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Using The iPhone To Track Medical Procedures

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If it’s free, it’s for me. Especially if it’s an iPhone application to track medical procedures:

That’s why Dr. Shanti Bansal developed a free iPhone application — “app” in Apple-talk — that lets doctors keep a record of each case and which procedure, from a cardiac MRI to a biopsy, they perform. “The goal is to help physicians in training be the best physicians they can,” said Bansal, who practices at Yale-New Haven Hospital. “One of the reasons I came up with this is that I’m a cardiologist and in cardiology we do a lot of procedures. I lost track of hundreds of procedures during my first and second year” of residency. Now, in about 30 seconds, each procedure can be entered into the iPhone.

Here’s the link to ProcedureTracker.com.

-WesMusings of a cardiologist and cardiac electrophysiologist.

*This blog post was originally published at Dr. Wes*

How CTs and MRIs Drive The Cost Of Healthcare

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It’s well known that the use of imaging scans, like CTs, MRIs and PET scans, have been growing at an alarming rate. But a recent study provides some stark numbers. According to a recent CDC report, “MRI, CT or PET scans were done or ordered in 14 percent of ER visits in 2007.” That’s four times as often as in 1996. Although a physician called that growth “astounding,” it’s really no surprise.

Emergency departments are becoming more crowded, and with patient satisfaction scores becoming more influential in financial incentives for physicians, sometimes just ordering a test is the path of least resistance. Factor in the spector of defensive medicine which, according to a survey from the Massachusetts Medical Society, accounts for up to 28 percent of tests ordered, it’s a wonder that more scans weren’t ordered.

Imaging scans are a clear cost driver in healthcare, contributing $12 billion to Medicare’s bill. But costs won’t resonate with patients requesting the tests or the doctors ordering them. One encouraging sign is the recent trend of publicizing the harms of scans, like radiation from CTs. I’m finding that patients are becoming increasingly aware of the risk, and making a more informed decision after I explain it to them. It’s a small step forward.

*This blog post was originally published at KevinMD.com*

The Human Arm: An Information Superhighway?

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Scientists at Korea University in Seoul have demonstrated a prototype of a new biomonitoring system that transmits data through the body, replacing wires and minimizing the need for batteries.

The device is 300 micrometres thick and in a test, using a metal electrode coated with a flexible silicon-rich polymer, the researchers transmitted data at a rate of 10 megabits per second through a person’s arm. The device was tested for skin safety after continuous wearing and the data was transmitted via low-frequency electromagnetic waves through the skin.

The technology may have implications for diagnostics, as it can be used to detect electric fluctuations as is currently done by ECG and EEG machines.

Read on at New Scientist: Human arm transmits broadband…

Abstract in Journal of Micromechanics and Microengineering: Wearable polyimide-PDMS electrodes for intrabody communication

*This blog post was originally published at Medgadget*

Concierge Medicine: Not Just For Primary Care Anymore

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Concierge medicine isn’t just for internal medicine or primary care anymore. It seems the concept is starting to take hold in cardiology, too:

Starting April 1, patients at Pacific Heart Institute can choose one of four plans for care. In the first option, they pay no “participation fee.” In the second option, called “Select,” they pay $500 a year for priority appointments, warfarin adjustments, defibrillator and pacemaker follow-up, notification of non-urgent lab, and test results, according to Pacific Heart Institute.

In the third option, called “Premier,” they pay $1,800, for everything in “Select,” plus e-mail communication with their doctor, same-day visits during regular office hours, priority lab testing and scheduling of diagnostics, free attendance at speaker seminars on cardiovascular issues, and a dedicated phone line to reach an institute nurse.
 
In the fourth option, “Concierge,” they pay $7,500 for everything in “Premier,” plus direct 24-hour access to a cardiologist via pager, e-mail, text message, plus the patient’s PHI cardiologist’s personal cell phone, annual personalized cardiovascular wellness screening, night and weekend access to a PHI cardiologist for hospital or emergency services, (regardless of whether he or she is on call) same-day visits with the cardiologist, evening and weekend office appointments and personal calls from the cardiologist.

-WesMusings of a cardiologist and cardiac electrophysiologist.

*This blog post was originally published at Dr. Wes*

Mayo Clinic: $400M, The Poor: $0

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The final House “Manager’s Amendment to Reconcilliation“  provides $400M for hospitals located in counties in the lowest quartile of Medicare spending, adjusted for age, sex and race — but not income. Coupled with annual cuts of $10B in DSH and $1.5B for re-admissions, this is bad news for the poor and the hospitals that care for them. Mayo Clinic wins!   

Note that adjustments cannot be based on counties. Urban counties are too big and economically varied. When the extremes of wealth and poverty are averaged, mean household income is 128% of average in Washington DC, 113% in LA, and 108% in Chicago (Cook County), all with dense and costly poverty ghettos. Without any poverty, mean household income in Olmsted County (home to Mayo Clinic) is the same as in LA. Very few truly poor counties will qualify for such payments. This is another example of the truism that “Poverty is the Problem; Wealth is the Solution.”

*This blog post was originally published at PHYSICIANS and HEALTH CARE REFORM Commentaries and Controversies*

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