Wednesday, May 15, 2013

NeHC helps Healthwise spur engagement



eHealth Readiness Tool will help gauge consumer engagement processes

National eHealth Collaborative and Healthwise, a nonprofit organization that develops patient education and engagement technology, announced Tuesday that, as part of their collaborative efforts, Healthwise will make NeHC's Consumer eHealth Readiness Tool available to clients.
NeHC officials note that Healthwise is a longtime partner in helping to advocate the use of eHealth tools to help patients become full partners in their care. Healthwise Senior Vice President for Policy Leslie Kelly Hall is a member of the NeHCBoard of Directors and NeHC's Consumer Consortium on eHealth Steering Committee. She led an effort to bring stakeholders together to develop the NeHC Patient Engagement Framework, which was developed to guide healthcare organizations in developing and strengthening their patient engagement strategies.
The Patient Engagement Framework, which was developed with input from consumer and patient advocates, policymakers, technology organizations, healthcare providers and health plans, has been downloaded from NeHC's website nearly 8,000 times, officials say, and is being used as a conceptual model to inform patient engagement strategies.
The NeHC Consumer eHealth Readiness Tool is mapped to the Patient Engagement Framework and meaningful usecriteria, and serves as an online diagnostic tool to help organizations quantify, prioritize, and focus their improvement efforts and measure their progress toward IT-enabled consumer engagement.
In addition to working with NeHC and other interested stakeholders to spread the word about the Patient Engagement Framework and the CeRT, Healthwise is sponsoring several annual CeRT subscriptions that will be provided to select Healthwise clients.
Big Data and Healthcare Analytics Forum June 4-5 Washington
"Healthwise is a leader in the healthcare community, working to accelerate the use of health IT tools that help physicians and other providers better connect, communicate and empower their patients to take a more active role in their care," said NeHC CEO Kate Berry in a press statement.
"Engaging patients directly is critical to the transformation of healthcare - engaged patients take better care of themselves, which leads to better outcomes and lower costs," added Hall. "Making the CeRT available to Healthwise clients supports our mission of helping patients make better health decisions."

Providence Memorial Hospital Top Texas Patient Engagement Index Ranking


PRESS RELEASE
May 15, 2013, 2:31 p.m. EDT

CORRECTING and REPLACING Houston Northwest Medical Center, Park Plaza Hospital and Providence Memorial Hospital Top Texas Patient Engagement Index Ranking

Axial Exchange's Patient Engagement Index Ranks Hospitals Based on Personal Health Management, Patient Satisfaction and Social Media Engagement Data

