The VA in testimony before Congress admitted its negligence in the loss of patient's personal information. The information continues to be unencrypted and they have no idea how many portable computers have some or alot of information on them. The last blunder was in Birmingham last month where a computer was lost and hundreds of thousands of vets have not been informed. There have been no implementation of the recommendations of 2001.
About two thousand names of patients at the Westerly Hospital in Rhode Island were posted on line. The information included the medical histories and surgical information. The hospital does not know how this happened and will send letters to all who were affected as soon as possible.
And yet another privacy breach. This one by the State of California. The Department of Health revealed the names and addresses of 53 HIV positive patients to other enrollees by putting benefit notification letters in the wrong envelopes. California is doing its due diligence on this matter.
And the beat goes on! WellPoint is notifying 75,000 enrollees that they may have lost a CD with their vital medical and other personal information. The disc has disappeared. The disc was unencrypted and sent to a mental health third party. The company will give one year of free monitoring of the credit reports. This was the second screw-up by WellPoint in three months. In October, 2006, they had a back up with 196,000 enrollees information taken. Top
The Army has removed from command two star General Weightman, the commander of Walter Reed Hospital. He knew about the squalid conditions and did not act. Following the removal of the general, the Army Secretary was asked to resign for assigning an interim general to oversee the hospital who knew about the problems and did nothing. After the resignation another general was appointed as head of the hospital.
The VA also fired the head Army Surgeon, Dr. Devin Kiley and is authorizing a report on 1400 VA clinics throughout the country.
There is now a hearing over the problems at Walter Reed and there will also be an investigation at all other VA hospitals. If anyone saw the special by Bob Woodward of ABC it was a scathing indictment of the problems vets have getting rehab at their local VA after the wonderful treatment they get at the inpatient at Reed and the major rehab centers. This is another reason to disband the entire system and mainstream all vets into Medicare with none of the Medicare restrictions on PT and meds.
I don't think the government or the VA gets it. The VA Secretary stated that the Department will immediately hire 100 more patient advocates to help the vets. Instead they need to fix the system that is broken so no advocates are needed.
Drew/King hospital is now King/Harbor Hospital and is only 48 beds, 1/4 of its original size. The employees were all either kept or sent to other facilities, about 1/2 each. The hospital still awaits the decision if its Medicare funding will be pulled. Sine 2004, 260 employees were fired, including 41 physicians. (See Recent Legal News)
Back to Kaiser. After all the bad press they received form me last newsletter, they will get more this one. First see Recent Legal to see the alleged screw-ups by transplant surgeons. Next, how do you feel about a hospital in a location finished and ready to open but will not due to the lack of performance by Kaiser's EMR. This is what is happening in Modesto, California. A 220 bed wing will be ready for occupancy in July 2007, but will not open until September 2008 due to the poor performance of the Kaiser standalone EMR.
Kaiser is beginning to have problems getting enough physicians in the primary care arena. They expect their physicians to work a full 40 hour week seeing patients and also do the several hours per day necessary to care and nourish their inoperable EHR system and other admin duties. The physicians won't do it. Since the HMO continues to believe their current physician hiring will keep pace, they only will take on the partnership track those who are willing to make the above sacrifices. There are only 20% of Kaiser physicians now either partners or on the partnership track. Sounds more like a legal firm. Kaiser is now either keeping even or losing slight ground with their 13% turnover rate. The CEO of the physician Permanente Medical Group either is an idiot, which I don't believe, or an ostrich, neither good characterizations for stating the recruitment is going well. This goes against his own medical executives. Kaiser actually hired 165 physicians last year in northern California. This compares to the hiring of 2343 physicians in 2004. As the cost of living in the area continues high, problems for all hirers of all employees in any part of business will be prevalent.
California has a new healthcare website. It shows a report card on about 200 hospital in patient quality of care in multiple disciplines. The site is www.calhospitalcompare.org
A report in JAMA states that there is a spike in procedures, mainly angioplasties, when a new cardiac specialty hospital opens, even if a community hospital nearby has the same procedures. The AHA blames it on physicians doing more than necessary. The authors of the study say that statement is not clear. It may be that more procedures are done due to a magnet status or a need not filled by the community hospital. It is interesting that in areas where no programs were opened there was a 7.4% increase in procedures. When a general hospital opened a new facility there was only a 6.6% increase. When a specialty hospital opened there was a 19.2% increase.
