emrupdate.com

Botox-Lawsuits, Fines, Suing the FDA and Now Waiting To Get Off Label Approval from the FDA for Migraines

The Medical Quack — Thu, 09 Sep 2010 00:57:00 GMT

Botox, made by Allergan has had quite the ride the last couple of years. It is approved for use for migraine headaches in Europe. Dysport is a cheaper drug that was approved by the FDA, that does the same thing as does Botox. Botox Given Approval in the UK for Migraine Headache Relief In October last year Allergan sued the FDA wanting the the label ban removed. There are also studies going on with Botox being able to shrink a prostate gland too. Allergan Suing the FDA – Wants...(read more)

Arianna Huffington Interview with ABC News–Finally Someone Who Speaks Out About How Technology Has Affected the World and the US Economy–She Knows Algorithms & Their Power

The Medical Quack — Wed, 08 Sep 2010 23:43:00 GMT

I have embedded the video below and this is as close as anyone has come to crawling out of denial with acknowledging the fact that technology and the use of algorithmic formulas is changing the world. I read all these items in the news that are jumping all around the place for the biggest OMG story and it get so tiring. As a politician you can get up there and make all kinds of statements, but if those algorithms running in the background prove you wrong, you’re sunk and thus we see tons...(read more)

Supporting EMR and HIPAA

EMR and HIPAA — Wed, 08 Sep 2010 17:56:55 GMT

I’ve really enjoyed the support of many people here on EMR and HIPAA. There’s a strong community here on EMR and HIPAA and plenty of new readers that keep things interesting. Then, of course I’m always grateful to the advertisers on Read More......(read more)

Your brand ain’t what it was

Healthcare IT: How good is your strategy? — Wed, 08 Sep 2010 15:51:58 GMT

Many brands have been redefined by a hospital’s patients through their patients’ use of social media. Your brand is now what their patients—their social mediaphiles—say it is. How’s that for a wakeup call? Hospitals spend millions of dollars each year marketing to build their internal and external image; Read More......(read more)

Gleeman’s Daily News—09/08/10

Robert Gleeman — Wed, 08 Sep 2010 11:41:32 GMT

No stay for ban on public support to embryonic stem cell research

A researcher removes a colony of stem cells from a incubator

WASHINGTON — A US federal judge denied Tuesday the White House's request to drop his decision to temporarily block federal funding for embryonic stem cell research pending an appeal of the decision.

"In this court's view, a stay would flout the will of Congress," Judge Royce Lamberth wrote in his order.

"Congress remains perfectly free to amend or revise the statute. This court is not free to do so."

Lamberth first issued his injunction on August 23, ruling in favor of a coalition that included several Christian organizations by saying that stem cell research involved the destruction of human embryos.

He said the federal funding, which President Barack Obama had authorized, violated the Dickey-Wicker amendment, a federal law barring federal tax funds from being used to fund any research that would cause human embryos to be destroyed.

That decision prompted the White House to say it would seek ways to keep the "life-saving" research going.

This only means that embryonic stem cell research must be conducted by private industry with no money from federal funds. Hopefully, those companies will be well-rewarded and their inventions well-protected by patents.

How can we cut the smoking rate?

Image: iStockphoto

The proportion of U.S. adults who smoke seems to be stalled at around 21%, where it’s hovered for the last several years, according to new figures out today from the CDC. What’s it going to take to push that number lower, and to further limit the number of tobacco-related deaths?

Thomas Frieden, the CDC’s director, says we know what to do: smoking bans, higher cigarette prices, “aggressive ad campaigns,” and tobacco-control programs, for example. As he did last year when announcing smoking stats, he criticized the small proportion of tobacco settlement money — he says 3% — the states are actually spending on tobacco prevention and cessation programs.

The CDC report says strategies need to be targeted at groups that still smoke at relatively high rates, such as those with less than a high school diploma. (More than 28% of non-high school grads aged 25 and up smoke, compared to 5.6% of those with a graduate degree). People earning less than the federal poverty level and those living in the South and Midwest also smoke at higher-than-average rates.

I notice more young girls smoking these days, I hope not a trend, and I still don’t think young folks realize how difficult it can be to quit smoking. Warning: smoking is highly addictive. Put that on the package.

