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Insurer offers option for surgery in India Resource Optimization & Innovation adopts GS1 healthcare standards Platte Valley Medical Center to implement Caduceus Systems’ materials management information system Insurer offers option for surgery in India The health insurer Wellpoint is testing a new program that gives covered patients the option of going to India for elective surgery, with no out-of-pocket medical costs and free travel for both the patient and a companion. The program is being tested at Serigraph, a printing company in Wisconsin whose managers have been looking for ways to curb rising healthcare costs, said Dr. Razia Hashmi, chief medical officer for national accounts for Anthem Blue Cross and Blue Shield, which is affiliated with Wellpoint. “We will be monitoring every aspect of this very closely, to make sure everyone is satisfied and there are good clinical outcomes,” Dr. Hashmi said. By the year 2010, more than 6 million Americans annually will be seeking medical treatment abroad, according to the Deloitte Center for Health Solutions, a consultancy. Knee surgery that costs $70,000 to $80,000 in the United States can be performed in India for $8,000 to $10,000, including follow-up care and rehabilitation, Dr. Hashmi said. Similar savings could be achieved for such common procedures as hip replacements and spine surgery. If other insurers follow Wellpoint, Dr. Hashmi said, the trend ultimately may pressure on United States hospitals to be more competitive in their pricing. Critics say that’s unlikely. “There have been some reports of hospitals that have been willing to match the prices, but I don’t know how they’re doing that,” said Howard Berliner, a professor of health policy and management at State University of New York Downstate Medical Center in Brooklyn. “The reality is there’s just no way that most hospitals can respond to this. It’s just like any service that’s outsourced — the price is so cheap abroad that there isn’t much an American company can do about it.” At the same time, he said, the program could potentially siphon off the healthiest, most profitable patients from a local hospital. The pilot program arranges for patients to be picked up at the airport and provides special meals to prevent food-borne illnesses. The program complies with the American Medical Association guidelines on medical tourism and uses hospitals accredited by the Joint Commission International. Dr. Hashmi said it had actually been easier to evaluate the quality of medical care abroad than in the United States. “There is a lot more willingness to share data about complication rates, the total number of procedures and the outcomes,” Dr. Hashmi said. “We’re able to get detail per hospital and per physician.” In addition to saving out-of-pocket costs for surgery for patients, the program could potentially help keep insurance premiums affordable, Dr. Hashmi said. But
Dr. Berliner predicted that medical tourism would be of limited appeal to
Americans with private health insurance. “Everyone is just waiting for the
one horrible case to happen over there,” he said, “and then everyone will
stop thinking this is such a great idea.” (The New York Times)
Read the complete article.
National survey finds numerous problems facing primary care doctors, predicts escalating shortage ahead A survey released by The Physicians’ Foundation depicts widespread frustration and concern among primary care physicians nationwide, which could lead to a dramatic decrease in practicing doctors in the near future. The survey examined the causes behind the doctors’ dissatisfaction, the state of their practices and the future of care. The resulting findings show the possibility of significantly decreased access for Americans in the years ahead, as many doctors are forced to reduce the number of patients they see or quit the practice of medicine outright. An overwhelming majority – 78 percent – of physicians believe that there is an existing shortage of primary care doctors in the United States today. Additionally, nearly half of them – 49 percent, or more than 150,000 practicing doctors– say that over the next three years they plan to reduce the number of patients they see or stop practicing entirely. The Physicians’ Foundation believes the future of primary care could have a significant impact on the American healthcare debate. “At a time when the new Administration and new Congress are talking about ways to expand access to healthcare, the harsh reality is that there might not be enough doctors to handle the increased number of people who might want to see them if they get health insurance,” said Walker Ray, MD, Vice President, The Physicians’ Foundation. The reported reasons for the widespread frustration among physicians include increased time dealing with non-clinical paperwork, difficulty receiving reimbursement and burdensome government regulations. Physicians say these issues keep them from the most satisfying aspect of their job: patient relationships.
“Tens of thousands of primary care doctors face the same problems as
millions of ordinary citizens: frustrations in dealing with HMOs and
government red tape,” said Sandra Johnson, Board Member, The Physicians’
Foundation. “The thing we heard over and over again from the physicians was
that they’re unhappy they can’t spend more time with their patients, which
is why they went into primary care in the first place.”
More information.
CDC monitors shortage of Hib vaccine; Shot protects against infection that can cause meningitis, pneumonia in young children U.S. health officials said Thursday that a shortage of vaccine is leading them to monitor Hib infections, one of the most important causes of bacterial illness in young children. Though the agency has yet to see an increase in cases, the stepped-up surveillance was prompted by a disruption in the supply of vaccine that has virtually eliminated Hib (Haemophilus influenzae type b) infections since it was introduced in 1988. Hib infection can cause a variety of illnesses, including meningitis, blood stream infections, and pneumonia, according to the U.S. Centers for Disease Control and Prevention. Hib is not a cause of the seasonal flu. “The shortage is not serious but it is concerning,” said Michael Jackson, an epidemiologist with the CDC. The shortfall was caused by a recall of certain lots of Hib conjugate vaccine, and then the suspension of production by drug maker Merck & Co. last December. Merck originally expected to resume production late this year, but delays have pushed that timetable back to the middle of 2009, the CDC said in its Nov. 21 Morbidity and Mortality Weekly Report. One reason the vaccine shortage hasn’t been more serious is that drug maker Sanofi-Aventis also makes Hib vaccine, Jackson said. Before the introduction of the vaccine, some 20,000 U.S. children would get serious and sometime fatal Hib infections each year, the CDC noted. Merck spokeswoman Amy Rose said that problems with the vaccine’s sterilization process necessitated recalling the vaccine and then stopping production. The vaccines are marketed as PedvaxHIB and Comvax. To manage the shortage, health officials are recommending giving the Hib vaccine to infants, but holding off on a recommended booster shot for children age 12 to 15 months, except those at increased risk for Hib disease. The
agency is asking doctors, state health departments and state laboratories to
increase their surveillance of Hib. Jackson said tracking Hib cases isn’t
easy. There are many different types of influenzae and there are many steps
involved in testing and reporting the various types, so information often
gets lost along the way, he said. “The information we are getting at CDC is
that we are missing about 40 percent of cases,” Jackson said. “That’s a
little worrisome because that’s 40 percent of people we don't know if they
have type b, which is the vaccine-preventable one, the one we are really
worried about, or if they have something else. It makes it harder for us to
see changes in Hib if there really is something going on in the population.”
(HealthDay News)
Get more information.
T.J. Samson Community Hospital to use OperationsAdvisor and Performance Partner to implement, manage labor productivity system T. J. Samson Community Hospital, a Planetree model hospital serving Glasgow and Barren County, KY, is expanding its relationship with the Premier healthcare alliance to include Premier’s labor management program. Premier’s OperationsAdvisor tool and comparative database will be included, as well as the services of a Premier Performance Partner to help implement and monitor labor use. T. J. Samson has been an owner of the Premier Purchasing Partners group purchasing organization since 1987 and recently installed SpendAdvisor MySpend, the alliance’s spend management decision-support tool. The community hospital also uses Premier’s Performance Improvement Portal.
Premier’s labor management program uses OperationsAdvisor, a Web-based tool
that offers a unique combination of productivity monitoring, assessment and
comparative data. OperationsAdvisor Productivity focuses on putting relevant
productivity and labor cost data into managers’ hands in an
easy-to-understand, timely basis and includes the ability to correlate labor
performance to quality indicator data. Hospitals and integrated delivery
networks use OperationsAdvisor Benchmarking for budgeting, developing labor
standards and prioritizing improvement projects by accessing a comparative
database made up of some 450 submitting facilities.