Congress can't understand how the Joint Commission could have screwed up so badly. The Joint gave West Texas Hospital full accreditation when it was plainly out of compliance with Medicare CoPs. The hospital has lost its Medicare certification. West Texas Hospital is a specialty hospital that called 911 for its patients 15 times from May 2005 to February 2007. This is poor form for any hospital. Congress can not understand how the Joint allowed the hospital to open when there was a moratorium in effect. That is not something that the Joint is to look at. It is a regulatory issue not covered by the Joint inspectors.
The University of California Irvine is again in the news for its outlandish behavior. This time they entered a contract with Dr. Reimer and his private Mission Orthopedic Medical Associates. The contract was to give Dr. Reimer a full time position at the school and pay the practice money to cover their overhead. Dr. Reimer would resign from the practice since no full time physician is allowed to have an outside practice. The school paid over $100,000 a year to Dr. Reimer's wife for secretarial work. This was done since Dr. Reimer was on disability due to cancer and not allowed to make over $100,000 per year. Dr. Reimer has several harassment suits filed against him by employees of this old private practice for demeaning them and demoting them when he had already turned the practice over to his associate. The new Orthopedic Dean has sent the contract out for audit since he felt it made no fiscal sense. To date, the cost of the contract was more than the money collected by Reimer's patients by about $1.7 million.
Peninsula Regional Medical Center in Salisbury, Maryland, has accepted the resignation of Dr. John McLean, a cardiologist. Dr. McLean resigned after disclosing an eye problem that may have led him to misread cardiograms and then doing stent procedures on patients that did not need them. The physician has been reported to the Medical Board and the Data Bank.
A recent study by the Mayo Clinic shows that there is no need to ban cell phones in the hospital. The only problems found were in department stores where the electric article surveillance systems that use a magnetic field has posed problems with some pacemakers.
In Pike County, Arkansas, there is one hospital and several thousand people. The hospital employs 55 people and is the second largest employer in Murfreesboro. The hospital was without a physician until an 81 year old physician came out of retirement after the last two physicians quit due to malpractice concerns. The physician will continue to practice until the hospital can recruit physicians to the area or until some dumb hospital attorney says the doctor is too old and forces him out closing the hospital and having the attorney lose his job with the rest of the 55 employees. Top
In South Florida, a new HMO product called Vista allows patients to go directly to specialists. The plan costs more than the standard HMO plan but would relieve the frustration of the rationing of care by the HMOs.
In a new poll, AMGA found that employed physicians turnover rate is now 6.7% with more males relocating than females. The number of female physicians is about half of the current graduates.
The GAO testified before Congress and stated that profiling physician efficiency (costs) could control spending. Efficiency means comparing actual physician costs for a patient with a certain disease compared to the expected costs.
Kaiser is not the only one having problems with their EHRs. The University of California Davis was to have theirs in place by the end of 2006 at a cost of $76 million. As of now it is almost half done at a cost of $85 million to date. Top
Blue Cross of California is again attempting to hamstring physicians and hospitals. They have started with a policy that they will only negotiate with attorneys or consultants for physicians and hospitals that they approve of or that the physician be present when the negotiation takes place. No provider has the time for that nonsense. They also originally wanted all privileged attorney client work product as well. They have backed down on that illegal requirement. Why physicians and hospitals put up with these hurdles is beyond me.
Speaking of hurdles, Humana is being investigated by the feds for pawning off their high use Part D patients to Sierra Health Services, a competing provider. I'm sure a nice company like Humana would never do such a thing, just to save megabucks.
The nice HMO "insurers" are having major problems in California. A new report shows a steady decline in HMOs using medical groups for capitated programs. These IPAs are also having a tough time getting PPO patients since they were geared to capitation. Hospitals are in better bargaining positions with insurers since their utilization rate is moving upward. They have less patients so less staff is needed. They can also ask for more money since the insurers have gotten big increases in premiums. Also large means more clout. This includes physicians as well as hospitals. Top
Arizona hospitals are bolting from the Joint to to their accreditation. Currently 23 hospitals in Arizona or 22% have opted out. An additional 11 are considering the opt out. Each hospital would save $40,000 for having the state do the inspections. Top
DISCLAIMER: Although this article is updated periodically, it reflects the author's point of view at the time of publication. Nothing in this article constitutes legal advice. Readers should consult with their own legal counsel before acting on any of the information presented.