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May 2006
Progress on AIDS is focus of assembly
Progress on AIDS is focus of assembly
Five years after the United Nations’ historic first general assembly
on AIDS, the world has seen a huge increase in money and attention
going to the 25-year-old epidemic, as well as evidence that the
disease has stabilized in many areas and is retreating in more than
a few. The number of people getting AIDS drug treatment in needy
countries has risen more than fivefold in five years, and the number
of sites providing it has jumped tenfold in just the past year. At
least a quarter-million people are alive today who would not be
without the money, effort and expertise expended just since 2003,
according to U.N. estimates released Tuesday. Thousands of AIDS
activists, diplomats, health ministers and heads of state are
gathering Wednesday to tackle the more difficult task of extending
the recent gains. They also will have to face the reality that the
world did not come close to putting 3 million low-income AIDS
patients on treatment by the end of 2005, the “3 by 5” target
proclaimed in 2003, and that far fewer than half the people who need
antiretroviral drugs immediately are getting them. Nevertheless,
today “the context is completely different” from the first general
assembly session in August 2001, Peter Piot, the Belgian physician
who directs UNAIDS, said. “In 2001 we were at the height of despair.
Today we have more than just proof of concept; we are beginning to
see results.” That success now presents the world's wealthy
countries with a serious responsibility: The lives of perhaps 1
million people on AIDS therapy in low- and middle-income countries
are now directly dependent on foreign aid. How to sustain that
therapy without interruptions of even days or weeks, while not
turning the United States and Europe into the health insurers of
millions of people in the developing world, is expected to be the
chief issue at the U.N. meeting. Over the next three days, delegates
will try to come up with a blueprint for reaching the new goal of
providing “universal access” to AIDS care and prevention by 2010.
UNAIDS estimates about $8.3 billion was spent last year in
treatment, prevention and care of orphans in low- and middle-income
countries. That meets the $7 billion to $10 billion target set five
years ago. Although the number of people getting AIDS drugs
increased from 240,000 in 2001 to about 1.4 million last year, of
people worldwide whose disease has advanced to the point of needing
the drugs, only one in five gets them. By next year, $18 billion
will be needed to pay for drug treatment, but only $10 billion will
be available, according to U.N. estimates, and the gap will continue
to grow. (The Washington Post)
What preventive health
measures would save the most lives for the least money? The top rank goes to
taking aspirin daily to prevent heart attacks and strokes in men over 40 and
women over 50, according to a study reported on the Web site of an alliance of
health insurers, state health departments, academics, and trade groups.
Immunizing children and discouraging people from smoking follow closely behind,
the Washington-based Partnership for Prevention found. Former Surgeon General
David Satcher led the effort, which entailed a review of more than 8,000
preventive-medicine studies. The rankings are intended as a checklist for
patients, doctors and insurers. Below are the top 20 preventive measures in rank
order. Preventive measures that are ignored by more than half of those who'd
benefit from them are indicated by asterisks. 1.) *Daily aspirin to prevent
heart attacks and stroke in men over 40 and women over 50. 2.) Childhood
immunizations for diphtheria, tetanus, whooping cough, measles, mumps, rubella,
polio, hepatitis B, etc. 3.) *Tobacco-use screening and brief counseling by
doctors. 4.) *Routine colorectal-cancer screening for adults 50 and older by any
recognized method. 5.) Hypertension screening via routine blood-pressure tests
and medication if necessary. 6.) Annual flu shots for adults 50 and older. 7.)
*Immunization of adults 65 and older against bacteria that cause pneumonia and
related diseases. 8.) *Screening and brief counseling of problem drinkers by
their physicians. 9.) *Vision screening for adults 65 and older. 10.) Cervical
cancer screening for sexually active women and women over 21. 11.) Cholesterol
screening for men 35 and older and women 45 and older. 12.) Routine
breast-cancer screening for women 50 and older and discussion with women ages 40
to 49 to set an age to begin screening. 13.) *Routine chlamydia screening for
sexually active women under 25. 14.) Calcium-supplement counseling for
adolescent girls and women; 15.) Vision screening for children under 5. 16.)
Routine counsel for women of childbearing age on the use of folic acid
supplements to prevent birth defects. 17.) Obesity screening for adults and
high-intensity diet and exercise counseling for the obese. 18.) Depression
screening for adults. 19.) Hearing-impairment screening for adults 65 and over.
20.) Promotion of child-safety measures such as car seats, pool fences, bicycle
helmets, poison control, and curbs on scalding-water burns. Analysts quantified
the health gains in terms of longer life and better quality of life for each
preventive measure. They also compared the cost-effectiveness of each preventive
intervention. They combined the two rankings into one score that measures
bang-for-the-buck for the top preventive-care options. Of the 10 preventive
measures that promise the greatest gains, six are ignored by more than half of
Americans who'd benefit from them, according to the study in the July issue of
the American Journal of Preventive Medicine.
www.prevent.org/content/view/46/96/. (Boston Globe)
Consumer-directed health plans; Small but growing
enrollment fueled by rising cost of health care coverage
Insurance carriers, employers, and individuals are showing increasing interest in consumer-directed health plans (CDHP). CDHPs typically combine a high-deductible health plan with a health reimbursement arrangement (HRA) or health savings account (HSA). HRAs and HSAs are tax-advantaged accounts used to pay enrollees’ health care expenses, and unused balances may accrue for future use, potentially giving enrollees an incentive to purchase health care more prudently. The plans also provide decision-support tools to help enrollees become more actively involved in making health care purchasing decisions. The United States Government Accountability Office (GAO) was asked to review the prevalence of CDHPs, how the associated accounts are funded and used, and the factors that may contribute to the growth or limit the appeal of these plans. Enrollment in CDHPs accounts for a small but growing share of the 177 million Americans with private health insurance coverage. From January 2005 to January 2006, the number of enrollees and dependents covered by a CDHP, either an HRA-based plan or an HSA-eligible plan, increased from about 3 million to between about 5 and 6 million. An increasing number of health insurance carriers and employers began offering CDHPs during 2005. Most employers made a contribution to their employees’ health accounts, and the share of account funds spent by enrollees varied. Industry representatives indicated that while most HSA account holders withdrew a portion of their account funds in 2005, some account holders used other, out-of-pocket funds, rather than their HSAs, to pay for medical care. According to industry officials and experts, the primary factor responsible for the growth of CDHPs is the rising cost of health care coverage. Prompting the growth of enrollment among individuals is the desire to lower premiums and accumulate tax-advantaged savings, according to the officials. Experts noted that employers would be more likely to offer a CDHP if the plans demonstrate the ability to restrain rising costs, and employees would be more likely to enroll in a CDHP if employers offered more comprehensive CDHP benefits coupled with education about the plans. www.gao.gov/cgi-bin/getrpt?GAO-06-514.
APIC/JCR/Joint Commission Infection Prevention
and Control Conference to focus on managing MRSA
The rapid spread of drug-resistant bacteria known as methicillin resistant staphylococcus aureus or MRSA is the focus of a three-day discussion to examine best practices to combat this growing problem. “Managing MRSA: A Call to Action” is the theme of the August 14-16 conference where experts from the Association for Professionals in Infection Control and Epidemiology (APIC), Joint Commission Resources (JCR), and the Joint Commission on Accreditation of Healthcare Organizations will meet with infection prevention and control leaders and other health care professionals to study this critical issue. The conference will be held at the Hyatt Regency Cambridge in Cambridge, MA. More than 70 percent of the bacteria that causes infections for two million hospitalized Americans each year are resistant to at least one of the drugs most commonly used to treat them, according to the Centers for Disease Control and Prevention (CDC). “This conference will specifically address the challenges of MRSA,” said Karen H. Timmons, chief executive officer, JCR. “This is significant because currently there is no clear single solution to combat MRSA. We need to identify and disseminate best practices to fight this problem. The conference will provide a forum for health care professionals to make strides in doing just that,” she continued. In addition to infections in hospitals, MRSA is now occurring with increasing frequency in the community. Estimates of the prevalence of MRSA vary significantly from country to country, as do prevention efforts and methods of control. Topics of discussion at the conference will include newer, faster screening methods to identify colonized or infected patients, together with contact-isolation, enhanced methods for hand hygiene, treatment options, personal protective equipment, antimicrobial prophylaxis and active surveillance cultures. The conference will provide information on state legislatures that are beginning to consider mandatory active surveillance. Participants will also examine which prevention and control strategies are realistic, practical and cost effective. Prior to July 14, the registration fee is $475 for APIC members and $575 for nonmembers. After July 14, the cost of the conference is $550 for APIC members and $650 for nonmembers. If you have questions, contact Shawn Boynes, APIC’s director of Education, phone 202-454-2640, e-mail sboynes@apic.org. Or contact Pamela Steinbach, JCR’s interim executive director of Education, phone 630-792-5405, e-mail psteinbach@jcaho.org.
Parata Systems announced yesterday that it has entered into a definitive agreement to acquire substantially all of the assets of McKesson Corporation’s Automated Prescription Systems (APS) business unit. Under the agreement, the McKesson APS product line will come under the Parata banner, creating an integrated portfolio of automation solutions; from low-volume, semi-automated systems, to mid-volume workflow and robotics solutions, and high-volume processing. The goal of the alliance is to enhance the retail pharmacy market’s access to the most advanced technologies for enhancing the safety and accuracy of the prescription process. The two companies also will enter into a long-term strategic alliance under which McKesson will become a sales lead resource for Parata in the United States and exclusive third-party distributor in Canada and Mexico. The transaction, is expected to close in mid-to-late June. McKesson’s High-Volume Solutions division, automated prescription fulfillment systems for the central fill, mail service and specialty pharmacy industries, will obtain exclusive rights to all of Parata’s products to serve this rapidly growing segment of the market.
Novation signs 17 medical-surgical distribution agreements
offering five-year price protection
Hospitals across the country are feeling the financial impact of increased
distribution costs due to the rising costs of petroleum, labor and spikes in the
prices of raw materials. However, Novation, the health care contracting services
company for VHA Inc. and the University HealthSystem Consortium (UHC), has
signed 17 new medical-surgical distribution agreements that will ensure that VHA
and UHC members will not experience higher supply distribution costs for the
next five years. VHA and UHC members purchase approximately $4.5 billion in
medical-surgical products through Novation annually. The new Novation
medical-surgical distribution agreements, which take effect Sept. 1, 2006 and
run through August 31, 2011, are with the following companies: American Medical
Depot; Buffalo Hospital Supply; Cardinal Health; Claflin Company;
Hardin’s-SYSCO; Kreisers Inc.; McKesson Medical-Surgical; Medline Industries;
Midland Hospital Supply; Midland Medical Supply; Midwest Medical Supply; N.S.
Low & Co.; Owens & Minor; Professional Hospital Supply; Seneca Medical; Shared
Services Systems; and The Burrows Company. The essential ingredient to the new
agreements is Novation’s one-cost plus approach, which separates the cost of
products from the cost of service and provides members with a single, fixed
percentage that represents all costs for distribution services. The percentage
charge for distribution services varies by distributor and is based on volume,
and members must select one primary distributor and a secondary distributor.
This accurate and easy-to-understand formula applies to both contracted and
non-contracted products, enabling members to forecast medical and surgical
supply costs with greater certainty. Approximately 60 percent of all
medical-surgical products are delivered to hospitals through a distributor. The
rest are sent directly from manufacturers. By working with a single distributor,
hospitals are able to build reliable distribution schedules and maintain more
efficient supply handling practices.
Canon U.S.A. awarded national contract for its
digital radiography solutions by Consorta
Canon U.S.A Inc. announced that its Medical Systems Division has been awarded a contract from Consorta Inc., to make Canon digital radiography (DR) solutions available to Consorta member facilities nationwide. As part of the Agreement, Consorta will offer the Canon CXDI-31 and CXDI-50G portable DR flat panel sensors and CXDI-40EG general DR flat panel sensor for digital upgrades to members' existing AMX-4 and Rad Room analog systems.
6 more bird flu cases in Indonesia
6 more bird flu cases in Indonesia
Six
more human cases of the H5N1 strain of avian flu have occurred in Indonesia, the
World Health Organization has said. Three of the cases were fatal. That means 48
of the 224 human cases confirmed worldwide by the organization have occurred in
Indonesia. Thirty-six of the Indonesian cases have proven fatal. Only Vietnam,
with 93 cases, 42 of them fatal, has tallied more. Four of the infected people
had been exposed to chickens or pigeon feces. Investigators are still looking
into how the other two contracted the virus. WHO spokesman Dick Thompson told
CNN it was highly unlikely that human-to-human transmission was responsible for
any of the six cases, given that all but two they were separated by great
distances. And those two, a brother and sister who have since died, both got
sick on the same day, making it unlikely one could have infected the other,
Thompson said. The six new cases are not related to a cluster of at least seven
cases, all of them blood relatives, reported last week in Kubu Sembelang
village, Karo District, of North Sumatra, Thompson said. WHO has said the virus
in that cluster may have been spread by human-to-human contact. The overwhelming
majority of human cases to date have been linked to exposure to poultry. Seven
of eight family members died in the outbreak. The first case was not confirmed
to be H5N1 since the body was buried without tissue samples being taken.
Researchers are working on the hypothesis that the family members involved in
the cluster were genetically more susceptible to H5N1, since spouses did not get
sick, Thompson said. (CNN)
Romania finds new suspect bird flu case
Romania found a suspected case of bird flu in a house on the outskirts of
Bucharest on Tuesday, as authorities struggled to contain a new wave of the
deadly disease which has hit poultry across the country. More than a hundred
outbreaks have been found in the last three weeks, some in Bucharest and many
around a poultry farm about 100 miles north of the capital which had sold live
chickens without health certificates. Romania was the first country to detect
the virus in birds in Europe last year but it had contained the first wave of
the disease earlier this year. Romania has not reported any cases of bird flu in
people. (Reuters)
Earthquake survivors need medical care,
safe water, vaccination
The
World Health Organization is sending emergency equipment, and will help to
support vaccination campaigns and set up a disease surveillance system following
the devastating earthquake on the island of Java, Indonesia on Saturday. Rescue
teams are still finding people who need medical help. The latest available
figures show that an estimated 5,000 people died and several thousand were
injured, including some 1,500 very seriously injured patients who need urgent
medical evacuation and care. About 200,000 people are displaced from their
homes. Bantul District, south of Yogyakarta and with a population of about
790,000, is reported to be the worst hit with the majority of houses destroyed.
At least one of the six hospitals in the District has been destroyed and other
hospitals in the area are overcrowded. WHO has several staff working with the
Ministry of Health (MOH) in the affected area. Additional national and
international staff are on stand-by in Jakarta. WHO has sent vehicles loaded
with medicines and communications equipment into the area, including with
emergency health kits containing drugs and medical supplies for 50,000 people
for three months, along with surgical kits to support 600 operations. WHO will
also help to set up a disease surveillance system in order to detect and control
outbreaks of communicable diseases, including diarrhoeal disease. Such a system
was instrumental in finding and controlling disease in Aceh following the
tsunami. WHO will also help to organize vaccination campaigns against measles,
which can be a major killer and spreads rapidly in crowded areas. Rather than
sending people to help with rescue and recovery, the Indonesian government has
requested more medicines and supplies. The MoH is mobilizing its medical and
health teams and is deploying more than 200 doctors and nurses to the affected
areas, to assist the injured and also to relieve the health staff who have been
working around the clock since the start of this disaster. Clean water, safe
sanitation and waste removal will rapidly be needed, particularly for people who
have been displaced, in order to prevent the spread of water-borne diseases.
WHO seeks data on avian flu treatment
Three years after the human H5N1 flu virus outbreak began, the World Health Organization lacks a comprehensive database of treatment and patient care. Of the 218 confirmed cases of human H5N1 infections since 2003, 124 have died. But the WHO's treatment information comprises only a handful of academic studies based on fewer than a third of all patients. “There is a paucity of this information at the WHO which we are working to correct,” said Maria Cheng, a spokeswoman for the WHO. “The information that we have is probably best described as fragmentary.” Greater details, on which drugs have been used, how long after the onset of symptoms and to what effect, would provide valuable extra information for doctors assessing how best to treat cases in future. The WHO is drafting a questionnaire to gather more information from frontline health workers, but still needs approval from the officials and countries concerned. Cheng said a study funded by the US National Institutes of Health would begin this autumn in just three of the 10 countries affected by bird flu, and could take two years to complete. The WHO, which has received extra finance in recent months amid rising concern about a human pandemic, says that, even though its network of staff incorporates most of the affected countries, its efforts to gather information have been hampered by factors such as a lack of funds. In revised treatment guidelines issued this month, which drew principally on three academic studies covering about 70 H5N1 patients and earlier research focused on milder seasonal flu, the WHO made a “strong recommendation” for the use of Tamiflu and a “weak recommendation” for Relenza. But little is known about the effectiveness of either drug in severe cases of human flu or of the H5N1 virus, about which experts are most concerned. “It would certainly be worthwhile to try to get hold of all the data. But it is not easy to approach hospitals for access to clinical notes, gain permission and hope they contain sufficient information,” said Menno de Jong from the hospital for tropical diseases in Ho Chi Minh City in Vietnam. Roche, the Swiss pharmaceutical company that manufactures Tamiflu, refers to just two academic papers, covering fewer than 20 treatment successes in Thailand and Vietnam, and to a conference presentation on 10 further cases in Turkey. (Financial Times)
Boston reports first measles outbreak in 7 years
Boston health officials worked on Thursday to contain the city's first outbreak
of measles in seven years after four people in a downtown office tower were
diagnosed with the highly infectious disease. The Boston Public Health
Commission opened a second emergency health clinic at the 60-story John Hancock
Tower after it became known that hundreds of workers may be at risk of
developing measles. Measles was long considered a normal childhood disease, but
the virus can cause severe complications in otherwise healthy children and
adults, including sometimes fatal encephalitis, pneumonia and diarrhea. The four
who were diagnosed with the disease all worked at Investors Bank & Trust, a
financial services firm. Three of the workers caught the disease from a contract
worker who recently traveled from India. An initial emergency clinic was set up
on May 11 after the first case emerged. Only 37 measles cases were reported in
the United States in 2004, an all-time low, according to the most recent data.
But a few cases are still imported from countries with lower vaccination rates
and the disease occurs domestically as well, health officials say. John Auerbach,
Boston Public Health Commission's executive director, said hundreds of workers
at Investors Bank & Trust had received vaccinations to prevent an outbreak.
While measles is very rare, Auerbach said, “there are still pockets of the
population that aren't immunized.” A month ago U.S. Public health officials
expressed concern about an outbreak of mumps in the Midwest and said some people
may have been infected on airline flights. John Riley, head of marketing and
communications at Investors Bank & Trust, a firm with 1,500 employees in Boston,
said all four workers had recovered. Most developed countries routinely
vaccinate children against measles but the virus still killed 500,000 people,
mostly children, around the world in 2003, according to the World Health
Organization. (Reuters)
Diagnostix announces new AccuPrice reporting
capabilities and training webcasts
Diagnostix, an Amerinet subsidiary, announces a new audit summary report for the AccuPrice price auditing tool for pharmacy purchases. The new report is available in Microsoft Excel format, allowing health care providers to perform in-depth data analysis. It is also customizable. Health care providers can choose which exceptions they would like to track, favorable price variances, unfavorable price variances, items not on file and/or inactive items. In addition, AccuPrice analysts will add comments indicating the cause of the exceptions. Diagnostix customers can preview the new report functionality at one of two training Webcasts. The next program is scheduled for June 8 at 2:00 p.m. Eastern time. To register for a Webcast, e-mail accupricefeedback@vectorsystems.com.
Amerinet announces its agreement with Continuant Inc. for telecom maintenance services effective through April 30, 2008. Continuant offers 24/7 technical support, on-site critical spares, live response to alarms and streamlined service.
Amerinet announces its agreement with Nilfisk-Advance Inc. for floor maintenance equipment. Effective through December 31, 2008, this contract includes a complete line of commercial and industrial floor maintenance equipment.
Amerinet announces its agreement with Stryker Medical for stretchers. Effective through March 31, 2009, this contract includes emergency, trauma, transport and procedure stretchers as well as stools and chairs.
Containing TB’s rising threat to hospital patients and staff
Mintie Technologies’ new
IcoRoom Portable Anteroom System will help hospitals protect their patients and
staff members against the spread of airborne TB bacteria from infected patients
as well as other airborne infectious diseases, said the company. The IcoRoom
innovation comes at a time when the Centers for Disease Control report that
cases of drug-resistant tuberculosis are on the rise. The IcoRoom System
consists of a lightweight, collapsible anteroom and a high-volume,
high-efficiency HEPA filtration negative air machine. IcoRoom is designed to
replicate permanent negative pressure anterooms, which the CDC has identified as
effective in containing airborne infectious droplet nuclei (AIDN) such as TB.
Clinically-tested and proven to deliver the same benefits, the IcoRoom is priced
at $7,500, a fraction of the cost of constructing a permanent anteroom, and
provides hospitals the flexibility to isolate multiple surgical and procedure
rooms with each System. “We developed IcoRoom as a result of insights we gained
working with the infection control professional community,” said Doug Erickson,
a healthcare regulatory compliance consultant to Mintie Technologies. “At both
the professional association and individual hospital level, we learned that the
HEPA-filtered portable anteroom had the potential to be an everyday solution for
rapid-response isolation needs, particularly for isolating TB patients.” TB
cases are most prevalent in states with high urban density such as California,
New York, and Texas, and the CDC recently reported a 20% increase in cases of
antibiotic-resistant strains of the bacteria. This increase has renewed interest
in TB containment methods. “Patients with these highly-resistant strains of M.
tuberculosis need to be treated surgically; their emergence is a potent reminder
that TB remains a formidable threat,” Erickson said. “IcoRoom offers hospitals a
rapid-response, clinically-effective, and low-cost solution for protecting their
patient population and personnel without treatment disruptions or costly
construction modifications.” Clinical testing in operating room environments,
where maintaining directional airflow is critically important, also demonstrated
that portable anterooms are superior to in-room air scrubbers in isolating AIDN.
“Since IcoRoom functions completely outside the operating room or procedure
room,” Erickson added, “it eliminates introducing dirty equipment into the OR
and cuts down on space intrusion, ventilation disruption, and noise introduced
by portable air scrubbers.” The IcoRoom portable anteroom is made with a
durable, flame-rated polyfabric envelope and high-strength, collapsible frame.
Paired with the HEPA filtration negative air machine, IcoRoom complies with the
latest CDC protocols for containing M. tuberculosis AIDN. Setting up the IcoRoom
takes less than thirty minutes, and take-down is fast and easy, with a simple
push-button frame collapse. IcoRoom’s portability and ease of installation also
make it valuable for creating temporary airborne infection isolation rooms.
IcoRoom will be introduced at the annual Association for Professionals in
Infection Control and Epidemiology conference in Tampa, FL beginning June 11,
2006.
http://onrampcomm.com/
press_room_home.php.
Arthritis Drug Approved for Expanded Use
Federal regulators on Friday approved wider use of Johnson & Johnson's drug
Remicade but also said that a new warning was being added about reports of an
often-fatal lymphoma in a small number of users. The company won permission to
market the prescription drug for treating children with active Crohn's disease,
a chronic bowel inflammation that can be debilitating. Remicade is already sold
for treating rheumatoid arthritis and other conditions. Dr. Steven Galson,
director of the Center for Drug Evaluation and Research, part of the Food and
Drug Administration, said, "Remicade is not a cure, but it provides a
much-needed option for reducing the symptoms and inducing and maintaining
disease remission in children who have no other safe and effective therapy." The
agency cleared Remicade for children who have moderate to severe Crohn's disease
symptoms despite treatment with older therapies. Safety and effectiveness were
not studied in children younger than 6, the F.D.A. noted. The agency said it had
received reports of rare cases of an aggressive and often fatal lymphoma in
adolescents and young adults treated with Remicade. The agency said it was
working with the manufacturer to add the information to the drug's prescribing
instructions. A spokesman for the Johnson & Johnson unit Centocor, Michael
Parks, said the company was aware of six reports of lymphoma in Crohn's disease
patients who took Remicade for varying lengths of time. It is unclear whether
Remicade contributed to the lymphoma, Mr. Parks added. The patients were also
treated with other drugs to suppress the immune system. Remicade, known
generically as infliximab, is in a group of drugs that suppress tumor necrosis
factor-alpha, a protein involved in inflammation. Other drugs in the class
include Enbrel from Amgen and Humira from Abbott Laboratories. All carry
warnings about the possibility of malignancies or serious infections. (Reuters)
The Supply Chain Consortium, known as the premier source for supply chain benchmarking and best practices knowledge, has grown to more than 90 companies in the retail, consumer goods and related industries and has their sights set on 200 companies for 2006. Now members have an even greater competitive advantage: online search and query tools that yield relevant results immediately. Consortium subscribers can access all data points online and find answers to questions that match their specific areas of interest using targeted queries and keywords. For example, if you want to know the percentage of companies with sales of more than $1 billion that outsource their private fleet operations to a third-party logistics provider, you would be able to retrieve that information with a few key strokes and then further qualify your request. “The search and query capabilities really put the power of the database in the hands of the members, and therefore allow organizations to go far beyond benchmarking to truly achieve supply chain cost reductions and customer service improvements,” says Jim Tompkins, President of Tompkins Associates and co-leader of the consortium. These exciting new Internet-based tools allow you to click on any question in the online interview and get an immediate analysis of participant responses. “This includes averages, highs, lows, percentage breakdowns, satisfaction ratings, vendor selections, quartile distributions and importance rankings,” notes John Traendly, Tompkins Associates Principal and consortium co-leader. This year’s consortium Advisory Boards are led by top supply chain executives from Polo Ralph Lauren, Campbell Soup, Molson Coors, Whirlpool, Coca-Cola, Hallmark, Best Buy, J.C. Penney, Target and Rite Aid. The Supply Chain Consortium sponsors a comprehensive repository of more than 7,600 benchmarks complemented by search capabilities, online analysis tools, topic forums, and education and peer networking for executives and practitioners. For 2006, the Consortium will consist of 9,000-plus benchmarks. Topics this year include: Air and Parcel Freight; Dedicated Fleets; Demand Planning, Forecasting and Allocation; Distribution Center Operations; Domestic and International Inbound Order Management; Ocean Transportation; Order Fulfillment-Internet/Catalog; Supply Chain Network Design; Supply Chain Technology; Supply, Distribution and Transportation Planning; and ruck Transportation. Companies representing over a trillion dollars in combined annual sales have benefited from consortium membership. Individual company data remains strictly confidential and interview results are only available to members. Participating in the Supply Chain Consortium is the best way possible to measure performance and determine exact areas to focus on for improvement. For more information, call 800-789-1257, ext. 55461.
IBM to help track spread of bird flu
IBM is announcing a new cooperative effort with health authorities to stem the
spread of bird flu and other infectious diseases using technology it developed
partly at its Almaden Research Center in San Jose. As part of the effort, IBM
said it will donate software designed to enable health authorities to share
data, track the geographic spread of diseases and predict how the bird flu virus
might mutate into a form that is deadlier to people. Giving health experts in
different countries the ability to share computer and other data would be a
major achievement, said David Spellmeyer, an IBM researcher in San Jose who is
involved in the project. He said he doesn't know of any health agency in the
world that can share all of its records with other agencies. Participants in the
so-called Global Pandemic Initiative include the World Health Organization, U.S.
