11 Temmuz 2012 Çarşamba
[CA] Police Chief's wife Brinda McCoy on trial for shooting at police officers
[NJ] Police Officer Klementovich's standoff: "Tell the police I have a surprise for them..."
10 Temmuz 2012 Salı
9 Temmuz 2012 Pazartesi
Walgreens is Making Another Purchase From LaFrance Holdings To Include USA Drug, Super D Drug and May’s Drug Stores Located in the US Southeast
Sales are down so buy some more drug stores? It certainly 
seems like this is what we are seeing out there. If we go back to the split with Express Scripts and the loss of revenue in prescriptions there, well that might shed some light on the size of the loss of revenue and maybe it’s bigger than anyone thought.
Anthem Blue Cross Members Will No Longer Be Able to Fill Prescriptions at Walgreens After January 1, 2012
Just a few weeks ago they bought into Boots in the UK with an option to completely own the chain in a few years too.
Walgreens to Invest in Alliance Boots Drug Chain in Europe With Option to Buy in Full in 3 Years
Along with the purchases comes another source of profit and that is more data potentially for sale which is becoming almost like oil these days and companies are making billions. On their 2010 SEC
statement, Walgreens made just short of $800 million, selling data alone, so when you add up all these acquisitions, just think of how much data for sale they might be getting access too and what additional dollars that could mean. I keep saying we need to tax banks, companies, etc. that make billions of dollars from selling data as it has behind the scenes crept in to where it “is” part of doing business today.
Walgreens And CVS Accused of Selling Customer Prescription Data in 2 Separate Law Suits-Sales for Marketing Data Continues and the Data Bases Gets Larger with Technology
They are spending $438 million on this purchase. The store has also been busy getting liquor licenses in the last year in stores where they have not sold it before to add to the number of products they carry.
Walgreens Applying For and Getting Liquor Licenses Across the US – Be Healthy and Get Your Alcohol Here Too
In addition to all of the above, they are also expanding their efforts into social networking to send ads to your cell phone to for promotional sales and there were several news items in the last year speculating on whether or not the drug stores will start selling insurance too. Back a couple years ago they announced that they were working with Orbitz travel services too so that those booking travel through the company could also get coupons for discounts at the store, in other words promoting “travel healthy”.
Walgreens Using Social Networks to Send Ads To Mobile Phones for Promotional Sale Items When You Check In at the Store –Will Sperm Check Make the List?
In view of all of the above, one certainly can gather the impression that profits may not specifically be found in selling prescriptions, but rather in all the other entities that are combined efforts with what we are seeing out there with acquisitions and promotions. BD
Walgreen also said Thursday it will spend about $438 million to buy a 144-store chain focused on the mid-South from the privately held Stephen L. LaFrance Holdings Inc., which is based in Little Rock, Ark.
Stores in the chain include USA Drug, Super D Drug and May's Drug. They are located in Arkansas, Kansas, Mississippi and Missouri, among other states.
http://www.usnews.com/news/business/articles/2012/07/05/walgreen-plans-new-acquisition-june-sales-fall
Pro-Prep Surgical Medical Device Company Gets FDA approval for It’s Nerve Monitoring System To Be Used During Minimally Invasive Robotic Prostate Cancer Surgery
What robot performs prostate cancer surgery, the daVinci and the device helps surgeons identify nerves that may otherwise not be visible. 
If you read the news there have been a few incidents reported with the robot, I have not seen a lot but there are some. The device consists of a Pep monitor, a control switch and an electrode kit. The kit is a single use disposable unit. The electrode connects to the monitor. This appears to make the procedure and the robot safer. BD
Urology - Nerve Sparing - Dr. Fagin - Nerve Mapping
ProPep Surgical, a privately-held, Austin-based medical device company, announced today it has received FDA 510(k) clearance for its ProPep Nerve Monitoring System – a family of products that allows surgeons, for the first time ever, to do intraoperative nerve monitoring during minimally invasive, robotic-assisted surgery for prostate cancer.
The ProPep Nerve Monitoring System is the first real-time nerve monitoring system specifically designed for use during robotic-assisted radical prostatectomy, the most common treatment for prostate cancer. Fast, accurate and easy to use, the System gives the surgeon real-time feedback regarding the location and integrity of otherwise invisible nerves during robotic-assisted radical prostatectomy. “One of the biggest fears about prostate cancer surgery is the potential for nerve damage. To reduce the side effects associated with this nerve damage, the surgeon must do two things; spare the nerve tissue, and not damage the nerve tissue while sparing it,” according to Dr. Randy Fagin, Chief Medical Advisor.