Dental sealants and fillings give off BPA?

Photo from: http://dentistry.about.com/od/toothmouthconditions/ig/Dental-Photo-Gallery/Dental-Sealant.htm

Parents worried about mercury in amalgam dental fillings now have a new bugbear: BPA from dental sealants and "white" fillings.

Bisphenol A -- BPA -- is a resin used in many kinds of plastics, including some water bottles and metal food can liners. Emerging evidence suggests, but does not prove, that BPA can have harmful effects on human health, particularly on child development.

Dental sealants and fillings don't contain BPA, but many of them contain compounds that turn into BPA on contact with saliva. Is this a problem? That's what one mother recently asked in a letter sent to Children's Hospital, Boston.

To answer the question, pediatric endocrinologist Abby F. Fleisch, MD, and colleagues performed an exhaustive review of the scientific evidence. They came to two conclusions:

BPA does indeed form in the mouth after some dental sealants and fillings are applied. BPA can be found in the saliva three hours after dental work is completed. It's not at all clear whether this poses a health risk.
A quick wipe and rinse of the completed dental work vastly decreases whatever risk there might be.

The article goes on to describe how to minimize the risks, seems like BPA is in just about everything. Slowly we will work BPA out of our food and medical care, but it was considered safe for a long time.

FDA warns makers of green tea to cut the health claims

The U.S. Food and Drug Administration issued warning letters to Dr Pepper Snapple Group and Unilever over their use of health claims to sell green tea products.

The agency, which regularly sends warning letters to companies that have violating manufacturing, marketing and testing requirements, took issue with Dr Pepper Snapple Group’s claim that its Canada Dry Green Tea Ginger Ale is “enhanced with 200 mg of antioxidants from green tea and Vitamin C”. FDA said the statement did not comply with rules governing nutrient content claims.

In its letter to Unilever, FDA said the company violated the Federal Food, Drug and Cosmetic Act with claims that consuming green tea, like its Lipton decaffeinated green tea, can help lower cholesterol.

It must make doctors angry when they see health claims on everything from tea to breakfast cereal, and as we all know, commercials are sometimes filled with wishful thinking.

Primary care evolving around technology

Photo: Hello Health founder Jay Parkinson speaks at a PopTech! conference Credit: PopTech! flickr stream

Primary care used to involve a physician and a patient. The physician would see the patient in a clinic, conduct an examination, enter notes in a paper record, prescribe a follow up appointment, and say goodbye until the next scheduled visit. Usually this process occurred within a 15-minute window arranged by the physician's front office staff. Although this type of primary care visit still occurs it is fast becoming an exception to the new rules of primary care. This column focuses on technology's role in driving change and is the first in a series examining some of the trends and companies at the vanguard of the evolution of primary care.

Many readers of www.emrupdate.com are primary care doctors, and I would be interested in anyone’s opinion of this article. Do you think it is fair and accurate?

Words from the brain

Researchers from the University of Utah have shown that they can detect articulated words from signals received by electrodes on the brain's surface.

This might one day enable patients with locked-in syndrome to communicate with their surroundings. The researchers used grids of microelectrodes placed on the cortical surface over speech centers during craniotomy in a patient with severe epileptic seizures. The microelectrodes consisted of 16 nonpenetrating microwires at millimetre intervals in a 4x4 grid pattern. They recorded local field potentials from the surface of face motor cortex and Wernicke's area. Brain signals corresponding to ten different words were analyzed: yes, no, hot, cold, hungry, thirsty, hello, goodbye, more and less. Accurately distinguishing between two different words, for example yes and no, was possible up to ninety percent of the time, while accuracy dropped to forty-eight percent when distinguishing between all ten words. These results were achieved without any patient training. There is still plenty of opportunity to improve on these results while reducing invasiveness and the researchers go as far as to speculate about wireless systems able to record high-resolution cortical surface potentials functioning as brain-computer interfaces. The results are published in the September issue of the Journal of Neural Engineering.

Press release: The Brain Speaks...

Article abstract: Decoding spoken words using local field potentials recorded from the cortical surface...

Flashback: microECoG Electrodes Create New Possibilities to Study, Intervene in Brain Function

This may be of interest to doctors, after all these years of probing the brain, we still have so much to learn about how it works. When the brain is ready to speak, I hope we are ready to listen.

