Friday, June 29, 2012

Docs adopt and adapt, yet still cling to old ways

ATLANTA – The technology takeover has begun, and physicians nationwide are acclimating one step at a time, a new physician survey reveals. Laptop, smartphone and iPad usage is increasingly common among U.S. physicians, but the report finds old-fashioned methods of communication continuing to stand their ground.

The second annual National Physicians Survey, conducted by the little blue book and Sharecare, polled 1,190 U.S. practitioners representing more than 75 medical specialties. It reveals physicians' perceptions about the ongoing changes in the healthcare system and how those changes are impacting their daily practices as well as their ability to provide optimal patient care. 

Two out of three physicians (66 percent) say the integration of electronic medical records (EMRs) is among their practice challenges. Despite that, most doctors (66 percent) acknowledge EMRs will at least improve or have a neutral effect on their future business.

Almost one out of three doctors (30 percent) are using laptops regularly for e-prescribing, EMRs and more. Almost a quarter (20 percent) are using smartphones, and 12 percent use iPads, for clinical needs.

Additional survey highlights:

Peer-to-peer communication is occurring via email – despite not being a "secure channel."Thirty-four percent of physicians communicate with other clinicians via email – not defined as a "secure channel" by HIPAA.Telephone (95 percent) and fax (63 percent) are still the primary forms of communication.A dinosaur in most other office environments today, the fax is still king with physicians, supporting hand-written notes, insurance forms and lab test result transmissions.Fifty-eight percent of doctors communicate with peers in person.Five percent use social networking sitesDoctor-to-patient communication remains fairly traditional, with some online inroads.The majority of physicians (91 percent) talk with patients via phone, 84 percent in person, 20 percent via email, 8 percent via personal health records (PHRs) and 6 percent via text.Few physicians are opting for solo practices these days -- a good portion are "employed" by hospitals, large practices or accountable care organizations (ACOs).Twenty-two percent of physicians are in ACO talks, up from 12 percent last yearOf those who said they were aware of ACOs, 37 percent stated that they would participate as a member of a group practice, 27 percent as a member of a physician-hospital organization, 10 percent as a hospital-employed physician.Only 17 percent of the respondents were unfamiliar with the ACO term, down from 45 percent last year.

Doctors say new patients find them via:

Word of mouth (71 percent)Practice networks referrals (33 percent)Print directories (29 percent)Internet searches (22 percent)

Despite an onslaught of healthcare regulations and requirements and shrinking practice margins, physicians are finding some advocates.

Forty-one percent say their state medical organization/society advocates for them. Thirty-nine percent say their national medical organization/society does.But 40 percent report "no one."

Still, overwhelmingly burdened by obtaining reimbursements from insurers (81 percent) and patient approvals (77 percent), most doctors (71 percent) believe the quality of healthcare will deteriorate over the next five years.

Fifty-five percent fear they aren't spending adequate time with each patient.Thirty-eight percent are concerned they aren't seeing enough patients in a day.

"Physicians today are practicing in a healthcare environment that they never could have predicted much less prepared for," said Keith Steward, MD, senior vice president of medical affairs at Sharecare. "This year's National Physicians Survey provides valuable insight into the frustrations and opportunities of the day-to-day management of practices, administration tools doctors use, and how communication with both colleagues and patients is evolving.

"Arming doctors with innovative solutions to ease administrative burdens is a top priority for the healthcare industry," he adds. "Doctors need to get back to what they were trained to do – provide their patients with the best care possible."

[See also: Docs believe EHRs safer than paper, but patients still ambivalent.]

Thursday, June 28, 2012

Woman battling flesh-eating bacteria upgraded to 'good' condition

AUGUSTA, Ga. -- The medical condition of the Georgia woman suffering from a flesh-eating bacteria has been upgraded to "good," Aimee Copeland's doctors announced Monday.

The upgrade means that the University of West Georgia graduate student's vital signs are stable, that she is conscious and comfortable, and that her indicators are excellent, said Barclay Bishop, media relations manager for Doctors Hospital in Augusta, Ga.

The upgrade is another victory for Copeland, 24, who has been hospitalized since May 1, battling kidney failure and other organ damage after she began exhibiting symptoms related to the necrotizing fasciitis, or flesh-eating bacteria. She contracted the bacteria through a gash in her leg while riding on a homemade zipline over the Lower Tallapoosa River.

Copeland lost her hands, left leg and right foot to the disease. She was upgraded from "serious" to "good" condition less than two weeks after being upgraded from "critical" to "serious."

Copeland's recovery has attracted nationwide attention.

Andy Copeland, Aimee's father, told WXIA-TV on Monday that his family is encouraged by the many milestones his daughter has recently achieved. He said that Aimee even went outside in her wheelchair for the first time over the weekend.

In Aimee Copeland's case, the necrotizing fasciitis was caused by bacteria known as Aeromonas hydrophila, found in warm rivers and streams. Many people exposed to the bacteria don't get sick. Only a handful of necrotizing fasciitis infections caused from that strain of bacteria have been reported in medical journals in recent decades.

Flesh-eating bacteria emit toxins that destroy muscle, fat and skin tissue. The federal Centers for Disease Control and Prevention estimates that 550 to 1,000 cases of necrotizing fasciitis occur each year. About 1 in 4 patients dies.

In this week’s Health Wonk Review:

The June 22 edition of Health Wonk Review is posted now at Managed Care Matters, and�features columns from healthinsurance.org bloggers Maggie Mahar, Harold Pollack, and Henry J. Aaron.

They discuss the pending Supreme Court decision on the constitutionality of the Affordable Care Act and its individual mandate, the 2012 elections and what both will mean to the health reform law.

Health Wonk Review is a biweekly compendium of the best of the health policy blogs. More than two dozen health policy, infrastructure, insurance, technology, and managed care bloggers participate by contributing their best recent blog postings to a roving digest, with each issue hosted at a different participant's blog.

Wednesday, June 27, 2012

In this week’s Health Wonk Review:

The June 22 edition of Health Wonk Review is posted now at Managed Care Matters, and�features columns from healthinsurance.org bloggers Maggie Mahar, Harold Pollack, and Henry J. Aaron.

They discuss the pending Supreme Court decision on the constitutionality of the Affordable Care Act and its individual mandate, the 2012 elections and what both will mean to the health reform law.

Health Wonk Review is a biweekly compendium of the best of the health policy blogs. More than two dozen health policy, infrastructure, insurance, technology, and managed care bloggers participate by contributing their best recent blog postings to a roving digest, with each issue hosted at a different participant's blog.

Tuesday, June 26, 2012

Mayo Clinic partners with Benefitfocus on health and wellness

ROCHESTER, MN – Mayo Clinic announced Monday that its products and services would be made available through HR InTouch, a benefit management and employee communication portal developed by Charleston, S.C.-based Benefitfocus.

Through this alliance, Mayo Clinic and Benefitfocus will help employers create a more informed and healthy workforce by providing access to more than 3,500 content pieces and articles, newsletters and a 24/7 nurse line staffed by registered nurses, officials say.

In addition, employers can access the Mayo Clinic EmbodyHealth portal, an online tool combining smart Web technology with proven behavior change methods to improve lifestyle habits and reduce health risks for employees.

Officials say these new offerings will allow employers to manage the entire benefits lifecycle in one place, and provide employees seamless access to quality health information and tools.

"Our patients have told us they want a more convenient way to access Mayo Clinic care and expertise," said Paul Limburg, MD, medical director of Mayo Clinic Global Business Solutions. "As a result of this relationship with Benefitfocus, we will be able to reach out in a new way and potentially help many more people who could benefit from Mayo Clinic expertise in the medical and behavioral sciences."

"The demand for employee health and wellness programs continues to skyrocket as employers search for the most effective employee engagement tools," said Shawn Jenkins, Benefitfocus president and CEO. "Wellness programs that are designed and implemented properly can have a strong impact on controlling an organization's healthcare costs and improving employee health. The relationship with Mayo Clinic gives our clients the expert resources and proven methods needed to engage employees, promote healthy lifestyle choices and support long-term behavior change."

Saturday, June 23, 2012

Consumer Assistance Programs: Making Sure Health Insurance Works for You

Recently, a woman in Maine was facing $34,000 in hospital bills for costs related to a mastectomy and reconstructive surgery that her insurance company was refusing to pay.� Thankfully, Maine�s Consumer Assistance Program identified a law that required the insurance company to pay part of those costs, and they helped her file an appeal that led to the insurance company covering an additional $24,000 of her medical expenses.

Health insurance problems are difficult enough to sort through in the midst of our busy lives, but they can be overwhelming when we or our loved ones are sick.

That�s why the Affordable Care Act includes resources to help states strengthen existing Consumer Assistance Programs or start new ones.� In this case, Maine used grant funds to increase its ability to file appeals on behalf of consumers and to educate consumers about the appeals process.

Today we�re releasing a report that shows the remarkable assistance that Consumer Assistance Programs have given to consumers over a one-year period.

From October 2010 to October 2011, Consumer Assistance Programs funded by grants authorized under the Affordable Care Act:

provided direct assistance to over 200,000 consumershelped overturn insurance company decisions in favor of more than 22,000 consumersobtained more than $18 million in direct savings on behalf of consumers and millions more due to more choices and better benefitsprovided valuable outreach and education to hundreds of thousands more

Put simply � these programs work.

That�s why we�re also announcing today that we�re providing nearly $30 million in grants to existing or new Consumer Assistance Programs.

We want to make sure that these programs have the resources to continue the critical work they do. It�s work that literally saves lives. Beth, a mother in Massachusetts, found this out first hand when her 20 year old son, Joe, was diagnosed with Stage 4 Hodgkin�s Lymphoma.