RALEIGH, N.C., May 15, 2013 (BUSINESS WIRE) -- Third graph, third sentence of release should read: Lower ranking hospitals in the PEI included notable healthcare institutions like Parkland Hospital, which scored a 41 and University Hospital in San Antonio, which scored a 36.
The corrected release reads:
HOUSTON NORTHWEST MEDICAL CENTER, PARK PLAZA HOSPITAL AND PROVIDENCE MEMORIAL HOSPITAL TOP TEXAS PATIENT ENGAGEMENT INDEX RANKING
Axial Exchange's Patient Engagement Index Ranks Hospitals Based on Personal Health Management, Patient Satisfaction and Social Media Engagement Data
Axial Exchange, Inc., a pioneer in using mobile apps to deepen the patient's role in improving outcomes, today announced the results of its Texas Patient Engagement Index (PEI), a groundbreaking index that ranks U.S. hospitals based on an analysis of publically available data in three categories: personal health management, patient satisfaction and social media engagement. This is the second regional PEI the company has issued; the first ranked top hospitals in Florida. Both states were selected because their demographics make them bellwethers for the rest of the country.
Axial Exchange's methodology for ranking hospitals' patient engagement performance is based on analyzing metrics that research has indicated lower costs and improve clinical outcomes. For each PEI, Axial Exchange evaluates provider organizations' personal health management strategies, awarding maximum points to those organizations that not only offer electronic access to patient health records, but also provide resources for ongoing disease management support, including mobile, tablet and desktop tools. Axial Exchange also ranks hospitals according to an annual Centers for Medicare and Medicaid (CMS) patient satisfaction survey called the Hospital Consumer Assessment of Health Plans Survey (HCAHPS), a standardized instrument for measuring patients' perspectives on hospital care. Lastly, Axial Exchange analyzes the extent to which hospitals and health systems engage their patients via social networking channels.
The highest possible ranking a hospital can receive in Axial Exchange PEI is a score of 100. Top ranking hospitals in the Texas PEI included Houston Northwest Medical Center, which received an overall score of 84; Park Plaza Hospital, which received a score of 83; and Providence Memorial Hospital in El Paso, which received a 76. Lower ranking hospitals in the PEI included notable healthcare institutions like Parkland Hospital, which scored a 41 and University Hospital in San Antonio, which scored a 36.
"The term 'patient engagement' has been so widely used that its true meaning has been diffused; people talk broadly about improving patient engagement, but have not done the analysis and research to determine exactly what types of patient engagement programs improve outcomes," said Joanne Rohde, CEO of Axial Exchange. "However, we have done the research to determine which programs and tools actually drive more meaningful patient engagement that leads to improved patient satisfaction and clinical outcomes, fewer readmissions and lower healthcare costs. My hope is that these indices we have issued, and will continue to compile and share, will encourage provider organizations across the country to reevaluate their patient engagement strategies and place higher emphasis on the programs that drive real change."
Future indices for other U.S. regions will debut throughout the coming months. Detailed methodology of the Patient Engagement Index is published here. All Texas hospitals were notified of their ranking, and provided with links to the published data for consideration in their own initiatives toward Meaningful Use and heightened reimbursement levels.
About Axial Exchange, Inc.
Axial Exchange is revolutionizing the way that patients manage their health. With Axial, hospitals are able to keep their patients continuously engaged resulting in dramatically improved health outcomes and much more satisfied patients. Axial drives engagement by giving patients the information and interactive tools patients need in order to get well -- all delivered securely to the device of the patient's choice. Patients can share their health information with providers and care givers. Health systems benefit via lower readmissions and improved patient satisfaction scores.
In December 2011 Axial's flagship solution was named first-prize winner in the US Department of Health and Human Services' Partnership for Patients Initiative innovation competition for "Ensuring Safe Transitions from Hospital to Home." Axial Exchange is backed by a syndicate of top venture capital firms, led by Canaan Partners (www.canaan.com). Visit www.axialexchange.com.
http://cts.businesswire.com/ct/CT?id=bwnews&sty=20130515005409r2&sid=cmtx4&distro=nx
SOURCE: Axial Exchange, Inc.

$500 Million Whistleblower False Claim Settlement



Indian-based Ranbaxy Laboratories Ltd., has agreed to pay out $500 million to resolve allegations that the company was selling tampered and corrupted drugs to government medical programs. The drugs at issue were Sotret, gabapentin, and ciprofloxacin. The penalty is a combination of $350 million for settlement and $150 million following a guilty plea to charges from the U.S. Department of Justice (DOJ), $130 million of which is a fine. According to the DOJ, this is the largest generic-drug settlement in history.
Pharmaceutical companies have a history of putting their profits ahead of the well-being of the patients. Whether by failing to inform physicians of the possible risks associated with a drug or failing to ensure that a drug or product has been made in a consistently secure or safe environment, these companies do little to prevent potential injury to patients before the fact.
“The Department of Justice, with the assistance of another brave whistleblower, has once again shown the power of the False Claims Act and its potency in protecting American consumers and taxpayers from the byproducts of corporate greed and profiteering,” said James Kauffman, an attorney with the Levin, Papantonio law firm.
Just this year, the FDA has published recalls on the Fisher and Paykel Healthcare – Reusable Breathing Circuit, the GE Healthcare, LLC, Giraffe and Panda T-Piece Resuscitation Systems and the Giraffe and Panda Bag and Mask Resuscitation Systems, the Ad-Tech Medical Instrument Corporation, Macro Micro Subdural Electrodes and over twenty other devices since January of this year. The threats posed by the defects in these products are potentially serious and can sometimes result in death.
Ranbaxy has had a tumultuous past few years. In 2009, the FDA issued a statement that it would halt reviewing Ranbaxy’s drug applications as it obtained information that the company had falsified data and test results. The allegations were that the data obtained from the company supported the claim that the company made a practice of falsifying such information. Failing to properly test the shelf-life of the drugs was one such test that resulted in many of the company’s drugs being banned from import in the United States.
The practice of falsifying the statements was brought to investigators’ attention by a former Ranbaxy executive, Dinesh Thakur. Thakur alleged that the company falsely billed Medicare and Medicaid along with other government agencies. Of the settlement, Thakur will reportedly $48.6 million.
“Whistleblowers are an important part of uncovering corrupt practices in companies stealing from the government. The law provides for these whistleblowers a means to share in a potential recovery, but the method for exposing corruption can be complicated. It’s important that someone wanting to expose a scheme should contact an experienced attorney,” said Christopher Paulos, an attorney practicing in the areas of qui tam and whistleblower law.
In addition to the monetary settlement, the company has agreed to improve the processes it has in place to guarantee the integrity of its safety-test data and will sign a consent decree that will govern its business practices in the United States.
Joshua is a writer and researcher with Ring of Fire.

