The Mystery of the Northwestern Settlement - the Plot Thickens
This article includes even more curiosities that raise even more questions.Dr Bennett Found Irregularities, Sangoleye Pleaded Guilty, Nobody Noticed In the original media coverage, Dr Bennett was accused based on complaints by a whistle blower.  For example, in an article in the Chicago Sun-Times, A whistleblower suit filed under seal in 2009 by former Lurie Cancer Center worker Melissa Theis first alleged the wrongdoing by Bennett. However, the story in the Cancer Letter suggests Dr Bennett had tried to blow the whistle himself.  First,Bennett said the allegations that he spent NCI money on dinners and vaca...
Source: Health Care Renewal - August 20, 2013 Category: Health Medicine and Bioethics Commentators Tags: Amgen whistle-blowers Northwestern University legal settlements cancer anechoic effect Source Type: blogs

Should We Cry for Non-Profit Hospital System CEOs Paid Less than For-Profit CEOs?
Two recent articles (here and here) in Modern Healthcare providing an update on the compensation of CEOs of non-profit hospital systems raised new questions.The CEOs' Compensation The first article documented the rich compensation of the top paid CEOs of non-profit US hospital systems.  A summary of their total compensation:-  Donald Faulk (now retired), Central Georgia Health System - $8 million -  George Halvorson, Kaiser Permanente - $7.9 million-  Jeffrey Romoff, UPMC - $6.1 million -  Pat Fry, Sutter Health - $5.2 million-  Gregory Beier (retired), Novant Health  - $5.1 million-...
Source: Health Care Renewal - August 16, 2013 Category: Health Medicine and Bioethics Commentators Tags: Novant Health UPMC Sentara hospitals executive compensation perverse incentives peer benchmarking Kaiser Permanente hospital systems Sutter Health Source Type: blogs

The Door Revolves Again: the Former White House Health Reform Czar Goes to Private Equity Firm Looking for Investments Created by Health Reform
Round and round it goes, and when it will stop, nobody knows.Background: The Former Health Care Reform Czar's Past Career It appears that Ms Nancy DeParle, formerly a White House Deputy Chief of Staff, and before then, from 2009 - 2011, the Director of the White House Office of Health Care Reform, has gone through the revolving door again.We raised concerns about Ms DeParle's strong ties to the commercial side of health care at the time she was put in charge of getting health care reform legislation passed (look here.)  Specifically, her background for shepherding this legislation included being on the boards of direc...
Source: Health Care Renewal - August 14, 2013 Category: Health Medicine and Bioethics Commentators Tags: health care reform private equity revolving doors Source Type: blogs

63% of Physicians are "Very Enthusiastic" about "Limiting Corporate Influence on Physician Behavior," but Will Anyone Notice?
On Health Care Renewal, we have noted how the direct care of patients in the US is increasingly in the hands of large corporations, often for-profit.  We have noted the plight of the corporate physicians who swore oaths to put patients first, and now report to managers who put revenue first.Health Care Renewal was hardly the first to raise these issues.  For years, the renowned editor emeritus of the New England Journal, Dr Arnold Relman, has been warning about the effects of the commercial practice of medicine, which once was illegal in most US states, and until 1980 was condemned by the American Medical Associa...
Source: Health Care Renewal - August 12, 2013 Category: Health Medicine and Bioethics Commentators Tags: anechoic effect corporate physician surveys Source Type: blogs

Doctors now spend more time with computers than they do with patients
This bodes poorly for future physician quality:The doctor won't see you nowDANIELLE OFRIPittsburgh Post-Gazette August 11, 2013 12:03 amBy Danielle Ofri Like the mail carrier or the milkman of yore, the doctor makes rounds every day in the hospital. If it's an academic institution, a bevy of medical students, interns and residents accompany an attending physician from room to room, checking up on the patient, doing a daily physical exam, reviewing the latest test results and highlighting the relevant teaching points. That's been the mainstay of medical education, and that's how my colleagues and I were taught to train th...
Source: Health Care Renewal - August 12, 2013 Category: Health Medicine and Bioethics Commentators Tags: Danielle Ofri healthcare IT difficulties Source Type: blogs

Who Would Have Thought, Comrades, That The Most Severe Form of Attempted Internet Censorship Could Originate in a Community Hospital, Abington Memorial, That Alleges Itself A Non-Profit Public Servant?
I would not have thought such an attempt at abridgement of fundamental American rights could originate in a local hospital, until this Motion by the defense in the EHR-related lawsuit initiated by my deceased mother in which I am now substitute plaintiff proved otherwise:75E4/19/2013MotionBY ABINGTON MEMORIAL HOSPITAL MOTION TO PROHIBIT COMMENTARY ABOUT THIS LITIGATION TO ANY PUBLIC CONTEXT WITH MEMORANDUM OF LAW WITH SERVICE ON 04/19/2013No9267260The hospital was attempting to have the Court issue a Motion for Prior Restraint (http://en.wikipedia.org/wiki/Prior_restraint), including against my writings here in the Healthc...
Source: Health Care Renewal - August 11, 2013 Category: Health Medicine and Bioethics Commentators Tags: Abington Memorial Hospital censorship First Amendment imperial CEO Internet censorship lawsuit Motion for Prior Restraint Source Type: blogs

