IT Support and Hardware for Clinics
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News, Information and Updates on Hardware and IT Tools to help improve your Medical practice
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Do you Know New Tech Trends in the Healthcare Industry? 

Do you Know New Tech Trends in the Healthcare Industry?  | IT Support and Hardware for Clinics | Scoop.it

Technology is always evolving within different industries, and the healthcare industry is no exception. Both hospitals and clinics need the most up-to-date machinery and programs that are reliable.

 

Healthcare professionals need to be able to have access to premium surgical equipment and billing software. Along with that, here are some tech trends happening in the healthcare industry: Remote monitoring Wearable technology and health apps have become increasingly popular among consumers.

 

Imagine if your doctor could monitor your health without you taking a trip to the hospital? It’s possible now, with new medical devices that patients can be sent home with that will monitor their health and send information to their primary doctor. Additionally, these devices will alert your doctor if an emergency arises. Health Apps As mentioned above, health apps are popular right now.

 

These apps allow you to monitor your blood pressure, calories, and heart rate and will send that information to your doctor in real-time. This will keep your information up-to-date and your doctor informed. Wireless sensor technology Let’s face it, nobody likes staying in the hospital. As a patient, being plugged in with chords and wires is annoying and intimidating. That’s all going to change. By 2018, it’s predicted that doctors will be able to use wireless sensors to monitor their patients’ vital signs and alert medical staff about any changes. Additionally, this data can be used in the patients’ electronic health records (EHRs) and shared with immediate relatives.

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Tech Talks: 8×8 Delivers Secure Cloud Communication Solutions

Tech Talks: 8×8 Delivers Secure Cloud Communication Solutions | IT Support and Hardware for Clinics | Scoop.it

Would you like to enhance your customer experience (CX) with reliable and secure cloud-based solutions? If so, you might want to consider 8×8, a leading provider of communication-related products for businesses of all sizes looking to enhance their customer experience and increase staff engagement.

 

Our consultants recently attended a presentation and “sales blitz” by this cloud solution provider and got a detailed look at their key offerings. Here’s some of what we know about 8×8 that we’d like to share with you if you’re a business leader looking to improve your communication capabilities. Provider Overview Founded in 1987 and based in San Jose, Calif., 8×8 focuses on delivering cloud solutions that help companies transform both their team members’ and customers’ experiences.

 

This vendor’s solutions give businesses the ability to communicate and collaborate effectively and quickly with a single system of engagement for contact center, voice, video, and collaboration. 8×8 has earned recognition as a leading cloud-based communication solutions provider: For instance, the vendor has been named a leader in the Gartner Magic Quadrant for Unified Communications as a Service, Worldwide for seven years in a row. Unique Differentiator 8×8 has its own platform and native cloud contact center, rather than running on BroadSoft or another third-party cloud contact center like many of its competitors.

 

This gives them a considerable edge, as their clients realize the benefits of an all-in-one platform and provider. Featured Offerings 8×8 provides a wide range of communication solutions, such as VoIP business phone service, web conferencing, hosted PBX, virtual contact center, UC and more. Here are just a couple of their notable offerings. Business Phone Systems: An X Series Business Phone System solution from 8×8 gives you a single cloud platform for meetings, voice, call center, collaboration and more. Select elements of the different plans (starting with X2) to meet your company’s specific needs. This solution is available for small businesses as well as larger enterprises.

 

Cloud Contact Center: Enhance your customer experience with a cost-effective X Series Cloud Contact Center. Choose the model that best fits your communication needs, from the X5 (voice contact center with predictive dialer) up to the X8 (multi-channel contact center with predictive dialer and advanced analytics). Security and Compliance Guaranteed Additionally, for clients that must comply with industry regulations, this vendor’s Virtual Office and Virtual Contact Center solutions are certified as compliant with the following standards: HIPAA FISMA CPNI ISO 27001 ISO 9001 UK Government ATO Privacy Shield Framework Cyber Essentials

 

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The dangers of autocomplete passwords

The dangers of autocomplete passwords | IT Support and Hardware for Clinics | Scoop.it

Hackers have found a new way to track you online. Aside from using advertisements and suggestions, they can now use autocomplete passwords to track you down. Feeling insecure? Here are some ways to keep you out of harm’s way.

Why auto-fill passwords are so dangerous

As of December 2018, there are 4.1 billion internet users in the world. This means users have to create dozens of passwords, either to protect their account or simply to meet the password-creation requirements of the platform they’re using. Unfortunately, only 20% of US internet users have different passwords for their multiple online accounts. 


Certain web browsers have integrated a mechanism that enables usernames and passwords to be automatically entered into a web form. On the other hand, password manager applications have made it easy to access login credentials. But these aren’t completely safe.


Tricking a browser or password manager into giving up this saved information is incredibly simple. All a hacker needs to do is place an invisible form on a compromised webpage to collect users’ login information.

Using auto-fill to track users

For over a decade, there’s been a password security tug-of-war between hackers and cybersecurity professionals. Little do many people know that shrewd digital marketers also use password auto-fill to track user activity.

 

Digital marketing groups AdThink and OnAudience have been placing these invisible login forms on websites to track the sites that users visit. They’ve made no attempts to steal passwords, but security professionals said it wouldn’t have been hard for them to do. AdThink and OnAudience simply tracked people based on the usernames in hidden auto-fill forms and sold the information they gathered to advertisers.

One simple security tip for today

A quick and effective way to improve your account security is to turn off auto-fill in your web browser. Here’s how to do it:

  • If you’re using Chrome – Open the Settings window, click Advanced, and select the appropriate settings under Manage Passwords.
  • If you’re using Firefox – Open the Options window, click Privacy, and under the History heading, select “Firefox will: Use custom settings for history.” In the new window, disable “Remember search and form history.”
  • If you’re using Safari – Open the Preferences window, select the Auto-fill tab, and turn off all the features related to usernames and passwords.

This is just one small thing you can do to keep your accounts and the information they contain safe. 

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Achieving Seamless Interoperability in Healthcare from Concept to Reality 

Achieving Seamless Interoperability in Healthcare from Concept to Reality  | IT Support and Hardware for Clinics | Scoop.it

What can we achieve with seamless interoperability in healthcare?

The era of digital healthcare is indeed revolutionizing the care landscape. Data- and technology-driven solutions are enabling every member of the care network to deliver a patient-centric experience. However, despite this tremendous leap, the care landscape is still facing challenges in simplifying care for both the patient and the provider.

 

Innumerable tools and solutions are facilitating multiple aspects of the care process – right from access to care and diagnostics to continued treatment. But these brilliant innovations often remain in silos, with almost zero scope for exchange of data across the various healthcare systems. This lack of interaction nullifies all the potential of these innovations.


This ability to communicate between systems, exchange precious data, and interpret them accurately is an essential enabler to complete the transition into digital healthcare, and is called interoperability.

What can we achieve with seamless interoperability in healthcare?
When devices, systems, and tools effortlessly share information across an interoperable interface, every care partner – from the patient, care and provider to the lab technician and pharmacist – receives the same version of the shared data regardless of the disparate technological environment of each stakeholder.

This capability delivers immense advantages:

1. Easy, secure, and real-time access to in-depth patient data

A critical enabler of delivering timely and efficient care across the healthcare system, interoperability eliminates duplication of work.

2. Supporting patient safety

Many reports have indicated that more than 50% of medication errors arise during care transition; hence, effective interoperability between all the care points ensures continuity of care and zero scope for error.

3. Effortless collaboration

Interoperability facilitates delivering a well-coordinated care, with increased clinical and business collaboration across the entire care network.

4. Efficient adoption of best practices across the landscape

extensive data insights from a well-connected and interoperable ecosystem help care partners to assess the process and derive optimal strategies and best practices.

5. Cost efficiency and high quality

With interoperability removing many administrative and data validation burdens, providers and other care partners can focus on delivering technology-enabled values to patients at a lower cost and high quality.

Thus, interoperability between every element of the healthcare ecosystem brings together three core pillars of the landscape – people, process, and technology. It enables seamless information capture, exchange, interpretation, and application of data across the landscape.

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7 Key Focus Areas of Mobile Healthcare Applications

7 Key Focus Areas of Mobile Healthcare Applications | IT Support and Hardware for Clinics | Scoop.it

We live in a perennially mobile world, managing almost every life activity (from work to shopping) “on the go” – thanks to the “smart” phones that have become such an integral part of lives. The healthcare ecosystem is certainly not lagging behind in embracing mobile technology.

The very term “mhealth” is proof of mobile technology’s relevance in healthcare. Mobile healthcare applications have exploded the care landscape because of their ability to simplify access to care and deliver a superior care experience from both the care providers’ and the patients’ point of view.

Here are 7 key focus areas of mobile healthcare applications that are gaining tremendous attention in today’s care landscape.

1. Easy access to care

Mobile apps have simplified the burdensome task of choosing a care provider, booking appointments, and follow-up sessions with the clinic or hospital. This has drastically reduced waiting times at the doctor’s office and increased the efficiency of the entire care process. With SMS reminders, prepaid options, and 24/7 call options, these apps also provide patients with options of rating care providers, thereby delivering a transparent care ecosystem.

2. Easy interaction between care providers

One of the primary source of delays in the care process is the long waiting period and the never-ending back and forth between multiple care points – doctors, labs, imaging system, second opinions, insurance companies, and pharmacies, for example. Mobile apps create a strong network of care providers who interact productively through apps, guaranteeing a secure and professional platform that enables informed and timely decision-making.

3. Medical record maintenance

Trusted app that effortlessly maintain medical records and patient history have always been on top of the care landscape’s list of priorities. These apps are simple interfaces that facilitate easy recording of diagnosis, examination, medication, and treatment regimens with zero need for multiple sources of data entry and minimal version issues.

4. Remote patient engagement

Delivering a positive patient experience is no longer restricted to focusing just on treatment and diagnostic modalities. It involves providing the patient with complete support – right from easy access to care even from remote. There are many examples of remote patient engagement:

  • Video-call options with patients
  • Engaging in healthcare awareness drives
  • e-Prescription and remote monitoring of medication compliance
  • Remote treatment of patients in remote locations and elderly patients by mapping their vital body parameters and alerting care providers in case of deviations

5. Chronic condition care support

Smartphone apps have become critical support systems in delivering care for chronic conditions such as diabetes. Many apps help patients to efficiently manage their blood sugar levels, maintain a nutrition diary, and transform their lifestyle to avoid the complications of diabetes.

