Ties between doctors and stent makers queried

Heart doctors and makers of medical devices meeting for their annual convention here got a sobering piece of news on Thursday — two senators are asking tough questions about financial ties between the doctors and the companies. Charles E. Grassley, Republican of Iowa, and Herb Kohl, Democrat of Wisconsin, sent a letter asking the nonprofit group that sponsors the conference, the Cardiovascular Research Foundation, for information about its financial relationships with device manufacturers and drug producers.

The senators also sent a letter to Columbia University, which has an affiliation with the Cardiovascular Research Foundation. In a statement, the foundation said it would “comply fully” with the information request. “C.R.F. is committed to maintaining the highest standards of integrity in all of its research and educational activities and ensuring independence, objectivity and scientific rigor in all of its programs,” the statement said. According to the foundation’s most recent tax filing on the website guidestar.org, it had revenue in 2005 of $47.2 million.

Columbia University Medical Center issued a statement saying it would respond to the request for information. “It is important to note that Columbia University and its Medical Center have conflict of interest policies and procedures in place, and we expect that they are followed by all members of the faculty," the statement said.

The manufacturers cited in the senators’ letters are Abbott Laboratories, Medtronic, Boston Scientific, Johnson & Johnson and Medinol.

The annual conference here, known as Transcatheter Cardiovascular Therapeutics (TCT), has attracted hundreds of doctors from around the world who specialize in using devices that are placed in the body through catheters, most notably heart stents. At the meeting, manufacturers of stents and related surgical products or drugs display their products in an exhibition hall.

The letters sent Thursday are part of a recent wave of inquiries by Senators Grassley and Kohl into potential conflicts of interests between medical researchers and drug and device companies. The lawmakers are also among those sponsoring legislation that would require the industry to more fully disclose such financial ties.

At the same conference on Thursday, researchers released results of a new study indicating that a drug-coated stent called Endeavor, made by Medtronic, was linked to more heart attacks and deadly blood clots than the Cypher stent made by Johnson & Johnson. Shares of the medical device maker Medtronic fell Thursday. Results from the study, which included more than 2,000 patients, showed that heart patients who received the Medtronic device, called Endeavor, had more heart attacks and blood clots and needed repeat procedures more often than those treated with the Johnson & Johnson Cypher stent. (The New York Times)  Read the complete story

Visit here for the complete Medtronic story

NJ flu-shot mandate for preschoolers draws outcry

AP - Many New Jersey parents are furious over a first-in-the-nation requirement that children get a flu shot in order to attend preschools and day-care centers. The decision should be the parents', not the state's, they contend. Hundreds of parents and other activists rallied outside the New Jersey Statehouse on Thursday, decrying the policy and voicing support for a bill that would allow parents to opt out of mandatory vaccinations for their children.

New Jersey's policy was approved last December by the state's Public Health Council and is taking effect this fall. Children from 6 months to 5 years old who attend a child-care center or preschool have until Dec. 31 to receive the flu vaccine, along with a pneumococcal vaccine. The Health Council was acting on the recommendations of the Centers for Disease Control and Prevention (CDC), which has depicted children under 5 as a group particularly in need of flu shots. But no other state has made the shots mandatory for children of any age.

Opposition to the policy is vehement. Assemblywoman Charlotte Vandervalk, one of the speakers at the rally, said she now has 34 co-sponsors for a bill that would allow for conscientious objections to mandatory vaccinations. “The right to informed consent is so basic," she said in an interview. "Parents have a right to decide for their own children what is injected in their bodies."

State policy now allows for medical and religious exemptions to mandatory vaccinations, but Vandervalk said requests for medical exemptions often have been turned down by local health authorities. She said 19 other states allow conscientious exemptions like those envisioned in her bill.

State health officials and the CDC insist the flu vaccine is safe and effective, but Vandervalk and the parent groups who support her bill contend there has been inadequate research into the vaccine's impact on small children. Critics note that flu vaccines contain trace amounts of thimerosol, a mercury-based preservative; the CDC says there's no convincing evidence these trace amounts cause harm. (Washington Post- Associated Press)   Read the complete story

Flu shots a tough sell to healthcare workers

AP - Operating room nurse Pauline Taylor from University Hospitals and Clinics in Iowa City, knows her refusal to get a flu shot is based on faulty logic. But ever since she got sick after getting a shot a few years ago, she's sworn off the vaccine.

Such stories frustrate Dr. William Schaffner. As chairman of the Department of Preventive Medicine at Vanderbilt University, he hears that kind of talk frequently and knows it's in part to blame for a surprising statistic - nearly 60 percent of health- care workers fail to get a flu shot.

That's despite recommendations from the CDC that all healthcare workers get vaccinated, from hospital volunteers to doctors.

