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Feasibility of the Delivery of Lab Specimen and Units of Blood by Drone
The use of drones for delivery of various types of goods has been in the news lately (see:Here ’s everything you need to know about Amazon’s drone delivery project, Prime Air). However, the use case that caught my attention was the delivery of clinical lab specimens (see:Johns Hopkins ’ Test Drone Travels 161 Miles to Set Record for Delivery Distance of Clinical Laboratory Specimens), Below is an excerpt from this article:....Johns Hopkins University Medicine (JHUM) has set a record in America for the longest distance drone delivery of viable medical specimens. In a project to demonstrate the viability of...
Source: Lab Soft News - November 16, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Blood banking Clinical Lab Industry News Lab Industry Trends Source Type: blogs

Down Syndrome Disappearing in Iceland; Similar Events Will Become More Common
We are now living in an era when infants born with genetic disorders such asDown Syndrome will disappear in some societies (see:"What kind of society do you want to live in?": Inside the country where Down syndrome is disappearing). Below is an excerpt from this article explaining this process. Read the whole article if you are so motivated. With the rise of prenatal screening tests across Europe and the United States, the number of babies born with Down syndrome has significantly decreased, but few countries have come as close to eradicating Down syndrome births as Iceland. Since prenatal screening tests we...
Source: Lab Soft News - November 14, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Clinical Lab Testing Lab Industry Trends Medical Ethics Medical Research Source Type: blogs

The Need for More Research in Provider-to-Provider Telemedicine
A recent article inDark Daily provided me with a useful way to better understand the field of telemedicine by dividing it into three segments (see:Telemedicine Gaining Momentum in US as Large Employers Look for Ways to Decrease Costs; Trend Has Implications for Pathology Groups and Medical Laboratories). Below is an excerpt from it:[A recent article] divides telemedicine technology into three distinct segments:1. Provider-to-provider2. Remote patient monitoring3. Patient-to-providerIn an article...[written[ for MedCityNews (see: Telemedicine: Take a lesson from retail to improve patient adoption),...[the author] calls...
Source: Lab Soft News - November 10, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Electronic Health Record (EHR) Healthcare Delivery Medical Research Quality of Care Telemedicine Source Type: blogs

The Case of the " Disappearing Hospital Beds " ; Implications for Pathologists
I have posted a number of previous notes about the greater emphasis being placed on ambulatory care and bedless hospitals (see, for example: Hospitals Investing Capital in Variety of Outpatient Facilities: IT Serves as the Glue;Some Additional Ideas About the Bedless Hospitals of the Future). I had not come across hard numbers about this phenomenon until now. A recent article discussed the case of the"disappearing hospital beds" (see:The case of the disappearing hospital beds). Below is an excerpt from it:Healthcare is leaving the traditional four walls of hospitals.As patients, payers, and providers se...
Source: Lab Soft News - November 8, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Clinical Lab Industry News Clinical Lab Testing Healthcare Delivery Lab Industry Trends Quality of Care Reference Laboratories Telemedicine Test Kits and Home Testing Source Type: blogs

Telemedicine and Home Monitoring Will Promote Healthcare Transformation
I believe that telemedicine and home monitoring of patients post hospital discharge will be more broadly adopted as common healthcare services. The reason that they have lagged in popularity up to now is that the reimbursement picture is confusing and physicians and nurses have not been trained in their use. These two types of services provide a substitution of technology for bricks-and-mortar investments and substitute technology for labor. A recent article discussed the involvement ofMedtronic in home monitoring devices (see: Medtronic alliance looks to expand use of home-monitoring devices). Below is an e...
Source: Lab Soft News - November 6, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Healthcare Delivery Healthcare Information Technology Medical Research Preventive Medicine Telemedicine Source Type: blogs

Ovarian Cancer Does Not Exist; Effect on Gynecologic Cancer Surgery
When I was both a medical student and a pathology resident, I was intrigued by the fact that many ovarian cancers I looked at under the microscope consisted of columnar cells and often seemed to grow on the surface of the ovary. Various teachers told me that the neoplasms were mimicking peritoneal and tubal epithelium. Experts now assert that there is no such thing as"ovarian cancer" -- all such neoplasms are now thought to originate in the uterine tubes, thus explaining their histologic appearance (see:Tackling Cancer Myths: It ’s time to accept that ovarian cancer doesn’t exist). Here is an excerpt ...
Source: Lab Soft News - November 3, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Medical Consumerism Medical Education Medical Research Preventive Medicine Quality of Care Surgical Pathology Source Type: blogs

