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Although telemedicine is bringing educational opportunities and consulting expertise to hospitals where it has not been available, reimbursement for the service is lagging, experts say.
“That’s one of our biggest problems right now,” said Lawrence Wechsler, vice president for telemedicine, Physician Services Division, at the University of Pittsburgh Medical CenterbizWatch University of Pittsburgh Medical Center Latest from The Business Journals UPMC, WPAHS making advancements in telemedicineGatesmanMarmion+Dave’s new accounts boost billings, lead to hiringWest Penn Allegheny Health System promotes shared savings model for efficiency of care Follow this company . Continue reading
– May 20, 2011 – (Beverly Hills, CA) – There seems to be no question as to whether the American public has an interest in the emerging world of Telemedicine. Just visit, E Patient Health Care dot Com. With over 100,000 page views a month, this Top 20 Blog doles out plenty of information on health issues Continue reading
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The Promise of Telemedicine
By: Jacques von Speyer – Chairman – CEO, US Tele-Medicine
Technology and communication channels exist today in such capacities that basic medical care may be provided to virtually Eighty Percent of the world population. That is a fact.
Family Medicine and all of its attending disciplines is the foothold of public and societal health. That too is a fact.
“Tele-Family Medicine” is the ultimate promise of Telemedicine worldwide.
The Family Medicine practitioner enjoys the greatest impact on community wellness and effective prevention in all of health care. These paramount discretions which when employed correctly saves lives, prevents illness, reduces costs and provides a management tool for the prodigious benefits found in continuation of care programs, on a mass basis.
These operational truths remain scalable from a small HMO population to a regional and national effort.
Telemedicine is the single rational modality for providing Mass E-Care to millions of families. Specifically for the multi-millions living within remote, underserved, urban, and disenfranchised populations.
Most recent Telemedicine endeavors have centered upon condition specific efforts such as Tele-Dermatology, Tele-Wound, Tele-Psychiatry, Tele-Cardiac, etc. Regrettably, very little effort, other than those of US Tele-Medicine, was invested to encompass basic, primary, and preventative care into new Telemedicine protocols and devices.
Current telehealth efforts mistakenly emulate today’s existing and failing healthcare model by focusing on Specialty Care. The trend however must promote Mass E-Care and recognizing that holistic/primary Family Medicine is the veritable cornerstone for any nation or society seeking a healthy foundation.
RPM (Remote Patient Monitoring) services using telemetric devices in patient’s homes are now becoming more the accepted and the preferred mode of managing some chronic conditions. These efforts are reporting excellent results with patient hospital readmission reduced, costly emergency room visits have decreased, and patients enjoy a measurable increase in wellness.
This is only the prologue. Device manufacturers are better served to consider initiating Family Medicine and preventative protocols into their programming. Most current RPM systems are robust enough to accommodate such indoctrination.
Of course, simply monitoring without the facility to access and initiate immediate medical intervention, limits the scope and effectiveness of the devices. US Tele-Medicine does provide 24 hour per day MD oversight at our National Triage Center, assuring our patients of immediate response to their needs.
The goal for US Tele-Medicine, our staff, and Medical Advisory Board is to merge Telemedicine protocols and devices with Family Medicine measures. New guidelines and strategies for incorporating Mass E-Care into the world of Family Medicine and basic care, which are so fundamental to the current and future general health of any population, are now in development.
Irrespective of politics, health care does need reform and new stratagems specifically when we consider increasing costs and while our birth rates have receded somewhat, we are living longer and incurring greater incidents of chronic diseases. There is also the daunting reality that soon, we shall be incorporating over Thirty Million new people into our health care rolls.
It is incumbent upon all of us in Health Care to provide a direct and personal channel for access to primary, cohesive, and coordinated medical care. We need to use monitoring devices and medical technologies linked to broadband, phone, cellular, or satellite systems, and deliver these services directly into the homes of families anywhere and almost everywhere.
