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Re: Who Got Those Trillions Of Dollars From The Federal Reserve?

Medicalquack — Sun, 26 Jul 2009 19:25:38 -0000

Same old story, they need some business intelligence software to track all of this, humanly almost impossible otherwise, but typical of what we have been dealt.

Re: Dear Mr President Letter on Health Insurance

Medicalquack — Sat, 08 Aug 2009 17:42:00 -0000

Thank you for the referral on the jets too! Along the subject of insurance, let's not forget how software creates profits too, a post I wrote asking are you insured by a technology or insurance company and how one company makes their money, more from technology than writing policies.

http://ducknetweb.blogspot....

A few more details here about software and how one company sells it to others:
http://ducknetweb.blogspot....

Long and short of all of this is the need for balance and someone keeping an eye on the books so healthcare is not totally ruled by the dollar and some forget that there are humans attached to those analytic reports too.
Yes there is money to be saved with efficiency, but it's a fine line as to what is efficient and what can be lifesaving for a patient and the care for the patient should remain with the doctor and not analytical reports controlling every decision as last I looked we are all still humans:)

Re: Proposed Health Care Plans Of 1971

Medicalquack — Thu, 27 Aug 2009 14:56:40 -0000

Good Post Happy! This is probably why the Town Hall Meeting I listened to on the phone last night was out of the 70s too. No advance publication of the Town Hall, phone rang and computer announced Congressman and it went from there, total waste of time in my opinion, lack of content to present and bad format. You can see where I said nice things about those in Congress too that make the effort, but you are right about people not changing.

It was simply an amazing day when our governor in California visited Twitter yesterday and at the end of the day I had to re-live the 70s. The phone format was irritating due to the fact that it was like "drop everything you are doing, I'm here" and people are busy today.

http://ducknetweb.blogspot....

Re: Why Primary Care Doctors Are Fed Up

Medicalquack — Thu, 27 Aug 2009 14:59:30 -0000

New PBS movie coming out Money Driven Medicine, based on the book of the same name, tomorrow I think is the debut and Bill Moyer will talk about it on PBS. Medical care needs to go back to the patient/md arena, agree!
http://ducknetweb.blogspot....

Re: Health care: It’s time for technology

Medicalquack — Fri, 25 Sep 2009 13:05:17 -0000

Nice write up from Sean Nolan. I have been a HealthVault advocate from day one and use it for myself and family, works good. What happens if your physician dies as I recently posted, and all your records are shredded? Something to think about. By the way I have an entire section on my blog along with a permanent link to get started with HealthVault on my blog. There are a lot of "how to'" and images on what you can do with HealthVault.

http://ducknetweb.blogspot....

Re: Why Are Americans Seeking Cheaper Care Abroad Being Refused Access?

Medicalquack — Sun, 11 Oct 2009 12:09:13 -0000

One hospital in Zurich said we want no part of the US legal system and no to tourism for procedures.
http://ducknetweb.blogspot....
Also, insurance companies putting pressure on US hospitals for price, New England hospital reduced their cost to keep 3 patients here instead of going over seas. Also, at the end of October, big medical tourism convention here in Los Angeles, many big insurance companies attending and speaking. The focus as stated is to lure more US health insurance companies, scary.

http://ducknetweb.blogspot....

Re: Fresh from Health 2.0: two dozen of the most innovative new health apps

Medicalquack — Sun, 11 Oct 2009 17:29:50 -0000

I absolutely love all the new software and technology, but getting it out into the real world is another issue. I didn't attend but published some nice items on the blog like the technology being used by Cisco and others so readers could see what's going on out there. We get back once again to training and education to get these things out in the world and it's a slow grow.

Part of the problem exists in the fact that we have no role models too. I don't see Oprah or Jay Leno talking it up:) For that matter is could be anyone in the public eye, just to draw attention to how important technology in healthcare is. Congress doesn't talk much about it either with anyone seeing the value. The link below might tell the story a bit better. Once you are on the front line trying to help others learn and comprehend the problem of getting more on the band wagon is apparent in about 5 minutes or less, doctors, patients, CEOs, etc.

http://ducknetweb.blogspot....

We have the struggling PHR pilot program in Arizona that has not caught on yet either. All of this technology is wonderful and creates better healthcare and efficiencies, but we have to do more than just build it as they are not coming yet.