The Challenge of Analyzing EHR Data; Can This Problem Be Solved?
A recent comprehensive and insightful article in theHarvard Business Review succinctly summarized the essence of the problem facing hospitals and their EHRs in the introduction (see: The IT Transformation Health Care Needs). I copy it below:A central reason the negatives [of EHRs] seem to outweigh the positives is the way IT systems are being used.To date, the priorities of most health care organizations have been replacing paper records with electronic ones and improving billing to maximize reimbursements. Although revenues have risen as a result, the impact of IT on reducing the costs and improving the quality ...
Source: Lab Soft News - November 1, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Cost of Healthcare Electronic Health Record (EHR) Healthcare Business Healthcare Information Technology Hospital Executive Management Hospital Financial Medical Research Quality of Care Source Type: blogs

Possible Purchase of Aetna by CVS; Strategic Healthcare Implications
CVS has been reported to be in engaged in talks for the purchase ofAetna in what I would describe as movement toward vertical healthcare integration (see: CVS Is Said to Be in Talks to Buy Aetna in Landmark Acquisition). Below is an excerpt from this article:CVS Health, the giant drugstore chain that also runs walk-in clinics and a pharmacy benefit business, is in talks to buy Aetna, one of the nation ’s largest health insurance companies, according to people briefed on the talks....[I]f consummated, the deal could be worth more than $60 billion based on Aetna ’s current market value, which would...
Source: Lab Soft News - October 30, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Source Type: blogs

Look Who Is Going to Be Appear at an Upcoming Geisinger Symposium?
Geisinger Health System, which I consider to be one of the most innovative and progressive health systems in the country, is planning a national health care symposium next month. The invitation-only event will be held Nov. 8, 9 and 10 on the Danville, Pennsylvania, campus of Geisinger Medical Center (see: “From Crisis to Cure” to be held in November on the campus of Geisinger Medical Center). I have posted a number of notes about Geisinger's innovation efforts in the past (see, for example:Geisinger Develops Its Own EHR Interconnectivity Software Solution; Should Hospitals Recruit Patien...
Source: Lab Soft News - October 28, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Electronic Health Record (EHR) Healthcare Business Hospital Executive Management Medical Education Source Type: blogs

Pharmaceutical Companies and PBMs Helped to Create Our Opioid Crisis
I have blogged previously about the role of PBMs in shipping drugs to retail drug stores that placed suspiciously high drug orders (see:Drug Distributor McKesson Pays Record Penalty For Suspicious Opioid Orders). The role of the Sackler family, owners ofPurdue Pharma, in aggressively pushing Oxycontin is also now coming to light (see:The Sackler Family: best known for philanthropy, they made billions promoting Oxycontin;Report: Stamford company confirms DOJ probe). Let's face facts. You can't have a country-wide epidemic of prescription drugs without the connivance of some of the major corporations. Some of th...
Source: Lab Soft News - October 27, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Healthcare Business Medical Ethics Pharmaceutical Industry Source Type: blogs

Centralized Cardiac Monitoring Center Developed by Cleveland Clinic
I have blogged about the development of virtual critical care units whereby smaller hospitals maintain critical care beds but rely upon remotely located intensivists to monitor their patients (see:Staffing An Intensive Care Unit From Miles Away Has Advantages;Telemedicine Transforms Intensive Care Units in Smaller Hospitals with Remote Monitoring). These units are developed in situations where skilled personnel are not available locally. The Cleveland Clinic has developed another variation on this theme with their centralized cardiac telemetry monitoring unit for non-critically ill patients (see:An Update on the Centr...
Source: Lab Soft News - October 26, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Healthcare Delivery Healthcare Information Technology Preventive Medicine Telemedicine Source Type: blogs

Apple Watch " Gifted " to Insurance Policy Holders; Any Gotcha's with the Deal?
I have posted a number of previous notes about both"wearables" and wellness advocacy by employers and insurance companies (see, for example:Wearable Health Monitoring Devices: a Means to Lower Insurance Costs?;United Healthcare Expands Its Wellness Program Using Activity Trackers). Now comes news that the John Hancock insurance company is giving away Apple Watches to participants in itsVitality program (see:You can get an Apple Watch for only $25 ... with one small catch). The latter insurance product is oriented toward customers who pursue a healthy lifestyle. Below is an excerpt from the article:John Hanco...
Source: Lab Soft News - October 24, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Healthcare Insurance Medical Consumerism Medical Research Preventive Medicine Source Type: blogs

Large Genomic Study to Explore Ways to Manage the Opioid Drug Crisis
A University of Michigan research group is using genomics to extract clues about how to contain the opioid crisis. The details were included in a recent article about the effort (see:U-M Precision Health Effort Looking Beyond Genomics in Researching Opioid Crisis). An excerpt from it is presented below:The University of Michigan's Genomics Initiative last week recruited the 50,000th patient who will contribute a biological sample for genomic analysis and phenotypic data to a growing repository for longitudinal research....The initiative's first project will investigate the many characteristics, including genomics, ...
Source: Lab Soft News - October 19, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Clinical Lab Industry News Clinical Lab Testing Lab Industry Trends Medical Research Pharmaceutical Industry Preventive Medicine Source Type: blogs