US Tele-Medicine remains at the forefront in global health care telehealth advances, with its committed efforts to provide Mass E-Care and Family Medical care, using the latest in telemedicine technologies and applications. We encourage and call upon medical device manufacturers and medical providers and join us, by undertaking immediate steps within their areas of influence to shape the tenets of Family Medicine into their future technologies and modalities. The need is evident.
The Promise of Telemedicine is the facility to provide Mass E-Care and will be fulfilled when a patient in the remote plains of the Dakotas, or on the banks of the Colorado River, can enjoy access to basic and primary medical care at the touch of a button. Collectively, we can reach this level of service in the very near future, and ensure our population of the medical support required and desired through life.
Scientists from Johns Hopkins are testing an infrared device to help detect skin cancer, the most deadly of which is melanoma that affects 68,720 individuals annually according to the National Cancer Institute. Melanoma can kill, and the infrared device could have profound benefits for detecting skin cancer early and non-invasively.
Finding melanoma is not easy, and relies on appearance such as dark color, irregular edges, and changes in skin moles that may have been present for years. Biopsy confirms the diagnosis. Melanoma can also hide under the fingernails, in the groin, on the scalp, and on the back where many individuals may neglect to look.
“The problem with diagnosing melanoma in the year 2010 is that we don’t have any objective way to diagnose this disease,” said Rhoda Alani, adjunct professor at the Johns Hopkins Kimmel Cancer Center and professor and chair of dermatology at the Boston University School of Medicine. “Our goal is to give an objective measurement as to whether a lesion may be malignant. It could take much of the guesswork out of screening patients for skin cancer.”
The infrared device uses a unique way to detect melanoma. Cancer cells on the skin emit more heat than healthy tissue, but the difference is very subtle. The researchers at Johns Hopkins first cool the skin with compressed air, then record temperature changes in the suspicious area over two to three minutes. Cancer cells reheat more quickly. Then images are captured on camera.
“The system is actually very simple. An infrared image is similar to the images seen through night-vision goggles. In this medical application, the technology itself is noninvasive; the only inconvenience to the patient is the cooling”, says heat transfer expert Cila Herman, a professor of mechanical engineering in Johns Hopkins’ Whiting School of Engineering who has teamed up with Dr. Alani for the project. The current study has enrolled 50 patients to determine if the infrared system can work for finding melanoma early.
“Obviously, there is a lot of work to do,” Herman said. “We need to fine-tune the instrument — the scanning system and the software — and develop diagnostic criteria for cancerous lesions. When the research and refinement are done, we hope to be able to show that our system can find melanoma at an early stage before it spreads and becomes dangerous to the patient.”
Dr. Alani is optimistic, but cautiously so. She warns that the infrared device would not replace a dermatologist’s diagnosis for suspicion of melanoma, but envisions “that this will be useful as a tool in helping to diagnose early-stage melanoma.” The hand held device could also be developed into a full body scanner to screen patients with multiple skin lesions for melanoma that when detected early would save lives. So far, all of the melanomas in the patients studied were detected with the infrared scanner.
NEW DELHI – Health Minister Ghulam Nabi Azad Friday urged the scientists to tap the potential of therapeutic cloning to heal and regenerate damaged body parts and find treatment for complex medical problems.
“Although India remains totally opposed to reproductive cloning owing to the doubtful nature of its safety, success utility and ethical acceptability, therapeutic cloning can be considered on case-to-case basis,” Azad said at an Indian Council of Medical Research (ICMR) function.
He said the ICMR should “play an active role in realizing the potential of stem cell research and its technology in modern therapeutic and regenerative medicine”.
“A draft of guidelines for stem cell research/regulation on regulatory aspects of stem cell research and its applications prepared by ICMR will be very useful in this regard, Azad added.
V.M. Katoch, secretary for health research, told IANS: Therapeutic cloning is somewhat similar to stem cell research. This technique is useful to heal completely damaged body parts.
He said, the health ministry will try to bring in a legislation in parliament soon to regulate any deviation in therapeutic cloning and stem cell research. There should not be any (mis-) adventure. Everything should be for treatment.