"It is a professional obligation on the part of health care workers to make sure that they are as protected against influenza as possible," Schaffner said. Schaffner argues that getting vaccinated for the flu should be standard for doctors and nurses, just like washing their hands. That's because the flu virus can be spread so easily.

"Being in close proximity to patients, having conversations with them, bending over their bed, seeing them in the clinic while you're doing procedures, you would be breathing out viruses and spreading influenza into your patients," said Schaffner, who is also president-elect of the National Foundation for Infectious Diseases.

The nonprofit group educates the public and healthcare industry about the causes, treatment and prevention of infectious diseases. It gets about 75 percent of its budget from major vaccine makers, but executive director Len Novick said the money comes with no strings attached.

According to the foundation, likely cases of flu outbreaks between healthcare workers and patients include: 19 babies in a neonatal intensive care unit in Ontario, Canada, infected in 2000; one died. Healthcare workers, only 15 percent of whom were immunized, were the likely source. 65 residents of a nursing home in New York got the flu during the 1991-1992 flu season, and two died. Only 10 percent of healthcare workers had been vaccinated before the outbreak, according to a report by the CDC.

The CDC recommends that health care facilities offer free flu vaccines to employees annually at work, and that hospitals obtain signed statements from workers who refuse.

Several states have laws requiring hospitals to make the vaccines available. At Allen Hospital in Waterloo, Iowa, the flu shot is mandatory for those with direct patient contact and recommended for everyone else. Those with allergies to the vaccine or other conditions can take a pass, but they must supply a note from their doctor. The hospital says the vaccination rate is 93 percent.

Some hospitals take a tougher stand on vaccinations. In Seattle, at Virginia Mason Medical Center, even sales reps, vendors and volunteers must be vaccinated unless they seek exceptions for religious or medical reasons. Even then, those who don't get a shot must wear a mask whenever they are in the hospital during the flu season. About 99 percent of the hospital's more than 5,000 employees were vaccinated. (Miami Herald – Associated Press)  Read the complete article

Docs find 'Stayin Alive' lives up to its name, with a great beat for reviving stopped hearts

"Stayin' Alive" might be more true to its name than the Bee Gees ever could have guessed: At 103 beats per minute, the old disco song has almost the perfect rhythm to help jump-start a stopped heart. And in a small but intriguing study from the University of Illinois medical school, doctors and students maintained close to the ideal number of chest compressions doing CPR while listening to the catchy, sung-in-falsetto tune from the 1977 movie "Saturday Night Fever."

The American Heart Association recommends 100 chest compressions per minute, far more than most people realize, study author Dr. David Matlock of the school's Peoria, IL, campus said Thursday. And while CPR can triple cardiac arrest survival rates when properly performed, many people hesitate to do it because they're not sure about keeping the proper rhythm, Matlock said.

He found that "Stayin' Alive," which has a way of getting stuck in your head anyway, can help with that. His study involved 15 students and doctors and had two parts. First they did CPR on mannequins while listening to the song on iPods. They were asked to time chest compressions with the song's beat.

"It drove them and motivated them to keep up the rate, which is the most important thing," he said. The study showed the song helped people who already know how to do CPR, and the results were promising enough to warrant larger, more definitive studies with real patients or untrained people, Matlock said.

It turns out the American Heart Association has been using the song as a training tip for CPR instructors for about two years. They learned of it from a physician "who sort of hit upon this as a training tool," said association spokesman Dr. Vinay Nadkarni of the University of Pennsylvania. He said he was not aware of any previous studies that tested the song.

Nadkarni said he has seen "Stayin' Alive" work wonders in classes where students were having trouble keeping the right beat while practicing on mannequins. When he turned on the song, "all of a sudden, within just a few seconds, they get it right on the dot."  ( ABC News -  Associated Press) Read the complete story

American Heart Association: http://www.americanheart.org/handsonlycpr

TSO3 announces agreement with MAGNET

Mr. W. Barry McDonald, Interim President and CEO of TSO3 Inc., is proud to announce that TSO3 has been selected as a vendor partner by the Mid-Atlantic Group Network of Shared Services (MAGNET), one of the oldest and largest group purchasing organizations in the United States. East coast-based MAGNET, serves 11,000 healthcare providers by offering access to a contract portfolio of high-quality capital equipment and services. As a vendor partner, TSO3 will supply MAGNET’s members with its low temperature ozone sterilization system for hospital environments. Significant sales are anticipated in the near-term as a result of this agreement. For more information, visit www.tso3.com.

B. Braun presents education guide for best practice in anesthesia

B. Braun Medical Inc. (B. Braun) has announced the publication of a first-of-its-kind educational guide, Dual Guidance – A Multimodal Approach to Nerve Location. The educational guide will be introduced at the 2008 Annual Meeting of the American Society of Anesthesiologists (ASA), to be held Oct. 19-21 in Orlando.

