A Weekly Compilation of Clinical Laboratory and Related Information
from The Division of Laboratory Science and Standards
February 7, 2013
View Previous Issues - Healthcare News Archive
Capitol Hill Briefing on Value of Clinical Laboratory Testing
The foundation for 70% of physician decision-making, clinical laboratory tests are one of the most critical elements in preventing chronic illness, curtailing epidemics, and improving cancer care. At the same time, clinical lab tests are making the U.S. health care delivery system more cost-effective.
On February 11, Kenneth Sisco, MD, Ph.D., medical director of Quest Diagnostics, will explore this topic at a Capitol Hill briefing for Congressional staff, members of the House and Senate, health care and patient organizations, and the news media in the visitors center of the U.S. Capitol building. The briefing is sponsored by "Results for Life," the educational arm of the American Clinical Laboratory Association (ACLA). At the briefing, "Clinical Laboratory Testing: Providing Critical Evidence for Diagnosis and Treatment," Dr. Sisco will explain what clinical laboratory tests are and why they are so crucial to improving patient health and utilization of health care resources. Alan Mertz, ACLA President, will discuss health policy issues before Congress and federal agencies that could affect innovation and the availability of clinical laboratory testing.
Are Citizens' Voices Heard in Rulemaking?
The government might be great at creating rules, but it is less skilled at getting feedback on them, according to the Government Accountability Office. Public comments are typically part of the rulemaking process and aim to increase transparency. Agencies publish an average of 3,000 to 4,000 final regulations each year, but a large percentage of them do not involve public feedback.
From 2003 to 2010, agencies published 568 major rules — those that could have an annual economic impact of $100 million or more — and about 30,000 non-major rules, which have less of an economic impact and may involve routine administrative issues. According to a newly released GAO report, 35 percent of the former and 44 percent of the latter did not include a notice of proposed rulemaking (NPRM) to alert the public to the opportunity for comment.
In addition, agencies commonly neglected to respond to public comments, often citing the “good cause” and other statutory exceptions for publishing final rules without an NPRM. “Good cause” is typically used when agencies deem notice-and-comment procedures “impracticable, unnecessary or contrary to the public interest.” That exception was claimed in 77 percent of major rules and 61 percent of nonmajor rules published without an NPRM.
The White House Reveals a Redesigned Electronic Medical Record
More than 200 design teams participated in the Health Design Challenge, a competition to redesign patient medical records. Soon, 6 million VA patients will see the benefits.
There are 315 million “patients” in America, and only 1 million physicians. Keeping track of their histories is a gargantuan task, and many doctors have turned to the Electronic Medical Record, a computerized list of everything from allergies to addresses, to keep up. But despite being a huge improvement from paper records, the EMR is in desperate need of a graphic and technological overhaul. Doctors often don’t have time to sift through dozens of printouts before they see a patient, and even if they do, the record might not be comprehensive or up to date.
The winning design, Nightingale, was devised by Amy Guterman, Stephen Menton, Defne Civelekoglu, Kunal Bhat, Amy Seng, and Justin Rheinfrank, a team of designers and strategists who work together at Chicago consultancy gravitytank. Their scheme imagines a responsive record that can act like a dashboard, letting doctors view patients holistically and track results and prescriptions in real-time. Remarkably, the Health Design Challenge’s winning proposals will soon migrate into the real world. Check out the rest of the proposals here.
Clancy Stepping Down as AHRQ Director
Dr. Carolyn Clancy, who has led HHS’ Agency for Healthcare Research and Quality for nearly a decade, will leave her post some time “in the coming months,” according to a memo to employees from HHS Secretary Kathleen Sebelius. Clancy, an internist, was named AHRQ’s director in February 2003 and was reappointed in October 2009. She joined AHRQ in 1990 and previously served as director of its Center for Outcomes and Effectiveness Research.
