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    Dr. Marcinko is originally from Loyola University MD, Temple University in Philadelphia and the Milton S. Hershey Medical Center in PA; as well as Oglethorpe University and Emory University in Georgia, the Atlanta Hospital & Medical Center; Kellogg-Keller Graduate School of Business and Management in Chicago, and the Aachen City University Hospital, Koln-Germany. He became one of the most innovative global thought leaders in medical business entrepreneurship today by leveraging and adding value with strategies to grow revenues and EBITDA while reducing non-essential expenditures and improving dated operational in-efficiencies.

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    Dr. David E. Marcinko’s professional memberships included: ASHE, AHIMA, ACHE, ACME, ACPE, MGMA, FMMA, FPA and HIMSS. He was a MSFT Beta tester, Google Scholar, “H” Index favorite and one of LinkedIn’s “Top Cited Voices”.

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ABOUT: e-Podiatry Consent Forms™

untitledhttp://www.ePodiatryConsentForms.com

By Dr. David Edward Marcinko MBBS DPM FACFAS MBA MEd

CUSTOMIZABLE CMS & AGENCY FOR HEALTHCARE RESEARCH AND QUALITY STYLED PROTOCOLS, CHECKLISTS AND TEMPLATES 

… Specifically for Podiatrists …    

e-Podiatry Consent Forms™ is an innovative new suite of software programs from the Institute of Medical Business Advisors [iMBA, Inc]. Our products solve your informed consent problems and enhance the education, discussion and documentation of the informed consent process for all podiatrists performing foot, ankle and leg reconstructive surgical procedures.

THE PROBLEM

All podiatrists are being pressured by the Centers for Medicare and Medicaid Services [CMS], the Joint Commission on Accreditation of Healthcare Organizations [JCAHO], liability carriers and private insurance payers to make their consent process more patient-friendly, informed and easily understood. And, the pressure to standardize and comply is great.

Most recently, based on the need to make healthcare even safer, the Agency for Healthcare Research and Quality (AHRQ) undertook a major study to identify patient safety issues and develop recommendations for “best practices”.

The AHRQ Evidence Report

The AHRQ report identified the challenge of addressing shortcomings such as missed, incomplete or not fully comprehended informed consent, as a significant patient safety issue and opportunity for improvement.

The authors of the AHRQ report hypothesized that better informed patients:

“are less likely to experience errors by acting as another layer of protection.”

And, the AHRQ study ranked a “more interactive informed consent process” among the top 11 practices supporting more widespread implementation; especially for surgical consent forms.

THE SOLUTION

Why Us: https://epodiatryconsentforms.com/why-us/

One answer to the modern risk-management problem of “informed consent interactivity” may be e-Podiatry Consent Forms™  We license two core interactive surgical products, and a reference library, with related concepts and products in development:

  • Forefoot, Mid-Foot and Simple Rear-Foot Version
  • Complex Rear-Foot, Ankle and Lower Leg Version
  • Comprehensive content library for extreme customization.

Each e-Podiatry Consent Forms™ CD-ROM [secure email delivery is now available] is increasingly trusted as the simple solution to standardized communications across the entire office-enterprise; from managing-risk, informing-patients and complying with modern regulatory requirements through enhanced patient-centric informed consent encounters.

Thus, by improving the consistency, details, documentation and effectiveness of the informed consent process, e-Podiatry Consent Forms™ equips all podiatric surgeons with the tools needed to augment quality standards, reduce litigation potential and improve patient outcomes and safety.

http://www.ePodiatryConsentForms.com

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Dr. David Edward Marcinko, editor-in-chief, is a next-generation apostle of Nobel Laureate Kenneth Joseph Arrow PhD, as a health-care economist, insurance advisor, financial advisor, risk manager, and board-certified surgeon from Temple University in Philadelphia.

In the past, he edited eight practice-management books, three medical textbooks and manuals in four languages, five financial planning yearbooks, dozens of interactive CD-ROMs, and three comprehensive health-care administration dictionaries.

Internationally recognized for his clinical work, he is a past endowed chair; professor of health economics, finance and public health policy management; and distinguished visiting professor of surgery as a Bachelor of Medicine–Bachelor of Surgery (MBBS) degree recipient from Marien Hospital in Aachen, Germany.

He provides litigation support and expert witness testimony in state and federal court, with medical publications archived in the Library of Congress and the Library of Medicine at the National Institutes of Health.

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[PHYSICIAN FOCUSED FINANCIAL PLANNING AND RISK MANAGEMENT COMPANION TEXTBOOK SET]

  Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

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[HOSPITAL OPERATIONS, ORGANIZATIONAL BEHAVIOR AND FINANCIAL MANAGEMENT COMPANION TEXTBOOK SET]

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[PRIVATE MEDICAL PRACTICE BUSINESS MANAGEMENT TEXTBOOK – 3rd.  Edition]

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Severity and Price of ER Visits

Severity Level – 2017

By http://www.MCOL.com

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Conclusion: Your thoughts are appreciated.

