Health insurance: Consolidation of insurers a concern for medical providers

Talk of potential mergers in the medical insurance industry has doctors and hospitals worried about health plans having too much clout over consumer choices and prices.

Speculation has run rampant that some of the nation's biggest health plans may be looking to consolidate, including a possible takeover of Humana Inc. by Aetna Inc., as well as UnitedHealth Group's interest in Coventry Health Care Inc.

Already, one in six metropolitan areas in a 2008 study of more than 300 U.S. markets is dominated by a single health insurer that controls at least 70 percent of enrollees in health maintenance organizations or preferred provider organizations, according to the American Medical Association.

"It becomes difficult for patients to have choice and doctors to get their patients the care that is needed because a monopoly has been created," said Dr. James Rohack, a Texas cardiologist and AMA president-elect. "Patients don't have as many other options."

Health insurers long have billed consolidation as a way to better control costs through efficiencies and leveraged buying power. Also, the recession is giving health plans another reason to merge as they lose business because more companies and workers can't afford coverage. And the federal government's desire to further cut payments to insurers that receive Medicare dollars could fuel the industry's push to consolidate.

With company-paid medical costs rising 8 percent to 10 percent this year for large companies, and higher for small businesses, health plans need more enrollees in order to spread out costs for their employer clients. A larger pool of patients gives benefits companies more power when negotiating payments with doctors and hospitals.

Health plans and the employers that hire them control the choices of doctors and hospitals. Providers worry that increased consolidation would add to their concerns about deteriorating reimbursement from government health programs as the federal deficit rises and state budgets tighten.

Humana, Aetna and UnitedHealth would not confirm merger talks, and Coventry could not be reached for comment. America's Health Insurance Plans, a health insurance lobby, declined comment. Hartford, CT-based Aetna said its acquisition strategies have focused on ways to add products and service capabilities, among other things, that improve its "ability to manage medical cost and quality," spokesman Fred Laberge said.

Medical-care providers say the promise of efficiencies historically has not lowered premiums to consumers. "The promise of saying we are going to come together and have administrative efficiencies and these other projected savings never materialize," Rohack said. "Most of these [health plans] have different IT platforms and software, so it is a false promise of being more efficient compared to what their track records are." (Chicago Tribune) Read the original story. 

April 9, 2009  Download print version

FDA to review medical devices marketed prior to 1976

FDA statement on the voluntary withdrawal of Raptiva from the U.S. market

Recommendation: Stop prescribing heartburn medications for asthmatics without serious heartburn

Research could lead to new non-antibiotic drugs to counter hospital infections

Dallas-Fort Worth hospital systems invest in infection prevention

Ex-Army nurse pleads guilty in hepatitis C case

Every 1.7 minutes a Medicare beneficiary experiences a patient safety event

Removing Medtronic heart cables is hard choice

FDA to review medical devices marketed prior to 1976

The FDA announced that manufacturers of 25 types of medical devices marketed prior to 1976 must submit safety and effectiveness information to the agency so that it may evaluate the risk level for each device type. Devices found by the FDA to be of high risk to consumers will be required to undergo the agency’s most stringent premarket review process.

These 25 device types, which are listed in the Federal Register announcement posted Wednesday, were marketed in the U.S. prior to the Medical Device Amendments to the Food, Drug, and Cosmetic Act of 1976. That law authorized the FDA to review new medical devices. This announcement is the first step towards completing the review of Class III device types predating the 1976 law, as was recommended by the U.S. Government Accountability Office (GAO) in a January 2009 report to Congress.

The FDA classifies medical devices into three categories according to their level of risk. Class III devices represent the highest level of risk and generally require a showing of safety and effectiveness before they may be marketed. Class III devices include heart valves and intraocular lenses. After Congress enacted the medical device law in 1976, the FDA classified these 25 devices types into Class III (premarket approval). Under the law, these devices were not immediately required to undergo the premarket approval process. The law required the FDA to issue a rule subjecting the devices to that requirement. Until that time, new devices within those device types have been cleared through the premarket notification process, in which the agency determines whether they are substantially equivalent to legally marketed devices not requiring premarket approval. Devices that present a new intended use or include new technology that presents new questions of safety or effectiveness may not be found substantially equivalent and require premarket approval.

Manufacturers of the 25 remaining device types must submit the requested information within 120 days. The FDA will review the submitted data and, based on the risk level, issue regulations for each device type that either will require manufacturers to submit premarket approval applications or will re-classify the devices into Class I or Class II.

Federal Register notice: http://edocket.access.gpo.gov/2009/pdf/E9-8022.pdf

FDA release:  http://www.fda.gov/bbs/topics/NEWS/2009/NEW01990.html

FDA statement on the voluntary withdrawal of Raptiva from the U.S. market

Genentech, the manufacturer of the psoriasis drug Raptiva (efalizumab), announced that it has begun a voluntary, phased withdrawal of the product from the U.S. market. The company is taking this action because of a potential risk to patients of developing progressive multifocal leukoencephalopathy (PML), a rare, serious, progressive neurologic disease caused by a virus that affects the central nervous system. By June 8, 2009, Raptiva will no longer be available in the United States.

