All the President's Trade Negotiators - Revolving Doors, Regulatory Capture, and Health Care Corporate Friendly Trade Agreements
This week's spectacle in Washington, DC was a nearly unanimous Democratic minority in the Senate blocking a proposal for expedited consideration of multinational trade agreements favored by the Republican majority, but also by the Democratic President and his trade negotiators (look here).  Democrats mainly based their actions on perceptions that the trade agreements favored multinational corporations  over people.While trade agreements may seem to be another, albeit international species of wonkery, these agreements could have major effects on patients' and the public's health.  Since these concerns have be...
Source: Health Care Renewal - May 14, 2015 Category: Health Management Tags: AbbeVie Abbott anechoic effect corporatism Eli Lilly global health health care prices Pfizer PhRMA regulatory capture revolving doors US Trade Representative Source Type: blogs

DaVita Settles Another Lawsuit Amidst Accusations of "Managing Witnesses to Provide False Testimony," After Justice Department Lost Interest in Participating
The Latest Case Less than a year since its last big settlement (look here), DaVita HealthCare Partners, the big for-profit dialysis provider, has to settle again.  The basics, according to the Denver Post, were:DaVita HealthCare Partners said Monday it will pay up to $495 million to settle a whistle-blower lawsuit accusing the Denver company of defrauding the federal Medicare program of millions of dollars. The company, which said it does not admit any wrongdoing, has now settled its third whistle-blower lawsuit since 2012, with payouts totaling nearly $1 billion.The civil suit, filed in Atlanta in 2011, revolves...
Source: Health Care Renewal - May 8, 2015 Category: Health Management Tags: DaVita fraud impunity legal settlements Source Type: blogs

Health IT - How Did Things Get So Bad? Look to Late 20th Century Recruiters and "The School of Hard Knocks" Leaders They Preferred
I have a long memory, unfortunately for health IT opportunists and hyper-enthusiasts.After reading letters and reports such as:The Jan. 15, 2015 Complaint Letter about EHRs to ONC from this country's major medical societies (http://hcrenewal.blogspot.com/2015/01/meaningful-use-not-so-meaningul.html), The 2015 Joint Commission Sentinel Events Alert on Health IT risk (http://www.jointcommission.org/assets/1/18/SEA_54.pdf), The stunning mishap and injury figures in the ECRI Institute Deep Dive study of EHR risk and the ECRI annual "Top Ten Technology Risks in Healthcare" reports (http://www.healthit.gov/fa...
Source: Health Care Renewal - May 7, 2015 Category: Health Management Tags: Flexner Report Goodman Group healthcare IT dissatisfaction Hersher Associates talent management Source Type: blogs

Politico: Electronic record errors growing issue in lawsuits
The indefatigable Arthur Allen of Politico.com has authored a nice piece on the issue of EHRs being a cause of medical malpractice, with resultant litigation.  I was a contributor:Electronic record errors growing issue in lawsuitsBy Arthur Allen5/4/15 6:40 AM EDThttp://www.politico.com/story/2015/05/electronic-record-errors-growing-issue-in-lawsuits-117591.htmlMedical errors that can be traced to the automation of the U.S. health care system are increasingly an issue in medical malpractice lawsuits.Some of the doctors, attorneys and health IT experts involved in the litigation fear that safety and data integrity probl...
Source: Health Care Renewal - May 6, 2015 Category: Health Management Tags: Arthur Allen healthcare IT litigation healthcare IT risk Politico Source Type: blogs

Another day, another EHR outage: MEDSTAR EHR goes dark for days
At my March 2, 2015 post "Rideout Hospital, California: CEO Pinocchio on quality of patient care during hospital computer crash" (http://hcrenewal.blogspot.com/2015/03/rideout-hospital-california-ceo.html) I highlighted a stunning example of when the light shone through the corporate B.S. about health IT outages, thanks to a letter to the editor by a family member of an affected patient:Letter: Re: Rideout Hospital computer problemshttp://www.appeal-democrat.com/opinion/letter-re-rideout-computer-problems/article_4a408cc0-be47-11e4-9b7b-93c22da930d4.html Friday, February 27, 2015 I am writing in regard ...
Source: Health Care Renewal - May 6, 2015 Category: Health Management Tags: healthcare IT crash healthcare IT outage MedStar Health Patient care has not been compromised Politico Source Type: blogs

MBA-holding Informatics Fellow's Portfolio: Revolutionizing Healthcare Through Plagiarism
I highlighted the MBA culture at least once before on this site, on April 16, 2010 at "Healthcare IT Corporate Ethics 101: 'A Strategy for Cerner Corporation to Address the HIT Stimulus Plan'", http://hcrenewal.blogspot.com/2010/04/healthcare-it-corporate-ethics-101.html.In that post, I noted MBA candidates/Cerner employees happily conspiring in a paper at Duke's Fuqua School of Business towards combination in restraint of trade through "recommending that Cerner collaborate with other incumbent vendors to establish high regulatory standards, effectively creating a barrier to new firm entry. "Combination...
Source: Health Care Renewal - May 6, 2015 Category: Health Management Tags: cerner David Ridley Duke Fuqua School of Bsuiness health care ethics MBA medical ethics medical informatics NextGen plagiarism Source Type: blogs