Joe faced a course of extensive and aggressive treatments � so much that he would have to take medical leave from college and go home to his mother in Massachusetts. But because he had to leave school, Joe was no longer eligible for his student health insurance.� Beth couldn�t afford the premiums if Joe joined her plan. Joe suddenly found himself uninsured and in need of thousands of dollars� worth of treatment�treatment that Beth couldn�t afford to pay out of pocket.

Fortunately, Beth called the Massachusetts Consumer Assistance Program. �Its staff worked with Beth and Joe to find affordable health insurance that met their needs, and helped Joe to enroll.

Beth says that, thanks to this program, Joe was able to receive treatment, and he�s responding well.

If you need help with a health insurance problem or have a question about your coverage or benefits, you can find out where to go in your state for help. Our interactive�Consumer Assistance Program Map, on HealthCare.gov, will show you where you can find the help you need. �For consumers in states that didn�t apply for Consumer Assistance Program grants, the map offers links to a variety of agencies and public programs that may also be able to offer assistance.

We can always use a helping hand in understanding our rights and protections as we find the best health coverage for ourselves, and for our families. �Thanks to the Consumer Assistance Program, that help is just a phone call away.

Friday, June 22, 2012

Technology at forefront of NHS treatment in Scotland

EDINBURGH – Online scanning to allow remote diagnosis for island patients and Scotland's biggest telehealth system are among a raft of hi-tech projects to help more patients be treated quicker and closer to home.

EHealth investment totalling £1.6million - including funding from the NHS's major IT partner - has been announced today by Scottish Health Secretary Nicola Sturgeon.

Speaking at the first annual Scottish Telehealth and Telecare conference, Sturgeon unveiled details of projects extending the use of electronic technology in the NHS, including:

 

Touch screens in the homes of hundreds of patients with chronic conditions in Lothian, allowing them to be monitored from home;

 

 

Online scanning allowing patients in Orkney to be diagnosed remotely, avoiding lengthy trips to hospital;

 

 

New software in Glasgow transmitting patients' records directly to consulting rooms.

 

"Telehealthcare technologies and eHealth have huge potential to benefit patients, by harnessing all that technology can offer to make care quicker, safer and closer to home. It also allows more efficient working and better support for our health and care staff," Sturgeon said.

"In eHealth, our joint investment in 16 pilot projects will help patients in hospital and at home. At the West of Scotland Heart and Lung Centre, for example, they're replacing cardiac databases with the latest systems to improve patient safety.

"Together with NHS Lothian, we're also rolling out Scotland's biggest telehome monitoring system. Four hundred people living with conditions like heart failure or chronic lung disease will have touch screens to monitor their vital signs from home, helping them avoid repeated hospital visits."

The overall eHealth funding announcements made by the Cabinet Secretary totalled £1.6million - £564,000 of which comes from the Atos Origin Alliance, an innovation fund from the NHS's main IT partner.

The Atos Origin Alliance comprises Atos Origin, BT, IBM and Sopra Group.

The roll-out of the £700,000 telehealth project for long term-condition patients is funded equally between the Scottish Government and NHS Lothian.

Thursday, June 21, 2012

Survey aims to 'amplify the conversation' on aging

There's no cure for growing old, but your attitude about what's important and how you feel about aging can depend in part on how old you are, a new survey finds.

The survey of 1,017 people over 18 finds, for instance, that 24% admit they have lied about their age. But of those 50-64, it's just 21%, and for those over 65, it's 18%.

The survey, out today, was commissioned by the drug company Pfizer in conjunction with about a dozen health advocacy organizations to help encourage dialogue about aging in America. In addition to the survey, the group plans to launch a website, GetOld.com, which invites users to share perspectives on aging.

Asked how they feel about getting old, the top choice was "optimistic" (39%). But not far behind was "uneasy" (36%). About 42% of those 50 to 64 are optimistic, the highest percentage of any age group.

Experts say findings are not surprising. Many adults spend more years in good health, says Nancy Perry Graham, editor in chief of AARP The Magazine.

People also enjoy more freedom as they age and stop having to prove themselves at work or in relationships, Graham says.

The survey also aimed to shed light on people's fears. Only 7% over 65 said their biggest fear was dying; 64% said they were most afraid of losing independence or living in pain.

More than half (51%) of those 18 to 65 would accept having a parent live with them, but just 25% over 65 would want to live with a younger relative if unable to care for themselves.

Freda Lewis-Hall, Pfizer's chief medical officer, says the company and partners did the survey to "shake things up."

"We think a good way to do that is to start by listening and then amplifying the conversation and learning how Americans are really tackling aging � and that's Americans of all ages."

The findings suggest that adults' priorities shift as they age: presented with a list of lifetime achievements, 45% of 18- to 34-year-olds most aspire to have $1 million, but 48% of those over 65 say they would rather see their grandchild graduate.

Linda Fried of the International Longevity Center at Columbia University says it's crucial that people deal with the realities of aging, not just the downsides. "We have such a human aversion to getting old; it's associated with death, and death is scary. But as a society, we have not had the conversations we need to have. There's huge opportunities there."

64%

over age 65 say their biggest fear is losing independence or living in pain

5 keys to evolving role of the CMIO

As strategic initiatives across IT continue to grow, many are looking to the CIO as a leader. But according to Pamela Dixon, managing partner at SSi-Search, another prominent position is evolving to aid the CIO in the development of new projects. 

"To assist in meeting these challenges, we see the chief medical information officer (CMIO) taking a seat next to the CIO in meeting Meaningful Use objectives – and possibly beyond," she said. "The CMIO's role is not new to healthcare but is rapidly gaining importance.  How the role will evolve is raising some questions for the C-suite."

Dixon helps outline five keys to the evolving role of the CMIO.

1. The role of the CMIO is "critically important." According to SSi-Search's recent study, about 95 percent of respondents felt the CMIO is "critical to the successful deployment of an EHR." Most respondents back up this statement, the survey concluded, with 90 percent of all respondents saying they have hired or plan to hire a CMIO in the near future. "However, the survey reveals C-Suite opinions differ on the reporting structure of the CMIO," said Dixon. "The respondents of the study, across all categories, were evenly divided. Looking specifically at CIOs and CMIOs, we see a conflict." More than half of the CIOs surveyed said the CMIO should report directly to them, she added, yet the other half of respondents believe the CMIO should report to the CMO of the CEO – not the CIO. "A few CIOs and CMIOs offered a doted line reporting structure," added Dixon.

2. Typically, the CMIO is a practicing physician with a strong understanding of IT. The CMIO is typically tasked with leading the strategic positioning, implementation, and support of clinical systems, said Dixon. "The CMIO must understand and translate physician needs while also translating the health system's business and clinical initiatives as well as constraints," she said. The CMIO needs to then communicate how the solutions, including CPOE and EMR, meet those needs, Dixon continued. "The CMIO is key to facilitating collaboration between IT and the clinical community and [is] considered highly strategic to achieving the clinical objectives of the health system."

3. The CMIO and CIO work best as a team. "The CMIO is involved in all facets of the clinical implementations and best practices," said Dixon. Typically, the CIO is focused on budget, IT infrastructure, including security and regulations. "Both CIO and CMIO understand and work together toward meeting the ARRA HITECH meaningful use requirements," she said. "The CMIO may report to the CIO with a dotted line to the CMO, or the reverse."

4. A core, clinical informatics-focused team is key. Dixon said a team focused on informatics will play a large part in defining and creating tools that can be successfully implemented and used in a meaningful way. "The purpose of this team is to help answer critically important questions during the design, content development, workflow, ease and speed of use as well as appropriateness of alerts for CPOE," she said. "The [team should] synthesize broad information, which medical staff advisors [should] review and will ultimately be broad-scale presented to all interested physicians in the health system."

5. Physician "champions" and clinical representatives can make all the difference. Achieving the core information Dixon mentioned above requires well-planned and regularly scheduled meetings with, what she calls, physician champions and clinical representatives in all key areas. "The [team] usually involves a range of disciplines: nurses, nurse informaticists, quality management, pharmacists, lab technicians, IT and others who see the value and can make the time commitment," she said. By working together, she concluded the CIO, CMIO, CMO, and the team should achieve consensus across the system, "through thoughtful communication that encourages involvement."

Wednesday, June 20, 2012

Dartmouth Board garners $26M innovation grant

With a $26 million government Health Care Innovation Award in hand, the Dartmouth Board of Trustees will  hire Patient Family Activators (PFAs), who will assume roles of patient advocate, assisting the patient with care choices and engaging them in a shared decision-making process.

The project will support and connect 15 High Value Healthcare Collaborative (HVHC) member healthcare systems throughout 16 states, and over the course of three years, will train 5,775 healthcare workers and create 48 new PFA positions.

A portion of the funding will also be used to improve patient data collection via health information technology, as William Weeks, MD, co-creator of the Dartmouth Institute for Health Policy and Clinical Practice, explained.

“Some funds will be used to both facilitate learning and deployment across the HVHC members as well as collecting data (through grant funded tablets that will be integrated into local EHRs), feeding back reports on results, and expanding current IT infrastructure to supplement current HVHC reporting abilities and better integrate such reporting into HVHC member IT systems.”

Health and Human Services (HHS) Secretary Kathleen Sebelius announced on June 15 the second round of recipients for the Health Care Innovation Awards, funded through the Affordable Care Act. The  Dartmouth Board of Trustees was among 81 groups nationwide that walked away with a win.

Three-year cost savings from the Dartmouth project are estimated to be more than $63.7 million, and Weeks explained the majority of savings would result from the overall reduction in Medicare costs of each patient.