Dr. Oz's Colonoscopy From the Show–Update On the Process From Preparation to Finish (Videos)

The Medical Quack — Wed, 08 Sep 2010 05:29:00 GMT

The videos are actually very good and the second video shows the actual procedure and nipping the polyp, so if you have never seen one, Dr. Oz shared his. The videos walk you through the whole process, even the first video is drinking that awful tasting stuff to clean out for the next day. Lot’s of flush noises in that video The preparation is not fun by any means. Dr. Oz Has Colon Polyp (Pre-Cancerous Growth) Found During Routine Colonoscopy–He Follows His Own Advice...(read more)

Patients Have No Way of Knowing If They Have Been Admitted or Not–Setting Patient Status is Confusing with Parameters Set by Software Tools to Meet the Designated Parameters

The Medical Quack — Wed, 08 Sep 2010 04:48:00 GMT

The article states a tool designed by McKesson is the software of choice that many hospitals use to guide the decision making process. As a patient if you are kept for observation, given a bed, meal, etc. that does not mean you have been “officially admitted as an inpatient”. The software is known as InterQual and recent filings with the SEC called it a “trade secret” – and what do we call this? The algorithms that are trade secrets. There are other companies that make software that...(read more)

Medicare Chief Moves Forward with New Web Sites For Testing Models for Patient Care

The Medical Quack — Wed, 08 Sep 2010 04:23:00 GMT

Overall Dr. Berwick is a breath of fresh air with innovative thinking and I hope he gets a chance to work on some of these long seeded problems with Medicare as it has been years since CMS has had a director. I get the feeling that we have folks in Congress that prefer to keep stirring the pot rather than see if someone can make some progress here. These are times like we have never lived through before so you can’t compare past performances of others to what we are dealing with today...(read more)

Blue Shield pulls out of Healthy Families in 15 Counties in California

The Medical Quack — Wed, 08 Sep 2010 03:55:00 GMT

This program is for affordable healthcare for children. Most of the counties affected here are in northern California or Mid-state. I wonder if is is part of the effect of our California budget cuts being able to pay? BD Blue Shield of California recently announced it will no longer provide coverage for 15,000 Healthy Families patients in 15 counties. Effective October 1, the insurer is pulling its Healthy Families HMO product out of nine counties (Alameda, Marin, Placer, San Joaquin...(read more)

Biggest Prescriber of Medicaid Drugs In New Jersey Charged with Fraud–Only Had 3 Employees

The Medical Quack — Wed, 08 Sep 2010 03:39:00 GMT

First of all if you are the biggest Medicaid prescriber I would expect more than 3 employees on staff. In addition, they were not doctors and many charges were billed with patients not seen and when they were see, they were not physicians. BD Medicare Fraud – Criminals Do a Better Job With Filing Claims And Coding Than Providers The problem with catching some of these folks is that they study the billing processes and bill better than real doctors, they know the data routine unfortunately...(read more)

Michael Douglas will ‘Stand Up to Cancer’ – September 10th

The Medical Quack — Wed, 08 Sep 2010 03:21:00 GMT

This is the 3rd year for this event and Michael Douglas has announced he will be there via a taped segment. Other attendees will include Dr. Oz, Christina Applegate and more. I have included some posts here and there on the Quack that give updates on where the money raised is going. You can also visit the website to find out more and donate. Stand Up to Cancer Grants Go to 2 Arizona Doctors and Their Teams to Turn Science Into Cures for Cancer Unless you have missed the news he...(read more)

Wyeth Used and Paid Ghostwriters to Downplay the Harm of Hormone Replacement Therapy After the Women’s Health Initiative–New HRT Documentary Hot Flash Havoc

The Medical Quack — Wed, 08 Sep 2010 01:54:00 GMT

Back in July of 2009 a judge ordered the unsealing of documents relating to how the drug was marketed, etc. Pfizer who now owns Wyeth and all the related issues is disputing the report. DesignWrite, a medical communications company in Princeton, N.J., proposed to Wyeth a two-year plan that would include the preparation of about 30 articles for publication in medical journals. Wyeth Used Ghostwriters - Video of the Premarin Horses One of the biggest issues with the Women’s Health Initiative...(read more)

