Browsing: Healthcare Systems

Protecting Veterans From Mesothelioma

In recent news, a San Francisco-based chemical risk assessment company claims that the United States Navy was ahead of the game when they attempted to protect veterans and civilians from mesothelioma back in the 1960s. At that time, US Naval ships were heavily laden with asbestos, making Navy servicemen among the most common victims of mesothelioma.

Mesothelioma is a rare form of cancer that affects the mesothelium, which is a protective layer surrounding the organs of the body. It has since been determined that there is a direct correlation between asbestos exposure and a person's likelihood of developing mesothelioma.

Understanding the Risks Associated with Asbestos

Researchers, Kara Franke and Dennis Paustenbach, examined dozens of published and unpublished documents on asbestos knowledge between the years of 1900 to 1970, and were able to determine that the Navy actually understood the health hazards of asbestos as far back as the 1930's. However, despite the known risks and dangers of asbestos, the Navy continued to require its use on ships. The Navy also recommended that certain precautions be taken in order to handle asbestos-laden materials more carefully. After mesothelioma was clearly linked to asbestos in the 1960's, the ChemRisk researchers claimed that the Navy “attempted to implement procedures that would minimize the opportunity for adverse effects on both servicemen and civilians.”

Too Little; Too Late

Permanent precautions taken by the US Navy, countless US Naval veterans have partially developed mesothelioma. Part of the inherent danger associated with mesothelioma stems from its latency period where it can take as long as 40 years to even become symptomatic after asbestos exposure. For many Naval veterans, this meant that they had already set them up for the likelihood that they would develop mesothelioma based on their previous asbestos exposure during the 1940's and 1950's. In addition, thousands of people working in other non-Naval industries were also exposed to asbestos and have the potential to develop mesothelioma either because their employers were unaware of the dangers, or simply because they deliberately chose to ignore the growing evidence of the material's toxicity and carcinogenicity.

The results of Franke and Paustenbach's study was published in the journal Inhalation Toxicology, and described that, by as early 1930, “It was clear that occupational exposure to asbestos caused a unique disease (asbestosis)”. Understanding of asbestos increased steadily between 1938 and 1965 during which time “a significant amount of exposure and epidemiology data was collected” by private and government scientists. Franke and Paustenbach's study was recently presented at the 21st annual International Society of Exposure Science meeting in Baltimore. Maryland.

Treating Mesothelioma in the US Today

Today, in the United States alone, more than 2,000 cases of mesothelioma are diagnosed each year. And while the treatments for some forms of cancer are improving, the prognosis for those who are diagnosed with mesothelioma is still challenging. Today, multi-modality treatments, immune therapies and gene therapies are being investigated as potential therapeutic modalities for mesothelioma victims.

Disclaimer: The information in this article is for educational and informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this article.

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Are You Optimizing Your Radiology Equipment?

As any medical professional knows, radiology is one of the most important aspects of any successful practice, as radiology is a key component of everything from ultrasounds to x-rays to CT scans to MRIs, but what many medical professionals fail to look at is the question of whether or not they are getting the most out of their radiology equipment; If you are a medical professional, here are a few aspects of radiology worth looking at more closely yourself.

How new is your equipment? While every doctor knows that the advances in medical science are never-ending, and must be kept up with on a consistent basis, many of these same doctors fail to recognize (or, at least, fail to acknowledge) that the same can be said about the equipment they are using. Of course, radiology equipment can be expensive, and you will not be able to replace everything you use each time some new product emerges (even though you may wish you could), but at the same time, it will be important that you make an effort to constantly update your equipment so that you are using the safest, most effective, and most efficient machines available.

How educated are your patients? Many patients now have a heightened level of concern when it comes to radiology equipment – but at the same time, they often have very little understanding of exactly where the risks in radiology will arise, which causes them plenty of concern that is not warranted at all . On the other hand, when you are able to devise a program through which you can educate your patients on the safety measures taken to ensure that they are not harmed by the side effects of radiology, you will be able to make sure you are retaining the patients you have, and (even more importantly) that they are allowing themselves to receive the medical attention their bodies require.

How technologically advanced are you? Recent studies have revealed that – with the evolving methods used to learn and teach radiology – mobile technology has taken on an important role. Make sure you are staying ahead of the curve when it comes to the manner in which radiology findings are shared among doctors and patients, and you will ensure that you are set up for success in the future, as well as in the present!

Because radiology is such an integral part of any medical practice, many doctors simply look at the negatives that come along with radiology as something that requires them to “take the bad with the good.” When you keep these things in mind, however, you will be able to turn a lot of those “bads” into “goods” as well!

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Strategies for Accurately Completing Residents’ Medical Records

The accuracy of a long-term care facility's medical records system requires effective training, ongoing education, and great communication among the staff that handle the records. Staff need to be constantly aware of issues that could impinge on that accuracy and have strategies in place to ensure that they have adequate time to document all events that occur-from a fall to a prescription drug reaction to gain gain or loss.

Some of the issues that may prevent accurate documentation include:

Staffing shortages. A facility must have an adequate resident to nursing staff ratio in order to operate effectively. When staff is short, the nurses and aides left to take care of the residents often do not have adequate time to accurately complete a resident's medical record or file an incident report. An effective facility would have an on-call roster of nurses and aides to fill in any nursing staff call in sick or have an emergency. Establishing good communication and relationships among the nursing staff would also help to mitigate scheduling issues. If a nurse or aide needed a day or afternoon off to handle an emergency or had become ill and could not work, the staff could work it out among them to fill in for one another.