More Than 450 Provider Organizations Join Payment-Bundling Initiative
The CMS announced that more than 450 healthcare organizations will participate in the Bundled Payments for Care Improvement initiative, a payment model program created in the healthcare reform law to test whether bundling payments for services in a single episode of care can improve quality and lower costs. Those selected organizations represent a wide range of healthcare providers—including not-for-profit and for-profit hospitals, academic medical centers, physician-owned facilities and post-acute providers—that were chosen by the CMS either as awardees for Model 1 starting in April, or as participants for the first phase of models 2, 3 and 4 that begins with this announcement.
Feds Want a More Robust Insurance Database Before Obamacare Rollout
The government is seeking a contractor to help expand and manage its database of information about private health insurance plans as new parts of President Obama’s Affordable Care Act come online, solicitation documents show. The contractor must design Web forms and other tools to ensure new data is entered into the HIOS system in a consistent, machine-readable way, the notice from the Centers for Medicare and Medicaid Services said. HIOS is housed inside a private CMS computer cloud.
CMS Issues Sunshine Rule
The Centers for Medicare and Medicaid Services issued a long-awaited rule finalizing the details for a database that will list payments made to physicians by pharmaceutical and device manufacturers. The rule "is intended to help reduce the potential for conflicts of interest that physicians or teaching hospitals could face as a result of their relationships with manufacturers," the statement continued.
- The event meets the accreditation or certification requirements and standards of the Accreditation Council for Continuing Medical Education, the American Dental Association's Continuing Education Recognition Program, the American Academy of Family Physicians, the American Medical Association, or the American Osteopathic Association
- The drug or device company doesn’t directly pay the speaker
- The drug or device company doesn’t select speakers for the event or “provide the third party (such as a continuing education vendor) with a distinct, identifiable set of individuals to be considered as speakers for the continuing education program”
U.S. Proposes Scrapping Some Obsolete Medicare Regulations
The Obama administration proposed eliminating certain obsolete Medicare regulations, a move it said would save hospitals and other healthcare providers an estimated $676 million a year, or $3.4 billion over five years. The Department of Health and Human Services described the targeted regulations as unnecessary or excessively burdensome and said their proposed elimination would allow greater efficiency without jeopardizing safety for the Medicare program's elderly and disabled beneficiaries. "We are committed to cutting the red tape for healthcare facilities, including rural providers," Health and Human Services Secretary Kathleen Sebelius said in a statement.
ASCP Urges Changes to Meaningful Use Rules
On Jan. 14, 2013, ASCP wrote the National Coordinator for Health Information Technology, Farzad Mostashari, MD, ScM, restating the Society’s concerns about the inability of pathologists to meet the Meaningful Use Requirements. ASCP’s letter, sent in response to a proposal outlining draft goals and measures for Stage 3 of the Electronic Health Records’ Meaningful Use Requirements, asserted that the program’s “‘one-size-fits-all’ approach … is neither appropriate nor realistic.” ASCP also said the program’s requirements “could result in anti-competitive effects on the market to provide anatomic pathology and clinical laboratory services, and could force small- and medium-size laboratories from the market to provide laboratory services.”
ASCP Weighing in on California Proposed Laboratory Personnel Licensure Rules
The California Department of Public Health has released a proposed rule to revamp the state’s current regulations governing the licensure of medical laboratory personnel. While the rule has not yet been officially released to the public, it has been sent to interested parties, including ASCP, for their review before it is made public later this year.
The proposed rule resumes a regulatory initiative the Department began in 2010. That rule, which had numerous flaws, was partly intended to eliminate licensing standards that “serve as barriers to licensure for qualified persons, especially those coming from outside the state of California.” Consequently, the Department received several thousand comments—the largest number it had ever received on a rule. Widespread concern and the complexity of the issues raised forced the Department to scuttle the rule and start over.
CDC accepts specimens from state public health laboratories and other federal agencies for analysis. Specimens from private healthcare providers and institutions must be submitted to the local state health department laboratory (state, county, city) for appropriate processing.
