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Archive for May, 2010

The latest Texas MD Anderson Cancer Center research reveal that,PEM scanners with high-resolution breast PET systems are able to assess early Neoadjuvant Chemotherapy signs. The research work was produced at the American Association of Cancer Research Annual Meeting in Washington, DC, by the University of Texas MD Anderson Cancer Center.

Positron Emission Mammography ( PEM ) scanners containing high-resolution breast PET systems, are capable of identifying the location and the metabolic phase of a lesion. The report is cruicial in evaluating a lesion’s malignancy and its effect on the process of patient care. Unfortunately, Mammography and ultrasound imaging systems are only confined to projection of their location and not the metabolic phase.

Dr. Wei Yang, Associate Professor of Radiology at the University of Texas MD Anderson Cancer Center in Houston and her team of researchers discovered that, PEM or Positron Emission Mammography capacitates medical practitioners to detect a patient’s reaction to neoadjuvant medical therapy, at an early stage. Neoadjuvant Chemotherapy is commonly a cancer treatment where the patient is medicated with a drug for the reduction of the size of a tumor before the surgery is conducted.

9 patients with HER2 over-expressing Inflammatory Breast Cancer (IBC) in a Phase II neoadjuvant trial of lapatinib were absorbed in the study over a period of 14 days with chemotherapy following suit. Baseline tumor measurements on mammography, sonography, PEM and PET/CT scans with serial biopsies were taken. The PEM and biopsies were again conducted on the 14 the day. Standardized uptake value (SUV) and Quantification of tumor activity known as PEM uptake value (PUV) were compared for PET/CT pre- and post-lapatinib and correlated with tumor size and proliferation marker Ki67.

The outcome of the study said, critical early recede in PUV as a functional reaction to targeted therapy makes PEM as an early evaluator of patient response of the Neoadjuvant Cancer treatment therapy. Look forward to further peer-reviews as and when the surgical results of the patients are published.

“The high spatial resolution of PEM combined with functional quantification tools has the potential to assess tumor response early in the course of treatment,” said Dr. Yang, lead author on the study. “The ability to perform correlative studies that may help discover early on if targeted therapy is working or not will potentially save a patient from enduring the wrong type of neoadjuvant chemotherapy and enable a timely switch to the right one.”

The new KLAS report indicates a high demand for Health Information Technology consultants and staff augmentation by providers to attain the ‘Meaningful Use’ criteria.

“Shifting Demand for Consultants: Who’s Hot, Who’s Not, and Why”, The new KLAS report involved 118 healthcare providers interviews. The Key Features of the Report are as follows;

• Almost 70 out of 100 providers interviewed by KLAS look forward to hiring professional services firms who’ll assist in achieving meaningful use.
• Atleast 13 consulting firms compared to only 5 in 2007, now have significant provider mindshare.
• CSC benifits from most of the mindshare among providers who are searching for hiring outside help, with 17% of deals. Vitalize is 2nd on 12 % of purchase decisions, followed by Dell Perot at 9 %.

“The healthcare IT professional services landscape has changed dramatically in the last three years,” said Mike Smith, general manager of financial and services research for KLAS and author of the new report. “Not only has the number of considered firms increased significantly, but the nature of services projects has changed as well. Since most large hospitals have already completed a major EMR implementation, more targeted engagements with smaller budgets – including advisory services and staff augmentation – are replacing the big budget, large-scale implementations.”

EHR Summit will share valuable data on the recent initiatives and progress made in healthcare reform from various medical institutes, hospitals, clinics and other healthcare providers.  This year’s event in Chicago,will feature “Meaningful Use,” ARRA stimulus funding, system cirtification and HITECH & HIPAA Policies.

