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Thursday, June 13, 2024

The Future of Health Care Wearables

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How will Artificial Intelligence (AI) support remote monitoring and telemedicine?
As AI technology continues to advance, we can expect to see even more innovative and transformative uses of this technology in the healthcare industry.





The addition of artificial intelligence to wearables will. facilitate automated monitoring, and notifications of vital signs, and blood glucose determination in the background. and in real-time.



Wednesday, June 12, 2024

We Found Over 700 Doctors Who Were Paid More Than a Million Dollars by Drug and Medical Device Companies — ProPublica



Back in 2013, ProPublica detailed what seemed a stunning development in the pharmaceutical industry’s drive to win the prescription pads of the nation’s doctors: In just four years, one doctor had earned $1 million giving promotional talks and consulting for drug companies; 21 others had made more than $500,000.

Six years later — despite often damning scrutiny from prosecutors and academics — such high earnings have become commonplace.

The process involves much more than taking doctors out to lunch or bringing donuts for the office staff.  That is no longer allowed and removes the drug salesmen out of the loop.

Pharmaceutical companies often utilize well-known physicians who are actively involved in clinical trials for drugs or those in early-stage marketing.

More than 2,500 physicians have received at least half a million dollars apiece from drugmakers and medical device companies in the past five years alone, a new ProPublica analysis of payment data shows. And that doesn’t include money for research or royalties from inventions.

ProPublica will gladly download the data file for a mere $2,000. 

Here is the listing:  The listing includes payments and the number of studies by each recipient.

Payments in 2018
Top 20 Companies
Click on a company to see how its payments break down by drug, device, or doctor. Or, see all companies »

GENENTECH, INC. $478M
ZIMMER BIOMET HOLDINGS, INC. $109M
STRYKER CORPORATION $91.9M
BOSTON SCIENTIFIC CORPORATION $82.2M
ALLERGAN INC. $73M
ARTHREX, INC. $70.3M
MEDTRONIC USA, INC. $66M
DEPUY SYNTHES PRODUCTS LLC $61.7M
PFIZER INC. $48.9M
ASTRAZENECA PHARMACEUTICALS LP $45M
ABBVIE, INC. $42.9M
AMGEN INC. $41.4M
INTUITIVE SURGICAL, INC. $39.8M
MEDICAL DEVICE BUSINESS SERVICES, INC. $39.1M
GILEAD SCIENCES INC $38.6M
MEDTRONIC VASCULAR, INC. $37.9M
MERCK SHARP & DOHME CORPORATION $37.4M
GENZYME CORPORATION $35.2M
ABBOTT LABORATORIES $33.8M
NOVARTIS PHARMACEUTICALS CORPORATION $32.1M
Payments in Your State
Click on a state to see payments made to doctors there.