Inadequate storage area. Paper medical records can become bent, torn, or damaged by liquids if the facility does not provide a secure, clean area for storage and documentation of records. For instance, if the records are stored in a closet with insufficient storage for all of the files, the files can become damaged as they are shoved in and out of a cramped space. Or if the nursing staff does not have adequate desk space to complete the records, they may spill coffee or liquids on the files. Having the proper storage space and clean, dry surfaces for writing is important to minimize this issue.

Computers crashing. As medical records are becoming automated on a universal scale, many long-term care facilities are implementing computerized medical record systems. Training and on-going education is instrumental in effectively implementing such a system, but what happens when the system goes down? The facility must have an IT person available, or at least a help desk to call, to help resolve a computer problem and get the system working as soon as possible. The facility must also have a temporary procedure for completing paperwork for the resident's medical record if the computer issue takes a while to resolve.

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How Documentation Helps Mitigate Risk in Long-Term Care Facilities

Accuracyfully documenting and completing health records is essential for a long-term care facility to minimize risk and liability. Written documentation supports and validates the actual events that took place during a resident's care or during an incident involving a resident. Should an incident occur-such as a fall-or or a resident becomes gravely ill, accurate documentation of events would be needed as evidence if the family or resident file a lawsuit.

For that reason, it is imperative to document the event on the resident's chart and follow the facility's incident reporting procedures. Completing both the medical record and incident report are important to support the defense of the facility if an incident is under investigation or goes into litigation.

Some examples include:

Recording resident fall history. The medical history of a resident who is at risk of falling should have every instance of falling recorded. This record should also include the resident's initial assessment of fall risk. If and when the at-risk resident falls, this documentation will help the care team continue to monitor, assess, and provide the proper interventions. Just as important is accurately reporting the fall incident, using the facility's reporting process. If any type of injury should occur as a result of a fall, the resident's accurate medical record, along with the reports of each incident can be used as evidence that staff acted appropriately on the resident's behalf and reported the incident accurately and in a timely manner .

Prescription drug use. Recording prescribed drugs on a resident's medical record is imperative to the proper care of the resident for the entire multidisciplinary team. This record must include the signed and dated physician's orders, when the drug was first administrated, any changes in dosage or changes in prescription, and any adverse effects that occurs as a result of the resident taking the drug. If an adverse event does occur, the incident must also be reported, following the facility's reporting process. Having these accurate records and reports is evidence and prevention against possible litigation, should anything happen to the resident as a result of drug interaction.

Keeping all medical records in secured areas. Because the confidentiality of a resident's medical history is legally and ethically required, it is extremely important to have all medical records stored in a secure and locked area. Only authorized staff should have access to these records. Records should never be left unattended, such as sitting on the counter of the nursing station or on the patient's bed, and when not being used, should always be kept in the secured area. Breaching the confidentiality of a resident's medical record could result in an invasion of privacy lawsuit. Staff need to be educated and clearly understand the importance of this policy and treatment resident's medical records using strict guidelines.

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The New Urgent Care Clinic Leaving Emergency Rooms in The Dust!

Even though life is running along smoothly we often entertain the thought of a deadly disease or at best an accident that will take us out of the game. It seems to be human nature to contemplate the negative. Sometimes as we snuggle under warm covers in bed at night trying to fall sleep, our minds will take on the subject matter of a nightmare of Biblical proportions. What if I get hit by a bus? Is that pain in my back cancer of the spinal? Can mosquitoes inject HIV into my veins when I get bit? All these questions and many more boil to the top of our conscious mind, making the simple act of falling asleep a Herculean task. It for this reason-and many others-that knowing the name and address of a certified, friendly, discreet and affordable urgent care clinic is such a good idea.

If you are unaware of the concept of the urgent care clinic, think hospital emergency room on steroids. An urgent care clinic is ready, willing and able to diagnose and treat any and all non life-threatening medical issues in the snap of a finger. A good urgent care clinic will pride itself on being there for you when you most need them and without the ridiculous wait that emergency rooms are infamous for.

Most days of the year you will not call them-on those good days you will not even think about them. Yet when you need them they will be there with the energy and expertise that you will be craving. We do not prepare to sprain an ankle when we go out jogging-or especially when we go out for a leisurely stroll in the park. But sometimes it will happen. One moment you are fine, walking along like a gallant gent with nary a care in the world. The next moment you are crumpled on the floor, moaning in agony as you clutch respectably to your newly sprained joint. It is at now that you utilize the information you have coveted for so long, and get to your neighborhood medical office.

Sprained ankles come in many degrees. It is only a medical professional – like the primary care doctor at your urgent care clinic-that will know what type of sprain you are suffering from and what type of treatment is necessary to get you back up and strolling once again in the fastest and most effective way possible.

Since your urgent care clinic will be staffed by a certified internist (your genuineness, every day, spent-a-ton-of-money-in-medical-school doctor), if in need of a prescription for pain relief-he will be there with his handy prescription pad to knock you off whatever miracle pill it is that alleviate your pain. A good urgent care clinician doctor is able to diagnose and treat a myriad of problems. From the everyday sprained ankle to a bad back, to a case of conjunctivitis to a sour stomach, and beyond-you will receive the same care as you would in a hospital emergency room only in a smaller, more personal venue and at a better more affordable price. You never have to feel like a number again armed with the name of a good urgent care clinic. There, you will become part of the family and you will never be rushed or passed over when visiting.

