Thursday, January 31, 2013
Doctor Tells U.S. Judge He Created Fake L.I.R.R. Injury Claims
By THE ASSOCIATED PRESS
Published: January 18, 2013
An orthopedist who was accused of taking cash payments for fake diagnoses and billing health insurance companies for unnecessary medical treatment in widespread disability fraud involving Long Island Rail Road workers pleaded guilty on Friday to conspiracy charges.
The doctor, Peter J. Ajemian, admitted that between the late 1990s and 2008 he invented “narratives” to justify illness and injury claims for hundreds of workers seeking to retire on disability.
The employees “were not in fact disabled and could have continued working in their railroad jobs, as they had no complaint right up to the time of their retirement date,” Dr. Ajemian told a judge in Federal District Court in Manhattan.
Prosecutors said that Dr. Ajemian, 63, received up to $1,200 for each of the fake assessments, as well as millions of dollars in health insurance payments. His patients received more than $90 million in disability benefits.
Dr. Ajemian was among 32 defendants who have been arrested in the past two years.
Three other retirees also pleaded guilty this week, bringing the number of guilty pleas in the case to 21.
Sentencing for Dr. Ajemian was set for May 24.
The story is here.
Accused gunman's doctor, university face lawsuits
By Jim Spellman,
CNN
Originally published January 17, 2013
The university psychiatrist who treated the accused gunman in last year's deadly Colorado theater rampage could face more than a dozen lawsuits that blame her and the school for not properly handling James Holmes' treatment.
At least 14 people have filed legal documents indicating they are planning to sue the University of Colorado Denver and Dr. Lynne Fenton for negligence.
Holmes, 25, was a doctoral student in neuroscience at the university.
Fenton has testified that her contact with Holmes ended on June 11, more than a month before he allegedly walked into a crowded movie theater in Aurora, Colorado, and opened fire, killing 12 people and wounding 58 others during a screening of the new Batman film.
She said she later contacted campus police because she was "so concerned" about what happened during her last meeting with him, but she declined to detail what bothered her.
The entire story is here.
CNN
Originally published January 17, 2013
The university psychiatrist who treated the accused gunman in last year's deadly Colorado theater rampage could face more than a dozen lawsuits that blame her and the school for not properly handling James Holmes' treatment.
At least 14 people have filed legal documents indicating they are planning to sue the University of Colorado Denver and Dr. Lynne Fenton for negligence.
Holmes, 25, was a doctoral student in neuroscience at the university.
Fenton has testified that her contact with Holmes ended on June 11, more than a month before he allegedly walked into a crowded movie theater in Aurora, Colorado, and opened fire, killing 12 people and wounding 58 others during a screening of the new Batman film.
She said she later contacted campus police because she was "so concerned" about what happened during her last meeting with him, but she declined to detail what bothered her.
The entire story is here.
Wednesday, January 30, 2013
Recovery from autism spectrum disorder (ASD) and the science of hope
Editorial in The Journal of Child Psychology and Psychiatry
Sally Ozonoff JCPP Joint Editor
Originally published January 16, 2013
DOI: 10.1111/jcpp.12045
The Journal of Child Psychology and Psychiatry, and the field of developmental psychopathology in general, is keenly interested in stability and change, continuities and discontinuities, and prediction of outcome. This issue of the journal presents several articles that examine influences and predictors of child difficulties, such as avoidant behavior (Aktar et al., 2012†) and antisocial behavior (Rhee et al., 2012). The effects of maternal depression and parental anxiety on child outcomes are also explored in this issue (Aktar et al., 2012; Hughes et al., 2012), as are the stability of symptoms in autism spectrum disorders (Corsello et al., 2012; Simonoff et al., 2012). All add to our understanding of the basic mechanisms and developmental pathways that underlie atypical child development. I call your attention to one article in particular that explores these concepts from a different angle and brings solid science to an understudied topic with a very controversial and contentious history, namely recovery from autism spectrum disorder (ASD).
Fein et al. (2012) recruited 34 children with clearly documented early histories of ASD who no longer met criteria for any autism spectrum diagnosis and, even further, had lost all symptoms of ASD. They compared these children to a group of typically developing participants and found no differences on multiple measures independent of the group classification process. They conclude, rather modestly, that these results “substantiate the possibility of optimal outcome,” demonstrating that some children with a clear early history and accurate diagnosis of ASD do indeed move into the entirely normal range of social and communication development later in childhood. Fein et al. use the word “recovery” only once in their paper, in reference to the findings and claims of another study. Their avoidance of the word is likely intentional. In fact, scientific papers have largely steered clear of this word, although it is alive and well on the Web. Why has recovery been such a provocative concept?
