits Against HMOs
The Washington Post, 6/22/2004

The Supreme Court yesterday struck down a Texas patients' rights law in a ruling that bars all states from letting patients sue managed-care companies whose refusal to pay for treatment allegedly results in death or injury.

Doctors Must Double - Check Before Surgery
The Associated Press via The New York Times, 6/22/2004

Starting July 1, operating rooms are supposed to be a little safer: Surgical teams must take new steps to prevent operating on the wrong body part or wrong patient. Among the requirements: Much as airline pilots go through a safety checklist before takeoff, surgeons and nurses must take what's being dubbed a ``time-out'' before cutting. It's to double-check that the right patient is on the table, if he's really to lose a kidney and not a gallbladder -- and if so, on which side.

Surgical robots revolutionize hospital OR
Cincinnati Business Courier, 6/18/2004

Coronary artery bypass. Mitral valve repair. Prostate surgery. All are major operations, and they conjure images of highly invasive surgeries followed by long and painful recoveries. But those days are in the past. Today, these and other surgeries are being performed via surgical robotics, a minimally invasive technology that is revolutionizing modern surgery. In contrast to traditional open surgery, robotics-assisted surgery allows the physician to see and access parts of the body through small, carefully located entry ports. At the core of the system is a sophisticated series of "robot" arms that are connected to a console near the operating table. Highly accurate extensions of the surgeon's hands and fingers, the arms allow the surgeon to conduct precise movements in tiny spaces and provide better flexibility and control when operating on delicate tissue. A video monitoring system provides a three-dimensional view of the surgery with 10 times the magnification of the naked eye.

Newt Gingrich Pushing 'Wired' Hospitals
The Associated Press via The Washington Post, 6/22/2004

Medical care would be improved and millions of dollars would be saved if hospitals were fully wired, said Rep. Patrick Kennedy and former House Speaker Newt Gingrich, who jointly announced a program to bring American medicine into the Internet age.

Nurses offering advice on design of new hospitals, clinics
The New York Times, 8/21/2004

The Justice Department has opened a broad criminal investigation of the medical-supply industry, apparently to determine whether hospitals and other medical care providers are fraudulently overcharging Medicare and other federal and state health programs for a wide array of goods - from rubber gloves to drugs to X-ray machines. More than a dozen medical-supply companies recently received federal subpoenas in what appears to be a wide-ranging investigation into the way suppliers market products to clinics, hospitals and nursing homes that serve Medicare and Medicaid patients, and whether those institutions properly account for the purchases.

Hospitals going 'lean' to become more efficient
The Business Journal of Milwaukee, 6/4/2004

Jerry McCormick has more than 30 years managing all aspects of manufacturing operations. A good part of his career was spent at Milwaukee Electric Tool Corp. in Brookfield, where until his retirement six years ago he was responsible for implementing lean production techniques to make the plant run more efficiently. He learned a lot in the process, and now has a full-time consulting business teaching other companies how to reduce waste and improve quality with so-called "lean thinking." McCormick estimated thousands of American companies are investing in lean techniques to eliminate waste in their production processes to improve product quality, customer service and satisfaction.

Out with the old, in with the new in hospital room luxury
Baltimore Business Journal, 6/14/2004

As soon as you step through the doors, a concierge greets you, takes your bags and escorts you to your room. The concierge then wheels in a laptop computer and types in your personal information. You're not in the Ritz-Carlton. You're at the local hospital of the future. Once you're settled in, an image of your interior is transmitted to the television in your private room so doctors and nurses can study your ailment. That image is beamed to one of the country's top doctors for advice on your procedure. Meanwhile, you are handed a menu with a list of appropriate foods after your operation. A bed in the corner of your room is prepared for your spouse. The room is lit with soft lights and painted in tones to make you feel at ease, which should lead to a faster recovery. A new look and feel for hospitals is being shaped by advances in technology and a desire to create settings that offer patients a sense of hospitality.

Surgical robotics revolutionize hospital OR
Cincinnati Business Courier, 6/18/2004

2004

When guests pull to the curb at 10500 Quivira Road, a valet greets them with a smile and offers to park their vehicle for free in a nearby lot. If they have bags or boxes in tow, a bell captain is ready to assist them into the lobby. But their destination is not a sparkling Overland Park hotel -- it's Overland Park Regional Medical Center. Within the past year, the hospital has beefed up its customer service efforts, offering five-star hotel-like features and services to patrons, patients and visitors alike. Hospitals are taking a page out of the hotel industry notebook by offering services that make patients' and families' stays easier.

Hospitalists emerging as new breed in specialized medicine
Memphis Business Journal, 6/25/2004

20 years ago the doctor who put you in a hospital was often the one who treated you there, but primary care docs who make hospital calls are quickly going the way of those who once made house calls. Stepping into that vacuum is the rising new specialty of the hospitalist, and starting June 28 a new hospitalist practice debuts at Methodist University Hospital. A hospitalist is most often a primary care internist, but doesn't keep an outpatient office. Instead, he works in the hospital full time, taking referrals from office-based physicians and taking patients from the emergency department who don't have a regular physician.

Hospital pharmacy gets robotic helper
Seattle Times, 7/6/2004

Ernie works the night shift. When most patients at Kirkland's Evergreen Hospital Medical Center are asleep, the robot comes to life. Its machinery thumps like a heart beating as it moves around the hospital pharmacy, preparing prescriptions. In a little more than an hour, he'll ready 1,500 doses of medication. Ernie, or Evergreen Robot Noticeably Improving Efficiency, is a new $3 million addition to pharmacy staff.

To understand new threats,
hospitals take the pulse of the market
Houston Business Journal, 7/9/2004

Recent health care trends have affected the way hospitals must present themselves to the outside world. With the rise of advanced technology and pharmacology, many services hospitals once offered exclusively are readily available outside of the traditional, inpatient hospital setting. Hospitals are competing not only against other hospitals in their markets, but also against a growing number of new competitors. In the near future, pharmacological advances, like statin drugs that reduce cholesterol, will also lower hospital admissions for patients suffering acute cardiovascular and other diseases.

15-minute emergency guarantee
Philadelphia Business Journal, 7/16/2004

Central Montgomery Medical Center is offering an unconventional incentive to get more patients to use its revamped emergency room -- patients are guaranteed to see a nurse within 15 minutes or the visit is free. CMMC's 15-minute guarantee, which was launched in the past week, is believed to be the only such offer being made in this region and comes a year after the hospital invested $2 million into its ER.

Technology is driving a shift in communication
Charlotte Business Journal, 7/23/2004

In the last few years, hospitals and doctors' practices -- like most U.S. businesses -- have been using computers and information technology in increasingly sophisticated ways in their administrative functions. Now the health-care industry is looking to automate, computerize and digitize clinical care as well.