“Currently, surgeons rely on anatomic landmarks to identify nerves during surgery but research has shown these landmarks are not always reliable and even if you successfully spare the nerve tissue, there has never been a way of knowing, in real-time, how much damage was done to the nerve while trying to sparing it.” The ProPep Nerve Monitoring System is the first product that provides the surgeon real-time information to not only make a more informed decision about which tissue to selectively preserve or remove during an operation, but to also assess the integrity of the nerve during the procedure. “This information has never been available before. Having it can change a surgeon’s decision making during an operation and could potentially reduce the incidence of nerve damage related side effects such as incontinence,” says Dr. Fagin.
http://www.sfgate.com/business/prweb/article/ProPep-Surgical-Receives-FDA-510-k-Clearance-for-3678030.php
Technorati Tags: cancer,robotics,roboti surgery,prostate,daVinci
EHR System Installed at Hospital in Australia Was Gamed by Executives With Manipulating Emergency Department Records, Wait Times And More to Improve Publicly Reported Statistics
I wonder has anyone in the US caught on to this game yet? I think our systems here are a little too tight for this to happen as it 
sounds like this installation was not very well done anyway. An executive admitted that he did it but gee if you are going to get in there and alter data for statistical purposes and the goal is to be within parameters, this looks kind of stupid to see an high number of patients checked out of the emergency room precisely 240 minutes after arrival. I would think that would stick out like a sore thumb. In addition round numbers were used as patients were seen exactly in 30 or 60 minutes from the time they arrived, again no imagination here and I guess someone thought nobody would ever look, wrong, not in today’s world of data.
So instead of being within the normal realms of statistics, they were way over the other side. The patients seen within 30 minutes was 19% over stated. In addition it was all done from one workstation, duh? Next odd issue here is that the hospital has 259 workstations and only 23 user accounts? Duh again like what’s up with this? 253 people had user accounts but only 23 users? The main four generic user accounts were: CLERK, NURSE, DOCTOR and BEDMAN and anyone in the hospital could use the accounts! 
The system, EDIS was not able to edit effectively either, again with all input coming from one work station. How in the world does this happen, I can’t believe this. The fact that someone outside of IT could get inside and do all of this is amazing so maybe there was a plan or reason for using only one workstation.
The article also said up to 72 hours after the visit that records could be changed and that is non unusual as long as you have an audit trail recording each change in case it was legally needed later. Heck I even wrote that in my system 6-7 years ago. Well obviously some folks figured out how to work the system and I wonder how the patient records looked, not that they were altered I am guessing but what kind of data was entered there? How can you run an ER on one workstation and four user accounts? Well after this incident I think many will be talking about some enhanced security soon. BD
A Canberra Hospital executive has admitted to manipulating Emergency Department records to make wait times and stays appear shorter than they were.
The executive told the Director-General of the Health Directorate they had made "approximately 20 to 30 changes to hospital records" a day from "late 2010" onwards.
ABC News reported that the matter has been referred to police, while the executive has been suspended without pay.
In total, PwC found 11,700 performance records - about six percent of all records stored in the hospital's iSOFT emergency department information solution (EDIS) - had been altered.
While EDIS was on approximately 259 workstations across the hospital and 253 users had permission to run the software, there were only 23 user accounts.
"Although EDIS has been disseminated widely throughout the Canberra Hospital each of these users logs into EDIS using the common “Workstation 14”.
Though the data manipulation was initially said to be motivated by concerns over job security, changes in 2011 and early 2012 were said to have been made due to "managerial pressure" to improve publicly-reported performance statistics.
http://www.scmagazine.com.au/News/307389,canberra-hospital-embroiled-in-data-scandal.aspx
WellPoint to Buy Amerigroup for $4.9 Billion As the Battle for Medicare and Medicaid Management Contracts/Exchanges Continues Between Two Major Health Insurers–Subsidiary Watch
In case you have not paid attention lately to what appears to be happening here there’s a big battle going on with contracts with health 
insurers. This has been a big area with the Tri-Care contracts as well with United recently winning the west coast contract to administer. But even in the midst of all of this with the subsidiary companies, United apparently found it necessary to award a portion of the contract they won to a Blue Cross subsidiary, as I am guessing all the IT infrastructure that was in place presently would be a huge project to move quickly. It’s all about that IT infrastructure and algorithms.