Weeks said, “Savings are therefore derived from both improving the efficiency and reducing the costs of each episode of care and using patient shared decision making to help patients make informed decisions, decisions which – according to the literature – are more conservative and less costly than the care that their providers would recommend.”

He continued, “By engaging providers in improving the efficiency and safety of care processes, and by engaging patients in the decision-making process regarding their healthcare choices, we believe that we can reduce this variation and waste, reduce the unrestrained growth in healthcare costs, and concurrently improve patient satisfaction and health outcomes.”

The Dartmouth Board of Trustees-sponsored program was one of 107 total projects nationwide that garnered an Innovation Award out of more than 3,000 applicants nationwide.

The Centers for Medicare & Medicaid Services (CMS) created the Center for Medicare & Medicaid Innovation to improve the health of Medicaid, Medicare and CHIP patients - and by extension all Americans - while combating escalating costs. The $1 Billion Health Care Innovation - carries a triple aim: better health, better healthcare and reduced costs. The Innovation Challenge provides three-year grants of $1 million to $30 million to healthcare providers, payers, local government entities, and public-private partnerships, including collaborative efforts among multiple payers.
 

Tuesday, June 19, 2012

HHS names Sivak as CTO

WASHINGTON – The Department of Health and Human Services has named as its new chief technology officer Bryan Sivak, who has been the state of Maryland’s first chief innovation officer.

He takes the position left open in March when Todd Park became the White House CTO. HHS announced Sivak’s appointment via Twitter on June 14.

[See also: President Obama appoints Todd Park nation's CTO]

Sivak joined the administration of Maryland Gov. Martin O’Malley in April 2011, where he has worked to help create the state health insurance exchange, as well as a project to use social media to engage residents and an initiative to promote research transfer from several Maryland universities for commercial use.

Prior to that, he was CTO for the District of Columbia government under former Mayor Adrian Fenty.

Also on Twitter, Sivak said that it has been “an honor and a privilege to work for Governor O’Malley and the citizens of Maryland and super excited to continue the amazing work started by Todd Park and HHS.”

[See also: HHS launches $1B innovation initiative]

Sivak came to public service after having founded InQuira, a Silicon Valley knowledge management and self-service software company, which Oracle acquired.“Working in partnership with Chief Technology Officer of the United States Todd Park, Bryan will ensure that the Department’s innovation initiatives continue to move ahead at full speed," HHS Secretary Kathleen Sebelius said in a statement. "We will benefit tremendously from his creativity, experience, and fresh ideas as we continue our work to harness the power of data and technology to improve the health of the nation.”

AMGA, Press Ganey launch ACO tool

ALEXANDRIA, VA – The American Medical Group Association (AMGA) and Press Ganey Associates have  launched of a new survey tool designed to help accountable care organizations (ACOs) improve efficiency, quality and the patient's experience.  

The tool, called the AMGA-Press Ganey Coordinated Care Solution, assesses a patient’s entire episode of care and enables better management of population health to create positive patient outcomes and maximize shared savings.

 [See also: ACOs digging in to stay, experts say.]

The Coordinated Care Solution was built to fill critical information gaps identified by members of the AMGA ACO Collaborative and provides in-depth analysis unmatched by event-based surveys, according to AMGA officials. Those concepts not captured by event-based surveying include effective use of care team members, provider engagement, and the patient’s assessment of their own level of engagement, loyalty, and compliance.

“AMGA members are on the vanguard of delivering high-quality and high-value care," said Donald W. Fisher, president and chief executive officer of AMGA. "So we wanted to be at the forefront of developing an innovative survey to capture the critical component of patient engagement which is essential to successfully operate in an accountable care environment, especially under the various Medicare ACO programs.

 “With more than five million lives now covered by ACOs, the success of these organizations and other integrated delivery models is vital to fulfilling the Institute for Healthcare Improvement’s ‘triple aim’ and transitioning from a volume-based system to one that is value-based,” said Patrick T. Ryan, CEO of Press Ganey. “A key component of that success is having the right tools to help providers strive for seamless coordination of care by understanding the viewpoint and behaviors of the patient who is interacting with different providers."

One of the participants in the Coordinated Care Solution pilot is Geisinger Health System, an organization known for its advanced patient-centered medical home called ProvenHealth Navigator, a collaborative effort between Geisinger Clinic and Geisinger Health Plan (GHP), the not-for-profit health insurance component of the health system.

Tom Graf, MD, Geisinger’s associate chief medical officer said, taking a holistic approach to care meant changing the relationship with patients. "As a pioneer in coordinated care, we recognized the need for a more comprehensive tool to support this new relationship by collecting important information that was previously unavailable information on what our patients thought we were doing right and what we could improve as they moved from one type of provider to another during their treatment,” he said.

 

Monday, June 18, 2012

Consumer Assistance Programs: Making Sure Health Insurance Works for You

Recently, a woman in Maine was facing $34,000 in hospital bills for costs related to a mastectomy and reconstructive surgery that her insurance company was refusing to pay.� Thankfully, Maine�s Consumer Assistance Program identified a law that required the insurance company to pay part of those costs, and they helped her file an appeal that led to the insurance company covering an additional $24,000 of her medical expenses.

Health insurance problems are difficult enough to sort through in the midst of our busy lives, but they can be overwhelming when we or our loved ones are sick.

That�s why the Affordable Care Act includes resources to help states strengthen existing Consumer Assistance Programs or start new ones.� In this case, Maine used grant funds to increase its ability to file appeals on behalf of consumers and to educate consumers about the appeals process.

Today we�re releasing a report that shows the remarkable assistance that Consumer Assistance Programs have given to consumers over a one-year period.

From October 2010 to October 2011, Consumer Assistance Programs funded by grants authorized under the Affordable Care Act:

provided direct assistance to over 200,000 consumershelped overturn insurance company decisions in favor of more than 22,000 consumersobtained more than $18 million in direct savings on behalf of consumers and millions more due to more choices and better benefitsprovided valuable outreach and education to hundreds of thousands more

Put simply � these programs work.

That�s why we�re also announcing today that we�re providing nearly $30 million in grants to existing or new Consumer Assistance Programs.

We want to make sure that these programs have the resources to continue the critical work they do. It�s work that literally saves lives. Beth, a mother in Massachusetts, found this out first hand when her 20 year old son, Joe, was diagnosed with Stage 4 Hodgkin�s Lymphoma.

Joe faced a course of extensive and aggressive treatments � so much that he would have to take medical leave from college and go home to his mother in Massachusetts. But because he had to leave school, Joe was no longer eligible for his student health insurance.� Beth couldn�t afford the premiums if Joe joined her plan. Joe suddenly found himself uninsured and in need of thousands of dollars� worth of treatment�treatment that Beth couldn�t afford to pay out of pocket.

Fortunately, Beth called the Massachusetts Consumer Assistance Program. �Its staff worked with Beth and Joe to find affordable health insurance that met their needs, and helped Joe to enroll.

Beth says that, thanks to this program, Joe was able to receive treatment, and he�s responding well.

If you need help with a health insurance problem or have a question about your coverage or benefits, you can find out where to go in your state for help. Our interactive�Consumer Assistance Program Map, on HealthCare.gov, will show you where you can find the help you need. �For consumers in states that didn�t apply for Consumer Assistance Program grants, the map offers links to a variety of agencies and public programs that may also be able to offer assistance.

We can always use a helping hand in understanding our rights and protections as we find the best health coverage for ourselves, and for our families. �Thanks to the Consumer Assistance Program, that help is just a phone call away.

Military to employ IT to improve traumatic brain injury care

WASHINGTON – The Military Health System will spend $14.1 million to enhance the collection of traumatic brain injury and associated behavioral health information for military service members throughout the entire continuum of care.

The program is managed from MHS' Defense Health Information Management System program office in support of the Department of Defense and Department of Veterans Affairs overarching response to the President's Commission on Care for America's Returning Wounded Warriors.

The Military Health System tapped Vagent, Inc. to do the job. Vangent will develop a clinical information technology solution to improve the workflow of patients' behavioral health information and integrate with the military's electronic health record.

When deployed, the technology will make behavioral health patients' information more quickly available for diagnosis, treatment and ultimately positive clinical outcomes, officials said.

Vangent's subcontractors include Akimeka, LLC; Guident, Inc.; Enterprise Information Management, Inc.; Forgentum, Inc. and n-tieractive, Inc.

"The Traumatic Brain Injury and Behavioral Health Clinical Data Documentation solutions are imperative to providing clinicians a tool to improve the treatment of our Wounded Warriors," said Mac Curtis, president and CEO of Vangent, Inc. "With Vangent's broad experience in healthcare, we are leveraging our experience to rethink the technologies and solutions utilized by our front-line clinicians providing care to their patients."

The award represents a major win for Vangent, which has grown its portfolio of military health business to more than $140 million over the past year providing mission critical services and support for health initiatives within the Department of Defense.

Other major contracts include the common user database for the Force Health Protection & Readiness Program, e-commerce operational system support for the TRICARE Management Activity and executive information and decision support for the Military Health System.

Sunday, June 17, 2012

ONC looks to grow the power of health gaming

BOSTON – At Games for Health 2012 on Thursday – amid talk of virtual worlds, avatars, Kinect sensors, biomechanics, social media crowdsourcing and exergaming – a policymaker from the Office of the National Coordinator for Health IT said that gaming is "on the radar of the federal government."

Games for Health, currently in its eighth year, is a different kind of health IT conference. Many speakers kicked off their talks with a slide showing "what I'm playing" – games that ranged from old-school Nintendo titles to mobile apps such as Words with Friends to multiplayer online games to Xbox dancing and kickboxing simulations. 