Second Order Generic Management: Lobbyist Named CEO of American Hospital Association
A long time ago, in a universe far, far away, hospitals had relatively small administrations, usually lead by a older physician or nurse who served as executive director or superintendent.  Leading a hospital was seen as a calling, not a means to become rich.  With the rise of generic management, hospital management grew, and became dominated by generic managers who were trained as managers, not as health care professionals.So if hospitals are now usually lead by generic managers, it should be no surprise that hospital organizations are lead by generic managers.  So it should be no surprise that the current ...
Source: Health Care Renewal - May 6, 2015 Category: Health Management Tags: American Hospital Association generic management generic managers hospitals non-profit organizations Source Type: blogs

Innovations form the Safra Center Ending iCorruption Conference
I had the pleasure of attending the Ending iCorruption Conference, the capstone conference for the Edmond J Safra Research Lab on Institutional Corruption, held at the Harvard Law School on May 1-2, 2015.  The conference included much material relevant to health care corruption and related topics, and provided some innovative approaches that could be used to address these issues.  I list these below, with citations or links when available.  At some point in the future, all conference proceedings should be available on video from the Safra Center.Uncovering Data on Conflicts of InterestUnearth: Using PubMed t...
Source: Health Care Renewal - May 3, 2015 Category: Health Management Tags: conflicts of interest health care corruption hospital systems pharmaceuticals regulatory capture Source Type: blogs

Pollyanna Rhetoric, Proximate Futures and Realist's Primer on Health IT Realities in 2015
In conclusion: Next time you encounter pollyanna/head-in-the-sand statements about health IT that ignore the risks, throw this primer the way of the authors and audience of such statements. -- SS (Source: Health Care Renewal)
Source: Health Care Renewal - April 27, 2015 Category: Health Management Tags: Charlie Jarvis David Blumenthal Edward Ehlinger healthcare IT difficulties healthcare IT myths healthcare IT pollyanna Mark Leavitt proximate future subjunctivisation bias Trisha Greenhalgh Source Type: blogs

Pollyanna Statements, Proximate Futures and Realist's Primer on Health IT Realities in 2015
In conclusion: Next time you encounter pollyanna/head-in-the-sand statements about health IT that ignore the risks, throw this primer the way of the authors and audience of such statements. -- SS (Source: Health Care Renewal)
Source: Health Care Renewal - April 27, 2015 Category: Health Management Tags: Charlie Jarvis David Blumenthal Edward Ehlinger healthcare IT difficulties healthcare IT myths healthcare IT pollyanna Mark Leavitt proximate future subjunctivisation bias Trisha Greenhalgh Source Type: blogs

More Barbarians at the Gates: Private Equity Puts Primary Care in Play
There are still some idealistic physicians who enter primary care practice as a calling.The usual informal definition of primary care is care which is continuous, coordinated, comprehensive and compassionate.  The official definition used by the American Academy of Family Physicians (AAFP) is:Primary care is that care provided by physicians specifically trained for and skilled in comprehensive first contact and continuing care for persons with any undiagnosed sign, symptom, or health concern (the 'undifferentiated' patient) not limited by problem origin (biological, behavioral, or social), organ system, or diagnosis.P...
Source: Health Care Renewal - April 26, 2015 Category: Health Management Tags: corporate physician primary care private equity You heard it here first Source Type: blogs

Open Letter to Minnesota's Heath Commissioner Dr. Edward Ehlinger on ill-informed health IT puff piece
Minnesota's Heath Commissioner Dr. Edward Ehlinger penned a puff piece on EHRs entitled "Electronic health records advance quality care for all Minnesotans" (Minn Post, 4/23/15, http://www.minnpost.com/community-voices/2015/04/electronic-health-records-advance-quality-care-all-minnesotans).It constains all the usual baloney (being kind here) about this technology:It starts with this:As Minnesota’s health commissioner, I work to improve the health of all Minnesotans. As a physician, I’m dedicated to providing the best care possible to patients. Secure electronic health records help achieve both goals b...
Source: Health Care Renewal - April 25, 2015 Category: Health Management Tags: Chair Adam Duininck Commissioner Kevin Lindsey Commissioner Lucinda Jesson Edward Ehlinger healthcare IT myths healthcare IT risk Minnesota Heath Commissioner minnpost.com Source Type: blogs

On Generic Management in Health Care: Hospital Chief Information Officers (CIOs) Say Patient Engagement is All About ... Themselves?
To laugh or to cry? - now it seems that hospital CIOs think they "own" patient engagement.  An article in Medscape summarized a presentation at the Healthcare Information and Management Systems Society (HIMSS) Annual meeting that provided a surprising insight into how some hospital managers think.  The survey focused on the concept of patient engagement:In separate surveys, researchers polled a national sample of 125 chief information officers, 359 primary care physicians, and 2567 patients who visited their doctor in the previous 90 days. Questions centered on beliefs about engagement, the perceived ro...
Source: Health Care Renewal - April 19, 2015 Category: Health Management Tags: generic management generic managers HIMSS information technology Source Type: blogs

