jueves, 21 de febrero de 2013

Laboratory Science, Policy and Practice Program Office ► LSPPPO|HEALTHCARE NEWS|February 21, 2013


Healthcare News

A Weekly Compilation of Clinical Laboratory and Related Information
from The Division of Laboratory Science and Standards


February 21, 2013

View Previous Issues - Healthcare News Archive

Doctors List Overused Medical Treatments
A coalition of healthcare provider associations says many common practices are costly, often unnecessary and sometimes even harmful.
Nearly 100 medical procedures, tests and therapies are overused and often unnecessary, a coalition of leading medical societies says in a new report aimed at improving healthcare and controlling runaway costs. The medical interventions — including early caesarean deliveries, CT scans for head injuries in children and annual Pap tests for middle-aged women — may be necessary in some cases, the physician groups said. But often they are not beneficial and may even cause harm. "We are very concerned about the rapidly escalating cost of healthcare," said Dr. Bruce Sigsbee, president of the American Academy of Neurology, which was among the 17 medical groups contributing to the list of procedures. "This is not healthy for the country, and something has to be done." Development of the list, which was organized by the American Board of Internal Medicine's ABIM Foundation, is a minor milestone in efforts to enlist physicians to rein in unnecessary services, a leading cause of the skyrocketing healthcare tab. In 2011, the ABIM Foundation published a similar list of procedures submitted by nine other medical societies as part of its Choosing Wisely campaign.

The United States spends more than $2.5 trillion a year on healthcare, or more than $8,000 per person. That is 2 and 1/2 times as much as the average spent by other industrialized nations, according to data collected by the Organization for Economic Cooperation and Development, whose members include the richest nations.

Source: http://www.latimes.com/External Web Site Icon

CMS Proposes Reforms to Reduce Provider Regulatory Burdens
The Centers for Medicare & Medicaid Services (CMS) published a proposed rule on February 7, 2013 that it estimates would save health care providers $676 million annually by streamlining unnecessary, obsolete, or excessively burdensome regulations and making reforms to the Clinical Laboratory Improvement Amendments of 1988 (CLIA). The provisions of the wide-ranging proposal would affect numerous policy areas

Source: http://www.healthindustrywashingtonwatch.com/External Web Site Icon

Supreme Court Rules Against Phoebe Putney
The U.S. Supreme Court has issued a ruling that could jeopardize a $200 million hospital acquisition involving Phoebe Putney Health System in Georgia, after a unanimous court decided that the hospital deal was not immune from antitrust laws. The Federal Trade Commission has been fighting since 2010 to block the acquisition of a former HCA hospital by its only competitor in Albany, Ga., the public hospital authority that also owns not-for-profit Phoebe Putney's hospitals. But until the Supreme Court ruled, the lower federal courts had said the deal was beyond the reach of federal antitrust laws because of the hospital authority's ownership.

Source: http://www.modernhealthcare.com/External Web Site Icon

Obama Seeking to Boost Study of Human Brain
The Obama administration is planning a decade-long scientific effort to examine the workings of the human brain and build a comprehensive map of its activity, seeking to do for the brain what the Human Genome Project did for genetics. The project, which the administration has been looking to unveil as early as March, will include federal agencies, private foundations and teams of neuroscientists and nanoscientists in a concerted effort to advance the knowledge of the brain’s billions of neurons and gain greater insights into perception, actions and, ultimately, consciousness.

Source: http://www.nytimes.com/External Web Site Icon

Report on Sequestration
On March 1st, the Office of Management and Budget (OMB) will sequester $85 billion in Fiscal Year (FY) 2013 spending as mandated by the Budget Control Act, unless Congress acts.

Centers for Disease Control and Prevention (CDC)
Sequestration would mean cuts of $350 million or more for the CDC, whose mission is to prevent and detect outbreaks of infectious diseases like flu, tuberculosis and foodborne illnesses, and to improve prevention and screening for chronic diseases like cancer and diabetes. Among other things, sequestration would result in about 25,000 fewer breast and cervical cancer screenings for low-income, high-risk women, and approximately 424,000 fewer HIV tests conducted by health departments. It would also mean purchase of about 540,000 fewer doses of vaccine against diseases like hepatitis, flu, measles and whooping cough for children and adults in need of immunizations.