Resource Optimization & Innovation adopts GS1 healthcare standards Resource Optimization & Innovation (ROi), the Sisters of Mercy Health System’s (Mercy) supply chain operating division, is taking a landmark step in the healthcare industry by adding specific terms to contract language requiring the use of GS1 standards in transactions and in production processing. Under the direction of Larry Dooley, vice president of group purchasing for ROi and former chairperson to the Coalition for Healthcare e-Standards, amended contract language is being sent to all ROi and Mercy contracted suppliers requiring the use of GS1 standards. These standards include: Global Trade Identification Number (GTIN) – a 14-digit code registered by the GS1 organization for each individual manufactured product as well as to each different packaging configuration; Global Location Number (GLN) – a 13-digit code registered by the GS1 organization used to uniquely identify healthcare supplier and provider locations; and Global Data Synchronization Network (GDSN) – a network of certified data pools enabling the standardization and synchronization of supply chain data between trading partners. According to Vance Moore, president of ROi, “A rough infrastructure is in place to support GS1 standards with some of our trading partners today, to the point where production processing has become possible. More and more progress is happening daily and every standards-enabled transaction that transmits through the system brings us one step closer to an efficient supply chain like those seen in other industries.” GS1 standards provide a framework that ensures effective exchanges between companies and act as basic guidelines that facilitate interoperability and provide structure to many industries. Recently, announcements in support of GS1 standards have been made from leading group purchasing organizations and healthcare-related agencies, but few have been made on the part of providers. ROi has already notified some trading partners of a date when production electronic data interchange (EDI) transactions using GTINs and GLNs will begin. Global Healthcare Exchange (GHX), the largest and most utilized electronic commerce exchange in the healthcare industry, is assisting ROi and Mercy in enabling the use of GS1 standards, as Mercy transacts many of its purchases with suppliers through the GHX exchange. MJ Wylie, director of global data standards with GHX, states: “As industry leaders such as Mercy adopt the GS1 standards, GHX can help them achieve the maximum benefit by making it possible to utilize those standards in transactions. Next year, when GHX becomes a GDSN-certified data pool, we will be able to further accelerate the use of those standards by Mercy, as well as others participating in the GDSN.” In
addition to improving current supply chain processes, the adoption of GS1
standards establishes a solid foundation for future healthcare regulatory
requirements, such as Pedigree and Unique Device Identification (UDI). The
necessity of regulatory and industry standards adoption is expected to
become more apparent as healthcare providers increase use of electronic
transactions, electronic health records and automatic identification
systems, all of which benefit from the use of precise standards. Visit
www.ghx.com for more information.
VHA Inc. identifies $3 million savings for Pennsylvania and New Jersey Hospitals; Decreasing patient length of stay increases CMS payments The Centers for Medicare and Medicaid Services’ (CMS) has implemented changes to the coding system it uses to determine payments to hospitals. The changes to the old diagnosis-related group (DRG) system, which helps hospitals classify patients into approximately 500 groups, have a major impact on how hospitals do business. VHA Inc., the national healthcare alliance, is helping hospitals to identify ways to decrease length of stay (LOS) and improve documentation of care so they can obtain the most appropriate reimbursement from CMS. In June, VHA issued reports to member hospitals in Southeastern Pennsylvania and New Jersey that identified an average of $6.6 million in potential cost savings and $3.2 million in potential length of stay savings (per hospital) when they were compared to best practice hospitals in the United States. “Nearly half of New Jersey hospitals (48 percent) are losing money because the length of stay for patients is longer than the CMS estimate, and the additional expenses associated with the longer stay aren’t covered by the set payment amount. VHA hopes to highlight the opportunities hospitals have to capture that revenue by helping them find ways to improve operations and shorten length of stay without compromising quality,” said Kathy Blandford, area senior vice president and executive officer for VHA East Coast. “Recognizing the financial impact, benchmarking against peers and finding out how others are achieving better results is essential to effectively adapt to the new CMS payment system.” VHA’s Medicare Severity Diagnosis-Related Group (MS-DRG) Impact Reports provide hospitals with a summary of potential gains and losses related to converting to the new MS-DRG system, the effects on case mix index and the impact of newly established present on admission guidelines. In
general, the top three DRGs identified for potential cost savings and LOS
savings were: heart failure and shock, sepsis and respiratory system
diagnosis with ventilator support. For more information, visit
www.vha.com.
26 percent of sleepless children become overweight; 1 quarter of children who sleep fewer than 10 hours a night become overweight by age 6 Between the ages of six months and six years old, close to 90 percent of children have at least one sleep-related problem. Among the most common issues are night terrors, teeth-grinding and bed-wetting. At least 30 percent of children in this age group have difficulties sleeping six consecutive hours, either because they can’t fall into slumber or they can’t stay asleep. While the effects of lack of sleep on learning are well documented, researchers at the Université de Montréal have found sleepless children can become overweight and hyperactive. Jacques Montplaisir, a professor in the Department of Psychiatry and director of Sleep Disorders Center at Sacré-Coeur Hospital said that 26 percent of children that sleep fewer than 10 hours a night between two and half years and six years are overweight. The figure drops to 15 percent of those that sleep 10 hours and falls to 10 percent among those that sleep 11 hours. The research team analyzed a sample of 1,138 children and found: 26 percent of kids who didn't sleep enough were overweight, 18.5 percent carried extra weight, while 7.4 percent were obese. The relationship between sleep and weight could be explained by a change in the secretion of hormones that’s brought on by lack of sleep. “When we sleep less, our stomach secretes more of the hormone that stimulates appetite,” Montplaisir explains. “And we also produce less of the hormone whose function is to reduce the intake of food.” Naps don’t compensate for nightly lack of sleep, Montplaisir pointed out. According to the same study, inadequate sleep could also lead to hyperactivity. Twenty-two percent of children who slept fewer than 10 hours at age two and a half suffered hyperactivity at six years old, which is twice the rate seen in those who slept 10 to 11 hours per night. According to Montplaisir, “in adults, inadequate sleep translates into sleepiness, but in children it creates excitement,” he said.
Children were also given a cognitive performance test in which they had to
copy a picture using blocks of two colors. Among the children who lacked
sleep, 41 percent did poorly, whereas only 17 to 21 percent of children with
10 or 11 hours of sleep per night performed badly. Problems experienced in
childhood risk continuing into later years if nothing is done and
Montplaisir suggests a new specialty in which sleep problems can be nipped
in the bud.
More information.
Platte Valley Medical Center to implement Caduceus Systems’ materials management information system Caduceus Systems, a provider of healthcare materials management information systems including wireless, real-time transaction processing and contract compliance systems, announced that Platte Valley Medical Center (PVMC) in Brighton, CO, has licensed the Caduceus Materials Management Information System (Caduceus MMIS) for implementation throughout its facility. PVMC has also contracted for consulting and implementation services associated with the deployment of the system. The Caduceus MMIS solution automates the processes and workflows associated with the requisitioning, procurement, receipt, movement, and charge capture of all medical and surgical supplies. A comprehensive solution, the Caduceus MMIS uses automatic data collection and mobile (wireless) computing for system-directed workflow. In addition to producing cost savings, the Caduceus MMIS eliminates redundant processes and enhances safety by reducing errors and allowing clinicians and caregivers to focus on patient care rather than supply management. The open architecture of the Caduceus MMIS facilitates integration with healthcare facilities’ financial and clinical systems used by PVMC, thereby reducing the time needed for implementation and preserving previous investments in existing systems.
Harold Dupper, Vice President of Finance at PVMC stated, “In addition to
Caduceus’ comprehensive, flexible, and feature-rich design, PVMC’s decision
in favor of Caduceus was swayed by its support of the Global Data
Synchronization Network (GDSN) and the use of manufacturers’ barcodes. PVMC
does not have to add a ‘custom’ barcode to its supply items, which is truly
time and money saved. More importantly, it allows PVMC to take advantage of
patient safety features for traceability of items by use of the embedded
barcode information. It will allow for greater compliance with regulations
regarding patient safety.”
