2007-08-26 00:00:00

Key Health IT opportunity: Medicare Says It Won???t Cover Hospital Errors

Last week the NY Times and others reported that Medicare will stop covering expenses incurred by hospitals for what the agency considers as errors:

In a significant policy change, Bush administration officials say that Medicare will no longer pay the extra costs of treating preventable errors, injuries and infections that occur in hospitals, a move they say could save lives and millions of dollars.

Assuming the rules get enacted as expected, this is a major opportunity for health IT firms to jump in with solutions. For example, firms that do any of the following will be in demand very soon:

  • Track medical errors and liabilities (this used to matter for legal cases, not it’ll be useful for reiumbursing)
  • Analyze billing patterns and CPT charges that would likely be for “cleaning up a mistake” rather than an orginating a procedure. Billing software vendors can start to add functionality into their applications to do better reporting.
  • Insurance company bill processing software will need better filters
  • Tracking hospital acquired infections (HAI) and tying them to specific bills at the hospital. Companies are doing this today but not really tying their reports to specific patients or into the financial side.

According to the NY Times article, the Medicare rule changes could save significant money:

The new policy ??? one of several federal initiatives to improve care purchased by Medicare, at a cost of more than $400 billion a year ??? is sending ripples through the health industry.

With this much money at stake and the government now ready to put new rules into effect, health IT firms should start their engines…and fast. This is a brave new world and we’ll need new software to make all this work efficiently for both the government and providers.

Filed under: — @ 2007-08-26 00:00:00
2007-08-26 00:00:00

Key Health IT opportunity: Medicare Says It Won???t Cover Hospital Errors

Last week the NY Times and others reported that Medicare will stop covering expenses incurred by hospitals for what the agency considers as errors:

In a significant policy change, Bush administration officials say that Medicare will no longer pay the extra costs of treating preventable errors, injuries and infections that occur in hospitals, a move they say could save lives and millions of dollars.

Assuming the rules get enacted as expected, this is a major opportunity for health IT firms to jump in with solutions. For example, firms that do any of the following will be in demand very soon:

  • Track medical errors and liabilities (this used to matter for legal cases, not it’ll be useful for reiumbursing)
  • Analyze billing patterns and CPT charges that would likely be for “cleaning up a mistake” rather than an orginating a procedure. Billing software vendors can start to add functionality into their applications to do better reporting.
  • Insurance company bill processing software will need better filters
  • Tracking hospital acquired infections (HAI) and tying them to specific bills at the hospital. Companies are doing this today but not really tying their reports to specific patients or into the financial side.

According to the NY Times article, the Medicare rule changes could save significant money:

The new policy ??? one of several federal initiatives to improve care purchased by Medicare, at a cost of more than $400 billion a year ??? is sending ripples through the health industry.

With this much money at stake and the government now ready to put new rules into effect, health IT firms should start their engines…and fast. This is a brave new world and we’ll need new software to make all this work efficiently for both the government and providers.

Filed under: — @ 2007-08-26 00:00:00
2007-08-14 00:00:00

Snacking…it doesn’t have to be a bad thing.

The following article is from Cooking Light. There are some great suggestions to keep your snacking in check and options for substitutions.

When you snack, you can fill in nutritional gaps, boost your intake of fruits and vegetables, keep your mood on an even keel, and help with appetite and weight control.

Every diet offers room for treats, and there’s no reason to feel guilty about enjoying one

“There’s even evidence that spreading calories out in frequent mini-meals and snacks requires less insulin, which can reduce your risk of developing diabetes,” says David Katz, M.D., M.P.H., director of the Yale Prevention Research Center in New Haven, Connecticut. “Snacking helps you avoid the waning of energy that comes with consuming large meals.” But when it comes to reaping all of these health benefits, every bite counts.

Snacking’s reputation hasn’t always been so rosy. “Most of the foods that have traditionally dominated as snack foods are not the healthiest choices — they provide a lot of calories without much nutrition,” says Cynthia Sass, R.D., M.P.H., a Tampa, Florida-based spokesperson for the American Dietetic Association. Unfortunately, many people choose snacks that derail their efforts to enhance their health — by grabbing a handful of candy at a colleague’s desk, a cookie from the coffee shop, or a bag of chips from the vending machine. And that doesn’t include the calories we might drink: People often swig high-calorie beverages with their snacks — and don’t compensate for those calories by eating less later.

