Medicexchange.com News

Archive for March, 2010

University of Nebraska Medical Center (UNMC) lymphoma experts say that patients who are completely treated for lymphoma are recieving unnecessary Computed Tomography (CT) and Positron Emission Tomography (PET) examinations during their follow-up visits, often on the patient’s requests.

UNMC oncologist, Julie Vose, M.D., and co-author Malik Juweid, M.D. published their comments regarding this issue in a letter the editor in the March Edition of the ‘New England Journal Of Medicine’. They said that only a small percent of the Hodgkin’s lymphoma recurrences are diagnosed by PET/CT while majority is detected by the patient himself or during the doctor’s routine examination of the patient without imaging.

This leads to unnecessary radiation exposure and also unnecessary expediture. The radiation exposure has the risk of other cancers like lung and breast cancer.

During follow-up, physical examination, educating the patient about symtioms, routine blood tests and a yearly chest x-ray would be sufficient. Dr. Vose said that that the policy is not to do a scan unless there are symptoms or positive examination findings.

“In patients at low risk of recurrence, reducing the exposure to excessive radiation is an important goal,” she said.

The NHS Database in England might be pulling in information from patient’s confidential medical records without consent, doctors have warned.

The British Medical Association (BMA) said it has “serious concerns” that patient medical records are being uploaded too quickly to a national database.

The system will eventually link more than 30,000 GPs to nearly 300 hospitals through an online appointments system (Choose and Book), a centralised medical records system for 50 million patients, e-prescriptions and faster computer network links.The centralised medical records system, Summary Care Record (SCR), will include dats on the patient’s allergies, medication and adverse reactions, and more with time.

Amidst criticism that the NHS IT upgrade is taking time, the department of health announced in december that they would accelerate the development of the medical records system will be accelerated.

The process will pull the required information from the patient’s medical records to the NHS, the patient will be notified during the process and then they can opt out if they want.

The British Medical Association fears that when the speed with which the programme is being implemented is raising concern.

Hamish Meldrum, chairman of the BMA, said “Patients’ right to opt out is crucial, and it is extremely alarming that records are apparently being created without them being aware of it.”

The American College of Radiology (ACR) writes to Obama stating the benefits of CT colonography (CTC), also known as virtual colonoscopy, and his recent physical examination which included the test, as a rationale to require medicare coverage for the latest colorectal cancer screening technology.

Studies have shown that CTC is accurate as standard colonography and the benefits include low invasiveness, lack of sedation, lesser cost, much less procedure time and more importantly the patient can go back to work directly after the procedure which will attract more people to undergo the test and thus saves more lives.

Colorectal is the second leading cause of cancer deaths in the United States; and while Medicare denies CTC coverage, many private insurers like CIGNA, United Healthcare, and Anthem Blue Cross Blue Shield now cover screening as wellas diagnostic CT colonography. The congress needs to act to require Medicare coverage to CTC.

The American Cancer Society endorses CT colonography and added it to its list of recommended colorectal cancer screening exams and suggests that the exam be repeated every five years.

With more international companies exploring opportunities to invest in the expanding healthcare industry in India, the ‘Hospital Infrastructure India 2010‘ provides an ideal platform to meet the key players in the Indian healthcare market as well as the major healthcare facilities.

According to KPMG ( https://www.kpmg.com/Global/en/IssuesAndInsights/ArticlesPublications/Documents/Infrastructure-trend-monitor-India-2009.pdf ), the Indian healthcare industry is expected to double the value by 2012 and quadruple by 2017 and the health infrastructure across Indian states is projected to grow by an average of 5.8% per annum between 2009 and 2013, taking the total expenditure in 2013 to $14.2 billion.

Healthcare Infrastucture India 2010, which will be held from 7-9th december 2010 in Mumbai, is the only international event in India focussed on healthcare infrastucture and supplies.

Even when the Medicare and Medicaid Services denies CT colonoscopy (CTC) coverage for senior citizens, President Obama himself underwent this screening test for colon cancer screening as part of his first physical exam as commander-in-chief.

CT colonoscopy (CTC), also called virtual colonoscopy, is a non-invasive test that is widely accepted by radiologists and gastro-enterologists as a patient friendly and quite effective screening test for large bowel cancer. Inspite of recommendations from organizations like American College of Radiology, and various studies supporting it,  the medicare has refused to cover the test.

Now the news that Obama has recieved virtual colonoscopy test has spiced up  the controversy again. The American College of Radiology (ACR) stated in their press release that the administration has to ensure that seniors have the same access as the President to this less invasive, cutting-edge care.

“……The President and his doctors have unparalleled access to the latest medical and scientific information. The fact that he opted for CTC should put to rest any empty arguments against the viability of CT colonography. It’s time for all patients who want a CT colonography to be covered for this lifesaving exam. Medicare needs to provide coverage now,”said James H. Thrall, MD, chair of the ACR Board of Chancellors.

Contrary to the opinion of ACR, American College of Gastroenterology (ACG) wrote to the President that “while a ‘virtual’ exam is better than no exam, for most people, colorectal screening by colonoscopy is the preferred strategy.”

ACG president Dr. Philip O. Katz, wrote that, “Our 11,000 physician members are concerned that you missed an important opportunity to set an example of the power of prevention by taking the test proven to prevent colorectal cancer by polyp detection and removal.”

The energy of the sound waves emitted by an ultrasound machine is the latest technology next in line of non-invasive and non-surgical cosmetic techniques for facelift.

The innovative procedure called Ultherapy™, which has been in use in Europe and Asia since early 2009, has recieved FDA clearance in september 2009. The Ulthera system uses tightens the folds of the facial and neck skin using ultrasound energy; and the patient gets a facelift and neck lift in mere 30 minutes as an out-patient procedure.

Dr. Michael Bailey, M.D. who uses this technology in his cosmetic clinic in Boise, ID is among the first cosmetic surgeons adopting the technology in the U.S.

“We now have the ability to use ultrasound imaging to see the layers of tissue we want to treat below the surface of the skin, and then focus the same ultrasound energy to treat just the targeted tissue,” says Dr.Bailey.

He explains further that the response and results to the procedure is gradual because the treatment triggers a tissue regeneration process in the treated area and the collagen fibres developed fills under the skin tightening and lifting it. He also hopes that patients will accept this procedure as it is non-invasive.