They Found a Use for Recalled Tylenol Products–Dead Mice Packed With Acetaminophen Dropped From Helicopters To Control the Brown Tree Snake In Guam

The Medical Quack — Wed, 08 Sep 2010 00:30:00 GMT

The product is safe for humans but deadly for these snakes who are taking over the island and this way they can catch up with the snakes when they munch. The snakes are wiping out bird populations on the island is not a native of the island but more than likely was brought here on ships or planes. It has no natural predators so the population just grows. The dead mice also have radio transmitters so they can track the dead snakes to see if this method of attack works. BD Guam–Snakes...(read more)

California Regulators Seeking up to 10 Billion in Fines Against United HealthCare With Over 1 Million Violations After The Purchase of Pacificare HMO

The Medical Quack — Tue, 07 Sep 2010 23:56:00 GMT

This is a large number of violations stacked up here by the State, 992,936 with a fine of 10k for each violation. This could stand to be the largest fine in US history against a health insurance company. United Health Group is appealing the process of course. When United took over Pacificare they stated they would maintain PacifiCare's workforce and relationships with providers. Providers soon complained after the take over as claims were not paid timely, customer service...(read more)

Niche Medical Applications – Blood Pressure Chart

EMR and EHR — Tue, 07 Sep 2010 19:05:16 GMT

I recently was contacted by a guy named Matt from Poland who had built a simple web application that tracked Blood Pressure called Blood Pressure Chart. If you want to really see what he’s created in action, you can see his own Blood Pressure records Read More......(read more)

Changing EMR Vendors Development Roadmap

EMR and HIPAA — Tue, 07 Sep 2010 17:00:46 GMT

In a perfect world, an EMR vendor would be completely focused on the customer in developing their EMR software. They’d be very deliberate in their development process where they’d consider feedback from existing users while still finding the Read More......(read more)

Gleeman’s Daily News—09/07/10

Robert Gleeman — Tue, 07 Sep 2010 11:47:30 GMT

Psilocybin improved the mood and reduced the anxiety of advanced cancer patients

Just one dose of the mushroom improved mood and reduced anxiety in the patient group for up to six months Photo: REX

Controversial research in America showed that one session with the drug, psilocybin, improved mood and reduced anxiety in the patient group for up to six months.

Psilocybin is the active ingredient in ''magic mushrooms'', and classified as an illegal Class A drug in the UK.

The drug has mind-altering effects that can include the enhancement of colours and visual hallucinations.

Professor Charles Grob, from the LA BioMed research institute in Los Angeles, California, said: ''We are working with a patient population that often does not respond well to conventional treatments.

''Following their treatments with psilocybin, the patients and their families reported benefit from the use of this hallucinogen in reducing their anxiety.

''This study shows psilocybin can be administered safely, and that further investigation of hallucinogens should be pursued to determine their potential benefits.''

The pilot study involving 12 volunteers aged 36 to 58 builds on work in the 1950s and 1960s which found that psychedelic drugs could benefit advanced-stage cancer patients, reducing anxiety and the need for pain medication.

This drug is also illegal in the US, but not in Jamaica, so there is some experimental data on the subject. I wonder how it changes the experience of pain—does it enhance or diminish pain?

Expert warns about the danger of a bird flu pandemic

Vincent Yu

Robert Webster, chairman of the Department of Virology and Molecular Biology at St. Jude Children's Research Hospital in Memphis, Tenn., attends the Options for the Control of Influenza conference in Hong Kong Sunday, Sept. 5, 2010 in Hong Kong. Webster urged health authorities around the world to stay vigilant even though the recent swine flu pandemic was less deadlier than expected, warning that bird flu could spark the next global outbreak.

A leading virus expert urged health authorities around the world Sunday to stay vigilant even though the recent swine flu pandemic was less deadly than expected, warning that bird flu could spark the next global outbreak.

A World Health Organization official also defended the U.N.'s health body against accusations that it wasted governments' money and enriched pharmaceutical companies with its strong warnings during the swine flu outbreak's early days last year.

Are we going to see people waiting in line for their bird flu vaccination? Is there such a vaccine? Are we just supposed to worry about the flu every year? It would seem so.