Prescribers are being asked not to initiate Raptiva treatment for any new patients. Prescribers should immediately begin discussing with patients currently using Raptiva on how to transition to alternative therapies. The FDA strongly recommends that patients work with their health care professional to transition to other alternative therapies for psoriasis.

The risk that an individual patient taking Raptiva will develop PML is rare and is generally associated with long-term use. Generally, PML occurs in people whose immune systems have been severely weakened and often leads to an irreversible decline in neurologic function and death. There is no known effective treatment for PML. On Oct. 16, 2008, FDA updated the FDA-approved labeling for Raptiva to warn of the risk of life-threatening infections, including PML. On Feb. 19, 2009, the FDA issued a Public Health Advisory informing patients and prescribers of the risk of PML in patients taking Raptiva, after receiving reports of four patients with PML, three of whom died. On March 13, 2009, the FDA approved a Medication Guide for Raptiva and included additional information in Raptiva's labeling regarding PML.

Raptiva was approved by the FDA in 2003. It is a once-weekly injection for adults with moderate to severe plaque psoriasis. Read the FDA news release.

Recommendation: Stop prescribing heartburn medications for asthmatics without serious heartburn

Lung experts from Johns Hopkins and elsewhere are calling on physicians to suspend the routine use of potent heartburn medications in asthmatics solely to temper recurrent attacks of wheezing, coughing and breathlessness. Calling the longstanding practice "ineffective" and "unnecessarily expensive," the experts say there is no benefit from using so-called proton pump inhibitors in the absence of the stomach upset. The condition plagues 5 million asthma sufferers in the US, of whom half (or 2.5 million) have what is known as "silent" reflux, and lack the characteristic symptom of heartburn from the backup of acid into the esophagus. Overall, as much as $10 million is spent each year in the US treating gastroesophageal reflux disease in asthmatics struggling to control their lung symptoms.

The scientists base their call on their latest research, believed to be the most extensive monitoring ever done of how well the drugs, first made available in the 1990s, tame respiratory flare-ups in asthmatics for whom steroid therapy and other drugs have already failed. Senior study investigator and Johns Hopkins pulmonologist Robert A. Wise, M.D., says the results dispel some common assumptions about the disease, offering the first solid evidence against silent acid reflux as having any significant role in poor asthma control.

Reporting in the New England Journal of Medicine online April 9, researchers at 20 medical centers in the United States collected detailed health reports on 412 men and women who still have asthma symptoms despite drug therapy. Half took daily doses of the most commonly used proton pump inhibitor -- 80 milligrams of esomeprazole (Nexium) -- while the rest received a placebo.

After six months, the average number of self-reported episodes of breathlessness -- those that required use of inhalers, and which stirred nighttime awakenings or led to visits to the hospital emergency room -- were the same for both groups (at 2.5 and 2.3 per person per year, respectively), disproving any drug benefit. Moreover, researchers saw no improvements in overall health or other quality-of-life measures, such as how much time study participants spent going out with friends, or how well they performed their work or kept pace with their college coursework.

Besides asthma attacks, study participants were surveyed for actual backup of stomach acid. In the test, probes were slid through the nose, down the throat and into the esophagus to measure acidity levels. Some 40 percent of participants were found to have gastroesophageal reflux, recorded as prolonged periods of severe acidity in the esophagus, as measured by a pH acidity level of less than 4 lasting more than two hours throughout the day.

But even among this group of asthma sufferers, the study showed that proton-pump inhibiting drugs offered no improvements in how fast people could blow air out of their lungs. Drug therapy also did not help open the airways in patients tested with bronchodilator medications.

According to study co-investigator Janet Holbrook, Ph.D., M.P.H., a "significant outlay" of money goes toward treating asthma and related gastric reflux -- proton pump inhibitors cost on average between $150 and $180 per month for the half dozen most common brands. Probe tests used to gauge the severity of the heartburn can cost as much as $1,200. Get more information here.

Research could lead to new non-antibiotic drugs to counter hospital infections

Lack of an adequate amount of the mineral phosphate can turn a common bacterium into a killer, according to research to be published in the April 14, 2009, issue of the Proceedings of the National Academies of Science. The findings could lead to new drugs that would disarm the increasingly antibiotic-resistant pathogen rather than attempting to kill it.

Pseudomonas aeruginosa is one of the most serious hospital-acquired pathogens. A common cause of lung infections, it is also found in the intestinal tract of 20 percent of all Americans and 50 percent of hospitalized patients in the US. It is one of the hundreds of bacteria that colonize the human intestinal tract, usually causing no apparent harm. It might even be beneficial to its host. Once the host is weakened by an illness, surgical procedure or immunosuppressive drugs, however, P. aeruginosa can cause infection, inflammation, sepsis and death.

Why P. aeruginosa can suddenly turn on its host has eluded researchers—until now. Scientists have long known that after an operation or organ surgery, levels of inorganic phosphate fall. The authors of the PNAS paper, led by scientists at the University of Chicago, hypothesized that phosphate depletion in the stressed intestinal tract signals P. aeruginosa to become lethal.

