| November 2007
November
30, 2007
Download print version
Cancer patients may benefit from reporting
symptoms online in real time
Message from Dr. Margaret Chan, WHO
Director-General, for World AIDS Day
Neopost introduces online shipping; web-based
multi-carrier solution
allows users to ship packages at optimal cost
New corporate headquarters for HPN
Wipak Medical & Healthmark Industries
announce the acquisition
of Kimberly-Clark’s peel pouch business
Healthmark Industries Co. Inc (St. Clair Shores, MI) and Wipak
Medical (Nastola, Finland) are pleased to announce acquisition
and assumption of Kimberly-Clark Health Care’s (Roswell, GA)
peel pouch business. Wipak produces and markets flexible
packaging, including peel pouches. Healthmark, founded in
1969, is a supplier of innovative products and solutions for
Central Sterilization, including sterilization packaging and
accessories. Information about Healthmark and Wipak can be
found at THIS LINK and
THIS LINK, respectively.
The acquisition will allow Healthmark and Wipak to establish a broader line
of sterilization packaging in the market while allowing Kimberly-Clark to
focus on innovation in the rest of its line of medical devices and supplies.
As of November 30, 2007, the Kimberly-Clark worldwide peel pouch and tubing
business will officially transition to Healthmark. Through November 30,
2007, customers will continue to purchase peel pouch and tubing products
from Kimberly-Clark. As of December 1, 2007 and from that date forward,
Healthmark will take ownership of all existing product inventories and
assume full accountability for order processing, customer service, and other
sales activities. Wipak and Healthmark will make the utmost effort to ensure
a seamless and pain-free transition for all Kimberly-Clark packaging
customers.
After December 1, 2007 direct inquiries to:
Healthmark Industries Company Inc.
Phone: 1-586-774-7600
Toll Free: 1-800-521-6224
Fax: 1-586-774-6473
Email: Healthmark@hmark.com
CMS publishes national list of poor-performing nursing
homes,
key tool for families seeking quality care
The
Centers for Medicare & Medicaid Services (CMS) released the first ranking of
the nation’s poor-performing nursing homes. Release of the national list of
facilities, identified as special focus facilities (SFFs), is expected to
offer individuals, seeking long-term healthcare services, and their families
powerful new information when choosing nursing homes. Release of the list
was prompted by the number of facilities that were consistently providing
poor quality of care, yet were periodically instituting enough improvement
that they would pass one survey only to fail the next (for many of the same
problems as before). Such facilities with a “yo-yo” compliance history
rarely addressed underlying systemic problems that were giving rise to
repeated cycles of serious deficiencies. Once a facility is selected as an
SFF, the state survey agency conducts twice the number of standard surveys
and will apply progressive enforcement until the nursing home either (a)
significantly improves and is no longer identified as an SFF, (b) is granted
additional time due to promising developments, or (c) is terminated from
Medicare and/or Medicaid. CMS and the state can more quickly terminate a
facility that is placing residents in immediate jeopardy.
The
CMS policy of progressive enforcement means that any nursing home, not just
those identified as an SFF, that reveals a pattern of persistent poor
quality is subject to increasingly stringent enforcement action. If problems
continue, the severity of penalties will increase over time, ranging from
civil monetary penalties, denial of payment for new admissions and,
ultimately, removal from Medicare and/or Medicaid. As of October 2007, there
were 128 SFFs, out of about 16,000 active nursing homes. The number of SFFs
in each state varies according to the number of nursing homes in the state.
These nursing homes, at the time of their selection as an SFF, had survey
results that were among the poorest five or 10 percent in each state.
Today’s list includes 54 facilities that are at the top of the poorest
performers in those states and among those facilities that have failed to
improve significantly. Typically, these facilities achieve improved survey
results after being selected for the initiative. The CMS data indicate that
about 50 percent of the nursing homes identified as SFFs significantly
improve their quality of care within 24-30 months, while about 16 percent
are terminated from Medicare and Medicaid.
In
addition to publishing the list of SFFs, CMS is taking many other steps to
improve the quality of care in the nation’s nursing homes including a new
program that will make the payment system more sensitive to quality
improvements; developing new, more stringent systems for criminal background
checks on facility workers and applicants; unprecedented focus on preventing
catastrophic pressure ulcers in nursing home residents; and improving the
state survey process. The CMS list of SFFs can be found at
THIS LINK
Oxygen suppliers fight to keep a Medicare boon
Millions of people
with respiratory diseases have relied on oxygen equipment, delivered to
their homes, to help them breathe. A basic setup, including three years of
deliveries of small oxygen tanks, can be bought from pharmacies and other
retailers for as little as $3,500, or about $100 a month. Unless, that is,
the buyer is Medicare. Despite enormous buying power, Medicare pays far
more. Rather than buy oxygen equipment outright, Medicare rents it for 36
months before patients take ownership, and pays for a variety of services
that critics say are often unnecessary. The total cost to taxpayers and
patients is as much as $8,280, or more than double what somebody might spend
at a drugstore. The high expense of oxygen equipment, which cost Medicare
over $1.8 billion last year, is hardly an anomaly. Medicare spends billions
of dollars each year on products and services that are available at far
lower prices from retail pharmacies and online stores, according to an
analysis of federal data by The New York Times. The government agency
has paid above-market costs for dozens of items, a comparison of Medicare
figures with retail catalogs finds.
For example, last year
Medicare spent more than $21 million on pumps to help older and disabled men
attain erections, paying about $450 for the same device that is available
online for as little as $108. Even for a simple walking cane, which can be
purchased online for about $11, the government pays $20, according to
government data. These widespread price discrepancies, including those for
oxygen services, have been noted in dozens of regulatory reports. But when
officials and politicians have tried to cut these costs, they have often
encountered a powerful foe: the companies that sell these devices, who ask
their elderly customers to serve, in effect, as unpaid lobbyists, calling
and writing to their representatives in Congress, protesting at rallies, and
even participating in political attacks against individual lawmakers who
take on the issue. As the nation’s elderly population grows, dozens of
industries have tried to harness the political might of older Americans for
corporate goals. Physician groups, medical device manufacturers, insurance
companies and other businesses have rallied aging voters to protest even
minor legislative changes.
Many of those battles
focus on the $427 billion Medicare program. Because of fierce patient and
corporate lobbying, for instance, Medicare still pays prices for many items
that are based on rates established in the early 1980s, when devices were
often much more expensive than they are now. Even as the actual cost of many
machines and services has fallen, Medicare has only occasionally lowered
what it pays. “There’s no question that parts of Medicare are mispriced,”
said Herb B. Kuhn, deputy administrator of the Centers for Medicare and
Medicaid Services, the agency overseeing Medicare. Kuhn said the program had
made price refinements and was in the process of carrying out a competitive
bidding system to help bring down the cost of products like oxygen
equipment. But, Kuhn acknowledged, officials have confronted political and
logistical obstacles in adjusting a program that last year provided services
to 43 million older and disabled Americans.
The battles over
oxygen equipment highlight many of those challenges. Medicare pays the same
rental amount to provide each oxygen patient with equipment and services,
regardless of how often they are used. For patients who require constant
monitoring and frequent deliveries of tanks, high prices may be justified.
And for people who use equipment for only a few months, renting may be
cheaper than buying. Earlier this decade, legislators ordered the government
agency to pay less and use the competitive bidding program. Then the oxygen
industry started fighting back. Companies organized themselves into a
deep-pocketed lobbying force that has defeated attempts to cut Medicare’s
rates, and has attacked the competitive bidding program. The government’s
overall bill for Medicare soared last year to an average of $8,568 per
beneficiary, up from $5,522 in 1999, an increase that outpaces inflation by
34 percent. In 1997 and 2003, Congress lowered oxygen reimbursements by a
total of about 39 percent. (The New York Times) To read the entire article
see
THIS LINK
FDA
is urged to toughen rules on salt; intake causing deaths, consumer group
says
A consumer group
prodded the Food and Drug Administration to regulate salt as a food
additive, arguing that excessive salt consumption by Americans may be
responsible for more than 100,000 deaths a year. The government has long
placed salt in a "generally recognized as safe" or GRAS category, which
grandfathers in a huge list of familiar food ingredients. But in an FDA
hearing this week, the Center for Science in the Public Interest (CSPI)
urged the agency to enforce tougher regulations for sodium. Doing so "lays
the foundation for saving tens of thousands of lives per year," said CSPI
Director Michael Jacobson in an interview after the hearing. It "just has
tremendous potential to health and to cut healthcare costs." CSPI first
petitioned the FDA in 1978 to regulate salt in food more closely and has
since sued the agency unsuccessfully in federal court twice over the
ingredient. A 2005 petition to the FDA by CSPI prompted the agency to hold
hearings yesterday to review sodium chloride's status in food.
"After 25 years of inactivity, the FDA is taking the salt issue seriously,"
Jacobson said. "They're really gathering information . . . and getting an
earful from all sides." The average American consumes 3,353 milligrams of
sodium every day, more than twice what the Institute of Medicine says is
adequate for healthy people and 1,000 milligrams more than the 2,300
milligrams set as a daily limit by the 2005 U.S. Dietary Guidelines. The
intake considered adequate is far lower: 1,500 milligrams for those 9 to 50
years old; 1,300 milligrams for those 51 to 70, and 1,200 milligrams for
people 70 and older, or less than what is found in a ham and Swiss cheese
sandwich on whole wheat with mustard. Salt intake is closely linked to
stroke, kidney disease and high blood pressure.
As a prelude to yesterday's hearing, CSPI and the Grocery Manufacturers
Association held a joint conference in October to encourage food companies,
restaurants, health professionals and government agencies to help Americans
limit sodium. Seventy-five percent of the salt consumed in the United States
is found in processed foods bought at grocery stores, vending machines,
restaurants and fast-food franchises. How best to cut sodium in the American
diet is greatly debated. CSPI advocates more federal regulation. Industry
groups want reductions to be voluntary. "There is no reason for the FDA to
revoke the GRAS status of salt," said Robert Earl, the Grocery
Manufacturers' senior director of nutrition policy. "It should look for
alternative approaches to support industry's efforts to reduce sodium in
food. There are lots and lots of companies trying to reduce salt." Five
years ago, ConAgra Foods, which produces Healthy Choice, Banquet, Chef
Boyardee, Orville Redenbacher and Smart Pop foods, began looking for ways to
cut sodium, said its director of nutrition, Patty Packard. "We found that we
could fairly easily remove 15 to 20 percent of sodium in most products,"
Packard said. "That totals 2.8 million pounds of salt that we have removed
on an annual basis." (The Washington Post) See
THIS LINK
Cancer patients may benefit from reporting symptoms online in real time
Traditionally,
clinicians have relied on information provided by cancer patients during
their office visits as the primary means of assessing patients’ symptoms and
side effects. However, potentially serious consequences could arise if
important symptoms go unreported during those visits because they occur
between appointments. A new study by researchers at Memorial Sloan-Kettering
Cancer Center (MSKCC) finds that even the sickest cancer patients are
willing and able to “self-report” symptoms using the Internet, thus
supplying key data in real time to their healthcare providers. Published in
the December 1, 2007, issue of the Journal of Clinical Oncology, the
study suggests a new direction in cancer care. According to the authors,
supplementing traditional office visit discussions with online patient
self-reporting can fill important gaps in clinicians’ knowledge and in doing
so may significantly improve patient safety and quality of care. “Cancer
care has become increasingly complex, causing office visits to become more
compressed. This makes it challenging for the clinician to comprehensively
assess each patient’s symptoms in that brief window of time,” said the
study’s lead author, Ethan Basch, MD, a medical oncologist at MSKCC.
“Because cancer therapies can be highly toxic, early detection of symptoms
and timely treatment is vital. What is exciting to us about online
self-reporting is that patients can alert clinicians to crucial symptoms in
real time.”
The research team
developed a Web-based system that patients in the study could access using
computers in waiting-room kiosks and at home to communicate their symptoms
directly to clinicians. Investigators adapted the National Cancer
Institute’s standard terminology for tracking patient toxicities in clinical
trials and translated it into patient-friendly language. The new terms were
uploaded to a secure Web site called Symptom Tracking and Reporting (STAR).
Participants used the system to report their cancer- and
chemotherapy-related side effects, including pain, fatigue, constipation,
diarrhea, nausea, vomiting, shortness of breath, and decreased mobility, as
well as their overall quality of life. From June 2005 through March 2006,
107 lung cancer patients receiving outpatient chemotherapy at MSKCC enrolled
in the study. Patients were followed for up to 16 months and 40 visits.
Patients were more likely to use the system if they had prior computer
experience; however, age, gender, and cancer stage had no effect on log-in
rates. Researchers found that 100 percent of patients used the waiting room
kiosks at some or all of their office visits. An average of 78 percent of
participants logged in to the system at any given office visit. According to
the findings, patients were satisfied with the system. Most respondents (98
percent) found STAR easy to use, 90 percent said it was useful, and 77
percent expressed that it improved the quality of their discussions with
clinicians.
Although the study focused on the patient experience, its results
suggest that self-reported data is a potentially valuable resource for
clinicians as well. At each follow-up office visit, symptom reports were
printed for clinical nurses. “All of the nurses who participated in the
study understood the reports and felt this information was highly useful for
clinical decisions, documentation, and discussions,” said Ann Culkin, RN, a
nurse on the Thoracic Oncology Service at MSKCC and a co-author of the
study. The nurses all noted that they had altered management based on
patient-reported information and alerts from STAR, including recommending
medication and lifestyle changes and arranging for additional physician
consultations. The authors concluded that online self-reporting is a
feasible long-term strategy for monitoring toxicities during chemotherapy,
even among very ill patients. However, explicit reminders to log in and
clinician feedback on self-reported information are important to maintain
patients’ continued interest and participation between visits.
Message from Dr. Margaret Chan, WHO Director-General, for
World AIDS Day
“The
first World AIDS Day was staged by WHO in 1988, at a time when the world was
waking up to this disease and its multiple catastrophic impact. Since then,
the face of the epidemic has changed in significant ways, and we are gaining
better insight every day. Some trends have been positive. Leaders in most
countries are fully awake to the threat. Awareness has brought commitment,
and resources continue to increase, including for the development of new
tools. This year’s report on the epidemic, jointly prepared by UNAIDS and
WHO, indicates that HIV incidence peaked in the late 1990s and prevalence
has been level since 2001. Data set out in this report further suggest that
prevention efforts are leading to fewer new infections, especially in young
people, and that greater access to treatment is contributing to fewer
HIV-associated deaths.
These positive trends mask some alarming changes in the epidemic.
My main message today is straightforward: do not forget Africa, and do not
forget women. Today, HIV/AIDS is overwhelmingly concentrated in sub-Saharan
Africa, where it thrives on and traps people in poverty. This region
accounts for over two thirds of people living with HIV and over three
quarters of HIV-associated deaths. In all regions, the proportion of women
living with HIV is growing. In sub-Saharan Africa, it now approaches 61%,
the highest in the world.” To read the full statement see
THIS LINK
Neopost introduces online shipping; web-based multi-carrier solution
allows users to ship packages at optimal cost
Neopost, a provider of mailing and shipping solutions, announces Neopost
Online Shipping. Through an agreement with United Parcel Service (UPS) and
the United States Postal Service (USPS), Neopost is able to provide its
customers with a new multi-carrier web-based shipping application that
allows users to easily compare shipping options. By taking advantage of this
advanced shipping tool, customers can access the best delivery options
available, reduce shipping costs and increase efficiency. Users will benefit
from the easy-to-use “Find Best Service” panel, while the built-in
CASS-certified address verification software minimizes the added cost of
returned packages. Enabling users to prepare a shipment in a simple three
step process, set default shipping service preferences and track multiple
orders from a central location, Neopost Online Shipping further increases
shipping productivity. The shipping solution sends automatic email
confirmation and tracking details to specified recipients, and lets users
view shipment histories and receive one combined activity report for all
shipments made during a specified date range. Neopost is a participating
member of the UPS Ready program which enables companies to integrate UPS
technologies and solutions within their offerings. To learn more, visit
THIS LINK or
THIS LINK
New corporate headquarters for HPN
Healthcare Purchasing
News has
moved its headquarters. Please note our new address: 2477 Stickney Point
Road, Suite 315B, Sarasota, FL 34231.
All other contact information remains the same: Phone:
(941)927-9345, FAX: (941)927-9588, Website:
www.hpnonline.com.
November
29, 2007
Download print version
Congress receives DHHS report on Medicare
hospital value-based purchasing program
Healthcare Supply Chain Standards Coalition
announces newest members
STERIS launches new generation Harmony LED
Surgical Lighting and Visualization System
Obesity epidemic in America shows signs of
plateauing;
rates stable among women for '05, '06
The
obesity epidemic that has been spreading for more than a quarter-century in
the United States
has leveled off among women and may have hit a plateau for men, as well,
federal health officials reported. While the proportion of adults who are
obese remains high at more than 30 percent, the rate in 2005 and 2006 was
statistically unchanged from the last time government researchers took a
national snapshot two years earlier. The findings confirm earlier
indications that the increase in obesity among women had stalled and
suggests that the same trend may have begun among men."This is
encouraging," said Cynthia L. Ogden of the
National Center for
Health Statistics, which released the new data."I think we can
say that obesity in women is stabilizing, and I'm optimistic that we may be
seeing a leveling off in men, as well." If both trends continue, it could
mean that the effort to stem the nation's growing girth could be starting to
pay off, Ogden
and others said."This doesn't show we've turned the corner on obesity, but
we might be at the corner," said William H. Dietz of the
Centers for Disease
Control and Prevention (CDC)."The first step in controlling any
epidemic is halting a rise in the number of cases, and this suggests that
might be happening."
But experts quickly cautioned that it is too soon to declare victory, noting
that the lull could be fleeting and that about 72 million adults are still
considered obese."This is still the biggest health problem of our time,"Gary D. Foster, director of obesity research and education at
Temple University,
who is president of the Obesity Society, said. The proportion of Americans
who are obese has increased dramatically in the last 25 years, doubling
among adults and tripling among children since 1980. Ogden and her
colleagues reported last year that the National Health and Nutrition
Examination Survey, an ongoing program tracking obesity and other major
health issues, showed that the increases may have stalled for American women
in 2003 and 2004. But they said more data were needed to confirm whether the
shift was real. The latest data collected from a nationally representative
sample of 4,400 Americans age 20 and older showed that, while the proportion
of women who were obese increased from 33.2 percent in 2003 and 2004 to 35.3
percent in 2005 and 2006, that difference was not statistically significant,
and the rate has been stable since 1999. Among men, Ogden and her colleagues
found that the rate increased from 31.1 percent to 33.3 percent, but that
change, too, was not statistically significant. But because the rate was
still up compared with 1999, Odgen said more data are needed to confirm the
stall. "I'm optimistic, but I'm wary about the trend for men until we see
more data," she said.
Ogden said the reasons that the epidemic might be easing were unclear, but
some have speculated that the nation may have reached a saturation point,
where most of those predisposed to obesity have already got there."Maybe
we've gotten as heavy as we can," she said. Efforts to get people to
exercise more and eat better may also be starting to pay off, the CDC's
Dietz said, citing data released last week showing a rise in exercise rates
and indications that eating patterns are improving and more employers are
focusing on helping employees control their weight. It is also unclear why
women appear to be leading the way, outpacing men at first in gaining weight
but now leveling off while men catch up. But experts said women tend to lead
the way in issues related to health."They also play a key role in most
families in terms of what kinds of foods come into the house and how it is
prepared." (Washington Post) See
THIS
LINK
Exercise may play role in reducing inflammation in
damaged skin tissue
In recent years, researchers at the University of Illinois have uncovered a
host of reasons for people to remain physically active as they age, ranging
from better brain function to improved immune responses. Now a new
U. of I. study points to yet
another benefit: a link between moderate exercise and decreased inflammation
of damaged skin tissue."The key point of the study is that moderate
exercise sped up how fast wounds heal in old mice,"said researcher K. Todd
Keylock, who noted that the improved healing response"may be the result of
an exercise-induced anti-inflammatory response in the wound."Keylock, now a
professor of kinesiology at
Bowling Green State
University, conducted the research as a doctoral student while working with
Jeffrey A. Woods, a U. of I. professor of kinesiology and integrative
immunology and behavior. The results appear in the current online edition of
the American Journal of Physiology: Regulatory, Integrative and
Comparative Physiology.
While previous research conducted at Ohio State University demonstrated a
correlation between wound healing response time and moderate exercise, that
research did not reveal a physiological cause for the reaction."That’s the
key part that our study adds, that the acceleration and healing were
associated with decreased levels of inflammation,"Keylock said."One of the
proposed mechanisms whereby aging adds to delayed healing is that the aged
have hyper-inflammatory response to wounding,"Woods said."The thought is
that the exaggerated inflammatory response slows the healing process. So, in
essence, what happened here is that the exercise reduced the exaggerated
inflammatory response."
Keylock explained that exercise may be contributing to that reduction in any
number of ways."Increasing blood flow during the time of exercise is one
(possibility),"he said."We’ve shown in the past that has an effect on how
certain immune cells, such as macrophages, function."And if exercise can
help decrease the amount of inflammatory cytokines put out by macrophages,
maybe that would help decrease the inflammation, and therefore, speed
healing."Cytokines are molecules that signal and direct immune cells, such
as macrophages, to the site of an infection, Woods said. Macrophages play
two critical roles in the wound-healing process, according to Keylock.
"First, they help fight any infection that may have gotten into the wound,
and they also help the wound repair itself and get back to its original
strength,"Keylock said.
Woods noted that if an exaggerated inflammatory response occurs when an
older person incurs a wound,"the proinflammatory cytokines that the
macropahges produce slow the rate of healing. And interestingly,"he said,
"macrophages are drawn to damaged tissue and hypoxic tissue, that is, tissue
that has low oxygen content. Wounds, because of the damage to the blood
vessels, typically are hypoxic, and macrophages are attracted to that. So
one potential thing that exercise might be doing, although we would need to
test this, is reducing hypoxia within the wounds. And it’s known that
hyperbaric oxygen therapy, which has been used with burn patients, speeds
wound healing in some people."The next step required to better understand
the mechanisms at work with respect to the exercise-healing relationship
will be to test the researchers’ theories in people."The public-health
message of this applies not just to older people, but also to diabetics,
those who are obese and many different populations at risk of having high
levels of inflammation,"he said.
Use of hyperbaric oxygen therapy decreases chance of
major amputations in diabetic patients
Hospital based wound
care clinics account for approximately $7.5 billion dollars in medical costs
annually. The market is expected to grow at a significant rate due to the
increase in diabetes, heart disease, and obesity. Hospitals with wound care
programs that utilize Hyperbaric Oxygen Therapy can anticipate a gain in
additional yearly revenue of an estimated 25%-40% and will typically see
profits in the first year, according to Perry Baromedical Corporation. Based
on current growth trends, by the year 2010 wound care clinics that offer
HBOT will exceed $13 billion dollars annually. Hyperbaric Oxygen Therapy (HBOT)
is used primarily for the treatment of non-healing wounds. The Centers for
Medicaid and Medicare Services recognize a total of 15 approved conditions.
Currently, only 30% of hospitals in half the states have an outpatient wound
care program that utilizes HBOT.