November 20, 2008 Download print version Health insurers offer to accept all applicants, on condition Researchers: Ban on fast food TV advertising would reverse childhood obesity trends ‘Hospital of the Future’ report urges major changes Antibiotics: It's the efficacy, stupid Iowa and Nebraska Hospitals partner to prevent pressure ulcers GAO: Rising healthcare costs drive long-term and immediate pressures Cholera epidemic reaches dangerous levels in Zimbabwe Surgical study highlights pros and cons of gastric bypass surgery for severe obesity Health insurers offer to accept all applicants, on condition The health insurance industry said Wednesday that it would support a healthcare overhaul requiring insurers to accept all customers, regardless of illness or disability. But in return, the industry said, Congress should require all Americans to have coverage. The proposals, put forward by the insurers’ two main trade associations, have the potential to reshape and advance the debate over universal health insurance just as President-elect Barack Obama prepares to take office. In separate actions, the two trade groups, America’s Health Insurance Plans and the Blue Cross and Blue Shield Association, announced their support for guaranteed coverage for people with pre-existing medical conditions, in conjunction with an enforceable mandate for individual coverage. In the absence of such a mandate, insurers said, many people will wait until they become sick before they buy insurance. Members of Congress said Wednesday that they wanted to pass legislation next year, as proposed by Obama, to expand coverage and rein in healthcare costs. The new position taken by the insurance industry — the industry that helped sink President Bill Clinton’s plan for universal health coverage in 1994 — could ease the way for passage of such legislation. In many cases, people with cancer, diabetes, traumatic brain injuries or other serious afflictions have found that they cannot obtain health insurance at any price. Research suggests that some insurers turn down 10 percent or more of applicants for individual coverage because of their pre-existing medical conditions. Donald G. Hamm Jr., president of Assurant Health, explained why the industry thought an individual mandate must be coupled with any ban on such underwriting practices. “In the individual market, people can choose whether or not to apply for coverage,” Hamm said in an interview. “If they know they can obtain coverage at any time, many will wait until they get sick to apply for it. That increases the price for everyone.” Insurers say that is just what happened in several states that prohibited insurers from turning down applicants on the basis of their health status. While insurers would be required to sell insurance to any applicant, nothing would guarantee that consumers could afford it. Rate regulation promises to be a highly contentious issue, since it pits the financial interests of insurers against those of consumers.
Insurers did
not say how the government should enforce an individual mandate: whether
through fines, tax penalties or other means. (NY Times)
Read the complete article.
Researchers: Ban on fast food TV advertising would reverse childhood obesity trends A ban on fast food advertisements in the United States could reduce the number of overweight children by as much as 18 percent, according to a new study being published this month in the Journal of Law and Economics. The study also reports that eliminating the tax deductibility associated with television advertising would result in a reduction of childhood obesity, though in smaller numbers. The study was conducted by researchers from the National Bureau of Economic Research (NBER). The authors found that a ban on fast food television advertisements during children's programming would reduce the number of overweight children ages 3-11 by 18 percent, while also lowering the number of overweight adolescents ages 12-18 by 14 percent. The effect is more pronounced for males than females. Should the U.S. pursue that path, they would follow Sweden, Norway and Finland as the only countries to have banned commercial sponsorship of children's programs.
The study
also found that the elimination of tax deductibility tied to advertising
would similarly produce declines in childhood obesity, albeit at a smaller
rate of 5-7 percent. Advertising is considered a business expense and, as
such, it can be used to reduce a company's taxable income. The authors
deduce that, since the corporate income tax rate is 35 percent, the
elimination of the tax deductibility of food advertising costs would be
equivalent to increasing the price of advertising by 54 percent. Such an
action would consequently result in the reduction of fast food advertising
messages by 40 percent for children, and 33 percent for adolescents.
View the news item for more information.
Antibiotics: It's the efficacy, stupid An FDA committee's vote on Targanta's oritavancin could have a big impact on drug development. It's not looking good for Targanta and its hospital antibiotic, oritavancin, after the meeting of an advisory committee to the Food and Drug Administration. The company will probably have to conduct more clinical trials. Earlier, the FDA committee voted 21 to five that the data presented demonstrate the safety and effectiveness of a rival drug, telavancin, from biotech firm Theravance, despite worries about the drug's safety for patients with kidney problems and for pregnant women. But a slightly smaller version of the same committee had big doubts about oritavancin, despite a good safety profile. It voted 10 to eight (with one abstention) that two trials presented by Targanta did not show clear evidence of efficacy, particularly against the current drug-resistant scourge, methicillin resistant staphylococcus aureus (MRSA). Part of the problem for Targanta was that one of the oritavancin studies was conducted more than six years ago when patients with tissue infections were a very different group and there were fewer cases of MRSA. That study was also small. It was conducted not by Targanta, but by Eli Lilly, which formerly owned the drug. Oritavancin was also for a time in the pipeline of Intermune, another biotech company.
The clear
message here: When it comes to hospital antibiotics, proof of effectiveness
is far more important than showing a lack of side effects. It will be
interesting to see what effect this has on drug development. (Forbes.com)
Read the complete article.
‘Hospital of the Future’ report urges major changes A report released today from The Joint Commission offers guiding principles and actions for the hospital of the future to meet the daunting challenges of older and sicker patients, patient safety and quality of care, economics and the work force. As these challenges escalate, hospitals can lead the effort to meet these demands. Health Care at the Crossroads: Guiding Principles for the Development of the Hospital of the Future contends that hospitals must respond in new ways as escalating health care costs are hitting record highs and the conditions and care needs of hospitalized patients are growing more complex. The report is the work of an expert panel comprising hospital executives and clinical leaders, as well as experts in technology, health care economics, hospital design and patient safety. The roundtable analyzed how socio-economic trends, technology, the physical environment of care, patient-centered care values and ongoing staffing challenges will impact the hospital of the future.
The report
recommends action in five core areas: Economic Viability, Technology
Adoption, Patient-Centered Care, Staffing, and Hospital Design. The full
report can be found at
www.jointcommission.org.
Iowa and Nebraska Hospitals partner to prevent pressure ulcers Hospitals in Nebraska and one in Iowa are working to improve clinical quality by preventing and reducing pressure ulcers. The hospitals have joined a Rapid Adoption Network (RAN), a virtual network that allows them to share information about clinical practices to accelerate the pace of clinical improvement. The RAN is sponsored by VHA Inc., the national health care alliance. A focal point for the RAN will be a clinical blueprint VHA developed to help its members prevent or reduce the incidence of pressure ulcers. This blueprint captures the clinical processes and people factors that drive superior performance at leading hospitals. Creative tactics include:
The following hospitals are working on this project: Columbus Community Hospital, Columbus, NE;Community Hospital, McCook, NE; Faith Regional Hospital, Norfolk, NE; Nebraska Methodist Health System, Omaha, NE;Tri-county, Lexington, NE; Jennie Edmundson Hospital, Council Bluffs, IA.
A Rapid
Adoption Network is one component of VHA’s overall clinical improvement
services platform, which also includes: Leading Practices Portal – a website
that enables VHA hospitals to access information about their performance in
specific clinical areas and compare their performance with other hospitals
regionally and nationally;
Leading Practice Blueprints –
process maps based on anthropological research at top performing VHA
members. For more information visit
www.vha.com
GAO: Rising healthcare costs drive long-term and immediate pressures Rapidly rising healthcare costs are not simply a federal budget problem. Growth in health-related spending also drives the fiscal challenges facing state and local governments. The magnitude of these challenges presents long-term sustainability challenges for all levels of government. The current financial sector turmoil and broader economic conditions add to fiscal and budgetary challenges for these governments as they attempt to remain in balance. States and localities are facing increased demand for services during a period of declining revenues and reduced access to capital. In the midst of these challenges, the federal government continues to rely on this sector for delivery of services such as Medicaid, the joint federal-state healthcare financing program for certain categories of low-income individuals. During economic downturns, states can experience difficulties financing programs such as Medicaid. Downturns result in rising unemployment, which can increase the number of individuals eligible for Medicaid, and declining tax revenues, which can decrease revenue available to fund coverage of additional enrollees. The Government Accountability Office’s (GAO) simulation model to help states respond to these circumstances is based on assumptions under which the existing Medicaid formula would remain unchanged and add a new, separate assistance formula that would operate only during times of economic downturn. Considerations involved in such a strategy could include: • Timing assistance so that it is delivered as soon as it is needed, • Targeting assistance according to the extent of each state’s downturn, • Temporarily increasing federal funding so that it turns off when states’ economic circumstances sufficiently improve, and • Triggering so the starting and ending points of assistance respond to indicators of economic distress.
