Minimization of Human Error within the Scope of Health Information Management

There can be no doubt that the HIM field has become increasingly complex as it has evolved.  Though this evolution has brought about innumerable benefits, it has also brought about a degree of risk that could be considered directly proportional to the former.  This risk is associated primarily with human error and the potentially adverse effects such error may cause.

It is clear that simple mistakes during patient registration can have far-reaching consequences.  Such mistakes can take the form of duplicate records or even erroneous records due to the confused entering of information into other individuals’ files.

The problem begins at registration, which is typically burdened by time constraints.  Most registrars are instructed to enter a patient into the system within two minutes upon arrival so that treatment may be promptly administered.  Erroneous or duplicate file information can be either due to pure accident or, unfortunately, negligence during the registration process.

What is particularly problematic about faulty patient information is that it eventually filters through the larger and more circuitous medical information framework which could potentially cause incidences such as faulty billing, unnecessary treatment (which may prove quite dangerous depending on the circumstance), or wasted time and money in the pursuit of correcting inaccurate file information.

The operational gap between patient registration and HIM departments seems to have led to the exasperation of these problems.  This reality has been recognized by medical professionals and subsequently has lead to the creation of less distance between the two entities, effecting remarkable results.

It has widely become protocol for HIM departments to work more closely with registration staff, providing individuals with feedback and education regarding the consequences of faulty medical recording.  Not only this, but many institutions have set higher standards for the minimization of mistakes during the entrance process, some implementing layoff at three cumulative faulty registrations per year.  Alterations in communication between these departments has lead to vast improvements, the likes of a nearly 60% decrease in duplication rates within some institutions.

Essentially, what was once a considerable problem is now far less of one thanks to the ingenuity of HIM professionals.  The result is less correction, less patient injury, less time, and less money.

Questions: Do you think registration errors are a problem in the facility you work at? Do you have any ideas as to how this process can be improved?

About the Author:  Patricia Heise is a Staff Writer with the Clear Medical Solutions Communication Team.  Her work is regularly shared on the Clear Medical Agency newsletter and the ClearManagementMatters.com blog.

Resources:
Dimick, Chris. “Exposing Double Identity at Patient Registration.” Journal of AHIMA 80, no.11 (November 2009): web extra.

The Clear Medical Network

With the rapid improvements in technology and communication, social networking is thriving and full of new potential.  Sites like Facebook, Twitter and LinkedIn are known among all people, young and old.  As the dynamics of online communication are quickly becoming more important, companies are adapting to the trends.  One example is the Clear Medical Network. 

It was formed to provide an avenue for networking, discussion, and fun among all different healthcare professionals, as well as provide opportunities through consulting projects, leadership positions, and per diem work to all its members.  Many nurses have already joined the free network and are intruigued about the opportunities that have already come their way. 

Members are also informed of any upcoming fun events in their area.  One example is the Nurses Night Out event planned every year during Nurses week, as well as the discounted 8 day cruise next year to the Mexican Riviera!  Starting at $319/person, this is not only great fun, but it’s a great value too.

Joining the network is free and takes less than a minute.  Once registered, members are informed of different forums they can join to network with other healthcare professionals within nursing as well as other areas of healthcare. 

If you are interested in joining, the site is www.ClearMedicalNetwork.com.  

There really is no downside, and it’s sort of fun to see the other side of things from the perspective of Doctors, PTs, HIM Directors, or any of the other professions that are getting involved.

Questions: What do you think of the Clear Medical Network?

About the Author: Sarah Fore is a Staff Writer with the Clear Medical Solutions Communication Team.  Her work is regularly shared on the Clear Medical Agency newsletter and the ClearHIMMatters.com blog.

Health Information Technology and the Stimulus Package: Information and Changes for the Public and Employment Opportunities

Health information technology (HIT) is a broad term used to describe the digital storage, managem ent, and secure exchange of health information between patients, providers, government, and insurers.  The information being exchange primarily refers to but is not limited to Electronic Health Records (EHRs are sometimes called electronic medical records (EMRs)).

Earlier this year, Obama’s American Recovery and Reinvestment Act of 2009 (the Stimulus Bill) was signed into law.  One part of the Stimulus Bill; the Health Information Technology for Economic and Clinical Health (HITECH) Act, aims to increase the use of an EHR by doctors and hospitals by:

• “Requiring the government to take a leadership role to develop standards by 2010 that allow for the nationwide electronic exchange and use of health information to improve quality and coordination of care.”
• “Investing $20 billion in health information technology infrastructure and Medicare and Medicaid incentives to encourage doctors and hospitals to use HIT to electronically exchange patients’ health information.”
• “Saving the government $10 billion, and generating additional savings throughout the health sector, through improvements in the quality of care and care coordination, and reductions in medical errors and duplicative care.”
• “Strengthening Federal privacy and security law to protect identifiable health information from misuse as the health care sector increases use of Health IT.”