Source: http://www.democrats.appropriations.house.gov/ Adobe PDF file [PDF 555.93KB]External Web Site Icon

CDC App Engages Public in Learning About Outbreaks
You may not be a disease detective, but now you can play one at home.

The nation's public health agency has released a free app for the iPad called "Solve the OutbreakExternal Web Site Icon." It allows users to run through fictional outbreaks and make decisions: Do you quarantine the village? Talk to people who are sick? The Centers for Disease Control and Prevention says the app was designed in-house and wouldn't give an estimate for development costs. The agency says it is using social media to educate the public about diseases and to promote an appreciation for public health work. The app went live this week.

Source: http://www.usatoday.com/External Web Site Icon

Coding Consultant Uses Crowdsourcing for Clinical Pathology Laboratories to Post Amounts Paid by Medicare Contractors for Molecular Test Claims
Medical laboratories have yet to learn how much to expect in payment for molecular pathology test claims submitted to the Medicare program Concern is rising among pathologists and clinical laboratory directors about what the Medicare program will pay this year for the 104 new molecular test CPT codes. These new CPT codes became effective on January 1, 2013. Few–if any–medical laboratories have received payments for Medicare claims submitted early in January. That’s because contractors for the federal Centers for Medicare & Medicaid Services (CMS) are just beginning to process those invoices. The first payments for these molecular test claims are expected within the next several weeks.

Source: http://www.darkdaily.com/External Web Site Icon

Proficiency Testing Matters
Far too many laboratories consider proficiency testing just a necessary evil, little more than periodic pass–fail exercises we perform solely to meet regulatory requirements. In addition, too many of us belittle point-of-care (POC) testing as a passing fad, a technology so inferior to what we use in our own laboratories that it hardly warrants our attention. Clearly, a report that combines these 2 topics, such as the one in this issue of Clinical Chemistry, runs the risk of commanding little attention. That would be a very unfortunate mistake, because it has important lessons for all of us who practice laboratory medicine in our efforts to improve patient care.

As Stavelin et al suggest, POC testing represents an important and growing segment of laboratory medicine. Many important clinical decisions are based on these technologies. Even if the CVs of POC testing, and indeed their accuracies, are not as good as central-laboratory techniques, POC testing modalities can sometimes have a more positive impact on certain aspects of healthcare.

Source: http://www.clinchem.org/External Web Site Icon

Groups Offer Guidance on Gene Testing in Kids
Decisions involving genetic testing of children must focus on the individual child's best interest, taking into account the implications for family members, according to a policy statement developed jointly by the American Academy of Pediatrics (AAP) and the American College of Medical Genetics and Genomics (ACMG). New recommendations have been needed because of the rapid technological advances in genetics in recent decades and broader interest on the part of the public in screening and testing, explained Lainie F. Ross, MD, PhD, of the University of Chicago, and colleagues from the two groups.

"The growing literature on the psychosocial and clinical effects of such testing and screening can help inform us about best practices," Ross and colleagues stated in the March issue of Pediatrics. Any such testing should preferably be done in conjunction with appropriate genetic counseling by a trained provider, and not in a school setting where privacy and confidentiality cannot be ensured, they advised.

Source: http://www.medpagetoday.com/External Web Site Icon

Multiple Tests Needed to Spot Infections in Newborns: Study
Some bacteria may avoid detection with standard exams, researchers contend
Multiple tests are needed to detect bacterial infections in newborns with a low birth weight, a new study suggests. The study authors looked at amniotic and umbilical cord blood samples from 44 premature infants who had low birth weights. Most of the infants had been diagnosed with early onset sepsis, which occurs within 72 hours of birth.

Sepsis is a life-threatening blood infection that can be caused by a number of types of bacteria. For the new study, the researchers found that cultures commonly used to detect bacterial infections in newborns with low birth weights and early-onset sepsis failed to detect more than 20 types of bacteria. Some of those bacteria species were present in both the amniotic fluid and umbilical cord blood, the researchers said. The study results point to the need for multiple tests -- such as DNA analysis -- to identify bacteria that may not be detected using standard culturing, said the team of researchers from Case Western Reserve University School of Dental Medicine and Yale University School of Medicine.