According to the
American Diabetes Association, more than 60 percent of non-traumatic lower
limb amputations occur in people with diabetes. In 2002, roughly 82,000 such
amputations were performed. The cost of treating non-healing lower extremity
diabetic wounds totals more than $200 million annually. Hyperbaric oxygen
therapy has been shown to decrease major amputations by more than 75%,
according to
Perry
Baromedical.
Based in Riviera Beach, FL, Perry Baromedical is a manufacturer of
hyperbaric oxygen chambers for over 45 years. See
THIS LINK
System of simplified, standardized dosing instructions
for prescription drug labels proposed
You have just been prescribed a new medication by your doctor and the
container label says:"take one tablet by mouth twice daily for 7 days." How
much and how often should you take your medicine? This might be easy for you
to answer, but 46 percent of adults misunderstand at least one prescription
container label, according to a 2006 study published in Annals of
Internal Medicine. Ninety million Americans, about half of the adult
population, suffer from low health literacy. The Institute of Medicine (IOM)
defines health literacy as the degree to which individuals can obtain,
process, and understand basic health information and services they need to
make appropriate health decisions. At the Sixth Annual National Health
Communication Conference co-sponsored by the American College of Physicians
Foundation (ACPF) and IOM, Alastair J.J. Wood, MD, FACP, proposed an
evidence-based system of simplified, standardized dosing instructions for
prescription medication container labels.
Dr. Wood, a member of the ACPF Medication Labeling Technical Advisory Board,
called for a Universal Medication Schedule (UMS) that standardizes
prescription medication dosing times on drug container labels so that
patients are told to take their medicine at the same four times per day,
such as breakfast, lunch, dinner, and bedtime. The UMS would replace the
current practice which either instructs patients to take the medicine a
specific number of times per day or at specific time intervals."The
benefits of the UMS include use of the same dosing schedule by patients,
physicians, and pharmacists; reduced variability in how the medication is
prescribed; reduced variability in how the prescription is interpreted by
the pharmacist; improved ability of patients to understand how to correctly
take their medications; and improved therapeutic outcome,"Dr. Wood said.
According to Michael Wolf, PhD, MPH, co-chair of the ACPF’s Medication
Labeling Technical Advisory Board, a randomized trial of 500 patients found
that understanding of the UMS label was five times greater compared to a
typical label.
The UMS idea comes in response to a recently released evidence-based ACPF
white paper,"Improving Prescription Drug Container Labeling in the United
States: A Health Literacy and Medication Safety Initiative,"that describes
problems with current medication labels and notes that poor patient
understanding of labels is prevalent and a significant safety concern. The
white paper, presented to the IOM Roundtable on Health Literacy on October
12, 2007, recommends the following standards for improving patient
understanding of prescription medication container labels: Use a UMS to
convey and simplify dosage/use instructions; Use explicit text to describe
dosage/interval in instructions; Organize label in a patient-centered
manner; Include distinguishable front and back sides to the label; When
possible, include indication for use; Simplify language, avoiding unfamiliar
words/medical jargon; Improve typography, use larger, sans serif font; When
applicable, use numeric vs. alphabet characters; Use typographic cues
(bolding and highlighting) for patient content only; Use horizontal text
only; Use a standard icon system for signaling and organizing auxiliary
warnings and instructions. See THIS LINK
Congress receives DHHS report on Medicare hospital
value-based purchasing program
On Monday Nov 26, the Secretary of Health & Human Services delivered to
Congress the Report on the Medicare Hospital Value-Based Purchasing Program
(VBP). It suggests ways to continue transforming Medicare into a prudent
purchaser of higher quality healthcare for Medicare beneficiaries."For
Medicare beneficiaries to get higher quality healthcare, our payment system
needs to encourage better care," said DHHS Secretary Mike Leavitt."Paying
hospitals for the quality of care they provide takes us closer to that
goal.""Value-based purchasing would benefit Medicare beneficiaries and
other healthcare consumers by encouraging higher quality hospital care,"said Kerry Weems, Acting Administrator, US Centers for Medicare & Medicaid
Services (CMS)."Under the plan, additional information would be collected
and publicly disseminated to patients and healthcare providers, so that they
can make better healthcare decisions."
The Report to Congress contains a plan for all facets of the proposed
Medicare Hospital VBP program and provides associated supporting materials.
The plan provides that quality of care information will be available to
patients on the CMS Hospital Compare website:
http://www.medicare.gov. Examples of hospital quality of care measures
that are currently reported by some hospitals include: how soon heart attack
patients are given aspirin after arriving at a hospital and how soon
pneumonia patients are given an antibiotic. Inclusion of a broad range of
such measures in value-based purchasing will enable Medicare beneficiaries
and other consumers to compare hospitals and make informed decisions about
where to seek care. In addition, the plan to implement the Medicare Hospital
VBP program builds on the foundation of the current pay-for-reporting
program, Reporting Hospital Quality Data for Annual Payment Update, which
ties a portion of the Annual Payment Update under the Medicare Inpatient
Prospective Payment System (IPPS) to a hospital's reporting on a defined set
of inpatient quality measures.
Officials said that under VBP, a percentage of the hospital's base operating
payment for each discharge (the diagnosis related group or DRG payment)
would be contingent on the hospital's actual performance on a specific set
of measures. The transition from pay-for-reporting to an incentive based
completely on performance would occur over a 3-year period. Public reporting
of quality measures on Medicare's Hospital Compare site, a key component of
the Reporting Hospital Quality program, would remain an essential component
of VBP. The proposed VBP program strengthens CMS' recently announced policy
on hospital-acquired conditions, including infections like methicillin-resistant
staphylococcus aureus (MRSA). By tying a portion of hospital payments to
actual performance on quality measures, VBP would provide additional
incentives for hospitals to prevent infections. The proposed VBP program
also ties directly to 2 of the 4 cornerstones of the Secretary's initiative
to build a value-driven healthcare system: measuring and publishing quality
information, and promoting the quality and efficiency of care.
Key components of the proposed program include: A measure development &
selection process, including selection criteria for choosing performance
measures for the VBP financial incentive & candidate measures to support
ongoing expansion of the measure set. A Performance Assessment Model that
incorporates quality measures, including clinical process of care, patient
perspectives of care, & clinical outcomes, to calculate a hospital's Total
Performance Score. The proposed model scores a hospital's performance on
each measure during a 12-month measurement period based on the higher of
attainment compared with national thresholds & benchmarks or improvement
compared with the hospital's own performance in the preceding 12-month
baseline period. The incentive is created by making a specified percentage
of the base operating payment amount for all discharges contingent on
performance. The percentage of incentive earned would be determined by the
hospital's Total Performance Score. Enhancements to the Hospital Compare
site to support expanded & more user-friendly public reporting. Ongoing
evaluation & monitoring efforts to assess experiences early in VBP
implementation, allowing for timely corrective action & building the
evidence base for future VBP programs in other settings.
Healthcare Supply Chain Standards Coalition announces
newest members
The
Healthcare Supply Chain Standards Coalition, a collaborative of
organizations representing the entire healthcare supply chain, today
announced that Owens & Minor Inc. (Richmond, VA) and Cardinal Health
(Dublin, OH) are the newest companies to join the critical effort to enable
the efficient delivery of quality patient care through the adoption of
industry data standards."We are excited to have Owens & Minor and Cardinal
Health join the Standards Coalition. The participation of these two leading
companies is instrumental to the continued success of the standards movement
in the healthcare supply chain,"said Joseph Dudas, chair of the Standards
Coalition and Mayo Clinic’s director of accounting and supply chain
informatics."Success for this initiative is contingent upon all partners in
the healthcare supply chain embracing and adopting a unified set of
globally-accepted standards, and we are pleased that Owens & Minor and
Cardinal Health have joined the conversation.”
With
these additions, the Standards Coalition now includes 28 leading healthcare
suppliers, providers, group purchasing organizations, distributors,
technology companies, industry associations and governmental entities united
to advance a more cost-effective and efficient healthcare supply chain.
Standards Coalition members are: Abbott, American Hospital Association,
Amerinet, Ascension Health, The Association for Healthcare Resource &
Materials Management (AHRMM), BD, Cardinal Health, The Coalition for
Healthcare eStandards, Consorta Catholic Resource Partners, The U.S.
Department of Defense, The U.S. Food and Drug Administration, Geisinger
Health System Foundation, GHX, HCA, Inland Northwest Health Services,
Intermountain Healthcare, Johnson & Johnson Healthcare System Inc., Lawson,
Mayo Clinic, McKesson Corporation, MedAssets, Mercy Health Systems ROI,
Owens & Minor Inc., Novation, Premier Inc., Sentara Healthcare, Strategic
Marketplace Initiative and University Hospitals. For more information see
THIS LINK.
STERIS launches new generation Harmony LED Surgical
Lighting and Visualization System
The
Harmony LED Surgical Lighting and Visualization System delivers 150,000 lux
of pure white light to the surgical field. The LED modules are
specifically engineered to provide a superior color rendering index (CRI) of
97, allowing you to see every detail in exposed tissue with clarity, comfort
and focus. The high performance lighthead is coupled to STERIS’s new
HD-capable suspension, bringing high definition images into the surgical
field with stunning image clarity and vivid color accuracy.
See THIS
LINK
November
28, 2007
Download print version
MedAssets Supply Chain Systems contracts with
National Healthcare Logistics
to provide new logistics model
Covidien’s SharpSafety Division wins national
award
for environmental achievement from
H2E
Study finds temporal artery thermometers
superior
Data seen as favorable for Abbott’s
proposed heart stent
The data continues to be favorable for
Abbott Laboratories’
new drug-coated heart
stent,
Xience V, which the company is hoping will win federal approval. The newest
data, released yesterday by the company and federal regulators, showed that
Xience outperformed
Boston Scientific’s
Taxus 2,
the market leader, in preventing coronary arteries from clogging again. The
study was conducted over a two-year period in more than 600 patients. There
was no difference between Xience and Taxus in terms of deaths or
heart attack
rates. But the newer stent’s advantage over Taxus in protecting against new
clogging led to fewer repeat procedures to keep patients’ arteries open.
That confirmed earlier results, covering shorter periods, which have raised
confidence on Wall Street that a federal advisory panel, meeting tomorrow,
will recommend that the
Food and Drug
Administration approve Xience.
Analysts predict that if the F.D.A. allows it on the market, Xience will
quickly become a best seller. The analysts estimate that Xience could gain
as much as 45 percent of a $1.8 billion American annual market for
drug-coated
stents
over the next few years. That would include Xience sales under a different
name, the Promus stent, which would be marketed in an arrangement with
Boston Scientific. The only two drug-coated devices currently approved for
use in the United States are the Taxus and
Johnson & Johnson’s
Cypher stent.
Medtronic
is expected to gain approval for its drug-coated Endeavor stent as early as
the end of December, and Wall Street anticipates that Xience could reach the
market by the summer. Analysts’ greatest concern has been that the advisory
panel that will meet tomorrow may recommend that Abbott be required to
submit more long-term safety data than it has accumulated, which could delay
approval.
Based in
part on experience in
Europe, where all four stents and several others
are on the market and prices have fallen below $1,000 for drug-coated
devices, some healthcare providers hope that the new devices will lead both
to improved outcomes for patients and a price war. The average price for the
devices in the
United States
now is more than $2,000. Endeavor and Xience both employ drugs that are
chemical relatives of the immune-system suppressant used in Cypher. Xience’s
drug, everolimus, is licensed from
Novartis,
and that company’s safety data is part of the package presented to federal
regulators for tomorrow’s meeting. An F.D.A. staff review of the data noted
that there was too little long-term evidence to reach any conclusions about
the chances that clots could form in Xience stents long after they were
implanted. Such clotting, a rare but potentially fatal problem, has been
linked to drug-coated stents now on the market. (The
New York Times) See
THIS LINK
Breast cancer risk underestimated for blacks, study says
The
formula that doctors use to calculate a woman's risk of breast cancer
underestimates the danger for black women most of the time and especially
for those age 50 and older, the age when they are most likely to benefit
from screening tests and protective drugs, according to the first major
reassessment of the widely used tool."We've been concerned about the
assumptions we had to make for African American women and other racial and
ethnic groups for some time," said
Mitchell H. Gail,
a biostatistician at the
National Cancer
Institute who led the reevaluation of the formula he himself
developed."It turns out that we have been underestimating the risk for
African American women." The advance could have broad implications for many
black women, prompting them to reconsider the danger they face from breast
cancer. That could translate into more women undergoing mammograms and other
examinations to detect the disease in its earliest, most treatable stages;
taking drugs such as
tamoxifen
to reduce their risk; and signing up for studies to identify better warning
signs or risk-reducing medicines."This could very much change the way we
counsel African American women," said Nancy E. Davidson, a breast cancer
expert who heads the American Society of Clinical Oncology."It will make
women better attuned to their personal risk and more eligible for standard
interventions, as well as for trials to improve prevention or detection."
The new findings, published online yesterday by the Journal of the
National Cancer Institute, are the latest revelation about how breast
cancer and other diseases can affect racial groups differently. A growing
body of evidence suggests that breast cancer tends to be much more
aggressive and deadly among black women, which could help explain why they
are more likely to die from it even though fewer of them get it. More than
19,000 African American women are diagnosed with breast cancer each year,
and nearly 6,000 die from it."This is extremely significant," said Lovell
A. Jones, director of the Center for Research on Minority Health at the
University of Texas M.D. Anderson Cancer Center."This is emblematic of a
broader problem, which is: We tend to make the assumption that one size fits
all. One size does not fit all."
The research examined the Breast Cancer Risk Assessment Tool,
known as the Gail model. Doctors use the model to calculate a woman's risk
by plugging in variables such as the age at which she started having her
period or had her first child and whether a mother or sister has had the
disease. Because the model was based largely on data collected from about
240,000 white women, Gail and his colleagues decided to try to develop a
more accurate alternative using data collected more recently on more than
3,200 black women, including more than 1,600 who had breast cancer. The
researchers tested the new version and showed that it would have accurately
predicted how many African American women in the federal government's
Women's Health Initiative would have developed breast cancer.
They also used both models to assess data collected from 20,278
African American women who were screened for eligibility for a landmark
breast cancer-prevention trial: the Study of Tamoxifen and Raloxifene (STAR)
trial. Overall the old model underestimated the risk in at least 90 percent
of all scenarios, particularly for older women, the team found. The old
model classified 14.5 percent of black women as candidates for the
prevention trial, whereas the new model would classify more than twice as
many, 33.3 percent, as eligible. The National Cancer Institute plans to use
the new model to update its calculator, which is online at
http://www.cancer.gov/bcrisktool, said Gail. Gail also said he plans to
try to develop similar alternative models for other groups, such as
Hispanics and Asians."Ultimately, what we want and what we need are tools
that are meaningful for the individual," said Carolina Hinestrosa of the
National Breast Cancer Coalition, a D.C.-based advocacy group. (Washington
Post) See
THIS LINK
CT scans to determine heart disease in the emergency room
may save time, money
In the future, patients who arrive at a hospital Emergency Department
complaining of chest pain may be diagnosed with a sophisticated CT scan. If
the diagnosis is negative, the patient can go home, and the total time at
the hospital will be much shorter than it is today. That is the theory
behind a study being presented at the RSNA by Rajan Agarwal, M.D., a
resident in Radiology at the University of Pennsylvania School of Medicine.
"The cost of chest pain triage (where patients in the Emergency Department
are prioritized based on their symptoms) and management has been estimated
to be as high as $8 billion annually, with most patients ultimately not
having to remain in the hospital. Therefore,"Dr. Agarwal states,"there is
a tremendous opportunity to reduce healthcare costs if we can demonstrate
the cost-effectiveness of this procedure with low-risk patients who go to
the Emergency Department."Further, this reduced length of stay improves
resource utilization by decreasing costs, improving inpatient bed shortages
and reducing crowding in the Emergency Department.
In the study, a total of 202 patients, older than age 30, who came to the
Emergency Department at the Hospital of the University of Pennsylvania
between October 2005 and February 2007, and whose primary complaint was
chest pain, were given an electrocardiogram and a specialized CT scan.
Patients were excluded from the study who were allergic to an iodine
contrast, had an abnormal heart rate or could not take beta blockers.
Patients who were admitted to the hospital were also excluded."We looked to
determine the length of stay and times between critical points in the
treatment of low-risk patients,"Dr. Agarwal explained."Patients were
divided into three areas: all patients who received CT scans; patients who
received the scans during
7 a.m. to 6 p.m. (ON hours) when the scans were available and
6 p.m. to 6 a.m. (OFF hours) when the scans were not available. Results showed that
patients who came into the Emergency Department during ON hours spent a
total of 9 hours and 39 minutes in the department before being discharged;
patients who came to the Emergency Department during OFF hours spent a total
of 12 hours and 15 minutes in the unit. Patients who were referred to the
CDU (Clinical Decision Unit, which provided the CT scan, as well as
additional evaluation and observation) spent 21 hours and 50 minutes in the
hospital if they came during ON hours and 18 hours and 38 minutes if they
came during OFF hours. Future studies, Dr. Agarwal suggests, will look at
all the costs, including lab tests and diagnostic tests, associated with a
low-risk patient’s visit to the Emergency Department.
Another complication for
gastric bypass patients
Obese patients who suffer complications after gastric bypass surgery may
face further health risks because their weight exceeds the limits of
diagnostic imaging equipment, according to a study presented today at the
annual meeting of the Radiological Society of North America (RSNA). In the
study, approximately 27 percent of patients weighing more than 450 pounds
needed imaging to diagnose a problem after surgery and could not be
accommodated because of their size.
"When patients weigh more than 450 pounds, standard diagnostic imaging often
cannot be used,"said Raul N. Uppot, M.D., an assistant radiologist at
Massachusetts General Hospital (MGH) and instructor of radiology at Harvard
Medical School in Boston."In these cases, physicians must resort to other
means of diagnosis such as exploratory surgery or using less accurate or
more invasive techniques.”
Dr. Uppot and colleagues conducted an eight-year retrospective study of all
patients weighing more than 450 pounds who underwent a gastric bypass
procedure at MGH between June 1999 and April 2007. Patient imaging usage and
clinical course were tracked using electronic health records and evaluated
to determine the outcomes of those who, based on their weight, were denied
their physicians’ first choice of imaging. The researchers found that 12 (27
percent) of the 44 patients who weighed more than 450 pounds required
postsurgical imaging because of a clinical condition, but were denied
because they were above the weight restriction for the equipment. Four
patients who could not be evaluated with imaging for suspected leaks were
required to return for surgery. Two additional patients with suspected lung
blood clots could not undergo a chest CT. Of two patients who came in with
nonspecific abdominal pain, one was evaluated with ultrasound and the other
one had a barium swallow test. Because imaging was not an option, one
patient who suffered trauma underwent exploratory surgery in lieu of
noninvasive imaging. Another patient was denied a chest CT and received no
further imaging evaluation.
MedAssets Supply Chain Systems contracts with National
Healthcare Logistics
to provide new logistics model
MedAssets Supply Chain
Systems has signed a contract with National Healthcare Logistics (NHCL) to
provide its customers with access to the new logistics model pioneered by
National Healthcare Logistics, Inc. Effective November 1, 2007, the NHCL
logistics model combines streamlining external distribution with
centralization of internal distribution through an"Integrated Service
Center"or"ISC."In addition to product distribution, as many supporting
services as possible are integrated into the ISC. Acute care,
multi-hospital & clinic systems in the US, referred to as Integrated
Healthcare Delivery Networks or IDNs, spend between 40 billion and 60
billion dollars per year for medical supplies. In addition to purchasing
this quantity of supplies, these IDNs also pay between 10 billion and 15
billion on supporting, ancillary services, such as laundry, sterilization
and reprocessing, housekeeping, biomedical engineering, and more. Taken
together, that is a total spend by IDNs for supplies and services of between
50 billion and 75 billion dollars per year. In addition, the cost of
healthcare in the US has reached crisis proportions, and an inefficient
Healthcare Supply Chain contributes to that crisis.
National Healthcare Logistics reengineers the current supply chain model to
correct its inefficiencies, and the company’s new logistics model purports
to save millions of dollars a year in both medical supply and ancillary
services cost, plus labor cost, transportation cost, cost of reprocessing
materials and instruments, and more. National Healthcare Logistics launched
its first new Integrated Service Center model in 1998 in Fort Myers, FL, and
the model was designated"The HUB & SPOKE PROGRAM.” The ISC is the"HUB"and
the"SPOKES"are the many ancillary services integrated into the ISC/HUB
operations. NHCL partners with IDNs to implement its Hub & Spoke Model which
reengineers the supply chain of the IDN, and thus generates millions of
dollars in savings and revenue generation. NHCL’s new logistics model was
built upon the pioneering work of NHCL founders going back to the 1980s. The
current model is based upon solid logistics principles, and can be
implemented on a fast track basis through partnerships or joint ventures.
For more information, see
THIS LINK
Covidien’s SharpSafety Division wins national award for
environmental achievement from
H2E
The
SharpSafety Division of Covidien Ltd. recently was honored by Hospitals for
a Healthy Environment (H2E) with its 2007 Champions for Change award. This
prestigious award recognizes SharpSafety for improvements in its own
environmental performance at its sharps container manufacturing facility in
Illinois and for industry leadership in environmentally responsible
healthcare. Covidien’s SharpSafety facility, located in Crystal Lake, IL,
has taken significant steps to demonstrate sustainable environmental
responsibility for its sharps disposal containers, while seeking to maintain
a high level of safety and clinical value for its customers including:
Recycling Programs; Reclaim Program; Closed Loop Water and Oil System;
Product Weight Reduction; and a Facility Lighting Upgrade. For more
information See THIS LINK or
THIS LINK
Study finds temporal artery thermometers superior
Exergen Corporation,
a
manufacturer of a line of patented infrared thermometers for professional
and consumer use, announced the publication of an independent study
comparing the accuracy and precision of all non-invasive temperature
measurement methods in a critical care setting. Published
in the September issue of the American Journal of Critical Care by
Lari Lawson, R.N., M.N.; Elizabeth J. Bridges, R.N. PhD., C.C.R.N.; Janie
Shively, R.N. B.S.N.; and Vanessa Sochulak, R.N., B.S.N, the study found
that temporal artery and oral thermometers registered temperatures more
accurately than other non-invasive methods when compared to core body
temperature. The study took place at the University of Washington Medical
Centers in
Seattle over a six
month period. It compared the pulmonary artery temperature of 60 adults
(with pulmonary artery catheters in place because of critical need) with
temporal artery, oral, ear-based and axillary thermometers. The study’s
purpose was to describe the accuracy and precision of four noninvasive
methods compared with core body temperature. It was the first study to
compare the entire four non-invasive thermometer methods together.