A War on Patients: Panel Says EHRs Should Not Be Vetted Before Marketing and Deployment
Joe Conn and Modern Healthcare published the following article:Work group says OK to some HIT safety regs (link), Joe Conn, Modern Healthcare, Aug. 7, 2013What is important is what safety regs the Workgroup said "no" to.  It comes as no surprise:A federally chartered special work group with representatives from three federal agencies has submitted its draft recommendations on establishing a regulatory framework for health information technology. Chief among those recommendations is that health IT should not be subjected to pre-market federal regulation, but there were a few exceptions.The exceptions are narr...
Source: Health Care Renewal - August 9, 2013 Category: Health Medicine and Bioethics Commentators Tags: healthcare IT risk FDA Safety Innovation Act work group premarket approval postmarketing sureveillance Joseph Conn healthcare IT regulation Modern Healthcare David Bates health IT extremism Source Type: blogs

Health Care Revolving Door Roundup
Increasingly, the regulatory and law enforcement functions of the US government in the health care sphere seem to be blending with the management of large health care organizations.  One mechanism for this is the "revolving door," the constant interchange of personnel between government agencies and corporate management.  Here is a list of some of this year's interesting cases of people transiting the revolving door between US government agencies that are supposed to regulate health care organizations or enforce the relevant laws and the organizations subject to these regulations and laws.   N...
Source: Health Care Renewal - August 7, 2013 Category: Health Medicine and Bioethics Commentators Tags: FDA US Department of Justice health care corruption revolving doors Mylan Teva conflicts of interest Source Type: blogs

Today's Bad Health IT Systems: More Dangerous Than Paper?
I believe in 2013 that they are.(Definition of bad health IT is here:  http://www.ischool.drexel.edu/faculty/ssilverstein/cases/)I recently posted about two "glitches" in a major EHR seller's clinical systems, Siemens Healthcare, affecting safety-critical functions of medication reconciliation and medication ordering.Another Health IT "Glitch" - Can Digital Disappearing Ink Kill Patients? Can Digital Disappearing Ink (An EHR "Glitch") Kill Patients? Part 2Considering these, plus the many "glitches" reported by the only EHR seller who does so via FDA's MAUDE database (see here: h...
Source: Health Care Renewal - August 7, 2013 Category: Health Medicine and Bioethics Commentators Tags: healthcare IT dangers glitch workarounds MAUDE FDA recall bad health IT Siemens Healthcare healthcare IT defects GE Centricity PACS Source Type: blogs

Can Digital Disappearing Ink (An EHR "Glitch") Kill Patients? Part 2
At "Another Health IT "Glitch" - Can Digital Disappearing Ink Kill Patients?" just yesterday, on August 5, 2013, I wrote about a Siemens EHR "glitch" worse than any paper records system problem.  Typed order changes in the medication reconciliation process on patient discharge are disappearing into thin air, unknown to the clinicians typing the orders.  This is likely due to an issue such as some programmer forgetting to put in a statement to write the text to disk, complicated by software testing problems that missed the defect.I noted:... "Glitch" is a banal term used by ...
Source: Health Care Renewal - August 7, 2013 Category: Health Medicine and Bioethics Commentators Tags: glitch healthcare IT risk Soarian Soarian Clinicals Medication Orders Siemens Siemens Healthcare CPOE Source Type: blogs

The Mystery of the Northwestern Settlement
Watson, quick, the game's afoot.  We have discussed a large number of legal settlements by large health care organizations that serve as markers of misbehavior and often lack of leaderships' responsibility for same.  These settlements often follow a common pattern.  Yet this week a settlement appeared that was quite different, and hence raised some important questions.The Basics of the SettlementI will summarize the settlement as described by the Wall Street Journal.  The basic points were:Northwestern University agreed to pay nearly $3 million to settle claims that a former cancer researcher fraudulent...
Source: Health Care Renewal - August 5, 2013 Category: Health Medicine and Bioethics Commentators Tags: whistle-blowers Northwestern University legal settlements conflicts of interest Source Type: blogs

Another Health IT "Glitch" - Can Digital Disappearing Ink Kill Patients?
Yes, it can.There's been yet another "glitch" in the world of health IT (see http://hcrenewal.blogspot.com/search/label/glitch for more examples)."Glitch" is a banal term used by health IT extremists (those who have abandoned a rigorous scientific approach to these medical devices as well as basic patient protections, in favor of unwarranted and inappropriate overconfidence and hyper-enthusiasm).  The term is used to represent potentially injurious and lethal problems with health IT, usually related to inadequate software vetting and perhaps even "sweatshop floor in foreign country directly to...
Source: Health Care Renewal - August 5, 2013 Category: Health Medicine and Bioethics Commentators Tags: glitch healthcare IT risk medication reconciliation Soarian Siemens Siemens Healthcare Source Type: blogs

Pfizer's Umpteenth Settlement (for $491 Million Plus a Guilty Plea), but No Person Held Responsible
The world's largest research based pharmaceutical company was in court again, as reported by the New York Times, The drug maker Pfizer agreed to pay $491 million to settle criminal and civil charges over the illegal marketing of the kidney-transplant drug Rapamune, the Justice Department announced on Tuesday. In particular, The recent case centers on the practices of Wyeth Pharmaceuticals, which Pfizer acquired in 2009.Rapamune, which prevents the body’s immune system from rejecting a transplanted organ, was approved by the Food and Drug Administration in 1999 for use in patients receiving a kidney tra...
Source: Health Care Renewal - July 31, 2013 Category: Health Medicine and Bioethics Commentators Tags: Wyeth impunity crime marketing Pfizer whistle-blowers legal settlements Source Type: blogs

