Hospitals May Have to Pay for Their Own Mistakes

As reported in this blog post from the Wall Street Journal, currently the state of California, and its MediCal program, is saddled with the cost of preventable hospital errors. A new bill has been introduced, AB 2146, where the government of California will stop reimbursement to hospitals for these avoidable mistakes based on Medicare’s no-pay list.

Maine, Massachusetts, Pennsylvania, and New York, make up a list of some states that have already limited payments. Hospitals in Minnesota, Washington, and Vermont, have already accepted responsibility by stating that they will not request payment from patients for hospital errors.

Privately owned companies, such as Cigna and Wellpoint, have also announced that they will be following this trend, and refuse payment for specific mistakes.

What’s the Real Cost of Healthcare?

Trisha Torrey brings up a good point in her latest post on the Patient Empowerment Blog, the true cost of healthcare remains a mystery still to many patients.

First is the copay, then the insurance takes the rest of the doctors charges if the patient is insured. If there is a balance after the insurance has paid their stated amount, the patient is responsible for remainder of the payment. Costs are sometimes negotiated between insurance companies and doctors, but for those who don’t have insurance, negotiations are made between the patient and the doctor. So here’s a solution that can possibly help patients make wiser decisions when it comes to costs.

Change Healthcare is an online service that finds average costs of doctor visits, services, and what insurance companies typically negotiate with doctors. You can upload information about your own costs to the website. By sharing information, it is possible to help people in your area discover the true costs of healthcare.

New Vaccine for US Infants

The FDA has just approved a new vaccine, Pentacel, for the immunization of infants. As stated here at Pharmalot, it provides immunization for these five diseases: Haemophilus influenza type b (HIb), diphtheria, tetanus, pertussis (whopping cough) and poliomyelitis. The doses are given to infants at 2, 4, 6, and 15 to 18 months. This single shot four times can reduce as many as 23 injections otherwise needed for the immunization of infants.

According to this article here at HealthNews, the vaccine was approved after 5,000 infants in Canada and the United States showed that the vaccine was safe and effective against those diseases. This immunization has been used in Canada since 1997, and immunizations in the United States will begin this summer.

Safety Checklist to be Circulated

BBC News reports that a list compiled by the World Health Organization designed to cut the risk of surgical complications will be issued to doctors world-wide. This list is being compiled due to a Lancet study that found that safety measures across hospitals are commonly overlooked.

The Harvard School of Public Health has aided WHO in drawing up this list and its main aim is to reduce the following complications during surgery: preventable infections, preventable complication from bleeding, and safety in anesthesia. The list includes six very basic steps in surgical care including verification of the patient, ensuring that equipment is not neglected and left inside the patient, and administering an antibiotic before making an incision which reduces the risk of infection by at least 50%.

Worldwide, about one million people die a year following major surgery, so hopefully this list can serve an intervention to help prevent common mistakes made in surgical care.

Exercise Helps Battle Age Related Diseases

This latest NY Times article reports that as people age they lose muscle strength and flexibility, and as a result of this it leads to frailty in bones and a loss of mobility. According to Miriam Nelson, director of the John Hancock Center for Physical Activity and Nutrition at Tufts University, exercise is becoming increasingly important in improving quality of life and decreasing the risk of chronic age-related diseases.

A common misconception is that exercise will cause injury or pain, especially with those who suffer from arthritis, but the truth of the matter is that building muscle strength and their joints it will actually reduce pain and decrease the risk of injury. The perfect balance of physical fitness preferred includes aerobic workouts (cardio, swimming, treadmill, crosstrainer), stretching, and muscle training (which can be done in a gym with a series of machines, or dumbbells or resistance bands and tubes at home).

Emerging Trends & Opportunities for Healthcare Organizations to Leverage Web 2.0

As part of this blog, we want to bring you the latest up-to-date information in wellness, prevention, and disease management. In conjunction with the 13^th Annual Health Management Congress, we’ve put together a free web seminar with John Sharp from Cleveland Clinic entitled “Emerging Trends & Opportunities for Healthcare Organizations to Leverage Web 2.0”. I’d like to invite you to join us on Wednesday June 23, 2008 from 2:00 PM to 3:00 PM EDT.