Centers for Disease Control and Prevention and businesses and universities, IBM
said. Dr. Richard Waldhorn, an analyst at Pittsburgh University's Center for
Biosecurity, who also is participating in the effort, agreed health authorities
could use IBM's help. “One of the big problems we face in preparation for an
epidemic is institutional awareness,” he said. “How can you communicate with
people in the field so you can collate this information together and get some
picture of what's going on? The World Health Organization is really a terrific
organization, but they are way overburdened.” One of the software components IBM
will donate, dubbed the Interoperable Health Information Infrastructure, was
developed at the Almaden Research Center in conjunction with IBM scientists
elsewhere. It is designed to help hospitals, laboratories and public health
agencies share data. Another software contribution, also developed largely at
Almaden, is the Spatiotemporal Epidemiological Modeler, or STEM, which can
create computer models of how a disease spreads geographically. Although both
products already are on the market, IBM's Spellmeyer said the company's
researchers in San Jose and elsewhere will update the software with new data as
bird flu or other infectious diseases evolve. IBM scientists in New York also
are working with the La Jolla-based Scripps Research Institute to create
computer technology that can predict how bird flu might mutate and become more
lethal to people. IBM officials said those predictions could help in the
development of effective bird-flu vaccines. (San Jose Mercury News)
HHS approves historic Medicaid Reform Plans in Idaho
Medicaid beneficiaries in Idaho will be among the first in the nation to have benefits designed to meet their needs based on age and health status -- changes allowed by the Deficit Reduction Act of 2005 (DRA), HHS Secretary Mike Leavitt announced Thursday.
Prior to enactment of the DRA states could not target benefits to one certain group of enrollees. The DRA, signed into law February 8, granted states new options for designing their Medicaid programs -- the first major revision to the program since its inception. Under the plan approved today, Idaho will offer three benefit packages aimed at meeting the health care needs of different groups -- children, people with disabilities and beneficiaries who are eligible for both Medicaid and Medicare. All of these packages are voluntary. Any enrollee who chooses one of the new plans can "opt out" at any time and return to standard Medicaid. The Benchmark Basic plan will serve healthy children and adults and will cover most of the traditional Medicaid benefits, except long-term care, organ transplants and intensive mental health treatment. The Enhanced Benchmark plan will serve individuals with more complex health care needs, such as the elderly and disabled. The Enhanced plan will cover all the traditional Medicaid benefits, including long-term or institutional care. The Coordinated Benchmark plan, will include all the benefits of the state's traditional Medicaid program and will serve Medicaid enrollees who are also eligible for the Medicare program-the so-called "dual eligibles." This group will be required to enroll in the Medicare outpatient coverage plan, or Part B, as well as the new prescription drug benefit, Medicare Part D. All three of the new packages will feature some new benefits, including preventive and nutrition services and "preventive health assistance" to help the obese, smokers and others adopt healthier health habits.
Idaho will also institute a program allowing the working disabled to purchase Medicaid's basic benefits package. The state's Medicaid reform will also include simplified eligibility for children in Medicaid and the State Children's Health Insurance Program (SCHIP) and the elimination of an assets test for some children. Today's approval will also allow the state to award grants under SCHIP for schools to offer preventive health services to low- income children.
Caffeine therapy gives premature infants a breathing boost
Caffeine therapy for apnea of prematurity reduced the need for continuous positive airway pressure and mechanical ventilation, as well as the likelihood of bronchopulmonary dysplasia. These are the secondary, short-term findings from the Caffeine for Apnea of Prematurity Trial Group, a large, international, randomized, placebo-controlled trial that will eventually provide data on the long-term efficacy and safety of methylxanthine therapy in very-low-birth-weight infants. The early outcomes were reported because of their clinical relevance, said Barbara Schmidt, M.D., at McMaster University, and colleagues, in the May 18 issue of the New England Journal of Medicine. The caffeine study's long-term primary outcomes will report composite outcomes, including death, cerebral palsy, cognitive delay, deafness, and blindness, they said. The report included 2,006 infants with birth weights of 500 g to 1,250 g, considered by clinicians to be eligible for methylxanthines to prevent or treat apnea of to facilitate extubation during the first 10 days of life. All infants were followed to their first discharge home, while long-term follow-up is still under way. Of 963 infants assigned to caffeine and who were alive at a postmenstrual age of 36 weeks, 350 (36%) received supplemental oxygen. This compared with 447 (47%) of 954 infants given placebo therapy. Positive airway pressure was discontinued one week earlier in the caffeine-treated infants compared with infants in the placebo group. The researchers speculated that an increase in bronchopulmonary dysplasia, the need for supplementary oxygen at a postmenstrual age of 36 weeks, among the placebo infants was caused mainly by their longer exposure to positive airway pressure. Caffeine appeared to reduce the frequency of patent ductus arteriosus, judged by the clinical staff to require closure with drug or surgical therapy. This finding, Dr. Schmidt said, was unexpected and should be interpreted cautiously. The reduced incidence of bronchopulmonary dysplasia is important as it is a major risk factor for neurosensory impairment in early childhood, the researchers concluded. However, they added, information about the therapy's short-term benefits is insufficient, and the long-term follow-up is needed before recommending the standard use of caffeine therapy for apnea of prematurity. MedPage Today, ABC News, Forbes Primary source: New England Journal of Medicine
Bird flu fears ignite debate on scientists' sharing of data
As fears of an influenza pandemic grow, a struggle has emerged between experts who believe the latest genetic data on the H5N1 bird flu virus should be made public immediately and others who fear that such a policy would alienate the countries collecting virus samples and the scientists analyzing them. The issue may come to a head this week at the World Health Assembly in Geneva, the governing body of the World Health Organization. Health ministers from more than 190 countries will consider a resolution that would require them to provide flu data and virus samples to the scientific community "in a timely manner." If adopted, that probably would end the current system whereby flu researchers decide when and how quickly crucial genetic data on the virus are made available to other scientists. WHO supports the change. But before it is adopted, developing countries where the H5N1 virus is circulating would need to be assured that their scientists would share credit for discoveries and that their citizens would have access to its fruits -- particularly a vaccine. Without guarantees, scientists and clinicians may be unwilling to hand over virus samples or collect them in the first place, Margaret Chan, WHO's director of pandemic influenza planning, said recently. Critics of the current system say the possibility of global catastrophe trumps any concern about hurt feelings or career advancement.
"Science just moves more rapidly when you share the data openly," said Steven L. Salzberg, a computer scientist at the University of Maryland and a leader of the Influenza Genome Sequencing Project at the National Institutes of Health. He said the chief fear is that one researcher will expropriate another's hard-earned data before the first can produce a scientific paper.
But the resistance to sharing data may wane as the specter of a pandemic grows.
This week, an international team of epidemiologists is investigating an H5N1 outbreak that has killed six members of a family in a remote Indonesian village. "The government has been extremely cooperative . . . unlike some previous examples where we have had a little more difficulty in getting specimens to the proper laboratories," Julie L. Gerberding, director of the Centers for Disease Control and Prevention, said yesterday from Geneva, where she is attending the World Health Assembly. A laboratory in Jakarta has been doing "gold-standard diagnostics" in the outbreak, she said. Although this cluster of cases appears to have the longest chain of transmission seen to date -- chicken to human to human to human -- preliminary analysis of the virus's genes has revealed no new mutations or evolutionary changes. The RNA letters that make up the virus's genes are at the center of the dispute. To a great degree, these "gene sequences" determine a microbe's behavior. Fewer than a dozen changes in flu's eight genes may be enough to give a strain pandemic potential . An essential step in charting the spread of the H5N1 strain of bird flu in the past two years has been the analysis of gene sequences by a small number of labs in the United States, Europe and Asia. Today, sequences from most newly collected samples of H5N1 are first deposited in the Influenza Sequence Database at Los Alamos National Laboratory in New Mexico. Access requires a password and is limited to about 15 research groups, mostly government and academic labs in WHO's global flu surveillance network. Although everyone in this fraternity can use the data, the researchers who provide them get to publish the first scientific paper. The people who collected the virus or isolated it from a patient are usually listed as coauthors. Only after the paper appears is the gene sequence deposited in GenBank, a public database. The details of the arrangement are murky, including the size of the Los Alamos repository and who ultimately controls access. Questions put to its manager, Catherine A. Macken, were answered with one sentence: "My policy . . . is to not reveal details about privately held data." The alternative is to deposit sequences in GenBank as soon they come off the sequencing machine. Run by the National Library of Medicine in Bethesda, GenBank is the world's largest collection of gene sequences (along with its European and Japanese counterparts, with which it shares data). About 2 million people around the world consult it each day. As of late last week, GenBank held 4,734 gene sequences from H5N1 influenza. The issue gained public attention in February when Ilaria Capua, a 40-year-old virologist at the Tri-Veneto Region Experimental Animal Health Care Institute in Italy, sequenced the first H5N1 sample from Africa, isolated from a chicken farm in northern Nigeria. Someone at WHO invited her to contribute it to the Los Alamos data, but she declined and instead filed it in GenBank. Most of the H5N1 samples his lab analyzes are provided by Asian scientists. Occasionally, they are given secretly if they come from a place where the virus has not been publicly reported. These collaborators have part ownership in the data, and Webster and others say they ask permission before loading the sequences into either the Los Alamos or GenBank databases. (Washington Post)
Ansell’s newest educational module explores methods to
prevent the spread of infection during a pandemic event
Ansell Healthcare recently published a new self-study educational module for
healthcare professionals entitled Optimizing Barrier Protection During a
Pandemic Event Caused by Influenza A. The self-study module, which is
available at no charge, has been developed for use by professionals who are
responsible for or involved in establishing institutional policy and procedure,
educating healthcare personnel, maintaining regulatory compliance (OSHA, ADA,
CDC), and overall employee health and infection control services. The
information contained in the self-study module could prove to be invaluable to
anyone on the front lines of a potential avian flu pandemic including law
enforcement officers, emergency response personnel, customs agents, USDA
inspectors, military personnel, agriculture workers, and food handlers. Key
areas explored in the module include: The history of pandemic events pertaining
to influenza A; the pathophysiology of influenza A disease; influenza A
infection control measures; influenza as a bioterroristic weapon; how influenza
A can mutate to become a new virus strain; who is at risk in a pandemic
situation; “Global Strategic Plan” for a pandemic event; and optimizing glove
performance during a pandemic event. The educational module is accredited by the
Association of periOperative Registered Nurses (AORN), an accredited approver by
the American Nurses Credentialing Center’s (ANCC) Commission on Accreditation,
for 2.4 contact hours. This module is for the sole purpose of educating and
informing nurses of pertinent issues and is not an endorsement for any product.
Additionally, this continuing nursing education activity has been approved by
the Association of Surgical Technologists, Inc. (AST) for 2 CE’s in the AST
Category 1 for continuing education in surgical technology. Approval refers to
recognition of educational activities only and does not imply endorsement of any
product or company displayed in any form during the educational activity.
Optimizing Barrier Protection During a Pandemic Event Caused by Influenza A
can be found at
www.ansellhealthcare.com under the Americas/United States link in the
AnsellCares section. AnsellCares is a program guided and supported by a
Scientific Advisory Network, which includes leading scientists, physicians,
educators, and researchers from around the world. The goal of the program is to
create education and awareness campaigns among healthcare professionals,
industry experts, and those at risk of infection, in the identification and
prevention of occupational diseases and infection transmission. For more
information about this module, other Ansell educational programs, or technical
questions regarding the suitability or performance of specific gloves, please
contact Ansell Healthcare Educational Services at 1-800-952-9916 ext. 7277, or
visit Ansell’s online educational services at
www.ansellhealthcare.com
MedAssets has been awarded the Ochsner Medical Center's Spirit of Leadership Award
MedAssets announced wednesday that it was awarded the Ochsner Medical Center's Spirit of Leadership Award for its efforts in aiding the hospital during Hurricane Katrina in 2005. The award was presented by Ochsner's Dr. Patrick J. Quinlan, chief executive officer, and Warner L. Thomas, president and chief operating officer, at the Second Annual Spirit of Leadership Program held on Saturday, May 13 in New Orleans. "The Ochsner Spirit of Leadership Award program honors leaders, physicians and departments providing outstanding service to patients and the community," stated Dr. Patrick Quinlan, chief executive officer, Ochsner Health System. "In the aftermath of Hurricane Katrina, MedAssets assisted Ochsner in re-establishing communications outside of New Orleans, coordinating the delivery of supplies, and obtaining much needed fuel to continue operations. On behalf of our patients, employees and community, Ochsner expresses its sincere gratitude and is pleased to recognize their efforts." Accepting the Spirit of Leadership award for MedAssets were John Bardis, chairman, president and chief executive officer; Rand Ballard, chief operating officer, and Mark Miriani, senior vice president of Contracting and Member Services. "Ochsner Medical Center and its entire staff should be nationally recognized for the courage and determination displayed during a very trying time," stated John Bardis, chairman, president, and chief executive officer, MedAssets, Inc. "So many companies rallied around Ochsner during Hurricane Katrina, and we should all feel proud to be part of an industry that supports one another in such significant ways." "Ochsner showed the nation their willingness to help others in emergency situations by assisting hospitals on the Gulf Coast during Hurricane Ivan in 2004," stated Rand Ballard, chief operating officer, MedAssets, Inc. "The core team at MedAssets who coordinated relief efforts, as well as our employees, vendors and friends who offered their time, money and well wishes to Ochsner were motivated by the heroic efforts of Ochsner staff in caring for others in times of crisis."
New GI solutions showcased at DDW
Olympus showcased a broad range of products and services that enhance observation, efficiency and functionality in gastroenterology. These products and services were presented at Digestive Disease Week, Los Angeles Convention Center, May 20-25. Key offerings include new EndoTherapy accessories for Endoscopic Retrograde Cholangio- Pancreatography (ERCP) and hemostasis procedures; a novel dual channel video management system; the world's first endoscope platform featuring high-definition and Narrow Band Imaging(TM) technologies; the world's first 360-degree electronic radial scanning gastrovideoscope for endoscopic ultrasound (EUS); a web-based clinical information management system; GI facility consulting services; customized financial solutions; and Olympus service and repair.Olympus EndoTherapy unveiled three new devices:The MaxPass(TM) single-use biliary dilation system, an addition to the V-System(TM), which delivers improved procedural efficiency through effective dilation and rapid balloon deflation. The SolarProbe, which works with most bipolar generators, enhances Olympus' market-leading hemostasis product offering.
IMPROVING FLEXIBILITY OF
MEDICAL VIDEO MANAGEMENT: n-Stream(TM) SystemOlympus' new n-Stream Dual Channel
Video Management System is ideally suited to the demands of surgical and
clinical workflow.
ENHANCING EFFICIENCY OF PATIENT CARE: EndoWorks(R) Clinical Information
Management SystemEndoWorks is a web-based information management solution that
spans all stages of patient care to increase facility productivity while
reducing costs for healthcare facilities. The latest release of this product,
EndoWorks 7.3, provides a more comprehensive array of services. Focal service
areas include EndoPlanner(R), a five-year strategic planning tool for new GI
facility development; EndoEfficiencies(TM), a patient flow simulation and
predictive outcomes analysis service; as well as GI Benchmarking, EASC Valuation
Services and Web-Based Practice Enhancements.
DEVELOPING COST-EFFECTIVE, BALANCE SHEET-SENSITIVE GI FINANCIAL
SOLUTIONS:including a Cost Per Procedure(R) (CPP) and Turnkey Project Financing
programs. Lastly, Olympus Service and Repair, as a part of its vendor service
portal, unveiled a newly released repair and service tool which allows customers
to electronically submit service orders and track instruments in
real-time, 24 hours a day, seven days a week. Free of charge to all Olympus
customers, the service portal also assists them with access to repair history
and offers a sales equipment log.
Obesity raises overall risk of breast cancer: study
Integrated Healthcare Association receives
grant
to improve adoption and use of new medical devices
Obesity raises overall risk of breast cancer:
study
Women who gain weight as adults face a higher lifetime risk of all
types of breast cancer, researchers reported on Monday. The study
adds to a large body of evidence showing that weight and breast
cancer can be closely linked. A study of more than 44,000 women
found that the more weight a woman gained, the greater her risk for
all types, stages, and grades of breast cancer. Compared to women
who gained 20 pounds (10 kg) or less during adulthood, women who
gained more than 60 pounds (27 kg) were almost twice as likely to
have ductal type breast tumors and more than 1.5 times more likely
to have lobular type cancers, Heather Spencer Feigelson of the
American Cancer Society and colleagues found. The risk of breast
cancer that had spread tripled for women who gained more than 60
pounds (27 kg), they reported in Monday's issue of the journal
Cancer. Breast cancer risk is linked to increased levels of the
hormone estrogen and fat tissue produces estrogen, adding to the
risk. “These data further illustrate the relationship between adult
weight gain and breast cancer, and the importance of maintaining a
healthy body weight throughout adulthood,” the researchers wrote. A
study published earlier this month found that women who take
estrogen-only hormone replacement therapy for 20 years or longer to
treat symptoms of menopause have a higher risk of developing breast
cancer. Breast cancer is the second leading cause of cancer death
among U.S. women, after lung cancer. More than 200,000 people are
diagnosed and another roughly 40,000 die from it each year,
according to the American Cancer Society. Globally more than 1.2
million men and women develop breast cancer every year. (Reuters)
Quest Diagnostics to acquire Focus
Diagnostics Inc.
Quest Diagnostics Incorporated, a provider of diagnostic testing,
information and services, has agreed to acquire Focus Diagnostics
Inc., an infectious disease testing provider, in a cash transaction
valued at approximately $185 million. Focus Diagnostics is privately
held and based in Herndon, VA. The acquisition will add annual
revenues of approximately $65 million. Focus Diagnostics is a
portfolio company of private equity firms DLJ Merchant Banking and
The Sprout Group. Excluded from the transaction is Focus Bio-Inova,
Focus Diagnostics' pharmaceutical testing operation. The
transaction, which is expected to be completed during the third
quarter of 2006, is subject to regulatory review and other customary
closing conditions. Focus Diagnostics offers its reference testing
services to large academic medical centers, hospitals and commercial
laboratories. The company has also established a reputation for
being first to introduce new assays to the market, including
diagnostic tests for Lyme disease, West Nile Virus and SARS. In
addition, Focus develops and markets diagnostic products.
Study: Certain arthritis drugs hike cancer risk
Rheumatoid arthritis patients taking Humira or Remicade face triple the risk of developing several kinds of cancer and double the risk of getting serious infections, a study led by the Mayo Clinic found. The analysis builds on previous reports about the risks associated with Abbott Laboratories’ Humira and Centocor's Remicade. But the earlier research focused mostly on one kind of cancer, lymphoma, and infections such as tuberculosis and pneumonia. The new study found an apparent link to other cancers, too, including skin, gastrointestinal, breast and lung tumors. It also quantifies the risks and says high doses appear to be the riskiest. While the drugs' packaging information mentions some of the risks, the manufacturers said the new study does not prove that the medication is at fault, and they said the research was flawed. Study co-author Dr. Eric Matteson, a Mayo Clinic rheumatologist, stressed that the overall chances of developing cancer while using these drugs is still small. The researchers also noted that the medications’ benefits include improving flexibility and range of movement, easing pain and increasing life expectancy, which arthritis can shorten. In addition, the researchers noted that the risks for individual patients probably vary widely. Older, sicker people who have taken the drugs for several years probably face the highest risks, they said. Still, the researchers said patients should be made aware of the dangers and told to seek medical help if they develop fevers, coughs or other symptoms of infection. They should also be sure to undergo the cancer screenings recommended for the general public, the researchers said. Their study appears in The Journal of the American Medical Association. Matteson is working with Centocor in developing a new drug that works similarly, and he and co-author Dr. Tim Bongartz have been paid consultants to Abbott for unrelated work, but neither company funded the study. The Mayo Foundation sponsored the research. Rheumatoid arthritis affects more than 2 million Americans, and involves a malfunctioning immune system that attacks joints throughout the body, causing pain, deformities and disability. Dr. John Klippel, president of the Arthritis Foundation, said the study will probably not change doctors' minds, because scores of patients have benefited from the drugs. Remicade was approved in 1998, Humira in 2002. More than a half-million patients have been treated with the two injectable drugs and a third similar medication, Enbrel, all of which block production of a protein linked with inflammation. Enbrel was not included in the study because it differs at the molecular level, Matteson said. He said he is getting paid by Enbrel marketers Wyeth and Amgen to do a similar analysis on Enbrel alone. Matteson's ties to Centocor and his work on Enbrel were among several omissions and errors included in disclosure statements that accompanied the study in JAMA. He said the omissions were an office mistake. But in an unusual move, journal editors posted a correction Tuesday on JAMA's Web site revealing that they have asked the Mayo Clinic College of Medicine to investigate. The editors cited “the nature and extensiveness of this incorrect and incomplete reporting.” The researchers analyzed data from nine studies comparing Humira or Remicade with placebos and pooled the results. There were 29 cancers in 3,493 patients who received at least one dose of either drug, compared with three cancers in 1,512 patients on placebos. Serious infections occurred in 126 patients on drugs and 26 on placebos. They included pneumonia and cellulitis. An Abbott spokesperson said the analysis “doesn't reflect all the data” on Humira and said the studies were too short to sufficiently monitor cancer incidence. Tom Schaible, Centocor vice president of medical affairs, said most of the analyzed studies used higher-than-recommended Remicade doses. “There's clearly a favorable benefits-risks ratio” with recommended doses, Schaible said. (The Associated Press)
Cardinal Health goes to next phase of RFID pilot
Cardinal Health has announced the next phase of its end-to-end pilot program to test technology to improve the safety and efficiency of the pharmaceutical supply chain in the US, beginning with the tagging of medication with RFID labels carrying unique data to verify authenticity at every stage in the supply chain. Verifying the authenticity of pharmaceuticals along each step of the distribution path adds an additional layer of security to lessen the chance of counterfeit pharmaceuticals entering the supply chain. In addition, the data gathered could improve efficiency as the logistics team at Cardinal Health will be able to analyze the data to identify bottlenecks and read rates, along with other opportunities to improve efficiency. The company is testing RFID at the unit level in a real-time setting, beginning with product labeling and packaging, and as it travels through the distribution centre, through to when the item is received by a customer. According to Renard Jackson, executive vice president of packaging services for Cardinal Health, “The security and operational efficiencies this technology adds to the pharmaceutical supply chain would benefit drug manufacturers, pharmacists and ultimately consumers.” In conducting the end-to-end pilot program, Cardinal Health will use new technology to place RFID tags on the labels of brand-name and generic solid-dose prescription drugs at the company's printed components facility in Moorestown, NJ. After that, the company's facility in Philadelphia will encode the electronic product code (EPC) data at the unit, case and pallet levels during the packaging process. The products will be then shipped to a Cardinal Health distribution centre in Findlay, OH, where the data will be read and authenticated as products are handled under normal operating conditions. Normal operating procedures will be enhanced with RFID hardware and software from Alien Technology Corporation and IBM, along with project management support from VeriSign. From Findlay, the tagged items will be sent to a health-care provider to further test read rates and data flow using the same technology as the distribution centre. Privacy advocates note: the product, as finally dispensed to patients, will not be in the RFID packaging. The company launched the initial phase of the pilot program in February 2006, and expects to complete the test toward the end of 2006. Cardinal Health is also currently working with Pfizer on a separate RFID pilot program to authenticate another product at its Findlay facility.
Integrated Healthcare Association receives grant to improve
adoption and use of new medical devices
The Integrated Healthcare Association (IHA) today announced receipt of a
$675,000 grant from the Blue Shield of California Foundation to launch a pilot
project that will help healthcare providers select medical devices more
efficiently. IHA's two-year demonstration project in Southern California will
focus on improving data collection, enhancing transparency of information,
and establishing quality benchmarks for orthopedic and cardiac medical devices.
"There's a lack of information on the comparative value of most new
and existing medical devices," said Bart Asner, M.D., CEO of Monarch HealthCare,
a prominent Orange County physician organization, and an IHA board member.
"Hospitals and doctors are often in the dark when trying to choose the
most appropriate devices for their patients and make value-based
buying decisions." Building on its successful "Pay for Performance" program --
which helps providers align financial incentives with improvements in the
efficiency and quality of care -- IHA will begin collecting data this fall on
the use of medical devices from hospital systems and physician organizations.
The project will identify ways that providers and health insurers can
purchase these technologies more efficiently, assure high quality, and provide
useful information about these products for payers and patients. "Ultimately our
goal is achieving superior quality, safety, and efficiency in the adoption and
use of these devices," said Tom Williams, executive director of IHA. "The
project will build on IHA's successful collaboration among hospitals, physician
organizations, and health insurance plans." Memorial HealthCare Medical
Centers, representing six hospitals, and Monarch HealthCare IPA, representing
1900 physicians, have already agreed to participate, and several health plans
have expressed interest in joining the project. "The IHA project is important
because more information and better incentives are needed to help providers
make evidence-based decisions," said Lisa Payne Simon, director of the Blue
Shield of California Foundation's health and technology program (www.blueshieldcafoundation.org).
Widely used medical devices such as hip replacements and cardiac stents
can be not only life-saving, but also expensive. "Collaboration will drive this
program's success," said Barry Arbuckle, Ph.D., president and CEO of
MemorialCare Medical Centers and an IHA board member. "IHA's project aims to
improve quality and control spiraling health care costs by gathering the
information needed to help providers more efficiently select the right products
for the right patients," he said. "When hospitals and doctors cooperate,
consumers are the winners."
(www.iha.org)
WHO announces new standards for registration of all human medical research
The World
Health Organization (WHO) is urging research institutions and companies to
register all medical studies that test treatments on human beings, including the
earliest studies, whether they involve patients or healthy volunteers. As part
of the International Clinical Trials Registry Platform, a major initiative aimed
at standardizing the way information on medical studies is made available to the
public through a process called registration, WHO is also recommending that 20
key details be disclosed at the time studies are begun. The initiative seeks to
respond to growing public demands for transparency regarding all studies
applying interventions to human participants, known as clinical trials. Before
making the recommendations, the Registry Platform initiative consulted with all
concerned stakeholders, including representatives from the pharmaceutical,
biotechnology and device industries, patient and consumer groups, governments,
medical journal editors, ethics committees, and academia over a period of nearly
two years. Although registration is voluntary, there is a groundswell of
policies aimed at spurring registration of all clinical trials. “Our aim is to
make clinical research transparent and enhance public trust in science, but we
are engaged in a fair and open process with all stakeholders. We look forward to
continued dialogue about trial registration and results reporting as we move
forward with the Registry Platform,” said Dr. Ida Sim, Associate Director for
Medical Informatics at the University of California, San Francisco and
coordinator of the Registry Platform initiative. The planned Registry Platform
will not be a register itself, but rather will provide a set of standards for
all registers. It has not only standardized what must be reported to register a
trial but is creating a global trial identification system that will confer a
unique reference number on every qualified trial. Currently, there are several
hundred registers of clinical trials around the world but little coordination
among them. The Registry Platform seeks to bring participating registers
together in a global network to provide a single point of access to the
information stored in them. Later this year, the WHO Registry Platform will
launch a web-based search portal where scientists, patients, doctors and anyone
else who is interested can search among participating registers for clinical
trials taking place or completed throughout the world.