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Of Pareto’s and Parkinson’s Law

The 2-Ps [80/20] Rule

[By staff reporters]

Pareto’s law is either of the following closely related ideas: Pareto principle or law of the vital few, stating that 80% of the effects come from 20% of the causes Pareto distribution

Pareto distribution

The Pareto distribution, named after the Italian civil engineer, economist, and sociologist Vilfredo Pareto, is a power law probability distribution that is used in description of social, scientific, geophysical, actuarial, and many other types of observable phenomena. en.wikipedia.org

Parkinson’s law

Originally, Parkinson’s law is the adage that “work expands so as to fill the time available for its completion”, and the title of a book which made it well-known.

Assessment

However, in current understanding, Parkinson’s law is a reference to the self-satisfying uncontrolled growth of the bureaucratic apparatus in an organization.

COMPARISON

Conclusion

Your thoughts are appreciated.

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8Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™8Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

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Ten “Unusual” ICD-11 Codes

You May not Have Known

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Understanding the Next Generation of “Symptom-Checkers”?

Will SCs  become one of the killer applications in digital health?
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By Ralf Jahns [Berlin, Germany]
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Dear David and ME-P Readers,
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Next generation of symptom checkers are entering the healthcare market with the intention to disrupt the way health services are provided. Symptoms checkers have a chance to belong to the set of killer applications within digital health market next to telehealth, e-prescription and chronic health management solutions. Market potential differs significantly country per country and could go up as high as 8 Bn EUR p.a. Payer and pharma companies must hurry up to close partnership deals as prices go up quickly.
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Symptom Checkers
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There are hundreds of symptom checker solutions available in the market for long. Quite a few have gone out of business or changed their business model (e.g. Medlanes) due to having started too early in a market either using B2B or B2C business models. Over the last few years a new generation of symptom checkers have been launched. These tools are building on AI for data management and a chat bot functionality for user communication. They also expanded into other service areas not only concentrating on offering expertise medical diagnostic advice, but also allowing to search for a doctor, remote HCP consultations, or shopping features for over-the-counter medicines.

Symptoms checkers have the potential to belong to the solution suite that will open up the traditional healthcare system for digital health solutions, similar to telehealth or chronic patient’s self-management services. They not only allow patients to remotely 24/7 access advice on their symptoms but are more and more used also by HCPs to support their diagnosing process.

The following list of next generation of symptom checkers shows current ranges of services, reach and business models.

  • Ada Health – a free symptom checker exclusively available as a mobile app. The app provides symptom advice for more than 6,000 diseases. The ADA app has 6 million users and 10 million assessments completed, it’s available in 5 languages and ranked as #1 medical app in over 130 countries. The Berlin-based company employs 130 workers and over 40 doctors and medical editors.
  • Your.MD – symptom checker and health tracker. The app for diagnosis, partners with online medical service providers and refers its apps users to pharmacies, test centers, doctors’ offices or recommends other medical apps which are suitable for them.
  • Sensely – an app for pre-diagnosis, video doctor consultation, allows remote monitoring, links user with local medical services and self-care resources. Currently Sensely app is available by an access code from an employer/health plan.
  • Infermedica – Symptomate is a suite of web, mobile and voice apps that help patients assess their symptom when they feel sick. The solution covers 13 languages and is available in three major voice platforms: Amazon Alexa, Microsoft Cortana and Google Assistant. According to the company the audience includes mainly young adults and more than 55% of the users are aged 18 – 30. Some of the most commonly reported symptoms include headaches, back pains, mild abdominal pains and overall fatigue.
  • Ask NHS – Virtual Assistant” app (powered by Sensely). A virtual assistant named Olivia asks questions about the symptoms and suggests what the problem is. If needed, Olivia arranges a call back from a “111 nurse” to discuss the symptoms further. Patients can also search NHS approved healthcare advice, and schedule GP appointments.
  • Isabel is a similar solution to Ada or Symptomate. The end users are patients, but the company – Isabel Healthcare – also makes the APIs available to others to integrate the symptom checker into their own systems.
In general, market readiness seems to be more advanced in terms of payer and user willingness to use and pay compared to few years back. Also, symptoms checkers are now seen as tools which not only substitute or shorten HCP visits by remote, anonymous and free-of-charge health assessments, but which also enable patient activation tools for pharma companies and enhance products by tech-companies.
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Research2Guidance Cost Savings Potential Opportunity For Sympoms Checkers Vary Between 0,5 BN and 8 BN Euros

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Market potential is big. 400 million people especially in developing economies lack access to essential health services. The situation in developed economies is different. Shortage of doctors, especially in rural areas also exists but the problem that symptoms checkers could address is the large amount of doctor visits. In the USA alone there are around 1.3 Bn visits to GPs in a year. Japan has an even higher GP visit numbers as people tend to go 3 times more often to a doctor compared to their US counterparts.By reducing the number of HCP visits (here only GP visits are shown), symptom checkers promise to have a significant impact on healthcare costs within each country. Regardless whether 5% or 10% of GP visits will be made obsolete, the cost saving potential is enormous. In the US alone a 5% reduction would lead to annual cost savings of 8 Bn EUR! Second biggest market opportunities are in Japan with potential cost savings of 6 Bn EUR, followed by Germany and Canada (1 Bn EUR).

