Subject: News from Dr. Kevin Fickenscher
From: "Dr. Kevin Fickenscher" <[email-masked]>
To: <[email-masked]>
Date: Tue, 1 May 2012 17:47:35 -0400 (EDT)

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The Fickenscher Files [http://r20.rs6.net/tn.jsp?e=001NGUFqPshmtQr-uTzV9cqdU7L6Z8UDR3QjDv3MVKMk8P1wjrgmZPvVjvDWStVVLn-AMKCmZ8OwRoexMNh_r3YPujH4-0y2ttLzvQY-iDHaqjSqlLkQE0GmWP1wYFC__zy-qrN80bdU0k=]
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The Fickenscher Files, Vol. 2, Issue 10 [http://r20.rs6.net/tn.jsp?e=001NGUFqPshmtQr-uTzV9cqdU7L6Z8UDR3QjDv3MVKMk8P1wjrgmZPvVjvDWStVVLn-AMKCmZ8OwRoexMNh_r3YPujH4-0y2ttLzvQY-iDHaqjSqlLkQE0GmWP1wYFC__zy-qrN80bdU0k=]
Kevin M. Fickenscher [http://r20.rs6.net/tn.jsp?e=001NGUFqPshmtT_xk2SxR8UgZ3h_Z6jktNjncfyFeBLAmPGjdH9HzPRqzbFJM8hYHiUQbG58F7QZpjSV1zADYpJxFiMURTRa4RgwKawd-GxkiOxMwFPaChVkut_OjiewF6Yas4nQTVWDmsNmqjoqUcF5q5qyuUSUo8N5dtkg-vYJVdZbimCx8iZKVTb29iXW-bHdaDtOKmOAXmGKL9xiZjozw==],
MD, CPE, FACPE, FAAFP
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Quote of the Week

"We continue to make good progress against a formidable foe.  There has been greater
access and evidence of impact."

Rob Newman, Head of the Malaria Program at the World Health Organization (WHO), 
in reporting the decline in death and illness rates from malaria in Africa. [See
 "The Good, The Bad, The Ugly [http://r20.rs6.net/tn.jsp?e=001NGUFqPshmtRvUdCW0pOy8jqa3-8yZd04Jsnd8UEoqXEoqE1iM15aP7cami82pNQircykpGDYXaVpp_BdFwLO5AiakCwAnTVpzmp5NG_AqF7YUVU11UM38q-EU5QjDZRECRUnvovwZL79qTfIugKFF5pFef5GKPrVxddxQ6C9wlSTddcaR5t0Ht5FvpbzBzNxS2SAlWwHGeSMQz_IIVenK5-0hIihmQgI]"
 for further commentary.]

"There is growing evidence that both the parasite and the mosquito are evolving 
in ways that could diminish the effectiveness of our most powerful tools for preventing
and treating the disease."

Ray Chambers, the UN Secretary-General's Special Envoy for Malaria, in cautioning
against too much optimism related to the reported decline in deaths and illness 
from malaria in Africa.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Consulo Indicium

Information for your Consideration ...

EHR Adoption Accelerates for Physicians and Slows in Hospitals -- According to a
 recent report by the Centers for Medicare and Medicaid Services (CMS), the adoption
of electronic health records by Medicare physicians is accelerating while simultaneously
slowing in hospitals.  In addition, the report noted that the cumulative incentive
payments for EHR adoption by physicians have reached just over one-half a billion
dollars, or $636 million -- a 57 percent increase over the prior month.  At the 
same time, hospital payments rose to $1.4 billion or 10 percent more than the prior
month. The fall off in hospital trends is most likely due to the fact that they 
have been at it longer than physician offices.  But, that's only my opinion ... 
I have no data.
In related news, CMS noted that physicians and other eligible professionals still
wanting to appeal their eligibility determinations for the 2011 Medicare electronic
health-record incentive payment program were granted an extra month to file the 
appeals. The extension deadline was April 30.
What's Up With Microsoft and GE? -- The recent announcement by Microsoft and GE 
on their joint venture [http://r20.rs6.net/tn.jsp?e=001NGUFqPshmtRQQkD_emNIvTPmxRZ7Er2PrVAr-50kxsTbxYTEGbjzo0KSR0FU6DIu1fJRpv-mdUF6ewLmDxsz4MPfLwB5Qzooqt3ouUgO6l2DJ_ryLJsj0R9Y4hoWv8ld]
raised the question -- can two companies who are incredibly successful finally develop
or deploy a product that meets the test of market place demand?  So, we've all been
watching and the first news out of both offices was that there was a significant
 personnel cut for the new Microsoft and GE initiative.  None of the physicians 
from the Microsoft side were invited to the new company with Brandon Savage, MD 
serving as the only remaining physician.  The remainder of the clinical side also
saw some deep cuts, so it's going to be interesting how the new joint venture prepares
itself for a strong informatics play.  Finally, the role for Intermountain is unclear
in the new "Caradigm."  I learned long ago never to underestimate the big boys ...
so, we all wait with anticipation.
Read more [http://r20.rs6.net/tn.jsp?e=001NGUFqPshmtTsIEJZSnkZhe-F3XO6VqzxVdXMMBUQcHF55BnUzCQpeuON7UrcOGEs5jg_MtGxIuvwLRn6GJxpWTXSxu-nKyTcgdggU92sBZd6bnUQJjlzYp-e0gG10gMclTeYtYb8ZaZSIlCEpjWkYquTpUI5DjSVPtp3yCXC8sIWyq83oydv4eX4gJWWbNr3h5ty3bZLXbWi80TAd9xLSA==]
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Implementation to Analytics: Future Work of Informatics

