CT Center for Patient Safety Newsletter
October 1, 2010

Carpe Diem, buyer beware, is a phrase often used when we think of used car purchases, promising speculative investments, land purchases- no money down.  But Carpe Diem is just as important when we think about health care.   Conflicts of interest have put themselves directly between you and what your physician may be recommending. 

The pharmaceutical industry and the medical device industry (artificial knees, hips, for example) have very deep pockets.  How deep?  We need to look no further than Purdue Pharma, headquartered in Stamford, CT.  In 2007 Purdue Pharma was fined $600 million for "misbranding" oxycontin.  But the fine did not stop there.  Three executives, including the President and the company's top lawyer, pleaded guilty to misbranding, a criminal violation.  They agreed to pay $34.5 million in fines.

What had they done?  Purdue Pharma had undertaken an aggressive marketing campaign - unusual for a narcotic.  They promoted the drug to general practitioners, not just pain specialists, promising a drug that posed a lower threat of addiction and abuse to patients than do the traditional painkillers like Percocet.

We now know how very addictive Oxycontin is and the aggressive marketing put the public in danger.    You have to wonder how many individuals and families suffered because of the highly addictive nature of the drug.  And what did aggressive marketing mean to individual physician practices?.  Did it mean trips to Deer Valley to ski or a jaunt to Hawaii during the winter months?  Did it mean lunches, dinners, reimbursement for speaking about the benefits of the drug or being paid for ghostwriting?  Ghostwriting is the pervasive practice of saying you wrote an article that was actually crafted by the pharmaceutical company.

When you get that prescription, before you fill it, do some of your own research.  Ask your doctor if that drug will interact with the others you are taking.  Did you know that the average 75 year old swallows eight different prescribed medications each day?  Talk to your pharmacist.  If it is a new drug, be extra careful.  The FDA from public and pharmaceutical company pressure is rolling out new drugs that are not adequately time tested.

Carpe Diem

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Dear Members,
The German philosopher Schopenhauer said that truth passes through three stages.  First, it is violently opposed. Then it is publicly ridiculed.  And finally, it is accepted as truth. 
We are making progress.  When we first got started we were ridiculed, contradicted and accused of being in the pocket of the trial lawyers.  And the industries and lobbyists would say that with no acknoledgement of who was signing their own paychecks. All they knew was that their trade association represented the patient voice. 
 But we have been around long enough to establish a credibility and an independence.  We have always said that we hold truth to power but last week at a meeting organized by Health and Human Services, I heard doctors, administrators and the Center for Disease Control acknowledge the pervasiveness of healthcare acquired infections and the impact those infections have on individuals, families and the economy.
How do we move knowledge to action?  We must keep shining that light, exposing the very dirty secrets of health care.  I find it tiresome that so many people need to start criticsm of the industry with sentences like "No one goes to work wanting to do harm."  If they do not do something about the problems they see, then they are complicit and put all of us at risk.  Nowhere is this truer than not washing hands and following established protocols in our hospitals and surgical centers. All of us need to continue to take action - we are just beginning to open the doors and provide accountability and transparency.  Your support is invaluable.  You are making a difference.
Connecticut Doctors Slow to Adopt Electronic Record-Keeping
Wednesday September 15th, 2010
Arielle Levin Becker and Deirdre Shesgreen
Connecticut Mirror

The federal government is set to roll out a massive incentive program aimed at making electronic record-keeping the standard in health care. But Connecticut doctors lag behind when it comes to making changes that experts say could save time and money, reduce medical errors and duplicate tests, and improve patient care.

Among state doctors, 25.8 percent used electronic medical records, and less than a quarter prescribed drugs electronically, according to a 2008 surveyhe Connecticut State Medical Society. In a national surveyted the same year by the National Center for Health Statistics, 41.5 percent of doctors reported using electronic medical records in their office-based practices.

Connecticut hospitals fared better. According to a recent study.  less than 12 percent of U.S. hospitals used either basic or comprehensive electronic health record systems to track patients in 2009. In Connecticut, 7 of the 28 hospitals that responded to the survey reported using basic or comprehensive systems.

"It is an absolutely essential ingredient to making the health care system work better," said Dr. Ashish Jha, an associate professor of public health at Harvard and an author of the hospital study.

Proponents of electronic medical records say the potential benefits are immense. Prescriptions transmitted electronically don't carry the risk of a pharmacist misreading a doctor's handwriting, and some electronic records systems can check for possible negative drug interactions with other medications a patient takes.

Even more significantly, Jha said, electronic records that multiple health care providers can access could help avoid duplicated tests that commonly occur when patients receive care at two or more places that don't share records. Avoiding extra tests would save time, money, and, in the case of some tests, unnecessary exposure to radiation.

A 2005 study estimated that using electronic record systems that could share information between providers could save nearly $80 billion a year. Jha predicted the figure would now be closer to $100 billion.

"We are at such an abysmal level," he said of health providers' current use of EMRs.

Report: Drug Costs for Seniors to Skyrocket Next Year
Thursday September 23rd, 2010
Mike Lillis

A vast majority of seniors enrolled in Medicare's prescription drug program will see double-digit rate hikes in 2011, according to an independent analysis released Thursday. 

Avalere Health, a Washington-based policy group, estimates the average monthly premium for Part D's top 10 plans - which cover roughly 70 percent of all Part D enrollees - will jump 10 percent in 2011. 

"Some major plans are no longer being offered and premiums for certain plans have increased significantly," Avalere CEO Dan Mendelson said in a statement. "Beneficiaries are going to need to be savvy consumers and shop around to find the plan that's best for them."

Of the top 10 drug plans catering to Medicare patients, seven are projected to increase their premiums next year between 43 and 3 percent, Avalere estimates. The remaining three plans - including the top plan by enrollment, AARP's MedicareRx Preferred - Avalere says will decrease rates, between 11 and 2 percent.

Two of the top 10 stand-alone drug plans - AARP's MedicareRx Saver and Universal American's PrescribaRX Bronze - are not being offered next year at all, shifting those patients (automatically) into different plans offered by the same sponsors, Avalere notes.  Those plans were the 2nd and 9th most popular, respectively, among seniors this year, the group says.