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Medical Fraud: A Big Dollar Concern

With reports about identity fraud making waves through the news media, it's especially important for those looking at the American health care industry to consider a specific kind of identity fraud that can be especially expensive for victims. Medical fraud is commonly defined as any kind of identity theft that facilitates the use of insurance or medical information which allows for an unauthorized individual to get access to medical insurance, medical care or other services, or that in some cases, allows for false billing or funneling money directly from the victim to the fraud perpetrator. Learning more about it can help you avoid medical bankruptcies or other problems.

The Numbers on Medical Fraud

Although it may be more obscure than other types of fraud, for instance, credit card fraud, some reports estimate that medical identity theft affects almost two million people in America each year, with an overall monetary impact of over $ 40 billion. Experts also estimate the costs of medical fraud per victim at over $ 20,000. That means that this kind of fraud can destroy the budgets of many American consumers or families who become victims of this type of identity theft.

Common Scenarios

Experts suggest that some identity thieves pursue medical fraud in order to get insurance coverage through illegitimate means, while others may be looking to get their hands on prescription drugs that they will sell on the black market. But although these kinds of situations can hit consumers or families out of nowhere, other reports suggest that in many cases of medical fraud, there's a gray area: the victims of these kinds of fraud may have let their family members misuse their medical information or otherwise been complicit in fraudulent claims or other types of identity theft.

Medical fraud is just one way that the average American family can find itself bogged down in medical debt or other trapped in periodic debt cycles. In order to prevent these kinds of nightmare scenarios, it's important to safeguard identity information and do regular credit checks and basic financial monitoring. You can also get help from third party medical advocates that understand the health care system and how to fight various kinds of financial challenges to make sure that you and your loved ones are not taken advantage of by a system that often generates extremely high costs. Talking to these types of agencies and organizations can help you gain a better idea of ​​how to prevent medical fraud, unfair denials or bills, or any other financial struggle that could have been avoided through good documentation and vigilance. Get the facts and protect yourself against medical fraud and unfair medical debt for a better financial future.

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Affordable Care Act (Obamacare): Now That It Is Ruled Constitutional, What Does It Mean

Here is what we know about President Obama's health care reform system in a simplified way after the US Supreme Court ruled it to be constitutional. Aside from its political aspects, the court's decision was a victory for all Americans. After digesting the decision, following are the different provisions of the law affecting the citizens and others.

1. If You Are a Young Adult: If you are under 26 you will be covered under your parents insurance if hey have any. Otherwise starting 2014 you have to buy your own insurance if not covered by that of your parents, by your employer or a government program. Otherwise, you must pay penalty prescribed by the law.

2.If You Have a Low to Middle Income: Starting 2014 you will be covered by Medicaid if you earn less than 133% of the federal poverty line, currently set at $ 14,856. States have right to accept or reject this new program. If your income is between 133% and 400% of the federal poverty level, currently set up at $ 44, 680, with no affordable employment based insurance, you will be eligible for federal subsidies to help you get insurance.

3. If You Are an Elderly Person: If you are under Medicare, you receive free preventive care such asannual checksups. In prescription drug coverage, you may hit so-called “donut hole” once total costs reach $ 2,930 and when you spend $ 4,700 on drugs. Under Obama Care you may have already received deep discount on brand name drugs plus a $ 250 rebate from the federal government. and the “donut hole” will disappear over time.

4. If You Have Pre-existing Condition: Starting 2014, insurance companies will not be able to deny you coverage or ask for higher rate because of your health status and pre-existing conditions.

5.If You Are a Small Business Owner: With 25 or less employees, you are already eligible for federal tax credits helping you purchase health insurance for your employees. Starting 2014, if you have 50 or more employees without providing them with affordable insurance, you may be fined. However, depending on the laws of the state where your business is located, you may be able to buy a less expensive small group policy through an indefinitely regulated insurance exchange.

5. If You Are an Employee of a Large Company: Starting 2014, companies with 200 or more employees will be required to enroll you, along with all other employees in a health insurance plan. You may opt out but then you must buy your own insurance. New federal regulations under Obama Care will require the company insurance plan as well as yours to meet minimum standards.

Rules and Penalties Under the Affordable Care Act

You are exempt from penal for not having a health insurance if you are:

a. unable to find insurance costing less than 8% of your annual income,

b. a taxpayer with low income that exempts you from filing a federal income tax return,

c. a member of religion that opposes health insurance,

d. a member of an Indian tribe,

e. an undocumented immigrant,

f. incarcerated

There is no individual penalty if you have insurance through a government program such as Medicare, Medicaid or through your employer. Otherwise, you have to purchase your own health insurance or pay penalty assessed as follows: $ 95 for 2014; $ 325 for 2015; $ 695 for 2016 and thereafter.

The Internal Revenue Service will enforce the law and collect the individual mandate penalties as an additional tax in your income tax return. But the Affordable Care Act violates the Internal Revenue Service from jailing you or seizing your property.