To test this theory, they let worms (Caenorhabditis elegans) feed on "lawns" of P. aeruginosa and Escherichia coli grown in both low-phosphate and high-phosphate media. Only the worms that ate P. aeruginosa with low levels of phosphate died. The researchers dubbed the phenomenon "Red Death" since unexpected large red spots appeared on the worms before they died.

"These findings provide novel insight into the mechanisms by which P. aeruginosa is able to shift from indolent colonizer to a lethal pathogen when present in the intestinal tract of a stressed host," said Alexander Zaborin, lead author of the study and a research professional at the University of Chicago’s Department of Surgery.

"It's almost as if the bacterium sense when to strike," said John Alverdy, corresponding author of the study and professor of surgery at the University of Chicago Medical Center. "That should come as no surprise since the bacteria are smart, having been around for 2 billion years."

Bacteria seek phosphate as an important nutrient, Alverdy explained. The research findings could lead to a pharmaceutical product that would restore healthy phosphate levels in the intestines of such patients. The PNAS paper is called "Red Death in Caenorhabditis elegans caused by Pseudomonas aeruginosa PA01." Read the release for more information.

Dallas-Fort Worth hospital systems invest in infection prevention

Just weeks after her son Josh's death in October 2006 from a hospital-acquired infection, Victoria Nahum, of Atlanta, started the Safe Care Campaign to educate hospital staff and administrators about the dangers of carelessness. Baylor Health Care System invited Nahum to speak in February to its hundreds of midlevel health managers in a downtown Dallas hotel conference room. Nahum hushed the audience with a somber recounting of how three family members became infected in three hospitals in three states in 10 months.

Baylor's daylong seminar, internally referred to as the "infection retreat," is part of the hospital system's $20 million earmarked for quality initiatives this year. And it underscores how seriously hospital systems are taking infections acquired within their rooms and corridors.

Most local efforts to fight infections revolve around creative programs that boil down to keeping hands clean. Meanwhile, Baylor spent $6 million on training and data collection across its 15 North Texas hospitals. In addition, $2 million was spent on a program that supplements incomes of physicians who conduct research on improving quality. That program greatly reduced pneumonia-related deaths because physicians implemented better infection-eliminating procedures, Baylor said. And in a report released last month, the CDC said hospital-acquired infections directly cost hospitals $28.4 billion to $33.8 billion annually, or $26,000 per patient.

Methodist Health System said treating a single case of MRSA can cost upward of $35,000. So last year the hospital system spent $403,000 on a MRSA detection system used on high-risk patients. The procedure involves taking a swab of a patient's sore and placing it in a petri dish to see if the bacteria are resistant to the hospital's antibiotics. A patient with nonresistant bacteria is quarantined and dealt with extra carefully.

Washing hands is still widely accepted as the best way to prevent hospital infections. It's so serious a preventive measure that Baylor has spies of sorts on every floor watching for hand-washing violators. Methodist gives out a "golden hand" award to nurses who practice good hygiene. In the past 12 months, Methodist spent $80,000 on small hand sanitizer pumps in and around patient rooms, a $30,000 increase from 2004. Methodist said the cost is not passed on to patients. (Dallas News) Read the original story.

Ex-Army nurse pleads guilty in hepatitis C case

EL PASO, Texas (AP) — A former Army hospital nurse accused of infecting more than a dozen patients with hepatitis C pleaded guilty Tuesday to assault and theft. Jon Dale Jones, a 46-year-old retired Army captain, entered into a plea agreement that includes one count of assault and one count of stealing drugs. Federal prosecutors said Jones infected at least 15 patients with hepatitis C in 2004 at William Beaumont Army Medical Center at Fort Bliss, just outside El Paso.

Assistant U.S. Attorney Bill Lewis said in court Tuesday that Jones is believed to have infected the patients after pulling fentanyl — a powerful painkiller routinely used for anesthesia — from a clean vial at the hospital and putting it in a contaminated container he brought from home. Jones would then give patients the remaining medicine from the hospital's newly infected vials, Lewis said.

Jones is free on bond pending sentencing in August. He faces up to 20 years in prison. Jones is believed to have contracted the disease at the hospital but it is unclear exactly how.

He was arrested early last year after a nearly three-year-long criminal investigation. During that time he had left the Fort Bliss hospital and worked elsewhere as a nurse, including Washington, D.C., Virginia and Florida. Prosecutors know of no other hepatitis C infections associated with Jones. (AP) Read the original article.

Every 1.7 minutes a Medicare beneficiary experiences a patient safety event

The 2009 HealthGrades Patient Safety Excellence Award recipients were identified in a report issued by the healthcare ratings organization. If all hospitals performed at the level of Patient Safety Excellence Award hospitals, approximately 211,697 patient safety events and 22,771 Medicare deaths could have been avoided while saving the U.S. approximately $2.0 billion from 2005 through 2007. Between 2005 and 2007, 913,215 total patient safety events were recorded among Medicare beneficiaries, which represents 2.3 percent of the nearly 38 million Medicare hospitalizations. This equates to one reported patient safety event every 1.7 minutes.

For the sixth consecutive year, HealthGrades has analyzed patient safety among Medicare patients in all of the nearly 5,000 U.S. non-federal hospitals based on 15 indicators of patient safety developed by the federal government's Agency for Healthcare Research and Quality (AHRQ).

