Heart Attack on The Health Train Express

HOW TO SURVIVE A HEART ATTACK WHEN ALONE

source: Google + Stream

Disclaimer ! Health Train Express nor it's author endorses this method of self CPR. The user must judge for themself whether to do this or not... The user accepts full responsibility, regardless of the outcomes. Note: Medicare does not allow for reimbursement...do not bill Medicare.

Let's say it's 6.15pm and you're going home (alone of course),
after an unusually hard day on the job. You're really tired, upset and frustrated. Suddenly you start experiencing severe pain in your chest that starts to drag out into your arm and up into your jaw. You are only about five miles from the hospital nearest your home. Unfortunately you don't know if you'll be able to make it that far. You have been trained in CPR, but the guy that taught the course did not tell you how to perform it on yourself..!!
KNOW HOW TO SURVIVE A HEART ATTACK WHEN ALONE..
Since many people are alone when they suffer a heart attack, without help, the person whose heart is beating improperly and who begins to feel faint, has only about 10 seconds left before losing consciousness.
However, these victims can help themselves by coughing repeatedly and very vigorously.
A deep breath should be taken before each cough, and the cough must be deep and prolonged, as when producing sputum from deep inside the chest.
A breath and a cough must be repeated about every two seconds without let-up until help arrives, or until the heart is felt to be beating normally again.
Deep breaths get oxygen into the lungs and coughing movements squeeze the heart and keep the blood circulating.
The squeezing pressure on the heart also helps it regain normal rhythm. In this way, heart attack victims can get to a hospital.
Rather than sharing jokes please.. contribute by Sharing this which can save a person's life!!!!

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A better idea: Use LIFE ALERT

Obama Whitehouse Hangout…what does it have to do with Health Care….NOT

 

I happened to sit in on the Google + Hangout on the Live Stream. There were only five active participants allowed. The questions were drawn from a pool of pre-submitted YouTube videos sent to the Whitehouse. Initially the guidelines were the most popular questions or watched videos watched by YouTube Videos would be addressed.  However at the last minute the guidelines were changed to the White House Selected questions.

The questions were from the usual list of candidate debate issues. It was a well manicured session from ‘the groupies’ with all smileys and nods,and thank you Mr. President.One of the questioners grilled Mr. Obama about the lack of employment opportunities for engineers, one sector of the economy that is supposedly was recovering quickly  Mr. Obama went so far as to ask one of the participant spouse’s to send his professional resume to him to assist his job search in engineering.

Some topics avoided:  SOPA, OWS, Education Costs

There was no discussion about healthcare and/or Obama care.

Mr. Obama and his managers obviously think healthcare is off the radar.

Even if healthcare was on the radar the committee of inquisition would not have known the right questions.

 

1. Will there be an ACO in my neighborhood? (Will I even have a doctor?)

2. Why doesn’t my doctor look at me during my visit instead of his computer?

3. Why did Google hibernate it’s Google Health personal health record?

4. Why (an what is) a Medicare Demonstration Program ?  Why haven’t the results been widely published from the Congressional Budget Office regarding their failure to control costs.?

5.Can HIPAA be waived voluntarily by patient and provider for the use of social media to improve efficiency and drive down the number of office visits and expense?

I summed it up like this when I was asked how it went. My response,  “I decided at half time to go out to get soda, popcorn, and a hot dog, then decided not to go back. The second half was like the first. no last minute touch down runs….interceptions, or fumbles.   At least the hot dogs were ballpark fresh !

reddit Tags: White house hangout, obama hangout, obamacare, medicare reform, demonstration project

Pilot Programs—A Waste of Tax Dollars

Vindicated ! I have always been of the opinion that ‘pilot studies’ are a good waste of the taxpayers money. HHS and CMS seem addicted to these studies. It is almost like sending a program ‘out to bid’. John Goodman just seconded my motion of three years ago, and I do not belong to any Foundation ‘study groups’. I thank John Goodman for doing the hard hands on work to prove my hypothesis. The CMS Demonstration Projects are a good example of pilot programs

Most of these pilot programs are modeled after other ‘exceptional program’ already in progress. The selection criteria is the cost of Medicare services in specific regions of the country and an attempt to duplicate practices in each of these regions. Keep in mind this is a report from the CBO (Congressional budget office) which is only one measure of success or failure of a project. Nothing is said about quality of outcomes, return on investment of new paradigms of bundled payment, readmission to hospitals, morbidity or mortality reports.  It is a report from an agency totally separate from HHS or     CMS.