New California Legislation Tries to Make Drug Pricing More Transparent
I personally believe that the drug companies have been running amok of late with their drug pricing policies. Their predatory prices have Invited a regulatory response from various quarters. The state of California has responded with a new law designed to make drug prices more transparent (see:California Governor Signs Law To Make Drug Pricing More Transparent). Below is an excerpt from one of the recent articles discussing this new law:The new law will require pharmaceutical companies to notify the state and health insurers if they plan to raise the price of a medication by 16 percent or more over two years. Gov...
Source: Lab Soft News - October 17, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Cost of Healthcare Medical Consumerism Medical Ethics Pharmaceutical Industry Source Type: blogs

Primary Care Docs Spending About Half Their Work Days Interacting with EHRs
I have posted a number of previous notes about the inefficiencies introduced by EHRs, particularly particularly relating to the fact that their use now constitutes a major time sink for physicians (see:Some of the Major Criticisms of EHRs; Why Few Changes Anticipated;Problems Associated with EHRs: A Medical Malpractice Perspective). A recent article quoted a research study about the time logged by primary care physicians on their EHRs (see:Family doctors spend 86 minutes of “pajama time” with EHRs nightly). Below is an excerpt from it:A new study using electronic health record (EHR) system event-logging data to...
Source: Lab Soft News - October 13, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Cost of Healthcare Electronic Health Record (EHR) Healthcare Business Healthcare Delivery Healthcare Information Technology Hospital Executive Management Hospital Financial Quality of Care Source Type: blogs

Lab Rules Firing at the Time of Test Order; Possible on the LIS?
I recently posted a note in which I asserted that the rules engine being developed by Mayo was not particularly novel in that pathology professionals have been deploying similar rules on their LISs for decades (see:Rule-Based Decision Support Tools Available on LISs for Decades). Dr. Curtis Hanson, chief medical officer of the Mayo Medial Laboratories and also a good friend and colleague, responded with the following relevant and probing comment: Appreciate your points below but I think you are missing some key points....We and others have obviously used rule capability within the LIS systems for years but they are&qu...
Source: Lab Soft News - October 9, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Clinical Lab Industry News Clinical Lab Testing Electronic Health Record (EHR) Healthcare Information Technology Lab Industry Trends Lab Information Lab Processes and Procedures LIS Definitions and Strategy Pathology Informatics Quality Source Type: blogs

Rule-Based Decision Support Tools Available on LISs for Decades
In my note of two days ago, I discussed how Mayo Clinic has developed a decision support and report generation tool calledCareSelect Lab in collaboration with a company called the National Decision Support. The system is deployed on the EHR side (see:Mayo Develops CareSelect Tool to Guide Best Lab Practices for Clinicians).I went on to point out that the tool performs functions such as flagging obsolete tests and clarifying confusing test names. It can also generate standardized reports of test utilization by hospital physicians. I went on to say the following:"Lab professionals have been tryi...
Source: Lab Soft News - October 7, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Clinical Lab Industry News Clinical Lab Testing Electronic Health Record (EHR) Healthcare Information Technology Lab Industry Trends Lab Information LIS Definitions and Strategy LIS Vendor News Pathology Informatics Source Type: blogs

Mayo Develops CareSelect Tool to Guide Best Lab Practices for Clinicians
We are now entering an era when sophisticated decision support tools will become commonplace in healthcare based on machine learning algorithms. Certainly, many such tools will be developed in relationship to the laboratory database where numerical results have a close relationship to diagnoses. Mayo Clinic has developed such a tool in conjunction with a company called the National Decision Support (see:Mayo Clinic, National Decision Support Company unveil CareSelect Lab ™ to provide real-time medical guidance when ordering laboratory tests). Below is an excerpt from the article describing it:Mayo Clinic ha...
Source: Lab Soft News - October 5, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Clinical Lab Industry News Clinical Lab Testing Cost of Healthcare Electronic Health Record (EHR) Healthcare Delivery Healthcare Information Technology Lab Industry Trends Medical Research Pathology Informatics Source Type: blogs

Patients' Out-of-Pocket Payments Now Make Up 30% of Hospital Revenues
I have posted a number of previous notes about high-deductible health insurance policies (see, for example:High Deductible-Health Plans Causing Hospital Billing Problems). I was aware of their growing"popularity" due to their lower cost but was not aware, on a percentage basis, of their impact on hospital revenues. A recent article filled in some of the blank spaces (see:Because of Expanded Numbers of Patients with High-deductible Health Plans, Patients Are Now Responsible for 30% of Hospital Revenues). Below is an excerpt from it:Much of the blame [for hospital bad debt] can be attributed to the increased n...
Source: Lab Soft News - October 4, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Healthcare Business Healthcare Delivery Healthcare Insurance Hospital Financial Medical Consumerism Preventive Medicine Source Type: blogs

