No SHSMD For You.

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There are a select number of healthcare marketing events every year that I can't wait to attend: the Spring Conference of the New England Society for Healthcare Communications, the Fall Conference of the Carolinas Society for Healthcare Public Relations & Marketing, the Forum for Healthcare Strategy's Healthcare Marketing Summit, and the annual conference of the Society for Healthcare Strategy and Market Development (SHSMD). Each of these gathering is a highpoint of my year.

The last time I missed a SHSMD Conference was in 2007. I skipped the conference to hang out with a friend who was undergoing chemotherapy. Every year since then I have either been a speaker at the event or have participated by hosting roundtable discussions and serving as a session moderator. I love this event because it's a chance for me to catch up with so many of my close industry friends. Every time I attend one of these conferences it is like going to a reunion. Frankly, it is better than any reunion I've ever been to.

So I can't tell you how disappointed I am to be missing this year's SHSMD Conference. Although I had every intention of being there (booked a flight and a hotel room), on Sunday I made up my mind that life has gotten too complicated and that I need to be at home with my family. When I finally came to that conclusion, it put my mind at ease. What a relief. It shouldn't have been a hard decision at all. Family comes first. There will be other conferences. But it was still a hard decision. This conference only happens once a year and I had planned for it. It provides an important marketing platform for my company. For me, it was hard to let go. At first I debated flying up for the day on Wednesday and Thursday and flying home each evening to be with my family. I know, crazy idea. I kept coming up with possibilities, but none of them were realistic.

"The thing about family disasters is that you never have to wait long before the next one puts the previous one into perspective." - Robert Brault

On Sunday I finally gave up trying to force the issue and reconciled myself to the fact that I wasn't going to Philadelphia. The reality was I would need to cancel client dinners scheduled for Wednesday and Thursday evenings, and cancel a number of meetings with various vendors and potential business partners. My colleagues from Jennings, Dewey Mooring and Mike Allen, are carrying on without me, manning our booth and attending interesting sessions. Meanwhile I'm following the Twitter feed from my desk in Chapel Hill.

Here's the important point: I made the right decision and it wasn't easy. There are far more important things in life than attending the annual SHSMD Conference. My family needs me at home right now, so I'm here. And, if all goes well, I'll attend SHSMD next year. Or not.

Pink, Pushy and Profitable

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One Caveat: Before reading this post, please know that I am not a cancer patient, nor am I a cancer survivor. When it comes to the whole Pink Movement, I defer to those on the front lines - cancer patients and survivors. If you'd like the perspective of one amazing cancer advocate and survivor, check out this blog post by Jody Schoger titled "Women with Cancer: Redefining Pink." I follow Jody on Twitter and recommend that you do the same. She is a writer, blogger and a self-proclaimed optimist. As a cancer survivor, I give her views on Pink a whole lot more credibility than my own. That said, within this blog post I will share with you my thoughts on how some businesses approach Pink. I know I am treading into dangerous territory, but I'm going there anyway.

This October I am seeing pink like never before. It's everywhere. And I'm no stranger to pink. Each year I participate in a number of breast cancer awareness and survivor events sponsored by my hospital clients. I even have an assortment of pink neck wear for October, including a couple by Lilly Pulitzer. Fancy!

Here's my problem. I already support a few cancer related organizations with donations each year. With that in mind, I'd prefer not to get a sales pitch about supporting a breast cancer charity when I walk up to the counter to buy my skinny Latte at my local coffee shop. On the most basic level, I don't want to be put in the position of having to say "no thank you" to the lady behind the counter wearing the crazy pink hat. I don't want to have a conversation with my Barista about my views on philanthropy and my history of giving. That's what happens at my local Caribou Coffee establishment. During October and part of November, Caribou Coffee Company sells its Amy's Blend collection in honor of their Roastmaster Amy Erickson who passed away from breast cancer. Amy was a real person who lost her tragically lost her life to breast cancer. That is real and should not get lost in this story about Caribou Coffee. When a customer purchases Amy's Blend products, Caribou donates 10% of sales to CancerCare - a non-profit organization that provides counseling and financial assistance to people dealing with cancer. Based on the most recent annual report I could access online, CancerCare spends $0.17 of every dollar it receives on fundraising, management and general expenses (overhead). The rest goes to support its programs. It gets three stars from Charity Navigator. So it looks like a good cause - and a less controversial choice than the Susan G. Komen Foundation.