The list of Speakers are as follows;

• Vish Sankaran,  Program Director, Federal Health Architecture, Office of the National Coordinator for Health IT, U.S. Department of Health and Human Services
• Dr. Robert A. Carlson, CIO, Marshfield Clinic
• Richard G. Korman, Esq., General Counsel/Organizational Integrity Officer, Saint Joseph Regional Medical Center
• Connie Tohara, RHIT, Director of Health Information, University of Utah Health Care
• Michelle Mills, Director of Project Management, University of Utah Health Care
• Hank Fanberg, Manager, Research & Development, CHRISTUS Health
• Dr. Todd Rothenhaus, MD, SVP & CIO, Caritas Christi Health Care
• Dr. David Kaelber, MD, PhD, MPH, Chief Medical Informatics Officer, The MetroHealth System
• Dr. Dexter W. Shurney, MD, MBA, MPH, Medical Director, Employee Healthcare Plan, Vanderbilt University and Medical Center
• Jane Shlaes Dowd, Chief Learning Officer, NorthShore University HealthSystem
• Dr. Douglas E. Rosendale, DO, FACOS, Enterprise System Manager, Office of Health Information, Veterans Health Administration Office of Health Information, Joint Interoperability Ventures
• Mark Moffitt, MBA, BSEE, CIO, Good Shepherd Health System
• Dr. Leslie S. Zun, MD, MBA, FAAEM, Chairman & Professor, Department of Emergency Medicine Chicago Medical School and Mount Sinai Hospital
• Dr. Jayna M. Holroyd-Leduc, MD, FRCPC, Assistant Professor, Departments of Medicine and Community Health Sciences University of Calgary and Clinical Informatics Lead for Medicine, Alberta Health Services-Calgary
• Martin J. Hatlie, JD, CEO, Coalition for Quality and Patient Safety
• Paul Keough, Principal, TurnKeough Corporation
• Robert E Matthews, Executive Director, PriMed Physicians & Health First Physicians, President & CEO MediSync
• Susan Miller, Director of Strategic Implementations, PriMed Physicians, Health First Physicians and MediSync

The conference is strongly EHR-centric. A distinct scope of collaboration and exchange of relevant information about how to positively implement affordable EHR plans will be the significant topics to look forward to. The other draw are the EHR Brilliance Bar and interactive workshops. Multiple communicative sessions will be held for attendants facilitating EHR specific Q&A.

“With the unprecedented new health care reforms it is more important than ever to understand what you need to do to keep pace with the digital age. This conference will provide best practice strategies intended to put your organization at the forefront of signature health delivery,” said Christopher Boucher, Senior Program Director, Healthcare IQ.

A new CT technology that utilizes cone-shaped X-ray beams and a digital flat panel detector to produce 3-D images are studied by Radiologists at Emory University.

Thousands of women are dying of breast cancer in US and the rest of the world every year.Mammograms and clinical breast exams are usually performed to investigate the intentsity or trace tumors. However, younger women below 50 years may not be detected accurately by mammograms.

Emory University is one of the only three sites in the United States studying the CT breast scanner manufactured by Koning Corporation.Three set studies are being conducted by Radiologists at Emory University with a new CT technology using cone-shaped X-ray beams and digital flat panel detectors to produce 3-D images. In the First Test The new breast CT scan is compared with diagnostic mammography as a tool for detecting cancer. The 2nd test included enhanced CT scans compared with contrast dye with MRI in the evaluation of newly diagnosed breast cancers. 3rd, they are examining the effectiveness of breast CT scans in tracking how tumors are responding to chemo treatment.

1,093 patients have been examined on both stereo and standard digital mammograms by the Emory doctors. All the patients were on high risk alert for developing breast cancer.

This capacitates the researchers to re-build a breast image from all angles. Further with computerised processing, focus on calcification is maintained. The CT may however, be used for routine screenings or in combination with other technologies for cancer diagnosis and treatment. 300 pictures in ten seconds from this new prototype cone beam CT scanner is expected each time. The X-ray beams and a digital detector rotate around the breast to take the desired images for checks. The 3D images from the scan can locate tumors upto five millimeters in size.

The new digital technology,called Stereo mammography may also decrease the number of women recalled due to false postives by 49% unlike the conventional digital mammography that only features a two-dimensional image.

“Standard mammography is widely considered to be one of the most difficult exams to read because lesions may be disguised by normal tissue,” says radiologist Carl D’Orsi, director of breast imaging.”

Black Duck Software analysis suggests, that, EMR and Practice management backed open source projects for health care applications development in the last one year.

