Senior home monitoring set to drive wearable wireless device market

LONDON – A growing senior demographic, combined with other economic, social and technological developments, are driving investment and demand for home monitoring devices that can extend and improve in-home care, says a recent study from ABI research.

As the market transitions from safety-focused offerings toward health monitoring and extending and enhancing the comfort, safety and well-being for seniors living in their own homes and care homes, monitoring devices will grow to more than 36 million units in 2017, up from under 3 million units in 2011 – a compound annual growth rate of 55.9 percent.

Over the same period, home monitoring will almost double its share of the wearable wireless device health market to 22 percent up from 12 percent, ABI researchers point out.

“Healthcare providers and caregivers alike are looking for devices to improve the monitoring of seniors in their own homes as economics and demographics increasingly drive that demand” said Jonathan Collins, principal analyst at ABI Research and author of the study.

The ability to leverage wireless communications – either using short range or cellular – in a form factor that can be worn without restriction or discomfort will help extend the ability of seniors to live independently and care givers to provide crucial care, the report shows.

The potential of this market will bring new players into the market, from traditional specialists to established healthcare device players, and a range of new start-ups looking to leverage device availability and broadband connections into senior’s homes.

“Connectivity suppliers, wearable device and health gateway vendors, online applications and existing vertically integrated players are all ramping up their offerings to meet the demands of this growing market,” said Collins.

The established personal emergency response systems (PERS) and ambient assisted living (AAL) market has traditionally been a service sold directly to consumers and largely separate from medical monitoring. But the ABI report finds that, given the significant link between seniors and chronic disease management, these services will be increasingly integrated with healthcare monitoring.

Learn more here.

AIDS In Black America: A Public Health Crisis

Of the more than 1 million people in the U.S. infected with HIV, nearly half are black men, women and children � even though blacks make up about 13 percent of the population. AIDS is the primary killer of African-Americans ages 19 to 44, and the mortality rate is 10 times higher for black Americans than for whites.

More on HIV/AIDS Health Treating HIV: From Impossible To Halfway There Author Interviews 'Tinderbox': How The West Fueled The AIDS Epidemic Health HIV Spikes For Young Gay Black Men In U.S.

February 28, 2006

Saving The Heart Of The Crescent City Add to Playlist Download  

A new Frontline documentary, Endgame: AIDS in Black America, explores why the HIV epidemic is so much more prevalent in the African-American community than among whites. The film is produced, written and directed by Renata Simone, whose series The Age of AIDS appeared on Frontline in 2006.

On Thursday's Fresh Air, Simone is joined by Robert Fullilove, a professor of clinical sociomedical studies at Columbia University's Mailman School of Public Health, and chairman of the HIV/AIDS advisory committee at the Centers for Disease Control and Prevention.

"When I started doing this work in 1986, roughly 20 percent of all of the people in the United States who were living with AIDS were African-American," Fullilove tells Fresh Air's Terry Gross. "The most recent statistics from the Centers for Disease Control indicate that 45 percent of all the new cases of HIV infection are amongst African-Americans. ... If we continue on the current trend, in the year 2015, especially in the South, it will probably be the case that 5 to 6 percent of all African-American adults who are sexually active will be infected with the virus."

Endgame explores how politics, social factors and cultural factors allowed the AIDS epidemic to spread rapidly in the African-American community over the past three decades. The film � shot in churches, harm-reduction clinics, prisons, nightclubs and high school classrooms � tells personal stories from children who were born with the virus, public health officials and educators who run HIV clinics, and clergy members around the country, many of whom have been divided on their response to the epidemic.

The film also explores how the war on drugs in the 1980s and 1990s affected the spread of HIV in communities where large percentages of African-American men were incarcerated.

Enlarge Frontline/Renata Simone Productions

Alabama is one of only 33 states that mandates HIV education in high schools. Among those states, students receive an average of 2.2 hours of education, and most focus on abstinence.

Frontline/Renata Simone Productions

Alabama is one of only 33 states that mandates HIV education in high schools. Among those states, students receive an average of 2.2 hours of education, and most focus on abstinence.

"A large number of marriageable men were taken out of the community," Fullilove says. "When you have this kind of population imbalance, many of the rules that govern mating behavior in the community are simply going to go out the window. The competition for a man becomes so extreme ... all of the prevention measures [like condom usage] that we've been trying to create over the last 30 years go out the window."

Only 3 percent of the federal domestic dollars spent on HIV go toward prevention, according to Simone.

"We still have a long way to go in policy terms," she says. "What I tried to do in the film is help a general audience see that this is an epidemic not just of drug users and people who are sex workers. This is an epidemic that affects people who make you think, 'But for the grace of God, there go I.' There's a 64-year-old grandmother, there's a woman who works in a restaurant, there's Magic Johnson. ... Right now, today in 2012, this is an epidemic of people that we recognize and, if our lives were any different, we could be."

Web Resources Columbia University: Robert Fullilove Interview Highlights � Robert Fullilove

On how AIDS, once called Gay-Related Immune Deficiency (GRID), was presented in the media during the early days of the epidemic

"The name itself gave rise to the notion that this was something that was affecting Americans from a particular community, identified by their sexual preference, separate and apart from folk in black communities like Harlem or Watts were experiencing themselves. The presentation in the press was of a white epidemic."

On secrets in the African-American community

"We were so much afraid of what it meant to have what was happening in the slave quarters revealed to those who were empowered to direct every aspect of our lives. So we became secretive, because if there was dissension, if there was anger, the last thing you wanted to do was to make it public. To make it public was to be punished. So it created the notion that silence was indeed golden. And to the degree that carried over well after slavery had ended, that did us a fundamental disservice when the epidemic began."

On the decision to treat drugs and addiction as a criminal justice problem and not as a health problem

"Sharing needles for intravenous drugs was a primary means by which many people became infected. It is especially important, in the African-American community, to understand that in the late '80s and early '90s, roughly 40 percent of the cases of AIDS were basically identified among people whose major risk behavior was intravenous drug use. Between 1970 and 2010, we made a practice of making the war on drugs, which meant we were locking up the folks who were at greatest risk for being exposed to this virus."

On prisons

Recognizing that the problem exists but not making moves to prevent terrible things from happening, like the transmission of HIV, means that more than anything else, we had a situation where prevention could have worked. We didn't seize the opportunity, and in failing to seize the opportunity, we're now living with the consequences.

