UnitedHealth Expands Bundled Payments in Its Medicare Advantage Plans
The essence of value-based care is that reimbursement is based on positive outcomes for patients as opposed to fee-for-service in which in which providers select the services delivered, often with insufficient attention to outcomes. Ideally, value-based care results in higher quality care at a lower cost (see:Provider Organizations Beginning to Compete on the Basis of Value-Based Care. One of the key questions regarding value-based care is how to achieve this goal. It now appears that a major"on-ramp" will be Medicare Advantage plans and bundled payments as explained in a recent article (see:UnitedHealt...
Source: Lab Soft News - April 23, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Healthcare Business Healthcare Delivery Healthcare Insurance Medical Consumerism Public Health Quality of Care Source Type: blogs

A New Way to Gain Additional Diagnostic Information from Radiology Images
I had previously thought that I had a good grasp of the term biomarkerwhen I posted a note about it more than thirteen years ago (see:Use of Term Biomarker vs. Analyte). The definition that I used at that time was:any molecular species found to provide correlation to a particular phenotype or perturbation of a biological system.Unstated at that time was that the molecular species was found in a biologic fluids like blood, serum, or urine. Now comes an article that upsets this definition but that makes a persuasive argument for doing so (see:U-M startup analyzes data from patient imaging files to he...
Source: Lab Soft News - April 21, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Diagnostics Healthcare Information Technology Healthcare Innovations Medical Research Radiology Source Type: blogs

Questions about the Interpretation of BRCA Testing by 23andMe
Lab testing for the genes that predispose a person to develop cancer is highly complex, both to preform and interpret. For example and relating to BRCA, I have blogged about some of the pitfalls of such testing (see:BRCA Exchange Available on the Web; Understanding BRCA Variants). Here's a quote from this note discussing some of the complexities that are encountered:It's not known among some healthcare consumers that there are a host of BRCA variants other than the standard ones. Normal BRCA testing looks forthree specific genetic variants that are linked to hereditary cancers. Two of these variants &mdas...
Source: Lab Soft News - April 19, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Clinical Lab Industry News Clinical Lab Testing Diagnostics Direct Access Testing (DAT) Food and Drug Administration Genomic Testing Healthcare Innovations Lab Industry Trends Lab Regulation Medical Consumerism Medical Education Medi Source Type: blogs

MIPACT Study Sponsored by Apple Provides a Preview of Home Health Monitoring
I will shortly enroll in theMIPACT study sponsored by Apple and being run at the University of Michigan. The acronym stands forMichigan Predictive Activity& Clinical Trajectories study. The goal of the study is to understand the relationship between biosensors, health information, and health outcomes. Participants are required to own an iPhone and are then providedgratis with anApple Watch and anOmron wireless blood pressure monitor. These devices are necessary to perform various tasks in the study such as blood pressure measurement with the Omron device. EHR access is part of the program and a blood sample i...
Source: Lab Soft News - April 17, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Diagnostics Electronic Health Record (EHR) Genomic Testing Healthcare Information Technology Healthcare Innovations Medical Consumerism Medical Research Predictive Analytics Preventive Medicine Test Kits and Home Testing Source Type: blogs

CMS Offers $1M Reward for AI to Predict Unplanned Hospitalizations
Regarding the use of artificial intelligence (AI) to provide efficiency gains in various healthcare processes, there have been a number of articles suggesting how to launch this new technology. I have discussed AI analytics in multiple blog notes (see, for example:Healthcare AI Market to Surge; Already Commonplace in Radiology;Cerner Offers AI Tool to Combat Physician EHR Burnout;Which Healthcare Jobs Are Safe from Replacement by Automation or Robots?). Hospitals will certainly be pursuing this goal on their own in order to reduce risk and costs. A recent article indicated that CMS was accelerating this process by launchin...
Source: Lab Soft News - April 16, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Cost of Healthcare Electronic Health Record (EHR) Healthcare Information Technology Healthcare Innovations Hospital Financial Predictive Analytics Preventive Medicine Source Type: blogs

Interactive Audio as an Emerging, Disruptive Technology in Healthcare
The voice-user interface device from Amazon calledAlexa is now HIPAA compliant (see:Amazon Alexa Now HIPAA Compliant; Watch for the Next Steps). This means that we are on the verge of a wide variety of new voice-user interface (VUI) apps relating to healthcare, some of which were detailed in a recent article (see:Voice Technology: A Disruptive Force in Healthcare). Below is an excerpt from the article:Last month, an Amazon spokesperson told a reporter that the company frequently receives positive feedback from “aging-in-place” customers who use Alexa’s smart-home features as an alternative to going u...
Source: Lab Soft News - April 10, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Healthcare Delivery Healthcare Information Technology Healthcare Innovations Medical Consumerism Point-of-Care Testing Preventive Medicine Test Kits and Home Testing Source Type: blogs