6. Wellness support

Care is no longer associated with the absence of any disease or disorder – it’s also about the wellness of the body and mind. Hence, wellness-related apps are exponentially increasing in popularity, from simple apps that measure the number of steps walked over a specified period and heart rate to apps that track exercise, diet, and sleep. Customized dashboards deliver a clear overview of the health condition of the patient.

7. Continued learning for care providers

Staying up-to-date in today’s care ecosystem requires that the care providers stay on top of every innovation, new disease and condition, novel medical device, ongoing research, and pharmaceutical discovery. Apps that consolidate specialty-specific data and references from across the medical world are hugely popular. Given the nature of the care providers, this service too needs to deliver a 24/7 access to any location – and mobility perfectly fits this bill.
Conclusion – anytime, anywhere care
mHealth is fast becoming synonymous with delivering smart care anytime from anywhere – a super-efficient means of enabling health and wellness. The challenge is to cut through the excessive clutter of mhealth apps and find your right fit and to ensure that your healthcare solution includes mobility-first features. Today’s care world is certainly on its way to fit right in your pocket! So how ready are you to go the mhealth way?

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Benefits Of Wearable Technology In The Health Sector

Benefits Of Wearable Technology In The Health Sector | IT Support and Hardware for Clinics | Scoop.it

When most of us consider wearables, we include devices such as Bluetooth headsets. However, in the medical industry, we expect more from our wearables and only include devices that not only provide a specific function but will also store sensor data for later retrieval by healthcare professionals. This data is then analysed to aid medical diagnosis.

 

In a growing telehealth market, it is these sensor-based devices that will improve healthcare services for millions of patients worldwide. Existing forecasts indicate that the global telehealth spend will increase tenfold within five years, rising to $4.5 billion by 2018.

 

Like any new technology, early adoption figures are quite weak but luckily, in Australia, we are always eager to experiment with new innovations. In fact, a 2014 Kronos survey demonstrates that no less than 30 per cent of Australians already use wearable technology, twice that of our U.S. counterparts. In addition, more than 40 per cent use them for work-related tasks. This high adoption rate is encouraging for future increased use of wearables in the health and fitness areas.

 

For this adoption rate to continue, I believe we need our healthcare providers to embrace the use of wearables, as they are best positioned to encourage their patients of wearable benefits, with the most important being improved care monitoring and increased efficiency for early diagnosis of common ailments. When a medical professional recommends a product, people listen. There are several reasons for this but primarily these include:

 

A company with a commercial interest in the product is unlikely to achieve the same positive response level.


Patients trust their doctors to act in their best interest.
By using these technologies themselves, patients are encouraged to take a more proactive approach to their personal health.
Fitness plans were perhaps the first wearable that provided useful data for medical professionals and were primarily used by those in cardiovascular activities such as running and cycling. Like any product type, the features available vary by model and manufacturer but most are capable of acting as a pedometer and can also record pulse and heart rates. The data gathered by the device sensors is then transmitted to your smartphone using Bluetooth or possibly ANT+ for cycling enthusiasts with bicycle computers. This data is often useful to doctors as it can aid diagnostics, surpassing the original plans for the device as a general fitness monitor.

 

Wearables that are specifically designed for the healthcare industry work in an identical manner. Senses are used to gather data, which is then transferred to another device for later analysis. Smartphones are most commonly used, with apps available for several platforms including Apple’s iOS and Google’s Android, but residential users can also use Wi-Fi to transfer data to the cloud or to another monitoring device.

 

In my opinion, as this technology grows, I believe real-time reporting will be possible, where data is displayed on the health professional’s monitor as soon as new data is uploaded. The exact direction this technology will take requires valuable input from knowledgeable medical professionals. That is not to say that the existing range of devices for the medical industry is limited as this is far from the situation. There are several preventative care devices already on the market and these include:

 

Glucose meters that notify clinics of an emergency situation, ideal for remote monitoring of elderly diabetics
Remote monitoring devices that store information such as blood pressure, temperature, ECG data and more. These can save a vast amount of clinic time, allowing healthcare professionals to prioritize according to patient ailment and creating an environment where early diagnosis is certain for many common ailments.
There are several dedicated devices and applications for monitoring diets, all of which act as a virtual personal trainer who recommends a specific diet according to age and cardiovascular status.
The examples listed above are probably the most common but there are many other devices available that monitor specific conditions. All share the same properties, to gather information and to monitor patients in real-time, thereby improving doctor-patient interaction and the healthcare service provided.

 

The use of wearable technology is a win-win for both healthcare professionals and patients and can reduce individual patient costs while also eliminating unnecessary clinic visits for the patient. For example, if you have high blood pressure and are prescribed specific medication to alleviate the condition, you will no doubt have to make several trips to the clinic to verify that the prescribed treatment is actually working. However, with the use of wearable technology, this is no longer necessary, as the data gathered from the device is simply analysed without travelling to the clinic.

 

Australian healthcare professionals need to adopt wearable technology as soon as possible, given that the benefits surpass any possible costs or training headaches. It is a fact but careful selection of wearable devices and software apps can increase the efficiency of any medical practice, whether it is immediate access to patient data from anywhere, guided surgery, health monitoring tasks and more. Early adopters have already discovered that these solutions can reduce the frequency of clinic visits and related clinic hours per patients.

 

Individual patient costs are reduced substantially but this does not mean that clinics will lose revenue, it merely means that available clinic time is spent treating the seriously ill or patients that require emergency care.

 

Mobile devices, remote data access and analysis with the resulting ability to increase early patient diagnosis are the way of the future. It may take some effort to define the correct processes, workflows and procedures but it is clearly worth it. Can you really afford to ignore the benefits of wearable technology?

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Medical Software On The Cloud

Medical Software On The Cloud | IT Support and Hardware for Clinics | Scoop.it

As more and more traditional companies leverage the benefits of the cloud, it’s no real surprise that the healthcare industry has embraced technology, with electronic health records now commonplace. We have provided a cloud-based solution for clinical and practice management software since 2012 and the adoption rate among Australian healthcare practices and clinics grows each year.

 

Cloud for Health allows users of popular clinical software packages (such as Medical Director and Best Practice) to access data from anywhere by simply using their web browsers on any internet-ready device. It allows users to concentrate on core activities without worry about servers, backup maintenance or essential security updates as we take care of all that under our service level agreement(SLA).

 

Other advantages include guaranteed data storage on Australian servers (also a legal requirement) and immediate access to an ideal solution for rural GPs that often need to travel long distances between clinics, allowing the easy use of mobile clinics, taking the practice on tour, so to speak.

 

Doctors located in the middle of the desert can access their clinic records remotely, simply by using a laptop and phone, tethering the laptop to a 3G or 4G connection if available. Alternatively, you can simply use a smartphone , netbook or other portable device with a browser. In times past, you would have needed to log in directly to your practice, with low speed often the result. Not so with the cloud, as maximum performance is always available.

 

As the whole process is browser-based, it’s no longer necessary to have a high-performance laptop for productive tasks. Even older laptops will work perfectly as long as an internet connection is available.

 

Not all healthcare professionals require mobility but cloud hosting has other advantages:

 

  • You no longer need a server and can eliminate associated hardware costs and maintenance issues.
  • Data backups are automated using redundant hard drives, preventing unexpected data loss
  • 24/7 maintenance and support is offered by reputable service providers
  • Software patches and security updates are handled by the service provider


Our aim as a service provide is to remove IT as a consideration for healthcare professionals and let them focus on patient care. Even in extreme situations where all hardware in the practice has failed (due to power loss, fire or water damage, for example) vital clinical data can still be accessed using a mobile phone. The benefit to business continuity is obvious.

 

The majority of clinical software is designed for use with Microsoft Windows, with Mac users often experiencing problems. However, by use of a Citrix Desktop Viewer, the platform does not matter as everything is viewed in a standard browser, regardless of whether the user is on Windows, Android, iOS or MacOS.

 

Coming from a family of doctors, I originally considered offering a free service to make the lives of healthcare professionals easier by allowing them to focus on patient care. However, I decided to implement a licence fee structure, given the variety of experts, hardware and hosting requirements necessary to provide a reliable service. It is true that ‘you get what you pay for’ and a free service would have compromised features and defeated my original goals.

 

The licence fee structure works well and is cost-effective, regardless of the size of the practice, given the backup protection and risk managements solutions that are immediately solved. In addition, we perform a full IT and business process audit to maximise the investment, ensuring that all systems are configured correctly.

 

While some are still reluctant to move to the cloud, due to perceive security issues, I believe these concerns to be ill-founded, especially when you consider that cloud service providers are held to a higher standard than traditional networks. We are subject to regular third party audits that we cannot avoid if we are to retain our IT and industry certification status. By achieving these standards, we publicly confirm that we exercise due diligence in security, data storage and internal disaster recover processes.

 

Therefore, we can offer a complete IT solution with confidence, whether it’s on the cloud, onsite or a combination of both. Eliminate your IT concerns and focus on your business. Contact us for further details.

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Medical Device Quality: Why Software Is More Challenging Than Hardware

Medical Device Quality: Why Software Is More Challenging Than Hardware | IT Support and Hardware for Clinics | Scoop.it

The U.S. Food and Drug Administration’s (FDA) Quality System Regulation 21 CFR Part 820.30(g) states, “Design validation shall include software validation and risk analysis, where appropriate.” The words, “where appropriate,” indicate that further guidance is necessary to successfully comply with the regulation. FDA’s guidance document, “General Principles of Software Validation,” is an important first read in that regard, but many medical device manufacturers are not sufficiently familiar with it.

 

It is impossible to imagine the medical device industry today without the software revolution. From defibrillators to infusion pumps and robotic surgical systems, a broad range of devices relies on software to function safely and effectively. At the same time, medical device software has introduced a level of complexity that dwarfs anything seen before in the field. This column addresses some basic facts about medical device software and how quality professionals, together with executive management, can work together to ensure that FDA’s rigorous requirements are satisfied.

 

Note that FDA has separate requirements for medical device software and quality system software. This column addresses only the software that is part of a medical device, such as software that triggers an alarm when a product fails. Other software, such as that used by a medical device manufacturer to manage complaints in its quality system, is outside of the scope of this discussion.

 

In October 2017, FDA released two new final guidance documents on the same day: “Deciding When to Submit a 510(k) for a Change to an Existing Device” and “Deciding When to Submit a 510(k) for a Software Change to an Existing Device.” In other words, medical device software changes have so many unique challenges and risks that they earn a guidance document of their own, separate from all other device changes.


