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Tuesday, May 31, 2016

‘We lose money doing this’: Tiny company caught in abortion debate takes on Congress -


PLACERVILLE, CALIF. — StemExpress, a tiny biomedical company in this foothill town east of Sacramento, has emerged at the heart of the contentious national debate over abortion and the scientific use of human fetal tissue. FBI agents say its floor-to-ceiling windows are security hazards, a potential line of sight for snipers. The backdrop of pine trees and hills provides cover, employees say, to strangers who crouch with cameras.
Inside, Melanie Rose, a laboratory technician, knows anyone could be watching. One recent May morning, she opened a foam box with fetal tissue packed in ice — a donation for medical research.
Rose, who is working toward a master’s degree in stem cell treatment, is one of 24 employees here thrust into view after antiabortion activists released a series of videos last year.
The videos shed light on an uncomfortable aspect of a little-known industry. They targeted Planned Parenthood, which provides abortions and, for a time, StemExpress paid a nominal fee to obtain the fetal tissue. The tissue, which is in limited supply, is a vital component in stem cell research — a great hope for medical breakthroughs. StemExpress collects the tissue and extracts the stem cells for researchers worldwide. Most of it is from adult sources — drawn from blood and bone marrow — but a small amount is from fetal tissue.
That work, with fetal tissue, has catapulted the small biotech firm out from under the radar. It is now the target of loiterers, protesters and death threats and the subject of a congressional inquiry.
At the heart of the issue is whether the work is done for profit. The exchange of fetal tissue for research is legal, so long as neither party makes money in the deal.
An undefined term is work done for profit. Whose profit ? Truth it be known,  most biological tissues are discarded as hazardous bio-waste, in special hazard containers. They are incinerated.   
Why do pro-lifers think that recycling biological waste is to be prohibited? This waste would be thrown away.  It is no longer living human tissue. It is unable to 'live' independently without extreme life support, perhaps in a tissue culture medium at best.  Harvesting early fetal remains as a result of an abortion, therapeutic or otherwise.  The fetus is dead ! Long live the fetal cells.
Are we destroying a life ? Our definition of life is hazy at best. It is an argument that will never end.  Some however like black and white answers because it eliminates the effort of careful thought and alternatives to conventional thinking.  The matter of equality and choice of rest rooms for transgenders becomes equal in the political spotlight along with abortion, and gay rights.  Our structured and catalogued life choices is disintegrating rapidly.
The choices are not black and white. they are different grays for each person.
House Republicans and antiabortion advocates assert that firms such as StemExpress do profit illegally and that that profit fuels a demand for abortions.
StemExpress chief executive Cate Dyer says profit is not a factor. “We lose money doing this,” Dyer said about working with fetal tissue. “We don’t have to do this, and we won’t stop doing this.”  And why is profit such a bad thing?  In no way can careful disposition of a biological waste substance be equated with a calculated murder, or even a negligent homicide. It's not solyent green, as many opposers would have us believe.
The consequences of this supercharged debate transcend one firm. Scientists and doctors across the country say the political turmoil on Capitol Hill has stalled lifesaving work and imperiled progress toward, among other treatments, a Zika virus vaccine.
“We want to accelerate lifesaving research,” Dyer said. “That’s what it’s all about. That is my passion.”
Dyer once worked as an emergency medical technician at Santa Barbara Cottage Hospital’s trauma center. Watching people die every day at the Southern California facility, she said, inspired her to search for ways to prevent death. She started the company in 2010 with $9,000 in savings. In 2015, StemExpress said it posted roughly $5 million in revenue.
Her company’s innovation, as she describes it, is isolating the stem cells from donor tissue from the clinic, which extends their lifespan for research. Otherwise, she said, a researcher in New York who wanted an adult liver in California would lose a substantial number of its usable cells during the cross-country flight.
Before the videos came out, Dyer said, StemExpress had never had so much as a threat. Hundreds have since hit the StemExpress inbox. She said a recent message was typical of what they’d received: “We know that you use aborted fetuses in your ‘research.’ Repent now before it is too late.”
