Health Train Blogging

Only I can change my life. No one can do it for me. Carol Burnett US actress & comedienne (1936 - ) What blog subjects are the most popular? My recent review of the Blog Catalog, in order are: 1. Blogging 2. Arts & Entertainment 3. Technology 4. Humor 5. Health So health is in the top five, but just barely. It is tied with Politics, and ahead of all the rest, law, business,financial,beliefs, social, and believe it or not social media. At this time Health and Politics go together, entrenched in the economy as top talking points in the presidential campaign for the world's most powerful office. An interesting observation from the Wall Street Journal by Robert Carroll points out the tax realities of each candidates. It gives a clear endorsement to John McCain's health...

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Health Train Dining Car

They aren't talking to one another, while they chew their food. Sometimes a whisper is more powerful than a shout. Here's a cartoon from Modern Medicine that shows a Medical Home counseling session between a primary care physician (PCP), a specialist and the health plan. The PCP looks forlorn, while the specialist and the insurer have their backs turned, fuming. It is perfectly true. American primary care is a shambles, and it is now clear that it will not be viable in the future unless significant changes occur in our national attitude about its value and in the way we pay for it. So what should we do? The National Committee for Quality Assurance proposes a plan Another interesting, and perhaps more far-reaching proposal (Download...

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Health Train Committees

  Quote of the day: Committee--a group of men who individually can do nothing but as a group decide that nothing can be done. - Fred Allen ************************************************ KevinMD.................. The High Points: A family physician shares her ideas on fixing our health care system. Someone better put Elizabeth Pector in charge of something, because her ideas need to be instilled stat. Like this one, explaining why physicians deserve equal rights: When it comes to equality, doctors get the short end of the stick in our health-care system.....duh !!! In short, as part of restructuring the health-care system, physicians need to be put back on a level playing field with the rest of the health-care players, so they can provide input prior to implementation of supposed...

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Post II

Financial Analytics vs. Health Analytics ...

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Health Train Express Roundtable

Today's Health Train Express takes us to The View from Here...my other blog. Click Here...

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Health Train Express International

  Perhaps we should emulate the Chinese in revising our health care system.  Long considered primitive regarding health care, China is taking a bold step toward caring for it's billion or more people. The Chinese however may have an advantage that much like building a home, it is much easier and less expensive to start from scratch.  The United States is faced with disassembling a system that has grown over the past 100 years or more and transitioning to a better means of financing health care.   We see that a large barrier to transitioning lies in the financing. Converting to a new system will be disruptive financially, and  old habits are difficult to break. The Wall Street Journal reports that China is aiming...

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Health Train Reform

I have reviewed the proposals of McCain and Obama. Frankly I do not think either proposal is going to do much to improve health care, reduce costs, or satisfy anyone for very long. 1.The proposals do not address internal problems with delivering health care wisely , or efficiently 2.Both  proposals use tax policy to create change, and campaign issues revolve around tax credits and/or deductions. 3. Neither proposal addresses the increased utilization from baby boomers 4. Both proposals do not address medicare's approaching insolvency. 5. Each proposal is bound by partisan politics 6. We should not decide upon health care issues during a heated political debate. We should step back, and allow the financial...

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Out of the Fog

The fog lifted quickly this morning. It burns off in mid morning and things become clearer as I head off , not on call, not worrying about seeing 40 or 50 patients with itchy burning eyes, floaters, flashing lights, computer vision problems, chldren referred for evaluation of dyslexia referred by a  school psychologist for eye exercises. Mixed in with that mix are the retinal detachments, acute narrow angle or undiagnosed chronic glaucoma, the ocassional herpes dendritic keratitis, zoster, macular hemorrhage, vein occlusion and central artery occlusions. and the bread and butter for most ophthalmologists....that cataract ! But as I said I am not going to be doing any of that for awhile.....perhaps never.  I have made my mind up...

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Health care vs. Health Care

Yesterday's posts were truncated by some other important issues. Today I am a bit overwhelmed by what to post. The issues are legion. Our first great event is the State of California being held in contempt regarding funding of Prison Health Reform  The issue is that  the courts are insisting that California write a bad check to initiate planning for the new prisons. (when I do that I get charged for overdrafts, and possible criminal charges.) Our second great event is the State of California v. the County of Santa Barbara.  The state claims it overpaid Santa Barbara in Medi-cal funds.  Just what I love...my government using my tax dollars to fight with one another...net gain less than zero...pure stupidity,...

