United American Healthcare Corporation Announces Fiscal 2010 Q2 Results

United American Healthcare Corporation announced financial results for the Company's fiscal second quarter ended Dec. 31, 2009.

Revenues for the second quarter were $1.7 million, down $2.8 million, or 62 percent, compared with revenues of $4.5 million for the second quarter of the prior fiscal year. The decline was primarily the result of the complete transfer of TennCare enrollees served by the Company's subsidiary, UAHC Health Plan of Tennessee (UAHC-TN), to other managed care organizations on Nov. 1, 2008, and the discontinuance of UAHC-TN's Medicaid managed care services as a TennCare contractor. The decrease in revenues was also attributable to the decrease in enrollment and associated revenue from the wind down of the Company's Medicare Advantage Special Needs Plan (MA-SNP), as the Medicare Advantage contract expired at the end of calendar 2009.

Total expenses decreased $3.3 million, or 53 percent, to $2.9 million in the fiscal 2010 second quarter, compared with total expenses of $6.2 million in the prior fiscal year's second quarter. The decrease was primarily related to reduced medical expenses, as well as lower marketing, general and administrative expenses in the quarter. For the second quarter of fiscal 2010, the Company reported a net loss of $1.1 million, or ($0.14) per share, compared with a net loss of $1.4 million, or ($0.16) per share, in the second quarter of fiscal 2009. The net loss in the most recent quarter was primarily the result of the loss of TennCare revenue and the wind down of the MA-SNP, partially offset by the reduction in expenses.

"United American Healthcare continues to move through a transitional period characterized by the end of our Medicare Advantage business at the end of the fiscal second quarter," said William C. Brooks, President and CEO of United American Healthcare. "As these operations come to an end, our revenues will no doubt be adversely affected. Moreover, the contraction of our revenue base is occurring even as we face the remaining medical expenses associated with our obligations as a Medicare provider. In light of these challenges, we continue to maintain tight control on all remaining expenses in our current lean operational structure."

As of Dec. 31, 2009, United American Healthcare reported cash, cash equivalents, short-term marketable securities and restricted marketable securities of $14.2 million, compared to $19.9 million as of June 30, 2009. The decrease in cash was primarily the result of the operating loss generated in the first half of fiscal 2010 as well as the payment in September 2009 of approximately $3.3 million in settlement of a lawsuit.

"Despite the tumultuous environment we find ourselves in, we are making progress in the ultimate transformation of our Company, while continuing to control costs and conserve our cash resources," concluded Brooks. "We now believe we are much closer to the end of this extensive process, and we remain committed to completing the hard work required to identify the best possible alternative to benefit all shareholders. When we conclude this process, we will communicate our results to shareholders and provide a strategic framework that will shape the future direction of our Company."

About United American Healthcare Corporation

United American Healthcare Corporation (UAHC) is a healthcare management company that has pioneered the delivery of healthcare services to Medicaid recipients since 1985. UAHC owns and manages UAHC Health Plan, which is based in western Tennessee and includes the Memphis market.

For more information, visit www.uahc.com .

Lab-on-chip traces circulating tumor cells

Liesbet Lagae is group leader of the nano-enabled systems group in IMEC. She is involved in several European and national research projects concerning magnetic and optical materials and devices and their application in the field of biosensing. Liesbet Lagae holds a PhD from the Catholic University of Leuven. Contact: Liesbet.Lagae@imec.be

Imagine a medical laboratory performing a genetic test to detect metastasis from blood in a breast cancer patient. Shrink this laboratory down to an area of 1x1cm² and you have a lab-on-chip. The tools in the real-life lab are replaced by microsystems, the medical staff placing the blood sample in subsequent tools, is replaced by microfluidic channels. The huge advantage of such systems is that they enable a fast, easy-to-use, cost-effective test method which can be performed in a doctor’s office or even near the patient’s bed.

Unfortunately, there are no real lab-on-chip systems on the market yet. The systems that are commercially available – often wrongfully labeled ‘lab-on-chip’ – only perform one task, for exa mple moving a fluid from one place to another. True lab-on-chips are multifunctional.

Technologies for true multifunctional lab-on-chip systems are being developed by research labs worldwide. One of these labs is situated in the Belgian nanoelectronics research center IMEC. They develop for example microsystems that are able to pick up specific cells in blood samples, to perform cell lysis, to realize amplification and detection of the cell’s genetic material.

Together with a German SME, specialized in test kits for detecting circulating tumor cells (CTC) in cancer patients, IMEC tailored its generic lab-on-chip technologies towards this application. Three lab-on-chip modules were developed integrating the different analytical steps for the isolation and characterization of circulating tumor cells in a blood sample.

Figure 1: Schematic presentation of the different operations to be performed by the lab-on-chip for the isolation and characterization of rare cells.

Circulating tumor cells are tumor cells that invade the bloodstream and cause distant metastases. The levels of CTC detected in metastatic breast cancer patients before and after therapy were shown to be significant predictors of progression and overall survival. The very low levels of CTC in peripheral blood, i.e. down to less than 1 cell per ml, make their detection very challenging.

Module 1: Cell isolation and detection

In a first step, the blood sample is injected into the LOC and mixed with antibody-coated magnetic beads. These beads bind specifically with the tumor cells. Next, a magnetic force is applied, allowing the transport of both the bead-cell complexes and excessive beads. Due to their different magnetophoretic mobility, the bead-cell complexes have a different velocity and can be separated from free beads. Combining such an isolation device with an H-shaped fluidic channel allows to specifically force the beads-cell complexes into the detection channel, where they are counted by flowing them over a spin-valve magnetic sensor.