Information and Changes for the Public:
Health information technology and electronic health records will not only improve patient care but also change the way we experience health care.   Even the best doctors can make mistakes or unintentionally overlook important details; an EHR will reduce the risk of these errors.   EHRs negate mistakes made due to sloppy handwritten notes.  They have automatic drug-drug/ drug-food interaction and allergy checks, and since they are online, standard drug dosage information and educational patient information can also be accessed.  Built- in alerts remind doctors of preventive care timelines, and can track referrals and test results.

Another major advantage of EHRs is they are maintained digitally and once they progress to their full potential, they can be accessed from anywhere.  Because it is simple to back-up this data to another location, EHRs also guarantee information will never be lost or damaged as a result of a natural disaster.  In the event of an emergency hospital visit or sickness while away from home, a doctor will immediately be able to pull up a patient’s chart and access information potentially crucial in diagnosing and treatment.  Referral doctors will be able to see any treatment a patient is undergoing by other doctors and make decisions that will not interfere with that treatment.

Though there are many benefits, HIT is not without its drawbacks.  Advocacy groups like the ACLU are wary of HIT and question how secure confidential medical records will really be if they are kept digitally online.  The potential for online medical records to be hacked is real and very serious; electronic databases and servers regularly experience hack attempts and an EHR would be no different. 

It is easy to placate the fear of EHRs being hacked and find comfort in the idea that “if someone really wanted my medical file they could just as easily break into my doctor’s office.”  This leads to the conclusion that “nobody would break into my doctor’s office to steal my records, because I am simply not that important.”  However, hacking into an EHR system is not the same as breaking into your doctors.  The threat of your EHR being attacked is not only about your personal health information; hacking into an EHR means gaining access to everyone’s valuable health information.  Hackers could sell the information found in the nation’s family histories, mental health history, test results, current medication, etc… or use it to bribe and blackmail people in countless ways for countless amounts of money.  Even worse, they could change the EHR causing unimaginable damage.

However, the benefits of an EHR far surpass the risks.  The government is working hard to minimize the threat of hacking.  Part of the HITECH is to strengthen “Federal privacy and security law to protect identifiable health information for misuse as the health care sector increases use of Health IT.”

Information and Changes for Employment:
Employment for medical records and health information technicians is very good and is expected to grow faster than the average professional field.  The projected employment for 2016 is 200,000.  That is 30,000 more than 2006 or an 18% increase.  Physicians’ offices, home health care services, outpatient care centers, and nursing and residential care facilities will have the most job growth and creation of new jobs.  Job growth in hospitals will not be as great but new jobs will still be created.

The growth of HIT and increased use of EHR will benefit everyone and is not something to be scared of.

Questions: Does anyone work in a facility that has already implemented an EHR?  Have you experienced or do you foresee any other problems or risks with an EHR other than hacking?

About the Author: Erika Christenson is a Staff Writer with the Clear Medical Solutions Communication Team.  Her work is regularly shared on the Clear Medical Agency newsletter and the ClearManagementMatters.com blog. 

References:
Bureau of Labor Statistics.  Occupational Outlook Handbook, 2008-2009 Edition.  Medical Records and Health Information Technicians. http://www.bls.gov/oco/ocoS103.htm

Title IV- Health Information Technology for Economic and Clinical Health Act.  January 16, 2009.  http://waysandmeans.house.gov/media/pdf/110/hit2.pdf

Why Consumers Need to Demand More From Drug Companies

A recent article in the New England Journal of Medicine, Lost in Transmission- FDA Drug Information That Never Reaches Clinicians reported that key information is missing from prescription drug labels.  Authors Dr. Lisa M. Schwartz and Dr. Steven Woloshin wrote, “Much critical information that the Food and Drug Administration (FDA) has at the time of approval may fail to make its way into the drug label and relevant journal articles.”  They go on to explain, “FDA approval does not mean that a drug works well; it means only that the agency deemed its benefits to outweigh its harms” and “drug labels are written by drug companies, then negotiated and approved by the FDA.”

 Schwartz and Woloshin profile three drugs, Zometa, Lunesta, and Rozerem as examples of how drug labels are missing information.  All three drug labels were indeed missing information.  In their review of Lunesta and Rozerem however something stands out, both Lunesta and Rozerem had intense direct- to- consumer advertising campaigns.  Lunesta is reported have spent more than $750,000 a day in its 2007 advertising campaign and to have sales reaching almost $800 million last year.  Rozerem is described as being “aggressively promoted to consumers.”  This information could easily be omitted from the article without detracting from the issue of drug information not reaching clinicians; the inclusion of this information is interesting.

In 1997 the FDA issued new regulations governing television advertising of prescription drugs; following this change direct- to- consumer drug advertising soared.  Prescription drugs became commercialized; direct- to- consumer advertising repackaged drugs into a shiny product to be sold to the public.  In this light, is it surprising that drug companies would over exaggerate the benefits of their drug and down play the risks?   The purpose of advertising is to make consumers think they need a product and make them want to buy it; drug companies are no different.  Consumers have learned to be skeptical of the dubious claims made by advertisements but direct- to- consumer drug advertising is new.  Consumers have more faith in the claims made by drug companies because the idea that drug companies might manipulate information at the risk of the consumer is so unsettling.