I applaud Caribou's support of the cause and the passion embodied in the actions of its employees. But I don't like being asked daily by a coffee worker to give to this cause by making an additional purchase. And by the way, the only way that I am aware of giving via Caribou is to buy more of its products. They are using this promotion to up-sell me on products I don't normally buy.

Here are the rough economics behind this promotion: A pound of Amy's blend is $15.99. My understanding is that a pound of beans, including packaging, costs an organization like Caribou about $4.00 per pound. That means they make $11.99 margin per pound, and donate $1.59 per pound to CancerCare. Amy's blend is also priced higher than most of their coffees (see the graphic to the right). Overall, Caribou is doing a good thing, but let's acknowledge that they are using it to drive business and build goodwill for their organization. That's the principle behind a lot of the corporate philanthropy. They are connecting with consumers around values. "Look at how passionate we are about breast cancer. Won't you join us." In Caribou's case, the link with their former employee (Amy) helps to take the promotion out of the realm of "pinkwashing." Amy is their genuine connection to the issue. This marketing practice is called Echo Branding - connecting with consumers through a display of shared values. I teach businesses how to do this. But I teach them to do it in a more genuine, authentic and less obtrusive manner.

I wouldn't mind it nearly as much if a Caribou employee asked if I would like to make a $1 donation to a breast cancer charity. But that is far different from asking me to buy a $15.99 product where 10% of the purchase will go to a charity and Caribou will make a large profit from the transaction. It is a win, win, win for them. They get goodwill from the association with breast cancer, increased $ per customer transaction during October, and they get to feel good about the real money they direct to CancerCare (a good outcome).

I want to close this post with a quote from Jody's blog post. Her words are far more powerful than mine. Please visit her blog and check out the post in its entirety.

"The first week of Breast Cancer Awareness has ended. Sometimes it reminds me of how Christmas has been commercialized - it starts early, is in your face, and makes myth of the experience itself. It can trivialize a serious disease, divert discussion and dollars. I happen to think if we continue to act fearlessly - as friends, as survivors, advocates and activists - in bringing our intellectual collective to bear on the issue we can change the landscape for your daughters. Last week I was stunned to hear someone on our weekly #BCSM chat express the thought that we - co-moderators Alicia Staley and Deanna Attai, MD and I -- had a political agenda. If having an anti-cancer, evidence-based, pro-survivorship, community-based agenda is political then yes, I'll be the first to print campaign buttons and banners. On my dollar. Not from pimping cancer."

Advice for Physicians on ACA Implementation

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(Guest post by by David Kassin Fried - Contributor, Software Advice Blog)

ACA is Here to Stay: What You Should Do

Like it or not, the ACA is a done deal, regardless of who gets inaugurated in January 2013. The best thing you can do as a doctor is to prepare for its effects. Here are five areas to focus on.

1. Prepare for More Patients
At least three components of the ACA will lead to a rise in the number of patients visiting doctors’ offices: 1) the extension of coverage to 32 million more Americans; 2) requirements for insurance companies to cover more preventive care procedures; and, 3) prohibiting insurance companies from denying coverage for pre-existing conditions. All of this could mean more patients for your practice, so you should evaluate your ability to accommodate them. You might, for example, want to expand your staff or extend your office hours.

2. Make Decisions Regarding Medicare and Medicaid
Medicaid payments are rising to match Medicare rates–a sizable jump over the next few years. Unfortunately, that’s still only 81 percent of private insurance reimbursements, a rate that’s projected to drop due to $716 billion in cuts for Medicare and Medicare Advantage payments. In addition, changes in qualification criteria may result in many people moving from a private insurer to Medicaid, as happened when CHIP was established in 1997. As a result, many doctors are facing the difficult decision to stop accepting Medicare or Medicaid patients unless they can find ways to offset the costs.

3. Embrace or Reject Electronic Health Records (EHRs)
The ACA expands reporting requirements and reimbursements for the Physician Quality Reporting System (PQRS), creating penalties on Medicare reimbursements starting in 2015 for failure to adopt an EHR. This will encourage some of the 70 percent of doctors not yet using EHRs to purchase one, though others may drop government payers from their practice entirely. Those leaning toward the former may want to start looking at strategies for successful implementation.