Figure 2: Cell isolation device bridged between two channels. Cell-bead complexes are moved towards a detection channel, while free beads are flown to the outlet.

Module 2: RNA extraction and amplification

Following isolation and detection, the CTC are lysed and their mRNA is extracted. The genes that are important for the identification of the tumor cells are amplified (cDNA). For this step, MRC Holland has developed kits for the multiplexed amplification of specific breast cancer genes.

The microsystem for cell lysis and mRNA amplification is based on an intelligent design of heating elements, active cooling principles and fluidic channels together with IMM, a german institute specializing in microfluidics.

Module 3: DNA detection

In the detection module, the amplified cDNA is identified. This can be done using an array of electrochemical or magnetic sensors. With the electrochemical detection (implemented by URV), one can reach a sensitivity in the range of nanomolar, while the magnetic-based detection is currently much more sensitive (picomolar). The magnetic-based detection strategy consists of binding functionalized magnetic beads to the target cDNA and counting these complexes with a magnetic sensor.

Even in the large equipment that is used today to count tumor cells in blood (e.g. Cellsearch), this extra step of DNA detection is not performed. However, it increases the test reliability and provides interesting information for doctors about the subclasses that the tumor cells belong to so that the best therapy can be selected.

Many possibilities

Today, the three modules described above are ready and are being tested with spike blood (i.e. blood with a known number of tumor cells). In a next phase, the lab-on-chip modules will be tested with blood from patients, and finally the modules will be integrated on one chip.

Future work will focus on clinical studies using the LOC approach as well as evaluating other application domains for the LOC technology, for example: detecting other sorts of cancer, tracing fetus cells in the blood of the mother (to detect mucoviscidose or other genetic diseases) or assisting in stem cell research.

This research was performed in the framework of the European MASCOT project. Project partners are: IMEC, Universitat Rovira i Virgili (URV), Fujirebio Diagnostics AB , Institut für Mikrotechnik Mainz (IMM) , AdnaGen AG, Norwegian Radium Hospital and MRC-Holland.

Science and Technology in Clinical Sterilization.

Hemant Shah is Chief Executive at Medica Instrument Mfg Co. He has more than 30 years experience in the manufacture of lab instruments. Under his stewardship, Medica has progressed from manufacture of simple pathology & sterilization equipments, to include products today for QC, QA, Micro, Organic Chemistry and R&D labs. Medica's Fully Automatic Autoclaves with documenting options are the preferred option at all leading Microbiology labs in the Indian Pharma Industry. The whole organization is focused towards customer support with over 50% of the Staff being in the QC, Sales & Customer Support departments.

There has been a growing understanding of the microbial threats that exist in laboratory & medical practice as of today. Simultaneously these threatening trends have been accompanied by a tremendous advance in the science and technology of in-clinic sterilization.

All Medical Professionals must possess a good basic knowledge about the process of sterilization as otherwise their patients' as well as their staff & their own health & lives are at risk.

So what exactly is sterilization?

Sterilization is the destruction or removal of all viable microorganisms, including many of the resistant bacterial spores. Since this process covers the broad range of pathogens that may be found in dental, ophthalmic & any surgical procedure, it is the only clinically acceptable means for dealing with reusable instruments between patients.

In order to understand "Why Class B Autoclave?", let us first understand how a Steam Pressure Steriliser - commonly known as an Autoclave - sterilizes.

Autoclaves commonly sterilize by exposing its charge (items to be sterilized) to elevated temperatures of 121 to 134ºC under pressure of 15 to 30 psi, for a holding time of anywhere between three to 30 minutes. Please note that the three to thirty minutes time is the holding time at the set elevated temperature & not the total process or cycle time. Total cycle time would be far greater. The combination of the three lethal parameters of time, temperature and steam, deliver a powerful kill rate which even the hardiest of bacteria find hard to survive. This effective & yet clean method of lethality is unmatched by any of the other methods of sterilisation.

Saturated steam at this temperature is an excellent carrier of heat. The operative word is saturated steam. The steam condenses onto its charge and as it does so it not only expends its huge latent heat but also draws in additional steam to replace the condensed steam. Thus the heat transfer is very efficient and the penetration levels extremely high.

However, if there is residual air in the chamber and load, it will interfere with steam-instrument contact, and may compromise sterilization. This residual air can prevent penetration of steam to the depths of the load, leaving your sterilisation incomplete. Why & how would this happen? When you load the Autoclave with instruments and close the lid, there is already a lot of stale air trapped inside. For sterilisation to take place, this air needs to be effectively purged and replaced with saturated steam.

To resolve this problem of purging entrapped air, normal Autoclaves will have a manual, mechanical or electrically operated valve open till about 100ºC. Once it is closed the pressure & temperature begins to rise. It is presumed that by this time, the entire entrapped inner air has been purged. However, tests have shown that this is not an effective method for vials, wrapped items, implants, garments and certain types of hollow ware. You can never be assured of efficient penetration of steam right inside, if you are using a regular Autoclave. Even a small volume of entrapped air can compromise your sterility assurance level simply because ordinary entrapped air is a very bad conductor of heat & moisture. These pockets of air cannot conduct heat to the load with the same vigor as steam and therefore cold spots remain within the load.

The type N-cycle is suitable for sterilizing only unwrapped and solid instruments. N-cycle sterilizers are the most popular bench top autoclaves (top or front loading), and are classified as passive systems (also known as gravity or non-vacuum). Typically, as steam is generated or admitted into the sterilization chamber, it forces unsaturated and saturated air out through a vent. The major concern with the N-cycle sterilizers is the non-removal of trapped air (especially air pockets in lumens and difficult-to-access areas of the load) during displacement.