Medical mistake epidemic fuels rapid growth for IHS
Puget Sound Business Journal, 7/23/2004

Buoyed by a recent Food and Drug Administration ruling that has hospitals scrambling to prevent rampant medication errors, a fast-growing pharmacy products company based in Kent has raised nearly $1 million to fund its expansion. Integrated Healthcare Systems Inc., which formed three years ago, sells bar-code labeling systems and software that allow hospitals to track a patient's medication from the pharmacy to the bedside. With an individual bar code on every dose of medication, nurses can record when they give patients medicine and reduce errors.

High-tech deals boost hospitals
Business First of Buffalo (NY), 8/9/2004

The long-term, mega-million-dollar deals struck between Buffalo's two major health-care systems and big medical technology companies could nudge the region's hospital services to a new level of operational sophistication. Hospital leaders say these multi-faceted agreements, signed between the Catholic Health System and Siemens last month and Kaleida Health and General Electric in October, give them the financial wherewithal to access the newest equipment that will improve the care they deliver. Siemens and other medical technology companies are striking exclusive arrangements with health systems across the country as a means of locking in customers for their pricey equipment over the long term. They are doing so by designing multi-faceted packages that reflect an array of their businesses, including lines of credit, business consulting and energy audits for example. Siemens alone has 21 such contracts.

Tiny Chips Could Combat Counterfeit Pills
Forbes.com, 6/30/2004

A year ago, the unthinkable happened. A drug distributor recalled 18 million tablets labeled as Pfizer's Lipitor because they might be fakes. Lipitor, the world's best-selling drug and the most commonly prescribed drug for people with high cholesterol, is proven to cut heart attacks by at least a third. Instead, some patients had got dummy pills. Pfizer, which has become the world's largest drugmaker, partly on the strength of Lipitor's $10 billion in annual sales, is determined to face down the shysters.

To Reduce Errors, Cut Here
Washington Post, 7/6/2004

Patients who check in to the nation's hospitals have new protections against one of the most devastating and preventable medical errors -- surgery on the wrong body part. Rules imposed July 1 by the agency that accredits most of the nation's hospitals, as well as some surgery centers, will require specific actions designed to prevent wrong-site surgery. Regulations issued by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) require that doctors "sign their site" -- writing "yes" or their initials on the operative site with a surgical pen after conferring with a patient just before surgery. The new rules also require that the medical team take a "timeout" in the operating room to verify the identity of the patient, confirm the procedure to be performed and ensure that all necessary equipment is present. Hospitals whose staffs fail to comply with the new procedures could face the loss of their accreditation, an action that would imperil their funding. The new rules are an effort to stem an alarming increase in the number of reports of operations conducted on the wrong body part, the wrong procedure or even the wrong patient.

Bionic Knee 'Learns' How to Walk
The Wall Street Journal, 7/6/2004

The human knee -- whose complexity is belied by its hinge-like appearance -- has proved to be second only to the hand in difficulty for doctors to replicate in the effort to help out amputees. Walking involves a delicate pattern of shifting between bearing weight and bending, doctors say, with the knee literally at the center. Enter the Rheo Knee, a bionic body part that its maker, Ossur, touts as being able to "learn" and adapt to a user's idiosyncratic movements.

Study links long hours, nurse errors
The Boston Globe, 7/7/2004

What they've long known about truck drivers, airplane pilots and doctors, researchers also are discovering about nurses: Those who work more than 12 straight hours make more mistakes. Nurses who worked shifts lasting at least 12.5 hours were three times more likely to commit an error, such as giving a patient the wrong medicine or the wrong dose, than nurses who worked less than 8.5 hours, about a regular shift, according to a new study from the University of Pennsylvania School of Nursing.

Clues from First CMS Advisory Opinion on Stark Moratorium
HealthLeaders, 7/9/2004

The Centers for Medicare and Medicaid Services released its first Stark specialty hospital advisory opinion on June 23, 2004. This opinion, which is the first in what is expected to be a line of opinions, provides some insight into which facts CMS considers significant in determining whether a specialty hospital was far enough "under development" on November 18, 2003 so as to escape the reach of the Stark specialty hospital moratorium.

Putting Pathogen Detection in the Palm of Your Hand
Washington Post, 7/12/2004

Someday, Joe Hernandez says, doctors will be able to carry a small device in the emergency room to detect infectious agents instantly, eliminating the need for elaborate and time-consuming lab tests. Innovative Biosensors Inc., of College Park, has set out to develop and market such a device, using biosensors that are drawn from the human immune system, then manipulated to detect certain types of bacteria, viruses and proteins. Hernandez, the company's founder and chief executive, said the technology will be able to find traces of pathogens such as anthrax or E. coli, depending on the reagent inserted in the device, which will resemble a handheld computer.

Vision of Newt
Washington Post, 7/13/2004

Like any good visionary, Newt Gingrich has a vision -- or two, or three. They come tumbling off his tongue in the self-assured tone of a man who does not hesitate to remind audiences he has a bit of experience making history. The ideas are, in Gingrich's words, "very big." Take his vision for the health system of the future. Each morning millions of Americans would awaken and log on to a secure, personal Web page featuring their individual medical record. It would track health status -- weight, height, blood pressure, maladies and medications -- and deliver reminders and advice where appropriate for managing their diseases and conditions. When they needed care, patients would shop online, comparing prices and quality scores of the doctors and hospitals in the region. They could research the efficacy and risk of various treatments. At the doctor's office, the physician could look up the latest innovations with a tap on a wireless, palm-sized computer and use the same device to write prescriptions or order tests, all of which would automatically be recorded in the patient's electronic file. And if a small-town doctor didn't have the expertise for a certain diagnosis or procedure, she could link via satellite with experts halfway around the globe.

Web tool aims to ease search for a hospital
The Boston Globe, 7/16/2004

Consumers who want to compare hospitals so they can check into the best one just got more help: an online comparison tool run by the nation's leading hospital oversight group. The Joint Commission on the Accreditation of Healthcare Organizations is the latest group to provide consumers with a way to compare how hospitals care for patients with specific illnesses. Employers are pushing for more transparency in how well hospitals care for patients -- and about where they fail -- in the belief that high-quality care leads to fewer medical errors and lower costs. They hope consumers will migrate toward higher-quality hospitals, and that the public reporting will force lower-quality hospitals to improve. At the same time, employers are starting to reward better-performing hospitals financially by paying them higher fees.

Hospitals in 'Most Wired' Ranking Make Progress on Electronic Records
The Wall Street Journal, 7/19/2004

The nation's top tech-savvy hospitals are forging ahead with the switch to electronic medical records from archaic paper files, according to a new survey. The annual Hospitals & Health Networks survey of the 100 "Most Wired" hospitals in America found 90% of hospitals and health systems in the ranking maintain electronic medical records that include current observations, orders and progress notes, compared with 63.5% of all hospitals surveyed.

