South Florida Doctors Seek New Practice Options to Offset Rising Expenses

Individually and in groups, South Florida doctors are trying new business models for their practices that can reduce costs but may increase their risk.

Palm Beach County neurologist James Goldenberg says his practice is weighing a "risk" model where government or managed-care providers pay doctors a flat sum to care for patients. The doctors make money if they control their costs.

In Broward County, Dr. Brian Polner reduced the cost of business operations 20 percent after forming HealthwoRx, a group of cardiovascular, internal medicine and family practice physicians who share a testing lab and other expenses.

"We're seeing more doctors forming groups, or they're going to work for the hospitals," said Cynthia Peterson, executive vice president for the Broward County Medical Association. Nearly half of doctors who responded to a recent survey by the Florida Medical Association said they would pursue alternatives that included trimming their hours, retiring early, providing "concierge" care to a limited number of well-heeled patients, seeking hospital employment, or cutting back on the patients they see.

The trend "bears watching because it could negatively affect Florida patients' access to health care," the state group said.

Goldenberg said physicians are frustrated with ever-changing regulations, lower reimbursements for their services, and bureaucracy that often gets in the way of patient care.

To diagnose a diabetic for nerve damage, for example, he conducts a common test. But insurers and Medicare are reimbursing doctors at a rate 30 percent lower today than in previous years.

Goldenberg said his 75-doctor group, Medical Specialists of the Palm Beaches, is considering "all options" to offset declining reimbursements while maintaining quality care. That includes a model that would encourage doctors to think twice about ordering an expensive test — or assume the financial responsibility if they proceed.

"I think that's going to be a very important model in the future," he said.

Polner, chief executive of HealthwoRx, helped found the 20-doctor Broward County practice in 2005. The goal: to improve patient care through collaboration, which also helps lower costs for the doctors.

"You reduce the redundancy of testing, improve patient compliance by following up with doctors in the group, and have better control of medical records," he said.

By year-end, HealthworRx's number of doctors will double after it forms a new multispecialty model, he said.

But even a larger practice isn't enough to curb spiraling health care costs. A year ago, Polner launched PremierMD, an independent physicians association that contracts with major insurers to reduce costs. If the cost-cutting is a success, the group shares profits with the insurer. The physicians remain independent but benefit from the power of group purchasing for medical and office equipment and supplies.

So far, 80 local doctors have joined the association.

In January, PremierMD will introduce a group that will collect data with the goal of reducing Medicare costs.

"Doctors, especially in South Florida, are afraid of being in a group practice because they're afraid of losing their autonomy. But they want to collaborate with other doctors," Polner said.

Dr. Octavio "Tony" Prieto, who has been practicing family medicine for more than 30 years, is feeling the pinch as a solo practitioner. The Plantation doctor said insurance companies pay less — or nothing at all in some case — while patients cut back on visits to save on co-pays.

At one point, he considered selling his practice to a corporation, but "they couldn't come up with the money to buy my practice," he said.

So Prieto presses on, but has reduced his practice from 14 workers to six. He's also considering eliminating in-office X-rays because they cost more than insurers will pay.

South Florida patients, many who've lost jobs and employer insurance, try to talk their doctors into reducing their bills. "People arm-wrestle you for the $10 co-pay," he said.

Meanwhile, Prieto, 65, said he loves his work too much to give it up.

But someday, "If I can afford it, I will cut down my hours," he said.

http://touch.sun-sentinel.com/#section/-1/article/p2p-77089126/

Preparing for the medical home transformation

August 07, 2013 | Pam Minichiello - Project Director, MAeHC; Courtney Beach - Practice Consultant, MAeHC

Photo used with permission from Shuttershock.com

Medical homes are considered one of the most promising experiments under way to improve the quality of care and lower costs. The concept has been gaining momentum and shows no signs of slowing.

The principles of the medical home model aren’t new and are geared to ensure that patient-centered care is comprehensive and coordinated, and that it enhances patient access and focuses on the provision of quality and safe care.

The concepts of the medical home require a team-based approach that utilizes health information technology to identify and assist with the management of patient populations while allowing for the measurement of clinical outcomes. Although many of the principles and concepts of the medical home model are part of the day-to-day operations of the small primary care practice, the full adoption of the model can appear overwhelming. Solo practitioners and small practices must deal with a combination of scarce staff resources, small operating budgets and large demands to meet volume targets under fee-for-service payment. Those factors make it less feasible for small practices to hire extra staff (such as a nutritionist, data analyst or care coordinator) to support and sustain the transformation.