Here’s a brief overview of the webinar:

The social-networking revolution is coming to health care, at the same time that new Internet technologies and software programs are making it easier than ever for consumers to find timely, personalized health information online. Patients who once connected mainly through email discussion groups and chat rooms are building more sophisticated virtual communities that enable them to share information about treatment and coping and build a personal network of friends. At the same time, traditional Web sites that once offered cumbersome pages of static data are developing blogs, podcasts, and customized search engines to deliver the most relevant and timely information on health topics.

What you will learn by attending:

• Improve care self-management using Web 2.0 strategies & resources
• Analyze the impact of Web 2.0 on healthcare stakeholders
• Leverage Web 2.0 content to drive traffic to your site and customers to your facility
• Explore the return on investment for these technologies

Take advantage of this free webinar and register now. Stay tuned to this blog for other updates on webinars within the healthcare industry.

Your Immune Cells May Help Treat Skin Cancer

This article in the NY Times that a man recently had a complete remission of melanoma, a deadly skin cancer, after treatment that boosted his immune system to fight the cancerous cells.

Doctors have long known that immune cells can effectively attack cancerous cells, but Dr. Steven Rosenberg of the National Cancer Institute recently took a different approach. Instead of focusing on the “T cells”, they decided to focus on specific helper T cells that help lock into the cancerous cells and guide the killer cells to fight off the bad cells. Researchers drew blood from 8 patients and grew more of the helper T cells in the laboratory. They later infused the patients with 5 billion of the cells back. After two months, one patient had no signs of tumors in his skin, and after two years he showed no symptoms.

More research is needed since only one of the eight patients who underwent the treatment survived.

Tainted Tomatoes Cause a Salmonella Outbreak

MSNBC reports that federal officials have learned of 106 more cases of salmonella outbreaks caused by tainted tomatoes, putting the national toll at 383 yesterday. The newest influxes of cases were from people who got sick weeks ago, but did not find out their results due to delays in jammed laboratories.

There is a great deal of frustration as researchers work frantically to try and trace the source of tainted tomatoes. Although, tomatoes are among the hardest foods to trace because it is sold without tags and people usually do not have any left by the time they get sick. The FDA states that Mexico and Florida are most likely the sources of where the contaminated tomatoes came from.

Eating a Big Breakfast Helps Weight Loss

BBC News reports that eating a wholesome, hearty breakfast in the morning might actually aid in losing weight. Dr Jakubowicz, from Virginia Commonwealth University, tested 96 obese and physically inactive women, half of who had a low diet and the other half ate a heartier breakfast.

For the first four months, the low-carb dieters appeared to do better , they lost an average of 28 pounds compared to the 23 pounds lost by those eating a big breakfast. However, the results reversed after eight months. The low-carb dieters put on an average of 18 of those pounds back, while the big breakfast eaters continued to lose weight, an average of 16.5 pounds.

A spokesman for the British Nutrition Foundation mentioned:

"This is probably because when we don't have breakfast we're more likely to get hungry before lunch and snack on foods that are high in fat and sugar, such as biscuits, doughnuts or pastries."

Spicy Meals Can Lead to Fitful Sleep

The NY Times reports that eating a spicy meal before you go to sleep can actually lead to poor sleep patterns. A study conducted by Australian researchers monitored the sleeping patterns of a group of healthy young men that had consumed mustard as well as Tabasco sauce before going to bed.

Most of these men had a shortened sleep time during stage 2-4 of sleep on nights that they had consumed spicy meals. Stage 2 is known as the light phase where stage 3 and 4 are known as the deep phase of sleep. Not only did these men experience less sleep, but it also took them longer to drift off.

Both indigestion and a heightened elevated body temperature may account for these effects on sleeping patterns.