"God Damn the Pusher Man" - Especially when Enabled by the FDA Revolving Door
Who is watching the watchers?  A story this week involving "speed" like drugs added to "dietary supplements" suggests how far the once respected US Food and Drug Administration has fallen.An Amphetamine-Like Drug Spiking "Nutritional Supplements" The story began with a paper by Cohen and colleagues published a relatively obscure medical journal, and then picked up by the news media.(1)  The main points of the article were:BMPEA (beta-methylphenylethylamine) is a compound first synthesized in the 1930s as a "potential replacement" for amphetamines.  Animal tests reveale...
Source: Health Care Renewal - April 13, 2015 Category: Health Management Tags: amphetamines conflicts of interest FDA health care corruption revolving doors You heard it here first Source Type: blogs

Three More Settlements by Medtronic of Allegations of Deceptive Behavior, but No Umpire Says "You're Out"
DiscussionMedtronic made three settlements over three months, all of allegations that it deceived, directly or indirectly, doctors, patients, or the government.  These settlements were not isolated events.  In June, 2014 we discussed a settlement Medtronic made of allegations that  Medtronic gave kickbacks (that is, bribes) to doctors to get them to use its cardiac devices.  Previously, as we noted then, ...   As Bloomberg summarized, Medtronic agreed in 2007 to pay about $130 million to settle consumer suits accusing the device maker of hiding defects in its defibrillators. The company agreed...
Source: Health Care Renewal - April 9, 2015 Category: Health Management Tags: anechoic effect deception fraud impunity kickbacks legal settlements Mark Leavitt Medtronic Victor Dzau Source Type: blogs

Not with a bang but with a whimper
This is the way the world endsThis is the way the world endsThis is the way the world endsNot with a bang but with a whimper     -- T. S. Eliot, The Hollow Men, 1925Those across the Commonwealth of Pennsylvania who lived through the disaster known as AHERF, the story of the Allegheny Health and Education Research Foundation, ending in one of the biggest non-profit health care bankruptcies in US history, may now note in passing the death some months ago--just recently announced--of its architect, one Sherif Abdelhak.Many books and articles have been written about this hubristic exercise in go-go cor...
Source: Health Care Renewal - April 7, 2015 Category: Health Management Tags: AAMC AHERF anechoic effect Source Type: blogs

The Troubles at Cooper Continue, Lately Gruesomely, But Will Its Leadership and Governance Change This Time? - Part II: the History since 2005
In our most recent post, we noted the latest tragic, and gruesome development at Cooper Health System, the largest hospital system in southern New Jersey.  Months after the system CEO, John F Sheridan, and his wife Joyce were found dead after a fire in their home, local law enforcement concluded that Mr Sheridan murdered his wife, set fire to the house, then committed suicide.  It turns out this is just the latest, albeit possibly most tragic and grisly, troubling news from that health care system.Our last post summarized the history from 1978, including:-  Seven people, including the hospital system chief f...
Source: Health Care Renewal - April 3, 2015 Category: Health Management Tags: boards of trustees conflicts of interest Cooper Hospital/ UMC crime kickbacks legal settlements revolving doors Source Type: blogs

The Troubles at Cooper Continue, Lately Gruesomely, But Will Its Leadership and Governance Change This Time? - Part I: Historical Background
Allegations of Murder-Suicide by a Hospital System CEO This will be a hard series of posts to write. It wa triggered by the latest, and perhaps most gruesome chapter in the troubled history of the leadership of Cooper Health, the largest hospital system in southern New Jersey (known locally as South Jersey).  As reported by the Philadelphia Inquirer on March 28, 2015,Cooper University Health System CEO John P. Sheridan Jr. stabbed his wife to death, set their bedroom on fire, and then took his own life, authorities have concluded, closing a six-month investigation into the deaths that shocked New Jersey's political an...
Source: Health Care Renewal - April 1, 2015 Category: Health Management Tags: anechoic effect boards of trustees conflicts of interest Cooper Hospital/ UMC crime governance health care corruption hospital systems leadership Source Type: blogs

Times: American boards are exceptional--and not necessarily in a good way
The recent New York Times piece on the behavior of (mainly for-profit, but by extension...) US organizations' boards of directors, goes some way toward explaining the anechoic effect.The redoubtable Gretchen Morgenson reports on the gulf between company directors' approach to transparency in the United States when compared, say, with a lot of boards in the UK, Holland, and the Scandinavian countries.The novel idea of taking shareholders' views into account seems to be far more common on the other side of the pond. When it comes to for-profit entities, of course, investors' expectations come into play--you'd think this...
Source: Health Care Renewal - March 30, 2015 Category: Health Management Source Type: blogs