Surgical robot crawls through FDA process
Sacramento Business Journal, 7/16/2004

After liquidating its French subsidiary and watching its stock drop into the pink sheets, Integrated Surgical Systems Inc. of Davis remains optimistic that its Robodoc surgical robots will win federal approval for U.S. sales by next summer. Integrated Surgical sells its hip-and-knee implant robot in Europe and Asia. Getting permission from the U.S. Food and Drug Administration, a key goal, has taken longer. Though the company has faced a serious cash crunch this year, chief executive officer Ramesh Trivedi said it can live off foreign sales until Robodoc is cleared in the United States.

Health care's paper trail is costly route
USA Today, 7/19/2004

Technology has cut costs and increased productivity in industry after industry. But health care, a $1.6 trillion beast that wallops business and consumer pocket books more and more, still largely runs on paper. Visits to new doctors require patients to fill out forms for the same old information. Getting test results from one office to another can take days. That often leads to duplicate tests, excess costs and poor care. It won't be an easy fix, though. Billions in investments have been lost on health care tech. The reasons are many. Health care is a huge, fragmented industry: 700,000 doctors; 5,700 hospitals. Each piece collects data its own way. Existing systems don't talk to each other. More common standards are needed. Privacy has been a concern. The biggest reason, though, is economic. Doctors and hospitals bear the cost of new hardware and software. Their productivity suffers when they change decades-old work processes. But those who pay for care, insurers and employers, get the first financial benefit because of increased efficiency and fewer costly errors.

Baby steps toward I.T. adoption
HealthLeaders, 7/21/2004

In his first major contribution as the new healthcare IT czar, David. J. Brailer, M.D., Ph.D., announced today the federal government's strategy for developing electronic health records for all Americans in the next 10 years. Called a "framework" by Brailer, the big-picture report did not mandate any specific technology standards or a timeframe for compliance.

Doctors urge 'superbug' fight
The Boston Globe, 7/22/2004

The pharmaceutical industry's failure to develop new antibiotics to treat ''superbug" bacteria prompted a warning yesterday from the nation's infectious disease doctors, who urged Congress to create incentives for drug companies to conduct more research. Drug-resistant bacteria are migrating into locker rooms, prisons, and other settings, ranging far beyond the hospital wards where they have lurked before. Estimates are that 70 percent of the 90,000 fatal infections Americans will contract this year will be from bacteria that are resistant to at least one antibiotic. But the nation's pharmaceutical industry, without strong market incentives, has slowed development of new antibiotics to a trickle. Instead, lured by bigger profits elsewhere, drug companies are pursuing pills to treat chronic conditions like high cholesterol and ''lifestyle" issues like impotence and baldness, according to a report released yesterday by the Infectious Disease Society of America.

Fatal Medical Errors Said To Be More Widespread
The Wall Street Journal, 7/27/2004

A new study coming out today estimates that the number of patients who died from medical errors is more than double the findings in a 1999 report that sparked widespread concern. The numbers in the new study are being challenged, but the findings promise to fuel the debate over hospital safety.

11 Problems with Healthcare Ratings
HealthLeaders, 7/28/2004

It's ratings season again. Despite the growing popularity of healthcare ratings, rankings and other quality measures, the ratings game is fraught with problems and challenges. There are so many problems that many healthcare professionals have shied away from promoting the use of healthcare ratings and healthcare quality data for so long.

Under-the-skin ID chips move toward U.S. hospitals
CNET News.com, 7/27/2004

VeriChip, the company that makes radio frequency identification--RFID--tags for humans, has moved one step closer to getting its technology into hospitals.

Catholics, Siemens sign $100M deal
Business First of Buffalo (NY), 7/30/2004

The Catholic Health System has made Siemens Medical Solutions USA its primary vendor of health-care technology in a $100 million, 10-year agreement that goes beyond the traditional buyer-seller relationship by including money for equipment, financing for renovations and a system-wide quality improvement initiative.

E Pluribus E-Unum
HealthLeaders, 8/3/2004

On July 21, before a packed audience of 3,000 in a Washington, D.C. hotel ballroom, David Brailer M.D., Ph. D., National Coordinator of Health Information Technology, presented a 178 page report "The Decade of Health Information: Delivering Consumer-Centric and Information-Rich Health Care" to HHS Secretary Tommy Thompson. The questions raised surrounding the report have been many: In the next decade, will government-private partnerships build a national unified information technology (IT) infrastructure? Will IT unite healthcare's factions - consumers, physicians, hospitals, and health plans? Will these factions talk to each other electronically, act in concert, cut costs, and improve health? The importance of Brailer's effort is that government may finally recognize that small physician practices matter. Indeed, any national IT infrastructure is meaningless unless it includes small practices. According to a recent article in the Archives of Internal Medicine, almost half (47 percent) of private physicians are in groups of one or two, and 82 percent are in groups of 10 or less. Large physician enterprises - hospital-owned practices, academic centers, multispecialty clinics - are vital to IT implementation, but they don't deliver most ambulatory care. Will it take 10 years to bring Brailer's scheme into reality? It may not. Two factors drive speed of change in the computer world. One is the number of information sources. Two is the number of connections.

Hospitals Move Toward Paperless Age
The Associated Press, 8/4/2004

With no patient chart in sight, Dr. Sheila Gamache strides into Thom Kolby's hospital room to check on him a day after the 54-year-old arrived ashen-faced and perilously close to death with a clogged artery starving his heart of oxygen. Rather than flipping through a clipboard thick with pages of notations and test results, Gamache gets up to speed on Kolby's condition simply by logging onto a wireless notepad she carries on her daily rounds at the Indiana Heart Hospital. Like a handful of others nationwide, the Indianapolis hospital has traded its once scattered medical charts, file folders, X-rays and other documents for a unified electronic records system accessible with a few keystrokes. Federal officials who are trying to convince more hospital executives to go "paperless" say electronic records can make hospitals more efficient, reduce medical errors and lower health-care costs. The costs of the transition can be high, and many physicians are also unwilling to trade the ease of jotting down paperbound notations of their patients' statuses for a system that requires them to type the same information into a computer. But concerns aside, digital records are a leap ahead for records system rooted in cumbersome 19th century filing systems.

Boston Scientific declares 3rd stent recall
The Boston Globe, 8/6/2004

Boston Scientific Inc. yesterday issued the third recall of its Taxus stents in just over a month, further tarnishing the introduction of its flagship product and raising the possibility that patients may have been put at risk after a manufacturing change designed to ensure safety.