Large Hospital Chains Developing More Specialized Standalone Centers
We are moving toward a future where inpatient admissions are becoming less common with more specialized, remote centers becoming more numerous. More hospitals are also being designed as"bedless" facilities (see:The Design of Bedless Hospitals Continue to Evolve Based on Cost and Technology;The Future of Healthcare: Virtual Physician Visits& Bedless Hospitals;Some Additional Ideas About the Bedless Hospitals of the Future). A recent article discussed how large hospital chains seems to be moving in this direction (see:Warding Off Decline, Hospitals Invest in Outpatient Clinics). Below is an excerpt from it...
Source: Lab Soft News - September 30, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Cost of Healthcare Healthcare Business Healthcare Delivery Hospital Executive Management Hospital Financial Radiology Source Type: blogs

An Algorithm Using Medical Record Data Predicts Risk for Parkinson's Disease
We are entering an era when algorithms will be used to analyze data in the LIS and EHR databases and predict the risk of a patient developing various disease(s) in the future. This field is often referred to aspredictive healthcare analytics. A recent article discussed this process in terms of predicting the onset of Parkinson's disease (see:Algorithm scans medical records for higher Parkinson ’s risk), Below is an excerpt from it:Researchers have developed an algorithm that could check patients ’ medical histories to find signs of increased risk for developing Parkinson’s disease and alert doctors to...
Source: Lab Soft News - September 28, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Clinical Lab Industry News Clinical Lab Testing Electronic Health Record (EHR) Healthcare Delivery Healthcare Information Technology Lab Industry Trends Medical Consumerism Medical Ethics Medical Research Source Type: blogs

Some Specific Areas Where Hospitals Are Investing in Innovations
Innovation is all the rage these days and hospitals are developing innovation centers to promote changes in the healthcare industry. A recent article listed the specific areas where hospital executives believe innovation will drive improvements in care (see:Here's where hospitals are investing in innovation today). I list the five specific areas listed in the article below with a short commentary following the list:Patient-generated data and customized services. With more and more patients wearing smartwatches, wristbands and other fitness trackers, hospitals are “eager to understand how to securely int...
Source: Lab Soft News - September 27, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Healthcare Delivery Healthcare Information Technology Medical Research Quality of Care Telemedicine Source Type: blogs

Graham-Cassidy Could Be an Additional Financial Blow to Smaller and Rural Hospitals
I have blogged previously about the shaky financial status of small and rural hospitals (see:Rural Hospitals Fighting for Survival; How Can Care in Them Be Improved?) and similar stories are common on the web (see: A Hospital Crisis Is Killing Rural Communities. This State Is ‘Ground Zero.’) A recent article suggested that theGraham-Cassidy bill will increase the financial pressure on rural and small hospitals (see:Rural hospitals see Graham-Cassidy as latest threat to survival). Below is an excerpt from it:Leaders of cash-strapped rural hospitals worry that the latest proposal to repeal and replace t...
Source: Lab Soft News - September 25, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Cost of Healthcare Healthcare Business Healthcare Delivery Healthcare Insurance Hospital Financial Source Type: blogs

The Science and Technology of Liquid Biopsies Improving Rapidly
I have blogged about liquid biopsies over the course of seven years (see, for example:Does the New Term"Liquid Biopsy" Make Any Sense?;Rapid Adoption of the Term"Liquid Biopsy" on the Web;"Liquid Biopsy" Used to Refer to Detection of Any Serum Cancer DNA). The procedure has the potential to revolutionize both the diagnosis and monitoring of malignant lessons. A recent article discussed the technology in detail (see:Going With the Flow: The Promise and Challenge of Liquid Biopsies). I offer below only a short excerpt from the article. Be sure to read the whole thing if you are interested.A...
Source: Lab Soft News - September 23, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Clinical Lab Industry News Clinical Lab Testing Food and Drug Administration Lab Industry Trends Lab Processes and Procedures Medical Research Surgical Pathology Source Type: blogs

Chikungunya Outbreak Halts Blood Collection in Parts of Rome
As a former blood banker, I often take notice of the relationship between blood donation and infectious disease, a sensitivity that harks back to the AIDS era. A recent article noted that blood donations were being halted in parts of Rome because of an outbreak of Chikungunya (see:Outbreak of disease carried by mosquitoes halts blood donation in Rome), Below is an excerpt from it:Italian health officials have banned residents across half of Rome from donating blood because of an outbreak of the painful, mosquito-borne illness Chikungunya. At least 17 people in southeastern Rome have been diagnosed with the virus since...
Source: Lab Soft News - September 18, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Blood banking Clinical Lab Industry News Clinical Lab Testing Medical Consumerism Medical Research Source Type: blogs