Source: http://consumer.healthday.com/External Web Site Icon

Screening Smarter, Not Harder, for Prostate Cancer
What is the problem and what is known about it so far?
Prostate cancer is the most commonly diagnosed non–skin cancer among U.S. men. It can be life-threatening, and many men have cancer without knowing it. For those reasons, doctors sometimes look for prostate cancer in healthy men (screen for cancer) by measuring blood levels of prostate-specific antigen (PSA), a protein secreted by the prostate gland. High PSA levels can be caused by cancer and may lead a doctor to take a sample of prostate tissue to see whether cancer is present (biopsy). Most prostate cancer grows very slowly, however, and many men with prostate cancer die of other causes. Neither PSA testing nor prostate biopsy tells doctors with certainty which cases of prostate cancer are threatening and which require treatment. As a result, many men with slow-growing cancer have biopsies and treatment after PSA testing that they would not have needed if doctors had never tested. For that reason, a group of experts recently recommended against prostate cancer screening with PSA testing. They concluded that men are hurt more than they are helped by the test. Their recommendation was based on standard practice, where men are tested every year and referred for biopsy and treatment at certain PSA levels. It is possible that using the PSA test differently (for example, by testing less often) would still be useful but reduce the harms of unnecessary treatment that come from more frequent testing.

Source: http://annals.org/External Web Site Icon

Predictive Value of Prostate Cancer Gene 3 Validated
Researchers have confirmed that the prostate cancer gene 3 (PCA3) is a valid predictor for current cancer and future biopsy outcomes. "These results confirm that PCA3 can be used in combination with other clinical information to help guide prostate biopsy decisions," say Sheila Aubin (Gen-Probe Incorporated, San Diego, California, USA) and team.

Source: http://www.medwirenews.com/External Web Site Icon

Next Generation Sequencing in the Clinic: A Perspective From Dr. Elaine Mardis
With rapid advances in next generation sequencing (NGS) technology and its increased use in clinical settings, the dawn of widespread personalized medicine appears to be upon us. Dr. Elaine Mardis, institute Co-director and Director of Technology Development at The Genome Institute, Washington University in St. Louis, Missouri, USA, shares her views on the current uses of NGS, the challenges that NGS technologies face, and what can be expected in the future.

Source: http://www.idtdna.com/External Web Site Icon

DNA Diagnosis Performed by Genetic Device
Scientists hope that one day in the distant future, miniature, medically-savvy computers will roam our bodies, detecting early-stage diseases and treating them on the spot by releasing a suitable drug, without any outside help. To make this vision a reality, computers must be sufficiently small to fit into body cells. Moreover, they must be able to "talk" to various cellular systems. These challenges can be best addressed by creating computers based on biological molecules such as DNA or proteins. The idea is far from outrageous; after all, biological organisms are capable of receiving and processing information, and of responding accordingly, in a way that resembles a computer.

Researchers at the Weizmann Institute of Science have recently made an important step in this direction: They have succeeded in creating a genetic device that operates independently in bacterial cells. The device has been programmed to identify certain parameters and mount an appropriate response.

Source: http://www.medicalnewstoday.com/External Web Site Icon

DNA Test for Rare Disorders Becomes More Routine
Scientists sequence all of a patient’s genes, systematically searching for disease-causing mutations. A few years ago, this sort of test was so difficult and expensive that it was generally only available to participants in research projects like those sponsored by the National Institutes of Health. But the price has plunged in just a few years from tens of thousands of dollars to around $7,000 to $9,000 for a family. Baylor College of Medicine and a handful of companies are now offering it. Insurers usually pay. Demand has soared — at Baylor, for example, scientists analyzed 5 to 10 DNA sequences a month when the program started in November 2011. Now they are doing more than 130 analyses a month. At the National Institutes of Health, which handles about 300 cases a year as part of its research program, demand is so great that the program is expected to ultimately take on 800 to 900 a year.

The test is beginning to transform life for patients and families who have often spent years searching for answers. They can now start the grueling process with DNA sequencing, says Dr. Wendy K. Chung, professor of pediatrics and medicine at Columbia University. “Most people originally thought of using it as a court of last resort,” Dr. Chung said. “Now we can think of it as a first-line test.”