Authored by three key opinion leaders in the anesthesiology field – Drs. Ralf Gebhard, William Urmey, and Admir Hadzic, with an introduction from Dr. Richard Brull – the four-chapter information resource defines the concept of “dual guidance,” or the use of ultrasound with nerve stimulation, as a best practice for nerve location in modern regional anesthesia, and presents an objective analysis of ultrasound and nerve stimulation studies.

Peripheral nerve blocks, which block pain at its source through precise injection of a local anesthetic, are used in an estimated two million procedures each year in North America. Nerve stimulation has long been the “gold standard” for nerve location when performing peripheral nerve blocks, stimulating the nerve and causing the target muscle to twitch. More recently, high-frequency ultrasound imaging has increasingly gained ground as a supplementary or complementary modality as it enables the anesthesiologist to see the nerve and the needle, as well as the spread of local anesthesia.

Nerve stimulation and ultrasound-guided regional anesthesia each offer distinct advantages and limitations. Until now, however, a comprehensive information source for anesthesiologists that provides an objective, clinical review of best practices using both technologies did not exist. 

Focused on the evolution of nerve location, the educational guide cites several key nerve stimulation and ultrasound studies that have influenced the use of nerve stimulation and ultrasound in clinical practice. For more information or to obtain a complimentary copy of the educational guide, please email dualguidance.us@bbraun.com.

CDC collaborates on Preventing Skin Infections program with wrestling coaches

The National Wrestling Coaches Association (NWCA) recently announced the release of Preventing Skin Infections, a Web-based seminar that is available for viewing by state high school activity associations, collegiate governing bodies, athletes, parents, certified athletic trainers and other medical personnel. CDC and NWCA collaborated in development of the MRSA topic. The producers also worked with the National Athletic Trainers Association (NATA) and other sports medicine agencies to produce all-sports and sport-specific modules for interactive classroom or one-on-one learning.

Keying in on three classifications of microbes—fungi (ringworm), bacteria (Strep and Staph, including MRSA) and virus (Herpes Gladiatorum). The goal is to help protect student-athletes from these pathogens. The seminar movies make extensive use of animation, special effects, graphics, studio and on-location shooting. The seminar is suitable for all sports with a special module devoted to the issues and procedures germane to wrestling. The presentation is informative, entertaining and educational for anyone in any type of skin contact activities.  Visit here for the presentation

Munson Healthcare signs Multi-Suite Lawson Software contract

Lawson Software announced that Munson Healthcare licensed the Lawson Human Resource Management Suite and Lawson Business Intelligence, part of the Lawson S3 Enterprise Performance Management Suite. The healthcare provider will use the Lawson system to consolidate administrative processes and support its integrated human resources and payroll services. The contract was signed during Lawson’s first quarter of fiscal 2009, which ended Aug. 31, 2008.

Munson Healthcare has a medical staff approaching 500 and is affiliated with eight hospitals in northern Michigan, including Munson Medical Center in Traverse City and Paul Oliver Memorial Hospital in Frankfort. The regional health system also consists of an air and ground medical transport service and a home health agency.

Munson Healthcare chose Lawson to support an organization-wide initiative to simplify and modernize its HR processes. The healthcare provider also wanted an HR system that would support its evolving technology and business needs. 

October 16, 2008   Download print version

MedAssets launches Medicare RAC solution for hospitals and health systems

Chinese citizens up for debate over healthcare reform

Premier CEO Rick Norling to retire

US rate of infant death worsens to 29th in world

FDA creates web page with drug safety information for patients, healthcare professionals

Hospira acquires Endotool from MD Scientific

Health firms to study clots in stent patients

Goodroe Healthcare Solutions earns first approval from the Inspector General for a multi-year gainsharing project

MedAssets launches Medicare RAC solution for hospitals and health systems

MedAssets, Inc. has announced the release of its Medicare Recovery Audit Contractor (RAC) solution to support healthcare providers’ strategies to address RAC audits. MedAssets’ comprehensive RAC solution assists providers throughout the entire RAC audit process – from assessment to appeal – and provides overall revenue integrity solutions for long-term financial performance improvement. It provides a RAC workflow tool that helps hospitals manage RAC audit timelines and activities, automate deadline notifications, track activity and audit historical claims to identify vulnerabilities. In addition, MedAssets consulting services assess reimbursement risk and its RAC appeal and recovery services help providers manage, defend and appeal RAC audits.  

Beyond reimbursement management, MedAssets’ suite of revenue cycle management solutions include concurrent denial management, claims management, contract management, and web-based data-driven applications that specifically address revenue integrity in the areas of patient estimates, charge capture, and clinical documentation. MedAssets’ end-to-end solutions offer providers a means to close the financial gaps created by RAC audits and other Centers for Medicare and Medicaid Services (CMS) initiatives. Visit www.medassets.com for more information.

