Tiny Bubbles

  Best of the WSJ Health Blog for 2010 By Katherine Hobson Tonight the Health Blog will close the book on 2010 as we head out for the long holiday weekend. Not, however, before highlighting a few of our favorite posts from the more than 1,100 that ran this year. Our thoroughly subjective list includes posts notable for their subject matter, news value or just because we liked them a lot. In no particular order: Cavs Have a Word for LeBron James: Narcissistic Jilted Cleveland Cavaliers majority owner Dan Gilbert put King James on the couch in July and came up with this diagnosis, but the sports psychologist we consulted disagreed. As things stand today, LeBron can certainly be described as “winning”; his new team, the Miami Heat,...

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The AMA is Lurking and Lurching

    The American Medical Association checked in and made a comment about my last posting.  The Good news is that I know someone out there is reading my  stuff. My post was about commentary published on SERMO for their fifth anniversary in regard to the AMA and it’s relationship with physicians.  It has been disseminated by many that the AMA represents 33% or less of physicians. You can  see the comments at my last post, or I will insert a few catchy PR mission statements  here. Actually the comments were made on Medpedia a blog aggregating service.     In all fairness I will publish the entire comment sent to me from the AMA. “As the nation’s largest physician organization, the American...

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Are Doctors lurking, or lurching?

  These are comments borrowed from SERMO (a physician only forum) and as they appeared in the Washington Times on December 27, 2010.   Doctors left in the lurch by own medical associations              By Dr. Douglas A. Perednia The Washington Times 6:53 p.m., Monday, December 27, 2010 Here's a tip for those wanting to overhaul Obama care: Ask doctors how to make health care more efficient. They can tell you where to find hundreds of billions of dollars in cost savings. But don't imagine that you'll get any useful insights from the American Medical Association (AMA), the American College of Physicians (ACP), the American Academy of Family Physicians (AAFP) or most other...

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Are We Selling our Patients Down The Road ?

  Freedom is a tenuous liberty. While we sleep it can be stolen in the wink of an eye.  2010 has not been a bellwether year for liberty in America.   We should not confuse freedom with social, financial, nor emotional security promised by recent health financing legislation. The Obama Care health finance reform promises something which no man can deliver. In the interest of offering monetary security (not good health) the price will be the forfeiting of choice and intelligent decision making in regard to most aspects of health  care encounters. These choices extend far beyond  a choice of providers.    It is a government takeover   The new law gives federal bureaucrats enormous say over nation's...

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Resolutions to Consider

by Gary Levin M.D.     It’s that time of the year.  As we close out 2010 we look back at another year of tremendous change in many areas of healthcare. I made many resolutions last December 2009, and unfortunately most of them did not come to pass.  At the time they seemed well intentioned, and who does not make New Year’s Resolutions without that goal in mind. Well, you and I, despite our self appraisal of estimates of high intelligence,  do not control government, or the weather. They however are very powerful forces, and when either runs well and the weather is fair, life can be good, and if it is stormy or a cold front meets a warm front, the results can be light rain or tornados. During the past year we...

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More Top Events in Medicine for 2010

    The Western  Journal of Emergency Medicine published The Colorado Compendium on Emergency Medicine, available online here as a pdf file from PubMed.  It offers a one stop solution for important advances in emergency medicine. It is authored by authorities in Emergency Medicine at University of Colorado, a major trauma center. The article should be a must read for all those in training and also practicing ER physicians. I have a bit of a personal interest in this subject, because I practiced ED medicine for five years prior to specializing. This was many years ago and it is gratifying to see how the American College of Emergency Physicians successfully navigated the road to board certification of this vital primary...

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More of the Top Health Train Blog for 2010

  With a brief interruption for holiday cheer I will continue my review of the ‘best’. If anyone has a particular fondness of other posts please tweet me  @oculogyric.    The List: Medicine from 40,000 feet Some Funny, some sad, some Ridiculous I Work So Hard ! Laughter is The Best Medicine How Statistics Lie This should give you something to read this week   del.icio.us Tags: health train top 20 posts,health train express,medicine,stastics...