Dyer said the company provides the samples to researchers at a financial loss to expedite the creation of medicines and vaccines — and that fetal tissue represents less than 1 percent of the business.
“I want to be able to focus on saving people’s lives,” Dyer said, “and instead I have to deal with death threats.”
David Daleiden, an activist who leads an outfit he calls the Center for Medical Progress, secretly shot the videos. He started looking into StemExpress after seeing a Craigslist posting for a contract job to collect tissue from a women’s health clinics.
"StemExpress is a business, and that’s clear from the list of products and bioservices on its website", Daleiden found it disturbing.
The company’s records indicate that roughly 1 percent of the tissue StemExpress collects is fetal. StemExpress typically gave Planned Parenthood $55 per sample, paying mostly for use of its rooms, storage and staffers.  Last year, a StemExpress catalog advertised a vial of two million “fresh” stem cells from a fetal liver for $1,932, and $1,840 for the same amount "cryopreserved," or frozen. Company records show they charge researchers a flat fee of $595 for each sample of fetal tissue, which costs an average $732 to prepare. In addition to compensating staffers who collect the tissue, the company pays for mileage, shipping, packaging, lab equipment, screening the sample for diseases and general upkeep.
In 2015, revenue from the transfer of fetal tissue to researchers totaled roughly $26,000. The cost of preparing the tissue, the company said, was about $33,000 — resulting in a $7,000 financial loss. That is not a profitable niche and certainly not a booming niche.  Part of the problem is the media's hype about biological research, genomics and computer science.  Much exaggeration and little truth.  The buzz words, even when spoken softly, elicit primal fears
There are already many safeguards in place about these issues.
The House Energy Committee’s Select Investigative Panel on Infant Lives has demanded that ­StemExpress and other biomedical players hand over thousands of pages of financial records and the names of their employees, issuing 36 subpoenas since March.
Its mission, according to its website, is to compile information about abortion providers and the biotech companies who “sell baby body parts.” The members plan to send their findings to Congress at the end of the year. On Tuesday, 180 of 188 House Democrats urged Speaker Paul D. Ryan (R-Wis.) to dissolve the panel, accusing it of harassment and McCarthyism.
Medical authorities have warned lawmakers that stigmatizing fetal tissue research could jeopardize public health. In March, the Association of American Medical Colleges — a group that includes the American Congress of Obstetricians and Gynecologists, Harvard University, and the Stanford University School of Medicine — sent a letter to congressional investigators.
The negative effects of these 'suspicious' activities has had a real negative impact on research.
Chilling effects on research
Those kinds of threats and the growing political pressure have chilled stem cell research at laboratories across the country.
Steven Goldman, a neurologist at the University of Rochester Medical Center in New York, said the outrage — and anxiety over becoming a target of it — has delayed his research on multiple sclerosis.
In 2012, Goldman’s team received a $12.1 million grant from the Empire State Stem Cell Board to develop a cure. The team extracted stem cells from fetal tissue — collected from abortions performed at local hospitals — to see whether they could regenerate myelin, the insulating sheath around nerve fibers, in mouse brains.
It worked, Goldman said. He and his colleagues planned to start clinical trials on late-stage multiple sclerosis patients this year. Since Daleiden’s first video, however, the researchers’ supply of fetal tissue dried up.
“Hospitals seemed less willing” to donate, Goldman said. “We’d never had significant rejections by patients, and all of the sudden they were turning down consent forms.”
Goldman has pushed his multiple sclerosis research schedule back to 2019.
“This kind of delay,” he said, “results in the additional deaths of people who could have been rescued.”
“If researchers are threatened, it’s going to make us think twice about continuing research,” she said, adding that her former boss has received death threats for her stem cell work. “Ultimately, the patients that could benefit from the research won’t.”
At the StemExpress lab, Dyer has hired armed guards, installed security cameras and put her staff through active-shooter training.
Rose, the 27-year-old lab technician, wears a silver Saint Christopher pendant for protection.
“This tissue,” she said, “would be thrown away if we didn’t send it to researchers who are truly trying to save lives. I want them to see what I’m doing. That something good can come of it.”