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Health Train Express Travels through the Cloud, or should we say Fog??

What's in a name? Is it a cloud or fog? It depends upon your altitude.....and the dew point.... Sublimation....the transformation of a solid directly into a gas, ie dry ice to vapor. Microsoft has announced it's new "Azure" platform...it's answer to Google's online microsoft look alike solutions available on the internet. They are calling this "Cloud computing".  We'll see if it a cloud or fog (vapor)  soon. Cloud Computing according to Wikipedia This announcement reveals a major shift in software development applications for health solutions in both business and clinical applications.  Look here for more information at a later date on specifics about cloud computing and healthcare. Our medical practices have gone from...

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Happy Hospitalist Express

  from THE HAPPY HOSPITALIST VIA GRUNT DOC For most of you out there, I will never meet you. You will live long, prosperous, healthy lives. You will raise families, remain gainfully employed, go to church, give back to the community and generally live. You will play by the rules. You will have your ups and downs and life will go on. What I describe in my blog and experience in my life as a hospitalist represents a very skewed representation of America. I am often lambasted by others for being unHappy and distressed with my situation. That couldn't be farther from he truth. What I try and present to you on the Happy Hospitalist is the gross abuse running rampant in our health care system. The abuse, I believe, entirely the result...

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More Medicare Nonsense

  CMS in it's infinite wisdon has declared war on those of you who are recalcitrant to adopt eRx. AmedNews reports this morning that since the  ''carrot" didn't work as fast as they wanted it to, and eRx adoption is lagging they would up the stakes. With electronic prescribing still far off the radar screen for many physicians just weeks before new Medicare e-prescribing incentives kick in, the Centers for Medicare & Medicaid Services hosted an event here in October to jump-start an all-out push for widespread adoption of the technology. (Most of the attendees were vendors, administrators, and a few physicians who have already adopted eRx (1400 attended).   Only about 2% of eligible prescriptions nationwide in 2007...

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Health Train Express & Halloween

I decided to post my Halloween 2006 blogpost here, again. I brought it forward from my original iteration, RiversideHealth THIS IS HALLOWEEN Friday, November 03, 2006 Halloween and RHIOs Several nights ago we participated in the annual ritual of door to door "trick or treating". It seemed to me there are some analogies between Halloween night and RHIOs. We are all looking for some "treats" without being "tricked". Some of the takers would shove their whole hand enthusiastically into the candy barrel and come out with a fistful of treats, while some would gingerly pick out one. My wife cautioned me to hand them out one at a time or we would soon run out. The same can be said about enthusiasm for RHIOs. Some are enthusiastic takers,...

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HealthVault Express

I was planning a post this AM, and my internet is flaky, fortunately I use Live writer from Microsoft. It's a simple task to write off line and then save a draft and/or upload to the blog. The internet is a complex "spider" of networks and supposed redundancy. This morning I only have access to google, and whatever is on their servers. The rest of the bilions of sites are unavailable.  I guess Google will save the world. I wonder if HealthVault is up. This brings to mind the fallibility of all things electronic. Imagine you are at your docs office and he want to pull up your PHR which is stored in Healthvault and/or Google Health. What now? Or how about your front or back office running an EMR on as asp solution?  Nada!!  Although not requiring much hardware investment and...

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Health Train Billboards

Obama Has Spent $113 Million on Health-Themed Ads My initial reaction was how many uninsured children would benefit from money thrown at TV ads. PEOPLE WANT MORE PERSONAL, EXPERT “HEALTH ENGAGEMENT,” GLOBAL STUDY REVEALS October 16, 2008, — New York – A 5,000-person, five-country study released today by Edelman shows that people want more active, trusted, and personal health interaction with companies, organizations and brands, effectively rewriting the “rules of engagement” in health.   Health Populi  Jane Sarasohn-Kahn A majority of employers who don't sponsor health would be unwilling to contribute over $50 per employee per month for coverage U.S. employer sponsored health system is experiencing some bipolar behavior:...

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Health Train Billboards

Obama Has Spent $113 Million on Health-Themed Ads My initial reaction was how many uninsured children would benefit from money thrown at TV ads. BuzzNet Tags: campaign ads,politics and healthcare...

