For Profit, Home-based EKG Telemetry Service

From Medgadget:

When a customer signs up for EKGuard, the company sends a handheld EKG monitor. They also take a customer’s medical history, contact his or her doctor and cardiologist, and explain how they should take a baseline EKG, for reference by cardiac specialists.

The portable monitor has three wires; placed in the right spots on the body, they record data from 12 different leads, like a standard hospital or ambulance EKG. When collected, the data build a picture of how efficiently electrical impulses are traveling through the heart. To transmit the EKG readings to the call center, the device translates the information into sound and plays it over a phone line to a computerized receiving station, where it is reconfigured into an EKG chart that can be analyzed for irregularities…

Now that the company is up and running stateside, Lichtenstein says, they plan to refine the technology. The next step: adding Bluetooth wireless capabilities to the device, so that it can communicate with a cell phone or a PDA…

Companies like EKGuard are already operating in Israel, England, Switzerland, Germany, Italy, and the Netherlands. More than 120,000 people in Israel alone are using a similar service, according to Lichtenstein, and a study by one company found that the technology helped its customers cut emergency-room visits by 30 percent. Even more telling, the average time it took for heart attack victims to call for help after their first symptoms appeared dropped from four hours to around 40 minutes.

Apparel for doctors and nurses no longer limited to just white

From Taiwan Headlines

Recently, several hospital supply stores have imported Italian made medical wear, which comes in a wide variety of colors and styles. With a bit of tailoring, the outfits are really quite fashionable. Some doctors said that they would not think twice about wearing the jackets out of the hospital and onto the street.

“Did you know that Matsushima Nanako, who stars in the Japanese series “The Female Doctor in the Emergency Room” wore this exact purple jacket? I had to search and search before finding one exactly like it,” said a dentist, Yang Po-ya, who works at the Talung Dental Clinic. This clinic is one of a small number in Taipei that has already begun purchasing the trendy medical outfits.

One can see jackets of all colors hanging in the clinic’s changing room. In addition there are many styles of jackets worn by the doctors as well as uniforms worn by nurses. All of the workers at the clinic are allowed to wear the style or color of uniform or jacket that suits them that day.

“Since everyone is wearing something different, it is no longer like wearing a uniform,” said Yang.

"Cuts signal ambulance wreck"

From San Jose Business Journal

Ambulance companies in Silicon Valley are bracing for a new round of Medicare reimbursement cuts next year that some predict will bring further consolidation to the industry.

In January, a new government policy will take effect that phases out payments for disposable supplies and oxygen that ambulances routinely use when transporting patients, the industry says. In addition, ambulance companies are expecting cuts in their mileage reimbursement rates at a time of record gasoline prices and a reduction in payments for transporting Medicare patients, which typically make up half their customers.

Statewide, the new fee schedule could mean a 23 percent cut, or $110 million less, in Medicare payments for California’s 280 ambulance companies, according to David Nevins, president of the California Ambulance Association, which is pushing for a freeze in next year’s rates. “We project in 2006 that we could see nine to 10 businesses in California go under.”

Ambulance companies say they cannot afford another decrease in government payments because Medicare reimbursement rates already fail to cover their costs. In 2002, the industry was shifted to a national fee schedule which bases reimbursements on national averages rather than on an individual company’s customary charges. The new policy, which is being phased in over five years, has meant that companies in California, which have some of the highest operating costs in the nation, saw a loss on Medicare patients of $29 million in 2005, Mr. Nevins says.

New "long term care acute hospitals" in Iowa

From the Des Moines Register:

Out-of-state medical corporations want to build up to four new hospitals in the Des Moines and Iowa City areas.

The hospitals, which would cost more than $10 million each, would focus on critically ill, elderly people who would need to stay for weeks at a time.

Select Medical Corp. of Mechanicsburg, Pa., wants to build a pair of $16 million, 50-bed hospitals in Polk and Johnson counties, according to initial documents filed with state regulators. Regency Hospital Co. of Alpharetta, Ga., wants to build an $11.4 million, 60-bed hospital in Des Moines and a $10.4 million, 44-bed hospital in Iowa City.

The facilities would be “long-term acute care hospitals,” a special class that has become increasingly common across the country. Backers say they focus on caring for patients who are too sick for nursing homes but who need longer-term care than do most hospital patients.

Select Medical, which runs 98 such hospitals nationwide, is setting up Iowa’s first one in Davenport. That facility, called Select Specialty Hospital-Quad Cities , is expected to open in March. Regency Hospital Co., which runs 15 hospitals in nine states, is a newcomer to Iowa. Both companies are for-profit operations, unlike the operators of all other Iowa hospitals, which are set up as tax-exempt charities. A Select Medical Corp. lawyer said his company probably would choose sites near larger hospitals in downtown Des Moines and Iowa City.

Legislators may let docs say sorry, but won’t limit malpractice damages

From the Des Moines Register:

“Sorry” seems to be the hardest word — at least for doctors who might get sued if they say it.

Legislators wrestling with malpractice issues said Monday that they likely would not be able to cap damages in malpractice lawsuits next year but they might be able to do smaller things, such as let doctors apologize for mistakes without it being grounds for a lawsuit.

A panel of lawmakers charged with making recommendations to the 2006 General Assembly offered ideas mostly aimed at reducing the cost of litigation. The rising expense of malpractice insurance to protect doctors against lawsuits is often blamed for the high costs of medical care.

One proposal would require medical experts to certify the validity of a malpractice claim earlier in the litigation process. Other ideas would be to provide state incentives to help specialty physicians pay for malpractice insurance and to require doctors and hospitals to publicly report errors.

The ideas were not without critics. A lobbyist for the Iowa State Bar Association said the state already has a quick judicial process. An official with the Iowa Hospital Association cautioned that error data can be unfairly manipulated and distorted.

The “I’m sorry” proposal is new to Iowa. The Iowa Medical Society said 16 other states have enacted some form of the law that excludes such statements as proof of liability.

Karla Fultz McHenry of the medical society told lawmakers that studies show such provisions have reduced the number of lawsuits brought against doctors.

“Patients feel better if their physician talks to them about what happened, rather than just finding out that there was an adverse event where something went wrong and not understanding why,” McHenry said.

The ideas come after years of disagreements between Republicans and Democrats over capping awards in malpractice cases. Republicans generally support caps, saying it will lower the cost of malpractice insurance. Most Democrats say it limits a patient’s right to seek damages. Leaders agreed Monday the caps debate won’t likely get anywhere in 2006.