Below mentioned are the project details:

• OsiriX – 3D DICOM Viewer
• CARE2X Integrated Hospital Information System, with surgery, nursing care, outpatient, Wards, Labs, Pharmacy, Security, Admission, Schedulers, Repair, Communication & more.
• FreeMED GPL- EMR and Practice Management system for medical providers that are liscenced
• OpenEMR Open Source Practice Management, Electronic Medical Record, Prescription Writing and Medical Billing application.
• Biosignal Tools – Software library for processing of biomedical signals (EEG, ECG, etc.)
• OpenHMS – Collection of projects and many subprojects developed by Health Market Science. This is a robust collection of development libraries, APIs, and tools oriented around data manipulation and professional software development.

For further details, visit the Black Duck website.

The Black Duck analysis indicates a 13 % growth in the number of projects, with a 38 % growth in lines of code from 2009. The cost of development of projects combined include over 124 million lines of code have grown to approximately $8 billion USD, up from 2009′s estimate of $6B, representing 45,000 staff-years of development effort.

Recently confirming its membership in Open Health Tools, Black Duck hovers over the Internet for open source code, collecting information about projects and code into the Black Duck KnowledgeBase, containing information on more than 230,000 open source projects from more than 4,500 unique websites.

In addition to improving access to data and bringing innovation to health care IT, the top projects in the Black Duck analysis offer faster time-to-solution and cost-avoidance to an industry facing sweeping reform at the federal level,” said Peter Vescuso, Executive Vice President, Black Duck Software. “The increased focus we see on interoperability as a project goal in health care reflects trends in the broader open source community, which supports the increasing role that open source projects can play in advancing the state of health care IT.”

The Extended Learning center,California State University Commission (CSUSM) was awarded $50,000 in order to motivate the progress of a new certification Health Information Technology (HIT).

A Swedish Research suggests, the premature death toll from breast cancer may be eliminated by more than 40 percent by Regular screening of mammogram Investigation.

A research based study in Sweden( 2003) explained how women in their 40s undergone mammograms had a 48% lower death toll from breast cancer. An estimated 18% reduction out of that 48% risk reduction, in mortality was from improved treatment, and a 30% mortality reduction was attributed to mammography alone.Data from Sweden suggests that breast cancers in women in their 40s are more biologically aggressive and therefore spread faster to other parts of the body sooner than in older women and yearly mammograms for those women may double the possibilities of survival than those undergoing mammograms once in 2 years. Yearly mammograms will save lives nine times more than those who underwent mammograms once in every three years. Thus,A Mammography is crucial every year in order to keep cancer in check at it’s onset.

The American Cancer Society recommends women to start mammograms at age 40 and continue for the rest of the lifespan. Women suffering from the terminal disease between the age group of 40 and higher have double the chances of spreading to lymph nodes within a year.

Surprisingly, men diagnosed with breast cancer do not die from the disease in maximum cases. But for women, the earlier it is detected, the better are the chances of survival.

Recent Dutch research reveals, refining radiotherapy to check the growing parts of patient’s tumor that are growing faster,could regulate cancer while keeping patients to lower doses of radiation.

The device used to perform this is a form of positron emission tomography scanning called FDG PET. PET scans measure the glucose metabolism of a tumor by injecting ‘radioactive sugar’ and measuring where the radioactivity (and hence the sugar) is absorbed in the body.

Tumors have an increased metabolism compared to normal tissue, which makes them show up well on PET scans. In most cases, lung tumors are visible on PET scans as a bright sphere, with the highest intensity in the middle.

“The underlying question that motivated this study was: can we give less radiation dose to these cold spots? If it turned out that these cold areas show less signal on a PET scan because there are less active tumor cells, then the answer would be yes. However, it could also have been that the radioactive sugar doesn’t reach the cold spots for other reasons.” Dr Siedschlag explains

At the ELCC meeting, the group reports preliminary results showing that indeed in most cases the cold spots consist of dead tumor cells. In 7 out of 61 patients they saw cold spots on PET scans. Surgical examination showed that in five cases, these spots were in fact dead cells.

“The only problem in radiotherapy is minimizing the side-effects,” says lead researcher Dr Christian Siedschlag from the Dutch Cancer Institute. “If one could hit the tumor with arbitrarily high doses without having to worry about complications, all tumor cells could be killed with 100 percent certainty. Unfortunately this is not the case, therefore one must take every chance to administer no more dose than is absolutely necessary.”