How waste is directly harmful to patients



Experts, most recently former CMS administrator Don Berwick, tell us that no less than 20% – 30% of medical care is waste. At the very least, waste is harmful to all those who pay for Medicare. But often it’s directly harmful to the patient as well.
I recently saw a friend at a party. Since we’d last seen each other my friend’s spouse had died. (I’m deliberately avoiding gendered pronouns and omitting other identifying details.) My friend contrasted the excellent hospice care the spouse received with problem-ridden hospital care. Here are two examples of waste that were thwarted only by my friend’s vigilance.
My friend’s spouse (“the patient”) was declining rapidly, and was admitted to the hospital. While my friend was attending to some bureaucratic aspects of the admission, the hospitalist ordered a CT and insertion of a PICC (peripherally inserted central catheter) line.
On returning to the patient’s bedside my friend pointed out that an identical CT scan had been done four days earlier.
The hospitalist responded, “I don’t have it.”
My friend replied, “Rather than putting such a sick person through another CT and spending another few thousand dollars, let’s get it.”
With regard to insertion of the catheter, my friend asked, “what aspect of the plan does it serve?”
The answer was it was an automatic part of a protocol, not tailored to the wishes of the patient and family. When their goals were clarified, the PICC line idea was dropped.
I know from my own practice experience that getting test results and records can be difficult. But repeating an identical test four days after it had been done elsewhere is a very expensive workaround that would have imposed avoidable distress on the patient. And although threading a catheter to place near the heart is a fairly routine hospital procedure, it carries risks (such as infection) and burdens (being hooked up to tubing). The hospital protocol should have required clarity about treatment goals before a non-emergency intervention was set into motion.
What struck me about these examples of overtreatment is how mundane they were. The hospitalist meant well. It was important for him to have the information the CT scan would provide, but repeating it wasn’t the right way to get it. And having routines can promote patient safety, but only when the routine is tailored to the true situation. In a non-emergency, getting clarity about the treatment goals of patient and family should be part of what we physicians routinely expect of ourselves.
My friend improved the spouse’s care and, at the same time, reduced costs. The public won’t be ready to consider reduced Medicare benefits or rationing until this kind of lose-lose waste is eliminated from the health system.
Jim Sabin is a psychiatrist and director, ethics program, Harvard Pilgrim Health Care.  He blogs at Health Care Organizational Ethics.

Assess for DBS is a handy app for physicians who treat patients with Parkinson’s disease



Purpose of App Review

How useful is this app in identifying patients for deep brain stimulation (DBS)?

Introduction

Deep brain stimulation is an invasive treatment that uses an implanted device to create electrical signals in the brain to help alleviate various treatment resistant neurological disorders such as Parkinson’s disease.
Although DBS is an effective therapeutic treatment, patients need to be evaluated according to their condition and extent of disease in order to be eligible for the procedure. The Assess for DBS medical app was created by medtronic to help physicians evaluate and identify if patients should be referred for DBS.