The results showed
that temporal artery and oral temperature measurements agreed most closely
with the pulmonary artery temperature. Axillary measurements underestimated
pulmonary artery temperature. Ear measurements were least accurate and
precise. It was also noted that patient intubation (use of a respirator)
affected the accuracy of oral measurements; diaphoresis (perspiration) and
airflow across the face were noted as conditions that could affect temporal
artery measurement. However, the study also showed that a combined forehead
and behind-the-ear method gave more accurate readings than temporal artery
measurements obtained from the forehead alone. This latest study showed that
the combined forehead and behind-the-ear method had the greatest accuracy of
all. The Lawson study is the 24th peer-reviewed abstract or full
study on temporal artery thermometers since the product was introduced in
2000. Exergen’s TemporalScanner, available for consumer or professional use,
is the world’s first temporal artery thermometer, delivering an accurate
temperature comparable to one taken rectally in two seconds. See
THIS LINK
November
27, 2007
Download print version
Scans of pregnant women on the rise
AMA meeting: Principles aimed at better
physician-hospital relations
Atlanta hospital moves to unburden itself of debt
Suits settled on pricing for
medical devices
A legal
battle between a Plymouth Meeting research firm and a
medical-device-maker over whether hospitals can be required to
keep price information confidential has ended in a truce.
Details of the settlement reached Saturday night are
confidential.
A lawsuit filed by ECRI Institute, a nonprofit organization
that collects healthcare information, and a countersuit by
Guidant Corp., a medical-device-maker, were scheduled to go to
trial in federal court in Philadelphia Dec. 3. The broader
public-policy issue, whether the prices hospitals pay
suppliers are a trade secret or information that should be
publicly disclosed to hold down medical costs, remains
unresolved. That question is also at the heart of a bill
introduced last month by U.S. Sens. Arlen Specter and Charles
Grassley. It would require companies that make implantable
medical devices, including heart defibrillators and artificial
joints, to report prices to the government each quarter. That
information would then be made public.
In the lawsuits, Guidant argued that its deals with hospitals
were confidential, precluding the sharing of price information
with anyone. ECRI sued for the right to gather price
information from hospitals, and then share average and low
prices."We think we have a right to benchmark data and
publish it," said Jeffrey Lerner, ECRI's president. He
declined to discuss the settlement, but said his organization
planned to continue collecting and sharing information about
heart-device prices, including Guidant's. Member hospitals
provide the price data voluntarily, he said, and will need to
make sure they are not violating contracts."Hospitals have to
be very alert to whatever they've signed off on," Lerner said.
Specter and Grassley argue that high device prices are passed
on to the government and other payers and that price
negotiations are currently one-sided because hospitals cannot
get enough information."The rising cost of healthcare and
health insurance is a problem for consumers, small-business
owners, large employers, and union health and welfare funds," Specter said when the bill was introduced."This bill says
that, if you want to do business with the federal government,
you have got to show us your prices." Specter's office said
the ECRI suit was not the impetus for the bill.
Dominic Panacio, director of materials management for
Doylestown Hospital, said his hospital spends $8 million to $9
million a year on implantable heart devices, which he
described as the most expensive"single-use" items he buys.
Confidentiality clauses are rare outside of this category, he
said."You're not going to see a lot of it, because everybody
knows what everybody's paying," he said. His hospital agreed
to such a clause with Medtronic Inc., a Guidant competitor,
because it offered an especially good deal. As a general rule,
though, he said he thought hospitals would be better off
without such limitations."It should be more competitive," he
said. (The Philadelphia Inquirer) See
THIS LINK
21
hospital units receive AACN Beacon Award;
Units recognized for
critical care excellence
The
American Association of Critical-Care Nurses (AACN) announced that 21 units
from 17 hospitals in 13 states recently received the Beacon Award for
Critical Care Excellence. This award recognizes the nation's top hospital
critical care units. Following are the units by state and institution that
achieved Beacon Award status in Fall 2007:
Connecticut -
Hartford Hospital, Hartford, Bliss7i-SICU;
Florida -
Munroe Regional Medical Center, Ocala,
ICU
(Two-time recipient); St. Vincent's Medical Center,
Jacksonville,
3N Intensive Care Unit
(3500 ICU);
Kansas - The
University of Kansas Hospital, Kansas City, Medical Intensive Care Unit
65; Maine - Maine Medical Center, Portland, Special Care Unit,
Michigan - Chelsea Community Hospital, Chelsea, ICCU;
Montana - Billings Clinic, Billings, ICU; New Jersey -
Morristown Memorial Hospital, Morristown, Intensive Care Unit (Two-time
recipient); New York - St. Joseph's Hospital Health Center,
Syracuse, Medical Intensive Care Unit; Ohio - Aultman
Hospital, Canton, CVSICU (Two-time recipient); Riverside
Methodist Hospital, Columbus, Intensive Care Unit; University
Hospitals Case Medical Center (Two units recognized), Cleveland,
Medical Intensive Care Unit (Three-time recipient), Surgical
Intensive Care Unit; Pennsylvania - Hospital of the University of
Pennsylvania (Three units recognized), Philadelphia, Cardio
Thoracic Surgical Intensive Care Unit (CTSICU),
Neuro
Trauma Surgical Intensive Care Unit,
Rhoads 5
Surgical Intensive
Care Unit (Two-time recipient);
PinnacleHealth System Harrisburg Hospital, Harrisburg, MSICU (Two-time
recipient); Virginia - Inova Fairfax Hospital (Two units
recognized), Falls Church, Neuroscience Intensive Care Unit, Trauma
Intensive Care Unit;
Washington -
Harborview
Medical Center, Seattle, Burn Intensive Care Unit (BICU);
Wisconsin - Aspirus Wausau Hospital, Wausau, Cardiac Intensive Care
Unit.
As
Beacon Award recipients, these units have demonstrated quantitative success
when measured against evidence-based national criteria in areas that impact
patient care: Recruitment and retention; Education, training and mentoring;
Research and evidence-based practice; Patient outcomes; Leadership and
organizational ethics and Healing environment. "The commitment to
high-quality standards and dedication to exceptional care of patients and
their families have brought clear, valuable recognition to these units and
institutions. Earning a Beacon Award sends a clear message that these units
are providing exceptional care and that their commitment to evidence-based
practice is unwavering,"said Dave Hanson,
RN, MSN, CCRN, CNS, President, AACN. "They
have set examples that serve as beacons for other hospitals and healthcare
facilities to use in navigating the rough waters of acute and critical care
nursing."The latest awards bring the total of Beacon units to 101 in 30
states. More than 200 units are in the process of applying at any given
time. The award is presented twice yearly. For
more information on the Beacon Award or AACN, call (800)
899-2226. Applicants are not required to be a member of AACN to receive a
Beacon Award. Application information and
requirements are available at THIS LINK >
Beacon Award.
R.I. raps hospital for errors in surgery; Facility is
fined after latest mix-up
The Rhode Island Department of Health reprimanded Rhode Island Hospital
yesterday, and fined it $50,000, for its third wrong-site surgery this year,
the most recent involving an 82-year-old patient in the neurosurgical
intensive care unit. The incident at the Providence hospital occurred
Friday, when a resident, a doctor in training, began drilling into the right
side of the patient's head during a bedside procedure. A CT scan had shown
bleeding on the left side of the patient's brain. The resident realized the
mistake, closed the initial incision, and performed the procedure on the
left side. The hospital reported the error to the health department, which
conducted a surprise inspection Sunday. State health officials had ordered
the hospital on Aug. 2, 2007, to improve its procedures, because of a pattern of wrong-site surgery
dating back to 2001. This latest incident is the hospital's fourth
wrong-site surgery in six years, all involving brain operations.
"We are extremely concerned about this continuing pattern," said Dr. David
R. Gifford, director of the agency, in a statement yesterday."We have not
seen an adequate response in the hospital's system and protocols since the
last order was issued. While the hospital has made improvements in the
operating room, they have not extended these changes to the rest of the
hospital." In July, a surgeon also operated on the wrong side of the brain
of a patient who had internal bleeding. Following that incident, the health
department ordered the hospital to hire a consultant to review policies and
procedures related to neurosurgical services. Health officials also required
the hospital to have a second physician review the proper site for all
surgical cases prior to surgery. The hospital said in a statement yesterday
that it had put the policy in place for procedures done in the operating
room. As a result of the latest incident, all intra-cranial neurosurgery
procedures will have an attending physician present for the entire
procedure, hospital officials said. A"time out" process to verify the site
for significant procedures in the operating room or at the bedside will
include a physician, a nurse or physician assistant, as well as the
resident. (Boston Globe)
Radiation risk; Doctors concerned about
the exploding use of CT scanners
Dr. David Bor, chief of medicine at the Cambridge Health Alliance, had been
concerned for years about the financial cost of the rampant use of CT scans.
But several months ago, after a conversation with the system's head of
radiology, he started to worry about another kind of cost: radiation
exposure to patients. Bor sent a memo to 150 doctors in his department in
June, warning them about overreliance on CT scans and about the potential
risk to patients; he recently invited in a radiation specialist to educate
physicians; and he has altered his medical practice. Bor said, for example,
that he no longer automatically orders a CT scan to diagnose abdominal pain
in a patient with previous bouts of kidney stones."I am much more likely to
suggest they have an ultrasound," which is harder to interpret but does not
emit radiation, he said.
The use of CT, or computed tomography, is soaring. The number of scans
performed on patients nationwide grew from 20 million in 1995 to 35 million
in 2000 to 63 million in 2005. The rise has been fueled by improvements in
the technology that give doctors clearer, more detailed pictures of the
body, making CT an invaluable diagnostic test. Companies are coming out with
faster scanners that take more comprehensive pictures; Brigham and Women's
Hospital recently bought one of the first 256-slice scanners in the world,
which can take a picture of the entire heart and surrounding blood vessels
in seconds. And doctors and hospitals are using CT scans to diagnose
patients complaining of headaches, abdominal pain, chest pain, and to
monitor cancer patients for their response to drugs and for recurrence after
treatment. Early data show that a CT scan of the colon may be as effective
as a colonoscopy for finding polyps that could lead to colon cancer, and if
these results are borne out, tens of thousands more people could get regular
CT scans. Researchers also are studying the effectiveness of CT scans in
screening smokers and former smokers for lung cancer.
But some physicians are starting to sound alarm bells about radiation
exposure from the expanding use of CT scanning. They are adopting practices
to reduce the number of patients scanned and the number getting repeat
scans. A chest CT, for example, exposes a patient to about 8 millisieverts
of radiation - 80 to 400 times the radiation exposure from a chest X-ray
and, recent studies show, close to the lowest doses received by Japanese
survivors of the atomic bombs who were farthest away from the blasts. These
survivors, irradiated with 5 to 20 millisieverts, have demonstrated a small
but measurable increase in their lifetime risk of dying from cancer. Dr.
James Brink, chairman of diagnostic radiology at the Yale University School
of Medicine and a member of the National Council on Radiation Protection and
Measurements, a group charted by Congress to make safety recommendations
said he is most concerned about patients, such as those with chronic kidney
stones or Crohn's disease, who are scanned"over and over and over again."Younger patients are at higher risk than elderly patients, because they have
more years to develop radiation-related cancer, which can take decades to
appear. (The Boston Globe) To read the original article see
THIS LINK
Scans of pregnant women on the rise
Pregnant women are exposed to twice the amount of radiation from medical
scans as they were a decade ago, a new study has found. Although the total
amount of radiation exposure to pregnant women is still relatively low, the
doubling effect in just a decade is the latest indicator that medical scans
are exposing patients to record amounts of ionizing radiation, a type of
radiation that can alter cells and lead to health risks, including cancer.
Researchers from Brown University's Warren Alpert School of Medicine looked
at the use of several imaging techniques that can expose a patient to
ionizing radiation, including nuclear medicine exams, CT scans and
plain-film X-rays. They studied more than 3,200 patients who had received
scans from 1997 to 2006, some of whom were pregnant. The investigators found
that during this time, the number of imaging studies that would expose
pregnant women to radiation increased by 121 percent. The findings are being
presented today at the annual meeting of the Radiological Society of North
America.
The
greatest increases were in the number of CT scans performed, although such
scans aren't routinely done during pregnancy. The most common scan performed
during pregnancy, an abdominal ultrasound, does not expose the patient or
fetus to ionizing radiation. The data showed that the use of scanning tests
is increasing far more rapidly than the number of deliveries, which rose
only 7 percent during the period. Earlier this year, a
government study
found that the per-capita dose of potentially hazardous ionizing radiation
from clinical imaging exams in the United States increased almost 600
percent in the last 25 years. CT scans expose patients to far more radiation
than standard X-rays. The notion that pregnant women are also being scanned
at an increasing rate is even more troubling, given that exposure to excess
radiation can severely damage a developing fetus.
Some of the rise is due to the fact that better technology is now available
to diagnose abnormalities, said Dr. Elizabeth Lazarus, assistant professor
of diagnostic imaging at Brown. She added that hospitals and insurers also
want to make fast diagnoses to shorten hospital stays and improve care,
which may prompt doctors to order scans more often. In some cases the
benefits of a scan to both mother and baby far outweigh the risks, but the
latest data suggest doctors are not always being circumspect before ordering
scans of pregnant women. "I want to assure patients that CT can be a safe,
effective test for pregnant patients,"said Dr. Lazarus. "However, there are
alternatives that should at least be explored. Pregnant patients should ask
their doctors about other imaging or diagnostic tests that may not expose
the fetus to radiation."(The New York Times)
AMA meeting: Principles aimed at better
physician-hospital relations
The American Medical Association House of Delegates adopted 12 detailed
principles aimed at easing strained physician-hospital relationships,
protecting medical staff self-governance and improving healthcare quality
and patient safety. Until last month's Interim Meeting, the AMA had no house
policy outlining the organization's stand on physician-hospital relations.
Physicians believe the new principles guiding how they work with hospital
leaders should"expedite discussions with the AHA, the Joint Commission and
the Centers for Medicare & Medicaid Services and ultimately signal to the
healthcare community that there is an urgent need to find and build upon
common ground between physicians and hospitals," the adopted resolution
says."This is a vital struggle," said Brian D. Johnston, MD, a California
emergency physician and delegate from the Organized Medical Staff Section.
"If physicians lose self-governance, our patients will be harmed, our
hospitals won't function as well and we won't be able to practice medicine
to the best of our ability."
The new policy comes on the heels of a pitched battle between organized
medical staffs and hospitals over revisions to Joint Commission Standard
MS.1.20, approved in June. The standard centers on what components of
governance must be included in organized medical staff bylaws, and therefore
voted on and approved by physicians, and what can be addressed in the
administrative rules, regulations and policies that hospital boards and
medical executive committees decide. Physicians are largely perceived to
have won that struggle, and the AMA's newly adopted principles, which are
four pages long, are aimed at further solidifying doctors' stance in future
negotiations. At the heart of the matter is a conflict"between what medical
staffs believe is necessary for patient care and patient safety versus what
the board of a hospital wants," said William B. Monnig, MD, an alternate
delegate for the Kentucky Medical Assn. and former OMSS chair.
In other house action related to hospitals, delegates directed the AMA to
press the Joint Commission, hospitals and health systems to interpret the
accrediting body's patient-safety standards consistently, especially the
commission's controversial standard on medication reconciliation. William E.
Jacott, MD, the Joint Commission's special adviser for professional
relations and a former AMA trustee, said the body"believes that medication
reconciliation remains a very important national patient-safety goal." He
added that the commission is"well on the way to satisfying concerns" that
delegates expressed about surveyors' inconsistency in interpreting the
standard. Surveyors receive targeted training on a continuing basis, Dr.
Jacott said. He noted that recent feedback from more than 50 healthcare
organization representatives could lead to changes in how the Joint
Commission evaluates the medication reconciliation performance of inpatient
versus ambulatory settings.
The house also authorized the AMA Board of Trustees to take steps to protect
medical staff members' financial data disclosed on conflict-of-interest
statements from being used by hospitals to punish doctors for referring
patients outside the hospital or health system, a process sometimes called
economic credentialing. There have been"multiple examples of abuses of
confidentiality and accumulation of financial data" on doctors, said
California alternate delegate Peter N. Bretan Jr., MD, in support of AMA
action on the issue. The resolution, referred to the board, calls on the
AMA's representatives to the Joint Commission to push for a standard
protecting the confidentiality of medical staff members' proprietary
financial information. The measure also calls on the AMA to press for state
and federal regulations on the issue. (American Medical News) See
THIS LINK
Atlanta hospital moves to unburden itself of debt
The politically appointed board of Atlanta's troubled charity hospital
effectively voted itself out of business Monday, the first step in at least
a short-term escape from the insolvency that had threatened the region's
only top-level trauma center. Without the financial bailout made possible by
the vote, the hospital, Grady Memorial, was at risk of not meeting its
payroll, perhaps by the end of the year, hospital officials had warned.
Though Grady, like most public
hospitals,
has faced intermittent financial crises in the past, this one has generated
real
anxiety
because of its roots in a collision of national forces, including the
unchecked growth of uncompensated care and deep cuts in government
reimbursements. Political leaders and medical officials have worried that
Grady, woven into Atlanta's social fabric since 1892, might follow Martin
Luther King Jr.-Harbor Hospital in Los Angeles County as a casualty in 2007.
If so, the consequence would be a "patient tsunami"at other area hospitals,
the Metropolitan Atlanta Chamber of Commerce said in a report earlier this
year.
Grady, which supplies the region with its only 24-hour trauma center as well
as poison control and burn units and large clinics for
AIDS and
sickle cell anemia,
has operated in the red for 10 of the last 11 years. It is expected to run a
deficit of $50 million to $55 million in this year's $730 million budget.
The hospital owes an accumulated $63 million to its biggest creditors, the
medical school at
Emory University
and the Morehouse School of Medicine, which provide its doctors and have
threatened to train residents elsewhere. Republican state legislators had
threatened a state takeover if local officials did not reconstitute the
hospital's governance structure. Following a meeting marked by chants and
protest, the 10-member Fulton-DeKalb Hospital Authority voted unanimously to
hand daily control of Grady and its affiliated clinics and services to a
nonprofit corporation to be formed for that purpose. A Chamber of Commerce
task force had
advised earlier this year that a governance change was needed to remove the
hospital from the control of the elected commissioners of Fulton and DeKalb
Counties and to restore the confidence of lenders, foundations and Georgia's
Republican leaders. Advocates for patients have warned that the hospital
would become less responsive to community needs if it was operated by a less
political board. But with few other options and Grady's fiscal condition
worsening, the authority felt it had little choice. "In three weeks, our
cash position would have been zero,"the authority's vice chairman, Dr.
Chris Edwards, said at the meeting Monday.
In its resolution, the hospital authority, which would continue to own
Grady's buildings and land, made explicit that its willingness to hand over
control depended on substantial financial commitments from both the public
and private sectors. Before the lease, to be executed by Dec. 31, becomes
effective, the hospital must receive written commitments for a capital
infusion of $200 million from businesses and philanthropies. In addition,
the resolution demands that state leaders provide written support for $30
million in new state aid. A. D. Correll, a former chairman of the
Georgia-Pacific Corporation and the co-chairman of the task force, said he
considered the vote a critical first step, though with provisos attached.
Correll said a single anonymous donor had agreed to give the hospital $200
million if the donor approved of the governance system changes. He said he
was confident that the private sector could raise an additional $100 million
in two or three years. (The New York Times) See
THIS
LINK
November
26, 2007
Download print version
'Mismatched' prostate cancer treatment more
common than expected
Siemens delivers molecular imaging solutions
across clinical specialties
Philips unveils computed tomography (CT)
system that scans the heart in two beats
Olympus America introduces new endoscopic ultrasound reprocessing video
Gene therapy study is allowed to resume;
woman's death had raised concerns
The Food and Drug Administration has given a Seattle company
permission to resume its human tests of an experimental,
gene-based arthritis treatment whose safety came into question
this summer after a 36-year-old study participant died.
Although a final report from outside investigators will not be
made public until Dec. 3, the regulatory agency has concluded
that the death was not related to the treatment, said a
spokeswoman for the company, Targeted Genetics. As many as 35
patients are still eligible to get one more injection of the
experimental product, the spokeswoman, Stacie Byars said,
adding that the company recognizes that some may opt out
because of the death. The treatment involves the injection of
viruses engineered to produce an immune-suppressing protein.
The protein helps block the inflammatory process that goes
awry in the joints of people with rheumatoid arthritis.
Jolee Mohr, of Taylorville, IL, died July 24, about three
weeks after getting trillions of the genetically engineered
viruses injected into her right knee as part of an experiment
sponsored by Targeted Genetics. She first became ill the day
she got that injection, eventually dying of a fungal infection
and massive internal bleeding. The timing of her death raised
the question of whether the treatment contributed to her
death. But investigations by company scientists, a National
Institutes of Health expert panel and doctors at the
University of Chicago, where Mohr was transferred before she
died, found no evidence that the treatment was at fault. Kyle
Hogarth, an intensive-care unit physician at the University of
Chicago who cared for Mohr and was involved in the
investigation, said yesterday that he feels reasonably certain
that the treatment did not kill her. But he is still bothered
by the study's design, he said, because it allows participants
to keep taking prescription medications that cannot be
distinguished from the immune-suppressing protein made by the
treatment's gene-modified viruses. That makes it impossible to
fully sort out whether problems that arise during the
experiment may be caused by the treatment or the drugs the
subjects are taking, he said.
Although conventional arthritis medications can, on rare
occasions, make patients especially susceptible to fungal
infections, Hogarth and others have questioned whether the
gene treatment left Mohr especially defenseless."I think they
have a horrible design," Hogarth said."It muddies the
picture." Hogarth also echoed a concern raised by others in
the course of the investigation: that Mohr was recruited into
the study by her personal physician, who stood to profit from
each new patient he enrolled. Robb Mohr, Jolee Mohr's widower,
said he was unaware that the company had gained permission to
resume the study. He said he and his lawyers have not yet had
substantive talks with the company, pending the release of
results from the National Institutes of Health investigation.
Those results, which are to be made public at a meeting a week
from today, conclude that the engineered viruses do not appear
to have replicated in Mohr's body, an initial concern.
Byars said the protocol for the experiment has been changed.
From now on, she said, participants will not be allowed to get
an injection of the experimental product if they have a fever,
as Jolee Mohr did the day she got her shot."We know this has
been incredibly tough on the Mohr family," Byars said,"and we
again offer our condolences to the family." (The Washington
Post) See
THIS LINK
FDA panel to review Tamiflu's effect on brain
A
Food and Drug Administration panel on Tuesday will review reports of
abnormal behavior and other brain effects in more than 1,800 children who
had taken the flu medicine Tamiflu since its approval in 1999, including 55
in the U.S. Twenty-two of the U.S. reports were considered"serious," with
symptoms such as convulsions, delirium or delusions, said Terry Hurley,
spokesman for drugmaker Roche Laboratories.
None of the U.S. cases
resulted in death. But in Japan, Hurley said, five deaths have been reported
in children under 16 as a result of neurological or psychiatric problems.
"Four were fatal falls, and one was encephalitis in a patient with
leukemia," he said. In addition, in people ages 17 to 21, there were two
deaths in Japan, one a"fatal accident with abnormal behavior," Hurley said,
and the second as a result of encephalopathy, a brain infection.
Seven adult deaths attributed to neuropsychiatric problems also have been
reported in Japan. But Hurley said there is no evidence Tamiflu caused the
episodes and noted that similar symptoms have been reported in flu patients
who had not taken Tamiflu. He said clinical studies have found no increased
risk for psychiatric or neurologic disturbances, and the company's
evaluation of scientific data found no"potential mechanisms for Tamiflu to
cause (central nervous system) effects." He said the company is doing
further studies. The possible association between Tamiflu and
neuropsychiatric effects was first reported in Japan, and in March, the
Japanese government issued a safety warning restricting the drug's use in
adolescents.