How to be a Healthcare Business Pundit
HealthLeaders, 8/6/2004

In today's news media environment, there are plenty of avenues for healthcare executives to build platforms for themselves as source matter experts and thought leaders. However, these avenues have also opened up heavy streams of traffic, competing voices and organizations that once again are tangled in a clutter of content. If you want to be a thought leader in this industry, you have to break a few traffic rules. Most likely, you have been trained vigorously by communications professionals on how to respond to the media. You have been taught how to deliver the perfect interview. You've been spoon fed statistics and catchy quotes. In many cases, you have been pushed right over the edge of useful.

Inside the ER: Some can pay. Some can't.
The Miami Herald, 8/9/2004

To see how the ER functions, a Herald reporter and photographer spent 12 hours each at two hospitals, one that struggles with patients that can't pay, the other in a typical middle-class suburb. Later the hospitals provided financial information on the cost of care during the period when The Herald team visited.

One firm's bold step helps doctors, patients avoid errors
USA Today, 8/10/2004

How does a doctor judge which medication is right for his or her patients? Many rely on what they're told by the salesmen who visit their offices. The more diligent physicians read medical journals to see how a drug fared during clinical trials, the rigorous testing that occurs before and after approval by the U.S. Food and Drug Administration (FDA). Trouble is, consumer advocates and others have complained for years that the studies may be distorted. Drugmakers fund more than 80% of medical research, so studies that raise doubts about a medicine's safety and effectiveness are rarely published.

Doctors turn to digital data
Raleigh (NC) News-Observer, 8/10/2004

Federal officials want doctors' offices and hospitals to convert to electronic patient records, and they're willing to provide financial incentives to those who do. That news -- delivered last month by Health and Human Services Secretary Tommy Thompson -- is the latest lift for an industry already endorsed by hospital organizations and physician professional groups. And it is good news for two Triangle electronic health records companies, A4 Health Systems and Misys Healthcare Systems.

'Disaster Medicine' Becomes a Specialty
The Wall Street Journal, 8/12/2004

As the nation focuses on the threat of terrorism, a whole new specialty is emerging to train health-care providers for the worst-case scenario: disaster medicine. The specialty builds on traditional emergency medicine, combining emergency medical and trauma skills with crisis management and new forms of triage. Disaster medicine is designed to treat trauma that most health-care providers have never seen -- post-explosion injuries like "blast lung," which occurs when a shock wave of pressure hits the body and collapses part of the lung, and crush-injury syndrome, which can be fatal if a heavy object is removed from a victim and causes blood to send chemicals such as potassium to the heart. Other techniques include the removal of flying debris and shrapnel, traumatic amputations, and the treatment of open brain injuries.

Successful Strategies for Planning the Digital Hospital
HealthLeaders, 8/13/2004

The members of the C-suite in most hospitals are grappling with dizzying messages about the pending explosion of IT. Increased national policy attention, technology advancements, emergence of standards and patient safety initiatives are driving momentum for renewing energy behind information technology's role in transforming the healthcare system. Without a doubt, the "digital hospital" is upon us, prompting executives to start understanding how the pieces fit together to shape IT strategy.

Boston Scientific Faces Scrutiny
The Wall Street Journal, 8/13/2004

The Food and Drug Administration is reviewing a recent death, along with six serious injuries, in patients treated with Boston Scientific Corp.'s Enteryx device for acid-reflux disease. The examination comes at a difficult time for Boston Scientific, which is trying to win back the confidence of the medical community amid an embarrassing recall of its much ballyhooed Taxus coronary stent. The recall involves 99,200 stents, after life-threatening malfunctions occurred in a small number of the devices during surgery.

Laptops to take guesswork out of docs' handwriting
Cincinnati Business Courier, 8/13/2004

Doctors at University and Christ hospitals will start entering their medication and treatment orders into mobile laptop computers -- and stop handwriting them -- in a pilot project set to begin next year. The hospitals' parent, the Health Alliance, is investing millions of dollars into a computer physician order entry (CPOE) system designed to reduce errors often caused by illegible handwriting, unintended drug interactions and communication gaps between doctors and the pharmacy.

Armchair M.B.A.: The Missing Rivalry in Health Care
The New York Times, 8/15/2004

Rising health care costs are a major concern for virtually every American company. Michael E. Porter, an expert on competitive strategy and the Bishop William Lawrence University professor at Harvard, argues that the heart of the problem is a health care system that needs less competition in some areas and more in others.

Colonoscopies Overdone, U.S. Study Suggests
Reuters Health, 8/16/2004

Doctors may be overdoing it a bit on colonoscopies, a procedure to screen for colon cancer using a tiny camera, even though they can save lives, researchers reported. Patients who had a low-risk polyp removed in a first colonoscopy do not need to have repeat colonoscopies as often as many doctors are prescribing them, the researchers report in this week's issue of the Annals of Internal Medicine.

I, Doctor Robot
Sacramento Bee, 8/17/2004

A new member of the UC Davis medical staff is turning more than a few heads as he wanders down hospital corridors, humming quietly. Never mind that he has no arms or legs and stands just 5 feet 6 inches tall. "Rudy" is gaining the respect of patients and making others squirm. The 200-pound robot is the star participant in a multihospital clinical trial to determine whether patients who have undergone certain types of surgery can be safely taken care of by a doctor in a different location.

Johnson & Johnson missing out on stent sales
The Boston Globe, 8/19/2004

Johnson & Johnson can't supply cardiac stents fast enough to capitalize on three recent recalls by archrival Boston Scientific Corp., say cardiologists who use both companies' medical devices. The reason may be related to manufacturing issues at Johnson & Johnson's Cordis Corp. unit, which is being closely monitored by the Food and Drug Administration. In April, the agency sent a scathing letter citing numerous problems it called ''serious violations of the law."

Robert Wachter: The Word on Medical Mistakes
HealthLeaders, 8/20/2004

Robert M. Wachter, M.D. has become a recognized expert and public voice on the issue of medical errors. Making the rounds of television news organizations following the release of his book Internal Bleeding: The Truth Behind America's Terrifying Epidemic of Medical Mistakes, the chief of medical service at the University of California, San Francisco Moffit-Long Hospital has spread the word about problems that plague the hospital industry and, in turn, pose a threat to patients dependent on the system for their health and safety. Until hospitals commit to investing as heavily in providing quality care and making cultural changes as they do in other projects and endeavors, Wachter says, they are at risk of omitting critical pieces of the scaffolding on which the future of medicine will be built.

Sisters of Mercy launches $226 million technology upgrade
St. Louis Business Journal, 8/20/2004

Sisters of Mercy Health System is putting money and people on a project to improve patient care through information technology. The St. Louis-based system, which includes 18 hospitals in four states, is investing an estimated $226 million on its four-year Genesis Project. It is pulling together leaders from both inside and outside the organization to build an information technology-supported program to make the hospitals safer and more efficient. Improvements could include streamlining patient registration and making patient information available electronically to doctors and nurses.