The Problem: Software Is Different from Hardware
Validation is at the heart of device design, and the validation of software design is especially challenging. Even though FDA’s guidance document, “General Principles of Software Validation,” was last updated in January 2002, that guidance is still highly relevant and useful. When a medical device incorporates software, FDA expects the manufacturer to be well-read in the guidance document.

 

Furthermore, FDA does not intend the guidance document on software validation to be read only by software developers or quality engineers, as it states, “Software engineering needs an even greater level of managerial scrutiny and control than hardware engineering.” The guidance is written in laymen’s terms, so executive management is not excused from this responsibility, even when they have limited experience in software development.

To get to the heart of the problem, the guidance document on software validation includes the deceptively simple statement: “Software is different from hardware.” Actually, there are many complex differences between software and hardware, and understanding those differences is key to ensuring that software validation will pass FDA muster. The comparison chart (above and on the previous page) is adapted from, and expands on, the FDA guidance.

 

The Solution: Software Validation Driven by Rigorous Requirements


Both of the last two differences in the chart use the phrase, “a clear set of detailed requirements.” This is the most crucial element for proper software validation, and one that is frequently neglected. The flow chart figure on page 20 illustrates how requirements play an early and crucial role in software development.

 

During the phases that developers are coding and testing the software, the requirements enter a tunnel that is closed to non-developers, and the software emerges from the other side as a complete design. The resulting software can support a safe and effective device only if executive management and other stakeholders have reviewed a detailed and unambiguous set of requirements. Quality and regulatory teams can expedite this crucial phase by ensuring smooth communications between engineering and the rest of the organization.

 

At the far end of the tunnel, quality and regulatory conduct the final stages of user site testing with faithful attention to the original requirements. As noted in the list of differences between software and hardware, “user expectations are often unexpected,” and any expectations that were not properly specified as requirements are likely to emerge as errors during testing.

 

Clearly, the future of medical device development is bound up with new advances in software—wearable devices, remote medicine, algorithmic diagnostics, and robotics. FDA expects that manufacturers’ quality systems and design controls will ensure safety and efficacy, even as the software code at the heart of the device remains opaque to executive management. Software design might be more challenging than hardware, but software validation will keep the differences manageable and the quality undiminished.

 

Dan Goldstein is a manager for Quality Assurance at Musculoskeletal Clinical Regulatory Advisors (MCRA), primarily focusing on quality system requirements for bringing new devices to market and keeping experienced manufacturers in compliance with FDA and Notified Bodies. He provides MCRA clients with gap assessments, mock FDA inspections, Form 483 remediations, Design History Files, Technical Files, Summary Technical Documents, and Clinical Evaluation Reports. A graduate of the University of Maryland University College, Dan has worked since 2002 in quality assurance for medical devices, including autologous blood products for wound healing and computer-aided-detection software for lung diseases. Musculoskeletal Clinical Regulatory Advisers LLC has broad experience in the area of software validation. MCRA’s staff is especially adept at promoting and maintaining the lines of communication that keep executive management, the “voice of the customer,” and software developers on the same page with regard to the detailed requirements that drive the development process. The organization believes in requirements that follow the “four Cs”—clear, concise, correct, and complete.

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Advanced Software Offers Metal Artifact Reduction For Extremities

Advanced Software Offers Metal Artifact Reduction For Extremities | IT Support and Hardware for Clinics | Scoop.it

Carestream Health will demonstrate new optional advanced metal artifact reduction software for its Carestream OnSight 3D Extremity System at the Radiological Society of North America tradeshow (Booth #6713). Carestream’s OnSight 3D Extremity system captures high-quality, low-dose 3D extremity exams. The company’s new metal artifact reduction software is pending FDA 510(k) Clearance.

“Carestream’s second generation of software takes our state-of-the-art original metal reduction software to a new level. It provides enhanced flexibility depending on the metal content present and reduces the visual distortion caused by screws, implants, rods and other metal objects to create improved visibility and diagnostic confidence,” said Helen Titus, Carestream’s worldwide marketing director for ultrasound & CT.

The optional software makes it easier for radiologists and orthopedic surgeons to accurately diagnose a patient’s condition and develop treatment plans. Image processing can be adjusted and optimized according to the amount of metal present.

The software uses information from the original scan to eliminate the need for additional imaging studies, which reduces costs and lowers radiation exposure for patients.

An intuitive touch screen interface allows technologists to adjust for either moderate or complex metal content. The metal artifact reduction software can be activated prior to the scan or it can be applied after the original reconstruction is complete. Both the original and corrected images are always available to view and compare.

The OnSight 3D Extremity System also assists surgeons in detecting occult and non-union bone fractures. Unlike traditional CT systems, this cone beam CT system has a large-area detector that captures a 3D image of the extremity in a single rotation, which takes only 25 seconds. A patient simply places the injured extremity into a donut-shaped opening in the system. Since the patient’s head and body are not confined, patients do not experience the claustrophobia that often occurs with traditional CT systems. Dose is significantly reduced because only the affected body part is imaged.

The compact extremity system can be installed in an exam room and plugs into a standard wall outlet.

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FDA Clears IlluminOss Medical's Bone Stabilization System

FDA Clears IlluminOss Medical's Bone Stabilization System | IT Support and Hardware for Clinics | Scoop.it

IlluminOss Medical, a privately held, commercial-stage medical device company focused on minimally invasive orthopedic fracture repair, announced that it has received U.S. Food and Drug Administration (FDA) de novo clearance for the IlluminOss Bone Stabilization System for treatment of impending and actual pathological fractures of the humerus, radius and ulna from metastatic bone disease.

The IlluminOss System incorporates the use of a thin-walled PET balloon that is infused with a liquid monomer and delivered in a minimally invasive fashion into the intramedullary canal of the bone through a small incision.

Once the balloon is infused with monomer, it conforms to the shape of the patient’s specific bone. The surgeon then activates a light source which delivers visible light to the PET balloon, polymerizing the monomer. The cured, hardened implant provides longitudinal strength and rotational stability over the length of the implant, stabilizing the fracture.

The IlluminOss System, which has been commercially available in international markets and been in clinical use since 2010, will now be available to patients in the U.S. for the treatment of pathological fractures of the humerus, radius and ulna.

“The FDA marketing clearance marks a significant milestone for IlluminOss Medical, allowing us to bring our products to the U.S. market,” said Robert Rabiner, chief technology officer, IlluminOss. “The IlluminOss System was developed with an aim to provide improved patient experiences and outcomes when treating pathologic fractures. There is a critical need to make less invasive orthopedic fracture repair options available to an aging and underserved market segment.”

Surgeons’ experiences with the product in the international markets have reported smaller incisions, shorter procedural times, faster return to patient’s daily living activities, with reduced hospital stays and lower complication rates for patients.

“The IlluminOss System has significantly changed the way we are able to approach the treatment of certain impending and actual pathological fractures resulting from metastatic bone disease,” said Dr. Richard McGough, Department of Orthopaedic Surgery, University of Pittsburgh Medical Center. “We were able to offer patients a quick, reliable surgical option that minimized pain and hospitalization. We were also able to consolidate their treatments; in some cases, we moved from two-day admissions to outpatient surgery, and we were ultimately able to complete radiation much more quickly.”

“I am delighted that we now have an improved option to help patients with metastatic bone disease of the humerus,” said John Healey, Chief of Orthopaedic Surgery, Memorial Sloan Kettering Cancer Center. “Since this device doesn’t violate the rotator cuff and can be inserted with reduced operative time and blood loss, it relieves pain and restores function more effectively than alternative treatments, in my experience. Furthermore, this new technology is versatile, and I anticipate that new applications will follow.”

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Nerve-on-a-Chip Platform Makes Neuroprosthetics More Effective

Nerve-on-a-Chip Platform Makes Neuroprosthetics More Effective | IT Support and Hardware for Clinics | Scoop.it

Neuroprosthetics—implants containing multi-contact electrodes that can substitute certain nerve functionalities—have the potential to work wonders. They may be able to restore amputees' sense of touch, help the paralyzed walk again by stimulating their spinal cords and silence the nerve activity of people suffering from chronic pain. Stimulating nerves at the right place and the right time is essential for implementing effective treatments, but still a challenge due to implants' inability to record neural activity precisely. "Our brain sends and receives millions of nerve impulses, but we typically implant only about a dozen electrodes in patients. This type of interface often doesn't have the resolution necessary to match the complex patterns of information exchange in a patient's nervous system," said Sandra Gribi, a Ph.D. student at the Bertarelli Foundation Chair in Neuroprosthetic Technology.

Replicating—and Improving—How Neuroprosthetics Work
Scientists at the lab run by Dr. Stéphanie Lacour, a professor at EPFL's School of Engineering, have developed a nerve-on-a-chip platform that can stimulate and record from explanted nerve fibers, just as an implanted neuroprosthetic would. Their platform contains microchannels embedded with electrodes and explanted nerve fibers faithfully replicate the architecture, maturity, and functioning of in vivo tissue.

The scientists tested their platform on explanted nerve fibers from rats' spinal cords, trying out various strategies for stimulating and inhibiting neural activity. "In vitro tests are usually carried out on neuron cultures in dishes. But these cultures don't replicate the diversity of neurons, like their different types and diameters, that you would find in vivo. Resulting nerve cells' properties are changed. What's more, the extracellular microelectrode arrays that some scientists use generally can't record all the activity of a single nerve cell in a culture," said Gribi.

The nerve-on-a-chip platform developed at EPFL can be manufactured in a clean room in two days and is able to rapidly record hundreds of nerve responses with a high signal-to-noise ratio. However, what really sets it apart is that it can record the activity of individual nerve cells. The research has just been published in Nature Communications.

Inhibiting the Activity of Specific Neurons
The scientists used their platform to test a photothermic method for inhibiting neural activity. "Neural inhibition could be a way to treat chronic pain like the phantom limb pain that appears after an arm or leg has been amputated, or neuropathic pain," said Lacour.

The scientists deposited a photothermic semiconducting polymer, called P3HT:PCBM, on some of the chip's electrodes. "The polymer heats up when subject to light. Thanks to the sensitivity of our electrodes, we were able to measure a difference in activity between the various explanted nerve fibers. More specifically, the activity of the thinnest fibers was dominantly blocked," said Gribi. And it's precisely those thin fibers that are nociceptors—the sensory neurons that cause pain. The next step will be to use the polymer in an implant placed around a nerve to study the inhibiting effect in vivo.