Source: http://www.nytimes.com/External Web Site Icon

Stool DNA Testing Helps Screen for Colorectal Neoplasia
In patients with inflammatory bowel disease (IBD), exfoliated DNA markers may help reduce the shortcomings of colonoscopy surveillance for colorectal neoplasia, a new paper suggests. "We currently know that IBD patients are at increased risk for colorectal cancer and pre-cancerous dysplasia. We currently perform colonoscopic surveillance (every one to two years) to find these high risk lesions, but this practice has important limitations in patients with IBD, and better approaches are needed," coauthor Dr. John B. Kiesel of the Mayo Clinic, Rochester, Minnesota told Reuters Health by email.

At 89% specificity, the combination of BMP3 and mNDRG4 detected 100% of colorectal cancers, 100% of high-grade and 67% of low-grade dysplasia. The researchers say, "Additional studies are needed to corroborate and expand these novel findings "Nevertheless, Dr. Kiesel went on to say, "Our early feasibility results demonstrate that stool DNA testing is an accurate, noninvasive approach for the detection of colon cancer and precancers in IBD patients. Stool DNA testing, may therefore complement colonoscopy in the future."

Source: http://www.medscape.com/External Web Site Icon

Troponin I Predicts Event Risk in CAD
In patients with stable coronary artery disease, troponin I levels measured with a high-sensitivity assay add prognostic information to conventional risk markers and troponin T levels, researchers found. The study shows "that both [troponin I] and troponin T provide strong and independent prognostic information for the endpoints of cardiovascular death or congestive heart failure, underscoring that chronic, low-grade injury may represent an intermediate phenotype in the pathway to congestive heart failure among at-risk patients," Omland and colleagues wrote.

Source: http://www.medpagetoday.com/External Web Site Icon

Fast New Test Could Find Leprosy Before Damage Is Lasting
A simple, fast and inexpensive new test for leprosy offers hope that, even in the poorest countries, victims can be found and cured before they become permanently disabled or disfigured like the shunned lepers of yore. American researchers developed the test, and Brazil’s drug-regulatory agency registered it last month. A Brazilian diagnostics company, OrangeLife, will manufacture it on the understanding that the price will be $1 or less. “This will bring leprosy management out of the Dark Ages,” said Dr. William Levis, who has treated leprosy patients at a Bellevue Hospital outpatient clinic for 30 years.

Source: http://www.nytimes.com/External Web Site Icon

Blood Test May Show Memory Loss in Older Women
The blood of healthy postmenopausal women may offer signs of increased risk of small areas of brain damage, dubbed white matter hyperintensities (WMH), which have been linked to memory loss, researchers reported. In a prospective observational study, women who began with higher levels of thrombogenic microvesicles were more likely to have greater volumes of WMH 4 years later, according to Kejal Kantarci, MD, of the Mayo Clinic in Minneapolis, and colleagues.

Source: http://www.medpagetoday.com/External Web Site Icon

Severe Childhood Asthma Blood Test Hopes Dashed
Blood eosinophil counts do not reliably reflect airway eosinophil concentrations in children with severe, therapy-resistant asthma, and therefore cannot be used to make therapeutic decisions, researchers report. The findings are a disappointing set back in the development of a blood test to substitute more invasive techniques to measure airway inflammation, which has previously shown promise for adults with severe asthma. "Our data suggest that if blood eosinophilia is present, it is highly probable that airway eosinophilia ([bronchoalveolar lavage] and biopsy) is also present, but if the blood eosinophil count is normal, it is not possible to predict whether airway eosinophilia is present," say Sejal Saglani (Imperial College London, UK) and colleagues.

Source: http://www.medwirenews.com/External Web Site Icon

FDA Clears Sanger Sequencing Platform and HLA Typing Kits for Diagnostic Use
Life Technologies Corporation has received U.S. Food and Drug Administration (FDA) 510(k) clearance for its 3500 Dx Genetic Analyzers and SeCore HLA typing kits. Life Technologies has also announced plans to submit its next-generation sequencing instrument, the Ion Torrent Personal Genome Machine (PGM) for 510(k) clearance.

Source: http://www.mlo-online.com/External Web Site Icon

FDA Approves Dako's HER2 IQFISH Assay
Dako announced that the US Food and Drug Administration has approved its HER2 IQFISH pharmDx assay for marketing in the US. HER2 IQFISH pharmDx is a fluorescence in situ hybridization assay based on Dako's "instant quality in situ hybridization" buffer chemistry, and according to the firm, the assay will reduce the cancer diagnosis turnaround time to three-and-a-half hours from the current two days.