Errors in packaging or overloading the sterilizer chamber can result in cool air pockets where items are not sterilized.

The type B sterilisation cycle is used to process loads that can retain air. It can sterilize solid, hollow, and porous instruments, be they wrapped or unwrapped. Pressurized steam is an effective sterilizing agent providedthat the internal air has first been removed from the chamber as well as the air retentive load. Residual air prevents direct contact between steam & the load to be sterilised. Hence this B-cycle involves the use of active (forced) air removal, usually by using an inbuilt vacuum pump. These pre vacuum or Class-B sterilizers create a vacuum, thus removing air from the load prior to the chamber being pressurized with steam. This can be done from 1 to 3 times - depending on the cycle selected. This technique allows faster and more effective steam penetration throughout the entire instrument load than the gravity displacement technique typically employed in sterilizers with N-cycles.

 

A typical cycle of a Class B Sterilizer:

A Class-B Autoclave is essential if you are:

• Pouching your instruments


• Double wrapping your instruments


• Sterilising lumens, implants or instruments that have difficult to access areas


• Sterilising porous loads like garments, gowns, dressings sterilizing


• Hollow ware of Type A Sterilising Vials

Contact Us:

E-mail: hs@medicainstrument.com

Ph: 022-66189999

http://www.medicainstrument.com

Telehealth: a keystone for future healthcare delivery

Written by Matthew Marshall, Director, Tunstall

Matt Marshall is responsible for developing Tunstall’s range of telehealth propositions within the health sector. He started his career within medical equipment before moving into telecoms and software and has nearly 20 years of experience building secure and rewarding customer relationships. He spends a lot of time working very closely with customers who are early adopters of telehealth and those evaluating the technology. Matthew Marshall of Tunstall explains the role telehealth is playing in supporting health and social care professionals and enabling them to deliver more integrated, flexible and person-centred care Over 17.5 million people in the UK live with a long-term condition, which places a significant strain on health and social care resources.  It is estimated that 80% of GP consultations relate to a long-term condition, and that 60% of hospital bed usage is by people with a long-term condition. The treatment and care of those with long-term conditions also accounts for 69% of the Primary and Acute care budget in England, placing a clear economic burden on the NHS.  Indeed, it is estimated that the UK economy stands to lose £16billion over the next 10 years through premature deaths due to heart disease, stroke and diabetes. As a result, momentum for telehealth has been growing over the last few years, as those with health and social care responsibilities look for innovative ways to manage long-term conditions effectively and help reduce some of the pressure on the NHS. Monitoring Long-Term Conditions with Telehealth The UK Government is making committed steps towards more person-centred and flexible care delivery.  Its Our Health Our Care Our Say white paper, Lord Darzi’s NHS Next Stage Review and Putting People First agenda all place a clear emphasis on longer-term planning and on providing more preventative community-based care delivered at a local level that is tailored to meet the specific health and social care needs of the individual. Telehealth supports the Darzi report’s call for greater provision of care closer to people’s homes, by supporting those living with single or multiple long-term conditions, including Chronic Heart Failure, COPD, diabetes and hypertension, helping them to continue living independently by providing more personalised, community-based care. Telehealth is now being mainstreamed by PCTs across the country in order to prevent avoidable hospital admissions to hospital and monitor long-term needs within the home. The increasingly widespread use of telehealth solutions is also transforming the ability to manage chronic disease and long-term conditions in the community and shift the balance away from a reliance on hospitals and long term institutional care. Telehealth: supporting effective, community-based care Telehealth allows nursing staff to remotely manage patients, ensuring support can be provided at an early stage when needed, and at the same time enabling them to prioritise visits and manage their case loads more effectively, for best use of healthcare resources. Patient data is transmitted to community nurses on a daily basis, enabling them to triage their ‘virtual ward’ against agreed vital signs criteria and apply an order of priority to the visitation schedule.  This approach provides clinical staff with more accurate information about a patient’s condition, allowing them to focus their time accordingly so patients experiencing a critical change receive treatment as soon as it is required. Being able to monitor and detect changes at an early stage also enables nursing staff to reduce the number of acute admissions to hospital and resulting dependency on secondary care, improving outcomes and ensuring best use of available resources. A key additional benefit of telehealth is that it also educates patients to be more aware of their own symptoms and to proactively manage them which leads to an improved quality of life for patients and carers. It encourages patients to feel more in control of their condition, which is a key factor in helping to improve healthcare outcomes. Measuring the benefits of telehealth: reducing admissions and ensuring effective use of resources Sheffield PCT took the decision to deploy telehealth solutions from Tunstall, in order to tackle the issue of COPD in the community.  During a recent pilot, home visits by community COPD nurses were reduced by an astonishing 80%, cutting travel costs and enabling healthcare staff to prioritise their workload, which ensured the most effective use of their time. This innovative approach saw COPD-related hospital admissions dramatically decrease by 50%, saving the PCT £30,000 to £40,000 on a small number of patients and allowing them to purchase more monitors, to further expand the use of telehealth for the management of long-term conditions. Meeting individual patient needs in Nottingham With around 22,000 hospital admissions per year in Nottingham linked to long-term conditions – 40% of all hospital activity – mainstreaming telehealth has dramatically reduced hospital admissions and GP visits, lessening the burden on primary and acute care providers and ensuring NHS resources are used effectively. Nottingham PCT uses the telehealth technology from Tunstall to monitor around 800 people each year with long-term conditions such as COPD and congestive heart failure. This approach supports independent living, promotes patient self-management and reduces the need for repeat hospital admissions. A key benefit of the telehealth solutions is that they can be tailored to meet the specific needs of the individual patient.  As well as using the monitor to measure vital signs, the community matron can programme the monitor to ask the patient a set of medical questions specific to their condition; this helps clinicians further determine the status of their patient’s condition. A healthy outlook for telehealth Telehealth solutions are playing a pivotal role in supporting older people and those with long-term needs to live independently, by effectively managing their health and well-being. Primary Care Trusts mainstreaming telehealth have demonstrated telehealth delivers clear benefits to the patient and the PCT and also to carers and other secondary care sources. As well as delivering significant reductions in hospital admissions, telehealth has also enabled Trusts to make financial savings. The use of telehealth in Sheffield has seen a 50% decrease in hospital admissions. It has been calculated that based on a cost of £2,000 per admission, saving 50 admissions a month, could potentially save the PCT £1,200,000 per year. Sheffield and Nottingham PCTs have witnessed the benefits of telehealth in improving patient care and in helping to ensure best use of resources.  Tunstall is working with these and many other Trusts across the country to further extend their use of telehealth to address other long-term conditions and continue to make it an integral part of their overall model of care. www.tunstallhealth.com  01977 661234