The Continuing Problem of Duplicate EHR Records for the Same Patient
I have previously blogged about the chronic and continuing problem of duplicate EHR records (see:Duplicate Patient Records as a Major and Costly EHR and EMPI Problem). Think of the problem in this way: it's relatively easy for a hospital registrar to create a new patient record but very risky to merge two nominally identical patient records because they may not represent the same person. This reluctance to merge records results in hidden data that may be critical in the care of a particular patient. A recent article dealt with this problem (see:Why Is It So Hard to Match Patients With Their Medical Records?) and b...
Source: Lab Soft News - April 8, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Computer Security Electronic Health Record (EHR) Healthcare Information Technology Healthcare Innovations Medical Consumerism Medical Research Medicolegal Issues Public Health Quality of Care Source Type: blogs

Amazon Alexa Now HIPAA Compliant; Watch for the Next Steps
Having Alexa HIPAA-compliant is a necessary first step in deploying the device and its supporting software into all manner of health settings. This goal has now been achieved (see:Amazon Alexa is now HIPAA-compliant). Below is an excerpt from the article announcing this step and whats's next:Alexa is moving into healthcare.Following a trial of Amazon ’s smart speakers in patients’ rooms at Cedars-Sinai, the company this morning announced an invite-only program allowing select developers to create and launch HIPAA-compliant healthcare skills for Alexa. The skills allow consumers to ask the virtual assis...
Source: Lab Soft News - April 6, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Cost of Healthcare Electronic Health Record (EHR) Healthcare Information Technology Healthcare Innovations Medical Research Quality of Care Source Type: blogs

Predatory " Publisher and Conference Organizer " Hit with a $50M Court Judgement
I first became aware of theOmics Group six years ago when I blogged about the fraud that the company was perpretating (see:Welcome to the World of Pseudo-Academia: Pathology-2013). Here's a quote from that note about how the company was offering a set of fake scientific conferences and journals to fleece the unwary:Here's a link to thetwenty different conferences that the Omics Group has planned for....[originally 2013 but the web site has now been updated to the present time].The only way that I can describe this conference enterprise, putting aside the journals, is comprehensively audacious. Do registrants a...
Source: Lab Soft News - April 5, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Healthcare Business Medical Consumerism Medical Education Medical Ethics Source Type: blogs

Need for Immediate Action to Eliminate Gag Clauses in EHR Contracts
I have blogged frequently about the gag clauses that have been a standard part of EHR contracts for decades (see, for example:Physician& Nurse Involvement in EHR Design; Patient Safety and EHR Gag Clauses;Gag Clauses in EHR Contracts Documented; Concerns Raised about Patient Safety;Legislation Introduced in Senate to Address Gag Orders in EHR Contracts). Hospital personnel encountering EHR issues that can compromise patient safety are restricted by such clauses from discussing them with anyone other than their EHR vendor. Compare this with drug adverse effects which by law must be reported to the FDA as well as to...
Source: Lab Soft News - April 3, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Blood banking Electronic Health Record (EHR) Food and Drug Administration Healthcare Information Technology Medicolegal Issues Pathology Informatics Public Health Quality of Care Source Type: blogs

Cash is the Best Incentive for Health Plan Members to Shop for Services
For many years, health plans have been searching for ways to incentivize their members to search for lower priced services such as imaging and surgical procedures like total hip replacement. I believe that the best incentive for this searching and cost-saving behavior is some sort of benefit like cash. A recent article covered this topic (see:How employers save money by paying employees to shop for healthcare) and below is an excerpt from it: According to a new RAND Corp. study published in Health Affairs, paying employees between $25 and $500 for using a transparency tool, and encouraging them to select a lower-...
Source: Lab Soft News - April 1, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Healthcare Business Healthcare Delivery Hospital Financial Medical Consumerism Medical Research Public Health Quality of Care Radiology Source Type: blogs

The Clinicians' Wristwatch and the Diagnostic Turnaround Time (DTAT)
I recently attended theDMT Conference sponsored by theUniversity of Texas Medical Branch in Galveston, Texas. One of the conference faculty members wasDr. Christopher Zahner from UTMB. During his lecture, he referred to thediagnostic turnaround time (DTAT), a term he defined as the interval from the time that a clinician begins a diagnostic workup for a patient until he or she arrives at the correct diagnosis. Contrast this with the lab turnaround time (LTAT) which has been cited in the laboratory literature for decades and is defined as the time interval from when a specimen arrives in a clinical laboratory until the time...
Source: Lab Soft News - March 27, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Clinical Lab Industry News Clinical Lab Testing Diagnostics Healthcare Innovations Lab Industry Trends Lab Processes and Procedures Pathology Informatics Quality of Care Source Type: blogs