After giving away ICMR awards to famous health scientists, Azad reiterated India’s progress on vaccine development especially on HIV. He said India has already completed phase one trial to develop vaccine for rota virus and HIV.
The two vaccines have completed phase I trials in India and there is promise of having a vaccine against this dreaded disease, the minister added.
Free software is secure, creators say
Researchers at Hamilton’s McMaster University say they have devised an electronic medical records system that can be implemented by physicians across Ontario for two per cent of the money the provincial government has spent on eHealth Ontario.
The web-based program, dubbed OSCAR, organizes medical records and can be set up on any computer system with a browser. It was first created in 2001, and has attracted more users each year.
Around 600 doctors across the country — including 450 family physicians in Ontario — currently use the software.
The software is open-source, which means users are allowed access to its basic code. Users are free to add to or modify the software without fear of legal repercussions, as long they abide by the conditions of the General Public Licence, which stipulates that the program must remain open and sharable.
Because it’s open-source, OSCAR is free. The costs to set it up come in the form of servers, hardware and support staff.
“In Ontario, there are approximately 8,000 family physicians that are not using electronic medical record systems. All these physicians could have OSCAR implemented within the next 24 months, and the cost would be less than $20 million,” Dr. David Price, chair of family medicine at McMaster’s medical school, said in a release.
While the software would be able to cover all the family physicians in Ontario, it is not as comprehensive in scope as eHealth, which is charged with linking all healthcare facilities, including hospitals and clinics, not just family doctors.
$1B spent already
Yet it can still help in digitizing Ontario’s medical records, said Dr. David Chan, who developed the software.
He said Ontario’s approach to building a health-record system is wrong. The province spent some $1 billion commissioning eHealth Ontario to produce an electronic medical database.
But in a report released Wednesday, Ontario Auditor General Jim McCarter said the province had wasted that investment and eHealth had little to show for its work.
We really don’t need to spend that kind of money. I think the government’s paranoia about building … a secure network is hugely expensive,” Chan said Friday.
People often get concerned about the security risks of open-source software, but Chan said it has passed stringent provincial security tests. It is no more vulnerable to hackers than more expensive proprietary software, he said.
American Medical News: Through teleconferencing technology, doctors are able to treat patients who live far away without access to a specialist. “Nationwide, telemedicine increasingly is being used to bridge gaps in access to care in rural and other medically underserved communities that have a hard time recruiting physicians. … The Centers for Medicare & Medicaid Services is making changes to promote telemedicine. In June, the agency proposed new policies that would make it easier for hospital officials to credential physicians who provide telemedicine services at their facilities. And in January 2011, CMS will expand Medicaid coverage for remote services, including disease management training for patients with diabetes or kidney disease” (Krupa, 11/22).
Austin American-Statesman: “Tech executives say Austin is positioned to be a player in health care technology, thanks to its deep pool of business software talent that is comfortable working in a startup environment and has expertise in creating products that save companies money. … So far, a handful of promising venture-backed players have emerged. … All in all, hundreds of computer hardware, software and services companies are competing for a piece of the market, which accelerated in 2009 with the passage of the federal economic stimulus bill, which set aside $19 billion in incentives for health care information technology. By one estimate, the government’s push to spur health care computer spending will help drive global health care IT spending to $106 billion by 2014, up from nearly $89 billion this year (Hawkins, 11/21).
The (Newark, N.J.) Star-Ledger: “Under federal health care reform, doctors must convert to an electronic system capable of chronicling each patient visit, tracking their care and sharing that information with hospitals and other doctors by 2015 — or the federal government will withhold some of the money it reimburses them for treating Medicare and Medicaid patients. … But so far, neither the promise of incentive nor threat of punishment is enticing a large number of New Jersey doctors to make the big switch. Only 20 percent of physicians in New Jersey have incorporated electronic medical records into their daily practice, compared to nearly 30 percent nationally, state Health and Senior Services Commissioner Poonam Alaigh said” (Livio, 11/21).