Japan has been the major market for Tamiflu, accounting for 75% of the 48
million prescriptions written. The drug's Japanese distributor, Chugai
Pharmaceutical Co., announced this month that it would cut by half the
supply it had been planning to sell this winter, from 12 million to 6
million courses of treatment. In a statement, the company said demand
dropped after reports in February that"several teenage patients with
influenza who were also taking Tamiflu had fallen from buildings after
taking the drug." Hurley said in an e-mail that 1,745 of the 1,808 reports
of problems associated with Tamiflu are in Japan. He said 81% of all reports
were"defined as non-serious." In the U.S., Hurley said, 2.85 million
Tamiflu prescriptions have been written since 1999. A year ago Roche added a
warning to its package insert label saying"people with the flu,
particularly children, may be at an increased risk of self-injury and
confusion shortly after taking Tamiflu," and their behavior should be
monitored. The anti-viral medication is licensed to treat or prevent flu in
patients older than 1 year. (USA Today)
Pediatric study bolsters case for rapid-response team
Adding a rapid-response team, a crisis team that is mobilized within the
hospital, reduced overall death rates in a pediatric hospital, according to
a Stanford
University study that found an 18% reduction in mortality over a 19-month
period. Rapid-response teams, or RRTs, are designed to mobilize around
patients showing signs of early distress before they need more acute care.
For example, the team can be called if a child shows a sudden drop in heart
rate or blood pressure or if a staff member feels something is wrong. The
Institute for Healthcare Improvement, a nonprofit agency focused on patient
care, first recommended their use in 2004 as a tool to improve patient care,
and the use of RRTs since then has grown rapidly.
Among adult-patient populations, some studies suggest RRTs help decrease the
number of"codes," cardiac or respiratory arrests, outside the
intensive-care unit and improve mortality. In the latest study, published in
the Journal of the American Medical Association,"We attempted to
translate the adult literature into the pediatric," said Paul Sharek, lead
author and assistant professor at the Stanford University School of
Medicine. Researchers compared 22,037 patient admissions across 102,537 days
patients spent in Stanford's Lucile Packard Children's Hospital in
Palo Alto,
CA, before the RRT was added, to 7,257 admissions and
34,420 days after the intervention was established in September 2005. The
authors found that the average monthly mortality rate decreased from 1.01
deaths to 0.83 deaths per 100 discharges. Because of the study's design, it
isn't possible to say definitely that RRTs caused the hospital-wide decrease
in mortality, according to Brad Winters, director of the surgical
rapid-response program at
Johns
Hopkins
Hospital
in Baltimore. (The Wall Street Journal) See
THIS LINK
FDA issues early communication for Chantix
The U.S. Food and Drug Administration (FDA) issued an Early Communication
about an Ongoing Safety Review of Chantix, a drug approved as an aid to
smoking cessation treatment. An Early Communication reflects FDA's current
analysis of available data concerning these drugs and does not mean that FDA
has concluded that there is a causal relationship between the drug and the
emerging safety issue.
FDA is evaluating
postmarketing adverse event reports for Chantix (varenicline), a
prescription medicine to help adults stop smoking. Based on FDA's request
for information from the manufacturer, Pfizer Inc., the company recently
submitted reports to the agency describing suicidal ideation (thoughts).
In the wake of a case report citing erratic behavior in an individual who
had used Chantix, FDA has also asked the company for any information on
additional cases that may be similar in patients who have taken the drug.
FDA's Center for Drug Evaluation and Research is working to complete an
analysis of the available information and data. When this analysis is
completed, FDA will communicate the conclusions and recommendations to the
public. In the meantime, FDA recommends that health care providers monitor
patients taking Chantix for behavior and mood changes. Patients taking
Chantix should contact their doctors if they experience behavior or mood
changes. FDA also advises that, due to reports of drowsiness, patients
should use caution when driving or operating machinery until they know how
using Chantix may affect them. Full text of the Early Communication about
the Ongoing Safety Review can be found at
THIS LINK.
'Mismatched' prostate
cancer treatment more common than expected
More than a third of men with early prostate cancer who participated in a
study analyzing treatment choice received therapies that might not be
appropriate, based on pre-existing problems with urinary, bowel or sexual
function. The prevalence of these treatment "mismatches"could reflect
patient' unwillingness to discuss such problems with their physicians. The
study will appear in the
January 1, 2007 issue of the journal Cancer and is being released
online. "Prostate cancer patients experience the same fears and hard
decisions as all cancer patients do, but prostate cancer treatment directly
affects very personal things that most people aren't comfortable talking
about – urinary, bowel and sexual function,"said James Talcott, MD, SM, of
the Center for Outcomes Research at Massachusetts General Hospital (MGH)
Cancer Center, who led the study. "In this case, however, having that
information matters because the three major treatments available to patients
have different patterns of potential side effects. Knowing if patients
already have problems in these areas should help guide treatment decisions.”
The standard treatment options for early prostate cancer are external
radiation therapy; brachytherapy, in which tiny radioactive particles are
implanted into the prostate gland; and prostatectomy, surgical removal of
the prostate gland. These approaches have similar levels of effectiveness,
but each presents a different risk of side effects – external radiation can
lead to bowel dysfunction, brachytherapy may cause urinary problems, and
surgery can damage nerves involved in sexual function. For patients who
already have problems in these areas, therapies that could worsen their
symptoms are usually not recommended. In addition, approaches designed to
preserve normal functions, such as nerve-sparing prostate-removal surgery,
would not be appropriate for patients for whom those functions have already
been lost.
Of the almost 440 patients who completed the entire study, 389 or 89 percent
reported having some level of urinary, bowel or sexual problem before
beginning treatment. Those participants were classified into four groups.
Group 1 was patients with serious symptoms in a single area, for whom
decisions would be expected to be the most straightforward. Group 2 had less
serious symptoms that would count against a single treatment option. Group 3
had problems in several areas but still had one potentially appropriate
treatment. Group 4 included those patients with significant dysfunction in
all three areas, for whom none of the treatment options would be
recommended. The study results showed similar levels of treatment mismatches
in all groups – 34 percent in Group 1, 37 percent in Group 2, and 40 percent
in Group 3. Among Group 4 patients, those with dysfunction in all three
areas, only 5 percent chose watchful waiting, a strategy in which they
receive no treatment but are followed closely by their medical team.
Since patients take many considerations into account when choosing
therapies, the surveys asked about several factors that might affect those
decisions, none of which could account for the mismatched choices. As
expected, patients reporting pre-existing conditions were more likely to
have problems after treatment if they had received a mismatched treatment.
"It could be that treatment choices are determined by factors other than
those we asked about, or patients may decide to go ahead with mismatched
treatments for their own reasons, knowing the risks,"Talcott said. "But it
also could be that the open, frank conversations patients should have with
their doctors aren't taking place or that doctors aren't making it clear to
patients why they should be forthright about urinary, bowel or sexual
problems they are having."He and his colleagues theorize that patients may
be more open about addressing sensitive topics on a questionnaire than they
are in conversation and suggest that factoring such a questionnaire into
treatment decisions could reduce mismatches, a strategy they hope to study
in the future.
Siemens delivers molecular imaging solutions across clinical specialties
Working across clinical areas, including oncology, neurology and cardiology,
Siemens Medical Solutions will be presenting its latest molecular imaging
technologies at the 93rd Scientific Assembly and Annual Meeting of the
Radiological Society of North America (RSNA) from Nov. 25 to 30 in Chicago.
Siemens introduces high-definition positron emission tomography. HD PET is
the world's first and only high-definition PET technology to offer
consistently sharper and clearly defined images across the entire field of
view. The clarity achieved by HD PET is the result of a unique and
proprietary technology that optimizes the elements of image uniformity,
resolution and contrast, that together change the whole picture.
Historically with PET imaging, intrinsic image quality has been known to
degrade with increasing distance from the center of the detector. HD PET
eliminates this effect, thus providing increased diagnostic confidence to
more accurately resolve peripheral lesions. The improved 2-mm resolution
enables physicians to clearly visualize the smallest of lesions from the
center to the edges of the field of view.
Siemens has also newly redesigned the mobile Biograph 6 TruePoint PET CT
system. The redesigned system incorporates hardware improvements such as a
shorter gantry to reclaim critical space in the scan room, a special
cantilevered patient handling system with automatic lock-down and a
completely integrated closed-loop cooling system with no external chilling
requirement. The new mobile systems also boast significant workflow
improvements to facilitate remote operation and support for multiple site
connectivity. With the introduction of another hybrid imaging technology,
the TruePoint
SPECT CT, clinicians can perform three different studies - single photon
emission computed tomography (SPECT), diagnostic multislice-CT, and SPECT
CT, on one compact, integrated system. Siemens has recently introduced the
Symbia T16 TruePoint SPECT CT configuration, which combines the power of
SPECT imaging with the precision of a 16-slice CT.
The Symbia E is the
newest addition to the Symbia family of SPECT and SPECT CT imaging systems.
For more information see
THIS LINK
Philips unveils computed tomography (CT) system that
scans the heart in two beats
At
the annual meeting of the RSNA, Royal Philips Electronics unveiled its
latest healthcare products and technologies that seek to make a difference
in how radiologists can prevent, diagnose, treat and monitor disease, and
allow them to focus more on their patients. Among the Philips innovations
featured at RSNA will be CT products designed specifically to improve image
quality and reduce dose in the most demanding studies.
The flagship product, the 256-slice Brilliance iCT
scanner, allows radiologists to produce high-quality images with
exceptional acquisition speed, including complete coverage of the heart and
brain. It is so powerful it can capture an image
of the entire heart in just two beats, while incorporating Philips
technology that has reduced radiation doses by up to 80 percent.
Brilliance iCT and a new 64-channel system both feature Philips
Essence technology, consisting of new X-ray tubes, detectors and
reconstruction design elements. This technology
can provide detailed and clear 3D images of an entire organ, including the
heart and brain, and can also show changes over time. All images also can be
accessed on any computer in a hospital or by colleagues and researchers
remotely, to make it easier for the whole team to share information. The
Brilliance iCT scanner is also designed to reduce patients' exposure to
X-rays. The scan is much quicker, as the machine's X-ray emitting gantry –
the giant ring-shaped part that surrounds the patient – can rotate four
times in a single second, which is 22 percent faster than current systems.
Additional company highlights at RSNA include the Philips Reading
Room 20/20, a future concept of the reading room where radiologists analyze
diagnostic images of patients. Philips is also
developing technologies like a wireless X-ray detector for Philips X-ray
systems used in the radiology department, emergency room and intensive care
unit. Additionally, Philips will showcase five research projects that
demonstrate where radiological technology for diagnosing and treating heart
disease and cancer is headed. For more information see
THIS LINK
Olympus America introduces new endoscopic ultrasound reprocessing video
Olympus America announces the online posting and availability of a new
Endoscopic Ultrasound (EUS) Flexible Endoscope Reprocessing video. The video
provides a step-by-step demonstration of the reprocessing procedure,
including pre-cleaning, manual cleaning and high-level disinfection. It is
an excellent reference, training tool, adjunct to the instruction manual and
refresher for staff. The video is also available in DVD format for viewing
via a laptop computer or television.
To
view the video go to:
http://olympusamerica.com/msg_section/cds/cds_videos.asp or navigate
through the Olympus web page (www.olympusamerica.com).
The video can also be ordered in DVD format from the web page. For more
specific information about Endoscopic Ultrasound related products please
contact your Olympus Sales Representative at 800-848-9024.
November
21, 2007
Download print version
UM med students learn how to prevent errors
that cost lives and money
Jackson Memorial plans $1 billion expansion
Approximately $2 million of potentially
harmful"cosmetic" eye product seized
CDC:
Humanitarian mission on
USNS Comfort, a floating hospital
Happy Thanksgiving from HPN!
Scientists bypass need for embryo to get
stem cells
Two teams of scientists reported yesterday that they had
turned human skin cells into what appear to be embryonic
stem
cells without having to make or destroy an embryo,
a feat that could quell the ethical debate troubling the
field. All they had to do, the scientists said, was add four
genes. The genes reprogrammed the chromosomes of the skin
cells, making the cells into blank slates that should be able
to turn into any of the 220 cell types of the human body, be
it heart, brain, blood or bone. Until now, the only way to get
such human universal cells was to pluck them from a human
embryo several days after fertilization, destroying the embryo
in the process. The need to destroy embryos has made stem cell
research one of the most divisive issues in American politics,
pitting President Bush against prominent Republicans like
Nancy
Reagan, and patient advocates who hoped that stem
cells could cure diseases like
Alzheimer's. The new studies could defuse the issue
as a presidential election nears. The reprogrammed skin cells
may yet prove to have subtle differences from embryonic stem
cells that come directly from human embryos, and the new
method includes potentially risky steps, like introducing a
cancer
gene. But stem cell researchers say they are confident that it
will not take long to perfect the method and that today's
drawbacks will prove to be temporary. Researchers and
ethicists not involved in the findings say the work, conducted
by independent teams from
Japan
and Wisconsin, should reshape the stem cell field. At some
time in the near future, they said, today's debate over
whether it is morally acceptable to create and destroy human
embryos to obtain stem cells should be moot.
The White House said that Mr. Bush was "very pleased" about
the new findings, adding that "By avoiding techniques that
destroy life, while vigorously supporting alternative
approaches, President Bush is encouraging scientific
advancement within ethical boundaries." The new method
sidesteps other ethical quandaries, creating stem cells that
genetically match the donor without having to resort to
cloning or the requisite donation of women's eggs. Genetically
matched cells would not be rejected by the immune system if
used as replacement tissues for patients. Even more important,
scientists say, is that genetically matched cells from
patients would enable them to study complex diseases, like
Alzheimer's, in the laboratory. Until now, the only way most
scientists thought such patient-specific stem cells could be
made would be to create embryos that were clones of that
person and extract their stem cells. Just last week,
scientists in
Oregon
reported that they did this with monkeys, but the prospect of
doing such experiments in humans has been ethically fraught.
But with the new method, human cloning for stem cell research,
like the creation of human embryos to extract stem cells, may
be unnecessary. The new cells in theory might be turned into
an embryo, but not by simply implanting them in a womb. (The
New York Times) To read the original article see
THIS LINK
Findings from initial healthcare product data synchronization pilot
The
healthcare industry is another step closer to finding the solution for the
standardization and synchronization of critical medical surgical product
data across its $200+ billion supply chain, according to the initial results
of an ongoing pilot program sponsored by the U.S. Department of Defense. A
solution is needed to reduce burgeoning healthcare costs, improve
efficiencies and, ultimately, increase patient safety. In the groundbreaking
pilot, overseen by the Defense Supply Center Philadelphia (DSCP), a Defense
Logistics Agency business unit, the DoD and industry participants tested an
existing product data network known as the Global Data Synchronization
Network (GDSN), and found that GDSN demonstrates the potential to meet
healthcare's complex data synchronization needs. Because the finding is so
promising, the DoD is expanding the pilot to include more industry
participants and to test the movement of a larger volume of manufacturer
data files via GDSN. Pilot findings are published in a newly released
report, Creating a Source of Truth in Healthcare: Testing the GDSN as a
Platform for the Healthcare Product Data Utility, available at
THIS LINK. GDSN is already widely used for the secure exchange of
standardized product information in other large industries in the U.S. and
around the world. "Through this initial pilot, we are confident that the
GDSN meets the minimum criteria needed by the healthcare industry," said
Kathleen Garvin, DoD data synchronization program manager at the Defense
Supply Center Philadelphia. "We look forward to testing the scalability of
GDSN with additional participants. The GDSN healthcare product data utility
is a good candidate for a single source of validated, standardized and
synchronized healthcare product information."
Specific lessons learned from each participant are detailed in the pilot
report. Participants in the initial phase were: BD and Sage Products, Inc.,
representing manufacturers; Premier Inc., representing group purchasing
organizations; Baptist Health South Florida, representing a hospital; Lawson
Software, representing an information system; 1SYNC, a GDSN-certified Data
Pool provider; and Ontuet, representing a data on-boarding partner. Pilot
participants tested the flow and usability of product data internally and
with their trading partners, using GDSN as a hub for the secure and
standardized transmission of items from manufacturers. Pilot participants
confirmed GDSN as a viable solution. "For manufacturers, it's important that
a product data synchronization solution and unique device identification
system for healthcare be global in nature in order to reduce data sharing
requirements, redundancy and costs," says Dennis Black, Director, eBusiness
for BD. "GDSN and the globally accepted product data standards show great
potential for healthcare. These processes and standards are already being
used successfully by our Diabetes Care Unit with major retailers."
GDSN
uses specific product and organizational identification standards--the
Global Trade Item Number (GTIN) and the Global Location Number (GLN). While
these standards are emerging in the healthcare industry, they are currently
in use by healthcare manufacturers that serve retail markets. In addition,
GDSN can support the healthcare industry's United Nation's Standard Products
and Services Code (UNSPSC) for product classification. Participants
acknowledged that the implementation of any industry PDU will likely require
information systems upgrades or process re-engineering, yet "the benefits of
implementing such a system far outweigh the unacceptable costs of the status
quo," said Joe Pleasant, CIO of Premier, a participating GPO. "Other
industries don't have the same kind of data problems we have in healthcare,
and now it is our turn to reap the benefits from a product data utility.
GDSN data could be implemented today using existing business systems." For
more information, see
THIS LINK or see THIS LINK
Cedars-Sinai Medical Center Chief Medical Officer releases statement on medical error
Cedars-Sinai Medical Center Chief Medical Officer
Michael L. Langberg,
MD, released the following statement on a recent medical error that
occurred at the facility:
"On November 18, three
patients who were receiving intravenous medications as part of their
treatment had their IV catheters flushed with a solution containing a higher
concentration of heparin (a medication used to keep IV catheters from
clotting) than normal protocol. As a result of a preventable error, the
patients' IV catheters were flushed with heparin from vials containing a
concentration of 10,000 units per milliliter instead of from vials
containing a concentration of 10 units per milliliter. The error was
identified by Cedars-Sinai staff, who immediately performed blood tests on
the patients to measure blood clotting function. Four additional patients in
the unit were tested as a precaution. The tests indicated that four of the
seven patients had normal blood clotting function, and three had tests
indicating prolonged blood clotting function. In one of the three patients,
the clotting tests returned quickly to normal. The other two patients were
given protamine sulfate, a drug that reverses the effects of heparin and
helps restore blood clotting function to normal. Additional medical tests
and clinical evaluation conducted on the two patients indicated no adverse
effects from the higher concentration of heparin or from the temporary
abnormal clotting function. Doctors continue to monitor the patients.
I want to extend my
deepest apologies to the families who were affected by this situation, and
we will continue to work with them on any concerns or questions they may
have. This was a preventable error, involving a failure to follow our
standard policies and procedures, and there is no excuse for that to occur
at Cedars-Sinai. Although it appears at this point that there was no harm to
any patient, we take this situation very seriously. We are conducting a
comprehensive investigation, cooperating fully with the Los Angeles County
Department of Health Services and will take all necessary steps to ensure
that this never happens here again." See
THIS
LINK.
For
a related report from ABC News, "Dennis Quaid's Newborns Given Accidental
Overdose", see
THIS LINK.
For another related article from ABC NEWS:
"Medical Errors: A Look Back; Errors of the Past -- And What Hospitals Are
Doing to Prevent Future Mishaps", see
THIS LINK.
UM med students learn how to prevent errors that cost
lives and money
The
patient's on the operating room table. His upper body is punctured with stab
wounds. He's kept alive via snaking tubes infiltrating the gashes. The
lights go out. Power failure. The ventilator, inoperable. The doctors,
nurses and anesthesiologists are in the dark; a senior surgeon barks orders.
Thankfully, the victim is a ''model patient.'' A mannequin. This is the UM/JMH
Center for Patient Safety, a program Dr. David Birnbach and his crew employ
to teach medical students, residents, interns and health care staff how to
react to emergencies, communicate more effectively and most importantly,
reduce medical errors, a critical area in the medical profession that can
lead to costly mistakes, medical malpractice suits and patient deaths.
Launched on a $950,000 state grant three years ago, the center offers a
series of mandatory courses like the in-the-dark operating room scenario.
Instructors simulate real-life situations, say, a mother showing up in the
emergency room with a breached baby halfway through the birth canal and too
late for a C-section, using medical equipment, mannequins, and the
occasional actor to play a patient or harried orderly.
One of the key goals? Communication, said Birnbach, the program's director
and the school's vice chair in the Department of Anesthesiology. It begins
from the early days of medical school. ''We are teaching doctors how to talk
to doctors, doctors how to talk nurses, and we start right from the
beginning. In their second year, they can't start working on patients in a
clinical scenario until they have 16 hours of lectures on communications,''
Birnbach said. "You are going to make mistakes. What are you going to do
then? What systems are going to help you? How are you going to remedy this
and make sure you never make this mistake again? That's what they get
lectured on and then they come to the simulator.'' A recent case centered on
a 3-year-old Gainesville boy who was accidentally given a dose of a drug 10
times greater than the doctor's prescribed amount. The child, Sebastian
Ferrero, died Oct. 10 at a Shands HealthCare facility at the University of
Florida. The error occurred even though the boy's mother questioned the dose
as it was being administered. (The Miami Herald) To read the original
article see THIS
LINK
Jackson Memorial plans $1 billion expansion
While the University of Miami is buying its own hospital, its longtime
teaching affiliate, Jackson Memorial (Miami, FL) is planning a massive
expansion and renovation of its own. ''We're looking to spend $1 billion
over the next 15 years,'' said Marvin O'Quinn, chief executive of the
tax-backed Jackson Health System. "We're planning a modern, competitive and
patient-friendly campus.'' The plans are ''the cumulation of several years
of work. We did a complete analysis of all of our facilities, what was
antiquated, what the issues were. Presentations were made to the board last
January,'' O'Quinn said. The public system's plans call for a major overhaul
of the Jackson Memorial campus, including the construction of a new tower
for pediatric services, a new emergency room, a new garage and converting
another tower into office space. Rooms at all three campuses, Jackson
Memorial, Jackson North and Jackson South, will be renovated over time. The
Jackson South campus will also be remodeled and expanded. Some of the
development will be paid by bonds and taxes, but the Jackson Memorial
Foundation is hoping to raise at least $100 million, to help create the new
children's hospital, a breast health center, renovated patient rooms and
upscale ''benefactor suites,'' a maternity center, a stroke center and the
emergency-trauma wing. ''We don't have the money for everything yet,'' said
O'Quinn, "but we have the ideas.''