Lab Outreach: Forge Ahead or Accept Purchase Bid; Upcoming Free Webinar
Beginning in the Fall of 2013, theAssociation for Pathology Informatics (API) andSunquest Information Systems have co-sponsored a webinar series focusing on pathology and the clinical lab industry with emphasis on informatics. The fifth annual webinar series will launch on Wednesday, Sep. 20, at 1:00 p.m. ET, with a lecture by Khosrow R. Shotorbani, President and Chief Executive Officer, and Richard VanNess, Diagnostic Optimization Product Manager, TriCore Reference Laboratories. Tricore is located in Albuquerque, New Mexico. The title of their lecture is: Outreach: Forge Ahead or Accept ...
Source: Lab Soft News - September 16, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Clinical Lab Industry News Clinical Lab Testing Healthcare Business Healthcare Delivery Hospital Executive Management Hospital Financial Lab Industry Trends Pathology Informatics Source Type: blogs

Hospitals Obstructing Medical Record Exchange; Here Are the Reasons Why
I recently came across an article byBruce Fryer discussing the problems he encountered when a relative of his was hospitalized atSt. Josephs Hospital in Atlanta which is part of Emory Healthcare. He was trying to get access to the patient's electronic records in a hospital across the street and was encountering an interoperability problem, a topic that I have blogged about repeatedly (see, for example:NYT Op-Ed on EHR Interoperability Blames Vendors and Greedy Hospitals;Integration and Interoperability Are Essential for Growth of Digital Pathology; Hospitals Need to Pressure Their EHR Vendors to Improve Software F...
Source: Lab Soft News - September 14, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Electronic Health Record (EHR) Healthcare Business Healthcare Information Technology Hospital Executive Management Medical Ethics Source Type: blogs

Alcoholic Beverages Cause Cancer; Industry Groups Advocate " Responsible " Drinking
Clear patterns have emerged relating alcoholic beverage consumption to the development of head and neck cancer, esophageal cancer, liver cancer, breast cancer, and colorectal cancer (see:Alcohol and Cancer Risk). Hence, when countries experience high consumption of alcoholic beverages, public health officials worry that their populations may experience a surge in the incidence of such lesions in the future. A recent article discussed this possibility in Europe, particularly GI cancers (see:Love Affair With Alcohol Is Driving GI Cancers). Below is an excerpt from the article:Europe could be headed for sharp increases in rat...
Source: Lab Soft News - September 13, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Medical Consumerism Medical Education Medical Ethics Medical Research Preventive Medicine Source Type: blogs

Healthcare Cost Estimator Tools Evolving; Consumers Can Compare Prices
I have posted multiple notes about the opacity of healthcare pricing, particularly that of hospital bills (see, for example:Maryland Controls Hospital Prices; Now Wants to Cap Overall Hospital Spending;Coding for Hospital Services; One Reason for the High Cost of Healthcare). There has been some progress in making prices more transparent and a recent article went into great detail about this topic (see:Is the price right? Solving healthcare ’s transparency problem). In today's note, I will only address healthcare cost-estimator tools but read this whole article if you are interested. Below is an excerpt from it:T...
Source: Lab Soft News - September 8, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Cost of Healthcare Healthcare Business Healthcare Delivery Healthcare Insurance Medical Consumerism Source Type: blogs

FDA Cracks Down on Some Stem Cell Clinics for Unproven Treatments
The FDA is still working to protect the U.S. population from medical chicanery while some of the federal government is wasting money, frittering away time, and trying to harm people. The new target for the agency is stem cell clinics and purveyors of"regenerative medicine" (see:FDA cracks down on stem-cell clinics, including one using smallpox vaccine in cancer patients). Below is an excerpt from the article:The Food and Drug Administration...announced a crackdown on stem-cell clinics offering unproven and potentially dangerous treatments, including an operation in California that the agency said was using the sm...
Source: Lab Soft News - September 5, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Food and Drug Administration Healthcare Business Lab Processes and Procedures Lab Regulation Lab Standards Medical Consumerism Medical Education Medical Ethics Medical Research Quality of Care Source Type: blogs

Anthem Won't Pay for Outpatient MRIs and CT Scans in Hospitals
This article brought to mind a previous post discussing the price advantage that surgicenters have over hospitals in terms of total knee replacements and the price war than was now being waged over these patients (see:Tug of War between Hospitals and Surgicenters for Knee Replacements). It's a story similar to the price tags for imaging costs raised above. For decades, hospital executives have turned to the labs, radiology, and certain highly remunerative surgical procedures to generate revenue to offset the cost of critical care, for example, with its high labor input and higher costs. In this previous note, I suggest...
Source: Lab Soft News - September 1, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Clinical Lab Testing Cost of Healthcare Healthcare Business Hospital Executive Management Hospital Financial Source Type: blogs

Your Doctor in a Kiosk; A New Variant of Telemedicine
Various types of new healthcare delivery strategies and venues are constantly being introduced. For example, I have reported how retail drug stores are being used for both walk-in clinic visits (see:Details about CVS' MinuteClinic POCT Strategy) as well as patient service centers for national reference laboratories (see:National Reference Labs Expand Their PSC Footprint in Groceries& Retail Pharmacy). In this same spirit, various types of telemedicine are being offered from the care of minor problems (see: Details of Cleveland Clinic's MyCare Online Virtual Telemedicine Visits; Kaiser Permanente Annou...
Source: Lab Soft News - August 30, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Healthcare Delivery Healthcare Information Technology Medical Consumerism Telemedicine Source Type: blogs

