August 31, 2016
AHRMM membership elects 2017 Board Members
The Association for Healthcare Resource & Materials Management (AHRMM) of the American Hospital Association has announced that Teresa L. Dail, R.N., B.S.N., CMRP, chief supply chain officer at Vanderbilt University Medical Center in Nashville, TN, will be chair-elect of the 2017 AHRMM Board of Directors and serve as the AHRMM board chair in 2018.
In addition, the AHRMM membership elected two new provider seat board members, Edmond (Ed) D. Hardin, Jr., FACHE, CMRP, and Dennis Mullins, M.B.A., CMRP, and one affiliate seat member, Alison Flynn Gaffney, FACHE, CMRP, to begin their terms in 2017.
Teresa Dail currently serves as chief supply chain officer at Vanderbilt University Medical Center and has an extensive clinical background in critical care, cardiology, perioperative services, and practice management. Dail started out her healthcare career 35 years ago as a critical care nurse. By 2001, Dail was transitioning into supply chain leadership roles where she developed relationships between clinicians and supply chain managers and changed the way supplies, services, and product decisions were made through physician committees. With her clinical background, Dail has been able to successfully develop a paired leadership model of physicians and clinicians to strategically evaluate opportunities to improve quality and outcomes while reducing cost.
Healthcare provider representatives Ed Hardin and Dennis Mullins join the current provider representatives, who advocate for AHRMM members by conveying provider issues to the AHRMM board and carry out AHRMM’s mission.
Hardin, system vice president, supply chain management at CHRISTUS Health in Irving, TX, brings 28 years of experience in the healthcare field and currently serves as the education and scholarship chairperson and president elect of the North Texas AHRMM Affiliated Chapter.
Mullins, vice president, supply chain operations at Indiana University Health in Indianapolis, brings more than 30 years of healthcare supply chain experience to the AHRMM Board and began his career as a 19-year-old Air Force medical materiel specialist. CHRISTUS Health is Healthcare Purchasing News’ Supply Chain Department of the Year.
As an affiliate representative, Alison Flynn Gaffney, senior vice president at GNYHA Services, Inc., Nexera, Inc. in New York, joins one current affiliate representative to advocate needs for the affiliate community and carry out AHRMM’s mission. Flynn Gaffney has served the healthcare field for 24 years, and in 2015 she contributed to writing and editing the book, Healthcare Supply Chain at the Intersection of Cost, Quality, and Outcomes, published by Nexera, Inc.
The new board representatives will begin their three-year term on January 1, 2017.
For more information and to review Teresa Dail’s platform, visit www.ahrmm.org/Elections.
Illegally manufactured Fentanyl linked to rise in overdoses
The increasing distribution of illicitly manufactured fentanyl (IMF) across the United States, and the sharp rise in overdose deaths linked to this drug, are causing more concern about a growing threat to public health and safety.
According to a report published in Morbidity and Mortality Weekly Report (MMWR), the number of drug products obtained by law enforcement that tested positive for fentanyl (fentanyl submissions) increased by 426% from 2013 through 2014. Deaths related to synthetic opioids (excluding methadone) increased by 79% during that period.
Pharmaceutical fentanyl, a synthetic opioid 50 to 100 times more potent than morphine, is approved for the management of surgical/postoperative pain, severe chronic pain, and breakthrough cancer pain. IMF, which is unlawfully produced fentanyl obtained through illicit drug markets, is commonly mixed with or sold as white powder heroin.
Starting in 2013, the production and distribution of IMF increased to unprecedented levels. In 2015, the Drug Enforcement Administration (DEA) and the CDC issued nationwide alerts identifying increases in fentanyl-related overdose deaths in multiple states.
The current report documents changes in synthetic opioid–related overdose deaths among 27 states where death certificates consistently report drugs involved in overdoses. These changes were highly correlated with fentanyl submissions, but not with fentanyl prescribing, which remained relatively stable.
The report identified eight states where increases in fentanyl submissions and synthetic opioid deaths were primarily concentrated. In these "high-burden" states, the synthetic opioid crude death rate increased 174%, and the rate of reported fentanyl submissions increased by 1000%.
These high-burden states were located in the Northeast (Massachusetts, Maine, and New Hampshire), the Midwest (Ohio), and the South (Florida, Kentucky, Maryland, and North Carolina). Increases in synthetic opioid deaths in high-burden states disproportionately involved non-Hispanic white men aged 25 to 44 years.