Source: http://www.genomeweb.com/External Web Site Icon

Biomarker Discovery Center Receives Grant to Develop Diagnostic Blood Test
The $799,800 grant from the Osteopathic Heritage Foundation to develop is for a blood test that can diagnose mild cognitive impairment (MCI) caused by early-stage Alzheimer's disease. MCI affects nearly one in every five adults older than 65, causing memory and language problems beyond those associated with normal aging. Individuals with MCI often exhibit early symptoms of dementia, and approximately 60 percent of all MCI cases are believed to be early-stage Alzheimer’s disease.

Source: http://www.technologynetworks.com/External Web Site Icon

LA BioMed to Launch Genomics Institute
The Los Angeles Biomedical Research Institute said that it is launching a new institute that will use a genome-based approach to pursue translational research aimed at the diverse populations of the Los Angeles area. The LA BioMed Institute for Translational Genomics and Population Sciences will focus its efforts on using genomics to address the healthcare needs of the Hispanic, African-American, and Asian populations that are served by LA BioMed and the Harbor-UCLA Medical Center. The institute will include a Center for Personalized Medicine and Pharmacogenomics and three population centers, with each focusing on one of the specific minority groups.

Source: http://www.genomeweb.com/External Web Site Icon

Protocol Stems Postpartum Bleeds
A comprehensive protocol for treating maternal hemorrhage reduced transfusions and hysterectomies, researchers found. The packed red blood cell use in this setting dropped a significant 22% across a group of hospitals after adopting the protocol, Larry Shields, MD, of Marian Regional Medical Center in Santa Maria, Calif., and colleagues reported.

Source: http://www.medpagetoday.com/External Web Site Icon

MIT Cell Circuits Perform Logic Functions, Remember Their Past
Bacterial cells that perform sensor duties in the body may be of great benefit for clinical medicine in the future. Cells have been made before to react in specific ways to a given stimulus, which can be detected externally. Now researchers at MIT have developed synthetic genetic circuits within living cells that have Boolean logic gates as well as memory function to remember the result. The bits of memory end up stored within the DNA of the cells and get passed on to their progeny for dozens of generations so that long term sensing is possible without having to keep individual cells alive indefinitely.

Source: http://www.medgadget.com/External Web Site Icon

New Carbapenem-Resistant Enterobacteriaceae Warrant Additional Action by Healthcare Providers 
Carbapenem-resistant Enterobacteriaceae (CRE) are untreatable or difficult-to-treat multidrug-resistant organisms that are emerging in the United States. Because of increased reports of these multidrug-resistant organisms, CDC is alerting clinicians about the need for additional prevention steps regarding CRE. Key points include:
  • While still uncommon, reports of unusual forms of CRE (e.g., New Delhi Metallo-β-lactamase and Verona Integron-mediated Metallo-β-lactamase) in the United States are increasing. Of the 37 unusual forms of CRE that have been reported in the United States, the last 15 have been reported since July, 2012.
  • This increase highlights the need for U.S. healthcare providers to act aggressively to prevent the emergence and spread of these unusual CRE organisms.
  • Current CDC guidance includes key elements of CRE prevention (e.g., use of Contact Precautions) in healthcare settings.
  • Because the vast majority of these unusual organisms were isolated from patients who received overnight medical treatment outside of the United States, additional measures described in this HAN advisory are now recommended to be taken when such patients are hospitalized in the United States
Source: http://content.govdelivery.com/External Web Site Icon

Consumers Have Few Negative Reactions to the Results of Genetic Testing for Cancer Mutations
Information prompts individuals to consult physician, inform relatives
A 23andMe study of consumers' reactions to genetic testing found that even when the tests revealed high-risk mutations in individuals, those individuals had few negative reactions to the news. Instead of inducing serious anxiety, the test results prompted people to take positive steps, including follow-up visits with a doctor and discussions with family members who could also be at risk. The study looked at how people reacted when they learned for the first time that they carried a mutation in either the BRCA1 or BRCA2 gene that put them at higher risk for breast and ovarian cancer.