Although these barriers are real, they are not insurmountable. With appropriate planning and development, a small practice can achieve a successful medical home transformation. The following areas deserve attention if your practice is considering pursuit of medical home status:

Practice education – It’s important that each member of the practice care team fully understand the concept and principles of a medical home. This knowledge drives buy-in and promotes active participation in the successful transformation.

Practice roles -- Utilize limited resources to maximum abilities and scope. First identify what each team member is currently responsible for and look for opportunities to align responsibilities across the team to match skill sets. It’s important to utilize each staff member to his/her fullest capabilities in this team-based approach.

Care team responsibilities – Clearly define the role each team member will play in the medical home and develop the processes that support the following medical home concepts:

• Patient tracking and follow-up;
• Patient and caregiver education;
• Health promotion and wellness care;
• Care coordination;
• Clinical outcome and performance monitoring; and
• IT support and EHR system management and configuration.

Relationships within the medical neighborhood – Identify the community resources outside of the practice that provide specialty care, care management, hospital services, home care and behavioral healthcare. You must be able to coordinate and effectively manage your patients’ care. Establish formalized relationships with these resources to define referral protocols and follow-up processes, as well as admission and discharge coordination services. Think in terms of streamlining these processes.

Enhanced payment programs – Many payers across the country offer enhanced reimbursement for primary care providers that receive NCQA PCMH recognition with the purpose of providing financial support to assist the small practice in increasing necessary staff and services to support the medical home.

EHR configuration and utilization -- The cornerstone to success is to ensure your EHR is working for you. Having an in-depth understanding of how your EHR works and flows is key to streamlining clinical processes in the office. In addition, configure your system to provide meaningful care alerts, pertinent decision support, patient education materials and customized documentation templates to optimize workflow.

Health information exchanges – An HIE can serve as an excellent resource for collecting comprehensive clinical information for your patient population. HIEs build a “community record” of sorts; that record aggregates the pertinent information from specialists and hospitals, provides diagnostic testing results geared to quickly give primary care practitioners the information needed to assist in managing their patients’ care.

Engaging the practice to make a “system-wide” transformation can be challenging, but with appropriate planning and development the small practice can successfully transform into a true medical home.

Pam Minichiello is project director for the Massachusetts eHealth Collaborative (MAeHC). Courtney Beach is a practice consultant with MAeHC.

http://www.physbiztech.com/best-practices/business/preparing-medical-home-transformation

Dallas heart surgeon uses medicine as ministry

By MARC RAMIREZ

DALLAS (AP) — At 83, Carl Smith found himself facing quadruple-bypass surgery and the real possibility that he might not survive.

Within hours on this spring morning, Dr. Mark Pool would temporarily bring Smith's heart to a stop in an attempt to circumvent its blocked passages.

And to help his patient confront the uncertainty, Pool did something unusual in his profession: He prayed with him.

The power of healing: Medicine and religion have both had their day, and they haven't always been able to coexist. But as today's medical treatment becomes more holistic, doctors are increasingly taking spirituality into account.

The Dallas Morning News (http://dallasne.ws/1cbWHgS) reports that studies show a majority of patients want their spirituality recognized, and most med schools now have classes related to the topic. In general, the new thinking asks doctors to note their patients' spiritual leanings and open doors to expression, especially when life is at risk.

Pool, a highly regarded heart and lung surgeon at Texas Health Presbyterian Hospital Dallas, is fervent about his Baptist faith. For about a year, he's routinely asked patients if they'd like him to pray with them pre-surgery — a gesture he says is always appreciated but one that exceeds advocates' suggested bounds.

"A physician should be open to a patient's spirituality but shouldn't push religion on patients," says Nathan Carlin, assistant professor at the University of Texas Health Science Center at Houston. "That's confusing personal and professional roles."

An inherent power differential divides doctors and patients, says Christina Puchalski, director of George Washington University's Institute for Spirituality and Health and co-editor of the recently published Oxford Textbook of Spirituality in Healthcare.

"They're coming to us for something other than prayer," Puchalski says. "If I, as a patient, perceive (a surgeon) as having my life in his hands, and he asks me to pray and I say no, he may not treat me well. And that's putting undue pressure on the patient."

