Of all the indignities that befall us at the doctor's office or in a hospital, the interminable wait is probably the most universal. It costs you time, money, agony. And guess what? It costs the hospital time and money, too. You'd think a solution to this constant and unsustainable economic problem would have revealed itself long ago. But the wait may be over -- based on lessons learned from a car manufacturer.
While patients and doctors often worry about medical records being hacked by cybercriminals and Internet snoops, the most common cause of health data breaches is physical theft of computing gear, according to reports by the U.S. Dept of Health and Human Services. Under the HITECH Act, HHS is required to post a list of incidents involving breaches and unsecured protected health information affecting 500 or more people. The HHS listing of the incidents reveals the top causes of breaches to be theft, not hacking of data. Of the 288 HIPAA breaches listed on the HHS site, physical theft is at the root of more than 49% of the violations, according to analysis by software research and consulting firm, Software Advisor. Meanwhile, human error and careless or accidental physical losses -- such as losing a laptop with patient data -- accounted for 14% of the incidents; unauthorized access and disclosure was involved in 16% of the casesp; and improper disposal was the root of 5% of the incidents.
It's impossible for the public to know when regulators first discovered Bacillus cereus at H&P Industry's plant because the FDA heavily redacted details from a decade's worth of inspection reports provided to the Journal Sentinel under the Freedom of Information Act. Records do show inspectors found the bacterium - which was the basis for the January recall of the alcohol wipes - during their weeks-long inspection starting Nov. 29. That was revealed only after the newspaper challenged the redaction. The newspaper's review shows H&P had serious problems including trouble with cleanliness - and that FDA inspectors knew it - as far back as 2000. Medikmark Inc., an Illinois company that sold medical kits that included Triad products, alleges Triad was aware of sterility issues as early as 2002 and continuing until the recent product recalls. "The products Medikmark purchased from Triad were unreasonably and inherently dangerous," according to a lawsuit Medikmark filed this year after the nationwide recall of antiseptic wipes. Triad has strongly denied the allegations, saying its products met FDA requirements.
Oregon and Illinois are two states that will launch their initial health information exchange core services in early 2012. Both states will shortly publish contractor proposals to help them develop the systems and databases they will need to support their health information exchanges. For Oregon, a vendor will set up a provider directory at the individual and entity level, which will also include a certificate authority, and a statewide health information service provider to offer Direct Project addresses to any state provider or consumer for free, said Carol Robinson, state coordinator for health IT, Oregon Health Authority. Oregon will onramp its exchange participants with messaging services using Direct protocols, which are secure email designed for simple exchanges between providers or between a provider and a patient. In Illinois, state officials anticipate putting its initial services in production in April 2012. These core HIE services will include a master patient index, which will be comprised of multiple repositories in the state starting with the Medicaid database, said Ivan Handler, CTO of the Illinois Office of Health IT.
Primary-care doctors take care of the young, the old and the in-between; the sick, the well and the dying. Ideally, they're familiar with us and our family history, have a comprehensive overview of our various ailments and medicines and provide us continuity in the world of fragmented medical specialties. But their trade, they say, is getting trickier and more time-consuming, and that's fast making them an endangered species. Patients, they say, want more from their doctor these days -- more office hours, more email and phone contact, more follow-up, more coordination with specialists and insurers, more discussion about options and more expertise on more topics (aided and abetted by that constant TV-ad refrain, "Ask your doctor if X is right for you"). And the healthcare system expects more of doctors too -- more preventive services, more care for chronic diseases, more healthful lifestyle coaching, more screening for depression and risky behavior (guns? cigarettes? bike helmets?), more delicate discussions (prostate biopsy? end-of-life wishes?), more documentation and now electronic records too.
A 60-year-old Army veteran won a $925,000 settlement with the Department of Veterans Affairs after he was blinded in one eye during a routine outpatient cataract operation, his attorney said Monday. Jose Goncalves of Hartford was blinded in his right eye when a third-year resident at the Veterans Affairs medical center in West Haven incorrectly administered an anesthetic during the procedure in 2007, attorney Christopher Bernard said. The resident injected too much anesthetic, causing Goncalves' eyeball to explode, Bernard explained. "Jose suffered excruciating pain after that botched surgery and continued to have severe pain for months afterward," Bernard said. "The damage to the eye is obvious because his iris is missing and his eyelid droops. If anything should ever happen to the undamaged left eye, he could face total blindness." The U.S. attorney's office, which represented the VA, declined to comment. The resident, Dr. Yue Michelle Wang, also declined to comment. She wasn't sued because doctors who work for the federal government have immunity, Bernard said. Wang incorrectly placed a needle with a local anesthetic directly into Goncalves' eye instead of behind his eye, Bernard said.