California $306M
Texas $188M
New York $179M
Florida $150M
Pennsylvania $97.6M
Ohio $86.1M
Illinois $80.9M
North Carolina $74.1M
Tennessee $69M
Massachusetts $68.5M
Georgia $60.4M
Michigan $58M
Arizona $53.9M
Colorado $49.1M
Maryland $48.8M
Washington $48M
Missouri $46.7M
New Jersey $42.3M
Virginia $42.2M
Minnesota $38.5M
Indiana $32.4M
Connecticut $27.3M
Wisconsin $24.9M
Louisiana $23.9M
Kentucky $23.7M
Utah $23.3M
Alabama $20.4M
South Carolina $20.3M
North Dakota $18.6M
Nevada $18.5M
District of Columbia $14.5M
Oklahoma $14.3M
Oregon $13.8M
Iowa $11.3M
Kansas $10.6M
Mississippi $9.99M
Puerto Rico $8.18M
Arkansas $7.28M
Nebraska $6.83M
Rhode Island $6.6M
West Virginia $6.3M
Idaho $5.45M
New Hampshire $5.15M
South Dakota $5.12M
New Mexico $5.08M
Hawaii $4.29M
Delaware $3.81M
Maine $3.06M
Montana $1.61M
Vermont $1.45M
Alaska $1.08M
Wyoming $1.02M
Palau $520K
Armed Forces Pacific $57,415
Armed Forces Europe $33,097
Guam $13,425
Virgin Islands $10,159
Armed Forces Americas $1,215
Northern Mariana Islands $157
Micronesia $60
Highest-Earning Doctors
KEVIN FOLEY
Neurological Surgery MEMPHIS, TN $29M
STEPHEN BURKHART
Orthopaedic Surgery SAN ANTONIO, TX $25.9M
TSONTCHO IANCHULEV
Ophthalmology SAN MATEO, CA $20.7M
WILLIAM BINDER
Plastic Surgery Within the Head and Neck BEVERLY HILLS, CA $16.7M
WILLIAM NOYES
Radiation Oncology GRAND FORKS, ND $15.8M
GAIL LEBOVIC
Plastic and Reconstructive Surgery DALLAS, TX $10.5M
LEO HOPKINS
Neurological Surgery BUFFALO, NY $9.45M
NEAL ELATTRACHE
Sports Medicine LOS ANGELES, CA $7.81M
CHARLES DECOOK
Family Medicine CUMMING, GA $7.46M
GARY CARR
Dentist, Endodontics SAN DIEGO, CA $6.25M
Doctors Paid the Most Often
RAKESH JAIN
Psychiatry LAKE JACKSON, TX 1,140
JASON KELLOGG
Psychiatry IRVINE, CA 961
ROBERT BUSCH
Endocrinology, Diabetes & Metabolism ALBANY, NY 926
ANDREW BLUMENFELD
Neurology CARLSBAD, CA 878
MITCHELL SORSBY
Endocrinology, Diabetes & Metabolism PLANO, TX 867
GUSTAVO ALVA
Psychiatry COSTA MESA, CA 866
STEVE FORDAN
Endocrinology, Diabetes & Metabolism DALLAS, TX 782
ARVINDER PAL WALIA
Psychiatry AUSTIN, TX 763
JOSELITO CABACCAN
Endocrinology, Diabetes & Metabolism SAN JOSE, CA 758
SANJAY CHABRA
Rheumatology EL PASO, TX 750
LESLIE CITROME
Psychiatry POMONA, NY 747
RICHARD KHALIL
Family Medicine YONKERS, NY 746
MICHAEL MEASOM
Psychiatry SLC, UT 741
AARON BROADWELL
Rheumatology SHREVEPORT, LA 740
GREGG FRIEDMAN
Psychiatry HALLANDALE BEACH, FL 734
ANTHONY TURKIEWICZ
Rheumatology BIRMINGHAM, AL 732
CORY RUBIN
Clinical & Laboratory Dermatological Immunology ANN ARBOR, MI 722
PAUL YAMAUCHI
Dermatology SANTA MONICA, CA 720
MATTHEW BUDOFF
Cardiovascular Disease TORRANCE, CA 715
NIKU SINGH
Psychiatry FALLS CHURCH, VA 715
Teaching Hospitals Paid the Most Often
See all teaching hospitals »

HOSPITAL OF THE UNIV OF PENNA
805
CLEVELAND CLINIC HOSPITAL
738
UNIVERSITY OF IOWA HOSP & CLINICS
693
RONALD REAGAN UCLA MEDICAL CENTER
551
EMORY UNIVERSITY HOSPITAL
543
LANGLEY PORTER PSYCHIATRIC HOSPTIAL
489
UNIVERSITY OF WASHINGTON MED CTR
484
FLORIDA HOSPITAL
484
UNIVERSITY OF ALABAMA HOSPITAL
464
UT MD ANDERSON CANCER CENTER
458
CEDARS-SINAI MEDICAL CENTER
446
THE METHODIST HOSPITAL
426
RUSH UNIVERSITY MEDICAL CENTER
414
BRIGHAM AND WOMENS HOSPITAL
400
UCI MEDICAL CENTER
389
MASSACHUSETTS GENERAL HOSPITAL
363
OHSU HOSPITAL AND CLINICS
345
DANA-FARBER CANCER INSTITUTE
340
STRONG MEMORIAL HOSPITAL
337
UNIV OF MI HOSPITALS & HLTH CTRS
332
Top 10 Drugs
Includes all general payments to doctors and teaching hospitals.