Source: http://www.eurekalert.org/pub_releases/2013-02/p-chf020513.phpExternal Web Site Icon

Chromosome Changes May Predict Susceptibility to Disease
Scientists say people with shorter telomeres, or DNA tips, were more likely to get colds.
Fortunetellers claim they can forecast the future by reading tea leaves, tarot cards or your horoscope. But a preliminary study suggests that our susceptibility to infections such as the common cold — and maybe our future health overall — may be foretold not in the creases of our palms but in the tips of our chromosomes. These tips, called telomeres, are special DNA sequences that act like the plastic tips on shoelaces, preventing the DNA in chromosomes from unraveling. They get shorter each time a cell divides, until a cell can't divide anymore and it dies.

Source: http://www.usatoday.com/External Web Site Icon

Potential Cause of Depression Identified
A protein involved in synaptic structure has been identified as a potential cause of depression, a finding that according to researchers has "enormous therapeutic potential for the development of biomarkers and novel therapeutic agents." Investigators at the Mount Sinai School of Medicine in New York City found decreased expression of Rac1 in the postmortem brains of people with major depressive disorder (MDD) and in mice subjected to chronic stress. They were able to control the depressive response in mice by manipulating the expression of Rac1.

Source: http://www.medscape.com/External Web Site Icon

NIH Study Shows Big Improvement in Diabetes Control Over Past Decades
Findings demonstrate need for improved care, especially among youth, some minorities
More people are meeting recommended goals in the three key markers of diabetes control, according to a study conducted and funded by the National Institutes of Health and the Centers for Disease Control and Prevention. The report, published online February 15 in Diabetes Care, shows that, from 1988 to 2010, the number of people with diabetes able to meet or exceed all three of the measures that demonstrate good diabetes management rose from about 2 percent to about 19 percent.  Each measure also showed substantial improvement, with over half of people meeting each individual goal in 2010.  The measures are A1C -- which assesses blood sugar (glucose) over the previous three months -- blood pressure and cholesterol.

Source: http://www.nih.gov/External Web Site Icon

Dogs Cured of Type 1 Diabetes
Beagles no longer showed diabetes symptoms following a single course of gene therapy.
Gene therapy has successfully banished type 1 diabetes in dogs, the first time this treatment has worked to treat the disease in a large animal, according to a study published online in the journal Diabetes earlier this month. For the study, Spanish researchers induced diabetes in beagles between 6 months and 1 year old. They then injected the dogs’ skeletal muscles with viruses carrying genes for insulin and glucokinase, an enzyme involved in processing glucose.

But sources warned New Scientist that the treatment might not work the same way in humans that it did in canines, as the dogs’ diabetes was induced by chemically destroying pancreas cells that produce insulin. In naturally occurring type 1 diabetes, on the other hand, the immune system destroys the insulin-producing cells.

Sources: http://www.the-scientist.com/External Web Site Icon

An Optimistic Era for Global Infectious Disease Control
The world has an "historic opportunity" to contain and end three of humanity's deadliest scourges by focusing on their "hot zones," according to Mark Dybul, the newly appointed director of the Geneva-based Global Fund to Fight HIV, Tuberculosis, and Malaria. Dybul said that a better understanding of the epidemiology of the diseases makes it clear there aren't what have been called "generalized" epidemics, even in hard-hit countries, but there are what he called "micro-epidemics."

Source: http://www.theatlantic.com/External Web Site Icon

Hydrogen Sulfide Seen Offering Promise of Extending Life
In the hunt for ways to extend life, scientists are turning to an unlikely source: the gas that gives rotten eggs their distinctive foul smell.  Hydrogen sulfide -- maligned for its toxic and explosive properties -- may slow aging and block damaging chemical reactions inside cells, according to scientists in China, who reviewed studies on the malodorous gas and its effects on the cardiovascular and nervous systems.

Source: http://www.bloomberg.com/External Web Site Icon

ACA Will Help Spark Boom in Remote Patient Monitoring
The number of Americans remotely monitored at home with devices such as pulse oximeters and peak-flow meters for 5 major chronic illnesses will grow 6-fold by 2017 as healthcare reform pushes hospitals and physicians to stop revolving-door admissions, reports InMedica, a division of IMS Research. In 2012, clinicians reviewed long-distance vital signs on computer screens for some 227,000 patients with congestive heart failure (CHF), chronic obstructive pulmonary disease, diabetes, hypertension, and mental illness, according to the InMedica report released in January. By 2017, that number will jump to almost 1.3 million. The figures include a smattering of patients followed for a grab bag of other conditions such as asthma, coronary artery disease, and hemophilia. Helping to spur this growth is the Affordable Care Act (ACA), said report coauthor Shane Walker, associate director for digital health at InMedica. "It's all about moving toward preventive care and reducing avoidable hospital readmissions," Walker told Medscape Medical News.