The annual report of the Agency for Health Care Administration
shows that Jackson Memorial had a stunning net surplus of $118 million last
year, but O'Quinn said that's misleading. AHCA lists all tax proceeds under
Jackson Memorial, O'Quinn said, but doesn't account for the nonhospital
funds the system spends, including $18 million for jail healthcare, $30
million for mental health, about $20 million for nursing homes and more than
$25 million for primary care in clinics. The system presently gets about
$1.5 billion a year in revenue. Last year, it received $190 million from
Miami-Dade County's half-penny sales tax, $140 million in county property
tax support and $30 million from the county for capital projects. According
to the system's own records, O'Quinn said the Jackson public health system
lost $82 million in 2004, gained $10.1 million in 2005 and then another
surplus of $57 million in 2006, bolstered by "a huge increase in sales tax
revenue and a settlement with Medicare that brought in $20 million in a
one-time deal.'' But many public hospitals around the nation have been
suffering the past several years, and O'Quinn is bracing for tough times
ahead. He says a slumping economy that started in the summer indicates sales
tax receipts will drop annually about $8 million to $10 million. Altogether,
he estimates the system will lose about $20 million in 2007. (Miami Herald)
See
THIS LINK
Approximately $2 million of potentially
harmful"cosmetic" eye product seized
At the
request of the U.S. Food and Drug Administration, U.S. Marshals seized
12,682 applicator tubes of Age Intervention Eyelash, a product that may, in
some users, lead to decreased vision. Authorities said the sales value of
the seized tubes is approximately $2 million. Age Intervention Eyelash is
sold and distributed by Jan Marini Skin Research Inc., of San Jose, CA. The
FDA considers Age Intervention Eyelash to be an unapproved and misbranded
drug because Jan Marini Skin Research has promoted the product to increase
eyelash growth. FDA also considers the seized Age Intervention Eyelash to be
an adulterated cosmetic. The product contains bimatoprost, an active
ingredient in an FDA-approved drug to treat elevated intraocular pressure
(elevated pressure inside the eye). For patients using the prescription
drug, using the Age Intervention Eyelash in addition to the drug may
increase the risk of optic nerve damage because the extra dose of
bimatoprost may decrease the prescription drug's effectiveness. Damage to
the optic nerve may lead to decreased vision and possibly blindness. In
addition, use of Age Intervention Eyelash may cause other adverse effects in
certain people due to the bimatoprost, including macular edema (swelling of
the retina) and uveitis (inflammation in the eye), which may lead to
decreased vision. For more information see
THIS LINK
CDC:
Humanitarian mission on USNS Comfort,
a floating hospital
One of the
largest U.S. trauma facilities is not on land. The
USNS Comfort, a converted
supertanker and hospital ship, served as the base for healthcare
professionals, including CDC medical personnel and staff, on a recent
four-month humanitarian mission in Latin America and the Caribbean. The
USNS Comfort is a floating hospital and one of the largest U.S. trauma
facilities. A converted supertanker, this U.S. Navy hospital ship recently
returned to Norfolk, VA, after a four-month humanitarian mission.
Experienced and highly-skilled CDC medical personnel and other CDC staff
joined an international team aboard the hospital ship and traveled to 12
countries of Latin America and the Caribbean. Healthcare professionals from
the U.S. Public Health Service (USPHS) and U.S. Navy, Air Force, Coast
Guard, Army, and Canadian Forces, along with non-governmental organizations
(NGOs) helped provide healthcare services to people both on and off this
giant, floating hospital. Services included adult and pediatric primary
care, preventive medicine, dental care, optometry, and more. More than 200
organizations were represented on USNS Comfort.
The USNS Comfort hospital ship was deployed from June 15 through
October 15, 2007, as a demonstration of continued U.S. commitment to South
and Latin America and the Caribbean. The deployment was a collaborative
effort between the U.S., partner nations, and NGOs to provide humanitarian
assistance, in support of the US Southern Command's Partnership for the
Americas initiative. Providing care to patients was not the only mission the
USNS Comfort set out to accomplish during the four months in South
and Latin America and the Caribbean. US personnel had a unique opportunity
to train in humanitarian assistance and disaster relief. For example, senior
environmental health officer Craig Shepherd adapted to the heat, the dirt,
and the less than ideal working conditions to conduct evaluations and
provide feedback on environmental health issues. He met with health
officials from host nations at various sites to promote teamwork and future
collaboration.
The ship itself is a first-class facility, designed to receive 300 surgical
patients a day. Patients arrive onboard by helicopter or small boat.
Patients are assessed for medical treatment then routed to surgery or other
services depending on the severity of their wounds or medical condition. And
while many patients are treated on the ship, many more are seen at various
medical locations in each of the countries. Over the course of the mission,
USNS Comfort healthcare
providers saw 98,658 patients, gave 32,322 immunizations, and dispersed
122,245 pharmaceuticals. The USNS
Comfort is one of the largest US trauma facilities and, even at
sea, it offers a full spectrum of surgical and medical services. As long as
three football fields, the ship has a total bed capacity of 1,000 patients.
There are 12 operating rooms and 4 X-ray rooms, as well as a pharmacy,
physical therapy and burn care center, dental suite, and laundry facility.
See THIS LINK
Happy Thanksgiving from HPN!
All
of us at
Healthcare Purchasing News
wish you and yours a safe and happy holiday! We'll see you again Monday!
November
20, 2007
Download print version
Blood clotting protein linked to rheumatoid
arthritis;
Cincinnati Children's study reveals possible
therapy
Rheumatoid arthritis death rate unchanged
Getinge/ARJO/Maquet New West Coast Showroom
simulates OR, ICU and SPD environment
Savings opportunities through UHC's supply
chain services
tops $100 million so far this year
Heart death rates worsening for middle-aged
adults
The gains made against coronary death rates in recent decades are
starting to slip away for middle-aged Americans, public health
officials report. Overall, the picture looks rosy, said a
report that used
U.S. vital statistics data between 1980 and 2002 for all
people aged 35 and older. The death rate from coronary disease
fell by 52 percent in men and 49 percent in women. "In older
age groups, the reduction is still going on," said lead
researcher Dr. Earl S. Ford, a medical officer in the U.S.
Public Health Service, who co-authored the report with Dr.
Simon Capewell of the University of Liverpool in England. But
the picture is more bleak for Americans aged 35 to 54. For men
of that age, the average annual rate of death from coronary
disease declined by 6.2 percent in the 1980s but only by 2.3
percent in the 1990s. It then dropped at an annual rate of 0.5
percent between 2000 and 2002.
For women between 35 and 54, the average annual death rate from
coronary disease dropped by 5.4 percent in the 1980s but then
slowed to 1.2 percent in the 1990s. Between 2000 and 2002, the
annual death rate for women in this age group actually
increased, by 1.5 percent annually. "What we are seeing
reflects experience among the youngest people we looked at,"
said Ford, whose team published its findings in the Nov. 27
issue of the Journal of the American College of Cardiology.
Things look better when all patients 35 and older are
included. On an annual basis, the coronary disease death rate
among men 35 and up declined by 2.9 percent a year during the
1980s, 2.6 percent a year during the 1990s and 4.4 percent a
year from 2000 to 2002. For all women aged 35 and over, the
annual coronary death rate declined by 2.6 percent, 2.4
percent and 4.4 percent annually for those periods,
respectively.
Why are
middle-aged adults faring more poorly? "We can't tie these
rates to anything in particular, so we have to speculate,"
Ford said. That speculation centers on well-known risk factors
for coronary disease, such as obesity, diabetes, high blood
pressure and lack of physical activity. "There is a major
epidemic of obesity in the United States," Ford said. "There
have been no major decreases in smoking. [Changes in]
cholesterol levels are also flat. Also, hypertension in the
United States is something people have to pay more attention
to." There is a steady drumbeat of public warnings and
doctors' advice about these risk factors, noted Dr. Philip
Greenland, a professor of preventive medicine at the
Northwestern University Feinberg School of Medicine, who wrote
an accompanying editorial. But somehow the message still isn't
getting through. The public may be getting a mixed message, he
added."We've been telling people for years that we've
conquered heart disease, that the mortality rates are going
progressively down. But the risk factors exist, and to say
that we've conquered the problem is a non sequitur." The
editorial was aimed at practicing physicians, Greenland said.
"There is a tendency for physicians to ignore what is known
about heart disease. I was trying to get across the idea that
if we in the medical profession don't wake up, the gains we
thought we achieved will be slipping away from us." The
increase in death rates has affected other areas of
cardiovascular disease, said Dr. Martha Daviglus, a professor
of medicine and preventive medicine at Northwestern
University, Chicago, and a spokeswoman for the American Heart
Association."For stroke, it is even worse," she said."The
decline in the last 10 years has been very bad." The message
on obesity and other factors of a healthy lifestyle are being
ignored by younger Americans, Daviglus said. (Health Day News)
Rural health groups to get millions From FCC;
Money to provide broadband access to isolated clinics
The
Federal
Communications Commission announced $417 million in grants to
help rural healthcare groups build high-speed Internet networks to connect
isolated clinics to sophisticated medical resources in urban areas. The
three-year pilot program aims to help extend broadband lines to about 6,000
hospitals, research centers, universities and clinics in hard-to-reach
regions, many of which still rely on dial-up Internet service. The faster
connection could be used to upload patient records or for sending videos and
pictures to diagnose the illness of someone hundreds of miles away. The
program will"play a critical role in the way technology will transform
healthcare," FCC Chairman
Kevin J. Martin
said."Not only will a telehealth network connect doctors to patients who
have never had access to medical treatment, but they can have access to the
top resources on the other side of the country." The FCC has been under
pressure from members of Congress and consumer advocates to more quickly
deploy broadband networks in underserved areas. The program will be paid for
with money from the universal service fund, a fee collected from
long-distance and wireless subscribers that subsidizes phone and Internet
service to schools and libraries as well as low-income populations and rural
areas. The funds allocated to telehealth services have been underemployed,
prompting the FCC to start the pilot program, Martin said.
The
FCC program will reimburse 69 organizations for what they spend to put the
infrastructure in place. The network could also help reduce healthcare costs
by letting doctors and nurses monitor patients with such chronic conditions
as diabetes or heart disease from a distance, preventing expensive hospital
visits, Martin said. Robert M. Kolodner, national coordinator for health
information technology at the
Department of Health
and Human Services, said the gap in the level of healthcare
received in rural areas compared with urban areas is exacerbated by the lack
of high-speed lines. He hopes the program will help speed up the use of
electronic records, which a slow adoption rate nationwide. The West Virginia
Telehealth Alliance, which services
West Virginia,
Virginia
and
Ohio, will
receive $8.4 million over the next three years to connect 450 facilities.
The Virginia Acute Stroke Telehealth Network will use $2.7 million to
provide live video consultation and remote monitoring in 48 locations.
(Washington Post)
FDA approves Nexavar for patients with inoperable liver
cancer
The U.S. Food and Drug Administration announced that it has approved Nexavar
(sorafenib) for use in patients with a form of liver cancer known as
hepatocellular carcinoma, when the cancer is inoperable. Nexavar was
originally approved in 2005 for the treatment of patients with advanced
renal cell carcinoma, a form of kidney cancer."In a randomized clinical
trial, the group of patients with inoperable hepatocellular carcinoma who
received Nexavar survived 2.8 months longer than the group of patients who
didn't receive the drug," said Robert Justice, M.D., director of FDA's
division of drug oncology products.
According to the National Library of Medicine, hepatocellular carcinoma
accounts for 80 to 90 percent of all liver cancers. This type of cancer can
be difficult to remove completely using surgery. If all of the cancer cannot
be removed, the disease is usually fatal within three to six months. Nexavar
is a type of anticancer drug called a kinase inhibitor. It interferes with
molecules that are thought to be involved in chemical messages sent within
cancer cells, in the formation of blood vessels that supply tumors, and in
cell death. FDA's approval of Nexavar was based on the results of an
international randomized placebo-controlled trial in patients with
inoperable hepatocellular carcinoma. A total of 602 patients were studied.
The trial was stopped after a planned interim analysis showed a
statistically significant advantage in overall survival for the patients who
had received Nexavar. Patients who received Nexavar survived a median of
10.7 months while patients who received placebo survived a median of 7.9
months. A separate analysis showed that tumors progressed more slowly in
patients who received Nexavar compared to patients who had received placebo.
Inadequate blood supply to the heart or heart attack were reported in 2.7
percent of patients who received Nexavar, compared to 1.3 percent for
patients who received placebo. New high blood pressure was reported in 9
percent of patients who received Nexavar, compared to 4 percent of patients
who received placebo. Elevated serum lipase, an enzyme that measures liver
function, occurred in 40 percent of patients who received Nexavar, compared
to 37 percent of patients who received placebo, and hypophosphatemia, or low
blood levels of phosphate, occurred in 35 percent of patients who received
Nexavar, compared to 11 percent of patients who received placebo. Nexavar is
manufactured by Bayer HealthCare AG, Leverkusen, Germany for Bayer
Pharmaceuticals Corporation, West Haven, CT, and by Onyx Pharmaceuticals
Inc., Emeryville, CA.
Blood clotting protein linked to rheumatoid arthritis;
Cincinnati Children's study reveals possible therapy
Researchers
at Cincinnati Children's have issued the first study showing that a protein
normally involved in blood clotting (fibrin), also plays an important role
in the inflammatory response and development of rheumatoid arthritis.
Inflammatory joint disease appears to be driven by the engagement of
inflammatory cells with fibrin matrices through a specific integrin
receptor, aMB2. Writing in the November issue of The Journal of Clinical
Investigation, researchers suggest that therapies designed to interrupt
the localized interaction of inflammatory cells and fibrin may help
arthritis patients. "Our study establishes that fibrin is a powerful,
although context-dependent, determinant of inflammatory joint disease," said
Jay Degen, Ph.D., a researcher in Developmental Biology at Cincinnati
Children's and the study's lead author. "These findings also suggest that
pharmacologically interrupting the interaction of fibrin and aMB2 might be
efficacious in the treatment of arthritic disease as well as many other
inflammatory diseases, such as multiple sclerosis."
Rheumatoid arthritis
is a painful and debilitating disease involving chronic inflammation, tissue
degeneration, loss of cartilage and bone and ultimately loss of joint
mobility and function, according to the National Institute of Arthritis and
Musculoskeletal and Skin Diseases. Although the disease's precise cause is
not fully known, activation of specific components in the body's immune
system seem to play a major role in its onset and early progression,
according to researchers. Fibrin deposits are a prominent feature of
arthritic joints and the protein appears to be a link between systems that
control inflammation and bleeding within joints. Dr. Degen and his
colleagues explained that in arthritic joints, the mesh-like matrices formed
by fibrin to create blood clots may control local activity of inflammatory
cells as well as support inappropriate tissue reorganization. The study was
conducted by a team that includes researchers from Cincinnati Children's and
the University of Cincinnati's College of Medicine using genetically
engineered mice with collagen-induced arthritis of the knee and paw. Dr.
Degen and the research team are continuing their research to determine more
definitively how the interruption of fibrin and aMb2 might translate into
potential therapeutic treatment for patients.
Rheumatoid arthritis death rate unchanged
Americans are likely to live longer than they did 40 years ago, but not if
they have rheumatoid arthritis, according to a study from the Mayo Clinic.
"When you look at persons with rheumatoid arthritis, they do not seem to
have experienced the benefits over the last several decades of improved
survival the rest of us have," said study co-author Dr. Sherine E. Gabriel,
a professor of medicine and epidemiology at the Mayo Clinic in Rochester,
MN. The findings, based on a large population sample of mostly white
Minnesotans, showed that women and men diagnosed with rheumatoid arthritis
between 1965 and 2000 died at a steady rate of 2.4 percent and 2.5 percent
per year, respectively. During the same period of time, annual death rates
declined for men and women without rheumatoid arthritis. The rate fell from
1 percent per year for women in 1965 to 0.20 percent in 2000, and for men it
dropped from 1.2 percent to 0.30 percent. "This suggests that the dramatic
changes in therapeutic strategies for rheumatoid arthritis in the last 4 to
5 decades have not had a major impact on excess mortality," the study
authors said.
Rheumatoid arthritis is a chronic disease where the body
mistakenly attacks its own tissues. It causes inflammation and painful
joints, and also may attack other organs such as the heart. About 2.1
million Americans, or 1 percent of the population, have rheumatoid
arthritis, according to the Arthritis Foundation. Cardiovascular deaths
accounted for about half of the deaths for rheumatoid arthritis patients in
the research sample. An earlier Mayo study confirmed a strong link between
rheumatoid arthritis and congestive heart failure."It is possible that the
cardiovascular interventions that improved life expectancy in the general
population may not have had the same beneficial effects in patients with
rheumatoid arthritis," Gabriel said.
The research did not study the causes of mortality, added Gabriel. She
speculates, however, that since inflammation is thought to be a risk factor
for cardiovascular disease, patients with rheumatoid arthritis represent a
higher risk group, because their illness involves active, systemic
inflammation. The study is published in the November issue of the Journal
of Arthritis & Rheumatism. Dr. Hayes Wilson, a medical adviser to the
Arthritis Foundation, said,"Get an early diagnosis and treat it
aggressively. The consequence of not treating it aggressively could be
excess mortality," Wilson said.
Dr. Stephen Lindsey,
chief of rheumatology at Ochsner Health Systems in Baton Rouge, LA, noted
that while the study does not cover the impact of the latest medications,
other new drugs did become available in the '80s and '90s. However, they
apparently did not improve mortality, he said."Even when we make [patients]
hurt less, they still may be susceptible to other chronic diseases such as
heart disease," he added. (HealthDay News)
Getinge/ARJO/Maquet New West Coast Showroom
simulates OR, ICU and SPD environment
ARJO
Inc. USA announces the opening of the Getinge / ARJO / Maquet West Coast
showroom in Costa Mesa (Orange
County)
California. The 6,000 square-foot facility gives prospective customers the
ability to evaluate ARJO Extended Care Products, GETINGE Infection Control
and MAQUET Surgical Workplace in realistic OR, ICU and SPD (CS) settings.
MAQUET Surgical Workplace products, for the surgical and ICU settings,
include the PowerLED Surgical Light, ALPHAMAQUET Fixed Base Surgical Tables
and MODUTEC Ceiling Service Units. The sterile processing department
includes GETINGE Infection Control products – 46-Series and 86-Series
Washer-Disinfectors, 9100 Cart Washer, a full range of Steam Sterilizers,
T-DOC Asset Management and Instrument Tracking System, and Consumable
products. ARJO offers a variety of innovative, versatile and easy-to-use
products to meet the unique demands of healthcare professionals, including
comprehensive lines of bathing, showering, lift/transport, bariatric
products, disinfection systems, and compatible skin care liquids and
lotions. For more information, or to schedule a visit, please contact Amy
McCaw at 800 323 1245 x6112 or email
amy.mccaw@arjousa.com.
Savings opportunities through UHC's supply chain services
tops $100 million so far this year
University HealthSystem Consortium (Oak Brook, IL) members participating in
UHC's Supply Chain Optimization Program have identified more than $107
million in supply chain savings opportunities as of September of this year
and have realized nearly $90 million in documented savings. These
significant bottom-line savings are a result of members' continued contract
portfolio adoption and standardization efforts. A key to uncovering and
implementing supply chain savings is the use of UHC's supply chain
informatics tools and UHC's expert resources in analytics. For information
about the value of UHC's Spend Analytics Tool for your organization or UHC's
customized implementation assistance, contact John Cunningham at
630-954-1748 or cunningham@uhc.edu.
November
19, 2007
Download print version
Class 1 Recall: Thoratec Corporation
Implantable Ventricular Assist Devices (IVAD)
Study shows weight-loss drug rimonabant is
associated
with severe adverse psychiatric events
Drug dosages often incorrect for obese
patients
Department of Managed Health Care fines Health Net
for not disclosing
bonus program for employees considering
cancellation of health policies
Physiotherapy, Stryker settle false claims
lawsuit
Amerinet announces Private Label and Niche
Supplier award winners
IMS provides online
account management system for
surgical instrument services; imsready.com
My Account
FDA announces steps to improve advisory
committee processes
The Food and Drug Administration is announcing several steps
to strengthen its advisory committee processes in ways
consistent with recommendations of the Institute of Medicine.
The measures include proposed new guidance or procedures on
advisory committee voting, on disclosing information on
conflicts of interest, and on security and appropriate conduct
for participants at meetings. Other improvements include
greater clarity to FDA's advisory committee Web site, which
can be found at
THIS LINK.
A draft guidance document being issued recommends advisory
committees adhere to a process of simultaneous voting, in
which all members vote at once. The results of the vote would
be announced immediately. How each member voted would be part
of the public record. The draft guidance document is available
at
THIS LINK.
A second draft guidance issued recently lays out recommended changes to the
process of public disclosure of financial interests that create conflicts of
interest for advisory committee members. The new draft guidance makes the
process more transparent and consistent by having all advisory committee
members publicly disclose interests for which a waiver is granted. The draft
guidance also includes redesigned disclosure and waiver templates that are
clearer and easier for the general public to understand. The draft guidance
document and redesigned templates are available at
THIS
LINK.
FDA also has formalized operating procedures designed to ensure appropriate
security and promote proper decorum and public conduct at advisory committee
meetings. They are intended to help ensure that meetings proceed in an
orderly fashion and that the work of the committees is not impeded, but that
the right of free speech is also protected. The FDA has also recently posted
the names of outside experts that it has named to a new risk communication
advisory committee to make recommendations to FDA about how best to
communicate the risks and benefits of FDA regulated products. More
information about this advisory committee and the list of members can be
found at
THIS LINK.
FDA's policies on advisory committees continue to be informed by new studies
on conflicts of interest. The agency asked a consultant, Eastern Research
Group, to study 16 recent advisory committees. The report highlights the
difficulty of assembling highly qualified experts who are free of conflicts
and finds that those who have received waivers appear to be significantly
more qualified than those who have not received waivers. The full report is
available online at
THIS LINK.
So far this year the agency has convened 47 meetings of expert independent
advisory committees to advise FDA on topics such as new gene therapies and
the safety of children's cough and cold medicines.
Class 1 Recall: Thoratec Corporation Implantable
Ventricular Assist Devices (IVAD)
The U.S. Food and Drug Administration (FDA)) has issued a Class 1 Recall for
Thoratec Corporation Implantable Ventricular Assist Devices (IVAD), Catalog
Number 10012-2555-001, serial numbers 488 or higher and manufactured and
distributed from October 1, 2004 through October 22, 2007. The affected
IVADs were distributed to 87 hospitals throughout the United States and
other countries. The serial number is located on the label of the sterile
package and on the driveline's "Y- connector." The recalling firm is
Thoratec Corporation (Pleasanton, CA).
The reason for the recall is that the current Instructions for Use state
that IVADs may be implanted or placed in the external position. If the IVAD
is placed in the external position, air leaks may develop in the pneumatic
driveline. These air leaks are a result of sharp bending of the driveline at
the connection to the pump. This could result in not enough blood flow to
and from the heart. This recall does not affect implanted IVADs. Customers
and patients with questions may call the company at 1-800-528-2577.
On October 19, 2007, Thoratec Corporation sent an Urgent Medical Device
Correction notice to all of its customers notifying them of the problem.
This notice also included new instructions regarding placement and care of
the IVAD driveline. Doctors should contact their patients if any Thoratec
IVAD was placed in the external position. If patients have any questions,
they should contact their doctor. For more information about this recall,
see the company's press release at
THIS LINK.
