Make your live is better

Make your live is better.

Friday, April 30, 2010

Medical transcription outsourcing: Who actually does the work?

Knowing who actually does the outsourced medical transcription work is very important because of the very sensitive and critical nature of the work. Making sure that the company chosen for outsourcing, executes the medical transcription work themselves, and not through subcontractors or home transcriptionists is very important. This has benefits like:· Better controlHaving to deal with one entity that does the work makes it easier to control all the processes. Otherwise it could result in dilution of control· Data securityData Security is one of the most important factors to be considered before engaging the services of an outsourced transcription vendor. Getting work done through a series of subcontractors and home-based transcriptionists would mean that patient data is exposed...

CEO Summit at the Governor's HIT Conference

On most Thursdays, I write about something personal. However, this week is filled with special HIT events convened by Massachusetts Governor Deval Patrick.Today, the Governor's Healthcare IT Conference began with a panel of CEOs from Humedica, Patientkeeper, Vecna, eCW, Microsoft, Intersystems, Concordant, Biscom, Bessemer Ventures, Life Image, EMC, NaviNet, Navigator Ventures, Meditech, and T2Bio.Here's a summary of their comments*The uncertainty in meaningful use and standards caused a delay in sales for 6 months, followed by record sales once hospitals and eligible professionals felt confident about their purchases*Qualified staff is getting harder to find. Over the next few years, there is likely to be a competition for trained healthcare IT professional, similar to the Dot Com era....

My Thanks to HITSP

Today I wrote this email to all HITSP members thanking them for all their service from October 2005 to the present.-------------Folks: Today is a milestone day. The HITSP Contract extension expires but our work will live on as a foundation to meaningful use, standards and certification. It is my hope that all of us will continue to be part of the ONC processes, providing input to the Federal Advisory Committees, staffing workgroups, and implementing interoperability solutions in our communities. The HITSP website, containing all the HITSP documents, will continue to be available. ANSI has graciously offered to maintain the website for the next few months until contracts are awarded and other arrangements are made.The new RFPs have not yet been awarded and we'll continue to watch for those...

Food Allergy Message from Trace Adkins

Country music star, Trace Adkins, has posted a public service announcement on YouTube. While it doesn't give much new information to those of us food allergy veterans, it is a fun to link to share with friends and family. Check it out and pass it ...

Thursday, April 29, 2010

Medical Transcription services

What is transcription and how does it relate to the field of medicine?Transcription is conversion of audio files to typed records in a paper form or in the form of computer files as per specified formats. Medical transcription is the conversion of audio files of a patient encounter as dictated by a healthcare professional into a typed version, which is then stored in the form of paper records or as a computer file.Why is medical transcription needed?Records of patient encounter need to be created and maintained for various reasons such as patient treatment, permanent patient records, referrals to other doctors, evidence in case of malpractice suits, coding, billing and insurance claims and satisfaction of regulatory norms. Medical transcription plays a vital role in creating accurate records...

Investigations, Indictments and Guilty Pleas at Famous US Teaching Hospitals

Some of the US most prestigious academic medical centers have been receiving unusual scrutiny lately.Mount Sinai Medical Center and New York - Presbyterian Hospital.As reported first by the Wall Street Journal,Federal prosecutors are investigating allegations that bid rigging and fraud at Mount Sinai Medical Center and New York-Presbyterian Hospital resulted in the hospitals awarding contracts worth tens of millions of dollars to outside contractors.Purchasing officials at the hospitals, two of the city's largest and most prestigious, are alleged to have gotten more than a million dollars in payments from companies that were then given lucrative contracts to perform work such as re-insulating pipes and removing asbestos, according to documents filed in the Southern District of New York. Nine...

Wednesday, April 28, 2010

The April HIT Standards Committee Meeting

The April HIT Standards Committee today had a rich agenda and very active discussion.We began with an update from the Implementation Workgroup and their desire to make toolkits, accelerators, and best practices available via the web. They'll align their efforts with the Tools and Standards Repository RFP described in my earlier blog.We next discussed healthcare reform and its requirements for comprehensive insurance plan enrollment standards support as written in SEC. 3021. HEALTH INFORMATION TECHNOLOGY ENROLLMENT STANDARDS AND PROTOCOLS."Not later than 180 days after the date of enactment of this title, the Secretary, in consultation with the HIT Policy Committee and the HIT Standards Committee, shall develop interoperable and secure standards and protocols that facilitate enrollment of...