By including information on the direct- to- consumer advertising campaigns of Lunesta and Rozerem, Schwartz and Woloshim provide further insight into the motivations (money) behind excluding certain information from drug labels.  It also highlights how for years the public has accepted and believed the claims of drug companies without question despite numerous incidents of drug companies being exposed as less than forthright.  You can be angry with the drug companies for omitting information or mad at the FDA for not making it easier to access the information.  But isn’t it time we as consumers start to demand more from drug companies?

Questions: Do you agree with the above statement that as consumers, it is time to start demanding more from drug companies?  Have you experienced any type of negative side effects to your medication that was not listed on the label?

About the Author:  Erika Christenson is a Staff Writer with the Clear Medical Solutions Communication Team.  Her work is regularly shared on the Clear Medical Agency newsletter and the ClearHIMMatters.com blog. 

References:
Lost in Transmission- FDA Drug Information That Never Reaches Clinicians
http://healthcarereform.nejm.org/?p=2126&query=home

HIPAA and Its Implications

From its birth in the U.S. Congress in 1996, HIPAA has played both normative and authoritative roles with respect to patient privacy as well as health insurance security.  The Health Insurance Portability and Accountability Act (HIPAA) is composed of two separate Titles, each pertaining to issues of health insurance protection for employees and their families during a change or loss of occupation, and medical record privacy.  This article will consider Title II of the Act and some of the ways in which it affects both health care workers and patients.

Title II, Administrative Simplification (AS) provisions, calls for and prescribes the establishment of nationally cohesive standards for all health care transactions, or rather, the use and dissemination of health care information.  Its primary intention is to help protect and retain the privacy of such health care information.  (I.e.: medical records, payment history, etc.)  The AS is comprised of five sets of rules, two of which are relevant to our purposes.  The Privacy Rule pertains to both paper and electronic health care files, and prescribes regulatory measures for both the use and disclosure of protected health information (PHI), being “any information held be a covered entity which concerns health status, providers of health care, or payment for health care that can be linked to an individual”.  This particular rule also requires the training of all individuals working within a medical establishment with regard to the proper procedures concerning both PHI and HIPAA.

Another relevant aspect of HIPAA, with respect to privacy, is a subsection of the Security Rule, a rule that is concerned only with electronic data, known as the Physical Safeguards. This facet of the Act itself attends to the control of physical access in order to protect against any inappropriate entrance into classified data.

HIPAA violations are far from uncommon.  Many are reported, but few are actually prosecuted.  This was not the case, however, in a recent incident involving a nurse in a midsize regional medical establishment.  This individual, Ms. A (whose actual name shall not be disclosed), had been employed by her respective clinic for 5 years and, as of late, was married to a man who had been involved in a car accident for which he was being sued.  She came upon the file of her husband’s plaintiff at her office during the course of the lawsuit, took some notes that had been kept in the plaintiff’s medical file, and brought them home to her husband.  In turn, Mr. A contacted the plaintiff urging him to drop the lawsuit given certain facts regarding what had surfaced in his medical record.  The plaintiff immediately contacted the clinic as well as his attorney.  Ms. A was subsequently and instantaneously fired from her job.  The couple were indicted a month later and charged with violating HIPAA, with “conspiracy to wrongfully disclose individual health information for personal gain with maliciously harmful intent in a personal dispute”, and with witness tampering (which was charged to her husband exclusively).  The charge against Mr. A was dropped after negotiations.  However, Ms. A still faces up to 10 years in prison and up to $250,000 in fines.  Not only this, but the nursing board in her respective state is attempting to have her nursing license revoked.  For the full story, visit http://www.renalandurologynews.com/Staff-Nurse-Faces-Jail-Time-for-HIPAA-Violations/article/119854/

This case is a blatant and highly perceptible situation in which a health care employee violated the boundaries of normative ethical privacy practices in the pursuit of personal gain.  However, no malicious intent need be present in order to carry out such violations.

Though HIPAA has undoubtedly protected innumerable individuals’ health care privacy, it has also raised certain complications as well as costs.  Training with respect to HIPAA has proved to be insufficient and toilsome as a staggering majority of health care workers report being uncertain of its scope and needless to say, its more specific mandates.  Not only this, but costs for medical institutions have significantly increased in tandem with the increase in paperwork required by the Act.  Due to the deducible detriments that have, and may very well continue to occur as a result of such confusion and costs, it is imperative that these matters are resolved by both legislators and by those who manage health care institutions.  

Questions: Do you think Mrs. A and Mr. A faced a fair punishment?  Should Ms. A be subject to high fines and 10 years in prison for her actions?

About the Author: Patricia Heise is a Staff Writer with the Clear Medical Solutions Communication Team.  Her work is regularly shared on the Clear Medical Agency newsletter and the ClearNursingMatters.com blog. 