Net Revenue Generation for Hospitals on the Basis of Physician Speciality
I have previously blogged about the wait time for primary care physicians in the U.S. (see:PCP and Family Physician Wait Times increasing 50% in Many Markets) and the fact that many health systems may be limiting the number of PCPs on their staff because they do not generate as much revenueper capitaas specialized physicians (see: same reference as above). This is because PCPs don't perform procedures like surgeons or interventional cardiologists who are highly reimbursed by our healthcare system. Along these same lines, I came across an article that discusses hospital revenue generated per physician by speciality and ...
Source: Lab Soft News - March 25, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Cost of Healthcare Healthcare Business Healthcare Delivery Hospital Executive Management Medical Consumerism Quality of Care Source Type: blogs

Cardiology as a " Collision Point " between Consumer IT and the Healthcare System
In arecent tweet, Matthew Herper, who covers science and medicine forForbes, pointed out that cardiology will be an important"collision" point between consumer IT and the practice of medicine. He's right on target as I have emphasized in a recent note about the importance of clinical information being generated by Apple watches and similar wearables (see:Apple Collaborates with Janssen on Apple Watch AFib/Stroke Clinical Trial). This note is also related to my previous notes about wearables and skin patches (see:Is Healthcare Ready to Embrace the Consumer"Wearable";Fitbit Moves into the He...
Source: Lab Soft News - March 22, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Clinical Lab Industry News Clinical Lab Testing Diagnostics Healthcare Innovations Lab Industry Trends Lab Processes and Procedures Lab Regulation Medical Consumerism Point-of-Care Testing Preventive Medicine Quality of Care Test Kit Source Type: blogs

Pathology and Radiology Collaborate with a Concordance Conference
TheUniversity Hospitals Cleveland Medical Center (UHCMC) is in the process of deploying a digital pathology system and therefore exploring ways to educate and prepare their pathologists for this new technology (see:Digital Pathology Pilot Predicts Prosperity: Pondering Pathology ’s Pivot). As part of the process, a pilot study was undertaken with a focus on frozen sections. In the study, pathologists ’ diagnoses using digitized slide images were compared with diagnoses using standard microscopy. Frozen sections were chosen as the focus of this study because digital pathology allows remote access by a specialize...
Source: Lab Soft News - March 19, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Diagnostics Digital Imaging in Pathology Healthcare Innovations Lab Industry Trends Medical Education Medical Research Pathology Informatics Quality of Care Radiology Surgical Pathology Source Type: blogs

Diagnostic Management Teams in Multi-Hospital Health Systems
I have posted two notes recently about diagnostic management teams (DMTs) (see: A Major Change Now Occurring in Both Clinical Pathology and Anatomic Pathology; DMTs as an Example of a Team Approach to Clinical Lab Diagnostics). Generally speaking, DMTs have usually been deployed in a single hospital with the diseases covered by the team limited to the special expertise of that team. With such a scenario, communication among the DMT members does not pose much of a challenge, given that all of the team personnel work in close proximity.I think that the next major hurdle relating to the broader adoption of DMTs is t...
Source: Lab Soft News - March 15, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Clinical Lab Industry News Clinical Lab Testing Cost of Healthcare Diagnostics Healthcare Information Technology Healthcare Innovations Lab Industry Trends Lab Information Lab Processes and Procedures Pathology Informatics Source Type: blogs

DMTs as an Example of a Team Approach to Clinical Lab Diagnostics
In a recent note, I discussed how the overall practice of clinical pathology was expanding into clinical diagnostics partly on the basis of the growing popularity ofdiagnostic management teams (DMTs) (see:A Major Change Now Occurring in Both Clinical Pathology and Anatomic Pathology). DMTs consist of a group of laboratory experts collaborating with clinicians in complex cases. Another example of the team approach in healthcare is the Multidisciplinary Team (MDT) that is most common in cancer care (see:Multidisciplinary team working in cancer: what is the evidence?). MDTs represent an example of the team approach in diagnos...
Source: Lab Soft News - March 13, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Diagnostics Healthcare Delivery Healthcare Innovations Medical Ethics Quality of Care Source Type: blogs

A Major Change Now Occurring in Both Clinical Pathology and Anatomic Pathology
I recently returned from theDigital Management Team Conference hosted by Dr. Michael Laposata at the University of Texas Medical Branch in Galveston. It occurred to me during the conference that a major change is now occurring in the fields of anatomic pathology (AP) and clinical pathology (CP). The major change in AP is the deployment of automated tissue processing integrated with digital pathology (see:Integration and Interoperability Are Essential for Growth of Digital Pathology;Possible New Strategic Initiatives for Best-of-Breed LIS Vendors). This automation of surgical pathology will reduce the cost and increase the ...
Source: Lab Soft News - March 11, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Blood banking Clinical Lab Industry News Clinical Lab Testing Cost of Healthcare Diagnostics Electronic Health Record (EHR) Genomic Testing Healthcare Information Technology Healthcare Innovations Lab Industry Trends Lab Processes and Source Type: blogs