Re: jay parkinson + md + mph = doctor in brooklyn - Engadget: Review of the Fitbit

Medicalquack — Fri, 16 Oct 2009 22:34:40 -0000

You might be right on the money on who might buy one, but Robert Scoble did and I asked him if he was sleeping with it too, as you can.

I originally wrote a post on the device almost a year ago when it was still being developed and their web site stated their markets were risk management, which is now not listed, but the data reporting devices are of special interest to wellness coaches as the emphasis on compliance raises with health insurance. Medication delivery systems are changing to adapt to devices that report data too, like the blue tooth inhaler. Yup, it can create an entire report, and when you don't inhale you get text messages reminding you.

http://ducknetweb.blogspot....

With employer related programs about 5% were using some type of biometric device this year and next year they anticipate it to be around 20%.

http://ducknetweb.blogspot....

The devices that report data are on the rise with some implants, like Merlin from St. Jude and a few others able to send full itemized data reports text messages and so on, so the key is to ensure your privacy as a patient and find out where and who gets that data if you choose to use one. My own personal opinion is that they should all go through a PHR as the first stop so you don't lose control if you do decide to participate. iPhones also have an accelerometer that collects movement data too.

This pill bottle will speak directly to your cellphone, do your refills at the pharmacy and is sponsored by insurance companies.

http://ducknetweb.blogspot....

Also, with the pharmacy benefit manager involvement here, you add more information that can be sold to insurance companies as PBMs are not under HIPAA, so companies like Ingenix and Milleman sell your information, been going on for years, and also the drug reps get to see these sales numbers (no patient info) to target doctors who are using their drugs as well.

Data reporting devices are a bit scary and it is brand new territory without a lot of specific laws to protect you.

Re: jay parkinson + md + mph = doctor in brooklyn - iRobot will watch over your grandma

Medicalquack — Thu, 29 Oct 2009 17:42:40 -0000

The Carebot is here and already had CPT Codes, and it can haul oxygen around too if needed. The video is interesting as grandma can talk and send it away too. It reminds me of Rosie the Robot right out of the Jetsons:) These things keep getting smarter all the time! You do have to laugh at grandma interacting in the video too, funny.

http://ducknetweb.blogspot....

Re: Pulmonary Embolism Diagnosis May Be Missed Due To Pigeon Hole Diagnostic Error

Medicalquack — Tue, 03 Nov 2009 14:30:37 -0000

Great article on pulmonary embolism diagnosis. Recently I did an interview on the blog and now as a result and being that I am only a geek healthcare, I have a greater understanding of how the diagnosis is done and that so many times it does not have any signs either for the patient to indicate.

I'm glad someone takes the time like you do to explain items as such from the clinical side, as until I did the interview on my blog, I had little idea as to what the impact of a PE was (it could kill you). Again, great post on PE and thanks!

Re: Find a New Doctor: The Best Reason I've Ever Heard

Medicalquack — Thu, 31 Dec 2009 14:50:36 -0000

Good information as always Happy! What I really like about your blog is the first hand experiences and opinions you include, in other words you have been there, seen and done that pretty much.

Sometimes there's nothing wrong with the doctor other than just personality differences too, but that is everywhere in life too, nobody likes everybody and healthcare is no different, but good care is vital sometimes and might need to go beyond who you may like. I have seen a doctor that I don't like, but I respect as he knows his stuff and is a good doctor and I have the confidence that he does what is right, whether or I like him or not:)

Even though I say I don't like him, truth is I really do, otherwise I would not keep going back for the good care and health education I receive:)

Re: Physician Review Scam? My Experience With the Managed Medicaid Physician Review Process

Medicalquack — Fri, 12 Feb 2010 14:05:31 -0000

Hello Happy and thanks for taking the time to write this up and bring it to light, you are not alone. I did a post to further discuss on my blog about the topic too.

I speak from the coder side of things and everybody somewhat chuckles a bit when they see the word "algorithms" smack dab on the center of my blog, but it is there for an awareness as this is what we are battling, the formulas used to calculate all the decision making processes used today by insurance companies and to the point of who can figure them out as your post stated.

Also note the wholly owned subsidiary of United Healthcare, Ingenix, they are the data folks that study and create the algorithms that sometimes create profits from software calculations where they did not exist before. I have quite a few posts about this, trying to let people know how some of this works and yet we give those same people contracts to fight fraud? The Ingenix lawsuits are far from being settled with Andrew Cuomo the attorney general in New York taking them to task over the out of network charges used in the corrupt data base used for years.