Besides failing to make a major nutritional contribution to your diet, sweet or starchy high-calorie snacks are easy to overindulge in because they taste good and are often readily accessible. Eating them is often a mindless transaction; we consume the food simply because it’s there. In a study at Pennsylvania State University, researchers found that when they increased the portion size of packaged potato chips on five separate days, people naturally ate more without realizing it, consuming an additional 143 calories per day. CookingLight.com: Super snacking — your guide to smart noshing

“The danger in snacking is that it can add extra calories to your day,” Katz says. “By consuming 100 calories per day above what your body needs to maintain its weight, you can gain 10 pounds in a year.” That’s why it’s important to budget calories for snacks, perhaps by shaving some calories from your meals. If you normally consume 1,800 calories per day, you might divide that into 500 calories for breakfast, lunch, and dinner, then allow yourself two 150-calorie snacks.

Calorie control is key, particularly because people often overestimate how many calories they need in a snack. “What they eat may be closer to a small meal,” Sass says. For example, 400 calories — the amount in an average single-serving frozen meal — is nearly equal to the number of calories in a candy bar and a cola.

Sensible Snacking

Many food manufacturers have caught on to consumers’ desire for healthful snacks they can grab quickly and have begun to stock grocery-store cases, convenience stores, and airports with precut fruits and veggies, nuts, and calorie-controlled snacks in small, handy packages. You can also pack your own. On any given morning, Katz might pack a zip-top bag with whole-grain cereal, fresh and dried fruits, nonfat yogurt, baby carrots, or a mix of nuts and seeds that he can eat periodically throughout the day. CookingLight.com: Tour the Cooking Light staff’s snack drawers

The timing of your snack can also help keep your diet on a healthful track. “The hungrier you are when you’re snacking, the more likely you are to overeat,” says Catherine Christie, Ph.D., R.D., director of nutrition programs at the University of North Florida in Jacksonville. “If you go too long between meals, you can get low on energy and become overly hungry.” Reach for a snack before you become ravenous, and you’re likely to eat less. CookingLight.com: 16 superior snacks

Ultimately, your snacking habits should follow the same formula as your overall diet — all things in moderation. Every diet offers room for treats, and there’s no reason to feel guilty about enjoying one. In fact, Keith Ayoob, Ed.D., R.D., a nutritionist at the Albert Einstein College of Medicine in New York, recommends saving 10 percent of your daily calories and using them for snacks that you really want. “Sometimes it’s not worth it to fight what you crave,” he says. “Eating well is all about eating the right foods and eating a variety of foods the right way, and that’s where snacking fits in,” Ayoob says.

If your energy levels are flagging…

Solution: Consuming caffeine — in the form of coffee or tea — can help boost energy and alertness. Adding a bit of sugar and low-fat milk — if you prefer — adds only about 50 calories. Eating foods that blend complex carbohydrates and lean protein can also provide energy. Complex carbohydrates provide readily available fuel for your body, while protein increases the brain’s dopamine levels, thereby boosting alertness. Healthful choices include a small handful of dried fruit and nuts, whole-grain crackers with a slice of cheese or a hard-boiled egg, or yogurt topped with a tablespoon of granola.

If mealtime is several hours away, but you’re hungry now…

Solution: For a snack with staying power, eat something that mixes fiber and protein. (This is also a good strategy to tide you over until morning if you become hungry before bedtime.) In a study at Wayne State University in Detroit, Michigan, researchers found that when nighttime snackers developed the habit of eating cereal with milk 90 minutes after dinner, they reduced their total daily calorie intake and increased their chances of losing weight, compared with those who ate whatever they wanted. The cereal’s fiber and protein combination kept them full — and prevented less mindful eating that can accompany evening routines. Other good hunger-curbing pairings include carrot sticks with hummus or black bean dip, or a slice of multigrain bread spread with a tablespoon of reduced-fat peanut butter.

If you need a pre- or post-workout pick-me-up…

Solution: Before a workout, consuming complex carbohydrates — such as fruit or whole-grain cereal — will provide your body energy for exercise. Afterward, eat high-quality protein, such as low-fat yogurt or whole-grain cereal — particularly if you performed resistance exercises. A weight workout will stimulate the growth of muscle cells, which depend on protein. And, as always, consume plenty of fluids before, during, and after exercising.