"I play a new game every day – like, as a policy," said Peter Smith, who researches immersive learning technologies at Joint ADL Co-Lab in Orlando.

Erin Poetter, from the ONC's department of Consumer e-Health/Innovations, also spends a lot of time thinking about policy.

In her presentation, "Adding Play to Our Toolbox: HHS & Games," she explained how, at ONC, "we see games a part of a larger initiative."

With their "miraculous ability to take complex data and make it actionable and meaningful," games are the perfect tool to help ONC expand its focus to engage consumers, said Poetter.

With just 10 to 20 percent of health outcomes determined by what happens in the healthcare system, it's important to do whatever's possible to improve wellness outside of the doc office walls. "Better engagement in health can make a real difference," she said. "More activated patients achieve better results."

Any tools or technology that could spur that engagement can help. Like games. "It's time that healthcare catch up with the way we live the rest of our lives," said Poetter.

Gaming is big business, after all. Really big: a projected $79 billion in revenues in 2012.

With applications affecting everything from health and wellness to rehab and physical therapy, PTSD, stroke rehabilitation, autism and more, there's no reason games shouldn't have a big role to play in health.

That's why experts from heavy hitters such as Microsoft and United Health, Yale and UPenn – designers, developers, care providers and more, from as far afield as Glasgow, Vienna and Kyushu – convened in Boston this week.

Games offer a whole lot more value beyond mere entertainment, Poetter pointed out. They can motivate people to overcome challenges; enable them to visualize change and progress; improve self-efficacy through knowledge and goal sharing and facilitate patient/provider communication and interaction.

And they can do even more than that. At Games for Health, one session explored how Xbox's Kinect could be be used not just burn calories with its virtual tennis, but be applied to gauging biomechanics and assisting with telesurgery and helping with catatonic schizophrenia. There were talks titled "Prescribing Video Games (Not Medication) for ADHD" and "Evaluating the Ergogenic Impact of Music During Exergaming When Players Are Co-Located."

It all points to an exciting future. But FDA regulations are a wild card.

As attorney James M. Flaherty of Foley Hoag LLP, said in his talk, "Games, Medical Devices and the FDA: Now, Near and Next," all video games are potentially subject to regulation by the Food and Drug Administration. "Once you start making therapeutic claims" about a product, he said, you "turn it into a medical device, just like that."

And on the FDA front, there are "a lot of unknowns" when it comes to gaming. So far, there have been no approved or cleared games with medical claims, said Flaherty. "They're not dealing with it right now," he said, but it seems likely that when they do get around to thinking of it, they will be seen through the lens of mobile medical devices.

Games are terra incognita for the FDA, Flaherty warned. And when "FDA doesn't know a particular industry or product line, they will overregulate – that's their nature."

The best way for game developers to make sure their products have the best and fastest chance to positively affect health is to "have your voice heard now, early on," he said.

In the meantime, Poetter said ONC was looking for opportunities to help, and that it wanted to hear how best to do that. Facilitate connections between gaming and research communities? Set standards for health data interoperability with technologies such as EHRs? Develop agency expertise to evaluate health games? Coordinate gaming activities across government agencies?

"Gaming is certainly on the radar of the federal government," she said. "We're looking to socialize it more broadly."

Axial Exchange acquires Mayo Clinic mobile platform mRemedy

RALEIGH, NC – Axial Exchange Inc. announced Thursday that it has acquired mRemedy, a mobile healthcare platform founded by Mayo Clinic and Minneapolis-based DoApp.

Officials say the acquisition will give Axial Exchange the software, pipeline and customers of the myTality patient-facing mobile healthcare application, which helps patients navigate a future hospital visit, and helps hospitals better market their services. Axial will use the myTality suite as the patient-facing complement to its care transition products, Axial Patient and Axial Provider.

The deal also provides Axial Exchange with access to consumer content from MayoClinic.com. This content will be incorporated into Axial’s current patient-facing products, as well as in future Axial offerings. The health information licensed to Axial includes detailed information on nearly 1,000 conditions and diseases.

Canaan Partners, Axial’s lead venture capital investor, and Mayo Clinic both invested in Axial Exchange to complete the deal, officials say. In addition, four Mayo Clinic physicians will join Axial’s advisory board and bring their expertise to the ongoing development of Axial’s solutions. These include Paul Y. Takahashi, MD, Nathan Jacobson, DO and two others to be named.

“Patients and their families want and expect the most up-to-date information about life, health, disease and treatment,” said Takahashi, associate professor of medicine at Mayo Clinic, an expert in the field of geriatric and internal medicine. “Mayo Clinic’s health information content will now reach even more people, providing accurate answers to common and uncommon health issues.”
 
“This is a case where one plus one definitely equals three,” added Stephen Bloch, MD, general partner at Canaan Partners. “Integrating a patient’s personalized care plan into a hospital’s mobile portal was the logical next step to allow hospitals to offer end-to-end patient care. Having Mayo Clinic on the Axial Advisory Board will augment our philosophy of offering the gold standard in patient engagement.”

Axial’s solutions won first prize in the U.S. Department of Health and Human Services’ Partnership for Patients Initiative innovation competition, run by Office of the National Coordinator’s (ONC), on “Ensuring Safe Transitions From Hospital to Home.”

The myTality acquisition will accelerate the firm's move into mobile healthcare and will enable Axial to more quickly scale to large numbers of mobile patient-customers – while interconnecting patient’s care plans and discharge information, and providing added patient engagement in the goal of reducing readmissions, officials say.
 
Axial Provider provides an at-a-glance clinical dashboard to connect hospitals, physicians, and health plans – automatically updating and sharing details about ER and inpatient encounters, and specialist test results. Axial Patient then delivers relevant information to patients and caregivers on their tablets, laptop and mobile phones. This better facilitates a safe patient transfer and helps the entire healthcare system to better manage treatment.

She added that, with 20 percent of patients discharged from the hospital being readmitted within 30 days, "our nation has lots of room for improvement. We owe it to patients and the professional healthcare community to start harnessing technology that can help them.”

Saturday, June 16, 2012

Would single-payer healthcare be less vulnerable to the court than the ACA?

If the Supreme Court does decide to strike down any or all of the Affordable Health Care Act, the implications will range from the political to the medical to the economic.

For me, such a decision will take its place among the more supremely ironic of unintended consequences: a law designed to avoid greater government intrusion into health care will have been invalidated as an unconstitutional overreach of government power, while a far more intrusive approach would have clearly passed muster.

How could this be possible? Welcome to the wonderful world of constitutional interpretation.

Let�s begin by imagining that Congress and the president decided to adopt a genuinely radical health care plan�the kind in place in most of the industrialized world. They decide on a �single-payer� system, where the government raises revenue with taxes, and pays the doctor, hospital and lab bills for just about everyone.

Put aside the question of whether this is a good idea, or an economically sustainable notion. The question is: would such a law be constitutional?

The answer, unquestionably, is �yes.� In fact, it would be the simplest law in the world to enact. All the Congress would need to do is to take the Medicare law and strike out the words �over 65.� Why is it constitutional? For the same reason Medicare and Social Security are: the taxing power. Its reach is immense. During World War II, the maximum income tax rate was 91 per cent (it was paid by few, thanks to loopholes, but still). The same Congress that could abolish the estate tax could set just about whatever limit it chose; it could impose a 100 percent tax on estates over, say, $5 million. If it decided that a national sales tax was an answer to huge budget deficits, it could impose one at whatever level it chose.

(The remedy, of course, lies with the voters, who would be more than likely to send a powerful message at the next election, which is why the lack of constitutional limits on the taxing power do not lead to confiscatory rates.)

So why is Obama�s health care plan, with a far more modest use of government power, in serious jeopardy? It�s because the key element in the plan�the �mandate� to purchase health insurance or pay a penalty�was not based on the taxing power, but on Congress�s power, under Article I, Section 8, to regulate interstate commerce. And that power, while broad, has its limits…even if those limits are murky.

Up until the late 1930s, those limits were more like shackles. The Supreme Court repeatedly struck down sate and federal laws regulating wages, hours and working conditions on the grounds that the commerce power only touched the distribution of goods, not their manufacture. But once the court changed its mind�after an effort by FDR to �pack� the court with additional justices had failed�there seemed to be no limits at all. Back in 1942, the court said the government could stop a farmer from growing his own wheat for his own use, because of the potential effects on the wider market. But in 1995, for the first time in decades, the court said �no� to a federal law based on the Commerce clause�one banning firearms within school zones�because it could find no reasonable connection between the law and interstate commerce.

In the health care case, the questioning by several justices indicated strong skepticism about the mandate. If the commerce clause can compel a citizen to buy a specific product�in this case, health insurance�what couldn�t it do? Could it, as the now famous question had it, compel citizens to buy broccoli on health grounds? (Well, a defender might have pointed out, the government does compel taxpayers to �pay for� all kinds of things in the form of government subsidies, such as ethanol. It could clearly do the same with a broccoli subsidy.)

As a policy matter, it�s clear that a �mandate� is a much more modest extension of government power than a single-payer system. The citizen would choose which insurance to buy; in fact, under the law, a citizen could choose not to buy any insurance, and pay a penalty instead. The whole premise of a mandate is to spread risk as widely as possible; as Mitt Romney used to note when he was defending the Massachusetts plan he designed, the mandate to prevent �free riders� from benefitting from treatment once they are sick or injured. That�s why the genesis of the idea came from such conservative roots as the Heritage Foundation.