Opinion, CIO Magazine: "The medical profession needs to get over its fear of information technology"- their complaints bogus
There comes a time when the pundits defending the status quo in the healthcare information technology sector and health IT utopianism simply need to be thoroughly and definitively refuted.This is such a time.  CIO magazine reaches the country's information technology leadership, including those in heathcare.   Hence, canards and meritless defamation of physicians can (and in my experience does) impact the attitudes and decisions of the leaders of the very technology physicians are increasingly dependent upon to deliver safe care.Ultimately, such misinformation can and does result in patient harm through bad ...
Source: Health Care Renewal - March 27, 2015 Category: Health Management Tags: CIO magazine healthcare IT dangers healthcare IT dissatisfaction healthcare IT usability healthcare IT utopianism Source Type: blogs

Two New Independent Reports on the Death of Dan Markingson, But Now What Will Happen?
This report is the first step toward accountability.'The Minnesota Post added the response of Professor Elliott and a colleague,'It’s nice to have an independent confirmation of what we’ve been telling the university for five years, but which they have refused to listen to,' he told MinnPost on Thursday.Elliott said he is not convinced, however, that Kaler and other university leaders are going to take responsibility for what happened in the Markingson case — or take the necessary steps to fix the problem going forward.'One of the most worrying findings in the report was the widespread belief on campus th...
Source: Health Care Renewal - March 25, 2015 Category: Health Management Tags: anechoic effect AstraZeneca atypical anti-psychotics clinical trials conflicts of interest manipulating clinical research research subjects suppression of medical research University of Minnesota Source Type: blogs

A $6.6 Million CEO Dreams of a "Doctor-Less" Future
The CEO of giant hospital system UPMC, Mr Jeffrey Romoff, has been one of the best compensated CEOs of ostensibly non-profit hospital systems.  As we noted here, his 2013-14 compensation was $6.6 million.  UPMC has become so big and its top managers so rich that a former Mayor of the city of Pittsburgh sued the organization claiming it was not really not-for-profit (look here and here).  The leadership of UPMC has previously supplied us with some interesting examples of conflicts of interest (look here and here).  The announcement of a new alliance of Pittsburgh organizations provided an interesting ins...
Source: Health Care Renewal - March 20, 2015 Category: Health Management Tags: generic managers Jeffrey Romoff UPMC Source Type: blogs

Same Old, Same Old - Johnson and Johnson Settles Charges it Concealed Adverse Effects of Risperdal, Vaginal Mesh Device, Pleads Guilty to Selling Adulterated Tylenol, Announces CEO Got 48% Raise to $25 Million
We have devoted a lot of bytes over the years to the stream of allegations and ethical questions about Johnson and Johnson, the giant pharmaceutical/ biotechnology/ device company, and resulting legal actions.  Meanwhile, the company has bestowed a gushing stream of money on its top executives.  Its almost spring, 2015, and it seems nothing has changed.Johnson and Johnson's Latest Legal MisadventuresJury Verdict that Company Concealed Harms of Risperdal Let us start with the latest legal news about J&J.  In late February, 2015, as reported on the PharmaLot blog by Ed Silverman,In a setback to Johnson &am...
Source: Health Care Renewal - March 18, 2015 Category: Health Management Tags: adulterated drugs adverse effects Alex Gorsky crime deception Johnson and Johnson legal settlements manufacturing problems William Weldon Source Type: blogs

Increasing Bad Press for Today's Healthcare Information Technology - Deserved and Overdue
Here are three candid, quite revealing articles about the distaste for today's health IT that appeared recently.  I will address each,The first seems like pure deja vu (see my June 4, 2009 post "If The Military Can't Get Electronic Health Records Right, Why Would We Think Conflicted EHR Companies And IT-Backwater Hospitals Can?" at http://hcrenewal.blogspot.com/2009/06/if-military-cant-get-electronic-health.html):1.  Forbes:  Pentagon's $11 Billion Healthcare Record System Will Be Obsolete Before It's Even Built -  March 3, 2015http://www.forbes.com/sites/lorenthompson/2015/03/03/military-heal...
Source: Health Care Renewal - March 16, 2015 Category: Health Management Tags: forbes health affairs healthcare IT difficulties healthcare IT risks HealthcareDive.com Source Type: blogs

An ironically titled session by ECRI Institute: "Would You Bet Your Mother's Life on the Safety of Your EHR?"
An ironically titled session by ECRI Institute "Would You Bet Your Mother's Life on the Safety of Your EHR?" is being held at the annual Health Information Management Systems Society (HIMSS) meeting by Ronni Solomon, JD and William Marella, MBA of the ECRI Institute on April 13, 2015 (http://www.himssconference.org/event.aspx?ItemNumber=36765).It is announced in the HIMSS press release below in Healthcare IT News. I should probably be the keynote speaker to that session, as I am suitably qualified to speak of that exact issue.  My mother and I lost such a "bet" (http://hcrenewal.blogspot.com/2013/0...
Source: Health Care Renewal - March 16, 2015 Category: Health Management Tags: ecri institute healthcare IT risks HIMSS Ronni Solomon William Marella Source Type: blogs