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Billion Dollar Losses

  Many of you are implementing EMRs using laptops and now even iPad or a form-factor such as Apple’s hot new selling addition to the hardware market.  This form factor is a natural human-machine interface. Several precautionary notes can be gleaned from other industries about these ‘hot’ items. img alt="" galleryimg="no" onload="var downlevelDiv = document.getElementById('6a8b3f7a-8135-41e4-8a08-ff194aaee870'); downlevelDiv.innerHTML = "";" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEghbUlU1eb_E9h6SfDZ8d3_QqNBHuQYp-FmYtHHby_FLhXReD82K-RHRZJG_kdA9AgzN-iVKuVxIJszSiPCSWKjqSSMWCXvbqk79ZYIt3jMQFpGr3ZAbD7Y3l5s6ChByOEyLflzWakYc-M/?imgmax=800" style="border-style: none">Lock it down, Use security software,...

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The IHI Open School

  Mention the name ‘Don Berwick’ and some physicians have a gut-wrenching feeling about him. He is the focal point and lightening rod as head of CMS due to his statements about the American Health System. There is another side to this man’s achievements.  I think you will find this video interesting. img alt="" galleryimg="no" onload="var downlevelDiv = document.getElementById('7324ae43-a84c-4537-8751-2a927bc76d23'); downlevelDiv.innerHTML = "";" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhaGwtStZYyjlk7ypfxRruvuj8zGO4Pbsf_eE1WwmR672OLwLBjWsobQfPb7hJDAY1PYq-zM9kT0HtOIRdxYqH5O1W3vJcVDyxhiZVOIY_iR82TCALi9IPJMsgslDMcZ0uaWORvEKZszM8/?imgmax=800" style="border-style: none">Will the Real Dr. Berwick please...

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Cost Estimates for EMRs

    eWeek.com today has a story about the true cost of EMR installation in the first year of acquisition. In a new report, CDW Healthcare estimates initial revenue losses for physician practices due to EHR costs, but predicts monetary gains upon completion of training.   Adoption of an EHR (electronic health record) application could cost a physician $120,000 in one year, CDW Healthcare reports in its Physician Practice EHR Price Tag study. Training of physicians on EHR platforms during the adoption period will lead to a 10 percent average loss in patient appointments in the first year of use, but then productivity should pick up, CDW reports in its survey of 200 physician practices over a six-month period. By using...

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Health Train's Top for 2010 Part I

  And here are the winners !!  Some of this is my bizarre sense of humor.     December 20,2010 December 18, 2010 December 5, 2010 November 23, 2010 November 21,2010 November 10,2010 October 26,2010 September 23,2010 September 12,2010 A Gem on HIT, even if I say so myself, a moment of inspiration ! August 24,2010 August 11, 2010   I will be posting Part II in the next blog post.   del.icio.us Tags: health train express,best in class,top ten for 2010...

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Predictions for Beyond 2011

  Perhaps I am foolish to even try to predict 2011, and even more so for the coming decade. However, I have found a reasonably credible business source for these predictions. The Crystal Ball The effects of information technology will increase not only in healthcare, but for the rest of the economy and the percentage of the GDP to which it will contribute. Gartner Consulting of Stamford, CT prognosticates By 2015, a G20 nation's critical infrastructure will be disrupted and damaged by online sabotage. By 2015, new revenue generated each year by IT will determine the annual compensation of most new Global 2000 CIOs. By 2015, information-smart businesses will increase recognized IT spending per head by 60 percent. By 2015, tools...

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Top Advances in Medicine during the Past Decade

    1. Thermo stabile vaccines and Nano particle enhancements The first attaches vaccines to nanoparticles that can be absorbed by the skin inside the nostrils. Dr. James R. Baker Jr., director of the University of Michigan’s nanotechnology institute, said it works with hepatitis B and flu vaccine. He won a new grant to test the respiratory syncytial virus, which causes pneumonia. The particles are in what Dr. Baker described as a “proprietary formulation of mayonnaise” based on soybean oil. The vaccine ends up inside the oil particles, which protect it from temperature changes and microbes. The immune system is “made to eat oil droplets,” Dr. Baker said, because it targets viruses, which are essentially time bombs of genetic...

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TOP 20 Software and Service Vendors (in HIT)

The end of a year and a decade (wasn’t it just 2000, Y2K)?. I have been busy reviewing things new, things old, things good, and things bad.  Here is the next. As part of the annual review of best and worst, here is the lineup for HIT.     KLAS, an organization that evaluates medical software has announced it’s top 20 list for 2010. The top are:   For software: The 2010 "Best in KLAS" vendors for software: Acute Care EMR – Epic EpicCare Inpatient EMR Ambulatory EMR (more than 100 Physicians) – Epic EpicCare Ambulatory EMR Ambulatory EMR (26-100 physicians) – eClinicalWorks EMR Ambulatory EMR (6-25 physicians) – Greenway Medical PrimeSuite Chart Ambulatory EMR (2-5 physicians) – e-MDs Chart ...

