Companies that buy up critical drugs in short supply and resell them to hospitals and pharmacies at a markup of as much as 80 times their price are under investigation by a U.S. lawmaker challenging the practice. While so-called gray-market resellers can offer life-saving drugs that are in low supply, they charge the typical contract price sevenfold on average, with some surgical and other medically critical treatments increasing 20-fold, according to a survey by the Premier Healthcare Alliance. Representative Elijah Cummings, a Maryland Democrat, launched the investigation as the U.S. faces record drug shortages. The scarcity is causing some hospitals to change medical practices and in some cases, use less-effective medicines, doctors and pharmacists say. Cummings said he found that one reseller charged a hospital 80 times the typical price for cytarabine, a pediatric cancer drug.
Immunizations, emergency preparations for hurricanes, and restaurant inspections are among local public-health services being cut back or eliminated amid budget constraints. Some 55% of the nation's county and city health departments reduced or eliminated at least one program between July 2010 and June 2011, and the public-health workforce continued to shrink, according to a new survey by the National Association of County and City Health Officials. The cuts hit maternal and child health services (at 21% of the departments reporting cuts), personal health services (20%), emergency preparedness (20%), chronic disease screenings (17%), and food safety (11%), among other programs. Health departments lost 5,400 jobs in the first half of this year, after losing 6,000 in all of 2010. There are currently about 120,600 local health department employees across the country after those cutbacks.
Why would a hospital screen every patient who visits the emergency room for domestic violence? If the patient doesn't have bruises or broken bones, doesn't the nurse and/or doctor who brings up domestic abuse run the risk of offending the person? Yes. But, Registered Nurse Karen Geffon doesn't care if she offends. It's her job to ask … and it might save a life. Experts who train volunteers and professionals who deal with domestic violence will tell you abuse doesn't discriminate. No amount of money, education, religion, medicine or security can guarantee protection from the effects of domestic violence. It literally happens everywhere and in one form or another, we all end up paying for the short and long term effects. It is everyone's business. That's why staff at OSF St. Joseph Medical Center in Bloomington aren't afraid to ask, "Do you feel safe at home?"
The California Department of Public Health has dismissed findings against Prime Healthcare Services over its documentation of bloodstream infections, saying the department lacked evidence to cite hospitals over incomplete or inaccurate medical records. But in a six-page analysis of the decision to rescind the findings, the department said it had not ruled out possible fraud as an explanation for high rates of septicemia. Kathleen Billingsley, deputy director of the Department of Public Health, said findings of the February septicemia inspections and just-completed malnutrition reports have been forwarded to Medi-Cal auditors and the federal Health and Human Services Department's Office of Inspector General. "It's their responsibility to look at billing issues," Billingsley said in an interview. "That is specifically what they do." Prime Healthcare, a 14-hospital chain based in Ontario, CA, declared the decision a victory.
Managing information in the 21st Century and whether to code or not to code was the keynote address presented Oct. 4 at the American Health Information Management Association conference by T. Bedirhan Ustun, MD, PhD, team coordinator of classification, terminology and standards in the Department of Health statistics at the World Health Organization. During his keynote address, Ustun noted that as he had visited a number of vendors on the exhibit hall floor on Monday afternoon, he was hesitant to speak. "Procrastinating over ICD-10 is not a good thing. It is more wrong to not make the transition," he said. "Healthcare is a very high information-intensive sector and integration is needed. Healthcare information is of vital importance for its patient safety, quality and efficiency." Health information systems and standards need to be built jointly.
IBM's Watson easily dispatched two teams of Cleveland Clinic cardiologists during a demonstration modeled on the game of "Jeopardy!" Tuesday afternoon as part of the Clinic's 2011 Medical Innovation Summit held at the InterContinental Hotel. The fun half-hour was designed to showcase a new kind of computing power that goes beyond what any spreadsheet or Google search can do. Watson processes natural language, in this case English, not just data points. That way it can churn through far more information, slice it in all kinds of ways, and stay up all night doing it. The Cleveland Clinic has computer decision support now, but it's limited to things like drug interaction alerts, said Dr. William Morris, a clinic doctor who participated in a panel discussion after the Jeopardy! game. One of the potential applications of Watson could be dealing with information overload, he said, a problem that's increasing exponentially. Dr. Doug Johnston, a heart surgeon on the panel, said Watson could one day provide expert opinions to rural doctors who may not have knowledge of the latest developments in their field.