ER Wait Times Still on the Increase

In this blog at the Wall Street Journal Health Blog, they tackle the issue of wait times in the ER. The average wait time in the ER has increased five minutes from 2006 to 2007 by five minutes, making the national average for waiting in the ER four hours and five minutes. One hospital in South Dakota, Avera McKennan is making it an important goal to shave the time that patients must wait in the ER. To do this, they’ve started video taping common ER cases and analyzing the video feed to make changes. The five things they’ve changed are:

1) Triage – Condensed the questions asked to the patient, made the route traveled throughout the ER more direct, and nurses caring for the patients assign the patient to the next nurse.

2) Next Step – The nurse and the doctor see the patient at the same time. If the nurse is not ready, the doctor can go ahead with the check up.

3) Universal rooms – The supplies typically needed to care for 85% of all patients are kept at the bedside. Others supplies are kept on a rolling cart.

4) Paper Work – This begins at the bedside only after the patient has begun to receive treatment.

5) Who goes where: Departments view their daily averages, and can therefore predict how many people might come in daily. The departments prepare for this average number.

These changes have lead to a 20 minute decrease in wait time since 2005.

Privacy and Employee Wellness Programs

The focus of this recent post on The Health Care Blog seems to be that there is an ongoing debate on whether employee wellness programs intrude on privacy issues. One reason why companies adopt to these programs is because it saves them costs, both indirect and direct. New employee wellness programs focus on smoking cessation, weight management, and fitness, yet concerns are still arising from employees.

Employees are worried that health risk appraisals could end up in the hands of employers, and that they can use this information to possibly reduce benefits or other purposes. Many employee health plans are now addressing this issue by creating set privacy programs. For now, these programs are voluntary; participants usually get credited for joining by getting cash, gift cards, or discounted gym memberships.

The battle between insurance companies and anorexia

In a recent report at ABC News, they tell of how Janell Smith committed suicide days after she was released from the hospital because of her anorexic disorder. Her parents cite the reason This is just one story in many where parents are fighting against the government because insurance companies are not providing enough money for disorders such as anorexia and bulimia.

Insurance companies cover minimal stays in hospitals for those being treated for anorexia, many only 30 to 60 days. Many are reluctant to cover the full costs, as it can run up to $1000 a day. Blue Cross Blue Shield of New Jersey states that they will not cover extended periods of time with anorexia because:

The insurers' argument that eating disorders should not be characterized as biologically based mental illness has been disputed by some leading researchers. The director of the National Institute of Mental Health wrote in a 2006 letter that anorexia has "a biological core, with genetic components."

Google Health: Are Consumers Ready?

Google’s latest health announcement last week has made headlines in the evolution of Health 2.0. This latest post on The Health Care Blog brings up the point that consumers might not be as interested in having online personal health records.

Keith goes on to mention that only 3% of patients actually keep a personal health record online, so how useful will it be? Online records of medical history remains industry-driven and not consumer driven, and consumers will only see the value of this service when the shift occurs to a consumer-driven industry. Patients are not ready to have this much control of their personal records, Google will have to slow down the process to get patients accustomed to having access to all their personal records.

One Glass of Wine a Day May Reduce the Risk of Liver Disease

A recent study mentioned in the latest NY Times article suggests that drinking one glass of wine a day might reduce the risk of developing the most common liver disorder, which we know as liver disease.

Over 10,000 people, both drinkers and non-drinkers were tested on their blood levels of ALT, which indicates liver damage. The study found excess amounts of ALT in 3.2% of non-drinkers, 3.5% in beer drinkers, 2.3% in daily hard liquor drinkers, and 0.4% in those who drank one glass of wine a day. The data from the study does not show results of those who drink large amounts of alcohol daily.

Delays in Teen Cancer Diagnoses

BBC News reports the latest study shows that diagnoses of cancer among teenagers tend to be delayed. One of the biggest reasons for delays is wrong tests being administered, and that doctors often fail to spot cancer signs. Cancer causes 11% of all deaths between the ages of 15-24, and so early diagnoses are crucial in saving lives.