If a stressful situation makes you feel an irrepressible urge to munch…

Solution: In this instance, your desire for food may be hard-wired: Research from the University of California, San Francisco, found that consuming food — particularly items that contain sugar and fat — appears to calm the body’s hormonal response to stress. But before you head to the vending machine, take a series of deep breaths; delay reaching for food for 15 minutes; drink a hot beverage such as tea, which can be soothing; and distract yourself by calling a friend or taking a walk. If you still feel like eating, then you’re probably hungry. Eat a smart snack that fits your craving — a small piece of chocolate with a glass of skim milk, for example.

What’s Your Snacking Style?

The desire for a snack can involve a hankering for a particular taste (like something sweet) or a yen for a texture (like something crunchy). But don’t put too much stock in the notion that what you crave is something your body truly needs. “That’s just not reliable,” says David Katz, M.D., M.P.H., director of the Yale Prevention Research Center in New Haven, Connecticut. “Very few people these days are sugar or salt deficient, but those remain the things we crave. It’s difficult to separate what’s physiological from what’s psychological, and it’s not all that useful anyway.”

A better strategy: Consider what taste or sensory sensation you really desire before reaching for a snack.

If you crave something sweet

Try: Raisins, dried cherries, or fresh apple slices dipped in melted dark chocolate chips

If you crave something salty

Try: Almonds, whole-grain crackers, brown rice cakes, or a small can of vegetable juice

If you crave something crunchy

Try: A handful of high-fiber cereal, a spoonful of peanut butter on celery or apple slices, pickles, or microwave popcorn

If you crave something creamy

Try: Low-fat pudding, whipped yogurt, or flavored oatmeal E-mail to a friend

Filed under: — @ 2007-08-14 00:00:00
2007-08-08 00:00:00

Recycle Your Old TV.

At first glance, an article about recycling televisions seems out of place on a health related blog. As you dig deeper it is easy to see the connection. Everything we do effects either our health of the health of others. Please take the time to read this article and learn how you can recycle your old TV.

BEAReCycling writes “As large numbers of consumers are starting to shift over to the latest in LCD and plasma screen televisions, the demand for television recycling is growing rapidly. With few options available to the public, Bear eCycling has opened a television recycling depot at their SE Portland facility at 4532 SE 63rd Avenue. “Ever since we got listed on the Metro Recycling Hot-line as a recycler who can handle televisions, the phone has been ringing quite steadily.” says company president Oso Martin, ???As a commercial recycler, our trucks are really too large provide cost effective pick-up from residential customers, so instead we created the public drop off option.”

Staff at the Bear eCycling facility deconstruct the televisions, separating the plastics, the gold and copper bearing materials, and prep the glass tubes for processing at an approved smelter that recovers the leaded glass for use in new televisions and computer monitors. Nearly all the televisions Bear eCycling receives are recycled. ???Unfortunately, with the digital TV transition coming up, there isn???t really a resale market for the good ones???, notes Martin, pointing to a row of working TVs ???nobody???s interested in buying these.???

The increasing demand for TV recycling looks to only get larger as all broadcast television signals will be switched over to Digital Television(DTV) on Feb. 27, 2009, making all non-DTV units obsolete. There are mandated low-cost, set-top converters scheduled to be available during the transition. Each US household will be eligible for up to $80 in coupons towards 2 converters ($40 for each converter) that allow analogue TVs to receive the DTV signal. This will allow the television to work, although without the higher resolution picture. As of March 2007, all TVs sold in the US are DTV capable.

Filed under: — @ 2007-08-08 00:00:00
2007-08-08 00:00:00

Health IT Blogs Visualized

Ryan Byrd over at healthTech.accordingtome.com has a great picture of the HIT blogosphere.

HIT Blogsphere Visualized

Here’s how he described what he did:

What does the healthcare blogosphere look like? That is, how are all the healthcare IT blogs interconnected?

I wrote a quick program that extracted the blogs listed there and for each of them, I spidered the first page for links and checked to see if those links linked back to the original 50. Then my program created a network graph that displayed the connections while scaling the size of each site???s node proportional to the number of other sites linking to it.

Looks like a great picture, Ryan. Nice job.

Filed under: — @ 2007-08-08 00:00:00
2007-08-08 00:00:00

Microsoft Health Common User Interface (CUI) Guidance and Controls

Microsoft’s been tying to make some major inroads into healthcare IT (some impressive, others that are a little “me too”). They are strong in the office automation and general computing space in hospitals but weak in the healthcare-specific vertical and clinical areas. One of the areas that Microsoft’s always been strong is supporting the development community and they’re starting to make some good progress in health IT (specifically health not the just IT part). I’m a Microsoft Solutions Architect MVP and believe me they know how to take care of developers.