The strong correlation between increases in fentanyl submissions, primarily driven by IMF, increases in synthetic opioid deaths, mostly related to fentanyl, and uncorrelated stable fentanyl prescriptions rates supports the hypothesis that IMF is driving the increases in fentanyl deaths, according to the report's authors.
Investigators found that from 2013 to 2014, fentanyl submissions increased 494% in Florida and 1043% in Ohio. This, they note, was "concurrent" with a 115% increase in fentanyl deaths in Florida and a 526% increase in Ohio. They also saw a "sharp increase" in fentanyl submissions and fentanyl deaths.
Their findings, the authors say, suggest that the surge in fentanyl deaths in Florida and Ohio is closely related to increases in the local IMF supply as opposed to diverted pharmaceutical fentanyl. The relationship between fentanyl deaths and fentanyl submissions suggests that law enforcement testing data on drug cases could act as an "early warning system" to identify changes in the illicit drug supply, the authors write.
Visit Medscape for the study.
Something to grapple with: How Lyme disease prowls the body
Lyme disease is an incredibly evasive adversary. No one is entirely sure how the bacterium that causes it spreads so widely throughout the body or why symptoms sometimes persist after the infection has been treated with antibiotics.
Now researchers at the University of Toronto may finally have an explanation: The tiny, spiral-shaped bacterium called Borrelia burgdorferi can quickly grapple along the inner surfaces of blood vessels to get to vulnerable tissues or to hiding places where it can hole up beyond the reach of drugs.
B. burgdorferi uses a special adhesive protein on its surface to grab like a hook onto the endothelial cells that line blood vessels, attaching and detaching rapidly as it migrates to its destination, the Toronto microbiologists explain in a new study published in Cell Reports.
The initial infection is transmitted to humans via the bite of an infected black-legged tick (aka deer tick), which usually leaves behind a characteristic bull’s-eye rash. Symptoms can include fever, headache and fatigue. It can be treated with antibiotics if it is caught early on.
But in about 20 percent of the cases severe symptoms such as joint pain and cognitive problems last even after treatment—a condition physicians call post treatment Lyme disease. Other more chronic symptoms can be similar to those of different illnesses such as arthritis or peripheral neuropathy, and scientists disagree about whether or not they should be labeled Lyme disease.
“Normally, when you pull on bonds they break. But this kind of ‘catch bond’ is the opposite—it strengthens with force and makes the bacteria even more firmly attached to cells in our body, kind of like if you twist two hooks together and end up locking them even tighter as you pull them,” says senior study author Tara Moriarty.
Ironically, this kind of attaching and rolling mechanism is very similar to how leukocytes—white blood cells that fight pathogens—find their way to infection and injury sites. But these beneficial cells are very different from spirochete bacteria like B. burgdorferi, both physiologically and genetically, Moriarty says. Although the same mechanism probably evolved independently in the bacteria and leukocytes, it could provide a glimpse into how other similarly resilient bacteria might move through the body and avoid detection by our immune system, she adds.
Visit Scientific American for the report.
Doctors get disciplined for misconduct; drug firms keep paying them
Hundreds of pharmaceutical and medical device companies continue to pay doctors as promotional speakers and advisers after they've been disciplined for serious misconduct, according to an analysis by ProPublica.
One such company is medical device maker Stryker Corp. In June 2015, New York's Board for Professional Medical Conduct accused orthopedic surgeon Alexios Apazidis of improperly prescribing pain medications to 28 of his patients. The board fined him $50,000 and placed him on three years' probation, requiring that a monitor keep an eye on his practice. Despite this, Stryker paid Apazidis more than $14,000 in consulting fees, plus travel expenses, in the last half of 2015.
Stryker paid another orthopedic surgeon, Mohammad Diab of San Francisco, more than $16,000 for consulting and travel, even though California's medical board had disciplined him for having a two-year-long inappropriate sexual relationship with a patient, whose two children he also treated. He was suspended from practice for 60 days, required to seek psychological treatment and given seven years' probation.
The company is one of more than at least 400 pharmaceutical and medical device makers that have made payments to doctors after they were disciplined by their state medical boards.
ProPublica reviewed disciplinary records for doctors in five states — California, Texas, New York, Florida and New Jersey — and checked them against data released by the Centers for Medicare and Medicaid Services on company payments to doctors. That included payments for things like speaking, consulting, education, travel and gifts, but not for meals, as these often don't reflect a formal relationship between companies and doctors.