As the saying goes, there are no atheists in foxholes: The idea that your fate is out of your hands offers fertile ground for re-examination.

"The moment somebody tells you that you have cancer," says Methodist Dallas Medical Center's Rohan Jeyarajah, a gastrointestinal surgeon who prays with patients, "you're going to believe in something."

But the situation, he says, requires caution: "We have to be careful about being in a position of perceived authority and not overstepping that bound. This is like a teacher-student relationship. There's a chance you could be inappropriate."

Pool pushes forward, eager to share the belief that drives him without making people feel awkward or flouting that power imbalance.

"I don't want to exploit their situation," he says. "At the same time, I want to give them the opportunity to explore the faith that I know."

You could say Pool comes from a religious background. His father, his grandfather, his father-in-law, his brother-in-law: all ministers. The family joke was that he started going to church nine months before he was born.

By age 6, he was well versed in Bible basics, but then something odd happened. One day at a prayer meeting, Pool says, he was touched by — well, not quite a vision, but an awareness.

"I had already understood that Jesus came to save the world," he says. "That was nice. But then I understood: Jesus came to save me. And that changed everything."

He's pursued a path of faith ever since. Medicine seemed like a good way to help people. Even so, as a med student, Pool pondered ditching the whole thing to go to seminary instead.

As a member of First Baptist Church of Dallas, he and wife Jessica lead relationship classes on Sundays for dozens of young married couples. Even in his crisp, black-patterned suit, Pool is impossibly youthful — lean and rosy-cheeked, posture straight as a fence post.

And as a cardiothoracic surgeon, another realization has set in: "I have a ministry. I don't need to be standing in a pulpit. I have found a ministry I did not expect. I am able to minister to people in times of need."

Since Texas Health is a faith-based hospital system, he felt at ease taking that step.

"The vast majority of people believe in God," he says, "and yet when people come to the hospital, that's completely ignored by doctors. If anything, they call the chaplain. It's unfortunate that more doctors don't try to engage that part of a patient's life."

That's starting to change. Two decades ago, barely a few med schools offered classes on spirituality. Now, three-fourths of them do.

"Medicine has figured out that we ignore the more human sides of health care at our own peril," says Craig Borchardt, interim chair of humanities and medicine at Texas A&M University.

Studies show 60 to 80 percent of patients want their beliefs noted, he says — not as affirmation but as a sign that the doctor actually cares. But fewer than 20 percent of doctors bring it up.

The push has met with some backlash — from busy doctors reluctant to take time away from other concerns or others who don't like talking about it.

"Some staff are more comfortable with it than others," says Mark Grace, vice president of mission and ministry for Baylor Health Care System.

He doesn't reject the idea of doctors offering to pray, but "if you don't listen to the answer, that's where you get into problems. . The doctor needs to be prepared if the patient says no."

George Washington University's Puchalski says the bottom line is doing what's best for the patient.

"Physicians are generally not trained to lead prayer," she says.

To illustrate the power differential she says exists, she recalls a patient who was also a fellow parishioner. One day, she noticed the woman hadn't been to church for a while, then realized the woman hadn't come into her office either.

When the patient finally resurfaced, Puchalski pressed the matter: "She told me, 'I thought you'd be upset that I switched churches.' That gives you an idea of the power we have over patients. So I would really caution against (taking advantage of) that."

Pool gleans his patients' spiritual beliefs at their initial meeting. Then, on the morning of surgery, he says: "This is a time when a lot of people turn to faith. Would you mind if I prayed with you?"

No one, he says, has ever declined, not even those who believe differently or not at all.

It's 6 a.m., and Pool, shiny black boots poking from beneath blue scrubs, briefs Smith on his surgery. At 83, Smith is fit, mowing the yard occasionally, an active driver.

But coronary artery disease caught up with the retired Farmers Branch pharmacist, slowing his blood flow and causing chest pain. Over time, it could lead to a heart attack.

Madge Smith, his wife of 63 years, and Leah Wilson, his youngest daughter, are near. Scott Smith, his son, would join later.

Pool explains his plan: He'll make an incision down Smith's breastbone, then take arteries from his left and right side, and a vein from his leg, to form new channels for blood to flow through his heart.

"So," he tells Smith, "you told me you're a Sunday school leader. . Would you mind if I said a prayer for you?"