User Interface

The user interface of this app makes it very easy to use and navigate. First, the app opens up with a screen that can lead you to start a patient evaluation, get background information on DBS, find information relating to the methodology of the app, as well as instructions on how to use the app.
photo (28)
The background information screen gives a summary of the methods the app uses to make its recommendation for DBS. The app states that it uses the RAND Appropriateness method and has an in-app link that opens up with more information about that method which includes citations. The information page also lists the doctors involved in developing that method.
photo (33)
The first patient evaluation screen has a series of questions about the patient that haveYes or No answers
photo (30)
If the answers are not Yes to all of these questions a pop-up shows up stating right away that the patient does not meet the requirements for DBS consideration.
photo (31)
However, if the answers are all Yes, then the next screen has another set of more specific questions such as age, duration of Parkinson’s disease, severity of dyskinesias, etc.
Some of these questions have tabs that open with more information such as definitions. Since many of the questions and answers depend on subjective information, the information tabs also include descriptions or explanations of what the patient may present with for each answer choice.
photo (29)
After completing these questions, a recommendation is revealed. The recommendation shows the recommendation for DBS referral as either inappropriate, uncertain or appropriate according to the answers to the questions. These results can then be sent as an email in PDF format. Overall, this app is very well made and can be a handy tool for physicians to have to help make an assessment for DBS referral.
photo (32)

Price

  • Free

Likes

  • Very well made app, easy to navigate
  • Has information on the method used to make the ratings of appropriateness for referral for DBS as well as citations for more information
  • The app includes tabs with helpful information about various questions

Dislikes

  • Although the app contains information of the methods used to make the ratings for DBS referral, it would be more convenient if the citations were hyper-linked
  • The app says that it should be used in the USA only at the very bottom of the safety page
  • It may be better if this was listed on the opening screen

 Healthcare workers that would benefit from the app

  • Any physician who is treats patients with Parkinson’s disease.

Conclusions

  • This app is a very well developed medical tool that can be used by physicians to assess patients eligibility for DBS. The app is very easy to use and navigate and gives very quick results. This app is not available on the Android platform.

iMedicalApps recommended?

  • Yes
Rating: (1 to 5 stars)
Overall: 4.66 Stars
  1. User Interface – 5/5 Stars. The app is easy to use and navigate and has a great layout.
  2. Multimedia usage: N/a
  3. Price – 5/5 Stars. Free.
  4. Real world applicability – 4/5 Stars. This app can be a great tool for physicians who treat Parkinson’s disease in the USA. Although this app does help evaluate patients for referral for DBS, the questions and answer choices are still subjective.
Compatibility: Compatible with iPhone 3GS, iPhone 4, iPhone 4S, iPhone 5, iPod touch (3rd generation), iPod touch (4th generation), iPod touch (5th generation) and iPad. Requires iOS 5.1 or later. This app is optimized for iPhone 5.
Tested on: iPhone 4
Disclaimer:
This post does not establish, nor is it intended to establish, a patient physician relationship with anyone. It does not substitute for professional advice, and does not substitute for an in-person evaluation with your health care provider. It does not provide the definitive statement on the subject addressed. Before using these apps please consult with your own physician or health care provider as to the apps validity and accuracy as this post is not intended to affirm the validity or accuracy of the apps in question. The app(s) mentioned in this post should not be used without discussing the app first with your health care provider.

iMedicalApps is at Health:Refactored today and tomorrow, #hrefactored


Post image for iMedicalApps is at Health:Refactored today and tomorrow, #hrefactored
By: Steven Chan, MD/MBA
The Health: Refactored 2-day conference will bring together designers, developers, and health/technology professionals to discuss the economics and governmental factors influencing health tech, the latest user experience paradigms, as well as API and data sources. Speakers include US Dept. of HHS CTO Bryan Sivak, Ginger.io CEO Anmol Madan, Microsoft Chief Architect – HealthVault Sean Nolan, and more.
We’re here at the Computer History Museum in Silicon Valley today and tomorrow to share the most exciting and interesting finds from this two-day event. Follow us @iMedicalApps for the latest and keep an eye out for posts here. The event hashtag is #hrefactored.
For more information on this event, check out their website.