4. Consider Going Rural
To improve access to care nationwide, the ACA creates a number of incentives to encourage physicians to practice in “underserved areas.” This primarily comes from the expansion of the National Health Service Corps, which provides loan repayments and scholarships to doctors practicing in rural areas. If you’re a young doctor considering a move, it might be worth exploring these incentives.

5. Evaluate Bundled Payments and ACOs
ACA creates Accountable Care Organizations (ACO)–groups of physicians who coordinate care for an individual patient or set of patients. By sharing information and taking joint accountability, an ACO can theoretically reduce the overall cost of care, with half the savings passed on to the providers as a bonus. Whether this will work remains to be seen–the results of the ACO pilot project suggest that for most providers this will result in more red tape that doesn’t improve care.

But whether you choose to participate in an ACO or not, government payers will be shifting from separately reimbursing physicians, labs and hospitals to “bundling payments.” This means you’ll have to collect payment for any treatments performed at a hospital from that hospital or a mutual association rather than from Medicare directly. This may require changes to your billing practices.

Of course, all of this is speculative. Large-scale initiatives like the ACA have a way of resulting in unintended consequences, and it’s impossible to forecast all the financial impacts it might have on medical practices. So, expect the unexpected–but do expect that the ACA will be there.

It's National VNA Week!

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The following is from an email I just sent to our fantastic staff:

This week, we celebrate National VNA Week and acknowledge and celebrate the invaluable work we do to keep patients home, where they most want to be. It’s even more special this year because we also are celebrating 125 years of providing excellent care for our community. We have a proud history and we can look forward to our future…. the VNA of Boston & Affiliates is more relevant now than ever before.

We are there at the start of life and we are there at the end of life providing compassionate care so that patients have the best quality of life they can with dignity and independence. Here is a sampling of some of the comments we receive from our patients:

“VNA of Boston is consistently excellent! VNA has improved my quality of life & sense of wellness!!!”

“I was treated with the greatest respect and courtesy.”

“They made me feel safe and secure in helping me get better and made a good recovery in regaining my health back.”

“We have had multiple experiences - OT's, PT's, nurses - all have been great.”

“I was very impressed with the professionalism of all who helped me. Thank you very much!”

“The care was excellent and I would highly recommend the VNA to anyone. Everyone was great.”

Thank you all – to all the clinicians in the field and the staff in the office who support their work – for your expertise, your passion and commitment, and your contribution to the future of the VNA of Boston & Affiliates.

Rey

"It's what we do... we are nurses..."

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For most of my career, I've been fortunate enough to work with clinicians who heal and who care.  Who bring skill and experience, and a frequently unquenchable compassion, into situations that many of the rest of us would do nearly anything to avoid.  I may be inclined to exit... while they rush in.

Meet Barbara, a nurse manager from the Visiting Nurse Association of Boston.  And here are a few of her photos of her native Haiti.  Idyllic and beautiful, as in the sunlit bay above.  Tragic and devastating, as in what follows.

Tuesday, January 12, 2010.  A catastrophic magnitude 7.0 earthquake with an epicenter only 25 kilometers west of capital city, Port-au-Prince.  Ultimately... 316,000 dead.  300,000 injured.  1,000,000 homeless.

And Barbara rushed in.

Here's her story... from the beginning.

Barbara grew up in Carrefour, a suburb of Port-au-Prince, with her mom, a teacher, and dad, an owner of an auto repair business, and brother and sister.  It was a happy, largely uneventful time... until her father became sick.  Among his ailments, Barbara's father also suffered from decubitius skin ulcers, which then (and even still today in Haiti) were poorly understood.  Barbara, then 13 years old, remembers being angry when her father, a proud man who resisted family pressure to move to the United States, told her "not to worry" and that he would be around for "another ten years".  Unfortunately, that was not to be the case.

At the age of 16, Barbara and her remaining family members moved to Florida and then eventually to Cambridge, Massachusetts.  Barbara and her sister, Beatrice, held a variety of jobs and when Barbara decided she wanted to become a nurse, Beatrice, then a medical assistant, helped her to pay for the training.  When Barbara completed nursing school, she began working and then helped to finance Beatrice's nursing education.  Barbara continued on to earn her bachelor's degree and is now studying for a master's in health care administration.

Barbara remembers well that day in January, 2010.  Reports of an earthquake began surfacing, with no one fully aware of its magnitude or impact.  Beatrice called Barbara and gave her an update.  It was far worse than expected.  Far worse.