Distinguishing Between Sensory and Motor Nerve Fibers
The scientists also used their platform to improve the geometry and position of recording electrodes, in order to develop an implant that can regenerate peripheral nerves. By running the measured neural data through a robust algorithm, they will be able to calculate the speed and direction of nerve impulse propagation—and therefore determine whether a given impulse comes from a sensory or motor nerve. "That will enable engineers to develop bidirectional, selective implants allowing for more natural control of artificial limbs such as prosthetic hands," said Lacour.

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'Dual Mobility' Hip Replacement Implant Reduces Risk Of Dislocation

'Dual Mobility' Hip Replacement Implant Reduces Risk Of Dislocation | IT Support and Hardware for Clinics | Scoop.it

Hip replacement surgery is highly successful in relieving pain, restoring mobility, and improving quality of life. More than 330,000 procedures are performed each year in the United States, and that number is expected to almost double by the year 2030.

As with all surgical procedures, the possibility of a complication exists, and dislocation is the most common problem. The risk of dislocation is higher in patients who have had a second hip replacement, known as revision surgery. Some people need revision surgery many years after their first hip replacement when the original implant wears out. Hip instability after joint replacement is another reason a patient might need a revision surgery.

Research conducted by Dr. Geoffrey Westrich and colleagues at Hospital for Special Surgery and other joint replacement centers indicates that a newer type of artificial hip known as a "modular dual mobility" implant could be a good option for patients who need a revision surgery. Their study was presented at the annual meeting of the American Association of Hip and Knee Surgeons in Dallas this month.

"Although the concept of dual mobility was originally developed in France in the 1970s, the technology is relatively new in the United States," said Dr. Westrich, director of research of the Adult Reconstruction and Joint Replacement Service at HSS. "Our study found that the newer technology with modular dual mobility components offered increased stability, lowering the risk of dislocation, without compromising hip range of motion in patients having a revision surgery."

"Dual mobility" refers to the bearing surface of the implant—where the joint surfaces come together to support one's body weight. A hip replacement implant is a ball-in-socket mechanism, designed to simulate a human hip joint. Typical components include a stem that inserts into the femur (thigh bone), a ball that replaces the round head of the thigh bone, and a shell that lines the hip socket.

Modular dual mobility implants provide an additional bearing surface compared to a traditional implant. With the dual mobility hip, a large polyethylene plastic head fits inside a polished metal hip socket component, and an additional smaller metal or ceramic head is snap-fit within the polyethylene head.

"Currently, there are few large-scale outcome studies on the modular dual mobility device in revision hip replacement," Dr. Westrich noted. "We set out to determine the rate of dislocation and the need for another surgery following revision hip replacement using this implant and report on the functional outcomes."

The study included 370 patients who underwent revision hip replacement with the dual mobility implant between April 2011 and April 2017. The average patient age at the time of surgery was 65.8 years. Clinical, radiographic, and patient reported-outcome information was collected.

To be included in the final report, patients needed to be seen for follow-up for at least two years after their surgery, and the average follow-up was 3.3 years. "At the latest follow-up, we found that surgery with the dual mobility implant resulted in a very low rate of instability for the revision patients, namely 2.9 percent, with good functional improvement and a low rate of reoperation," Dr. Westrich noted. "While longer-term follow-up is needed to fully assess the newer device, in our study there was clearly a benefit provided by the dual mobility implant in the first few years following revision surgery."

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4 Industries That Find Blockchain Technology Useful

4 Industries That Find Blockchain Technology Useful | IT Support and Hardware for Clinics | Scoop.it

 

By 2024, the global blockchain market is expected to be worth $20 billion, and according to a recent study by IBM, one-third of C-level executives are considering adopting these technologies. Does that surprise you? Is your organization exploring blockchain or distributed ledger solutions?

 

Recent reports indicate that blockchain has the potential to reduce certain industries’ infrastructure costs by 30 percent. Additionally, there’s a $8-12 billion annual savings for certain industries that use blockchain technology. Let that sink in.

 

Companies of all industry types are using blockchain technology to help them improve transparency, traceability and trust; but here are four industry-specific benefits.

 

  1. Healthcare: Hospitals are now able to seamlessly access patient data shared between member hospitals and participating hospitals.
  2. Banking: Financial institutions are able to simplify and speed up the transfer of funds, while ensuring the identity of the user.
  3. Supply chain: Manufacturers can ensure the authenticity of goods and products with better transparency and accountability.
  4. Insurance: Companies can eliminate common sources of fraud, and use smart contracts to improve efficiency and improve customer experience.

 

With all of these sample use cases, blockchain helps companies increase efficiency and reduce friction. Sirius offers various services to help organizations define and develop their blockchain solution.

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How Serious is the Cybersecurity Talent Shortage? 

How Serious is the Cybersecurity Talent Shortage?  | IT Support and Hardware for Clinics | Scoop.it

Across all industries worldwide, cybersecurity has become a top priority. Hackers keep pumping out new types of malware, and data breaches keep occurring. As of April 8, there were already 281 breaches exposing nearly 6 million records in 2019 so far, according to the Identity Theft Resource Center. Businesses can’t afford to sit back and wait until they’re attacked to defend themselves against cybercriminals.

 

With the average cost of a data breach globally totaling $3.86 million according to IBM and the Ponemon Institute, the wisest course of action is to proactively protect your organization with a comprehensive cybersecurity strategy.

 

However, everyone looking to effectively combat IT security threats faces a significant obstacle: a cybersecurity talent shortage. If you’re a business leader seeking to minimize your data breach risk, consider the following information on the extent of this issue and what you can do to overcome it.

 

The Cybersecurity Workforce Gap by the Numbers (ISC)² – an international, nonprofit association for information security professionals – released a report on the cybersecurity workforce gap in 2018. The report draws on a survey of nearly 1,500 cybersecurity pros and IT pros who spend at least 25 percent of their time on cybersecurity tasks.

 

Here are a few key statistics from the report that illustrate the extent of the talent shortage: The global shortage of cybersecurity professionals is approximately 2.93 million. 63 percent of survey respondents said their organizations have a shortage of IT staff focused on cybersecurity. 59 percent also say their organizations have a moderate or extreme cyberattack risk level because they lack sufficient cybersecurity talent. “Awareness of the cybersecurity skills shortage has been growing worldwide,” the report’s introduction states.

 

“Nevertheless, that workforce gap continues to grow, putting organizations at risk. Despite increases in tech spending, this imbalance between supply and demand of skilled professionals continues to leave companies vulnerable.” What’s Behind the Cybersecurity Talent Gap?

 

The increasing popularity of e-commerce and the rise of new technologies like mobile devices and the Internet of Things has created more opportunities for cybercrime. In the past few years, in particular, the demand for cybersecurity talent has surged, according to Verizon. Basically, the supply hasn’t had time to catch up to the skyrocketing demand. Universities and training programs need time to develop the right courses so that job candidates have the cybersecurity skills companies are searching for, Verizon explains.

 

However, it will take a while for college students to complete the new coursework and find their way into the workforce. Another, faster answer to the talent shortage is for workers to learn through on-the-job training.

 

What Can Businesses that Need IT Security Expertise Do to Overcome the Talent Gap? There are several ideas out there already concerning how to remedy the growing and highly concerning cybersecurity skills shortage.

 

Here are a few notable proposals: Form an industry-wide alliance: If large enterprises in the IT world (e.g., Dell, Cisco, Microsoft, Google and so on) join forces, they could put cybersecurity training programs in motion to address the talent shortage, according to the CSO opinion piece “The cybersecurity skills shortage is getting worse” by Jon Oltsik, a principal analyst at Enterprise Strategy Group. Broaden the job search to include candidates with the potential to learn.

 

Companies shouldn’t necessarily rule out professionals who don’t have the ideal qualifications in terms of degrees, certifications, and experience, Arctic Wolf Networks CEO Brian NeSmith advises in the Forbes article “The Cybersecurity Talent Gap Is An Industry Crisis.” Be open-minded and consider that intelligent candidates with great problem-solving skills might do well in the role, even if they don’t have all the prerequisites.

 

Turn to a third-party provider for assistance. A managed security services provider like Stratosphere Networks can help you gain access to high-level cybersecurity expertise while still containing costs. Services such as virtual CISO and CSO can give you all the benefits of having a security pro on staff without drawbacks like the price of training and hiring an in-house executive.

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3 Cisco Cloud Security Products to Check Out 

3 Cisco Cloud Security Products to Check Out  | IT Support and Hardware for Clinics | Scoop.it

Cisco continues to evolve its cloud security profile with new developments from Meraki, Umbrella and Duo products. These three products are made to seamlessly integrate with your systems to better protect your business. Learn more about each below.

Cisco Meraki

Cisco Meraki combines security cameras, cloud-management, and analytics with the MV lineup. The MV22 and MV72 cameras provide reliable security. They are easy to set up and manage through the Meraki dashboard. This tool eliminates the single point of failure, so you don’t have to worry about one camera failing and taking down the whole system. Both models have 256GB of solid states storage and up to 1080 pixels of high definition resolution. The Meraki dashboard allows for monitoring and management of all cameras from anywhere in one or multiple locations with no extra software required. The dashboard uses analytics to provide valuable insights to protect your business. An example is performing a motion search, which can detect people using pixels at certain periods of time during the day. Additionally, under the Meraki brand, the Meraki SD-WAN is 100% centralized cloud management for security, networking and application control. The dashboard enables network admins to view networked clients, bandwidth consumption, and application usage across all sites. Some of its features include no external modem, high availability, and advanced security license/firewire.

Cisco Umbrella

Cisco Umbrella Solution is a cloud-based secure internet gateway and provides the first line of defense from threats on the internet – even if the end-user is working remotely from a company device or their own computer. The Umbrella boasts an easy deployment and an even easier system to operate. It integrates directly with Meraki products and the rest of the Cisco security profile. With Umbrella, users are protected anywhere they access the internet with or without a VPN. The DNS is the biggest threat to security and most of the time isn’t monitored. The Umbrella Cloud Solution solves this gap as the first line of defense. It not only solves requests, but it also looks at comparisons in the data to better detect similar threats from cyber fingerprints used by attackers.

Duo

The duo is the most recent addition to the Cisco family. This tool offers a streamlined way to improve the user experience during the multi-factor authorization while also protecting your business. The duo takes it a step further by checking devices managed and unmanaged to ensure it meets security standards before granting access. 