- Dr. Robert Fullilove

"The simple fact that we're not taking appropriate public health measures to prevent the transmission of this virus means that in the very beginning of the epidemic, prisons became places where the virus had to have become transmitted freely. The danger, of course, in this kind of discourse is to demonize and stigmatize prisoners. I think it's probably more important to think about putting the onus for taking public health measures to prevent this kind of tragedy from happening on the folk who are responsible for running the prisons. Recognizing that the problem exists but not making moves to prevent terrible things from happening, like the transmission of HIV, means that more than anything else, we had a situation where prevention could have worked. We didn't seize the opportunity, and in failing to seize the opportunity, we're now living with the consequences."

On the attitude in some black churches

"In 1964, I was part of something called Mississippi Freedom Summer. I was a field secretary for the Student Nonviolent Coordinating Committee. I worked in a number of counties in Northern Mississippi, and really got a sense of the importance of the church and its capacity to galvanize community support around, for example, getting people to register to vote. When I started doing research and community work in HIV in the 1980s, I, like many folk working in the black community, went first to the church and said, 'Hey, we have another problem that really requires the galvanization of all elements of the community. You're the only institution left standing that really has the capacity to bring us all together. Let's get all this work done.' And what we were met with was an enormous amount of resistance. There were many, many folk who were clear about the importance of what we were doing, but they were in the minority. The vast majority were either unaware or uninterested or worse, were extremely homophobic � saw this as a gay problem that had nothing to do with them and were much more likely to engage in the kind of preaching [that was harmful] than just about anything else."

On the Affordable Care Act

"It's thought that maybe 20 percent of all African-Americans who are living with HIV/AIDS don't know that they're infected. And they don't know that they're infected because they haven't been tested. If the act is successful in increasing the rate at which people get regular checkups, become aware of their status and enter treatment, then I think we're going to see an important change in the direction of the epidemic. It's sad to say that prevention, right now in the U.S., is neatly characterized by the phrase: 'Treatment is prevention.' If you're in treatment and your viral load has been lowered, you're very unlikely to pass the virus onto someone else. It means we've taken a step back � we've acknowledged that there are some folk that are already infected, and the best we can do is make sure they don't infect someone else. That's a real tragedy compared to where we were in the 1980s, when we thought keeping folk from being infected in the first place was going to be our primary goal and objective."

Better Coordinated Care

If you are like millions of Americans, you have seen multiple doctors or specialists for the same medical condition. And you might have noticed that, too often, those doctors don�t communicate with one another. That�s not just inefficient � it has the potential to be hazardous to your health.

Fortunately, the Affordable Care Act is helping create Accountable Care Organizations � new groups where doctors, nurses and specialists will work together to coordinate your care. Participation in these groups is entirely voluntary. Here�s one example of how this works:

When a California Medicare beneficiary called to say she hadn�t been feeling well, her doctor�s office knew she was taking multiple medications for several health conditions.� Because she thought she might be suffering from side effects, she stopped taking some of her pills.��The office asked the ACO nurse case-manager to look in on the patient and the case-manager contacted the ACO�s pharmacist.�The pharmacist then went through each prescription to determine where there might be interactions.�He followed up with the patient�s specialists to make sure the prescriptions were right, and he followed up with the case-manager too.

This is just one example of how Accountable Care Organizations can make health care better for patients. We also know from experience that this kind of care also saves money for the Medicare program by preventing bigger health problems before they start.�

And we�re so confident that the ACO approach will create a better, more affordable Medicare program that this program lets ACOs share in the savings they achieve.

Better-coordinated care is especially important for people with Medicare.� One in five seniors has five or more chronic conditions. On average, they see 14 different doctors and get 50 prescriptions and refills a year. �

While some initially doubted that doctors and hospitals would participate in ACOs, it�s now clear that this initiative offers a viable pathway toward delivering better, more affordable care to patients. Today, we announced the selection of 89 ACOs that will serve 1.2 million people with Medicare. That means that 154 ACOs that are already operating in cities and rural communities across the country are serving 2.4 million people with Medicare. These organizations are working hard to provide coordinated, patient-centered health care to Medicare beneficiaries to help them manage their health and stay out of hospitals and nursing facilities.� And that could save the federal government as much as $940 million over four years.

When we look at ACOs we�re seeing a path to a more effective, less expensive health care of the future�just one of the ways the Affordable Care Act is putting all Americans on the road to better care and better health.

Obama paves way for FDA's mobile app guidelines

WASHINGTON – The U.S. Food and Drug Administration hopes to release guidelines by the end of the year on how it would govern certain mobile medical apps.

The FDA's path was cleared this past week when President Barack Obama signed the bipartisan Food and Drug Administration Safety and Innovation Act (S. 3187), which was approved by Congress last month after some wrangling. The law allows the FDA to move ahead with plans to regulate mobile medical apps while the Department of Health and Human Services develops a report on an "appropriate, risk-based regulatory framework pertaining to health information technology, including mobile medical applications, that promotes innovation, protects patient safety and avoids regular duplication."

An earlier version of the bill would have stalled or even stopped the FDA's actions on mobile medical apps while HHS drafted its report, but legislators agreed to amend the bill to allow the FDA to proceed independent of HHS action.

The law also reauthorizes user fees that the FDA collects from the drug and medical device industries (an action that must be taken every five years) and creates a new fee for generic drug sellers. It also amends FDA policy to speed up the approval of potentially life-saving products and improves the agency's oversight of safety regulations.

The law has support in the San Diego-based independent non-profit West Wireless Health Institute, which issued a joint press release on July 9 with BIOCOM and CONNECT, two other southern California-based life sciences advocacy groups.

“The entire mobile health ecosystem is developing inherently low-risk technologies to extend care beyond offices and hospitals, and these novel, low-risk devices and integrated solutions can be expedited via these changes to the FDA’s de novo pathway,” said Joseph Smith, the WWHI's chief medical and science officer, in a press release. “It’s great to see our region’s healthcare innovation community work together with our elected officials on this legislation that speeds medical device innovation and lowers costs in the healthcare system, benefitting patients through common sense policies that safely expedite approvals.”