References:

“Staff Nurse Faces Jail Time for HIPAA Violations.” Ann W. Latner, JD. October 1, 2008. http://www.renalandurologynews.com/Staff-Nurse-Faces-Jail-Time-for-HIPAA-Violations/article/119854/

“Health Insurance Portability and Accountability Act of 1996.” 104^th Congress. August 21, 1996. http://aspe.hhs.gov/admnsimp/pl104191.htm

“Health Insurance Portability and Accountability Act.” http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act

Experiences with Health Care in South Korea

 One of our writers for Clear Medical Solutions is currently residing in Seoul, South Korea and wanted to share her experiences with the health care system.  Below is an interesting article on her experience and point of view of the South Korean health care system and how it differs from health care in the U.S.

 I teach English in Korea and have lived here for little over a year.  During my stay, I have had several encounters and experiences with the health care system.  Korea has a National Health Insurance Corporation (NHIC), which guarantees health insurance for all Korean Citizens.  Foreigners are also covered by the National Health Insurance (NHI) provided they meet the necessary requirements.  My status as a registered, employed alien, with a proper visa (E2 for me) grants me access to the same NHI benefits as those for Korean nationals.

I am by no means an expert on the NHI; most of my knowledge about the NHI and health care in Korea comes from experience.  However, I do know the basics of how it works, the benefits, and what is covered.  Only properly documented and employed foreigners are eligible for NHI.  A monthly contribution is deducted from each pay check.  The contribution is determined by the monthly wage multiplied by the contribution rate (currently 5.08%).  The employee pays half of the contribution and the employer is responsible for the other half. 

The NHI has a co-pay system; patients pay 10- 20% of the total cost for inpatient care. Outpatient co-pay varies between 30- 50%.  General hospitals require 50% co-pay, while hospitals require 40%.  The co- pay for clinics and pharmacies is 30%.   There is mandatory minimum payment of 3,000 Won for visits when the charges do not exceed 15,000W. 

Currently 1 USD equals about 1,164W or .85 USD equals about 1,000W.  It may be easier to think 1 USD equals 1,000W, since I will be quoting all prices in Won; just remember the actual cost in U.S. dollars will be slightly less.

In my experience, the quality of health care in Korea is equal to the U.S.  The major difference is NHI makes the healthcare vastly more affordable and accessible.  The costs for doctor visits and prescriptions are literally pocket change.  Appointments are unnecessary for small clinics.  Hospitals and dental offices usually require (or strongly recommend) making an appointment, but there is rarely more than a two day wait for an appointment.

Recently, I severely burned my feet in a few places.  I tried treating them myself at first but was unsuccessful.  On my way home one night, I sought the advice of a pharmacist.  I showed the pharmacist my burned feet and he sold me a box of Band-Aids and a tube of Silmazin Cream (1% silver sulfadiazine cream; the Korean equivalent to Silvadene or Flamazine).  The total cost of the cream and Band- Aids came out to be around 6,000W.  The next morning I went downstairs to my regular pharmacist and bought gauze and medical tape; 3,000W.  A few hours later, I noticed one of the burns was developing a red circle around it, was warm to the touch, and was increasingly uncomfortable.  I headed back downstairs to the pharmacist hoping she could help me and she sent me to the doctor on the second floor.  The doctor examined the burns, cleaned them, put an ointment on them, dressed them and wrote me a prescription for antibiotics; 4,000W.  Back downstairs at the pharmacy, I filled the prescription, a 2-week course of antibiotics; 7,000W.  The total expenditure for treating my 2^nd degree burns was 20,000W; I did not have to make any appointments nor sit idly in the waiting room of a doctor’s office. 

All foreign teachers must undergo a yearly physical.  These are usually performed at bigger hospitals opposed to clinics.  The physical includes but is not limited to a chest x-ray, vision and hearing test, urine test, CBC, and HIV/ AIDS STD test.  You change into a hospital gown/top and you are pushed from one room to the next for each test to be performed. The most jarring aspect of the physical for me was the urine test.  The nurse handed me a Dixie cup, which I thanked her for and used to get a cup of water before proceeding with the test.  As I turned back from the water cooler and saw her face, I realized the Dixie cup was meant to collect my urine, not for me to drink out of.  I do not think it matters how many times you do it, walking out of a bathroom holding a Dixie cup of your own urine and placing it on a tray next to other cups urine always feels wrong.  Dixie cups aside, the physicals are easy to get and it usually does not take more than 30 min from when you walk in the door to when you walk out.  I paid 60,000W for my physical this year, but the cost can vary from 55,000- 70,000W depending on where you go.

Dental work also costs much less in Korea than in the U.S.  Friends of mine have had root canals, cavities filled, and crowns made (all things covered by NHI);they all rave about the price and how the quality of care was the same (some said better) as what they were used to back home.  I have not had dental work of that nature done.  However, I am currently undergoing Invisalign treatment for cosmetic purposes, which is not covered by NHI.  Even without the benefit of NHI, I am saving a great deal of money by having it done here rather than in the U.S.   Invisalign performed in the U.S. by an American doctor costs on average $5,000.   My Korean dentist received her degree from Tufts University, is an ADA member and is licensed to practice in several East coast states. I am paying 3,500,000W for my treatment (note: at the time of payment the exchange rate was different so 3,500,000W was about $2,800USD).   And my experience with Invisalign in Korea far surpasses the one I had with braces in the U.S.