Patients as lab rats for beta software: have sancrosanct patient's rights been trivialized, while poor software of non-trivial risk been sanctified?
I have noted a class action lawsuit vs. Allscripts and Eclipsys, EHR producers, regarding a merger:UNITED STATES DISTRICT COURT, NORTHERN DISTRICT OF ILLINOIS, EASTERN DIVISION; BRISTOL COUNTY RETIREMENT SYSTEM, Individually and on Behalf of All Others Similarly Situated, Plaintiff, vs. ALLSCRIPTS HEALTHCARE SOLUTIONS, INC., GLEN E. TULLMAN, WILLIAM J. DAVIS AND LEE SHAPIRO, Defendants.The Lead Plaintiffs' Amended Complaint is available here in PDF:  http://securities.stanford.edu/1048/MDRX00_01/2013515_r02c_12CV03297.pdf.  It is worth reading, if just to understand the inner workings of an unregulated healthcare...
Source: Health Care Renewal - July 31, 2013 Category: Health Medicine and Bioethics Commentators Tags: Blessing Hospital New York Presbyterian Hospitals class action lawsuit Eclipsys healthcare IT beta testing healthcare IT risks Allscripts Source Type: blogs

Guest Post: Incompetent Management Breeds Demoralized Physicians
Health Care Renewal presents a guest post by Dr Howard Brody, John P McGovern Centennial Chair of Family Medicine, Director of the Institute for Medical Humanities at University of Texas - Medical Branch at Galveston, and blogger at Hooked: Ethics, Medicine and Pharma. Danielle Ofri, a prominent internist/author at Bellevue in New York, started a recent op-ed piece, “Last week I was ready to quit medicine." She described an encounter most physicians can relate to—a 15-minute appointment slot, a new patient who spoke only Bengali, a long and complicated problem list, a bag containing 18 different medi...
Source: Health Care Renewal - July 30, 2013 Category: Health Medicine and Bioethics Commentators Tags: burnout economism financialization generic management learned helplessness mission-hostile management Source Type: blogs

Candid Nurse EHR Opinions at Facebook Page "Friend a Nurse" Are Not So Friendly
At my Jan. 2010 post "An Honest Physician Survey on EHR's" (http://hcrenewal.blogspot.com/2010/01/honest-physician-survey-on-ehrs.html) I wrote:I often believe surveys of physicians about EHR's do not present the results candidly, but rather are selective in what is reported - and what is omitted - and generally sugar-coated. I then presented a candid physician survey on EHR's that was not very complimentary of the technology's value to real-world practicing physicians.The following candid, informal nurse's survey about EHR's came to my attention the other day via Google.  The thread is on Facebook in the &q...
Source: Health Care Renewal - July 27, 2013 Category: Health Medicine and Bioethics Commentators Tags: healthcare IT difficulties Facebook surveys healthcare IT toxicity Friend a Nurse Source Type: blogs

Why Do People Think US Health Care is Corrupt? - The Examples of Amgen, Mallinckrodt Settling Charges of Giving Kickbacks to Doctors to Induce them to Prescribe Their Products, While No Individual Suffers Negative Consequences
We recently posted a discussion of the results of Transparency International's 2013 corruption barometer, focusing on the US results.  43% of survey respondents thought US health care is corrupt.  Our coverage, apparently the only substantial discussion of the US results published in the US, got star ranking for a while on Reddit.  But many anonymous commentators dismissed the survey results as coming from a naive public who does not understand health care economics.I submit that one can recognize corruption without a degree in economics.  In fact, as we discussed in the initial post, there is a lot of ...
Source: Health Care Renewal - July 25, 2013 Category: Health Medicine and Bioethics Commentators Tags: Amgen deception kickbacks health care corruption Covidien legal settlements Mallinckrodt Source Type: blogs

EHR importance vastly oversold? Community health center battles for electronic patients' records - but patient care goes on anyway
There are two lessons from the Milwaukee Journal Sentinel story below.1) Beware outsourcing the ownership of your hospital or clinic's medical records.2) The value of EHRs has been massively and repeatedly exaggerated.  Milwaukee Health Services have been operating without access to electronic patient charts for almost a month, yet there are no reports of massive casualties.  There are numerous reports on this blog of EHR system downtimes lasting weeks, loss and sabotage of electronic records, and other mishaps, yet patient care is claimed to have not been compromised.  Perhaps those who make such claims nee...
Source: Health Care Renewal - July 24, 2013 Category: Health Medicine and Bioethics Commentators Tags: healthcare IT difficulties Milwaukee Health Services EHR oversell Source Type: blogs

Electronic siloing: An unintended consequence of the electronic health record - Cleveland Clinic Journal of Medicine
EHR systems have largely been designed by those of a manufacturing, mercantile, and management computing background, largely due to abdication of responsibility and acquiescence by medical professionals, and political impotence of organized medicine and medical informatics organizations.The results were predictable - a toxic effect on healthcare.  One such toxic effect is an impairment of essential communications between caregiving personnel - exactly the opposite effect the hundreds of billions of dollars spent on today's health IT was intended to improve.From the Cleveland Clinic Journal of Medicine:Electronic siloi...
Source: Health Care Renewal - July 24, 2013 Category: Health Medicine and Bioethics Commentators Tags: electronic siloing healthcare IT difficulties Cleveland Clinic Journal of Medicine James Stoller MD MS Source Type: blogs