This year, 242 hospitals, which represent the top five percent of all hospitals in the U.S., were recognized with a HealthGrades 2009 Patient Safety Excellence Award. HealthGrades developed this award to give patients more information about choosing a hospital.

Study highlights: Patients treated at top-performing hospitals had, on average, a 43% lower chance of experiencing one or more medical errors compared to the poorest-performing hospitals.; Between 2005 and 2007 there were 913,215 total patient safety events among Medicare beneficiaries.; Between 2005 and 2007 these patient safety events were associated with over $6.9 billion of wasted healthcare cost.; Approximately one-in-ten Medicare patients with patient safety events died; Between 2005 and 2007 there were 97,755 actual in-hospital deaths that occurred among patients who experienced one or more of the 15 patient safety events. Read the news release.

Removing Medtronic heart cables is hard choice

Pulling a medical device off the market is one thing. Removing it from the bodies of thousands of patients is a lot more complicated and dangerous. Consider the Sprint Fidelis, a heart defibrillator cable. In 2007 its maker, Medtronic, stopped selling it after five patients who had the cables died. But only now is the full scope of the public health problem becoming clear for the Sprint Fidelis, which is still used by 150,000 people in this country.

In the next few years, thousands of those patients may face risky surgical procedures to remove and replace the electrical cable, which connects a defibrillator to a chamber of the heart. Medtronic estimates that the cable has failed in a little more than 5 percent of patients after 45 months of being implanted. But as a preventive measure, some patients with working cables are having them removed.

Already, four patients have died during extractions. Experts fear that the toll could quickly rise if such procedures are not performed by skilled doctors at medical centers that have performed many of the operations. For many of the patients around the country who may need the procedure, finding the right medical center will not be easy.

There is little publicly available data on the volumes and success rates of the procedures at the nation’s hospitals. Some hospitals disclose their own numbers, but many more do not. The deaths of the four Sprint Fidelis patients at other hospitals apparently occurred when less practiced doctors damaged a vein or the heart, causing extensive bleeding.

A quarter-million people around the world received a Sprint Fidelis in the three years from its introduction in 2004 to its recall in October 2007. The cable’s chief flaw is the tendency for it to crack, creating electrical problems. The defibrillator may fail to give a heart a life-saving jolt to disrupt a potentially fatal rhythm. Or it may repeatedly discharge, shocking patients for no reason.

Also, when a Sprint Fidelis is used with a device that combines a defibrillator with a pacemaker, the cable’s flaw may interfere with the pacemaker’s ability to keep a patient’s heart beating at a steady rhythm.

Medtronic has given patients some guidance about extractions, like telling them to seek a hospital experienced in the procedure if they decide to have a Sprint Fidelis removed. Though the company has declined to indicate which medical centers have such experience, it recently compiled such a list. Last year, to win approval for a new heart cable from the FDA, the company agreed to provide the FDA with future data from “10 experienced extraction centers,” according to agency records. But Medtronic says it does not plan to make such a list public.

Medtronic has been shielded so far from legal claims over the recalled device. More than 1,000 patient lawsuits involving the Sprint Fidelis have been thrown out because of a ruling last year by the Supreme Court. The court held in a ruling involving a different medical device that federal law protects device makers from liability suits involving some products, as long as the FDA has approved their products. Some Democrats in Congress have vowed to pass legislation that would override the Supreme Court decision.

Medtronic is supplying replacement cables, but the cost of the operation to implant a cable, which can run $15,000 to $20,000, is being borne by Medicare or private insurers.

Medtronic’s recent estimates indicate the cables are likely to stop working in thousands of people in the next few years. (NY Times) Read the original story.

April 8, 2009  Download print version

Hospital gets subpoena tied to doctor's studies

Webcast to address compliance with The Joint Commission's Emergency Management Standards

Novation offers additional financing options with Siemens and Hill-Rom

LG Electronics showcases new Smart Vine monitors and network attached storage

CMS issues 2010 payment information for Part C Medicare Advantage Plans and Part D Prescription Drug Plans

IDN Summit & Expo spring event takes collaboration to new level

Unotron integrates Micromem Hall Sensor technology in new soft key computer keyboards

Flo Healthcare introduces new power systems to support increasing demands on wireless mobile workstations

Hospital gets subpoena tied to doctor's studies

Federal investigators have subpoenaed financial records related to Scott S. Reuben, a Massachusetts doctor and Tufts University medical school professor, who was accused of faking data used in at least 21 anesthesiology studies, according to the hospital where he worked until recently. The Baystate Medical Center, where Dr. Reuben was the head of the acute-pain unit, said it received a subpoena from the Boston U.S. attorney's office for financial records related to the anesthesiologist's work. A spokeswoman said that the Springfield, MA, medical center is not a target of the investigation. The hospital is "fully cooperating," the spokeswoman said.

Dr. Reuben's privileges and staff position at the hospital were terminated on March 19, but he has not been charged. The hospital said Dr. Reuben had been on a medical leave since May 2008. In an interview last month, attorney Ingrid Martin said Dr. Reuben "deeply regrets that this happened" and cited unspecified "extenuating circumstances." A call to his attorney was not immediately returned. A spokeswoman for the U.S. attorney's office declined to comment.