Specimen Management activities at CDC include the receipt, categorization, and distribution of specimens from public health facilities to CDC laboratories for reference diagnostic testing and research studies. State-of-the-art technology is used to provide data and information summaries that are crucial in the assessment of public health trends and epidemic dynamics on a national scale.
How Often Are Biopsies Wrong?
A million things can go through your head when you get the results of a biopsy from your doc. But asking if the results belong to you probably isn't one of them—though new research suggests that maybe it should be. Turns out getting someone else's results isn't exactly rare. After a biopsy is collected at a doctor’s office, it goes through several steps. The biopsy is transported to a pathology lab, processed, turned into a glass slide, and then delivered to a pathologist who writes up a report. All said and done, it takes around 20 steps—in different buildings and sometimes across state lines—to reach a diagnosis.
Dr. Pfeifer decided to find out just how rampant biopsy mix-ups are. In a new study published in the American Journal of Clinical Pathology, he and a colleague analyzed data from about 13,000 prostate biopsies, provided by a private lab called Strand Diagnostics. (The company also markets a system that can detect whether the biopsy matches the DNA of the supposed patient.) Of those 13,000 samples, researchers found a total error rate of less than half a percent, which translates to around 5 patients in 1,000, Dr. Pfeifer says. More data is needed to find out if the study is representative on a larger scale, but if it is, those numbers would metastasize: About 1 million prostate cancer biopsies occur annually, so this error rate would affect close to 5,000 people. Breast biopsies, which travel the same test cycle as prostate biopsies, occur 1.6 million times a year.
In reality, the error rates are at least twice as high, Dr. Pfeifer speculates. For every patient linked to the wrong biopsy, there’s another patient in the same boat (whose sample wasn’t retested for accuracy.) And sometimes, samples are mixed or contaminated between three or more patients, he says.
Which Cancer Screenings Should You Skip? Consumer Reports Weighs In
Cancer 2.0. That’s what Consumer Reports has dubbed the new age of cancer screening where patients should be taking a good hard look at all those blood tests, X-rays, and ultrasounds before agreeing to be tested. The magazine released a report rating screening tests by effectiveness and found that many aren’t worth the time, money, or risk. (Yes, cancer screening tests have risks, leading to more invasive tests such as biopsies and treatments that aren’t ultimately lifesaving.)
Consumer Reports largely agreed with the assessments of the US Preventive Services Task Force -- a panel of independent primary care physicians convened by the federal government to evaluate screening tests and other preventive health measures. But the ratings also factored in the cost of the test, whether the cancer being screened for was prevalent or rare, and whether the test has benefits beyond screening for a particular cancer, according to Joel Keehn, senior editor at the magazine.
Lyme Culture Test Causes Uproar
A new chapter in the Lyme disease controversy opened in September 2011 when Advanced Laboratory Services, Inc, announced the commercial availability of a new culture test for Borrelia burgdorferi. Some Lyme patient advocacy groups and physicians began encouraging patients to have the $595 test, but others are concerned about the early commercialization of the still-unvalidated test. This concern may result in changes to how the US Food and Drug Administration (FDA) regulates so-called "homebrew" or laboratory-developed tests (LDTs). Physicians on all sides of the Lyme disease arena agree that a reliable culture test for active Borrelia infection would be a breakthrough. They differ on whether it is a good idea to market a blood test to consumers before it has been validated, peer-reviewed, published, reviewed by the FDA, or widely vetted by infectious disease experts with experience in Borrelia infections.
Quick TB Test Builds Up Arsenal Against Drug-Resistant Bacteria
Worldwide the number of TB cases is going down. The bad news is that the number of drug-resistant cases is going up. The World Health Organization estimates that the number of reported TB cases that were multi, extremely- or totally-drug resistant doubled between 2009 and 2011.