“By decreasing the doses given to the cold spots, one might be able to increase the dose given to the rest of the tumor, while keeping the normal tissue dose constant. Or one could keep the dose given to the rest of the tumor constant, which would lead to less side-effects with an identical therapeutic result.”on dose to these cold spots? If it turned out that these cold areas show less signal on a PET scan because there are less active tumor cells, then the answer would be yes. However, it could also have been that the radioactive sugar doesn’t reach the cold spots for other reasons.”

The latest report in KLAS says, that, BI or The enterprise business intelligence solutions positioned at hospitals are more inclined to evolve from general software companies like SAP and IBM

The newest KLAS report , ‘Enterprise Business Intelligence’ is about opinions of approximately 180 healthcare provider executives to determine the market for enterprise BI solutions, that binds financial and clinical data analytics to assist providers analyze recent developments and make subjective decisions.The report stands witness to the popularity of industry-agnostic vendors, largely shadowing the interest in solutions from Cerner, Eclipsys, Epic, GE and Siemens.

Even if the concern BI adoption is still comparitively unspoken of, in the healthcare industry, Dimensional Insight, IBM, Information Builders and SAP had adequate and authenticated deployments to be ranked in the KLAS report. Basically, the providers appreciated the sellers for rendering strong and well-balenced devices that offered a whole new range of information options and their customers generally represent the deepest adopters of business intelligence. However, expanded balence may also result in complications.

Dimensional Insight was first on the enterprises list in the report. Information Builders and McKesson came after. The others include Cerner, IBM, Lawson, Microsoft, Oracle, Precision.BI, SAP, SAS and Siemens. McKesson, among principal hospital vendors, was ranked in the KLAS report with its Horizon Business Insight product.Cerner offered its BI capabilities ahead of clinical analytics and into the financial realm, with limited access. The KLAS report also mentions about the part where providers hope BI to consider meaningful use. Many observers are of the impression,that, BI solutions will be pivotal in meaningful use.

“Providers have indicated that many of the industry-agnostic vendor solutions are so highly configurable and complex that organizations without a sizable IT department find the systems unwieldy and sometimes beyond their capacity,” said Lorin Bird, KLAS research director and author of the new report. “For instance, IBM clients who used consultants to implement Cognos scored the solution roughly 10 points higher than those who did it themselves.”  As one provider said, “BI will play a critical role. Never before have we been so carefully scrutinized, and the BI system helps us provide the information and reports needed to be successful.”

A study finds that surgeons specially trained to perform breast cancer surgeries can interpret a mammogram as good as a trained breast radiologist and they provide an excellent alternative to meet the shortage of radiologists.

The findings of the study, titled ‘Surgeon-Read Screening Mammography: An Analysis of 10 020 Examinations,’ was presented at the 11th Annual Meeting of the American Society of Breast Surgeons.

The objective of the study was to determine whether the reading performance of breast surgeons can be compared to that of mammography radiologists.

The prospective research involved 13 622 mammograms read at a dedicated, surgeon-run breast health centre between January 2003 and June 2009.

Mammograms were conducted according to conventional mammography guidelines by certified technicians on state of the art film-screen and from July 2006 on full-field digital equipment.

All the mammograms were double read by two experienced breast surgeons and the findings were catagorised according to BIRADS.

The study concluded that the findings of the breast surgeons were equivalent to that in organized national screening programs run by specialized breast radiologists in Europe and Australia. With fewer recalls, a lower biopsy rate with a higher malignancy rate of biopsy and a high cancer detection rate, they were better than highly skilled radiologists in the United States.

This study provide a first benchmark for surgeon-read screening mammography.

“These findings suggest that the ability to precisely analyze breast images is enhanced by both ongoing experience and specialized training,” comments Justus Apffelstaedt, MD, FCS (SA), Associate Professor of Surgery and Head: Breast Clinic, University of Stellenbosch, chief author of the study, who practices at the South African site. He added that, ‘Breast surgeons review large numbers of breast images as part of their ongoing treatment planning and delivery.  Now, this study shows that with appropriate training, they prove to be highly accurate primary mammography interpreters.’