Here are some good sources of protein, as listed by the U.S. Department of Agriculture:
|1 ounce meat, fish, poultry||7|
|1 large egg||6|
|4 ounces milk||4|
|4 ounces low-fat yogurt||6|
|4 ounces soy milk||5|
|3 ounces tofu, firm||13|
|1 ounce cheese||7|
|1/2 cup low-fat cottage cheese||14|
|1/2 cup cooked kidney beans||7|
|1/2 cup lentils||9|
|1 ounce nuts||7|
|2 tablespoons peanut butter||8|
|1/2 cup vegetables||2|
|1 slice bread||2|
|1/2 cup of most grains/pastas||2|
8 Ways to Pump Up the Protein
If you’d like to start including more lean protein in your daily diet, try these eight simple tips:
- Take yogurt with you to the gym and enjoy it as a post-workout booster.
- Make your breakfast oatmeal with milk instead of water.
- Snack on fat-free mozzarella cheese.
- Use a whole cup of milk on your cereal.
- Try smoked salmon or one of the new lean sausages for breakfast.
- Take along a hard-boiled egg for an easy snack.
- Munch on edamame beans at meals and snacks.
- Choose round or tenderloin cuts of meat.
A surprising jump in the number of Americans hobbled by arthritis may be due to obesity, health experts said.
About 22 percent of U.S. adults have been told by a doctor that they have arthritis, the Centers for Disease Control and Prevention reported. The statistic comes from national telephone polling of tens of thousands of adults in 2007 through 2009.
That translates to nearly 50 million people with the joint disease. It’s also roughly the same percentage with arthritis as reported in a 2003-2005 study.
But there was a significant jump in adults who said their joint pain or other arthritis symptoms limited their usual activities, to 9.4 percent from 8.3 percent. That means more than 21 million adults have trouble climbing stairs, dressing, gardening or doing other things, up from less than 19 million only a few years before, the CDC researchers estimated.
That jump was “more than we would have expected,” said Dr. John Klippel, president of the Atlanta-based Arthritis Foundation.
Klippel said the increase probably was due mainly to baby boomers, who are at an age when they are more likely to suffer osteoarthritis, the most common form of arthritis. It breaks down cartilage and causes pain and joint stiffness.
He added that a complicating factor is high rates of baby boomers who are overweight and obese. Extra weight puts more pressure on arthritic joints, making the problem worse, he said.
The percentage of people who were hobbled was more than twice as high in obese people as those who were normal weight or were underweight, the CDC researchers found. Obesity can lead to or worsen osteoarthritis in the knees, the researchers wrote.
The study is published in a CDC publication, Morbidity and Mortality Weekly Report.
The male-female orgasm gap. The sex lives of 14-year-olds. An intriguing breakdown of condom usage rates, by age and ethnicity, with teens emerging as more safe-sex-conscious than boomers.
That’s just a tiny sampling of the data being unveiled Monday in what the researchers say is the largest, most comprehensive national survey of Americans’ sexual behavior since 1994.
Filling 130 pages of a special issue of the Journal of Sexual Medicine, the study offers detailed findings on how often Americans have sex, with whom, and how they respond. In all, 5,865 people, ranging in age from 14 to 94, participated in the survey.
The lead researchers, from Indiana University’s Center for Sexual Health Promotion, said the study fills a void that has grown since the last comparable endeavor -— the National Health and Social Life Survey — was published 16 years ago. Major changes since then include the spread of sexually transmitted diseases, the types of sex education available to young people, the advent of same-sex marriage, and the emergence of the Internet as a tool for social interaction.
Dr. Dennis Fortenberry, a pediatrics professor who was lead author of the study’s section about teen sex, said the overall findings of such a huge survey should provide reassurance to Americans who are curious about how their sex lives compare with others.
“Unless, like al-Qaida, you feel there’s something abnormal about the American people, what these data say is, ‘This is normal — everything in there is normal.'”
The researchers said they were struck by the variety of ways in which the subjects engaged in sex — 41 different combinations of sexual acts were tallied, encompassing vaginal and anal intercourse, oral sex, and partnered masturbation.