Class 1 recalls are the most serious type of recall and involve situations
in which there is a reasonable probability that use of the product will
cause serious injury or death. Healthcare professionals and consumers may
report adverse reactions or quality problems experienced with the use of
this product to the FDA's MedWatch Adverse Event Reporting program:
Online; via Regular Mail: use postage-paid FDA form 3500 available at
THIS LINK and mail to
MedWatch 5600 Fishers Lane, Rockville, MD 20852-9787; or FAX:
1-800-FDA-0178.
Study shows weight-loss drug
rimonabant is associated with severe adverse psychiatric events
Patients given the weight-loss drug rimonabant are at increased
risk of severe psychiatric events, conclude authors of an article published
in The Lancet. Professor Arne Astrup, Department of Human Nutrition,
Faculty of Life Sciences,
University of Copenhagen, Denmark, and colleagues did a meta-analysis of
four double-blind randomized controlled trials featuring 4105 patients,
which compared treatment with 20mg per day rimonabant with placebo. They
found that patients given rimonabant had a 4.7kg greater weight reduction
after one year than did those given placebo. However, patients given
rimonabant were at 40% higher risk of having adverse events or serious
adverse events. Patients given rimonabant were 2.5 times more likely to
discontinue treatment because of depressive disorders than were those given
placebo, and three times more likely to discontinue treatment due to
anxiety.
The authors point out that there were no follow-ups after discontinuation of
active treatment with rimonabant, thus any weight regain could not be
assessed. They say: "As with other weight-loss drugs, relapse is expected to
occur after treatment has ended, and to achieve weight maintenance and
maintain the improvement of the cardiovascular and diabetes risk factors the
drug needs to be taken for life." They conclude: "Our findings suggest that
20mg per day of rimonabant increases the risk of psychiatric events, i.e.,
depressed mood disorders and anxiety, despite depressed mood being an
exclusion criterion in these trials. Taken together with the recent US Food
and Drug Administration finding of increased risk of suicide during
treatment with rimonabant, we recommend increased alertness by physicians to
these potentially severe psychiatric adverse reactions."
In an accompanying Comment, Professor Philip Mitchell and
Professor Margaret Morris, School of Psychiatry and School of Medical
Sciences, University of New South Wales, Sydney, NSW, Australia, say: "These
findings are especially striking since those with a history of significant
depression or other psychiatric illnesses had been excluded before study
entry; there is strong evidence that people with severe obesity are at high
risk of depression, [this] meta-analysis raises major questions about the
safety of rimonabant in obese people, who are already at an increased risk
of depression, especially since the FDA review suggests that the risk of
suicide is increased with this agent." The Comment authors add that other
companies which have drugs similar to rimonabant in phase II or III
development need to monitor them very carefully for psychiatric
complications.
Drug dosages often incorrect
for obese patients
As if severely overweight people didn't already have enough health
concerns, experts are raising another red flag, the possibility that some of
their prescription medications, especially antibiotics, may not be
prescribed at the appropriate dosage and could be ineffective. Because most
adult antibiotics are produced in a "one size fits all" dosage and some
doctors are not attuned to this issue, the societal trend towards severe
obesity is resulting in more individuals who get inappropriate drug
therapies for infectious disease, a new study in the journal
Pharmacotherapy suggests. "The number of individuals with the highest
body mass index, very obese people, is up 600 percent between 1986 and
2000," said David Bearden, a clinical associate professor in the
College of Pharmacy at Oregon State University. "Very obese individuals in
some cases, even those with severe infections, may be getting only half the
necessary dose of a prescription drug such as an antibiotic," Bearden said.
"That's a problem. It could lead not only to antibiotic failure but also an
increase in antibiotic resistance, another serious issue."
The problem is somewhat less of a concern with dosages of medications that
patients take for extended periods, such as blood pressure or cholesterol
medications, because the results of taking those medications are more
routinely monitored and dosages can be increased as necessary. It's a
particular concern with antibiotics, Bearden said, because they are often
used to treat severe or even life-threatening infections, and "bad things
can happen quickly if the drug is ineffective." Drug companies are just now
becoming more aware of this issue and beginning to test and recommend
dosages more appropriate for adults of varying weights, Bearden said. But
with older drugs that are commonly used, there often is very little or no
data for adjusting dosages. In actual practice the issue is often ignored
outright, or "educated guesses" are made with whatever data is available.
Without more attention, the issue may only get worse, and it's not just a
U.S. phenomenon. The World Health Organization estimates that 400 million
people were obese in 2005 and that the total will increase to 700 million by
2015. It considers these numbers a "global pandemic" that is affecting low,
middle and high-income nations around the world. Obesity is also considered
an independent risk factor for surgical site infections and is associated
with higher mortality rates in critically ill patients.
Even if the problem is carefully considered, Bearden said, it's not simple.
"It would be nice if we could just use a simple multiplier to adjust drug
dosages for overweight people," Bearden said. "But it's not that easy. There
are a lot of factors that affect drug distribution in the body, including
age, weight, kidney function, other disease problems and the type of
antibiotic or other drug." Adipose tissue, or body fat, affects how the
human body interacts with drugs. With some drugs it absorbs large amounts of
a prescription medication, but with others, it doesn't. And sometimes there
is a very fine line between a drug being effective at one dose, ineffective
if the dose is too low, and toxic if it's too high. All of these issues
affect appropriate dosages, and in many situations, the data needed to
evaluate the problem simply doesn't exist.
Department of Managed Health Care fines Health
Net for not disclosing
bonus program for employees considering cancellation of health
policies
The
California Department of Managed Health Care (DMHC) has fined Health Net $1
million for failing to disclose information on two separate occasions about
a bonus program paid to employees considering cancellation of health
policies. "Just as health plans require applicants to be truthful about
their health history when applying for coverage, the DMHC requires health
plans to provide full information to regulators," said Cindy Ehnes, Director
of the DMHC. "Through the DMHC, the public must have confidence that if
health plans do not cooperate with official investigations or do not follow
the law, action will be swift." Under
California
law, the DMHC is charged with overseeing and regulating health plan
operations. Plans can be subject to disciplinary action by the director if
they fail to fully and openly disclose information to the DMHC. Since late
2005, the DMHC has been investigating
California
health plans that offer individual health policies for engaging in the
illegal practice of post-claims underwriting or rescinding health policies
without proving that the applicant willfully misrepresented themselves on
the health application. These investigations have been conducted on five of
the largest health plans in California, including Health Net. In the course
of the Health Net investigation, the DMHC held on-site interviews on October
17 and again on November 6, 2007, at which investigators asked Health Net officials about the
existence of any compensation or bonus programs. On both occasions, the
answer was no.
However, on November 8, following an order from the Los Angeles
Superior Court for Health Net to produce documents in a rescission lawsuit
against the plan, Bates v. Health Net, the plan disclosed to
regulators the existence of compensation based in part on rescission of
health care policies paid to a company employee. Although Health Net
officials have agreed to pay the $1 million fine for non-disclosure, the
fine does not have any effect on other aspects of the DMHC's investigation
into the rescission practices of the plan. The final survey results on
Health Net rescission practices are expected in the early half of 2008.
In addition to the investigations, the DMHC is proposing new state
regulations to protect consumers from illegal rescissions. These regulations
will clarify existing law which requires health plans to show that a
consumer willfully misrepresented his/her health history before a health
care policy can be rescinded. The proposed regulations will also require
that health plans complete medical underwriting before issuing a policy
and that they
fully investigate questionable responses on health history questionnaires.
The DMHC will solicit public comment on the regulations during the early
half of 2008. The California Department of Managed Health Care is the only
stand-alone watchdog agency in the nation, touching the lives of nearly 21
million enrollees. The DMHC has assisted more than 800,000 Californians
through its 24-hour Help Center by resolving HMO problems while educating
consumers on health care rights and responsibilities, and working closely
with health plans to ensure a solvent and stable managed healthcare system.
Physiotherapy, Stryker settle false claims lawsuit
Stryker Corp. and its former outpatient therapy
division,
Physiotherapy
Associates Inc., will pay $16.6 million to settle
allegations of false claims to federal healthcare programs. The United
States Justice Department announced the settlement Wednesday. It alleges
Memphis-based Physiotherapy submitted false claims to Medicare, state
Medicaid programs and the Department of Defense's TRICARE program.
Physiotherapy improperly retained excess or duplicate payments it received
from federal healthcare programs, according to the settlement. Under terms
of the settlement, Physiotherapy agreed also to enter into a corporate
integrity agreement with the Office of Inspector General for the Department
of Health and Human Services. The settlement resulted from two qui tams, or
whistle blower suits, filed by private citizens against Kalamazoo, MI-based
Stryker and Physiotherapy. Both of the whistle blowers, Kerry Deering and
Wendy Whitcomb, were employees of Physiotherapy and will receive $3 million
each from the settlement. Under the whistle blower provisions of the False
Claims Act, private parties can file an action on behalf of the United
States and receive a portion of the proceeds of a settlement or judgment
awarded against a defendant. (Memphis Business Journal)
Amerinet announces Private
Label and Niche Supplier award winners
Amerinet, a national group purchasing organization for the healthcare
industry, announced the winners of its Amerinet Choice, private label, and
Niche Supplier Awards.
Amerinet Choice Award
"We are honored to recognize Clarity Images
as Amerinet Choices' high-performance supplier for 2007," said Dale Wright,
Amerinet Choice, president.
Headquartered in
Waltham,
MA, Clarity Imaging Technologies is a manufacturer of
toner cartridges. Using a unique, patented process, they produce PageMax, to
double the page yield versus the OEM cartridges, while providing comparable
quality and reliability.
Niche Supplier Award
"The Niche Supplier Award is a unique
recognition," said Allen Dunehew, Amerinet's chief contracting officer.
"Through this award, Amerinet recognizes Nonin Medical, Inc. for being a
leader in providing small, lightweight, portable pulse oximeters for spot
checking, transport and continuous monitoring applications." Headquartered
in Plymouth, MN, Nonin Medical Inc., a
privately owned company founded for the purpose of providing physiological
monitoring solutions, is one of the fastest growing medical device
manufacturers in the field. For more information see
THIS LINK.
IMS provides online account management
system
for surgical instrument services; imsready.com My Account
IMS, the InstrumentReady company, has announced a new
service for customers to instantly track their account information and
surgical instrument repair history. imsready.com My Account is an
Oracle based system that provides customers with a wealth of
information through a standard internet connection, meaning there is no
hardware or software to install. My Account uses a simple log-in that
allows customers to instantly view the real time
status of instruments and equipment that are being serviced. Enhanced
reporting features allow users to view equipment repair histories by
instrument or by category, which provides valuable information for budgeting
and planning of surgical instrument needs. This reporting can also reveal
instruments that require frequent repair, which can signal a need for
additional education or instrument replacement. Customers can also contact
their IMS sales representative and account manager through the system, and
track their instrument shipping status. To take advantage of imsready.com
My Account, IMS customers simply contact their sales representative. To
learn more about the IMS InstrumentReady approach, see
THIS LINK.
November 16, 2007
Download print version
World Health Organization:
Unknown illness in Angola
Patients were not told of misuse of
syringes
Bluetooth SIG announces Medical
Device Profile at Medica show
Selected product highlights at
MEDICA 2007
Amerinet Choice announces new
agreement with Hospira Worldwide
for pharmaceuticals
Burdened Japanese obstetricians fail
to deliver
CDC: New respiratory bug has
killed 10 people
U.S.
health officials say a mutated version of a common cold virus has caused 10
deaths over the last 18 months, including a 12-day old infant in New York
City. The virus usually causes respiratory infections. But a report issued
today by the U.S. Centers for Disease Control and Prevention says the new
mutation has caused at least 140 illnesses in New York, Oregon, Washington
and Texas. CDC officials don't consider the mutation to be a cause for alarm
for most people, and they're not recommending any new precautions for the
general public. In
the CDC report, the earliest case of the mutated virus was found in an
infant girl in New York City, who died last year. The child seemed healthy
right after birth, but then became dehydrated and lost appetite. She died 12
days after she was born. There have been no new reported cases since last
Spring. (The Associated Press, wnbc.com) For the original article see
THIS LINK
World Health Organization: Unknown illness in Angola
An outbreak of a disease of unknown etiology is currently ongoing in Cacuaco
municipality, Angola. The first cases were reported on October 2. As of
November 15, 2007, a total of 370 cases had
presented for treatment at the Municipal Hospital in Cacuaco. It is
anticipated that additional unreported cases may be occurring within
communities among patients preferring to remain at home or to receive
treatment from traditional healers. The clinical symptoms of the disease are
extreme drowsiness, waking only to painful stimuli. Patients recover slowly,
over a number of days, but remain ataxic with many unable to walk unaided.
The symptoms are most extreme in children. The neurological indication is of
a cerebellar abnormality with no sign of peripheral neuropathy. Reflexes are
normal. The case presentation suggests a toxicological cause, however, the
etiological agent has not yet been identified. Samples taken from patients
have been tested for 300 organic solvents and a general drug screen covering
800 compounds has also been carried out. These tests have so far proved
negative. Tests for cadmium, lead, mercury and manganese have shown levels
within the normal range. Environmental samples, as well as food and drinking
water, have also been taken and results of tests are awaited.
Epidemiological investigations so far have not revealed a common source or
route of exposure, and these investigations are now being extended in scope.
Patients were not told of
misuse of syringes
New
York state health officials notified 628 patients this week that they should
be tested for
hepatitis
and
H.I.V.
infection because they were treated years ago by an anesthesiologist in
Nassau County who used improper procedures for preventing the spread of
blood-borne diseases. The anesthesiologist, Dr. Harvey Finkelstein, of
Plainview, first became the focus of a state health investigation in 2005
after two of his patients contracted hepatitis C. His name was reported by
Newsday. Yesterday, county and state officials traded blame over the
34-month delay in notifying the patients. At the same time, the incident led
state health officials to seek a meeting with the
Centers for Disease
Control and Prevention to address an issue of drug packaging that
was apparently at the heart of the problem. In 2005, investigators found
that, in violation of widely accepted practices recommended by the C.D.C.,
Dr. Finkelstein, 52, who specializes in pain management, was reusing
syringes when drawing doses of medicine from vials that hold more than one
dose. He would use a new syringe for each patient. But when giving one
patient more than one type of drug by injection, his practice of using the
same syringe to draw medicine from more than one vial led to the potential
contamination of the vials. The blood of a patient who was infected with
hepatitis C
could, by backing up through the syringe and entering the vials, infect
another patient when the same vial of medicine was used again. This is what
happened in at least one case, health officials said.
State health officials said yesterday they hoped to get the C.D.C." support
in seeking the elimination of such multidose vials. Any fix would come too
late for Raymond Bookstaver, 49, a
Hicksville mechanic who was one of two patients initially identified
as having been infected by Dr. Finkelstein" improper use of syringes."I
feel like I went to a doctor for help, and what I got instead was a death
sentence," Bookstaver said. His hepatitis is being treated, but erupts
unpredictably, causing him to suffer flulike symptoms including nausea,
vomiting
and aching that leaves him bedridden, he said. At least one and possibly
more doctors in the state, including a
New York City
anesthesiologist, have been reported to state health officials in the last
several years for reusing syringes.
In 2005, Dr. Finkelstein was instructed in the proper use of syringes in
administering
pain medications
by state health investigators and he has since been monitored to make sure
he complied, a State Health Department spokesman said. For reasons that were
unclear yesterday, his case was not referred to the State Board for
Professional Medical Conduct of the State Education Department until nine
months after his unsafe practices were known. That agency, charged with
taking disciplinary actions against doctors, found no evidence of
wrongdoing, and recommended no disciplinary action. Michael Duffy, a lawyer
who specializes in medical malpractice cases and vice president of the New
York State Academy of Trial Lawyers, said that the long delay in notifying
the 628 potential victims of Dr. Finkelstein" practice was especially
troubling because none would be able to seek damages in court. (The
New York Times) See
THIS LINK
Bluetooth SIG announces Medical Device
Profile at Medica show
The Bluetooth Special Interest Group (SIG) is announcing the Medical Device
Profile for Bluetooth wireless technology at Medica, the 39th World Forum
for Medicine in Düsseldorf (14-17 November 2007). The Bluetooth SIG is
hosting a pavilion at the show for 12 member companies that will be showing
how to use Bluetooth wireless technology in medical, health and fitness
applications. A Bluetooth profile defines how different applications use
Bluetooth wireless technology to set up a connection and exchange data. The
Medical Devices Working Group of the Bluetooth SIG developed this profile to
ensure that devices in the medical environment can transfer data between
devices in a secure and well defined way via Bluetooth wireless technology.
Thanks to its elementary values such as low power, low cost, high security
and robustness, Bluetooth wireless technology is ideally suited for these
applications. With the healthcare costs globally caught in a relentless
upward spiral, the healthcare industry needs creative solutions to meet the
ever-growing need for quality health services with wireless convenience
while allowing patients, insurers, and governments to keep their budgets in
check.
In the Bluetooth SIG pavilion A&D Medical, Bluegiga, ConnectBlue, Cybercom,
Ezurio, Intel Corporation, lesswire, National Semiconductor, Nonin Medical
Inc., Stollmann, Lintech and IMST will display innovative and creative
products and prototypes that contribute to an improved medical environment.
The recently announced ultra low power addition to Bluetooth technology will
further strengthen the opportunities to reduce cost size and power
consumption for many small, button-cell operated health and fitness devices.
This is expected to be available for general use in such devices in 2008.
The rapidly expanding health market is increasingly making use of Bluetooth
wireless technology to connect devices. Most of these connections are
between a computing device (e.g. home health station, cellular phone,
telemedicine device, computer or PDA) and one or more Bluetooth enabled
devices (e.g. medical, health and fitness sensors such as heart rate, blood
pressure, glucose, weight, and oximeters etc). The transmission of data
takes place quickly and seamlessly such that the user need not be involved.
The Bluetooth enabled telemedicine solutions will help patients to recover
or monitor their health and wellness while at home or away potentially
saving significant amounts of money by reducing in-hospital care. For the
elderly, wireless applications allow a more mobile monitoring system and
less confinement to a room or a bed, thereby contributing to a better
quality of life. For more information see
THIS LINK.
Selected product highlights at MEDICA 2007
The world" smallest, pocket-size ultrasound device: In emergency
situations, the first minutes are often decisive. In such cases, a new
system from Siemens Medical Solutions will provide medical staff with
valuable support. The Acuson P10 is a mini-ultrasound device the size of a
pocket computer or Smartphone. It weighs a mere 700 grams, lies comfortably
in the physician" palm and is intended primarily for initial diagnosis and
assessment of the severity of the injury, for instance in cardiology or in
the case of abdominal complaints.
Rescue trailer for emergency quad: A highlight of the last MEDICA was
a motor-quad with which emergency physicians in regions where access is
difficult can quickly reach their patients. One thing was missing, however:
a transport solution for cases where it is vital to get the patient to a
hospital quickly. Now a solution has been found: A transport trailer with
patient bed adapted for use with the motor-quad. The relatively light
trailer weighing 250 kg and equipped with special tires, for instance for
use on beaches, is built on commission by Karmann in Osnabrück and is
certified for road use. Because it is equipped with a normal trailer hitch,
it can be pulled by any passenger car with a trailer hitch.
A strong step forward: Biodynamic orthotic insert distributes weight
evenly: How extensive product development can transform a relatively
"simple" product such as an orthotic insert into an extraordinary product is
demonstrated at MEDICA 2007 by accessory specialist Bauerfeind with his
BInamic orthotic insert. It is what is known as an active-core insert, which
acts biodynamically. A special fit and the alternation of hard and soft
material components ensures that the natural rolling movement of the foot in
the shoe is maintained. The user" weight is evenly distributed from toe to
heel. When standing, severely strained regions of the foot are spared.
Innovative bed for
newborns – bringing mother and child very close!
Neontechnik
Elektroanlagen Leipzig GmbH is showcasing the prototype of a special bed for
newborns which brings mother and newborn very close together after birth.
The new development goes by the name of BabyNELBed soft. The C-shape of the
bed for newborns allows mothers to pull the newborn over her own bed and
take it in her arms. The clear baby tub on a metal rack allows eye contact
between mother and child at any time.
Blood sugar measuring device with Bluetooth interface and Internet
access: The latest innovation from Heidelberger Medical Marketing (HMM)
again confirms the trend towards ever more compact, easier-to-use medical
products. smartLABgenie, a small blood sugar measuring device the size of a
box of chewing gum, will be showcased at MEDICA. The special feature:
According to its manufacturer, the device is the first of its kind with a
Bluetooth interface. Amongst other things, it can transfer the measured
blood sugar levels to any Bluetooth capable PC or any mobile phone with the
corresponding wireless interface. Alternatively, for data transfer to the
attending physician, the blood sugar data can be"transmitted" to a box
similar to a modem. The box transfers the data to the Internet, and the
physician can evaluate them via a specific website.
MONICARD – Monitoring patients with cardiac insufficiency: Patients
suffering from cardiac insufficiency frequently notice an insidious
deterioration too late. Therefore, it is advantageous to have continuous
home monitoring with appropriate devices. The innovative MONICARD system and
device will be introduced within the framework of the MEDICA MEDIA Theme
Park. The device developed by Norbert Rösch, Dipl.-Ing., and his team can be
used at home even by elderly and seriously ill patients without the presence
of a physician. Measurements include: an ECG using hand electrodes, the
oxygen content in the blood recorded through the finger as oxygen saturation
graphs, blood pressure using a cuff, and even weight via an electronic
scale.
For more information see
THIS LINK
Amerinet Choice announces new agreement
with Hospira Worldwide
for pharmaceuticals
Amerinet Choice announces a new agreement with Hospira Worldwide for
Pharmaceuticals – CLAVE Oncology System. Effective October 1, 2007 through
September 30, 2008, this agreement provides Amerinet members with
cost-savings opportunities on Hospira" CLAVE IV Delivery System. New to the
market, this new system is specifically designed to safely handle and
deliver hazardous IV medications. Sets and components work with any delivery
system to allow for closed, needle-free access to any solution container.
The Spiros Syringe Adapter performs closed draws and transfers without the
risk of drips or spills. Medical-surgical and pharmacy divisions both will
benefit from this closed system. For more information see
THIS LINK.
Burdened Japanese obstetricians fail to
deliver
Grueling workloads and a high risk of possible lawsuits
are discouraging many young Japanese doctors from joining the obstetrics
profession, which in turn is causing an increasing number of hospitals to
withdraw maternity services. Some obstetricians say they are concerned that
a continuing shortage of doctors in the field may lead to the collapse of
birth-related medical services."Too much hard work leaves young doctors
exhausted," said Buichi Tochigi, deputy president of Kawaguchi Municipal
Medical Center in Saitama Prefecture. The hospital has a neonatal intensive
care unit and is the region" designated comprehensive perinatal center for
mothers and infants. As such, it has a steady intake of pregnant women with
high-risk conditions, such as likely premature delivery or multiple births,
from both inside and outside the prefecture. Tochigi, 60, works a 36-hour
shift four or five times a month. Younger doctors must do so six or seven
times a month. In addition, the hospital's obstetricians are roused in the
middle of the night several times a month to deal with emergency cases.
Because many hospitals and clinics in the region have stopped offering
maternity services, the number of babies delivered by Kawaguchi Municipal
Medical Center this fiscal year is set to increase by at least 20 percent
from last fiscal year" 700. Though many hospitals have been criticized for
turning away pregnant women who have arrived in ambulances, Tochigi said:
"Obstetricians' working conditions are too severe. These cases were not
refusals per se. It was simply impossible to accept [more patients]."