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5 tips to lower your printing costs

5 tips to lower your printing costs | IT Support and Hardware for Clinics | Scoop.it

Your growing printing expenditures may be the result of over-dependence on hard copies, the lack of effective printing workflow, and obsolete printers. With some fresh ideas, clever problem-solving, and the following tips, you could significantly cut down your printing budget.

 

Replace outdated printers

Outdated and cheap printers may be functional, but they are putting a huge dent in your IT budget.

Any piece of equipment that is seven years old (or older) requires frequent repairs and causes more trouble than it’s worth. Because old printers are no longer under warranty, fixing them is more costly and challenging. It’s also difficult to replace parts for old printers because manufacturers have stopped carrying them for models that have been phased out.

When you replace outdated equipment with newer, multi-functional printers, you’re investing in hardware that will pay for itself with increases in productivity and efficiency.

 

Avoid purchasing unnecessary supplies

A poorly managed printer environment could result in a stockpile of cartridges, toners, and reams of paper. This happens when, for example, an employee uses a printer that’s about to run out of ink and makes an unnecessary request for new ink or toner. This is more common than you may think and definitely more expensive.

In the absence of a dedicated printer manager, you can avoid this situation by automating supply replacement. Assign a point person to proactively place orders when supplies are about to run out, so your company can avoid needless purchases.

 

Impose strict process workflows

Submitting expense reports, filing reimbursements, and other administrative tasks require a proper document workflow. Without a guideline, employees and administrative staff tend to print an unnecessary amount of documents.

Automate your company’s document-driven processes to reduce or prevent redundant print jobs that result in stacks of abandoned documents. Not only are these printouts wasteful, but they’re also a security and privacy concern.

 

Go paperless

Designing a document management solution that reduces paper consumption is the best way to save money. It may not be possible in every department, but those who can do their jobs without printing should be encouraged to do so by management. Printing lengthy email chains that can be discussed in a meeting is just one example of a wasteful practice that should be avoided.

 

Reduce IT support calls for printing issues

Calling your company’s IT guys to assist with problems like paper jams, printer Wi-Fi issues, and other concerns reduce employee frustration. You and your IT personnel could avoid dealing with these productivity killers by identifying the problem areas of your print environment. Then, you can work on solutions specific to your office, such as drafting a printing workflow or getting help from document management experts who can recommend time- and budget-saving solutions.

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6 Outstanding Applications of AI in Today's Care Ecosystem

6 Outstanding Applications of AI in Today's Care Ecosystem | IT Support and Hardware for Clinics | Scoop.it

Behold the Magic of Intelligent Care Healthcare with Artificial Intelligence

Artificial intelligence (AI) – the smart, cognitive devices of today’s era – has penetrated extensively across all possible verticals – from financial services to manufacturing – and healthcare is no exception. With interest in AI booming exponentially, its scope of application in care-based applications has widened beyond imagination.

 

Reports indicate that the AI-driven healthcare market will see a tremendous growth of almost 40% by the end of this decade. From delivering advanced care-related information to physicians to make informed decisions to personalized real-time treatment, advanced applications of AI in healthcare are indeed revolutionizing care.

 

Let’s check out some of the outstanding applications of AI in today’s care ecosystem.

1. Diagnosis

One of the most advanced applications of AI in healthcare is in disease diagnosis. With AI, machines are supercharged with the ability to analyze voluminous data from medical images, prompting early diagnosis of many disorders. AI provides an easy solution through intelligent diagnostic imaging. This approach has multiple applications in proactive diagnosis of the possibility of stroke, tumor growth, and certain types of cancer, giving the physician the chance to derive a comprehensive treatment plans for patients well ahead of time.

2. Biomarkers

Biomarkers automatically provide accurate visual and audio data of patients’ vital health parameters that indicate the presence of specific medical conditions, help choose the ideal medications, or assess treatment sensitivity. Biomarkers accurately capture symptoms, as against the guesswork of symptoms perceived by patients. The accuracy and speed of biomarkers have made them the preferred tools of diagnosis, promptly highlighting possibilities of any disorders.

3. Virtual nursing assistance

AI -based applications and chat bots support care providers in delivering nursing assistance after discharge from hospital. This feature helps simplify provision of outpatient services and increases the accuracy of monitoring patient compliance post discharge. Available even as simple wearable’s and on smart phones, these AI-enabled devices also act as virtual health assistants that remind patients about their medications, encourage them to follow their exercise routines, answer simple medical clarifications sought by patients, and warn care providers about any untoward incidents such as sudden increase in blood pressure or a fall.

4. Remote monitoring of patients

This involves round-the-clock remote monitoring of patients, constant evaluation of their vital signs, and real-time alerts to caretakers and care providers. This remote assessment of vital health parameters helps physicians identify core symptoms of diseases and disorders in patients and respond accordingly. This approach clearly prevents unnecessary visits to the physician to a great extent.

5. AI and drug discovery

AI-driven computing can accurately and promptly study structures of multiple drug molecules and predict their pharmacological activity, potency, and adverse effects. This possibility opens up a rapid and cost-efficient route of drug discovery. It also has the chance of drastically reducing the cost of medications. Used across pharmaceutical companies, AI-based drug discovery has contributed to supporting the treatment of cancer and neurodegenerative disorders.

6. AI-enabled hospital care

AI simplifies care delivery in hospitals through a wide range of solutions including smart monitoring of IV solutions, patient medication tracking, patient alert systems, nursing staff performance assessment systems, and patient movement tracking within hospitals. Robot-assisted surgeries and AI applications in routine phlebotomy procedures are other potentially useful applications. AI has been found to considerably decrease dosage errors and increase nursing staff productivity in hospitals.

 

Conclusion – the era of AI has arrived in style
With voluminous investments pouring in for AI applications in healthcare, this technology still has a long way to go, despite its presence in healthcare for quite many years now. The main reasons for its slow adoption are the cost of research, the security concerns involved in opening up extensive databases, and misconceptions or errors in coming to quick conclusions. But the quest for ideal AI solutions looks quite promising indeed, with AI supplementing healthcare and improving the quality of care from diagnosis to prognosis.
So, where are you in your journey towards an AI-driven care ecosystem?

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Medical billing for dummies

Medical billing for dummies | IT Support and Hardware for Clinics | Scoop.it

Here are some frequently asked questions about medical billing and their answers that will serve as your first lesson on the field of medical billing.

What is medical billing?

Medical billing is the process of submitting and following up on health insurance claims with the insurance company. This process is undertaken by a medical billing specialist with the support of the insurance desk team of the hospital or healthcare provider.

 

It is the responsibility of the medical biller to ensure that the service provided to the patient (who is insured with the insurance company) receives reimbursement. As part of this process, the medical biller sends an invoice detailing the treatment and the health services provided to the health insurance company on behalf of the healthcare provider. Therefore, when done efficiently, medical billing can optimise revenue performance for the healthcare provider. Today, most medical billers make use of specialised software which help in automating and improving the speed and efficiency of the process.

How is medical billing different from medical coding?

Both medical coding and medical billing are processes that are largely responsible for the smooth progress of the healthcare provider’s revenue cycle. Medical coding, carried out by a medical coder, is the process of assigning specific codes to the different health services rendered to the patient.

 

Medical billing, carried out by a medical biller, utilises the diagnosis and procedure codes derived from the medical record documentation to assemble all data concerning the medical bill or claim accurately and efficiently. Therefore, medical billing is a process that is dependent on medical coding.

What are the steps involved in medical billing?

The basic steps involved in medical billing are:

  1. Charge Entry
    • The medical biller, in this step, enters the charges for services provided to the patient. The charge entry also includes the appropriate linking of medical codes to services and procedures rendered during the patient’s visit.
  2. Claims Transmission
    • Once the claim has been properly completed, it must be submitted to the insurance company for payment. This step is called claims transmission or claims submission and is done electronically in formats specifically required by the insurance companies. Sometimes, clearing houses are used to reformat the claims in the format that matches the need of the insurance company.
  3. Monitoring of Adjudication
    • Once a claim is submitted to the insurance company, it undergoes a process called claims adjudication wherein the insurance company evaluates the claim and decides whether or not the claim is eligible for reimbursement based on factors including validity and compliance.
    • At the end of the adjudication, the insurance company sends a report to the healthcare provider. It is the medical biller’s responsibility to review this report and ensure that all procedures listed on the claim are accounted for. If there are any discrepancies, the biller will enter into an appeal process with the insurance company.
  4. Payment Posting
    • This step marks the end of the billing cycle and involves posting and deposit functions. Payment or settlement is received from the insurance company at this point, and the payment records of every patient are recorded in the billing management software.
  5. Patient follow-up
    • Medical billers follow up with patients whose bills are delinquent, rejected or partially paid to make sure that the payment due for the healthcare service, which has not been settled by the health insurance company, is received. This may involve contacting the patient directly, sending follow-up bills, or, enlisting a collection agency.

 

In conclusion, it can be said that the medical biller is the bridge between the healthcare provider and the health insurance company. Additionally, the medical biller may also be involved in supporting the insurance desk, communicating with the physician for clarifications and many such tasks that are related to the claims process.

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Cloud Computing Supports Telemedicine Growth

Cloud Computing Supports Telemedicine Growth | IT Support and Hardware for Clinics | Scoop.it

Today’s healthcare professionals enjoy convenient access to a multitude of tools that would have amazed previous generations. Unfortunately, lack of awareness or access to technical experts means that many practices are unable or unwilling to take advantage of the latest technological advances, advances that increase efficiency, security and productivity. Others are intimidated by the technical jargon often associated with eHealth. All that is needed to eliminate all these issues is a partnership with a provider that specialises in the health industry, rather than deal with IT companies that are themselves unwilling to recommend healthcare-specific solutions that they are unfamiliar with.

 

Providers of healthcare solutions are familiar with the inner workings of practices and clinics and can easily review existing processes and recommend solutions that will integrate technology in the best possible manner. They will also support any new technological solutions, leaving medical professionals more time for patient care, which will ultimately provide substantial benefits that aid early diagnosis and prolong lives.

 

Providers without healthcare knowledge will recommend solutions that they are familiar with, ones that are normally selected by traditional commercial enterprises. Such solutions are generally unsuitable for healthcare clinics and practices and often require expensive customisation, assuming that they can even be customised sufficiently to meet existing regulations.
Smaller clinics and practices do not have an on-site IT team and often eliminate IT requirements by automating server maintenance, data backups and archiving using a cloud solution. In such a scenario, it is the provider that is responsible for all of these activities.