Anyway, here's the post where I hopefully maybe connected a few dots along the way.

http://ducknetweb.blogspot....

There's a few links there for additional information too. Hospitals are working hard for quality and this topic has appeared quite a bit on the web on how sometimes they are not getting the benefits of their hard work to improve quality of care, due to the fact that we have other algorithmic formulas from other areas that run interference. I just try to hopefully connect some dots here if I can. Again, very good post and thanks for taking the time to write about it!

Re: Why health insurance reform bothers me.

Medicalquack — Thu, 25 Mar 2010 00:32:55 -0000

This is very good post and tells it like it is. I agree on not supporting big business for profit. I think health insurance should be in the non profit category as well and not traded on Wall Street with shareholder dividends calling the shots to determine what quantity and quality of care we receive. Big business gets bailed out, but what about the consumers, that was a very good point indeed.

Re: What Was The Original Generic Name For Viagra?

Medicalquack — Wed, 31 Mar 2010 17:53:27 -0000

Somewhat on this same topic and worth a chuckle, US copyright office turned down the copyright for Viagra, said the active ingredient was too similar to "Horny Goat Weed", which is a real herb if folks have not heard of it. When used in the same sentence, it is a but strange I agree, but this is a real story:)

http://ducknetweb.blogspot....

Re: Concierge Medicine Changes Hospital Dynamics: No More Oprah For You

Medicalquack — Tue, 13 Apr 2010 20:34:29 -0000

I think you are on to something here Happy. In addition I think we might start seeing additional "admnistrative" type charges creeping in too.

Re: Will controversy cool Arizona tourism?

Medicalquack — Wed, 28 Apr 2010 13:43:37 -0000

Perhaps the tourism business won't hurt too bad as I read this morning where they are closing 1/3 of the State Parks, so tourists will lose some parks to visit, no money in the budget.

Re: Wall Street blames the computers again

Medicalquack — Fri, 07 May 2010 12:37:40 -0000

We will be hearing about this for a long time, no doubt, but the first thing that popped into my head was an interruption in "server fall over" as a potential issue, and I say that just due to how the data re-populated itself so quickly. Of course this is just a guess like everyone else may have out there too:) With the speed of trading today perhaps a "perfect storm" setting here with all the elements taking place at the right time occurred. It seems to make more sense though than the "fat finger" theory we are hearing.

Re: Physician Credentialing Software Is Out of Control As Medical Credentialing at Hospitals Borders On Absurd

Medicalquack — Sun, 06 Jun 2010 04:21:55 -0000

I think you make some very good points and the "fishing license" violation is unreal. When we get to that point, I agree we have a problem and pretty soon those "flawless" records are going to become far and few between.

On a similar subject I had a doctor tell me he was turned down when he signed up for the free e-prescribing tool as he missed on question and answered that 20 years ago he lived in a 2 bedroom house, records showed 3 but the 3rd bedroom was a den, go figure and an error anyone could make. Long and short he had to call and fax information to substantiate who he was and answer some additional questions. When you sign up for that service it scrubs the web and creates questions for you to answer to validate who you are and if you miss any, you go through a long process. Overall not a bad thing as far as making sure who you are but the questions asked are really pretty detailed.

I guess anymore the answer is to pay one of those agencies and find out all the hidden details about you on the web first, kind of defense data mining if you will and this way you won't forget that ticket for the missing fishing license:)

Re: The 21% Medicare Cut Has Arrived Today June 18th, 2010. It's Time To Go Flip Burgers.

Medicalquack — Fri, 18 Jun 2010 10:54:32 -0000

I don't know if you have seen this or not, a new documentary about the diminishing relationship between the patient/doctor. The 4 minute trailer pretty much says it all and you can hear a doctor, just 6 years out of residency talking about how she works a part time job at Blockbuster so she can afford health insurance of her own. This is an eye opener for patients in particular to see what's happening on the other side. So if it's not flipping burgers its working at Blockbuster and that's not so secure either as they are closing stores right and left.

http://ducknetweb.blogspot....

Re: How To Deregulate Narcotics And Prevent Narcotic Abuse. Demorphentanylaudid Is Not The Answer

Medicalquack — Tue, 22 Jun 2010 20:05:11 -0000

Yes you bring about some very good points. Prescriptive solutions is the pharmacy benefit manager for United Health Care. The service they are doing here is good but I get upset when they turn around and sell medication records of patients and make big money at it. Ingenix, also part of United makes millions at this every year.