Successful innovations are produced by entrepreneurs, challenging conventional thinking — not by bureaucrats trying to implement conventional thinking.

On the supply side, we have the islands of excellence (Mayo, Intermountain Healthcare, Cleveland Clinic, etc.). On the demand side, we have a whole slew of experiments with pay-for-performance and other pilot programs designed to see whether demand-side reforms can provoke supply-side behavioral improvements. And never the twain shall meet

Can you think of any other market where the buyers of a product are trying to tell the sellers how to efficiently produce it?

Well put John Goodman. You have articulated well my meager general common sense approach and decades long observations of clinical practice.

Once again, ‘boots on the ground’ can quickly size up a problem.

Read John Goodman’s article on the Health Care Blog

digg Tags: cms, demonstration project, pilot program, outcome study, health train express, health care blog

Health 2.0 India

Health 2.0 India Conference #health2india
This meeting should be extraordinary given that so much software development originates in Asia.
I invite the attendees to tweet using the  hashtag given by Matt Holt  #health2india.
I am providing information about Google Plus Hangouts. The invitation will be in my Google + stream   +Gary Levin  Instructions for joining and using Google + and hangouts are readily available via Google + and searching. I will also send invites to anyone who wants to receive a direct link, Just send me your email.
Here’s the link to look at G+ and see if you want to prepare early.
Join Google +
The Hangout will open in 6 hours (Sunday) (6 PM PST)  Monday 7AM (Delhi) It will be operational from 7AM to 7PM Delhi time.
Other participants can open their own hangout, however hangouts cannot be initiated on smartphones or tablets unless you are on Wi-Fi.

Health Train #

No, the # sign is not an unprintable explicative. Any tweep recognizes # as the hashtag for identifying interest group. The one we use most often in health social media is #hcsm (health care social media). If you search using the # it will identify and stream that interest.  If you are sending a tweet using that # it will appear in those tweeps who are searching for #hcsm. It is a bit like the Search of twitter like Google Search.

The Foxe group provides the definitive wiki for #hcsm. T. Lee has developed a glossary of hashtags for specialties, conferences,diseases and more. The Fox Group had the prescience to develop a division strictly devoted to social media in all of it’s iterations.

We are still working out some ‘bugs’ in the new template(s)  Our blogroll and other items of interest do not appear in the templates other than in the ‘classic’ view. Our webmaster (me) is working feverishly on this with Larry Paige’s staff.

Despite Google hibernating Google Health there is still a strong interest in the Health Space. Health Train is encouraging this interest. Google has the power, market influence and capital to do some great innovative things in supporting healthcare, such as chrome books and the android operating system which is ‘open source’.  Many great innovations (like health and medical science advances) are developed by young developers, many of whom do not work directly for Google.  It is amazing how much of it is from high school students who are not employed by anyone and who either donate their ideas or are paid on a contract basis.

I encourage you all to search Google for their product development division to open a dialogue with your ideas.

For now, Health Train Express is leaving the station, bound for our next stop.

del.icio.us Tags: healthcare social media,google,google hangouts,chromebook,blogger dynamic view

What Will Google + Hangouts Offer ?

 

Anyone who has been observing social media can see that Social Media adoption in Medicine will make electronic medical record adoption seem turtle slow, , and SM has not required governmental funding or incentives. No you won’t be penalized financially for not adopting it, and it’s meaningful use becomes apparent without a cookie cutter list developed by some unknown bureaucrats who have never seen, treated or healed a patient.

Google has a winner in Google Hangouts….almost as large an impact as the original Google claim to fame…SEARCH .

Here are only some of the things doctors and their staff will be using it for.

1 Human Resources:  Interviewing job candidates with two or three of your staff in the hangout.  Prospective employees will be able to share documents right in the hangout. Your staff can “grill” the candidates and size them up. This will save enormous time for both sides in the process of hiring. Unemployed people do not have much disposable cash for driving to interviews.

2.Purchasing: A hangout with your supplier or medical device representative to ask questions and receive direct video feedback on items you wish to purchase.