Visit here
for the complete summary
http://www.gao.gov/highlights/d09210thigh.pdf
Cholera epidemic reaches dangerous levels in Zimbabwe According to doctors in Zimbabwe, the cholera epidemic in Harare is claiming many lives and the government is massively under reporting the death statistics from this easily preventable disease. Local reports say that broken water pipes and sewage systems are responsible for most of the cases in Harare at a time when almost all government health services have collapsed. In Harare Tuesday, doctors from the state's largest hospital in Harare were prevented by riot police from demonstrating against the government's lack provision of medicines, equipment and living wages. They have also demanded salaries in foreign currency. The Parirenyatwa Hospital where the doctors were demonstrating stopped admitting patients last month because specialist doctors refused to work under the present conditions. Now the rest of the doctors have formally announced a work stoppage. Zimbabwe University closed the country's only medical school Monday and sent all third fourth and fifth year students home because of what it describes as the prevailing conditions. This unrest in the state medical fraternity comes against the background one of the worst cholera epidemic in Zimbabwe. Doctors Without Borders, which is trying to assist, says 1.4 million people in Harare are now at risk of catching this preventable disease. Many people are at home with the disease which can and has killed people in Harare in 24 hours from first symptom. Donors are providing drugs and equipment to the Infectious Diseases Hospital in Harare which is the only one left in the city able to treat people for cholera. The only doctors available are some from the Zimbabwe National Army.
Doctors say
only those who can afford private healthcare can get medical treatment in
Zimbabwe now. They say most of the state's health centers are closed around
the country. Zimbabwe had the best state medical care in Africa for at least
10 years after 1980 independence.
http://voanews.com/english/2008-11-18-voa28.cfm
Surgical study highlights pros and cons of gastric bypass surgery for severe obesity Severely obese patients who underwent two different gastric bypass techniques had lost up to 31 per cent of their Body Mass Index (BMI) after four years, with no deaths reported among the 50 study subjects, according to the November issue of the British Journal of Surgery. The number of patients suffering from high blood pressure fell by 76 per cent; diabetes fell by 90 per cent and cases of dyslipidaemia – abnormal concentrations of lipids or lipoproteins in the blood – fell by 77 per cent. However 29 complications were reported in 27 patients, including minor wound infections and narrowing of the anastomotic suture, and ten patients had to be operated on again in the four-year period after surgery. Surgeons at the University Hospital Zurich, Switzerland, carried out the study to compare two techniques and find out whether varying the length of the small bowel limb during surgery could offer superior weight loss. It had been suggested by several studies that a longer length would reduce the body's ability to absorb certain sugars and fats. As a result of the four-year study, they now perform proximal gastric bypass as the operation of first choice, having decided that the distal gastric bypass technique, with its longer alimentary limb, doesn't offer any significant advantages but does have a number of drawbacks. Key findings included: BMI decreased from 45.9 to 31.7 in the proximal group (31 per cent) and from 45.8 to 33.1 in the distal group (28 per cent).
Average
operating time was significantly longer in patients undergoing distal than
proximal bypass surgery (242 minutes versus 170 minutes) and distal patients
stayed in hospital longer (nine days versus eight days). For more
information visit
www.bjs.co.uk
November 19, 2008 Download print version Thomson Reuters announces top hospitals for cardiovascular care Case studies: Rigorous testing slows MRSA germ in VA hospitals, Tacoma General Suburban Detroit's hospital system cuts 500 jobs First operation for transplantation of a tissue-engineered airway is successful Hospital visits for respiratory illnesses spiked during Southern California wildfires AARP orders investigation concerning its marketing Ted Kennedy asks Hillary Clinton to head Senate healthcare team Novation announces recipients of 2009 Bob Majors Scholarship Thomson Reuters announces top hospitals for cardiovascular care The Healthcare business of Thomson Reuters today released its annual study identifying the 100 U.S. hospitals that are setting the nation's benchmarks for cardiovascular care. The study - 2008 Thomson Reuters 100 Top Hospitals: Cardiovascular Benchmarks for Success - examined the performance of 970 hospitals by analyzing clinical outcomes for patients diagnosed with heart failure and heart attacks and for those who received coronary bypass surgery and angioplasties. A list of the 100 Top Hospitals is provided below. "These hospitals provide enormous value to their communities because heart disease is still the nation's number one killer. They have set the new national standard for cardiovascular disease outcomes, process of care, efficiency, and lower costs," said Jean Chenoweth, senior vice president for performance improvement and 100 Top Hospitals programs in the Healthcare business of Thomson Reuters. The study, in its tenth year, found that the 100 Top Hospitals cardiovascular award winners, as a group, performed 63 percent more bypass surgeries and 42 percent more angioplasties than peer hospitals. This may suggest that performance of bypass surgery is increasingly performed in centers of excellence.
While the average mortality rate for cardiovascular patients is very low
(3.4 percent), the mortality rate for bypass surgery was 26 percent lower in
the 100 Top Hospitals cardiovascular winners. The award-winning hospitals
demonstrated higher performance on the evidence-based core measures
published by the Centers for Medicare and Medicaid Services and cost $1,542
less per case, on average.
Read the original story and winners list
Case studies: Rigorous testing slows MRSA germ in VA hospitals, Tacoma General The nation's most aggressive MRSA screening program is run by the U.S. Department of Veterans Affairs (VA). All patients are tested at 155 VA medical centers, including five in this state. Patients are screened on arrival, once a week during their stay, and whenever transferred within the hospital, said Marcus Grandjean, a MRSA project coordinator for the VA Puget Sound Health Care System. VA officials ordered screening in May 2007, after pilot projects yielded dramatic reductions in infection rates. MRSA infections have been reduced to nearly zero inside the hospitals, VA officials report. Their success underscores how widespread screening halts the spread of MRSA infections, reduces treatment costs and enhances basic infection-control measures such as washing hands, Grandjean said. Outside the VA system, several Washington hospitals have adopted aggressive MRSA screening and isolation policies — for example, Seattle Children's hospital. Tacoma General Hospital has held down MRSA infections with widespread screening that began in 1999 — one of Washington's first hospitals to hunt down the germ. Tacoma General tests all high-risk patients, such as those in the intensive-care unit, said Marcia Patrick, who directs infection control at MultiCare Health System, which oversees four hospitals and dozens of clinics in Pierce County. Now, fewer than 1 percent of Tacoma General's patients get MRSA, she said. Tacoma General uses a more expensive procedure, called PCR testing, that produces results in two hours. Patients can be quickly isolated and treated, inhibiting the germ's spread. A PCR test, which averages about $40, can save tens of thousands of dollars in medical expenses for just one patient, Patrick said. "The program pays for itself," she said. Most
hospitals use a standard culture test to detect germs: They collect bodily
fluids with a nasal swab, incubate the fluids, then examine them under
microscopes. Getting a result typically takes two days and costs about $20.
(Seattle Times)
Read the complete report.
Suburban Detroit's hospital system cuts 500 jobs ROYAL OAK, MI - The Beaumont Hospitals medical system says it's eliminating 500 of its 18,000 jobs in response to the nation's economic problems. The system includes three suburban Detroit hospitals with 1,711 beds. They're in Royal Oak, Troy and Grosse Pointe. A Beaumont news release says the cuts will save $60 million in 2009. President and Chief Executive Kenneth Matzick says, "These are challenging times, and hospital systems across America are not immune to the problems."
Beaumont says more than 200 of the 500 jobs already have been eliminated
through a hiring freeze that started in September. The system says it's also
cutting pay for executives and staff doctors, slowing or freezing
development plans and reducing supply costs. (Business Week)
Read the entire article.