“Many BIOCOM member companies have one thing in common: Their fate is dependent on the FDA. Without FDA approval during each step of the commercialization process, nothing else matters,” added Joe Panetta, BIOCOM's president and CEO. “During the course of the debate, BIOCOM weighed in with Congress by communicating the importance of specific parts of the legislation. BIOCOM praises Congress for addressing industry concerns and is pleased with the final outcome. The FDA reforms help create a more predictable, safe and effective regulatory process that encourages the immense investment to get a concept from discovery to commercialization, giving patients access to high quality products in a timely fashion.”

“As a leading voice representing startup and emerging companies, we applaud the FDA reforms included in the bill because they will help spur young companies to grow, create jobs and continue to revolutionize life-changing medical care," added Duane Roth, CEO of CONNECT, "In a time when gridlock is more common on Capitol Hill, it is heartening to see Congress act in a bipartisan manner to ensure that our life science innovators in San Diego and throughout the U.S. can stay focused on developing breakthroughs that save lives and improve health.”

Not everyone approved of the amended legislation.

The Health IT Now Coalition had lobbied to stop the FDA from issuing its guidelines, at least until the HHS report comes out. “There are a lot of agencies that have at least some regulatory jurisdiction here: FDA, FCC, FTC, CMS, ONC all have a little piece of the pie,” said Joel White, executive director of Health IT Now, in a story in thenextweb.com. "For example, the Office of the National Coordinator for Health IT is pushing for electronic medical record standards, while the Center for Medicare and Medicaid Services is developing Accountable Care Organization standards. Simultaneously, the Federal Communications Commission is creating requirements for enforcing communications requirements between mobile phones."

As for mobile medical apps, said White, “Congress should have a role in helping develop a framework that makes sense for mobile health technologies as they exist today, but is flexible enough to evolve with the market.”

In a recent interview with NPR's Rob Stein, Jeffrey Shuren, who leads the FDA's Center for Devices and Radiological Health, cautioned that the FDA doesn't want to regulate all apps – just those that act as medical devices or contribute to the clinical decision-making process. Health and wellness apps or apps that help users manage medical conditions won't fall under the FDA's purview, he said.

Texas Gov. Perry Says No To Medicaid Expansion

Wikimedia Commons

Any doubt, and there probably wasn't much, that Texas would reject an expansion of Medicaid under the big federal health law was dispelled today.

The Supreme Court decision on the Patient Protection and Affordable Care Act allows states to opt out of the expansion without losing all federal Medicaid funding. Only the federal money that would have gone toward the expansion is affected.

Texas Republican Gov. Rick Perry wrote in a letter to Health and Human Services Secretary Kathleen Sebelius that he was joining "the growing chorus of governors who reject the PPACA power grab."

The Medicaid expansion "would simply enlarge a broken system that is already financially unsustainable," he wrote. "Expanding it as the PPACA provides would only exacerbate the failure of the current system, and would threaten even Texas with financial ruin."

 

About 1 in 4 Texans has no health insurance. And if Medicaid had been expanded as the federal law originally planned, more than 1.7 million people in the state were expected to get coverage.

As Heard On All Things Considered heard on All Things Considered

July 9, 2012

Texas Rejects Medicaid Expansion In Health Law [4 min 30 sec] Add to Playlist Download  

Under the law, people with an annual income up to 133 percent of the federal poverty line would qualify for Medicaid.

Perry had telegraphed the move. "The cost of this bill to the states is going to be absolutely stunning," Perry said last week on CNBC's Squawk Box. "We don't believe it's right and we know it's going to basically bankrupt the states."

He was on the cable show when Florida Gov. Rick Scott co-hosting. Scott gave a thumbs down to Medicaid expansion and taking part in the insurance exchanges.

Like Florida, Texas also won't come up with its own insurance exchange.

And some states, including Maine, are now looking at whether they can use the Supreme Court's recent decision to roll back some required benefits.

Diabetes: Combating a Silent and Costly Killer

By 2050, as many as 1 in 3 adults in the United States could have diabetes if current trends continue, according to the Centers for Disease Control and Prevention (CDC). �Diabetes was the seventh leading cause of death in 2009, and people with diagnosed diabetes have medical costs that are more than twice as high as for people without the disease. The Affordable Care Act, the health care law passed in 2010, includes a number of provisions that directly address gaps in diabetes prevention, screening, care, and treatment.

Last week, CDC released its Diabetes Report Card 2012, which provides a snapshot of the impact of diabetes on our nation. Required by the Affordable Care Act, the Report Card profiles national and state data on diabetes and pre-diabetes, preventive care practices, risk factors, quality of care, and diabetes outcomes. ��It also documents the steps the Department of Health and Human Services (HHS) is taking to make a difference in the lives of millions of Americans living with diabetes and pre-diabetes today and to improve the lives of millions of Americans in the future through prevention.�

HHS is committed to fighting the diabetes epidemic across all of its relevant agencies and programs through a broad range of research, education, and programs that strengthen prevention, detection, and treatment of diabetes.� Thanks to the health care law, potentially life-saving preventive services are now offered in many health plans with no cost-sharing. These include:

Type 2 Diabetes Screenings for people with high blood pressure,Diet Counseling for people with known risk factors for cardiovascular and diet-related chronic disease, andBlood Pressure Screenings.

In addition, the Affordable Care Act expanded� CDC�s National Diabetes Prevention Program, a public-private partnership of community organizations, private insurers, employers, health care organizations, and government agencies working together to combat diabetes.�� The law also provides opportunities to improve treatment for people living with diabetes by supporting the creation of Medicaid health homes for enrollees with chronic conditions, and expands opportunities to address diabetes risk factors through community-based programs such as Community Transformation Grants.

We hope this Report Card will encourage individuals, communities, businesses, and other organizations to work with HHS to address the rising rates of diabetes and its consequences.� And we hope that more and more Americans will take advantage of the benefits of the Affordable Care Act, including the many free preventive services, so we can stop the current diabetes trends and be a healthier nation.

Read the full Diabetes Report Card 2012 (PDF - 1.36 MB).

State Legislatures Stay Busy On Abortion Laws

Enlarge Steve Helber/AP

Virginia Senate Republican Leader Thomas Norment, of James City, (left), and State Sen. Stephen Newman, of Lynchburg, listen to a Feb. debate on a bill requiring an ultrasound before an abortion. The bill was later amended to remove a requirement for transvaginal ultrasound.

