What Big Pharma pays your doctor

It takes at least a couple of mouse clicks to locate the material. Nor is there any more detail this year than last year about how the money is used.


Members of Innovative Medicines Canada (IMC), the lobby group for the large pharmaceutical companies, recently released their voluntary reports of payments to health-care professionals and health-care organizations.

Altogether, the 10 reporting companies paid out more than $75 million in 2017.

This is the second year of these disclosures. When they started, Russell Williams, then the IMC president, said on CBC’s The Current: “We’re open to continually improving and monitoring” the disclosures. According to the new president, Pamela Fralick, the 2016 revelations were only a first step and she expected more companies to disclose payments in 2017.

Come the 2017 disclosures, and there are still the same 10 companies. Moreover, the disclosures are actually not on the IMC website, they are on the individual companies’ websites and are not easy to find. It takes at least a couple of mouse clicks to locate the material. Nor is there any more detail this year than last year about how the money is used.

IMC touts these disclosures as “part of our commitment to high ethical standards and enhancing trust.”

But all that the companies have disclosed are gross figures — with no information about what they paid for.

Paid to promote opioids?

Why did Purdue Pharma, makers of OxyContin and a host of other opioid products, give almost $1.9 million to health-care professionals in 2017?

All Purdue’s website says is that the money was for “services.” Were some of those services speeches made by doctors on behalf of Purdue? In the past Purdue has paid doctors $2,000 a talk.

Amgen Canada gave more than $6 million to health-care organizations, but we don’t know what these organizations did with that money.

Novartis spent $350,000 on travel expenses so that doctors and possibly other professionals could go to international congresses and/or global stand-alone meetings.

Who were these health-care professionals? What meetings did they go to? Where were the meetings?

Canada lags behind

Big Pharma here in Canada is far behind the curve when it comes to disclosing where the money is going. The federal government doesn’t seem to be in any hurry to force the companies to make more information public either.

Just over a year ago, then Health Minister Jane Philpott’s position was that forcing the disclosure of payments to individual doctors was, “in principle…an important concept” but should be left to the provinces.

In the United States, companies have had to disclose any payment of more than $10 to a doctor since 2013. The doctors are named.

In Australia, an analysis of information that companies must disclose found that, from October 2011 to September 2015, 42 companies sponsored 116,845 events for health professionals.

In nine European countries, disclosure is either mandatory or voluntary. Many of the European voluntary codes allow doctors to opt out of having their names disclosed.

IMC justified not linking doctors’ names to payments on the grounds of Canadian privacy laws but Ontario’s recently passed legislation will require disclosures to include the names of all health-care professionals who receive money or any other “transfer of value.”

Later this summer, British Columbia will hold public consultations about the same type of legislation.

Point-of-care ultrasound: a reliable bedrock of the general hospital

Medical scope of practice can vary by state, country and/or local jurisdiction.

Point-of-care ultrasound is at the heart of Frimley Park Hospital’s anaesthesia department, guiding procedures such as vascular access and nerve blocks. Dr Tim Pepall, a consultant anaesthetist at Frimley Park, explained: “It’s essential to use ultrasound for central vascular access because of NICE guidelines, but we also use it occasionally for difficult peripheral vascular access and arterial lines.

Ultrasound has transformed regional anaesthetic practice and we were relatively early adopters of it – it made sense to see the nerves, rather than going in blind. There is so much variation in nerve and vascular anatomy that you realise your previous techniques were really feeling in the dark. Nowadays, I would be very reluctant to do a plexus block without an ultrasound machine.”

Tim continued: “We’ve been using FUJIFILM SonoSite point-of-care systems for the last 10 years. There are five SonoSite instruments in the anaesthetic department and we’ve stayed with the one manufacturer because we’ve been very happy with it – we like the back-up service, as well as the simplicity of the systems and the quality of images it provides.

The SonoSite S-Nerve interface is very intuitive, and it is great for portability, we can transfer it onto the wards and take it wherever we need to use ultrasound. With the new SonoSite X­Porte, we’re also doing more echocardiography than before – which saves us having to discuss preoperative cases with the cardiologists as often – and we can see dynamic changes as they occur, and responses to our interventions.”

SonoSite, the SonoSite logo, S-Nerve and X-Porte are trademarks and registered trademarks of FUJIFILM SonoSite, Inc. in various jurisdictions. FUJIFILM is a trademark and registered trademark of FUJIFILM Corporation in various jurisdictions. All other trademarks are the property of their respective owners. Copyright (c) 2018 FUJIFILM SonoSite, Inc. All rights reserved. Subject to change.