Barbara recalls: "We were looking at the news.  We couldn't believe it.  Nobody knew what was happening.  We started calling our family there but no lines were open.  We were so worried.  We couldn't sleep.  We tried calling the UN but couldn't get through.  We just didn't know what to do.  I was desperate..."

The overwhelming emotion was helplessness.  "People there were dying and I thought, I'm a nurse.  I have to help."  Partners in Health, an organization dedicated to improving the quality and access to health care services in poor and developing areas, called Beatrice on Saturday and asked to deploy her to Haiti on the following Monday.  A month later, Barbara's call came.

It was a two week assignment.  The lead time was limited.  According to Barbara, "you just pack your bag and go."

She recalls departing the airport in Haiti.  She remembers looking around at the rubble, the devastation, the places where buildings once stood.  "It was tough to see a country you left and is no longer there."

Barbara was stationed at the General Hospital in Port-au-Prince.  "Once you got there, the gate was closed and you couldn't leave."  And once there, she and her companions worked for 10 days straight, during 7PM to 7AM shifts.  Barbara remembers being struck when she saw the former sight of a nursing school next to the hospital which she had seen as a child.  "It was no longer there.  It was completely flat.  I wondered how many people were trapped underneath."

After a quick orientation from the physician-in-charge, Barbara was given a brief tour and was immediately "put to work."  She described the first day as "one of the worst days of my life.  There were 300 to 400 patients there all needing care... from TB to fractures to missing limbs to wounds... to people who were just dying.  Just name it - it was right there looking at you..."

When asked how she responded to that, Barbara describes: "You start to work.  Your forget about everything else.  You just tried to save everyone you could.  You just do whatever you can."

She remembers one young girl at the hospital.  She had lost nine members of her family in the tragedy.  "She was so thin.  You could see only bones.  She would not eat or drink... and she never spoke... except at night, she would scream out the names of her family who were now lost to her.  I remember seeing a lady who stayed with her.  She was from the local church and she slept on the floor, giving the girl a sip of water."  Despite their efforts, the patient passed away.

Another patient, a 27 year old woman with renal failure and high blood pressure, was experiencing significant physical and emotional stress.  Barbara knew the patient needed oxygen and fast, so she ran down the hall looking for a tank.  A simple tank of oxygen.  Plentiful in every hospital where Barbara has worked, but scarce in Port-au-Prince's General Hospital.  Barbara called out: "This girl's going to die, her heart's going to give out soon... "... and remembers seeing the desperate look in the woman's eyes.  The patient said to Barbara: "Please don't leave me.  If you leave me, they're going to let me die."  Barbara knew she was right.

The patient eventually received the oxygen and the vital dialysis she required and lived.

There was also an older woman patient who "could have been my mother."  She had two wounds in her lower legs; "it looked to be a diabetic ulcer".  Barbara watched this patient fade from an amiable, even joking, favorite among the nurses, to one who became more and more ill and despondent.  At one point, she had no clothing or even sheets, leaving one of the nurses to donate some of her own clothing to the patient.  The patient died, alone and in pain.  Per Barbara, "there was no reason for her to die that way..."

Barbara looks back at the experience and feels that: "We didn't do enough.  There's so much more to do there.  And it's not over there.  It's terrible what's happening in the tent cities there now.  It's just horrible still... but I want to go back."

When asked why she wants to return, Barbara lowered her eyes and said, simply and solemnly: "It's what we do... we are nurses..."

If you're interested in learning more about Partners in Health, please click here.

If you'd like to help, click here.

 

Posted by Rey

Cambridge Consultants Develops A Liquid Biopsy Test Without the Procedure–Only Blood Test Required

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Cambridge Consultants, is working with Singapore-based Clearbridge BioMedics on a new low cost, non-invasive system to improve cancer testing and diagnostics.   The ClearCell System finds circulating tumor cells that have attached to a cancerous tumor.  This got buried in my mailbox so I’m getting it out today.  I have written about several of the devices before that have been created by Cambridge and this time they are working with a company from Singapore.  Here’s a couple examples and they have also worked with Qualcomm.  The first device they created that got my attention was the blue tooth inhaler, something maybe that is still to come of age. 