According to the Japan Association of Obstetricians & Gynecologists, the
frequency of doctors working overnight at hospitals in fiscal 2006 increased
about 30 percent to 6.3 times a month, from 4.7 times six years ago.
Obstetricians work night shifts more often than pediatricians or surgeons.
In more than 90 percent of Japanese hospitals, obstetricians have to work
normal day shifts immediately after finishing their overnight duties. The
high risk of a possible lawsuit is another reason doctors are shunning the
obstetrics profession. According to the Supreme Court, 1,140 medically
related lawsuits were filed in 2004, nearly double the figure for 1997.
Among 1,000 doctors in various fields of treatment, 12.4 obstetricians faced
lawsuits. This figure was much larger than the figures of 10.9 for surgeons
and 3.8 for internal medicine doctors. A medical expert said:"Because
births are not related to disease, people believe they should be safe. If
problems arise, obstetricians face a high risk of being sued." The
government plans to introduce next fiscal year a system that quickly
compensates patients, even if doctors are not at fault, such as when babies
suffer brain damage or other serious disability as a result of a normal
delivery, for example.
A rise in the percentage of female doctors has contributed to the shortage
of obstetricians working in hospitals. Women account for more than half of
obstetricians aged 41 or younger. In recent years, this ratio has exceeded
two-thirds among newly graduated doctors. As most female obstetricians have
children of their own when they reach their 30s, many stop working in
hospitals, where such doctors are especially busy and frequently have to
work night shifts. Only a small number of hospitals provide assistance to
help female doctors resume their careers, such as setting up day care
centers inside hospitals and allowing the women to work only day shifts.
Prof. Shinya Unno of Kitasato Univers-ity's School of Medicine said:"Ten
years from now, half of hospital doctors will be women. There is no time to
lose in terms of helping female doctors." (The Daily Yomiuri, The Yomiuri
Shimbun)To read the
original article see
THIS LINK
November 15, 2007
Download print version
A dozen DC hospitals are going
tobacco-free; Even outside, smoking will be barred
Florida health facilities snuff out
smoking
Novation offers smoking cessation
program for hospitals
Scientists use monkey clones to
extract stem cells
Two new members elected to serve at
the ASHES Board
FDA clears silver-coated breathing
tube for marketing; Reduces risk of pneumonia for patients using
ventilators
They're Back - Alien Droppings 2
debuts today!
Last call for nominations:
HPN to recognize"Supply Chain-Focused CEOs"
Many
industries outside of healthcare recognize and respect the
value that effective and efficient supply chain management
contributes to the top and bottom lines. Among healthcare
providers, such recognition and support is growing, slowly but
surely, from the top post in the executive suite. That" why
Healthcare Purchasing News launched its yearly search for
"supply chain focused CEOs" three years ago. We wanted to
locate forward-thinking men and women to share their insights
with you, and you've helped us do that. In fact, we've
profiled of 10 of them already since January 2005.
Well,
it" that time of the year again – time to nominate noteworthy
hospital presidents/CEOs for HPN" fourth annual"S.U.R.E.
Award for Supply Chain Focused CEOs" award. We're looking to
recognize chief executives who SUPPORT, UNDERSTAND,
RECOGNIZE and EMPOWER the materials management department to
do what needs to be done to achieve bottom-line savings and
top-line revenue. We ask you, our dedicated readers, to
recommend worthy candidates for recognition in our January
2008 edition by e-mailing us reasons how and why they deserve
the spotlight – no more than a couple of paragraphs are needed
for each of the four S.U.R.E. categories listed above that
comprise the"SURE" acronym.
For your
nomination to qualify, please comply with the following rules:
1. Any
nomination must be original and exclusive to HPN and not have
been submitted, either original or edited, to any other
publication or online media outlet currently or within the
previous year.
2. GPO
and distributor support is commendable, but we're looking for
internally driven details beyond GPO- and distributor-driven
contributions.
3. Any
nominated executive (or nominator) must be willing to share
relevant basic financial details with our readers, including
annual revenues, annual expenses and annual purchasing volume.
Help us
share the stories of these remarkable CEOs in our January 2008
edition so that the industry may learn from them and be
inspired. Thanks in advance.
E-mail us your nominations by Friday, November 16, to
editor@hpnonline.com.
A dozen DC hospitals are
going tobacco-free; Even outside, smoking will be barred
A dozen
hospitals in Montgomery and Frederick counties in Maryland,
and Northern Virginia will declare themselves"tobacco-free
health zones" starting today, a pointed and sweeping move that
will apply to employees, patients and visitors alike. The use
of tobacco products will be prohibited anywhere on the
hospitals' grounds, outside entrances, on walkways or in
parking lots and garages. Gazebos where smoking has been
permitted are being dismantled, and cans for cigarette butts
will disappear. The ban, which takes effect on the American
Cancer Society" 31st annual Great American Smokeout, affects
Frederick Memorial Hospital, all five Montgomery hospitals and
the entire Inova Health System. They join more than 500
healthcare institutions across the country that have forbidden
tobacco on their property. The number has increased
exponentially in the past several years, though with
relatively little momentum in the Washington region.
In suburban Maryland, the collective nature of the hospitals'
action is meant to amplify the message. The six facilities
planned the change together, bringing in experts from the Mayo
Clinic to train tobacco-cessation counselors this summer and
agreeing to offer certain benefits, from stop-smoking classes
to nicotine patches and medications. They also printed small
cards with"scripts" for staff members to follow if they see a
colleague, visitor, patient or family member puffing away. The
suggested dialogue is more courteous than curt, but employees
could face disciplinary action for repeated violations. A
worker with clothes smelling of tobacco might be issued
disposable coveralls or asked to go home and change."We're
healthcare professionals, and so you have to treat this as an
addiction. You're not going to treat it as a crime," said
Brian A. Gragnolati, Suburban Hospital" president.
Although the days are long gone when nurses and doctors
lighted up outside patients' rooms, he and his counterparts
estimate that up to 20 percent of their employees smoke. The
hospitals acknowledge that they are playing catch-up.
Montgomery passed a no-smoking law for bars and restaurants
more than four years ago, and a statewide prohibition will
take effect in February. Officials now peg Maryland healthcare
costs related to smoking at $2 billion."To permit an act to
occur on our campuses that is recognized as the single most
common cause of death and disease was simply a disconnect that
none of us could allow to continue," Thomas A. Kleinhanzl,
president of Frederick Memorial, explained at a news
conference. (Washington Post)
Florida health facilities
snuff out smoking
Starting
today, workers and visitors to five hospitals and the county
health departments in Sarasota, Charlotte and DeSoto counties
in Florida will have to find another place to smoke. Those
organizations are making their campuses tobacco-free as part
of a regional effort to set an example. Smoking will be banned
at Doctors Hospital, DeSoto Memorial Hospital, Venice Regional
Medical Center, Englewood Community Hospital and Fawcett
Memorial Hospital. The campus smoking ban coincides with the
Great American Smokeout, the American Cancer Society's effort
to encourage smokers to quit for a day in the hope they might
quit for good.
Peace River Regional Medical Center and Charlotte Regional
Medical Center already banned smoking as part of the regional
effort. Sarasota Memorial Hospital will implement the policy
Jan. 1. Hospitals said their biggest challenge would be
stressed-out families of emergency-room patients, and said
task force caregivers would work on how to support them.
Candidly, some hospital spokespeople said they expected
leniency for patients and their families. Hospital and health
department employees got assistance programs to stop using
tobacco as part of their overall employee wellness efforts.
(Sarasota Herald-Tribune)
Novation offers smoking
cessation program for hospitals
The
third Thursday in November is the American Cancer Society" Great American Smokeout. In the spirit of helping people to
stop smoking, Novation, a contracting services company for the
healthcare industry, offers a new smoking cessation product
guide to help hospitals make informed decisions about
treatment options and improve care options for patients who
want to quit smoking. There are several smoking cessation
treatment options, including behavioral modification and
pharmacotherapy. Pharmacotherapeutic options include nicotine
replacement therapy in a variety of forms (gum, patch,
inhaler, lozenge, nasal spray), and the non-nicotinic agents
such as bupropion SR and varenicline. The guide includes
extended patient information about available treatment
options, including adverse reactions and clinical efficacy.
Products covered include: Nicotine Polacrilex Gum, Transdermal
Nicotine Patch, Nicotine Inhaler, Nicotine Lozenge, Nicotine
Sublingual Tablets and Other Smoking Cessation Therapies.
Scientists use monkey clones
to extract stem cells
Researchers in Oregon are reporting that they used cloning to
produce monkey embryos and then extracted stem cells from the
embryos. Not only is this the first time such cells have been
produced in any animal other than a mouse, but the method, the
researchers say, should also work in humans. In 2004, South
Korean researchers reported making stem cells from cloned
human embryos, but the claim turned out fraudulent."We hope
the technology will be useful for other labs that are working
on human eggs and human cells," the lead researcher of the
group, Shoukhrat Mitalipov at Oregon Health and Science
University in Beaverton, said."I am quite sure it will work
in humans." The monkey stem cells were genetically identical
to an adult monkey, Semos, whose cells were cloned. They are a
sort of universal cell that can, in theory, develop into any
tissue or organ. Medical researchers and patient advocacy
groups have long hoped to use human embryonic stem cells to
study diseases and supply replacement cells to treat them. So
far, though, stem cell research has not yielded cures, and
many obstacles lie ahead. An advantage of using cloning to
obtain stem cells is that they would genetically match a
patient" cells, making it unnecessary to suppress the immune
system if the stem cells are used in treatment. Cloning could
also produce stem cells that genetically match patients with
complex diseases like Alzheimer". That might let scientists
study those cells and understand how the diseases progress.
With the monkey work, some researchers say, cloned human
embryonic stem cells seem more feasible. There is no way to
know, of course, whether it will be harder or easier to repeat
the work with humans."I'm very enthusiastic," said Dr.
Leonard Zon, director of the stem cell program at Harvard" Children" Hospital."The next step is definitely doing it in
humans." Groups opposing human cloning and the destruction of
human embryos to extract stem cells say the report makes it
more urgent than ever to draw a moral line."I certainly think
that this represents a new threshold in the entire
discussion," said the Rev. Tadeusz Pacholczyk, director of
education at the National Catholic Bioethics Center."At this
point, it becomes essential to ask a question as a society:
Are there ever going to be circumstances where it is morally
justifiable to clone human beings?" The report on cloned stem
cells, which appears in the Nov. 22 issue of Nature, was
published online yesterday, after some details of the work had
filtered into the news media. Dr. Mitalipov said his team
showed that the cloned cells had features characteristic of
universal cells. For instance, they developed into monkey
heart cells and nerve cells. The team also put the cells in
mice, where they turned into a wide array of cell types. The
stem cells, Dr. Mitalipov said,"can contribute to any cell of
the body." (The
New York Times)
To read
the original article see
THIS LINK.
Two new members elected to
serve at the ASHES Board
On
October 31, members of the American Society for Healthcare
Environmental Services (ASHES) elected Fiona Nemetz, CHESP,
and Mark Regna, MBA, MHA, to serve on the board of directors
from 2008 to 2010. Nemetz has 15 years experience in
healthcare and is the director of Environmental Services and
Transportation for Saint Joseph" Hospital in Atlanta, GA.
Nemetz has served in multiple ASHES committees and taskforces
since joining the society in 1998. Regna has 25 years
experience in health care and is currently the Director of
Healthcare Services for Jani-King International; a contracting
service company based in Addison, TX. Regna currently serves
as knowledge and content advisor to ASHES and committee chair
for the publications committee. Both Regna and Nemetz will
serve 3 years term beginning January 1, 2008.
The
American Society for Healthcare Environmental Services, of the
American Hospital Association, is the premier health care
organization for over 2,200 environmental services,
housekeeping, waste management, transport and textile care
professionals, the only healthcare environmental services
organization affiliated with the American Hospital
Association.
For more
information see
THIS LINK.
FDA clears silver-coated
breathing tube for marketing; Reduces risk of pneumonia for
patients using ventilators
The U.S.
Food and Drug Administration announced that it has cleared for
marketing a breathing tube coated with a thin layer of silver.
The coating, a material known to have antimicrobial
properties, reduces the risk that patients on ventilators will
acquire pneumonia while in the hospital. The Agento
endotracheal tube, manufactured by C.R. Bard Inc., is intended
for patients who must rely on a ventilator to breathe for 24
hours or more. Patients requiring such a breathing support
system are at risk of exposure to hospital-acquired bacteria
that can build up on the breathing tube or pass through the
tube to their lungs, eventually causing a lung infection known
as ventilator-associated pneumonia (VAP).
Fifteen percent of the patients on ventilators develop VAP
every year and 26,000 die from the infection, according to the
Centers for Disease Control and Prevention."Patients who
require ventilator support are at increased risk for
pneumonia, which poses a significant public health issue. This
product can help to lower this risk," said Daniel Schultz,
M.D., director of FDA" Center for Devices and Radiological
Health. Silver has been known for its antimicrobial properties
for decades and has been used for this purpose on several
types of devices. This is the first endotracheal tube coated
with silver. In a multicenter clinical trial comparing the
Agento breathing tube to an uncoated tube, the percentage of
patients who developed pneumonia was reduced from 7.5 percent
to 4.8 percent. The Agento also delayed the onset of
pneumonia. The FDA in July issued a proposed guidance document
on antimicrobial device submissions stating that when
companies claim their product reduces or prevents
device-related infections, the claim should be supported by
such clinical data. C.R. Bard is located in Murray Hill, NJ.
They're Back - Alien
Droppings 2 debuts today!
After
boldly going where no health and hygiene company had gone
before with its launch of the first electronic touchless bath
tissue dispenser, Kimberly-Clark Professional is now set to
enter alien territory. And the public is invited to travel
along, through an out-of-this-world contest being announced at
www.aliendroppings.com. To enter, contestants must first
view a quirky two-part video of a hapless earthling" encounter
with a superior life form inside a men" room stall. The brief
vignettes depict what happens when an alien competes with a
human for access to a new restroom technology. The contest
challenge is to watch both videos and create a three-minute
script treatment for the duo" close encounter of the third
time. The grand prize winner will have their video produced
and will also receive a SONY HD video camera. Additional
prizes will be awarded for first and second place. Full
contest rules and prize information are available at
http://www.aliendroppings.com/welcome.html. The
second video installment debuts today. Contest entries must be
received by January 31, 2008.
November 14, 2007
Download print version
Scientists indicate HIPAA
privacy rule has had negative influence on health research
Four transplant recipients
contract H.I.V.
Number of cases of most
vaccine-preventable diseases in US at all-time low
Scientists indicate HIPAA
privacy rule has had negative influence on health research
About
two-thirds of clinical scientists surveyed report that the
HIPAA Privacy Rule for patients has had a negative influence
on the conduct of health research, often adding uncertainty,
cost and delays, according to a study in the November 14 issue
of JAMA. The Health Insurance Portability and
Accountability Act (HIPAA) Privacy Rule was intended to strike
a balance between protecting the privacy of individually
identifiable health information and preserving the legitimate
use and disclosure of this information for important social
goals, according to background information in the article.
However, many researchers have expressed concerns that since
implementation in April 2003, the Privacy Rule has adversely
affected the progress of biomedical research.
Roberta B. Ness, M.D., M.P.H., of the University of
Pittsburgh, PA, and colleagues with the Joint Policy
Committee, Societies of Epidemiology, conducted a survey to
determine the degree, type, and variability of influence from
the HIPAA Privacy Rule experienced by epidemiologists
conducting research on U.S. human subjects (participants).
Thirteen societies of epidemiology distributed a national
Web-based survey and 1,527 eligible professionals anonymously
answered questions. The researchers found that regarding
general perceptions of the HIPAA Privacy Rule, a majority of
respondents reported that the degree to which the rule made
research easier was low, at 1 to 2 (84.1 percent) on a 5-point
scale (with 1 = none, 5 = a great deal), and that the degree
to which the rule made research more difficult was high (67.8
percent), at 4 to 5 on the scale.
Almost 40 percent indicated that the Privacy Rule increased
research costs in the high range of 4 to 5, and half indicated
that the additional time added by the rule to complete
research projects was high. Almost half indicated that the
Privacy Rule had affected research related to public health
surveillance at the high level. The perceived benefit of the
rule with respect to strengthening public trust was reported
as high by only 10.5 percent of respondents, and only 25.9
percent believed that the rule had enhanced participant
confidentiality/privacy in the high range of 4 to 5.
Respondents also indicated that the proportion of
institutional review board applications in which the Privacy
Rule had a negative influence on human subjects (participants)
protection was significantly greater than the proportion in
which it had a positive influence.
Probe finds 30,000 Medicaid providers
cheating on taxes
More
than 30,000 Medicaid providers in seven states failed to pay more than $1
billion in federal taxes last year, but the government can't trim healthcare
payments in order to collect, according to a report to be released today. In
its fifth report to a Senate panel investigating tax cheats that do business
with the government, the Government Accountability Office (GAO) says that
about 5% of Medicaid providers in the seven states cheat on their taxes,
particularly payroll taxes collected from employees.
Some of the more
flagrant violators had multimillion dollar homes, along with fancy cars and
boats, the report says. Others were guilty of patient abuse or other
healthcare violations. None of the doctors or providers was identified in
the report."These doctors are supposed to be serving the most needy.
Instead, they are cheating taxpayers in order to line their pockets," said
Sen. Norm Coleman, R-MN, who initiated the tax-delinquency investigations
four years ago.
The latest report follows others that detailed how tens of thousands of
defense and other government contractors and Medicare providers also cheated
on their taxes. All told, the reports show, nearly $10 billion went
uncollected. Since the inquiry began in 2003, the government has reduced
payments in order to recover about $122 million in back taxes. The most has
come from defense contractors: $78 million, including $31 million last year.
The original goal of the Senate Permanent Subcommittee on Investigations was
to go after"waste, fraud and abuse." As tax cheats were forced to pay by
having their payments reduced, it also became a way for the Internal Revenue
Service to close a tiny portion of the"tax gap," an estimated $400 billion
or more that goes uncollected each year."You have a unique opportunity with
somebody you're paying to say, ‘Wait a minute, does he owe me anything?'"
said Mark Greenblatt, the Senate panel" Republican staff director. With
Medicaid, however, it won't be easy to collect. The federal government pays
about 57% of the $324 billion cost for the federal-state healthcare program, but
it is run through the states."The federal tax levy program is designed to
make sure that folks who get paid with taxpayer dollars get a portion of
those dollars withheld if they have outstanding tax debt," said Sen. Carl
Levin, D-MI, the panel" chairman."We need to figure out how to … stop those
Medicaid medical providers from putting taxpayer dollars into one pocket
while stiffing Uncle Sam by dodging their taxes."
The GAO conducted in-depth probes of 25 tax cheats and found"abusive and
related criminal activity" in every case. Among those detailed in the
report, which studied
California, Colorado, Florida, Maryland, New York, Pennsylvania and Texas:
The owner of a chain of nursing homes who owed more than $14 million in
taxes had a $2 million home decorated with crystal chandeliers, porcelain
china and Oriental rugs. The owners of a hospital who owed $5 million in
payroll taxes purchased a vacation home worth about $1 million. A
medical-clinic owner who owed more than $1 million had a $4 million house,
luxury vehicles and a pleasure boat. (USA Today)
Four transplant recipients contract H.I.V.
Four transplant recipients in Chicago have contracted
H.I.V.
from an organ donor, the first known cases in more than a decade in which
the virus was spread by organ transplants. The organs also gave all four
patients
hepatitis C, in what health officials said was the first
reported instance in which the two viruses were spread simultaneously by a
transplant. Though exceedingly rare, this type of transmission highlights a
known weakness in the system for checking organ donors for infection: the
most commonly used tests can fail to detect viral diseases if they are
performed too early in the course of the infection. Officials say the events
in Chicago may lead to widespread changes in testing methods."There are
important policy implications," said Dr. Matthew Kuehnert, director of the
Office of Blood, Organ and Other Tissue Safety at the federal
Centers for Disease Control and Prevention, which is
investigating the case."Clearly, the organ transplant community is going to
think about the issues raised by this, and we look forward to being involved
in those discussions."
The cases were first reported yesterday by The Chicago Tribune. Two
patients were infected at the
University of Chicago Medical Center, and one each at
Rush
University Medical Center and Northwestern Memorial Hospital. The
transplants were coordinated by an organization called the Gift of Hope of
Elmhurst, IL. Officials would not say what organs were transplanted, but a
transplant expert not connected with the case said they were most likely the
kidneys, liver and either the heart or lungs. Only four organs, and no other
tissue, were taken from the donor. The
University
of Chicago said that the operations took place in January, and that the
donor was an adult who died in an
Illinois hospital"three days after traumatic
injury." Neither the donor" age nor sex were disclosed. The other
hospitals declined to discuss what happened, except to
confirm that each had an infected patient. The situation came to light
earlier this month when one of the recipients, who was being evaluated for a
retransplant, tested positive for H.I.V. and
hepatitis C. At that point, blood preserved from the donor
was given a highly sensitive test for viruses, and the infection was found.
Dr. J. Michael Millis, the chief of transplantation at the
University
of Chicago, said the diseases were treatable. Initially, the donor had
tested negative for H.I.V. and hepatitis C, apparently because the infection
was too recent to be detected by commonly used blood tests. Those tests do
not find the virus itself, but instead look for the body" reaction to the
infection, the
antibodies produced by the immune system. But the body
takes time to react, and if the test is done too soon, within 22 days of
H.I.V. infection or 82 days for hepatitis C, antibodies may not yet be
detectable. Doctors say that is what probably occurred in
Chicago.
It has always been known that this kind of transmission was theoretically
possible, but it was considered highly unlikely. Since 1994 nearly 300,000
transplants from cadavers have occurred without any reported cases of H.I.V.
transmission. Another more sensitive type of test can pick up viral
infections earlier, but was not used. That test looks for evidence of the
virus itself, and can reduce the"window," the early period in which the
test does not work, to 12 days for H.I.V. and 25 days for hepatitis C. That
test, the nucleic acid amplification test, or Naat, is not widely available,
and doctors said it was more difficult and time-consuming than other tests,
and there is usually no time to spare with transplants because organs
deteriorate quickly when the donor dies. Another concern is that the test is
more likely than others to give false-positive results, and lead to the
needless destruction of healthy organs, a scarce resource. According to the
University of Chicago, the organ donor in Illinois was known to be"high
risk," based on a risk factor revealed by a close friend who provided"a
health and social history." The exact nature of the risk was not disclosed.