Smith is touched. Pool places his hand on Smith's shoulder and begins:

"God, thank you for Mr. Smith. We ask that you would guard his life, keep him safe and bring him through this operation. Replace any anxiety that he may have. Give him a great assurance of your love and your power.

"I ask you to watch over our team, that you give us all clarity of thought, that you guide my hands as they move. We pray these things in Christ's name. Amen."

"Amen," Smith says.

Later, as Smith's family awaits the outcome, his wife says: "I have never had a doctor do that. It just meant so much to us. We just thought it was sent from God."

At 6:45 a.m., Pool starts in, using a tiny electric saw to patiently work through Smith's chest and breastbone.

The arteries he wants dangle inside like strings of soaked cooking twine above Smith's quivering lungs. He snips one end of each, then applies small plastic clamps to stop the thin spurt of blood.

"See that?" he says. "That's the blood flow that will be going into the heart."

A shot of potassium literally stops Smith's heart cold, temporarily abdicating its work to a heart and lung machine. To the heart, Pool will divert the snipped arteries, and repurpose a vein taken from Smith's leg, to offset the blockages within.

But first he has to open the heart's protective sac, unveiling the still-beating organ as it heaves inside. Pool eases it to one side, to reach a portion underneath — and in that moment, Smith's heart, the force pumping blood and oxygen throughout his body, rests in Pool's cradling grip.

Out in the family waiting area, Smith's son Scott says: "God has his hand on everything. He's in control. We're not. It's in God's hands."

Pool initially wondered if his praying might give patients pause, whether they'd worry he wasn't confident enough in his own skills to get through the surgery.

"It's been the opposite," he says. "They value the humility."

Last year, Shea Bowen of Kaufman had just delivered a son at Texas Health Presbyterian Hospital Rockwall four weeks early. Suddenly, she became short of breath. Tests revealed a tumor in her heart.

She was rushed to the network's Dallas hospital, where Pool met with her and her husband. She was shaking then, a complete wreck.

"It was terrifying for me," Bowen says. "I had to leave my few-hours-old baby. We knew there was a chance that . Not everyone comes out of surgery.

"Dr. Pool could tell. His words were 'I don't know if you guys believe in God, but I do,' and as soon as he said that, we both burst into tears. He said, 'I can cut and I can sew, but God is going to heal you, and I'm going to do everything in my power to make sure that happens.'

"There's a lot that's a blur, but I remember the comfort of knowing the person who was literally going to stop my heart and cut me open was going to do that for me under God."

Not long ago, Pool contacted a local evangelistic organization. "So I could up my game," he says. He wants to learn how to share his faith without being a "turn or burn" proselytizer.

"I wouldn't want for somebody to make a decision in a moment of crisis that they wouldn't make otherwise," he says. "I don't want to say, 'It's your last chance: Smarten up or else.'

"It doesn't mean I can't share my faith just because it might upset somebody in the world. This nation was founded on Christian ideals."

Pool pauses when asked if he'd pray with followers of Islam, a faith he considers antagonistic and unforgiving.

"I don't think they would get the same meaning" from it, he says. "Not that they would feel offended, but . not comforted."

He tries to avoid a holier-than-thou air and — with patients, anyway — doesn't claim only certain believers get into heaven.

"It's not my job to get somebody to make certain decisions," Pool says. "All I can do is live a life that makes it appealing to somebody and then share it with them. If I share and they say, 'I'm not interested,' I say no problem and move on. But seeds can be sown that you never see the fruit of."

Smith's operation was a success. Six weeks later, Pool meets with him one last time.

"You're doing extremely well," Pool says. "I'm going to fade away now. You don't have to come back and see me."

"I'd be 6 feet under if it wasn't for you," Smith says.

Pool dismisses the thought. "I'd like to say a prayer with you," he says.

Smith bows his head and closes his eyes.

"Lord," Pool begins, "thank you for getting Mr. Smith out of the hospital and getting him home. We ask that you continue that process of healing and give him a spring in his step once again. In Jesus' name we pray."

Smith is upbeat. He believes the gesture will help him get better. And in the end, that might be the most important thing of all.

___

Information from: The Dallas Morning News,

http://www.necn.com/08/04/13/Dallas-heart-surgeon-uses-medicine-as-mi/landing_nation.html?&apID=0f389f14177f4a05b0e9de465c5d3004

Capital BlueCross challenges student developers nationwide to create web or mobile applications that improve health care

HARRISBURG, Pa., July 17, 2013 - Capital BlueCross is challenging student developers nationwide to create web-based tools or mobile applications that enrich the health care consumer experience. Winning entries can earn one of three prizes totaling $30,000.

