Franklin, TN-based MedSolutions Inc. is being criticized for making it difficult for people to get high-tech imaging tests by deciding they aren't medically necessary. BlueCross BlueShield of Delaware, one of MedSolutions' clients, was found to have violated state law in its home state by giving the third-party contractor financial incentives to deny doctors' requests for certain heart tests. Also, a study released on Monday by the U.S. Senate's Commerce Committee raised concerns about patients being denied critical heart disease tests, including one that helps doctors diagnose coronary artery disease. "Too many Americans who need lifesaving tests don't get them," said U.S. Sen. John D. "Jay" Rockerfeller IV, the West Virginia Democrat who chairs the commerce committee. "This practice is putting profits over people ? and putting lives at risk." Greg Allen, MedSolutions' CMO, however, said that the company stands by its criteria for evaluating requests.
Over the last few years, a small slice of medicine has moved out of the doctor's office and into clinics at CVS, Walmart, or other retail outlets. QuickCheck Health, a startup based in Excelsior, MN, aims to push this trend further by bringing more diagnostic testing to the home. The company is developing tests for urinary tract infections, strep throat, and other ailments that will be sold at drugstores for consumers to use at home. While consumer diagnostic tests are already in use for pregnancy, ovulation, fertility, HIV, and other conditions, treatment or follow-up care requires a visit to the doctor. At-home tests for other conditions, such as urinary tract infections, are available, but most doctors are reluctant to prescribe antibiotics or other medication without validating the results. QuickCheck Health plans to change that by requiring patients to log on to a website or call to learn the results of the test. If the test is positive, the user will be directed to an online healthcare provider, who can prescribe treatment.
After a heart attack, waiting at least 2 months before an elective surgery is linked to a lower risk of dying or having a second heart attack, a new study of Californians says. Patients who've had a heart attack should wait at least 8 weeks before surgery, said Christian de Virgilio, MD, professor of surgery at the UCLA School of Medicine. However, doctors "have to balance risk of heart attack versus the risk of delaying surgery," said de Virgilio, who co-authored the study published in the Annals of Surgery. In an analysis of outcomes for more than half a million people in a California hospital database, 16 out of 50 who had surgery less than a month after a heart attack had a second heart attack within 30 days, compared to 4 in 50 that waited at least 2 months.
An aggressive four-year effort to reduce the spread of deadly bacterial infections at veterans' hospitals is showing impressive results and may have broad implications at medical centers across the country, according to the first comprehensive assessment of the program, which was released Wednesday afternoon. The study of 153 Veterans Affairs hospitals nationwide found a 62% drop in the rate of infections caused by methicillin-resistant Staphylococcus aureus, or MRSA, in intensive care units over a 32-month period. There was a 45% drop in MRSA prevalence in other hospital wards, like surgical and rehabilitation units.
A shortage of a key leukemia drug that started last year has worsened, causing many major cancer centers such as the Johns Hopkins Hospital to start rationing the drug and others to turn away patients from community hospitals that have run out of the medication. The three companies that make the drug, called cytarabine, have all suffered production difficulties in the past year. Only one of them, Hospira Inc., is currently shipping the drug, but only in limited quantities that are not nearly enough to meet demand. A shortage in 2010 of the active ingredient used to make cytarabine slowed production at Hospira. "I really think what's happening is a national tragedy," said Hagop Kantarjian, MD, chairman of the leukemia department at the University of Texas M.D. Anderson Cancer Center in Houston, one of the world's leading cancer-treatment facilities.
For decades, heart and lung transplant surgeons have followed a strict directive: Get the donor organ into the recipient as soon as possible. That practice may be changing. In a study published Wednesday in the New England Journal of Medicine, researchers said both the number of donor lungs and successful transplants may be dramatically increased by treating the organs on a perfusion machine for several hours before transplantation. The technique marks a paradigm shift in the transplantation field, experts said. About 85% of lungs made available for donation are not used because of tissue damage that potentially could be repaired with perfusion or other techniques.