GAO: Observations on the evacuation of vulnerable populations
due to hurricanes
and other disasters
Hurricane Katrina struck near the Louisiana-Mississippi border and became one of
the worst natural disasters in U.S. history, affecting a large geographic area
and necessitating the evacuation of people from parts of the area, including
vulnerable populations, such as hospital patients, nursing home residents and
transportation-disadvantaged populations who were not in such facilities. The
disaster highlighted the challenges involved in evacuating vulnerable
populations due to hurricanes. The United States Government Accountability
Office (GAO) was asked to discuss efforts to plan and prepare for the needs of
seniors in the event of a national emergency. GAO describes its ongoing work on
evacuation in the event of emergencies, such as hurricanes, and provides
preliminary observations on (1) challenges faced by hospital and nursing home
administrators that are related to hurricane evacuations; (2) the federal
program that supports the evacuation of patients needing hospital care and
nursing home residents; and (3) challenges states and localities face in
preparing for and carrying out the evacuation of transportation-disadvantaged
populations and efforts to address evacuation needs. Hospital and nursing home
administrators face challenges related to evacuations caused by hurricanes,
including deciding whether to evacuate and obtaining transportation. Although
state and local governments can order evacuations, health care facilities can be
exempt from these orders. Facility administrators are generally responsible for
deciding whether to evacuate, and if they decide not to evacuate, they face the
challenge of ensuring that their facilities have sufficient resources to provide
care until assistance
arrives. If they evacuate, contractors providing transportation for hospitals
and nursing homes could be unlikely to provide facilities with enough vehicles
during a major disaster such as a hurricane because local demand for
transportation would likely exceed supply. Nursing home administrators told GAO
they face unique challenges during evacuations. For example, they must locate
receiving facilities that can accommodate residents who may need a place to live
for a long period of time. The National Disaster Medical System (NDMS), a
partnership of four federal departments, is the primary federal program that
supports the evacuation of patients in need of hospital care during disasters
such as hurricanes, but the program was not designed nor is currently configured
to move nursing home residents. NDMS supplements state and local emergency
response capabilities with federal resources and services and helped evacuate
about 2,900 people during recent hurricanes, including Hurricane Katrina.
Although NDMS supported evacuation efforts during Hurricane Katrina that
included nursing home residents, according to program officials it is not
designed to evacuate this population. Officials explained that the program does
not have agreements with nursing homes that could receive evacuated nursing home
residents. In preparing for and carrying out the evacuation of
transportation-disadvantaged populations, such as the elderly or persons with
disabilities, during a disaster, states and localities face challenges in
identifying these populations, determining their needs, and providing for and
coordinating their transportation. The elderly are likely to be represented
among the transportation disadvantaged because they are more likely, compared
with the general population, to have a disability, have a low income, or choose
not to drive. GAO has observed mixed efforts at the state and local levels to
address the evacuation needs of the transportation disadvantaged. Some emergency
management officials told GAO they did not yet have a good understanding of the
size, location, and composition of the transportation disadvantaged in their
community. However, GAO also observed efforts in some locations to address the
evacuation needs of the transportation disadvantaged by encouraging citizens to
voluntarily register with their local emergency management agency, integrating
social service providers into emergency planning, and other measures. GAO will
continue to examine the extent to which the transportation disadvantaged are
addressed in state and local evacuation efforts as part of its ongoing work.
www.gao.gov/cgi-bin/getrpt?GAO-06-790T.
WHO Update on cholera in Angola
As of 16 May 2006, Angola has reported a total of 35,775 cases and 1,298 deaths
(case fatality rate (CFR) 4%). In the last 24 hours, 546 new cases including 31
deaths have been reported. Eleven out of 18 provinces are affected; of all
cases, 51% have occurred in Luanda and 21% in Benguela province. The CFR, broken
down by province, ranges between 1 and 30%. A daily incidence of around 600
cases is still being reported. The Ministry of Health (MoH), WHO and other
partners continue to develop field activities to control the outbreak: daily
coordination meetings; house to house visits for following up of contacts;
disinfestations; collection of specimen for bacteriological laboratory
examination; distribution of safe drinking water and chlorine; dissemination of
preventive measures through the local media and distribution of health education
materials by social mobilization groups. WHO has sent six international experts
to reinforce the national team in providing support for coordination, water and
sanitation, logistics and epidemiological surveillance.
Infection reducing coating technology among top prize
winners in MIT $100K
Entrepreneurship Competition
A coating technology targeting the billion dollar medical catheter market
secured $30,000 start-up money during the MIT $100K Entrepreneurship Competition
awards ceremony held Thursday at MIT. The multi-faceted business plan
competition remains an economic barometer on what new ideas are being funded by
venture capitalists. Business Venture Robert P. Goldberg Grand Prize Winner:
SteriCoat Inc. has developed a coating technology targeting the billion dollar
medical catheter market, which significantly reduces the incident of catheter
associated infections by preventing the formation of bacterial “biofilms” and
killing bacterial invaders. SeriCoat's application technology allows coating of
devices of virtually any size, shape or material. Its initial target market is
central venous catheters (CVC), which access the patient's bloodstream directly.
For providers, it minimizes expenses associated with treating catheter related
bloodstream infections, which cost $10K-50K per infection. Also, OneWorld
Medical Devices is introducing The Vaccine Pac to help reduce the 4.3 million
vaccine-preventable deaths each year, which occur primarily in developing
countries and during natural disasters or epidemics. The Vaccine Pac is a
portable, self-contained, and strict temperature-controlled transport and
storage unit that counter the large vaccine wastage problem that often results
from improper temperature control. The technology and design was implemented by
a team from the MIT Mechanical Engineering Department and has been filed for
both U.S. and Foreign PCT patents. The Program for Appropriate Technologies in
Health (PATH) is slated to promote the Vaccine Pac to United Nations agencies,
NGOs, and aid organizations.
http://www.mit100K.org.
Mentor executes definitive agreement for sale of urology businesss to Coloplast
W.H.O. chief dies after surgery
Dr. Lee Jong Wook, director general of the World Health
Organization, died in Geneva this morning after undergoing emergency
brain surgery for a blood clot on Saturday, the organization said in
a statement. He was 61 and had led the health organization since
2003. Dr. Anderes Nordstrom, currently its assistant director
general for general management, will become the organization's
temporary leader, the statement said. The weeklong meeting, called
the World Health Assembly, gathers representatives of the 192 member
countries of the W. H. O. to approve plans and make other critical
decisions about policies and work. Steps to prepare for and respond
to any influenza pandemic will be a main topic of the meeting. Dr.
Lee, 61, a South Korean, fell ill at a luncheon on Saturday in
Geneva at the beginning of a weeklong meeting called the World
Health Assembly. He complained of a severe headache and later
vomited, an official who was present said. Paramedics took him to
the Cantonal Hospital in Geneva. Surgeons found that he had a blood
clot on the brain known as a subdural hematoma and removed it. Such
clots often follow injuries to the head like those from a fall. But
the W.H.O. said Dr. Lee had been in good health and was not known to
have had any such injury. The clot also could have resulted from a
bleeding artery in his brain. The meeting gathers representatives of
the 192 member countries of the W. H. O. to approve plans and make
other critical decisions about policies and work. Steps to prepare
for and respond to any influenza pandemic will be a main topic of
the meeting. (The New York Times)
Study finds high rate of recalls of heart devicesused in emergencies
As the use of life-saving emergency defibrillators has proliferated over the last decade, so have recalls of the devices because of their potential to fail, according to data presented at a medical meeting in Boston. A study based on Food and Drug Administration records from the last 10 years found that about 164,000 emergency defibrillators, or about one out of every five units sold during the period, had been subject to an agency recall or alert. During that period, the F.D.A. also received 370 reports of deaths in which defibrillators or critical components malfunctioned during attempts to resuscitate patients in cardiac arrest, researchers reported. It is not clear how many of those patients might have been saved had the devices functioned properly. The study's lead author, Dr. William H. Maisel of Beth Israel Deaconess Medical Center in Boston, said the growing use of emergency external defibrillators has led to thousands of saved lives. But Dr. Maisel, who is a consultant to the F.D.A., said the data raised questions about the reliability of external defibrillators and how quickly users are learning about recalls. “Many failures occurred during life-threatening circumstances,” Dr. Maisel said. “It does not mean that every one of these people could have been saved, but these are very high-risk malfunctions.” The study did not address internal defibrillators. For F.D.A. officials, the issue of how to alert owners of external defibrillators about problems is particularly complex because the devices have increasingly moved outside traditional medical settings into places like hotels, schools and homes. That trend has meant defibrillators are readily available when needed, but it also means alerting users to problems has become more problematic. A separate report presented at a meeting of the Heart Rhythm Society, found a far lower rate of complications from device replacements than a recent medical journal had reported. Such complications can occur when an implanted heart device is removed because of a recall or to replace the batteries. In the latest study, researchers from the Mayo Clinic said a five-year review of complications like infections and blood clots at that center found a rate of about 1.24 percent, which is consistent with previous estimates of such risks. A study by Canadian researchers published last month in The Journal of the American Medical Association found that 5.8 percent of patients in that country who underwent replacement procedures because their defibrillators were the subject of recalls experienced serious complications. Most experts agree that devices should be replaced early only in patients who have health problems that make them dependent on the device. With respect to the new data on external defibrillators, Dr. Maisel and a colleague, Dr. Jignesh S. Shah, conducted their study by reviewing all recall notices and safety alerts contained in weekly F.D.A. reports from 1996 to 2005. During that period, sales of the units increased on an annual basis about tenfold, growing to 200,000 last year from about 20,000 in 1996, researchers said. Over that time, the agency issued 52 advisories about malfunctions in either emergency units or their critical components, like the cables used to connect a unit to a patient's chest. The annual number of alerts issued by the agency grew significantly over the period, the researchers said. Dr. Maisel and Dr. Shah also reviewed so-called adverse event reports filed with the F.D.A. over the period and found 370 episodes in which a defibrillator reportedly malfunctioned during efforts to revive a patient with a particular type of deadly heart rhythm. Dr. Maisel said the number of episodes in which an external defibrillator malfunctioned might be significantly higher because the F.D.A. had received 801 adverse-event reports associated with a death. However, he said that he and Dr. Shah had decided to use the lower 370 figure because that number represented the number of cases in which an emergency worker or a manufacturer had confirmed a malfunction. Dr. Maisel said he had been unable to correlate the number of malfunctions with devices that had been recalled because there was not enough information in public records to make that connection. (The New York Times)
IG: Nursing homes not penalized for errors
Nursing homes that jeopardize patients’ safety or have long-standing problems
often are not penalized by Medicare, a government watchdog reported. Medicare
contracts should have been subject to termination at 55 nursing homes between
2000 and 2002, according to the inspector general for the Health and Human
Services Department. Yet the Centers for Medicare and Medicaid Services did not
end the contracts, as required, in 30 cases, the agency's internal watchdog
said. When investigators looked at follow-up surveys of the 30 nursing homes,
they found that all of the homes had later problems that led states to refer the
facilities for federal action. Several factors appeared to contribute to the
lack of action, the report said: In some, states did not refer cases to the
Medicare agency before the required termination date. In others cases, the
agency's regional staff reported that they were reluctant to displace nursing
home residents if they thought a facility would come back into compliance. This
position put the agency at odds with federal law, Inspector General Daniel R.
Levinson said. “Contrary to our recommendation regarding facility termination,
... (CMS) will continue to apply the remedy in a manner that it believes best
protects the well-being of residents,” the report said. Mark McClellan,
administrator for the Centers for Medicare and Medicaid Services, said the
period reviewed, 2000-2002, preceded significant improvements his agency made in
enforcement. He also said his agency has worked with the nursing homes to
improve their performance. Without that effort, “thousands of nursing home
residents would have been forced to relocate even though the problems were
abated within a few weeks,” McClellan said. Sen. Charles Grassley, chairman of
the Senate Finance Committee, said the findings showed a lack of enforcement
against bad nursing homes. “I'm sympathetic to the argument that termination
would displace residents. But residents in immediate jeopardy at a nursing home
need to be somewhere safer,” said Grassley, R-IA. “They're the most vulnerable
to abuse and neglect. Termination has to be real and enforced, or troubled
nursing homes may have no other incentive to clean up their act.” In addition to
ending a home's Medicare contract, the government is required to deny payment
for new admissions when nursing homes take more than three months to come into
“substantial compliance” with federal rules. Of 706 cases requiring denial of
payment, that step was not taken 28 percent of the time, the report said.
http://oig.hhs.gov/w-new.html
(The
Associated Press)
Panel votes to strengthen mumps
protection
A
government vaccine panel is urging mumps shots for everyone in the region of an
outbreak unless they are immune to the virus from childhood exposure or from
being vaccinated. And healthcare workers under age 50 should get two doses
unless they still have immunity from childhood, the immunization advisory
committee said. Wednesday's more aggressive policy by the panel, which advises
the federal Centers for Disease Control and Prevention, is an effort to thwart
future outbreaks like the one that is plaguing Iowa and some other Midwestern
states. “Hopefully the current outbreak is waning,” said CDC spokesman Curtis
Allen. “This is for future outbreaks.” Health officials in Iowa say there are
still more than 1,700 cases statewide, but the number is on the decline. Last
week the state urged people ages 18 to 46 to get vaccinated. The CDC and a drug
company have been providing extra vaccine. Since 1989, the government has
recommended two doses of measles-mumps-rubella vaccine for all children, a
regimen considered effective at preventing mumps in about 90 percent of people.
Children are recommended to receive the first dose around their first birthday
and the second between the ages of 4 and 6. But not all adults have received two
doses, health officials learned from the outbreak. So the committee made its
recommendations Wednesday to ensure that health care workers and specific groups
affected in the midst of an outbreak are properly protected. The committee
recommended that health care workers born in 1957 or later receive two doses of
measles-mumps-rubella vaccine rather than a single dose, as the panel previously
recommended in 1998. Two doses of vaccine provide protection about 90 percent of
the time. In contrast, a single dose is about 80 percent effective. Health
officials generally believe that people born before 1957 tend to be immune to
the disease because they likely were infected as children when the disease was
more common in the United States. In addition, the committee recommended that
two groups that typically only have had a single dose of vaccine, children ages
1 to 4 who may not have been vaccinated a second time and adults born in 1957 or
later are fine with just the one dose even during an outbreak. But if those
groups have high numbers of mumps cases in an outbreak, they should get a second
dose, said Jane Seward of the CDC's National Center for Immunizations and
Respiratory Diseases. The Midwestern mumps outbreak hit colleges especially
hard, and health officials believe it's partly because many of those students
were born before 1989 and got only one dose of vaccine. The panel also said when
there is an outbreak, the committee recommended that everyone should be
vaccinated, unless they can prove through lab tests or a doctor's diagnosis that
they are immune to mumps. The panel considers an outbreak to be any area with
five or more cases. The Midwestern epidemic has affected a dozen states, with
more than 3,000 cases reported since November.
http://www.cdc.gov
(The Associated Press)
Scientists map genes on Chromosome 1
A team of American and British scientists say they've completed a genetic map of human chromosome 1, the single largest unit of genetic material in the human genome. It's also the last of the 23 human chromosomes to be mapped. The effort involved more than 150 scientists and took about 10 years. Their findings appear in the May 18 issue of Nature. Chromosome 1 makes up about 8 percent of the overall human genome, and contains about twice as many genes (3,141) as an average-sized chromosome. A thousand of the genes in chromosome 1 have never before been identified, the scientists said. The chromosome plays a major role in health and well-being. Genetic mutations of chromosome 1 have been linked to more than 350 human diseases and structural alterations. Chromosome 1 genes are believed to play a role in a number of mental retardation syndromes. “This achievement effectively closes the book on an important volume of the Human Genome Project, which was started in 1990 to identify the genes and DNA sequences that provide a ‘blueprint’ for human beings,” lead investigator Simon G. Gregory, an assistant professor, Duke University Center for Human Genetics, said. “Armed with this new information, researchers now have new tools for probing fundamental biological questions and examining the genetic factors involved in a range of diseases and medical conditions, including Alzheimer's disease, Parkinson's disease, cancer, autism and mental retardation,” Gregory said. http://www.genome.gov/page.cfm?pageID=10001772 (HealthDay News)
Vioxx data suggest risks started earlier
Previously unpublished data from the study that led the drug maker Merck to halt
sales of its blockbuster painkiller Vioxx appear to show the drug raised the
risk of heart attack and stroke within just a few months, not after at least 18
months' use, as Merck has consistently argued. The company disputed that
Thursday, saying it was “not scientifically appropriate” to draw conclusions
based on a key graph in a 108-page report on the data.
The news, first reported by National Public Radio, comes after prominent doctors
said Merck misrepresented other data from the same study last week. Merck
officials said last week that the new data, from a follow-up of patients a year
after they stopped taking Vioxx, showed heart and stroke risks ended soon after
they stopped taking it. The officials also said patients who later had such
complications did not have a legitimate lawsuit. But several doctors said that
depending on how one interpreted the data, the heart and stroke risks could
persist for at least a year or longer. Now, a closer look at that same data
indicates that the increased cardiovascular risk with Vioxx use most likely
begins as early as four to six months and then gets bigger, said Dr. Steven
Nissen, a Cleveland Clinic cardiologist and frequent Vioxx critic who is leading
an international study of the risks of other
painkillers. “It
didn't really make a lot of sense that nothing happened for 18 months and then
all of a sudden you would see a hazard,” Dr. Nissen said. (The Associated Press)
Mentor
executes definitive agreement for sale of urology businesss to Coloplast
Mentor Corporation and Coloplast A/S announced they have executed a definitive
agreement for the sale of Mentor's Surgical Urology and Clinical and Consumer
Healthcare business segments to Coloplast for $463 million. “We are pleased to
have executed the definitive agreement with Coloplast, and expect to complete
this transaction soon,” said Joshua H. Levine, president and chief executive
officer of Mentor. “We believe this transaction will enable us to enhance
shareholder value and focus more fully on expanding our global position in the
fast-growing field of aesthetic medicine.” The transaction is expected to close
in June, pending regulatory clearance. As previously announced on March 27,
2006, Mentor had received a binding offer from Coloplast to purchase Mentor's
urology business and has subsequently been working on an exclusive basis with
Coloplast toward the consummation of the transaction.
Doctor: States unprepared
for bird flu
CDC releases
instructions to estimate the potential impact
of the next influenza pandemic upon locale Y
Cincinnati
Sub Sub-Zero celebrates 65 years
Abbott accused of inflating drug prices
Abbott Laboratories allegedly inflated the prices of some drugs by as much as 10 times the actual sales price so its hospital customers could bill Medicare and Medicaid for more than they paid and pocket the difference, the Department of Justice said Thursday. Customers who bought Abbott's products were reimbursed more than $175 million by the two government programs, said the department, which joined a whistle-blower suit against the company. Melissa Brotz, a spokeswoman for Abbott, says the company has complied with all laws and regulations and intends to vigorously defend itself against the claims. The case alleges that Abbott falsely listed average wholesale prices for some of the products, including intravenous antibiotic vancomycin, sold by its hospital division from 1991 to 2001. That division, Hospira, has since been spun off into an independent company. Because of the difference between the list price and the actual sales price, the complaint alleges, hospital customers sought more money from government programs than they should have, and Abbott gained business. “This complaint marks another step in the government's investigation and prosecution of pharmaceutical manufacturers who submit fraudulent drug-pricing information,” said Assistant Attorney General Peter Keisler. Dozens of similar cases involving drugmakers, including Abbott, have been filed by state prosecutors. Many were initiated by the same whistle-blower, Ven-A-Care pharmacy of the Florida Keys. The case alleges civil violations of the federal False Claims Act. The government has intervened in some other wholesale price cases, but they generally also had other elements, such as allegations of kickbacks to doctors. The Abbott case could have ramifications for others in the drug industry. “It's significant because this is an area where (the law) is a little gray and the conduct has not been clear-cut,” said attorney James Becker, a partner at the Saul Ewing law firm in Philadelphia. (USA Today)
Brain surgery patient dies, others alerted
Officials at a suburban Denver hospital were alerting brain surgery patients
after another patient died of a rare degenerative brain ailment called classic
Creutzfeldt-Jakob Disease, the hospital said Thursday. Six people who had
neurosurgery at Littleton Adventist Hospital after an operation on the
Creutzfeldt-Jakob patient and were alerted because of the remote possibility
that the disease could be transmitted by surgical instruments, even after they
are sterilized, the hospital said. It was not immediately clear whether the
instruments used on the victim were also used on any of the other six patients.
Classic Creutzfeldt-Jakob Disease is not related to mad cow disease, unlike
variant Creutzfeldt-Jakob Disease. Classic CJD occurs sporadically, appearing in
about one in 1 million people in the United States each year, according to the
Centers for Disease Control and Prevention Web site. It progresses quickly and
is always fatal. (Associated Press)
5 bird flu deaths in Indonesia not linked to human exchange
World Health Organization officials said Thursday that the five avian flu deaths
confirmed this week on Sumatra were probably not a result of human-to-human
infection and did not suggest that the virus had mutated into a more deadly
form. Five family members were confirmed dead from the A(H5N1) strain of avian
influenza by the World Health Organization on Wednesday, the largest such
cluster recorded. A sixth family member died of flulike symptoms but was not
tested for the virus. Clusters like the one in Kubu Sembilang village in
northern Sumatra, where the victims lived, worry health officials because they
indicate that the virus may have been transmitted between humans. Gina Samaan, a
field epidemiologist for the World Health Organization in Kubu Sembilang
investigating the recent cluster, said that the number of deaths had raised
eyebrows but that so far the outbreak was similar to others in Indonesia that
were caused by close contact with infected poultry. “Current evidence doesn't
suggest at all that the virus was passed between humans,” she said. Agriculture
Minister Anton Apriyantono said Thursday that a number of chickens, ducks and
pigs in the village had tested positive for the virus. He said infected flocks
of poultry would be culled immediately. No new cases were reported beyond the
Sumatra cluster, which officials said was encouraging. Investigators are
scouring the village to determine why only this family had caught the disease.
Indonesia's death toll has reached 30, second only to Vietnam, which has
recorded 42. Indonesia, however, has been recording bird flu deaths at a much
higher rate than any other country in recent months. The latest fatalities
prompted the Indonesian president to ask Thursday for additional international
financial and technical support to help terminate the spread of the disease.
Indonesian bird flu patients reported their symptoms an average of five days
after they began, making it hard for doctors to prevent deaths. In Jakarta,
where the majority of the Indonesian deaths have occurred, all major hospitals
and even smaller health clinics have plastered bright orange-and-yellow posters
on their walls detailing bird flu symptoms and treatments. Booklets have been
distributed to far-flung villages throughout the country. (The New York Times)
Doctor: States unprepared for bird flu
Bird flu will hit the United States, it's only a matter of time, and not all states are ready to respond to the deadly virus, the Homeland Security Department's top doctor warns. Dr. Jeffrey Runge, homeland security's chief medical officer, said “it's not a matter of if, but when” bird flu enters the country. But it won't pose a critical threat until the virus can spread consistently between people, he said. Runge said states with experience in dealing with hurricanes or terrorist attacks are more ready to face bird flu. He did not identify those that have been slow to prepare, but said state and local governments must carry most of burden of planning for an outbreak, including readying emergency medical workers, providing hospital beds and setting up treatment centers outside of immediate disaster areas. “Some states still have the idea that if it makes people sick, it's simply a health event,” Runge said. “And others are much more forward reaching, and understand that they have to prepare for things like civil unrest, or interruption of the supply chain, or the failure of critical infrastructure to keep going, to keep the nation going in the event of some catastrophic event. And those are the ones that we think are the best prepared.” Scientists believe the flu most likely would be carried into the United States by a wild bird migrating from a country that has had an outbreak. Runge credited agriculture inspectors and poultry producers with adopting tough security standards to prevent visitors from exposing fowl to the virus. Runge's department is responsible for blocking potentially infected birds and bird products from entering the U.S. at airports, seaports and international borders. Unions representing U.S. Customs and Border Protection officers have complained they have not been trained to identify bird smugglers or to quarantine birds arriving from countries that have had flu outbreaks. Runge expressed some frustration with the level of training so far. “I wish I could say it had all already been done,” he said. “Right now the planning is coordinated, but the education is not as coordinated as we'd like. That having been said, everybody around here's gotten a lot smarter about it.” http://www.dhs.gov/dhspublic
CDC releases instructions to estimate the potential impact
of
the next influenza pandemic upon locale Y
Provided
below are downloadable instructions on using the software programs FluAid 2.0
and FluSurge 2.0 to estimate the potential impact of the next influenza pandemic
on any given locale, such as a country, state, city, or county. These
instructions illustrate how to calculate the potential number of deaths,
hospitalizations, and outpatient visits for two influenza pandemic scenarios; a
1968-type scenario and a 1918-type scenario. The instructions also include a
template of a draft report, which a user can fill in with the estimates
calculated by following these instructions.
http://www.cdc.gov/flu/pandemic/
pdf/pandemic-impact-estimate-instructions.pdf
Cincinnati Sub Sub-Zero celebrates 65 years
Cincinnati Sub-Zero (CSZ) Products celebrates their 65th anniversary. CSZ began their journey by distributing freezers. In 1949, they switched gears to manufacturing industrial freezers which were followed by a full line of environmental test chambers. In 1963, the Medical Division was created when the company began manufacturing products for the health care arena, supplying a full line of temperature management products for use with water and air. In 1989, CSZ opened ESSC test laboratory to meet the testing needs of their customers by providing contract climatic testing and independent qualification testing services. CSZ employs approximately 225 employees many of whom have worked for the company for decades, and have first, second, and third generation family members who work there as well.
WHO investigating human bird
flu cases in Indonesia
Competition about to
heat up for J&J spine disc
FDA: Cervical cancer
vaccine safe
InterMetro awarded Premier contract
Nominate your team for the 2006 Materials
Management
Department of the Year award
Healthcare Purchasing News
announces the Third Annual HPN Materials Management Department of
the Year Competition. Nominate your team today for the 2006
Materials Management Department of the Year Award. Our panel of
judges considers: Teamwork; Innovation/Creativity; Customer service;
Productivity; Patient Care; Problem Solving; Cost savings; and
Efficiency. Document your accomplishments and submit by Friday, June
2 to Editor, Healthcare Purchasing News 7650 So. Tamiami Trail, Ste.
10, Sarasota,FL 34231 Fax: (941) 927-9588 or e-mail: editor@hpnonline.com.