Titled Blue Innovates, the challenge is an opportunity for students 18 years of age or older to bring their innovative ideas to life in one of three categories:

Financial: Applications that assist health care consumers in finding, accessing, organizing, simplifying, understanding or minimizing health care expenditures.

Telemedical: Technology that provides consumers with affordable and high quality health care while saving time and money.

Experiential: Tools that help consumers have a more personalized and satisfying health care experience and that enhance their well-being.

"As a leader in the health care industry, Capital BlueCross is seeking to develop new solutions that will meet the evolving needs of consumers who want to interact with health care like every other retail experience," said Donna K. Lencki, Capital BlueCross chief marketing officer. "We recognize there are a lot of talented people looking for an outlet to showcase their ideas and creativity. Blue Innovates allows us to tap into the minds of'millennials' to drive innovation in a rapidly changing industry to help consumers better understand and navigate the health care system for the best possible outcomes. We are delighted to kick-off this challenge."

Students may use their preferred tools, programming languages and technologies to develop a unique solution. All entries for Blue Innovates must be submitted by Nov. 22, 2013. Winners will be announced by Dec. 20, 2013. Entries must be original work created by the developer who is submitting the application for consideration.

To get started, students can visit Blue Innovates to register and review contest rules. Developers can also use the online forum on the Blue Innovates web site for support and advice throughout the process.

The developer of the first-place winning application will receive $15,000, while the second and third place winners will receive $10,000 and $5,000 respectively.

About Capital BlueCross

In 2013, Capital BlueCross is celebrating 75 years of serving central Pennsylvania and Lehigh Valley residents and businesses as the region's leading health insurer. Through its family of companies, Capital BlueCross brings innovative services and clinical solutions to the marketplace. Committed to delivering medical value to its communities, Capital BlueCross focuses on improving patient satisfaction, enhancing quality of care and reducing costs. The company continues to lead the change in the industry by meeting the evolving health needs of its customers, most recently by entering the retail market and building a first-of-its-kind health and wellness store called Capital Blue. Headquartered in Harrisburg, Pa., Capital BlueCross is an independent licensee of the Blue Cross and Blue Shield Association, employing more than 1,800 people. More information about Capital BlueCross can be found at capbluecross.com.

http://m.bwwgeeksworld.com/article/Capital-BlueCross-challenges-student-developers-nationwide-to-create-web-or-mobile-applications-that-improve-health-care-20130717

The Digital Takeover of America’s Health Care System

6/23/2013 – Kameron Gifford, CPC

Eric Schmidt of Google recently pointed out that from the dawn of civilization to 2003 there were a total of 5 exabytes or 1 billion gigabytes of data total. Today, we are producing a minimum of 5 exabytes every 2 days. That is incredible. This powerful explosion into “Big Data” was made possible by advancements in technology such as the smart phone, cloud servers and remarkable biosensors. Consumers have harnessed this technology to drive revolutions in every industry outside of healthcare. The internet allowed a frontier for the convergence of influence and technology capable of altering an entire culture. Could the internet be the one technology that has fundamentally changed the clinical practice of medicine more than any other advancement? Will a new generation of tech savy consumers finally force a transition from population based health into a new era of individualized medicine? Will the next generation of patient-centered care focus on what is best for the individual patient and not big business?
Consider these statistics from 2011:

•   42% of Internet users went online to find health information for self-diagnosis or treatment.
•  38% of users ages 65 and older went online for medical research.
• 48% of Internet users with an annual income over 100,000 used the internet to research information on health plans or practitioners.
• 37% of internet users between the ages 25 and 44 and 35% of users between the ages of 45 and 64 also went online to find information on health plans and physicians.

Powerful indications that the internet does have the ability to engage users and improve overall healthcare outcomes. An open space filled with collective tools that lay the groundwork for a new era of medicine. This is the end of generalized, population based approaches to care. The future will be dominated by those with a vision of something better. This new journey will be empowered by the digitalization of human beings.  Influenced and controlled by those who understand innovation. The convergence of this technology to decode and define individual granularity at the molecular level, from womb to tomb, will enhance the experience for all stake holders.