RITUXAN $53.6M
HERCEPTIN $34.7M
AVASTIN $31.2M
XIFAXAN $24.6M
OCREVUS $24.4M
BOTOX $23.3M
ACTEMRA $22.2M
XOLAIR $21.5M
PERJETA $20.1M
LUCENTIS $18.9M

Top 10 Devices
Includes all general payments to doctors and teaching hospitals.

GENERAL THERAPIES $44.9M
DA VINCI SURGICAL SYSTEM $39.8M
SHOULDER IMPLANTS SPEEDBRIDGE COMPOSITE ANCHORS $37.9M
SHOULDER IMPLANTS PUSHLOCKS COMPOSITE ANCHORS $33.9M
SHOULDER IMPLANTS SWIVELOCKS PEEK ANCHORS $33.8M
SHOULDER IMPLANTS SWIVELOCKS COMPOSITE ANCHORS $33.8M
ATTUNE $29.3M
MILOOP $25.5M
DISTAL EXTREMITIES IMPLANTS SOFT TISSUE ACHILLES $23.1M
ACCOLADE $21.4M
Source: The Centers for Medicare and Medicaid Services Open Payments data.





















We Found Over 700 Doctors Who Were Paid More Than a Million Dollars by Drug and Medical Device Companies — ProPublica

Tuesday, June 11, 2024

Where is My Medical Record? - Where is My Medical Record?

Your health records contain a lot of information. Here’s just some of what is in them:

  • Your medical history
  • Your family medical history
  • Your test results
  • Your doctor’s, nurse’s, and other clinicians’ notes
  • Findings from check-ups and examinations
  • Medicines that have been prescribed for you
  • Suggestions and next steps for your care
A law called HIPAA gives you the right to see all of your records from doctors, hospitals, pharmacies, and other places. HIPAA stands for “Health Insurance Portability and Accountability Act” and was passed by the U.S. Congress in 1996.

In 2016, the U.S. Congress made that rule stronger by passing the 21st Century Cures Act. The Cures Act orders hospitals and doctors to make it easy for you to see health records.

As of April 2021, “blocking” you from your health records is against the law and may result in fines for hospitals and doctors.

The new law requires doctors and hospitals to give patients access to their electronic medical records. You have the right to see them quickly and at no cost.

The problem is that some people are having a hard time finding or getting their medical records. If that is true for you, you may be experiencing medical record “information blocking.”

Review the 3 Common Situations below to figure out whether you are experiencing information blocking. Most people fall into Situations 1 and 2. When you decide which applies to you, follow our prompts to find help.

Accessing, downloading, and reading your medical record is your right. If a doctor or hospital is preventing you from getting your record, it is important to report it.

You can report “information blocking” to the Office of the National Coordinator (ONC) for Health IT (information technology). The ONC is part of the U.S. Department of Health & Human Services. The ONC is responsible for researching public complaints of information blocking.

The reporting website is a bit complicated—check it out

Why would you want your medical information?

You may want to access your medical records for many reasons.
Here are just a few:


Sharing information with other doctors or health care providers. You are going to see a new doctor or other clinician. Before you do that, make sure you review information from your current or former providers. That will help you be fully prepared to discuss your health care.
Reminders from past visits. You might want to review what was discussed in a recent healthcare visit. Studies show that patients forget or do not remember more than half of what is discussed with their doctors and other clinicians. Reading your doctor’s notes from a visit can help remind you of the next steps and instructions.
Sharing information with others helping with your health care. It is easy to share information with others who help you with your health care when you have a copy of your health records.
Find errors or mistakes. Review the information in your record to make sure it’s correct. You may find errors or mistakes. Some of them may have little or no impact on your health care, but others may be important to point out to your doctor.
Getting ready for future visits. Reading information from medical visits can help you prepare questions and topics you want to be sure to cover.
Decision-making. You might want to review past visits and notes from your doctors and nurses. Reviewing can help you make informed choices about your health care.
Better understand and manage your health and health care. Your records help you remember your past and current health care. They make it easier to ask good questions. They guide you in making choices for your care and following suggestions.
Keeping your old records. Laws about health records are different in each state. In general, doctors' offices do not have to keep copies of your old medical records. Some offices choose to shred or get rid of your health records after a few years. Keep a copy of your records in a safe place. Old records can be helpful if you develop a serious medical condition in the future.