Until recently, it was extremely difficult to even diagnose drug-resistant TB, particularly in developing countries where the disease is most prevalent. Tests had to be sent to fancy labs and could take up to three months to process. But hope arrived a few years ago, in the form of a new screening tool called Xpert. It was designed to identify TB bacteria and the most common form of drug resistance in only two hours. But as a new technology, no one was quite sure how effective it was. Now, a comprehensive analysis of Xpert's performance, published y in the influential Cochrane Library, validates the test as an accurate tool for detecting resistance to one of the leading TB drugs, rifampicin.
At $17,000 for the machine and $9.98 for each test, Xpert is pricey. But this stamp of approval could encourage more health departments in TB endemic countries to spend the dough on this new method of testing.
Flow Cytometry, the Gold Standard, Meets a New Technology, High Throughput Sequencing
When it comes to laboratory diagnosis of leukemia, technology needs to multitask. It must be specific enough to produce a diagnosis and classify the type of cancer rapidly. It must also detect any residual disease during and, especially, after treatment.
Flow cytometry, the rapid measurement of multiple characteristics of large numbers of individual cells, has been the gold standard for years. But it is getting some competition from technological improvements to a genomic technology - high throughput sequencing.
"High throughput sequencing (HTS), also called next-generation sequencing, uses laser and high- resolution imaging technology to sequence hundreds of millions of DNA fragments simultaneously on an instrument," explained Robert Daber, PhD, DABMG, technical director of Clinical Genomics, Center for Personalized Diagnostics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia.
Modeling Tool Uses Lab Results to Predict Patients' Benefit From Statins
A web-based tool that incorporates routine laboratory test results into a calculation can predict gains in life expectancy from starting statin therapy in asymptomatic patients, according to a study published online Dec. 27 in PLoS Medicine. The prediction of individualized long-term benefits may aid physicians in personalizing preventative care. The web-based calculator relies on laboratory results including lipids, glucose, and creatinine measures as well as other patient characteristics including age, sex, smoking, blood pressure, hypertension, diabetes, body mass index, and waist-to-hip ratio.
What’s in a Blood Type? Could Be Your Risk of Developing Clots
A study confirms the connection between the AB blood type and an increased risk of blood clots. Blood clots that form in the veins of the lower legs can pose serious health problems since they can break off and then get lodged in tiny arteries in the lungs, where they block blood flow and cause intense pain, difficulty breathing and even sudden death if blood can no longer pick up much-needed oxygen from the lungs.
In the study, Dr. Borge G. Nordestgaard of Herlev Hospital at Copenhagen University Hospital and his colleagues analyzed blood-type and clotting-disorder information from 66,001 people participating in two Danish studies who were followed from 1977 through 2010. After the lengthy follow-up, one trend emerged: people with the AB blood type showed a 4% higher risk of venous-blood clotting compared with those with the O blood type. Those with Factor V Leiden increased their risk of clotting events sevenfold compared with those with no variants of Factor V, and those with the clot-favoring prothrombin mutation showed an 11-fold increased risk of clotting incidents compared with those without the genetic aberration.
Hanging A Price Tag on Radiology Tests Didn't Change Doctors' Habits
If doctors would just pay attention to how much things cost, they might be more careful when ordering tests for patients, right? Well, that's the theory behind some research and projects to cut wasteful health spending. But a study at Johns Hopkins Hospital found that changing doctors' behavior may be not be as easy as simply making them aware of prices.
Radiologist and hospitalists collaborated on an experiment to see if disclosing the cost of some of the most frequently ordered imaging tests, including standard chest X-rays and CT scans of the head, would reduce their use in the hospital. The short answer is no.
Mayo Clinic Taps SV Bio to Combine Clinical Interpretation Pipeline With Patient Sequencing
The Mayo Clinic and startup Silicon Valley Biosystems are joining forces to develop a clinical sequencing pipeline that Mayo plans to implement within its Center for Individualized Medicine for cancer patients and patients with rare, undiagnosed diseases. The collaboration expands on plans the Mayo Clinic announced around a year ago to begin implementing sequencing as part of routine patient care.
