-
April 30th, 2009UncategorizedYou know something's a commodity when the big W gets involved--so I guess EMRs have officially arrived. Wal-Mart Stores has set its sights on the scorching-hot market for electronic health records, focusing on the small medical practices which have proven unwilling to invest in higher-end systems.
Hoping, no doubt, to capture some of the $19 billion in health IT stimulus dollars, Wal-Mart will team with Dell and EMR maker eClinicalWorks to offer a turnkey package including hardware, software, installation, maintenance and product training.
This package should be far more affordable than many other EMR offerings, undercutting some rivals by as much as 50 percent. The EMR system, offered through Sam's Club, will be under $25,000 for the first physician in a practice, and about $10,000 for each additional doctor. Maintenance should cost $4,000 to $6,500 a year.
Wal-Mart has been testing the technology in the 30 retail clinics it operates in eight states. -
April 29th, 2009Uncategorized
If you're a patient that needs drugs in a dose, form or combination not available, your pharmacist may be able to help. Every year, more than 30 million prescription drugs are compounded each year by pharmacists, who are permitted to do so as part of their licensure.
Often, compounding involves simple changes in the mixture to say, provide a pediatric dose of a drug that comes in adult doses--and all of the nearly 200,000 pharmacists in the U.S. are permitted to do this. On the other hand, when pharmacists begin making large volumes of such doses and distribute them, the compounder essentially becomes a drug manufacturer, without facing the level of scrutiny that drug makers face.Some compounders actually come far too close practicing medicine themselves, critics argue, especially when it comes to promoting a drug class known as "bioidenticals" which are manufactured to be molecularly identical to human hormones. The FDA is on record as saying that claims made by some compounders about these substances are actually untrue.
In extreme cases, compounded substances have been linked to deaths or serious side effects, particularly those made in mass quantities by what some have called a "shadow drug industry." However, pharmacists note that most compounding is far simpler and safer, and that deaths and harmful side effects are very rare.
-
April 28th, 2009UncategorizedState Health Commissioner Richard Daines was in Syracuse last week to meet with hospital CEOs and their staffs about community health issues. One of Dr. Daines' questions: what percentage of hospital employees received the flu vaccination?
At Community General, 85% of our active employees were vaccinated this season, and that's up from our 73% vaccination rate last year. In addition, Community immunized over 400 members of employee families and the medical staff.
Congratulations to the staffs of Community's Infection Control and Employee Health Offices, as well as to the nursing leaders who assisted in achieving the 85%. And thanks, especially, to employees who recognize their responsibility to patients and staff in helping prevent the spread of influenza.
Nationally the average flu vaccination rate for hospital employees was 44% during the 2007-2008 flu season. -
April 27th, 2009UncategorizedThe Wall Street Journal is reporting that Massachusetts is contemplating a 2.5% state tax on university endowments in excess of $1 billion per university. Now personally, I could care less about Harvard's financial concerns. It's hard to worry about a school with a $34 billion endowment. I'd be happy if my net worth was half that amount.
Here's an idea that would take some of the wind out of these legislative proponents' sails. Harvard could take 2% of their endowment each year and give it to their 19,000 undergraduates and graduate students. This is surely a fraction of the annual interest Harvard makes on its investments each year.
This would amount to over $35,000 per year per student and would essentially give them free tuition. Of course the B-school students would still have to cough up about $7,000 more per year but well...they're B-school students. They'll be able to pay that off after their first few weeks of gainful employment.
Massachusetts would have an awfully hard time taxing such "good" citizens as the Harvard administrators for providing a world class education for free.
I don't know. 2.5% going to taxes vs. 2.0% going to their own students? Seems like a no brainer to me. Maybe the legislature is threatening the universities with this tax just to achieve this end. Either way, it seems like an abuse of their authority to me. 
Too often, emergency departments care for young men who have been beaten, stabbed and shot as part of their dedication to an ugly profession--participation in an urban gang. Now, in New Jersey, law enforcement officials have begun teaching hospitals how to recognize members of specific gangs--including the colors they wear, marks they use and more--in an effort to make sure that inter-gang scuffles occurring at hospitals in other states are less likely to happen in their facility.
Yet another former executive at City of Angels Medical Center in Los Angeles has pleaded guilty in the case involving homeless people being recruited for unnecessary medical treatment. Dante Nicholson, a former vice president with the hospital, pleaded guilty to paying the recruiters who brought the homeless people into the facility for treatment between 2004 and 2007. City of Angels then charged Medicare and Medi-Cal for the services they provided.