Wide U.S. Inquiry Into Purchasing for Health Care
The New York Times, 8/23/2004

Scales tipping against tax-exempt hospitals
USA Today, 8/23/2004

From Congress to the local property tax assessor, not-for-profit hospitals are under increasing pressure to defend their tax-exempt status, which saves the industry billions of dollars in federal, local and state taxes. Hospitals are on the defensive over long-standing practices that often result in charging the highest prices to uninsured patients, who may be harassed, threatened or even jailed when they fail to pay their bills. Non-profit hospitals — which make up 85% of the nearly 5,000 hospitals nationwide — have come under particular scrutiny because they are expected to provide community benefits, including charity care, in exchange for freedom from federal, state and local taxes.

Conflict Alleged at King/Drew
Los Angeles Times, 8/26/2004

Martin Luther King Jr./Drew Medical Center has paid nearly $1 million in the last five years to a surgical instrument company owned by one of its orthopedic surgeons a clear violation of Los Angeles County's conflict of interest laws, according to documents obtained by The Times. In addition, the county-owned hospital often paid more than twice as much for surgeon James K. Brannon's devices as it would have for more conventional instruments used by most hospitals, experts said.

Obese Patients Spur Hospital Changes
The Associated Press, 8/27/2004

At St. Luke's Hospital, each of the 14 new neurology intensive care rooms has a feature that's becoming standard in the health care industry: a patient lift system that can handle 600 pounds. Severely overweight people tend to have more health problems and they often can't fit in standard beds or wheelchairs built for 300-pound people. The $3 billion market for hospital beds, wheelchairs and other equipment designed for plus-size patients is rapidly growing as more Americans become obese.

Attempt to Track Malpractice Cases Is Often Thwarted
The Wall Street Journal, 8/27/2004

Some of the largest medical malpractice awards never get reported to the nation's only central repository for malpractice information, a government-run facility known as the National Practitioner Data Bank, because such cases are allowed to go unreported under a widely used but little-known clause in the rules governing the Data Bank's operation. The clause is known in the medical and insurance worlds as the "corporate shield." It comes into play when individuals filing malpractice claims remove a doctor's name from the claim, leaving only the hospital or another corporate entity identified as the responsible party. The Data Bank's rules require the reporting only of doctors named in final malpractice settlements, so a payment doesn't have to be reported when a doctor's name is removed from the claim. Such an omission appears to undermine the main purpose of the Data Bank.

Cypher market share climbs
The Boston Globe, 8/27/2004

Guidant Corp. said that the Cypher cardiac stent regained some market share after rival Boston Scientific Corp. conducted three recalls of its competing device. Guidant is the marketing partner for Johnson & Johnson’s drug-coated stent Cypher. On a conference call with investors yesterday, Guidant executive Dana G. Mead Jr. said Cypher's share stands between 40 and 42 percent of the U.S. market. Once the only supplier in the market, Cypher's share fell as low as 28 percent after Boston Scientific introduced Taxus, its drug-coated stent, in March.

New CEO hits ground running at Moses Cone
The Business Journal of the Greater Triad Area, 8/27/2004

Tim Rice officially became chief executive of Moses Cone Health System last week, and he officially hit the ground running. Rice was the system's chief operating officer until taking the reins from retiring CEO Dennis Barry. He inherits a system that is growing, financially and otherwise, and looking to beef up its core technology and patient-safety tools in the immediate years ahead. It is all part of the balancing act that modern-day health care managers face: Costly investments are imperative to provide quality service to the community they serve, but at the same time revenues are under pressure from flat to declining reimbursements from government payers. Rice started at Moses Cone in 1978 as a pharmacist.

Business, interrupted: Outage from Hurricane Charley forces local surgery centers to reschedule procedures
Orlando Business Journal, 8/27/2004

When Hurricane Charley turned out the lights on hundreds of Central Florida companies, at least two local outpatient surgery centers found themselves temporarily out of business -- and, thus, forced to have to reschedule roughly 175 elective procedures.

Virginia Inspector Pleads Guilty In Hospital Fraud Case
Washington Post, 9/1/2004

A Virginia man pleaded guilty yesterday to defrauding some of the Washington area's most prestigious hospitals by faking his credentials to inspect their mammography machines and other radiological equipment and sometimes not inspecting them at all. Perry M. Beale admitted that he gave many hospitals passing marks without leaving his home in Fredericksburg and in some cases never set foot in the buildings, according to federal officials and documents filed with Beale's plea in U.S. District Court in Charlottesville. For those services, Beale was paid $400,000 to $1 million by medical facilities, which included the George Washington University Ambulatory Care Center, Georgetown University Radiology Associates and the CIA's Office of Medical Services in Langley.

Taxus Stent Usage Declined in July; Cypher Rose
The Wall Street Journal, 9/1/2004

Boston Scientific Corp.'s Taxus stent, its once-stellar reputation damaged by a major recall, accounted for only 51.8% of drug-coated stents used in July by doctors, down from 56.3% in June, according to data from Goodroe Healthcare Solutions LLC. Johnson & Johnson’s rival Cypher, meanwhile, was used 48.2% of the time in July, up from 43.7% in June, the firm said. August data was not yet available. Goodroe, based in Atlanta, tracks doctor utilization of stents, but does not have sales data.

Nearly Pain-Free Surgery More Common
The Associated Press, 9/1/2004

Doctors say patients timid about having surgeries for fear of pain shouldn't put it off: A new focus on patient comfort and advances in pain management are making many procedures nearly pain-free. In fact, some experts say pain-free surgery is not so far off.

The Muslim Patient Will See You Now, Doctor
The New York Times, 9/1/2004

Until recently, Rahmah, a Muslim woman who moved here from Somalia in 1997, was embarrassed when she was told to disrobe for doctor's examinations at Maine Medical Center. The short hem and open back of the flimsy robe she was asked to put on affronted her religious belief that women should dress to preserve their modesty. When a nurse could not provide her with a longer johnny, as the gowns are called, she covered her legs with a shawl before the doctor entered. The hospital gown, she and others thought, needed to be redesigned for Muslim women.

Seven years later, Maine Medical Center is doing just that, after discovering that a number of Muslim women were skipping appointments rather than expose their skin to a doctor. The hospital is offering all patients a two-piece alternative to the traditional short gown. It cloaks patients from neck to feet, in accordance with Muslim standards of modesty and the desire of many other patients to cover up in the hospital.

Virtual Colonoscopy Shows Promise, Experts Say
Reuters Health, 9/1/2004

Virtual colonoscopy, which uses souped-up x-rays to check for colon cancer instead of threading a tube through the gut, shows promise but is not ready to replace traditional colonoscopies yet, experts said. Virtual scans are still not as good as the old-fashioned colonoscopy at spotting smaller pre-cancerous growths and polyps, the task force of experts said.