How the Affordable Care Act Affects You Now and in the Future


a. States have established public insurance plans to cover certain people with pre-existing conditions.

b. Some health insurance plans cover 100% of the preventive services.

c. Insurance companies are required to cover some adult siblings up to the age 26 in their parents' insurance policies.

d. Seniors with Medicare prescription drug coverage reaching the “donut hole” have received $ 250 federal rebate and deep discounts when they purchase brand-name drugs.

2014 and Thereafter:

a. Millions who purchase insurance independently will be subsidized by federal government if their annual income is between 133% and 400% of the federal poverty level amount, in 2012, between $ 14,856 and $ 44,680.

b. Insurance companies have to price their policies as required by the mandate and sell those to anyone regardless of health status and pre-existing conditions.

c. Nearly all people will be required to have health insurance except those who only cover options except 8% of their annual income after federal subsidies and employer contributions are considered.

d. By the ruling of the US Supreme Court, states, which were required under the Affordable Care Act, to expand their Medicaid programs to include all people learning less than 133% of the federal poverty line, now have the option not to comply with it.

e. Companies with 50 or more employees will be fined if they do not provide insurance benefits or offer coverage their employees can not afford.

f. To partially offset the costs of implementing the law, individuals with an annual income over $ 200,000 ($ 250,000 for couples) will pay higher taxes.

After the US Supreme Court ruling the Act has become subject to extensive dispute mainly between the two opposing political forces. It will continue to be so even after the presidential elections in November. The above information will qualify you as an informed citizen and a conscious participant in dealing with and evaluating the issues relating to the national health care.

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Joe Klein, “And Now, How to Improve Obamacare,” Time, July 16, 2012, p. 29

David Von Drehle, “Special Report,” [Obama care] Time, July 16, 2012, pp.30-35.

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The Patient Protection And Affordable Health Care Act – Is Obamacare Healthy For America?

The American public is totally divided about the merits and demerits of Obamacare. The whole episode has also become a contentious political issue. However, people who oppose the Health Care Act seldom understand the true benefits that it can bring to the people of America.

The main focus of the Act is to bring as many people as possible under health insurance coverage. When the Act is enforced, people would be adequately covered by health insurance, and enjoy the benefits of Obamacare. Here is a brief overview of the real benefits of the Affordable Health Care Act.

First of all, insurance companies will not be allowed to discriminate based on the pre-existing conditions of applicants. Currently, guaranteed issue is mandatory only in the small group market. Employees who are enrolled in a company with a size of 2 to 50 employees alone currently enjoy this benefit. People who apply for insurance in the individual health insurance market can be denied insurance in many states based on their pre-existing condition. Obamacare seeks to eliminate this practice by requiring all insurers to offer uniform awards to all applicants of similar age and geographical location, without taking pre-existing conditions into consideration.

Under the provisions of the Act, insurance companies offering individual or group health insurance coverage to dependent children of the policy holder would be required to extend that coverage until the child is 26 years old. Therefore, a number of youngsters can benefit from their parents' health insurance coverage until they turn 26. This would benefit most youngsters who are struggling to pay for their personal health insurance coverage. In case these youngsters have children of their own, those children would not come under this coverage however. Thanks to the Act, six million young people would now enjoy health insurance coverage.

Obamacare also comprehensively addresses the infamous 'donut hole' problem in the Medicare Part D program. From 2010, eligible seniors who entered the donut hole were issued a $ 250 rebate check. In 2011, they were entitled to receive a 50% discount on branded medicines within the donut hole. The prices of generic Part D drugs were also discounted. From 2013, even the cost of branded Part D prescription drugs would be discounted. By 2020, the hole would be completely eliminated. Seniors who are on a prescription drug plan will continue to receive Part D coverage through this period.

These are some of the benefits of the Affordable Health Care Act. Just as auto insurance is mandatory in the United States, the Act strives to make health insurance also mandatory so that every American can enjoy affordable health care.

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Cardiologist – Providing Effective Treatment for Heart-Related Problems

A cardiologist is a doctor that specializes in medical problems of the heart. This physician usually works in medical facilities to include private practices, universities, and hospitals. This doctor must have a medical degree, specialized training in cardiology, and additional training in internal medicine.
The role of a cardiologist is to prevent problems associated with the heart. Examples of heart conditions this doctor trips include:

• Heart Attacks

• Congenital Heart Defects

• Coronary artery disease

• Heart Disease

• Heart Rhythm Disturbance

During a patient's health assessment through the medical health care of a cardiologist, their medical history will be reviewed and a physical exam will be conducted. The doctor will obtain vital signs such as height, weight, blood pressure, respiration, and pulse, in addition to checking the lungs, blood vessels, and heart. The doctor may even be able to diagnose a potential problem through the physical exam. When the cardiologist reviews the finding of the tests, he will make a diagnosis, and then treat the condition with echo cardiology, medications, stent insertions, and angioplasty.

When the cardiologist diagnosis a patient's condition, they will discuss this information with the patient in order to form an effective treatment plan. The doctor will also counsel with the patient about risks of heart disease and how to prevent it by adopting a better lifestyle to include eating healthy, losing weight, exercise, and quitting smoking. The doctor will also provide information on treatment methods available and advise the patient when they will need to schedule a follow-up.

Another effective service provided by cardiologists is answering any question their patient has related to their condition. This doctor is committed to helping the patient understand their medical condition then encourages the patient to play an active role is his treatment plan. This physician can help individuals with cardiovascular problems return to an active and full lifestyle.