Steve Helber/AP

Virginia Senate Republican Leader Thomas Norment, of James City, (left), and State Sen. Stephen Newman, of Lynchburg, listen to a Feb. debate on a bill requiring an ultrasound before an abortion. The bill was later amended to remove a requirement for transvaginal ultrasound.

2011 was a banner year for state laws restricting abortion. And 2012 looks like runner-up.

That's the central finding of the midyear report from the Guttmacher Institute, the reproductive policy research group that keeps track of such things.

There were 39 laws restricting abortion enacted in the first half of 2012. While that's less than half the 80 put in place during the first half of last year, the number of laws already on the books for 2012 is higher than any other year before 2011.

Among the popular targets this year are:

  Restrictions on medication abortions (passed by three states); Banning abortion prior to fetal viability (also passed by three states); and, Limiting coverage of abortion by insurance policies participating in health exchanges that will sell policies under the new health law starting in 2014 (passed by four states).

And while some bills that got a lot of attention didn't pass �- such as ones to ban abortion beginning when a fetal heartbeat can be detected in Ohio, or one requiring a transvaginal ultrasound in Virginia � remarkably similar ones did make it through in other states with far less fanfare.

It seems a new law inLouisiana that requires abortion providers to make the fetal heartbeat audible to women seeking an abortion necessitates a transvaginal ultrasound for many first trimester procedures. One in Oklahoma requires that women be given the opportunity to hear a fetal heartbeat before the procedure.

Guttmacher researchers suggest a few reasons for the slightly slower pace. "Election year sessions tend to be shorter, and focus more and bread-and butter issues, as opposed to social issues," they wrote. "In addition, mirroring the situation nationally, legislatures in states such as New Hampshire and Indiana appear to be in near-total gridlock, seeming able to tackle only 'essential' issue relating to spending and basic state services."

Insurers Wait For Verdict On Health Care Law And Their Bottom Line

John Rose/NPR

Demonstrators both for and against the health care law turned out on the steps of the Supreme Court on March 27, the second day of oral arguments before the court.

All eyes these days are trained on the U.S. Supreme Court, which is expected to rule sometime this month on the constitutionality of the Affordable Care Act.

But some people are waiting more anxiously for the court to rule than others. Among them are those with a major financial stake in whether the law goes forward or not and if so, in what form.

Among them is Mark Bertolini, the chairman, president and CEO of Aetna, the nation's third-largest health insurer.

He says at one level, the Affordable Care Act represents a huge opportunity for the U.S. health insurance industry.

"Our organization has taken the view that when someone takes a $2.5 trillion industry and throws another trillion dollars into the bag, shakes it up, throws it on the table, and says 'Who wants it?' that's the time to get creative," Bertolini said in an interview.

 

That trillion dollars, of course, represents federal government's contribution to the 30 million or so people expected to gain insurance coverage under the law � about half of them with private insurance.

But even with the prospect of all those new customers, the law has been something of a mixed blessing for the insurance industry.

For example, you'd think the industry would love the idea of requiring most people to either have insurance or to pay a penalty. But from the start, insurers have been worried that the penalty in the law for not having insurance is too small.

Our organization has taken the view that when someone takes a $2.5 trillion industry and throws another trillion dollars into the bag, shakes it up, throws it on the table, and says 'Who wants it?' that's the time to get creative.

- Mark Bertolini, chairman, president and CEO of Aetna

They worry that healthy young people in particular would rather pay the penalty than pay for insurance.

Bertolini says that incentive for young people to forgo coverage gets even bigger because the law also requires insurers to narrow their price variations based on age, "which means generally the healthier, younger people will pay more, and the sicker, older people will pay less." Currently, insurers can charge older people seven times more than younger people; under the law, that will be reduced to three times.

And while that will save money for those who are older, he says, "the impetus, even beyond the penalty, to not get coverage will be even driven harder by the fact that younger, healthier people will have to pay a lot more for their health care."

As a result, he says, if the court strikes down the insurance mandate, even with all the new customers it might not be the worst thing in the world for the insurance industry.

"I'm less concerned about how they rule and more concerned about when we can actually get at fixing this," Bertolini said.

But by fixing, Bertolini means likely getting Congress involved again; either to remedy what he sees as the law's existing flaws, or to address the aftermath of a decision that strikes down all or part of the measure. He presumes neither will happen until after this fall's elections.

Toni Preckwinkle, president of the Cook County Board in Illinois, on the other hand, hopes she won't have to wait that long for relief under the health law.

Even though Preckwinkle isn't technically a health care provider, she still has a major stake in the Affordable Care Act.

"We have a county budget of about $3 billion," she said in an interview. "And 35 percent of it, so it's a little more than a billion dollars, is health care."

That includes Preckwinkle's county hospital that the television show ER was based on. More than half of the county's hospital patients have no insurance, and more than 4 out of 5 of its outpatients are uninsured.

And the result?

"Out of that billion dollars in the budget, we provide more than half a billion dollars in uncompensated care," she says.

The Affordable Care Act, however, is scheduled to provide some financial relief for places like Cook County. Starting in 2014, many more people will be eligible for the Medicaid program for those with low incomes. The county estimates this will mean about a quarter of a million more among its population alone.

So officials recently got approval from the state to start enrolling many of those people early � possibly as soon as next month. Now they just need a final OK from the state's governor and officials in Washington.

Preckwinkle says it could make a big difference to the county's budget. "It would mean tens of millions of dollars to our system immediately, and over time, hundreds of millions."

And if the court overturns the law, or the Medicaid expansion � which is one of the issues before it? Does the county have a Plan B?

"Uhhhh � I guess the short answer is no," Preckwinkle said.

Which leaves Preckwinkle, and millions of others intimately attached to the nation's health care system, just watching, and waiting, for the court.

Kentucky, Healthbridge partnership 'tip of the iceberg' for health data sharing

The Kentucky Health Information Exchange, St. Elizabeth Healthcare and Healthbridge are successfully sharing patient information. The partnership, says Trudi Matthews, director of policy and public relations for HealthBridge, is just the “tip of the iceberg” in terms of connecting healthcare providers and sharing patient information in Kentucky and healthcare markets in bordering states.

Connecting to St. Elizabeth Healthcare, one of the largest healthcare providers in the Greater Cincinnati-Northern Kentucky region with six facilities and 62 physician practices, represents a significant milestone for KHIE towards achieving connectivity throughout the state. St. Elizabeth Healthcare is also one of the first participants of HealthBridge, which was founded in 1997 and is one of the largest and financially sustainable health information exchanges in the U.S.