Microwave popcorn and non-stick cookware may both boost cholesterol

A freshly popped bag of microwave popcorn

Exposure to chemicals used to make non-stick cookware and which are found in microwave popcorn may raise blood cholesterol levels in children, a study says.

Researchers led by Stephanie Frisbee of West Virginia University School of Medicine assessed blood lipid levels in 12,476 children and teens aged one to 18 years for the study published in Archives of Pediatric and Adolescent Medicine, a journal of the American Medical Association.

The children who took part in the study were part of a health project that began after a lawsuit was settled in 2002 after perfluorooctanoic acid (PFOA) was found in the water supply in the mid-Ohio River Valley.

As the years and studies tick by, we will become alerted to many different poisons in our food and water, and it is my opinion that many of these chemicals will be replaced by safer organic versions.

FDA considers approval of GM salmon

A size comparison of an AquAdvantage® Salmon (background) versus a non-transgenic Atlantic salmon of the same age

WASHINGTON — US authorities have begun to consider approval for the first time the sale of genetically engineered salmon, a move that some say could open the door to more transgenic animals on American dinner tables.

A US Food and Drug Administration panel has set a hearing for September 19-20 to consider a proposal by Massachusetts-based AquaBounty Technologies for production and sale of a new Atlantic salmon with a growth hormone gene from the Chinook salmon that allows it to grow faster.

The company said the genetic change allows the fish to grow to market size in half the time of conventional salmon but that in all other respects, its AquAdvantage salmon "are identical to other Atlantic salmon."

Yes, by all means bring on the super salmon, here the world is trying to fight hunger, and some people are picky about the genetics of their food? All the food we eat has gone through generations of genetic breeding, I don’t think people should be afraid to eat these fish.

Wastefulness studied in the health care field

Image from: http://www.captainscomments.com/comment/728

In a snapshot of systemic waste, researchers have calculated that more than half of the 354 million doctor visits made each year for acute medical care, like for fevers, stomachaches and coughs, are not with a patient’s primary physician, and that more than a quarter take place in hospital emergency rooms.

The authors of the study, which was published Tuesday in the journal Health Affairs, said it highlighted a significant question about the new federal health care law: can access to primary care be maintained, much less improved, when an already inadequate and inefficient system takes on an expected 32 million newly insured customers?

The study is the first to quantify the problem, according to Dr. Stephen R. Pitts, the lead author and an associate professor of emergency medicine at Emory University. Examining records of acute care visits from 2001 to 2004, the researchers concluded that 28 percent took place in emergency rooms, including almost all of the visits made on weekends and after office hours.

This article has many links to studies, and all I want to add is that going to the ER is not free, you get billed, and if you don’t pay, you get sued and your credit ruined. Again, the hospital ER is not free.

Telemedicine becomes reality aboard Virgin Airlines

Way back (in internet time) in 2006 we posted about Virgin Airways' plans to use the Tempus from RDT in their aircraft for long haul flights. The Tempus is a minimal training vital signs monitor for use in way out of hospital settings that can transmit all the recorded data to medical control on the ground or other locations. Now, in 2010, the plan has been implemented and several other carriers use the device as well. Recently The Economist wrote it up and included a gripping tale of its use:

HALF way through a flight from Mumbai to London, a male passenger complained of a swollen right hand and an inability to bend his fingers. The flight attendants were uncertain about what to do and hooked the passenger up to a small device which took and transmitted vital signs, including his pulse, blood pressure and a picture of his hand, to a ground-based medical team.
As the passenger’s condition worsened, the device was also used to transmit an electrocardiographic (ECG) trace. The resulting information was used to rule out heart problems, and the passenger was stabilised and monitored with the assistance of a doctor on the flight. The decision was made to continue the journey rather than divert to the nearest airport.

The article goes on to detail RDT's future plans for the Tempus, including making it more rugged for military applications and including ultrasound and a laryngoscope.

The Economist: An online medic...

Product page: Tempus IC...

Previously: Virgin Atlantic To Introduce On-Board Telemedicine

There is a certain feeling of helplessness if you get sick while in flight, and this article looks at some hardware to handle the problems. Looks like a nice medical tool.