Judge Rejects Prosecutors' Lenient Settlement of the Case of the Hidden Defibrillator Defects

We just discussed the proposed settlement of a case in which the Guidant subsidiary of Boston Scientific was alleged to have withheld information about defects in its implantable cardiac defibrillators that were associated with six patient deaths (see next most recent post here with more complete summary).  The devices were manufactured in 2000-02, and the issue first became public in 2005.  The proposed settlement included a seemingly large fine for the company.  Now the New York Times has reported that the presiding judge has rejected the settlement as too lenient.A federal judge in Minnesota on Tuesday rejected a plea agreement between the federal government and the Guidant Corporation, saying that the deal did not hold the company sufficiently accountable for an episode...

Pondering Leadership

This blog often talks about the failure of leaders in health care. The April, 2010, issue of Harvard Business Review boasts an entire "Spotlight" Section on this subject.Perhaps the two most interesting articles in this section, both by big names--Atul Gawande and Tom Lee--among today's medical chattering classes, are entitled, respectively, "Health care needs a new kind of hero," and "Turning doctors into leaders." The first, an interview, first touts the good doctor's vaunted emphasis on checklists, then goes on to plead for improved training in team-play: "we don't train physicians how to lead teams or be team members."The second, by Dr. Lee, is more substantive. The network president of Boston's Partners Healthcare System and CEO of Partners Community HealthCare, formed quite a while back...

Oh, the Prices We Pay, Reloaded - Celgene Balks at Explaining High Price of Thalidomide

A brief article on Bloomberg.com implied that Celgene has been fighting efforts by the Canadian Patented Medicine Prices Review Board to get pricing data about the drug Thalidomid (thalidomide):Celgene Corp., the biotechnology company specializing in blood-cancer medicines, will get a hearing before Canada�s highest court over the country�s demands to provide pricing information for the drug Thalomid.The Supreme Court of Canada today agreed to hear Celgene�s appeal of a Federal Court of Appeal ruling that said Canada�s Patented Medicine Prices Review Board was entitled to information about the pricing of the drug. The high court gave no reason for its decision.Celgene�s two top-selling drugs are Revlimid and Thalomid, for a form of blood-cancer called multiple myeloma. They brought in more...

Food Allergy and EpiPens

So, a new study shows that an increased number of us are accidentally poking ourselves with epinephrine auto-injectors. Well, at least teenagers are. The study, with data from 1994-2007, didn't give information about the circumstances of these accidents.I suspect that as more people carry and use auto-injectors, we'll see more accidents.The recommendation is improved design of the auto-injector and better training. EpiPen® has a new design. Have you seen it yet? It does seem to be easier to hold. When this new one expires, I'll try it out in an orange- taking great care not to inject myse...

Tuesday, April 27, 2010

The Genomes, Environments and Traits Conference

This morning, I'll be on stage with all the humans who have had their genomes sequenced - James Watson (pictured above), Henry Louis Gates, Misha Angrist, John West, Jay Flatley, Greg Lucier, Seong-Jim Kim, Rosalynn Gill, George Church, and James Lupski.The GET Conference 2010 marks the last chance in history to collect everyone with a personal genome sequence on the same stage to share their experiences and discuss the important ways in which personal genomes will affect all of our lives in the coming years.From 9a-12p, we'll discuss our personal experiences with sequencing and its impact on our lives, families, medical care, and policy thinking.At...

Monday, April 26, 2010

The Governor's Healthcare IT Conference

Although healthcare reform has its supporters and detractors, healthcare IT reform - the use of technology to improve the quality, safety and efficiency of healthcare throughout the country - has broad support from all stakeholders.The passage of last year�s $787 billion economic stimulus bill brought with it a healthcare IT modernization program that could inject about $30 billion into the economy. Since Massachusetts is a leader both in the use and the manufacturing of healthcare IT systems, this could translate into over a $1 billion for the Commonwealth of Massachusetts.This isn�t a �cash for computers� program though � it�s much more than that. The stimulus bill was crafted very wisely. It�s not a field day either for the doctors and hospitals who would receive these funds, or for...