Last month, Baystate alleged that Dr. Reuben fabricated 21 medical studies, which showed the benefits of painkillers such as Vioxx and Celebrex. Some of his research was funded by Pfizer Inc., Wyeth and Merck & Co., according to officials at each of these companies. In a statement, Merck said it "was not aware of any issues with Dr. Reuben's papers, or the data underlying them, until very recently." Pfizer said its support for Dr. Reuben's research was based on the fact "he worked for a credible academic medical center and appeared to be a reputable investigator." Wyeth said it provided $10,000 in grant money to Dr. Reuben from 2001 to 2003. (Wall Street Journal) Read the original article.

Webcast to address compliance with The Joint Commission's Emergency Management Standards

The Premier healthcare alliance will host a national teleconference on Wednesday, April 8, from 2-3:30 p.m. EST, entitled "Compliance with The Joint Commission's Emergency Management Standards and lessons learned from the front line on Sept. 11.” The session will feature the following experts: Mark Ackermann - former chief administrative officer, Saint Vincent Catholic Medical Centers, New York, NY; Jim Rush - CEO, JVR Health Readiness Inc.; Steve Spaanbroek - director, Premier Consulting Services.

Ackermann will provide a management perspective of his former facility’s response to the Sept. 11 attack on the World Trade Center, as well as advice on preparedness for future mass casualty events.

Premier's Advisor Live is a teleconference series that provides information and discussion on timely topics and best practices in the field of healthcare. Everyone is invited to attend - there is no charge to participate. To register, obtain additional information or access past audio recordings, visit www.premierinc.com/advisorlive.

Novation offers additional financing options with Siemens and Hill-Rom

As hospitals find it increasingly difficult, or impossible, to access tax-exempt bonds and borrow funds, many hospitals are deferring or canceling capital expenditures. A recent survey conducted by Novation, found that more than 69 percent of respondents will cancel or delay capital equipment projects. Postponing capital expenditures impacts a hospital’s ability to meet community needs and corporate goals such as improved quality, efficiency and coordination of care. Novation is providing members of VHA Inc, University HealthSystem Consortium (UHC) and Provista secure innovative financing options.

Novation has captured financing options with two key suppliers Siemens and Hill-Rom. Both suppliers are offering alliance member’s flexible financing terms. Siemens is offering financing terms exclusive to Novation for key products, including all products available in the following categories: magnetic resonance, computed tomography, molecular imaging, and cardiovascular. Siemens is also offering special financing for select c-arm and ultrasound products. Hill-Rom is offering alliance members flexible financing terms on acute care beds that integrate with their Navicare technology. Visit www.novationco.com for more information.

LG Electronics showcases new Smart Vine monitors and network attached storage

LG Electronics healthcare products unveiled this week at the 2009 Healthcare Information and Management Systems Society Conference and Exhibition (booth #8315) make the use of technology easier for health care professionals and patients alike. The new Smart Vine Virtual Desktop monitors maximize a computer’s resources by allowing up to 11 users to share a single PC simultaneously. Smart Vine technology simplifies installation as well as reduces maintenance, IT support and energy consumption compared with multiple computers.

LG’s award-winning N4B1 Network Attached Storage (NAS) enables hospital staff members to utilize and share information with the convenience of shared data over a network. As the worlds first NAS device with a built-in Blu-ray drive, the N4B1 allows users on different operating systems to store and share data, whether directly connected to the NAS, on a network, or over the Internet for faster inquiry or retrieval of hospital information.

LG’s line of UL-Listed Hospital Grade LCD HDTVs (LG3DCH series) and UL-Listed monitors designed specifically for the healthcare industry feature advanced technologies with sleek design. With invisible speakers and unique pillow speaker ports, the LG3DCH series is designed to help patients feel more comfortable during their hospital stay.

New information technology products such as networked monitors and NAS enable ease-of-use for hospital staff, decreasing system maintenance and minimizing IT support needs. LG’s new Smart Vine monitors allow up to 11 nurses, administrative staff or doctors to connect to a single PC. Each user runs their own applications, just like if they had their own PC. Compared to multiple computers, this provides easier installation and reduced maintenance, IT support and energy consumption. Get more information. 

CMS issues 2010 payment information for Part C Medicare Advantage Plans and Part D Prescription Drug Plans

The Centers for Medicare & Medicaid Services (CMS) announced calendar year 2010 Medicare Advantage payment rates and Medicare Advantage and Part D prescription drug benefit payment policies. By law, CMS annually updates the Medicare Advantage capitation rates by a growth percentage that reflects growth in all Medicare expenditures, including expenditures under Part A and Part B payment rules. This growth percentage thus reflects the projected reduction in 2010 physician payments provided for under Part B payment rules. CMS announced Tuesday that this amount for 2010 will be 0.81 percent.

For prescription drug program enrollees, the Announcement includes important information about the 2010 Part D deductible, initial coverage limit, out-of-pocket threshold, and related parameters for the standard benefit. The annual percentage increase in average per capita Part D spending – used to update the deductible, initial coverage limit, and out-of-pocket threshold for the defined standard benefit for 2010 – is 4.66 percent.