Healthcare Challenge: To Heal or Die

Fewer hospitals are dealing with more patients, more diseases, more costs, and bigger headaches. The good news is that we have answers! We can save costs while saving lives.

John Shoemaker is President of Shipcom Wireless and has focused on delivering hybrid data capture, RFID, and data management solutions across several industries, including transportation, aviation, government, and, most recently, healthcare with an important contract with the Air Force to create a technology showcase for a major medical center. Formerly VP of Amtech/Subsidiary of Intermec, Executive VP of TransCore, and Senior VP of Matrics and Symbol Technologies, he has extensive experience in the Middle East and Asia. Mr. Shoemaker is also a U.S. Army combat infantry veteran and is committed to leveraging technology to bring improved healthcare for active and retired military personnel. E-Mail: jshoemaker@shipcomwireless.com

Charles Olmeda is a Sr. Project Manager for Shipcom Healthcare Solutions focusing on delivering Automatic Identification Technology solutions to the healthcare industry, most recently as the Project Manager for a contract with a major Air Force Medical Center. Formerly an IBM Systems Engineer, Shared Medical Systems (now Siemens) Healthcare Systems Consultant and First Consulting Group Integration Manager. Before joining Shipcom Mr. Olmeda provided independent healthcare consulting and project management to various healthcare organizations, he has over twenty years in Healthcare Information Technology.E-Mail: colmeda@shipcomwireless.com

From the TV show, “House”, the irascible but brilliant Doctor House tells a class of med students that they will make mistakes and they will lose lives and that they better get used to it or either find another job or become a teacher. The silence in the room was deafening.  Tough words, but unfortunately they are very true.  And the likelihood of making more mistakes that cost lives increases with the rapid introduction of millions of baby boomers as they enter their sixties and seventies. All of this is coming at a time of increasing healthcare costs, fewer numbers of hospitals as consolidation continues from the past decade, lack of an agreed upon national healthcare strategy, the crunch on Social Security and government medical programs like Medicare and Medicaid, and the overall economic malaise we find ourselves experiencing today.

Answers are needed as at the statistics show that as healthcare needs increase, so do the errors, deaths, and lawsuits. DOA has succumbed all too often to DIH or died in hospital. Reports show 90,000 people had avoidable deaths in hospitals last year in the U.S.

Yet, there are answers.  Healthcare beckons innovation.

There is one potential hero that could come to the rescue at a time of great need for the healthcare industry: Hybrid AIDC Technologies for Real Time Visibility (RTV). This is quite a mouthful.

Although most of us are familiar with bar codes (UPC or uniform product codes) and routinely manage them at the supermarket with coupons, or purchases in retail stores or self service POS (point of sale) in places like Home Depot and airline check-in kiosks. Interestingly, hospitals have yet to exploit what is known as automatic identification and data collection (AIDC) and one of its related technologies, RFID (radio frequency identification) which now have electronic product codes, formerly EPC, now GS1 or one global standard for the world.

As a result and one example, President Obama has repeatedly called for a national effort to convert paper documents to secure digital form (EMR or EHR: electronic medical or health records) that will allow uses not currently available in the health care industry, but is routine in other industries.

Bar codes can be used to track items in hospitals, especially medical supplies or pharmaceuticals in inventories, but even that is not commonly used. Just as many third world countries have bypassed the use of wired communications or landlines and have implemented wireless/cell phone technologies; hospitals now have the chance not to necessarily bypass bar codes, but to complement their use where it makes sense while exploiting the wireless world with RFID.

Not all RFID is the same. There is active, battery powered RF; there is passive, non-battery or backscatter RF; and RF used with different frequencies – all dependent on the application. In simple terms, RF Active is used when long range is needed and passive use is best when very low cost tags are needed. Then there is RTLS (real time locating system) that wirelessly transmits signals to read a tag, obtains an ID and then calculates (using triangulation) the location of the tag.  But the list of applications is long, especially when including sensors for temperature, humidity, motion, or chemical presence.

So, for hospitals, we can deploy RFID, Bar Code and other sensor technologies to provide RTV for many specific medical applications. The first priority is to tag the items/people/assets that move or can move that can influence operational decisions.  We have lots of opportunities to leverage these hybrid technologies to a hospital’s operational and financial advantage. Hospitals are bleeding, but they may not know how badly, where or for how long.