First operation for transplantation of a tissue-engineered airway is successfulThe first operation for transplantation of a tissue-engineered airway has been successful, and has massively improved the quality of life of the 30-year-old Colombian female recipient, a mother of two, who needed the transplant after contracting tuberculosis. These pioneering results are reported in an Article published Online first and in an upcoming edition of The Lancet. The work was done by a team from four institutions: Hospital Clínic of Barcelona (Universitat de Barcelona), Spain, University of Bristol, UK, Politecnico di Milano, Italy, and University of Padua, Italy, and was led by Professor Paolo Macchiarini (Hospital Clínic of Barcelona). The loss of a normal airway is devastating, and attempts to replace large airways have met with serious problems, such as graft necrosis, lethal bleeding, and severe and life-threatening infections. Pre-requisites for a tissue-engineered replacement are a suitable matrix, cells, ideal mechanical properties, and the absence of antigenicity (rejection). The team removed the cells from a human donor trachea, principally because these cells have transplant rejection antigens. The decellularized trachea was then readily colonized with cartilage cells (chondrocytes) derived from the patient's own stem cells, and epithelial cells taken from a healthy part of her trachea. This graft was then used to replace the recipient's left main bronchus—which connects the main windpipe (trachea) to the left lung. Her own left bronchus had been damaged by an irreversible, end-stage collapse (malacia). The recipient had no complications from the operation and was discharged from hospital on the 10th postoperative day. The graft had a normal appearance and properties at 4 months, and the patient had no anti-donor antibodies and did not need to take immunosuppressive drugs. The graft also developed its own blood supply, with active bleeding within 30 days. The authors conclude:
"The results show that a cellular, tissue-engineered airway can be produced
with mechanical properties that allow normal functioning, and which is free
from the risks of rejection. This patient provides new evidence that
autologous cells combined with appropriate biomaterials might provide, in
future, successful functional solutions for serious clinical disorders."
Read the original Lancet article.
Hospital visits for respiratory illnesses spiked during Southern California wildfiresRaging wildfires that engulfed Southern California earlier this decade not only destroyed neighborhoods laying in their path, they also caused significant health problems for many who lived outside the fires' reach. An analysis of hospital and emergency department admissions directly before, during and after the 2003 Southern California wildfires shows a dramatic increase in treatment for those with asthma, bronchitis and other respiratory disorders. Data points to the importance of educating people with existing respiratory ailments to react quickly to symptom onset and take precautionary measures. Results suggest that those at risk face similar health issues during current Southern California firestorm activity. The hardest hit patients were young children and the elderly. Teens with asthma also were affected. Heavy smoke conditions were associated with: 34 percent increase in asthma admissions; 67 percent increase in acute bronchitis admissions; 48 percent increase in chronic obstructive pulmonary disease admissions; and 45 percent increase in pneumonia admissions. UC Irvine environmental epidemiologist Dr. Ralph Delfino led the study, which analyzed more than 40,000 admissions to Southern California hospitals in a month-and-a-half period surrounding raging wildfires in October 2003 that burned nearly three-quarters of a million acres and destroyed approximately 5,000 buildings. According to study findings, public health officials need to increase preventive measures – such as advising people to avoid outdoor activities and advocating use of anti-inflammatory medications at the first sign of a wildfire for people who have asthma. The study has been
presented to the South Coast Air Quality Management District and will appear
in the online version of Occupational and Environmental Medicine.
Read the original news release.
AARP orders investigation concerning its marketing After a Senate inquiry found evidence of deceptive marketing, AARP, the lobby for older Americans, has hired an outside investigator to look into sales of some of its popular health insurance products. AARP and UnitedHealth Group, one of the nation’s largest insurers, have voluntarily suspended sales of the policies, which pay fixed cash benefits — often much less than consumers had expected — for selected services. At issue are insurance plans that were sold by UnitedHealth and carry the AARP brand. More than a million people have bought the policies, which have names like AARP Medical Advantage, Essential Plus and Hospital Indemnity Plan. The senior Republican on the Senate Finance Committee, Charles E. Grassley of Iowa, said marketing of the products was often misleading because it suggested that they offered comprehensive coverage. “In fact,” Mr. Grassley said, “there’s no basic protection against high medical costs. The products may leave consumers seriously in debt if they need intensive medical care.” The criticism is potentially embarrassing to AARP because the organization has long taken pride in its role as a champion of its members and consumers in general. It has criticized “hard-sell tactics” of private insurers and has accused the Bush administration of overstating the value of private health plans offered to Medicare beneficiaries. For example, one of AARP’s Medical Advantage plans pays a maximum of $5,000 for surgical procedures that may cost two or three times that amount. The marketing materials highlight coverage for relatively low-cost procedures. A consumer guide to AARP’s Medical Advantage plans says they “can be a real lifesaver for early retirees, part-time workers or people who just need to supplement their current health insurance.” Though known in Washington as a potent lobby, AARP is also a huge business that offers travel services, life and homeowner’s insurance, mutual funds and credit cards. Its operating revenue last year was $1.2 billion, more than 40 percent of which came from royalties, according to its 2007 financial statement. Senator Grassley said he wanted AARP to disclose the profits it had made from sales of its limited-benefit insurance products, which are managed by a taxable subsidiary of AARP Inc., the parent organization. The
investigation does not concern the marketing of prescription drug plans or
Medicare Advantage plans offered by UnitedHealth and endorsed by AARP. Read
the New York Times article.
Ted Kennedy asks Hillary Clinton to head Senate healthcare team Sen. Hillary Rodham Clinton (D-N.Y), considered a prominent contender to become secretary of State in the Obama administration, was offered an alternative Tuesday -- to be a senior member of the Senate team aiming to overhaul the nation's healthcare system. Sen. Edward M. Kennedy (D-Mass.), who has announced plans to craft sweeping healthcare legislation next year, asked the former presidential contender to head a working group focused on insurance coverage. The potential assignment comes a decade and a half after Clinton led a controversial effort to reshape the healthcare system as first lady during her husband's first term in the White House. That campaign collapsed amid bitter opposition from many in the healthcare industry and accusations that Clinton ran a secretive process that ignored input from important stakeholders. President-elect Barack Obama has not indicated how he plans to tackle healthcare. But many involved in the debate have high hopes that his push will be more successful. Kennedy, who chairs the Senate Health, Education, Labor and Pensions Committee, announced Tuesday that he also had asked Sen. Tom Harkin (D-Iowa) to head a working group on prevention and public health, and Sen. Barbara A. Mikulski (D-Md.) to head a working group on improving the quality of care.
Clinton had no immediate reaction to Kennedy's invitation. (LA Times)
Read the original story.
Novation announces recipients of 2009 Bob Majors Scholarship Novation has announced the 2009 Bob Majors Scholarship competition winners, whose excellence in health care materials management warrant this prestigious award. Novation established the scholarship to honor Robert “Bob” Majors, a director of materials management at Bloomington Hospital in Indiana who passed away January 2007. The winners receive a $2,500 scholarship to apply toward costs associated with attending and participating in a 2009 materials- or leadership-related conference. University HealthSystem Consortium (UHC) Recipient - Mr. Ed Smith is the executive director for supply chain management at the University of Mississippi Medical Center in Jackson, MS. Smith has more than 15 years experience in health system purchasing and is involved in the industry through many leadership positions. VHA Inc. Recipient - Mr. Steve Krauz is the director of materials management at Claxton Hepburn Medical Center in Ogdensburg, NY. A passionate promoter of the health care materials management profession, Krauz is a member of the Association for Healthcare Resource & Materials Management (AHRMM) and is heavily involved in his local organization. He is also a Certified Materials and Resource Professional.
“These winners deliver exceptional value to their organization, said Jody
Hatcher, interim president at Novation. “They are an inspiration to the
materials management profession and serve as examples of innovation, passion
for the industry, and having a laser-like focus on the bottom-line.”