AMGA, MGMA Data Show 2003 Was Good Year for MD Incomes in Most Specialties
Physician Compensation Report, 9/1/2004

Physicians in most specialties, especially outside of primary care, had income increases in 2003 well above those in 2002, according to the physician compensation benchmark surveys for 2003 income published by the Medical Group Management Association (MGMA) and the American Medical Group Association (AMGA). Both associations issued their reports early in August.

Insuring Controversy: When Malpractice Premiums
Jump, Some Docs Ask Patients to 'Donate' to the Cause
The Washington Post, 9/21/2004

Rising expenses and static reimbursements have led a growing number of physicians, most of them in the less lucrative primary care specialties of pediatrics, family practice and internal medicine, to begin charging so-called access fees for services they once provided for free. These include filling out camp and disability forms, taking after-hours phone calls, and answering e-mail questions. Some are also dunning patients for canceled appointments. A malpractice surcharge, some doctors say, is simply one more access fee, although it is usually presented as voluntary to avoid running afoul of Medicare rules that prohibit such mandatory charges. Its appeal is enhanced by the anger many doctors feel about rising insurance rates, which has touched off a fierce political battle in Maryland and other states.

Anatomy of a Hospital Bill
The Wall Street Journal, 9/21/2004

How much does an overnight stay at a Virginia hospital cost? If Medicaid is paying, the answer is $6,000. If Paul Shipman is paying, it's $29,500. Like many of the 45 million Americans who don't have health insurance, the Shipmans gambled -- unwisely, it turns out -- that they could make do without it. Among the many factors they didn't take into account was the high markups hospitals tag onto care for uninsured patients, charging them far more than what they charge big private or government plans for the same care.

Are You Ready for 'Big Box' Healthcare?
HealthLeaders, 9/24/2004

What keeps hospital CEOs up at night? The thought of their specialists breaking out on their own may cause some tossing and turning. A JCAHO audit is unnerving. But, in the future, what might make the blood drain from a provider CEO's face is this thought: What if the mass merchandising giants like Wal-Mart, or Target got into the healthcare delivery business in a big way?

Help Wanted: Clockmakers in Healthcare
HealthLeaders, 10/6/2004

Healthcare is learning that leadership is not enough. It is not about having a great vision or being a remarkable strategist. It is about creating a healthcare organization that is capable of reinventing itself over and over again. Leadership is not about having a great year. It is about building distinctive competencies that enable the organization to have great year after great year, in all types of conditions. Leadership is not about brilliant leaders who are the consummate experts. It is about systematically institutionalizing skills and knowledge throughout the organization. Leadership is not about the leader. It is about the enduring systems that the leader establishes to foster the success of the organization long after she is gone.

Are ASCs Sellouts or Saviors?
HealthLeaders Magazine, 10/15/2004

The Medicare prescription drug, improvement and Modernization Act of 2003 signaled at least short-term doom for the specialty hospital industry. Convinced that such facilities represent a clear and present danger to the long-term viability of full-service community hospitals, legislators placed an 18-month moratorium on physician self-referrals to new specialty hospitals-essentially gutting the business case for new construction. As structured, it gave full-service hospitals a temporary reprieve. But specialty hospitals aren't the only healthcare business to make the community hospital's "top predators" list. Ambulatory surgery centers, which escaped the regulatory rifle blast last year, continue to be a concern for hospital executives guarding slim margins, and a growing number of ASC advocates are convinced that their line of business is the next target.

How to Pay For Healthcare Reform
HealthLeaders, 10/22/2004

If healthcare reform is going to happen it has to be seen as a multidimensional problem that will take multidimensional solutions. These solutions include a new form of funding coming from multiple sources simultaneously. Healthcare is not a simple concept and the complexities have lead to a confusing set of business models that intertwine to create a fragmented and locally focused, nationwide industry.

Hospitals Could Use a Hand With Basic Hygiene
The Wall Street Journal, 11/3/2004

Frequent hand washing is one of the oldest rules in the book when it comes to preventing infections. But despite intensive efforts to drum the habit into health-care workers, hand hygiene remains woefully inadequate at many hospitals, a new report says. The Centers for Disease Control and Prevention issued updated hand hygiene guidelines two years ago, including a new recommendation that hospitals use alcohol rubs for routine decontamination. Yet compliance remains "far below" the 80% level necessary to significantly reduce infections, according to a new report from ECRI, a nonprofit research group formerly known as the Emergency Care Research Institute. The CDC acknowledges that compliance averages about 50%, with some hospitals as low as 20% and others at the 80% level. Hand hygiene is often the worst in the areas where it is needed most, such as intensive care, surgery, anesthesia and the emergency room. Even when workers do wash their hands they may skip necessary steps such as wetting hands before using soap and turning off the faucet with a towel, or failing to rub their hands together long enough for alcohol rubs to dry and disinfect thoroughly.

Big IT Spenders
HealthLeaders Magazine, 11/11/2004

Nick Turkal, M.D., didn't spend a day or even an hour waiting to receive a patient's emergency room medical records earlier this year. He didn't track them down by phone, fax or courier, even though they resided at a hospital some 40 miles south of his Milwaukee medical practice. Rather, Turkal quickly logged on to an electronic medical record system and reviewed the charts, tests and orders online. Predictably, by having access to an electronic medical record system, Turkal avoided repeating expensive tests, spent more time with his patient, and provided better care. The cost of this convenience? Turkal's parent organization, Aurora Health Care, is spending close to $163 million as part of a long-term IT upgrade to make such data exchange possible. The nonprofit's goal is simple: provide a common electronic medical record and supporting data-entry devices across its 14 member hospitals and scores of clinics that serve eastern Wisconsin. For a paper-heavy industry with a checkered history of IT implementations, it's an ambitious goal. Yet Aurora is not an anomaly. Numerous large health systems are rearranging spending priorities and committing millions to IT initiatives.

Physicians and Hospitals: In the Same Lifeboat, Again
HealthLeaders, 11/12/2004

Healthcare has long been tarnished by a certain degree of enmity between its key players. On the one hand there are the physicians, who are small business owners. On the other are the hospitals, which are large business enterprises. Both know they need each other, but they continue to struggle with cooperation, especially following a series of failed joint ventures in the 1990s that only recently unraveled. Thrust together in business models designed to close the gap between the two and their competing interests, hospitals and physicians sought to align themselves in integrated delivery systems that failed to integrate at the core business level. 'Integrated delivery networks appeared across the healthcare landscape in a flurry of activity. Then, just as quickly, the bottom fell out, and mounting losses compelled hospitals to shed unprofitable physician practices and unwind complex entities. Now, healthcare leaders are again facing the inescapable truth of the need to collaborate with physicians.