Cholesterol Finding Offers New Way to Kill Lymphoma Without Chemotherapy
How do you annihilate lymphoma without using any drugs? Starve it to death by depriving it of what appears to be a favorite food: HDL cholesterol.
Northwestern Medicine® researchers discovered this with a new nanoparticle that acts like a secret double agent. It appears to the cancerous lymphoma cell like a preferred meal -- natural HDL. But when the particle engages the cell, it actually plugs it up and blocks cholesterol from entering. Deprived of an essential nutrient, the cell eventually dies. A new study by C. Shad Thaxton, M.D., and Leo I. Gordon, M.D. shows that synthetic HDL nanoparticles killed B-cell lymphoma, the most common form of the disease, in cultured human cells, and inhibited human B-cell lymphoma tumor growth in mice.
The paper is published in the journal Proceedings of the National Academy of Sciences.
DNA-Repairing Protein May Be Key to Preventing Recurrence of Some Cancers
Scientists tested one specific cancer-fighting drug used in the treatment of breast cancer to determine the role of the protein. Just as the body can become resistant to antibiotics, certain methods of killing cancer tumors can end up creating resistant tumor cells. But a University of Central Florida professor has found a protein present in several types of cancer, including breast and ovarian cancer, which could be helpful in preventing tumors from coming back.
The protein, KLF8, appears to protect tumor cells from drugs aimed at killing them and even aid the tumor cells’ ability to regenerate.
Cervical Cancer-Causing Virus Found in the Brain, Shows Potential Connection to Epilepsy
The virus becomes a potential new target for treating a common form of childhood epilepsy Researchers at Shriner's Hospital Pediatric Research Center at the Temple University School of Medicine, and the University of Pennsylvania have evidence linking the human papillomavirus 16 (HPV16) - the most common cause of cervical cancer - to a common form of childhood epilepsy. They have shown for the first time that HPV16 may be present in the human brain, and found that when they added a viral protein to the brains of fetal mice, the mice all demonstrated the same developmental problems in the cerebral cortex associated with this type of epilepsy, called focal cortical dysplasia type IIB (FCDIIB). The findings suggest that the virus could play a role in the development of epilepsy. The results also mean that doctors may have to re-think their approach to treating this type of epilepsy, and perhaps consider other therapeutic options related to HPV, an infectious disease.
"This is a novel mechanism, and it fills a gap in our understanding about the development of congenital brain malformations," said Peter Crino, MD, PhD, Professor of Neurology at Temple University School of Medicine, and a member of Shriner's Hospital Pediatric Research Center, and the senior author of a recent report in the Annals of Neurology.
Tuberculosis Hiding in Bone Marrow Helps Deadly Bacteria Survive
Tuberculosis can hide in peoples’ bone marrow, lying dormant after aggressive drug therapy and emerging years later to re-infect, according to a finding that may help explain why the disease is difficult to eradicate. Investigators writing in Science Translational Medicine said they have uncovered the first evidence of tuberculosis nestled in mesenchymal stem cells in the bone marrow of people treated for the disease. The bacteria’s hideout in the self-renewing cells, where they capitalize on protection from the body’s own immune system, may explain how the germs survive. The next step is to find out how a re-infection is triggered, and then how to stop it, researchers said.
Drug Discovery the Target of New Tool for Mining Bacterial Genome
Vanderbilt biochemists have discovered that the process bacteria undergo when they become drug resistant can act as a powerful tool for drug discovery. Their findings - reported in the Online Early Edition of the Proceedings of the National Academy of Sciences - should give a major boost to natural products drug discovery - the process of finding new drugs from compounds isolated from living organisms - by substantially increasing the number of novel compounds that scientists can extract from individual microorganisms.