Chinese citizens up for debate over healthcare reform  

BEIJING -- China's new healthcare reform plan, which aims to provide universal medical service to 1.3 billion people, has triggered nationwide debate since it was publicized on Tuesday morning. News articles on healthcare reform showed up in major newspapers and online forums were swarmed with netizens eager to express their opinion.  

Growing public criticism of soaring medical fees, a lack of access to affordable medical services, poor doctor-patient relationships and low medical insurance coverage compelled the government to launch the new round of reforms. China first started reforming healthcare in 1992 to abolish a system under which the government covered more than 90 percent of expenses. The country then gradually switched to a market-oriented medical system. However, soaring medical costs plunged many rural and urban Chinese into poverty.  

In the new plan, the government promised to set up a "safe, effective, convenient and affordable" healthcare system that would cover all urban and rural residents by 2020. The draft lists five priorities: speeding up the establishment of a universal healthcare system, setting up a basic drug system, improving the grassroots health service network, providing equal public health service to rural and urban residents and pushing forward reform trials in state-run hospitals.  

Healthcare reform debates have been going on in China for years. In 2006, the State Council, the country's Cabinet, set up a joint-working team consisting of experts from 16 departments to create a reform plan. It also entrusted nine domestic and overseas organizations, including the World Health Organization, to conduct independent research.  

"Healthcare reform is a tough problem worldwide," Peking University professor Li Ling said. "To mobilize the whole nation to join the debate is an unprecedented move of the Chinese government, which ensures that the decision could be made in a prudent, scientific and democratic way." (China View) Read the original story.

Premier CEO Rick Norling to retire 

Richard A. (Rick) Norling will retire as president and chief executive officer of Premier Inc., the nationwide healthcare alliance, on June 30, 2009, the end of his current contract term. A process is underway to have a successor identified well before then and ensure a smooth transition, said Premier Board Chair Lowell C. Kruse, president and CEO of Heartland Health in St. Joseph, Mo. Norling has been planning for his eventual retirement for some time and the succession planning process allows for orderly transition before he leaves. 

Norling first joined Premier as chief operating officer in 1997, the year after Premier was created through the mergers of three smaller organizations. He became its president and CEO in 1998. Earlier, he was president and chief executive officer of Fairview Hospital and Healthcare System, headquartered in Minneapolis/St. Paul in Minnesota.  

The Premier Board and its committees are engaged in the customary work associated with identifying a successor leader, Kruse reported. An executive search firm, Spencer Stuart, is engaged to assist the board, and, consistent with best-practice principles, external and internal candidates are to be considered. 

US rate of infant death worsens to 29th in world

Infant deaths in the United States continue to surpass most other rich nations, stalling at the same level from 2000 through 2005 while other countries improved, government researchers said. Latest international data show the US ranking in infant mortality worsened to 29th worldwide, down from 27th in 2000 and 23rd in 1990, according to a report from the National Center for Health Statistics in Hyattsville, Md.

Researchers attribute the lack of progress in part to greater numbers of premature births, though the report said preliminary results suggested a small drop in US infant deaths from 2005 to 2006.

Infant mortality is one of the most important statistics for researchers assessing the health of nations. Japan, Sweden, Britain, Spain, France, Germany, Australia, and 15 other countries all had infant mortality rates of fewer than 5 deaths for every 1,000 births in 2004, about 26 percent below the US rate of just under seven deaths per 1,000 live births through the last five years for which data are complete, ending in 2005.

An analysis of about 95 percent of US birth records suggests a 2 percent decline in infant mortality in 2006, MacDorman said. The US ranking of 29th puts it even with Poland and Slovakia. Blacks had the highest rate of infant mortality in 2005, at 13.63 deaths per 1,000 live births, or about double the national average. Rates among Puerto Ricans and Native Americans topped eight deaths per 1,000 live births. Read the original story.

FDA creates web page with drug safety information for patients, healthcare professionals

Consumers and healthcare professionals can now go to a single page on the U.S. Food and Drug Administration's Web site to find a wide variety of safety information about prescription drugs. The Web page, http://www.fda.gov/cder/drugSafety.htm, provides links to information on: drug-specific safety information and safety sheets; drug labeling and patient package inserts; drugs that have a Risk Evaluation and Mitigation Strategy (REMS) to ensure that their benefits outweigh their risks; a searchable database of postmarket studies with additional information about a drug's safety, efficacy, or optimal use; a searchable database of clinical trials, including information about each trial's purpose, who may participate, locations, and useful phone numbers.

Also included: Warning Letters, Import Alerts, Recalls, Market Withdrawals, and Safety Alerts; Regulations and guidance documents; Instructions how to report problems to the FDA through its MedWatch program.  