Pharmaceutical Industry "'Mobilised' an Army of Patient Groups to Lobby Against" Improving Clinical Research Integrity
I had guessed that this sort of thing was going on all the time, but being kept very well hidden.  Now we have some more evidence.An article in yesterdays Guardian showed how the pharmaceutical industry is using pet patient advocacy groups in a public relations campaign to defeat calls for for measures against suppression and manipulation of clinical research. In summary,The pharmaceutical industry has 'mobilised' an army of patient groups to lobby against plans to force companies to publish secret documents on drugs trials.More specifically,The strategy was drawn up by two large trade groups, the Pharmaceutical Resea...
Source: Health Care Renewal - July 23, 2013 Category: Health Medicine and Bioethics Commentators Tags: PhRMA deception health care corruption manipulating clinical research patient advocacy groups public relations suppression of medical research conflicts of interest Source Type: blogs

Johnson and Johnson Settles Suit Alleging Management Incompetence and Deception, Managers Continue to Prosper
Very quietly, pharmaceutical/ biotechnology/ medical device corporate giant Johnson & Johnson just settled another lawsuit. The most pithy version is by Ed Silverman on Pharmalot, although Reuters and Bloomberg published short accounts.The New Settlement Per Mr Silverman, the gist is:The health care giant agreed to resolve the dispute brought over allegations that J&J management shirked their responsibilities and allowed a chain of events that resulted in congressional probes; lost market share, consumer confidence and revenue, and a consent decree with the FDA. In the lawsuit, a shareholder charged that J&J bu...
Source: Health Care Renewal - July 18, 2013 Category: Health Medicine and Bioethics Commentators Tags: executive compensation deception Johnson and Johnson adulterated drugs legal settlements manufacturing problems Source Type: blogs

More than Just a Conflict of Interest? - Should Rutgers University's Own Contract Research Organizations Report to the Board of Covance?
This report, and its recommendations have gotten scant attention, maybe because they would threaten a status quo that enriches conflicted health professionals and the companies that create these conflicts.  However, in my humble opinion, implementing all the report's recommendations would only be a beginning down the road of restoring the integrity of clinical care, teaching, and research. Hat tip to Prof Margaret Soltan on the University Diaries blog.See also the comments by Dr Carl Elliott on the Fear and Loathing in Bioethics blog.   (Source: Health Care Renewal)
Source: Health Care Renewal - July 16, 2013 Category: Health Medicine and Bioethics Commentators Tags: boards of directors Covance Rutgers University contract research organizations UMDNJ conflicts of interest Source Type: blogs

Kim Kardashian, Meet Electronic Medical Records
In yet another example of breach of medical record privacy (http://hcrenewal.blogspot.com/search/label/medical%20record%20privacy), Kim Kardashian's privacy on the birth of her daughter, as well as the privacy of more than a dozen other patients, was violated between June 18 and June 24:  Workers fired in privacy breach at L.A. hospital popular with starsLOS ANGELES | Sat Jul 13, 2013(Reuters) - Five medical workers have been fired over a patient data breach at Cedars-Sinai Medical Center, the Los Angeles facility said in a statement, while celebrity website TMZ reported on Saturday that the hacking effort targeted re...
Source: Health Care Renewal - July 14, 2013 Category: Health Medicine and Bioethics Commentators Tags: Cedars-Sinai Medical Center medical record privacy medical record confidentiality Kim Kardashian Source Type: blogs

RNs Say Sutter’s New Electronic System Causing Serious Disruptions to Safe Patient Care at East Bay Hospitals
Add the following from Sutter East Bay Hospitals to nurses' and physicians' complaints at Marin General Hospital (http://hcrenewal.blogspot.com/2013/05/marin-general-hospitals-nurses-are.html), Affinity Medical Center (http://hcrenewal.blogspot.com/2013/06/affinity-rns-call-for-halt-to-flawed.html), Contra Costa County (http://hcrenewal.blogspot.com/2012/08/contra-costas-45-million-computer.html), San Francisco Department of Public Health (http://hcrenewal.blogspot.com/2010/11/avatar-fails-no-not-cameron-movie-but.html), and others: For Immediate Release July 11, 2013Contact-  Charles Idelson, 510-273-2246RNs Say...
Source: Health Care Renewal - July 12, 2013 Category: Health Medicine and Bioethics Commentators Tags: glitch Patient care has not been compromised Sutter East Bay Hospitals EPIC healthcare IT risks California Nurses Association Sutter Health Alta Bates Summit Medical Center Source Type: blogs

A "Simply Outstanding," "Superb" Hospital CEO Cops a Plea to Two Felonies
In all the discussions of what is wrong with US health care, very rarely is the quality of the leadership of health care organizations questioned.  In fact, no major US health care organization seems to have leadership that is anything short of brilliant.  The amazing brilliance of these leaders serves as a rationale for the ever increasing compensation that they receive.  Yet while subordinates, friendly members of boards of trustees, and hard working public relations flacks may stress their leaders' wondrous qualities, there rarely is an opportunity to compare their proclamations with results.A few small i...
Source: Health Care Renewal - July 12, 2013 Category: Health Medicine and Bioethics Commentators Tags: executive compensation deception kickbacks Hospital for Special Surgery crime Source Type: blogs