United HealthCare Awards Contract to One Blue Cross/Blue Shield Subsidiary to Process Tri-Care Claims While The Other BlueCross BlueShield Company Lost the Over All Tri-Care Bid To United In the West
Here’s another recent example below of a battle between the two insurance giants duking it out over who gets the contract, all about those cost and risk algorithms and their respective parameters of predictions that keep falling off the scales today as things change so rapidly.
Blue Cross and United Healthcare Duking It Out In Nebraska Over State Health Insurance Contract–We Have More Subsidiaries My Cost Algorithms Are Better Than Yours?
Blue Cross Protesting Award of Texas Employee Retirement Health Plan to United Healthcare–Price Cut by $25 Million With Little or No Out of Network Coverage for Members
In addition of late, WellPoint also bought this company who makes contact lens and perhaps this was in answer to United and their “cheap hearing aides” company they bought a few months ago, so one may have a deal on contact lenses and glasses and the other has hearing aides.
WellPoint to Purchase 1-800 Contacts Eyewear and Contact Lens Retailer For Around $900 Million–Subsidiary Watch
UnitedHealthCare Throws in Free Hearing Aids for Those Who Enroll In AARP Medicare Advantage, HMO & POS Plans in Miami-Dade County From Their New Subsidiary
This activity is noted to somewhat prepare for State insurance exchanges which in itself will be interesting to see how that works as IT infrastructure is becoming so complex these days and “will they” be able to do it without a huge array of flawed data in there, and of course usual and customary legal battle of who received which contract. All of this stuff just fills the news wires today and continues to keep consumers in an uproar and state of confusion until someone settles the matter and then again even when that is accomplished, flawed data and spasmodic algorithms live on. The VC firm owned by the Blues just recently moved to San Francisco and started an incubator for start ups and let me see, I can bet some of the new companies will be focusing on the payable areas as well as new parameters that will help determine risk and benefits…that’s what they do out there today.
Here’s one more example of WellPoint and their preparation
for exchanges..they bought their own but still want to be in the game for what the government is going to dole out too. WellPoint may have an disadvantage here to a degree as the former HHS executive who wrote the healthcare laws is now on the payroll at United Healthcare as an Optum VP, so loopholes or other items in the complex IT contracts could be easier to locate, again this is a battle of IT to determine risk and how to profit.
WellPoint & Partners Buy Bloom Private Health Insurance Exchange From Their Own Venture Capital Company (Sandbox) –Subsidiary Watch
Meantime back at the consumer ranch, when we get sick we just hope there’s someone around to pay the bill so we don’t end up filing for bankruptcy and losing what we have left, i.e. homes. Both of the carriers are also buying up HMOs such as CareMore bought by WellPoint and then you have a few giants under the care of United in southern California to include Memorial Care and Monarch and there’s more out there too that are smaller that have been gobbled up by insurers.
As I read this article, this would put WellPoint in the number one 
spot for having the most covered under Medicaid contracts and at this point it looks like United still holds the number one spot for Medicare, I think? This is the world we live in today and hopefully by the time all the big corporations figure out their algorithms and what risk and profit exists for them, as consumers we can hopefully still get some decent care and have doctors that are not cut to the absolute brim to where more private practices continue to close.
That’s a big issue out there today as of course insurers drive those rates and we get shuffled from one area into another, like a cattle call with contracts as it’s in constant motion and keeping up with the contracts is a complex issue for not only consumers but also doctors and hospitals. In the meantime too, let’s not over look the money that stands to be made from combined efforts here too with selling data, insurers make billions do this as well as other industries. With all these mergers and acquisitions, the very least we can do is to at least start taxing these huge profits on a quarterly basis and think about devaluating some algorithms before the big bubble bursts, as at some point in time it will as something has to give here. BD
“Devaluate the Algorithm” And “Tax the Data Sellers”–A Cure for Both Healthcare and an Economy Based Heavily on Intangibles–We’ve Lost Our Balance
WellPoint Inc., the second-biggest U.S. health insurer, agreed to buy Amerigroup Corp.for $4.9 billion in cash to expand the number of Medicaid patients it serves as the U.S. health plan for the poor undergoes broad changes in how it is managed.
Amerigroup stockholders will receive $92 a share, the companies said in a statement today. The price is 43 percent higher than the closing level on July 6 for the Virginia Beach, Virginia-based company. WellPoint, based in Indianapolis, rose 5% to $62.89 at 6:30 a.m. Pacific time.
The acquisition will make WellPoint the top private manager of Medicaid benefits in the U.S., with 4.5 million members in the program. The deal should also boost the value of other insurers focusing on Medicaid, includingWellCare Health Plans Inc.andMolina Healthcare Inc., said Thomas Carroll, a Stifel Nicolaus & Co. analyst in Baltimore.