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Gene Train Express

  Quote of the day: The effort to understand the universe is one of the very few things that lifts human life a little above the level of farce, and gives it some of the grace of tragedy. - Steven Weinberg ************************************************* The rapid scientific progress in genomics is now translating into almost everyday clinical applications. It becomes obvious,although expensive at this time, that DNA analysis will cause a revolutionary catalytic disruption in how medicine will be practiced. One-stop' embryo test unveiled A gene mapping test could tell parents-to-be if embryos are affected by almost any inherited disease, UK scientists have claimed. The team from London's Bridge Centre say the £1,500 test could...

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Health Train at San Francisco

By now those of you who read my blog regularly realize that I did not go on a media fast.  It didn't seem quite right in the middle of the Health 2.0 ver 3.0 in San Francisco. If Matt, Sarah, Michael are working, who am I  to be a slack? So I am monitoring Health 2.0 from afar. I received an email from Wellsphere asking if they could link to my blog here at Health Train Express.  The "train" is getting new routes. I must admit as I have extracted myself from all the 'wonderful' things of patient care, the only thing I miss is the personal  interactions between myself and patients.  I always aimed for the best outcomes, and was disappointed and somehow always felt guilty when the outcome of an eye surgery was not...

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Health Train Genetic Transcription

John Hamlaka, M.D. the Chief Information Officer at Harvard Medical School and the Beth Israel Deaconess Hospital  has "donated"  his genome for the PGP (personal genome project. It is now in a public space, accessible to anyone who can read AGTC code. Audio transcript--John Hamlaka M.D. Thought Leader #1 Thought Leader #2--David Altshuler Thought Leader #3 I took a wrong turn surfing looking for blog material and happened upon these wonderfully informative daring innovators Listen to the podcasts...you will need either iTune or Windows media player. from Harvard Medical Labs Episode 1- The Science of Social Networks--Audio Episode 2- The Secrets of Aging--Audio Episode 3- The Art of Perception--Audio Episode 4- ...

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Successful Health Train Reform

In many ways healthcare and education have taken a similar path. Education has endeavoured to equalize the playing field by increasing the number of pe0ple who are educated, thereby elevating them from impoverished lives, both economically and socially. Despite increased spending in education, and a number of 'innovative' techniques' some of which have suceeded in their own relaively narrow segment, the effort has largely failed....left behind. Max Ladner and Dan Lips write about the Heritage Foundation and about "A  successful model for education reform." Parallels can certainly be drawn between our educational system and our health care non system.There  remains a large number of uninsured. Obesity and dys nutrition abound fueling chronic diseases. Florida has...

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Health Train Rest Stop

Well, frankly I need a break from blogging, healthcare and politics.  I am going on a  7 day media fast (not fest). So you all enjoy Health 2.0, don't step on the homeless people, and use protection!!! See you in a week....

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Health Financial Markets Impacted

iHealthbeat reported this morning that the merger between WEBMD and HLTH was cancelled due to current economic situation.  They cited several reasons for cancelling the merger which was announced in February 2008 In a statement, Martin Wygod, chair of HLTH and WebMD, said, "The boards of directors of HLTH and WebMD believe that, in the current economic environment, it is important for a growth company like WebMD not to be encumbered by $650 million in [HLTH's] long-term debt that would be coming due in 18 to 36 months" (Washington Post, 10/21). Health IT experts tackle vendor collaboration Dan Michelson -- chief marketing officer of physician software vendor AllscriptsMisys Healthcare Solutions -- recommended that physician group buyers "contractually obligate" their vendors to provide...

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Health Train 2008

Health 2.0's annual conference begins tomorrow in San Francisco. Although registration deadline has passed and there are over 900 attendees, an additional room has been opened across the hall from the main room.  There will be large screen presentations, and audio.  You will be able to attend the breakout sessions, and exhibit hall. You can't go in the ballroom for the main sessions, but you can attend the breakout sessions, the exhibit hall, the "unconference" lunch, the IDEO session (there are actualy only limited spaces available anyway HEALTH 2.0  REGISTER HERE MEETING OCTOBER 22,2008 Prognosticators are theorizing how our current economic crisit will affect health care reform and what the impact will be on Health 2.0,...

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Economic Transformation

The real bad news Always listen to your elders....the indians knew this. Technorati Tags: reform,health crisis,financial crisis...