November 18, 2008 Download print version Protests over a rule to protect health providers Political temperature may be just right for healthcare overhaul Medicare proposes revised coverage policy for bariatric surgery as a diabetes treatment Hospitals facing tight credit must seek creative expense control Flu shots lower risk of blood clots Brand name drug makers could be liable for injuries caused by generic versions Brim Healthcare and Broadlane renew contact Protests over a rule to protect health providers A last-minute Bush administration plan to grant sweeping new protections to healthcare providers who oppose abortion and other procedures on religious or moral grounds has provoked a torrent of objections, including a strenuous protest from the government agency that enforces job discrimination laws. The proposed rule would prohibit recipients of federal money from discriminating against doctors, nurses and other healthcare workers who refuse to perform or to assist in the performance of abortions or sterilization procedures because of their “religious beliefs or moral convictions.” It would also prevent hospitals, clinics, doctors’ offices and drugstores from requiring employees with religious or moral objections to “assist in the performance of any part of a health service program or research activity” financed by the Department of Health and Human Services. But three officials from the Equal Employment Opportunity Commission, including its legal counsel, whom President Bush appointed, said the proposal would overturn 40 years of civil rights law prohibiting job discrimination based on religion. The counsel, Reed L. Russell, and two Democratic members of the commission, Stuart J. Ishimaru and Christine M. Griffin, also said that the rule was unnecessary for the protection of employees and potentially confusing to employers. Title VII of the Civil Rights Act of 1964 already prohibits employment discrimination based on religion, Mr. Russell said, and the courts have defined “religion” broadly to include “moral or ethical beliefs as to what is right and wrong, which are sincerely held with the strength of traditional religious views.” Ishimaru and senior members of the commission staff said that neither the Department of Health and Human Services nor the White House had consulted their agency before issuing the proposed rule. The White House Office of Management and Budget received the proposal on Aug. 21 and cleared it on the same day, according to a government website that keeps track of the rule-making process. The protest from the commission comes on the heels of other objections to the rule by doctors, pharmacists, hospitals, state attorneys general and political leaders, including President-elect Barack Obama. Obama has said the proposal will raise new hurdles to women seeking reproductive health services, like abortion and some contraceptives. Michael O. Leavitt, the health and human services secretary, said that was not the purpose. Officials at the Health and Human Services Department said they intended to issue a final version of the rule within days. Aides and advisers to Obama said he would try to rescind it, a process that could take three to six months. The proposal is supported by the United States Conference of Catholic Bishops and the Catholic Health Association, which represents Catholic hospitals. But the National Association of Chain Drug Stores, the American Hospital Association, the American Medical Association, 28 senators, more than 110 representatives and the attorneys general of 13 states have urged the Bush administration to withdraw the proposed rule.
Pharmacies said the rule would allow their employees to refuse to fill
prescriptions for contraceptives and could “lead to Medicaid patients being
turned away.” State officials said the rule could void state laws that
require insurance plans to cover contraceptives and require hospitals to
offer emergency contraception to rape victims. (NY Times)
Read the original article.
Political temperature may be just right for healthcare overhaul
Hospitals and physicians are increasingly worried about the escalating
burden of newly unemployed workers being thrown onto the rolls of the
uninsured. Liberal advocacy groups see the Treasury Department's
$700-billion commitment to banks and other financial institutions bolstering
the case for a similar investment to help sick Americans get medical care.
And businesses see new urgency in addressing the nation's healthcare crisis
as they struggle to pay costs for medical benefits while sales plummet and
profit margins shrivel.
Medicare proposes revised coverage policy for bariatric surgery as a diabetes treatment The Centers for Medicare & Medicaid Services (CMS) announced Monday its proposal to clarify its policies for Medicare coverage of bariatric surgery as a treatment for beneficiaries with type 2 (or non-insulin-dependent) diabetes. Following an extensive evidence review, CMS proposes to revise its existing coverage policy for bariatric surgery. The proposed decision notes that type 2 diabetes is one of the co-morbidities CMS would consider in determining whether bariatric surgery would be covered for a Medicare beneficiary who is morbidly obese. An individual with a body-mass index (BMI) of at least 35 is considered morbidly obese. CMS also proposes to not cover bariatric surgery when it is used to treat type 2 diabetes in a beneficiary with a BMI below 35. In 2006, CMS expanded coverage of bariatric surgery for Medicare beneficiaries who received surgery in high-volume centers from highly qualified surgeons (as certified by the American College of Surgeons or the American Society for Bariatric Surgery, and as reported on the Medicare coverage Web site). To be considered for coverage, Medicare beneficiaries must have a BMI of 35 or higher, and must have exhibited a serious health condition in addition to morbid obesity, such as hypertension, coronary artery disease, or osteoarthritis. With the 2006 decision, CMS covered four types of bariatric surgery procedures: gastric bypass, open and laparoscopic Roux-en-Y gastric bypass, laparoscopic adjustable gastric banding, and open and laparoscopic biliopancreatic diversion with duodenal switch. No other bariatric surgery procedure is currently covered.
After a careful review of the medical evidence available on bariatric
surgery, CMS today proposes to not cover bariatric surgery for patients who
do not meet the definition of morbid obesity, but do have type 2 diabetes.
The memorandum is available on CMS’ Coverage website at
http://www.cms.hhs.gov/center/coverage.asp
Hospitals facing tight credit must seek creative expense control Hospitals, long used to slim margins and careful expense management, must seek new and creative ways to manage expenses in the wake of the nation's financial crisis, according to healthcare experts at IMA Consulting. In a recent customer briefing, experts from IMA Consulting clarified the financial challenges through the healthcare lens, and recommended that hospitals compensate by reducing discretionary and supply spending and closely monitoring labor productivity. "Hospitals already face limited access to and increased costs of capital, along with decreased returns on investments," said Mary Ann Holt, RN, a senior partner in IMA Consulting's operations improvement practice. "One hospital client has seen his interest rate on short-term demand notes quadruple, moving from below two percent to almost eight percent in fewer than three weeks." This challenge to financing comes at a time when many hospitals have significant building and renovation projects in process. The demand for new and updated facilities, with expanded diagnostic and therapeutic capabilities, fuels the demand for healthcare financing. Suppliers are also passing on cost increases, and hospitals are bracing for reduction in charitable giving. But according to Holt, the biggest impact may stem from debt financing bonds, which require certain performance levels. Decreased revenues and increased costs may call debt covenant ratios into play and trigger potentially draconian measures by bondholders to assure financial viability. "Crisis can mean opportunity, and we are encouraging our clients to find savings through less traditional approaches," said Holt. "Labor costs often take top priority, but our analysis shows that discretionary spending, such as marketing, travel, and professional fees, presents new opportunities to save." IMA Consulting's analysis of three years of expense data from recent client engagements shows that as salaries, benefits and supplies were decreasing or remaining steady, discretionary spending was creeping upwards. When each expense category is reviewed against the number of patient discharges, IMA's calculation of the compound annual growth rate (CAGR) puts the spotlight again on discretionary spending. "Discretionary spending can be a black hole for hospitals, as data is limited on the exact nature of some expenses," said Holt. "Our clients who clarify program-specific costs by category are better equipped to determine the strategic importance of each program and the related costs." "While supply costs remained steady in our analyses, we still encourage clients to review this category to reduce both costs and environmental impact," said Holt. "We recently helped a client achieve $300,000 in savings by eliminating the one-time use disposable supplies. While savings was the goal, the reduced environmental impact was also appreciated by staff and patients." To
read the full report that appears in the November IMA Insights, go to
www.ima-consulting.com/insights.html
Flu shots lower risk of blood clots People who get their annual flu shot may reap an extra benefit: a reduction in their risk of developing a blood clot. The benefit appeared stronger in those under the age of 52, according to research that was presented at the American Heart Association's annual scientific sessions, in New Orleans. The findings, the first to demonstrate such an effect, may help explain why the flu shot lessens the risk of cardiovascular events in people with coronary artery disease, but the real current value of the data may lie in it convincing more people to get their annual shot. "This kind of data is super helpful to me with patients in the clinic, particularly if they've had a blood clot," said Dr. Ann Bolger, the William Watt Kerr professor of clinical medicine at the University of California, San Francisco, said during a news conference on Sunday. "It's another nail to hammer on." Experts had previously known that the flu vaccine can reduce the risk of cardiovascular events in people with coronary artery disease, but it wasn't clear why. "We had interesting epidemiological data before that flu increased cardiovascular deaths, but we didn't know where from," Bolger said. "This interesting observation implies that if you get the flu shot and avoid infection, you're less likely to get clots in the veins and arteries."
Study results showed that individuals who had had a flu shot were 26 percent
less likely to develop a blood clot. People younger than 52 were 48 percent
less likely to form a blood clot. In women under the age of 51, the risk
reduction was 50 percent, and in women under 51 taking birth control pills
or estrogen replacement therapy, the risk reduction was 59 percent.
Read the entire news release.