 

Telemedicine allows easier collaboration and involves the use of mobile or other internet-enabled devices. Advantages include instant videoconferencing, remote consults, immediate access to electronic health records and the elimination of geographical issues, where patients are unable to visit the practice or clinic in person. These collaborative features are used between medical teams in multiple locations, between mobile clinics and their headquarters and of course can be used by any medical professional on the move.

 

When cloud services are used, connectivity is possible from anywhere a broadband signal is present, whether to a PC or portable device. This is ideal for patients in remote are rural areas and eliminates the time and expense necessary to consult with a specialist in the traditional manner. With videoconferencing, for example, no travel is required yet an excellent service is provided by the healthcare professional involved. Even follow-ups are possible online. Security concerns are also eliminated as a travelling professional accesses data remotely and never stores it on their own personal devices.

 

There are additional cloud benefits for healthcare professionals and these include:


• Scalability – you pay for the amount of space you use and it can be increased on demand


• Automatic updates – the provider’s IT team install security patches promptly


• Disaster recovery – automated regular backups take place and are restored when active data is lost


• Redundancy – multiple broadband connections are available. When one fails, another takes over


• Flexibility – if additional bandwidth is needed, it is readily available. This is not possible with traditional networks


• Works from anywhere – an internet-ready device, a 3G or broadband connection and you are good to go


• Collaboration – depending on requirements, there are specific software applications available to aid collaboration between team members and patients


• Document management – a single document repository allows secure and controlled access to confidential information


• Security – the use of the cloud ensures data is never stored in portable devices, given that thousands are lost or stolen every year

 

• Green-tech – the carbon footprint for each practice or clinic is substantially reduced, with cloud servers using less power per client due to virtualisation technology


• Cost savings – every clinic and practice uses the latest in hardware and software technology but without the initial investment. Ongoing IT maintenance costs are also dramatically reduced

 

When it comes to telemedicine, in addition to data management and document control features, there are software applications available that maximise patient turnover per clinic, improve patient care and even improve follow-up treatment and remote monitoring processes.

 

With benefits of this magnitude and with evolving regulations to embrace technological advances in eHealth, clinics need to install a telemedicine solution sooner rather than later or give competitive advantage to those that adopt now. This is especially true if patients and colleagues are in other geographical areas. In fact, government services are already active for eligible aged-care homes and to patients of Aboriginal Medical Services throughout Australia.

 

 

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The Promising Future For AI In Orthopedics

The Promising Future For AI In Orthopedics | IT Support and Hardware for Clinics | Scoop.it

In their most simple form, AI applications in healthcare consist of a collection of technologies that will enable machines to sense, comprehend, predict, act, and learn. The first application for AI-based machines, as discussed at the World Medical Innovation Forum (held in April 2018), is to execute healthcare administrator and clinical healthcare functions. Current technologies are limited because they are algorithm based. The future of AI will make the leap past algorithm-only tools to become indispensable instruments for patients, providers, physicians, and payers. AI has the potential to truly augment human activity.

 

Why This Is Important
The potential to drive improvements in quality, cost, and access has made AI a notable buzzword in healthcare. The AI health market is growing rapidly and is forecasted to reach $6.6 billion by 20211 (Table 1).

 

AI Applications in Orthopedics
AI has demonstrated high utility in classifying non-medical images. A study2 looked at the feasibility of using AI for skeletal radiographs. The study authors compared an AI program against the radiography gold standard for fractures. They also compared the performance of the AI program with two orthopedic surgeons who reviewed the same images. They found the AI program had an accuracy of at least 90 percent when identifying laterality, body part, and exam view. AI also performed comparably to the senior orthopedic surgeons’ image reviews. The study outcomes support the use of AI in orthopedic radiographs. While the current AI technology does not provide important features surgeons need, such as advanced measurements, classifications, and the ability to combine multiple exam views, these are technical details that can be worked out in future iterations for the orthopedic surgeon community.

 

AI in Computer-Assisted Navigation3
Orthopedic surgeons have had access to robotic technology to help them position screws, prostheses, or tunnels for some time, but AI enhanced applications are in development (Table 2). For example, one device utilizes infrared light to locate bones intraoperatively. Another technology uses a form of AI to mill the canal for a prosthesis based on CT scans. In total hip surgery, computer assistance in placing the cup of the prosthesis is reported to have the same accuracy as with traditional methods. In the realm of knee replacement surgery, AI-supplemented robotics technology assists to align prostheses. In spine surgery, AI-enhanced computer-assisted navigation helps surgeons avoid neurovascular structures, and place thoracic and lumbar pedicle screws accurately. It is reported that the incidence of poorly placed screws has reached 42 percent with conventional surgical techniques, according to some studies, but is as low as 10 percent with AI-based computer assistance.

 

We Have Needed a Tool Like AI for a Long Time
AI will change the way healthcare work is performed. AI will fill the gaps we all know are coming in the future, such as the labor shortage in healthcare (Table 3). Through AI, we will empower clinicians and give workers tools to increase their productivity. Healthcare institutions will need an AI-trained workforce and culture. Think of the value your products will bring with AI and the ability to gain clinician face-time and recognition as they use AI to enhance efficiency, quality, and outcomes.

 

The Medi-Vantage Perspective
In almost every strategy research project we manage, when we look at adjacent technologies in consumer markets, we see AI being utilized again and again. Our strategy research helps clients understand the opportunity to integrate AI technology into their product strategies. Someday, even the most common medical devices will have an AI component.

 

Maria Shepherd has more than 20 years of leadership experience in medical device/life-science marketing in both small startups and top-tier companies. After her industry career, including her role as vice president of marketing for Oridion Medical where she boosted the company valuation prior to its acquisition by Covidien/Medtronic, director of marketing for Philips Medical, and senior management roles at Boston Scientific Corp., she founded Medi-Vantage. Medi-Vantage provides marketing and business strategy as well as innovation research for the medical device industry. The firm quantitatively and qualitatively sizes and segments opportunities, evaluates new technologies, provides marketing services, and assesses prospective acquisitions. Shepherd has taught marketing and product development courses and is a member of the Aligo Medtech Investment Committee (www.msbiv.com). She can be reached at 855-343-3100, ext. 102, or at mshepherd@medi-vantage.com. Visit her website at www.medi-vantage.com.

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EHR Hardware Basics in Health IT Guides

EHR Hardware Basics in Health IT Guides | IT Support and Hardware for Clinics | Scoop.it

Hardware Basics for Electronic Health Records

 

Basic Terms


Workstation - This refers to the hardware that holds everything a physician or office staff worker needs to perform their jobs: word processing, practice management software, EHR software, fax software, etc.


Desktop - One of three basic types of workstations. This describes a fixed, hard-wired computer that does not move around. The computer can actually sit on the top of the desk (desktop) or on the floor (tower).


Laptop - One of three basic types of workstations. This is a portable computer that has a keyboard and either a touchpad, stick, or mouse for moving the cursor around the screen. It is a fully functioning computer that can be carried or placed on a cart and moved around the office.


Tablet PC - One of three basic types of workstations. Tablet PCs contain built-in handwriting recognitions software that allows the user to "write" on the screen using a stylus, much as they would write on paper attached to a clipboard. Tablet PCs can have add-on keyboards for instances when typing is preferred.


Desktops


The basics:

 

  • A desktop computer usually has a standard configuration consisting of a CPU, monitor, keyboard, and mouse.
  • It is stationary; it resides in one location and cannot be moved from room to room.
  • It can stand alone or work with any of a variety of network arrangements

 

Advantages:

  • Desktops are low-cost and available from a wide variety of vendors.
  • Because desktop PCs are standardized, it is relatively easy and inexpensive to find spare parts and support, or to replace a machine.
  • Desktops will run just about any software you need.
  • Additional devices such as microphones, speakers, and headsets are readily available at low cost.

 

Disadvantages:

  • Because it's stationary, you need to buy a desktop PC for each room in which you need access to your EHR software.
  • Desktops typically take up more space than a laptop or tablet PC. While flat screen monitors and tower units save actual desktop space, the standard desktop computer requires more room than either a laptop or tablet PC.
  • You must purchase additional equipment to take full advantage of voice recognition and/or handwriting recognition programs.

 

What your peers have to say:
"Have had wired computers [desktops] in the exam room since 1998 and think it is the best way. I find it less hassle than carrying a computer around all day, worrying about batteries running out or losing wireless connectivity or dropping the computers. The computers are much cheaper both to buy initially and fix if something does happen. Tried a tablet but did not like it all. Never had a problem with children or adults interfering with the computer in the examining room and if you log out when you leave, HIPAA is not an issue."
-- Keith Stafford, MD, Greenville, South Carolina


Laptops


The basics:


A laptop is a fully functioning computer that is small enough to be portable. Laptops can take advantage of wireless as well as traditional networks. A laptop can easily serve as a desktop machine and can connect via a docking station to a larger monitor and a standard keyboard.

 

Advantages:

  • A laptop has a smaller footprint and can easily be turned to allow patients to view information on the screen.
  • A laptop is less obtrusive during patient interviews.
    Most have fairly long battery life and/or an A/C adaptor.
    Laptops use standard PC inputs such as keyboard and mouse and/or touchpad.

 

Disadvantages:

  • Although laptops are portable, they can be heavy to carry, typically weighing five to eight pounds.
  • Repairs and maintenance tend to be more expensive because laptops use non-standard or proprietary parts. You may have to send a laptop off-site for diagnosis and repair.

 

What your peers have to say:
"

  • We work wirelessly with laptops. All [prescriptions] print from one central printer right outside the exam rooms. Benefits of laptop:
  • Can open the note and chart before entering the room and bring up appropriate templates. Can enter the room already knowing what HM is late and what the purpose of the visit is.
  • Can close the note right outside the room if you want to go ahead and have the patient leave before finishing a note.
    Can see with bifocals; no neck strain.
  • Can have all my personal settings and programs handy all the time - PDR, links, hospital links, etc.
  • Can look at patient easily over the top of the laptop and can easily show patients what I'm doing.
  • Touchpad is always in the same place in relation to keys; easy to switch from it to typing or tabbing without looking. I like having a full size keyboard.

 

"I'm hooked on my laptop and am so accustomed to carrying it around that I don't even notice even though it is Dell's heaviest one."
-- Sue Andrews, MD, Murfreesboro, Tennessee

 

Tablet PCs


The basics:
There are two main types of tablet PCs: a slate tablet PC, which is a tablet with no attached keyboard (although one can be added), and a convertible tablet PC, which is basically a laptop computer with a screen that can swivel and fold onto the keyboard to create the tablet.