In 2010, Dr. Richard Ablin, the pathologist who discovered the PSA in 1970, wrote an Op-Ed that was published in the New York Times entitled, “The Great Prostate Mistake”. Dr. Ablin wrote, “The tests popularity has led to a hugely expensive public disaster. The medical community must confront reality and stop the inappropriate use of PSA screening. Doing so would save billions of dollars and rescue millions of men from unnecessary, debilitating treatments.”

In “The Creative Destruction of Medicine” Dr. Eric Topol introduces us to his friend who is 1 of 250,000 men in America every year who are subjected to serial prostate biopsies subsequent to a false positive PSA test. This mass screening of 30 million men every year costs the United States $3 billion annually and that doesn’t include the cumulative costs of all the biopsies, surgeries, treatments and the complications of the surgery such as urinary incontinence or impotence. Is this the best that we can do?

A mediocre healthcare system that wastes billions and is incapable of meaningful engaement. A system in which we allow pharmaceutical companies to spend $14 billion a year to influence the 600,000 people who can write a prescription.  A system in which we have enabled corporations to dictate treatment plans of friends and family members.

Science and technology have provided consumers with the crucial tools for disruption. The hostile takeover of our health care system is as inevitable as it is necessary. We must embrace this unique opportune, moment in medicine, a once in a lifetime Kairos.

***the entire report from the US Dept. of Commerce can be downloaded here:  Exploring the Digital Nation: America's Emerging Online Experience - See more at: http://www.ermconsultinginc.com/resources/

Doctors should be able to veto treament data until 'happy' with it, say surgeons

Doctors should be able to veto the publication of data showing how their patients fare after treatment until they are "happy" with the figures, the Royal College of Surgeons has said.

Mr Hunt's intervention provoked fury from the Royal College of Surgeons Photo: PA

By Robert Winnett, and Rowena Mason

9:39AM BST 14 Jun 2013

30 Comments

Professor Norman Williams, president of the surgeons' group, said some doctors are concerned the data is not "reliable and robust" enough, given the complexities of their work.

His comments come after Jeremy Hunt, the Health Secretary, said there was “no valid reason” why doctors should be able to stop the release of the information, which would help patients identify the best place for treatment.

The Government is preparing to "name and shame" surgeons who refuse to make their data public.

It comes after the Daily Telegraph disclosed that doctors were secretly being given the opportunity to opt out of new Government league tables next month.

However, the Royal College of Surgeons has said the plan to name and shame doctors risks undermining public confidence and "stigmatising" them.

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Professor Williams said the medical profession is committed to publishing surgical data, but there is a risk some doctors could shy away from doing difficult operations to keep up their good records.

He said the "way forward" is for all surgeons to publish their data when they are "happy with it". Only a small minority are vetoing publication, he added.

The first data – covering ten different surgical specialisms – will be released imminently before the transparency drive is extended throughout the NHS.

However, 92 surgeons have so far vetoed the publication of “their” data. Many are thought to have death rates which are worse than the average.

NHS England refused to name the surgeons and Mr Hunt has now ordered his officials to draw up plans to “name and shame”.

He said: “Subject to proper risk adjustment of the data there can be no valid reason why it should not be published – and the majority of consultants strongly support the case for doing so.

“In an era of public concern over patient safety issues at Mid Staffordshire Hospital, this will be a major step forward in restoring public confidence.”

Senior health officials said that the public can “draw their own conclusions” about whether they wish to be treated by those withholding data about performance. Whitehall sources have described the situation as “farcical”.

This newspaper disclosed that the surgeons were being privately contacted and asked if they wish to opt out of the publication of so-called “outcomes data”.

The Royal College of Surgeons said that its members were being asked to give their consent to comply with data protection laws.

However, it has now emerged that the Government has not even sought legal advice to establish whether this is the case – but relied on the advice given to it by the professional bodies.

Stephen Dorrell, a former Conservative Cabinet minister who chairs the health select committee, said the law should be rewritten if it was preventing full disclosure. “If it’s true that the Data Protection Act cuts across the principle of professional accountability as it needs to be applied in the modern world, then in my mind it’s very clear that the Data Protection Act needs amendment.”

On Thursday NHS England released further details of the approval process which will lead to the data being published, or withheld. For reasons which are unclear, surgeons with average survival or recovery rates will automatically have their data published unless they raise objections – but those with poor mortality rates will be asked to give explicit approval to publication.