3.Pharmacy reps no longer have to visit you directly to talk about their new wonder drugs.  However food cannot be served in the hangout. You can order Domino’s Pizza online.

4. Medical Management meetings between you, your consultants and staff members.

5.There are many other potential uses for G+ Hangouts, I am sure your staff and patients will think of many more.

The new dynamic view is in full swing, and I hope you are enjoying it. You may have noticed you have a choice of views from the tabs on the top banner. I like Flip board due to it’s ability to find older posts without scrolling.

Our next step will be integrating Google + Hangouts directly from the blog where you will be able to Join Me in my hangouts to offer criticism, and knowledge. You will be able to share documents, you tube videos, and windows running in the background, such as spreadsheets, slide programs, and PowerPoint decks.  Isn't technology great?!

  Who will rule, after man destroys himself?

del.icio.us Tags: google +,hangouts,bloggers,social media

Health Train Makeover

About a year ago I had thoughts about a major change in the Health Train layout. Well, I thought about it, and thought about it, and thought about it some more. Much happened in health reform, health IT and also in social media during 2011 As it turned out I am  happy I waited..

Six months ago 64% of physicians were using social media. In January 2012 over 95% of MDs were using social media in some form in their medical practice routine.

Health Train Express was one of the first health related blogs in the  social media stream;  we have been a loyal user of the blogger platform all these years (almost ten years)

Under-rated blogger has given us consistent performance all along. It is much simpler to use than WordPress, Drupal and other blog platforms. 

It suffers from the illusion that since it is not a standard .com domain it receives less respect among bloggers.  Platforms however do not make the content.

The announcement  Health Train Express will transform later today or tomorrow onto the new Blogger dynamic platform. This will create an exciting visual display of posts which will easily allow access of older posts and archived posts without a more……tab at the bottom of each page

As you may know Blogger has been owned by Google for some time. You also know that Google turned of it’s Google Health Platform on December 3, 2012.

Look for the

          

The change will create a tight integration with most of Google’s services and applications. Health Train Express will also be  available as a Google Page.

It will increase it’s readership and visibility using all of Google’s power with integration into Google plus with each post and also enable real-time access to Google Hangout’s for those who wish to do so. There will be a Google + widget to enter our Google + stream and any active hangouts.  If you own a Google plus ID it will allow you to send an invitation to Health Train Express’ hangouts by way of a ‘JOIN’ button that pops up in our G+ stream, our email and a pop-up Google IM chat box. 

It may be several days until all is working smoothly.

Health Train Express is now aggregated by Health Works Collective, Friendfeed, Social Media Today, Summify,

del.icio.us Tags: Google+hangouts,health train express social media,#hcsm,dynamic view,blogger

Obama Care Makes Medicaid An Offer States Can't Refuse

 

Have the feds stepped over the line? It would appear so according to a report  from Forbes Magazine. Peter Ferrara reports the Social Security Institute (not to be confused with the  SSA) and the American Civil Rites Union (ACRU) filed an amicus curiae brief at the Supreme Court.arguing that Obama Care's expansion and transformation of the Medicaid program violates the Tenth Amendment under the Court’s Coercion Doctrine.  In overstepping the bounds between acceptable pressure and unacceptable compulsion, Obama Care transgresses state sovereignty and violates the constitutional framework of federalism.

Without going into great detail the Medicaid requires an all or none approach to receiving federal matching funds. A refusal to accept the mandate could lead to a loss of all Medi-caid matching funds.

Medicaid is an all-or-nothing, take-it-or-leave-it proposition for the states; they must comply with all federal terms and conditions as a requirement of participating in any part of the program.  Consequently, Medicaid has become a contract of adhesion, which gives the appearance of mutual consent between both parties but, in fact, allows one party to impose terms on the other party who has no real ability to negotiate terms due to its extremely unequal bargaining position.

To change the terms so drastically to the detriment of the states of what might originally have been a truly “voluntary” program—now, after the states have become financially dependent on (literally addicted to) the federal aid it offers—saps all semblance of “voluntariness” from Medicaid.

The brief calls this ‘unacceptable coercion’ and violates the terms of the tenth amendment of the U.S. Constitution.