Source: http://www.medscape.com/External Web Site Icon

Harnessing the Power of Enhanced Data for Healthcare Quality Improvement: Lessons From a Minnesota Hospital Association Pilot Project
The imperative to achieve quality improvement and cost-containment goals is driving healthcare organizations to make better use of existing health information. One strategy, the construction of hybrid data sets combining clinical and administrative data, has strong potential to improve the cost-effectiveness of hospital quality reporting processes, improve the accuracy of quality measures and rankings, and strengthen data systems. Through a two-year contract with the Agency for Healthcare Research and Quality, the Minnesota Hospital Association launched a pilot project in 2007 to link hospital clinical information to administrative data. Despite some initial challenges, this project was successful. Results showed that the use of hybrid data allowed for more accurate comparisons of risk-adjusted mortality and risk-adjusted complications across Minnesota hospitals.

Source: http://www.ncbi.nlm.nih.gov/External Web Site Icon

The Best Practices for Protecting Sensitive Documents Wherever They Reside is to Secure the Documents Themselves
As more hospitals hire temporary and freelance workers who move between facilities and access sensitive patient information via mobile devices, security threats are rising. The recent infraction at Massachusetts Eye and Ear Infirmary is a cautionary tale about the consequences of violating the privacy regulations in the Health Insurance Portability and Accountability Act (HIPAA). After the loss of an unencrypted mobile device containing patient data at Mass. Eye and Ear, the facility was hit with a $1.5 million fine in a resolution agreement with the Office for Civil Rights.  Healthcare professionals are increasing their use of mobile devices to share patient data. IT decision-makers in hospitals across North America are exploring text messaging as a replacement for paging. Doctors say they expect to use text messaging to communicate with patients, even as IT personnel struggle to craft a plan for keeping texting activity in compliance with HIPAA. And the security crisis in healthcare is further heightened by the U.S. Department of Health and Human Services' Stage 2 Meaningful Use requirement for patient access to electronic health data.

Source: http://health-information.advanceweb.com/External Web Site Icon

A Digital Shift on Health Data Swells Profits in an Industry
While doctors and hospitals struggle to make new records systems work, the clear winners are big companies like Allscripts that lobbied for that legislation and pushed aside smaller competitors. While proponents say new record-keeping technologies will one day reduce costs and improve care, profits and sales are soaring now across the records industry. At Allscripts, annual sales have more than doubled from $548 million in 2009 to an estimated $1.44 billion last year, partly reflecting daring acquisitions made on the bet that the legislation would be a boon for the industry. At the Cerner Corporation of Kansas City, Mo., sales rose 60 percent during that period. With money pouring in, top executives are enjoying Wall Street-style paydays.

Source: http://www.nytimes.com/External Web Site Icon

Balancing High Costs, Potential Savings
ECRI highlights tech with prices that should be weighed carefully by execs
The ECRI Institute queried experts to identify the top 10 technologies that healthcare executives should watch in 2013:
  1. Electronic health records
  2. Mobile health
  3. Alarm integration
  4. Minimally invasive cardiac surgery
  5. Imaging and surgery
  6. PET/MRI scanners
  7. Bariatric surgery
  8. MRI-compatible pacemakers
  9. Radiation dose safety
  10. Lung cancer screenings
Source: http://www.modernhealthcare.com/External Web Site Icon

Consumer Group Wants Limits on Added Sugars in Beverages
The Center for Science in the Public Interest filed a petition with the Food and Drug Administration urging the agency to identify a safe level for added sugars in beverages. Soda and other sugary drinks have unsafe levels of high-fructose corn syrup or other added sugars, a consumer group says, and it is urging the government to determine a safe level to reduce Americans' "dangerously high sugar consumption." A diet high in high-fructose corn syrup and added sugars is linked to an increased risk of obesity, type 2 diabetes, heart disease, gout and tooth decay, says CSPI executive director Michael Jacobson. About two-thirds of adults and one-third of children in the USA are overweight or obese.