Let’s take a look at some specific examples of target applications…

1. 
   
   General Asset Management of Medical and IT Equipment 
   Hospitals across the nation are faced with an equipment financing and management squeeze. The expense of constantly buying new equipment can annually strain the finances of even the best managed healthcare organizations. Medical equipment that is essential to maintaining a high standard of patient care and competitive advantage also involves high cost and the complexity of maintaining and managing equipment that may affect the hospital operations and could divert valuable facility resources away from the core mission of patient care. A hospital, by using RFID or other sensor technologies, could enable the automated collection of asset information including location, maintenance status, and more without a person needing direct line of sight or contact with that asset. Once the sensor technology gathers data, the information is passed to the organization's enterprise or asset management application. As a result, the system may trigger an alert, release a work order, update inventory, conduct inspections, create an invoice or locate an asset.  Hospitals could experience improvements in productivity, reduce costs by implementing automated maintenance schedules rather than an arbitrary calendar-based schedule, increase revenue by accurately valuing assets being used, and increase equipment longevity by identifying usage patterns.
   
   


2. 
   
   Patient Tracking/Flow 
   As the evolution of RFID moves forward, most hospitals are still waiting for continued technology development and for prices to perhaps inch downward. Experts in the industry estimate that only about 200 hospitals out of over 5,600 in the US are using automatic identification technology. Very few have implemented the technology for patient tracking to optimize  patient flows, reduce wait times in waiting rooms and improve patient satisfaction.  A small RFID tag on a patient wristband emits a radio wave that is detected by a network of receivers around the hospital. The system graphically displays the locations on a virtual map of the facility, or in a table view or into a hospital information system (HIMS).  In the few situations where RFID has been implemented, it has mainly been for emergency departments, operating rooms or small pilot programs on a single floor. RFID technology for patient tracking improves and streamlines patient care processes by coordinating crucial events from patient admission to discharge processes, all while improving patient safety by giving hospital staff the real-time data and task coordination tools required to improve patient care.
   
   


3. 
   
   Inventory Control 
   RFID technology has great potential in healthcare to significantly reduce cost, while improving materials management and inventory operations. Cost-conscious industries like retail and manufacturing traditionally have focused on using RFID systems to enhance the efficiency in supply management and logistics processes, including inventory control. Effective inventory management affects costs that can range 45-90% of total expenses. If the use of automatic identification technology can save just a percentage of that cost, the cost saving is real and drives to the bottom line profitability of the hospital. Use of RFID for managing and controlling inventory can provide more control over uses of capital that affects all departments. After all, why buy inventory when it is not needed. Overstocking is expensive. Also, having the right stock available at the right time is critical. A lack of RTV data on stock levels means that stocks often run low or even run out altogether, causing unnecessary disruption to operations. Additionally, staff normally must fill in paper-based forms so that supplies can be distributed to the wards or departments. This can waste valuable staff time and reduce hospital efficiency. RFID can provide real-time data on inventory logistics as items move from storage cabinets in the hospital and out to the wards and individual users, and back to storage if necessary.
   
   


4. 
   
   Bedside Services 
   The escalation of healthcare costs has created market pressure to increase the efficiency of patient care while continuing to increase quality. One means of addressing that challenge has been the advancement of computing solutions in various digital health initiatives. RFID introduces a new approach involving proximity-detection and association of the patient to assets, items, caregivers and other points of concern with automatic detection and presentment.  This approach enables a new generation of patient identification solutions for the healthcare industry that is going “digital”. An integrated patient-identification solution addresses the inefficiencies and potential for human error associated with traditional patient identification. Increased accuracy helps to avoid hospital liabilities associated with bedside services mistakes. While many hospitals are considering technology for patient identification, most hospitals have not considered automated patient association to create an audit trail with automated tracking and tracing and with a system of alarms/alerts when mistakes are anticipated or in progress.
   
   


5. 
   
   Surgical Trays and Instruments, Track & Trace 
   Surgical instrument storage and sterilization systems include surgical instrument trays and kits which typically consist of trays or boxes that hold a variety of general purpose and or specific surgical instruments such as forceps, scissors, clamps, retractors, scalpels, etc. These pre-prepared, surgery-specific instrument trays are brought into the operating room (OR) when preparing for surgery and are used as a means to organize and store surgical instruments. These trays are used to transport medical instruments within a hospital or even in and out of medical facilities. Advances in medical technology have created an enormous increase on the number and type of surgical instruments now in use.  It has become necessary to manage and track these instrument trays more quickly and efficiently to ensure they are properly cleaned and sterilized (autoclave) and that the kit is complete and accurate.  Use of RFID technology is effective for tracking surgical trays and managing the number of instruments within a tray or surgical kit to ensure “right instrument, right kit”.
   
   


6. 
   
   Medication Administration 
   One of the most difficult areas for technology to address is the medication administration process.  This is due to complex staff workflows and procedures - and in many cases, mandate compliance. A fundamental set of requirements that nurses must satisfy on a daily basis is embodied in the 'five rights': getting the right medication, in the right dose, using the right methodology, to the right patient at the right time. Errors in administering medication can have grave impacts on a patient's health.  There are the challenges for nurses of maintaining accuracy on long shifts while juggling multiple patients. Despite the importance of accuracy in meeting this set of requirements, nurses and other caregivers too often must rely upon hand-written orders from doctors, matched up to hand-written or printed ink patient wristbands. Those wristbands may be partially illegible, and the manual transcription of data when they are made can introduce errors. Mismatching patients to the proper care can result in consequences such as incorrect medications or missed doses, use of the incorrect blood type, mixed-up pathology samples and incorrect surgical procedures (e.g., wrong parts of the body operated on or removed). Automatic identification technology complements and may eliminate the use of manual patient identification using somewhat unreliable wristbands, which can reduce the prevalence of errors and improve efficiency. It involves tracking the patient at every stage of their treatment, using a digital means of automatic identification that is machine-read and allows matching the actual patient to their medical chart and physician's orders, plus non-medical aspects of their care such as meals and billing.
   