Mr Hunt had hoped that the new system would drive up standards across the NHS and save hundreds of lives by embarrassing those with poor records.

Prof Norman Williams, the President of the Royal College of Surgeons, said the College was “not there to defend 'bad’ doctors, or those who are not performing as well as they should. Patients have a right to know of doctors who are not meeting the standards expected of them.

“We always expected this information would be mandated but it was the Government’s own legal advice, taken earlier this year, that made it clear that in preparation for the publication of data from nine national surgical clinical audits, they would have to ask for doctors to consent to the use of their data, under the Data Protection Act of 1998.

“We would urge the Government to work with us on this, for the sake of better patient care and more transparency.”

http://www.telegraph.co.uk/health/healthnews/10120098/Doctors-should-be-able-to-veto-treament-data-until-happy-with-it-say-surgeons.html

Bill Gates leads $35 million investment in research network

Bill Gates speaks during Peterson Institute 2013 Fiscal Summit on Facing the Future in Washington, May 7, 2013.

Credit: Reuters/Yuri Gripas

By Sarah McBride

SAN FRANCISCO | Tue Jun 4, 2013 12:03pm EDT

(Reuters) - Microsoft co-founder Bill Gates is leading a $35 million investment in ResearchGate, a Berlin-based network for scientists that ties into his interest in fighting disease.

ResearchGate allows researchers around the world to collaborate more easily. They might put out a call to colleagues to find, say, free samples of diseased tissue to analyze, or a partner to work with on a project.

A recent ResearchGate-launched collaboration between researchers in Europe and Nigeria resulted in the discovery of a deadly pathogen that had jumped from plants to humans, said ResearchGate Chief Executive Ijad Madisch in a phone interview.

The Bill and Melinda Gates Foundation works to eradicate the world's most deadly diseases and poverty. Founded by Gates and his wife in 2000, its endowment totals $36.4 billion.

A spokesman for the Gates family said the investment in ResearchGate was a private investment that did not come from the foundation. He declined to comment further.

The collaboration between Gates and ResearchGate developed after one of Madisch's existing backers, Matt Cohler of Benchmark Capital, introduced Madisch to one of Gates' advisers, Madisch said. Earlier this year, Madisch flew to France to talk with Gates about his start-up.

"He understands things extremely fast," Madisch said, adding that meeting Gates was a longtime goal because of the Microsoft founder's philanthropy. "It was the coolest meeting I had in the last year."

Gates is leading the investment with Tenaya Capital, a late-stage investment firm based in Woodside, Calif. Existing investors, Benchmark and Founders Fund, participated.

Madisch, a Harvard-trained Ph.D, co-founded ResearchGate in 2008. It now has 2.8 million members. Its most popular fields are biology, medicine and computer science, and its top four countries by membership are the U.S., India, the U.K., and Germany, a spokesman said.

Many German start-ups have become known for successfully replicating business models developed elsewhere, chiefly in the U.S., rather than coming up with their own ideas. Madisch hopes ResearchGate will help change that reputation.

When asked if he would ever consider taking an investment from the Samwer brothers, the German investors known for funding companies that excel at German replications of U.S. start-ups, Madisch said he would not.

"Definitely not," he said.

(Reporting By Sarah McBride; Editing by Bernard Or)

Wireless Pill Bottle Wins Healthcare Innovation World Cup

 

AdhereTech receives $50,000 grand prize in global diabetes innovation challenge funded by Boehringer Ingelheim