Brand name drug makers could be liable for injuries caused by generic versions A recent ruling in San Francisco’s 1st District Court of Appeals held that brand name drug makers could be liable not only for injuries occurring from their own product, but also for injuries caused by generic drug makers who sell generic versions of their products. Although California stands alone in its decision, it is possible for other districts to follow their lead, which has been done in the past. This could mean that brand-name drug makers will not only need to warn their own consumers about the risks associated with their product, but the duty to warn could spill over into consumers of generic versions of their products as well. Elizabeth Conte filed suit for fraud and negligent misrepresentation in San Francisco against a name-brand New Jersey pharmaceutical company, Wyeth Inc, and three generic companies, Teva Pharmaceuticals, Pliva, and Purepac Pharmaceuticals. For four years Conte had been taking a generic version of Wyeth’s Reglan medication, or metoclopramide, which treats heartburn and gastroesophageal reflux disease. As a result of taking Reglan for an extended period of time, Conte developed tardive dyskinesia, a neurological disorder which is incurable and causes involuntary, repetitive, purposeless movements. Conte’s attorneys claimed the drug makers failed to warn her about the long-term risks of the medication. Justice Peter Siggins and the 1st District Court of Appeals agreed with Conte holding, "We believe California law supports Conte’s position that Wyeth owes a duty of care to those people it should reasonably foresee are likely to ingest metoclopramide in either the name-brand or generic versions when it is prescribed by their physicians in reliance on Wyeth’s representations." Although the brand name pharmaceuticals are not liable pursuant to strict products liability because they did not manufacture or sell the drug, they may be liable under negligent misrepresentation. As to the generic manufacturers, the Court upheld summary judgment in favor of the three companies based on the fact Conte’s physician did not rely on their warnings when prescribing Reglan.
Although the jurisdiction of this ruling is limited, there is potential for
it to have widespread effects across the drug market. Not only may
name-brand manufacturers see an increased number of lawsuits, but they may
resort to paying off generic companies to avoid competition and liability.
Read the original article.
STERIS Corporation and VTS Medical Systems announce new company to offer fully integrated operating room technology STERIS Corporation and VTS Medical Systems Inc., have announced the signing of a joint venture agreement designed to bring the latest high-definition video, touch-screen integration, and communication technology into hospital operating rooms. STERIS and VTS Medical Systems have designed and installed integrated OR systems since 2005. “This joint venture solidifies our long-term relationship,” commented William O’Riordan, vice president and general manager, STERIS Surgical and Critical Care Technologies. “Our continued relationship with VTS Medical Systems will lead to new innovations in operating room management. We will leverage each company’s core capabilities to deliver an ideal working environment for surgeons through enhanced information flow, room configuration, and productivity that ultimately will lead to better patient outcomes.”
Financial details of the joint venture were not disclosed. STERIS will hold
a minority ownership position in the newly formed entity, VTS Medical
Systems, LLC.
Brim Healthcare and Broadlane renew contact Broadlane announced today that Brim Healthcare has renewed its exclusive relationship with Broadlane. Brim Healthcare will continue to access Broadlane’s unparalleled national GPO portfolio of consumable supplies, equipment, pharmaceuticals and purchased services to help manage its approximate $150 million in annual spend for 35 hospitals across the country. Terms of the agreement were not disclosed. Brim Healthcare also will continue to utilize Broadlane’s proprietary client portal OnRamp to access the GPO contract portfolio, informatics, Broadlane and industry news and education and added BroadLink (Broadlane’s e-commerce exchange) to the list of services it will use. BroadLink automates and manages transactions between Brim hospitals and suppliers electronically. Brim
Healthcare will continue to actively utilize Broadlane’s Capital Equipment
Services, including Live Group Buys, Equipment Planning, Budget Assessment
and Quote Reviews. Three Brim Healthcare hospitals saved nearly 25 percent
and three months of research and negotiation time on new computed tomography
(CT) scanners at a Broadlane Live Group.
November 17, 2008 Download print version South Korea joins lucrative practice of inviting medical tourists to its hospitals Intervention program boosts survival in breast cancer patients New bacteria discovered in raw milk Men who take aspirin have significantly lower PSA levels Downsizing of UTMB causes concerns New CDC study finds community physical activity programs are money well spent USDA awards $1.5 million to expand access to high-quality critical care in rural communities Register by November 21 and save 10% for the third annual Health Care Supply Chain Management Summit South Korea joins lucrative practice of inviting medical tourists to its hospitals SEOUL, South Korea — On the resort island of Jeju, the government is building Health Care Town, a 370-acre complex of medical clinics and upscale apartments surrounded by 18-hole golf courses and scenic beaches, to lure foreigners in need of medical care. West of Seoul, on the muddy beaches of Inchon where American troops splashed ashore 58 years ago to fight in the Korean War, a new steel-and-glass town is rising to attract foreign visitors, including medical tourists. South Korea has joined Thailand, Singapore, India and other Asian nations in the lucrative business of medical tourism. Heart bypasses, spinal surgery, hip-joint replacements, cosmetic surgery — procedures that may cost tens of thousands of dollars in the United States — can often be done for one-third or even one-tenth of the cost in Asia, with much shorter waiting times and by specialists often trained in the West. Americans fleeing the high cost of medicine at home have spurred the trend. Last year, 750,000 Americans sought cheaper treatment abroad, a figure projected to reach 6 million by 2010, according to a recent study by the Deloitte Center for Health Solutions, a consultancy. Asian nations are also wooing wealthy Middle Eastern patients who have found it more difficult to get a visa to enter the United States since the 2001 terrorist attacks. The number of foreigners coming to South Korea for medical care is still a fraction of those getting treatment in India, Thailand and Singapore, industry officials said. But clinics and the South Korean government are trying hard to attract these tourists, who not only bring in money for cash-strapped hospitals but also help the economy by staying on to shop and sightsee after their procedure is over. The government has revised immigration rules to allow foreign patients and their families to get long-term medical visas and altered laws to permit local hospitals to form joint ventures with foreign hospitals in some cases. Wooridul Spine Hospital said it expected to draw about 1,000 foreign patients and $1 million in revenue from their treatments in 2008, its third year of wooing foreigners. It said its patients hailed from 47 countries, with about a third from the United States. Wooridul plans to build a hospital branch, apartments, a concert hall and an art museum on the Jeju island as part of its medical tourism offerings, in addition to the golf course it has already built. No government records are available on how many medical tourists come to South Korea. But a survey of 29 hospitals showed that they treated 38,822 uninsured foreign patients — excluding certain categories like long-term Korean expatriates — between January and August, compared with 15,680 in 2007, according to the government-financed Korea Health Industry Development Institute. It said 25 percent of those patients were from the U.S., and 10 percent each were from China and Japan. Medical fees are strictly controlled by the government as part of a national health insurance program, but hospitals like Wooridul can negotiate fees with foreign patients without interference from insurance authorities. Some Koreans fear that social inequality will grow if medical resources and skilled workers migrate from public health care to better-paying jobs that cater to foreigners, said Dr. Yoon Dae-hyun, a psychiatrist at the Healthcare System Gangnam Center at Seoul National University Hospital. But he added that the effort to attract foreigners could inspire more local hospitals to upgrade their services. “There isn’t much of a gap anymore between the good hospitals in Asia and the United States,” he said. His center plans to open a marketing office in Los Angeles, and hopes to attract medical tourists from the pool of two million Korean-Americans. Foreigners who can document Korean ancestry can qualify for the South Korean national health insurance. A
Korean-American from Honolulu, recently traveled to Wooridul for back
surgery. They paid two months’ worth of premiums — about $90 — on their
arrival, a portion of their medical bill was covered by the South Korean
government. They ended up spending $3,200, rather than the $30,000 that her
operation would have cost in the U.S, Wooridul said. (NY Times)
Read the entire story.
Intervention program boosts survival in breast cancer patients A new study provides the best evidence to date that a psychological intervention program designed for breast cancer patients not only improves their health – it actually increases their chance of survival. Researchers at Ohio State University’s Comprehensive Cancer Center found that patients participating in an intervention program reduced their risk of dying of breast cancer by 56 percent after an average of 11 years. Participants in the program, which taught strategies to reduce stress, improve mood and alter health behaviors, also reduced the risk of breast cancer recurrence by 45 percent. The study will be published in the Dec. 15 issue of the journal Cancer. The study is part of the long-running Stress and Immunity Breast Cancer Project at Ohio State. Half of the patients were enrolled in the intervention program, while the other half were simply assessed on a regular basis. All received their regular medical treatments as well. Those in the intervention group met weekly in groups of 8 to 12 with a clinical psychologist. During these weekly sessions, which continued for four months, participants learned progressive muscle relaxation for stress reduction, problem solving for common difficulties (such as fatigue), how to find support from family and friends, exercise and diet tips, and how to deal with treatment side effects and keep up with medical treatment and follow-up. After four months of weekly sessions, participants met monthly for eight months. Among patients who died of breast cancer, those who participated in the intervention program lived longer – an average of 6.1 years for program participants versus 4.8 years for those who were simply assessed. Intervention participants were also less likely to die from causes other than breast cancer, such as heart disease or other cancers. For those who died of any cause, participants in the intervention lived an average of 6 years compared to 5 years for those who didn’t. The
researchers found that patients in the intervention group who had the
greatest reductions in distress and physical symptoms were those who
practiced progressive muscle relaxation most frequently. They also
understood and remembered that continued stress could hurt their health and
now knew several ways to reduce stress.