Health Care Run by Those "Who See the Practice of Medicine as a Set of Economic Transactions," or as a "Moral Endeavor?"
Calls are getting louder for restoring medicine and health care as a calling that puts patients first, versus a business that puts money first.  For example, in the conclusion of her opening talk for the 2015 Lown Institute Annual Conference: the Road to RightCare, Shannon Brownlee said, [with italics added for emphasis]So today I stand before you not as a writer turned health policy expert turned health care activist, though I’m still all of those things. I stand before you as a mother, a wife, a daughter . . . and a citizen. I stand before you filled on the one hand, with dismay . . . and on the other hand wit...
Source: Health Care Renewal - March 10, 2015 Category: Health Management Tags: generic management generic managers market fundamentalism Source Type: blogs

A "PR Pawn" Confounds the Public Relations Burnishing of Texas Health Resources and its CEO
The Ebola virus epidemic in Africa is hopefully winding down.  The uproar, if not panic, over Ebola virus in the US has been eclipsed by the latest  internet craze.  However, we are still learning from the echoes of the brief, and thankfully very localized US experience with Ebola.In particular, the country's response to the virus should continue to inspire unease about how our supposedly market based, managerially focused health care non-system can handle real public health threats.Background - Ebola at Texas Health PresbyterianStarting on October 2, 2015, we discussed numerous concerns about whether proble...
Source: Health Care Renewal - March 5, 2015 Category: Health Management Tags: Ebola virus generic management generic managers public relations Texas Health Presbyterian Hospital Texas Health Resources Source Type: blogs

Rideout Hospital, California: CEO Pinocchio on quality of patient care during hospital computer crash
EHRs and other clinical IT are touted as essential to improving safety, among many other benefits.Yet when hospital systems crash, the common refrain by hospital executives to the press, when such stories are reported, is "...but quality of care was not compromised."  In fact, I've made an indexing term for this refrain.  The following query link retrieves the posts so indexed, numbering almost 30 at present:  http://hcrenewal.blogspot.com/search/label/Patient%20care%20has%20not%20been%20compromisedOne hospital in California 40 minutes north of Sacramento had a crash and its CEO made exactly t...
Source: Health Care Renewal - March 2, 2015 Category: Health Management Tags: Appeal-Democrat healthcare IT crash healthcare IT risk Patient care has not been compromised Rideout Hospital Robert Chason Source Type: blogs

Turn, Turn, Turn - Another Health Care Revolving Door Update
DiscussionI apologize for the somewhat desultory way I have been summarizing health care revolving door cases.  My excuse is that such cases are almost never publicized as such.  Most of the stories above were found when looking for something else.  Despite its potential importance, the revolving door phenomenon gets little consistent coverage in the news media, and the particular issue of the revolving door affecting health care is particularly anechoic.  (If one searches for "'health care revolving door," one finds discussion of patients who are frequently re-admitted to the hospital.) ...
Source: Health Care Renewal - March 2, 2015 Category: Health Management Tags: CDC CMS corporatism Covidien DHHS Medtronic Merck ONC revolving doors UnitedHealth Source Type: blogs

Did You Ever Notice?
To quote the late 60 Minutes curmudgeon Andy Rooney, "did you ever notice" how documentary movies--we could extend this to all sorts of documentation as Lancet does it far better than any American medical journals--on anechoic topics seem to come mostly from the Brits?A telling new example: the just-released film The Widowmaker, found both here online and in a few E and W Coast theaters. (Real world locations given at above link. Seemingly, and sadly, no red states need apply.)Widowmaker, boasting fine production values and an 'A' team of Gillian Anderson (fittingly of X-Files fame!) and the d...
Source: Health Care Renewal - February 28, 2015 Category: Health Management Source Type: blogs

Promoting Amphetamines for Over-Eating - What Could Possibly Go Wrong?
In this study, about 5% of patients given any dosage of Vyvanse had to discontinue its use because of adverse effects.  3/196 patients initially randomized to Vyvanse had serious adverse effects, and one patient died, apparently of an amphetamine overdose.  Oddly, the article declared that the one death, due to methamphetamine overdose, was thought by a study investigator not to be related to treatment with another amphetamine, lisdexamfetamine.  That makes little sense, given that in a randomized controlled trial, the presumption is that differences in groups given different treatments were caused by these ...
Source: Health Care Renewal - February 26, 2015 Category: Health Management Tags: clinical trials conflicts of interest deception evidence-based medicine FDA marketing Shire stealth marketing Source Type: blogs

Timing Discharges to Maximize Revenue - "Corruption" of Corporate Long-Term Hospitals?
A recent Wall Street Journal article that focused on a quirk in US Medicare payment rules that may be gamed by long-term hospitals also revealed the plight of physicians employed by such hospitals, and worse, the danger posed by such gaming to patients.Discharging Patients at Particular Times Maximizes Hospital RevenueHere is how the rule works: Under Medicare rules, long-term acute-care hospitals like Kindred’s typically receive smaller payments for what is considered a short stay, until a patient hits a threshold. After that threshold, payment jumps to a lump sum meant to cover the full course of long-term treatmen...
Source: Health Care Renewal - February 23, 2015 Category: Health Management Tags: corporate physician health care corruption Kindred Health mission-hostile management Select Medical Source Type: blogs