The health care system in Korea also has some differences which are cultural.  Confidentiality, which is paramount and a cornerstone in health care in the U.S. is pretty much non-existent here.  I read warnings about this before I came here so I was prepared for it to be a little lax, but I was beyond shocked when my co-teacher showed the parking attendant the results of my physical in order to get her parking validated.  When I recovered from my shock and asked her about it, she did not see anything wrong, strange, or inappropriate with sharing the test results with a stranger whose job it was to monitor a parking lot.  As it turns out, it is not uncommon for doctors or nurses to discuss one patient in front of other patients or for the pharmacist to talk to other people about what medication you are taking.

Koreans typically do not play an active role in their health care.  For the most part, they believe in their doctors, trust them completely and never question them.  As a result they are often less informed about their treatment.  Experience has taught me not to question a Korean on the specifics of any treatment they are receiving because the answers alternate between “Because the doctor told me to” or “I don’t know.” 

I on the other hand like to know about my treatment.  I want to know what’s wrong with me.  I want to know what medication I am being given and why and I want to know the possible side-effects of this medication.  All this proved to be too much for one doctor.  My questioning of him during the examination and then disagreeing with his initial diagnosis that I had an STD (an unfortunate assumption sometimes made about foreigners, which is why a test is included in our physical) did not go over well.  I think I pushed him too far when I asked him for a translated version of the prescription he was writing so I could know what I was taking (or could at least Google it).  He was taken back by this request and stunned for a moment before he ordered one of his nurses to do it and shut the door on me.  The other doctor I have seen did not have a problem with this request and in addition to writing the English name of the drug he also wrote its purpose.

The physical manner in which prescriptions are filled is another difference between health care in Korea and the U.S.  Instead of the nice little orange bottles, clearly labeled with a patients name, drug dosage, and instructions; prescriptions in Korea come in rows of sealed little bags.  Each bag represents one dose.  When I filled my prescription for two weeks of antibiotics, the pharmacist handed me 14 little rows with three bags to each row (take 3 times a day for 2 weeks).  My qualm with the bag system is the loss of control I feel by not being able to control my own medication and again not knowing what I am taking.  However, I see how this system might have its merits for older patients taking multiple pills a day and how it could help prevent them from missing a dose or taking the wrong medication.

Korean pharmacies bare little resemblance to the big corporate owned pharmacies like Walgreens and CVS found the in the U.S.  The wide florescent lit aisles with rows upon rows of cold, flu, headache, stomachache, heartburn, etc., medicine are replaced with surprisingly small shops, stocked floor to ceiling with foreign medication, most of it behind a counter and controlled by the pharmacist.  When you have a cold (or any other ailment) in Korea you go talk to the pharmacist and s/he supplies you with the proper medication (in baggies) based on your symptoms; opposed to going to the drugstore in the U.S. and matching your symptoms to a box of cold medication.  I prefer the U.S. system and so do most foreign teachers, which is why there is a cabinet stocked full of Advil, DayQuil, NyQuil, Imodium AD, etc., in most of our apartments.  The benefit of the Korean system is that more drugs are available over the counter than in the U.S.  The Silmazin I bought for my burns would have required a prescription in the U.S.  More significantly, birth control does not require a doctor’s prescription and can be obtained from a pharmacist.

Health care in Korea has its pros and cons; it has been an adventure for me to experience and has given me numerous stories to tell.  In the end, what has surprised me the most about health care in Korea is how even as a foreigner who does not speak the language; I have never had a problem accessing the health care.  Come January 1, 2010 I will no longer be covered under my mother’s health insurance (which was very good insurance).  With that date looming I have actually started to think about health insurance and health care for the first time in my life.  I know the high quality health care the U.S. is capable of providing because I am used to receiving it; however, as of January 1^st I am not sure how to access that care.  I am dismayed by this fact; the fact that accessing healthcare in a foreign country where I am temporarily residing may be easier than accessing healthcare in my home county where I am a citizen. 

Questions: Based on the above story, how do you feel about the health care system offered in South Korea? Patient confidentiality is a huge focus point for health care in the U.S.; would you be willing to give up patient confidentiality for more available and affordable health care?

About the Author: Erika Christenson is a Staff Writer with the Clear Medical Solutions Communication Team.  Her work is regularly shared on the Clear Medical Agency newsletter and the ClearNursingMatters.com blog. 

References:

NHIC- National Health Insurance Corporation
http://www.nhic.or.kr/eng/

 Invisalign Payment Options and Treatment Costs
 http://www.invisalign.com/WillFit/Pages/PaymentOptions.aspx

Some Alternative Ideas During Breast Cancer Awareness Month

For the last 25 years, Breast Cancer Awareness Month has been an international campaign aimed at sharing information about the disease as well as raising funds in order to find better treatment and hopefully a cure.  It appears as though this effort is finally beginning to prove successful, as evidenced by a plateau in incidence rates that has now occurred after decades of steady increases.  