43% Believe that US Health Care is Corrupt, 64% that Government is Run by a Few Big Interests, Media Shrug
We have noted  (most recently here),  that health care corruption, particularly its global nature and its presence in developed countries like the US, is a taboo topic and thus remains anechoic.   Transparency International just released its yearly massive survey on corruption worldwide.  The results are not pretty for health care and related sectors world wide and in the US.  As expected, these results appear to be causing few echoes.  Global Results Some useful summary statements found in the written version of the report:Governments are not thought to be doing enough to hold the corrupt to ...
Source: Health Care Renewal - July 10, 2013 Category: Health Medicine and Bioethics Commentators Tags: global health health care corruption Transparency International anechoic effect Source Type: blogs

Another Attempt to Show the RUC Behind the Curtain
In 2007, readers of the Annals of Internal Medicine could read part of the solution to a great medical mystery.(1)  For years, health care costs in the US had been levitating faster than inflation, without producing any noticeable positive effect on patients.  Many possible reasons were proposed, but as the problem continued to worsen, none were proven.Prices are High Because They are Fixed That WayThe article in the Annals, however, proposed one conceptually simple answer.The prices of most physicians' services, at least most of those that involved procedures or operations for Medicare patients, were high becaus...
Source: Health Care Renewal - July 8, 2013 Category: Health Medicine and Bioethics Commentators Tags: perverse incentives Medicare RUC reimbursement anechoic effect Source Type: blogs

More Perversity on Health IT Risks, and ... EHR Sense from Nurses on "Nurse Talk", a Syndicated Radio Show
As I mentioned on July 2 at this post, in a June 25, 2013 Bloomberg News article "Digital Health Records’ Risks Emerge as Deaths Blamed on Systems" by technology reporter Jordan Robertson an EHR-harms case in which I am (unfortunately) intimately involved as substitute plaintiff is mentioned: that of the death of my mother.I'd previously written about EHR-related electronic encounters with truly perverse individuals at my Jan. 2010 post "More on Perversity in the Healthcare IT World: Is Meditech Employing Sockpuppets?" at http://hcrenewal.blogspot.com/2010/01/more-on-perversity-in-hit-world.html.T...
Source: Health Care Renewal - July 5, 2013 Category: Health Medicine and Bioethics Commentators Tags: Bloomberg News Nurse Talk To Err is Human perverse defense of health IT ECRI Deep Dive Study IOM ecri institute Source Type: blogs

How's this for patient rights? Affinity Medical Center manager: file a safety complaint, and I'll plaster it to your head!
At my June 19, 2013 post "Affinity RNs Call for Halt to Flawed Electronic Medical Records System Scheduled to Go Live Friday" (http://hcrenewal.blogspot.com/2013/06/affinity-rns-call-for-halt-to-flawed.html) I noted what appeared to be an imperial hospital leadership recklessly and negligently ignoring their own nurses' concerns about safety of a new EHR system implementation.Now there's this at IndeOnline.com: "Judge orders Affinity to bargain with union" (http://www.indeonline.com/news/x1808710525/Judge-orders-Affinity-to-bargain-with-union?zc_p=1)CANTON (OH) — July 2, 2013A judge ruled Affinity...
Source: Health Care Renewal - July 3, 2013 Category: Health Medicine and Bioethics Commentators Tags: Affinity Medical Center National Nurses United National Labor Relations Board imperial CEO Ann Wayt bullying Source Type: blogs

55 of Medtronic's Best Hospital Friends, Including HCA, Settle for $34 Million
The case of the over-marketing of Kyphon's kyphoplasty device (look here) just got more complicated, and now appears to have involved an amazing number of players. The State of Play  As reported by the AP (via the Washington Post), Fifty-five hospitals in 21 states have agreed to pay $34 million to the U.S. government to settle allegations that they used more expensive inpatient procedures rather than outpatient spinal surgeries to get bigger payments from Medicare, the U.S. Justice Department said Tuesday.The settlement involves kyphoplasty procedures used to treat spinal fractures usually caused by osteopo...
Source: Health Care Renewal - July 3, 2013 Category: Health Medicine and Bioethics Commentators Tags: Medtronic HCA medical devices impunity Kyphon legal settlements mergers Source Type: blogs

Is ONC's definition of "Significant EHR Risk" when body bags start to accumulate on the steps of the Capitol?
In a June 25, 2013 Bloomberg News article "Digital Health Records’ Risks Emerge as Deaths Blamed on Systems" by technology reporter Jordan Robertson (http://go.bloomberg.com/tech-blog/author/jrobertson40/), an EHR-harms case in which I am (unfortunately) intimately involved as substitute plaintiff is mentioned:When Scot Silverstein’s 84-year-old mother, Betty, starting mixing up her words, he worried she was having a stroke. So he rushed her to Abington Memorial Hospital in Pennsylvania.After she was admitted, Silverstein, who is a doctor, looked at his mother’s electronic health records, which ...
Source: Health Care Renewal - July 2, 2013 Category: Health Medicine and Bioethics Commentators Tags: Jodi Daniel healthcare IT risk FDA Abington Memorial Hospital Bloomberg News prior restraint Jordan Robertson IOM Committee on Patient Safety and Health Information Technology ONC ecri institute Source Type: blogs