Deploying a DMT at the Front-End of Lab Orders for a Complex Patient
Dr. Mike Laposata who is Chairman of the Department of Pathology at UTMB in Galveston has been an advocate for diagnostic management teams (DMTs) and the clinical pathologist as a consultant for decades (see: The Clinical Pathologist as Consultant). He launched a conference aboutDiagnostic Management Teams (DMTs) last year that was highly successful and it will be repeated this coming February. In a recent article inCAP Today, Mike discussed the role of a DMT at the"front-end" of test orders for presumably complex patients (see:The what and why of diagnostic management teams). Here is an excer...
Source: Lab Soft News - August 24, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Clinical Lab Industry News Clinical Lab Testing Lab Industry Trends Lab Information Lab Processes and Procedures Pathology Informatics Quality of Care Source Type: blogs

Surgeons Extol the Advantage of Telemedicine in Rural British Columbia
Telemedicine is one of my favorite topics because it provides the solution for the challenge of providing healthcare to a larger segment of the population without incurring the expense of adding bricks-and-mortar structures (see:The Future of Healthcare: Virtual Physician Visits& Bedless Hospitals;The Design of Bedless Hospitals Continue to Evolve Based on Cost and Technology;Some Additional Ideas About the Bedless Hospitals of the Future). Another problem we are facing is inadequate healthcare coverage in rural parts of the country (see:Doctor Shortage In Rural Arizona Sparks Another Crisis In'Forgotten America...
Source: Lab Soft News - August 22, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Healthcare Delivery Healthcare Information Technology Medical Consumerism Medical Education Quality of Care Telemedicine Source Type: blogs

Much of the Future for Pathology and Lab Medicine Rests with Analytics
I have posted a number of notes in the past about"analytics" as it relates to pathology and lab medicine (see, for example: Lab Analytics Emerges as Hot Area for Software Development; Using Lab Analytics Software to Manage Customers Relationships in the Clinical Labs;Using Lab Analytics Software to Manage Customers Relationships in the Clinical Labs). Simply put, analytics is the systematic computational analysis of data or statistics. Pathologists will always be involved with various types of analytics because they are responsible for a large hospital computer system, the LISs, and thus are respon...
Source: Lab Soft News - August 18, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Clinical Lab Industry News Clinical Lab Testing Digital Imaging in Pathology Healthcare Information Technology Lab Industry Trends Medical Research Pathology Informatics Source Type: blogs

John Glaser of Cerner Discusses Ways to Fix the EHR Usability Problem
A recent article byJohn Glaser, Senior VP of Population Health at Cerner, discussed how to fix EHR usability problem (see:Cerner's John Glaser: How to finally fix the EHR usability problem). As I would expect from John who has been a visionary in healthcare IT for decades, the article is filled with pearls of wisdom. I am thus not able to capture in this blog note all of the wisdom that it contained. Nevertheless, below are some of the highlights from it about which I will not provide without any additional editorial comments. Read the whole article for more insights.Why have usability issues come to dominate so m...
Source: Lab Soft News - August 16, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Electronic Health Record (EHR) Healthcare Information Technology Medical Research Quality of Care Source Type: blogs

Progress on Cloud Storage by UC San Diego Health
I started blogging about cloud computing ten years ago (see: A Closer Look at the Vertical Cloud in Healthcare Computing). Here are some other examples of my notes about cloud computing over the years with consideration of its relevance for healthcare (see, for example: The Term"Cloud" Used in Web-Enabled Computing Takes Another Turn; Salesforce Health Cloud as One Possible Solution to Health Data Interoperability; "Extinction" for Hospital Data Centers Predicted in Five Years). Now comes concrete news that one large health system is deploying its EHR in the cloud (see:Epic...
Source: Lab Soft News - August 14, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Source Type: blogs

Is Judy Faulkner's Interaction with Joe Biden Only an Example of Medical Paternalism?
In a recent post, I commented on an interaction between Judy Faulkner, CEO and founder of Epic, and former VP Joe Biden (see:Do Patients Really Need Access to Their Access to Their Health Records?). The debate about this incident continues to simmer on social media and a subsequent article added to the temperature of the discussion (see:Joe Biden just brought the debate over medical records into the limelight). Below is an excerpt from it:For some, this discussion seemed to a rare window into her psychology -- Faulkner...is notoriously reluctant to speak to the press. Others see this exchange as indicative of Epic'...
Source: Lab Soft News - August 10, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Electronic Health Record (EHR) Healthcare Business Healthcare Information Technology Hospital Executive Management Hospital Financial Medical Consumerism Source Type: blogs