   

We have presented six areas of opportunity for hospitals to re-examine how they operate and offer more effective and efficient solutions to save costs and lives. Hospitals need to manage multiple business processes, just like any other business. This includes management of medical equipment, medication administration, tracking of blood and specimen and tracking patients from admission to discharge to optimize the patient flow.

We need to make these opportunities visible to hospital management, not only to smooth process flows, but to verify each process step and help prevent problems before they occur. It all starts with collecting relevant, real time information that allows you to analyze what is happening: identify errors, determine what and who are causing errors and then adjusting or modifying processes to resolve these issues.  Hopefully we can assist the medical community with our expertise in providing real time visibility to operational and clinical processes and improve Patient Safety and quality of care and at the same time reduce   costs and errors. We want to heal both the patient and the hospital and keep them both healthy.

Obama gives GOP 6-week deadline to get on board with healthcare package

WASHINGTON – At a White House healthcare summit held Thursday, President Barack Obama urged Republican congressional leaders to consider working on several areas of common interest in the healthcare reform package, giving them a rough 6-week deadline before Democrats may consider using alternative measures to pass the plan.

Obama named health insurance reform, the purchase of health insurance across state lines and medical liability reform among the top three areas where agreement could possibly be reached.

Republicans argued they wanted to scrap all proposals on the table and rework a set of smaller steps to reform healthcare.

For Democrats, starting over is not an option they said, because of the dire situation many Americans face.

According to Sen. Chris Dodd (D-Conn.), 14,000 Americans lose their healthcare daily, while six to eight Americans die per day because of no health insurance.

Democrats said healthcare reform is interconnected and cannot be tackled one step at a time. "We can't handle healthcare incrementally," Dodd said. "It has to be dealt with holistically. You can't get to quality and affordability, if you don't deal with coverage."

Much of the day's debate focused on coverage and whether or not it could be expanded without including more people in the insurance pool.

Sen. Tom Harkin (D-Iowa) said, "If you don't bring more people in together, the only people who get a break are the people who are healthy. People who are sick pay more. Is that what we want in this country?"

Republicans at the summit backed a health reform plan proposed by House Minority Leader John Beohner of Ohio, which would expand healthcare to some 3 million uninsured Americans.

The Democrat House and Senate bills, passed last year, would extend coverage to 30 million.

Sen. John McCain (R-Ariz.) said the unspoken issue overriding the entire summit was the threat of Democrats using an alternative measure to pass a bill with a simple majority, rather than the 60 that would be normally required in the Senate.

The special mechanism, called "reconciliation," was never meant to be used for issues that involve 17 percent of the Gross Domestic Product, as healthcare does, McCain said.

President Obama and Speaker of the House Nancy Pelosi (D-Calif.) would not guarantee that they would not use the method to pass a healthcare reform bill, when asked directly by several Republicans during the summit.

Obama said, "We cannot have another year-long debate about this."

"So the question that I'm going to ask myself and I ask of all of you is, is there enough serious effort that in a month's time or a few weeks' time or six weeks' time, we could actually resolve something," Obama said. "And if we can't, then I think we've got to go ahead and make some decisions and then that's what elections are for."

"We have honest disagreements about the vision for the country and we'll go ahead and test those out over the next several months till November," he said.

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Obama releases his own plan for healthcare reform

WASHINGTON – As Congressional leaders prepare for Thursday's White House summit on healthcare reform, President Barack Obama has released his own version of a healthcare reform plan.

Obama said his plan would put American families and small business owners in control of their own healthcare and build on legislation passed by the House and Senate last year, with a focus on providing health insurance reform "that lowers costs, guarantees choices and enhances quality healthcare for all Americans."

A White House statement on Monday said, "The president has long said he is open to any good ideas for reforming our healthcare system, and he looks forward to discussing ideas for further improvements from Republicans and Democrats at an open, bipartisan meeting on Thursday."

According to the White House, the Obama proposal would make healthcare more affordable, make health insurers more accountable, expand health coverage to all Americans and make the health system sustainable, stabilizing family budgets, the Federal budget and the economy.

"It makes insurance more affordable by providing the largest middle class tax cut for healthcare in history, reducing premium costs for tens of millions of families and small business owners who are priced out of coverage today," according to the White House. "This helps over 31 million Americans afford healthcare who do not get it today – and makes coverage more affordable for many more."

The White House said the Obama plan would also:

• set up a new competitive health insurance market, giving tens of millions of Americans the same insurance choices that members of Congress will have;


• bring greater accountability to healthcare by laying out so-called "rules of the road" to keep premiums down and prevent insurance industry abuses and denial of care;


• end discrimination against Americans with pre-existing conditions; and


• put the budget and economy on a more stable path by reducing the deficit by $100 billion over the next 10 years – and about $1 trillion over the second decade – by cutting government overspending and reining in waste, fraud and abuse.

The plan would also provide significant additional financing to all states for the expansion of Medicaid, eliminating any promised favoritism in bills proposed by Congress.