Pfizer May No Longer be Able to Delay Paying Its Asbestos Claims of Nearly $1 Billion
Pfizer, which claims to be the "world's largest research-based pharmaceutical company," is one step closer to paying a nearly one billion dollar settlement of legal claims of harms due to the asbestos products it used to manufacture.Pfizer Settles - More or Less - Some of its Asbestos Liability Most people would not think of Pfizer as a producer of asbestos.  However, the back-story, as reported in the Philadelphia Inquirer, and as we discussed here in 2011, is thatPfizer used to have a minerals, pigments and metals division and, in 1968, it bought Quigley Company Inc., which made insulation for heavy indust...
Source: Health Care Renewal - June 28, 2013 Category: Health Medicine and Bioethics Commentators Tags: deception Quigley Pfizer mission-hostile management legal settlements asbestos Source Type: blogs

Shut Up and Sell - the Corporate Physician's New Motto?
Evidence has been seeping into public view about the extent physicians who sign up to take care of patients as corporate employees give up their professionalism.Shut Up...In April, 2013, Medscape published an article whose striking title was "Can You Speak Out Without Getting Fired or Being Labeled a Troublemaker?"  The answer was basically "no."Physicians often see problems at their workplaces relating to patient quality of care, financial practices, mistreatment of staff, and other issues. But as more doctors take jobs as employees of hospitals, medical groups, and other large organizations, they...
Source: Health Care Renewal - June 26, 2013 Category: Health Medicine and Bioethics Commentators Tags: deception corporate physician confidentiality clause contracts marketing health care ethics whistle-blowers mission-hostile management Source Type: blogs

Monetary losses and layoffs from EHR expenses and EHR mismanagement
More on monetary losses and layoffs from EHR expenses and EHR mismanagement:1.  Layoffs to balance the budget...http://www.news-record.com/news/local_news/article_da765340-d912-11e2-9eac-001a4bcf6878.html... Wake Forest University Baptist Medical Center [Winston-Salem, NC] said in November 2012, that it would cut 950 jobs — 6 percent of its total staff.Electronic records programs continue to push costs higher. The Winston-Salem Journal reported that Wake Forest’s Epic [EHR] program caused $8 million in work interruptions during the 2012-2013 year alone. Wake Forest is cutting costs at least through June 30...
Source: Health Care Renewal - June 21, 2013 Category: Health Medicine and Bioethics Commentators Tags: Healthcare IT failure cerner millenium UPMC Ed Donald NPfIT Royal Berkshire Foundation Trust Wake Forest University Baptist Medical Center layoffs healthcare IT cost Source Type: blogs

No Blues, but Lots of Green for St Louis Hospital System CEOs
A recent article in the St Louis Post Dispatch provided the latest examples of how hospital executive compensation continues to defy gravity.  In summary,In recent years, executives at St. Louis-area nonprofit health organizations have seen annual double-digit increases of as much as 40 percent in their total compensation packages, which typically include salaries, bonuses, pensions and health benefits.Such pay hikes occurred as these nonprofit organizations enjoyed their largest operating margins in years,...The examples include...BJC HealthcareSteven Lipstein, president and chief executive of St. Louis-based BJC Hea...
Source: Health Care Renewal - June 20, 2013 Category: Health Medicine and Bioethics Commentators Tags: executive compensation BJC Healthcare Ascension Health SSM Health Care Mercy Health System Source Type: blogs

Affinity RNs Call for Halt to Flawed Electronic Medical Records System Scheduled to Go Live Friday
At my May 30, 2013 post "Marin General Hospital's Nurses are Afraid a Defective EMR Implementation Will Harm or Kill Patients ... CEO Cites Defective HHS Paper and Red Herrings As Excuse Why He Knowingly Allows This To Continue" at http://hcrenewal.blogspot.com/2013/05/marin-general-hospitals-nurses-are.html, I lamented that hospital management felt they could ignore clinicians calling for implementation postponement of what they viewed as bad health IT, dangerous to patients, with impunity.Finally, medical professionals stand up to imperial hospital management that, in a perhaps criminally negligent fashion (e.g...
Source: Health Care Renewal - June 19, 2013 Category: Health Medicine and Bioethics Commentators Tags: Affinity Medical Center National Nurses United imperial CEO healthcare IT risks Michelle Mahon RN ill-informed management labor unions Source Type: blogs

"Computer problems" force docs back to paper charts at Memorial Hospital - From June 11 until at least June 24?
More on the wonders and dependability of commercial health IT, as implemented in hospitals, which are generally an IT backwaters: Computer problems force docs back to paper charts at Memorial HospitalPublished: June 17, 2013 BELLEVILLE (Illinois) — Computer problems have caused Memorial Hospital (http://www.memhosp.com/Pages/Home.aspx) staff back to the old days of using paper to chart patients' treatments.The hospital's computer system, Meditech, went down late on Tuesday, June 11 and is not expected to be fully restored until at least Monday, June 24, according to the hospital. In the m...
Source: Health Care Renewal - June 19, 2013 Category: Health Medicine and Bioethics Commentators Tags: core incompetence Healthcare IT failure Meditech Mark Turner Memorial Hospital of Belleville Ill. healthcare IT risks Source Type: blogs