A general physician reflects many patients to a cardiologist when a cardiovascular related problem is suspected. Cardiologists usually diagnose and treat patients and when a patient requires surgery, the doctor will consult with a cardiovascular surgeon.

If a person is in need of cardiologists to address a heart related problem they may have, a reputable medical center is a great option. All a person has to do is schedule an appointment at the medical center to get the treatment they need through many of the technically advanced heart care programs. Patients benefit from a heart care team that offers the latest in treatment and rehabilitation care and coronary diagnosis, which will be in close proximity to the patient's friends, family, and home.

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4 Characteristics Of The Best Cardiac Care Units

To get the best possible care for your heart, you should choose from the best cardiac care units. Not all cardiac centers provide the same level of care and expertise. In order to make sure you find the best cardiac care available, keep these factors in mind.

  • National referral centers. Where does a doctor send his or her difficult cardiac cases? The answer will point you in the direction of the best cardiac care. Some cardiac units are distinguished by receiving hundreds of referrals, meaning that they are capable of handling the most difficult and sensitive cardiac issues.
  • Connection to a medical school. Many of the best cardiac treatment centers are connected with a prestigious medical school. At first blush, such a connection seems to be risky. That's because people may fear that students who are inexperienced may be doing complicated procedures which is not exactly the case at all. Nearly every hospital has student doctors – interns or residents – who perform medical procedures. The connection with a medical school or “teaching hospital” means instead that you'll have the best doctors, those professors, researchers, and doctors who are respected within medical academia. These are the doctors who write the journal articles, and who pioneer new advances in medicine. These are the doctors with what you want to work. These are the doctors found at top-rated medical school hospitals.
  • High ratings, reviews, and awards. You can find publicized reviews for just about anything these days – from cruise ships to cardiac care. Look for the reviews, and choose a care center that receives high marks in all categories. Like most other industries, the medical industry has its share of industry awards and recognitions. When a hospital consistently receives rewards, interviews, positive media coverage, journal mentions, and other accolades, you know that their cardiac care is top-notch.
  • Advanced technology. Finding the facilities with the best technology means you'll receive better care and those with the best cutting-edge technology gives you the highest quality care possible. In cardiac care, look for a place that has full cardiac catheterization capability, interventional and neurointerventional radiology, intravascular ultrasound, and electrophysiological study equipment. Such advanced tools will provide a better level of treatment and testing than you would otherwise receive. High level of follow-up care. Your heart treatment experience does not end with your final hospital discharge. You'll want to find a treatment center that provides checks and monitors and your case until your situation is totally resolved.

Cardiac health difficulties can create a lot of anxiety. Taking care of your health and keeping your peace of mind is best served by choosing the best cardiac units units possible.

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The Various Financing Options for Behavioral Health Services

Behavioral Health Services are some of the latest beneficiaries of reimbursements from Medicaid, which is acting under instructions from the Program Information Notice by the Health Resources and Services Administration. All nursing practitioners, physicians, physician assistants, clinical social workers and clinical psychologists, as well as Federally Qualified Health Centers that provide these services are entitled to reimbursements from Medicaid, which operates under the guidelines of the Program Information Notice, regardless of whether they are state Medicaid plan includes their services. However, these service providers must practice according to the state law in order to benefit from these guidelines.

Although the blind, disabled and aged people, who are the main benefiaries of the Medicaid fund that is available for behavioral health services, may not have easy access to public health services that meet medical needs by targeting populations, the Program Information Notice means a lot to them and the overall Medicaid population. This is because it varies from one state to another.

Although CHC offers behavioral health services to Medicaid populations that have lower behavioral health and higher physical health risks, the Program Information Notice is the overall financier in all states that have public health systems which focus is on populations that have serious emotional problems and mental illnesses since it has the ability to create opportunities for other Medicaid populations. The Program Information Notice serves to assure net populations of their safety by ensuring consistencies between CHCs and HRS initiatives, which are essential for the creation of behavioral health capacities and the reduction of disparities in the provision of health services.

Medicaid models, which are different in each state, have numerous financing implications for the Behavioral Health Services that populations with various illnesses receive since their differences make possible for CHC, CMHC and every community partnership with them to identify business models that provide the necessary support for their integration activities by assessing their specific policy and financing environments.

The aforementioned partnerships enable the Medicaid population to access behavioral health services easily since they are largely responsible for the development of policy directions that deal directly with the access to these services without harm or excluding any populations that receive their services from the public health system.

The Program Information Notice, which has a responsibility to implement and address the structural and financial issues of the various clinical models, plays a vital role in helping to make the treatment for depression more effective especially in primary care settings because its special link to Clinical and System Strategies.

Although some resulting papers from special issues of Administration and Policy Mental Health and Mental Health Services Research provide useful information about the various policy and financial barriers that exist in the system, the Program Information Notice provides a different integration approach. Consequently, it has proven to be more effective in patching together various sources of funding.

State Medicaid pilot sites seek to find similar financing components even though the Federally Qualified Health Center and CMHC have a partnership that has a sustainable model for financing CMHC clinicians in through the various FQHC sites.

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A Shortcut to Medical Device Reimbursement in the UK

1. The Problem

You developed a new and innovative medical device that provides substantial clinical benefits in a cost effective manner.

You know the UK has one of the largest medical device markets in the world, positioned alongside France as the second largest in Europe behind Germany.