FDA Authorizes 23andMe to Offer Pharmacogenetic Testing on Consumers
Direct access testing (DAT), also called direct to consumer (DTC) testing, is consumer-initiated testing via the web with consumer payment. Such testing has been available for many years. Here's my note about the topic from 2006:Four Categories of Direct Access Testing. The early DAT test menu covered mainly routine tests with the addition of more esoteric ones over time. Now comes news that the FDA is authorizing direct-to-consumer (DTC) pharmacogenetics tests (PGx) without a physician order by 23andMe (see:FDA Authorizes 23andMe to Report Results of Direct-to-Consumer Pharmacogenetics Test to Customers without a Pres...
Source: Lab Soft News - March 6, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Source Type: blogs

AT & T Offers the LTE-M, Low-Powered Network for Uploading Wearable Health Data
So-called wearables, including wrist devices and skin patches, are continuing to have a major impact on the delivery of healthcare (see:Is Healthcare Ready to Embrace the Consumer"Wearable" Revolution?). One key aspect of the adoption of wearables is uploading data from the consumers' devices to a network where is can be monitored and analyzed with subsequent notification of health professionals about the status of the patient. Part of this process was referred to in a recent article (see:AT&T ’s new smartwatch will drive transformation in healthcare). Below is an excerpt from the article:AT&am...
Source: Lab Soft News - March 4, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Diagnostics Healthcare Information Technology Healthcare Innovations Medical Consumerism Medical Research Point-of-Care Testing Telemedicine Source Type: blogs

Fitbit Moves into the Health Coaching Area with Fitbit Care
I have been posting a number of notes lately about health wearables because they are becoming increasingly important. Here's another article about the expansion of health services relating to theFitbit, one of the earliest devices on the market: Fitbit Launches Fitbit Care, A Powerful New Enterprise Health Platform for Wellness and Prevention and Disease Management. Below is an excerpt from the article; Fitbit...announced Fitbit Care, a connected health platform for health plans, employers, and health systems that combines health coaching and virtual care through the new Fitbit Plus app....Fitbit Care leverag...
Source: Lab Soft News - March 1, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Healthcare Business Healthcare Delivery Healthcare Information Technology Healthcare Insurance Medical Consumerism Point-of-Care Testing Preventive Medicine Source Type: blogs

Healthcare AI Market to Surge; Already Commonplace in Radiology
The healthcare artificial intelligence (AI) market is going to grow enormously and has the potential to increase the efficiency of all healthcare processes and procedures; it may even reduce physician burnout (see:Cerner Offers AI Tool to Combat Physician EHR Burnout). A recent article discussed how the healthcare AI market will increase in value (see:Healthcare AI market expected to surge from $2.1 to $36.1 billion by 2025). It's a long and complex article so read it in its entirely if you're interested. Below is a small excerpt from it:The healthcare artificial intelligence market is expected to grow from $2.1 bi...
Source: Lab Soft News - February 27, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Digital Imaging in Pathology Electronic Health Record (EHR) Healthcare Information Technology Predictive Analytics Preventive Medicine Quality of Care Source Type: blogs

Is Healthcare Ready to Embrace the Consumer " Wearable " Revolution?
Here's an important think piece about the future of health wearables: Is the Healthcare Industry Ready to Embrace a Consumer Wearable Device Revolution). It approaches the topic from the perspective of the steps that healthcare executives need to take to more fully embrace and adapt to this new technology. Below is an excerpt from it:There are at least two categories of...[wearable health] devices in existence today that relate to healthcare. One type is a consumer wearable, such as a fitness tracker or a smartwatch that has been amended with health tracking features largely controlled by a device manufacturer. An...
Source: Lab Soft News - February 25, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Cost of Healthcare Healthcare Delivery Healthcare Information Technology Healthcare Innovations Medical Consumerism Medical Research Point-of-Care Testing Predictive Analytics Preventive Medicine Test Kits and Home Testing Source Type: blogs

Swapping Personal Exercise Data for a Free Apple Watch; What's the Catch?
I have previously blogged about the use of wearables to generate health data with feedback to health insurance companies (see:Apple Watch"Gifted" to Insurance Policy Holders; Any Gotcha's with the Deal?;Microsoft Publishes Guidelines for"Health Wearables"). As part of this trend,UnitedHealthcare is now offering a freeApple watch for customers who meet certain activity milestones. This was described in a recent article (see:UnitedHealthcare Offers Apple Watches to Wellness Program Participants Who Meet Fitness Goals) and some of the details are provided below....[L]everaging the popularity of mo...
Source: Lab Soft News - February 22, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Cost of Healthcare Healthcare Innovations Healthcare Insurance Medical Consumerism Medical Ethics Point-of-Care Testing Preventive Medicine Test Kits and Home Testing Source Type: blogs