I don't usually replicate other works, but I thought that Dr. Hersh  did a great
 job of outlining the "future work of informatics" ... so, I'm  including his complete
article in this week's edition.

William Hersh, MD serves as the Professor and Chair of the Oregon Health Sciences
University (OHSU) [http://r20.rs6.net/tn.jsp?e=001NGUFqPshmtRJWLmK3Wq1nNRoVkZ6rPRmMnR05o63qDH7XpFlrEVRtx2E9FqDYhkVENU1tCG-2By0dcgJTacKa1ERCeZFHPHdbybwdZyqiQbSDA0glZVD46Qv2Aom5EN2AwQOTvSPzr3FN-JEFsHxM5A-eBOv9-98M-wp8JiDf5iQ0qKxAS9q7egio6j_E_1mmmOZegZxFzXtvrAjIGWINrO1-_lzeZBGnF-rLQQv3QQ=]
based in Portland, Ore.  His regular blog is Informatics Professor [http://r20.rs6.net/tn.jsp?e=001NGUFqPshmtQ4DCBRVnjz5fckUqO1KQzyqs1d26Q3IJ3pnCcpDexQtwu2a8gWAQXaMhVCG6ip3ZBAmhvSCCThYpiBg6rF8o5ImEB0MEbH0Jg2qQY4TmY2XlaK_COCtSqnKO-OcxW8x9U=].
This article post first appeared on The Informatics Professor [http://r20.rs6.net/tn.jsp?e=001NGUFqPshmtQ4DCBRVnjz5fckUqO1KQzyqs1d26Q3IJ3pnCcpDexQtwu2a8gWAQXaMhVCG6ip3ZBAmhvSCCThYpiBg6rF8o5ImEB0MEbH0Jg2qQY4TmY2XlaK_COCtSqnKO-OcxW8x9U=]
on April 1, 2012.

I am occasionally asked whether the work of informatics will be  "done" when everyone
is finishing implementing electronic health record  (EHR) systems. Sometimes the
 query is further qualified by, "once  everyone gets their HITECH money."

My answer is always an emphatic "No!" There is no question that some  informatics
implementation activity may slow down when healthcare  organizations are no longer
fueled by pursuit of  HITECH incentive [http://r20.rs6.net/tn.jsp?e=001NGUFqPshmtQ9k1cgjWdg61sbSZZRbDlG9ZmfHzj0Gtsaxlp2lXo_aO9roqEQDDAox-LBWMLIA7isNUm5zIpeHKxWFbE1XhcDQbeQg-1XxgqKFbApu1PoFkIriveYmZskUl-BNl_FFe9OSD-FrnTbYmHJUVrXyrLBeLyJAUsXToA=]
dollars. These activities may be impacted even further by bottom line  woes that
 are likely to impact healthcare no matter what the outcome of  healthcare reform,
or other distractions come along, such as ICD-10.

Read more [http://r20.rs6.net/tn.jsp?e=001NGUFqPshmtTjohKwoqatuvs8Z8gBqYKzD9OcB7mcTGskI3HMB6ZhCEu_CVmJk71Lan7F-gJEbcHSV_F0MSDKpWOzvktWfYX8adKHHQt4gMCukKFBceIii5fPq0Xfch7FGEJ7vb494twvdRBo_YQOMECRw_mpKPB-UEfWsQ8RUys8iQA1Q9VfWehbAVh-SaSMIWtQ5fdUe-ueB6_EEWk_q-tP-OGwMhpjR_AbSK_21s1Cp047ssOIPNqDCoIdOX0v-8yp-7BYH3M=]
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A Consideration

Perhaps, we're focused on the wrong thing? While healthcare is important, there 
may be other elements of society that create the healthcare problem? Some thoughts
for consideration ...