Establishing such a web page is one of the requirements of the Food and Drug Administration Amendments Act of 2007, and is among FDA's many efforts to address the safe use of drugs throughout their lifecycle.  

Hospira acquires Endotool from MD Scientific

Hospira, Inc. announced yesterday that it has acquired the EndoTool business from MD Scientific, LLC. The EndoTool glucose management system is a FDA approved software system which helps establish and maintain glycemic control in acute, critical care and operating room settings by calculating the dose of intravenous (I.V.) insulin needed to effectively control blood glucose levels.

Traditionally, nurses and other clinicians use paper-based protocols to manually monitor and adjust I.V. insulin dosing. The EndoTool software system is easy to operate, runs on a hospital's existing computer system and can interface with a hospital information system (HIS). EndoTool actively models and adapts to individual patient responses to I.V. insulin to help manage current and predict future dosage levels. It is the only software that uses five separate data points -- based on the patient's most recent blood glucose readings -- to provide personalized, safe and effective glycemic control.  

As part of the agreement, Hospira acquired additional assets related to the EndoTool business, including the MD Scientific headquarters in Charlotte, N. C., and the employees supporting the product. Financial details of the agreement were not disclosed. www.hospira.com

Health firms to study clots in stent patients  

In an unusual display of collaboration, eight medical companies are joining forces to launch a $100 million study to determine how best to protect heart patients from rare but dangerous clots after they are treated with artery-opening devices called stents. The four-year, 20,000-patient study is intended to determine whether stent patients can safely go off aggressive blood-thinning treatment after one year, or if they'd be better to remain on the medication for at least 2½ years after getting a stent.

Current guidelines call for patients who get a drug-coated stent to remain on the medicine for at least a year. But concern that, in rare instances, clots can form in the devices well over a year after they are implanted, with potentially lethal consequences, has left doctors and patients in a quandary over how long treatment should be prescribed.

Four of the companies are stent makers Boston Scientific Corp., Johnson & Johnson, Medtronic Inc. and Abbott Laboratories Inc. The companies are fierce rivals in the $5 billion global market for the devices. Four drug companies are also participating. Bristol-Myers Squibb Co. and Sanofi Aventis SA co-market the antiplatelet drug Plavix, which combined with aspirin makes up the current regimen for most stent patients. They are bracing for competition from Eli Lilly & Co. and Daiichi Sankyo of Japan, which are co-developing prasugrel, which is awaiting FDA approval.

The study is the result of an FDA request for stent and drug makers to determine the optimal duration for blood thinning. Separately at the heart meeting, a Boston Scientific-sponsored study suggested that heart-attack victims fare better with drug-coated stents instead of older bare-metal models. Wednesday's study found coated stents reduced the need for repeat procedures within a year to 4.5% from 7.5%. It didn't find a difference between the two stents' safety. Read the original story,

Goodroe Healthcare Solutions earns first approval from the Inspector General for a multi-year gainsharing project

Goodroe Healthcare Solutions, LLC, a VHA company, announced that the U.S. Department of Health and Human Services' Office of the Inspector General (OIG) has approved a three-year gainsharing project for cardiovascular procedures. This is Goodroe's first approval for a multi-year project and its twelfth OIG approval.  

Gainsharing allows hospitals to share cost savings with participating physicians who achieve operational efficiencies. Currently, Goodroe's gainsharing model is used in clinical areas where physicians control the majority of costs, such as cardiac catheterization procedures, open heart surgery and orthopedic and spine procedures.  

While arrangements with individual hospitals vary, most allow participating physicians to be paid as much as 50 percent of the savings generated through increased hospital and physician collaboration to decrease overall costs while demonstrating quality patient outcomes. Goodroe has used its approved gainsharing methodology to identify nearly $75 million in savings for hospitals while ensuring the best quality of care for patients.  

Goodroe's gainsharing model is based on documented patient information collected by Goodroe's proprietary software and database while the patient is receiving care. Visit www.goodroe.com for more information.

October 15, 2008   Download print version

Broadlane to manage procurement and materials management at Tenet Healthcare Corporation’s 52 hospitals

GAO report: Variation in standards and guidance limits comparison of how nonprofit hospitals meet community benefit requirements

3M RAC ready program helps hospitals identify compliance risks, prepare for RAC audits

LSU Health Care Services selects IntelliDOT as its barcode point-of-care partner

Johnson & Johnson posts strong results

World Health Report calls for return to primary healthcare approach

Hospitals protest new California rules on patient billing

Kimberly-Clark Health Care adds two-hour option to oral care kit portfolio
 

Broadlane to manage procurement and materials management at Tenet Healthcare Corporation’s 52 hospitals

Broadlane has announced that Tenet Healthcare Corporation (THC) in Dallas, TX, has outsourced its materials management and procurement functions for its 52 hospitals. In September, Tenet signed a seven-year agreement with Broadlane to manage its approximate $1.5 billion in annual spend. Beginning January 1, 2009 and continuing through early 2010, Tenet’s approximately 200 materials management and procurement employees will become Broadlane employees.