Cambridge Consultants and Sun Pharma Develop a High Performance Dry Powder Drug Inhaler for Use Beginning in 2011

 

The Minder Wireless Device Connects to Collect Patient Medical Data and Transmit Via Wireless Network to Medical Record Systems Via HL7 Standards

The device is called the ClearCell system and even at low concentration levels it is able to find stray cells in the bloodstream that have detached from the tumor. BD

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Press Release:

Cambridge, UK and MA – September 25, 2012 – Innovative technology design and development firm Cambridge Consultants is working with Singapore-based Clearbridge BioMedics on a groundbreaking device to improve cancer testing and research. The innovative second-generation ClearCell^TM System enables tumor cells to be retrieved and detected even faster, and potentially more accurately, from a simple blood sample – paving the way for a new generation of personalized cancer treatments and increasing the chance of saving lives^*.

 

There were an estimated 12.7 million new cancer cases diagnosed around the world in 2008 – the latest year for which figures are available – and 7.6 million deaths. The number of cases is expected to increase to 21 million by 2030. The spread of the disease around the body is the major cause of death from cancer^*. But the traditional diagnosis method of a tumor biopsy often involves invasive surgery and cannot easily detect whether the disease has spread.

 

Clearbridge BioMedics’s proprietary second-generation ClearCell^TM System is a new low-cost non-invasive ‘liquid biopsy’ that is drawing on the diagnostic device expertise of Cambridge Consultants – particularly in the fields of microfluidics and automation control – to give early warning of the spread of the disease. It detects circulating tumor cells (CTCs) in the bloodstream that have detached from a patient’s primary tumor – even at concentrations of as low as one in a billion blood cells.

 

Early detection of these CTCs can increase patients’ chances of survival – and tracking the cell count over time could help ensure treatment is more effective. The new testing device has also solved the technical challenge of retrieving the cells intact – offering detailed insight into the exact nature of the cancer and its unique characteristics, and so paving the way for a new generation of personalized cancer treatments to fit the needs of each patient’s unique tumor biology.

 

“It is a tribute to our world-leading track record in diagnostic device development that we have been approached from Singapore to help with this development work,” said Duncan Bishop, program director in the Medical Technology division of Cambridge Consultants. “We can also offer a complete end-to-end solution, including blood handling, rapid prototyping and manufacturing trial devices, which is invaluable to start-up companies.”

 

Clearbridge BioMedics is a spin-off from the National University of Singapore and the first member of the Clearbridge Accelerator technology incubator, which is supported by the Singapore government’s National Research Foundation and SPRING Singapore. Clearbridge BioMedics specializes in novel applications for cancer research and diagnostics, and has customers spanning Asia, Europe and North America.

 

Johnson Chen, managing partner of Clearbridge Accelerator, said: “The ClearCell^TM System from Clearbridge BioMedics is designed to resolve the current limitations of today’s technologies for detecting and isolating circulating tumor cells. It potentially represents the next generation of cancer screening, diagnosis, personalized medicine and treatment monitoring. The world-class diagnostic device expertise of Cambridge Consultants made it the clear winner when it came to selecting a development partner.”

 

^* World Health Organization fact sheet no 297, February 2012

 

Cambridge Consultants develops breakthrough products, creates and licenses intellectual property, and provides business consultancy in technology critical issues for clients worldwide. For 50 years, the company has been helping its clients turn business opportunities into commercial successes, whether they are launching first-to-market products, entering new markets or expanding existing markets through the introduction of new technologies. With a team of more than 360 staff, including scientists, mathematicians, engineers and designers, in offices in Cambridge (UK) and Boston (USA), Cambridge Consultants offers solutions across a diverse range of industries including medical technology, industrial and consumer products, transport, energy, cleantech and wireless communications. For more information visit: www.CambridgeConsultants.com 

 

Cambridge Consultants is part of Altran, a global leader in innovation and high-tech engineering consulting which supports companies in the creation and development of their new products and services. With a global network of 17,000 collaborators (including 15,000 consultants) throughout more than 20 countries, and 500 major clients, the Group reported sales of €1,420m in 2011. For more information visit: www.altran.com

 