[See also: HealthBridge data exchange gives boost to e-prescribing, diabetes registry]

St. Elizabeth Healthcare didn’t want to duplicate its HIE activities with KHIE, so now as data flows to HealthBridge, the HIE sends a copy of the feeds – with appropriate filters in place – to KHIE, Matthews said. Authorized healthcare providers can securely access critical patient information in order to make timely, better-informed decisions.

KHIE uses a query model, enabling emergency department physicians, for example, to search and receive a matched summary of care record with health information from Medicaid and healthcare providers such as St. Elizabeth Healthcare. KHIE now has the capability to receive and send patient information from St. Elizabeth Healthcare to other participants of the statewide HIE.

For HealthBridge, this partnership also represents a significant milestone. HealthBridge serves a healthcare market that spans three states – Ohio, Kentucky and Indiana. It is already connected with the Indiana HIE and four other HIEs, including HealthLINC, based in Bloomington, Ind.

[See also: HealthBridge offers HIE advice]

“This is a perfect microcosm for inter-state exchange,” Matthews said, of the partnership. “This effort is going to grow over time.”

The Office of the National Coordinator for Health IT (ONC) funded connectivity among KHIE, HealthBridge and St. Elizabeth Healthcare through its State Health Information Exchange Program and Beacon Community Program. ONC selected the Greater Cincinnati-Northern Kentucky community as one of the 17 ONC-funded Beacon Communities. St. Elizabeth Healthcare is participating in the Greater Cincinnati Beacon Collaboration.

HealthBridge is also connecting with the Nationwide Health Information Network. It has already installed Direct and Connect, as additional means for connectivity with other exchanges. “There’s still a lot of work to do with standards to make it [connectivity] easy, but we’re showing it can be done,” Matthews said.

[See also: Kentucky health data exchange kicks off e-prescribing initiative]

How’s this for a stimulus — let’s give Medicare to everyone

By Andy Everman for MLive.com–

Often we hear about how education (especially higher education) is crucial for economic development and job creation.

Rarely do we get any credible specifics about how this actually works, even from our knowledgeable colleges and universities. In fact, can our colleges and universities demonstrate that they truly are sending out a significant percentage of students who are starting small businesses — the heart and soul of economic development these days — and creating good jobs?

Students and parents cannot afford continual, well-above-inflation tuition and fees increases, and we know that our colleges and universities certainly want to use more existing, as well as new, money for higher education. So what do we do?

Since the departing Bush Administration and the incoming Obama Administration are all about stimulus packages, what about this kind of stimulus: single-payer national health care — see U.S. Rep. John Conyers’ bill, H.R. 676, which now has over 70 supporters.

Yes, that’s right, Medicare for everyone! Do our senior citizens think they are being “socialized” to death?

Big business and small business, unions and nurses, around 50 percent of doctors, and a clear majority of Americans are now ready and are calling for a single-payer health care system which already exists in all the advanced democratic countries).

The cost savings to our businesses and colleges/universities would immediately improve their financial situation, as well as improve our global competitiveness. The automobile industry would get significant relief without any loans or bail-outs. Why our colleges/universities might even be able to decrease tuition and fees a bit, given the financial savings windfall!

Accordingly, Americans need not fear huge tax increases to cover such a national health-care system. At the present time, 5 percent to 15 percent annual health-care cost increases (not found in any other country) are unsustainable.

These exorbitant health-care cost increases prevent wage and salary increases that at least keep up with inflation. Fifty percent of Americans in bankruptcy or foreclosure say health-care debt is their primary problem. Forty percent of households today are financially stressed by out-of-pocket health-care expenses.

This is where Americans need real relief, as opposed to sending us checks in the mail or more tax cuts that do not jump start the economy and only put a huge debt burden on future generations.

Continue reading the full article.

Mental Health and the Call for Single-Payer Healthcare

Join Healthcare for the 99% in recognizing Mental Health Awareness Month this May. Mental health is an integral part of overall health, and its prevalence and severity are yet another reason to demand single-payer healthcare. About one in six adults lives with a disorder of the brain such as depression, bipolar disorder, schizophrenia and post-traumatic stress disorder. The pain caused by mental illness radiates even further, through family, friends, neighbors, co-workers and more, into the fabric of our society. Mental health is also a key issue for our veterans, many of whom return home with PTSD caused by violence seen and experienced in combat. The pervasiveness of mental illness calls for a single-payer healthcare system, as such a system would finance mental healthcare for many of those who cannot afford it on their own.

So if one in six adults lives with a mental illness, why don�t we all know a lot of mentally ill people? You do. However, stigma prohibits many people from speaking openly about their mental health problems. Our language is riddled with offensive terminology (�schizo�, etc). Incorrect ideas about mental illness abound, such as the idea that mentally ill people are obviously strange or abnormal, or that mentally ill people will never recover from their illnesses.

Contrary to popular belief, some mental illnesses do in fact go away with treatment, and those who do have lifelong illnesses can still live extremely normal lives. However, this requires treatment, generally a combination of medication and therapy, and that requires insurance and money. Mental illness left untreated often leads to poverty and eventually to homelessness. When people cannot get out of bed or perform daily activities, they soon end up out of work, and this can snowball into homelessness and abject poverty. All of this can be prevented by treatment of the mental illness. However, therapy can cost two hundred dollars a session or more, and even good insurance often covers only 12 sessions a year. This is absolutely inadequate, and yet further sessions are often prohibitively expensive. Add to that the cost of medication, which drug companies drive up as much as possible by patenting their drugs so that no generic form is made, causing some drugs to cost as much as $8 per pill without insurance, or when insurance companies refuse to pay. Additionally, since in American society health insurance is tied to jobs, when one loses one�s job one loses health insurance as well, compounding the problem: exactly when the mental health treatment is most needed, all funding for it is taken away. It�s simple: some people can afford treatment and can lead relatively normal, healthy lives, and others who cannot afford treatment get sicker and sicker as society turns away.

It has also been established that poverty and homelessness can themselves lead to mental health problems, as the impoverished and homeless face factors the rest of us don�t. The stress of having many unpaid bills or not having food or shelter, as well as a lack of security for the future, can be the catalyst for a mental illness, or can exacerbate an existing one. The homeless are also far more likely to be victims of crime and trauma. The poor and the homeless generally do not have the money for early treatment that can stop the disorder from becoming severe (or for any treatment at all).