Drug Wholesalers Change Methods
The Wall Street Journal, 11/12/2004

America's three big drug wholesalers are trying to kick the habit. The habit, in this case, is the risky business of betting on drug-price increases. And the wholesalers are asking their suppliers -- the nation's pharmaceutical manufacturers -- for help.

FDA guidelines call for radio technology to control counterfeit drugs
USAToday, 11/16/2004

The Food and Drug Administration on Monday issued guidelines it hopes will prompt drugmakers to use tiny radio tracking chips on their product packaging to help thwart counterfeiters. Drugmakers who follow the guidelines don't have to worry about running afoul of FDA labeling rules, the agency said. Some drug firms already have plans to use radio frequency identification devices (RFIDs), which will allow them to track products from factory to pharmacy.

Heart Scanner Stirs New Hope and a Debate
The New York Times, 11/17/2004

What if doctors had a new way to diagnose heart disease that took only seconds and provided pictures so clear it showed every clogged artery, so detailed that it was like holding a living heart in your hand? In fact, that new way exists and is coming into use in scattered areas of the country, and there is wide agreement that it will revolutionize cardiology. The scans can largely replace diagnostic angiograms, the expensive, onerous way of looking for blockages in arteries, and can make diagnosis so easy that doctors would not hesitate to use them. They are expected to cost about $700, compared with about $4,000 for an angiogram.

Nurses Find Hidden Cameras at Hospital
Los Angeles Times, 11/18/2004

It was the wires dangling from a wall clock that first caught the eye of the nurse, who was taking a breather after a stint in the labor and delivery unit of Good Samaritan Hospital. A closer inspection revealed a tiny, pea-sized camera lens above the numeral "9." Within minutes, nurses at the hospital just west of downtown Los Angeles hit the phones, alerting colleagues about the device in the break room and asking them to check other clocks for hidden cameras. In all, they found 16 tiny devices hidden within timepieces placed on the walls of lounges, a fitness center, a conference room and a pharmacy, among other locations.

We Hope You Enjoy Your Stay'
The Wall Street Journal, 11/22/2004

Consumerism is hitting the hospital business. New and older hospitals alike are focusing on friendlier staff, better food, more creature comforts and possibly even better care. Hospitals are stepping up their amenities, hoping to lure customers with private rooms and consultation spaces, in-room Internet access and even plasma-screen televisions. And consumers are getting pickier.

Wake-Up Call
Washington Post, 11/23/2004

The first thing Sidney L. Williams says he heard when he awoke in the operating room during open heart surgery two years ago was the insistent whine of a bone saw cleaving his sternum. As doctors began discussing his badly damaged heart, Williams wondered whether he was eavesdropping on his own death: The surgeon had warned him before surgery that there was a 50 percent chance he would die on the table. Seconds later, Williams said, he felt jolts of searing pain as the doctor shocked his heart, which had stopped. Worst of all, said Williams, who lives in Austin, was his utter helplessness, his inability to let anyone know he was awake. Williams couldn't make a sound: A breathing tube had been snaked down his throat. He couldn't move a muscle: He had been given standard paralytic drugs that rendered him motionless during surgery. And he couldn't cry: His eyes were taped shut and the drugs he was given stopped tear production.

In Malpractice Trials, Juries Rarely Have the Last Word
The Wall Street Journal, 11/30/2004

Earlier this year, a New York state jury awarded Elizabeth and John Reden $112 million in a medical-malpractice case filed on behalf of their brain-damaged daughter. But the Redens didn't get $112 million. They got $6 million. In the debate over medical-malpractice lawsuits, multimillion-dollar verdicts have become an important rallying cry for advocates of legislation to curtail jury awards. From emergency rooms to state houses to the White House, the advocates point to the heavy cost of large malpractice awards. Behind the big dollar numbers, the reality is more complex. Many plaintiffs settle for less than a jury's verdict, to eliminate delays and the uncertainty of appeal. Sometimes, even before a jury rules, a plaintiff has signed an agreement that limits how much money actually changes hands. The Redens, for example, hedged the outcome of their case through a common device known as a "high low" agreement. No matter what the jury ruled, the two sides agreed to settle for between $2 million and $6 million. Such agreements protect plaintiffs from a lengthy appeals process and typically set the top end of any potential award close to the limit on the physician's insurance policy.

Consumer-Driven Care: Eight Directions for 2005
HealthLeaders, 12/6/2004

Consumer-driven healthcare may be the "next big thing" after managed care. Indeed, it may change healthcare as profoundly as managed care did 20 years ago. Consumerism drivers include double-digit premium hikes, employers desperate to cover employees yet to lower costs to remain competitive, and 45 million uninsured. The latter, increasingly unable to pay, could undermine investments in our healthcare infrastructure, causing a cascade of personal bankruptcies, bad debts, failing hospitals, closing emergency rooms, falling income for insurers and suppliers, and widespread economic contraction. The healthcare industry is undergoing a shrinking paying customer base. This is occurring because the health inflation rate, now five times the rate of general inflation, is unsustainable for growing numbers of ordinary Americans, including many in the middle class.

Doctors put on a pay-for-performance alert
Chicago Tribune, 12/9/2004

The nation's largest doctor group is bracing physicians for the day they will join the ranks of millions of U.S. employees who only get raises when they perform well at work. Although not new to most workers, pay for performance is a relatively new concept to most doctors. The American Medical Association this week launched a new push to educate doctors about this concept, as employers and insurers attempt to rein in health-care costs.

Do Nonprofit Hospitals Deserve Tax-Exempt Status?
HealthLeaders Magazine, 12/10/2004

When for-profit hospitals first appeared in numbers on the healthcare landscape, more than a few nonprofit advocates worried out loud that a for-profit mentality would ruin healthcare. It was the 1970s, and the fear was that for-profits, by injecting a capitalistic model into the business of healthcare, would squeeze out the nonprofits. That didn't happen, as nonprofits still make up about 85 percent of the nation's hospitals. In fact, nonprofits have weathered a challenging operating environment by increasingly adopting the more aggressive business practices pioneered by for-profit hospitals. But in their efforts to turn a profit or at the very least to stem losses, nonprofit hospitals have raised the ire of more than a few legislators and patient advocate lawyers, as well as the IRS. Over the past year, hundreds of nonprofit hospitals have been accused of price discrimination against the uninsured, placing a spotlight on the "community benefit" they are supposed to provide in return for tax exemptions. Now, a cacophony of bad publicity is threatening to wash over the healthcare industry with many believing that for-profit and nonprofit healthcare have become practically indistinguishable.