In all the scam netted the hospital $4.1 million. Former chief executive, Dr. Rudra Sabaratnam, pleaded guilty in December in the case, as did recruiter Estill Mitts, who was paid $500,000 to find the homeless people used in the scam; the homeless people, found on Skid Row, were paid $100 or less.
Nicholson was indicted in January along with former hospital co-owner Robert Bourseau, who is still awaiting trial. Each initially were charged with 13 counts. Nicholson faces up to 10 years in prison, and agreed to pay back more than $4.1 million in restitution to the federal government.
The following information should be helpful in getting some idea of the pay for different nursing fields. Hospital Nurse Recruiters will inform the new graduate nurse that obtaining a bachelor degree in nursing is favored. Many hospitals will offer some form of tuition reimbursement for those nurses who seek to obtain a BSN degree. Tuition reimbursement can go as high as one hundred percent to fifty percent. For nurses who work in hospitals, there is a world of opportunity to move into many different nursing specialties. As the nurse gains more experience in their field, their salary will also increase. The salaries listed below are not all inclusive, but merely present to the reader a general idea of the salary range that exists. The reader should keep in mind that each hospital will be unique in what type of salary is offered depending on the nurse’s qualifications and prior work experience.
Just as you might think, large cities like New York, Los Angeles, and Chicago hold the top spots for the number of nursing jobs available. The larger cities also have higher salaries and better benefits for their nurses. The tradeoff is longer hours and more stress in large city nursing jobs versus the small community jobs where hours are usually better and the number of patients to serve is lower.
The median expected salary for a typical Staff Nurse - RN in *Detroit**, MI*, is *$65,817*. This basic market pricing report was prepared using our Certified Compensation Professionals' analysis of survey data collected from thousands of HR departments at employers of all sizes, industries and geographies.
Job Description
Staff Nurse - RN:
Evaluates, plans, implements, and documents nursing care for an assigned patient population. Assists physician during examinations and procedures. Performs various patient tests and administers medications within the scope of practice of the registered nurse. Promotes patient's independence by establishing patient care goals and teaching patient and family to understand condition, medications, and self-care skills. Requires an associate's degree and is certified as a registered nurse. Familiar with standard concepts, practices, and procedures within a particular field. Relies on experience and judgment to plan and accomplish goals. Performs a variety of tasks. A wide degree of creativity and latitude is expected. Typically reports to a manager or head of a unit/department.
Registered Nurse Salaries
Staff RNs working in the United States average a median base salary of $41,642. Half of all US RN's are expected to earn between $38,792 and $44,869. Nearly 67% of nurses are employed in hospital inpatient and outpatient settings. 32% of all nurses are employed in medical offices and clinics, home healthcare agencies, nursing homes, temporary help agencies, academia, and government agencies.
People will of course argue that some patients might die after having been mistriaged to home. Unfortunately, it is the nature of things that this is so. Triage nurses will always make mistakes on occasion and as sure as the sun rises in the east, some patients or their families will pay a tragic price.
Inevitably, such cases will become front page headlines, but rare as they may be, the victims will be "named" and therefore worthy of our sympathy and compassion. Consider though, that in California alone, at least 65 E.D.'s have closed in the last decade. Unreimbursed care is at the root of most or all of these closures.
How many more patients will die, however, because of a lack of nearby or conveniently located E.D.'s? Moreover, these patients will not be named but will instead be mere statistics in some as-yet-unperformed observational study.
In a recent crackdown on right-to-die group Final Exit Network, four members of the group--including medical director Dr. Lawrence Egbert--were arrested and charged with violating assisted-suicide and racketeering laws, and tampering with evidence, in Georgia and Maryland. The group's assets also were frozen.
Final Exit Network initially began in 2005 in Chicago to help counsel, support and sometimes "guide [people] to self-deliverance" who "suffer from an intolerable condition." According to Jerry Dincin, the network's new president, potential members are "repeatedly" interviewed and their medical records are looked over extensively before being accepted.
While Dr. Egbert claims that volunteer guides "never pin down" those who are receiving their services, Georgia Bureau of Investigation spokesman John Bankhead disagrees. He said that when his undercover agent's hand was held, it was more to "prevent flailing."
The group maintains its innocence, claiming that it doesn't "pressure members to commit suicide."