When mental illness becomes severe, with a person of any socioeconomic class, suicide is always a concern. A death by suicide is always a tragedy, yet becomes even more tragic when one realizes how preventable these deaths are. Ninety percent of those who die by suicide have a psychiatric illness that is not only diagnosable, but also treatable. But if people are denied the means to treat their mental health problems, they are often quite literally being left to die.

America needs single-payer healthcare. It will ensure that all of the mentally ill get the treatment they deserve and that they can live normal, successful lives. Insurance companies must stop letting people fall through the cracks by refusing to provide adequate mental health benefits. When single-payer healthcare becomes a reality, the mentally ill will have the support and resources to live the fruitful and happy lives they were meant to live.

New Poll: The Supreme Court and the Health Care Law

More than two-thirds of Americans hope the Supreme Court will overturn some or all of the 2010 health care law, according to a new poll conducted by The New York Times and CBS News. Just 24 percent said they hoped the court “would keep the entire health care law in place.”

The Supreme Court is expected to decide a challenge to the law by the end of this month.

Forty-one percent of those surveyed said the court should strike down the entire law, and another 27 percent said the justices should overturn only the individual mandate, which requires most Americans to obtain health insurance or pay a penalty.

These numbers have not changed much in recent months and appeared to be largely unaffected by the more than six hours of arguments in the Supreme Court in March.

There was greater Republican opposition to the law than Democratic support. About two-thirds of Republicans in the recent survey said the entire law should be overturned, while 43 percent of Democrats said all of the law should be upheld.

More than 70 percent of independent voters said they wanted to see some or all of the law struck down, with a majority saying they hoped to see the whole law overturned. Twenty-two percent of independents said they hoped the entire law would survive.

Responses varied by education, too. Nearly a third of respondents with a college education said they would like to see the law upheld, compared with about 20 percent of those without a college degree.

Legal scholars and political scientists are divided over whether the justices take account of public opinion in making their decisions.

In a 2010 study published in The Georgetown Law Journal, Lawrence Baum of Ohio State University and Neal Devins of the College of William & Mary concluded that the justices were not much concerned with mass opinion.

�Supreme Court justices care more about the views of academics, journalists and other elites than they do about public opinion,� they wrote. �This is true of nearly all justices and is especially true of swing justices, who often cast the critical votes in the court�s most visible decisions.�

The nationwide poll is based on telephone interviews conducted May 31 through June 3 on land-lines and cellphones with 976 adults, and has a margin of sampling error of plus or minus three percentage points.

Join Us for an Online Seniors Health Town Hall

This past Thursday, officials from the White House and the Department of Health and Human Services held a town hall meeting to discuss how the health care law is helping women and families across the country. On Monday June 11, we will turn our attention to America�s seniors when we host a Seniors Health Town Hall.

The event will be streamed live from the White House�from 10 am to 11:30 am ET.

Similar to our Women�s Health Town Hall, this event will be an interactive, open dialogue about how the health care law, the Affordable Care Act, is improving the health and quality of life for the nation�s senior citizens by strengthening the Medicare program:

It makes preventive services available for free. This includes mammograms, colonoscopies, and an annual wellness visit where seniors can spend more time with their doctor.It makes prescription drugs cheaper. Seniors who hit the donut hole get a 50 percent discount on their prescription drugs and the donut hole will be closed completely in the years ahead. It cracks down on waste, fraud and abuse.

Submit questions using the Twitter hashtag #SeniorsHealth or on the HealthCareGov Facebook page.

Participants in the Town Hall include:

Kathleen Sebelius, Secretary of Health and Human ServicesCecilia Mu�oz, Director of the White House Domestic Policy CouncilKathy Greenlee, Assistant Secretary for Aging, HHSJonathan Blum, Deputy Administrator and Director for the Center of Medicare at the Centers for Medicare and Medicaid Services, HHSSandy Markwood, Chief Executive, National Association of Area Agencies on AgingJim Firman, President and Chief Executive, National Council on Aging and Chair, Leadership Council of Aging OrganizationsLouise Chang, MD, Senior Medical Editor, WebMD

The Town Hall will begin at 10 a.m., Monday, June 11, 2012.

Healthcare-NOW! Activist, Alison Landes, on the air

Yesterday, Alison Landes, a single-payer activist with Healthcare-NOW! and Floridians for Health Care was interviewed on WMNF 88.5 by Rob Lorei. Listen to the full show.

The show’s topic was “Does the Nation Need Health Care Reform?”

Excerpt from the show: Today we�ll talk about health care reform. It�s near the top of the agenda of the incoming president. Obama supporters will soon be holding house parties to discuss what people at the grassroots level would like to see done about health care. Also, Pinellas Democrats will soon hold a series of meetings to talk about health care reform.

Our first guests today are nearing a financial crisis because they don�t have health insurance. They are Joycelyn and Jim Elliott. He is a chiropractor by profession. She has been unable to work due to stress. In 2004, they moved from Tampa to Nebraska to restart their lives. I spoke with them yesterday.

Allison Landes lives in Boca Raton and she�s a volunteer with Floridian�s for Health Care, a group that advocates a single payer style health care system.

Read the full article here.

Doc community stalks Influenza online

CAMBRIDGE. MA – Sermo, Inc., an online physician community, is investigating the ability of 100,000 physicians to track and potentially prevent infectious diseases.

Participating physicians will use technology from Sermo called Sermo FluMonitor to collect and aggregate clinical observations across the country.

Cambridge, Mass.-based Sermo provides U.S. licensed physicians with a free memberships to its community. Adam Sharp, an emergency physician and chief medical officer of Sermo, says its membership is currently more than 100,000.

The Sermo FluMonitor will allow physicians to report geographically-based clinical observations in real time. 

“This endeavor has the potential to be an extremely useful resource in tracking disease and saving lives,” says Sharp. “Sermo’s unique online community already brings physicians together to report bedside data and exchange clinical insights. Until now, this type of tracking mechanism was simply not possible.”

Physicians can monetize their Sermo experience by providing their expertise as a resource for financial services firms, healthcare institutions and government agencies.

The 120 physicians who are participating in the FluMonitor tracking will be paid a nominal fee for their participation, says Sharp.