You plan on getting your product approved in Europe and complete the CE mark process relatively quickly and you already signed agreements with local UK distributors.

The only problem – will your device be reimbursed, or in other words, will the UK National Health Service (NHS) pay for it?

Since your device is new, there are probably no existing reimbursements mechanisms (codes, coverage and payment rates) into which it could fit. On the other hand, in order to apply for the development of new reimbursement mechanisms, your device should first be in wide use by UK doctors for the local patient population. But since your device does not currently fit into any reimbursement mechanisms, doctors are related to use it, and therefore it will never reach a wide user base to justify the creation of new reimbursements mechanisms …

Sounds like a Catch-22, right?

Luckily, the NHS operates an Innovation Procurement Plan designed to encourage the quick uptake of innovative new technologies. Similar to the USA Centers for Medicare & Medicaid services (CMS) “Health Care Innovation Awards” program, the UK's NHS understands that “innovation must be central to the NHS”, indicating that innovation will be driven regionally by strategic health authorities (SHAs) with a legal duty to promote innovation; and that front-line innovation will be supported through the creation of substantive new innovation funds held by SHAs.

In this article, we will try to describe the requirements, the relevant decision makers and the overall process that may help you leverage this plan to expedite the commercialization of your product in the UK market.

But first, we provide a short description of the NHS below.

2. The UK Healthcare System

* The United Kingdom of Great Britain and Northern Ireland (commonly known as the UK) consists of England and the devolved administrations of Northern Ireland, Scotland and Wales, each with varying powers.

* Population: 62 million.

* Type of Healthcare System: Single Payer / national health service (NHS).

Public health system: England provides public healthcare to all of its permanent residents. Public health is free at the point of need. The responsibility for providing NHS healthcare services in England is divided between 10 Strategic Health Authorities.

SHAs issue guidelines for healthcare in their region, verify appropriate distribution of funds and carry out regional plans and projects to improve public health. In addition, each SHA is responsible for the Primary Care Trusts (PCTs) in its region.

PCTs examine local needs and negotiate with healthcare providers to provide health care services to the local population. PCTs have their own budgets and set their own priorities, within the overriding priorities and budgets set by the relevant SHA and extremely the national Department of Health (DH).

PCTs provide a range of community health services, including: funding for general practitioners, medical prescriptions, and commissioning of hospital and mental health services, as such they are considered key stakeholders in healthcare decision making.

Altogether, there are 151 PCTs in England.

3. National Innovation Procurement Plan

As mentioned above, the NHS is interested in encouraging the diffusion of innovation into the healthcare system and has launched a package of proposals to promote this. One of them is the National Innovation Procurement Plan which seeks to bring clarity and coherence by organizing the adoption of technology-led innovation at the regional level. Supporting this legal duty, an Innovation Fund has been created worth  £ 220m over five years. This fund will support faster innovation and more universal diffusion of best practice – innovation will be encouraged, recognized and rewarded.

a. Process

1) Medical device companies, usually partnered with local healthcare providers, may submit details of specific medical technologies that can contribute to the NHS by downloading a submission form from the DH website and submitting details of innovative technologies using the email address that appears there.

2) NICE (National Institute for Health and Clinical Excellence) [1] – analyzes and prioritizes submitted technologies according to their potential to increase the quality of care provided to patients, while reducing the overall cost of care for the NHS. The NICE Implementation Collaborative (NIC) supports implementation of NICE guidance within each SHA.

The prioritized list is then shared to inform the technology selection process with:

3) NTAC (NHS Technology Adoption Center) – formed in 2007 following recommendations by the Health Care Industries Taskforce who recognized that the NHS, despite the potential of innovative healthcare technologies to improve health outcomes and productivity, is slow to adopt healthcare technology when compared to health care systems in other developed countries. NTAC was commissioned by the DH to support NHS regional Innovation Leads to facilitate the selection of high impact technologies for wide adoption across their regions. Working with key regional influencers, NTAC helps individual NHS organizations to deploy the selected technologies

4) Regional Innovation Leads – each SHA holds a legal duty to promote innovation, raising the profile of innovation and encouraging a more rapid adoption of innovation through the health service. 'Innovation leads' are employed in each SHA to deliver this requirement.

5) Commercial Support Units (CSUs) are being created in each region, and as part of their role, will support their innovation lead by providing a key interface between industry and the NHS.

b. Application

All companies that make in-scope submissions will be offered an initial meeting with the iTAPP team (now, NICE). This meeting will be used to clarify any questions relating to the submission and to:

* Gain a deeper understanding of the potential benefits for patients and taxpayers.

* Explain how the program operates.

* Agree any next steps.

Technology submissions will be made up of three sections:

* Management Case: To demonstrate the overall benefits and challenges of adopting the proposed technology.

* Clinical Case: To demonstrate the clinical benefits offered by adoption of the proposed technology.

* Financial Case: To demonstrate the costs and savings applicable to adoption of the proposed technology.

c. Prioritization

The process does not provide a pass / fail approach to inclusion of technologies on the list. Instead, all technologies remain on the list so that they can be re-categorized and reprioritized in response to changing circumstances. Technologies are categorized on the list as follows:

* Level 3: On the market, with sufficient evidence for wide adoption

* Level 2: On the market, without sufficient evidence for wide adoption

* Level 1: Not yet on the market

* Level 0: Out of scope (ie not a medical technology)

* Level -1: Pending categorization

* Level -2: Withdrawn by manufacturer

Levels 1, 2 and 3 represent a pipeline of innovative medical technologies. The overarching aim of iTAPP (now, NICE) to realize benefits from technology adoption earlier than would otherwise be the case, supporting high impact technologies to move through the pipeline more quickly.