This is certainly an issue that more Americans need to educate themselves about before making political decisions based  upon electoral rhetoric.. Don't let the politicians pick your brain apart. (they might sell the tissues for fund raising.)












‘We lose money doing this’: Tiny company caught in abortion debate takes on Congress - The Washington Post

Thursday, May 26, 2016

11 TOP PATIENT QUESTIONS ABOUT TELEHEALTH






As we’ve written before, a majority of patients are now interested in doing telehealth visits.

If you are one of  them, this article will give you some of the basics.




The trick is getting them engaged and informed about how to do telehealth visits. How do you address their questions and anticipate any potential hesitations?
We’ve worked with many healthcare providers to develop their patient adoption plan, which gets the news out to patients and gets them excited to start! Once patients have their initial questions answered, they’re next question is usually “how do I sign up?”
With this in mind, we’ve gathered together 11 common patient questions we hear about telehealth, along with quick answers to give you a starting point as you’re communicating with your patients. Note that the answers will vary depending on your use case and the telehealth platform you’re using!
  1. What do “telehealth” and “telemedicine” mean?

    Telehealth and telemedicine both describe a way to deliver and get healthcare using telecommunications technology (phone, computer). If you hear that your doctor is offering “live telehealth visits,” it means you can now videochat your doctor online!
  2. What equipment do I need to do a telehealth visit?

    At minimum, most patients will need a computer or mobile device with an integrated camera and microphone. If your device doesn’t have a built-in microphone or webcam, you’ll need to get those. You also need a decent internet connection that allows you to stream video.
  3. Will it work with wifi?

    Yes! As long as your wireless connection is strong enough. Your internet speeds should be at least 15mbps for uploads and 5mbps for downloads. You can check your internet speed by going to speedtest.net and clicking “Begin test.”
  4. I’m not very tech-savvy. Is telehealth right for me?

    We’ve had patients of all ages (and well into their 90’s!) use our telehealth platform successfully. Have you ever used Skype or Facetime? Doing a virtual doctor’s visit can be just as simple.
  5. What should I do if I have a technical issue?

    If you’re an eVisit user, you can simply contact our eVisit support team if you have any issues. We also include a quick equipment test when you enroll to make sure your sound, video etc is working, and lower the possibility of technical glitches.
  6. What conditions can I get treated for via telehealth?

    Telehealth is currently being used to treat conditions across many different specialties. Here are just a few examples: Rashes, flu, sinus infections, UTI, migraines, acne, mental health counseling, substance abuse counseling, post-op check-ins, lab result reviews, contraceptive counseling, prescription refills, and much more. Check with you doctor to see what conditions they treat via telehealth.
  7. How can the doctor diagnose me without actually doing a physical exam?

    Your doctor actually doesn’t need to do a physical exam to diagnose and treat many conditions. That’s because knowing your medical history is considered “90% of the evaluation” when combined with the doctor-patient interaction. How you’re feeling can be just as important to your doctor as the results of a physical exam. Plus, being able to see you and view any picture uploads on the eVisit platform gives your doctor the additional visual information needed to make a diagnosis.
  8. How do I sign-up?

    The sign-up process can vary from provider to provider. Check your healthcare provider’s website for an eVisit login button or link. Simply click on that and answer a few questions about your medical history to get started.
  9. When can I do virtual visits with my doctor?

    Check with your doctor about the specific hours they’ll be offering virtual visits. They might be offering on-demand visits during certain timeblocks or scheduling out your virtual visit the same way as an in-person appointment.
  10. Will I be seeing my own doctor or someone I don’t know?

    This all depends on the practice you’re doing a telehealth visit with. If you’re doing a virtual visit with an urgent care center, chances are you’ll be seeing a new doctor.
    But if you’re doing a telehealth visit at a practice where you’re an established patient, you’ll likely be seeing your own doctor. Many practices treat telehealth visits the same as a normal in-person visit with your own doctor – except online!
  11. Can I get a prescription filled from the visit?

    Yes! As long as your diagnosis doesn’t require further in-person examination, your doctor can simply electronically prescribe your medication and send it directly to the nearest pharmacy of your choice.
  12. Will my insurance cover the visit?

    All of the Big Five insurance carriers (Aetna, BCBS, United Healthcare, Cigna, Humana) offer some sort of coverage for telehealth visits. However, you should always call your insurance and verify what your individual policy covers
  13. Why should I use telehealth? 
  14.     

  15. If you are a busy woman or man, the time and money saved can be signicant issue. Telehealth actually is a telephone call with video.  Most office or clinc visits are for a verbal confirmation and/or a discussion that can be accomplished using telemedicine. The time and money savings can be very significant, espcially if you are an hourly employee.  A typical office encounter can take as much as two hours, and consume several gallons of gas, all for a 15 minute face-face visit with your doctor.   Included in that time is waiting room time, processing time by the office staff and administrative paper work.