Women doctors paid less: reluctant to push for raises?

CHICAGO(AP)�Women physician-scientists are paid much less than their male counterparts, researchers found, with a salary difference that over the course of a career could pay for a college education, a spacious house, or a retirement nest egg.

To get the fairest comparison, the study authors took into account work hours, academic titles, medical specialties, age and other factors that influence salaries. They included only doctors who were involved in research at U.S. medical schools and teaching hospitals, all at the same stage in their careers. And they still found men's average yearly salaries were at least $12,000 higher than women's.

Over a 30-year career, that adds up to more than $350,000.

The results are sobering and "disappointing. I think we have much work to do," said lead author Dr. Reshma Jagsi, a breast cancer radiation specialist and researcher at the University of Michigan.

Why the big disparity?

Two women who have been prominent in medical research say this: Men tend to be more aggressive at self-promoting and asking for pay raises than women.

"Male faculty members are willing to negotiate more aggressively. It may be social and cultural. It seems to be fairly deep-rooted," said Dr. JoAnn Manson, chief of preventive medicine at Brigham and Women's Hospital and a professor at Harvard Medical School.

Manson, who as a division chief helps makes salary decisions, says men much more frequently than women ask her for salary increases and promotions.

Dr. Julie Gerberding, former head of the federal Centers for Disease Control and Prevention, agrees.

Gerberding did infectious disease research at the University of California at San Francisco before joining the CDC and says early in her career she was bothered that relatively few women held high-paying leadership positions in academic medicine.

"There were some moments when I was angry, but that was motivating. I thought it was an intolerable situation and it just motivated me to work harder," said Gerberding, who left CDC in 2009 and now heads Merck & Co.'s vaccine unit.

She and Manson declined to say if they think they've been paid less than male counterparts.

While previous studies have found that female doctors are frequently paid less than male doctors, many observers have assumed that's often related to having children � working fewer hours, or choosing less time-consuming, lower-paying specialties to allow time for child-rearing.

The new study did find more women in less lucrative specialties, including pediatrics and family medicine, and more men in the highest-paying fields, including heart surgery and radiology. But it still found salary inequities even among women and men without parental responsibilities, in similar jobs.

The findings are from a mailed 2009-10 survey of 800 doctors who had received prestigious federal research grants in 2000-03. The findings appear in Wednesday's Journal of the American Medical Association.

Women's yearly salaries averaged almost $168,000, compared with $200,400 for men � a difference of more than $32,000. Taking into account academic rank, choice of medical specialties and other factors that could affect salary, the difference wound up being $12,194.

Dr. Peter Ubel, the study's senior author and a Duke University professor, said there's no formula for pay increases; doctor-researchers don't automatically get a raise every time one of their studies is published. That makes the decision-making process more subjective, he said.

About equal numbers of men and women attend and graduate from medical school. But women make up a tiny portion of leadership positions at medical schools. And Jagsi said people in hiring positions may be biased, perhaps unconsciously, toward hiring men.

Ann Bonham, chief scientific officer at the American Association of Medical Colleges, a national group that represents U.S. medical schools and teaching hospitals, said medicine isn't the only field with gender differences in salaries. Medical schools are aware of the problem and are moving to ensure that decision-making on salaries "is a fair process and transparent. Nobody intends to be unfair in distributing resources," Bonham said.

Gerberding praised the study for raising awareness.

"Institutions need to take this information seriously and take a hard and closer look at their own salary parity issues," she said. Career advancement often depends on having a strong mentor and sponsor, so women and men in leadership positions at medical schools and teaching hospitals should make sure they're actively advocating for qualified women and suggesting them for promotions, Gerberding said.

Boston, Philadelphia top list of best children's hospitals

WASHINGTON – Boston Children's Hospital and Children's Hospital of Philadelphia tie for first place in U.S. News & World Report's 2012-13 Best Children's Hospitals Rankings.

Much of the quality related data collected for the rankings are based on measures underpinned by health information technology, such as electronic health records.

[See also: U.S. News & World Report taps HIMSS Analytics for hospital measures]

U.S. News & World Report released the rankings on June 5.

They feature 50 hospitals in each of 10 pediatric specialties: cancer, cardiology and heart surgery, diabetes and endocrinology, gastroenterology, neonatology, nephrology, neurology and neurosurgery, orthopedics, pulmonology and urology. The rankings will also be published in the U.S. News Best Hospitals 2013 guidebook, which will be available in August.

Eighty hospitals across the country ranked in one or more specialties. In addition, the 2012-13 Honor Roll recognizes 12 hospitals with high scores in a least three specialties:

[See also: 118 'Most Connected Hospitals']

1. (tie) Boston Children's Hospital
1. (tie) Children's Hospital of Philadelphia
3. Cincinnati Children's Hospital Medical Center
4. Texas Children's Hospital, Houston
5. Children's Hospital Los Angeles
6. Seattle Children's Hospital
7. Ann and Robert H. Lurie Children's Hospital of Chicago
8. (tie) Nationwide Children's Hospital, Columbus, Ohio
8. (tie) Children's Hospital Colorado, Aurora
10. (tie) Children's Hospital of Pittsburgh of UPMC
10. (tie) Johns Hopkins Children's Center, Baltimore
10. (tie) St. Louis Children's Hospital-Washington University

For families of sick children, Best Children's Hospitals provides unparalleled quality-related information in addition to rankings, including survival rates, adequacy of nurse staffing, procedure volume, and much more, according to U.S. News & World Report. Since their 2007 debut, the rankings have put an increasing emphasis on data that directly reflect hospitals' performance over the opinions of physicians.

This year, U.S. News surveyed 178 pediatric centers to obtain data such as availability of key resources and ability to prevent complications and infections. The hospital survey made up 75 percent of the rankings. A separate reputational survey in which 1,500 pediatric specialists – 150 in each specialty – were asked where they would send the sickest children in their specialty made up the remaining 25 percent.

"The pressure on hospitals to release data that reveal their quality of care is increasing, but it is still much harder for someone caring for a sick child to dig out important facts about pediatric quality of care than to get that kind of information about hospital performance with adult patients," says Health Rankings Editor Avery Comarow. "No less than adults, children deserve the best possible care when they need it the most. Through Best Children's Hospitals, we highlight pediatric centers with that unique level of expertise."