Source: http://www.usatoday.com/External Web Site Icon

Food, Drink Industries Undermine Health Policy, Study Finds
Multinational food, drink and alcohol companies are using strategies similar to those employed by the tobacco industry to undermine public health policies, health experts said. In an international analysis of involvement by so-called "unhealthy commodity" companies in health policy-making, researchers from Australia, Britain, Brazil and elsewhere said self-regulation was failing and it was time the industry was regulated more stringently from outside. The researchers said that through the aggressive marketing of ultra-processed food and drink, multinational companies were now major drivers of the world's growing epidemic of chronic diseases such as heart disease, cancer and diabetes. http://bit.ly/U8PCoNExternal Web Site Icon Lancet 2013.

Source: http://www.medscape.com/External Web Site Icon

Renewal of AIDS Program Backed

The 10-year-old program to fight global AIDS started by the Bush administration is doing a good job and should be funded again after it expires this year, a panel of medical experts recommended. But countries getting aid should be pushed to manage more of their own programs and pay more of the costs, the panel said. The experts, from the Institute of Medicine, part of the National Academies of Science, were asked by Congress to evaluate the President’s Emergency Plan for AIDS Relief, which has spent about $38 billion.

Source: http://www.nytimes.com/External Web Site Icon

Sex Diseases Cost $16 Billion a Year to Treat, CDC Says
Sexually transmitted diseases cost $16 billion each year to treat in the U.S., with 19.7 million infections diagnosed annually, the nation’s health agency found.  People ages 15 to 24 account for half of the annual cases, according to reports released by the Centers for Disease Control and Prevention. There are about 110 million total infections among U.S. men and women of all ages, the agency said, with the most common infection human papillomavirus, a virus linked to cancer.
The CDC reported data on eight sexually transmitted infections, including HIV, syphilis, gonorrhea, hepatitis B, chlamydia, trichomoniasis, herpes and HPV.

Source: http://www.bloomberg.com/External Web Site Icon

Bad Blood
US scientists struggle to complete studies in Ecuador in the wake of biopiracy accusations.

American biomedical researchers working in Ecuador have met with hostility and distrust in the aftermath of announcements last year that the country plans to sue researchers at Harvard University and the Coriell Institute for Medical Research over blood samples allegedly taken without the Ecuadorian government’s permission during the early 1990s.

In statements last July, Ecuadorian Deputy Ombudsman Patricio Benalcazar explained his country’s outrage. Through research breakthroughs and future patents, he wrote, scientists could prosper from the genetic heritage rightly owned by the Ecuadorian state. The case was brought to the government’s attention in 2010 when a representative of the Waorani people, an indigenous group of approximately 4,000 people from the Amazonian region of Ecuador, filed a complaint with the government.

Source: http://www.the-scientist.com/External Web Site Icon

Ethics of 2 Cancer Studies Questioned
India studies funded by Gates Foundation, National Cancer Institute draw scrutiny.
For more than 12 years, as part of two massive U.S-funded studies in India, researchers tracked a large group of women for cervical cancer but didn’t screen them, instead monitoring them as their cancers progressed. At least 79 of the women died.

One study, funded by the National Cancer Institute, did not adequately inform more than 76,000 women taking part about their alternatives for getting cervical-cancer screening; and those women did not give adequate informed consent, according to the Office of Human Research Protection, part of the U.S. Department of Health and Human Services. The other study, funded by the Gates Foundation, is under review by the Food and Drug Administration, according to Kristina Borror, the OHRP’s director of compliance oversight. That study has raised similar concerns regarding 31,000 women who were tracked but not routinely screened or treated for cervical cancer. Both studies continue today, though researchers for both told The Arizona Republic they have begun to offer screening to the women.

While the two studies differ in important respects, both included large numbers of women placed in “control groups” who were offered free visits with health-care workers, but who, until recently, were not screened for cervical cancer. Instead, researchers met with and tracked these women to monitor how many would develop cervical cancer and die, so their death rates could be compared with those of women who were being screened and treated for free. Researchers for both studies said they told women in the control groups they would not be screened or treated, but they were given health-care information and told they could seek screening on their own. The women signed consent forms; but it’s unclear how many of them fully understood.

Source: http://www.azcentral.com/External Web Site Icon

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