A Call to Restore the Integrity of Clinical Research - but Will Anyone Heed it?
Concerns about suppression and manipulation of clinical research to serve vested interests have finally gotten a little more mainstream.Background: Suppression and Manipulation of Clinical Research For a long time, we have decried and discussed examples of manipulation of clinical research done to increase the likelihood that its results would please vested interests, often drug, device or other corporations that sponsored the research and often exerted considerable control over its design, implementation, analysis, and dissemination.  We have also decried and discussed examples of suppression of research whose result...
Source: Health Care Renewal - June 19, 2013 Category: Health Medicine and Bioethics Commentators Tags: institutional conflicts of interest manipulating clinical research research subjects anechoic effect suppression of medical research Source Type: blogs

Professor nemeroff goes to london
THREE STRIKES AND …Professor Charles Nemeroff is being honored today in London. He will deliver a high profile lecture at the Institute of Psychiatry, King’s College London, a component of The University of London. IoP and its associated Maudsley Hospital have long been at the forefront of psychiatric research in Britain. The occasion today is the establishment of a new program on mood disorders, and Professor Nemeroff’s topic will be “The Neurobiology of Child Abuse: Treatment Implications.” He will be introduced by Professor Allan Young and the vote of thanks will be proposed by Professor S...
Source: Health Care Renewal - June 17, 2013 Category: Health Medicine and Bioethics Commentators Tags: University of London Institute of Psychiatry Charles Nemeroff King's College London Sir Robin Murray Allan Young Maudsley Hospital Carmine Pariante Shitij Kapur Bernard Carroll Source Type: blogs

IT Specialist and the job he wouldn't take: hospital management's health IT "plan" is a checklist for failure
Received unsolicited on June 14, 2013 from a computer professional whose identity I am redacting.  Posted with his permission:Dr. Silverstein,Thank you very much for the many insights and helpful references provided on your "Contemporary Issues in Medical Informatics" (http://www.ischool.drexel.edu/faculty/ssilverstein/cases/) web site! In performing my due diligence for a position as an IT Director at a small rural hospital, I have come across your writings. I originally applied for this position in the hopes of leveraging my IT, project management, compliance and security experience to gain new e...
Source: Health Care Renewal - June 17, 2013 Category: Health Medicine and Bioethics Commentators Tags: healthcare IT dangers Mismanagement Healthcare IT failure Source Type: blogs

The Financialized Medical Center - Executives of Non-Profit Wake Forest Baptist Medical Center Make an "Investor Call," but Have no Investors
We recently discussed the uncomfortable situation of Wake Forest Baptist Medical Center, the non-profit health system/ academic medical center of Wake Forest School of Medicine.  The organization suffered acute monetary losses after a problem plagued roll out of its new electronic health record.  Presiding over this mess were some extremely well paid executives who had been hailed as "visionaries" by their own public relations people. (Look here and here.)An Even Bigger Financial Loss The resourceful Richard Craver, writing in the Winston-Salem Journal, just documented that the financial losses due to t...
Source: Health Care Renewal - June 13, 2013 Category: Health Medicine and Bioethics Commentators Tags: non-profit organizations financialization Wake Forest University Wake Forest Baptist Medical Center Source Type: blogs

A Legal Settlement of One Aspect of the Fall of AHERF, Only 15 Years Later
It only took 15 years, but litigation related to one of the most important, but obscure cases of bad health care leadership and governance from the 1990s was finally settled.   Background The Allegheny Health Education and Research Foundation (AHERF) was a large integrated health care system formed out of multiple mergers.  AHERF went bankrupt in 1998, leading to massive layoffs, hospital closures, and the near dissolution of a medical school (which ended up taken over by Drexel University).  We last discussed the case in 2012 here.. A summary of other important points about it is appended below.&n...
Source: Health Care Renewal - June 12, 2013 Category: Health Medicine and Bioethics Commentators Tags: AHERF You heard it here first legal settlements anechoic effect Source Type: blogs

Is the Cystic Fibrosis Foundation a Charity or a Venture Capital Firm?
This article deserves considerably more attention than it apparently initially received.Background The background was,What happens when a disease-fighting charity dives into venture capitalism?In the first case of its kind, the results include one of the planet's most expensive pills, huge sales projections for a drug company and windfalls for executives who sold stock in the glow of enthusiastic news releases about the drug.Kalydeco is a breakthrough drug designed from knowledge of the genetic roots of cystic fibrosis, a lung disease that kills most victims before they reach middle age. Developed by Vertex Pharmaceuticals...
Source: Health Care Renewal - June 10, 2013 Category: Health Medicine and Bioethics Commentators Tags: Vertex Pharmaceutical executive compensation disease-specific organizations manipulating clinical research mission-hostile management guidelines Cystic Fibrosis Foundation Source Type: blogs

Long After the Start of the "War on Terror," a Conflict of Interest about an Anthrax Scare Comes to Light
In May, David Willman writing for the Los Angeles Times broke a story of a somewhat new variant on the conflict of interest theme, one that has not gotten a lot of attention, but should.The issue was medical, with a twist, - how to best treat a bioterror attack with anthrax engineered to be resistant to multiple drugs, an event that luckily is not known to ever have occurred.  The story came from the bad old days of the "war on terror," but only has now come to light years later. The Alarm RaiserThe story opened thus,Over the last decade, former Navy Secretary Richard J. Danzig, a prominent lawyer, president...
Source: Health Care Renewal - June 6, 2013 Category: Health Medicine and Bioethics Commentators Tags: Human Genome Sciences deception terrorism biotechnology government GlaxoSmithKline conflicts of interest Source Type: blogs