Tenet agrees to sell or close hospital
The owner of Alvarado Hospital Medical Center said that it has agreed to sell or close the San Diego facility and pay $21 million to get rid of criminal and civil charges that have dogged the hospital for more than three years. The settlement with U.S. Attorney Carol Lam averts a third trial for the hospital, owner Tenet Healthcare Corp. and former Alvarado chief executive Barry Weinbaum over allegations of inappropriate relocation payments to doctors. Prosecutors contend that millions of dollars of those payments amounted to illegal kickbacks for patient referrals, but two trials have ended in hung juries. In a related agreement, Alvarado managers put to rest a recent effort by the U.S. Department of Health and Human Services to bar the hospital from seeing Medicare and Medi-Cal patients, a move that likely would have shuttered the 306-bed facility. If Tenet doesn't sell Alvarado by February, the department will move again to block the hospital from seeing patients in the federal programs. The deals settle just one of many legal problems that have plagued Tenet in recent years. The Dallas-based health care company has spent more than $1 billion during the past 12 years settling lawsuits and criminal cases alleging everything from Medicare fraud to tax evasion to misleading shareholders. It was not clear who might buy the 34-year-old hospital or whether it would continue to operate as an acute-care center. Potential buyers could include Scripps Health or Sharp, nonprofit health care providers that already operate large networks of hospitals in San Diego County. Some observers said the site also might be attractive for residential development. “This was not something we wanted to do,” Tenet general counsel E. Peter Urbanowicz wrote in a memo about the settlements to Alvarado's employees. “It was a condition demanded by the government.” Though careful not to admit guilt to the Alvarado criminal charges, hospital managers conceded that they failed to adequately ensure that doctors properly spent relocation payments on office renovations, overhead costs and other legitimate expenses associated with establishing a new practice or joining an existing one. “There are aspects of how the recruitment program operated that are troubling,” Tenet said in a written statement. (The San Diego Union-Tribune)
WHO investigating human bird flu cases in Indonesia
An international team of health investigators arrived on Indonesia's Sumatra island Thursday to determine whether an unusually large cluster of human bird flu cases indicates that the highly lethal virus has mutated into a form easily spread among people. Laboratory tests conducted for the World Health Organization confirmed this week that five members of one extended family in Kubuh Sembilang village had died of bird flu during the first two weeks of this month and a sixth had been infected but is recovering. Yet another family member, a 37-year-old woman who fell sick first, is also suspected of succumbing to the disease but was buried before samples could be taken. The Sumatran cluster is the world's largest since the disease emerged in East Asia in 2003, though several dozen others have been reported. Any cluster raises the prospect that the virus has undergone genetic changes that allow it to spread more readily among people, increasing the likelihood of a global pandemic. Influenza specialists suspect that human transmission has played a role in several other clusters, including earlier instances in Thailand, Vietnam, and Indonesia. But the disease has yet to demonstrate it can pass beyond the close confines of a family, which would be necessary for bird flu to spark a global epidemic. Agriculture Minister Anton Apriyantono disclosed Thursday that samples taken from chickens, ducks and pigs from the surrounding district had tested positive for exposure to bird flu. But the timing of the cases allows for the possibility that the 37-year-old woman who fell ill in late April, may have infected one or more of her relatives. Had they all caught bird flu from the same contaminated source, the victims would have been expected to become sick within the normal incubation period for the disease, which at most is slightly more than one week. The final victim, a toddler, became ill later than that, raising the possibility that the virus was passed between relatives. The Sumatra cases and a separate fatal infection confirmed this week in Surabaya, Indonesia's second city, increased the country's death toll from the disease to at least 30. (The Washington Post)
Promising data for an artificial spinal disc from
Swiss maker Synthes Inc. suggest the device will give
Johnson & Johnson’s
disc a strong run for market share, analysts said. Artificial spinal discs have
been heralded as a step forward in the treatment of degenerative disc disease
because they are designed to preserve greater range of motion than traditional
back surgery, which fuses together two bones in the lower spine. J&J, through
its DePuy unit, is the only device maker with an artificial disc on the
U.S.
market after gaining approval to sell its product, called Charite, in October
2004. Doctors have been slow to embrace the product, however, after the Medicare
federal health insurance program last year denied J&J's request to provide
national coverage for it. J&J on Tuesday said Medicare agreed to allow its local
medical directors to approve paying for the device in beneficiaries under the
age of 60, a decision the company believes will open the door to better coverage
among private insurers. The agency in February proposed denying national
coverage for a second time, saying J&J had not proved the treatment benefited
patients more than spinal fusion surgery. It also raised concerns about
complications from the surgery, which involves delivering the implant through
the abdomen. Meanwhile, new data on the Synthes disc, presented at a recent
meeting of spine surgeons in Montreal, could sway Medicare to pay for that
device, which is expected to be launched in the United States in the second half
of this year, some analysts said. (Reuters)
FDA: Cervical cancer vaccine safe
A vaccine that blocks infection by the four virus types that cause most cervical
cancers and genital warts appears safe and effective, but may actually increase
the chance of disease in some patients, according to Food and Drug
Administration documents released Wednesday. Merck & Co. seeks FDA approval for
its Gardasil vaccine against four types of human papilloma virus, or HPV. Two of
those four types are believed responsible for about 70 percent of cervical
cancer cases. The cancer kills roughly 3,500 U.S. women a year; the other two
types cause 90 percent of genital wart cases. An FDA panel of outside experts is
to meet Thursday and discuss whether to recommend that the agency approve the
vaccine. Merck said the vaccine has the potential to reduce the annual number of
new cervical cancers worldwide to roughly 150,000, from the current 500,000, and
cut global deaths from the cancer by more than two-thirds, to an estimated
90,000. An FDA review of the results of studies on the vaccine found two
important concerns, according to the documents released ahead of Thursday's
meeting of the Vaccines and Related Biological Products advisory committee. The
first is that the vaccine may lead to an increased number of cases of a cancer
precursor among patients already infected by any of the four virus types at the
time they receive the vaccine, and whose immune systems have not cleared the
virus from their bodies. The second concern is that any advantage the vaccine
provides in protecting against the four virus types could be offset by infection
by any of the multiple other types of HPV that the vaccine does not cover,
according to the FDA documents. FDA staff also asked that the committee examine
five cases where children with birth defects were born to women who had received
the vaccine around the time of conception. Merck developed the vaccine and
tested it in both women and men, but Thursday's discussion is expected to focus
on its use in preventing HPV-related disease in women. An FDA decision is
expected by June 8. Should it approve it, the national Advisory Committee on
Immunization Practices will decide later that month whether to endorse routine
vaccination with the vaccine. The committee's HPV vaccine workgroup is
recommending the vaccine be given to girls 11 and 12, and the committee will
consider recommendations for females 13 to 26. (The
Associated Press)
InterMetro awarded Premier contract
InterMetro Industries Corporation (Metro), a manufacturer of medical carts, shelving units, and clinical workstations, was awarded a 38 month contract effective through June 30, 2009 by Premier Inc. (San Diego, CA.) The agreement covers Metro’s line of Clinical Modular Casework, Material Handling, Storage and Transport Equipment and High Density Storage Systems. www.metro.com.
Rising diabetes threat meets a
falling budget
New Jersey Hospital
Association members
award $85 million energy contract
Cardinal Health
receives Frost & Sullivan award
for cost efficient manufacturing
Aspen Healthcare Metrics and Guidant Sales Corporation have agreed to settle their court issues regarding pricing confidentiality and have reached mutually accepted settlement terms, which are confidential. “We are satisfied with the settlement in that its terms allow Aspen to continue to provide the highest quality clinical service line and physician preference item consulting which includes all cardiac rhythm management products,” stated Eileen McGinnity, president, Aspen Healthcare Metrics. Aspen Health Metrics is a subsidiary of MedAssets Inc. The settlement was reached on the eve of a jury trial set to begin on Monday, May 15, in Minneapolis federal court to determine damages in the case. The court issued a summary judgment on February 2, 2006, which ruled Aspen had wrongfully induced hospitals to breach certain obligations of confidentiality in Guidant contracts by providing Aspen with access to those contracts during Aspen’s consulting engagements with the hospitals. Aspen Healthcare Metrics disagrees with Guidant’s position, which claims the prices paid by hospitals for cardiac rhythm management devices is confidential and that hospitals do not own this data even when it is contained in the hospital’s accounting system. Aspen Healthcare Metrics and its parent company MedAssets will continue to challenge this point in the court of public opinion. “Aspen Healthcare Metrics will continue to work to help hospitals reduce their purchasing costs, as every dollar saved on high cost medical devices is a dollar to reinvest to deliver the best possible healthcare to the public,” said John Bardis, chairman, president and chief executive officer of MedAssets. “An appeal would have diverted tremendous time and focus from helping our customers improve their financial health at a crucial time in the industry given the increased demand for healthcare services from our aging population and shrinking reimbursements. Settling out of court with acceptable conditions was the best option.” MedAssets is committing resources to help build awareness of the need for hospitals to protect their rights to ownership of their supply purchasing data. “The key message of this awareness campaign is that hospitals should be careful in signing any supplier agreements without first gaining their legal counsel’s opinion regarding any confidentiality clauses that impact the hospital’s rights to own the purchase price data, and their right to share that information with physicians, patients, consultants and any other parties they need to share the data with in the course of their business,” Bardis said.
Outlook: Nanotechnology will be applied
at all stages of drug development
Research and Markets has announced the addition of Nanobiotechnologies Applications, Markets and Companies to their offering. Nanotechnology is the creation and utilization of materials, devices, and systems through the control of matter on the nanometer-length scale (a nanometer is one billionth of a meter.) Nanobiotechnology, an integration of physical sciences, molecular engineering, biology, chemistry and biotechnology holds considerable promise of advances in pharmaceuticals and healthcare. The report starts with an introduction to various techniques and materials that are relevant to nanobiotechnology. It includes some of the physical forms of energy such as nanolasers. Application in life sciences research, particularly at the cell level sets the stage for the role of nanobiotechnology in healthcare in subsequent chapters. Some of the earliest applications are in molecular diagnostics. An increasing use of nanobiotechnology by the pharmaceutical and biotechnology industries is anticipated. Nanotechnology will be applied at all stages of drug development, from formulations for optimal delivery to diagnostic applications in clinical trials. The most important pharmaceutical applications are in drug delivery. Apart from offering a solution to solubility problems, nanobiotechnology provides intracellular delivery possibilities. Skin penetration is improved in transdermal drug delivery. Nanomedicine is now within the realm of reality starting with nanodiagnostics and drug delivery facilitated by nanobiotechnology. Miniature devices such as nanorobots could carry out integrated diagnosis and therapy by refined and minimally invasive procedures, nanosurgery, as an alternative to crude surgery. Nanotechnology will markedly improve the implants and tissue engineering approaches as well. There is some concern about the safety of nanoparticles introduced in the human body and released into the environment. Research is underway to address these issues. As yet there are no FDA directives to regulate nanobiotechnology but as products are ready to enter market, these are expected to be in place. http://www.researchandmarkets.com/reports/c37144
FDA asked to better regulate nanotechnology
Citing research suggesting that some invisibly small engineered nanoparticles might pose health risks, a coalition of consumer and environmental groups petitioned the Food and Drug Administration to strengthen its regulation of nanoparticle-containing sunscreens and cosmetics and recall some products. The legal filing was synchronized with the release of a report by the environmental group Friends of the Earth that highlighted the growing number of personal care products with nanoingredients, defined as smaller than 100-millionths of a millimeter. At least 116 such products are on the market, the report found. “Scientific bodies are beginning to develop an understanding of the serious risks that may be associated with nanomaterials,” said Joseph Mendelson, legal director of the Washington-based International Center for Technology Assessment, which spearheaded the FDA filing. “Every day, consumers are being asked to be a test market for some of those risks.” Nanotechnology encompasses a wide range of materials that, because of their small size, exhibit novel chemical or biological properties. Among the FDA-regulated products being sold are sunscreens containing titanium dioxide or zinc oxide nanoparticles (which offer strong ultraviolet protection while remaining colorless) and cosmetics with nanoscale liposomes, tiny chemical bubbles that deliver moisteners and other ingredients to the skin. A number of animal studies have shown that at least some nanoparticles can penetrate cells and tissues, migrate through the body and brain and cause biochemical damage. But whether nano-spiked cosmetics and sunscreens pose health risks remains largely unknown, pending completion of long-range studies recently begun by the FDA and other agencies. An Australian government medical committee concluded this year that metal oxide nanoparticles in sunscreens mostly remain on the outer layer of skin, where DNA damage is not a big concern. Two years ago, Britain's Royal Society recommended that nanoproducts not be sold until they have undergone independent safety assessments and the results are made public. It also said that products containing engineered nanoparticles should be labeled as such, a move the industry has opposed. (The Washington Post)
Rising diabetes threat meets a falling budget
Across the country, healthcare officials who rely on federal money to help stem the growing epidemic of Type 2 diabetes say they have become increasingly frustrated and alarmed. Diabetes is the only major disease with a death rate that is still rising, up 22 percent since 1990, and it has emerged as the leading cause of kidney failure, blindness and nontraumatic amputation. But public health experts say federal spending on the disease has historically fallen short of what is needed. And now the government has cut diabetes funds in the budgets for this year and next, despite the explosive growth of a disease that now figures in the deaths of 225,000 Americans each year. “Diabetes is clearly one of the most important threats facing us,” said Dr. Georges C. Benjamin, executive director of the American Public Health Association, “and its funding is decades behind other diseases.” Until this year, federal health spending had risen steadily for more than 20 years, fueling expanded efforts against many diseases, including diabetes. But the experts say the commitment to Type 2 diabetes never kept pace with the spread of the disease. The number of Type 2 diabetics in the United States has doubled in the past two decades, to an estimated 20 million, when undiagnosed cases are included, making the disease the country's fastest-growing public health problem. Epidemiologists predict that one in three American children born in 2000 will join the ranks of those afflicted with Type 2. This year, the federal government is spending $1.1 billion to study diabetes, less than a quarter of what is spent to study cancer. The government spends 10 times more per patient on cancer research, and the death rate for that disease, unlike that for diabetes, has begun to fall. Some budget analysts said that diabetes activists have not properly credited tens of millions of dollars that the federal government spends annually to stem obesity, a leading cause of Type 2 diabetes. The American Diabetes Association has estimated that diabetes costs the United States economy about $132 billion per year for treatment and lost productivity at work. Federal spending for both research and treatment, meanwhile, is $1.2 billion annually. “That means the federal government is putting less than 1 percent of what this disease costs us into research and development,” said Dr. C. Ronald Kahn, president of the Joslin Diabetes Center in Boston, a leading research institution. “Even the tire industry spends at least 3 percent of their total sales on research and development.” Federal efforts to fight diabetes are concentrated on two major missions: research on how to prevent, treat or cure the disease going forward, and treatment of people who already have diabetes. Roughly a third of the federal research money is being used to study Type 1, which often surfaces in children and is viewed as potentially curable. More is being spent to study Type 2, which is generally viewed as incurable, although medicine and lifestyle changes have been thought to delay, even impede, the treacherous consequences. Research efforts are traditionally financed though the National Institutes of Health, based in Bethesda, MD. Programs to prevent, track and treat the disease at the community level are paid for by the federal Centers for Disease Control and Prevention. This year, after two decades of increases, Congress trimmed healthcare spending across the board. Efforts to fight diabetes at both the National Institutes of Health and the Centers for Disease Control were cut. The 2007 budget proposes further reductions. The C.D.C. is facing a cut of $700,000 next year from its $63 million diabetes budget, or just over 1 percent. At the National Institutes of Health, money for diabetes will be cut $1.2 million next year, or a tenth of a percent of the agency's $1.1 billion budget. (The New York Times)
New Jersey Hospital Association members
award $85 million energy contract
The New Jersey Hospital Association (NJHA) announced its members have awarded Sempra Commodities’ retail group an $85 million 24-month contract to provide electricity to 36 hospital facilities as part of a collective buying agreement. Sempra Commodities is the group of commodities marketing and trading companies owned by Sempra Energy. Participating members of NJHA, including Atlantic Health System, Capital Health System, Saint Barnabas Health Care System and others, pooled resources to create an aggregate energy load, which gave them greater buying power and purchasing flexibility, and subsequently, greater savings potential. “Due to the high cost of electricity and extreme volatility in energy prices, we continue to approach electricity purchasing from a risk-management perspective,” said William Kennedy, senior vice president, NJHA Corporate Services. “Budget certainty is always a prime consideration when our members purchase electricity, but we also looked for a way to benefit in the future if electricity prices fell. So we created a procurement strategy for our members that offered a choice of purchasing options, and that allowed us to use our combined purchasing power to secure blocks of electricity throughout the term of the agreement, thereby spreading our purchases over several months instead of buying all of our electricity at the same time. This way, we were able to provide the hospitals with predictable costs and the ability to lower costs if electricity prices fell in the future.” NJHA worked with Honeywell Building Solutions, a business unit of technology and manufacturing leader Honeywell, to develop the strategy.
Cardinal Health receives Frost & Sullivan award
for cost efficient manufacturing
Frost & Sullivan selected Cardinal Health Inc. as the recipient of its 2006 Best Bang for the Buck Award in the global pharmaceutical contract manufacturing markets. Each year, this Award is presented to a company that has provided customers with the solution and/or service that provides the highest ratio of value to cost. The recipient has provided customers with a product that provides quality, while staying extremely competitively priced. Cardinal Health is the largest global contract manufacturer serving the pharmaceutical and biotechnology industries. It also offers the broadest range of manufacturing options, including oral dosage forms, and sterile and topical products. “What differentiates Cardinal Health from numerous other contract manufacturing organizations is its ability to move beyond typical manufacturing services and offering unique solutions to its clients, thereby leveraging its value proposition,” said Frost & Sullivan Research Analyst Barath Shankar S. “Cardinal Health holds more than a thousand patents and applications in drug delivery technologies that enable pharmaceutical and biopharmaceutical companies to relaunch their existing products using these novel delivery technologies, helping revive late life-cycle products.” In the oral dosage form segment, Cardinal Health offers novel proprietary drug delivery techniques through their softgel capsules, Zydis, a fast dissolving dosage form; EnCirc, EnVel and EnSolv, oral modified release formulations; and controlled release formulations. In the sterile products segment, Cardinal Health offers sterile fill/finish, blow/fill/seal and lyophilization services, catering to clients from pre-clinical to commercial stages. In the topical products segment, Cardinal Health provides novel technologies such as Microsponge timed release and DelPouch unit dose delivery system to clients that wish to manufacture and market their own compounds as innovative products. Apart from manufacturing, Cardinal Health also offers packaging services that enable pharmaceutical and biopharmaceutical companies to increase their brand awareness by improving their presence and patient compliance. Cardinal Health, which offers a ‘one-stop-shop’ solution service, has been able to gain visibility and reputation as a ‘solution provider’ among companies. The post-launch support by Cardinal Health includes life-cycle management, which ensures increased product profitability from its services. “One of the key competitive advantages that Cardinal Health has acquired is the continuous interaction and the communication path it has established with pharmacists and physicians,” noted Barath Shankar. “As a result, Cardinal Health has been able to stay up to date with trends in the industry and offer solutions to its clients to stay competitive and grow their businesses successfully.” http://www.awards.frost.com
Surgery helps if even breast
cancer spread: report
Study finds surgical teams
lacking in teamwork
Thousands of children and adults who weren’t in the hospital have been infected by MRSA, or methicillin-resistant Staphylococcus aureus, a bug once found only in hospitals or nursing homes. They are victims of a dangerous newer strain of MRSA that is spreading through communities. It is causing infections from abscesses to deadly blood poisoning, bone infections and pneumonia, often in the young and the fit, including professional football players, high school athletes and previously healthy children. Whether it spread from the hospital into the community or developed as a separate strain outside the hospital is a mystery, said John McGowan, professor of epidemiology at Emory University. But recent genome studies suggest the MRSA strain circulating in the community is significantly different from the strains that are typically found in hospitals. “There are differences in the sequence of the community strain that may make it more virulent, more able to affect people with (healthy immune systems), and with biological differences that make it spread readily,” he said. MRSA has become so common that in many hospitals more than half of all staph infections tested are drug-resistant. That's changing the way doctors treat these common infections. “When a patient comes in with a staph infection, we assume it's resistant until proven otherwise,” said pediatrician Sheldon Kaplan of Texas Children's Hospital in Houston, where MRSA rates have gone from 33% of all staph tested in 2000 to 75%. Drug-resistant bugs, including MRSA and several others that are emerging in hospitals, are more difficult to treat, requiring stronger antibiotics that are more costly and in some cases have to be given intravenously. Few major pharmaceutical companies have new medicines in the pipeline that target the drug-resistant organisms, said George Talbot of the Infectious Diseases Society of America's task force on anti-microbial availability. “In a number of these companies, there were active decisions taken that antibiotic research was not going to be profitable enough to meet their obligation to shareholders,” said Talbot, an infectious-disease specialist and consultant to drug companies. Jumping into the breach are smaller biotech companies that are doing the basic research to identify promising new drugs, he said, “but it's not clear yet that these smaller companies will have the development expertise or financial wherewithal to bring them to market.” One of the new strains of community-acquired MRSA, known as USA300, was identified in 2000 and has been found in at least 21 states. “What we're seeing is the emergence of a new epidemic strain of the MRSA in the community,” said Daniel Jernigan, medical epidemiologist at the Centers for Disease Control and Prevention (CDC). The CDC reported in March that the strain had caused outbreaks in hospital nurseries in Chicago and Los Angeles. Nine of the 22 infected babies required hospitalization. Other studies have reported longer hospital stays and higher death rates in MRSA-infected patients. The new super-strain of MRSA has been concentrated in geographic regions, including California, Texas and Georgia, but Kaplan says that is changing. “It's in Pittsburgh, Memphis, St. Louis, Omaha. It's becoming more common on the East Coast now. It's literally all over the country.” University of California researchers who sequenced the genome of USA300 reported in the March 4 issue of The Lancet that the strain contains genes that make it hardy and able to cause “unusually invasive disease” such as severe blood infections and necrotizing pneumonia, in which lung tissue is destroyed. Community-acquired MRSA has sidelined athletes; it has broken out in prisons, military bases and day care centers, anywhere there is crowding, poor hygiene and broken skin. CDC epidemiologist John Jernigan said the type of MRSA in the community are genetically different from those found in hospitals, he said, but that line is blurring. “We have the sense that more and more those strains associated with the community are finding their way into the hospital and causing health care-associated infections,” he said. MRSA spreads through skin-to-skin contact and can be passed by using shared objects, such as razors or towels. It frequently hits more than one person in a family, and researchers in Canada have found that pets and their human owners can pass it back and forth. “We're seeing transmission of MRSA from people to pets and pets to people,” said researcher Scott Weese of the Ontario Veterinary College at the University of Guelph. He says dogs, cats, rabbits and ferrets have been found carrying the USA300 strain. As in people, it can cause serious skin infections and other illnesses. (USA Today)
Less health care can be better for elderly
The amount of money Medicare spends on chronically ill patients varies substantially from state to state, with nearly $40,000 spent per patient in New Jersey and the District of Columbia, but less than $24,000 spent in states such as Indiana and West Virginia. Yet, there is no indication that patients in the states with the highest spending are better off than those in states with the lowest spending. In fact, the reverse seems to be true, according to researchers at Dartmouth Medical School. Their findings, released in a report Tuesday, could have important policy implications as the nation struggles with the soaring expense of its Medicare program. “We must fundamentally redesign the way we care for chronically ill Americans,” said the authors of the report. “We must reward, rather than penalize provider organizations that successfully reduce excessive care and develop broader strategies for managing patients with chronic illness.” Researchers looked at how often Medicare patients went to the hospital during their last six months. They found that a dying person in Hawaii spends an average of 16.4 days in the hospital versus 7.3 days in Utah. They also looked at the number of times Medicare patients went to the doctor during the last six months of life. New Jersey had the highest number of visits, 41.5. Again, Utah's Medicare patients tended to go to the doctor the least, 17 times. Researchers did not measure whether those who died in Utah got better or worse care than patients in New Jersey. But they did try to monitor care by following three types of patients for up to five years after they suffered a heart attack, a fractured hip, or a colectomy for colon cancer. For each illness, they found higher mortality rates for patients in the regions with the most intense care. Dr. John E. Wennberg, director of the Center for the Evaluative Clinical Sciences at Dartmouth Medical School, said the higher mortality rates in some regions could be caused in part by medical error. “If you hospitalize people twice as often in a community on a per capita basis, you have twice the risk of having a medical error problem,” Wennberg said. He said another policy ramification for the government to consider is hospital capacity. The more hospital beds there are per capita, the greater the likelihood the patient will be admitted. “We need to redirect resources away from acute care and invest in infrastructure that can better coordinate and integrate care outside of hospitals, for example, home health and hospice care,” the report said. The researchers concluded that the federal government could save tens of billions of dollars a year, plus improve care, if it took steps to prevent the overuse of health care. http://www.dartmouthatlas.com (The Associated Press)
Goal: Intensify treatment for heart patients
Mounting evidence that scores of heart patients can avoid second heart attacks or strokes with intensive treatment to reduce their risks prompted the nation’s two top heart organizations on Monday to jointly issue new prevention recommendations. The two groups call for more routine use of high-potency statins to lower bad cholesterol (low-density lipoprotein or LDL). They recommend expanding the use of other drugs that lower blood pressure and ease the heart's workload. They also, for the first time, back seasonal flu shots for all chronic heart disease patients. “That's a really important major new recommendation,” said Sidney Smith, of the University of North Carolina-Chapel Hill, and chairman of the American Heart Association and American College of Cardiology group that issued the guidelines. Because new studies also show that lower aspirin doses are just as effective for prevention as higher ones, the guidelines recommend dropping daily doses to between 75 milligrams a day and 162 milligrams, except in patients who have had bypass surgery. Bypass patients fare best on 100 to 300 milligrams a day for up to a year. The so-called secondary prevention guidelines could affect as many as 26 million people in the USA who have survived heart attacks and strokes and those with chronic coronary heart disease, Smith says. They don't address primary prevention, or what to do for people who don't yet have heart disease. Multiple studies show that “aggressive, comprehensive risk-factor management” boosts survival, prevents second heart attacks and strokes, reduces the need for bypass surgery and balloon angioplasty and improves the quality of life for heart patients, the authors write. “Thanks to the clinical trials, we have definitive proof on all these things, which we can't say for primary prevention,” said Robert Califf, director of the Duke University Clinical Research Institute. Califf says primary prevention studies are far more difficult to carry out because they require tens of thousands of low-risk people and may take decades to yield clear results. For instance, he says, the Women's Health Initiative study failed to prove something that most people take for granted: that a low-fat diet helps healthy women prevent heart attacks and strokes. (USA Today)
Surgery helps if even breast cancer spread: report
Surgery greatly increases a patient's chances of surviving with breast
cancer, even if the cancer has spread by the time a woman is diagnosed, Swiss
researchers reported on Monday. Although many women around the world are simply
offered what is known as palliative care, to help them live a little longer and
make them comfortable while they wait to die, surgery could help them live much
longer, the researchers found. “Based on these findings, we believe that it is
time to take a hard look at the current standard of care for breast cancer
patients initially diagnosed with metastatic disease,” said Dr. Elisabetta
Rapiti of the Geneva Cancer Registry at the University of Geneva, who led the
study. “Our study strongly suggests that surgery of the primary tumor could
provide an important survival gain for women with metastatic breast cancer at
initial diagnosis,” Rapiti added. More than 211,000 men and women will be
diagnosed with breast cancer in the United States alone this year and 43,300
will die. Globally, more than 500,000 people die each year of breast cancer,
according to the World Health Organization. Only about 6 percent of women are
initially diagnosed with metastatic breast cancer, which is considered
incurable. Rapiti's team studied 5,000 patient records from the past 35 years
and found that women with metastatic breast cancer at initial diagnosis were 40
percent less likely to die from the disease if they had the primary tumor
surgically removed. Of the 300 women diagnosed with breast cancer that had
already spread, 58 percent did not get any surgery while 42 percent got either a
mastectomy or had the tumor removed. The five-year survival rate for women who
had successful surgery was 27 percent, compared to 16 percent for women who had
surgery but whose tumors were not completely removed, and 12 percent for women
who did not undergo surgery, Rapiti reported in the Journal of Clinical
Oncology. Among women whose cancer had spread only to the bone, those who had
successful surgery were 80 percent more likely to be alive five years after
diagnosis than women who did not have surgery, they found. (Reuters)
They call it a surgical team, but there may be a lot of teamwork left to be desired, a new study finds. The researchers surveyed more than 2,100 surgeons, anesthesiologists and nurses about operating room communications. Their views, and the divergence among them, may shed light on how some surgical mistakes happen. When the participants were asked to “describe the quality of communication and collaboration you have experienced” with other members of operating teams, surgeons were given the lowest rating for teamwork. Their worst assessment was from nurses, the group that got the highest rating. “The study is somewhat humbling to me,” said the lead author of the study, Dr. Martin A. Makary, a surgeon at Johns Hopkins who has been advocating a new approach to operating room communication. “There's a lot of pride in the surgical community. We need to balance out the captain-of-the-ship doctrine.” For the study, described in the current issues Annals of Surgery and The Journal of the American College of Surgeons, the researchers surveyed medical workers at 60 hospitals in 16 states. The survey was based on the Safety Attitudes Questionnaire that airlines use to improve cockpit management. The goal is to make sure all members of a team feel free to speak out if they feel a mistake is being made. Many operating room mistakes, like sponges left in patients or the wrong body part being operated on, could be avoided through better communication, the researchers said. But this can mean getting over barriers of class, race, gender and even general outlook. Afterward, the researchers spoke with participants and found that “nurses often describe good collaboration as having their input respected, and physicians often describe good collaboration as having nurses who anticipate their needs and follow instructions.” (The New York Times)
HDMA
joins the Counterfeit Alert Network
VHA Inc. Performance
Improvement Financial Toolkit
Tyco Healthcare/Mallinckrodt and IRadimed
announce North American agreement
Kaiser Permanente announced Friday that it was indefinitely suspending its kidney transplant program in Northern California after revelations that it had endangered hundreds of patients. “I think, quite frankly, they searched their souls and they decided that it just was going to be very difficult to ensure that all the patients' needs were met,” said Cindy Ehnes, director of the California Department of Managed Health Care. The decision, which Kaiser described as voluntary, followed reports in The Times last week detailing the problems that arose after the giant HMO forced up to 1,500 patients to move to its start-up program in the fall of 2004. The patients had been treated in established centers at UC San Francisco and UC Davis, under contract with Kaiser. At Kaiser's new center in San Francisco, twice as many people died on the waiting list as received kidneys last year. The statewide pattern for transplant centers was the reverse: Twice as many patients received kidneys as died. Hundreds of patients were not properly transferred from their old programs to Kaiser's, leaving them in limbo with little hope of receiving new kidneys. Now, Kaiser will send all of its patients back to the UC hospitals. The move solves some problems but creates another: how to safely transfer a caseload now totaling more than 2,000 patients. Before Kaiser launched its program in 2004, the HMO worked more than a year on a plan to move its patients from UC San Francisco and UC Davis. Even so, the transition was fraught with problems. More than 200 Kaiser patients were never properly shifted to the Kaiser program. The reverse migration will essentially happen on the fly. “There's no plans in place,” said Dr. Stephen Tomlanovich, medical director of UC San Francisco's renal transplant service. Kaiser's Thode said the transplant program would continue to perform surgeries on willing patients until the shift was complete. One key issue is ensuring that patients do not lose their seniority on a waiting list. In San Francisco, the typical wait for a new kidney is about six years. The failure of the San Francisco transplant program is a setback for Kaiser, which had said that bringing transplants in-house would provide patients with coordinated care among physicians, labs, pharmacies and hospitals. Tomlanovich said he is confident that his program can safely handle the Kaiser patients, hundreds of whom were awaiting kidneys at UC San Francisco before 2004. The program, which already has 2,741 patients on its kidney waiting list, has eight kidney surgeons and four nephrologists, kidney specialists, compared with Kaiser's two surgeons and one active nephrologist. Officials at the United Network for Organ Sharing, which oversees the national transplantation system, said they will be actively involved in the process. The suspension of Kaiser's program does not halt investigations by the state and federal governments, or Ehnes’ own agency, into its failures. The probes could bring severe financial penalties. (Los Angeles Times)
Selecting ventilators for the intensive care unit
Intensive care ventilators provide temporary support for critically ill patients
who require total or partial assistance to maintain adequate ventilation in the
intensive care unit. ECRI, an independent, nonprofit health services research
agency, recently published its ratings for ten ventilators designed for use in
the intensive care unit. The article in the April 2006 issue of ECRI's Health
Devices journal highlights ECRI’s product testing results, and describes the
product capabilities and safety features to alert users of potentially dangerous
conditions that can help hospitals protect patients. In this issue, ECRI
presents complete product profiles for four newly tested models and updated
findings for six previously tested models; products marketed by Draeger,
Hamilton, Maquet, Puritan Bennett, Respironics, and Viasys are included. The
study focuses on the models that meet the needs of hospitals and offers
purchasing strategies to make the appropriate choice. ECRI identifies key
advantages related to alarms and safety mechanisms, ease of use,
cost-effectiveness, and scope of capabilities and features in treating many
patients. For more information, click here
http://www.ecri.org/Newsroom/
Document_Detail.aspx?docid=
20060511_242.