Medical scope of practice can vary by state, country and/or local jurisdiction.

FUJIFILM SonoSite, Inc., is the innovator and world leader in bedside and point-of-care ultrasound, and an industry leader in ultra high-frequency micro-ultrasound technology. Headquartered near Seattle, the company is represented by a global distribution network in over 100 countries. SonoSite’s portable, compact systems are expanding the use of ultrasound across the clinical spectrum by cost-effectively bringing high-performance ultrasound to the point of patient care.

How outcome can be improved for every patient with state-of-the-art cardiac solutions

Healthcare providers and payers to quickly and securely integrate and flow data across the healthcare network.

DXC Technology , the world’s leading independent, end-to-end IT services company, announced DXC Open Health Connect, a digital health platform that enables healthcare providers to give better quality of care and patient outcomes by enabling interoperability between disparate environments to provide data when and where it’s needed across the healthcare system.

Rising costs, increased regulations and shifting consumer expectations are leading healthcare organizations to seek efficiencies through digital transformation. According to the IDC FutureScape: Worldwide Healthcare 2018 Predictions, “By 2019, more than 50 percent of life-science and healthcare companies will have dedicated resources to support accessing, sharing and analyzing real-world evidence for use across their organizations.”

Click here to know how outcome can be improved for every patient with state-of-the-art cardiac solutions.

A connected healthcare ecosystem — including integrated delivery networks, accurate patient data and increased access to information — is essential to lowering costs, improving care quality and boosting patient outcomes. DXC’s agile, cloud-based DXC Open Health Connect enterprise platform delivers the necessary tools and blueprints to healthcare providers and payers to quickly and securely integrate and flow data across the healthcare network.

“As the healthcare industry moves away from a volume-based model in favor of outcomes-based programs, interoperability and data sharing — financial, clinical and operational — will be key to achieving enhanced patient care,” said Andrea Fiumicelli, vice president and general manager, Healthcare and Life Sciences, DXC Technology.

“The future of connected healthcare will be about collaboration and care within and beyond the walls of a hospital or clinic. DXC Open Health Connect encapsulates the future of healthcare by delivering the speed, scale, flexibility and continuous innovation necessary for clients to turn their traditional healthcare systems into major digital-health enablers.”

DXC co-created DXC Open Health Connect with a large academic and research hospital system in metropolitan New York. The solution went into production in 2017, enabling better access to all of the data and technology across the network to discover new insights that are helping to enhance patient engagement, improve operational efficiencies and boost flexibility. Ultimately, DXC Open Health Connect is enabling a shift in focus away from acute care only to concentrating more on promoting lifelong wellness.

Combining partner, product and composite application programming interfaces (APIs) with cloud services and common protocols, DXC Open Health Connect delivers faster time to value by automating deployment, personalizing the user experience and accelerating service development to seamlessly move information between disparate environments.

DXC Open Health Connect, available globally, is offered as either a technology platform or in three easy-to-consume modules:

  1. The DXC Open Health Connect interoperability module helps integrate disparate data from across the healthcare ecosystem to support the creation of an integrated care record;
  2. DXC Open Health Connect analytics provide evidence-based insights about populations and individual health to improve care; and
  3. DXC Open Health Connect’s API Director supports the ability to rapidly create new, information-rich applications while governing and controlling access to patient data. It provides enterprise security, metering, billing and policy enforcement.

The digital platform allows for the deployment of DXC Technology’s mobile applications, such as PatientAide, NurseAideand ClinicalAide, which drive appropriate behavioral changes in the healthcare ecosystem and support changes in the patient journey.

http://bit.ly/2Kv5H4W Click here to read more

90,000 people had avoidable deaths in hospitals last year in the U.S.

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.

Read more @ http://bit.ly/2Nv6epr

How health care fares in California’s new spending plan

To help lower the premiums that consumers pay for health insurance through the state’s marketplace, Covered California.

California has been a national leader in the effort to expand health care coverage, but some advocates say this year’s state budget marks a step backward in the quest to reduce and ultimately eliminate the number of uninsured people.

Gov. Jerry Brown today signed a $201 billion spending plan that adds significant sums to the state’s rainy-day reserves, education and programs to aid affordable housing and homeless people.

But of the nearly $1.17 billion in new money that Democratic lawmakers sought to expand coverage, the final deal agreed to by Brown contains just $65 million specifically aimed at making premiums more affordable or addressing the millions of Californians who still have no health insurance at all.