Study Looks at Particles Used in Food
Nanomaterials, substances broken down by technology into molecule-size particles, are starting to enter the food chain through well-known food products and their packaging, but there is little acknowledgment by the companies using them, according to a new report from a nonprofit group that works to enhance corporate accountability. Some companies may not even know whether nanomaterials are present in their products, the corporate accountability group As You Sow said.
Their small size allows nanoparticles to go places in the body where larger particles cannot and enter cells. They have been found in the blood stream after ingestion and inhalation, and while research on their health effects is limited, studies have shown them to have deleterious effects on mice and cells.
Computer Scientists Develop New Way to Study Molecular Networks
In biology, molecules can have multi-way interactions within cells, and until recently, computational analysis of these links has been "incomplete," according to T. M. Murali, associate professor of computer science in the College of Engineering at Virginia Tech. His group authored an article on their new approach to address these shortcomings, titled "Reverse Engineering Molecular Hypergraphs," that received the Best Paper Award at the recent 2012 ACM Conference on Bioinformatics, Computational Biology and Biomedicine.
7 in 10 Americans Track Health
The first national US survey to measure health data tracking finds 70% of American adults track at least one health indicator either for themselves or a loved one, although half of "trackers" report they do it "in their heads". The Pew Research Center study, which was released online, carried out telephone interviews with over 3,000 adults living in the US. The survey finds that 6 in 10 American adults say they track their weight, diet or exercise routine, one third track a health symptom or indicator like blood sugar, headaches, blood pressure or sleep pattern, and just over 1 in 10 says they do the tracking for a loved one.
Interactive Map Lets California Consumers Compare Hospital Infection Rates
Patients in U.S. hospitals experience about 290,000 surgical site infections annually. These infections are the second most common healthcare associated infection in the country. California’s Department of Public Health (CDPH) educates more than 36 million residents about health dangers like these, but it’s not an easy job. Anita Gore, deputy director of the department’s Office of Public Affairs, strategizes ways to inform citizens so they make intelligent health-care decisions. Unfortunately taxpayers don’t always understand the intricate health information that the department provides online.
The map displays more than 300 California hospitals with symbols representing surgical infection rates for about a dozen procedures. Users click a symbol to generate a pop-up box disclosing the hospital’s stats for different surgeries. Data reveals whether the facility’s infection rates are lower, higher or equal to state or national averages. Gore and her colleagues designed the map to package data in ways that will have fewer Californians scratching their heads. “This is an attempt to take the information we were being given and make it usable for people,” she said.
Rekindling the Patient ID Debate
Imagine an identification number containing every iota of your health data – documenting every disease and ailment you’ve been treated for, every doctor you’ve seen – a number unique only to you. With such holistic data, the implications for improving patient care and reducing inefficiencies appear enormous. Now imagine your personal health data peddled to pharmaceutical behemoths, research corporations and third-party miners, a place where you, in fact, are not in control of your own information. All of a sudden, things appear differently. The idea of unique patient identifiers (UPIs) is not a concept extracted from the next dystopian novel. It could very well be reality in the not-so-distant future. The question remaining, however, is whether or not the benefits of such technology outweigh constitutional privacy and patient trust concerns. Naturally, depending on whom you ask, the answer varies considerably.
Patients Often Dissatisfied When Doctors Utilize Digital Diagnostic Tools
Health care practitioners now can access patients' data using electronic medical records, which often include information systems that assess individuals' medical histories and clinical research to facilitate doctors' diagnoses. A University of Missouri researcher says the increased use of computerized clinical decision support systems (CDSSs) leads to greater patient dissatisfaction and could increase noncompliance with preventative care and treatment recommendations.
Victoria Shaffer, an assistant professor of health sciences and psychological sciences, says CDSSs offer several types of decision aids, including alerts about medication errors; suggestions for alternative prescriptions or courses of treatment; ideas for managing chronic diseases; and reminders to discuss vaccinations, screenings or other preventative care services. Physicians concerned about whether using CDSSs will negatively affect their relationships with clients could incorporate the tools to engage patients and help them understand diagnoses and recommendations, she said.