With the addition of Tenet Healthcare, Broadlane will provide outsourced supply chain management services to 110 acute care hospitals, manage more than $4 billion in annual supply spend and employ 375 outsourced supply chain management specialists.

Broadlane will provide national GPO portfolio management, regional GPO portfolio management and custom agreements for Tenet. In addition, Broadlane will assume day-to-day responsibility for receiving and internal product distribution, inventory management and Value Analysis Teams (VAT) management. Tenet will continue to utilize Broadlane Informatics for access to reports and to improve insight related to contracts, capital equipment, pharmacy and other key areas of spend management. 

In addition to all materials and inventory management functions, Broadlane will support Tenet with Procurement Services, supporting the purchasing processes related to supply chain products, consumable goods, purchased services and capital equipment and manage Tenet’s item master. Broadlane’s Item Master Services, also part of Procurement Services, will manage processes and data related to Tenet’s item master. For more visit www.broadlane.com

GAO report: Variation in standards and guidance limits comparison of how nonprofit hospitals meet community benefit requirements

Nonprofit hospitals qualify for federal tax exemption from the Internal Revenue Service (IRS) if they meet certain requirements. Since 1969, IRS has not specified that these hospitals have to provide charity care to meet these requirements, so long as they engage in activities that benefit the community. Many of these activities are intended to benefit the approximately 47 million uninsured individuals in the United States who need financial and other help to obtain medical care.

Previous studies indicated that nonprofit hospitals may not be defining community benefit in a consistent and transparent manner that would enable policymakers to hold them accountable for providing benefits commensurate with their tax-exempt status. IRS’s community benefit standard allows nonprofit hospitals broad latitude to determine the services and activities that constitute community benefit. Furthermore, state community benefit requirements that hospitals must meet in order to qualify for state tax-exempt or nonprofit status vary substantially in scope and detail.

GAO found that among the standards and guidance used by nonprofit hospitals, consensus exists to define charity care, the unreimbursed cost of means-tested government healthcare programs (programs for which eligibility is based on financial need, such as Medicaid), and many other activities that benefit the community as community benefit. However, consensus does not exist to define bad debt (the amount that the patient is expected to, but does not, pay) and the unreimbursed cost of Medicare (the difference between a hospital’s costs and its payment from Medicare) as community benefit. Variations in the activities nonprofit hospitals define as community benefit lead to substantial differences in the amount of community benefits they report.

With the added attention to community benefit has come a growing realization of the extent of variability among stakeholders in what should count and how to measure it. At present, determination and measurement of activities as community benefit for federal purposes are still largely a matter of individual hospital discretion. Given the large number of uninsured individuals, and the critical role of hospitals in caring for them, it is important that federal and state policymakers and industry groups continue their discussion addressing the variability in defining and measuring community benefit activities. Click here.

3M RAC ready program helps hospitals identify compliance risks, prepare for RAC audits

3M Health Information Systems has introduced the 3M RAC Ready Program, a new solution that combines expert consulting with advanced software to help hospitals prepare for increased compliance scrutiny under the federal government's Recovery Audit Contractor (RAC) program. The program provides comprehensive tools and services to identify areas of risk, reduce audit vulnerability, and promote fast and efficient responses to RAC activities.

Mandated by Congress and administered by the Centers for Medicare and Medicaid Services (CMS), the RACs seek to identify improper Medicare payments through in-depth auditing of hospitals, physicians, and suppliers that submit claims to the Medicare Fee-for-Service program.

The 3M RAC Ready Program builds on the foundation of the 3M Coding and Reimbursement System, which promotes accurate, complete and compliant coding. Core components include 3M Validation and Appeal Services for Recovery Audit Contractors (RACs), a complete baseline assessment that determines a hospital's exposure under the RAC program. 3M consultants work onsite with clients to target areas of risk, focusing on coding, medical necessity and documentation to improve claims accuracy and reduce denials.