Men are more likely to experience orgasm when vaginal intercourse is involved, while women are more likely to reach orgasm when they engage in variety of acts, including oral sex, said researcher Debra Herbenick, lead author of the section about women’s sex lives.
She noted there was a gap in perceptions — 85 percent of the men said their latest sexual partner had an orgasm, while only 64 percent of the women reported having an orgasm in their most recent sexual event.
One-third of women experienced genital pain during their most recent sex, compared to 5 percent of men, said Herbenick, citing this as an area warranting further study.
The study, which began taking shape in 2007, was funded by Church & Dwight Co., the manufacturer of Trojan condoms. Questions about condom usage figured prominently in the study, but the researchers — during a teleconference — insisted the integrity of their findings was not affected by the corporate tie.
Among the findings was a high rate of condom usage among 14- to 17-year-olds. Of the surveyed boys who had sexual intercourse, 79 percent reported using a condom on the most recent occasion, compared to 25 percent for all the men in the survey.
However, the sample for that particular question involved only 57 teens in the 14-to-17 age range. That’s far smaller than the thousands involved in latest federal Youth Risk Behavior Survey last year which calculated condom use among sexually active high school students at 61 percent.
Fortenberry nonetheless found the new findings encouraging.
“There’s been a major shift among young people in the role condoms have in their sexual lives,” he said. “Condoms have become normative.”
Another intriguing finding — rates of condom usage among black and Hispanic men were significantly higher than for whites. The researchers said this suggested that HIV-AIDS awareness programs were now making headway in those communities, which have relatively high rates of the disease.
The lowest condom usage rates were for men over 50 — and the researchers said this was worrisome. Although men in that age group are more likely to be married than males in their teens and 20s, other surveys have shown 50s-and-over to be far more open to multiple sexual partners than in the past, raising the risk for disease.
Other notable findings:
–While about 7 percent of adult women and 8 percent of men identify as gay, lesbian or bisexual, the proportion of individuals who have had same-gender sex at some point in their lives is higher. For example, 15 percent of the men aged 50-59 said they had received oral sex from another man at some point.
–Among adolescent boys, only about 2 percent of the 14-year-olds — but 40 percent of the 17-year-olds — said they had engaged in sexual intercourse in the past year.
The survey was conducted from March through May of 2009, with the assistance of Knowledge Networks, among a nationally representative sample of adolescents and adults. Once people were selected to participate, they were interviewed online; participants without Internet access were provided it for free.
The researchers said the 1994 survey was compiled through in-person interviews, while the new method — collecting data over the Internet — may help make respondents more comfortable about discussing sexual behaviors.
Dr. Irwin Goldstein, editor-in-chief of the Journal of Sexual Medicine, noted that the new study came more than 60 years after Alfred Kinsey -— also based at Indiana University -— published his groundbreaking report, “Sexual Behavior in the Human Male.”
“Just like then, these papers contain material that is avant garde and often considered off-limits,” Goldstein wrote in a forward to the study. “At a time when we can have nudity on HBO but cannot use the names of our genitals on the evening news, there remains a need to continue research on sexual health.”
Millions of people who take vitamin pills could be putting themselves at risk of the deadliest form of skin cancer. Research has revealed that supplements containing antioxidants and minerals appear to increase the chances of developing a malignant melanoma.
Volunteers given pills containing vitamin E, ascorbic acid, beta-carotene, selenium and zinc were four times more likely to get cancer than those who took dummy pills.
The findings come from a follow-up study to one in 2007, which revealed the risks to vitamin-pill poppers.
The results of that research, by French scientists, showed that out of 13,000 adults, those who took daily supplements to stay healthy were at much higher risk of skin cancer.
To double-check their findings, the same team monitored patients for several more years. These results, published in the latest European Journal of Cancer Prevention, confirm that the increased risk virtually disappeared once patients stopped daily supplements.