WEDI Conducts ICD-10 Readiness Survey
The Workgroup for Electronic Data Interchange (WEDI) is conducting a survey of ICD-10 preparedness. The questions are geared toward an organization's status and how the one-year delay affected plans. Information will be used to inform WEDI, the Centers for Medicare and Medicaid Services (CMS) and other organizations the state of ICD-10 readiness. It also can help plan how to assist vendors, health plans and healthcare providers meet the Oct 1, 2014 deadline.
All types of healthcare organizations are encouraged to participate in the WEDI ICD-10 Progress Survey online
Can Computers Predict Medical Problems? VA Thinks Maybe
The Veterans Health Administration plans to test how advanced clinical reasoning and prediction systems can use massive amounts of archived patient data to help improve care, efficiency and health outcomes. The Veterans Affairs Department’s electronic health record system – the Veterans Health Information Systems and Technology Architecture, or VistA – stores data on 30 million veterans, including 3.2 billion clinical orders, 1.8 billion medication prescriptions and 2.3 billion vital sign measurements. This structured data is accompanied by 2 billion clinical text notes, with a growth rate of one hundred thousand additional notes per day.
In a request to potential vendors, VA emphasized that such a system goes far beyond traditional data mining techniques and rules-based clinical decision support systems. The agency wants to test an emerging class of computer systems that can sift through structured and unstructured data and use advanced natural language processing techniques and machine learning to detect patterns – the results of which would flag problems, inform decision-making and ultimately, improve patient care.
VA Awards Record Number of Grants for Women's Health Services
In its continuing effort to improve the health care services of women veterans, the Department of Veterans Affairs has released the largest number of one-year grants ever awarded to facilities targeting women’s health services.
The VA has awarded 33 grants to VA facilities that plan to improve female vets' health through emergency health care services, education programs for VA staff and telehealth services for women vets living in rural areas. Women represent 15 percent of active duty military and nearly 18 percent of National Guard and Reserve forces. By 2020, VA estimates that women will make up 10 percent of the entire veteran population.
Disease-specific ACOs Make Their Debut
Two high-profile organizations are focusing on patient groups with significant medical needs, looking to improve care and recoup greater savings than traditional ACOs.
A small number of entities are testing the accountable care organization concept, originally designed to improve care and reduce costs for populations of primary care patients, on groups of people with high-cost diseases such as cancer or end-stage renal disease. For instance, Florida Blue, formerly Blue Cross and Blue Shield of Florida, announced Dec. 20, 2012, the launch of an ACO for cancer patients cared for by the Moffitt Cancer Center in Tampa, Fla.
$124.6 billion was spent on cancer treatments in 2010.
Disease-specific ACOs also are looking at slightly different strategies to reduce costs. Those working on ESRD are identifying ways to cut hospitalizations. Those focusing on cancer are looking to standardize care protocols and help patients navigate the copious amounts of information that can follow a diagnosis.
HIV Patients Stranded as PEPFAR Funds Dry Up
The news that the United States President's Emergency Plan for Aids Relief (PEPFAR) was discontinuing its financial support to non-governmental organisations in South Africa was received with shock by the thousands of patients at Hope for Life, an NGO in Winterveld in the northern region of the City of Tshwane that is now facing closure. Hope for Life provides various HIV-related services, including antiretroviral treatment and home-based care to the Winterveld community.
An Alzheimer's 'Epidemic' Could Hit the USA by 2050
The number of people with the brain disease could nearly triple during the next three decades.
A new government-funded report confirms what advocacy groups have been warning for years: The number of people in the USA with Alzheimer's disease will almost triple by 2050, straining the health care system and taxing the health of caregivers. Numbers are projected to rise from about 5 million now to 13.8 million. The disease robs people of their memory, erases personality and makes even routine tasks like dressing and bathing impossible.