The 3M Audit Expert System works in conjunction with the 3M Coding and Reimbursement System to review 100 percent of inpatient records for compliance errors at the point of coding, and offers customized coding alerts, retrospective auditing tools, and trending reports that allow comparisons with national norms. The software features a RAC tracking and management tool that streamlines workflow by tracking RAC communications, denials and related appeals, monies recovered, and areas of risk. For more information visit here

LSU Health Care Services selects IntelliDOT as its barcode point-of-care partner

IntelliDOT Corporation, a provider of wireless handheld, barcode point-of-care (BPOC) solutions to hospitals, announced that the Louisiana State University Health Care Services Division (LSUHCSD) has selected IntelliDOT Bedside Medication Administration, Vital Signs Collection and Mother-Baby Breast Milk Matching modules as part of an enhanced patient safety initiative. LSUHCSD is a division of the Louisiana State University Health System, Baton Rouge, LA and consists of seven hospitals with 704 beds and 300 outpatient clinics that serve the underprivileged and uninsured in Louisiana. LSUHCSD is one of the largest public hospital systems in the United States.

The IntelliDOT Bedside Medication Administration prompts the nurse through medication administration workflows at the bedside. The system is used to verify the five rights of medication administration: right medication, right dose, right route, right patient, and right time. Each nurse receives customized prompts and warnings to assure medications are administered and documented correctly.

IntelliDOT Mother-Baby Breast Milk Matching – Using the same handheld device and a small portable wireless printer, a nurse prints barcode labels for milk containers at the time milk is received from the mother or the mother can take and apply the labels at home. At administration, the infant’s ID band is scanned along with the breast milk container, assuring positive identification and accurate feeding.

IntelliDOT Vital Signs Collection – Vital signs information plus virtually any clinical documentation can be captured using the same handheld device. The captured data can populate the eMAR or electronic flow sheets and/or print on separate patient-specific flow sheets. For more information visit here.

Johnson & Johnson posts strong results

Johnson & Johnson showed resilience Tuesday in the face of an economic downturn, posting higher third-quarter sales and earnings. Because the large medical products company is more broadly diversified than many other drug and medical device makers, Johnson & Johnson’s report is not necessarily considered a bellwether for the entire healthcare industry. Hospitals, for example, tend to be retrenching, squeezed by the credit crisis and concerns about patients’ ability to pay their bills.

But healthcare products, like the artificial joints made by Johnson & Johnson’s DePuy division, may be less subject to the economic winds buffeting most sectors of the economy.

“Everything we’ve seen so far has shown that healthcare has been pretty defensive and volumes have not been affected by the downturn in the economy,” said David H. Roman, a medical devices analyst for Morgan Stanley.

For example, up to 70 percent of hip and knee replacements, a large part of the medical device industry, are performed on Medicare beneficiaries — a group whose insurance coverage is guaranteed and who would be unlikely to delay surgery because of the economy. And, as Roman said, Medicare beneficiaries are growing in numbers.

Another medical products company, Abbott, is set to announce its earnings Wednesday morning. Many analysts predict those numbers will also be strong, largely because of the company’s Xience drug-coated heart stent, a device that has become popular among interventional cardiologists, Roman said. Xience’s success is coming in part at the expense of Johnson & Johnson’s Cypher stent, which is one of the rare devices in the company’s portfolio that did not show solid growth.

In Johnson & Johnson’s earnings call with analysts on Tuesday, Dominic Caruso, the chief financial officer, said that the company’s access to commercial paper had been unfettered and available at what he called “very, very good” rates. That could bode well for other health products company.

Johnson & Johnson announced sales of $15.9 billion for the third quarter, up 6.4 percent from a year earlier. Excluding special charges, the company said it earned $1.17 a share in the third quarter, versus 88 cents a year earlier. (NY Times) Visit here for the complete story.

World Health Report calls for return to primary healthcare approach

The World Health Report 2008 critically assesses the way that healthcare is organized, financed, and delivered in rich and poor countries around the world. The WHO report documents a number of failures and shortcomings that have left the health status of different populations, both within and between countries, dangerously out of balance. The report, titled PrimaryHealth Care – now more than ever, commemorates the 30th anniversary of the Alma-Ata International Conference held in 1978. That event was the first to put health equity on the international political agenda.

In a wide-ranging review, the new report found striking inequities in health outcomes, in access to care, and in what people have to pay for care. Differences in life expectancy between the richest and poorest countries now exceed 40 years. Of the estimated 136 million women who will give birth this year, around 58 million will receive no medical assistance whatsoever during childbirth and the postpartum period, endangering their lives and that of their infants.

Globally, annual government expenditure on health varies from as little as US$ 20 per person to well over US$ 6000. For 5.6 billion people in low- and middle-income countries, more than half of all healthcare expenditure is through out-of-pocket payments. With the costs of healthcare rising and systems for financial protection in disarray, personal expenditures on health now push more than 100 million people below the poverty line each year.

Data set out in the report are indicative of a situation in which many health systems have lost their focus on fair access to care, their ability to invest resources wisely, and their capacity to meet the needs and expectations of people, especially in impoverished and marginalized groups. As the report notes, conditions of “inequitable access, impoverishing costs, and erosion of trust in healthcare constitute a threat to social stability.”