In what promises to be a turning point in the battle against Breast Cancer, new cases of Breast Cancer actually experienced a decline from 1999 to 2005.   This drop in new cases has led to quite a bit of speculation, and some have even gone so far to say that this drop may be due to a sudden accompanying drop in the use of mammography or post-menopausal hormone replacement therapy.  This idea (and other similar ideas), if proven true, would fly in the face of conventional cancer treatment, and is worthy of discussion. 

In one such case, a Norwegian study that appeared in the Journal of American Medical Association’s Archives of Internal Medicine in 2008 revealed that there was a sudden 22% increase in breast cancer occurrences in women who began regularly receiving mammography screening (i.e. every two years).  Though there are a number of possible reasons for this increase (such as radiation and trauma to breast tissue), it seems to be the case that the increase in cases is not, at least purely, a result of heightened awareness linked to more frequent testing.    

Some researchers speculate that the procedures that follow positive mammographic results may actually be the culprits in the progression of cancer.  Typically, after one becomes aware of a cancerous growth in one’s body, discovering whether or not the growth is malignant is the subsequent step.  However, the way some practitioners go about this task has become the target of new research to learn more about the progression of the relevant cancerous activity.  

Traditionally, biopsy is the main method utilized in discovering the nature of the cancer.  This procedure is one in which a sample is removed from the growth for the purpose of observing its behavior on a cellular level.  Though the biopsy does achieve its objective, some researchers wonder if it may lead to a greater problem.  

When a person is experiencing a cancerous growth within their body, sometimes the body itself responds in such a way as to create a barrier around the growth in order to contain it.  When this barrier is broken, particularly in the case of biopsy, metastasis (the spread of cancer) may occur more rapidly than it would otherwise.

One alternative form of screening that does not involve radiation is known as thermography.  This method utilizes a medical screening device that emits infrared detectors, which produces little to no harm to the bodily tissue.  Obviously much more research is needed on the subject, and is just one more reason why we need to raise more money for research.  

In addition to alternative treatments out there, there are also some alternative prevention ideas out there as well.  It appears that some in the community believe that vitamin D may be a tremendously effective route towards the avoidance of developing a variety of cancers.  

When the body produces vitamin D, organs such as the kidneys and liver activate a hormone.  This hormone causes a phenomenon called cellular differentiation, which is an effect that in many ways seems opposite to that of cancer.  In fact, human cancer cells have been shown to have specific receptor sites for vitamin D.  As exhibited in lab animals, vitamin D3 also inhibits a process known as angiogenesis, or the growth of new blood vessels that permit the spread of cancer.

In conclusion, we have a long way to go towards minimizing the effect of Breast Cancer on our loved ones, and it is always helpful to have an understanding of varying ideas on treatment and prevention.  This month, donate money to research and continue to urge your loved ones to be aware of their bodies and the very real potential for Breast Cancer.  Together we can help make a difference.

Question:  What do you think about the Norwegian study done in 2008?

About the Author: Ashley Montore is a Staff Writer with the Clear Medical Solutions Communication Team.  Her work is regularly shared on the Clear Medical Agency newsletter and the ClearManagementMatters.com blog.            

References:

“Breast Cancer Rates Soar after Mammograms and Some Cancers May Heal Naturally.” Sherry Baker. November 24, 2008. http://www.naturalnews.com/024901.html

“The Risks Associated with Biopsies.” Jo Hartley. December 24, 2008. http://naturalnews.com/025159_cancer_biopsy_Prostate.html

“Vitamin D is Nutritional Key for Prevention of Breast Cancer.” Mike Adams. October 13, 2009. http://www.naturalnews.com/027230_cancer_Vitamin_D_brst.html

(Clear Medical Solutions and Clear Medical Agency do not actively engage in cancer research and this article is not a position paper supporting any particular school of thought on treatment or prevention of Breast Cancer.  This article is for information purposes only and is only meant to stimulate discussion and awareness about this very serious topic.  We are thankful for all the men and woman that work day and night to make a difference in this fight and we believe that preventing the deaths of thousands of loved ones around the world is a noble cause worth investing in.  We support all research and ideas that may lead to a safer world where the fear of Breast Cancer can someday be history.)

Home Health Care Approved by Patients, Families, and Hospitals

In the 1950’s the average American lived to be 68.  Thanks to medical breakthroughs and advances the average American can now expect to live to be 78.   This increased life expectancy coupled with the fact that the baby boomers are beginning to enter their “golden years” is a growing concern among the medical community.  The aging baby boomers will require more medical attention, will make up a greater proportion of hospital patients, and will have more demands and expectations of the health care system.  Yet, the number of doctors and nurses can not increase at the same rate as these demands nor can the capacity or capability of hospitals.  Due to the growing imbalance of supply and demand of the health care system, home health care has become an increasingly popular option.

Home health care allows patients to receive the necessary care in the comfort of their own home by trained professionals.  It reduces hospitalization time and opens more beds in the hospitals.   Both patients and their families benefit from home care and it reduces the strain put on the hospitals.  The services provided by home caregivers are diverse and are suited to match the patient’s needs.  Home caregivers do more than tend to the medical needs of the patient.  They can help with housekeeping, cleaning, washing/ bathing, transportation to appointments, and any other duties that help the patient return to a level of independence.