Lovaas (1987) was the first to use the term “recovery” in relation to ASD, describing the outcomes of children he had treated using the methods of applied behavior analysis. He did not provide an explicit definition of recovery, but described this group of children as having normal educational and intellectual functioning. His interpretation of this outcome as “recovery” was embraced wholeheartedly by some and scrutinized skeptically by others. It was pointed out that many children who meet criteria for ASD attain this level of functioning, but continue to display significant symptoms. Whether they had achieved “recovery” that fit with the Merriam-Webster definition of “regaining or returning to a normal or healthy state” was disputed. Researchers have generally avoided the term for fear of being viewed as naïve, idealistic, political, or simply just not good scientists. But recovery has remained a very powerful construct, one that many parents talk about and that has been the subject of much media and internet attention.
The entire article and issue can be found here.
Sally Ozonoff JCPP Joint Editor
Originally published January 16, 2013
DOI: 10.1111/jcpp.12045
The Journal of Child Psychology and Psychiatry, and the field of developmental psychopathology in general, is keenly interested in stability and change, continuities and discontinuities, and prediction of outcome. This issue of the journal presents several articles that examine influences and predictors of child difficulties, such as avoidant behavior (Aktar et al., 2012†) and antisocial behavior (Rhee et al., 2012). The effects of maternal depression and parental anxiety on child outcomes are also explored in this issue (Aktar et al., 2012; Hughes et al., 2012), as are the stability of symptoms in autism spectrum disorders (Corsello et al., 2012; Simonoff et al., 2012). All add to our understanding of the basic mechanisms and developmental pathways that underlie atypical child development. I call your attention to one article in particular that explores these concepts from a different angle and brings solid science to an understudied topic with a very controversial and contentious history, namely recovery from autism spectrum disorder (ASD).
Fein et al. (2012) recruited 34 children with clearly documented early histories of ASD who no longer met criteria for any autism spectrum diagnosis and, even further, had lost all symptoms of ASD. They compared these children to a group of typically developing participants and found no differences on multiple measures independent of the group classification process. They conclude, rather modestly, that these results “substantiate the possibility of optimal outcome,” demonstrating that some children with a clear early history and accurate diagnosis of ASD do indeed move into the entirely normal range of social and communication development later in childhood. Fein et al. use the word “recovery” only once in their paper, in reference to the findings and claims of another study. Their avoidance of the word is likely intentional. In fact, scientific papers have largely steered clear of this word, although it is alive and well on the Web. Why has recovery been such a provocative concept?
Lovaas (1987) was the first to use the term “recovery” in relation to ASD, describing the outcomes of children he had treated using the methods of applied behavior analysis. He did not provide an explicit definition of recovery, but described this group of children as having normal educational and intellectual functioning. His interpretation of this outcome as “recovery” was embraced wholeheartedly by some and scrutinized skeptically by others. It was pointed out that many children who meet criteria for ASD attain this level of functioning, but continue to display significant symptoms. Whether they had achieved “recovery” that fit with the Merriam-Webster definition of “regaining or returning to a normal or healthy state” was disputed. Researchers have generally avoided the term for fear of being viewed as naïve, idealistic, political, or simply just not good scientists. But recovery has remained a very powerful construct, one that many parents talk about and that has been the subject of much media and internet attention.
The entire article and issue can be found here.
Pa. sends mental health data for gun checks
By Moriah Balingit / Pittsburgh Post-Gazette
Originally published January 19, 2013
After facing legal and technical challenges for more than two years, the Pennsylvania State Police this week began transmitting hundreds of thousands of mental health records to a federal database used to conduct background checks for potential gun buyers.
On Tuesday, 643,167 mental health records were sent to the FBI-run National Instant Check System (NICS), according to the state police. The records represent people who are prohibited from buying guns because of involuntary mental health commitments.
"It's been an objective of ours for close to two years, so I think it's an important accomplishment that these records were able to be uploaded to NICS," said Lt. Col. Scott Snyder, deputy commissioner for the state police. The state police are working to fix a program that will upload the records automatically as they're created.
Strengthening the national database and universal background checks have been pillars of President Barack Obama's gun control agenda. On Wednesday, when he unfurled a massive gun control package, some executive orders were intended to make it easier for states to transmit mental health records to NICS.
Despite the state's achieving that goal, a disagreement between the state police and the Bureau of Alcohol, Tobacco, Firearms and Explosives over interpretation of federal gun law throws into question how the records will be used. At issue is the 302, the shortest and most common type of involuntary mental health commitment.
On Friday, a spokeswoman for the ATF said the bureau was still reviewing whether a 302 should preclude someone under federal law from buying a gun.
The entire story is here.