As a constitutional matter, however, the idea of compelling a citizen into a specific economic activity raises alarm bells. It evokes the specter of some bureaucrat inviting himself into your home, while checking the shelves to make sure you�ve purchased multigrain cereal and cage-free eggs. (It�s a specter the administration tried to avoid by arguing that the health-care market is unique, one in which we are all likely participants at some point, voluntarily or otherwise. Unlike life in a Robert Heinlien libertarian �utopia,� hospital ERs do not have the power to say to an uninsured heart attack or auto accident victim: “you chose not to buy insurance? Sorry…have a nice day.�)

So, for its effort to design a health care plan that moved in the direction of less government intrusion, the Obama administration faces the distinct prospect of having its signature domestic program shot down for exceeding the limits of the constitutional power it did choose to use.

I somehow doubt the White House will appreciate the irony.

Friday, June 15, 2012

Healthcare in the USA Pt. 2

Despite the fact the US continues to rank poorly in worldwide health care standards, John McCain like many, maintains that the United States health care is the best in the world.

The Real News Network spoke to Steven Lewis, health policy and research consultant from Canada, Dr. Don McCanne of Physicians for a National Health Program, and Dr. Steffie Woolhandler from the Harvard Medical School. Comparisons with other countries on costs and quality still leave the United States low in health care standards amongst rich industrialized nations.

Thursday, June 14, 2012

Obama and Daschle should opt for single-payer

Barack Obama needs to make good on his campaign pledge to reform health care. It is not enough to throw the issue off to former Senator Tom Daschle, Obama�s choice to head the Department of Health and Human Services.

Daschle says he wants to hear from us, the American people, on this issue. So we should oblige him.

Obama and Daschle have a choice: Rely on a private insurance-based plan that does little to mitigate the escalating health care crisis, or solve the problem once and for all and adopt universal, single-payer health care.

Many in Congress, the media, conservative think tanks and some advocacy groups � led by the Service Employees International Union and its business allies � are stumping for piecemeal changes.

Such a path would perpetuate the crisis and deal a cruel blow to the hopes of Americans for real reform. Those in Congress and liberal policy organizations who are embracing caution or promoting more insurance, not more care, are playing a risky game. It could jeopardize the health security of tens of millions of Americans and, in the process, fatally erode public support for the Obama administration.

Hardly a day passes without fresh signs of the health-care implosion.

Just days after the election, the New York Times reported a sharp increase in cost-shifting in employer-paid health plans, with more employers pushing high deductible plans that typically cost workers thousands of dollars in out-of-pocket payments.

Similarly, the Wall Street Journal reported a huge spike in health care premiums for small businesses, which prompted many to raise deductibles or cut coverage.

The consequences are chillingly apparent. In October, the Washington Post cited a study that found one-fourth of Americans are skipping doctors� visits, and 10 percent could not take their child to the doctor because of cost.

That same month, USA Today reported that one in eight patients with advanced cancer turn down recommended treatment because of the bills.

America is falling embarrassingly behind.

A study by the Commonwealth Fund in November compared adults with chronic conditions, such as high blood pressure, diabetes, or heart disease, in seven major industrialized countries. A stunning 54 percent of the American respondents said they were likely to go without recommended care, compared to just 7 percent of chronically ill patients in the Netherlands. Over 40 percent of the Americans spent more than $1,000 on medical bills, compared to just 4 percent of British and 5 percent of French patients.

If we adopted a universal, single-payer system like these European countries, or if we simply expanded Medicare to all Americans, we would rectify this problem.

The need is urgent. Today 46 million Americans are without health care.

Millions more are at risk of losing it during this recession. And huge numbers of Americans with insurance can�t afford the cost hikes.

At some point, our government must stop subsidizing these private companies and start investing in the American people.

The time to do so is now.

The best way to get it done is to guarantee all Americans health care in a single-payer system.

Tell Obama and Daschle to support improved Medicare for all.

Rose Ann DeMoro is executive director of the 85,000-member California Nurses Association/National Nurses Organizing Committee.

This article is from the Progressive.

New platform aims to make video easy for healthcare

SEATTLE, WA – Another cloud-based product made itself known to the healthcare industry on Wednesday. Experts say the platform will allow for efficient and affordable uploading, storing and distributing of videos on virtually any device. 

The product, dubbed mpx Essentials, was created by thePlatform, a video publishing company and independent subsidiary of Comcast. Previously focused on the entertainment industry, thePlatform is now extending its cloud-based product to the healthcare industry in hopes of procuring new success.

Tim Sale, director of technical sales and program leader of mpx Essentials, said he expects the product will take off, partly due to the increasingly ubiquitous nature of health information technology these days. 

“What we’re seeing is that healthcare providers are using video for a variety things, from virtual facility tours to patient education programs,” Sale said. “We think it will continue to expand,” because the product allows healthcare facilities to “provide a really high-end experience to their customers on any device – without requiring IT and without requiring a developer."

The product was created in response to the growing demand for cloud-based platforms, a technology catching like wildfire in the healthcare industry.

“More and more organizations are using video to communicate with their customers, employees and stakeholders, and their needs are rapidly evolving,” said Ian Blaine, CEO of thePlatform. 

Sale said he sees this product as a “business tool” for the healthcare industry without the need for web developers or IT professionals. “It’s not generally the focus of a healthcare service or provider to be in the business of managing video content or developing video players, so we think this product frees up resources to do other things and really simplifies how much time you spend on the service.”

Key features of mpx Essentials include: 

Ease of use: A Web-based console, with consistent blade-based navigation and customizable shortcuts; Increased video views: Mix and match play-lists with generated video lineups; Improve search and discoverability with metadata toolset and other features; Search-optimized feeds for Google and Bing, as well as a Connector for auto-publishing to a YouTube account;Custom video player designs: Choose dimensions, skins, colors, layers, social media integration (such as Facebook and Twitter), closed captioning support, and other third-party plugins; Playback across devices: Smart video players provide video playback on PCs, Macs, smartphones, tablets and other internet-connected devices;   Support: 24X7 customer support and content delivery network (CDN) services for storage and multi-bitrate streaming.

Wednesday, June 13, 2012

Consumer Assistance Programs: Making Sure Health Insurance Works for You

Recently, a woman in Maine was facing $34,000 in hospital bills for costs related to a mastectomy and reconstructive surgery that her insurance company was refusing to pay.� Thankfully, Maine�s Consumer Assistance Program identified a law that required the insurance company to pay part of those costs, and they helped her file an appeal that led to the insurance company covering an additional $24,000 of her medical expenses.

Health insurance problems are difficult enough to sort through in the midst of our busy lives, but they can be overwhelming when we or our loved ones are sick.

That�s why the Affordable Care Act includes resources to help states strengthen existing Consumer Assistance Programs or start new ones.� In this case, Maine used grant funds to increase its ability to file appeals on behalf of consumers and to educate consumers about the appeals process.

Today we�re releasing a report that shows the remarkable assistance that Consumer Assistance Programs have given to consumers over a one-year period.

From October 2010 to October 2011, Consumer Assistance Programs funded by grants authorized under the Affordable Care Act:

provided direct assistance to over 200,000 consumershelped overturn insurance company decisions in favor of more than 22,000 consumersobtained more than $18 million in direct savings on behalf of consumers and millions more due to more choices and better benefitsprovided valuable outreach and education to hundreds of thousands more

Put simply � these programs work.

That�s why we�re also announcing today that we�re providing nearly $30 million in grants to existing or new Consumer Assistance Programs.

We want to make sure that these programs have the resources to continue the critical work they do. It�s work that literally saves lives. Beth, a mother in Massachusetts, found this out first hand when her 20 year old son, Joe, was diagnosed with Stage 4 Hodgkin�s Lymphoma.

Joe faced a course of extensive and aggressive treatments � so much that he would have to take medical leave from college and go home to his mother in Massachusetts. But because he had to leave school, Joe was no longer eligible for his student health insurance.� Beth couldn�t afford the premiums if Joe joined her plan. Joe suddenly found himself uninsured and in need of thousands of dollars� worth of treatment�treatment that Beth couldn�t afford to pay out of pocket.

Fortunately, Beth called the Massachusetts Consumer Assistance Program. �Its staff worked with Beth and Joe to find affordable health insurance that met their needs, and helped Joe to enroll.

Beth says that, thanks to this program, Joe was able to receive treatment, and he�s responding well.

If you need help with a health insurance problem or have a question about your coverage or benefits, you can find out where to go in your state for help. Our interactive�Consumer Assistance Program Map, on HealthCare.gov, will show you where you can find the help you need. �For consumers in states that didn�t apply for Consumer Assistance Program grants, the map offers links to a variety of agencies and public programs that may also be able to offer assistance.

We can always use a helping hand in understanding our rights and protections as we find the best health coverage for ourselves, and for our families. �Thanks to the Consumer Assistance Program, that help is just a phone call away.

Study: Newborns are 40% of preventable child deaths

WASHINGTON�Newborns now account for 40% of preventable child deaths worldwide, but only a tiny fraction of international aid targets newborns, according to a report to be published in the medical journal Health Policy and Planning Tuesday.

The study, which was spearheaded by the advocacy group Save the Children and funded by the Bill & Melinda Gates Foundation, comes as the Obama administration, India and Ethiopia prepare to host a summit in Washington on Thursday focused on bolstering efforts to reduce the number of children younger than 5 who die from preventable ailments.

The world is far off track in achieving one of the Millennium Development Goals set in 2000 � of reducing preventable child deaths by 66% by 2015 � but U.S. Agency for International Development (USAID) Administrator Raj Shah told USA TODAY he hasn't given up hope of reaching the target.

