GLG News by Ambulatory Surgery Center Experts

John HsuDirector of AnesthesiologyPRESBYTERIAN INTERCOMMUNITY HOSPITAL, INC.

Computer Technology Really Does Improve Patient Care

February 6, 2009

Analysis of:Health Info Technology Saves Lists, Costs: Study | news.yahoo.com

Information technology in healthcare saves lives if it is frequently used by doctors for medical practice.  Scientific papers in the past have suggested that information technology saves lives by preventing medication errors but this paper suggests that the way doctors practice medicine may be modified to saves lives as well. 

John HsuDirector of AnesthesiologyPRESBYTERIAN INTERCOMMUNITY HOSPITAL, INC.

Why hasn't EHR been adopted faster

November 26, 2008

Analysis of:Survey: Hospital EHR Adoption Rate is Below 12% | www.govhealthit.com

The lack of a comprehensive EHR implementation suggests that we are failing at our goal of improving the healthcare system.  While the article highlights many problems, very few solutions are offered to remedy this part of our healthcare crises. The key implications are: 1. The adoption rate of electronic health records in nonfederal U.S. hospitals is low 2. The percentage of these electronic record systems may be classified as "fully functional is low 3. The companies that can fill the enormous gaps in adoption have laid the foundation for future adoption.

Michael BlumeGastroenterologistHELIXCARE INC

A relief, albeit a temporary one

April 14, 2008

Analysis of:Aetna to Delay Reduced Colonoscopy Coverage | online.wsj.com

This potential issue has been of concern since we changed to Propofol based anesthesia for all of our patients approximately five years ago.  We made this decision because it made endoscopic procedures significantly more tolerable (essentially painless, except for the bowel prep) for just about all of our patients, as well as, frankly, safer.  While many patients did well with standard conscious sedation using agents such as Sublimaze and Versed, others did not do as well.  Using an anesthesiologist benefited not only high risk patients, but also patients who had rather high sedation tolerances, who often were difficult to identify prior to performing the procedure. 

Barry SchechterDirector of Cornea and External DiseaseFLORIDA EYE MICROSURGICAL INSTITUTE INC

Bausch makes foray into presbyopic arena

January 29, 2008

Analysis of:Bausch & Lomb announces acquisition of eyeonics | www.osnsupersite.com

With the recent trends of presbyopic correction , Bausch and Lomb has now entered the arena.

Michael BlumeGastroenterologistHELIXCARE INC

Important data in a difficult to treat subpopulation

December 17, 2007

Analysis of:Study Data Show Asacol(R) (Mesalamine) is Effective in Treating All Extents of Ulcerative Colitis Including Isolated Proctitis | www.prnewswire.com

Patients with isolated proctitis remain a difficult to treat subpopulation of patients with UC.  Topical mesalamine is often efficacious, but is not always the preferred mode of administration for many patients.  As we have a variety of options as to which oral mesalamine preparation to use in our patients, seeing data on treating proctitis can be useful in making a decision as to which one to use.

Michael BlumeGastroenterologistHELIXCARE INC

A small niche in the PPI market

December 10, 2007

Analysis of:Wyeth Receives FDA Approval of Protonix for Delayed-Release Oral Suspension | pharmalive.com

Which PPI to prescribe?  We already have a myriad of choices between brands, which in general, are all quite effective when used for the correct indications.  An oral suspension is useful in a patient who requires PPI therapy, but who is unable to swallow pills for a variety of reasons.  This scenario, however, represents a very small percentage of the large patient population who are on PPI's.  This formulation would be unlikely to dramatically affect prescribing habits for most physicians in the community.

John HsuDirector of AnesthesiologyPRESBYTERIAN INTERCOMMUNITY HOSPITAL, INC.

Theword of mouth

November 16, 2007

Analysis of:Cigna reaches deal on doctors' rankings | news.yahoo.com

Missing in the article is the fact patients will still go to the physicians that they like regardless of the rating system.  This rating system of doctors is really economic credentialling.  Insurance companies will lower reimbursement unit values of physicians that are not rated well. 

Michael BlumeGastroenterologistHELIXCARE INC

Clinical data not surprising, cost data may be misleading...The question is when to use Remicade and in whom.

October 29, 2007

Analysis of:Clinical Studies Show REMICADE® Reduces Incidence Of Bowel Surgeries In Ulcerative Colitis Patients | www.medicalnewstoday.com

The clinical outcome information in this report regarding decreasing colectomy rate is not particularly surprising, but the cost statements may be misleading.  One wonders if the increased health care costs in the colectomy group reflect that fact that the observation period was only twelve months, and is skewed because of issues involving the immediate post-op period.  One should be looking at cost related issues in the long run, and would expect that five years down the line, for example, given the costs involved with drug therapy and monitoring patients with IBD and the fact that colectomy in UC is curative, the costs in the colectomy group would be significantly lower.  Remicade has been an important addition in how we treat inflammatory bowel disease for some time, and has been FDA approved for use in UC for several years now. It has allowed us to not only get more patients into remission, but also keep patients in remission and decrease steroid usage.

Michael BlumeGastroenterologistHELIXCARE INC

A potentially welcome addition to managing a difficult problem, but response rate is not overwhelming

October 29, 2007

Analysis of:FDA Accepts Sucampo's SNDA For Lubiprostone (8 Mcg) For The Treatment Of Irritable Bowel Syndrome With Constipation (IBS-C) | www.medicalnewstoday.com

Constipation predominant IBS is an extremely common problem, which while not life threatening, interferes significantly with daily function in many people.  We have very few effective drugs (especially since Zelnorm was taken off of the market) for this condition.  Lubiprostone may be a welcome addition to what are limited therapeutic options, however its efficaciousness, while statistically better than placebo, is not overwhelming.  Its utility may be limited by its limited efficaciousness, pregnancy concerns (it is category C, and many patients with this disorder are young females), and cost.  It will probably have a place, however, in how we treat some patients with this disorder, either as a stand alone drug, or part of some type of combination regimen.

John HsuDirector of AnesthesiologyPRESBYTERIAN INTERCOMMUNITY HOSPITAL, INC.

Pain has not killed anyone

October 1, 2007

Analysis of:FDA Warns About Misuse Of Fentora Cancer Pain Drug | www.medicalnewstoday.com

Because the FDA warns about the misuse Of Fentora as a Cancer Pain Drug,  I hope that physicians will be very carefull about prescribing this very potent opiate medication.  Fortunately, the company Cephalon is correcting the problem without taking away the important role of this drug in controlling breakthrough pain.  Patience, education, and vigilence could make this drug safer.  Pain has not killed anyone but opiates have killed many.  

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