Want to help a hospital go bankrupt? Get a bad EHR - Westchester hospitals' sale price over $54 million, Hospitals' debt about $200M
- Posted at the Healthcare Renewal Blog on June 3, 2013 -  Sound Shore Medical Center (New Rochelle, NY) is filing for bankruptcy protection:Montefiore Medical Center is offering to buy Sound Shore Health System for $54 million plus furniture and equipment, according to the latter’s bankruptcy filing — which also reveals just how far the troubled Westchester health network had fallen into the red. Sound Shore Medical Center in New Rochelle, Mount Vernon Hospital and five related entities have about $200 million in debts owed to more than 3,000 creditors, while possessing only $159.6 million in assets, the ...
Source: Health Care Renewal - June 3, 2013 Category: Health Medicine and Bioethics Commentators Tags: bankruptcy healthcare IT difficulties healthcare IT cost Sound Shore Medical Center Montefiore Medical Center Source Type: blogs

Is the Patient Centered Outcomes Research Institute Really More Industry-Centered?
One of the biggest reasons our health care system seems so dysfunctional is that clinicians and patients have great difficulty determining what might be the appropriate management of particular clinical problems.  Due to endless and sometimes deceptive marketing, conflicts of interest affecting health care professionals and academics, and manipulation and suppression of clinical research, making truly evidence based decisions that put individual patients interests first has become very difficult.  Instead, we may end up using excessively expensive, relatively ineffective, and more dangerous than anticipated drugs...
Source: Health Care Renewal - May 31, 2013 Category: Health Medicine and Bioethics Commentators Tags: PCORI health care reform deception comparative effectiveness research conflicts of interest Source Type: blogs

Marin General Hospital's Nurses are Afraid a Defective EMR Implementation Will Harm or Kill Patients .. CEO Cites Defective HHS Paper and Red Herrings As Excuse Why He Knowingly Allows This To Continue
- Posted at the Healthcare Renewal Blog on May 30, 2013 - The following appeared in the Marin County Independent Journal about an EHR system so bad the nurses at Marin General Hospital were publicly complaining, putting their careers at risk (see my May 17, 2013 post "Marin General Hospital nurses warn that new computer system is causing errors, call for time out"):National critic of health care information technology says Marin General should heed nurses' adviceBy Richard HalsteadMarin Independent JournalPosted:   05/27/2013 04:03:00 PM PDTThe critic is me.   I spoke to the reporter but did not k...
Source: Health Care Renewal - May 30, 2013 Category: Health Medicine and Bioethics Commentators Tags: Lee Domanico Marin Independent Journal Marin General Hospital Marin Healthcare District red herring fallacy healthcare IT risks Richard Halstead ONC Source Type: blogs

Ghosts in the Criminal Machine - How a Drug Company Can Plead Guilty to Federal Fraud, Yet No One is Held Responsible
We have often discussed how leaders of health care organizations have become increasingly unaccountable for their actions.  A recent, slightly obscure story shows how a corporate admission of guilt to a felony can be used to prevent anyone, including anyone in corporate management, from being held responsible for that fraud.Basics of the SettlementThe case was that of ISTA Pharmaceuticals.  The basics appeared in brief wire service articles, like this one from Rueters (via Fox News):Ista Pharmaceuticals pleaded guilty on Friday to charges it used kickbacks and improper marketing to boost sales of a drug meant to ...
Source: Health Care Renewal - May 28, 2013 Category: Health Medicine and Bioethics Commentators Tags: Bausch and Lomb conspiracy Warburg Pincus impunity crime felony legal settlements fraud Source Type: blogs

The Best Governance for Medicines ... is in Thailand
Discussion of deception, conflicts of interest, crime and corruption affecting large health care organizations is muted and anechoic.  I know of precisely one course on health care corruption in any US medical, public health, or health administration school (look here, and its focus is on developing countries.)Time to head to Bangkok?....  But if we all cannot...  In the US, we will not have a chance of meaningfully improving our health care system until we start listening to unbiased health care professionals and academics (in particular, who have not been paid off by vested interests),  civil society ...
Source: Health Care Renewal - May 23, 2013 Category: Health Medicine and Bioethics Commentators Tags: WHO Good Governance for Medicines Programme National Health Assembly pharmaceuticals Thailand Source Type: blogs

The Best Governance for Medicine ... is in Thailand
Discussion of deception, conflicts of interest, crime and corruption affecting large health care organizations is muted and anechoic.  I know of precisely one course on health care corruption in any US medical, public health, or health administration school (look here, and its focus is on developing countries.)Time to head to Bangkok?....  But if we all cannot...  In the US, we will not have a chance of meaningfully improving our health care system until we start listening to unbiased health care professionals and academics (in particular, who have not been paid off by vested interests),  civil society ...
Source: Health Care Renewal - May 23, 2013 Category: Health Medicine and Bioethics Commentators Tags: WHO Good Governance for Medicines Programme National Health Assembly pharmaceuticals Thailand Source Type: blogs