Data warehousing in healthcare: what is it and why do it?

In its 1996 Data Warehouse Roadmap, the Data Warehouse Institute outlines a number factors which help justify investment in a data warehouse. The Institute envisions these factors as only a starting block and maintains, logically, that every organization needs to review, at greater depth, the benefits of such an investment in its own unique business environment. With this in mind, following is a look at the benefits of data warehousing, using these factors as a framework. But first, what is a data warehouse and how does it differ from a transactional database.?Data Warehouse Defined

A data warehouse is essentially a large-scale central database loaded with information from multiple operating databases, for the express purpose of easy end-user access and decision support. It consolidates disparate data sources, making available the resources to support information generation critical to making strategic business decisions.

A data warehouse differs from a transactional system in that the data it contains is static and updated in a scheduled manner in massive loads. Data from multiple and disparate operational systems is brought into a data warehouse and "normalized." In this new environment, previously prohibitive data formats are stripped away, leaving a virtually limitless, user-friendly, uniform data format. In other words, a data warehouse readies inaccessible, disparate data for transformation into usable business information. This fact alone spawns the majority of the benefits of data warehousing. These benefits include, but are not limited to, the following:

Newly Enabled Workers
Historically, employees in need of strategic information have chosen from a limited number of reports available through MIS, submitted a request, and waited for as long as 30 days to get results. In addition, most healthcare organizations have been burdened by a multitude of disjointed sources of information. With a data warehouse, all of this disparate data can be pulled together and put into the hands of users. A data warehouse is specifically developed to give users the ability to explore data in an unlimited number of ways, accommodating essentially any query a manager could dream up, and providing access to the data sources which are behind the results. A data warehouse affords this ability to an increased number of employees, reduces the MIS report load and provides improved response time.

The user-driven nature of a data warehouse allows for exploration by users with a wide range of computer literacy, providing ready views for less experienced users and drill down and open query capabilities for those with more advanced skills. This benefit is particularly relevant considering the widespread decrease in the numbers of middle managers, who historically played the role of preparing and summarizing data for upper management.

Exposure to New Business Opportunities/Improved Cost Control
There are endless ways management can utilize a data warehouse for business gain. One is user-defined investigative querying. A manager, for example, can investigate resource utilization by a particular group of doctors or for a healthplan's different lines of business. In addition, a data warehouse performs a second, and very valuable, function by examining data for trends and abnormalities which users may not know to look for. In this way, the system can lead users toward hidden business opportunities and cost centers. For example, a data warehouse could assist healthcare organizations in detecting erroneous or fraudulent billing, identify patient or provider trends or uncover seemingly insignificant pockets of loss which, over extended periods, could become significant.

Improved Customer Bond
In addition to the constant pressure to reduce costs, healthcare organizations are increasingly confronted with demands to improve the quality, of care. As is often the case, knowledge is one key to improving the quality of care and thereby improving customer satisfaction. A data warehouse can help healthcare organizations watch trends in patient care and physician practices, utilize quality care measurements, and apply this knowledge for improved customer satisfaction.
For a healthcare organization, however, the patient is only one of many customers. Others include employers, providers, and the government. A data warehouse can help an organization meet the needs of these customers as well through decreased response time and improved reporting. Whether "customers" means patients, providers or whomever, an organization stands to benefit greatly by knowing its customers better.
Precise Marketing Tools
In addition to serving customers better, the knowledge gleaned through a data warehouse can improve a healthcare organization's reach to potential customers. Data warehouse reports can provide solid proof of the benefits the plan can offer, including indications of quality and efficiency of care. These "bragging rights" can help a healthcare organization differentiate itself from its competition. A data warehouse can aid in detecting geographic or demographic segments of the marketplace which remain untapped and help show the best way to reach out to these potential members. In addition, a data warehouse can help managers anticipate changes on the business horizon and assist them in altering their marketing plan accordingly. Finally, managers can utilize a data warehouse to measure the effectiveness of a particular marketing campaign, helping further maximize marketing dollars.

The obvious result of effective marketing and improved customer satisfaction is increased revenue. By engaging in more precise marketing tactics and more effectively meeting the needs of existing customers, an organization can increase its awareness and draw in business, thereby increasing its revenue intake. Also affecting revenue is the decision to enter new markets or offer new products or services.

A data warehouse can bolster revenue in more subtle ways as well. For example, information gleaned from a data warehouse can assist a managed care plan in deciding which type of contract to offer a potential member group. After simulating costs and profitability with different contract options, a healthplan can develop a more targeted proposal for a potential client, not to mention delivering a convincing sales presentation, complete with solid evidence of the plan's merits.

Ability to Respond More Rapidly to Key Business Events
It is important to think of a data warehouse as a strategic business tool. While the warehouse system itself may fall under the heading of information technology, the purpose of, benefits of, and responsibility for a data warehouse fall to management. A data warehouse is only as good as its ability to guide management in making strategic business decisions for the organization. Rapid reporting response and unlimited access to information translate into improved ability to anticipate, guide and respond to changes in a dynamic business atmosphere.

Ability to Respond More Rapially to Market and Technology Trends
By being aware of the marketplace and future trends, a healthcare organization can take advantage of the "first mover" principle, creating ownership of new offerings in the minds of consumers by coming to market first. A data warehouse can also help a healthcare organization forecast the potential profitability of new products and services and extend the life cycles of existing ones by adapting them appropriately. This is, once again, a result of knowing the customer and the marketplace.

Conclusion
While data warehousing is a significant task to undertake, the potential benefits are tremendous. The bottom line, however, is that it can help an organization succeed financially.