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The Cookie Monster or Who Ate My Cookie ?

  Kermit and the rest of the Sesame Street not withstanding, there is a great danger in talking about cookies. So  Steven Duckett discovered when he was summarily dispatched from the cookie jar of Alberta’s Health System.  He was caught with his hand in the ‘ proverbial cookie jar, and on camera.  When discovered,  he had the audacity to exclaim “ I am eating my cookie, you will have to wait.” Politely he offered the remains of one cookie to an eager news lady as she chased him through the lobby.  Numerous passerby's were noted to ignore the incident and offered no assistance to Duckett. Neither Duckett or his attorney are returning telephone calls. The incident has been documented on several videos that have...

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More on Merger Mania

There is a flurry of mergers and acquisitions in the health insurance and hospital industry. There are several driving forces creating this activity. The first is the mandate to obtain electronic medical records both by individual providers, and hospital systems. The federal government is incentivizing this activity but also holding a big stick threatening penalties in reimbursements if providers do not adopt EMR and HIT systems. The second factor is the proposition to form Accountable Care Organizations (ACOs). The merger mantra is not fueled by healthcare reform, the rationale is market share. The acquisition of HIT is expensive, either way. However hospital administrators wish to capitalize on size for market share, as well as IT....

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What is a Prezi ??

  I wanted to take a break from all the ‘serious nonsense’ that effects each and every one of us, from doctors to patients. In today’s blog I am introducing “Prezi”.  Rather than go into a long dissertation about it, just go to prezi.com  I have inserted just a sample in today’s posting. Give it a second or two to load, then click on the play arrow. To proceed, advance by clicking on the arrow again.  Caution, the web site advises that some viewers become disoriented, dizzy and nauseous.  I am usually that way without Prezi. Enjoy, there will be more coming as I learn how to  use Prezi. IceRocket Tags: prezi,presentations,health train express...

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The Lancet Commissions

  Health professionals for a new century: transforming education to strengthen health systems in an interdependent world The Journal Lancet this week features an article whose research has been supported by,  The Bill and Melinda Gates Foundation, The China Medical Board, and The Rockefeller Foundation. It is an exemplary and exhaustive analysis of world health resources, past, present and future requirements. As we rush along into the second decade of the 21st Century it seems that health care throughout the world is suffering.  The United States is battling with the concepts of ‘collective health’ delivery which seems to run counter to the republic and it’s constitutional guarantees of freedom of choice....

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Mergers and Acquisitions

  Mergers and acquisitions are not something most physicians pay any attention to, unless it is one of your daughters getting married. In the world of finance and industrial companies they are common. Witness the recent bailouts of huge financial institutions where mergers of banks,  and acquisitions of financial organizations took place faster than a roving sperm trying to get to the ova. The recent passage of the Affordable Patient Care Bill has alerted many insurance companies, hospitals, medical groups and even individual solo practitioners that something huge may be about to take place in health care and the health industry at large. Accountable Care Organization (ACO) stands for much more than it’s name implies. Not...

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The Year in Review 2010–Hospitals

Gary Levin M.D.       The last half and quarter of 2010 unveiled an explosion of mergers and acquisitions in the hospital industry. This is also occurring in the health insurance sector.  Hospitals  have reacted to the Affordable Care Act, and the prospects of Accountable Care Organizations (ACO) with a flurry of activity to increase their size for multiple reasons. A major factor is the enormous investment of capital and human resources to obtain and implement HIT as mandated by ONCHIT and HITECH. The magnitude of the investment for HIT can only be well served by a larger organization.  Even large systems feel the threat of being unable to manage this aspect of technology. In rather typical fashion...

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It’s That Time of Year

  Beginning on Halloween the fall and winter season begin with a variety of sequential days off, decorations and fond memories of past year’s events.  We anticipate the holidays each year either in dread, or with excitement and anticipation and/or a little of each. I am preparing my “The Year in Review” in regard to health care reform, innovation, and scientific breakthroughs.  We all know 2010 was a banner year for health care debate. (And it is far from over)   I will include the new category,  “Movers and Shakers” in the Annual Review of Health Train Express.                                                                                              ...

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