Do Patients Really Need Access to Their Access to Their Health Records?
I strongly support broad access by patients to their medical records and EHR interoperability and have blogged frequently about both topics (see, for example:Patients Often Lukewarm about Patient Portals; Problems with Training?;NYT Op-Ed on EHR Interoperability Blames Vendors and Greedy Hospitals). A recent article discussed Judy Faulkner of Epic and her questioning of former VP Joe Biden about the need for patients' access to their medical records. The article also touched on the topic of EHR interoperability (see:Cancer moonshot head recounts exchange with Epic ’s Faulkner). Below is an excerpt from the a...
Source: Lab Soft News - August 8, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Electronic Health Record (EHR) Healthcare Information Technology Hospital Executive Management Hospital Financial Source Type: blogs

Patients Often Lukewarm about Patient Portals; Problems with Training?
Patient portals are an underused and unappreciated asset available as part of an EHR. I have blogged about them in the past (see:Next Step in Patient Portals: Secure Messaging and Administrative Functions;Publishing Test Results in Patient Portals: Holding a Tiger by the Tail). Below is an excerpt from a recent article suggesting that patient are"fed up" with them (see:GAO finds further proof patients are fed up with portals, EHRs): Despite the fact that close to 90 percent of providers participating in meaningful use offer their patients online access, only about one-third of patients actually log in t...
Source: Lab Soft News - August 5, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Clinical Lab Industry News Clinical Lab Testing Electronic Health Record (EHR) Healthcare Information Technology Lab Industry Trends Lab Information Lab Regulation Medical Consumerism Quality of Care Source Type: blogs

National Reference Labs Expand Their PSC Footprint in Groceries & Retail Pharmacy
TheDark Daily recently discussed the accelerated pace of patient service center (PSC) development by Quest and LabCorp (see:Quest Diagnostics and LabCorp Ink Deals to Put Patient Services Centers in Grocery Stores and Retail Pharmacies, But Not for the Same Reasons as Theranos). This trend started in Arizona and California in relationship to Theranos' ill-fated expansion but is now spreading to other states. Below is an excerpt from the article:Greater use of retail stores as the location for patient services centers (PSCs) may be an important new trend for the clinical laboratory industry. That ’s because, ...
Source: Lab Soft News - August 3, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Clinical Lab Industry News Clinical Lab Testing Electronic Health Record (EHR) Healthcare Delivery Healthcare Insurance Lab Industry Trends Medical Consumerism Telemedicine Source Type: blogs

Helix Makes DNA Sequencing Available to Consumers; Where Do We Go From Here?
For a number of years, I have speculated about one of the dilemmas of routine lab testing as compared to whole genome sequencing (WGS). This latter is the process of determining the complete DNA sequence of one's genome at a single time. The value of, say, a serum sodium is transient and dependent on the patho-physiological status of the patient. The value is reported by labs normally only accompanied by the reference range. Further interpretation is left to the test-ordering physician.In the case of WGS, the result is theoretically relevant for the life of the patient but the analysis and interpretadtion of the D...
Source: Lab Soft News - August 1, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Clinical Lab Industry News Clinical Lab Testing Healthcare Information Technology Lab Industry Trends Lab Processes and Procedures Medical Consumerism Medical Research Pharmaceutical Industry Reference Laboratories Source Type: blogs

Cigna Continues to Expand into the Provider Side of Healthcare
It has become clear to me that some health insurance companies have decided to try to control some aspects of healthcare delivery as a cost-saving measure. Evidence of this trend was the recent decision byCigna to partner withCVS' MinuteClinics. This new program applies only to Cigna's employer-sponsored health plans. (see:Cigna teams with CVS Health in collaboration to rival urgent care clinics). Below is an excerpt from the article:In June,...[Cigna] and CVS Healthannounced the initiative [to partner with CVS] for Cigna's self-funded employer-sponsored health plans. Retail pharmacies are c...
Source: Lab Soft News - July 26, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Clinical Lab Industry News Clinical Lab Testing Cost of Healthcare Healthcare Delivery Healthcare Insurance Lab Industry Trends Lab Processes and Procedures Medical Consumerism Preventive Medicine Reference Laboratories Source Type: blogs

Ancestry.com Uses Quest as Its Reference Lab for DNA Testing
I have wondered on occasion which reference lab was performing the DNA testing for consumer genealogy/genomic web sites likeAncestryDNA.com and23andMe. Part of the answer was recently revealed by theDark Daily (see:AncestryDNA Collaborates with Quest Diagnostics to Provide Home DNA Testing to Healthcare Consumers). Below is an excerpt from the article:Did you ever wonder which lab does all the genetic testing for Ancestry as it offers to help consumers learn more about their family histories?....[I]t isQuest Diagnostics...,one of the world ’s largest clinical laboratory companies—that does the genetic sequ...
Source: Lab Soft News - July 25, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Clinical Lab Industry News Clinical Lab Testing Food and Drug Administration Lab Industry Trends Lab Information Lab Processes and Procedures Medical Consumerism Reference Laboratories Source Type: blogs