Healthcare's role grows with federal IT suppliers
Defense, intelligence and homeland security remain powerful growth engines for information technology contractors, but companies also are bulking up their healthcare operations. Work attracting their interest ranges from improving the efficiency of Medicare and Medicaid systems to sharing health records and using advanced technologies to spot and track emerging health threats. That was one of the trends spotted by Washington Technology for its annual Top 100 report on federal contractors in information technology services. Compiled by Federal Sources Inc. of McLean, the magazine's list ranks companies according to their revenue from prime contracts. Northrop Grumman Corp. of Los Angeles (No. 2 on the Top 100, after Lockheed Corp)., acquired Integic Corp., a Chantilly company that specializes in enterprise health and business process management in March 2005. The deal helped Northrop Grumman win a share of the National Health Information Network contract, said James R. O'Neill, corporate vice president and president of Northrop Grumman IT. The company shares the $18.6 million contract with Computer Sciences Corp. (No.5), International Business Machines Corp. (No. 17) and Accenture Ltd. (No. 24). The Health and Human Services Department contract will be used to develop prototypes for a nationwide health information network architecture that would let disparate systems exchange electronic health records. In part to pursue healthcare opportunities, Perot Systems Corp. of Plano, TX, (ranked No. 44), spent most of last year centralizing its fragmented business development organization to go after bigger government business, said James C. Ballard, president of Perot Systems Government Services. To push into the market, Perot formed a team of sales people from its healthcare and government practices, he said. And Accenture of Hamilton, Bermuda, last spring bought Capgemini U.S.'s 600-person North American healthcare practice for $175 million. The acquisition brought the number of Accenture professionals serving health and life sciences clients to more than 4,600. Healthcare may be gaining momentum, but billions are already being spent in areas such as defense, intelligence and homeland security. From fiscal 2005 to fiscal 2007, spending on information technology for homeland security is expected to show a compound annual growth rate of 19.6 percent, rising to $2.7 billion in 2007 from $1.9 billion in 2005, according to Federal Sources Inc's. most recent analysis of the government IT market. Some companies also see more opportunities for outsourcing by government agencies as increasing numbers of federal employees retire and agencies face budget shortfalls. “As more and more federal workers retire, we believe there will be a demand for more managed services,” said Robert A. Coleman, president and chief operating officer of ManTech International Inc. (No. 21) of Fairfax. For a full report on Washington Technology's Top 100 go to http://www.washingtontechnology.com. (The Washington Post)
HDMA joins the Counterfeit Alert Network
As part of ongoing efforts to fight the threat of counterfeit drugs to the U.S. medicine supply, the Healthcare Distribution Management Association (HDMA) joined the Food and Drug Administration’s (FDA) Counterfeit Alert Network. The Counterfeit Alert Network is designed to inform consumers, pharmacists, healthcare professionals, distributors and other healthcare organizations of counterfeit drug incidents, and provides education on ways to identify and prevent counterfeits from entering the U.S. medicine supply. As a partner in the Counterfeit Alert Network, HDMA will distribute time-sensitive FDA messages and information on specific counterfeit incidents to member distribution companies. HDMA also will provide educational messages about counterfeit drugs, as well as information needed to recognize and report suspect or counterfeit drug products to FDA. Joining the Counterfeit Alert Network is the latest in a series of measures led by HDMA to fight the threat of counterfeit drugs. HDMA has and will continue to petition states across the United States to crack down on criminals who seek to obtain drug distribution licenses, and has been leading the call for stricter licensing standards, stronger regulations, greater enforcement, tougher criminal penalties and best business practices to help secure the nation’s medicine supply. HDMA is also a strong advocate for current and emerging anti-counterfeiting technologies, such as EPC/RFID.
VHA Inc. Performance Improvement Financial Toolkit
Recognizing the increasing need for hospital executives and staff to prove economic value in their quest to provide quality care, VHA Inc., a national health care alliance, has created a measurement tool that helps build the business case for pursuing clinical improvement projects. The tool takes into account the complex principles that drive hospital finances and provides a reliable, standardized way to estimate the impact of clinical improvement efforts. It helps hospital performance improvement (PI) leaders identify the ROI and impact on cash flow from clinical improvement programs. The tool is available to any hospital through VHA’s public Web site www.vha.com. How it Works: Traditionally, hospital PI leaders look at clinical improvement efforts in terms of the cost vs. cost savings achieved from the initiative. That approach is based on average cost information and does not generate an accurate picture of cash flow; to determine cash flow impact, improvement activities need a different approach. VHA’s tool helps staff look at other variables, such as fixed costs, overhead and throughput to determine a “marginal price” for each service and develop a more accurate ROI value; By adopting the marginal price logic, hospital decision makers are able to design clinical improvement projects to have optimum impact on both patient outcomes and patient throughput. By excluding fixed costs, such as administrative expenses and plant and equipment costs, PI leaders and finance staff can more accurately project the true economic value for the hospital.
Tyco Healthcare/Mallinckrodt and IRadimed
announce North American agreement
Allowing continuous flow of intravenous drugs during magnetic resonance imaging (MRI) procedures has been very challenging. The strong magnetic field always present with MRI scanners prohibited the use of traditional infusion pumps in the scan room. The need to continue administration of life-sustaining drugs necessitated makeshift methods to ensure patients receive necessary fluids throughout the MR procedure. A solution to that problem arrived last year in the form of the MRidium MRI IV pump, manufactured by IRadimed Corporation of Winter Park, FL. This new product will soon be sold in the U.S., Canada and Mexico exclusively through Mallinckrodt Inc. of St. Louis, MO, a division of Tyco Healthcare. The MRidium is the only truly non-magnetic infusion pump on the market, utilizing a unique ultra-sonic ceramic motor, said the Company. The MRidium MR pump received the Frost and Sullivan Product Innovation Award for 2005. Recently UL-listed and CE-marked, the pump has also received certification for use with 1.0 to 3.0 Tesla MRI systems from both Phillips Medical Systems and Siemens Medical Systems.
Human embryos in Britain may
be screened for cancer risk
Regent Medical merges with
Mölnlycke
Emerson announces acquisition
of Flo Healthcare
Ansell Healthcare
contributes exam gloves to women’s
health centers during National Women’s Health Week
The supply
chain mantra is being heard in sessions at the GHX Supply Chain
Summit in San Diego this week. Numerous sessions examine every facet
of the supply chain and the solutions that can help streamline the
process of finding the right product, at the right place, the right
time and at the right price. Over 400 attendees including suppliers,
providers, and staff are in attendance that focuses heavily on data
cleansing and synchronization as the key to successful cost-saving
operations. The conference opened Wednesday with MMIS platform User
Group meetings and continued Thursday with sessions that included
success stories from providers and suppliers on measuring value,
restructuring work forces, market intelligence - usage and best
practices; how to measure value and evaluate current processes and
identify strategies that your organization can implement; electronic
ordering; physician preference and pharmacy supply chain. Mike
Mahoney, CEO of GHX provided an overview of 2005-2006 GHX events
including the Neoforma merger (which he stated is moving forward
ahead of their plan) and acquisition of several other new businesses
which are being integrated into new solutions GHX will be offering
in late 2006-2007. GHX is now connecting over 3300 hospitals and
non-acute providers in the U.S. and 260 in Canada and they are also
expanding their operations in Europe. Currently they process 40,000
purchase orders a day and have achieved growth of 40-50% per year
since 2000. Mahoney said their growth is attributable to the cost
and time savings that users are realizing. In addition they have the
ability to grow these savings exponentially in their organization as
they increase the number of vendors they transact with using GHX, at
no additional cost because one subscription fee gets you ‘all you
can eat’. With over 240 suppliers currently subscribing, Mahoney
said he expects additional suppliers to subscribe since the merger.
However, they already offer a solution for non-subscribing vendors
that still allows providers to keep all their data in one
repository. Mahoney said they expect transaction values to be $20
billion in 2006, in contrast to the $1 billion they did 5 years ago
and that data standards are the future. The conference ends today.
Baby in
Djibouti
diagnosed with bird flu
The World Health Organization said Thursday that a baby in Djibouti has contracted the H5N1 virus, the country’s first human case of bird flu. “I believe the person is still alive. It's a 2-year-old girl,” a WHO spokesman said. He said the girl was confirmed as H5N1 positive by the U.S. Naval Medical Research Unit 3 (NAMRU-3) in Cairo, but could not provide any further details. The Djibouti government confirmed the human case in the capital and said three chickens also had been infected with the virus. “Djibouti thus becomes the first country in the Horn of Africa to have detected a human case and bird cases of H5N1,” the government said on the official Djiboutian Information Agency web site. It was not clear from the government statement whether the case of the chickens was related to the human case. It also did not provide any details on the health of the girl, saying only that she was tested after showing flu symptoms on April 27. The Health Ministry said the infection occurred despite a heightened alert, but that the government would further increase surveillance of the disease. It told citizens to keep away from any birds showing symptoms of sickness. Djibouti is now the 10th country where a person has been infected with the deadly virus. As of April 27, there had been no reports of H5N1 in poultry or wild fowl in Djibouti, according to the Paris-based World Organization for Animal Health. (The Associated Press)
Flu vaccine priorities test pandemic planning
In
the event of a global flu pandemic, federal officials have said they intend to
give vaccine first to health-care workers, followed by the oldest, sickest
patients, a policy aimed at saving the most lives. But one of the government's
top medical ethicists is challenging that approach, arguing it is more
appropriate to give young adults priority because they are at higher risk of
dying in a flu pandemic and still have many productive years left. Ezekiel
Emanuel, head of the bioethics department at the National Institutes of Health,
said, “We are not interested in purely the number of lives [saved], but also
life-years.” There is no debate that vaccine makers and medical personnel should
be first to be immunized, because they will then be able to save many more
lives. But deciding who follows is not an easy call, said Jon Abramson, chair of
pediatrics at Wake Forest University School of Medicine and chair of one of two
federal advisory panels that helped develop the current policy. Some panel
members argued that children should be the top priority, he said. Already
federal agencies are sparring over who is “critical,” posing no-win dilemmas
such as: air traffic controllers or border patrol officers? Meanwhile, state
leaders and private corporations are scrambling to build their own stockpiles of
antiviral medication, fearful the federal government will not deliver. The two
advisory panels unanimously recommended ranking the elderly ahead of other sick
or healthy individuals because they believe senior citizens “are at high risk of
hospitalization and death.” In addition to the elderly, the two panels advised
offering vaccine first to patients with at least two high-risk conditions such
as heart disease, and to anyone with a history of severe pneumonia. Below them
on the priority list would be pregnant women, first responders and “key
government leaders,” followed by healthy seniors, people with one risk factor
and people employed in the utility, transportation and telecommunications
industries. One of the guiding principles in the deliberations was “equity,”
Abramson said. “They strongly felt you cannot prioritize on the basis of age or
gender or race.” But in the 1918 pandemic, Emanuel said, “the people who died
were young, healthy 20-year-olds.” If the next pandemic resembles that outbreak,
as some scientists suggest, “and you immunize the elderly, then you will have
hundreds of thousands of deaths of people in their twenties.” Emanuel and
co-author Alan Wertheimer, writing in the journal Science, spell out an
alternative ranking, with medical workers first and young adults next, followed
by people ages 41 to 50 and finally those 51 and older. “Children under 13 could
be confined to home instead of receiving a vaccine,” they wrote. Within each
tier, the two suggest, there should be sub-rankings for “critical” workers, such
as firefighters, utility workers and food delivery personnel. Because it will
take as long as six months after an outbreak begins to produce an effective
vaccine, Abramson said, it will be possible to adjust the policy as scientists
learn more about the virus, who is most vulnerable and what strategies appear
most successful. Neither the federal advisory panels nor Emanuel and Wertheimer
waded into yet another issue; whether to share vaccine with other countries.
(The Washington Post)
Human embryos in Britain may be screened for cancer risk
British regulators ruled that fertility clinics may screen out human embryos
carrying genes that raise the risk of cancer in adulthood, a move the government
said could prevent future suffering but that others said was proof that the age
of handpicked, “designer” babies is at hand. The Human Fertilisation and
Embryology Authority, which oversees tests involving human embryos in Britain,
had previously allowed the use of genetic tests only to eliminate “test tube”
embryos bearing genes for fatal childhood diseases. The new decision expands
that policy to include some genes that significantly increase the odds, but do
not guarantee, that a person will get cancer. The policy also for the first time
includes diseases, primarily breast, ovarian and colon cancer, that do not
strike until adulthood and often respond to treatment. Similar embryo screening
tests have been used in the United States for years. But because they are not
regulated or tracked, no one knows how often they are performed or the full
range of conditions being screened for. Some experts fear that as scientists
discover genes affecting traits such as obesity, addiction, intelligence or
height, a market in elective embryo screening may emerge, backed by evidence
that selected children would be healthier, happier and more successful. The kind
of testing in question, known as preimplantation genetic diagnosis, is conducted
on one or two cells removed harmlessly from a three-day-old test tube embryo
created by in vitro fertilization. If a cell is found to harbor an unwanted
gene, that embryo is not used. “The role of medicine has always been to try to
relieve pain and suffering and to try to improve the quality of life for
people,” said HFEA chair Suzi Leather, in a statement. “The decision today deals
only with serious genetic conditions that we have a single-gene test for. We
would not consider mild conditions, like asthma and eczema, which can be
well-managed; we would not consider conditions like schizophrenia where a number
of genes have been identified but there is no single gene that dictates the
condition.” The genes noted in the decision are BRCA1 and BRCA2, which confer an
approximately 80 percent lifetime risk of breast cancer (and, with BRCA1, a 40
percent chance of ovarian cancer), and HNPCC, which carries a 78 percent
lifetime risk of colon cancer. BRCA cancers can strike women in their thirties
and forties. Half of the people carrying HNPCC get colon cancer by age 50. The
ruling is not a blanket acceptance but means the HFEA will now consider
screening requests on a case-by-case basis. “It raises a number of obvious
ethical issues,” said Bert Vogelstein, a medical geneticist at Johns Hopkins
University and a co-discoverer of the HNPCC gene. Most people he has spoken
with, including patients and their relatives, don't think embryo screening for
the disease is justified, Vogelstein said. “But there are some who have seen
their families devastated by these diseases . . . and they are not so sure.”
Some groups in Britain had vigorously opposed the move. And in the United
States, the ruling was lambasted by the Catholic Church. “There does seem to be
grade inflation here,” said Richard Doerflinger, deputy director of pro-life
activities for the U.S. Conference of Catholic Bishops. “You need fewer and
fewer things wrong with you to fail to measure up.” The British Medical
Association said it welcomed the decision “to extend the criteria for embryo
selection.” Its chief of ethics and science, Vivienne Nathanson, tried to allay
fears of a slippery slope. “We do not see that today's decision is moving
towards ‘designer babies,’” she said. (The Washington Post)
Regent Medical merges with Mölnlycke
Regent Medical Americas, the North American arm of
Regent Medical Ltd, the
only major medical glove company with an exclusively powder-free medical glove
line, announces completion of Regent Medical Ltd’s merger with Mölnlycke Health
Care and Medlock Medical, creating a leading medical products group, Mölnlycke
Health Care Group, with a strong brand focus. According to Lundy Fields,
formerly Regent Medical Americas President and now Mölnlycke Health Care US
President, the merger of Gothenburg, Sweden-based Mölnlycke Health Care with two
Manchester, UK-based companies (Regent Medical and Medlock Medical), results in
a new force in global healthcare. The company’s two strategic divisions will be
Surgical and Wound Care. The Surgical Division will focus on prevention of
surgically-related infections for both patients and healthcare workers. The
Wound Care Division’s market dynamics are driven by an aging population, higher
incidence of pressure ulcers and increased home treatment.
Emerson
announces acquisition of Flo Healthcare
Emerson announced that it has acquired Flo Healthcare, a provider of comprehensive wireless and mobile clinical workstation solutions to the healthcare industry, from UBSS, LLC. Based in Norcross, GA, Flo Healthcare will become part of Emerson Storage Solutions’ InterMetro division. Both InterMetro and Flo Healthcare are addressing a growing and important healthcare trend: the convergence of information technology with traditional mobile storage products for improved patient care, safety and recordkeeping. This trend is driving accelerated demand for mobile medical carts embedded with computers and wireless communications. The acquisition of Flo Healthcare further expands InterMetro’s strong position in meeting that demand with integrated solutions. With more than 45,000 mobile devices and wireless infrastructure systems installed within approximately 800 hospitals, Flo Healthcare is the leader in wireless and mobile clinical workstation installations across the United States and Canada.
Ansell Healthcare contributes exam gloves to women’s health
centers
during National Women’s Health Week
Ansell Healthcare (“Ansell”), a provider of healthcare barrier protective products, is honoring National Women’s Health Week by contributing exam gloves to woman’s health centers throughout the United States that are observing the occasion by conducting free health screenings. National Women’s Health Week kicks off on Mother’s Day, May 14th, with Monday, May 15th designated as National Women’s Check-Up Day. This day reminds women to schedule an appointment with their healthcare provider. Ansell has offered free exam gloves to academic health centers across the United States that serve as demonstration models for the Nation to provide innovative, comprehensive, multidisciplinary, and integrated health care systems for women, including the underserved and minorities. Among the health centers participating in Ansell’s exam glove donation program are the University of Illinois at Chicago, Sanford School of Medicine of the University of South Dakota and The Jersey City Family Health Center.
Study asserts many medical
malpractice suits groundless
AVID Medical awarded a
Consorta CPT multi-source agreement
Novation, the health care contracting services company for VHA Inc. and the University HealthSystem Consortium, has named Joellyn Willis, 45, as its new president. Willis replaces Mark McKenna, who announced his retirement in November after working at both VHA and Novation for 19 years. Willis brings to Novation more than 15 years of senior leadership experience directing sourcing and logistics operations in the electronics and utilities industries. Most recently she was the senior supply chain executive for Constellation Energy Group, the nation’s leading supplier of competitive energy, based in Baltimore. She has considerable strategic, operational and corporate management experience. Throughout her 25-year career, Willis led organizations to create and use best practices and implement innovative supply chain processes, driving substantial savings along the way. “Joellyn’s vast knowledge of complex supply chain issues will help Novation create even greater value for member health care organizations working to control cost while improving patient care,” said Robert J. Baker, president and chief executive officer of UHC. Prior to her service with Constellation, Willis worked as a consultant for two years in the manufacturing industry. From 1983 to 2002, Willis held key positions at Schneider Electric, a global electric equipment manufacturer based in Paris. She served as chairperson of the board of Schneider Electric Canada and had profit and loss responsibility for this $200 million operation and its 1,100 employees. She also was senior vice president of operations for Schneider Electric North America, a $2.5 billion division where she was in charge of manufacturing, purchasing, logistics and real estate. Schneider’s North American division has 31 facilities and 8,000 employees.
The
Centers for Medicare & Medicaid Services (CMS) released an Interim Report to
Congress outlining the steps CMS is taking to implement a provision in the
Deficit Reduction Act of 2005 (DRA) affecting specialty hospitals. That
provision requires CMS to develop a strategic and implementing plan (Strategic
Plan) to determine whether physician investments in specialty hospitals are
proportional to their investment returns; whether the investment is a bona fide
investment; and whether the Secretary of Health and Human Services (HHS) should
require specialty hospitals to disclose investment information on an annual
basis. The DRA also requires the Secretary to consider the provision of care by
specialty hospitals to Medicaid and other low income patients, as well as
charity care. Finally, the DRA requires the Strategic Plan to address
appropriate enforcement of the rules affecting specialty hospitals. Concerned
about the growth in the number of specialty hospitals and their implications for
health care delivery, Congress in the MMA required the Secretary to impose an
18-month moratorium on payments to certain specialty hospitals for services
furnished to Medicare beneficiaries as a result of a referral from a physician
with an investment interest in the hospital. Excepted from the moratorium were
specialty hospitals that were in operation, or “under development,” as of
November 18, 2003. The MMA further required that during the moratorium, the
Secretary should develop a study of investment and referral patterns and quality
of care provided by specialty hospitals, while the Medicare Payment Advisory
Commission (MedPAC) should study payment issues. The Secretary and MedPAC
submitted their findings in Reports to Congress last year. The Secretary’s May
12, 2005 Report (HHS Report) found that, based on an analysis of claims data,
cardiac specialty hospitals delivered high quality of care that was as good as
or better than their competitor hospitals. (Because of the small number of
discharges, a statistically valid assessment could not be made for orthopedic
and surgery hospitals.) As with all types of hospitals, there will be
exceptions, and CMS will have to be vigilant in monitoring quality of care
issues. Patient satisfaction was also very high in cardiac, orthopedic and
surgical specialty hospitals. The HHS Report also found that specialty hospitals
offer greater predictability in scheduling of services and make significant tax
contributions to the community. In addition, the Report did not find evidence
that physician ownership in cardiac hospitals resulted in selective
referrals. However, after analyzing the findings and recommendations of the
MedPAC Report, CMS concluded that inaccuracies in Medicare payments to hospitals
and to ambulatory surgical centers (ASCs) needed to be corrected as quickly as
possible. Following the release of the HHS and MedPAC Reports, CMS announced
four key CMS recommendations: (1) reform payment rates for inpatient hospital
services through diagnosis-related group (“DRG”) refinements; (2) reform payment
rates for ASCs; (3) more closely scrutinize whether specialty hospitals meet the
definition of a hospital contained in section 1861(e) of the Social Security
Act; and (4) review procedures for approval and for participation in
Medicare. The Interim Report includes a summary of steps CMS has taken since
June 2005 to respond to the recommendations contained in the HHS and MedPAC
reports, and outlines many of the steps CMS is considering for the future:
Enforcement of Payment Restrictions for New Specialty Hospitals; Proposed
Payment Reforms For More Accurate Inpatient Hospital Reimbursement; Payments
for Services by Ambulatory Surgical Centers; Clarifying EMTALA Obligations;
Better Evidence on Financial Arrangements and Care to Low Income and Charity
Patients; Support for Enforcement against Inappropriate Investment Activities.
CMS is accepting public comments on the Interim Report. Comments should be sent
by close of business on June 12, 2006, to
Donald.Romano@cms.hhs.gov. A final Report to Congress will be issued later
this year.
http://www.cms.hhs.gov/apps/media
/press/release.asp?Counter=1856
Survey
shows need for renewed focus on privacy efforts
The number of hospitals and health systems achieving significant compliance with
Health Insurance Portability and Accountability Act (HIPAA) privacy regulations
has dropped slightly in the last year according to a survey conducted by the
American Health Information Management Association (AHIMA). The percentage of
healthcare privacy officers and others whose jobs relate to HIPAA privacy who
believe their institution is more than 85 percent compliant dropped to 85
percent in 2006, down from 91 percent in 2005. As a result, the percent who
believe they are less than 85 percent compliant increased from 9 percent in 2005
to 15 percent in 2006. The majority of respondents, 55 percent, cited a lack of
sufficient resources as the most significant barrier to full privacy compliance.
Respondents report sensing a loss of support from senior management, both in
ensuring facility staff is aware of the need for privacy as well as ensuring
sufficient budgeting for continued education and training. This lack of
resources and competing priorities has led to a diminished focus on the privacy
rule by some hospital and health system staff. “HIPAA implementation has been a
challenge for organizations and the majority are meeting that challenge, but the
need for privacy, confidentiality, and security remains—especially as
organizations tighten staffing and budgets,” said Jill Callahan Dennis, JD, RHIA,
AHIMA president. “A slight drop in the number of facilities reporting themselves
to be fully or mostly compliant with HIPAA should serve as a warning to the
industry that compliance should not be taken for granted.” The survey also
highlights the continued difficulties with certain provisions of the privacy
rule, most notably accounting for disclosures. Many respondents would like to
see changes in this provision, finding it not only burdensome but also
significantly inefficient since demand for such accounting is extremely low. An
overwhelming majority of respondents reported receiving only a few requests for
an accounting with 64 percent receiving no requests at all. One year into the
HIPAA security regulations, 25 percent of respondents indicate full compliance
with another 50 percent indicating they are between 85 and 95 percent compliant.