Wednesday, May 25, 2016

Opiod Addiction is a greater menace than Zeka virus or Ebola


WASHINGTON — While the attention on Capitol Hill this week has focused on Donald Trump’s visit, a quieter — and potentially more substantive — conversation is underway in Congress to address the opioid addiction crisis sweeping the country.
House Speaker Paul Ryan, after a morning meeting with Trump, is planning Thursday to continue pushing for passage of 18 initiatives to help stem the epidemic.
The legislation has been in the works for months, with the Massachusetts delegation at the forefront of shaping the national agenda for an issue that’s particularly potent in New England.
It’s one that Massachusetts Governor Charlie Baker brought up on his first visit to the White House, and one that found its way into the presidential campaign during frequent candidate stops in New Hampshire.
“What today marks is the beginning of a very divided Congress coming together to tackle an issue that is a national epidemic and crisis,” said Representative Bill Keating, a Bourne Democrat who represents counties in southeastern Massachusetts and the Cape that have the highest per capita death rates from opioid overdoses in the state.
“Seeing Congress come together on this issue is a more important statement to make than watching them tomorrow being divided on the political campaign,” said Keating, referring to Trump’s first visit with Republican congressional leaders as a “political reality show.” “The real reality people are dealing with is the life and death nature of this epidemic.”
Ryan, at a press conference Wednesday highlighting congressional efforts to combat opioid abuse, acknowledged that the Trump show has overshadowed substantive policy matters of late.
“I know some of you are here about a meeting that’s happening tomorrow. I’d like to talk to you about a meeting that I had yesterday,” Ryan said before telling a story about a Marine corporal from Wisconsin who died from an opiate overdose while being treated for anxiety in a VA hospital.
The House on Tuesday evening had passed a bill that would reform the way VA hospitals monitor opiate prescriptions. The passage of a slew of opiate-related bipartisan legislation picked up Wednesday and is expected to continue Thursday — from protecting infants and stopping drug kingpins to closer monitoring of prescription data.
The Senate has already passed its own opioid legislation; both sides of Congress still must reconcile any differences in a final package before President Obama can sign it into law.
Ryan vowed to “take all of these ideas, pass them through the House” and work with the Senate to “put a bill on the president’s desk fast.”
“That is what this week is about,” the speaker said.
The reporters before him did not get the message, peppering him with questions only about Trump. (Ryan said he doesn’t really know Trump, having met him only once — in 2012. “We had a very good conversation in March, on the phone,” he added.)
Among the series of opioid-related bills and amendments being considered this week are several sponsored by members of the all-Democratic Massachusetts delegation, including representatives Keating, Katherine Clark of Melrose, and Joe Kennedy III of Brookline.
The passage of a slew of opiate-related bipartisan legislation picked up Wednesday and is set to continue on Thursday.
Quote Icon
Kennedy’s bill updates federal guidelines for pain management and the prescription of painkillers. Keating’s amendment to that bill urges doctors to consider prescribing the overdose reversal drug naloxone along with painkillers.
Keating, a former district attorney who investigated his share of drug overdose deaths, also has sponsored legislation to expand federal grants to help communities collect leftover painkillers so they don’t end up in the wrong hands.
Clark’s bills would increase the availability of naloxone and ensure that infants born with opiate withdrawal get the help they need.
Her legislation would also reduce the number of unused painkillers by allowing pharmacists to partly fill prescriptions for opioid medications at the request of patients or doctors — something Baker had signed into law earlier this year, making Massachusetts the first state to allow the practice.
Clark said she hopes the flurry of opioid legislation this week will serve as a reminder to Trump about the focus of public service.
“This is why people run for office. This is the type of work we need to get back to,” Clark said. “We are not just speaking on the campaign trail about this but we’re actually providing families some solutions and hope for the future. That’s where our focus is in the House and I certainly hope that will be Donald Trump’s focus as he proceeds in this campaign.”
Trump himself talked a lot about addiction while campaigning in New Hampshire, where he addressed the state’s “tremendous problem with heroin and drugs.”
“You see this place and you say it’s so beautiful. You have a tremendous problem,” Trump said.
His solution? Build a wall.
“I’m going to create borders. No drugs are coming in,” he said in a video he posted on Facebook in February. “Believe me, I will solve the problem. They will stop coming to New Hampshire. They will stop coming to our country.”
Tracy Jan can be reached at tracy.jan@globe.com. Follow her on Twitter @TracyJan.