Microsoft recently released their Common User Interface (CUI) documents which provides developers, users, and UI specialists with healthcare-specific guidance.

I’ve gone through many of the documents and for people that have been in the business for a while (or like me who have actually built about dozen healthcare systems) much of the information is obvious. However, if you’re new to healthcare IT and design, I definitely recommend taking a look. Even if you already know the material, it’s great to base new development on something like this so that your engineers and UI specialists don’t reinvent the wheel. All development teams need guidelines like these and if you lead a team creating healthcare software you owe it to yourself to take a look and use the guidelines directly or adapt them to your liking.

In addition to the guidelines there are also .NET (ASP.NET and desktop) controls that put into practice much of the guidance. Just be careful that once you start using the controls you may no longer be platform-independent. Before jumping straight into the code, try to adapt the documents and build your own UI standards around it and then see if the controls make sense to use.

Here are the common user interface guidance areas they’ve implemented so far:

  • Accessibility

    • Accessibility Principles
    • Accessibility Checklist
  • Information Display

    • Address Information Display
    • Date Display
    • Gender/Sex Display
    • Patient ID Number Display
    • Telephone Number Display
    • Time Display
  • Information Input

    • Date Input
    • Time Input
  • Terminology

    • Terminology Matching
    • Terminology Elaboration
    • Terminology Display Standards
  • Medications Management

    • Medications Views
    • Drug Administration
  • Patient Administration

    • Find a Patient
    • Patient Identification
Filed under: — @ 2007-08-08 00:00:00
2007-08-08 00:00:00

Health IT Blogs Visualized

Ryan Byrd over at healthTech.accordingtome.com has a great picture of the HIT blogosphere.

HIT Blogsphere Visualized

Here’s how he described what he did:

What does the healthcare blogosphere look like? That is, how are all the healthcare IT blogs interconnected?

I wrote a quick program that extracted the blogs listed there and for each of them, I spidered the first page for links and checked to see if those links linked back to the original 50. Then my program created a network graph that displayed the connections while scaling the size of each site???s node proportional to the number of other sites linking to it.

Looks like a great picture, Ryan. Nice job.

Filed under: — @ 2007-08-08 00:00:00
2007-08-08 00:00:00

Microsoft Health Common User Interface (CUI) Guidance and Controls

Microsoft’s been tying to make some major inroads into healthcare IT (some impressive, others that are a little “me too”). They are strong in the office automation and general computing space in hospitals but weak in the healthcare-specific vertical and clinical areas. One of the areas that Microsoft’s always been strong is supporting the development community and they’re starting to make some good progress in health IT (specifically health not the just IT part). I’m a Microsoft Solutions Architect MVP and believe me they know how to take care of developers.

Microsoft recently released their Common User Interface (CUI) documents which provides developers, users, and UI specialists with healthcare-specific guidance.

I’ve gone through many of the documents and for people that have been in the business for a while (or like me who have actually built about dozen healthcare systems) much of the information is obvious. However, if you’re new to healthcare IT and design, I definitely recommend taking a look. Even if you already know the material, it’s great to base new development on something like this so that your engineers and UI specialists don’t reinvent the wheel. All development teams need guidelines like these and if you lead a team creating healthcare software you owe it to yourself to take a look and use the guidelines directly or adapt them to your liking.

In addition to the guidelines there are also .NET (ASP.NET and desktop) controls that put into practice much of the guidance. Just be careful that once you start using the controls you may no longer be platform-independent. Before jumping straight into the code, try to adapt the documents and build your own UI standards around it and then see if the controls make sense to use.

Here are the common user interface guidance areas they’ve implemented so far:

  • Accessibility

    • Accessibility Principles
    • Accessibility Checklist
  • Information Display

    • Address Information Display
    • Date Display
    • Gender/Sex Display
    • Patient ID Number Display
    • Telephone Number Display
    • Time Display
  • Information Input

    • Date Input
    • Time Input
  • Terminology

    • Terminology Matching
    • Terminology Elaboration
    • Terminology Display Standards
  • Medications Management

    • Medications Views
    • Drug Administration
  • Patient Administration

    • Find a Patient
    • Patient Identification
Filed under: — @ 2007-08-08 00:00:00
2007-08-06 00:00:00

Maximizing the Minute

This is the third installment of the four part series from Sean Coster, running coach.