Patients prefer the comfort of their home to the impersonal sterile hospital environment.  They also recuperate better and faster in familiar home settings.  Patients develop a more meaningful relationship with their home caregiver that is not possible in a hospital setting.  This relationship provides the patient with a sense of security that can aid in the recovery process.  Many elderly patients are resistant to moving into nursing homes or assisted living centers because they feel like they are giving up their freedom; home caregivers are the perfect solution for individuals who need assistance but do not want to lose the independence living in their own home gives them.

 Home caregivers help more than just the patient; they give the families of patients the security of knowing their loved one is being taken care of.  Illness of or the assistance required by an elderly relative or parent can be both stressful and overwhelming.  Families do not have to worry about whether or not their loved one is eating properly or taking their medication when a home caregiver is hired.  Nor do they have to worry about if their loved one is lonely or feeling isolated.  Home caregivers provide companionship to their patients and help them stay connected to the world.

Patients, families, and hospitals all prefer home health care to long hospital stays.  It gives patients more personalized care and lessens the stress put on families. Home health care is usually cheaper for the patient and more cost effective for the hospital.  As a result of the strain the baby boomers are putting on the health care system, the home health care industry is booming.  In light of all the benefits home health care offers, one has to wonder why it has taken so long to catch on.

About the Author: Erika Christenson is a Staff Writer with the Clear Medical Solutions Communication Team. Her work is regularly shared on the Clear Medical Agency newsletter and the ClearRetiringDoctorMatters.com blog.

References:

“The Benefits of Using Home Health Care” http://ezinearticles.com/?The-Benefits-of-Using-Home-Health-Care&id=1892252

 AHA: Press Release: “Baby Boomers to Challenge and Change Tomorrow’s Health Care System” http://www.aha.org/aha/press-release/2007/070508-pr-boomers.html

Man Dies After a Feeding Tube is Inserted Into His Lung

In May of 2006, 78 year-old Gene Riggs decided it was time for him to see a doctor for a stomachache that had been bothering him for a few days. He entered the Brooke Army Medical Center where doctors immediately began running a series of tests, and inserted a feeding tube into his lung. Four months later, Riggs was dead.

Tinie Riggs, middle, sits by her children, Melissa Riggs and Steve Riggs. Tinie lost her husband in 2006 after he went into BAMC for stomach trouble. A feeding tube was inadvertently put in his right lung instead of his stomach. The family is claiming in a lawsuit that the feeding tube misplacement killed him, although lawyers for the government dispute that. June 23, 2009. ( Photo by Billy Calzada / San Antonio Express-News ) Stoeltje story

Tinie Riggs, Gene’s wife, waited hopefully while the tests were performed only to find out later from Gene that he’d have to spend the night at the hospital. He told her he might need surgery, but that the hospital would call before any plan was sent into action.

Tinie Riggs, middle, sits by her children, Melissa Riggs and Steve Riggs. Tinie lost her husband in 2006 after he went into BAMC for stomach trouble. A feeding tube was inadvertently put in his right lung instead of his stomach. The family is claiming in a lawsuit that the feeding tube misplacement killed him, although lawyers for the government dispute that. June 23, 2009. ( Photo by Billy Calzada / San Antonio Express-News ) Stoeltje story

By the next morning Tinie still hadn’t heard anything. She called the hospital and was taken aback to discover doctors had performed a procedure, an exploratory laparotomy, which allowed doctors to examine Rigg’s abdominal cavity. Doctors found no signs of the ailment they thought Riggs had. Following the procedure doctors complained that Riggs wasn’t getting the proper nutrition, so they threaded a feeding tube down his throat, into his lung.

Following the insertion of the feeding tube, an X-ray was taken which evidenced the mistake. According to the family’s lawsuit complaint, the nursing staff continued to administer feedings all night. Allegedly, a nurse twice told a doctor, but she insisted that the feeding continue despite nurses having to suction out a “milky pinkish” fluid, consistent with the color of liquid food, from the tube which maintained his airway.

The following morning doctors removed the feeding tube and performed a bronscopy, a procedure that allowed doctors to view Riggs’ airways and lungs. In his lungs, doctors found liquid food and an infection-caused fluid.

After the procedure, Riggs’ health began deteriorating. Riggs was put on a ventilator, and for 24 hours a day, seven days a week, Riggs had his own nurse. Shortly before Riggs died, the Brooke Army Medical Center discharged Riggs to Kindred Hospital.

While at Kindred, doctors performed a dialysis on Riggs and discovered that he had injury to his kidneys. The doctors at Kindred believed it may have had something to do with Riggs’ dopamine IV running out, which falls in the hands of the doctors at the Brooke Army Medical Center.

Lawyers for Brooke Army Medical Center have said very little about the case, however they admitted that the feeding tube was indeed misplaced, but claimed it didn’t’ cause any infection. The antibiotics Riggs was on would have prevented any infection. They also contend that Riggs death was a result of other health problems, including chronic leukemia.