To steer health systems towards better performance, the report calls for a return to primary healthcare, a holistic approach to healthcare formally launched 30 years ago. When countries at the same level of economic development are compared, those where healthcare is organized around the tenets of primary healthcare produce a higher level of heath for the same investment.

In far too many cases, people who are well-off and generally healthier have the best access to the best care, while the poor are left to fend for themselves. Healthcare is often delivered according to a model that concentrates on diseases, high technology, and specialist care, with health viewed as a product of biomedical interventions and the power of prevention largely ignored. WHO estimates that better use of existing preventive measures could reduce the global burden of disease by as much as 70%. Visit here for the complete summary.

Hospitals protest new California rules on patient billing

California emergency room patients can no longer be stuck with the bill when hospitals or physicians disagree with insurance companies on their fees. Under new state rules that take effect today, hospitals and physicians are barred from billing patients for the balance of emergency care not covered by insurers. But the relief for patients may not last long. Hospitals and physicians are protesting the rules in court. Meanwhile, the state Supreme Court is set to hear another "balance billing" challenge next month.

In another court test set for hearing this month, the state Department of Managed Health Care sued Prime Healthcare Services Inc. of Victorville. The state is seeking to bar Prime from billing insured patients for unpaid medical bills that the hospital chain contends it is owed from insurers and is seeking from patients as a last resort.

Department director Cindy Ehnes, called Prime a "serial balance biller whose actions have unjustly threatened the credit rating of thousands of Californians." Ehnes said she wanted to take patients out of the middle of billing disputes between insurers, hospitals and physicians.

"No longer will Californians face the possibility that if they have to use an emergency room, they may be stuck with a bill, asking them to pay a second time for emergency care, which they already purchased with their [insurance] policy," she said. The disputes typically occur when an insured patient ends up in an emergency room that is not in his or her carrier's network.

These hospitals and physicians may send insurers bills that are higher than what the insurance firms usually pay providers in their network. And insurers often balk, sending back less than the full payment. Insurers accuse hospitals and physicians of taking advantage of the situation and sending out inflated bills. Hospitals and physicians counter that it is the insurers that take advantage by paying far less than reasonable and customary rates. Patients wind up in the middle of such disputes when a hospital or physician bills them for the balance.

The department also announced that it would address what Ehnes called "the root cause of balance billing", the unfair or late payment of legitimate emergency room claims by insurers. She said the department would add resources to speed up the resolution of hospital and physician complaints over such practices.
 
Prime Healthcare lawyer Michael Sarrao said the new rules favored insurers and hurt doctors and hospitals. Sarrao said hospitals had no idea what they would get paid by insurers with which they had no contracts. One of Prime's hospitals in Chino, for example, treated two children for coyote bites within three months. In the first case, the insurer paid about 90% of billed charges. In the second, the same insurer paid less than 40%. (LA Times) Visit here for the complete story.

Kimberly-Clark Health Care adds two-hour option to oral care kit portfolio

Kimberly-Clark Health Care announced today that as part of its ongoing commitment to providing clinicians with a range of effective clinical solutions and best practice education to address Ventilator-Associated Pneumonia (VAP), it has added the KimVent Oral Care q2 Kit to its portfolio of oral care solutions. Now, caregivers will have the ability to administer oral hygiene care every two hours to ventilator-dependent patients at risk for VAP.

A leader in developing clinical solutions against healthcare-associated infections, Kimberly-Clark Health Care introduced the KimVent Oral Care q4 Kit in October 2007. With the addition of the new KimVent Oral Care q2 Kit, along with individual components and packs, Kimberly-Clark Health Care now allows caregivers the flexibility to choose from a portfolio of oral care solutions. The KimVent Oral Care portfolio is designed to provide comprehensive oral care for individual patient needs as well as q2 and q4 hospital oral care protocols, helping to meet clinical recommendations from organizations such as the Centers for Disease Control and Prevention and the American Association for Critical Care Nurses for an oral hygiene program for at-risk patients.

The new KimVent Oral Care q2 Kit includes all components of the original q4 Kit, but also contains extra features for more frequent oral care administration. Unique to the q2 Kit are six additional suction swab packs with alcohol-free mouthwash and a color-coded “Order of Use Guide.” The guide provides nurses with easy identification of component packs and step-by-step visual instructions to promote proper continuity of care and compliance as well as support both individual patient needs and hospital oral care protocol.

Designed by nurses, for nurses to address the challenges associated with oral care products, the KimVent Oral Care q4 and q2 products incorporate a convenient and portable design as well as ergonomic and user-friendly tools. Both kits can be kept at the patient’s bedside and contain individual procedure packs that allow nurses to choose the appropriate tools easily. For more information visit http://www.kchealthcare.com/kimvent.