Maximizing the Minute

For runners, minutes come and minutes go. Some feel like hours and others like seconds???reflecting our state of body and mind at that moment in time. Little real benefit is typically attached to any ONE minute of running. When it comes to nurturing racing fitness for the 10K through the half marathon distance, you need to make your minutes count.

Fast one minute runs with a brief, 60-second recovery will turn your strength and endurance into personal bests. The key to these weekly workouts is waiting to invite them into your training regime until a proper foundation of base work and stamina training has been completed (see ???Foundations of Base Training??? and ???Making the Transition??? for details). From this point in training, these 60 second romps will be savored for the speed currency you are earning with each bout. The runs must be no faster than your current 800m to 1600m race pace. Therefore, the most common mistake in this workout is beginning the session by running the first rep too quickly. Adhering to the painfully brief 60 seconds of standing rest between each repetition is the cornerstone to developing the speed-endurance that you will gain from this workout. The repetitions can be continued until a subsequent repetition deviates from the first by more than 2-3 seconds. Beginners will be pleased with the fitness gains that four of these reps can produce, while experienced racers over distances from 5K to the half marathon will likely be able to build up to 8-10 reps in a period of 4 weeks.

The body responds favorably in many ways to this workout. The heart develops a greater efficiency at delivering large volumes of oxygen-rich blood to hypoxic muscles. The 60-second bouts also provide you with improved running economy by requiring less energy to move the body in the running motion over the slower speeds. You???ll also develop an ability to find a use for the misunderstood energetic commodity of lactic acid with these peppy moments of running.

With the spring racing season looming for many with 10K???s, 15K???s and half marathons, anxiety can creep in over how to translate the strength of winter training into racing fitness at these distances. As the saying goes, ???Reputations are created every day and every minute??? so develop the reputation of a runner who challenges himself to continually improve by making the most of your 60 seconds.

Long may you run, Sean Coster

Sean Coster is the founder of Complete Running Programs, a custom running coaching service. To learn more about Sean???s coaching services, visit www.completerunningprograms.com .

Filed under: — @ 2007-08-06 00:00:00
2007-08-01 00:00:00

Muscle Pain Following Whiplash Injuries.

One of the most common symptoms experienced after a motor vehicle accident, is head and neck pain especially when the occupant is struck from behind. Neck injuries associated with auto accidents have been studied for many years, recently a new study published in the prestigious medical journal Spine, was released that helped to explain the cause of this pain.

The impact experienced by an occupant in an auto accident produces a large amount of force over a very short period of time, lasting only milliseconds. A new research study explains that it is may be the short time frame that may play a larger role in neck injuries than once thought. When an occupant is struck from behind, the force travels from the back of the car through the occupant finally exiting through the front. In order to protect the body, the body muscles of the neck contract to prevent injury. The muscles have been shown to fire at 100 milliseconds post impact which is 25 milliseconds after the majority of damage has occurred to the ligaments in the neck. (1)
The conclusion of the study: The muscles of the neck fire to late in a rear end collision to prevent injury to the spine and ligaments.
Ligaments heal very slowly because they lack the blood supply that muscles have. Ligaments in the neck also do not get the rest needed due to the demands on the neck at we go about our daily activities. The muscles of the neck are required to support a greater portion of the weight of the head and therefore become tired and sore while supporting this weight.
When structures of the neck are injured, the once healthy tissue is replaced with scar tissue. This new tissue is not nearly as strong or flexible as its predecessor. Encouraging proper healing of these tissues requires maintaining the mobility through spinal manipulation and stretching. Once the injured areas become less painful, it is imperative to strengthen the supporting muscles that have been injured. These muscles will be responsible for supporting the neck and preventing exacerbations or flare ups.
Injuries in the neck can also produce symptoms of pain in areas other than the location of the injury, this is called referred pain. For example and injury that occurs in the neck from a motor vehicle collision can present at pain in the shoulder blade. Referral pain patterns have been mapped out in the neck by injecting a stimulus to a specific area in the spine with a stimulating agent and the patient is asked to identify any symptoms they are experiencing outside of the location of the injection.
1. Vasavada AN, Brault JR, Siegmund GP. Musculotendon and fascicle strains in anterior and posterior neck muscles during whiplash injury. Spine 2007;32(7):756-765.

Filed under: — @ 2007-08-01 00:00:00