 

del.icio.us Tags: obamacare,supreme court,medicaid,constitution

Obama on the Health Train

(AP)

Some say;

This is the year that will make or break the health care law  States were supposed to be partners in carrying out the biggest safety net expansion since Medicare and Medicaid, and the White House claims they're making steady progress.

However, Three out of four uninsured Americans live in states that have yet to figure out how to deliver on its promise of affordable medical care.

It reveals a patchwork nation. If it continues, it will mean disparities and delays from state to state in carrying out an immense expansion of health insurance scheduled in the law for 2014. That could happen even if the Supreme Court upholds Obama's law, called the Patient Protection and Affordable Care Act.

 

About half the states are suing to overturn the law. The Obama administration says uninsured patients have nothing to fear. Steve Larsen, director of the Center for Consumer Information and Insurance Oversight at the federal Department of Health and Human Services.says “"The fact of states moving at different rates does not create disparities for a particular state's uninsured population,"

That's because the law says that if a state isn't ready, the federal government will step in. Larsen insists the government will be ready,

Easier said than done.  It’s complicated. Some of the necessary steps follow.

Someone has to set up health insurance exchanges, new one-stop supermarkets with online and landline capabilities for those who buy coverage individually. Many states have refused to do this.

A secure infrastructure must be created to verify income, legal residency and other personal information, and smooth enrollment in private insurance plans or Medicaid.(this sounds like a lot of duplication and paperwork. It also  raises the specter of the IRS and State taxation agencies providing data to the HHS or State Health Departments. (or send your W2s to the State HIE, and then they will cross check with the IRS….That sounds very ominous but should be no surprise seeing how Congress passed NDAA and almost did the same with SOPA. note: Secure infrastructure? Does this sound like health care and/or health insurance?

Over half the states are suing the federal government, which will be heard by the Supreme Court this spring. Not much will take place at the state level until there is a decision regarding constitutional issues.  It is pitiful that the states had to resort to quoting the constitution when there are so many other good reasons for not enacting this financially irresponsible mandate..

The startup, re-organization and continuing maintenance of these new bureaucracies will undoubtedly devour any ‘savings” predicted from ACOs, revisions of payment methodology based upon better outcomes and improved quality of care.

The final coup d’ etat  is the state of the economy where job production is poor. These added responsibilities will not foster new businesses, nor jobs.

So be insured, and remain unemployed. Does it have to be one or the other?

How about some sensible moderation and common sense? Is anyone listening in Washington?

del.icio.us Tags: obamacare,health insurance exchange,supreme Court,constitution,ndaa,sopa,pipa

Mobile Technology Is Transforming The Health Industry

 

Mobile Technology Is Transforming The Health Industry, But To What Extent?

Dave Chase

Technology is in the process of bringing change to every piece of the health industry — wellness, fitness, healthcare, medicine — you name it. And as it always seems with introduction of new technologies, it’s awe-inspiring how quickly they can transform entire industries yet, at the same time, make us realize just how far we have to go (or how far behind we really are). The health industry has been touched (and defined) by cutting-edge technology for years, yet its relics, legacy infrastructure, paper-pushing, and archaic procedures are as obvious today as ever before.

Mobile Technology for health  can be classified in two categories:

Physician oriented: Apps designed to access reference materials, calculators, formularies, eRx, EMR remote access, Social Media, Calendaring, email, Video Conferencing, Algorithms

Patient oriented:Health Knowledge Base, Remote monitoring sensors, like Basis’ heart and health tracker,Lark, Fitbit, and Jawbone’s Up.

Some mobile apps interface patient and physician, Mobile devices will also change the way that we communicate with our doctors, as physicians may help describe possible treatments or procedures to patients on an iPad using multimedia, visual cues, genomic/anatomical maps, etc., prescribe post-treatment apps to our smartphones so that treatment doesn’t end once you walk out the door of the hospital, or become a conduit for modern communication platforms, a la Skype, that will facilitate remote checkups, treatments, diagnostics, through the phone, or over video. Got a strange looking rash? Take a picture, or scan it on this app. Telemedicine is there in a pinch!

All this has developed almost spontaneously with the development of competing hardware devices and software which is open source. and at affordable prices given the size of the patient market. The primary ingredient is innovation, entrepreneurial spirit, and with little governmental funding and/or intrusion.