Integration and Interoperability Are Essential for Growth of Digital Pathology
Now that digital pathology has been approved for primary diagnosis of surgical pathology specimens (see:FDA Approves the Philips Digital Pathology WSI Solution for Primary Diagnosis), pathology departments will inevitably need to develop plans to integrate this new technology into their existing LISs and automated lines (see:Seamless automation: within reach for AP?). This topic was recently addressed as a blog note by Nathan Buchbinder who is Vice President for Operations atProscia (see:Integration and Interoperability Are Essential for the Growth of Digital Pathology). It's a longish article so I could...
Source: Lab Soft News - July 20, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Digital Imaging in Pathology Food and Drug Administration Lab Industry Trends Lab Processes and Procedures Lab Standards LIS Definitions and Strategy Pathology Informatics Surgical Pathology Source Type: blogs

Why is EHR Software So Difficult to Modify and Improve?
This is a guest blog note by Dr. Bob Miller who is a pathologist and the Director of Pathology Informatics at Johns Hopkins University School of Medicine. He has extensive experience with LIS software development and instrument interfaces for anatomic and clinical pathology, and for the blood bank -- as well as experience with both best-of-breed and integrated EHR systems.The recent blog note entitled Hospitals Need to Pressure Their EHR Vendors to Improve Software Functionality is a reminder of the many complexities of EHR software development. Unpacking the details, however, requires a look at bo...
Source: Lab Soft News - July 18, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Clinical Lab Industry News Electronic Health Record (EHR) Healthcare Information Technology Lab Information LIS Definitions and Strategy LIS Vendor News Pathology Informatics Source Type: blogs

EHR Copy Feature Has Promoted " Note-Bloat " ; Vendors, Hospitals Seek Solutions
EHRs have brought many benefits to physicians and hospitals but also problems such asnote-bloat. This latter problem is caused by physicians copying and pasting data from a patient's older record rather than manually generated new information. I have covered this problem in a number of previous notes (see, for example:Copy-and-Paste Errors with EHRs; Some Possible Solutions to the Problem). A recent study documented the magnitude of this problems (see:EHRs are overflowing with copy-and-paste records, JAMA study shows). Below is an excerpt from the article:For all the benefits brought about by electronic health rec...
Source: Lab Soft News - July 17, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Electronic Health Record (EHR) Healthcare Information Technology Medical Ethics Medical Research Quality of Care Source Type: blogs

Hospitals Need to Pressure Their EHR Vendors to Improve Software Functionality
I have mentioned on a number of occasions that part of the reason for the lack of interoperability of EHRs is that hospital executives are not always enthusiastic about making medical records more portable (see, for example:NYT Op-Ed on EHR Interoperability Blames Vendors and Greedy Hospitals). The fact remains, however, that EHR vendors like Epic exercise a high degree ofclient control over hospital executives, a business model that was earlier practiced by Meditech. Now comes an article quoting a hospital executive that hospitals need to turn up the heat on vendors in order to improve the functionality of their EHRs...
Source: Lab Soft News - July 13, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Electronic Health Record (EHR) Healthcare Business Healthcare Information Technology Hospital Executive Management Quality of Care Source Type: blogs

A Tribute to Neal Patterson, Co-Founder of Cerner and LIS Pioneer
Neal Patterson, co-founder and CEO of Cerner Corp, died last Sunday at age 67. The company announced that Patterson had experienced unexpected complications from a soft-tissue tumor for which he had been treated previously (see:A profound loss: Cerner CEO Neal Patterson dies from cancer at age 67). The company has named Cerner vice-chairman and co-founder Cliff Illig as chairman and interim CEO. Neal had surprised a crowd of about 15,000 at the November 2016 Cerner Health Conference by publicly revealing his health problems (see:Cerner co-founder Neal Patterson surprises crowd at health conference). Cerner was founded...
Source: Lab Soft News - July 10, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Electronic Health Record (EHR) Healthcare Business Healthcare Information Technology LIS Definitions and Strategy LIS Vendor News Pathology Informatics Source Type: blogs

Assessing Drugs Using " Real World Evidence " in Addition to Clinical Trials
Randomized clinical trials (RCTs) have proven over time to be the gold standard for assessing the safety and efficacy of new drugs. However, there are a number of known deficiencies of them such as not enrolling certain types of patients (e.g., pregnant women) and their high cost (see:Computer-Simulated Tests Eyed at FDA to Cut Drug Approval Costs). One alternative to RCTs for post-market drug testing is the use of EHR databases which would seem to be an ideal tool because they provide information about drugs as well as patients' clinical signs and symptoms. Even the fact that much of the relevant EHR data is in textua...
Source: Lab Soft News - July 7, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Food and Drug Administration Medical Research Pharmaceutical Industry Source Type: blogs