Back on track in California we have a data base established to help catch the doctor shoppers and it is helping out, but I realize all states do not have this or a similar data base for doctors to check.

http://ducknetweb.blogspot....

There's also some technology in the works to use a cell phone with the new e-prescribing rules from the DEA and it's actually pretty neat. What it would also be able to do is to pull records from let's say a DEA maintained data base of all the prescriptions given that are controlled substances that were authenticated in this fashion too, so it would be more than just being state by state for looking up information.

The technology is 2D and3D barcodes and I have another campaign using the technology too for drug /device companies to start using them on product labels so we could as consumers find recalls instantly with our cell phones. Here's the working DEA project link below.

http://ducknetweb.blogspot....

Here's the goods for consumers. It looks more complicated than it is, as all you do is open program on phone, shoot and aim and instant information. One technology could solve a number of evils and be simple at the same time for everyone to use.

http://ducknetweb.blogspot....

Once the drug shopper is found then as you suggested, decisions need to be made somehow too, but this starts the process to find them at least and quickly.

Re: Double Dip Recession Or Massive Depression About To Shock The World. Leading Economic Indicators Say So.

Medicalquack — Mon, 28 Jun 2010 20:24:07 -0000

I agree there as we start seeing hospitals being bought by private equity firms to enable them to continue operations and with health insurers and Wall Street investing more in China, makes for a very nervous situation. Add on top more Wall Street new hires making millions more to add more fuel to the fire as well.

http://ducknetweb.blogspot....

Re: City of New York Blankets Times Square with Giant QR Codes

Medicalquack — Fri, 16 Jul 2010 13:16:03 -0000

Very nice article and 2-3D bar codes is where everything is going. I have done a series of articles about using Microsoft Tags for FDA recalls for both devices and drugs. I'll give a link to one article but you can use the 2nd search box and find tons more. The reason I said Microsoft Tags instead of the QR tags, which I like too are due to the extended capabilities of encrypted gateways, etc. that are already in place, plus the Tag technology is already developed to add information into Google Health and HealthVault for PHR information via Razcode, got posts on that too.

Also via the gateways, the Tags can also serve to authenticate MDs with new DEA e-prescribing rules, so one technology goes a lot of places with a lot of development already in place. Here's a couple links and the first one is somewhat of a summary of most of what I have been talking about as posted on MSDN and Microsoft Gov too.

http://ducknetweb.blogspot....

Had some good tweets on this too with consumers liking the idea of using their cell phones to find recalls and some hospital CIOs too. Bottom line here is simplicity and ease of use for consumers.

Re: City of New York Blankets Times Square with Giant QR Codes

Medicalquack — Fri, 16 Jul 2010 13:18:20 -0000

Very nice article and 2-3D barcodes is where everything is going. I have done a series of articles about using Microsoft Tags for FDA recalls for both devices and drugs. I'll give a link to one article but you can use the 2nd search box and find tons more. The reason I said Microsoft Tags instead of the QR tags, which I like too are due to the extended capabilities of encrypted gateways, etc. that are already in place, plus the Tag technology is already developed to add information into Google Health and HealthVault for PHR information via Razcode, got posts on that too.

http://ducknetweb.blogspot....

Re: Is The AMA Losing Power In Washington?

Medicalquack — Mon, 19 Jul 2010 17:44:15 -0000

That same insurance company also owns a bank with deposits over 1 billion from HSA accounts. They are everywhere.

http://ducknetweb.blogspot....

Re: http://blog.jayparkinsonmd.com/post/877664675

Medicalquack — Thu, 29 Jul 2010 22:15:15 -0000

There's another side to this too, and that is the pressure code writers have to get the job done and perhaps sometimes it is turned out before it's time if you will as companies want to get the product out there and start making money. This might be more prevalent with small VC backed companies with limited funds and if they don't meet certain deadlines they could be out of business.

It could happen at big companies too with the desire to get a product to market but not facing the same future issues. Devices that are implanted have very specific software/hardware configurations and it's not as easy as it seems. Granted I agree with getting others to review the code and never minded that myself as none of us are perfect code writers and we see that every day with new code emerging with our Tuesday updates! Things are changing rapidly and these 2 worlds of safety versus money are on collision courses all the time and we will never know the full chapters of all of it.