All told, the analysis identified at least 2,300 doctors who received industry payments between August 2013 and December 2015 despite histories of misconduct.
While many doctors were sanctioned for minor offenses such as failing to attend required continuing medical education courses, hundreds were disciplined for more severe offenses, including providing poor care, inappropriately prescribing addictive medications, bilking public insurance programs and even sexual misconduct.
At least 40 physicians had their licenses revoked or surrendered them, in most cases permanently. More than 180 had their licenses temporarily suspended or restricted. Almost 250 were placed on probation.
Industry payments to doctors are legal as long as they are not an inducement to use a particular product.
Does your doctor accept payments from pharmaceutical and medical device companies? Find out using Dollars for Docs.
Visit NPR for the report.
Health insurers’ pullback threatens to create monopolies
Nearly a third of the nation’s counties look likely to have just a single insurer offering health plans on the Affordable Care Act’s exchanges next year, according to a new analysis, an industry pullback that adds to the challenges facing the law.
The new study, by the Kaiser Family Foundation, suggests there could be just one option for coverage in 31% of counties in 2017, and there might be only two in another 31%. That would give exchange customers in large swaths of the U.S. far less choice than they had this year, when 7% of counties had one insurer and 29% had two.
Many insurers are losing money on the health plans they sell through the exchanges, and the fallout is coming into focus. Companies including UnitedHealth Group Inc., Humana Inc. and Aetna Inc. have cited their losses in withdrawing from ACA marketplaces, as have smaller insurers that have been retreating, or even shutting down.
The insurers that remain are in some cases seeking sharp premium increases for next year, trying to get back in the black amid higher-than-expected costs. Insurance executives say premiums reflect the cost of care, but in some markets they worry about a cycle of rising prices that might encourage the consumers who need healthcare least to opt out.
Most of the likely one-insurer counties are predominantly rural, according to the Kaiser analysis, which updates one it did in May. But several urban areas, such as Charlotte, NC, Philadelphia and Oklahoma City, also face a lack of competition. The analysis suggests that about 19% of current exchange enrollees may have just one option next year; another 19% would have two.
President Barack Obama has called for the creation of a public insurance option to compete alongside private plans in places where competition is limited.
States including Alabama, Alaska, Missouri, Arizona, Florida, North Carolina, Mississippi, Oklahoma and Tennessee are likely to go next year to having one insurer in all or most counties, Kaiser’s analysis found. Regulators in those states confirmed the findings, except in Florida and Missouri,where officialssaid they didn’t yet have counts.
UnitedHealth’s planned withdrawal from Oklahoma came after two regional insurers bowed out, according to the state’s regulator. Aetna, meanwhile, canceled plans to join the state’s exchange. The upshot: Only one remaining exchange insurer statewide.
Visit the Wall Street Journal for the article.
MEDICAL FAIR ASIA 2016 grows alongside strong medical, healthcare, and MedTech sectors
MEDICAL FAIR ASIA and MEDICAL MANUFACTURING ASIA 2016, two of the region’s leading exhibitions for the medical, healthcare and MedTech sectors kick off today till Friday, September 2nd, at the Sands Expo and Convention Centre, Marina Bay Sands, Singapore.
The exhibitions feature an international showcase, industry-focused activities, and innovative solutions and they are modeled after globally leading events for the medical and MedTech sectors – MEDICA and COMPAMED in Düsseldorf, Germany.
Held biennially, the eleventh edition of MEDICAL FAIR ASIA and third edition of MEDICAL MANUFACTURING ASIA feature a 20% growth that will highlight 1,200 companies from over 40 countries, including first time group participation from Saudi Arabia and Turkey, as well as numerous visiting delegations from the region.
The inaugural Asian editions of DiMiMED, the International Conference on Disaster will present issues on natural disasters and vector-borne diseases, including earthquake disaster relief, management of radiation leaks, threats from Dengue and Zika virus, as well as technical subjects on SATCOM (satellite communications) based telemedicine and aeromedical evacuation.
The Military Medicine and the MEDICAL FAIR ASIA Medicine + Sports Conference will center on topics around disease prevention through physical activity and the latest innovations in sports medicine and wearables.
According to the 2016 Global healthcare outlook report by Deloitte, Asia Pacific’s spending on healthcare will grow at an annual average of 6.6% through to 2019, largely driven by rising affluence and consumer spending and the growing grey population.