Carmat has won approval to proceed with the first implantations of artificial hearts




PARIS | Tue May 14, 2013 10:00am EDT
(Reuters) - France's Carmat has won approval to proceed with the first human implantations of its artificial heart in four countries, the company said on Tuesday, sending its shares up 25 percent.
The approval were given by the four international cardiac surgery centers in Belgium, Poland, Saudi Arabia and Slovenia, where the tests will be carried out, but not in France, where Carmat's artificial heart is still to gain approval from the drug safety agency, ANSM.
Shares of Carmat rose 24.56 percent at 12.12 GMT to 129.5 euros, valuing the company at 535 million euros ($694.56 million).
Among Carmat's competitors are privately-held SynCardia Systems andAbiomed Inc., both of the United States.
The approval is "good news" that allows the French medical devices maker "to make progress on the subject of human implantation despite the growing demands of the ASNM," Portzamparc analysts wrote in a note.
The French regulator has asked Carmat to test the device on animals before it can allow implantation in humans.
"The patient selection process and the training of the clinical teams are ongoing in these four countries (...) Implantations could start shortly following the completion of the training," Carmat said in a press release.
Developed by a team of engineers from Airbus parent company EADS, the Carmat devices - expected to cost 150,000 euros ($193,600) each - mimic heart muscle contractions with two micro pumps, one for each ventricle or heart chamber.
"Carmat expects to receive additional approvals in a near future, potentially in France and in other countries," Chief Executive Marcello Conviti said in the press statement.
Last October, Carmat had said it expected to seek approval for its artificial heart from French authorities by the end of the year, enabling it to carry out its first implant in early 2013.
($1 = 0.7703 euros)
(Reporting by Alice Cannet; editing by James Jukwey)

C.R. Bard Inc. to Pay U.S. $48.26 Million to Resolve False Claims Act Claims

WASHINGTON—C.R. Bard Inc. has agreed to pay the United States $48.26 million to resolve claims that it knowingly caused false claims to be submitted to the Medicare program for brachytherapy seeds used to treat prostate cancer in violation of the False Claims Act. Bard is a New Jersey based corporation that develops, manufacturers, and markets medical products used for a variety of conditions, including prostate cancer.

The settlement requires that Bard pay $48.26 million and it resolves claims relating to Bard’s sale of brachytherapy seeds, a form of radiation therapy, to hospitals. The United States alleged that from 1998 to 2006, Bard provided illegal remuneration to customers and physicians to induce them to purchase Bard’s seeds in violation of the Anti-Kickback Statute. The illegal remuneration allegedly took the form of certain grants, guaranteed minimum rebates, conference fees, marketing assistance, and/or free medical equipment that Bard paid to customers and/or physicians who used the seeds to perform treatment for prostate cancer. Hospitals ultimately submitted bills to Medicare for these seeds, which the government alleged were rendered false by Bard’s illegal kickback activity.

The government alleged that Bard was liable under the False Claims Act for causing the submission of those false claims. “This settlement is part of the United States’ ongoing effort to combat the payment of illegal kickbacks to health care providers,” said Stuart F Delery, Acting Assistant Attorney General for the Department of Justice’s Civil Division. “Such illegal payments subvert the medical marketplace and provide an unfair advantage to those who break the law.” “Illegal kickbacks in any form pervert our health care system, which is designed to insure that health care providers make decisions based solely on what is best for the patient,” said United States Attorney for the Northern District of Georgia Sally Quillian Yates. “We will continue to work with our various law enforcement partners in the pursuit of those who abuse publicly funded health care programs, such as Medicare and Medicaid, through criminal prosecutions or civil settlements under the False Claims Act,” stated Mark F Giuliano, Special Agent in Charge, FBI Atlanta Field Office.

“Such abuses as we’ve seen in this case will not be tolerated.” “Kickbacks, basically no more than bribes, erode trust in the health care system,” said Derrick L Jackson, Special Agent in Charge of the United States Department of Health and Human Services, Office of Inspector General (HHS-OIG), Atlanta Region. “Companies paying illegal kickbacks to fatten their bottom lines should be prepared for aggressive investigation and prosecution.” The civil settlement resolves a lawsuit filed in the United States District Court for the Northern District of Georgia by Julie Darity, a former Bard manager for brachytherapy contracts administration under the qui tam, or whistleblower, provisions of the False Claims Act. United States ex rel. Darity v.