Instagram Influencers Promote Prescription Drugs; FDA's Continuing Monitoring
The FDS has warned pharmaceutical companies in the past about their use of paid surrogates on social media sites like Instagram to promote their products (see:Pharmaceutical Companies Continue to Experiment with Social Media;FDA Issues Warning Letter to Drug Company about Use of Instagram;GlaxoSmithKline Mines Social Media for Information about Adverse Drug Events). This issue has recently returned to the news (see:The latest Instagram influencer frontier? Medical promotions. Big pharma is partnering with influencers to sell new drugs and medical devices). Below is an excerpt from the article. It's long and provides ma...
Source: Lab Soft News - February 20, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Source Type: blogs

CVS Expands Its Healthcare Presence with Its New HealthHUB Stores
CVS, Walgreens, and Walmart are all experimenting with new and innovative ways to capture a larger share of the primary healthcare business. In my opinion, they are generally succeeding whereas the health systems seem to be unable or unwilling to compete for this same business. The latest news about this topic is that CVS is prototyping their so-calledHealthHUBs in Houston (see:CVS Health shows off new HealthHUB store design. Makeover includes dietitians, wellness rooms for yoga). Below are details excerpted from the article:CVS Health has unveiled its new health-focused concept store that's designed to help the p...
Source: Lab Soft News - February 19, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Clinical Lab Testing Healthcare Delivery Healthcare Innovations Healthcare Insurance Lab Industry Trends Medical Consumerism Point-of-Care Testing Source Type: blogs

Cerner Offers AI Tool to Combat Physician EHR Burnout
The termsEHR andphysician burnout have become somewhat synonymous lately (see:6 stats on EHR-related physician burnout and 7 tips to combat it;WRITE SHORTER EHR NOTES, FIGHT PHYSICIAN BURNOUT). You may have been wondering how the major EHR vendors would respond to such criticism? We now have at least part of Cerner's response as announced at the recent HIMSS conference (see:At HIMSS19, Cerner unveils AI tool to fight physician burnout. Below is an excerpt from the article:[Cerner has release new software called] Chart Assist, a new AI-enabled workflow, to join a suite of systems designed to reduce physician burnou...
Source: Lab Soft News - February 15, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Electronic Health Record (EHR) Healthcare Information Technology Healthcare Innovations LIS Definitions and Strategy Medical Research Source Type: blogs

Size of Health Insurance Conglomerates in U.S. Exceeds That of Big Tech Companies
I have been aware that that large health insurance companies have been expanding by the purchase of PBMs and also entering the market as providers (see, for example:UnitedHealth Group to Launch Its Own Variant of an EHR in 2019; OptumHealth, a Division of UnitedHealth, to Offer Virtual Patient Visits Nationwide). However, I did not really have a sense of their size compared to other sectors of U.S. business. Thus, a recent article on this topic caught my attention (see:Health insurance is as big as Big Tech Data). Below is an excerpt from it:The 5 largest conglomerates combining health insurance and pharmacy bene...
Source: Lab Soft News - February 14, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Cost of Healthcare Healthcare Business Healthcare Insurance Pharmaceutical Industry Source Type: blogs

BRCA Exchange Available on the Web; Understanding BRCA Variants
It's not known among some healthcare consumers that there are a host of BRCA variants other than the standard ones. Normal BRCA testing looks forthree specific genetic variants that are linked to hereditary cancers. Two of these variants — 185delAG and 5382insC — are in the BRCA1 gene. One variant — called 6174delT — is in the BRCA2 gene. A patient may test positive for a variant other than these common ones and it may not be clear under such circumstances what treatment to offer to the patient. The BRCA Exchange is now avai lable on the web that may be of assistance to researchers, ph...
Source: Lab Soft News - February 13, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Clinical Lab Industry News Clinical Lab Testing Healthcare Innovations Lab Industry Trends Lab Processes and Procedures Medical Consumerism Medical Research Preventive Medicine Public Health Source Type: blogs

Community Hospitals Create Affiliation Agreements with Prestigious, Brand-Name Hospitals
An interesting new concept is arising among community hospitals whereby they are affiliating with prestigious, often distant health systems like Cleveland Clinic and Mayo Clinic. This phenomenon should be distinguished from the actual purchase of smaller hospitals or the opening of new hospitals by, say, Cleveland Clinic. The latter system is extremely large by any standard with 52,082 employees; it includes a main campus in Cleveland and 11 regional hospitals (see:Cleveland Clinic by the Numbers). A recent article discussed the aforementioned affiliation trend (see:Community Hospitals Link Arms With Prestigious ...
Source: Lab Soft News - February 12, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Healthcare Business Healthcare Delivery Healthcare Innovations Medical Consumerism Quality of Care Source Type: blogs