You Called Me "Greedy?" - $2.2 Million/Year CEO of Catholic Health Care Whose Mission is to Bring "God’s Mercy to the Poor and Under-served" Sues Union for Defamation
From the annals of cognitive dissonance....Background Here is the background.  Mercy Health, formerly Catholic Health Partners, claims to be the largest health system in Ohio, and one of the largest in the US (look here).  It's mission is:to extend the healing ministry of Jesus by improving the health of our communities with emphasis on people who are poor and underserved.  In all that we do, we strive to demonstrate our core values of compassion, excellence, human dignity, justice, sacredness of life and service.Its current CEO is Michael D Connelly, MA, JD.  In his latest CEO's message, he stated,our ...
Source: Health Care Renewal - February 19, 2015 Category: Health Management Tags: executive compensation labor unions Mercy Health (Ohio) SLAPP Source Type: blogs

Pay 'em When They're Up, Pay 'em When They're Down - CEO Value Extraction Even at Small Non-Profit Hospitals
To the tune of "Dirty Laundry," by Don Henley, some more of health care's dirty laundry...We have frequently discussed the seemingly unstoppable rise of compensation given to top hired managers of health care organizations.  Their compensation seems to rise regardless of the financial status of their organizations, much less how well their organizations are caring for patients or otherwise fulfilling the mission.  Top hired managers of other organizations, particularly big for-profit corporations, have seen similar enhancements of their personal wealth, leading to the charge that they are acting as &quo...
Source: Health Care Renewal - February 17, 2015 Category: Health Management Tags: executive compensation hospital systems hospitals St Luke ' s Health System West Georgia Health Source Type: blogs

Wall Street Journal: "ObamaCare’s Electronic-Records Debacle"
This WSJ Op-Ed could have been entitled "President Sucker:  Led Down the Garden Path by The Healthcare IT Industry."It is entitled "ObamaCare’s Electronic-Records Debacle", as below.  First, though:On Feb. 18, 2009 the WSJ published the following Letter to the Editor authored by me (http://www.wsj.com/articles/SB123492035330205101):Digitizing Medical Records May Help, but It's ComplexDear WSJ:You observe that the true political goal is socialized medicine facilitated by health care information technology. You note that the public is being deceived, as the rules behind this takeover were ...
Source: Health Care Renewal - February 17, 2015 Category: Health Management Tags: AMA healthcare IT dangers healthcare IT distraction healthcare IT risk HITECH Jeffrey A. Singer MD Wall Street Journal Source Type: blogs

The $5.3 Million a Year Government Bureaucrat - The Top Administrator, or CEO of a "Government Entity," Charlotte-Mecklenburg Hospital Authority, "Doing Business as" Carolinas Healthcare Gets a Raise
The pay given to top managers of health care organizations continues its seemingly inexorable rise, and the justifications for it seem to be increasingly perfunctory.  However, a closer look at individual cases can generate even more questions about how we got to this pass.  Our latest example arises from a recent news article about the compensation of top managers at Carolinas Healthcare.   CEO Pay Levitating Since 2009 In 2011, we started following executive compensation at the hospital system now known as Carolinas Healthcare. Our posts in 2011, 2012, and 2013 all fit the same pattern.The total compensati...
Source: Health Care Renewal - February 12, 2015 Category: Health Management Tags: Carolinas HealthCare Charlotte-Mecklenburg Hospital Authority executive compensation government managers ' coup d etat public hospitals Source Type: blogs

Outsize Compensation for "Teflon-Coated" Executives - After Many Lawsuits and Negative News Stories, Norton Healthcare Executives Still Get Millions
In an earlier era of chemistry, politicians who continued to acquire votes while shedding doubts, criticisms, and allegations were called "Teflon-coated."  Teflon may be outdated now, but there certainly seems to be some health care executives who have unique non-stick coatings.The Executives' Compensation Our latest example comes from the Louisville (KY) Courier-Journal, which just published an article about the compensation received by top executives of one of the region's major hospital systems.  The essentials were:From 2011 to 2013, the three most recent years available, tax records show the chief ...
Source: Health Care Renewal - February 5, 2015 Category: Health Management Tags: conflicts of interest cross fire executive compensation Medtronic Norton Healthcare public relations spine surgeons Source Type: blogs

ONC on healthcare IT and patient rights: These systems "have to be rolled out to know where the problems lie"
An anonymous commenter to my blog post about the USA Today article on bad health IT (http://hcrenewal.blogspot.com/2015/02/former-onc-director-david-blumenthal.html) noted this, that I myself missed:Anonymous said...Gettinger's comment is stunning, especially coming from a director of safety and quality for HHS' Office of the National Commissioner for Health Information Technology: "You don't just plunk down EHRs and everyone's happy. You use an incremental kind of approach (and) that takes time, that takes energy and that takes effort," he says, adding that they have to be rolled out to know where the probl...
Source: Health Care Renewal - February 3, 2015 Category: Health Management Tags: Andrew Gettinger MD healthcare IT defects Healthcare IT experiment healthcare IT safety human experimentation ONC patient rights Source Type: blogs