This represents an increase over 2005, when 17 percent of all respondents
described themselves as fully compliant and 43 percent described themselves as
85 to 95 percent compliant. These results appear to indicate that the security
regulations were much easier to achieve than the privacy rules. When asked about
patient privacy concerns, 30 percent of respondents said they encountered more
questions from consumers this year and, more disturbingly, 22 percent reported
an increase in the number of patients who refused to sign release of information
forms. While more research is needed to understand the concerns behind this
increase, it is clear the industry has an opportunity to better educate
consumers regarding the protection of their personal health information.
“Communicating with consumers, answering their questions and addressing their
concerns, is a key to advancing health information exchange activities,” says
Linda Kloss, MA, RHIA, AHIMA CEO. “Without consumer confidence the nationwide
health information network will never succeed.” For a copy of the report, “State
of HIPAA Privacy and Security Compliance 2006,” visit AHIMA’s Web site at
http://www.ahima.org/emerging_issues/2006StateofHIPAACompliance.pdf.
Study
asserts many medical malpractice suits groundless
About
40 percent of the medical malpractice cases filed in the United States are
groundless, according to a Harvard analysis of the issue. Many of the lawsuits
analyzed contained no evidence that a medical error was committed or that the
patient suffered any injury, the researchers reported. They said the vast
majority of those dubious cases were dismissed with no payout to the patient.
However, groundless lawsuits still accounted for 15 percent of the money paid
out in settlements or verdicts. The study's lead researcher, David Studdert of
the Harvard School of Public Health, said the findings challenge the view among
tort-reform supporters that the legal system is riddled with frivolous claims
that lead to exorbitant payouts. “We found the system did reasonably well in
sorting the good claims from the bad ones, but there were problems,” he said.
However, the American Medical Association, which favors caps on malpractice
awards, called the study proof that a substantial number of meritless claims
continue to slip through the cracks, “clogging the courts” and forcing doctors
to waste time defending them, association board member Dr. Cecil Wilson said.
The findings were published in today's New England Journal of Medicine. The
study found 3 percent of claims analyzed were filed by patients who had no
injury. Of the claims that involved injuries, about two-thirds were caused by
medical error. But the remaining injury claims, or 37 percent, lacked evidence
of a medical mistake, and most of those, 72 percent, were thrown out or
otherwise resolved without a payout. Altogether, the Harvard researchers
reviewed 1,452 malpractice claims randomly selected from five insurance
companies. The cases were resolved between 1984 and 2004, resulting in a
combined $449 million in verdicts and settlements. The researchers examined
medical records, depositions and court transcripts to determine if the patients
were injured and whether the injury was because of a medical error. The study
also confirmed that defending a claim is expensive and long, taking an average
of five years to resolve. It also found that for every dollar awarded to
patients, about half went to cover lawyers' fees and other expenses. Chris
Mather, of the Association of Trial Lawyers for America, said the study was
biased because data was taken from insurers, which sometimes are the defendants
in malpractice suits. Among the findings: An overwhelming number of malpractice
claims (97 percent) involved a severe disability or death. Seventy-three percent
of all of the injury claims that were because of medical error were settled with
a payment. In about a quarter of cases where a groundless claim was settled, the
average payout was lower than that given to a legitimate claim ($313,000 versus
$521,000). (Associated Press)
AVID Medical awarded a Consorta CPT multi-source agreement
AVID Medical Inc. (Toano, VA) was recently awarded a new three-year national agreement that will begin May 1, 2006 to provide custom procedure trays to members of Consorta Inc. (Schaumburg, IL), a healthcare resource management and group purchasing organization. The multisource agreement is effective through April 30, 2009. AVID Medical, the Custom Procedure Tray Company, distinguishes itself as a brand neutral CPT supplier that delivers exactly what the customer requests, on time, every time. www.avidmedical.com.
Production of Anthrax vaccine
delayed again
Steelcase Inc. launches
healthcare focused organization
Amerinet announces
agreements
The state's top HMO regulator said late Tuesday that Kaiser Permanente would pay for kidney transplants at outside hospitals for patients dissatisfied with Kaiser's troubled new transplant program in Northern California. “Let me put it this way, they will do what the patients want them to do,” said Cindy Ehnes, director of the California Department of Managed Health Care. Kaiser, the nation's largest HMO, “will be ending up financially responsible for transplants that are received in other institutions,” she said. The arrangement is part of an agreement with Kaiser that will be formally announced today at a news conference in Oakland, Ehnes said. The scope of the agreement was not entirely clear. At the very least, it will allow up to 1,200 patients to return to UC Davis or UC San Francisco, where they had been awaiting transplants before Kaiser opened its own center in San Francisco in 2004. The UC hospitals had been caring for Kaiser patients under contract. It was unclear whether about 850 patients who joined Kaiser's waiting list more recently would also be allowed to switch programs. The deal stems from reports in The Times last week that described how Kaiser patients were imperiled when the HMO directed its patients to transfer from established transplant centers to its fledgling program in San Francisco. The number of transplants dropped sharply, leaving many patients on prolonged dialysis, which can lead to fatal complications and reduce prospects for a successful transplant later. Hundreds of patients were stuck in limbo for months, with little hope of receiving new kidneys, because Kaiser failed to properly handle paperwork transferring them to its new program. And 25 Kaiser patients who had been treated at UC San Francisco were denied the chance to receive kidneys that were nearly perfectly matched to them because Kaiser directed the university to reject the organs during the transition between programs. Mary Ann Thode, president of the Northern California region of Kaiser Foundation Health Plan and Hospitals, said late Tuesday that HMO officials had a “really good, productive meeting” with state regulators. Kaiser members are part of a unique health care entity that runs both a health plan and a hospital system. Except in rare circumstances, members get their care from Kaiser hospitals and affiliated Permanente medical group doctors only. Previously, Kaiser had paid outside hospitals a discounted rate of about $65,000 per kidney transplant. Ehnes said her department would step in if patients felt that Kaiser was not responding appropriately to their requests for transfer. The managed care department plans to step up its oversight of Kaiser's transplant unit in other ways, she said. The agency, for instance, will oversee an independent panel of experts that Kaiser has said it will assemble to review its transplant program and make recommendations for improvement. The department will also coordinate its activities with other regulators, including the state Department of Health Services and the U.S. Centers for Medicare and Medicaid Services, both of which are investigating Kaiser's program. “The amount of handholding that will go forward from this point will be extreme,” Ehnes said. “Kaiser is very committed to getting their house in order here.” Ehnes said her agency's review had uncovered other potential lapses by the Kaiser program, such as its failure to receive prior approval from the managed care department for moving transplant patients in the first place. The agency requires health plans to receive approval before they implement “material" changes.” (Los Angeles Times)
The Cleveland Clinic's board has agreed to take steps
to address concerns about potential conflicts of interest that have dogged the
institution and its doctors for more than a year. The clinic, a nonprofit
medical research and treatment center, said that the new measures would give the
board of trustees a greater role in examining and curtailing industry
relationships that might bias research or patient care. The monitoring will
examine outside ties not only of doctors but anyone working at the clinic and
the trustees themselves. The clinic said it would use an extensive database to
flag any potential conflicts, allowing them to be better vetted and managed by
the institution. “We're taking all the excuses away,” said William E. MacDonald
III, the vice chairman of
National City Corporation, a
Cleveland financial services company, who is a trustee. The trustees have
established a permanent board committee to address potential conflicts of
interest, and the committee will receive regular reports about the handling of
conflicts among doctors and researchers. Like most other institutions of its
type, the Cleveland Clinic is grappling with the growing challenge of managing
the potential conflicts that arise when doctors work closely with drug and
medical device makers, whether as consultants or investors. Often, those same
doctors may study the same drugs and devices or use them to treat patients,
which raises concerns about the possibility that business considerations may
inappropriately influence medical care. “The spotlight is extraordinary,” said
David J. Rothman, the director of the Center for the Study of Society and
Medicine at the Columbia College of Physicians and Surgeons, who has been among
medical ethicists worried about the integrity of research and care. The steps
taken by the Cleveland Clinic demonstrate an unusual commitment by board members
to oversee conflict-of-interest issues, he said. Among the steps, the clinic
will prevent doctors who have relationships to particular drug or device
companies from involvement in the clinic's purchasing decisions about those
companies' products. The clinic also plans to review its patient consent forms
to address concerns that patients may not be fully aware of potential conflicts.
So far, though, the clinic has stopped short of making information about the
outside relationships of its doctors and trustees available to patients and
others outside of the clinic itself. (The New York Times)
U.S. has second worst newborn death rate in modern world, report says
An estimated 2 million babies die within their first 24 hours each year worldwide and the United States has the second worst newborn mortality rate in the developed world, according to a new report. American babies are three times more likely to die in their first month as children born in Japan, and newborn mortality is 2.5 times higher in the U.S. than in Finland, Iceland or Norway, Save the Children researchers found. Only Latvia, with six deaths per 1,000 live births, has a higher death rate for newborns than the U.S., which is tied near the bottom of industrialized nations with Hungary, Malta, Poland and Slovakia with five deaths per 1,000 births. “The United States has more neonatologists and neonatal intensive care beds per person than Australia, Canada and the United Kingdom, but its newborn rate is higher than any of those countries,” said the annual State of the World's Mothers report. The report, which analyzed data from governments, research institutions and international agencies, found higher newborn death rates among U.S. minorities and disadvantaged groups. For African-Americans, the mortality rate is nearly double that of the U.S. as a whole, with 9.3 deaths per 1,000 births. Sub-Saharan Africa remains the worst place in the world to be a mother or child, with Scandinavian nations again taking the top spots in the rankings by the Connecticut-based humanitarian group. Sweden heads the list, with Niger last. The “Mothers’ Index” in the report ranks 125 nations according to 10 gauges of well-being, six for mothers and four for children, including objective measures such as lifetime mortality risk for mothers and infant mortality rate and subjective measures such as the political status of women. Charles MacCormack, president and CEO of Save the Children, said the report card “illustrates the direct line between the status of mothers and the status of their children.” But each year, according to the report, more than a half-million women die as a result of pregnancy and childbirth difficulties, 2 million babies die within their first 24 hours, more than 5,000 deaths a day, 2 million more die within their first month and 3 million are stillborn. MacCormack said “significant progress” had been made in reducing deaths in children under age 5 in recent years, but “we have made little progress in reducing mortality rates for babies during the first month of life.” Anne Tinker, director of Save the Children's Saving Newborn Lives initiative, said Japan was among a number of nations highly ranked mainly because they offer free health services for pregnant women and babies, while the U.S. suffers from disparities in access to health care. The report said almost all newborn and maternal deaths take place in developing nations, 99 percent and 98 percent, respectively. “Three out of four newborn deaths could be avoided with simple, low-cost tools that already exist, such as antibiotics for pneumonia, sterile blades to cut umbilical cords and knit caps to keep babies warm,” Melinda Gates wrote in a foreword to the report, which was funded in part by the foundation she runs with her husband, Microsoft co-founder Bill Gates. Compared with mothers in the top 10 countries, a mother in the bottom 10 was found to be more than 750 times more likely to die in pregnancy or childbirth. In top-ranked Sweden, skilled personnel are present at nearly all births, but in bottom-ranked Niger, such help is available for only 16 percent of women in labor. The report highlights the three areas it says have the most influence on child well-being: female education, presence of a trained attendant at birth and use of family planning services. (CNN)
Production of Anthrax vaccine delayed again
A troubled government program to produce a new anthrax vaccine has fallen at least another year behind schedule, and sources said last night that tensions between the government and its main contractor have become so severe the future of the program could be in doubt. VaxGen Inc., the contractor producing the anthrax vaccine, has scheduled a news briefing for this afternoon. In testimony before a House panel yesterday, Gerald Parker, a ranking administrator at the Department of Health and Human Services, revealed that the government has approved contract changes under which the company will not begin delivering anthrax vaccine until late 2008, with final delivery in 2009. Until the changes, the company was required to deliver the vaccine starting at the end of this year, a schedule it has acknowledged it has no hope of achieving. The company previously predicted it would begin delivering some doses in late 2007, but now even that delayed schedule appears to be out the window. VaxGen, of Brisbane, CA, has blamed the delay on problems with the potency of the vaccine but has said it is well on its way to fixing them. The Bush administration awarded VaxGen some $1 billion in contracts to produce what was supposed to be a modern vaccine that could protect as many as 25 million people from exposure to deadly anthrax spores in the event of a terrorist attack. VaxGen is expected to seek millions of dollars in compensation for new requirements imposed by the government. (The Washington Post)
Steelcase Inc. launches healthcare focused organization
Steelcase Inc., a global office environments manufacturer, announced the launch of Nurture by Steelcase, a new organization focused on the healthcare environment. “Nurture concentrates on space and environments and how products within those environments can help make them more comfortable, more efficient and more conducive to the healing process,” said Michael I. Love, president, Nurture by Steelcase. Nurture brings a holistic viewpoint to healthcare environments and works with doctors, nurses and other healthcare professionals to gain insight into environments that promote healing. Nurture partners with architects, designers and organizations such as Planetree and The Center for Health Care Design’s Pebble Project to research and develop healthcare environment solutions. Over the past two years, members of the current Nurture team conducted ethnographic research at leading health facilities like Ascension Health, Intermountain Healthcare, Kaiser Permanente, Massachusetts General, Mayo Clinic and other top Integrated Delivery Networks (IDNs) to evaluate a wide variety of interactions in numerous healthcare environments, especially how caregivers perform their duties and how patients receive their care. For example, Nurture is working to improve the safety of patients and efficiency of caregivers by rethinking something as simple and ubiquitous as the overbed table. “Our research at a major metropolitan hospital showed that this tiny surface is much more than a place for patients’ meals; it’s used by patients, by doctors, by nurses and by family members to accommodate almost everything happening in the room,” said Kingshuk Das, Nurture’s director of applied research. “Rethinking this table as a flexible, dual surface to address the needs of patient as well as the caregiver, we have the opportunity to transform it from something that is often in the way, into an effective and versatile tool.” Nurture solutions focus on making the healthcare experience better for three key groups: Patients, caregivers and carepartners. Each has its own distinct needs within the healthcare environment, ranging from workflow and productivity issues to concerns about safety and privacy. Nurture offerings include products from the entire Steelcase family of companies, Brayton, Designtex, Details, Metro, Polyvision, Turnstone, and Vecta. www.nurturebysteelcase.com.
Amerinet announces agreements
Amerinet announces its agreement with
Children’s Medical Ventures LLC
for newborn and preemie products. Effective through March 31, 2009, this
contract includes ventilators, positioning and handling devices, pacifiers,
and tubs and bathing support needs. The contract was the result of a competitive
bidding process.
Amerinet announces its agreement with
Stryker Medical
for hospital beds and accessories. Effective through March 31, 2009, this
contract includes acute and non-acute beds, critical care beds, labor and
delivery beds, specialty surfaces, and patient room furniture. The contract was
the result of a competitive bidding process.
Senate defeats effort to limit
medical malpractice awards
Celebrate National
Nurses Week 2006
Germ warfare: Expert
says desktops, fresh laundry
pose more risks than toilets
Novation plasma program adds
new allocation and enrollment tool
Nonprofit ECRI, an independent medical products testing organization, has sued the Guidant Corporation, a manufacturer of cardiac rhythm devices, in Federal District Court in Pennsylvania. ECRI asserts First Amendment rights to publish comparisons of prices paid by hospitals for medical devices. ECRI has asked the court to rule on whether ECRI is within its rights to reject Guidant’s claim that ECRI’s publication of prices paid by hospitals is forbidden. ECRI believes that there is a pressing national interest in allowing the healthcare community to engage in comparative shopping based on the safety, performance, and cost of medical products. Keeping this information secret is not acceptable in other industries, and Guidant’s policy comes at a time when there is a growing belief that transparency in prices can make a strong contribution toward permitting patients, physicians, and hospitals to assess the value of the products and services they purchase. ECRI believes that if Guidant succeeds in enforcing its policy, other manufacturers will follow its lead, and that this strikes at the heart of efforts to hold down costs and ensure the safety and performance of medical products. “No matter where you sit on the political spectrum,” said ECRI President and Chief Executive Officer Jeffrey C. Lerner, Ph.D., “you know that the ability to compare products, whether it is cars or lifesaving technologies, is fundamental to an efficient marketplace. In our opinion, Guidant’s actions would give far too much power to manufacturers.” There is no reasonable rationale for limiting the ability of a competitive market to function in healthcare. Simply put, ECRI believes that patients, along with their implanting physicians, have the right to know the cost of the pacemakers that are implanted in their chests. ECRI obtains and publishes pricing data on single-use medical products, including disposables, implants, and consumables, from information provided voluntarily by hospitals. ECRI standardizes the vendor names and item descriptions and organizes the information in an online database. ECRI’s system, PriceGuide, has been in operation since 1996. The information in PriceGuide is used by member hospitals to benchmark supply costs. (www.ecri.org).
GAO:
Operational and clinical
changes largely unaffected
by presence of competing specialty hospitals
There has been much debate about specialty hospitals, short-term acute care hospitals with physician owners or investors that primarily treat patients who have specific medical conditions or need surgical procedures, and the competitive effects they may have on general hospitals. Advocates of specialty hospitals contend that competition from these physician-owned facilities can prompt general hospitals to implement efficiency, quality, and amenity improvements, thus favorably affecting the overall health care delivery system. Critics of specialty hospitals are concerned that general hospitals may respond to such competition by making changes that do not necessarily increase efficiency or benefit patients or communities, for example, by adding services already available in the community. The appropriateness of physicians’ financial interests in specialty hospitals has also been questioned. The Government Accountability Office (GAO) was asked to provide information on the competitive response of general hospitals to specialty hospitals. GAO surveyed approximately 600 general hospitals in markets with and without specialty hospitals to provide information on the extent to which these two groups of general hospitals reported implementing operational and clinical service changes to remain competitive. GAO received responses from 401 general hospitals. Nearly all general hospitals responding to GAO’s survey reported making operational and clinical service changes to remain competitive in what they viewed as increasingly competitive healthcare markets; however, there was little evidence to suggest that general hospitals made substantially more or fewer changes or different types of changes if some of their competition came from a specialty hospital. While the majority of survey respondents indicated that competition from other general hospitals had increased, a larger proportion of respondents, 91 percent of urban general hospitals and 74 percent of rural general hospitals, reported increases in competition from limited service facilities, a category that includes approximately 100 specialty hospitals across the nation and thousands of ambulatory surgical centers and imaging centers. To enhance their ability to compete, general hospitals reported making an average of 22 operational changes, such as introducing a formal process for evaluating efforts to improve quality and reduce costs, and 8 clinical service changes, such as adding or expanding cardiology services, from 2000 through 2005. Although specialty hospital advocates have hypothesized that the entrance of a specialty hospital into a market encourages the area’s existing general hospitals to adopt changes that make them more efficient and better able to compete, the survey responses largely did not support this view. There were no substantial differences in the average number of operational and clinical service changes made by general hospitals in markets with and without specialty hospitals and, for the vast majority of the potential changes included on GAO’s survey, there was no statistical difference between the two groups of hospitals in terms of the specific changes they reported implementing. GAO received comments on a draft of this report from the Centers for Medicare & Medicaid Services (CMS). In its comments, CMS stated that GAO’s study, by providing quantitative data on the market effect of specialty hospitals, was extremely helpful. http://www.gao.gov/cgi-bin/getrpt?GAO-06-520.
Senate to take up health coverage bill
Health insurance coverage for mammograms, annual children's physicals and drug abuse counseling could disappear for some workers under legislation moving through Congress. The measure, which the Senate takes up Tuesday, would let insurers bypass coverage requirements mandated by states. Supporters say that pre-empting the state requirements creates a trade-off that will help more businesses and their employers afford health insurance. Opponents say the bill would result in health insurance policies that don't protect workers when they get ill. Under legislation sponsored by Sen. Mike Enzi, R-WY, businesses could band together based on their membership in a professional trade association to offer their workers scaled-back health insurance. Enzi predicts that most businesses will stick with the policies they currently offer rather than switch to a less comprehensive benefit. However, many of the businesses that don't offer health insurance will find they can now afford to do so through the small business health plans. As a result, about 1 million currently uninsured workers would get coverage, he said. The vote is expected to be close. http://www.allhealth.org/event_042406.asp (The Associated Press)
The Senate blocked legislation Monday that would have limited jury awards in medical malpractice cases, shunting aside one of President Bush's most sought-after domestic policy objectives. In procedural votes on two separate bills, proponents of the caps on damages failed to cut off debate. The defeat means that the effort to restrain malpractice awards, stalled in the Senate for two years, is unlikely to move forward in Congress unless Republicans increase their numbers on Capitol Hill in November's election. The bills would have limited damages for pain and suffering to $250,000 in most instances, with an upper limit of $750,000 for cases involving multiple medical facilities. One bill would have applied to healthcare providers generally, while the other sought to shield obstetrician-gynecologists. Foes say such caps are unfair because they would fall disproportionately on people who suffer the most severe injuries. The bills’ Republican backers fell far short of the 60 votes needed to end Democratic-led stalling tactics. The vote to end debate on the broader legislation was 48 to 42; the tally on the second measure was 49 to 44. The House passed its version in July. (Los Angeles Times)
Celebrate National Nurses Week 2006
National Nurses Week is celebrated May 6-12 each year. The American Nurses
Association (ANA) and its 54 constituent member associations (CMAs) salute
nurses across the country with the theme “Nurses:
Strength, Commitment, Compassion.” ANA selected this
theme because it embodies what it means to be a registered nurse today.
Congresswoman Eddie Bernice Johnson (D-30th TX) has introduced House Resolution
245 supporting the goals and ideals of National Nurses Week. The resolution was
co-sponsored by 59 members of the United States House of Representatives.
Novation plasma program adds new allocation and enrollment tool
Novation LLC, the health care contracting services company of VHA and University HealthSystem Consortium (UHC), has added a new allocation and enrollment tool to its plasma program to simplify the allocation process for members. The new tool will enable participating members to: View and update current allocations and/or distributor selections; View monthly year-to-date average of intravenous immune globulin (IVIG) grams and albumin units, instantly, without going through a Novation representative. Requested allocation and/or distributor changes are instantly communicated to the corresponding suppliers and distributors, allowing improved product shipment determination; Reduce the time it takes to complete the program’s annual needs assessment. The process typically takes a few months, but using the tool it now takes approximately a month and a half to complete; Receive the following year’s allocations earlier than in previous years; Use the automated enrollment feature to submit plasma program enrollment information; Update contact information to ensure receipt of program correspondence. Novation contracts for fractionated products derived from human plasma. Products include IVIG, albumin, antihemophilic factors, hyper-immune globulins, and surgical fibrin sealants.
WSJ: To reduce errors,
hospitals prescribe innovative designs
Report forecasts RFID's
future in healthcare
CDC to urge routine HIV
tests for a broad swath of Americans
Thermo, Fisher set $10.6
billion pact; lab-equipment
firms
aim to create industry titan
Only half of
human bird-flu cases are being reported to the World Health
Organization within two weeks of being detected, a response time
that must be improved to avert a pandemic, a senior official from
the United Nations agency said. Shigeru Omi, the WHO's regional
director for the Western Pacific, said it is estimated that
countries would have only two to three weeks to stamp out, or at
least slow, a pandemic flu strain after it began spreading in
humans. The first move would be to identify cluster cases and report
them to the WHO, he said. International teams would then be deployed
to investigate the site of the outbreak, the area would be
quarantined and antiviral treatment would be administered. “All the
steps have to be done within two to three weeks. As of now, even
reporting the first step, it takes sometimes more than two weeks for
half of the cases,” Dr. Omi said Saturday at the end of an
Asian-Pacific meeting on bird flu in central Vietnam. Dr. Omi said
political commitment to fight the disease is now strong among
governments across the region, but public awareness must increase so
ordinary people will know what to do if they see a large number of
people or birds getting sick at the same time. Dr. Omi attended a
meeting with agriculture and health ministers representing the
21-member Asia-Pacific Economic Cooperation forum. On Friday, they
endorsed a plan aimed at stamping out bird flu and preparing for a
potential pandemic.
The government Friday reported an outbreak of bird flu in wild birds
in remote western China in a further sign of the difficulties in
controlling the spread of the virus. The Ministry of Agriculture
said 125 migratory birds, all but two of them bar-headed geese, have
died in the outbreak first detected April 23 in Qinghai province. A
government laboratory tested samples of the dead fowl and confirmed
Wednesday that the birds were infected with the bird-flu virus,
H5N1, the ministry said on its Web site. It is at least the second
time H5N1 has turned up in Qinghai, a region of high-altitude plains
and mountains on a prime migration route for birds between Siberia
and South Asia. (Associated Press)
Test confirms 25th bird flu death in Indonesia
International tests have confirmed a 30-year-old Indonesian man who died last month had bird flu, a Health Ministry official said on Monday, taking the country's death toll from the virus to 25. Joko Suyono from the ministry's bird flu information centre told Reuters the man had been in contact with sick fowl. Indonesia has the world's second highest bird flu death toll for humans after Vietnam. But the government has resisted mass culling of birds, citing the expense and impracticality in a country where keeping a few chickens or ducks in backyards is common. Local tests are not considered definitive and blood samples are sent to a World Health Organization-affiliated laboratory in Hong Kong for confirmation. Not counting the latest death, the H5N1 avian flu virus has killed 114 people worldwide since 2003, according to the WHO. In Indonesia, the H5N1 virus has been reported in birds in about two-thirds of the country's provinces. (Reuters)
Gap widens in hospital patient satisfaction
The gap in patient satisfaction is widening between hospitals that deliver exemplary patient service and those that provide lower levels of care. Press Ganey Associates Inc., which measures health care satisfaction across thousands of health care delivery organizations, captured the trend in its 2006 Health Care Satisfaction Report, which includes data from more than 2.2 million patients who had inpatient stays at nearly 1,600 U.S. hospitals. According to Press Ganey data, hospitals, emergency departments, physicians' offices and other health care facilities have shown significant improvement over the past several years, directly opposite the trends in health care at large. The hospitals with the greatest commitment to improvement averaged a 2.7 mean score increase over the past year despite the national decline in health care satisfaction. “The American Consumer Satisfaction Index (ACSI) from the University of Michigan has shown that consumers’ satisfaction with health care has decreased significantly over the past several years,” said Melvin F. Hall, Ph.D., president and chief executive officer of Press Ganey. Patients receiving care at health care facilities in the upper 90th percentile of Press Ganey's database almost never report “very poor” or “poor” care while patients at health care facilities in the 10th percentile report “very poor” or “poor” care with far greater frequency. Press Ganey's second annual Health Care Satisfaction Report measures key data on the drivers of patient, resident, physician and employee satisfaction across a myriad of health care delivery organizations, hospitals, outpatient clinics, nursing homes and medical practices, among others. In addition to the inpatient data, the Report covers more than 1.8 million patients of outpatient clinics as well as more than 150,000 employees and more than 15,000 physicians at health care organizations nationwide. Following are some of the major findings: Patient satisfaction in physician offices declines substantially for every five minutes an appointment is delayed. The critical tipping point for waiting comes at 10 minutes. After 10 minutes, patient satisfaction plunges to a level where patient loyalty is at risk; Satisfaction with emergency room waiting times increases by simply providing patients with information about any delay at regular intervals. Patients with long wait times who receive information about delays are more satisfied and understanding than those with short wait times who are less informed; Nurses and technical workers are the most dissatisfied health care employees while health care executives and administrators, by a wide margin, are the most satisfied. This gap is so significant that it may suggest health care management is losing touch with front-line employees like nurses. The higher a physician's level of satisfaction with a hospital, the higher a patient's level of satisfaction with the care he or she receives; The high correlation of physicians' overall satisfaction with patients' perception of the quality of care indicates that physicians are loyal to facilities that are customer focused. Appealing to physician desires at the expense of patients may have a negative impact on physician loyalty. The same can be applied to employee satisfaction; As more and more procedures are done through ambulatory surgery and outpatient centers, hospitals face stiff competition for patients. With an average mean satisfaction score of 91.1 for ambulatory surgery and 90.3 for outpatient services, hospitals must achieve a new level of excellence to remain competitive. The full report is available at http://www.pressganey.com.