By HITLAB; Boehringer Ingelheim GmbH

HITLAB; Boehringer Ingelheim GmbH

Last modified: 2013-05-16T15:03:28Z

Published: Thursday, May. 16, 2013 - 8:02 am

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NEW YORK, May 16, 2013 -- /PRNewswire/ -- Developers of a pill bottle that wirelessly transmits data, measures medication and sends patient reminders have emerged as grand prize winners in the Healthcare Innovation World Cup, the international diabetes innovation challenge funded by Boehringer Ingelheim and organized by HITLAB.
Winning team members Josh Stein, John Langhauser and Mike Morena of Team AdhereTech from the United States will receive $50,000 in prize money. They earned the top spot by demonstrating the exceptional impact, innovation, feasibility and financial sustainability of their idea, and for engaging with community members via social media.
AdhereTech received its honors at the Healthcare Innovation World Cup finals event on Friday, May 10 at the German Center for Research and Innovation in New York City. Judges selected Team IITKgp for second place, Team SmartSense for third place, and Team EndoGoal as the fourth-place finalist.
First-place AdhereTech has created wireless pill bottles to help improve medication adherence. According to AdhereTech, the bottles measure the exact number of pills in the bottle in real-time, wirelessly send this HIPAA-compliant data into the cloud, and remind patients to take their medication via automated phone call or text message. The devices also record and send adherence data with an unprecedented level of granularity. This summer, AdhereTech, which is based in New York, NY, will begin a trial with The Walter Reed Army Medical Center to test its full-service solution for type 2 diabetes patients. According to Josh Stein, CEO of AdhereTech, there are both issued patents and patents pending for the devices. The company has secured funding, and is actively seeking additional investors. Visit www.adheretech.com for more information.
"We are impressed with AdhereTech's prototype and the feasibility of their business model, and believe the solution has merit in supporting medication adherence," said Klaus Wilgenbus, SVP, PM business development and licensing strategy at Boehringer Ingelheim and Healthcare Innovation World Cup judge. "All of the finalists demonstrated outstanding quality and ingenuity in developing their solutions. It is evident that they are committed to creating innovations with the potential to make a real difference in the lives of people with diabetes and their families."
The three other finalists were:

• Team IITKgp, second place winners of $10,000; members Praful P. Pai, Pradyut Kumar Sanki, Satyabrata Sarangi. Team IITKgp is developing a non-invasive blood glucose measurement device, based on photoacoustic spectroscopy, to enable painless, sample-free and accurate glucose measurement for diabetics. Initial measurements performed on tissue have provided an accuracy of nearly 70% compared to reference measurements. The team is working to improve this accuracy and developing a portable prototype device for wide-scale use and commercialization. IITKgp operates from the Department of Electronics & Electrical Communication Engineering on the campus of the Indian Institute of Technology Kharagpur.
• Team SmartSense, third place winners of $5,000; members Dr. Mayur M. Sadawana, Dr. Rohit Srivastava, and Dr. Yogesh Patil. SmartSense is a multianalyte sensing device for diabetic ketoacidosis (DKA). It is being developed to sense all the metabolites necessary for management of the condition with a single prick. According to team members, it is designed to reduce the pain and economic burden faced by patients with DKA. The developing team of SmartSense is based at the Indian Institute of Technology Bombay.
• Team EndoGoal; members Dr. Jennifer Shine Dyer (Twitter's @EndoGoddess), and Jeff Harper, DuetHealth. EndoGoal is a mobile and web-based rewards program for people with insulin-dependent diabetes who track daily glucoses. Rewards include weekly prepaid visa cards and a virtual pet, and are based on a social business model. Revenue comes from users' family-and-friend 'sponsors.' For more information about the Columbus, Ohio-based initiative, visit www.endogoal.com.

"Considering the caliber of these finalists – as well as many other participants in this competition – the future of diabetes innovation is exceptionally bright. We anticipate big achievements for all four finalists, and are excited to follow their trajectories in the healthcare industry," said Cole Manship, director of the Healthcare Innovation World Cup and manager of new programs and initiatives at HITLAB. "We hope this competition serves as a solid platform for their ongoing success."
All four teams received $2,500 each for reaching the final round of the competition. Overall, more than 100 teams representing 20 countries around the globe submitted diabetes innovations for the Healthcare Innovation World Cup, which awarded a total $75,000 in prizes to semifinalists and finalists. For more information about the competition and judges, visit www.healthcareinnovationworldcup.com.
About the Healthcare Innovation World Cup
The Healthcare Innovation World Cup challenges entrepreneurs and innovators in healthcare and information technology to tackle global public health issues. In 2013, the competition invited participants worldwide to propose solutions for improving diabetes prevention and management, offering $75,000 in total prize money and opportunities to showcase their work. www.healthcareinnovationworldcup.com
About HITLAB
HITLAB is a cross-disciplinary public health teaching and research organization that studies and educates others about the impact of healthcare information and communications technology on public health. Based in New York, NY, the Lab's team includes faculty, scientists, research scholars and students from top universities around the world. www.hitlab.org

Read more here: http://www.sacbee.com/2013/05/16/5425784/wireless-pill-bottle-wins-healthcare.html#storylink=cpy

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.