Former ONC Director David Blumenthal (Inadvertently?) Honest About EHRs in USA Today Story
USA Today has published a story on health IT difficulties.  Read it in its entirety; it is fairly balanced, though mild, e.g., it omits mention of the ECRI Deep Dive study on patient harms (http://hcrenewal.blogspot.com/2013/02/peering-underneath-icebergs-water-level.html) and other actual reports of patient harm.  (I was one of many who spoke to the reporters about this story.) Feds move into digital medicine, face doctor backlashLaura Ungar and Jayne O'Donnell, USA TODAYFeb. 1, 2015   http://www.usatoday.com/story/news/nation/2015/02/01/backlash-against-electronic-medical-records/21693669/I am only go...
Source: Health Care Renewal - February 2, 2015 Category: Health Management Tags: David Blumenthal healthcare IT difficulties healthcare IT dissatisfaction Source Type: blogs

Time to "Look for the Union Label?" - "First US Doctors' Strike in Decades," at University of California Student Health
The First US Doctors' Strike in Decades A few news media outlets in California have reported on what has been up to now a very rare event - a strike by physicians.  An initial summary was in an article in the San Diego Union - Tribune, whose title wasFirst U.S. Doctors' Strike in DecadesA handful of doctors providing medical services to students at UC San Diego — and their colleagues at nine other University of California campuses — went on strike Tuesday.It's the first time in 25 years that fully licensed doctors are picketing a U.S. employer, according to the Union of American Physicians and Dentists, wh...
Source: Health Care Renewal - January 30, 2015 Category: Health Management Tags: corporate physician executive compensation labor unions physician strikes transparency University of California Source Type: blogs

CMS: Millions of patients across the nation are benefiting from the - um - potential - of Health IT?
I presume this is, in part, a response to the Jan. 21 letter from AMA and the other medical societies as I wrote about two days ago at http://hcrenewal.blogspot.com/2015/01/meaningful-use-not-so-meaningul.html:CMS intends to modify requirements for Meaningful Usehttp://blog.cms.gov/2015/01/29/cms-intends-to-modify-requirements-for-meaningful-use/January 29By Patrick Conway, MDToday, we at the Centers for Medicare & Medicaid Services (CMS) are pleased to announce our intent to engage in rulemaking to update the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs beginning in 2015. These intended chan...
Source: Health Care Renewal - January 29, 2015 Category: Health Management Tags: CMS healthcare IT difficulties healthcare IT dissatisfaction healthcare IT myths MD Patrick Conway Source Type: blogs

CMS: Millions of patients across the nation are benefiting from the - um - potential - of Health IT!
I presume this is, in part, a response to the Jan. 21 letter from AMA and the other medical societies as I wrote about two days ago at http://hcrenewal.blogspot.com/2015/01/meaningful-use-not-so-meaningul.html:CMS intends to modify requirements for Meaningful Usehttp://blog.cms.gov/2015/01/29/cms-intends-to-modify-requirements-for-meaningful-use/January 29By Patrick Conway, MDToday, we at the Centers for Medicare & Medicaid Services (CMS) are pleased to announce our intent to engage in rulemaking to update the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs beginning in 2015. These intended chan...
Source: Health Care Renewal - January 29, 2015 Category: Health Management Tags: CMS healthcare IT difficulties healthcare IT dissatisfaction healthcare IT myths MD Patrick Conway Source Type: blogs

None Dare Call It Health Care Corruption
... even when allegedly a prominent academic physician's traded referrals of cancer patients to a law firm, resulting in referral fees to a prominent politician who worked for the firm, for government research grants to the physician's foundation and another foundation on whose board he sat, and a job for his son at yet another non-profit organization.***Health care corruption, remains a largely taboo topic, especially when it occurs in developed countries like the US.  Searching PubMed or major medical and health care journals at best will reveal a few articles on health care corruption, nearly all about corruption i...
Source: Health Care Renewal - January 28, 2015 Category: Health Management Tags: anechoic effect bribery cancer Columbia University crime fraud health care corruption Source Type: blogs

"Meaningful Use" not so meaningul: Multiple medical specialty societies now go on record about hazards of EHR misdirection, mismanagement and sloppy hospital computing
The "Meaningful Use" program for EHRs is a mismanaged boondoggle causing critical issues of patient safety, EHR usability, etc. to be sidestepped.This is on top of the grossly mismanaged and unregulated U.S. boondoggle which should probably be called "the National Programme for IT in the HHS" - in recognition of the now-defunct multi-billion-pound debacle known as the National Programme for IT in the NHS (NPfIT), see my Sept. 2011 post "NPfIT Programme goes PfffT" at http://hcrenewal.blogspot.com/2011/09/npfit-programme-going-pffft.html.The complaints are not just coming from me now.As of Janu...
Source: Health Care Renewal - January 28, 2015 Category: Health Management Tags: AMIA healthcare IT safety Kaizen Event Karen De Salvo management mysticism MAUDE meaningful use Source Type: blogs