What’s quite disturbing is the family was never notified that the feeding tube was misplaced. Instead, Tinie Riggs was lead to believe that he had inhaled food while he was eating. It was only after she and the rest of the family reviewed boxes of medical documents that they discovered Riggs’ feeding tube was placed in his lung.

Doctors kept telling Trinie that there wasn’t a whole lot she could expect because he was 78 years-old, and dealing with this problem would take a lot. After a while she began to feel that there wasn’t any hope for good care unless you were in your 30’s or 40’s, which isn’t fair.

The Army has since offered Trinie $15,000 to settle the case, which she felt insulted by. If she wins, she could get around $1.7 million for wrongful death and at least $120,000 in non-economic losses.

What do you think? Would Gene Riggs have lived longer if it wasn’t for the misplaced feeding tube?

About The Author:

Todd Michalek is a Staff Writer with the Clear Medical Solutions Communication Team.  His work is regularly shared on the Clear Medical Agency newsletter and the ClearManagementMatters.com blog.  

Link to Full Article: http://www.chron.com/disp/story.mpl/deadbymistake/6555186.html

American Healthcare within an International Context

Issues regarding health care in the United States are no doubt thriving at the present moment. The matter is everywhere; as inextricable from political discourse as it is from personal life. We are at a nexus with respect to health care in this country, a transition that will likely forever alter the way that we perceive and receive medical treatment and attention in the U.S. Given the weight of the circumstance, it seems prudent to search for an alternative to our current health care system by taking into consideration the ways in which other nations provide their citizens with such care.

A very recent interview, conducted by Terry Gross on National Public Radio’s Fresh Air, really spoke to the issue itself and of the broader international setting in which the largely ideologically-driven battle is taking place. Gross’ guest was the journalist T.R. Reid, a man who spent approximately three years traveling the world in order to quantify various modes of health care. Essentially, Reid was embarking on a mission that could feasibly clarify what it means to have an effective and sound system of health care.

The discussion was, as one could imagine, terribly interesting and undoubtedly pertinent. As a result of his travels, Reid managed to categorize four distinct models of health care.

The first model, the William Beveridge model (commonly referred to as “socialized medicine”), is a system that one would come to find in countries such as Britain, Spain, and Italy. This system is entirely run by a particular country’s government in that it operates, employs, and pays for all medical institutions, practitioners, and treatments. As a result of such dynamics, a number of things occur. For instance, a citizen will likely never pay a medical bill. However, a citizen will instead have to wait to see specialists and may also be subject to a “rationing” of care in certain situations.

Reid’s second model is the Bismarck model. This system has been adopted and developed in countries such as Germany and Japan. In contrast to the prior model, all health care is private. Despite the system’s privacy, however, there is significant governmental regulation with respect to insurance company profits and strict rules regarding premiums and coverage.

The National Health Insurance model is Reid’s third category. This system is unique to Canada and can be easily identified by its blended characteristics. Canada’s system is comprised of private medical institutions and practitioners. The blend is a result of private entities operating within a public payment system. This system provides universal coverage, yet neglects the provision of adequate numbers of specialists, operating rooms, and technology. Beyond that, citizens must wait many weeks or months to receive medical attention if his or her condition is not considered acute.

Finally, Reid defines a type of “out-of-pocket” model. This model essentially identifies a reality that is experienced by most of the world’s distinct populations. The model reflects the idea that if one is able to pay immediately for health care, then one will receive it. However, the opposite also applies. This sort of thing occurs in the United States for approximately 16% of the population. In fact, Reid ultimately shows that the U.S. embodies aspects of all four models. He hypothesizes that this combination becomes manifest in our system’s “enormous administrative complexity”, thus leading to the consequent enormous expense – the United States spends roughly 16% GDP on health care, vastly more than other populations who average around 9-10% GDP.

Though this interview provides tremendous insight with respect to the structure of various health care systems, I believe that an equally important matter pertains to a given system’s qualitative perception with respect to characteristics of health itself. If one considers this issue thoroughly, one will eventually come to understand that a particular population’s definition of health is utterly inextricable from the way it goes about administering health care. Longevity, prevalence of disease, and means of treatment and prevention vary dramatically throughout the world – some populations prevent disease with food and treat the sick through natural means while others use synthetic medications and neglect the issue of prevention entirely. Perhaps the more relevant question relates to these matters as opposed to those concerning the structural arrangement of health care systems.

Which model of healthcare do you agree with most? What do you see in the future of healthcare in America?

About the Author:

Patricia Heise is a Staff Writer with the Clear Medical Solutions Communication Team.  Her work is regularly shared on the Clear Medical Agency newsletter and the ClearHIMMatters.com blog. 

References:

“T.R. Reid: Looking Overseas for ‘Healing of America’”, Terry Gross. NPR c. 2009. August 24, 2009. http://www.npr.org/templates/transcript/transcript.php?storyid=112172939

“Health Care Spending in the United States and OECD Countries”, January, 2007. Exhibit 4. http://www.kff.org/insurance/snapshot/chcm010307oth.cfm