Antibiotic-Resistant Pneumonia Strain Spreading Across Nation
Infection with Klebsiella pneumoniae is a serious danger to older hospitalized patients, with an estimated mortality rate as high as 40 percent. It has generally been treated with broad-spectrum cephalosporin antibiotics. Another class of antibiotics, carbapenems, is used as an antibiotic of last resort for the most persistent infections. But now carbapenem-resistant Klebsiella strains, or CRKP, are appearing across the nation, even outside of health care facilities.
A study in the March issue of Infection Control and Hospital Epidemiology reports that the proportion of Klebsiella cases resistant to cephalosporins increased to 11.6 percent in 2010 from 5.3 percent in 1999. The proportion resistant to carbapenems increased to 4.5 percent in 2010 from less than 0.1 percent in 2002. The senior author, Ramanan Laxminarayan, a researcher at the Center for Disease Dynamics, Economics and Policy in Washington, D.C., compared the problem to that of methicillin-resistant Staphylococcus aureus.
Clinicians Perform “Chart Biopsies” to Prepare for Patient Handoffs
An AHRQ-funded study examines the practice of “chart biopsies,” a process that allows receiving clinicians to understand patients’ clinical course prior to handoff. According to the article, “Chart Biopsy: An Emerging Medical Practice Enabled by Electronic Health Records and Its Impacts on Emergency Department-Inpatient Admission Handoffs,” the term ”chart biopsy” refers to the activity of examining portions of a patient’s electronic health record (EHR) to gather specific information about that patient or to develop a broader understanding of the patient’s care. With many hospitals moving to EHRs, practitioners are now able to view patient records prior to the physical transfer of the patient. Chart biopsies enable receiving clinicians to gain a stronger understanding of the patient’s condition, allow receiving practitioners to better prepare for handoff and subsequent care, and guard against possible bias in verbal reports. Chart biopsy is an emerging practice that is not yet available as a tool in all hospitals. However, proponents point out that chart biopsy provides a tool to enrich coordination and collaboration, which may enable safety, efficiency, and effectiveness of medical care.
Massachusetts Cracks Down on Compounding Pharmacies
Massachusetts health officials ordered 11 compounding pharmacies to completely or partially shut down, after unannounced inspections were conducted in the wake of a fungal meningitis outbreak. The state's Department of Public Health began inspecting 40 sterile compounding pharmacies after the multistate outbreak last fall was linked to steroid injections distributed by the Massachusetts-based New England Compounding Center (NECC). "Over the course of the unannounced inspections, partial or complete cease and desist orders were issued to 11 pharmacies for a range of violations," the health department said.
BRICS Nations to Collaborate in Fighting Diseases
BRICS, a grouping of five key nations, today resolved to fight together various forms of diseases, including AIDS and TB, and decided to collaborate to promote access to cost-effective cures for people. At the end of the two-day meeting of Health Ministers of member states here, Brazil, Russia, India, China and South Africa (BRICS) adopted the Delhi Communique which stressed on fighting communicable, non-communicable disease and mental disorders together.
Focusing on Chinese Market, Berry Genomics Expects to Run 100K Noninvasive Prenatal Tests in 2013
As several companies are vying for a share of the noninvasive prenatal testing market in the US, Berry Genomics has been focusing its efforts on providing sequencing-based NIPT in China.
Like Sequenom and Verinata, Berry sequences cell-free genomic DNA from maternal plasma, which contains fetal DNA, and looks for an overrepresentation of DNA from certain chromosomes. The company currently runs its test on Illumina's HiSeq 2000, processing samples at its Beijing and Qingdao facilities. A third facility, in Shanghai, will become operational "very soon," according to Zhou. Turnaround time is currently 10 business days, which the firm plans to reduce to five days by making each step in the testing process more efficient.
Disclaimer- The information provided in this news digest is intended only to be general summary information. It does not represent the official position of the Centers for Disease Control and Prevention and is not intended to take the place of applicable laws or regulations.
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