Not surprisingly payer organizations in western countries have started to offer symptoms checker solutions to their member base but also to HCPs. For example, Ada and German health insurer Techniker Krankenkasse(TK) are offering the symptoms checker in emergency rooms. Patients insured by TK might be asked to complete in a waiting room an assessment on Ada. Depending on the results, the patient may be redirected to a nurse or a doctor. In another trial run with a large NHS GP clinic, 14% of patients that completed an Ada assessment in the waiting room said that if they had used Ada at home, they would not have felt the need to come to see the doctor that day.”

Babylon a telehealth service also using symptoms checkers is now embedded into Samsung Health, which is available on millions of Samsung mobile devices in the UK and US, and has recently signed major partnership agreements with Tencent, Bupa and Prudential.

Companies wanting to enter the market should hurry up as development times of symptoms checkers are long and existing players are closing deals with payers and tech companies at high speed. Ada, for example, claims to have spent seven years to build up their database of symptoms and recommendations, while integrating more than 6.000 diseases linked to symptoms including 1,100 rare diseases curated by HCPs.

On the other side, payerspharmahospitals and tech companies that want to enrich their service offering with next generation of symptoms checkers are urged to start selection and further on integration process of next generation symptoms checkers as prices go up quickly and flexibility to incorporate specific change requests will go down with increasing success of symptoms checkers.

P.S. If you need any insights or quotes about the digital health, digital diabetes and / or the digital respiratory markets, please do not hesitate to contact me. I will be happy to provide you with reliable data and latest market insights.

[HOSPITAL OPERATIONS, ORGANIZATIONAL BEHAVIOR AND FINANCIAL MANAGEMENT COMPANION TEXTBOOK SET]

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On the Clinical Efficacy of the Apple Watch?

New Studies Seek to Define Clinical Efficacy

[By Catalyst @ Health 2.0]

Preliminary results from the Apple Heart Study show the potential health benefits of wearables. Researchers from the Stanford University School of Medicine partnered with Apple to conduct a virtual observational study with more than 400,000 participants. The study used the Apple Watch’s irregular rhythm notification (IRN) system to detect atrial fibrillation (AFib). The results showed 0.5% of participants received irregular rhythm notifications. For those who were notified, 21% received and wore an ECG patch. Of those, Afib was confirmed 34% of the time. The positive predictive value of the overall study was 71%, however, this increased to 84% for the subgroup who also used an ECG patch. It should be noted that the study has not yet been published in a peer-reviewed journal.

Johnson & Johnson’s HEARTLINE Study aims to build on the Apple Heart Study. Announced back in January, the virtual clinical trial will enroll 150,000 Americans 65 years and older to detect AFib and collect outcomes data. Participants will be randomized to either receive the Apple Watch 4 or no watch at all. Compared to the Apple Heart Study, one key technical design difference allows the HEARTLINE Study to draw a clearer connection between AFib observance and confirmation. Instead of waiting for an ECG patch to be mailed to the participant, the ECG app on the user’s Apple Watch 4 will be engaged once the “IRN software detects five out of six consecutive irregular rhythms each lasting one minute.” Both the IRN software and the ECG app are FDA cleared for AFib detection. Although the clinical efficacy of wearables is far from conclusive, the innovative use of virtual clinical trials will likely be commonplace in the future with the continued proliferation of consumer-driven health technologies.

Healthcare Executives Under Threat of Business Model Disruption

Healthcare executives are increasingly worried about business model disruption due to the influx of new entrants, processes, and technologies into the healthcare industry. According to Change Healthcare’s 9th Annual Industry Pulse Survey, 13.3% of 185 healthcare leaders believe that innovations in care delivery will lead to potential advancement within the industry and 11.1% believe that refinement of customer experience will create disruptive change. Other potential disruptors include supply chain innovations (9%), launch of vertical one-stop healthcare companies (8%), and advances in artificial capabilities (7%). However, the survey findings also suggest that healthcare leaders are increasingly embracing healthcare technologies. Thirty percent of leaders indicate that EHRs are their leading source of clinical data and another 30% of respondents say that analytics are “extremely effective” or “very effective” at increasing workflow productivity.

Health systems are also jumping into the digital age, with patients portals employed by 73% and telehealth solutions employed by 54% of all surveyed respondents. Twenty percent of respondents indicate they currently use machine learning and 51% plan to employ the technology in the future. Interestingly, the survey reveals a marked lack of attention toward cybersecurity. Even while 40% of healthcare leaders see cybercrime as a potential risk, 38% answered that there are “too many competing priorities” to warrant the level of attention that cybersecurity needs. Nevertheless, the threat of disruption has charged healthcare leaders to intensify its commitment to combating new market entrants.

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Assessment

Your thoughts are appreciated.

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