 

Advantages:

  • Tablets are truly portable and lightweight, typically weighing three to four pounds.
  • It is as powerful as a PC, but it doesn't require a keyboard. Instead, you add information by writing on the screen with a digital pen or stylus, much like you do in a paper chart.
  • Handwriting recognition software developed for tablet PCs is excellent, even for very poor handwriting.
  • Tablet PCs have integrated dictation capability with voice recognition software that transcribes directly into the patient record.


Disadvantages:

  • Writing with a stylus takes getting used to; there is a longer learning curve in adapting to a new way of using a computer.
  • Handwriting recognition dictionaries have not yet fully integrated medical terminology and acronyms, requiring more correction.
  • There is not as much standardized software yet available for tablets.
  • Screens are easily scratched and can become unusable without screen protectors purchased at additional cost.

 

What your peers have to say:
"I have been using a Gateway tablet in the room with my OB patients for the past two years. We use an ASP prenatal record called eNatal. I wouldn't trade for it. It has three methods of entering data on the screen, all vastly improved with the SP2 for Windows XP for Tablet.

 

"The first method is through tapping on a screen-based keyboard with the stylus (slow but very accurate). The second is through straight handwriting recognition. I have relatively poor handwriting, but it is amazing how accurate and fast this is! The only thing that seems to trip it up is some abbreviations, acronyms, or words that it can not find in the dictionary. The third option is a letter-by-letter handwriting recognition panel that is slower but extremely accurate.

 

"We've had no downtime. The wireless connection works well. The battery life is good (I plug it into the docking cradle between OB patients). We have used laptops and desktops for eNatal in the rooms and the tablet works best by far. As we look to add a full EMR, we hope to use a tablet-based system, probably the Motion Computing tablets with the biometric (fingerprint) access."
-- G. Jeffrey Young, MD, FAAFP, Levelland, Texas


Using EHR technology require a certain adjustment in the way you're used to interacting with your patiens and their charts. Deciding how to do this in the way that makes you the most comfortable will help guide your choice of hardware -- e.g. using a desktop, laptop, or tablet PC.

 

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Tips To Help Ensure A Successful Surgeon Design Team

Tips To Help Ensure A Successful Surgeon Design Team | IT Support and Hardware for Clinics | Scoop.it

Design surgeons and surgeon design times have been at the core of the significant advances that have occurred in the medical device market in the last few decades. Working with surgeon design teams is inspirational, mentally demanding, and exciting.

 

Let’s assume a new opportunity has been identified that will improve your organization’s financial position. The marketing team has studied the market space—that is, classified at least three types of current and potentially new innovative strategies this opportunity should incorporate (as was described in the March/April 2018 issue of ODT, “Innovation and the Development Engineer”).

 

Once a complete financial plan, which includes cost to develop/introduce, and a sales/marketing plan have both been vetted and approved by the organization’s senior staff, it is time to move ahead to develop the surgeon design team.

 

I have had experience with two different types of surgeon design teams. The first—a “Hub and Spoke” model—was utilized in situations where aligning with a given group of surgeons or an institution would alienate others from using the product once it was released. The second is the more traditional surgeon design team with a group of surgeons selected to work on a project from beginning to end.

 

The Hub and Spoke model concept relies on one or two core key opinion leading (KOL) surgeons to serve as the hub of the wheel. Different surgeons or groups of surgeons meet independently with the KOL surgeon and the development engineering lead at a series of low-key meetings held at various time points to obtain feedback on different aspects of the design. There is a significant amount of reliance placed upon the KOL surgeon as the amount of involvement of the non-KOL surgeons is substantially less than in a traditional surgeon design team model. In this model, the non-KOL surgeons are assisting with validating the market assessments and need requirements, as well as providing market acceptance feedback of the new product later in the process. It is the responsibility of the KOL surgeon and the development staff to turn that information into a viable product.

 

With the more common traditional surgeon design team, assembling a good design team is critical to the success of the endeavor. The product development team needs to work closely with the marketing department in the selection and assembly of the surgeon design team. The selection process is very much like picking players for a team sport. The desire is to pick the most talented team, with personalities that mesh with each other while becoming aligned to win in the same way.

 

The training and clinical experience of the surgeons, the number of surgeons on the team, and their geographic locations are just a few of the important factors to be considered. The surgeon’s CV is a great reference as are their publications to discover where and by whom they were trained, as well as if they have any won any awards or honors. This process helps an organizer begin to understand a surgeon’s philosophy so as to determine if it matches with the objectives of the project. If these elements do not seem to align, it is best to move on. Further, there are other important considerations—is this the first design team the surgeon has been a part of or is it just the most recent? Has he or she been a part of prior design projects, and if so, what has been the success of those products? You need to fully understand the motivation of a surgeon to be a member of a design team.

 

It is critical the surgeons understand the commitment they will need to make to be part of the design team, as there will be meetings and other activities that will take them away from their clinical practice and surgery. Provide an understanding of the duration of the project and the time periods where their involvement will be greater than other periods as the project progresses. For example, one design project required great commitment from the surgeons as it met approximately every two to three weeks and for full weekends. As a result of the commitment from the surgeons and support of the company, a very large implant/instrument project was conceived and introduced in 18 months. Conversely, projects without full commitment from all surgeons has resulted in the opposite effect, significantly delaying the project, and doubling the anticipated time to market. Therefore, if the surgeon is not willing to commit the time, they are not a good candidate.

 

I have had the opportunity to work with a wide group of surgeons from around the world on numerous design teams. All were excellent surgeons, but their interests and how they assisted the design teams varied greatly. There were some true innovators and designers who would design or create their own drawings of new and innovative products. When the product was introduced, they were willing to stand behind the new concept until it was clinically proven, even in the face of being questioned by traditionalists. Others were known for performing clinical studies or understanding the issues surgeons were facing. Still others offered their strengths in addressing the surgical technique. It is crucial to understand the strengths and weaknesses of the members of the design team.

 

Regarding the project itself, it is vital to have the project well-scoped. The scope needs to be flexible in nature but, at the same time, there need to be boundaries in place to avoid creep and to ensure the end results fulfill the original unmet market requirement. What is the new product or service expected to perform and what is it not going to address? What shouldn’t be addressed is, many times, more important than determining what needs to be. Ensure everyone understands the project’s clinical scope, the financial objectives, and the other innovative aspects desired. In order to keep the team focused and grounded as time progresses, it is often necessary to reflect back upon the scope to avoid derailing and delaying the project.

 

Having the development engineer/staff gain the respect of the surgeon design team is also important. The engineer must have a wide base of knowledge to keep multiple elements of the development project within his or her view. As the process progresses, certain elements of the product are being locked down that impact the long-term commercial success, design attributes, manufacturability, inventory costs, marketing/sales, user experience, and clinical outcomes. Throughout the project, subject matter experts (e.g., the surgeons, manufacturing engineers, etc.) will provide input and support, but the development engineer is ultimately the one who must sift through all the information and recommendations to decide which to accept, modify, or reject. As such, the development engineer must be a jack-of-all-trades. Leading a development program should not be handled as if it is a democracy, but rather, as a benevolent dictatorship. The leader must listen, assess the situation, make a decision, and move on. Attempting to satisfy all parties will only cause delays.

 

There are techniques that can be used to help sort through the issues to attempt to make the best decisions. One technique is to note how many times the same concern is raised. If the issue is repeated by numerous surgeons and/or other advisors, it likely requires further exploration. If it is rarely stated or only by one surgeon, it may be safe to consider it a much lower priority. If the factor significantly impacts cost, however, determine how significantly it could impact the marketability of the product.

 

If a new, creative solution is conceived by a surgeon that seems to have originated from out of left field, it should not be automatically dismissed. Instead, challenge the surgeon to “sell” the idea to the rest of the design team. If he or she cannot earn their acceptance, it may be best to move on. This does not mean the concept was not worthy, but perhaps it needs to be sidelined from the current program and examined independently on its own merits at a later time or for a future generation of the product. Some creative solutions may seem like an idea that makes sense, but ultimately, must be considered within the scope definition for the project.

 

When having a design meeting, it is important to know the outcome ahead of time. Since design meetings can sometimes become confrontational, first addressing key topics individually with surgeons to understand their concerns and issues will provide a means to be better prepared for the full meeting and make it more productive. If there are controversial issues to be addressed, have one of the surgeon designers present them, which can also assist in making the meeting more productive.

 

After the concept for the product design has been finalized, enroll a second group of surgeons not part of the original design team to objectively review the new product concept. This can help ensure market acceptance and help identify issues that may have been overlooked. All members of the design team are too close to the project to objectively review the new product. While this review occurs late in the design process, it is still early enough to allow for modifications to be made relativity inexpensively.

 

Surgeon design teams have been and will continue to be a critical element for the advancement of healthcare in the development of new and innovative medical devices. Leading surgeon design teams is a skill a development engineer needs to hone and refine. It involves technical knowledge, psychology, business acumen, and most importantly, strong leadership attributes.

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EMPOWR Porous And Complex Primary Knee Systems

EMPOWR Porous And Complex Primary Knee Systems | IT Support and Hardware for Clinics | Scoop.it

DJO, a provider of medical technologies designed to get and keep people moving, introduced the EMPOWR Porous Knee System and EMPOWR Complex Primary Knee System at the 2018 Annual Meeting of the American Association of Hip and Knee Surgeons (AAHKS). These new additions to the EMPOWR Knee Platform expand one of the industry’s most modern total knee replacement systems, which now offers primary, cementless primary, complex primary, and tibial revision solutions for surgeons and patients.

EMPOWR Porous Knee System is based on two decades of clinical experience and highly porous materials designed to enhance early implant fixation, while creating an ideal environment for both immediate and long-term biologic fixation.1 DJO’s surface coating technologies, including DJO’s proprietary, highly porous coating, P2 aids in bone apposition for superior in-growth performance.1 EMPOWR Porous’ bladed keel has a bone sparing geometry optimized for cementless application.2 The bladed keel of the asymmetric baseplate was developed to provide robust fixation, while the cruciform pegs provide initial component fixation and durable rotational stability.2

EMPOWR Complex Primary Knee System, with the EMPOWR Universal Tibial Baseplate and EMPOWR Varus Valgus Constraint (VVC) Tibial Insert expand the utility of the EMPOWR Knee Platform and provide a wider range of solutions for complex primary and revision knee arthroplasty. These new implant technologies are designed to provide an efficient and seamless transition from standard primary to revision knee procedures, with a minimal number of additional instruments and trays. The EMPOWR Universal Tibial baseplate maintains the EMPOWR System’s characteristic asymmetric footprint which maximizes cortical coverage and prevents component overhang to ensure long-term fixation without tissue irritation4. This baseplate also provides the ability to stem and augment when more supplementary fixation is required. The VVC insert is offered in e+ polyethene, formulated to reduce long-term wear3, while the insert is designed to provide the necessary support and stability in knees with supportive soft tissue deficiencies.