EHR: know when to ask for help

Healthcare IT: How good is your strategy? — Tue, 07 Sep 2010 11:44:53 GMT

I was thinking about the time I was teaching rappelling in the Rockies during the summer between my two years of graduate school. The camp was for high school students of varying backgrounds and their counselors. On more than one occasion, the person on the other end of my rope would freeze and I would Read More......(read more)

Happy Labor Day

EMR and HIPAA — Mon, 06 Sep 2010 16:00:06 GMT

Happy Labor Day to all those readers in the US, and there’s no reason my international readers can’t enjoy a nice celebration today too. It’s been interesting leading up to this holiday for me now that I’m a full time blogger and Read More......(read more)

The Breform Invisible Bra Implant–New Breast Lift Procedure–Available in Europe but Not US FDA Approved

The Medical Quack — Mon, 06 Sep 2010 07:12:00 GMT

The advertisements say you never have to wear a bra again. So far the FDA has not granted approval but in western Europe it seems to be taking off a preferred method for uplifts. A woman needs to be beyond child bearing age. The website has a full display of media to include videos and other newspaper articles. The Breform is a permanent implant and can be removed and it uses a mesh scaffold for support. The article states there’s no loss of feeling. BD From the website...(read more)

Long Island MD Michael Eisenberg–Phone Sex With Patient Cost Him His Medical License

The Medical Quack — Mon, 06 Sep 2010 06:35:00 GMT

This seems to be quite a long series of messages via text and phone calls. The female patient told his wife and the patient had threatened suicide if he stopped. The doctor is 65 and the patient is 26. Strangely enough the doctor treated patients for drug and alcohol addictions and the article also said he had stopped seeing the patient before the phone sex began. Eventually they met in person but never did commit the the act but lot of petting and other items were mentioned...(read more)

Compliance Police Out In Force for Seniors–Health Plans and Drug Stores Making Phone Calls-Business Models & Caller Behavior Sucks -A Result of Pay for Performance Efforts?

The Medical Quack — Sun, 05 Sep 2010 23:54:00 GMT

I’m going to use some experiences that my 86 year old mother had this week with phone calls from both entities. She’s a diabetic and has been for around 12 years and thus so is tuned in to taking her blood sugar readings every day and she does it like clockwork. She also has a good record of getting in for her appointments for her annual physicals and breast screenings. A couple weeks ago she received a call from her Medicare Part D insurer reminding her that it is time for her...(read more)

Dr. Oz Has Colon Polyp (Pre-Cancerous Growth) Found During Routine Colonoscopy–He Follows His Own Advice and Is A Good Role Model for The Rest of Us (A Rare Find Today)

The Medical Quack — Sun, 05 Sep 2010 21:09:00 GMT

I talk a lot about our serious lack of role models today, not only in healthcare but in other areas of government and Dr. Oz certainly stands to defy what we get a daily dose of with the usual attitude and paradigm of “its for those guys over there’ . He just recently turned 50 and went in for the suggested colonoscopy upon reaching that age. On September 7th, he’s slated to discuss more on his show. He has a way with utilizing television and other medias to get his message across and...(read more)

FDA and DEA Approve Study to Use Ecstasy for PTSD–Vet Participants Get to Trip Out for 3 Hours and Revisit Traumatic Experiences–MDMA

The Medical Quack — Sun, 05 Sep 2010 20:25:00 GMT

The group has actually been conducting the FDA approved testing since 2004. Other countries have studies doing about the same thing. So far since 2004, 21 patients have been treated in the study. The funding for the study comes from the Multidisciplinary Association of Psychedelic Studies . There will be a screening process for applicants to go through. The group is also working to get the Department of Defense involved in the study as well. BD A pair of...(read more)

Clinical Trials to Begin for Malaria Vaccine Later This Year

The Medical Quack — Sun, 05 Sep 2010 19:46:00 GMT

This is something that is needed like now. I also posted about a movie that is coming out that discusses DDT and the desire to bring the chemical back and discussed the potential dangers and non dangers associated along with the decision to stop DDT back in the Nixon administration. 3 BILLION AND COUNTING Documentary About The Needless Ban of DDT–Decision of One Scientist and The Reason for the Huge Outbreak of Malaria and Why Bed Bugs are Back Malaria and the cure has also been a big focus...(read more)