Archive for July, 2010
CTC not cost-effective at colonoscopy reimbursement rate
July 28th, 2010 | 
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It has been found that the CT colonography or the virtual colonoscopy is not cost-effective when reimbursed at the same rate as colonoscopy, in a latest study published in The Journal of the National Cancer Institute.
As many people are aware of the fact that colon cancer is one of the most common cancers in people over a certain age, it is also noted that a patient has to go through several screening methods to detect it. The most wide spread procedure that is used and suggested is of colonoscopy. This procedure consists of a small camera on a tube which is inserted through the anus to remove polyps that pose a risk of colorectal cancer and biopsy lesions suspicious of cancer. Computed tomographic colonography or rather known as CTC is a type of CT scan that brings out 3D images from the interior of the colon. If an unhealthy atmosphere is noticed during scan then the individual is referred for a follow-up colonoscopy to eradicate the lesions.
It was Amy B. Knudsen, Ph.D., of the Institute for Technology Assessment at Massachusetts General Hospital, and colleagues, who was the one behind the use of three different simulation models to calculate the lifetime costs and life expectancy associated with 15 screening strategies, including no screening, CTC screening every five years, annual fecal occult blood test (FOBT), flexible sigmoidoscopy every five years, flexible sigmoidoscopy every five years in conjunction with the annual FOBT, and colonoscopy every ten years.
The researchers concluded from their finding that “the number of life-years gained from 5-yearly CTC were just a bit less than the number gained from 10-yearly colonoscopy screening. Further research found out that if the CTC was reimbursed at $488, almost the same rate as colonoscopy, then the costs associated with CTC screening exceed those of colonoscopy. It was also found that if the rate of unscreened groups was reduced, then the procedure turned out to be cost-effective. As the Centers for Medicare and Medicaid Services is at present not providing reimbursements for CTC screening, the percentage of individuals who would opt for colon cancer screening is still in dark.
In conclusion, the authors write, “If CTC screening is reimbursed at roughly the same rate as colonoscopy, the cost, relative to the benefit derived and to the availability and costs of other colorectal screening tests, is too high for it to be a cost-effective screening strategy.”
It turns out that $108-205 per scan would be the perfect reimbursement cost-effective range. The study also “highlights that comparative effectiveness research, and cost-effectiveness analysis in particular, can also be used to inform reimbursement levels,” the authors write.
Russell Harris, M.D, MPH, of the Cecil G. Sheps Center for Health Services Research at the University of North Carolina, has raised few concerns on the safety and efficacy of both CTC and colonoscopy. It is noticed that CTC often has reactions in the kidneys or adrenal glands which will need few more tests to diagnose them. Colonoscopy often leads to removal of small polyps that are harmless if left in the body which leads to bleeding. Harris writes, adding:”Wouldn’t it be interesting if we ended up, a few years from now, with neither CT colonography nor optical colonoscopy as the primary screening test but rather an improved fecal test as our ‘gold standard’?
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Wi-Fi, RTLS Usage rising in Healthcare and Medical Sector
It is also seen that WiFi is made available and reachable to patients and health care practitioners.
A study presented by ABI shows the use or machines and wearable wireless sensors have increased to a great extend. This helps the doctors to monitor the patients remotely. WiFi Real Time Location System (RTLS) enables hospital administrators to keep a watch on whatever the hospital owns and the patients that are present at the hospital.
ABI Research principal analyst Jonathan Collins said “WiFi adoption has helped overcome initial concerns about complexity and reliability of wireless within health care. The growing number of wireless technologies and wireless applications being developed, piloted and deployed within health care further underline the level of interest in using wireless to improve the flexibility and efficiency of health care services around the world.”
It has been tracked by ABI that WiFi is being used in areas such as remote patient monitoring, telehealth and telepresence. Through videoconferencing or other messaging services, a large group of individuals can work together no matter how distant they are.
It is also concluded by research firms that the recession that hit during 2009-2010 had absolutely no obstructions to the growth of the wireless activity. Another feature of this system is the advantage to stay in touch with your relatives even when the patient is hospitalized.
Kelly Davis-Felner, marketing director for the Wi-Fi Alliance said “The health care industry has come to rely on Wi-Fi because of its versatile, proven technology that meets health care’s unique needs — data-intensive work in highly mobile environments. It has advanced security mechanisms, high-performance technology, a robust certification ecosystem and an enormous range of certified devices”
The ABI’s Wireless Health Care Research Service has also tracked various wireless technologies like Bluetooth, Low-Energy Bluetooth and proprietary low power RF offerings to see how it’s used in areas such as WLAN, personal monitoring, disease management, assisted living and telepresence.
Collins said “Wi-Fi can certainly support this kind of application, but there are some lower-power technologies that it will have to compete with such as Bluetooth Low Energy, Zigbee and proprietary offerings. Any offering in this market will have to be extremely simple to install, and operate. And existing Wi-Fi connections can’t be relied upon to always be present.”