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WASHINGTON — While the attention on Capitol Hill this week has focused on Donald Trump’s visit, a quieter — and potentially more substantive — conversation is underway in Congress to address the opioid addiction crisis sweeping the country.
House Speaker Paul Ryan, after a morning meeting with Trump, is planning Thursday to continue pushing for passage of 18 initiatives to help stem the epidemic.
The legislation has been in the works for months, with the Massachusetts delegation at the forefront of shaping the national agenda for an issue that’s particularly potent in New England.
It’s one that Massachusetts Governor Charlie Baker brought up on his first visit to the White House, and one that found its way into the presidential campaign during frequent candidate stops in New Hampshire.
“What today marks is the beginning of a very divided Congress coming together to tackle an issue that is a national epidemic and crisis,” said Representative Bill Keating, a Bourne Democrat who represents counties in southeastern Massachusetts and the Cape that have the highest per capita death rates from opioid overdoses in the state.
“Seeing Congress come together on this issue is a more important statement to make than watching them tomorrow being divided on the political campaign,” said Keating, referring to Trump’s first visit with Republican congressional leaders as a “political reality show.” “The real reality people are dealing with is the life and death nature of this epidemic.”
Ryan, at a press conference Wednesday highlighting congressional efforts to combat opioid abuse, acknowledged that the Trump show has overshadowed substantive policy matters of late.
“I know some of you are here about a meeting that’s happening tomorrow. I’d like to talk to you about a meeting that I had yesterday,” Ryan said before telling a story about a Marine corporal from Wisconsin who died from an opiate overdose while being treated for anxiety in a VA hospital.
The House on Tuesday evening had passed a bill that would reform the way VA hospitals monitor opiate prescriptions. The passage of a slew of opiate-related bipartisan legislation picked up Wednesday and is expected to continue Thursday — from protecting infants and stopping drug kingpins to closer monitoring of prescription data.
The Senate has already passed its own opioid legislation; both sides of Congress still must reconcile any differences in a final package before President Obama can sign it into law.
Ryan vowed to “take all of these ideas, pass them through the House” and work with the Senate to “put a bill on the president’s desk fast.”
“That is what this week is about,” the speaker said.
The reporters before him did not get the message, peppering him with questions only about Trump. (Ryan said he doesn’t really know Trump, having met him only once — in 2012. “We had a very good conversation in March, on the phone,” he added.)
Among the series of opioid-related bills and amendments being considered this week are several sponsored by members of the all-Democratic Massachusetts delegation, including representatives Keating, Katherine Clark of Melrose, and Joe Kennedy III of Brookline.
The passage of a slew of opiate-related bipartisan legislation picked up Wednesday and is set to continue on Thursday.
Quote Icon
Kennedy’s bill updates federal guidelines for pain management and the prescription of painkillers. Keating’s amendment to that bill urges doctors to consider prescribing the overdose reversal drug naloxone along with painkillers.
Keating, a former district attorney who investigated his share of drug overdose deaths, also has sponsored legislation to expand federal grants to help communities collect leftover painkillers so they don’t end up in the wrong hands.
Clark’s bills would increase the availability of naloxone and ensure that infants born with opiate withdrawal get the help they need.
Her legislation would also reduce the number of unused painkillers by allowing pharmacists to partly fill prescriptions for opioid medications at the request of patients or doctors — something Baker had signed into law earlier this year, making Massachusetts the first state to allow the practice.
Clark said she hopes the flurry of opioid legislation this week will serve as a reminder to Trump about the focus of public service.
“This is why people run for office. This is the type of work we need to get back to,” Clark said. “We are not just speaking on the campaign trail about this but we’re actually providing families some solutions and hope for the future. That’s where our focus is in the House and I certainly hope that will be Donald Trump’s focus as he proceeds in this campaign.”
Trump himself talked a lot about addiction while campaigning in New Hampshire, where he addressed the state’s “tremendous problem with heroin and drugs.”
“You see this place and you say it’s so beautiful. You have a tremendous problem,” Trump said.
His solution? Build a wall.
“I’m going to create borders. No drugs are coming in,” he said in a video he posted on Facebook in February. “Believe me, I will solve the problem. They will stop coming to New Hampshire. They will stop coming to our country.”
Tracy Jan can be reached at tracy.jan@globe.com. Follow her on Twitter @TracyJan.



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