Clearbridge BioMedics specializes in novel platforms with applications in oncology research and diagnostics. It is a National University of Singapore spin-off company that is committed to developing medical devices which will impact the world and revolutionize cancer diagnostics and patient care by leveraging groundbreaking technology from research partners. The ClearCell™ System comprises patent-pending CTChips®, which are microfluidic biochips able to effectively detect, isolate and retrieve wholly-intact circulating tumor cells (CTCs) from small quantities of patient blood samples. The isolated CTCs can then be stained directly on the CTChips® for identification and enumeration, or retrieved for further molecular analysis. Headquartered in Singapore, Clearbridge BioMedics currently has customers spanning Asia, Europe and North America. For more information visit www.clearbridgebiomedics.com

Buy or Build, or the Best of Both Worlds–Dr. Edmund Billings from Medsphere, OpenVista EHR

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If you are not aware of Medsphere, they have been around for a while and created OpenVista, using the VA Vista Medical Record system and customized it for commercial use. I have talked about their software a few times here and a while back even had their demo loaded on my tablet to test and play around with. In this discussion Dr. Billings talks about the advantages of such a system versus a full commercial install or the ability to mix and match.

Lutheran Medical Center Goes Live with OpenVista Electronic Health Records In New York and 2 More In New Jersey Up Next

One installation was back in 2008 and was one of the fastest installs only to have the hospital close down due to lack of money and Century City is on the outskirts of Beverly Hills pretty much. 

Century City Doctors Hospital Implement Enterprise-wide Clinical Application in Record Time - Open Vista (VA EHR)

Enjoy the article…as there are a lot of good points made pro and con.  BD

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When it comes to IT system decisions, healthcare organizations often ask a key question: Should we buy it or should we build it ourselves? Open source offers a new option to this traditionally binary decision. This option becomes more compelling when the open source solution is the most broadly deployed EHR in the world—the VistA system from the U.S. Department of Veterans Affairs (VA). Instead of Buy vs. Build, it’s the Best of Both.

Traditionally, organizations look at their new system requirements and weigh pros and cons as described below.

In

a Buy vs. Build decision, the key drivers are control and cost.  Do you have control over your system at a cost you can afford?  The decision calculus then shifts to ownership on two levels:  First, can we have true ownership of our solution and make it work ourselves?  Second, is the total cost of ownership economically sustainable?

Yes + Yes = “Best of Both

”

Red Hat, the company that fundamentally changed the buy-versus-build mentality when it came to UNIX systems, provides a proof point outside of healthcare. Red Hat clients were looking to move away from legacy UNIX operating systems, which were tied to costly, difficult-to-maintain proprietary hardware.  Open-source Linux offered prospective customers a choice they could download and build on, but such a transition seemed too risky for most mainstream companies. Red Hat’s Enterprise Linux subscription minimized the perceived risk and affordably provided infrastructure management capabilities, toolsets and a proven implementation process.  Many organizations could have done it themselves, but at a higher total cost of ownership and with greater risk.  With Red Hat, they can still build on Linux but without the ongoing code maintenance.  There is a single point of accountability that knows their unique environment and facilitates integration and collaboration with other systems and vendors.  They don’t have to create their own software company internally—they don’t have to choose between Buy or Build.

In the electronic health record (EHR) market, even though an enterprise solution is not an operating system, the parallels are clear. Healthcare organizations use expensive and complex proprietary systems that are difficult to maintain.  The leading systems have prohibitive total costs of ownership. Ownership is undermined by vendor lock. The most important and valuable enhancements are held back for the next chargeable upgrade.  Lack of interoperability is a business model.

Just as Linux was to UNIX, so open-source VistA is an alternative to proprietary EHRs. The difference is that VistA is a proven enterprise solution—the most widely deployed and fully adopted EHR in the world with an open source solution stack that includes toolsets and configuration capabilities enabling an organization to truly own the solution and solve problems themselves.

A hospital can download VistA and build their own VistA-based system, as was recently described at Forbes.com.

Oroville Hospital (153 beds in California) is completing implementation of its EHR, a process that took three years and cost an estimated $10 million (including hardware)—probably half the price of a commercial EHR.

Oroville wanted total control, successful adoption and meaningful use, so they used an open source version of VistA to build their own system. They became their own software company, which means they retain absolute control over the incorporation of their own enhancements and those from the VA. But they also shoulder all the associated costs, with no opportunity to maximize economies of scale. What will their system cost over the next three years?

Because most organizations can’t or don’t want do it all themselves, but still want control, predictability and economic sustainability, OpenVista provides a “Best of Both” alternative to “Buy or Build”. For a hospital similar to Oroville, a subscription for the complete OpenVista solution and hardware would total approximately $4 million over 5 years.