Within each category, technologies are prioritized based on an impact scoring calculation, as follows:


* Benefiting population: Less than 250k

* Net financial savings: Less than £ 250k

* Deployment timescale: 3 yrs


* Benefiting population: 250k – 2.5m

* Net financial savings: £ 250k – £ 2.5m

* Deployment timescale: 2 yrs


* Benefitting population: More than 2.5m

* Net financial savings: More than £ 2.5m

* Deployment timescale: 1 yr

In each case, high scores 3, medium scores 2, and low scores 1. To calculate the total score, the scores are multiplied together. This gives a maximum score of 27 and a minimum score of 1. Advice is thought from National Clinical Directors at the Department of Health to enable a clinical perspective to be added to each technology.

The list of all technologies, indicating their level and primary benefit, can be downloaded from the DH website.

As can be noted, the device's score is not affected by the number of UK doctors that currently use the device for the local population.

4. The Strategy

Each of the SHAs publishes calls for applications for its regional innovation fund. Prior to submitting an application, we recommend taking the following Steps.

a. Step 1 – Reimbursement Landscape Report

The purpose of this step is to understand the current reimbursements landscape for the company's device. It includes:

* Identification of relevant coding systems, available coverage policies, limitations and guidelines, relevant payment mechanisms and payment rates, outside of the National Innovation Procurement Plan.

* Identification of existing reimbursements mechanisms that could be utilized or compared to the company's device, regardless of the National Innovation Procurement Plan. Recommendation on whether new mechanisms will have to be developed and if so, which mechanisms.

* Identification of the main decision makers and their specific incentives and a description of the typical path towards obtaining third-party reimbursements, including milestones and typical timelines.

b. Step 2 – Plan Evidence

Following the completion of Step 1, the company should clarify what 'evidence' needs to be developed in order to receive high priority according to the above mentioned criteria: (1) Benefitting population; (2) Net financial savings; and (3) Deployment timescale. This step includes:

1) Development of a Value Story, indicating specific claims that explain how the use of the new device promotes the above criteria in comparison with the current alternatives.

2) Development of an Economic Model, quantifying the economic benefits and allowing for sensitivity analysis.

3) Verification of available clinical data supporting the clinical and economic claims in the above Value Story and Economic Model. If needed, the addition of reimbursements related aspects to any planned clinical study protocols.

4) Presentation of the above Value Story, Economic Model and existing / planned clinical data to relevant stakeholders within the NHS. It is important to verify, in advance, that these stalkers understand the benefits and would agree to provide funding for the new device, the generated data support the claims in the Value Story and Economic Model.

In case of negative feedback consider changing the Value Story, Economic Model, clinical data or product. Repeat this step until receiving positive feedback from the relevant stakeholders.

c. Step 3 – Generate Evidence

Perform clinical study / ies to substantiate the claims in the value Story or verify that existing clinical data supports them. Compile the Value Story, Economic Model and clinical data to a Dossier.

d. Step 4 – Establish Support / Demand

Use the developed dossier to:

1) Convince the relevant healthcare providers in the clinical and economic benefits of using the new device.

2) Convince the local key opinion leaders to provide lectures, write articles and issue supporting letters highlighting the benefits of using the new device.

3) Similarly, convince the relevant medical societies and organizations to provide position statements.

Add these documents to the dossier.

e. Step 5 – Implementation

Use the developed dossier as a sales tool and apply for funding from the Innovation Fund.

5. Conclusion

According to an assessment conducted by PwC, the UK, with its very large single-payer, government-controlled system, ranks third in ease of reimbursements and significantly above European countries such as Germany and France. The NHS's focus on innovation may make it even easier for smaller companies, introducing their first product into the market.

It should be noted that in order to prepare a winning application, a great deal of preliminary reimbursements related work should take place, in advance. This preparatory work should result in the development of evidence, supporting the required criteria for high priority on the list of new devices, which are eligible for funding from the Innovation Fund.


[1] Initially, this task was assigned with the Department's Procurement Investment and Commercial Division (PICD) which later on was renamed as the Innovation Technology Adoption Procurement Program (iTAPP). In 2012, according to the “Innovation Health and Wealth” document, NICE replaced ITAPP and took responsibility for these applications.

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Tosoh 600 II Immunoassay Analyzer Offers Flexible Operation

Tosoh 600 II Immunoassay Analyzer – Ideal Laboratory Equipment Worth Investing In

Tosoh 600 II is an advanced immunoassay system featuring automated random access options to meet various lab testing requirements in present day clinical and research facilities. This innovative device can perform tests for infectious diseases, reproductive hormones, cancer markers, tumor marks, cardiac markers, reproductive hormones, anemia and other assays. Tosoh 600 II immunoassay analyzer offers flexible operation that is most convenient to lab professionals.