For the first time, for plan year 2010, CMS will make a “coding pattern differences adjustment” to Medicare Advantage risk scores, reducing Medicare Advantage payment rates to account for differences in disease coding patterns between Medicare Advantage organizations under Part C and the Original Medicare program (Parts A and B).  The adjustment will be applied as a uniform 3.41 percentage reduction to all Medicare Advantage plans’ Part C risk scores in 2010.  View the fact sheet.

IDN Summit & Expo spring event takes collaboration to new level

Collaboration became more than an industry buzz-word at the spring IDN Summit & Expo in Orlando. It was the centerpiece of the entire event. “By design, we wanted to put collaboration at the center of everything,” said John Kelly, CEO of Healthcare Business Media which hosted the event. Breakout sessions, general sessions, the keynote speaker, and even the Reverse Expo were all structured to emphasize the importance of breaking down silos.

The renewed focus of the event was also effective, as there was a nearly 20 percent increase in registration compared to the Spring 2008 IDN Summit. “A combination of factors contributed to the event’s success, but certainly, showing how collaboration can work by featuring presenters who have made it work, adding CE hours for providers and a stronger sales and marketing track for suppliers, and increasing the number of breakout sessions made the event go from a nice idea to something very practical,” Kelly said.

This year, the IDN Summit & Expo featured the inaugural Search For Excellence Awards, to recognize collaborative initiatives that were effective in the realm of supply chain leadership.  Four “Peer Awards” were given to Aurora Health Care, Covenant Health Systems, Sisters of Mercy Health System, and Texas Children’s Hospital. The Summit of Excellence Award was won by University of Pittsburgh Medical Center (UPMC), based upon voting by their peers.  UPMC was honored for the steps they took towards the goal of reducing healthcare cost by creating a “touch free” purchasing system for their end users. The Google-like system uses eMarketplace technology which allows over 7,000 end users in the UPMC system the flexibility to order directly from the supplier. Forty percent of their nearly 350,000 purchasing transactions are now conducted entirely electronically. By going to the electronic ordering system UPMC has saved their system approximately four million dollars, based upon an average of $30 per transaction.

The eMarketplace technology was provided by Vinimaya Inc., and has been used in companies like Alcoa, 3M, and Agilent.

The Fall Summit, which will be held September 23rd – 25th, will be located at the Gaylord Texan Resort and Convention Center. Get more information about the Fall IDN Summit & Expo.

Unotron integrates Micromem Hall Sensor technology in new soft key computer keyboards

Unotron announces the integration of Micromem Hall sensor technology into their new line of SoftKey washable keyboards and upcoming production projects. This follows the November 2008 joint development agreement between Unotron and Micromem Technologies Inc., through its wholly owned U.S. based subsidiary Micromem Applied Sensor Technologies Inc. enhancing the user experience with improved sensitivity, more rapid data input and greater comfort.

Renowned for manufacturing high quality, washable data input and security devices that are easily cleaned and disinfected to mitigate the spread of infection in healthcare, education, commercial and government environments, Unotron’s patented SpillSeal protection allows keyboards to be fully submerged in water or antibacterial solutions for disinfecting. Unotron’s computer keyboards and mice can be disinfected with a bleach solution without corroding the technology or compromising usability. For information visit www.unotron.com.

Flo Healthcare introduces new power systems to support increasing demands on wireless mobile workstations

Flo Healthcare announced an expanded line of power systems designed to offer hospitals more flexibility for maximizing performance and enhancing the long-term value of workstations. Power systems are a critical issue as hospitals require workstations to support an increasing number of energy-intensive point-of-care technologies such as advanced telehealth and PACS/imaging review.

Flo Healthcare’s new line-up, offered with the new Flo 1760, the Flo 1800 and as an upgrade for the Flo 1750 to extend lifecycles, includes a revolutionary lithium nanophosphate power system that delivers an unsurpassed combination of durability (cycle life), run time between re-charging, consistent performance, and light weight for improved workstation mobility and ergonomics. Other new options include improved systems powered by nickel metal hydride (NiMH) and sealed lead acid (SLA), as well as a swappable battery system.

Matching power systems to the specific workflows of each department is a key element in a Mobile Power Strategy. Flo Healthcare’s flexible power options also ensure workstations can be upgraded as point-of-care technology evolves and requires more power. In addition, older workstations can be refreshed to include lower-cost power options to meet the needs of less demanding units. As a result, the hospital can add years to the lifespan of the workstation to substantially reduce total cost of ownership. For more background on developing a Mobile Power Strategy, download the Flo Healthcare white paper here: http://www.flohealthcare.com/info.html

April 7, 2009  Download print version

Medicare expands coverage of PET scans as cancer diagnostic tool

Lawson announces agreement with PeaceHealth

Honeywell is mobilizing patient safety at HIMSS09

HIMSS annual survey results:  Healthcare IT continues to grow, despite the economy

Hill-Rom and TeleTracking Technologies announce strategic relationship

Vioguard introduces world's first self-sanitizing keyboard

Introducing the world's only PC keyboard with built-in color document scanner

Reva Systems extends the reach of healthcare tracking systems

Medicare expands coverage of PET scans as cancer diagnostic tool

The Centers for Medicare & Medicaid Services (CMS) issued a final national coverage determination (NCD) to expand coverage for initial testing with positron emission tomography (PET) for Medicare beneficiaries who are diagnosed with and treated for most solid tumor cancers. This NCD removes a clinical study requirement for PET scan use in these patients. 