KlAS: Few Vendor Options in The HIE Market
The latest KLAS report discusses the Healthcare providers organizations’ consideration of atleast 38 serious vendors in their quest for health information exchange (HIE).
The plan includes both connecting competitive hospitals and providing a link between community physicians. However, only 5 companies were deemed significant in more than 10 % of buying decisions, among the rest. The HIE planned software purchases of 95 healthcare providers, also including those vendors who were considered by them in their search are all mentioned in the new KLAS report, called Health Information Exchanges: Perception in an Expanding Frontier.
Out of 40 vendors that were mentioned in the research, only a few were weighed with relative frequency, Medicity was considered in 23 % of HIE buying decisions, Axolotl at 22 %, RelayHealth -16 %, ICA -11 %, and Epic 11 %. Epic is however, strongly considered only for Epic-to-Epic connections.
The KLAS report also identifies the HIE management structure, in part, for healthcare providers to understand the type of solution a provider will consider:
- Public HIEs – A public exchange may either be a part of official state agencies, or semi-independent with direct and temporary government support. Public HIEs greatly expect strongly scalable solutions and standards-based technology.
- Cooperative HIEs – In this format, hospitals, that are otherwise competitive, cooperate to create independent Health Information Exchange organizations.They will forward open invitation to other hospitals, clinics and physician practices. These HIEs are constantly searching for vendor solutions that offer flexible and affordable cost alternatives while best adapting diverse EMR technologies. They are also making efforts to establish long-term funding.
- Private HIEs – This category of private HIEs is meant to improve relationships as well as information exchange . These Health Information Exchanges will possibly settle for solutions, best suited to support their existing technology. Funding is easy.
Axolotl, Cerner, dbMotion, Epic, GE, ICA, InterSystems, Medicity, Orion and RelayHealth were most frequently considered out of 38 vendors referred by providers in Health Information Exchanges: Perception in an Expanding Frontier
To learn more about the health information exchange market, as well as the vendor solutions being considered by potential buyers, the new KLAS report is available to healthcare providers online for a significant discount off the standard retail price. To purchase the full report, healthcare providers and vendors can visit the official KLAS website.
“The sheer number of HIE vendors vying for provider mindshare makes finding the right solution uniquely challenging,” said Jason Hess, general manager of clinical research for KLAS and author of the new report. “Technology, cost and integration were the selection criteria most often mentioned by prospective buyers, but evaluating those factors is especially difficult when most HIE vendors can point to only a handful of live deployments.”
KLAS: Cardiology IT Users Contemplate CVIS Replacement
The recent KLAS report, Cardiology IT: Has the industry missed a beat?, discusses the CVIS solutions market and notices the client discontent for majority of vendors, apparently, showing a deteriorating trend.
About 30% of those who were questioned in the new KLAS report responded with disappointment and mentioned that they are contemplating replacement of their cardiovascular information system (CVIS) software due to constant product disfunction and integration.
The KLAS report interviewed 371 provider organizations. Their experiences with about a number of CVIS software vendors instigated the consideration of system replacement. The major reason being unsatisfactory performance from maximum vendors in the circuit.
Digisonics and Philips, however, have been able to retain their reputation. The other vendors in the study met with low client-satisfaction score compared to last year’s report. Hence, making the market segment one of the lowest, KLAS has monitored.
General Manager of Medical Imaging and Medical Equipment research for KLAS and author of the new CVIS study, Ben Brown, has said that, “When providers speak about the cardiology market, the overall tone is one of stagnation, Client satisfaction continues to trend downward industry-wide as vendors fail to deliver on integration, functionality and service expectations.Cardiology is a fragmented IT environment with a wide-open market waiting for a leader to step forward and deliver.”
An intensively researched and genuinely integrated IT base for the cardiovascular department as a whole is still missing in the industry.The providers have seen minimal advancement from last year’s study, analysed KLAS. Vendors who can deliver a complete package to the market is still very few. Even though, Agfa, Merge (AMICAS) and GE are compatible to offer wider solutions and providers also appreciate LUMEDX’s and McKesson’s integrated systems.
KLAS also noted, ScImage and Merge (AMICAS) to be losing the most in the inconsistent market. Approximately, half of their customers responded in the interview with the idea of replacing their current software systems. Merge customers though, promptly added that, the replacement is not exactly what they are really keen on, instead, they are looking forward to view how the company fares in its recent acquisitions.
The Top Scores among the 10 vendors fully rated in the KLAS report:
- Digisonics has scored highest in their performance with 83.6% with its DigiView product
- Philips Xcelera at 75.4%
- Merge VERCIS (AMICAS) at 72.3%
CVIS solutions from Agfa, Digisonics, FUJIFILM, GE, HeartIT, LUMEDX, McKesson, Merge (AMICAS), Philips, ScImage, Siemens and Thinking Systems were the focus of the KLAS report, Cardiology IT: Has the industry missed a beat?
With a significant discount, the report is available online for healthcare providers. Healthcare providers and vendors can visit the official KLAS website for further details.