CR. Bard, Inc ., et al ., Civ. Action No. 1:06-cv-0208-SCJ (Northern District of Georgia).

Under the False Claims Act, private citizens may bring suit for false claims on behalf of the United States and share in any recovery obtained by the government. The former manager will receive $10,134,600 as her share of the civil settlement. In addition, according to a non-prosecution agreement with the United States, Bard has agreed to pay an additional $2.2 million and to take numerous remedial steps, many of which the company identified and began to implement prior to the criminal investigation, to enhance its corporate compliance program to prevent similar illegal actions in the future. For example, Bard has agreed to refine its code of conduct and other written policies and procedures that promote Bard’s commitment to full compliance with all federal health care program requirements and to develop an effective program to monitor medical education grants provided by Bard to ensure compliance with those requirements.

The resolutions announced today are part of the government’s emphasis on combating health care fraud and another step for the Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative, which was announced by Attorney General Eric Holder and Kathleen Sebelius, Secretary of the Department of Health and Human Services in May 2009. The partnership between the two departments has focused efforts to reduce and prevent Medicare and Medicaid financial fraud through enhanced cooperation. One of the most powerful tools in that effort is the False Claims Act, which the Justice Department has used to recover nearly $10.3 billion since January 2009 in cases involving fraud against federal health care programs. The Justice Department’s total recoveries in False Claims Act cases since January 2009 are over $14.3 billion.

These settlements were the result of a coordinated effort by the United States Attorney’s Office for the Northern District of Georgia; the Department of Justice, Civil Division, Commercial Litigation Branch; the FBI; and HHS-OIG, in investigating the allegations in this case. 

Reported by: FBI

Probe Of Medicare Advantage Leak Finds Wide Speculation On Deal - Kaiser Health News



Tuesday, May 14, 2013

Is the “Online Health Clinic” the Wave of the Future?


HealthPartners argues that the answer is yes. In a 2013 Health Affairs article, they argue the following:

HealthPartners in Minnesota launched an online clinic called virtuwell in late 2010. After more than 40,000 cases, we report an average $88 lower cost per episode compared with care received in traditional settings, strong indicators of clinical effectiveness, and a 98 percent “would recommend” rating from customers. The possibility of extrapolating such savings to larger volumes of cases is compelling.

Although I believe that there will be some savings from online health clinics, I believe that much of this perceived savings is due to patients sorting. If relatively healthier patients use the online health clinic, then it could be the case that average costs will be lower for those who use the online services simply due to patient sorting. The report does risk adjust for patient comorbidities and other factors.

Risk adjustment, however, is always imperfect. Thus, three confounding factors could bias these estiamtes.

Individuals who are more educated, wealthier, more technologically savvy are more likely to use the online health clinic, but are also more likely to be relatively healthy conditional on observables.
Individuals who use the online clinics may be more likely to seek treatment for less severe cases. If this is the case, then the treatment received during the online clinic may appear cheaper than is really the case since treating this same people in the clinic may have been cheaper than the average patient. Thus, there would still be cost savingings but the magnitude would not be as large.
Whereas the points above mention that there could be differences in the types of patients that use the online services, within each individual preferences for online treatment may vary. The less serious an illness appears to be (i.e., the lower the likelihood urgent care is needed from the patient’s perspective) the more likely individuals will seek online care.
Thus, although online health clinics may save money, extrapolating these savings over the entire population is likely to produce an overestimate.

The demand side of the equation–that patients will demand online access to around the clock medical care–may drive the market (especially for young adults and families) in the future.

Source:

Patrick T. Courneya, Kevin J. Palattao and Jason M. Gallagher. HealthPartners’ Online Clinic For Simple Conditions Delivers Savings Of $88 Per Episode And High Patient Approval. Health Aff February 2013 vol. 32 no. 2 385-392.