Read the Ohio State Survey.
New bacteria discovered in raw milk Raw milk is illegal in many countries as it can be contaminated with potentially harmful microbes. Contamination can also spoil the milk, making it taste bitter and turn thick and sticky. Now scientists have discovered new species of bacteria that can grow at low temperatures, spoiling raw milk even when it is refrigerated. According to research published in the November issue of the International Journal of Systematic and Evolutionary Microbiology, the microbial population of raw milk is much more complex than previously thought. "When we looked at the bacteria living in raw milk, we found that many of them had not been identified before," said Dr Malka Halpern from the University of Haifa, Israel. "We have now identified and described one of these bacteria, Chryseobacterium oranimense, which can grow at cold temperatures and secretes enzymes that have the potential to spoil milk." New technologies are being developed to reduce the initial bacterial counts of pasteurized milk to very low levels. Most enzymes will be denatured at the high temperatures used during pasteurisation, which means they will stop working. However, the heat-stable enzymes made by cold-tolerant bacteria will still affect the flavour quality of fluid milk and its products. Because of this, research into cold-tolerant bacteria and the spoilage enzymes they produce is vital.
There is an ongoing debate about the benefits and risks of drinking
unpasteurized milk. Some people believe the health benefits resulting from
the extra nutrient content of raw milk outweigh the risk of ingesting
potentially dangerous microbes, such as Mycobacterium bovis, which can cause
tuberculosis, and Salmonella species. Because of these risks, many countries
have made the sale of unpasteurized milk illegal. Pasteurization involves
heating milk to around 72°C for 15-20 seconds in order to reduce the number
of microbes in the liquid so they are unlikely to cause disease. Some
bacteria produce extracellular enzymes that are remarkably heat tolerant and
can resist pasteurization. Lipase enzymes cause flavor defects and proteases
can lead to bitterness and reduced yields of soft cheese.
Men who take aspirin have significantly lower PSA levels The use of aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) is significantly associated with lower PSA levels, especially among men with prostate cancer, say researchers at Vanderbilt University. This large analysis known as the Nashville Men's Health Study included 1,277 participants referred to a urologist for a biopsy of their prostate. Approximately 46 percent of the men reported taking an NSAID, mostly aspirin (37 percent of all men). After adjusting for age, race, family prostate cancer history, obesity, and other variables that have independent effects on the size of the prostate organ, cancer risk, and PSA levels, the researchers found that aspirin use was significantly associated with lower PSA levels. PSA levels were 9 percent lower in men taking aspirin (the NSAID most commonly used) compared with men who did not use aspirin, say the researchers, who will present their findings at the American Association for Cancer Research's Seventh Annual International Conference on Frontiers in Cancer Prevention Research. A PSA (Prostate-specific antigen) test is used widely as a method to screen men for the possibility of prostate cancer, with higher blood PSA levels suggesting a greater chance of having prostate cancer. "To begin to understand how aspirin may lower PSA, we also looked at the association between NSAID use and prostate volume," said the study's lead investigator Jay H. Fowke, Ph.D., an assistant professor in medicine at Vanderbilt. "Aspirin users and men who didn't use aspirin had the same prostate volume, so I don't think aspirin was changing PSA by changing the prostate volume. It was doing something different, and that suggests a beneficial effect on cancer development." Furthermore, "the effect of aspirin on PSA was only somewhat evident among men without prostate cancer but was strongest in men later found to have prostate cancer. This also suggests an effect on cancer as opposed to other prostate diseases." "There are several ways to consider the impact of these results," said Dr. Fowke. "Several prior studies reported anti-inflammatory drugs like NSAIDs were associated with lower prostate cancer risk. Our data also suggest that NSAID use has a beneficial effect on prostate cancer. These findings could be consistent with a protective effect, because aspirin reduced PSA levels more among those men who were diagnosed with prostate cancer than among men with other prostate diseases."
However, these data also indicate that NSAID use could affect our ability to
detect prostate cancer, regardless of any reduction in prostate cancer risk.
"This analysis raises the concern that aspirin and other NSAIDs may lower
PSA levels below the level of clinical suspicion without having any effect
on prostate cancer development, and if that is true, use of these agents
could be hampering our ability to detect early-stage prostate cancer through
PSA screening," Fowke said.
Read the
original story.
Downsizing of UTMB causes concerns
State health care leaders said a plan to downsize the University of Texas
Medical Branch (UTMB) poses many questions about the future of Galveston
County’s poorest and most traumatically injured patients. The medical branch
might be the first major hospital in recent Texas history to scale back its
services to the extent University of Texas regents have approved, said Anne
Dunkelberg, associate director for the Center for Public Policy Priorities —
a nonprofit research agency.
New CDC study finds community physical activity programs are money well spent Community-based physical activity interventions designed to promote more active lifestyles among adults are cost-effective in reducing heart disease, stroke, colorectal and breast cancers, and type 2 diabetes, according to a study by the Centers for Disease Control and Prevention, with support from the Robert Wood Johnson Foundation. Using a rigorous economic model developed to assess the cost-effectiveness of community-based physical activity interventions, the study found these interventions to be cost-effective; reducing new cases of many chronic diseases and improving quality of life. Researchers found that community-based physical activity programs appeared to reduce new cases of disease by: 5-15 cases per 100,000 people for colon cancer; 15-58 cases per 100,000 for breast cancer; 59-207 cases per 100,000 for type 2 diabetes, and 140-476 cases per 100,000 for heart disease. The study, “Cost Effectiveness of Community-Based Physical Activity Intervention,” is being published in the online version of the American Journal of Preventive Medicine. “This study supports the value and effectiveness of the physical activity interventions that were studied,” said William Dietz, M.D., Ph.D., director of CDC′s Division of Nutrition, Physical Activity and Obesity. “This study also shows the importance of the new physical activity guidelines put forth last month by the U.S. Department of Health and Human Services.” For
more information about the U.S.
Department of Health and Human Services Physical Activity Guidelines
visit www.health.gov/paguidelines/
USDA awards $1.5 million to expand access to high-quality critical care in rural communities The
government recently took steps to alleviate the problem of critical care
access for rural Nebraska and Iowa residents -- a problem that is being
exacerbated by growing physician and nurse shortages. In total, the USDA has
awarded more than $1.5 million in Rural Utility Service (RUS) grants to
hospitals around the country to fund expansion of eICU critical care
services to rural communities. This has helped to reduce the cost burden for
rural communities to bring critical care expertise and a greater sense of
security to critically ill patients and their families.
Register by November 21 and save 10% for the third annual Health Care Supply Chain Management Summit The third annual Leadership Summit on Health Care Supply Chain Management will convene the industry's most respected, forward-thinking opinion leaders to present solutions that will drive industry change. The World Health Care Congress 3rd Annual Leadership Summit on Health Care Supply Chain Management – also co-Located with RFID in Health Care, is being held January 20-22, in Las Vegas. This executive forum will present innovative supply chain management solutions for the acceleration of financial returns, the containment of costs and control of waste, the implementation of integrated IT systems, the streamlining of supply chain management processes and the critical push toward stakeholder collaboration in the healthcare industry. The supply chain conference is also co-located with RFID in Health Care. Don't miss this unique opportunity to learn how hospitals and healthcare providers are utilizing RFID today, and gain valuable insights into how to utilize RFID in your healthcare organization.
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Rate Not Applicable)
Visit this link to find out more. |