Logical Fallacies in Defense of Aggresive Screening for and Treatment of Hepatitis C
And the hepatitis C follies continue... As we have frequently written, most recently last week, the hepatitis C screening and treatment bandwagon keeps rolling along.  There is constant public argument about the prices of treatment regimens, which approach $100,000 per patient in the US.  However, nearly all the public chatter, which seems mostly to come from corporate public relations people and marketers, investors and investment advisers, physicians with financial conflicts of interest, and pundits with little background in clinical epidemiology, seems never to question the assumption that the new drugs for he...
Source: Health Care Renewal - January 21, 2015 Category: Health Management Tags: anechoic effect evidence-based medicine hepatitis C logical fallacies Sovaldi Source Type: blogs

Making the Arc of the Moral Universe Bend
On this day, the US celebrates the legacy of the Rev Martin Luther King Jr.Martin Luther King Jr once famously addressed the question of how long it would take to achieve some measure of real equality in the US (in the "Our God is Marching on Speech.")  He stated,the arc of the moral universe is long, but it bends towards justice.  In context, he clearly meant that such bending was possible when people devoted hard work and concerted action toward this end.  Rev King was hardly one to sit back and passively expect good things to happen. However, as pointed out in the Huffington Post entry by Christ...
Source: Health Care Renewal - January 19, 2015 Category: Health Management Source Type: blogs

The Fashion Challenges of the Emperor of Hepatitis C Treatment - Now in the BMJ, but Who Will Notice?
As we wrote, most recently last week, the hepatitis C screening and treatment bandwagon keeps rolling along.  There is constant public argument whether about the prices of treatment regimens, which approach $100,000 per patient in the US.  However, nearly all the public chatter, which seems mostly to come from corporate public relations people and marketers, investors and investment advisers, physicians with financial conflicts of interest, and pundits with little background in clinical epidemiology, seems never to question the assumption that the new drugs for hepatitis C are miraculous cures, which, of course, ...
Source: Health Care Renewal - January 15, 2015 Category: Health Management Tags: clinical trials evidence-based medicine health care prices hepatitis C Sovaldi Source Type: blogs

The March of Legal Settlements Continues into 2015 - Daiichi Sankyo Settles Charges of Kickbacks to Doctors for $39 Million
We are just into January and have our first legal settlement by a major health care corporation of charges of giving physicians kickbacks to spur use of a commercial product.  Like most such stories, this one got little notice.  The most extensive report was in Ed Silverman's PharmaLot blog on the Wall Street Journal site.The Summary and Allegations The basic summary...Daiichi Sankyo agreed to pay $39 million to the U.S. federal government and state Medicaid programs to settle allegations of paying kickbacks to physicians to prescribe several of its drugs. The allegations were ...that Daiichi initiated different ...
Source: Health Care Renewal - January 13, 2015 Category: Health Management Tags: conflicts of interest corporate integrity agreement Daiichi Sankyo impunity kickbacks legal settlements Source Type: blogs

Once More, the Hospital CEO as Scrooge - Cape Cod Healthcare CEO Collected Millions in Severance After Laying Off Hundreds of Health Professionals, and Being Sanctioned by the State Medical Board
The theme of non-profit hospital CEO as Scrooge seems to be persisting in the media even beyond the holiday season.  (Our last post on this theme was in December, 2014).  The previous cases we discussed (also here) involved  marked contrasts between how well top hired managers of non-profit hospitals were doing, and how their institutions were doing.Turning Around the Hospital, but Turning Away Employees The background to this story comes from an article in the Cape Cod (MA) Times from January, 2014.  Cape Cod Healthcare, a regional non-profit hospital system, hired Dr Richard Saluzzo as CEO to turn aro...
Source: Health Care Renewal - January 8, 2015 Category: Health Management Tags: boards of trustees Cape Cod Healthcare executive compensation perverse incentives Source Type: blogs

As the Hepatitis C Marketing Frenzy Continues, a Reminder Not to Ignore the Evidence
The Hepatitis C Spin Cycle Continues Since our last post in July, 2014, about sofosbuvir (Sovaldi, Gilead), the $1000 pill proclaimed to be a wonder drug for the treatment of hepatitis C, the marketing juggernaut for new antiviral drugs for this condition continues to roll along.For example, I just got a notice to look at a Gilead website which proclaims  HCV can be curedIn October, Gilead got permission so sell Harvoni, a new combination drug that includes sofosbuvir and ledipasvir, hailed as a once daily pill that can cure hepatitis C, for a mere $94,500 for a typical treatment course. (See this article in the Wall ...
Source: Health Care Renewal - January 5, 2015 Category: Health Management Tags: AbbeVie clinical trials evidence-based medicine Gilead marketing Sovaldi Source Type: blogs