Last week, I met with a friend and colleague who is involved in literacy.  She has
been involved in the Dallas-Fort Worth area for many years teaching English as a
 second language. The conversation started because I had heard on a program the 
previous weekend that only 53 percent of 9th graders enrolled in the Washington,
 D.C., school system complete high school in four years. I was appalled, but she
 said, "Oh, but that's the way it is ... "
The statistics she cited were haunting for society and healthcare.  Here are a few
of the gems I gleaned from our conversation:

Read more [http://r20.rs6.net/tn.jsp?e=001NGUFqPshmtQH3hMg3k4_VN3ZmcbZlvCEeBMho6DK0DmWBUey-q3bp-kHIdwJ6qFGAzCTqM58NMWycJahNqEBoQ8rqcKGwZS64BfFWKk_vslro7XF-K1BB1ij2cayRaWftdOv4lDBNrE2DROlnGp0rZa0x8y75eo6G4kUbp28pGr5iEZYUQBoEWk8we1T_XhFMAUQunVEzkbo1WPCpk9_0A==]
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The Weekly Whisk

Musings from a foodie ...

So, I usually do a review of restaurants.  But, this week, I decided to change the
pace and consider another topic which has been in the back of my mind for some time
-- antioxidants!  I suspect that most of think about antioxidants as fruit -- blueberries,
pomegranates, and the like -- right?  And, you're absolutely on track.  It's just
that I've recently learned that spices are also a plentiful source of antioxidants.
 Yes, your favorites -- oregano, turmeric, cinnamon and clove -- are all rich in
 heart-healthy antioxidants. In fact, just a half-teaspoon of cloves has as many
 antioxidants as one-half cup of blueberries.  This may be the best bit of news 
I've passed along in some time [].
There's even research from Penn State suggesting that the antioxidant boost gained
by overlaying fatty food with a heavily spiced flavor may, in fact, cancel out some
of the negative effects of the fat. Does that make you want to have a spicy steak?
And that's not all spices can offer. Look at cinnamon. It's a hugely popular spice
(and delicious on baked apples) that's not only packed with antioxidants, but also
has all sorts of anti-microbial, anti-fungal, anti-viral, anti-tumor, blood pressure-lowering,
cholesterol and lipid-lowering, and gastro-protective properties. Wow! Food is an
antidote to life, it seems.

Read more [http://r20.rs6.net/tn.jsp?e=001NGUFqPshmtTkt5t1_kjFxWlMtYOrdHJumPSmkdMKcQWOGRh1CJFPaVdXgUJ4IbKqWEiKOXh3H_clf6zP-0WRzvqA72ZLkBuXRaV3cwMnLhBv3WK-kO1S7emAHq8Eg97ax0aOg_vnRC_lTS5fWsJamgmsbStgCRQ-KyNdUTfZ3_cmHsv41ddhuBQEKHd-sqz0K2gDLCfyjWA=]
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The Good, The Bad, and The Ugly

The ongoing saga ...

The Good - There is optimism spreading across Africa that the malaria scourge may
be coming under some degree of control.  The sharp decline in deaths and illness
 from malaria is bringing some hope that Africa could potentially turn the corner
in its economic development thereby bringing renewed hope among the nations of the
world that the people of Africa could benefit in a global economy.

The Bad - At the same time that malaria deaths and illness are declining, there 
is growing evidence that drug resistance by the plasmodium falciparum parasite, 
responsible for 75 percent of [http://r20.rs6.net/tn.jsp?e=001NGUFqPshmtRmwTA3SJuYdn7fAjqWWkPuIazpQZNgT--UdAnkWji7x0sBGHvkHtU9DG5KDLvWgmalfrbyd7-4JrXShKQhL8zDFfmsZxYU28_D1oO7cpYhLGLmHLC67uW5iI3rGlpgs8hAFnmVRhrUO0ETGkEmxBE3DWrfuTdU8WE=]
 malaria infections in Sub-Saharan Africa [http://r20.rs6.net/tn.jsp?e=001NGUFqPshmtRmwTA3SJuYdn7fAjqWWkPuIazpQZNgT--UdAnkWji7x0sBGHvkHtU9DG5KDLvWgmalfrbyd7-4JrXShKQhL8zDFfmsZxYU28_D1oO7cpYhLGLmHLC67uW5iI3rGlpgs8hAFnmVRhrUO0ETGkEmxBE3DWrfuTdU8WE=],
is being fueled by inappropriate use of medications and the vast migrations of people
that occur throughout Africa.

The Ugly - China's disregard for laws that allow companies to recoup their investments
in technologies is fueling concern among those battling malaria.
Read more [http://r20.rs6.net/tn.jsp?e=001NGUFqPshmtSV1Mm8edwTaIg8XeioQtQIqOWdbpixn0zPnItKmB5743Oy5heiRFRmewT-tg7EyKHzgTcLRlvjRMiDbcyT-DI2zCJUgmfSwaudsMO8D8RAdpfcUfzMa7z-irS0LTzIavD5Xob6byEP1OjMSVnT3ffVdIX3uhE52aReKybFg8etEdjWhBBgLOcBtWwMcHP1wNWKQrJigslnL1z0swFvJdyE]
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

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In This Edition

Quote of the Week
Consulo Indicium
	Implementation to Analytics
A Consideration
The Weekly Whisk
The Good, The Bad,  and The Ugly

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