Which Healthcare Jobs Are Safe from Replacement by Automation or Robots?
One facet of modernity that is getting more attention is that many of today's jobs will be encroached upon (i.e., replaced) by automation and robots. As one current example, you will not find many people working in modern hospital clinical labs because much of this human labor has been replaced by automated equipment. That's why lab testing is one of the biggest bargains in healthcare today. A recent article addressed the question of whether healthcare jobs in particular are safe from replacement by AI (See:Are healthcare jobs safe from AI?). Below is an excerpt from the it:Across the country and across industries,...
Source: Lab Soft News - February 9, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Clinical Lab Industry News Clinical Lab Testing Digital Imaging in Pathology Healthcare Innovations Lab Industry Trends Lab Processes and Procedures LIS Definitions and Strategy Pathology Informatics Predictive Analytics Source Type: blogs

Shriner's Hospital in Tampa Closes Inpatient Beds; Part of a Major Trend
I have posted a number of previous notes about the shift away from hospital inpatient care and toward outpatient visits and virtual care (i.e., telemedicine). Some of the new hospitals bring built are referred to as"bedless" (see:The Case of the"Disappearing Hospital Beds"; Implications for Pathologists;Some Additional Ideas About the Bedless Hospitals of the Future;The Design of Bedless Hospitals Continue to Evolve Based on Cost and Technology;The Future of Healthcare: Virtual Physician Visits& Bedless Hospitals). The focus of such facilities is on ambulatory visits and diagnostics, particularly pa...
Source: Lab Soft News - February 7, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Cost of Healthcare Healthcare Delivery Hospital Financial Source Type: blogs

Proposed Federal Regulations on Sharing of Patient Health Data
(see:PROPOSED FEDERAL RULE PUTS PATIENT RECORDS ON SMART PHONES)A federal regulation proposed February 11 would require physicians ’ offices to not only share medical records electronically with patients via their smart phones, but to implement systems which let patients electronically transfer those medical records to another care provider if the patient requested it. In some cases, patients will want to use that capacity to digitally send records from your office to a complementary care provider. In other instances, it’ll mean “Hasta la vista, baby!”—or “Hola, new patient!” if su...
Source: Lab Soft News - February 6, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Source Type: blogs

U.S. Plasma Collection Centers Supply a Booming Industry But Is It Exploitative of Donors?
Earlier in my career I was a hospital blood banker and became familiar with commercial plasma centers that paid individuals for their plasma. Here's a link to the web page of one of them currently in business:CSL Plasma. Such centers are often located in poorer sections of towns. This aligns with the notion that they cater to people down on their luck who donate their plasma because of a financial need. The plasma collected in such centers has various uses including the manufacture of components such as albumin and coagulation factors. I had largely forgotten about this plasma industry until I read a recent a...
Source: Lab Soft News - February 5, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Blood banking Food and Drug Administration Healthcare Business Medical Consumerism Medical Ethics Source Type: blogs

Apple Collaborates with Janssen on Apple Watch AFib/Stroke Clinical Trial
Apple has been in the news recently regarding innovations with iPhones in partnership with hospitals (see:Apple Has Plans to Copy EHR Records to iPhones and Apple Watches) and with health insurance about the Apple Watch (see:Apple Watch"Gifted" to Insurance Policy Holders; Any Gotcha's with the Deal?). Continuing to expand the functionality of the Apple Watch, the company is now partnering withJanssen Pharmaceuticals, a division of J&J, on a clinical trial (see:Johnson& Johnson partners with Apple to see if Watch can prevent strokes). Below are some of the details, copied from the article:Th...
Source: Lab Soft News - February 1, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Food and Drug Administration Healthcare Information Technology Healthcare Innovations Lab Industry Trends Medical Consumerism Medical Research Preventive Medicine Test Kits and Home Testing Source Type: blogs

Provider Organizations Beginning to Compete on the Basis of Value-Based Care
We are transitioning from a fee-for-service healthcare system to a value-based one. This new approach is not well understood, particularly by patients. Value-based care is characterized by the documentation of organizational efficiency and effectiveness combined with positive outcomes for patients. One of the major goals is cost-savings. This is in contrast to fee-for-service where providers decide which services are provided to patients with insufficient attention to outcomes. In line with these changes, some provider organizations are marketing themselves as value-based organizations. Details about this were pr...
Source: Lab Soft News - January 30, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Clinical Lab Testing Cost of Healthcare Diagnostics Healthcare Business Healthcare Information Technology Healthcare Innovations Medical Research Preventive Medicine Quality of Care Source Type: blogs

PCP and Family Physician Wait Times increasing 50% in Many Markets
The majority of physicians in the U.S. are now salaried and working for large health systems (see:For the first time ever, less than half of physicians are independent). Also, wait times for an appointment with a family physician or primary care physician (PCP) are increasing (see:PCP wait times are 50% higher than 2014). This can be the source of great frustration for patients (see:Report: 20% of patients have changed doctors because of long wait times). These two facts may or may not be related. Here is an excerpt from the article on physician wait times:The average patient waits 29.3 days to see a family medicine physic...
Source: Lab Soft News - January 28, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Electronic Health Record (EHR) Healthcare Business Healthcare Delivery Medical Consumerism Public Health Source Type: blogs