Originally published January 19, 2013
After facing legal and technical challenges for more than two years, the Pennsylvania State Police this week began transmitting hundreds of thousands of mental health records to a federal database used to conduct background checks for potential gun buyers.
On Tuesday, 643,167 mental health records were sent to the FBI-run National Instant Check System (NICS), according to the state police. The records represent people who are prohibited from buying guns because of involuntary mental health commitments.
"It's been an objective of ours for close to two years, so I think it's an important accomplishment that these records were able to be uploaded to NICS," said Lt. Col. Scott Snyder, deputy commissioner for the state police. The state police are working to fix a program that will upload the records automatically as they're created.
Strengthening the national database and universal background checks have been pillars of President Barack Obama's gun control agenda. On Wednesday, when he unfurled a massive gun control package, some executive orders were intended to make it easier for states to transmit mental health records to NICS.
Despite the state's achieving that goal, a disagreement between the state police and the Bureau of Alcohol, Tobacco, Firearms and Explosives over interpretation of federal gun law throws into question how the records will be used. At issue is the 302, the shortest and most common type of involuntary mental health commitment.
On Friday, a spokeswoman for the ATF said the bureau was still reviewing whether a 302 should preclude someone under federal law from buying a gun.
The entire story is here.
Tuesday, January 29, 2013
Hickenlooper's Gun Control
The Colorado Governor's plan to fix mental health, not firearms alone.
Review and Outlook - The Wall Street Journal
Originally published January 15, 2013
Gun control has been the exclusive political fixation of President Obama's Washington after Newtown, so perhaps readers will be surprised to learn that some states are being more constructive. One of them is Colorado, where Governor John Hickenlooper is promoting an innovative overhaul of his state's mental health-care system.
In his State of the State address last week, the Democrat said that "our democracy demands" a debate over guns, violence and mental illness—not least in the aftermath of James Holmes's attack on an Aurora movie theater that killed 12 and wounded 58 in July. "Let me prime the pump," Mr. Hickenlooper said. "Why not have universal background checks for all gun sales?"
There was a lot of media attention for that line, but much less for what followed. As Mr. Hickenlooper continued, "It's not enough to prevent dangerous people from getting weapons. We have to do a better job identifying and helping people who are a threat to themselves and others." His office spent the last five months developing a detailed $18.5 million plan to modernize civil commitment laws while expanding community-based mental health treatment.
The rest of the story is here.
Review and Outlook - The Wall Street Journal
Originally published January 15, 2013
Gun control has been the exclusive political fixation of President Obama's Washington after Newtown, so perhaps readers will be surprised to learn that some states are being more constructive. One of them is Colorado, where Governor John Hickenlooper is promoting an innovative overhaul of his state's mental health-care system.
In his State of the State address last week, the Democrat said that "our democracy demands" a debate over guns, violence and mental illness—not least in the aftermath of James Holmes's attack on an Aurora movie theater that killed 12 and wounded 58 in July. "Let me prime the pump," Mr. Hickenlooper said. "Why not have universal background checks for all gun sales?"
There was a lot of media attention for that line, but much less for what followed. As Mr. Hickenlooper continued, "It's not enough to prevent dangerous people from getting weapons. We have to do a better job identifying and helping people who are a threat to themselves and others." His office spent the last five months developing a detailed $18.5 million plan to modernize civil commitment laws while expanding community-based mental health treatment.
The rest of the story is here.
Warning Signs of Violent Acts Often Unclear
By BENEDICT CAREY and ANEMONA HARTOCOLLIS
The New York Times
Published: January 15, 2013
No one but a deeply disturbed individual marches into an elementary school or a movie theater and guns down random, innocent people.
That hard fact drives the public longing for a mental health system that produces clear warning signals and can somehow stop the violence. And it is now fueling a surge in legislative activity, in Washington and New York.
But these proposed changes and others like them may backfire and only reveal how broken the system is, experts said.
“Anytime you have one of these tragic cases like Newtown, it’s going to expose deficiencies in the mental health system, and provide some opportunity for reform,” said Richard J. Bonnie, a professor of public policy at the University of Virginia’s law school who led a state commission that overhauled policies after the 2007 Virginia Tech shootings that left 33 people dead. “But you have to be very careful not to overreact.”
The entire story is here.
The New York Times
Published: January 15, 2013
No one but a deeply disturbed individual marches into an elementary school or a movie theater and guns down random, innocent people.
That hard fact drives the public longing for a mental health system that produces clear warning signals and can somehow stop the violence. And it is now fueling a surge in legislative activity, in Washington and New York.
But these proposed changes and others like them may backfire and only reveal how broken the system is, experts said.