Food Allergy Friendly Baseball

It's baseball season again (Go Phillies!) and I need to give a shout out to Jennifer over at Food Allergy Buzz. She also writes Free to Enjoy Baseball, which is a listing of baseball teams and games that have made special accommodations for those with peanut and other food allergy. So make plans this spring or summer to take in a game- safely. If your team doesn't offer food allergy friendly games, contact them through their website and ask them to consider it. If you hear of any special games, shoot the info over to Jennifer (e-mail: jennifer@foodallergybuzz.com)so she can list it on her site for everyone's benefit.Time to play ball!...

Sunday, April 25, 2010

BLOGSCAN: CMSS New Ethics Code Analyzed

The Council of Medical Specialty Societies got some good press for its new code of ethics regarding medical associations' interaction with industry.  Two of the best skeptical bloggers about health care dissected the code, suggesting it will not be as tough as it was cracked up to be.  See these posts by Dr Daniel Carlat on the Carlat Psychiatry Blog and by Dr Howard Brody on the Hooked: Ethics, Medicine and Pharma bl...

Friday, April 23, 2010

Explaining Health Care Executives' Impunity - the (Unexplained) Leniency of Prosecutors

On Health Care Renewal, we noted many legal settlements and criminal convictions in cases alleging unethical behavior by health care organizations.  Some organizations have settled, and/or pleaded guilty, and/or been convicted numerous times.  And we have said repeatedly, (e.g., here) such legal actions will not deter unethical behavior by health care organizations until the people who authorize, direct or implement bad behavior fear some meaningfully negative consequences. Relatively small fines imposed on large corporations pain workers on the line and stockholders while sparing the richly paid top hired management and the boards that will not reign them in. A recent article in the New York Times about a plea agreement in a case in which the Guidant subsidiary of Boston...

Pay for Hypocrisy for Health Insurance Executives

A few weeks ago, we discussed the cognitive dissonance produced by huge salary boosts for top executives of health care companies with miserable ethical track records.  One of our examples contrasted a long list of ethical violations by US giant health insurance company/ managed care organization WellPoint and the huge raises given its CEO and top executives.  Now more ethical questions are being raised about WellPoint.Rate Hikes Retrospectively for Golden ParachutesAn op-ed published in several California newspapers (here via the Sonoma Index-Tribune) claimed that the huge rate hike that WellPoint's California subsidiary proposed earlier this year, an action that helped to revitalize the US legislative health care reform process, was meant to recoup costs of a previous...

Cool Technology of the Week

While touring colleges this week, I was impressed by the focus on green technologies at many institutions. Many have LEED certified buildings, extensive recycling programs and innovative alternative energy sources.I was most intrigued by Middlebury's commitment to be carbon neutral by 2016. A major component of that effort is their Biomass gasification facility pictured above, my cool technology of the week. The idea is simple. Biomass is fuel derived from plants, such as trees, grass, soybeans and corn. Middlebury's plant uses a highly efficient gasification process in which wood chips are super-heated in an oxygen deprived environment,...

Cookie Contest Winner

For all you cookie lovers out there, a new allergy friendly cookie will soon be on the market. Congratulations to Elizabeth Ilson of Tarpon Springs, Florida with her Double Chocolate Brownie Bites. The contest was co-sponsored by FAAN and Divvies.Here's the full press relea...

Thursday, April 22, 2010

Smoke Screen - How a Conflict of Interest Muddled the Debate on the Smoke-Free Initiative at the University of Michigan

As a physician, not being a big fan of cigarette smoking, I would have found little to criticize had anyone showed me the Smoke-Free Initiative at the University of Michigan, as promoted by the University President, Mary Sue Coleman.  A Conflict of Interest: University President and Johnson & Johnson Board MemberIt turns out, though, that this initative has provoked debate on that campus, not so much about its possible benefits and harms, but about whether the Ms Coleman's promotion of it had to do with a conflict of interest.  The debate broke out with an op-ed in the Michigan Daily:It�s clear, then, that University President Mary Sue Coleman is the architect of the Smoke-Free Initiative, which will take effect in July of 2011. The initiative will prohibit smoking on all outdoor...

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