"This meeting is about that acceleration," Shah said. "It's about looking at the evidence, making the tough calls and doing things much differently and engaging a much broader set of partners so that we can accelerate progress."

President Obama has emphasized the need to reduce child mortality rates, and USAID has attempted to raise the profile of the issue by enlisting celebrities (Kim Kardashian and Mandy Moore) and politicians (former president Bill Clinton) to submit childhood photos for an online project called Every Child Deserves a 5th Birthday.

The world has made progress in reducing preventable child deaths in recent years. More than 7 million children are expected to die from preventable illnesses this year, down from the approximately 12.4 million who died worldwide in 1990. But the numbers � roughly 20,000 children dying each day � continue to have a transformational effect on societies seeking to achieve peace and stability, Shah said.

In 2010, 3.1 million newborns worldwide died in their first month, 17% fewer than in 2000. But the annual reduction rate of deaths of newborns, now at 2.1%, lags behind that of children ages 1-59 months, which stands at 2.9%.

Official development assistance for maternal, newborn and child health doubled from 2003 to 2008, yet only 6% of this funding mentioned newborns in 2008 and 0.1% of these funds exclusively targeted newborns. The U.S. accounted for $619.5 million in aid from 2002 to 2009 targeting newborns and maternal care, doubling the next biggest donor, the World Bank.

"When we did the funding analysis, it made you feel like laughing and crying at the same time," said Joy Lawn, lead author of the Save the Children study.

UNICEF said in a report last week that pneumonia and diarrhea are two of the leading killers � accounting for 29% of deaths among children under age 5 worldwide � and said the global community should increase its focus on those diseases.

"Deaths due to these diseases are largely preventable through optimal breastfeeding practices and adequate nutrition, vaccinations, hand washing with soap, safe drinking water and basic sanitation, among other measures," the report said.

Shah said the global community needs to do more on all fronts to reduce the yawning death toll.

Ethiopia, India, Nigeria, Pakistan and the Democratic Republic of Congo� five countries that account for nearly half of all preventable deaths of children under 5 � are expected to announce a series of initiatives and new policies at this week's meeting in Washington. Performance needs to improve dramatically among these countries in order to get back on track, Shah said.

"Unlike in prior efforts, where maybe donor countries like the United States, the U.K. or others would dictate the solutions," he said, "in this effort, these countries are co-convening and are defining their efforts."

E. coli outbreak sickens 14 in six states

An outbreak of a less-common form of E. coli has sickened at least 14 people across six states and killed a 21-month old girl in New Orleans, the Centers for Disease Control and Prevention reports.

As of Friday, state health officials in Alabama, California, Florida, Georgia, Louisiana and Tennessee reported cases of the Shiga toxin-producing E. coli strain called O145. The more commonly known form is E. coli O157:H7. The first illness report came April 15, and the most recent is from June 4, the CDC says.

With E. coli infections, it can take up to two to three weeks from "the beginning of a patient's illness to the confirmation that he or she was part of an outbreak," according to the CDC.

No source of the infection has been identified. State public health officials are interviewing ill persons to obtain information regarding foods they might have eaten and other exposures in the week before illness.

Shiga toxin-producing strains of E. coli usually manifest as illness two to eight days after a person has swallowed the bacteria. Most people develop diarrhea, usually watery and often bloody, and abdominal cramps. Most illnesses resolve on their own within seven days, but some can last longer and be more severe.

Most people recover within a week, but in rare cases, some develop a more severe infection. Hemolytic uremic syndrome, a type of kidney failure, can begin as the diarrhea is improving. HUS can occur in people of any age but is most common in children under 5 years old and the elderly.

Because the source isn't known, health officials can't give consumers specific advice on how to avoid the infection, but in general, E. coli can be prevented using these tips from the CDC:

�Wash hands thoroughly after using the bathroom or changing diapers and before preparing or eating food.

�Wash hands after contact with animals or their environments (at farms, petting zoos, fairs, even your own backyard).

�Cook meats thoroughly. Ground beef and meat that has been needle-tenderized should be cooked to a temperature of at least 160 degrees. It's best to use a thermometer, as color is not a very reliable indicator of "doneness."

�Avoid raw milk, unpasteurized dairy products and unpasteurized juices (such as fresh apple cider).

�Avoid swallowing water when swimming or playing in lakes, ponds, streams, swimming pools and backyard "kiddie" pools.

Tuesday, June 12, 2012

Mobile telehealth solution helps UK patients monitor chronic illness

In July 2011, NHS Bristol awarded a £1.4 million contract to Safe Patient Systems to provide telehealth monitoring to patients with chronic conditions. The contract has since enabled patients with chronic obstructive pulmonary disease (COPD) and congestive heart disease to benefit from daily remote clinical monitoring using mobile phones, officials say.

The Safe Mobile Care system uses mobile phones programmed with personalized care plans created from the system’s Web-base application software. Patients receive daily prompts to complete clinically validated questionnaires and capture relevant vital signs using wirelessly connected monitoring devices.

Responses are automatically sent to Safe Mobile Care Triage Management software. If a response indicates that a patient’s condition may be worsening, an alert is generated automatically and sent to a nurse or doctor. They then advise the patient on the next course of action.

Safe Mobile requires no broadband installation or complex technical support, officials say. A nurse or clinician can also install the system’s devices and guide the patient through any of the processes in using the system.

“This technology will play a key part in delivering the self-care agenda in Bristol, supporting patients to understand the link between symptoms and related treatments and behaviors," said Sian Jones, program manager, long-term conditions at NHS Bristol. "Having started with COPD and congestive heart failure patients, there is an interest in rolling this out to include other long term conditions, to maximize the benefits for people in Bristol."

Obesity app takes first place in D.C. competition

WASHINGTON – The winners of the Washington D.C. Health Data & Innovation Week Code-a-Thon were announced Tuesday. School Fit was awarded first place for developing an application that utilizes physical fitness data to monitor the health of children in public schools.

The app will allow communities to recognize and collaboratively address obesity problems in California public schools. School Fit earned $4,000 and two passes to the Health Data Initiative Forum III and the 2012 Health 2.0 Annual Fall Conference. 

The Health 2.0 Code-a-Thon, sponsored by the Office of the National Coordinator for Health Information Technology (ONC) and Kaiser Permanente, attracted thousands of healthcare providers, policymakers and innovators from across the U.S.  

Teams comprising students, software developers and researchers participated in the two-day event, which required contestants to use publicly available data to create online tools and applications to enhance quality of care and prevent obesity.

"The judges had an especially difficult time choosing a winner and extended passes to the Health 2.0 fall conference to the second place team to encourage further development of its app," said Indu Subaiya, co-chair and CEO of Health 2.0.

Healthy Plate placed second by creating a mobile app that educates and improves nutritional literacy by displaying the nutritional information about the user's food they intend to purchase by portion, recipe or grocery list. It won $3,000 and two passes to Health 2.0's annual conference.

The LessBadd and SMS2Live teams tied for third place. Both teams received $1,000.

Calif. voters split on tax targeted by Big Tobacco

LOS ANGELES(AP)�A California initiative to raise the tax on tobacco products was losing early Wednesday but the vote was still too close to call because hundreds of thousands of ballots potentially remained uncounted.

The day after Election Day, Proposition 29 was losing by just over 1% or about 64,000 votes out of more than 3.8 million counted.

However, even with all precincts reporting, there typically are many late-arriving ballots from early and absentee voting not counted until after election day. These ballots typically comprise up to 20% of all votes, meaning potentially hundreds of thousands of votes were still to be counted statewide.

It could be days or longer before a winner is declared.

Cycling legend Lance Armstrong backed the measure to impose an additional $1-per-pack tax on cigarettes to fund cancer research. A $50 million opposition ad campaign was led by Big Tobacco.

In March, a statewide poll suggested the Proposition 29 would pass with two-thirds approval.

The situation reminded some of a 2006 California cigarette tax measure that was leading by wide margins until tobacco companies spent $66 million to defeat it.

The attempt to hike taxes on cigarettes and other tobacco products grew into a national fight last month with tobacco companies pouring in millions to quash the effort and celebrities including the New York City Mayor urging voters to support it.

As returns came in, both camps said they expected a close race but remained confident they would emerge the winner.

"We expected that as voters took a look at the measure, they would recognize the serious flaws, and as well intentioned as the measure is, they would realize it's not right for California," Beth Miller, spokeswoman for the No on 29 campaign said Wednesday.

Tobacco taxes have been proven to reduce smoking. But opponents said the initiative would create an unaccountable bureaucracy in charge of doling out the tax revenue, which is expected to start at $735 million a year.

An extra tax in the nation's most populous state also could mean major losses for tobacco companies, and Proposition 29 supporters said industry heavyweights were inventing arguments to obscure their true motive � safeguarding profits.

"I think the public health message has gotten through the smoke screen of the tobacco companies' nearly $50 million misinformation campaign," Jim Knox of the American Cancer Society said Tuesday.

Armstrong and a coalition of anti-smoking groups raised about $18 million to bolster the measure. New York City Mayor Michael Bloomberg gave $500,000 to the campaign to help offset the industry donations.

Majorities in the Democratic-leaning counties along the Northern California coast favored the tax, while majorities in most other regions others opposed it. Voters on both sides expressed strong convictions as they cast their ballots.

"I think that we should aggressively discourage smoking � make it less convenient, make it more expensive," said Susan Hyman of Long Beach.

In nearby Glendale, Craig Jerpseth, a 43 year-old nurse, was equally certain about voting the measure down.

"I hope we don't get any more taxes. That's pretty much it," he said.

A slew of newspapers, including the Los Angeles Times, opposed the measure while proclaiming their reluctance to side with tobacco companies. They argued that the revenue should go to the state, which Gov. Jerry Brown announced last month now faces a deficit of $16 billion.