An OpenVista subscription keeps the hospital up to date with enhancements from the VA, the Indian Health Service and other OpenVista facilities. It provides all the code management to keep the system in sync, with testing and certified quality of the client’s production environment. Based on knowledge transfer and true ownership, the OpenVista subscription model facilitates autonomy through “Superusers” capable of driving system change themselves. Designated 24×7 customer care provides backstop support, but hospitals are in control and remain independent.

The “Best of Both” means a hospital can truly own and control its system, and predict and manage costs.

http://blog.medsphere.com/buy-vs-build-or-the-best-of-both/#more-24

Genetic Blood Test To Identify the Most Aggressive Prostate Cancers Being Tested in the UK– Research on Why Some Cancer Tumors Are Aggressive While Others Are Not And Help Identify Patient Risk

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Researchers were able to test and find patients with the “gad”gene signature and compared it to those without and those that did not have it survived 21 months versus those who did have it to where survival was around 9 months.  It’s called a six gene test and could help establish high and low risk groups of patients.  This helps with the type of treatment of course and it helps with studying the role of the immune systems to see how a cancerous tumor behaves.  This was a group of 70 men and further studies are needed to see if the same results are played out again. 

I just recently posted about a new blood test in the works for a “liquid biopsy” with the ClearCell System so if both of these types of tests were combined it certainly is going to be a much better experience for the patient and give more definitive results.  BD

Cambridge Consultants Develops A Liquid Biopsy Test Without the Procedure–Only Blood Test Required

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The test, which looks at the signature pattern of genes switched on and off in blood cells triggered by the tumour, can sort the "tigers" from the "pussycats"  .

London's Institute of Cancer Research trialled the test in 94 patients.

The findings are published in the Lancet Oncology medical journal.

Prostate cancer is a very diverse disease - some people live with it for years without symptoms, but for others it can be aggressive and life-threatening.

Experts hope that ultimately the barcode blood test could be used to make a more accurate estimation.

In the study, the scientists were able to split the patients into four groups based on the results of the barcode test. One of these groups fared far worse, surviving for significantly less time than the other patients.

Patients with this "bad" gene signature survived for an average of nine months compared with 21 months for those without it.

US researchers at the Dana-Faber Cancer Institute and the Memorial Sloan-Kettering Cancer Centre have also been testing a similar prostate cancer blood test

http://www.bbc.co.uk/news/health-19873166#?utm_source=twitterfeed&utm_medium=twitter

Walmart Becomes the Next Employer to Negotiate Surgical Procedures Direct With Major Medical Centers, Just Need More Employees Covered

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A while back Lowes was one of the first to negotiate with the Cleveland Clinic followed by Pepsico and now we have Walmart. If you have read the news of late Walmart employees are striking for better healthcare benefits, even though they are not union, but making a statement.

Johns Hopkins and PepsiCo Sign a Contract To Allow Employees and Their Dependents To Have Certain Surgical Procedures Performed At the Medical Center in Maryland

Employees must be healthy enough to travel but as this reads there’s no out of pocket expenditures for them to pay.  This agreement covers some additional items that were not mentioned in the Lowes or Pepsico agreements; however it’s been over a year and perhaps their agreements have expanded.  Transplant surgeries will all be performed at the Mayo Clinic.  The full press release can be read here.  Now all Walmart needs is more employees covered as many are part time and do not work enough hours to qualify for health insurance coverage.  Not all but some part time employees qualify for health insurance and that’s still the big problem is getting more covered.  BD

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Walmart employees will now be able to get heart, spine and transplant surgeries at six of the nation's most prestigious hospitals at no cost, the world's largest retailer announced Thursday.

Under what Walmart calls the "Centers of Excellence" program, employees and dependents enrolled in the company's health benefits won't pay out-of-pocket for medical care or related travel when they receive complex, expensive procedures including open-heart surgery, spinal fusion and organ transplants at select facilities. The Mayo Clinic in Rochester, Minn., the Cleveland Clinic in Ohio and the Geisinger Medical Center in Danville, Pa., are among the health systems participating in the program.

Walmart employees who undergo surgery at one of the six selected medical centers will save between $5,000 and $12,000 because they'll be exempt from health insurance deductibles and cost-sharing payments, Walmart spokesman Randy Hargrove said. Workers will gain access to the new benefit at the beginning of 2013.

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