Nonprofit Hospitals and the Year of Living Transparently
HealthLeaders, 12/13/2004

It does not really matter to the healthcare consuming public whether nonprofit hospitals are part of a larger organism that is the American healthcare system. They also don't particularly care that that system is interdependent, paid for out of the same more-or-less fixed pile of reimbursement assets and is, by many accounts, systemically flawed in the way healthcare is distributed to those who need it. They care about what it costs them. Rightly or wrongly, blame for flaws in the healthcare system gets shifted around every year or so, and the bright lights of the Congressional committees, local regulators and the media flash to where the flaws are the easiest to pop into a sound bite. One year the target may be HMOs, the next it may be malpractice premiums. In 2004, it was nonprofit hospitals' turn.

Docs and Hospitals: Trust in Mutual Interests
HealthLeaders, 12/14/2004

Around 1750, history has it that Dr. Thomas Bond of Philadelphia had made the rounds of the wealthy colonists with the idea on bringing the first hospital to the colony. But in each patron's home, he kept getting the same response: What does Benjamin Franklin think of the idea? Bond and Franklin were friends already, and their collaboration led to the founding of Pennsylvania Hospital in May of 1751. They agreed on using the "Story of the Good Samaritan" and its message of "Take care of him and I will repay thee" as the hospital's seal. Bond served on the hospital staff and earned the title "Father of Clinical Medicine." Franklin served on the board as secretary and president, and was later quoted as saying none of his political maneuvers had given him as much pleasure as the hospital business. If this historical footnote suggests where physician/hospital relations started in this country 253 years ago, then where those relations ended up in 2004 would make Poor Richard shudder. Physicians and hospitals pushed and pulled in 2004 over everything from governance to quality to technology. At the root of the relationship is a power struggle. Hospitals say they are trying to protect their institutions -- and the community's health -- from the threat of physicians in high-profit specialties leaving to form standalone ventures. Physicians say they are protecting their profession --and the community's health -- by offering faster, more efficient and higher-quality service in an outpatient or clinic setting.

Nonprofit launches plan to reduce medical errors
The Boston Globe, 12/15/2004

The Institute for Healthcare Improvement in Boston, run by Harvard physician Dr. Donald Berwick, will try to save 100,000 patients from fatal medical errors and poor care in the next 18 months by persuading hospitals to improve in six areas. The nation's Veterans Administration hospitals already have signed on, and Blue Cross and Blue Shield of Massachusetts donated $3 million to the effort. Numerous organizations and government agencies have developed ways for hospitals to reduce dangerous medical errors and improve quality of care and are publicly rating hospitals' efforts. But the institute's program is the first to set a specific goal of lives saved over a set period, and it has attracted a prestigious group of supporters. The institute's measures are extremely specific, providing a checklist, for example, of six things hospitals can do to prevent intensive care patients on ventilators from developing pneumonia.

Now, If We Just Add the Consumers...
HealthLeaders, 12/15/2004

The most powerful person in the healthcare world probably doesn't know it yet. Maybe it's an active 55-year-old baby boomer in Seattle who is considering whether to get his sore knee arthroscopically repaired before next spring. Maybe it's a 75-year-old woman in Atlanta who has found out that she can go to the chemotherapy clinic nearest her home or the one nearest her daughter's home for her treatments. Healthcare consumerism - the idea that patients themselves will make their own healthcare choices based on cost and quality - has been debated in theory for years. To its advocates, consumerism is the cure that will hold down costs in ways that managed care could not.

Soon, Cellphones Will Monitor Vital Signs of the Chronically Ill
The Wall Street Journal, 12/15/2004

Recognizing the need for easier and less-intrusive monitoring of vital signs like blood sugar, medical companies are enlisting an everyday device: the cellphone. They're teaming up with telecommunications companies to develop modified cellphones that can monitor things like glucose, weight and blood pressure, and automatically send the information to the doctor. For diabetics, cellphones already exist with the capability of reading glucose test strips. For people with heart disease, devices under development will be able to monitor their vitals and send the information to a doctor on a regular basis, reducing the number of office visits.

Healthcare IT Becomes an Adolescent
HealthLeaders, 12/16/2004

Healthcare clinical information technology has been a kid for a long time. The parents-vendors, the government, providers and payors alike-have beamed proudly at the thought that this gangly kid would one day contribute to society. But so far the kid has just sort of skated along. After all, these parents have shelled out a lot of money, worried incessantly and planned diligently to raise the child. Now they are hoping the kid will realize that the time has come to learn how to work as part of a team and just generally grow the heck up. In 2004, healthcare clinical information technology started to pay off on some of the enormous promise that advocates of paperless healthcare have been pushing for a long time.

Hospitals expect uptick in defibrillator implants in 2005
St. Louis Business Journal, 12/20/2004

Next year, more people will be eligible to have medical devices implanted in their chests to prevent heart attacks thanks to expanded coverage by Medicare.

Clinic Infections Put a Sterilizer Of Lab Devices Under Microscope
The Wall Street Journal, 12/27/2004

Two years ago, the chairman of medicine at Allegheny General Hospital here wrote to more than 500 former patients warning that they might have been exposed to deadly bacteria during a simple test at the hospital. The warning was too late for Earl Foster. He had his lungs examined at the hospital with an endoscope, a tubular device with a tiny camera and light. Days later, he died of pneumonia, which the hospital and a coroner linked to bacteria from the endoscope. In all, 16 patients who had such procedures picked up the bacteria, and nine died, according to the hospital. It didn't attribute the other eight deaths to the infection. After a two-month investigation, the hospital told the Food and Drug Administration that water filters in a device used to sterilize the endoscopes can lead to bacteria in the rinse water, and this was the "probable cause" of the outbreak.

Around the Nation Archives
2005 ● 2006 ● 2007

HealthLeaders, 4/28/2004

HealthLeaders, 4/30/2004

Hospitals work to make stays hospitable by adding amenities The Business Journal of Kansas City, 6/18/2004

To understand new threats, hospitals take the pulse of the market Houston Business Journal, 7/9/2004

Technology is driving a shift in communication Charlotte Business Journal, 7/23/2004

Medical mistake epidemic fuels rapid growth for IHS Puget Sound Business Journal, 7/23/2004

High-tech deals boost hospitals Business First of Buffalo (NY), 8/9/2004

Tiny Chips Could Combat Counterfeit Pills Forbes.com, 6/30/2004

Study links long hours, nurse errors The Boston Globe, 7/7/2004

Web tool aims to ease search for a hospital The Boston Globe, 7/16/2004

Surgical robot crawls through FDA process Sacramento Business Journal, 7/16/2004

Boston Scientific declares 3rd stent recall The Boston Globe, 8/6/2004

Hospitals expect uptick in defibrillator implants in 2005 St. Louis Business Journal, 12/20/2004