With a smoking rate of 12.1%, California has not raised these taxes since 2000. If the measure passes, California would still have only the 16th highest tax rate in the nation.

Monday, June 11, 2012

RPSGB responds to pharmacists gaining access to patient records

LONDON – UK pharmacists will gain access to patients' electronic Care Record for the first time under plans by NHS IT chiefs. Access has previously been limited to general practitionerss.

In a key step towards Government proposals for pharmacies to take on more clinical work, pilots are being considered in community pharmacies across the country.

The Royal Pharmaceutical Society of Great Britain's Director of Policy and Communications, David Pruce said: "Pharmacists are highly-trained healthcare professionals, with unique expertise in medicines use. Community pharmacists are highly accessible to the public, and well-placed to provide a range of healthcare services."

"Access to care records by pharmacists will improve patient safety because pharmacists will be able to view the patient record, and be fully aware of what care a patient is receiving elsewhere," he said.

"Access to care records will strengthen pharmacists' ability to make the best possible decisions for their patients, and will enable them to develop new health promotion and screening services, for the benefit of patients and doctors alike," Pruce said.

"Like other trusted healthcare professionals, pharmacists have a duty of confidentiality to their patients. Pharmacists already have access to care records in a variety of settings, including hospital wards and GP surgeries. Access to electronic care records in the community pharmacy will not present a risk to patient confidentiality," he added. "As the subject of their patient records, it is ultimately the patient's decision concerning which health professionals can view their records. However, we believe patients and doctors will experience a clear benefit when pharmacists are able to access their records."

Sunday, June 10, 2012

Houston HIE to connect 130 hospitals via 'network of networks'

HOUSTON – Greater Houston Healthconnect announced Thursday that it will partner with Medicity to establish a community-wide health information exchange, connecting more than 130 hospitals and some 14,000 physicians in a 20-county region of Southeast Texas.

Officicials say Healthconnect will bridge existing networks of major health systems, together with independent hospitals and providers to improve care quality and lower costs for 7 million area residents.

Healthconnect has received signed letters of interest in support of the HIE from the major providers in the Texas Medical Center, officials say. With every major health system in Houston having or planning to implement an HIE for their organization, Healthconnect will work with them to link their HIEs to each other, creating an interoperable, standards-based network of networks that adds value to the IT investments these health systems have already made.

"We're excited to begin working with Medicity to establish a safe, efficient, low-cost way to share medical information among providers," said Lamar Pritchard, Healthconnect board member and dean of the College of Pharmacy at the University of Houston. "We selected Medicity's technology due to their experience and track record of interfacing with all major EHR systems currently in use by area hospitals. Medicity has helped more than 800 hospitals achieve connectivity without disrupting existing systems. One of the biggest benefits of the technology is its ability to easily integrate with any major EHR system, which will facilitate rapid implementation in Houston and allow for sustainable growth in the future."

Saturday, June 9, 2012

From glow caps to cell scopes, mobile health future is near

CHICAGO – The future is getting closer for emerging mobile technologies to take a critical role in engaging consumers to make better health decisions, and in equipping providers with tools to obtain more data from their patients to improve outcomes.

Two early examples are contact lenses that can send and receive data, and vital signs sensors capable of continuously monitoring the wearer.

[See also: Mobile health app market in growth mode]

A “super” convergence of technology and market trends is opening up new ways to coordinate care and manage personal health, said Mike Wisz, a health IT consultant.

“Clinical workflows will be impacted by changing care delivery that becomes more preventive. The basic idea is to keep patients out of the hospital,” he said at a recent HIMSS online briefing. “We’re going to see more pieces deployed, used, worn, ingested and implanted, and it’s going to be a data tsunami."

The flood of mobile health technologies and devices can be viewed as an eco-system. Sensors and other medical devices that measure person-specific information may be attached to or embedded within the body or work within the person’s home. Many emerging software applications also run on mobile or Web-based platforms for use by the patient.

[See also: Mobile health monitoring market on the rise]

Platforms are emerging that offer easier ways to communicate the patient’s information from all these devices and applications through gateways, which can include home health hubs, mobile phones and other machine-to-machine devices, said Wisz. They deliver information to the cloud, where systems may aggregate the data for physicians to access and use.

Some providers are testing or adopting remote patient monitoring systems but hurdles persist, such as who pays for the technology, concerns about privacy and security, and the fact that providers are already busy with meaningful use and other mandated changes, he said.

Mobile product designers are moving beyond touch screens and multi-touch interfaces to experiment with new forms and systems, like Google glasses for “third eye” capability, said Rob Campbell, CEO of Voalte Inc., a provider of mobile clinical communications technologies.

Wearable computing will likely deliver ways to manage information and interact with the world. “For example, personal see-through devices could overlay computer-generated visual information on the real world in real time allowing immediate hands-free access to information,” he said.

The first step to this always accessible information will be deployed through see-through glasses. Ultimately, a much less cumbersome display of augmented reality will come in the form of contact lenses.

In the future, contact lens systems may receive data from external platforms, like mobile phones, to provide real-time notifications and event alerts. As contact lens bio-sensors advance they may alert the wearer of a health anomaly occurring in the body.

The long-term goal is to create a display that can be comfortably worn in the form of a contact lens, which will include a pixel array for imaging. An antenna can be connected with a wireless network. “They’ve even figured out how to monitor tears for glucose levels,” he said.

Some devices start out in acute care but new versions could eventually make their way outside of the hospital, Wisz added.

“With the trend for devices getting faster, smaller and cheaper, many are looking forward to using the devices as a monitoring system for the patient across the continuum of care," he said.

A platform for comprehensive vital signs monitoring, for instance, keeps clinicians connected to their patients that are in the hospital anywhere within the facility. Patients wear comfortable body sensors that allow for better freedom of movement outside of traditional ICU-monitored environments. Eventually systems like these will be modified for use outside of the hospital to enable early detection of potential problems, Wisz said.

Some of the growing connected smartphone devices include:Blood diagnostic product that uses high resolution imaging sensor that lets users snap photo of a blood smear from finger prick to determine if it detects malariaCellscope that attaches to smartphone so that doctors, and eventually parents, can take photos inside of a child’s ears to determine if there is ear infectionAdaptor and system software for eye test for glasses through which user receives measurements needed for eyeglasses for nearsightedness, farsightedness and astigmatismVoice, alarm and text messaging with consumer-grade usability for major smartphone platforms to improve physician and nurse communications within healthcare facilities to improve coordination of care and alerts among the care teamGlow-caps on standard medication pill bottles that use light and sound reminders and follow-up phone call or text message so patients don’t miss a dose to assure medication adherence.

[See also: Mobile health developers see bright future ahead]

Author fears for future of the American breast

The American breast is bigger than ever before.

And breasts are developing in girls earlier than at any time in recorded history.

But do breasts have a future?

The biology of the breast is changing � and not for the better, says journalist Florence Williams, author of the new book Breasts: A Natural and Unnatural History (W.W. Norton & Co., $25.95).

She details a number of alarming trends that may be contributing to the USA's high rate of breast cancer � today and in years to come.

Women's breasts are expanding with their waistlines, Williams says. The average bra size has grown from a 34B to a 36C in just a generation. That's troubling, given that weight gain has been associated with an increased risk of postmenopausal breast cancer.

Girls also are hitting puberty earlier than ever before � another trend that increases their long-term breast cancer risk. About 15% of all American girls begin developing breasts at age 7, according to an influential 2010 study in Pediatrics.

Breasts today also are under assault from pollutants, Williams says. Because chemicals such as PCBs and mercury are stored in fatty tissue, they tend to end up in breasts � and breast milk. "Breast-feeding, it turns out, is a very efficient way to transfer our society's industrial flotsam to the next generation," Williams writes. "Our breasts soak up pollution. � Breasts carry the burden of the mistakes we have made."

While nursing her second child, Williams had a sample of her own milk analyzed. It contained perchlorate, an ingredient in jet fuel, as well as chemical flame retardants, at levels 10 to 100 times higher than in European women. Williams says she believes in breast-feeding, and she spends considerable time in her book noting its benefits for a baby's brain, body and immune system.

But she notes that many industrial toxins will persist in our bodies � and our children's bodies � for years, long enough for today's baby girls to pass them on to their own children.

"What happens in our environment is reflected in our breasts," she says. "If we really care about human health, we need to care about our planet."

Surprisingly, doctors stand to learn a great deal about the environment's effect on the breast by studying men, Williams says.

Marine Pfc. Joe Glowacki was exposed to a wide variety of chemicals when he arrived at Camp Lejeune, N.C., in 1959, at age 17. At the time, the Marine Corps didn't realize the danger of allowing petroleum and other chemicals to pollute the groundwater. The base is now home to dozens of Superfund cleanup sites, and at one point Camp Lejeune had the "most contaminated drinking water supply ever discovered in the United States," Williams writes.

Three years ago, Glowacki found a lump on the right side of his chest. "The next thing you know, I'm one of the girls," says Glowacki, now 70, of Medford, N.J. Glowacki was diagnosed with breast cancer and had a mastectomy and chemotherapy. About 2,190 of the 229,060 breast cancers diagnosed in the USA each year are in men, according to the American Cancer Society. More than 70 have been diagnosed in men who have lived at Camp Lejeune, Williams writes.

"In 1957, who knew all of this?" Glowacki writes. "We disposed of our excesses by pouring them down the drain."

Friday, June 8, 2012

VA awards $19M contract for mobility network

WASHINGTON – The Department of Veterans Affairs will create one of the world's largest wireless mobility infrastructures for healthcare, supporting 26 medical centers across the country. The network will accommodate voice, video and real-time location services.