Recruiting Patients for Clinical Trials Via a Smartphone App
Recruiting subjects for clinical trials has been a recurring challenge over the years including concerns that low-income and minorities are underrepresented in them (see:Low-Income, Uninsured Patients Often Excluded from Clinical Trials;Site-Less Clinical Trials as a Possible Means to Democratize Them). Because of this underrepresentation, the results of trials are often less valid. Here's an excerpt from an article on this topic (see: Barriers to Clinical Trial Recruitment and Possible Solutions: A Stakeholder Survey):A staggering number of clinical trials fail to meet recruitment goals, which leads to delays, early t...
Source: Lab Soft News - January 25, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Source Type: blogs

The Diagnosis and Treatment of Pre-Diseases: A Look at the Future
One of the interesting aspects of the deployment of new wearable medical devices is the use of sensors attached to patients that have the capability of monitoring disease progression in a manner never before possible. This idea was discussed in a recent article (see:IBM Research develops fingerprint sensor to monitor disease progression). Here is a brief excerpt from it:IBM...announced that it has developed a small sensor that sits on a person ’s fingernail to help monitor the effectiveness of drugs used to combat the symptoms of Parkinson’s and other diseases. Together with the custom software that analyz...
Source: Lab Soft News - January 23, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Diagnostics Pharmaceutical Industry Source Type: blogs

Why " Virtual Assistants " Won't Remove EHR Pain Points Quickly
In a recent note, I commented on the emergence of"virtual scribes" (see:Virtual Scribe Vendors Remotely Generate EHR Notes and Coding). This is hospital service with physicians dictating the details of a patient office encounter. At a later time, a remote transcriptionist employed by a virtual scribe company enters the essential dictated data into the hospital EHR. These remote transcriptionists have access to the hospital EHR for this data entry. This is in contrast with the original and continuing idea of EHR scribes who are physically present in the examining room with the doctor and patient and perform a...
Source: Lab Soft News - January 21, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Electronic Health Record (EHR) Healthcare Information Technology Healthcare Innovations Medical Research Source Type: blogs

M***Why " Virtual Assistants " Cannot Remove EHR Pain Points
In a recent note, I commented on the emergence of"virtual scribes" (see:Virtual Scribe Vendors Remotely Generate EHR Notes and Coding). This hospital service consists of having the treating physician dictate the details of a patent office encounter. At a later time, a transcriptionist working for a virtual scribe company remotely enters the essential data into the hospital EHR. This is by way of contrast with the original concept of virtual scribes when they were present in the examining room with the doctor and patient and performed all of the EHR keyboard entries. It should not some as a surprise that the ...
Source: Lab Soft News - January 21, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Source Type: blogs

Duplicate Patient Records as a Major and Costly EHR and EMPI Problem
I have posted a number of notes about the use of IT to improve efficiency and effectiveness in healthcare. A gnarly but persistent problem has been duplicate patent records and substantial IT resources are required to correct the problem. Below is an excerpt from an article on this topic (see:Artificial Intelligence and ethics will drive a patient matching revolution in 2019):Existing patient matching technologies are failing, as evidenced by skyrocketing rates of duplicate records in electronic health record (EHR) and enterprise master patient index (EMPI) systems. In fact, duplicate record rates have nearly doubled ...
Source: Lab Soft News - January 19, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Computer Security Cost of Healthcare Electronic Health Record (EHR) Healthcare Information Technology Healthcare Innovations Hospital Financial Medical Research Source Type: blogs

Proposed Classification for Health Information Systems: Provider and Individual
Discussion about the LIS of the Future; Analytics as a Key Feature?). Such systems would change from classic, best-of-breed LIS's to systems that support descriptive, predictive, and diagnostic algorithms. By developing such LIS-A's, LIS companies may cede ground to the LIS's provided by large EHR vendors as part of their enterprise-wide offerings. 2.Individual (or personal) health systems (IHS's): These are systems designed primarily for consumers. I blogged recently about the Rally system of UnitedHealth Group that initially provided coaching and other health services (see: UnitedHealth Group to...
Source: Lab Soft News - January 18, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Computer Security Electronic Health Record (EHR) Healthcare Information Technology Healthcare Innovations LIS Definitions and Strategy LIS Vendor News Medical Research Medicolegal Issues Pathology Informatics Predictive Analytics Source Type: blogs

UnitedHealth Group to Launch Its Own Variant of an EHR in 2019
I have commented in previous notes about the increasing role of health insurance companies likeUnitedHealth Group as healthcare providers (see, for example:Major Trends for the Year: Payers Use IT to Provide Total Care Management;OptumHealth, a Division of UnitedHealth, to Offer Virtual Patient Visits Nationwide). This trend, along with the growth of walk-in clinics in"big box" stores, will provide competition for health systems in the area of primary care. Now comes news that the UnitedHealth Group is launching its own e-health record in 2019 (see:UnitedHealth Group to Launch Electronic Health Records Platf...
Source: Lab Soft News - January 14, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Electronic Health Record (EHR) Healthcare Information Technology Healthcare Innovations Healthcare Insurance Medical Consumerism Predictive Analytics Preventive Medicine Source Type: blogs