The law clearly states your medical records are your property, not the hospital nor providers.
If they prevent your access it is a federal crime, punishable by fines.

The punishment for violating the Health Insurance Portability and Accountability Act (HIPAA) can vary depending on the severity and nature of the violation. Here are some of the potential penalties:

1. Civil Penalties:
   - Penalties range from $100 to $50,000 per violation, with a maximum of $1.5 million per year for all violations of an identical provision.
   - Penalties are tiered based on the level of negligence, from "did not know" to "willful neglect."

2. Criminal Penalties:
   - Fines up to $50,000 and/or imprisonment up to 1 year for knowingly obtaining or disclosing protected health information (PHI).
   - Fines up to $100,000 and/or imprisonment up to 5 years for obtaining PHI under false pretenses.
   - Fines up to $250,000 and/or imprisonment up to 10 years for obtaining PHI with the intent to sell, transfer, or use it for commercial advantage, personal gain, or malicious harm.

3. Other Consequences:
   - Corrective action plans and ongoing monitoring by the Department of Health and Human Services (HHS) Office for Civil Rights.
   - Potential loss of medical licenses or exclusion from federal healthcare programs.
   - Lawsuits from affected individuals or entities.

The severity of the penalties depends on factors such as the nature of the PHI disclosed, whether the violation was intentional or due to negligence, and the steps taken to mitigate the breach and prevent future occurrences. It's important for healthcare organizations and professionals to fully understand and comply with HIPAA regulations to avoid these potential consequences.


Where is My Medical Record? - Where is My Medical Record?

Monday, June 10, 2024

As Medical Care Evolves....Is your doctor a dinosaur?

Robert Pearl says that most advances in life are due to serendipity, not vision.  He outlines his unique career direction and the inevitable of advances.


Will ChatGPT be the new MD?

Top 40 Digital Health Trends In One Complex Infographic


Digestible sensors? Artificial organs? Medical tricorders? Does any of these already exist, is their development in progress, or do they only appear in our imagination? The world of medical innovations is complex and diverse, full of promising technologies but also hype and marketing. That’s why we collected the most relevant trends that shape digital health in one infographic that also explains at which stage these innovations are delivered, and which medical process and actor they influence. Check out the infographic here!

How to analyze digital health trends?



An infographic about 40 trends shaping digital health. It analyzed how promising each trend was, whether they would benefit patients or doctors; and if they would improve prevention, diagnostics, treatments, or long-term consequences. This illustration became so popular that we keep updating it, it currently exists in its third reincarnation.

Despite the updates, the basis for visually explaining the trends hasn’t changed. We still take three perspectives answering three questions to efficiently interpret the forces shaping the world of medical innovation. These are the following:

Does the trend affect patients or healthcare professionals?
Which stage of healthcare delivery and the practice of medicine is affected by the trend? Does it appear in prevention, data input and diagnostics, therapy, and follow-up, or does it rather impact patient outcomes and the consequences of certain conditions?
Is the outcome of the trend already available, is its development in progress, or does it still need some time to materialize?

For instance, along these lines, the infographic could tell that direct-to-consumer (DTC) artificial intelligence would impact prevention and diagnostics, it would mean a huge difference for patients, but its availability and applicability are further down the road. We still have to wait for a couple of years, if not decades, for DTC AI to appear in the family physician’s office. DTC is already used in many other industries.  Physicians are often late adopters of technology (EHRs)

DTC Brand Examples

Allbirds
Away
Casper
Dollar Shave Club
Glossier
Harry’s
Hims & Hers
Rent the Runway
Stitch Fix
Warby Parker

In Silico Clinical  Trials:

Imagine a clinical trial performed by artificial intelligence or an LLM?