“DJO has a proven record of bringing high-quality products to market with incredible cadence—faster than any other implant company today,” said Dr. Eugene S. Krauss, an orthopedic surgeon with Northwell Health. “In 2018 alone, the EMPOWR Porous Knee and EMPOWR Complex Primary Knee launches have significantly expanded our ability to treat a wide variety of patients in our practices.”

“The efficiency of DJO’s instrument trays and the streamlined instrumentation enables my surgical team and I to perform up to 12 knee replacements in a single day, making the system well-suited for both hospital and ambulatory surgery center environments,” said Dr. Krauss.

Over the past decade, the science of highly porous metals, including DJO’s P2, has significantly advanced, helping to improve implant longevity and ultimately patient outcomes. These scientific advancements coupled with a younger, healthier patient population, have resulted in a resurgence of cementless knee arthroplasty. Therefore, the contemporary design of the EMPOWR Porous Knee, is certain to have a meaningful impact on the market.

“DJO Surgical’s strong growth over the past few years is a reflection of our commitment to developing products and solutions that help improve clinical outcomes and enhance patient experience,” said Jeffery A. McCaulley, Global President of DJO Surgical. “Our continued expansion of the EMPOWR Platform reflects the overwhelmingly positive reaction we’ve received from surgeons and patients since the first EMPOWR Knee System was launched here at AAHKS in 2015.”

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Robotic Arm Offers Self-Help Mobile Rehab For Stroke Patients 

Robotic Arm Offers Self-Help Mobile Rehab For Stroke Patients  | IT Support and Hardware for Clinics | Scoop.it

The Hong Kong Polytechnic University (PolyU) recently developed a robotic arm to facilitate self-help and upper-limb mobile rehabilitation for stroke patients. The lightweight device enables the patients to engage in intensive and effective self-help rehabilitation exercise anywhere, anytime after they are discharged from the hospital. The robotic arm, called “mobile exo-neuro-musculo-skeleton,” is the first-of-its-kind integration of exoskeleton, soft robot, and exo-nerve stimulation technologies.

Stroke is the third leading cause of disability worldwide1. In Hong Kong, there are about 25,000 new incidences of stroke annually in recent years2. Research studies have proven that intensive, repeated and long-term rehabilitation training are critical for enhancing the physical mobility of stroke patients, thus helping to alleviate post-stroke symptoms such as disability. However, access to the outpatient rehabilitation service for stroke patients has been difficult. Due to the overwhelming demand for rehabilitation services, patients have to queue up for a long time to get a slot for rehabilitation training. As such, they can’t get timely support and routine rehabilitation exercises. Stroke patients also find it challenging to travel from home to outpatient clinics.

The “mobile exo-neuro-musculo-skeleton,” developed by Dr. Hu Xiao-ling and her research team in the Department of Biomedical Engineering (BME) of PolyU, features lightweight design (up to 300g for wearable upper limb components, which are fit for different functional training needs), low power demand (12V rechargeable battery supply for 4-hour continuous use), and sportswear features. The robotic arm thus provides a flexible, self-help, easy-to-use, mobile tool for patients to supplement their rehabilitation sessions at the clinic. The innovative training option can effectively enhance the rehabilitation progress.

 

Dr. Hu Xiaoling said development of the novel device was inspired by the feedback of many stroke patients who were discharged from the hospital. They faced problems in having regular and intensive rehabilitation training crucial for limb recovery. “We are confident that with our mobile exo-neuro-musculo-skeleton, stroke patients can conduct rehabilitation training anytime and anywhere, turning the training into part of their daily activities. We hope such flexible self-help training can well supplement traditional outpatient rehabilitation services, helping stroke patients achieve a much better rehabilitation progress.” Her team anticipated that the robotic arm could be commercialized in two years.

The BME innovation integrates exoskeleton and soft robot structural designs—the two technologies commonly adopted in existing upper-limb rehabilitation training devices for stroke patients as well as the PolyU-patented exo-nerve stimulation technology.

Integration of Exoskeleton, Soft Robot, and Exo-Nerve Stimulation Technologies
The working principle of both exoskeleton and soft robot designs is to provide external mechanical forces driven by voluntary muscle signals to assist the patient’s desired joint movement. Conventional exoskeleton structure is mainly constructed by orthotic materials such as metal and plastic, simulating external bones of the patient. Although it is compact, it is heavy and uncomfortable to wear. The soft robot, made of air-filled or liquid-filled pipes to simulate one’s external muscles, is light in weight but very bulky in size. Both types of structures demand high electrical power for driving motors or pumps, thus it is not convenient for patients to use them outside hospitals or rehabilitation centers. Combining the advantages of both structural designs, the BME innovative robotic arm is light in weight, compact in size, fast in response and demands minimal power supply, therefore it is suitable for use in both indoor and outdoor environment.

 

The robotic arm is unique in performing outstanding rehabilitation effect by further integrating the external mechanical force design with the PolyU-patented Neuro-muscular Electrical Stimulation (NMES) technology. Upon detecting the electromyography signals at the user’s muscles, the device will respond by applying NMES to contract the muscles, as well as exerting external mechanical forces to assist the joint’s desired voluntary movement. Research studies found that the combination of muscle strength triggered by NMES and external mechanical forces is 40 percent more effective for stroke rehabilitation than applying external mechanical forces alone.

Rehabilitation Effect Proven in Trials
An initial trial of the robotic arm on 10 stroke patients indicated better muscle coordination, wrist and finger functions, and lower muscle spasticity of all after they have completed 20 two-hour training sessions. Further clinical trials will be carried out in collaboration with hospitals and clinics.

The robotic arm consists of components for wrist/hand, elbow, and fingers which can be worn separately or together for different functional training needs. The sportswear design, using washable fabric with ultraviolet protection and good ventilation, also makes the robotic arm a comfortable wear for the patients.

The device also has a value-added feature of connecting to a mobile application (APP) where users can use the APP interface to control their own training. The APP also records real-time training data for better monitoring of the rehabilitation progress by both healthcare practitioners and the patients themselves. It can also serve as a social network platform for stroke patients to communicate online with each other for mutual support.

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Health Care Providers Face More Direct Billing, More and Tougher Collections

Health Care Providers Face More Direct Billing, More and Tougher Collections | IT Support and Hardware for Clinics | Scoop.it

Opponents figure that they pretty much killed the Affordable Care Act in December when they ended the individual mandate. They may be right. The mandate – the part of the ACA that required Americans to buy health insurance or face a minor penalty – was a key to trying to broaden and deepen the insurance pool, mitigate payers’ risk and, not least, keep premiums at least remotely tethered to people’s ability to pay.

 

Another part of the ACA is also under threat. The law allowed states to agree to an expansion of Medicaid that was meant to help people who couldn’t afford to meet the mandate on their own.  Still another: it also offered subsidies to help payers meet the expenses of covering all the previously untreated people they’d have to insure and of covering everyone’s pre-existing conditions. 

Premiums in fact did not grow as fast in states that accepted the Medicaid expansion during the past three years and as an estimated 40 million more people gained some form of health insurance.

The end of the individual mandate, the junking of one of the subsidies for health insurers and last year’s drastically truncated open enrollment period for the remaining Exchange plans, however, have again started to reduce the number of Americans with health insurance.

 

These changes affect more than practice volume. They impact operations for practices that retain patients, too.

For without increased attention to “revenue cycle,” all health care providers can expect to be doing more direct billing of patients, doing more collections work and assuming more bad debt from people with higher, tougher-to-pay deductibles in the coming months and years.

 

Here’s why: No one yet knows how many people who bought insurance only because they were required to. There’s reason to believe the end of the individual mandate will start making them drop out of all kinds of plans during the next open enrollment period.

A federally truncated open enrollment period October-December, 2017 has already reduced the number of insured people in the nation.  A number of forces are leading fewer people – and fewer younger, healthy people – to buy plans, and some predictions have premiums rising an extra 10 percent this coming year.

 

More shrinkage is coming. Newly permitted work requirements for Medicaid coverage promise to push still more people into the ranks of the uninsured. Kentucky’s new rules, for example, will drive an estimated 40,000 people out of Medicaid coverage during the next five years. As of this writing, nine other states are considering imposing new restrictions on who can qualify for Medicaid coverage.

 

The increase in the numbers of the uninsured obviously has disturbing implications for the nation’s health as a whole. It will also force payers to raise premiums to make up for the rising costs of being able to spread their risk across smaller, riskier customer pools.

 

The uninsured aren’t the only ones threatening practice finances.

Rising premiums, in turn, are leading employers to offer employees more high-deductible health plans. These HDHPs have lower premiums but higher risk for patients, who in addition to their premiums must pay an average of the first $2,400 of their families’ medical bills out of their own pockets. Some plans have deductibles as high as $10,000.

 

The lower premium costs, however, are attracting more and more people.

 

They are also higher risks for physician practices, which have a harder time collecting from patients with HDHPs. Thirty-seven percent of the people working for employers who offered plans in 2017 chose high-deductible plans. That’s up from 28 percent in 2016. The same year, that accounted for 39.3 percent of all Americans on employer-based health plans. All told, up to 37 percent of insured Americans, regardless of where they bought it, were using HDHPs.

 

But there have been dire unintended consequences. With the costs of care so high, 64 percent of those with high-deductible plans say they’ve put off care because they didn’t want to or couldn’t pay the deductible. And 62 percent said that, despite the lower premiums, they end up spending more on health care than under their previous plan.

 

People with the high-deductible plans thus tend to be bigger financial risks for providers.

Of HDHP customers, 15.5 percent reported having trouble paying medical bills in 2016 (versus 10.3 percent of those with “traditional” plans).

 

In sum, this means everyone in health care – providers, hospitals, practices – are going to chance offending more patients by billing them directly and, at minimum, going to have to devote more resources to revenue cycle and collecting what patients owe them.

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