Contrast this with the stuttering acceptance of EMRs and HIEs with government mandates, artificial support with incentive subsidies to support the HIT vendor market. The real beneficiary for CMS’ incentive program are the HIT vendors, not patients, not doctors nor insurers. The data collectors will benefit from the system which will be mined for the benefit of cost containment and perhaps better outcomes.

del.icio.us Tags: health 20,mobile apps,mobile technology,emr,hie,hit

Social Media in a Hospital Bed

 

No this post is not about pubescent hormonal hyper sexuality nor the story about the sex life of fan boys or fan girls,  G+strings,, or tantalizing twitter tweepes. It is a story about Fred and Regina Holladay and their experience (bad) when Fred was diagnosed with advanced Renal Cancer.

Dr. to Dr.

View more presentations from Regina Holliday

The program is self-explanatory and does not require expansion here.

del.icio.us Tags: hospitals,social media,healthcare,cancer,twitter,facebook,Google plus

Bold New Approach to Funding Medical School Tuition

 

Over the past ten years both college and medical school tuitions have increased in some cases four times. This has effected college graduates and physicians. Tuition at the state run UC system in 2001-2002 was $ 3429 and has risen to  $13,200 per year. This places an extraordinary debt burden on students at a time when they have little income.

In California which has faced the perfect storm of decreasing revenues in the face of economic distress Chris Occasion, President of the FixUCR movement at the University of California presented a manifesto

Their manifesto is the UC Student Investment Proposal, which calls for eliminating the upfront costs of college and having working graduates pay 5 percent of their salary back to the system for 20 years.

The idea was conceived by students, and although designed for the UC system could very well be adapted to  other states and private universities.

The investment proposal concept has captured the attention of the Board of Regents of the UC system and was a concept previously studied and discussed by Robert Reich former Secretary of Labor under the Clinton Administration. He presented a similar idea in 2008 for California’s  mounting fiscal stresses. Economists at the time termed the financial plan feasible however it was deemed politically undoable. This would not be the same for privately funded schools of higher education.

A similar perfect storm has developed in health care and medical education which is even more expensive and extended eight years up to twelve years. And while college graduates may complete undergraduate education with a $100,000 debt load, some physicians will  exit from medical student and

training with up to $ 250,000 debt.

Health reform promises two events, more insured patients, decreased reimbursements and a shortage of primary care physicians (family physicians).This will decrease ability for  physician graduates to repay  education loans. Adjusting payment rates as a percentage of income adjusts for future changes in income.

Many well qualified students rule out medicine as a career because of it’ prospect of prolonged poverty and what often appears to be insurmountable debt. Some highly qualified  students will change career goals

ref: Zimmerman, Riverside Press Enterprise.com

del.icio.us Tags: college,tuition,loans,debt,primary care,physician shortage,education loans

5% of patients account for half of health care spending

USA TODAY reports that 22 % of healthcare spending is from less than 1% of patients.(2009).

That's about $90,000 per person, according to the Agency for Healthcare Research and Quality. U.S. residents spent $1.26 trillion that year on health care.

Five percent accounted for 50% of health care costs, about $36,000 each, the report said.

Why is this number so important? According to AHRQ the report showed how a tiny segment of the population can drive health care spending and that efforts to control cost should focus on this segment to improve efficiency using new technology, outcome studies,

About one in five health care consumers remained in the top 1% of spenders for at least two consecutive years, the report showed. They tended to be white, non-Hispanic women in poor health; the elderly; and users of publicly funded health care.

•Sixty percent were women

•Forty percent were 65 or older.

•Only 3% were ages 18 to 29.

•Eighty percent were white.

•Only 2% were Asian.

The  found that Hispanics, 16% of the population in 2009, spent less on health care. Twenty-five percent of Hispanics were in the bottom half of health care spenders, the report showed, while only 7% of Hispanics were in the top 10% of spenders.

Next, Cohen plans to look at whether cost-cutting measures make a difference. Beginning in October 2012, the government has told hospitals with Medicare patients that it will no longer pay for patients who are readmitted to hospitals for the same condition soon after being released. Cohen said he'll look at whether that will change the spending averages for people in the top health care cost brackets.

Another way of stating this is, “unmarried women” (uninsured) (or Medicaid)  and  old people on Medicare

del.icio.us Tags: health consumer,medicare reform,medicaid,usa today