Cost of Hospital Care in Michigan; Numbers Not Necessary Relevant for Consumers
Hospitals are now being required to reveal their master price lists but these data may not be of much help to consumers (see:Hospitals must post prices online, but they may be more confusing than helpful). That's because the price lists displayed recently on the basis of a federal requirement, called chargemasters, are massive compendiums of the prices set by each hospital for every service or drug that a patient might encounter. However, I did find some of the prices published for a set of hospitals in Michigan by diagnosis were interesting in a general way to assess the cost of healthcare (see:Hospital price lists re...
Source: Lab Soft News - January 11, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Cost of Healthcare Healthcare Business Healthcare Delivery Healthcare Insurance Hospital Financial Medical Consumerism Public Health Quality of Care Source Type: blogs

M***Cost of Hospital Care in Michigan; Numbers Not Necessary Relevant for Consumers
Hospitals are now being required to reveal their master price lists but these data may not be of much help to consumers (see:Hospitals must post prices online, but they may be more confusing than helpful). That's because the price lists displayed recently on the basis of a federal requirement, called chargemasters, are massive compendiums of the prices set by each hospital for every service or drug that a patient might encounter. However, I did find some of the prices published for a set of hospitals in Michigan by diagnosis were interesting in a general way to assess the cost of healthcare (see:Hospital price lists re...
Source: Lab Soft News - January 11, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Cost of Healthcare Healthcare Business Healthcare Delivery Healthcare Insurance Hospital Financial Medical Consumerism Public Health Quality of Care Source Type: blogs

23andMe Adds Weight Loss Coaching to Its DNA Testing Service
I have generally been supportive of23andMe but their latest"wellness" oriented initiative has me wondering. Here's a report about it (see:23andMe Will Add Weight-Loss Advice to Its DNA-Testing Services) and below is an excerpt from the article:Consumer DNA-testing giant 23andMe...plans to add new wellness offerings it hopes will help its customers shed a few pounds, but some genetics experts say the jury is still out on the science behind the products....[The company] announced a partnership withLark Health, an artificial-intelligence coaching service that delivers personalized advice for weight loss and...
Source: Lab Soft News - January 10, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Clinical Lab Industry News Genomic Testing Healthcare Innovations Lab Information Medical Consumerism Medical Ethics Preventive Medicine Source Type: blogs

Free Genomic Testing Offered by Nebula Genomics but for a " Price "
Given the popularity of genomic testing among healthcare consumers, it's not surprising that such programs are proliferating. Keep in mind, however, that the test results of such consumer DNA testing can be of great value to pharmaceutical companies because they can contribute to drug research. More than two years ago I reported thatStrata Oncology was performing free DNA and RNA sequencing for cancer patients in order to identifying those with certain gene mutations. Patients were then referred to pharmaceutical companies where drug therapy may have been recommended or, possibly, patients were enrolled in clinical tri...
Source: Lab Soft News - January 9, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Clinical Lab Industry News Clinical Lab Testing Genomic Testing Healthcare Innovations Lab Industry Trends Lab Information Lab Processes and Procedures Medical Research Pharmaceutical Industry Source Type: blogs

Can the Number of Unnecessary Knee Replacements Be Reduced?
An article that I came across recently suggested that up to one-third of patients undergoing knee replacement continue to experience pain post-operatively and one in five of them regret having had the procedure. The conclusion is that this procedure is perhaps being performed too frequently (see:Up To A Third Of Knee Replacements Pack Pain And Regret). Below is an excerpt from the article:Most knee replacements are considered successful, and the procedure is known for being safe and cost-effective. Rates of the surgery doubled from 1999 to 2008, with 3.5 million procedures a year expected by 2030....Doctors are increasingl...
Source: Lab Soft News - January 7, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Cost of Healthcare Medical Consumerism Medical Education Medical Research Quality of Care Source Type: blogs

Reducing the Cost of Care; Provide Home Care for Sicker Patients with Remote Monitoring
Although changes often come slowly in healthcare, we are now in the midst of the following three major changes in the field: (1) reduction in inpatient admissions that is driving the growth of bedless or mini-hospitals; (2) provision of first-tier outpatient care in walk-in clinics such as CVS/MinuteClinics; (3) the transfer of some inpatient care to patients' homes, partly as a cost-reduction strategy. This latter topic was previously covered in one of my blog notes (see:Some Details about Hospital-at-Home (HaH) Services for Selected ER Patients) and also in a recent article (see:Commentary: Reducing the cost of ...
Source: Lab Soft News - January 4, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Cost of Healthcare Healthcare Delivery Healthcare Information Technology Healthcare Innovations Quality of Care Telemedicine Source Type: blogs