General Features of Tosoh 600 II

Stability and accuracy are the major characteristics of Tosoh 600 II immunoassay system. Other advantages and features that need to be stated are:

• Ensures high productivity and effective workload administration

• Involves simple operational procedures to guarantee low labor savings benefits

• Executes both STAT and routine immunoassays precisely

• Delivers precise analytical results in a short span of time

• Facilitates primary tube sampling and dual clot detection

• Availability of data for 60 results in an hour

• Automatic specimen dilution and pretreatment

• Full test menu and unit dose test cup reagent facility

• Requires counter space less than three feet only

• Accessibility of first result in 18 minutes

• Less maintenance cost

• Bidirectional interface and high resolution touch screen

• Features to monitor and repair the system automatically according to the preset modes

• Programmed reflex testing with cascade options

• Top-to-top fluorescence recognition system to ensure third generation sensitivity

• Assay methodology involves one-step and two-step sandwich and effective FEIA

Dilution and automatic repeat capacities, and refrigeration facilities to keep reagents / supplies are other advantageous features of this advanced chemistry analyzer. Tosoh 600 II designed by Tosoh Bioscience ensures quick reporting and lab efficiency. Consumables, controls and reagents are easily available to perform various research and clinical tasks. Annual maintenance contracts, after sales service and adequate warranty are available along with the instrument.

Hospital and laboratories around the world would find this chemistry lab equipment very beneficial.

How to Make a Profitable Purchase

To buy Tosoh 600 II that caters to your specific testing and investigation needs, find an established laboratory equipment supplier. Such dealers provide quality products of different brands at reasonable prices. You can collect the necessary information by searching on the internet or talking to your friends. Most recognized dealers offer convenient online shopping facility. Choose the product you want from the catalog displayed on their websites. Established lab equipment suppliers also offer other products such as coagulation analyzers, autoclaves, immunology analyzers, electrolyte analyzers, blood gas analyzers and blood collection sets. Refurbished as well as new medical equipment come with full warranties and service contracts.

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Saving Money On Medical Equipment

Any person who is starting a new business understands that there will be a lot of startup costs involved, and not only will the question of how quickly you are able to recover these startup costs be a big determining factor in the long-term success of your business, but the amount of money you are able to save in the first place on these startup costs will make a big difference as well – and while every startup deals with these issues, it is also true that some startups have more to worry about in this area than others!

One of the main areas of business in which it is extremely important to make sure you recover your startup costs as quickly as possible – and in which you will want to make sure you are finding the best deals possible – is those businesses that operate in the medical fields, as the equipment required in order for you to get started can send your expenses through the roof. Furthermore, as you go through the years of running and maintaining your medical practice, you will want to make sure you are staying up-to-date on the equipment you are using in order to ensure this equipment will be functional, practical, and time -saving – and as you update this equipment, you will want to make sure you are finding great deals!

Of course, there are plenty of places you can go in order to purchase the medical equipment you need, but what many medical practitioners fail to realize is that most of the “conventional” options are overpriced compared to what they could – and should – be paying, as much better prices can typically be found online. It may seem odd, of course, to purchase something online that is so much more important than the typical online purchases of “music,” “clothes,” and the like, but it is also an intelligent wise and intelligent move to make!

Regardless of what medical field you are in – whether you need simple items such as utility carts and two-step stools, or need more advanced items such as x-ray and radiology filing cabinets and radiology work stations – it is possible to find these items online from quality sellers, and for a much better price than you could possibly find anywhere else.

Regardless of whether you are just now branching out into your own medical practice or are in need of updating the equipment you have already been working with for a while, consider shopping for your equipment online – where you can find great deals, and can save a great deal of money!

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How Voice/Speech Recognition Technology (SRT) Is Going to Affect Medical Transcription in the Future

Future of Medical Transcription / Trancriptionists:

For over a decade, voice recognition companies have been working to improve their softwares for MT purposes and now Naunce Dragon has introduced a powerful software other than before that is “Naunce Naturally Speaking Medical 10 software”. According to the company, it provides 90-95% accuracy. There are also other companies that are providing such softwares, eg M * Model, etc.

A lot of doctors tested this software when it was launched. The doctors thought that it was great, at first, but when they had to train the software to their voices, and has to go back to correct the many mistakes the software would create on the report; they realized that they were losing time and money, as there was also need to review or QA the files … that would not be feasible those doctors who do not invest more time after dictations. Most of them came back to use the medical transcriptionist.

And the remaining doctors, who are continuing to use the SRT (Speech Recognition Technology also known as Voice Recognition) are still having medical transcriptionists to edit and QA the reports, or they themselves have to edit or review it to ensure accuracy.

Second danger to MTs would be EMR system, which called Electronic Medical Records system, it is also not enough danger to MTs, but it can affect initially little setups, as it would be difficult for them to afford EMR software. In fact it's an effort to make a paperless environment, not to finish MT career.

In fact, it will be more easy and beneficial to the MTs, who will do editing and QA the SRT / VR report, as they will not have to transcribe the dictations, just to edit or QA / QC the files.

In SRT / VR methods, doctors will need an “extra set of eyes” same as QCs / Qs to edit the patient report and make sure it is accurate.

As you all know, MTs are the best having “extra set of eyes” because of their experience and daily routines.

The EMR will allow information to all the doctors to look at. If a patient's report has inaccurate information in it, then it is possible the next physician would make a wrong decision for that patient based on the report created by SRT / VR.

So, you can easily find that it is very important to have MTs / QA editing and reviewing medical reports for perfect accuracy.

Usman Ali Kokab

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