Now scientists behind the research, carried out at the National Centre for Rare Skin Diseases in Bordeaux, are calling for those most at risk of skin cancer — fair-skinned types or those with a history of excessive sun exposure — to steer clear of supplements.
Women may be more at risk than men, possibly because they have more fat around the skin, where antioxidants and vitamins are mainly stored.
Malignant melanomas kill about 1,700 a year in the UK and are the third most common cancer in those aged 15 to 39. Over-exposure to the sun’s rays is the biggest cause. So far, the only proven way of reducing risk is to use high protection creams and wearing suitable clothing.
But it had been widely assumed that taking antioxidants would reduce the risk, since supplements theoretically protect the skin against damage from the sun’s rays.
The study, however, suggests supplements have the opposite effect. Scientists do not think taking vitamins actually causes malignant melanoma, rather it somehow speeds up the development of a tumor.
The findings are likely to heighten concerns about overuse of vitamins. Earlier this year, Swedish researchers found that taking daily multivitamin pills raised the risk of breast cancer in women by almost 20 per cent.
It is estimated that nearly a quarter of all adults in the UK take antioxidant supplements or multi-vitamins on a regular basis. The market is worth about Pounds 500million a year.
Dr Carrie Ruxton, from the Health Supplements Information Service, which represents supplement suppliers, said other studies had found no link between vitamins and skin cancer. She added the low number of skin cancer cases in the French research also cast doubt on the results.
Cancer Research UK stressed that vitamins and minerals found in foods did not appear to harm skin in the same way.
A spokesman said: ‘The best way to reduce the risk is to avoid sunburn.’
RECORD numbers of Scots from the ‘package holiday generation’ are dying of skin cancer, new figures show.
Deaths have risen by a third in only two years, most markedly among the age group which first took sunshine breaks in the 1960s and 70s.
The disease is now a bigger killer than either cervical or uterine cancer in Scotland. General Register Office for Scotland figures show that between January and June 2010, 102 people died from malignant melanoma. A decade ago, the disease claimed 115 in the entire year.
The Scottish Executive said it was funding campaigns to raise awareness of the disease.
America has a love affair with soy especially women who believe it fights osteoporosis and that soy formula is a good choice for infants. Although promoted as a health food, soy has been linked with numerous diseases including infertility and cancer.
Soybean farming is a multibillion-dollar industry. In fact, many of the worlds rain forests were cleared to provide more land to grow them. And as with so many health issues, once enormous profits are involved, it becomes difficult to get to the truth
I have two concerns about soy products. One is the direct effect of all soy products on health. The second is that more than 80 percent of all soybeans used for manufacturing foods are GMO (genetically modified). Genetic modifications cause the plant to produce abnormal proteins as well as to overproduce toxins normally produced by the plant. (For a detailed discussion on food safety, read my report “How to Avoid Poisonous Foods.”
But it’s not just modified soy that poses problems. Even natural soybeans have real dangers for health. One study found that infant monkeys fed soy extract soon after birth exhibited increased aggressiveness later in life and were socially withdrawn. Bad dietary choices can have profound effects on behavior, even producing criminal and sociopathic behavior. Soy foods are major players in this process.
Because soy contains estrogenic compounds, there is worry that it may disrupt the normal development of the brain, especially the brain’s sexual development. One study found that soy extracts could alter the development of the male hypothalamus, causing males to act more like females. It is the hypothalamus that determines our sexual behavioral development, especially a nucleus called the sexually dimorphic nucleus of the preoptic area (SDN-POA). (
When newborn male animals were fed soy formula (similar to human soy infant formula), this critical nucleus was reduced in size. In addition, males had greater difficulty maneuvering a maze when fed soy formula as an infant. In humans, this would mean boys would have greater difficulty learning.
Some studies have found soy formula had no effect on testosterone levels, but others found they were decreased. Most found that the prostate gland was significantly smaller in the soy-exposed males. Of considerable importance is the worry that feeding soy infant formulas to babies may cause them to act more feminine.