WSJ: To reduce errors, hospitals prescribe innovative designs
In May 2003, St. Joseph's Hospital (West Bend, WI) hired a local accounting firm to install a hotline for staff to anonymously report medical errors and near-misses, either their own or those of colleagues. Before the system was set up, the hospital collected 250 reports per month. Afterward, the number shot up to 3,000 per month. The cases confirmed what administrators at St. Joseph's had suspected: The hospital wasn't adequately addressing safety issues. At the same time, the cost of the preventable errors was escalating. St. Joseph's paid more than $70,000 in malpractice insurance premiums in 2000. In 2004, the figure exceeded $440,000. Rather than merely overhaul medical procedures, the hospital decided to try a different approach. St. Joseph's then-chief, John Reiling, was already leading a $55 million effort to build a new facility. His idea: cram the new building with innovative design to help staffers do their jobs more precisely, more carefully, and, he hoped, prevent errors in the process. “We decided to use patient safety as the guiding principle,” he said. Many hospitals aim to improve safety by focusing on ways to reduce human error. They encourage nurses to wash their hands more often to prevent the spread of infections and push doctors to write prescriptions more legibly in order to avoid mix-ups. A growing number of administrators are now factoring hospital layout and design into the patient-safety equation. Traditionally, architects designed hospitals much like any other building, making adjustments along the way for things like toilet location, medical equipment and ventilation. Reiling persuaded the facility's architects to draw up blueprints with specific medical benefits, such as slip-proof floors and soundproof walls, already built in. The old St. Joseph's suffered from all the faults of a typical U.S. hospital. Lighting varied from one area to the next, making visual diagnoses inconsistent. Noise levels were higher than those recommended by health experts, making it harder for patients to rest. At the new 80-bed facility, which opened its doors in August, the size and set-up of every room is identical. That means doctors and nurses quickly can find everything from syringes to emergency oxygen lines. Nurse stations are placed so that all patients are visible, without pillars to block the view. Filters and ultraviolet devices trap and kill germs and other particles, making for healthier airflow throughout the hospital. Though the changes are relatively new, the hospital says it is reaping benefits on both safety and financial fronts. Anecdotal evidence suggests that infection rates, injuries from falls and medication errors are lower than at the old facility. The hospital expects that over the next year, the average length of stay could decline by as much as half a day, freeing up beds more quickly and allowing St. Joseph's to serve more patients. "Many people are now aware of the impact that environment has on patient safety," said Craig Zimring, an environmental psychologist and a professor of architecture at the Georgia Institute of Technology in Atlanta. He is also a member of the board of the Center for Health Design, an advocacy group whose main goal is to provide "researched and documented examples of healthcare facilities whose design has made a difference in the quality of care." The University of Michigan Health System has made patient safety its main priority at its new $523 million children and women's hospital in Ann Arbor, MI. Virtually all corners in the hospital interior are being built with round edges. And while most hospitals recycle their air up to eight times, thus increasing the risk of spreading infectious germs, the new building won't recycle air at all. A big benefit of the system: "Our terrorism expert advised us that if a biological or chemical outbreak or attack occurred, the agent would be confined to one room," said Robert Merwin, CEO of the hospital's owner, Mills-Peninsula Health Services in Burlingame, CA. HCA Inc. of Nashville, which runs more than 180 hospitals, says it will no longer use vinyl coverings on exterior walls because the material attracts infection-causing mold. At SSM Health Care's new hospital in St. Louis, MO, set to open in 2008, nurses will pass medicines to patients via a small sliding drawer from an adjoining alcove. This limits the number of times a nurse enters the room, thus lowering the infection risk for a patient. (Wall Street Journal)
Report forecasts RFID's future in healthcare
The market for RFID tags and systems in healthcare will rise rapidly from US$90 million in 2006 to US$2.1 billion in 2016, according to a new market forecast report published by IDTechEx. This growth, the company says, will be because of item level tagging of drugs and Real Time Locating Systems (RTLS) for staff, patients and assets to improve efficiency, safety and availability and to reduce losses. In the RFID in Healthcare 2006-2016 report, Dr Peter Harrop of IDTechEx summarizes the situation: “RFID is an enabling technology that saves lives, prevents errors, saves costs and increases security. It removers tedious procedures and provides patients with more freedom and dignity. For example, it reduces the amount of personal intervention by staff because it automates procedures such as protecting the disoriented elderly from danger and matching patient to treatment.” “In addition, RFID is now used in smart packaging that records when patients take medication and how much they take and provides prompts to help them comply with instructions.” The report contains 72 case studies, supplier profiles, technology analysis and ten year forecasts. Over the next ten years, Harrop suggests that the largest use of RFID in healthcare will be labels on drugs at item level and the infrastructure and services to support this throughout the supply chain and in healthcare facilities. The primary purpose of this will be anti-counterfeiting by establishing the full history of that package at all times, called a “pedigree”. The second largest application of RFID in healthcare by value will be Real Time Locating Systems (RTLS) for staff, patients, visitors and assets. Here the systems and support cost more than the tags, partly because many of the tags are reused. The tags cost from US$1 to US$100, depending on their sophistication. Some record threatening behavior, many have an alarm button to fetch help to the exact location. Error prevention cuts across both of item level drug tagging and RTLS applications. It will remain one of the biggest uses of RFID in healthcare. An electronic handshake prevents the wrong procedure taking place and the RFID system may even record what actually happens, for future reference. However, RFID error prevention systems are also being set up in their own right. For example, a disposable passive RFID wristband that talks to the RFID label on the blood bag to prevent error is not anti-counterfeiting or RTLS. The largest use of RFID in healthcare so far by numbers of tags is the 40 million used for error prevention on AstraZeneca Diprivan syringes. These do not employ a silicon chip, the largest element of cost in conventional RFID tags. IDTechEx expects the market to see a slow move to chipless tags over the next ten years, although they will remain a minor percentage of expenditure on RFID tags for healthcare until much later. http://www.idtechex.com
CDC to urge routine HIV tests for a broad swath of Americans
The U.S. Centers for Disease Control and Prevention is planning to recommend
that doctors begin to offer voluntary HIV tests as a part of routine medical
care for everyone in the U.S., ages 13 to 64, regardless of lifestyle or
perceived risk for HIV. In a sweeping revision of HIV guidelines, CDC officials
say the agency also will recommend that patients no longer be required to sign
separate informed-consent forms before submitting to an HIV test, a current
guideline that is law in New York and some other states. The CDC also plans to
suggest eliminating or abbreviating requirements for often-lengthy pretest
counseling. The aim, CDC officials and doctors who support the changes say, is
to broaden the scope and simplify the process of HIV testing to reach more
infected people as early as possible. The CDC estimates that about 25% of the
one million people now infected with HIV in the U.S. are unaware that they carry
the virus, and may not find out until the infection progresses to the
potentially lethal symptoms of AIDS. By that time, the patient could have
unknowingly infected many other people. While few people argue against broader
testing, some patient advocates and others have already protested to the CDC
that routine universal testing without strictly enforced informed consent could
lead to coercion that drives people away from care and undermines HIV
prevention. Others worry about breaches of privacy, particularly since the CDC
recommends that states switch to name-based reporting of HIV cases from
alpha-numeric codes. Another concern is loss of insurance coverage or jobs. Many
doctors, as well as the CDC, favor widespread proactive testing because, they
say, early diagnosis leads to treatment and longer life and reduces the spread
of infection. Routine testing of pregnant women and treatment of those who are
HIV positive have reduced the incidence of HIV in newborns from about 1,750 a
year in the 1990s to about 300 a year since 2000. The CDC says details of the
new guidelines are being finalized and are likely to be published this summer in
the agency's Morbidity and Mortality Weekly Report, which 25 years ago first
reported about a previously unknown, fatal disease that attacks the immune
system. (Wall Street Journal)
Thermo, Fisher set $10.6 billion pact; lab-equipment
firms
aim to create industry titan
Thermo Electron Corp. and
Fisher Scientific International Inc.,
announced a $10.6 billion all-stock deal. The combination will create a massive
supplier of scientific and lab equipment ranging from test tubes and autopsy
tables to infrared microscopes and DNA-analysis tools. Fisher's $9.04 billion
market capitalization is 40% greater than Thermo's, but the deal is structured
as an acquisition of Fisher by Thermo. Fisher shareholders will own about 60% of
the combined company, which will be named Thermo Fisher Scientific Inc. and
employ about 30,000. Marijn E. Dekkers, Thermo's president and chief executive,
will be CEO of the combined company. (Wall Street
Journal)
Case grows for leaving in
recalled defibrillators
The Department of Health and Human Services Thursday awarded more
than $1 billion worth of contracts to continue development of a new
technology aimed at more quickly producing influenza vaccines.
Companies that won the contracts include Novartis AG,
GlaxoSmithKline PLC, MedImmune Inc., Solvay Pharmaceuticals, and a
unit of Computer Sciences Corp. The contracts are aimed at
developing so-called cell-based vaccine production technologies to
replace the current method of producing influenza vaccines in eggs,
a process that takes months. The technology could be used to produce
vaccines to protect against both seasonal influenza and a pandemic
influenza virus. Specifically, GlaxoSmithKline was awarded $274.75
million; MedImmune, $169.46 million; Novartis, $220.51 million; and
Solvay, $298.59 million. All of the contracts are valued over a
five-year period. DVC LLC, a unit of Computer Sciences, was awarded
a contract worth $40.97 million through July 31, 2007, to develop
seasonal and pandemic influenza vaccines using the cell-based
culture technology in collaboration with Baxter International Inc.
However, DVC said the contract is valued at $242.5 million over five
years, assuming the government keeps the contract funded after July
2007. The money for the contracts is coming from $3.3 billion worth
of funds approved by Congress for the current fiscal year that are
earmarked for flu pandemic planning. Novartis has been testing an
influenza vaccine manufactured using cell lines that were originally
derived from dog kidneys in the 1960s. New lines can continually be
grown in the lab. Such cell lines can be quickly produced and frozen
for later use. Cells derived from other sources could also be used.
Novartis said it plans to file for approval of a cell-based vaccine
with European regulators by the end of the year. Health and Human
Services Secretary Mike Leavitt said the goal of the contracts would
be to allow all Americans to receive a flu vaccine that could
protect against a pandemic virus within six months of the time it
appears a new flu virus is circulating among humans. The current
chicken egg-based technology used to produce vaccines simply can't
produce enough vaccines to protect nearly 300 million Americans in
the event of a flu pandemic, Leavitt said. Cell-based technology
would also allow for increased production of annual, seasonal
influenza vaccines and would eliminate periodic shortages. While the
companies are all in various stages of developing cell-based
technologies and vaccines, Leavitt said he believed the technology
overall would become viable in about three-to-five years. (Wall
Street Journal)
New
Hampshire senate vote to ban sale of drug data
The New Hampshire state Senate voted unanimously Thursday for a
first-in-the-nation proposal to bar pharmaceutical companies from obtaining
doctors' prescription information to increase sales. The data are considered
invaluable by the tens of thousands of drug company sales representatives, who
use them to identify doctors' drug preferences, whether they favor brand-name
medicines over generics, and whether they have been willing to prescribe drugs
new to the market. The bill, passed 22-0, would prohibit pharmacies, benefits
managers, insurance companies and data-mining companies from selling,
transferring and using prescription information for commercial purposes,
including any purpose “that could be used to influence sales or market share of
a pharmaceutical product, influence or evaluate the prescribing behavior of an
individual health care professional.” The bill passed the House earlier. If it
becomes law, New Hampshire would be the first state with such a ban. “I believe
that people are entitled to the privacy of their medical information and I
believe that includes the privacy of their relationship with their health-care
provider,” the bill's prime sponsor, Rep. Cindy Rosenwald (D-NH) saidy. Money
also is a concern; pharmaceutical companies should not lean on doctors who have
a tendency to prescribe cheaper generics over name-brand drugs, nor should they
pressure them to switch from competing name-brand drugs, she said. Starting in
July, the American Medical Association plans to let physicians opt out of
data-mining arrangements. But Rep. Rosenwald said prescribers such as nurse
practitioners, physician's assistants and dentists would not be covered. “It
also does not keep physicians' prescription data out of the hands of the drug
companies. It only says they are not supposed to share them with the sales
forces,” she said. Drugstore chains, data companies and pharmaceutical companies
oppose the bill. The Pharmaceutical Research and Manufacturers of America, which
represents pharmaceutical research and biotechnology companies, said patients
benefit from having the data available. “Appropriate use of prescribing data
allows pharmaceutical sales representatives to work with physicians to help them
provide the best quality care for their patients,” the trade group said. It also
said patient confidentiality is respected. The state attorney general's office,
AARP and New Hampshire Medical Society, which represents about three-quarters of
New Hampshire doctors, support the bill, as does the state Department of Health
and Human Services. (Associated Press)
Kodak exploring possible sale of Health unit
Eastman Kodak said it is exploring strategic alternatives for its
Health Group, including a possible sale of
the unit. While the Health Group is turning in strong organic growth in some
parts of its digital portfolio, such as digital capture and healthcare
information solutions, Kodak has observed for some time a consolidation in the
industry, according to chairman and CEO Antonio Perez.
As a result, Kodak has determined that now is the
appropriate time to explore alternatives, Perez said. Kodak has been preparing
for this possibility for some time, and will move the process forward as rapidly
as possible, Perez said. Kodak’s Health Group is focused on the healthcare IT
market, a segment that has been maturing for some time, said president
Kevin Hobert. While that industry is taking off and its fundamentals are very
strong, it’s starting to consolidate, he said. Kodak will be exploring
alternatives ranging from a partnership or a joint venture, on up to divestiture
of the group, Hobert told AuntMinnie.com. The Health Group's financial
performance has slipped in recent quarters. In its first quarter (end-March 31),
sales were $585 million, down 7% from the $626 million reported in the first
quarter of 2005. Earnings from operations also dipped, dropping from $78 million
last year to $46 million. The results were primarily due to lower earnings from
traditional radiography film and digital output segments, and higher silver
costs, according to the firm. These factors were partially offset by improved
earnings in computed radiography, healthcare information systems, and digital
radiography, Kodak said. Earnings from digital products were $17 million, down
from $33 million last year. (AuntMinnnie.com)
Case grows for leaving in recalled defibrillators
Rare malfunctions in heart defibrillators have gotten lots of attention recently, but new research suggests the greater risk may lie in patients' having their devices removed, because the surgical removal itself can prove fatal or produce serious complications. Curious about how patients fared after makers of the cardiac electrical devices issued recalls in Canada, doctors there found that 5.8% of patients suffered “major complications” from surgical procedures to have their devices removed and replaced. Two patients died, one of cardiac arrest after doctors removing the device's wire “lead” inadvertently tore a small bit of heart muscle. The other died of an infection after surgical removal. The research, published in the Journal of the American Medical Association, is the first large-scope study of the dangers of surgical “explant” procedures. One intriguing aspect of the research is that the 5.8% rate of serious complications is greater than that seen in previous, smaller studies. “We know the risk of replacement is not trivial,” said Andrew Krahn, the cardiologist from the University of Western Ontario who co-wrote the study. He and research colleagues surveyed 17 hospitals where 2,915 patients had defibrillators that were subject to manufacturers' recalls because of rare malfunctions. Of these, 533 got devices replaced, 31 of whom then had major complications requiring another operation. The study looked at a period from October 2004 to October 2005. Most of the recalled devices were made by leading manufacturers Medtronic Inc. and Guidant Corp., now a unit of Boston Scientific Corp. The study encompassed about 93% of Canadian patients who had defibrillator models that were covered by the recalls. Last year saw an unusual number of such advisories from defibrillator makers, including a string of them from Guidant. By contrast, the rate in the Canadian study of serious complications is “higher than in the literature I've seen,” said Eric N. Prystowsky, director of the clinical electrophysiology laboratory at St. Vincent Hospital in Indianapolis. Dr. Prystowsky said one message from the research is that patients should question their doctors about whether they are experienced in putting in such devices, because complication rates can vary. He suggested the complication rates are higher when procedures are performed by doctors lacking specific electrophysiology training. Dr. Prystowsky said he also conducted a U.S. survey of leading doctors who implant such devices and found that, in many cases, surgery to replace devices with possible flaws took place because patients were frightened about rare malfunctions and insisted on it. A separate study in JAMA focused on pacemaker and defibrillator malfunctions over a 13-year period, as reported by manufacturers to the Food and Drug Administration. It found that from 1990 through 2002, 31 people died because their defibrillators failed to function properly, out of 415,780 such devices installed. Medtronic concluded from the two studies: “One finds that the lifetime risk of dying from medical/surgical complications is 33 times greater than from having a [defibrillator] malfunction.” (Wall Street Journal)
FDA: Two executives convicted
in unapproved
sterilization device scheme
Hospital mishap may have
exposed 300 patients
to HIV or hepatitis
State and local health officials said
they welcomed the federal government's latest plan for dealing with
a
pandemic
flu
outbreak, but some complained that the Bush administration had
failed to provide the money needed to pay for the plan's long list
of recommendations. The plan, presented Wednesday, is the latest
effort by the administration to detail how federal, state and local
agencies would react if a virulent flu strain threatened the
United States. Closing the nation's borders is not among its
recommendations. The government would, however, probably limit the
number of airports that accept international flights and would
closely screen travelers. Domestic travel could also be restricted,
and officials would probably advise the cancellation of vacations,
would advise people to keep a distance of three feet from others
and, perhaps, keep children home from school. The 227-page plan
estimates that a third of the population could become infected, two
million people could die, 40 percent of employees might be absent
from work during the height of the outbreak, and $600 billion in
income could be lost nationwide. If rioting broke out and
overwhelmed the National Guard, the plan says, the president could
call out the Army to establish order. Dr. Josh Sharfstein,
commissioner of the Baltimore Health Department, said the plan was
welcome but offered “new expectations without new resources.” The
plan asks local governments to deal with a flood of hospital
patients, care for more patients at home and spend millions of
dollars on antiviral drugs, Dr. Sharfstein said. Senator
Tom Harkin,
Democrat of Iowa, who advocated preparations for a pandemic, said
the administration had been slow in implementing plans and spending
money already appropriated. A bill to provide another $2.3 billion
for flu preparations is moving through Congress. Divided into nine
chapters, the plan provides a list of actions federal departments
must complete as a pandemic spread. The plan says that the secretary
for health and human services would lead the federal health and
medical response but that the secretary for homeland security “is
responsible for coordination of federal operations and resources.”
Dr. William Schaffner, chairman of the preventive medicine
department at Vanderbilt University, called the plan “realistic” in
advising against shutting the borders and said that cities and
states need to prepare. “Localities cannot rely on the feds to be
the cavalry that rides over the hill to rescue every U.S. town and
city from pandemic influenza,” Dr. Schaffner said. (The New York
Times)
For a complete
copy of the report – click here
http://www.whitehouse.gov/homeland/nspi_implementation.pdf
APIC pursues business case for infection prevention; will provide update at 2006 annual conference
The Association for Professionals in Infection Control and Epidemiology (APIC) convened a summit to complete the business case for infection prevention. The outcomes of the summit will help position infection prevention and control professionals as partners in profitability with hospital financial leaders. The summit brought together APIC’s Board of Directors, Strategic Partners and key thought leaders. The outcomes will be presented at APIC’s 33rd Annual Educational Conference and International Meeting, which will be held June 11-14 in Tampa, FL. “The fact is, most hospitals don't understand the costliness of infections,” said Richard Shannon, MD, chair of the Department of Medicine at Allegheny General Hospital in Pittsburgh, PA, who was among the presenters at the summit. “The costs of these preventable infections in both human and economic terms are staggering.” At Allegheny General, Shannon proved that healthcare-associated infections in general, and central line infections (CLABs) and ventilator-associated pneumonias (VAP) in particular, are not inevitable consequences of complex health care but are indicative of unreliable processes. He showed that these infections and their consequences can be reduced through work standardization and commitment to safety. As a result, infection prevention became the hospital’s fourth most profitable product line. Allegheny General Hospital saved $2.2 million by reducing CLABs and VAPs by 80-90 percent. Most importantly, 47 lives were saved. “Professionals in infection prevention must learn the business of health care, and preventing infection and adverse outcomes for those who entrust us with their lives and the lives of loved ones is our core business,” said Denise Murphy, RN, BSN, MPH, CIC, vice president of safety and quality at Barnes-Jewish Hospital at the Washington University Medical Center in St. Louis, MO, who also presented at the summit. As follow-up to the summit, APIC will prepare a position paper that will communicate the potential economic value of the eradiation of healthcare-associated infections to hospital chief financial officers. As part of this effort, APIC will also: Create a tool kit for APIC members that will help them make a clear and comprehensive business case at their facilities and use this knowledge to secure increased resources to further fight HAIs; Cultivate relationships with other organizations who share APIC’s commitment to prove infection prevention saves lives and money. APIC also emphasizes the need for ICPs to develop new partnerships within their facilities and to identify leaders who will champion the activity. APIC thanks it Strategic Partners for making the April economic summit possible: BD, Bard, Cereplex, ChloraPrep, Clorox, Ethicon, Medline, MedMined, PDI, Steris, and Tyco Healthcare/Kendall. (www.apic.org)
Lawson and Intentia merge to focus on simplifying use of
ERP applications
Lawson Software and Intentia International officially began operating as one company today, vowing to simplify the process of developing, deploying, maintaining and using ERP applications. Lawson will deliver a broad portfolio of enterprise applications in 20 languages to more than 4,000 customers in more than 40 countries. The combined entity will retain the name of Lawson Software. The company’s new brand and website also debuted. A key part of Lawson’s integration plans is ensuring continuity, serving customers without interruption and protecting their long-term investments. This means existing customers will work with the same account executives, the same consultants, and the same support center contacts. Regional management will also be little changed, and Lawson promises a 24-hour guaranteed response to any customer inquiry made to any Lawson employee. Lawson will continue to maintain two separate product lines, known as Lawson M3 and Lawson S3. Lawson M3 applications are designed for the “make, move, maintain” markets traditionally addressed by Intentia including fashion and apparel, food and beverage, wholesale distribution and asset-intensive industries. The Lawson S3 applications are designed for the “staff, source, serve” markets Lawson historically addressed. These markets include healthcare, retail, local government, K-12 education and banking and insurance. The Lawson S3 applications include human capital management, enterprise financial management, supply chain management and enterprise performance management. The company expects to provide an enterprise asset management suite to its Lawson S3 customers to track both human and physical assets, such as medical equipment.
Two executives of a Mundelein, IL, company were convicted April 13, 2006, of fraudulently selling uncleared surgical sterilizing devices that led to eye damage in eighteen patients, causing them to lose sight in one eye. Ross Caputo was president and CEO of AbTox, and Robert Riley was the vice-president of regulatory affairs of AbTox, when the company received permission to market a small gas plasma sterilizer only for use in sterilizing flat stainless-steel surgical instruments without lumens (tubes) or hinges. The defendants instead marketed a larger, unauthorized version of the sterilizer and promoted its use for a wide array of non stainless-steel instruments. The hospitals that purchased the larger unauthorized units were shown by AbTox the clearance letter for the smaller, authorized unit. These larger units were used in an unauthorized manner, because AbTox marketed them that way, to sterilize complex instruments, including cataract instruments that have small tubes which are used to put solution into the patient’s eye. One unauthorized use was to sterilize ophthalmic instruments that had brass joints which reacted to the sterilizing agent creating a toxic residue. AbTox knew of the reaction but did not advise users or seek proper corrective action. The blindness was caused by a harmful copper acetate residue that remained in the tube of the instrument after sterilization by this machine. One hundred sixty eight (168) of the unauthorized units were sold to hospitals nationwide, including Department of Veterans Affairs hospitals and other government agencies, totaling over $18 million in sales. Hospitals in Chicago, IL, Columbia, MO, and St. Louis, MO, reported to AbTox that their sterilizer was suspected of causing injuries to several patients. The company failed to notify the FDA about these reports as required. The conviction of these two men is the result of an investigation conducted by the U.S. Food and Drug Administration’s Office of Criminal Investigations (OCI). The defendants were convicted of three counts of wire fraud, four counts of mail fraud, seven counts of selling an adulterated (unapproved) or misbranded (mislabeled) human medical device, and conspiracy to defraud the FDA. Riley was also convicted of one count of making a false statement for lying to the FDA. The defendants face significant penalties including incarceration, fines, and restitution. Sentencing will be at a later date. Two other defendants, Mark E. Schmitt, formerly director of marketing of AbTox, and Marilyn M. Lynch, formerly director of clinical services of Abtox, previously pled guilty in this case. http://www.fda.gov/bbs/topics/NEWS/2006/NEW01367.html
Hospital mishap may have exposed 300 patients
to HIV or hepatitis
State health officials are investigating a mishap at Scripps Memorial Hospital in San Diego that may have exposed nearly 300 obese patients who underwent stomach-reduction surgery to hepatitis or HIV. Scripps officials said Wednesday the patients had a “very low” risk of infection because a registered nurse had knowingly violated operating room procedures. The female nurse, whose name was not released, failed to fully clean a gastroscope, which is used to retrieve other surgical instruments from the stomach. The nurse worked at the hospital from September 2004 until last month when she resigned after hospital officials confronted her about the issue. “This employee was aware of the procedures and chose not to follow them, which is something we do not tolerate,” said Scripps spokesman Don Stanziano. The hospital has contacted 250 of the 299 patients at risk, many of whom reside outside Southern California. Lea Brooks, a spokeswoman for Department of Health Services, said investigators would examine what happened and what Scripps is doing to ensure problems are fixed. The hospital will have to prepare a plan of corrective action, Brooks said. The state Department of Consumer Affairs will decide whether to initiate disciplinary action against the nurse. Stanziano said the chances of infection were remote because the gastroscopes had undergone preliminary washes and rinses, although they were not sterilized with chemicals. (Associated Press)
England found to be healthier
than America
PanGo integrates active
and passive RFID to deliver
advanced location management platform
Beaufort
Memorial Hospital signs with MedAssets
for revenue cycle and supply chain solutions
A report just
released and authored by Pam Dixon, Executive Director, from The
World Privacy Forum discusses the issue of medical identity theft.
The report finds that one of the significant harms a victim may
experience is a false entry made to his or her medical history due
to the activities of an imposter. Erroneous information in health
files can lead and has led to a number of negative consequences for
victims. Identity theft may be done by criminals, doctors, nurses,
hospital employees, and increasingly, by highly sophisticated crime
rings. The report finds that medical identity theft victims need an
expanded right to correct their medical files in order to recover
from this crime, and need more specialized consumer education that
is focused on correcting the specific harms of medical identity
theft including the individuals’ rights to correct errors in their
medical histories and files need to be expanded to allow them to
remove false information from their files and get copies of their
medical files. All working prototypes for the National Health
Information Network need comprehensive risk assessments focused on
preventing medical identity theft while protecting patient privacy.