Ideally, warehousing should be viewed as an ongoing activity, wherein it is essential for managers to be intricately involved in planning, to reprogram the way they do business, and to make the warehouse an indispensible advisor. By incoporating the technology fully into business practices and by seeking to further apply the information available, a healthcare organization can assure that it is realizing maximum return on its investment in data warehousing.

Data Warehousing:
What's In It For You?
* Newly Enabled Workers
* Exposure to New Business Opportunities/Improved Cost Control
* Improved Customer Bond
* Precise Marketing Tools
* Increased Revenue
* Ability to Respond More Rapidly to Key Business Events
* Ability to Respond More Rapidly to Market and Technology Trends

New Jersey announces multi-payer portal to connect doctors with insurers

TRENTON, NJ – In a development that was compared for its convenience and usefulness to banks' establishment of ATM networks, NaviNet, the country's largest real-time healthcare communications network, announced Thursday it would partner with major health insurers in New Jersey to build a multi-payer portal as a "one-stop shop" for physicians to communicate directly with an array of health plans.

Developed in concert with two insurance trade groups – America’s Health Insurance Plans and the Blue Cross Blue Shield Association – NaviNet's Insurer Connect will offer providers easy communication with five of New Jersey's largest insurers: Aetna, AmeriHealth New Jersey, Cigna, Horizon Blue Cross Blue Shield of New Jersey, and United Healthcare.

"We absolutely believe that our coming together to use the NaviNet provider portal will be making better use of doctors' times and their staffs' times, will streamline services to our members and ultimately will improve quality and reduce costs," said Christy Bell, senior vice president of healthcare management for Horizon Blue Cross Blue Shield of New Jersey, on a conference call.

Doctors in New Jersey spend an average of $68,000 annually simply checking referrals and benefit eligibility, and ensuring their patients are enrolled in the correct plans, it was noted. Such expensive, "time-intensive, redundant administrative tasks add no value to the healthcare system, and [are of] no direct benefit to patients," said Sal Bernardo, MD, of the New Jersey Academy of Family Physicians, who uses the portal. "It's an "excessive amount of time on paperwork that could otherwise be spent on direct patient care."

Working to obviate that administrative burden of all those phone calls and faxes is the aim, said NaviNet president and CEO Brad Waugh. "We’ve seen positive feedback and results from the more than 50,000 New Jersey providers that already use NaviNet on behalf of 95 percent of the state’s commercially insured population, so we’re confident that this initiative will improve efficiencies as well as deliver a foundation for a comprehensive national health information exchange.”

"Over the years," noted Bell, "healthcare has become very complex, with inherent tensions built into the system, and that's eroded trust between the parties that really do need to work together. [There are] many different carriers doctors have to deal with, different coverages they have to deal with, and these different coverages may have different rules….  This collaboration will reduce that complexity and improve interactions and relationships."

“In order to ensure our patients receive the best possible care in a timely manner, family physicians are always eager to find a more uniform, efficient and cost effective manner in which to exchange patient information with health plans," said Stephen Nurkiewicz, MD, president, New Jersey Academy of Family Physicians. "In this current healthcare delivery system, family medicine and other primary care practices must make a significant investment in their front desk staff time managing these types of communications with multiple health plans in New Jersey.  We are hopeful that the NaviNet Web-based portal will provide a uniform means to interact with health plans and access a broad range of information for our patients from a single Web site in real time."

iPhone app to keep track of alcohol units

The NHS has launched a free iPhone app to let people keep track of how much alcohol they are drinking.

By Rebecca Smith, Medical Editor
Published: 6:45AM GMT 01 Dec 2009

Drinkers will be able to keep track of their units with a new iphone app launched by the Department of Health Photo: PAUL GROVER

The new application was launched by Gillian Merron, public health minister, as the festive party season gets under way to help people keep track of their alcohol consumption.

The device which can be downloaded onto smart phones like the iPhone, will allow users to see how many units of alcohol there are in their drink, keep a running total of their consumption and get personalised feedback on their drinking habits.

Studies have shown that people underestimate how much alcohol they have drunk on a night out and may exceed the safe limits without realizing it.

Recommended limits are two to three units a day for women - the equivalent of a medium to a large glass of wine - and three to four a day for men - a large glass to a glass and a half, or two pints - with at least two alcohol-free days a week.

Because of the increasing strength of alcoholic drinks and the trend for larger measures, one large glass of wine now counts as three units, a medium glass as two and a small glass as one-and-a-half.

Research earlier this year by Government statisticians showed more than 7 million middle-class drinkers are putting their health at risk by enjoying evenings at home with a bottle of wine.

Public Health Minister, Gillian Merron said: “It is all too easy to lose track of how much you drink. So as the festive parties start to build up, this innovative tool will help people keep tabs on their drinking – wherever they are.

“It’s one of many ways the Government is helping people to understand how much they are drinking. Sticking within the NHS recommended limits means you reduce the risk of serious conditions such as mouth cancer and strokes.”

Chris Sorek, Chief Executive of Drinkaware, said: “Efforts to help people keep track of how much they’re drinking over the festive season and throughout the year are a good idea. Trying to stick within the daily unit guidelines will help people avoid the January slump and the long term health implications associated with drinking too much alcohol.”

The app is available from iTunes and www.nhs.uk and people who do not have a smart phone can text the word UNIT to 64746 and receive information on the NHS Choices alcohol unit calculator.

The application can be found at:http://www.nhs.uk/Tools/Pages/NHSAlcoholtracker.aspx