Dr. Millis said that he did not know whether the patients there had been
informed of the donor" status. About 9 percent of organ donors qualify as
high-risk based on behaviors like prostitution or drug use with
needle-sharing.(The New York Times) To read the original article see
THIS LINK
HHS unveils
plan to strengthen, update food safety efforts
HHS Secretary Mike Leavitt announced a comprehensive initiative by the Food
and Drug Administration designed to bolster efforts to better protect the
nation" food supply. The Food Protection Plan proposes the use of science
and a risk-based approach to ensure
the safety of domestic and imported foods eaten by American consumers. The
Food Protection Plan, which focuses on both domestic and imported food,
complements the Import Safety Action Plan delivered by Secretary Leavitt to
the President earlier today that recommends how the U.S. can improve the
safety of all imported products. This year, $2 trillion worth of goods will
be imported into the U.S., and experts predict that amount will triple by
2015. The Import Safety Action Plan lays out a road map with short- and
long-term recommendations to enhance product safety at every step of the
import life cycle. Taken together, the two plans will improve efforts by the
public and private sector to enhance the safety of a wide array of products
used by American consumers. Advances in food production technology, rapid
methods of food distribution, and globalization have transformed supermarket
shelves and restaurant menus, broadened the tastes of consumers, and
challenged the existing food protection framework.
The plan is premised on preventing harm before it can occur, intervening at
key points in the food production system, and responding immediately when
problems are identified. Within these three overarching areas of protection,
the plan contains a number of action steps as well as a set of legislative
proposals. Taken together, these efforts will provide a food protection
framework that ensures that the U.S. food supply remains safe. To strengthen its
efforts to
prevent
contamination, FDA plans to strengthen support of food industry efforts
to build safety into products manufactured either domestically or imported.
The FDA will work with industry, state, local, and foreign governments to
identify vulnerabilities and will look to industry to mitigate those
vulnerabilities, using effective methods such as preventive controls. The
plan"
intervention
element emphasizes focusing inspections and sampling based on risk at the
manufacturer and processor level, for both domestic and imported products,
that will help verify the preventive controls. This approach is complemented
by targeted, risk-based inspections at the points where foreign food
products enter the
United States, including ports. The plan calls for
enhancing FDA" information systems related to both domestic and imported
foods to better
respond
to food safety threats and communicate during an emergency.
The Food Protection Plan" three core elements, prevention, intervention, and
response, incorporate four cross-cutting principles for comprehensive food
protection along the entire production chain: Focus on risks over a product"life cycle from production to consumption; Target resources to achieve
greatest risk reduction; Use interventions that address both food safety
(unintentional contamination) and food defense (deliberate contamination);
and Use science and employ modern technology, including enhanced information
technology systems. The Food Protection Plan is available at
THIS LINK.
Number of cases of most vaccine-preventable
diseases in US at all-time low
A comparison of illness and death rates for 13 vaccine-preventable diseases
in the U.S., before
and after use of the vaccine, indicates there have been significant
decreases in the number of cases, hospitalizations and deaths for each of
the diseases examined, according to a study in the November 14 issue of
JAMA. In the United States,
vaccination programs have made a major contribution to the elimination of
many vaccine-preventable diseases and significantly reduced the incidence of
others."Vaccine-preventable diseases have societal and economic costs in
addition to the morbidity and premature deaths resulting from these
diseases—the costs include missed time from school and work, physician
office visits, and hospitalizations," the authors write. National
recommendations provide guidance for use of vaccines to prevent or eliminate
17 vaccine-preventable diseases.
Sandra W. Roush, M.T., M.P.H., of the Centers for Disease Control and
Prevention, Atlanta, and colleagues with the Vaccine-Preventable Disease Table
Working Group, examined the illness and death rates before and after
widespread implementation of national vaccine recommendations (in place
before 2005) for 13 vaccine-preventable diseases. The diseases were
diphtheria, pertussis, tetanus, poliomyelitis, measles, mumps, rubella
(including congenital rubella syndrome), invasive Haemophilus influenzae
type b (Hib), acute hepatitis B, hepatitis A, varicella (chickenpox),
Streptococcus pneumoniae and smallpox. For eight diseases for which a
vaccine was licensed or recommended prior to 1980, the comparison of the
period before national vaccination recommendations vs. the 2006 number of
reported cases shows greater than 99 percent declines in the number of cases
for diphtheria (100 percent), measles (99.9 percent), paralytic
poliomyelitis (100 percent), rubella (99.9 percent), congenital rubella
syndrome (99.3 percent), and smallpox (100 percent). Smallpox has been
eradicated worldwide, and endemic transmission of poliovirus, measles virus,
and rubella virus has been eliminated in the
United States.
There were no reported deaths due to diphtheria, measles, mumps, paralytic
poliomyelitis, or rubella; deaths due to congenital rubella syndrome are not
reported. The decline in cases of mumps was 95.9 percent, of tetanus 92.9
percent, and of pertussis 92.2 percent. The decline in tetanus deaths was
99.2 percent and in pertussis deaths 99.3 percent. For five diseases for
which a vaccine was licensed or recommended after 1980 but before 2005,
cases of invasive Hib disease declined 99.8 percent or greater and deaths
declined 99.5 percent or greater; for hepatitis A, reduction in cases was
87.0 percent, deaths 86.9 percent; a decrease of 80.1 percent in cases and
80.2 percent in deaths for acute hepatitis B; a decline of 34.1 percent in
cases and 25.4 percent in deaths for invasive pneumococcal disease; and a
reduction of 85.0 percent in cases and 81.9 percent in deaths for varicella.
Hospitalizations declined by 87.0 percent for hepatitis A, 80.1 percent for
acute hepatitis B, and 88.0 percent for varicella.
"The number of cases of most vaccine-preventable diseases is at an all-time
low; hospitalizations and deaths from vaccine-preventable diseases have also
shown striking decreases. These achievements are largely due to reaching and
maintaining high vaccine coverage levels from infancy throughout childhood
by successful implementation of the infant and childhood immunization
program," the authors write."Continued
efforts to improve the efficacy and safety of vaccines and vaccine coverage
among all age groups will provide overall public health benefit.
The challenges in vaccine development, vaccine
financing, surveillance, assessment, and vaccine delivery are opportunities
for the future," the authors conclude.
Premier healthcare alliance lays out
principles for improved quality
and greater transparency in healthcare
In
policy principle papers released today, the Premier healthcare alliance
called for greater transparency in healthcare and improved quality of care
through comparative effectiveness research and prevention of
healthcare-associated infections (HAIs). In three separate papers
developed by Premier" board of directors and committees comprised of CEOs
from alliance member hospitals, Premier offers specific recommendations on:
Quality and pricing
transparency in healthcare
(See
THIS LINK)
Preventing
healthcare-associated infections (See
THIS LINK)
Support for comparative
effectiveness research (See
THIS LINK)
To
increase the transparency of healthcare, information on both quality and
cost for all providers should be made publicly available and be designed
specifically to enable patients to make informed decisions, the Premier
principles state. Supporting steps which many Premier hospitals at the
forefront of infection control are already taking, Premier calls for
transparent, evidenced-based strategies to reduce identifiable, measurable
and preventable HAIs."Premier supports public reporting that is intended to
provide a basis for the collection of HAI information that will be useful to
improve patient safety and healthcare outcomes," the principles suggest.
Premier further states that any legislative or regulatory effort to require
public reporting of HAIs should recognize the need for improved data
resources and infection surveillance, education for healthcare teams and the
costs of infection control efforts to healthcare providers. Helping
hospitals in their commitment to providing treatments to their patients with
the safest and most effective medical devices and medicines will require
more scientific, evidence-based data on which to make the best clinical
decisions, Premier states in its principles. To address this information
gap, Premier supports the establishment of a federally sanctioned
organization that is independent and its processes transparent in
identifying priority areas of comparative clinical research. For more
information, see THIS
LINK
Amerinet announces 2007
Supplier Performance Award winners
Amerinet, a national
group purchasing organization for the healthcare industry, announced the
winners of its 2007 Supplier Performance Awards. Each year, Amerinet
recognizes its suppliers for delivering quality products and services to
health care providers across the nation.
"Amerinet continually strives to work with our suppliers to enhance
savings opportunities for our members," said Allen Dunehew, Amerinet" chief
contracting officer."Through the Amerinet supplier awards, we recognize our
suppliers' efforts for delivering high-performance supply chain and
workforce solutions to our members."
This year" Supplier Performance award winners are:
ASD Healthcare – Distributor over $25 Million in Amerinet Sales volume. Healthcare
organizations nationwide rely on ASD Healthcare for albumin, immune
globulins, hyper-immune globulins, antihemophilic factors, influenza vaccine
and other specialty pharmaceutical products. See
THIS LINK.
Graybar – Distributor
under $25 Million Amerinet Sales Volume.
Graybar, a
Fortune 500 company, specializes in supply chain management services and is
a leading North American distributor of high-quality components, equipment
and materials for the electrical and telecommunications industries. See
THIS LINK.
Philips Medical Systems – Manufacturer over $25 Million in Amerinet Sales
Volume.
Philips portfolio of medical systems includes best-in-class technologies in
X-ray, ultrasound, magnetic resonance, computed tomography, nuclear
medicine, PET, radiation oncology systems, patient monitoring, information
management and resuscitation products. See
THIS LINK.
Kellogg" Food Away from Home – Manufacturer under $25 Million in Amerinet
Sales Volume.
Kellogg" Food Away From Home provides business-building solutions for health
care foodservice or vending operations. See
THIS LINK.
MedAssets Supply Chain Systems signs
contract with IMS for instrument services
IMS,
the InstrumentReady company, has announced that MedAssets Supply Chain
Systems has awarded IMS a multi-year contract to provide surgical instrument
repair, minimally invasive surgical support and central sterile process
improvement to MedAssets' customers nationwide. MedAssets Supply Chain
Systems is one of the largest group purchasing organizations in the U.S. and
builds customized solutions encompassing procurement of common medical
supplies, pharmaceuticals, physician preference supplies, food/nutrition
items, and capital equipment."The value of proactively managing instrument
repair costs was a key component in the selection of IMS," said Karlee
Koenig, Director, Clinical Supply Chain, MedAssets Supply Chain Systems.
"Our goal is to help healthcare providers improve their margins, and IMS
brings a refreshing approach to cost containment by being proactive and
helping hospitals eliminate the causes of instrument repair." To learn more
see THIS LINK or
THIS LINK
November 13, 2007
Download print version
Are antimicrobial soaps breeding
tougher bugs?
Burn injuries take devastating
toll on nation" children
Surgical errors rare but serious
in ophthalmic procedures
Methodist" new $300M hospital to
break ground early next year
Are antimicrobial soaps
breeding tougher bugs?
The problem
about our obsession with killing germs, some scientists and
public health advocates warn, is that it may ultimately do us
more harm than good. Chief among those skeptics is
microbiologist Stuart Levy of Tufts University School of
Medicine, president of the Alliance for the Prudent Use of
Antibiotics (APUA). Levy" research has led him to question why
"antibacterial ingredients, once successfully used to prevent
transmission of disease-causing microorganisms among patients,
particularly in hospitals . . . are now being added to
products used in healthy households . . . even though an added
health benefit has not been demonstrated." That" happening,
Levy said, despite several"potential negative consequences"
of these products, including weakening the immune system,
which could lead to a greater chance of allergies in children,
and their possible link to the emergence of antibiotic
resistance, the very problem that is making some diseases,
such as methicillin-resistant Staphylococcus aureus, or MRSA,
so difficult to treat. Members of the manufacturing industry,
meanwhile, including Brian Sansoni, vice president of
communications at the Soap and Detergent Association, contend
that consumers can use these products"with confidence"
because"they reduce or kill germs on the skin that can make
us sick."
And
that message has found a following. According to Mintel GNPD, a market
research firm based in Chicago, 71 percent of adults who do some or all of
the household cleaning"prefer [to use] antibacterial and germ-killing
cleaning products." The first mass-marketed antimicrobial product was put
out in 1948 by the Dial Corp."Aren't you glad you use Dial?" the marketing
campaign asked:"Don't you wish everybody did?" The implied biology lesson,
a correct one, as it happens, was that bacteria are partly responsible for
body odor. The new deodorant was a hit; Liquid Dial followed in 1987, and a
waterless hand-sanitizing gel in 1998. Major marketing breakthroughs came
when companies figured out how to put the antimicrobial compounds into more
than just soap. Hand sanitizers were swiftly followed by germ-killing
plastics and synthetic fibers, and suddenly nearly every product in your
house, from air filters to wallpaper, bathroom appliances, door frames, food
storage containers and the kitchen sink, could be part of the fight against
bugs. Check your computer keyboard; chances are it was treated with a film
of Microban, one of the leading trade names for triclosan.
Plain old soap relied for its chemistry primarily on animal and vegetable
fat, and its cleaning power came essentially from its ability to create suds
and lather, as the soap molecules formed a thin film around dirt, allowing
it to be washed away under running water. Down the drain go not only
bacteria but also viruses, such as those that cause the common cold.
Compounds like chlorine, alcohol and peroxide (which kill immediately and at
random rather than inhibiting the growth of bacteria) were often added to
give soap extra cleansing kick. Those products are also commonly found in
travel wipes and towelettes. Adding specifically antibacterial agents seemed
a natural next step. And although Levy and other scientists don't dispute
that these chemicals can kill bacteria, they argue there" no evidence they
do any good."No study has shown that," Levy said. What" more, many
illnesses such as flu and the common cold, are caused not by bacteria but by
viruses, and antibacterials can't slow a virus at all. (Washington Post) To
read the original article see
THIS LINK
MRSA staph infection hits senior citizens
hardest, hospitalizations up 10 fold since 1995
The
highest rate of MRSA hospitalization was among the elderly - 360.8 of every
100,000 hospital stays were for MRSA treatment. This was more than three
times higher than for any other age group: >19.2 for 1- to 17-year-olds,
>58.1 for 18- to 44-year-olds, and > 111.5 for 45- to 64-year-olds per
100,000. These are just some of the facts released in a statistical report,
"Infections with Methicillin-Resistant Staphylococcus Aureus (MRSA) in U.S.
Hospitals, 1993–2005," from Healthcare Cost and Utilization Project of the
Agency for Healthcare Research and Quality. Authors are Anne Elixhauser,
Ph.D. and Claudia Steiner, M.D., M.P.H. Infections with
methicillin-resistant Staphylococcus aureus (MRSA) are resistant to the
antibiotics normally used to treat them (beta-lactam antibiotics, including
methicillin, oxacillin, amoxicillin, and penicillin), according to the
brief. The authors say that from current evidence it is not possible to
determine whether these infections originated in the hospital or were
community acquired.
Key
findings include: MRSA hospitalizations were more likely to begin in the
emergency department, to be transfers from another hospital, or transfers
from long-term care settings. The in-hospital death rate for MRSA stays was
4.7 percent compared with 2.1 percent for non-MRSA stays. The most common
conditions associated with MRSA are skin infections (18.9 percent of all
MRSA cases), pneumonia (9.0 percent), complications of medical care (about
16 percent), and septicemia (7.3 percent). Overall, 44.0 percent of all
hospital inpatients with MRSA in 2004 were over the age of 65, 27.6 percent
were 45 to 64 years old, and 22.2 percent were age 18 to 44. Compared with
patients without MRSA infections, a significantly larger proportion of
patients in the hospital with MRSA infections tended to be 45 years and
older. With respect to gender, only 47.3 percent of MRSA patients were
female compared with 59.0 percent of non-MRSA patients. Parallel to the age
distribution, 45.6 percent of all MRSA hospitalizations were covered by
Medicare compared with 32.9 percent of hospital stays during which MRSA was
not recorded. There was no difference in MRSA infection rates for
patients covered by Medicaid and for the uninsured. The highest rate of MRSA
hospitalization was for those 65 years and older with 360.8 stays per
100,000. Infants less than one year of age were the next highest group with
114.7 MRSA stays per 100,000 population. This group was followed closely by
45 to 64 year olds who had 111.5 MRSA stays per 100,000 population. Patients
covered by Medicaid had 184.1 stays per 100,000, and the uninsured had 43.2
stays per 100,000. For more information see
THIS LINK
Burn injuries take devastating toll on
nation" children
The
approach of winter season brings with it an increase in burn-related
injuries to our nation" children. Annually in the United States, fires and
burns result in almost 4,000 deaths and more than 745,000 non-hospitalized
injuries among all age groups. A new study conducted by researchers at the
Center for Injury Research and Policy at Nationwide Children" Hospital,
concludes that burn-associated injuries among children and adolescents in
the U.S. may be a more significant public health concern than previously
estimated. The study, published in the November issue of the Journal of
Burn Care and Rehabilitation, estimates there are approximately 10,000
pediatric (18-years-old and younger) burn injuries annually in the U.S.,
resulting in almost $212 million in hospital inpatient charges."Burns are a
major source of pediatric death and disability and are associated with
significant national healthcare resource utilization," said study senior
author Gary Smith, MD, DrPH, director of the Center for Injury Research and
Policy at Nationwide Children" Hospital, and faculty member at The Ohio
State University College of Medicine."Burns often require long periods of
rehabilitation, multiple skin grafts and extensive physical therapy. Not
only can burn-related injuries leave patients with lifelong physical and
psychological disabilities, they often also result in significant burdens
for the patients' families and caregivers."
The
study found that children 2-years-old or younger were more likely to be
hospitalized for burns to their hands or wrists and from contact with hot
liquids or objects, compared with children 3 to 17-years-old who were more
likely to be burned by fire. Children 2 years of age and younger accounted
for half of the children hospitalized for burns, and almost two-thirds of
hospitalized children were male. The average length of hospital stay was 7
days with an average inpatient hospital charge of $21,800."Findings from
our study underscore the importance of promoting known strategies that are
effective in preventing burns among children," said Smith."Examples include
the installation and maintenance of residential smoke alarms, residential
sprinkler systems, developing and practicing an escape plan in case of a
fire, anti-scald devices on faucets, limiting water heater temperature and
child-resistant cigarette lighters." This is the first study to analyze
patient and injury characteristics associated with pediatric burn
hospitalizations utilizing a nationally representative sample. Data for the
study were obtained from the Healthcare Cost and Utilization Project Kids'
Inpatient Database.
Surgical errors rare but serious in
ophthalmic procedures
Surgical confusions, for instance, operations involving the wrong site, the
wrong patient or the wrong procedure, occur infrequently in eye surgery
procedures, according to a report in the November issue of Archives of
Ophthalmology, one of the JAMA/Archives journals. Although most surgical
confusions cause little or no permanent injury, they may involve serious
consequences for the patient, physician and profession, yet could often be
prevented."Surgical confusions (i.e., wrong patient, wrong site, wrong
procedure) are an increasingly recognized cause of morbidity, recently
representing the most common category of reportable medical error," the
authors write as background information in the article."In July 2004, the
Joint Commission on Accreditation of Healthcare Organizations, in concert
with many professional organizations, including the American Academy of
Ophthalmology, promulgated the Universal Protocol in an effort to prevent
such confusions in all surgical procedures. This protocol includes
consistent preoperative verification, site marking and a time-out
immediately before incision."
John W. Simon, M.D., of the Lions Eye Institute, Albany Medical
College, NY, and colleagues retrospectively analyzed 106 cases of surgical
confusions involving eye operations that occurred between 1982 and 2005.
This included 42 cases from the Ophthalmic Mutual Insurance Company and 64
from the New York State Health Department. Their analysis found that: The
most common confusion was wrong lens implants, which occurred in 67 of 106
cases (63 percent) and most often happened because lens specifications were
not checked properly before implantation. The wrong eye was injected with
anesthesia in 14 cases (13 percent) and operated on in 15 cases (14
percent). In eight cases, confusions involved the wrong patient or the wrong
procedure. The wrong tissue was transplanted in two cases.
Confusions involving the wrong implant or transplant more often
caused severe injuries than those involving the wrong eye, patient or
procedure. The Universal Protocol, if implemented, would have prevented 85
percent of the confusions. The authors estimate that these data suggest a
rate of 69 surgical confusions for every 1 million eye operations."The
causes of these confusions were faulty systems, processes and conditions
that led people to make mistakes, more often than an individual"recklessness," the authors write."The traditional response to medical
error, ‘blame, shame and train,' therefore misses the point. Humiliating or
otherwise disciplining caregivers tends to perpetuate a culture of secrecy
that impedes effective root-cause analysis and future improvement. A more
enlightened approach is entirely non-punitive, drawing on methods of crew
resource management adapted from the airlines and the defense department."
Methodist" new $300M hospital to break
ground early next year
The
Methodist Hospital System has released additional information on plans to
build a $300 million hospital in west Houston. Methodist will break ground
in early 2008 on a 192-bed hospital on the north side of Interstate 10,
between Barker Cypress and Green House road. The hospital will be
constructed next to the Texas Children" Hospital on 88 acres purchased
recently by Methodist. When it opens in 2010, this will be the fourth
community hospital in the Methodist system. Some features of the upcoming
west side facility include 14 operating rooms, a breast center, radiation
therapy and labor and delivery services."Methodist has served the broader
Houston
community for almost 90 years," said Ron Girotto, president and CEO of The
Methodist Hospital System, in a prepared statement."And now we have the
opportunity to bring our long history of leading medicine and excellent
patient care to the residents of west Houston." Methodist also announced
plans for a state-of-the-art imaging center to open in late 2008 on I-10
near Voss. The healthcare system is the midst of a $1.5 billion expansion
effort that includes the
Methodist
Outpatient
Center,
The Methodist Hospital Research Institute and a new inpatient tower in the
Texas Medical Center. (Houston Business Journal)
Public hospital ban on cosmetic surgery
Cosmetic surgical procedures have been banned in South Australian public
hospitals. Health Minister John Hill said it will free up hospital beds and
operating theatres for other patients."This is just another example of the
activity we are going through to try to make the system work better," he
said."But I guess there is an ethical issue too. Should our public
hospitals be involved in doing procedures which are not medically based?"
Hill said the ban includes liposuction, facelifts and circumcision of boys.
He expects some families to be disappointed that they will have to go to a
private hospital or clinic for their child" circumcision."I think some
people will object very strongly and think it is their right to have a free
procedure done in a public hospital for cultural reasons," he said."Of
course there are others who strongly support this procedure being stopped."
(ABC News) See
THIS LINK
New Zealand puts in quarantine 223 Koreans in bird flu scare
After a passenger of a Korean airlines plane displayed possible symptoms of
bird flu in New Zealand
airport, 223 people from this plane were put in quarantine by the health
authorities. The woman was later deemed to be"no risk" and suffering from
suspected gastroenteritis, airport police Inspector Richard Middleton said,
congratulating the flight crew for notifying authorities about the potential
problem. The woman, whose name was not released, was briefly treated at a
hospital in Auckland, Middleton said. Crew on the flight, from
South Korea
via Australia, alerted airport authorities when the woman began vomiting and
showing other possible bird flu symptoms, sparking a lockdown on the tarmac
as the plane landed, said Norman Upjon, an ambulance duty manager. The 223
people aboard the Boeing 747 were held for about an hour under"full
quarantine procedure" while a paramedic in protective clothing examined the
woman, Upjohn said. South Korea declared itself bird flu free in June, after
reporting no new cases of the H5N1 strain of bird flu - in birds or humans,
for three months. Australia and New Zealand have reported no infections of
H5N1, which has killed at least 204 people worldwide since 2003, according
to the World Health Organization. (Pravada.Ru) See
THIS LINK
November 12, 2007
Download print version
A heart stent gets a reprieve
from doctors
Chicago
hospitals'
profits soaring to new highs
Obesity and overweight linked to
higher prostate cancer mortality
Antivirals reduce deaths from
flu in hospitalized patients
China Med - Messe Dusseldforf |