UnitedHealth Group Inc., based in Minnetonka, Minnesota, is the largest Medicaid contractor with 3.5 million members. Medicaid is the joint state-federal program for the poor, while Medicare serves the elderly and the disabled.
http://www.latimes.com/business/la-fi-wellpoint-20120709,0,7872259.story Technorati Tags: WellPoint,Amerigroup,healthcare,health insurance,HeatlhIT,mergers and acquisitions
FDA Approves Evolution Colonic Stent To Relieve Pain and Assist With Obstructions Prior to Colectomy Procedures
The stent is said to potentially eliminate multiple procedures and if you are familiar with Cook Medical they make quite a few stents for use in treating PAD and pulmonary areas so we have a stent for another part of the body. The mechanism makes it easier to place and retract the stent and can provide relief to those with colon cancer with relieving pain associated with obstructions. I am thinking that with other colon diseases where pain and discomfort enters such as irritable bowel or maybe even Crones disease, or any other disorder of the bowel area this could prove to be an effective therapy. BD Press Release:
Winston-Salem, N.C., July 9, 2012 — The U.S. Food and Drug Administration (FDA) has granted Cook Medical 510(k) clearance for the Evolution® Colonic Controlled-Release Stent, Cook announced today. The new stent expands Cook's line of Evolution controlled-release
stents and is used to palliate uncomfortable symptoms associated with colonic obstructions caused by malignant neoplasms and relieve large-bowel obstructions prior to colectomy procedures. The product's design offers physicians the control and maneuverability required to deliver a stent that conforms to the natural curves of the anatomy.
In a recent multi-center, international registry study of 80 patients, the Evolution Colonic Controlled-Release Stent was evaluated for use in palliation of symptoms and as a bridge to surgery. Resulting clinical success rates were 97.8 percent and 85.7 percent, respectively. At least 85 percent of patients in both groups reported mild or no symptoms of abdominal pain, difficulty defecating or constipation at the first post-procedure report.
There were no adverse events associated with device malfunction and no deaths were considered to be caused by a device complication.1
The American Cancer Society estimates that more than 103,000 new cases of colon cancer will be reported in 2012 in the U.S. alone.2 Some patients with colon cancer may experience colonic obstruction, which can be painful and uncomfortable.
The Evolution colonic stent helps physicians reduce the symptoms associated with obstruction, which can include abdominal pain, vomiting, nausea, difficult defecation, constipation, diarrhea and GI tract bleeding.
The Evolution Colonic Controlled-Release Stent and delivery system
include several features designed to provide control and maneuverability to physicians. These features include a stent design that provides enhanced expansion and better wall apposition and a unique delivery system that employs kink-resistant Flexor® technology for pushability and stability.
The delivery system, which is the same across all Evolution stents, provides physicians with a trigger action that deploys — or recaptures — a proportional length of the stent for precise placement. The Evolution colonic stent also adds a highly visible endoscopic marker to define the proximal end of the stent.
“The new Evolution colonic stent reiterates Cook Medical's commitment to pioneering a full line of efficient, effective products to improve the quality of life in patients who suffer discomfort or pain,” said Barry Slowey, global business unit leader for Cook Medical's Endoscopy division. “Now clinicians have the ability to precisely deploy and recapture colonic stents. That can make it easier to place the stent the first time around, potentially reducing the need for repeat procedures, while increasing efficiency in the GI unit.”
The Evolution colonic stent is now available to select physicians across the United States, and will be widely available in the coming months. The Evolution colonic stent adds to the existing line of Evolution stents, which includes fully covered, partially covered, and uncovered esophageal stents, as well as the duodenal stent which received FDA approval in March of 2011.
About Cook Medical
A global pioneer in medical breakthroughs, Cook Medical is committed to creating effective solutions that benefit millions of patients worldwide. Today, we combine medical devices, drugs, biologic grafts and cell therapies across more than 16,000 products serving more than 40 medical specialties. Founded in 1963 by a visionary who put patient needs and ethical business practices first, Cook is a family-owned company that has created more than 10,000 jobs worldwide. For more information, visit www.cookmedical.com. Follow Cook Medical on Twitter and LinkedIn.
1 Repici A, Ter Borg F, Giovannini M, et al. Treatment of colonic obstruction with the Cook Evolution® Colonic Stent System. Dig Liver Dis. 2012;44(2):9.
2 American Cancer Society. Cancer Facts and Figures 2012. Atlanta, GA: American Cancer Society; 2012.