The soy-fed males also were found to have lower levels of brain 5-alpha-reductase in the hypothalamus and amygdala. These areas of the brain play a major role in sexual behavior. Low levels of this enzyme reduce levels of deoxytestosterone in the brain, the more powerful form of testosterone. A careful balance between estrogen and testosterone in the hypothalamus during early development is critical to sexual behavioral development.
The females fed soy had their own problems. The study found that when soy was fed to female newborns there was a significant fall in the release of oxytocin (dubbed the love hormone) from their brains. At least in the mice, this caused a decrease in sexual receptivity that is, they were less interested in sex. Oxytocin is also critical for normal social development. Among its many additional functions is protecting the brain from inflammation.
The females fed soy as infants also had much lower brain 17-estradiol (estrogen), which was found to have adverse effects on normal female behavior.
In essence, these studies clearly indicate that even small changes in estrogen and testosterone can have undesirable effects on the sexual behavior of both male and female animals. They also demonstrate that compounds such as soy extracts can have negative effects on these delicate hypothalamic nuclei even in adulthood.
Courtesy of Dr. Blaylock
For Immediate Release:
Hospital ‘Center of Excellence Program’ launched by US Tele-Medicine
Qualifying hospitals and clinics can now earn revenues derived from Telemedicine referrals. In addition, these hospitals and clinics will access a national Telemedicine provider as a solution to overflow issues and to support expansion.
“The global world of Telemedicine opens to these facilities without the major up-front costs and effort normally associated with developing an in-house Telemedicine department,” said Gideon Ilumin, Director of Business Affairs for US Tele-Medicine.
US Tele-Medicine, a national health care provider based in Beverly Hills, CA and licensed in twelve states, providing General Practice and Family Practice services, is forming joint ventures with hospitals and clinics in its territories. The program is called “Center of Excellence” and identifies these facilities as telemedicine approved. In the agreements, US Tele-Medicine refers its telehealth patients to the joint venture partners for consultation, imaging, surgical procedures, and specialty care.
“We present a number of solutions. First we increase hospital/clinic revenues, as the nature of telemedicine referrals generally involve more expensive specialty procedures that a telemedicine doctor cannot accomplish on the phone or internet,” said Ilumin. “Secondly our infrastructure brings a solution to clinics and hospitals wishing to expand their patient base, yet finding they are restrained by finances, personnel or structural limitations,” said Ilumin.
US Tele-Medicine supplies remote and wireless monitoring devices to patients that measure a number of vital signs and transmit that information to the US Tele-Medicine EMR (EHR) platform, for medical oversight. The strength of US Tele-Medicine is providing management for many chronic conditions in a less expensive environment such as the home or office.
Randy Ryder, US Tele-Medicine’s Director of Patient Services says, “Most clinics and hospitals need to expand to stay afloat. I understand that, but I also know that many people come to these facilities and wait, sometimes for hours, to see a physician, when all they are seeking is basic primary care or some support for a chronic condition. US Tele-Medicine is especially effective at treating this type of patient.”
“Imagine the improvement in ease of operation for a hospital or a clinic when you remove that patient load from over-utilizing facilities,” said Ryder. “Hospitals can then concentrate on being hospitals, rather than Doctor’s offices, and expand their specialties or surgical centers, where their economic strengths come from.”
So what happens to these patients? “They receive their care at home, in their offices or on the go,” answered Ryder. “Telemedicine is a modality proven to promote greater wellness, provide accessible medical care at reduced costs and do it immediately.”
Ilumin said “We are the most advanced telemedicine operation in the USA today, far ahead of others in the use of technology. By referring their patients to US Tele-Medicine, hospitals and clinics enter the world of telemedicine without the substantial up-front investment. Strategically this is very smart both financially and for reputations’ sake (marketing effectiveness) of that facility. Adopting the “Center of Excellence” program increases revenues and demonstrates to the world the inclusivity and understanding of state-of-the art medicine as well as adding tremendous public prestige.”