Recently, a Colorado man whose Social Security Number, name, and
address was stolen, found out he was a victim of medical identity
theft when a bill collector wrote to demand the $44,000 he owed to a
hospital for a surgery he never had. The victim did not have
insurance, and had to go through a lengthy procedure to clear his
name, a process that is ongoing after more than two years. But
unlike purely financial forms of identity theft, medical identity
theft also harms its victims by creating false entries in their
health records at hospitals, doctors' offices. Victims of medical
identity theft may receive the wrong medical treatment, find their
health insurance exhausted, and could become uninsurable for both
life and health insurance coverage. They may fail physical exams for
employment due to the presence of diseases in their health record
that do not belong to them. A consumer wrote to the Federal Trade
Commission after receiving a peculiar invoice. The consumer wrote:
“On March 20, 2006, someone used my Social Security Number at the
Primary Diagnostic Clinic at Duke University to obtain medical
services and I was billed for these services. The individual did not
show proof of insurance or any type of ID. I have never been a
patient at any Duke facility so the bill was quite a surprise.” A
Boston area psychiatrist made false entries in charts of individuals
who were not his patients. He gave individuals diagnoses of drug
addiction and abuse, severe depression and numerous psychiatric
sessions which they did not actually have, then used their personal
information to submit false bills to insurance. One medical identity
theft victim from Florida went for medical treatment and says she
found that her medical files had been altered. She discovered that
an imposter had caused false entries on her file, including changes
to her blood type. A Pennsylvania man discovered that an imposter
with a heart condition used his identity at five different hospitals
to receive more than $100,000 worth of medical treatment. At each
hospital, the imposter created extended medical histories in the
victim’s name. Victims of financial identity theft can depend on
rights such as the ability to see and correct errors in their credit
report, the ability to file fraud alerts, the right to obtain
documents or information relating to transactions involving their
personal information. But victims of medical identity theft do not
have a similar complete set of rights or redresses. It is remarkable
that medical identity theft has not been recognized as a separate
and distinct crime. There have been 19,428 complaints regarding
medical identity theft to the Federal Trade Commission since January
1, 1992, the earliest date the FTC began recording such complaints.
The Office of Civil Rights at the Department of Health and Human
Services should review the HIPAA health privacy rule and propose
changes to expand the rights of medical identity theft victims. A
clear and effective pathway of recourse needs to be developed for
victims of medical identity theft that is at least equal to the
protections that victims of financial identity theft have. The World
Privacy Forum is a non-profit public interest research and consumer
education group. It focuses on a range of privacy matters, including
financial, medical, employment, and Internet privacy. For the
complete copy: visit:
http://www.worldprivacyforum.org/pdf/wpf_medicalidtheft2006.pdf
Study: Spray flu vaccine may be better for kids under 5
Spraying flu vaccine into the noses of babies and preschoolers offers significantly more protection than shots, says one of the largest comparisons of flu inoculations ever performed. The study found the spray vaccine was 55 percent more effective than traditional flu shots when given to nearly 8,000 children under age 5. The nasal spray FluMist, the only flu vaccine made of live but weakened influenza virus, now is sold only for children 5 and older. Manufacturer MedImmune Inc., which funded the new research, plans to seek government approval to sell FluMist for younger children as well. But to flu experts, the findings have important public health implications. Doctors have long known that flu shots don't work quite as well in very young children as they do in older youngsters or adults. And children are the prime spreaders of flu virus, fueling infections in older people who may not survive. Each winter, flu kills 36,000 Americans, most of them elderly. “Our current thinking is that to control influenza, we really have to vaccinate all children,” said Dr. Robert Belshe, a vaccine specialist at St. Louis University who led the new study. “Anything that makes it easier and more effective (to vaccinate) children is going to contribute a lot to the protection against influenza.” The study did find a safety concern: A few of the very youngest patients, those ages 6 months to 2 years, had an episode of asthma-like wheezing in the weeks after the first FluMist dose. The increased risk was slight, 1 percent more children wheezed after FluMist than after flu shots, and the reaction was temporary. Belshe’s study didn't use the exact version of FluMist sold today, but one slightly altered so that it requires refrigerator instead of freezer storage. Apart from regular winter flu, the government is experimenting with FluMist for bird flu. (The Associated Press)
PanGo
integrates active and passive RFID to deliver
advanced location management platform
PanGo Networks introduces
a major enhancement to its PanOS Platform, a software product that acquires
location information from active and passive RFID sources and provides a rich
services-based interface for higher level systems to consume asset location
information in an efficient and extensible way. Now, applications used by
hospitals, manufacturers and third-party solution providers can tap
standards-based active and passive RFID technologies from a single platform,
thereby dramatically increasing the number of assets that can be tracked and
eliminating the need for proprietary choke point or portal solutions that add
complexity and cost to corporate networks. This aggregation and refinement of
location from multiple standards-based sources gives users unprecedented
flexibility to apply the appropriate mix of RFID-tracking technologies to best
match their unique and varying needs. Through presence detection, real-time
location and high-resolution choke-point visibility, the PanOS Platform allows
customers and application vendors to benefit from timely and accurate tracking
of assets and inventory, while capitalizing on the pervasive adoption of WLAN
and RFID technology.
http://www.pangonetworks.com/
Beaufort Memorial Hospital signs with MedAssets
for revenue cycle and supply chain solutions
MedAssets announced that Beaufort Memorial Hospital, based in Beaufort, SC, has signed a multi-year agreement for revenue cycle and supply chain solutions. Beaufort Memorial has a total supply spend of $23 million and net patient revenue of $124 million. Through the new agreement, MedAssets Supply Chain Systems will provide access to a comprehensive contract portfolio. Beaufort Memorial will also engage the services of MedAssets Analytical Systems for data cleansing of the supply item file and advanced supply chain analytics technology. MedAssets Net Revenue Systems will provide a comparative rate modeling service and leave-behind web based tool, CRM.Net, which will assist Beaufort Memorial Hospital in implementing competitive and defensible pricing. Additionally, through MedAssets’ strategic business partner, Chamberlin Edmonds, Beaufort Memorial will gain assistance with the hospital’s uninsured, underinsured and indigent patients. Chamberlin Edmonds will assist these patients in applying for Supplemental Security Income and Social Security Disability Insurance. Chamberlin Edmonds will provide its services to patients for free on behalf of the 197-bed hospital. www.medassets.com.
HCA CEO makes commitment to
pricing transparency
Bush administration
predicts massive disruptions
if pandemic hits
Few U.S. companies are
prepared for bird flu outbreak
Silica lawsuits hamper
disposable respirator mask industry
ability to meet demand for avian flu response plans
Each year the Trustees of the Social Security and Medicare trust funds report on the current status and projected condition of the funds over the next 75 years. This message summarizes the 2006 Annual Reports. The fundamentals of the financial status of Social Security and Medicare remain problematic under the intermediate economic and demographic assumptions. Social Security's current annual surpluses of tax income over expenditures will soon begin to decline, and will be followed by deficits that begin to grow rapidly toward the end of the next decade as the baby-boom generation retires. Expenditures of Medicare's Hospital Insurance (HI) Trust Fund that pays hospital benefits are projected to exceed taxes and other dedicated revenues in 2006, with annual cash flow deficits expected to continue and to grow rapidly after 2010 as baby boomers begin to retire. The projected growing deficits in both programs will exhaust HI trust fund reserves in 2018 and Social Security reserves in 2040, under current financing arrangements. In addition, the Medicare Supplementary Medical Insurance (SMI) Trust Fund that pays for physician services and the new prescription drug benefit will require substantial increases over time in both general revenue financing and beneficiary premium charges. As Social Security and HI reserves are drawn down and SMI general revenue financing requirements continue to grow, pressure on the Federal budget will intensify. The Trustees do not believe the currently projected long-run growth rates of Social Security or Medicare are sustainable under current financing arrangements. Though highly challenging, the financial difficulties facing Social Security and Medicare are not insurmountable. We must, however, take action to address them in a timely manner. The sooner these challenges are addressed, the more varied and less disruptive their solutions can be. http://www.cms.hhs.gov/ReportsTrustFunds/downloads/tr2006.pdf
The Centers for Medicare & Medicaid Services (CMS) has issued a proposed rule to improve Medicare’s payments for certain durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) through a new competitive acquisition program. This proposal would reduce beneficiary out-of-pocket expenses and save the Medicare program money while ensuring beneficiary access to quality DMEPOS items and services. “We intend to implement these DME competitive reforms to get savings for beneficiaries and taxpayers, while maintaining and improving quality,” said CMS Administrator Mark B. McClellan, M.D., Ph.D. “This is another way in which Medicare is now using competition to bring lower-cost, up-to-date care to our beneficiaries.” The new competitive acquisition program, which is required by the Medicare Modernization Act of 2003 (MMA), would replace the current DMEPOS fee schedule payment amounts for selected items in select areas. CMS has discretion under the law to first phase in DMEPOS items for bidding based on high cost and volume or largest savings potential. Suppliers in a competitive bidding area would submit bids for selected items, and CMS would use these bids to establish Medicare payment amounts for these items. Under the proposed rule, the Medicare payment amounts would be the median of the winning suppliers’ bids for selected items. Suppliers whose bids are lower than the Medicare payment amounts set under the competitive bidding program could offer a rebate to beneficiaries, lowering their costs for acquiring the DME items they need. Within five years of implementing the competitive bidding programs, savings to taxpayers are expected to exceed over $1 billion annually. Competition under the program would be phased in beginning in 2007 in 10 of the largest metropolitan statistical areas (MSAs), in 80 of the largest MSAs in 2009, and in other areas after 2009. Areas that may be exempt from competitive acquisition of DMEPOS include rural areas and areas with low population density within urban areas that are not competitive, unless there is a significant national market through mail order for a particular item or service. CMS proposes that for 2007, the New York City, New York; Los Angeles, California; and Chicago, Illinois MSAs would be excluded from competitive bidding. This proposed rule also details CMS’ process for implementing new quality standards and the application process for organizations that would accredit all DMEPOS suppliers, including those who would participate in the DMEPOS competitive bidding program. CMS will establish the quality standards through program instructions. The standards will be applied prospectively and will be published on the CMS website this spring. All suppliers must be accredited by an approved accreditation organization to ensure they meet applicable quality standards. Failure to meet those standards can result in the revocation or suspension of billing privileges and the inability to participate in the competitive bidding program. The recently-enacted Deficit Reduction Act of 2005 (DRA) changed the way Medicare pays for oxygen equipment and certain rented DMEPOS items. This proposed rule is consistent with the DRA changes, which will be fully implemented in future rulemaking. In addition to the DMEPOS competitive acquisition program, the proposed rule includes a new fee schedule for home dialysis supplies and equipment that are still paid on a reasonable charge basis, clarification of CMS policy on the scope of the statutory eyeglass coverage exclusion, and implementation of a revised methodology for calculating fee schedule amounts for new DMEPOS items. The proposed rule will be published in the May 1 Federal Register. Comments will be accepted until June 30, and a final rule will be issued later this year. The proposed rule can be viewed at: http://www.cms.hhs.gov/CompetitiveAcqforDMEPOS/downloads/cms1270p_dme.pdf
For a Washington Post column on the CMS proposed rule go to http://www.washingtonpost.com/wp-dyn/content/article/2006/05/01/AR2006050101266.html
AHA policy outlines ‘roadmap’ to transparency in health care pricing
The AHA
Board of Trustees announced a policy designed to spur efforts that share helpful
information about the price of hospital care. The policy supports federal
requirements for states, working with state hospital associations, to expand
existing efforts to make available to consumers hospital charge information. It
also supports federal requirements for states, working with insurers, to make
available in advance of medical visits information about an enrollee’s expected
out-of-pocket costs. Finally, the policy supports federal-led research efforts
to better understand what type of pricing information consumers want and would
use in their health care decision-making, and a hospital-led effort to create
consumer-friendly pricing language.
http://www.aha.org/aha/members
_only/content/04_27_06_trans.pdf
HCA
CEO makes commitment to pricing transparency
HCA Chairman and CEO Jack O. Bovender, Jr. pledged the company's 183
hospitals will make transparency in pricing a top priority. Bovender's statement
coincided with President Bush's address before the American Hospital
Association, and was issued in support of the Bush Administration's initiative
to make hospital pricing more readily available to the general public. HCA, the
largest hospital provider in the United States, has been at the forefront of
several key initiatives in healthcare in recent years, including the
establishment of broad uninsured discount and charity care policies, and the use
of barcoding technology in HCA facilities to prevent medication errors.
Employers should have plans to keep workers at least three feet apart, colleges should consider which dormitories could be used to quarantine the sick, and flight crews should have surgical masks to put on coughing travelers, according to a draft of the government's pandemic flu plan. The Bush administration forecasts massive disruptions if bird flu or some other super-strain of influenza arises in the United States. A response plan scheduled to be released at the White House on Wednesday warns employers that as much as 40% of the workforce could be off the job and says every segment of society must prepare. “The collective response of 300 million Americans will significantly influence the shape of the pandemic and its medical, social and economic outcomes,” said an undated 228-page draft version of the report that had not been finalized. An outbreak could lead to a variety of restrictions on movement in and around the country, including limiting the number of international flights and quarantining exposed travelers. But the government does not foresee closing U.S. borders to fight the spread of flu, in part because it would only slow the pandemic's spread by a few weeks and because it would have such significant consequences for the economy and foreign affairs. With no border restrictions, pandemic influenza would arrive in the United States within two months of an outbreak abroad, the document estimates. But models of influenza's spread suggest that sealing the U.S. border would not only be impractical, 1.1 million people cross the nation's 317 official ports of entry daily, but it would only delay the inevitable by a few weeks, it said. The new document calls mandatory quarantine a last resort, and urges planners to consider, for example, that closing a community would sever it from the delivery of groceries and other essential goods. The report aims to energize the private sector, noting that 85% of the systems that are vital to society, such as food production, medicine and financial services, are privately run. Not only would sick workers stay home, but so would anyone who was caring for ill family members, under quarantine because of possible exposure to the flu or taking care of children when schools shut down. Included in the report's advice: Employers should have workers remain at least three feet apart or otherwise limit face-to-face contact to limit the flu's spread, including by working from home or substituting teleconferences for office meetings; Colleges should consider whether dormitories could be used to house or quarantine the sick, and establish mandatory sick-leave policies for anyone exposed to the flu. The report envisions possible breakdowns in public order and says governors might deploy National Guard troops or request federal troops to maintain order. The military also could be activated to enforce travel restrictions and deliver vaccines and medicines, the report said. This new report outlines how every branch of government would have to work with federal health officials to try to contain a pandemic and minimize its damage to the economy and society. By early next month, government agencies are to release the specific steps they plan. The report said the Health and Human Services Department would lead the government's interagency response effort and the Homeland Security Department would have a secondary role to assist with the health response and non-medical support. (The Associated Press)
Few
U.S. companies are prepared for bird flu outbreak
Just 15% of
large U.S. companies have any bird-flu plan according to a survey in March by
human resources consultant Watson Wyatt Worldwide. But, that's starting to
change: Corning started its corporate pandemic preparedness team in mid-2005.
Best Buy has a bird flu team under orders to report to company leadership by
October. Mutual of Omaha's plan includes flexible hours to reduce building
population. It just launched Germ Buster, CEO Dan Neary said, an employee
education campaign focused on hygiene. One of the more extreme examples is
biotechnology company Biogen Idec, which says it formed a bird-flu team in
September that meets every two weeks. Recommendations include a “3-foot rule”
that prohibits handshaking, head-count restrictions on elevators, stations with
alcohol-based hand-cleaning gel, and more frequent cleaning of bathrooms. The
real issue is absenteeism, which the World Health Organization (WHO) predicts
could climb above 40% and last for weeks. Emcor Group, a commercial-building
management company, feels secure in that only 100 of its 27,000 employees work
at corporate headquarters in Norwalk, CT. Likewise, Xerox has only 350 of its
30,000 U.S. employees working at Stamford, CT, headquarters, and even the 8,000
employees concentrated in Rochester, NY, are scattered among several buildings.
More than 200 companies paid $1,800 each in registration fees to send a
representative to a two-day conference on business planning for bird flu in
December sponsored by the University of Minnesota Center for Infectious Disease
Research and Policy and the Minnesota Chamber of Commerce. But when pressed,
companies say there is little they will be able to do if H5N1 avian flu morphs
into a highly contagious and deadly virus like the Spanish flu pandemic of
1918-19. The WHO calls this worst-case scenario Phase 6. Health and Human
Services Secretary Michael Leavitt says 92 million Americans could get sick.
Sales of the N95 mask made by Ammex are up 500% in a year to 5 million a month,
and the company will soon double its capacity. Ammex employees are among the
best-informed about bird flu. Even those that plan must worry about their
suppliers. Emcor CEO Frank MacInnis said that in a worst-case scenario,
companies will be trying to keep non-critical employees out of buildings so that
essential workers can work safely and spread out one or two to a floor. Even
then, ventilation systems will need to be adjusted to bring in outside air
through ultraviolet filtration, MacInnis said. Xerox says it has been advised by
government officials to plan for 30% to 50% absenteeism for up to six weeks. The
pandemic could even last in waves up to 18 months as it comes to a city, leaves
for a while, then returns. (USA TODAY)
Silica lawsuits hamper disposable respirator mask industry
ability
to meet demand for avian flu response plans
The Coalition for Breathing Safety cautioned that the capacity of respirator
manufacturers to meet federal, state and local government demand for N95
disposable respirator masks was being severely hampered by an ongoing deluge of
frivolous silicosis and asbestos lawsuits and urged Congress to quickly pass
legislation that would help ensure an adequate supply of masks. The warning
comes on the heels of a report issued by an Institute of Medicine panel convened
by the U.S. government that warned against reusing N- 95 respirator masks in a
flu pandemic because there is no simple way to decontaminate them. It is
expected that there will be a staggering demand for N-95 masks during the coming
months. “U.S. respirator manufacturers are doing everything they can to meet
unprecedented demand for N-95 respirators, but they cannot invest in additional
capacity if every new mask that comes on line simply offers one more target for
trial lawyers,” said Daniel K. Shipp, President of the International Safety
Equipment Association (ISEA), a member of the Coalition for Breathing Safety.
“Manufacturers of disposable respirators are facing tens of thousands of
silicosis claims, even as Centers for Disease Control figures show that
silicosis deaths nationwide have declined 93% from 1968 to 2002,” explained
Shipp. The National Institute for Occupational Safety and Health (NIOSH) tightly
regulates the respirator industry by setting strict design standards, conducting
tests to ensure they are met, and approving each and every respirator model as
well as the warning labels that accompany the product. However, trial lawyers
have deluged the industry with lawsuits claiming defective design or failure to
warn users, despite the fact that manufacturers cannot affect how or when the
respirators are used. “Even though the claims are routinely dropped, dismissed,
or settled for very small amounts, the number of cases is overwhelming.
Respirator manufacturers' litigation costs in 2004 equaled 90% of the net income
earned from selling the products that same year,” said Shipp. The Coalition
supports bi-partisan legislation introduced by Senator John Cornyn in the Senate
(S. 1406) and Rep. Bud Shuster in the House (H.R. 2357) that would preempt
lawsuits claiming defective design or insufficient warning if a respirator is
NIOSH approved. Concluded Shipp: “Respirator manufacturers have no need for
blanket indemnity from the government. That's not what we're looking for. The
legislative solution we seek would protect manufacturers from having state
judges and juries overrule federal standards that they have to meet, and allow
these companies to keep making respirators to protect workers and the public.”
Recipients: Stolen body parts
infected
Critical care’s efforts
to disclose medical errors and
adverse events; disclosure may not increase lawsuits
FDA notification:
Important safety recommendations
for
Baxter’s COLLEAGUE infusion
pumps
Bird flu entering the U.S. through smuggled wildlife is a growing worry for government officials already on the lookout for migrating wild birds. The concern over the trade in wild animals, pets and animal parts has some precedent, here and abroad. Gambian rats imported from Africa brought the monkey pox virus to the United States in 2003. They infected prairie dogs bought as pets. Seventy-two people in the Midwest became ill, but none died. In 2004, two crested hawk-eagles carrying the virulent strain of the H5N1 bird flu virus were seized from the hand luggage of a Thai passenger at Brussels International Airport in Belgium. The passenger had planned to sell the birds to a Belgian falconer. Not one of the 25 people exposed to the virus became ill. Officials killed 200 parrots and 600 smaller birds that had contact with the crested hawk-eagles. A surveillance plan for monitoring migratory birds says a migrating wild bird is the most likely carrier of the H5N1 virus. The plan, developed by the Interior and Agriculture departments and the state of Alaska for use in all 50 states, also says the virus could arrive through smuggled poultry, an infected traveler, black-market trade in exotic birds or even an act of bioterrorism. Authorities in other countries are similarly wary. An estimated 4,500 chickens from China are smuggled into Vietnam every day, and the H5N1 virus has shown up in samples taken from some of the confiscated birds. The United States and China are the biggest markets for an estimated $10 billion global trade in illegal wildlife. The black market in wildlife and wildlife parts is second only to trafficking in arms and drugs. About 330,000 live birds were imported into the U.S. in 2004. Just 374 were denied entry, suggesting smugglers may focus on different routes. The birds denied entry came mainly from Mexico, Guyana and Ghana. The biggest sources of live birds were Canada, with 117,000; Taiwan, 50,000; Tanzania, nearly 40,000; and Belgium, 24,000. The U.S. banned imports of all live birds, bird parts and bird products from Cambodia, China, Hong Kong, Indonesia, Japan, Laos, South Korea, Thailand and Vietnam in February 2004. Since then, the ban has been expanded to any country or region where bird flu is thought to exist. (The Associated Press)
WHO update on avian influenza situation in China
The Food and Drug Administration (FDA) and the Medical Products Agency (MPA) of Sweden have signed a mutual Confidentiality Arrangement effective as of April 2006. The Arrangement allows the two Agencies to share certain non-public information, including law enforcement information and internal pre-decisional information. “This is an important milestone,” said Director General Gunnar Alvan of the Swedish MPA. “Drug approval processes and drug safety surveillance programs become more global by the day.” The Confidentiality Arrangement is useful when it comes to sharing drug safety data potentially resulting in regulatory measures we want to implement globally in a concerted manner. The difficulties experienced in simultaneous risk communications, due to the time-difference between North America and Europe have effectively been alleviated.
At least a
dozen people who had routine operations say they caught deadly viruses and other
germs from body parts stolen from corpses in a scandal that has sent hundreds of
people for tests. The patients tested positive for germs that cause AIDS,
hepatitis or syphilis after receiving tissue transplants, according to their
attorneys and court records. Lawsuits have been filed for two men, one in
Nebraska and one in Ohio. Each contends he caught a hepatitis virus from tissue
implanted in back and spine operations, an assertion that lawyers acknowledge
will be difficult to prove. A New Jersey company, Biomedical Tissue Services, is
accused of failing to gain consent to take bones, tendons, ligaments, skin and
other tissue from cadavers. The most famous example involved the corpse of
Alistair Cooke, the longtime host of the PBS series “Masterpiece Theater.” Cooke
died of cancer at age 95, and his leg bones were removed and shipped to tissue
processors for use in medical procedures. So far, about two dozen lawsuits have
been filed in federal courts across the country, most seeking class-action
status for hundreds of people who were implanted with tissues that the U.S.
government recalled. About 1 million procedures a year involve implants of
cadaver tissues. The companies that process the body parts for those surgeries
say their products are safe and believe the case involving Biomedical Tissue of
Fort Lee, NJ, is an aberration. The owner of BTS and three others have pleaded
not guilty to the charges against them. BTS has since closed. At least 8,000
people received BTS tissue, according to one of the tissue distributors. The
U.S. Food and Drug Administration has said the chance of getting a disease from
BTS tissue is low. But attorneys for the plaintiffs are challenging that
assertion. (The
Associated Press)
Critical care’s efforts to disclose medical errors and adverse
events;
disclosure may not increase lawsuits
The benefits of disclosing medical errors and adverse events are greater than the potential drawbacks and disclosure corresponds with the ethical responsibilities of physicians, according to an article in the May issue of Critical Care Medicine, the journal of the Society of Critical Care Medicine. “My co-investigators and I expect that disclosure will become the standard in the near future,” said lead author Dennis Boyle, M.D., assistant professor of medicine at University of Colorado Health Sciences Center and assistant professor of rheumatology at Denver Health Medical Center. “At the University of Colorado Health Sciences Center, medical students learn the skills that help with the disclosure of errors and adverse events.” In a critical care setting, the complexity of illness and trauma exponentially increases the risk of error and subsequent adverse events. Dr. Boyle said that many medical practitioners are currently unaccustomed to revealing medical errors and adverse events to patients and families. In the article, the researchers review the issues surrounding disclosure of errors in care and adverse events that harmed critical care patients and then provide a framework for implementing a disclosure. The researchers found that failure to disclose errors and adverse events in critical care is an important and common problem. Although the authors believe not all errors or adverse events require disclosure, they discuss ethical, financial, legal, and personal benefits to disclosing errors. They conclude that the use of a standard framework for doing so will facilitate developing a disclosure process. “The process of disclosing errors requires courage, composure, communication skills and a belief that the patient is entitled to know the truth,” comments Dr. Boyle. “It typically takes a team of people and a series of conversations to complete all the steps necessary to understand, disclose, correct and arrange for appropriate help or compensation for the injured party.” Dr. Boyle and colleagues found that open disclosure leads to more rapid diagnosis and additional treatment while at the same time preventing additional complications. Disclosure can help patients receive injury compensation and, on a more personal level, disclosure may diminish concerns about other unanticipated outcomes and may help re-establish trust, strengthening the physician-patient relationship. Benefits to physicians include reduced risk of malpractice litigation since patients and families feel that the situation has been handled honorably. Physicians may also feel less guilt and receive absolution from patients and their families. Disclosure also encourages improvements in medical practice. The dangers of disclosure include patient rejection of physicians, malpractice lawsuits, a loss of referrals, hospital admitting privileges, and licensure. http://www.sccm.org/press_room/press_releases/April272006.asp
FDA
notification: Important safety recommendations
for Baxter’s
COLLEAGUE infusion
pumps
The Food and Drug Administration (FDA) is recommending that healthcare providers and biomedical engineers take important safety steps, in addition to those recommended by the manufacturer, when using the COLLEAGUE Volumetric Infusion Pump manufactured by Baxter Healthcare Corporation. The COLLEAGUE pump has exhibited a variety of problems, including under-infusion, battery failures, false alarms and failure to alarm. Over the past year, Baxter has issued four urgent safety notices and recalls for COLLEAGUE infusion pumps. These notices identify the specific problems and steps that you should take to address them. FDA strongly recommends that, in addition to the steps identified by Baxter, providers follow these measures: If possible, do not use the COLLEAGUE pumps in situations where delaying or interrupting therapy in order to reprogram or replace a malfunctioning pump may be life threatening, such as with critically ill patients being maintained on inotropic infusions and patients in mobile transfer units. Have a contingency plan to mitigate any disruption of infusion therapy (e.g., have a back-up pump available). Contingency plans should take into account both the patient’s condition and the reasons for the infusion. Monitor patients and check the pumps frequently. Report any problems as soon as possible to Baxter and FDA. If your facility relies primarily or entirely on COLLEAGUE Pumps, you may wish to consider evaluating other options for infusion therapy. You can find a complete list of legally marketed infusion pump devices on the FDA’s web site http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfPMN/pmn.cfm by using “FRN” in the “Product Code” field. Other options that may be appropriate for certain IV therapies include gravity drip and flow control devices (e.g., buretrol, volutrol, micro tubing, and flow control tubing devices). However, these are generally considered backup or last-resort measures and FDA does not recommend them as long-term solutions or as a permanent replacement for the Baxter infusion pump. FDA is working with Baxter to resolve problems with the COLLEAGUE pump as quickly as possible, mindful of concerns about the availability of replacement units. However, users should understand that at this point FDA cannot assure that the company’s proposed corrections adequately address the problems encountered with these Baxter pumps. Baxter’s replacement units have not been cleared for marketing at this time, and will not be cleared until FDA is able to provide reasonable assurance that they will function reliably to meet user needs. You may obtain paper copies of the notices that Baxter has issued for the COLLEAGUE pump by contacting Baxter at 1-800-843-7867. http://www.fda.gov/cdrh/safety.html