VA has awarded a $19 million contract to Melbourne, Fla.-based Harris Corp. to get the job done.

[See also: Mobile tech touted as way to give veterans better access to healthcare]

Harris, an international communications and information technology company, has six years of experience delivering information management services to the VA.

"The wireless infrastructure designed and installed by Harris will make secure, enterprise-wide healthcare mobility at medical centers a reality for the Department of Veterans Affairs," said Jim Traficant, president, Harris Healthcare Solutions. "It will be a crucial element in ensuring those who serve our nation's veterans have access to mission-essential data where and when they need it."

The Harris team includes subcontractors Advanced Management Strategies Group, Synaptek Corporation, and TL Services, Inc. The contract was awarded under the U.S. Department of Veterans Affairs Transformation Twenty-One Total Technology contract vehicle.

[See also: VA to help veterans with diabetes with remote monitoring]

A nationally recognized leader in healthcare IT integration, Harris delivers business intelligence, image management, health information exchange, workflow management, portals, managed services and systems integration.

Boston, Philadelphia top list of best children's hospitals

WASHINGTON – Boston Children's Hospital and Children's Hospital of Philadelphia tie for first place in U.S. News & World Report's 2012-13 Best Children's Hospitals Rankings.

Much of the quality related data collected for the rankings are based on measures underpinned by health information technology, such as electronic health records.

[See also: U.S. News & World Report taps HIMSS Analytics for hospital measures]

U.S. News & World Report released the rankings on June 5.

They feature 50 hospitals in each of 10 pediatric specialties: cancer, cardiology and heart surgery, diabetes and endocrinology, gastroenterology, neonatology, nephrology, neurology and neurosurgery, orthopedics, pulmonology and urology. The rankings will also be published in the U.S. News Best Hospitals 2013 guidebook, which will be available in August.

Eighty hospitals across the country ranked in one or more specialties. In addition, the 2012-13 Honor Roll recognizes 12 hospitals with high scores in a least three specialties:

[See also: 118 'Most Connected Hospitals']

1. (tie) Boston Children's Hospital
1. (tie) Children's Hospital of Philadelphia
3. Cincinnati Children's Hospital Medical Center
4. Texas Children's Hospital, Houston
5. Children's Hospital Los Angeles
6. Seattle Children's Hospital
7. Ann and Robert H. Lurie Children's Hospital of Chicago
8. (tie) Nationwide Children's Hospital, Columbus, Ohio
8. (tie) Children's Hospital Colorado, Aurora
10. (tie) Children's Hospital of Pittsburgh of UPMC
10. (tie) Johns Hopkins Children's Center, Baltimore
10. (tie) St. Louis Children's Hospital-Washington University

For families of sick children, Best Children's Hospitals provides unparalleled quality-related information in addition to rankings, including survival rates, adequacy of nurse staffing, procedure volume, and much more, according to U.S. News & World Report. Since their 2007 debut, the rankings have put an increasing emphasis on data that directly reflect hospitals' performance over the opinions of physicians.

This year, U.S. News surveyed 178 pediatric centers to obtain data such as availability of key resources and ability to prevent complications and infections. The hospital survey made up 75 percent of the rankings. A separate reputational survey in which 1,500 pediatric specialists – 150 in each specialty – were asked where they would send the sickest children in their specialty made up the remaining 25 percent.

"The pressure on hospitals to release data that reveal their quality of care is increasing, but it is still much harder for someone caring for a sick child to dig out important facts about pediatric quality of care than to get that kind of information about hospital performance with adult patients," says Health Rankings Editor Avery Comarow. "No less than adults, children deserve the best possible care when they need it the most. Through Best Children's Hospitals, we highlight pediatric centers with that unique level of expertise."

A typical candidate for ranking in Best Children's Hospitals was a member of the Children's Hospital Association (CHA), was either a freestanding children's hospital or a "hospital within a hospital" – a collection of large, multidisciplinary pediatric departments within a medical center – and was affiliated with a medical school. Several non-CHA members were added because of specific expertise or because of experts' recommendations.
 
RTI International, the research organization that generates the Best Hospitals rankings and created the Best Children's Hospitals methodology produced the 2012-13 rankings and administered the hospital and physician surveys. The hospital survey was designed with the help of 125 medical directors, pediatric specialists, and other experts organized by RTI into working groups.

A detailed description of the methodology is available here.

Tuesday, June 5, 2012

Drug combination offers new hope in fighting breast cancer

Doctors today will unveil the results of the first large trial of a new kind of "precision medicine" against breast cancer: a drug combination designed to act like a smart bomb, which delivers its payload directly to tumor cells while reducing collateral damage to the rest of the body.

The experimental drug, T-DM1, doesn't cure anyone.

But it attacks breast cancer in a whole new way � one that may be useful against a variety of other tumors � and appears significantly better at controlling cancer than the current standard of care, says Kimberly Blackwell, who presents her findings today in Chicago at the annual meeting of the American Society of Clinical Oncology.

T-DMI combines the drug Herceptin, a man-made antibody, with an old-fashioned chemotherapy drug called emtansine, Blackwell says.

Herceptin, approved in 1998, was designed to block growth signals from a protein found almost exclusively on cancer cells called HER2, says Sandra Horning, global head of development at Genentech, the drug's developer. Herceptin homes in on HER2 proteins, binds to them and blocks them from transmitting run-away growth signals. To create T-DM1, scientists attached chemotherapy molecules to Herceptin, hanging them like ornaments on a Christmas tree. When T-DM1 is infused into the body, Herceptin zeroes in on HER2 proteins and releases its "payload" of toxin directly at the cancer cell. The toxin then enters the cancer cell and kills it, Horning says.

That's a big change from traditional chemo, in which controlled doses of poison are infused into the bloodstream. While chemo kills cancer cells, it also kills healthy tissues, too, often causing grueling side effects of nausea, vomiting and fatigue, as well as life-threatening infections.

Doctors tested T-DM1 in a study of nearly 1,000 women with advanced cancers who had been on Herceptin, but who are no longer benefitting from it. All of the women had breast cancers that make lots of HER2.

T-DM1 kept these women's cancers in check for 9.6 months, about three months longer than standard therapy, which combines the anti-cancer pills Tykerb and Xeloda, according to the study.

Doctors also noticed a trend suggesting that women randomly assigned to take T-DM1 live longer, as well. After two years, 65% of those on T-DM1 were alive, compared to 48% of those on Tykerb and Xeloda.

"It's a major advance," says Jo Anne Zujewski, a breast cancer researcher at the National Cancer Institute, who was not involved in the study. "I'm excited for women."

The T-DMI stats

An experimental breast cancer drug, T-DM1, was more effective and produced fewer side effects than the standard approved therapy, which combines the pills Xeloda and Tykerb, researchers said Sunday.

New therapy: T-DM1/ Standard care: Xeloda + Tykerb

Percent of patients alive at 1 year 85% /77%

Percent of patients alive at 2 years 65% /48%

Percent of patients whose tumors shrank at least 30%: 44% /31%

Percent of patients who developed serious side effects 41%/ 57%

Percent of patients who had to reduce medication dose due to side effects: 16% Reduced Xeloda dose: 53%/Reduced Tykerb dose: 27%

Source: American Society of Clinical Oncology

People should be cautious about overestimating T-DM1's survival advantage, because, statistically, it's possible that those findings could be due to chance, Horning says. As researchers continue to monitor the women's progress, doctors will get a better sense if T-DM1 really improves survival.

Louis Weiner, director of the Georgetown Lombardi Comprehensive Cancer Center in Washington, says breast cancer patients are in great need of new treatment options. While Herceptin has helped many women, most breast cancer patients with advanced disease eventually relapse, he says.

Breast cancer patient Shirley Mertz, 65, says she's also glad to see women with another option. She knows women who don't respond well to standard treatments, or who find the side effects intolerable, says Mertz, who lives in the Chicago area and takes Herceptin for advanced breast cancer that recurred in spite of an earlier mastectomy.

T-DM1 has generated enormous excitement among breast cancer patients, says Mertz, a board member of an advocacy group called the Metastatic Breast Cancer Network. Women's main frustration, she says, is that it's not yet widely available. Because T-DM1 is experimental, it's available only through clinical trials, Horning says. Genentech plans to apply for Food and Drug Administration approval later this year. Genentech, which plans to test T-DM1 in early breast cancer, has not yet announced how much T-DM1 will cost. Herceptin alone, in the doses currently used to treat breast cancer, costs thousands of dollars a month.

Blackwell says she's pleased that women on T-DM1 almost never suffer from the nausea, diarrhea or hair loss that's typical of chemo. In the study, 41% of those taking T-DM1 had serious side effects, compared to 57% of those on standard therapy.

The drug used in T-DM1, emtansine, is an incredibly potent poison, Blackwell says. Early tests showed it was far too toxic to be used in people, at least when given in a typical intravenous infusion. But doctors can administer very strong doses by targeting its poison directly at cancer cells, she says.

Zujewski says she hopes this technique will catch on.

Genentech is testing eight similar antibody-drug combinations in the clinic, with 25 in its research pipeline, Horning says.

"It does lead me to believe that more molecules are going to be developed that will work this way," she says.

Weiner notes that doctors are already using other man-made antibodies to fight cancer, including the drugs Erbitux and Rituxan. These drugs could find additional uses, if researchers can successfully attach chemo molecules to them, too, he says.

"We talk a lot about developing a cancer bomb," Blackwell says. "This is an example of delivering that bomb to the cancer, not the patient."