Since 2005, Medicare coverage of PET scans for diagnosing some forms of cancer and guiding treatment has been tied to a requirement that providers collect clinical information about how the scans have affected doctors’ treatment decisions.  This information was gathered through the National Oncologic PET Registry (NOPR) observational study. The new decision removes the requirement to report data to the NOPR when the PET scan is used to support initial treatment (or diagnosis and “staging”) of most solid tumor cancers.

This decision is based, in part, on the information generated as a result of CMS’ 2005 decision to require NOPR reporting for many cancer PET scans.  As a result of this evidence from NOPR, CMS reconsidered its 2005 coverage policy. This decision is the first time that CMS has reconsidered a coverage policy based on new evidence developed under the CED program. 

This decision applies to PET scans used to support initial diagnosis and treatment for most types of solid tumor cancers.  It also expands coverage of PET scans for subsequent follow up testing in beneficiaries who have cervical or ovarian cancer, or who are being treated for myeloma, a cancer that affects white blood cells.  For these cancers, NOPR data collection will no longer be required.

It is important to note that the decision still requires clinicians to report data to the NOPR when using PET scans to monitor the progress of treatment or remission of cancer in some cases.  Although the evidence generated by the NOPR study helped CMS determine that PET scans are useful in helping guide treatment when cancer is first diagnosed, scientific evidence is not as strong in showing that PET scans are as useful in making subsequent treatment decisions for some types of cancer. Read the final decision.

Lawson announces agreement with PeaceHealth

Lawson announced at HIMSS that PeaceHealth licensed the Lawson S3 Healthcare, Supply Chain Management, Enterprise Financial Management and Lawson Human Resource Management suites to replace disparate systems and help standardize processes for its most critical support services, including accounting, finance, supply chain and human resources. Lawson also announced the availability of Lawson S3 Point of Use, an intuitive software application that helps keep healthcare supplies in stock while providing tools to more accurately capture patient charges via touch screen and scanner, with a handheld device or through a standard desktop computer.

Honeywell is mobilizing patient safety at HIMSS09

Honeywell announced the presence of its Scanning & Mobility business at the HIMSS09 Annual Conference & Exhibition. Honeywell’s full line of bar-code scanning, mobility and data management solutions for healthcare will be on display at the booth.

The booth will exhibit bar code scanners and mobile computers with disinfectant-ready housing built to withstand frequent exposure to harsh cleaning solutions used commonly in healthcare environments. These units include: 4600g – a hand-held area-imager scanner that can perform aggressive scanning of 1D and 2D bar codes found on prescriptions and insurance cards; 4820 – a cordless area-imager scanner purpose built for cart-on-wheels applications; and Dolphin 9900hc – a new model that puts the field-tested Dolphin 9900 mobile computer in a healthcare-friendly casing. For more information, visit http://www.honeywell.com/aidc.

HIMSS annual survey results:  Healthcare IT continues to grow, despite the economy

Implementing clinical systems, including an electronic medical record (EMR) and computerized provider order entry systems (CPOE), was cited as the top priority for healthcare information technology professionals who responded to the 20th Annual Healthcare Information and Management Systems Society (HIMSS) Leadership Survey.  41 percent say at least one of their facilities has a fully functioning EMR – up from 32 percent two years ago. Security issues remain a top concern, with one in four reporting a security breach in the past year. Nearly half or the respondents, say they plan to implement single sign-on technology to address security risks.

Respondents were most likely to indicate that IT can have an impact by reducing medical errors (38 percent) and improving quality outcomes (24 percent). However, more than half (54 percent) said financial considerations was the business issue that would most impact on healthcare, with 28 percent indicating that financial considerations was the top barrier to successful implementation of IT.

Hill-Rom and TeleTracking Technologies announce strategic relationship

TeleTracking Technologies, Inc., and Hill-Rom, announced a strategic development agreement to invest in and commercialize the next generation of patient flow and nurse communication solutions designed to enhance efficiency, improve patient safety and integrate communication within the healthcare environment. The long-term agreement will support investment in integrating Hill-Rom’s NaviCare Nurse Call system with TeleTracking’s leading Capacity Management Suite powered by TeleTrackingXT to deliver new, integrated value between patient flow technology and nurse communications solutions.

In addition, Hill-Rom and TeleTracking have established a joint sales and marketing arrangement. Visit them at HIMSS booth # 503 and TeleTracking Technologies is located at Booth # 3603. Read the release for more information.

Vioguard introduces world's first self-sanitizing keyboard

The world's first self-sanitizing computer keyboard was introduced at the HIMSS Conference. Using the power of ultraviolet light, Vioguard's self-sanitizing keyboard -- utilizing two powerful 25-watt germicidal fluorescent lamps-kills more than 99.9% of MRSA in less than 10 seconds.