HumMod is one of the most advanced simulations in this respect. It provides a top-down model of human physiology from whole organs to individual molecules. It features more than 1,500 equations and 10,000 variables such as bodily fluids, circulation, electrolytes, hormones, metabolism, and skin temperature. HumMod aims to simulate how human physiology works, and claims to be the most sophisticated mathematical model of human physiology ever created. HumMod has been in development for decades and it is still far from completion. It may take decades to get there.

Most of these will take considerable time to translate to daily clinical medicine and are presently used for testing purposes in nonclinical situations.  They will all require vetting by the Food and Drug Administration.



























Top 40 Digital Health Trends In One Complex Infographic

A new mobility guide for the blind

The 'white cane' in the digital age.  This is an autonomous driving cane for the blind.  Fashioned after the autonomous driving automobile.  It uses sensors such as infrared, cameras, and lidar to move through the environment avoiding obstacles, and sensing stairs and people.




Much like the autonomous vacuum, or autonomous automobile, the system can follow a map to guide a blind patient around his environment


Take this image and downsize it to be used in the head of the cane.  The wheels in the base will rotate per the obstructions.  The head of the cane will have vibration motors that the patient can feel for tactile guidance.









NATIONAL HEALTH SERVICE TO OFFER. PHYSIOTHERAPY USING A.I.

The NHS will open its first "AI-run physiotherapy clinic" to cut waiting times amid growing demand and staff shortages. An inevitable step that many other health providers will also have to take.

The new platform (the first to be approved by the health regulator) will provide same-day automated video appointments with a digital physiotherapist via an app that responds to information provided by a patient in real-time.

In short, a digital platform, a generative AI agent, and a video database.

What do patients think about it?

"𝐴𝑙𝑙 𝑜𝑓 𝑡ℎ𝑜𝑠𝑒 𝑠𝑢𝑟𝑣𝑒𝑦𝑒𝑑 𝑝𝑎𝑡𝑖𝑒𝑛𝑡𝑠 𝑓𝑟𝑜𝑚 𝑡ℎ𝑒 𝑁𝐻𝑆 𝑝𝑖𝑙𝑜𝑡 𝑠𝑎𝑖𝑑 𝑡ℎ𝑒𝑖𝑟 𝑒𝑥𝑝𝑒𝑟𝑖𝑒𝑛𝑐𝑒 𝑤𝑖𝑡ℎ 𝐹𝑙𝑜𝑘 ℎ𝑎𝑑 𝑏𝑒𝑒𝑛 𝑎𝑡 𝑙𝑒𝑎𝑠𝑡 𝑒𝑞𝑢𝑖𝑣𝑎𝑙𝑒𝑛𝑡 𝑡𝑜 𝑠𝑒𝑒𝑖𝑛𝑔 𝑎 ℎ𝑢𝑚𝑎𝑛 𝑝ℎ𝑦𝑠𝑖𝑜𝑡ℎ𝑒𝑟𝑎𝑝𝑖𝑠𝑡, 𝑎𝑛𝑑 𝟧𝟩% 𝑜𝑓 𝑝𝑎𝑡𝑖𝑒𝑛𝑡𝑠 𝑠𝑎𝑖𝑑 𝑡ℎ𝑒𝑦 𝑡ℎ𝑜𝑢𝑔ℎ𝑡 𝑡ℎ𝑒 𝐴𝐼 𝑒𝑥𝑝𝑒𝑟𝑖𝑒𝑛𝑐𝑒 𝑤𝑎𝑠 𝑏𝑒𝑡𝑡𝑒𝑟."

The provider behind the platform is called @Flok.

The first NHS AI-run physiotherapy clinic is to be rolled out this year to cut waiting times amid growing demand and staff shortages.