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Health Train Express International

  Perhaps we should emulate the Chinese in revising our health care system.  Long considered primitive regarding health care, China is taking a bold step toward caring for it's billion or more people. The Chinese however may have an advantage that much like building a home, it is much easier and less expensive to start from scratch.  The United States is faced with disassembling a system that has grown over the past 100 years or more and transitioning to a better means of financing health care.   We see that a large barrier to transitioning lies in the financing. Converting to a new system will be disruptive financially, and  old habits are difficult to break. The Wall Street Journal reports that China is aiming...

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Health Train Express--Sunday Edition

On the heels of Colin Powell's endorsement of Senator Obama, we can begin to look at the options for health care reform that the two candidates espouse. Before I talk about that I make the following observations. Few if any Physicians have access to the national stage in a manner that prominent senators, governors, and other publicly elected officials enjoy.  We have relied on our national organizations, the AMA, specialty societies, lobbyists. There are other major players and foundations ,fund policy analysts, and speakers on the national circuit of speakers that elaborate on options for health care reform. In fact there is an alphabet soup variety of publicly funded organizations active in these matters. Some are underwritten by non profit organizations that are actually underwritten...

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Health Train Transformation

Morality, like art, means drawing a line someplace. Oscar Wilde Irish dramatist, novelist, & poet (1854 - 1900)********************************* Today's post, is indirectly related to healthcare. Electrifying news this morning, as we awoke from slumber.  To me it was almost as punctuating as the events of JFKs assassination, and the bombings of 9-11.   Colin Powell who was George Bush's Secretary of State, and critical of the Iraqi war as it boged down, endorsed Barak Obama for the Presidency. Colin Powell  has such enormous stature from not only his role and experience in government, but also his eminence as a person of great integrity and moral stature.  Mr. Powell did not have to endorse anyone, he could have remained silent.  His love...

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Californians' health premiums rise 5 times faster than pay

The Sacremento Bee reports In California from 2000 to 2007, annual premiums rose from $6,227 to $12,194. During that same period, the median pay went from $25,740 to $30,702. About 6.6 million are medically uninsured in California. On average nationally, health premiums rose 78 percent, lower than California's rate, during the seven-year period. However, earnings in California outpaced the rest of the country, which saw wages rise by 14.5 percent. What is clear is that health care is becoming less and less affordable," said Anthony Wright, executive director of Oakland-based Health Access California The system is broken and needs to be fixed," said Wright, who called for greater oversight of the insurance industry. del.icio.us Tags: health premiums,medical inflation,sacramento bee...

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Knowledge is Power-iNFORMATION ASSYMETRY

Quote of the day: An ignorant person is one who doesn't know what you have just found out. - Will Rogers ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^ I want to share an article posted on SERMO by it's creator, Dan Palestrant M.D. (give this link a moment to load, and then click on the video window...it should open in iTunes it is an iTunes video cast            click to JOIN   LICENSED PHYSICIANS ONLY, all applications are 'vetted'.   Please excuse the length of the quote, it is included since SERMO is a protected secure website accessible only to licensed physicians.    Those of you who are physicians should JOIN The pictures are mine, inserted and are...

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Health Train Travelling Taxes

Following last night's 3rd and thankfully last presidential debate I am taking a grim view on the possibility for real reform in our health system.  The reality here is that we have two candidates with diametrically opposed views on health care reform. Senator McCain advocates that our health non system challenges are limited to the premiums and availablility of health care coverage.. This does not speak to all the other areas in health care that need reform.  His  proposal will be a battle of the payers, and the employers and a new book of IRS tax codes. Insurers have no real interest in providing more payments for more patients, nor hospitalizations.  His proposal is not well thought out, and fails to address most of the fundamental challenges for patients and providers...

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Health Train Express, Number Six on the List of Most Important Voter Issues

Graph from The Health Care Blog article by Chris Weaver. Media coverage of two issues - health care and taxes - nearly doubled. Health care stories increased across all media from 256 stories to 439. Tax stories rose from just over 400 for the week to nearly 800 between the weeks ending Sept. 29 and Oct. 6, according to stories polled for the LexisNexis Analytics dashboard.    This spike in incidence is not unrelated. Tax stories are hot as voters stare at a growing deficit and watch their 401k's plunge, but tax talk has also become a predictable symptom of health care reform stories.   An excerpt from a New York Times article states,  (link) "It is health care, advisers said, that they believe resonates...

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