A typical candidate for ranking in Best Children's Hospitals was a member of the Children's Hospital Association (CHA), was either a freestanding children's hospital or a "hospital within a hospital" – a collection of large, multidisciplinary pediatric departments within a medical center – and was affiliated with a medical school. Several non-CHA members were added because of specific expertise or because of experts' recommendations.
 
RTI International, the research organization that generates the Best Hospitals rankings and created the Best Children's Hospitals methodology produced the 2012-13 rankings and administered the hospital and physician surveys. The hospital survey was designed with the help of 125 medical directors, pediatric specialists, and other experts organized by RTI into working groups.

A detailed description of the methodology is available here.

Healthcare leads jobs growth, reports show

The Bureau of Labor Statistics reported that 155,000 jobs were added to the economy last month, with the healthcare industry alone responsible for 19,000 of these newly added positions.

According to the Center for Health Workforce Studies at the University of Albany, State University in New York, more than 4.2 million healthcare employment opportunities are expected to be added by 2020.

[See also: Jobs abound]

The report concluded that the U.S. will be requiring workers to fill nearly 7.5 million new and existing positions over the next seven years. While experts may be conflicted over when the next economic boom may occur, the medical field is already experiencing this economic growth, abounding with its own employment opportunities.

The Employment Situation Summary from the Bureau of Labor Statiistics came back with good news for workers in healthcare and other professional industry positions in April. Although some lawmakers were concerned that job creation is stalling, not all experts agree.

[See also: Jobs and cures top of mind]

"There have been some concerns that the economy may be headed for a repeat of last year’s spring and summer slowdown. While job gains may indeed hit a lull in the coming months, we do not foresee a sudden upsurge in downsizing activity,” says John A. Challenger, chief executive officer of Challenger, Gray & Christmas, quoted in a report from Medzilla, a career website.  Challenger added: “Even with the increased job cuts in consumer products, retail and transportation, the monthly totals remain well below levels that would signal a reversal in the recovery.”

Reminiscent of some of Challenger’s sentiments, Nariman Behravesh, chief economist for the economic research company IHS says that with an aging population and the struggle by policymakers to contain medical spending, healthcare “is almost recession proof.”

There have been other indications of the overall job situation picking up momentum. According to recent reports, relocation assistance, hiring bonuses and other incentives are starting to make a comeback for all levels and positions.

"There are certain indicators you start to see when things are beginning to improve for job seekers. It’s been an incredibly competitive market recently,” says John Burkhardt, managing director of MedZilla.com. “It’s nice to be able to show that when the opportunities start presenting themselves, they are quality opportunities that our applicants can be excited about applying for. That’s what we find happening now and it’s a great sign for economy," Burkhardt continued.  

In Texas, clinics and hospitals are projecting they will need at least 10,000 employees between now and 2013. This comes from an Employer Needs Assessment Report, and according to the report’s executive summary, the number is actually quite conservative.

The workers must support the state’s $103.6 billion healthcare industry that has to implement the effective use of electronic health records in order to comply with impending federal deadlines for EHR implementation.

Medzilla.com is a resource for accessing and finding healthcare, pharmaceutical and bio-tech employment information on the internet. Their employment experts connect qualified workers with industry employers.

[See also: Texas city claims first Web-based system in the country to track H1N1 virus]

Experts to Senate: Healthcare reform won't be easy

WASHINGTON – Witnesses at separate hearings held Wednesday by the Senate Health, Education, Labor and Pensions Committee and the Senate Finance Committee said healthcare reform is  necessary and can't be achieved without spending money up front. The experts also recommended providing broader risk pools and establishing comparative effectiveness.

The new stimulus package provides incentives for doctors and hospitals to adopt healthcare IT and provides funding for comparative effectiveness research.

The Congressional Budget Office's new Director, Doug Elmendorf, said increasing health insurance pools – a concept contained in President Barack Obama's plan to expand healthcare coverage – will not work without mandating coverage.  Without mandating, only the sick will purchase insurance, jacking the price for those who aren't sick and driving away those who only marginally wanted to purchase it in the first place.

It will take time to make a change and investment up front, Elmendorf said.

"It's a big ship that's not moving that fast, but it's very big and very hard to turn," he said. "No doubt, if you started shifting incentives, the faster the ship will turn."

Many believe, along with President Obama, that healthcare IT will lay a foundation for change in the U.S. healthcare system and a venue for improving quality of care, cutting costs and saving lives. Healthcare IT will also allow the government to pay providers based on performance.

Cathy Schoen, senior vice president of The Commonwealth Fund, told the Senate HELP Committee that changes will require new leadership and collaboration across public and private sectors.

"Effective payment reforms will require time to develop and implement and flexibility to innovate as the nation learns," she said – a notion backed by the CBO. "Information systems require investment and time to yield maximum returns through adoption and use."

"Yet, wide public concern and stress on businesses and public sectors make it increasingly clear that we cannot afford to maintain the status quo. Each year we wait, the problems grow worse," Schoen said.

Sen. Sherrod Brown (D-Ohio), on the Senate HELP Committee, said, "It’s not enough to fight for affordable coverage, we must fight for real coverage. Health insurance shouldn’t be a vehicle for punishing the sick and rewarding the healthy. It shouldn’t be a hammer that beats healthcare costs down by arbitrarily denying care to those who need it."

Sen. Max Baucus (D-Mont.), chairman of the Senate Finance Committee, said healthcare is the next big objective. "We need fundamental reform in cost, quality and coverage. We need to address all three objectives at the same time. They are interconnected," he said.

Republicans agree that reform is urgent and necessary, but differ on the means needed to get there. Sen. Charles Grassley (R-Iowa), disturbed by the lack of debate over the stimulus package, urged caution. "I have heard some folks say it is our moral responsibility to provide healthcare coverage for all. We have an equal if not greater moral responsibility to do so in a fiscally sustainable manner," he said.

Grassley said he is wary of spending money up front to reap savings in the future. "The President has an opportunity as he walks this razor’s edge between a broken healthcare system and fiscal catastrophe," he said.

Obama has called a gathering of stakeholders and a bipartisan mix of lawmakers to meet next week and begin the difficult work of smoothing out differences. The Obama administration had plans for healthcare reform prepared prior to the election, and the Senate Finance Committee has held hearings on the issue since last summer. Last fall, key Democratic congressional leaders said they were "ready to roll" on healthcare reform, and they will take the cue from Obama's guidelines.