Developed by former Microsoft Hardware veterans and their business partners, the proprietary product is the first introduced by Bothell, Washington-based Vioguard.  First shipments of the units are anticipated in the second half of 2009. Visit www.vioguard.com for more information.

Introducing the world's only PC keyboard with built-in color document scanner

In a world of cluttered desks, KeyScan, a developer of hardware and software scanning solutions, unveils the only computer keyboard with built-in full-page color scanner. The KeyScan KS810-P integrated keyboard and sheetfeed scanner occupies the same footprint as a standard keyboard. It quickly and easily scans black-and-white and color documents ranging from smooth surface plastic cards like medical, insurance cards, driver’s licenses, and other documents. It takes about five seconds to scan a full-page, 300dpi, grayscale document.

The KS810-P is bundled with KeyScan's exclusive NoTouch-AutoScan software. This No Touch-Auto Scan proprietary software lets users activate and complete the scanning process without pressing any buttons, simply by inserting a document into the scanner feeding slot. The scanned document automatically becomes a searchable PDF email attachment. In addition to email, users can choose to copy, fax or save the document to a file using PDF, Word, JPG, TIF or other available formats. Four hotkeys on the keyboard make selecting all these functions a breeze. With the Twain interface, third-party software can also be used to scan documents. KeyScan's intuitive software uses the IRIS OCR engine for easy word recognition and lets the user manipulate documents with images and/or text.  Save $40 this week as a HIMSS special. For more information, visit www.keyscan.com.

Reva Systems extends the reach of healthcare tracking systems

Reva Systems announced it will demonstrate the first passive RFID solution package, Reva-4-Healthcare, designed to support healthcare tracking applications. Reva-4-Healthcare is designed to integrate seamlessly with AeroScout’s MobileView RTLS track and trace application platform.

Specific benefits are realized in a variety of ways such as reducing of the incidence of preventable medical errors; monitoring compliance with equipment procedures or other hospital protocols; enabling the assessment of key hospital operational metrics including response times and treatment schedules; and raising critical asset utilization rates and reducing the loss rate of expensive biomedical equipment.

The Reva-4-Healthcare demonstration at HIMSS will explain how the use of passive RFID technology complements active RTLS-based solutions to enable healthcare facilities to track resources including assets, consumables and people that until now could not be tracked using active RTLS due to form-factor or cost reasons. Passive RFID tags do not require batteries and are economical enough to be used for tracking disposable and consumable items such as fluid bags, specimen vials, and single-use medical devices such as stents. Items requiring sterilization can also be tracked using passive tags packaged to survive the chemicals and heat of sterilization systems. Since passive tags can be produced in thin and flexible form factors, they can also be used to create labels and wristbands expanding the realm of trackable healthcare-related assets to include medications or people. Visit Reva Systems at HIMSS in booth #8149. For more information, visit www.revasystems.com.

April 6, 2009  Download print version

Dennis Quaid opens HIMSS keynote with medication errors reality talk

Socket mobilizes the fight against germs with antimicrobial product suite

Tri-State Hospital Supply Centurion brand trays and kits: Class 1 recall due to lack of sterility

STERIS Corporation receives FDA clearance for unique crossover surgical table

G.E. and Intel working on remote monitors to provide home healthcare

Vericom and LG Electronics Partner at HIMSS 2009

Ekahau refines Wi-Fi RTLS performance with new location beacon

RF Technologies to release Help Alert wireless, staff-duress call solution at HIMSS09

B. Braun Medical Inc. to demonstrate Infusion Systems Technologies at HIMSS 2009 Interoperability Showcase

AeroScout announces world’s first Wi-Fi asset tracking solution with embedded ultrasound capabilities

Dennis Quaid opens HIMSS keynote with medication errors reality talk

Actor Dennis Quaid focused on his recent experience with medication errors at HIMSS. Quaid was the featured keynote speaker Sunday, April 5th. Speaking to a packed ballroom Quaid told his emotional story about medication errors that almost killed his twin babies at Cedars Sinai Hospital. His story unfolded after his twins were diagnosed with an infection after their birth and their doctor put them in the hospital on IV antibiotics.

The nurse in charge when changing the IV solution gave the twins 10,000 USP of Heparin instead of 10 USP Hep-Loc. A group of nurses the following morning made the same error. Quaid blames the manufacturer on not differentiating the bottles and labels which were almost identical. He also blamed the fact that it got past the pharmacy, and nurse double check systems that failed, as well as what he calls the lack of a “hospital technological backup” that would protect from human factors that could cause errors in the event that human checklists were ignored.

Quaid and his wife Kimberly have started the Quaid Foundation to reduce medical errors. Since the errors occurred at Cedars, the hospital has adopted barcoding, special pharmaceutical cabinets and other safety measures. HIMSS has donated $10,000 to their foundation to help facilitate safety measures.

Quaid ended his talk by saying that the next step for healthcare should be to make all of these systems interoperable and that systems must be user friendly. He stated that “we have to make barcoding, CPOE and electronic record keeping common in all hospitals”. He continued, “It takes leadership to make it happen in order to adopt the technology.”