The average time of spotting the first symptom and diagnoses ranges from four to 184 weeks. Also, children over the age of 12 who often see their general practitioner instead of a specialist were more likely to have a delayed diagnosis, since X-rays are not likely to be carried out at the GP’s office.

Professor Steve Field, Royal College of GPs states that “cancer in this age group is extremely rare”, and that might be another reason for the added delay. GPs will have to look back at patients who have cancer, and determine whether or not there were signs that could have been picked up sooner rather than later.

Employers and Health Insurance

In a recent post at Managed Care Matters, Joseph Paduda discusses the link between employers and the health insurance they offer. He thinks that the reason employers offer health insurance is the important link between health and productivity.

In fact, he states this of the topic:

Keeping workers, and their families, healthy and productive is the primary objective of health insurance

There is another reason employers offer good health insurance: to attract and keep good workers. At the end of the article, he points out that if the system were to reform to individuals choosing policies, health care agencies would have no companies would be responsible for choosing a carrier. As a result, insurance companies would win out, and lower premiums would result in poorer care.

Could you be asked to Sign Away Your Rights?

Trisha Torrey from the Patient Empowerment Blog wrote about a new service offered by Medical Justice, which will ensure that patients do not make any comments about their experiences with the doctor on the internet. This process requires patients to sign a form of release before beginning any examinations, diagnoses, or treatment recommendations.

Medical Justice promises that any physician who pays for this service will not suffer from comments a patient might make about their practice on the web. There is a growing concern though, that many patients will sign away documents without even knowing what the form is for. Also, patients might not fully trust a physician who will not allow them to pass judgments and critique their services.

Heart Bypass Surgery Care: Is it Flawed?

According to this article on BBC News, patients undergoing heart bypass surgery might not be receiving the best possible care. A worldwide study conducted by the National Confidential Enquiry into Patient Outcome and Death on 20,000 patients suggests among of third of the patients who did not survive, delays were to blame.

Problems were found in all processes beginning from start to finish. Delays after a referral to the cardiologist, the way tests were carried out, communication between doctors, and post-op treatment and care all attributed to the death of many patients. An example is given of how one patient was referred to a cardiologist by his general doctor, but since the cardiologist went on vacation the letter remained unopened for a whole month. The patient’s condition worsened dramatically and he died shortly after the operation.

The Chairman of NCEPOD, Professor Tom Treasure mentions:

"Coronary surgery will not always succeed and death comes to us all in the end but if the means at our disposal are not deployed effectively and in a timely way, appropriate to the circumstances, lives that might have been saved will be lost."

Can Flat Soda Really Ease an Upset Stomach?

Contrary to popular belief, drinking flat soda when you have an upset stomach might do more harm than good. The NY Times reports that a when British researchers studied this claim to see if there was any evidence supporting, they found none.

Over the counter re-hydration solutions contain a very low amount of sugar, and high level of electrolytes. When analyzed, soft drinks like colas contained low amounts of electrolytes, potassium, sodium, and it contained seven times the healthy amount of glucose recommended for rehydration.

The World Health Organization mentions:

“Carbonated drinks, flat or otherwise, including cola, provide inadequate fluid and electrolyte replacement and cannot be recommended,”

Harnessing the Immune System to Fight off Alzheimer’s

Alzheimer's disease is caused by the formation of "amyloid plaques" in brain cells. According to this article in BBC News, researchers from Yale University engineered to block a part of the immune system in mice to fight off the harmful amyloid plaques that cause Alzheimer’s.

Researchers blocked immune cells called macrophages, whose normal function is to fight off cell debris and harmful bacteria, and by doing this the immune cells turned their attention to the plaques. The mice’s memories were tested afterwards using mazes, and significant improvements were found. 90% of the plaque material had been removed from the brains of the mice.

More research will be done in the future to see if a drug in humans can reproduce this same effect.