“There’s no way to sugar coat this: There was no new investment to help Californians access or afford health care,” said Anthony Wright, executive director of Health Access California, a consumer advocacy nonprofit that lobbies for single-payer and universal health care.

Communication is critical for a successful surgery

As the Republican-controlled U.S. Congress continues its push to dismantle the Affordable Care Act—known as Obamacare—health care advocates in the Golden State had hoped to get more state funding to offset policies coming from Washington, D.C.

The goal of Senate and Assembly Democrats was to bring the state as near as possible to universal coverage. To get there, they fashioned complementary bills aimed at covering different segments of California’s underinsured or uninsured populations.

Last year, the state Senate passed a $400 billion bill to create a government-run universal health care system. The Assembly balked and shelved the bill, noting that it failed to detail how to pay for a plan whose costs appeared to exceeded the entire state budget.

This year, a scaled-back Assembly Democrats wish list sought just under $1 billion to expand coverage, with some $500 million intended to help lower the premiums that consumers pay for health insurance through the state’s marketplace, Covered California.

The Assembly proposal also would have allocated $250 million in recurring annual spending to extend coverage so uninsured young adults between 19 and 25, including undocumented immigrants, would have coverage. And it would have increased spending for health and nutrition programs for low-income women and children, and expansion of healthcare access for disabled undocumented immigrants.

Of the roughly 2.8 million California residents who remain uninsured, about 58 percent are undocumented immigrants, according to Health Access California.

To know more about this http://bit.ly/2MwzZVQ

National health targets lead to perverse outcomes

Those health targets were such a miserable failure that we have to find something that works and that’s better.

National has warned that there will be more preventable deaths in the health system now that the Government has dropped national health targets.

The performance targets for district health boards, which the former government introduced in 2009, have been stopped by the Coalition Government, and no data has been published since August 2017.

“Over time dropping the targets, losing the accountability, will mean more illnesses and more fatalities in our health system that could have been avoided,” National leader Simon Bridges told reporters today.

But Ian Powell, executive director of the Association of Salaried Medical Specialists, said that was not true.

“That’s crap. The obsessional nature of certain targets has contributed to some patients going blind,” he said.

Powell said the targets had not worked and they needed to be outcomes–based.

“They have led to superficial assessments of how the system has performed, they grossly mislead the public and they have had, especially in the context of underfunding, very perverse outcomes.

“The [Health] Minister, and we would agree with him, is looking more towards things that focus more on improved health outcomes,” he said.

Acting Prime Minister Winston Peters said the targets had been a “miserable failure”.

“It’s not correct to say we’ve dropped health targets. I just think those health targets were such a miserable failure that we have to find something that works and that’s better,” Peters told reporters this morning.

Health Minister David Clark said the Ministry of Health had stopped publishing data based on the previous government’s targets while other measures were developed.

“The previous government’s targets produced perverse incentives leading to what were traditionally cheaper surgeries being performed in more expensive environments. That meant the health dollar was not being spent as wisely as it could be,” Clark said.

“I want a health system that has honest and transparent measures, unlike the previous Government, which was pumping up its numbers by counting Avastin injections [used to treat eye disease] and skin lesion removals as surgeries when many could have been done in primary care.”


General Electric’s booted from the blue-chip Dow Jones index

GE’s lackluster performance in recent years has made it an outlier compared with other Dow components.

General Electric’s (GE) 111-year run as one of the Dow Jones industrial average’s 30 components is coming to a close. S&P Dow Jones Indices announced Tuesday that Walgreens Boots Alliance (WBA) will replace the conglomerate in the blue-chip index on June 26.

GE had been the only remaining original member of the Dow — it joined in 1896 but was booted twice in its early years — and had been a regular in the index since 1907.

“Walgreens is a national retail drugstore chain offering prescription and nonprescription drugs, related health services and general goods,” David Blitzer, managing director and chairman of the index committee at S&P Dow Jones Indices, said in a statement. “Today’s change to the DJIA will make the index a better measure of the economy and the stock market.”


A better measure indeed. GE’s lackluster performance in recent years has made it an outlier compared with other Dow components, heightening expectations on Wall Street that an exit from the index was likely.

GE has struggled with a turnaround under new CEO John Flannery Jr., who has called the company a “self-help story” and referred to 2018 as a “reset year.” The question is whether he has the capability and determination to achieve the seemingly impossible goal of revamping the venerable company.