The new platform will provide same-day automated video appointments with a digital physiotherapist via an app that responds to information provided by a patient in real-time.

It is the first platform of its kind to be approved by the health regulator, the Care Quality Commission, as a registered healthcare provider.

Patients seeking physiotherapy for issues such as back pain can be referred to the platform Flok Health through a community or primary care healthcare setting, such as their GP. They can also self-refer directly into the service.

The service aims to provide faster care and reduce waiting times and pressure on clinicians, those behind it say.


HOW IT WORKS

Get assessed

Where we’ve been contracted by the NHS in your area (or your insurer) you can self-refer straight to our service - no need to go via your GP. Your first appointment with Flok will be with our AI-powered digital doctor, who will ask you some questions to assess your back pain and ensure our digital treatment is right for you.


Get treatment

If physiotherapy is likely to be effective for you, we'll prescribe you a series of weekly appointments with our digital physio. Each appointment is like a 30-minute video call, except our side of the call is created by our AI engine in real-time, just for you. You can answer questions and your digital physio will respond to you live, in a continuously generated personal video stream.




Get better

During each of your appointments, your digital physio will prescribe a set of exercises for you to practice for the coming week before your next appointment. These exercises are specifically selected for you based on a detailed analysis of your symptoms and movement patterns. Our app guides you through practicing your exercises between appointments and helps you see your progress and stay on track.

An A.I. guided physiotherapy session will provide not only a visual interaction but also an interactive audio session.  The therapist will ask questions of the patient, such as 'where does it hurt?  Is it tender, does it hurt more if you move it. A patient can ask questions such as  "How long will it last?"


Sure! I can help you develop a chatbot for physiotherapy to facilitate communication between a patient and a therapist. Here's a basic outline of how the chatbot could be structured:

1. **Introduction and Assessment**
   - The chatbot greets the patient and introduces itself as a physiotherapy assistant.
   - It asks the patient to provide some basic information, such as their name, age, and any relevant medical history.
   - The chatbot may also ask the patient about their current symptoms, pain levels, and any specific areas of concern.

2. **Educational Resources**
   - The chatbot can provide educational resources on various physiotherapy topics, such as common injuries, rehabilitation exercises, and proper posture.
   - It can share articles, videos, or infographics to help the patient understand their condition and the therapeutic process better.

3. **Treatment Plan and Exercises**
   - Based on the information provided by the patient, the chatbot can provide a general overview of the treatment plan.
   - It can suggest specific exercises or stretches tailored to the patient's condition, along with instructions and visual aids.
   - The chatbot can also remind the patient about the importance of consistency and adherence to the treatment plan.

4. **Progress Tracking**
   - The chatbot can periodically check in with the patient to assess their progress and gather feedback.
   - It may ask questions about pain levels, functional improvements, or any difficulties encountered during exercises.
   - The chatbot can maintain a record of the patient's progress and update the therapist accordingly.

5. **Appointment Scheduling and Reminders**
   - If the patient needs to schedule or reschedule an appointment, the chatbot can provide available time slots and assist in booking.
   - It can send automated reminders about upcoming appointments, ensuring the patient doesn't miss any sessions.

6. **FAQs and Support**
   - The chatbot can have a database of frequently asked questions and provide instant answers to common queries.
   - If the patient requires additional support or has specific concerns, the chatbot can offer guidance and suggest reaching out to the therapist for further assistance.

7. **Referrals and Emergency Situations**
   - If the chatbot detects any emergency situations or symptoms that require immediate attention, it can provide instructions to contact emergency services.
   - In cases where the patient's condition falls outside the scope of the chatbot's capabilities, it can recommend seeking in-person medical advice or referring to a specialist.

It's important to note that while a chatbot can be a useful tool, it should not replace the expertise and personalized care provided by a qualified physiotherapist. The chatbot should always encourage the patient to consult with their therapist for a comprehensive evaluation and individualized treatment plan.










https://www.linkedin.com/news/story/nhs-to-offer-patients-ai-physio-6794986/