For more information, go to www.ustelemedicine.com,
email: firstname.lastname@example.org, or call 800-498-1081
Surgery to remove healthy ovaries gives a triple benefit to high-risk women: It lowers their threat of breast and ovarian cancer, and boosts their chances of living longer, new research suggests.
The study is the largest to date to find advantages for preventive surgery for women who carry BRCA gene mutations. Women with the faulty genes have a dramatically higher cancer risk than other women — five times greater for breast cancer and at least 10 times greater for ovarian cancer.
The study, appearing in Wednesday’s Journal of the American Medical Association, found benefits for women with two different BRCA gene variants whether they had previously had breast cancer or not.
The results offer more tailored evidence for women considering ovary removal, a surgery that ends fertility, fast-forwards them into early menopause and may contribute to osteoporosis or heart problems later in life.
“It’s really critical to have the best information when making such a profound decision,” said senior author Timothy Rebbeck of the University of Pennsylvania School of Medicine.
The researchers followed nearly 2,500 women with BRCA mutations in Austria, England, the Netherlands and the United States. All the women were cancer-free at the start. They were watched for an average of four years. Most of the women were younger than 50 at the start of the study.
They got counseling to help them choose between surgery or increased screening to watch for cancers early.
Ten percent of the women chose mastectomy and 40 percent chose to have their ovaries removed; some had both. More than half the women had neither surgery.
The women who chose ovary removal had impressive results:
_1 percent were later diagnosed with ovarian cancer that showed up in cells missed by surgeons, compared to 6 percent of the women who kept their ovaries.
_11 percent were diagnosed with breast cancer, compared to 19 percent of the women who kept their ovaries.
_3 percent of those who had surgery died, compared to 10 percent of the others.
The study also found preventive mastectomy lowered the risk of breast cancer. No breast cancers were seen in the women who had their breasts removed. That may seem unsurprising, but mastectomy can leave behind breast tissue that can turn cancerous.
The study was observational, meaning it can’t prove one choice was better than another. Other factors could have caused differences in the women’s cancer rates.
But the results will help doctors counsel their patients, said Dr. Virginia Kaklamani of Northwestern University’s Feinberg School of Medicine in Chicago, who wrote an accompanying editorial in the journal.
“I’ll use it mostly in talking to people considering genetic testing,” Kaklamani said. “I can tell them, ‘If we know you test positive, there are things to do that will help you live longer.'”
The increased risk for BRCA carriers is frightening. In the general population, about 12 in 100 women will get breast cancer during their lifetimes, compared to about 60 in 100 women who have faulty BRCA genes, according to the National Cancer Institute. For ovarian cancer, the lifetime risk in the general population is a little more than 1 in 100 compared to 15-to-40 in 100 women with BRCA mutations.
For women with a family history of breast or ovarian cancer, the decision to get tested can be agonizing. The $3,300 blood test, while often covered by insurance, can disrupt families, force decisions on childbearing and leave a woman feeling stigmatized. Surgery costs thousands of dollars, not including lost time at work. Without preventive surgery, a woman faces a regimen of mammograms, MRIs and blood tests to look for cancer.
But several signs point to “the beginning of a new era” for high-risk women, said Joanna Rudnick, a 36-year-old Los Angeles filmmaker. She has known for nine years that she carries a breast cancer gene mutation. Engaged and planning to have children, she’s also planning to have her breasts and ovaries removed when she’s 40. Her documentary “In the Family” tells about her choices and those faced by other “BRCA-positive” women.
With testing more than a decade old, researchers are just beginning to have better data to understand the benefits of risk-reducing surgery. For high-risk women, equally important are the breakthroughs in cosmetic breast reconstruction, laws to prevent genetic discrimination and evolving attitudes toward removing body parts to avoid cancer, Rudnick said. A federal judge recently struck down patents on the two genes held by Myriad Genetics Inc., which may widen research possibilities and testing options.
Rudnick’s glad to hear ovary removal may reduce her risk of breast cancer as well as ovarian cancer.
“This is one of the rare silver linings that has been learned from these prospective studies,” Rudnick said