“Anytime you have one of these tragic cases like Newtown, it’s going to expose deficiencies in the mental health system, and provide some opportunity for reform,” said Richard J. Bonnie, a professor of public policy at the University of Virginia’s law school who led a state commission that overhauled policies after the 2007 Virginia Tech shootings that left 33 people dead. “But you have to be very careful not to overreact.”
The entire story is here.
Monday, January 28, 2013
In Second Look, Few Savings From Digital Health Records
By REED ABELSON and JULIE CRESWELL
The New York Times
Published: January 10, 2013
The conversion to electronic health records has failed so far to produce the hoped-for savings in health care costs and has had mixed results, at best, in improving efficiency and patient care, according to a new analysis by the influential RAND Corporation.
Optimistic predictions by RAND in 2005 helped drive explosive growth in the electronic records industry and encouraged the federal government to give billions of dollars in financial incentives to hospitals and doctors that put the systems in place.
“We’ve not achieved the productivity and quality benefits that are unquestionably there for the taking,” said Dr. Arthur L. Kellermann, one of the authors of a reassessment by RAND that was published in this month’s edition of Health Affairs, an academic journal.
RAND’s 2005 report was paid for by a group of companies, including General Electric and Cerner Corporation, that have profited by developing and selling electronic records systems to hospitals and physician practices. Cerner’s revenue has nearly tripled since the report was released, to a projected $3 billion in 2013, from $1 billion in 2005.
The entire story is here.
New designs to make health records easier for patients to use
HHS.gov
U.S. Department of Health & Human Services
NEWS RELEASE
FOR IMMEDIATE RELEASE
January 15, 2013
Winning designs of printed health records to help patients better understand and use their electronic health records (EHRs) were announced today by Farzad Mostashari, M.D., the national coordinator for health information technology. The designs, created through a HHS Office of the National Coordinator for Health Information Technology (ONC) challenge contest, all met the goal of making EHRs valuable to patients and their family members.
“Patients that are engaged in their health care treatments have better outcomes in their health,” said Farzad Mostashari, M.D., national coordinator for Health Information Technology. “The design challenge winners all proposed patient-friendly designs that will help to translate technical health information into easy-to-understand information that will help patients work closely with their doctors to manage their care.”
More than 230 submissions to the design challenge were submitted. Winners of the Health Design Challenge include:
The Health Design Challenge supports ONC’s efforts to engage consumers in their health through the use of technology, including the Blue Button, and is part of ONC’s Investing in Innovation (i2) Initiative. The i2 Initiative holds competitions to accelerate development and adoption of technology solutions that enhance quality and outcomes.
"This challenge was unique because it engaged professionals and students inside and outside of the health care industry to participate and propose real solutions," said Ryan Panchadsaram, presidential innovation fellow for ONC." We’ve assembled a showcase of top entries that challenged the status quo and inspired the health community."
More information about the winning submissions and other top entries can be viewed in the online gallery at http://healthdesignchallenge.com . For more information about health information technology, visit: www.healthit.gov.
The release was posted here.
U.S. Department of Health & Human Services
NEWS RELEASE
FOR IMMEDIATE RELEASE
January 15, 2013
Winning designs of printed health records to help patients better understand and use their electronic health records (EHRs) were announced today by Farzad Mostashari, M.D., the national coordinator for health information technology. The designs, created through a HHS Office of the National Coordinator for Health Information Technology (ONC) challenge contest, all met the goal of making EHRs valuable to patients and their family members.
“Patients that are engaged in their health care treatments have better outcomes in their health,” said Farzad Mostashari, M.D., national coordinator for Health Information Technology. “The design challenge winners all proposed patient-friendly designs that will help to translate technical health information into easy-to-understand information that will help patients work closely with their doctors to manage their care.”
More than 230 submissions to the design challenge were submitted. Winners of the Health Design Challenge include:
- Best Overall Design – “Nightingale” - Amy Guterman, Stephen Menton, Defne Civelekoglu, Kunal Bhat, Amy Seng, and Justin Rheinfrank from gravitytank in Chicago, Ill.
- Best Medication Section – “M.ed” - Josh Hemsley from Orange County, Calif., presented a modern and intuitive design to help patients better understand how to properly adhere to their medication
- Best Medical/Problem History – “Grouping by Time” – Mathew Sanders from Brooklyn, N.Y., aimed to provide more context by listing items in chronological order instead of grouping by functional type so cause and effect can be seen
- Best Lab Summaries – “Health Summary” – Mike Parker, Dan McGorry, and Kel Smith from HealthEd in Clark, N.J., brought life to lab summaries through an aggregate health score and rich graphs of lab values
- The Best Overall Design winner will receive $16,000, while the winners in the remaining categories will each receive $5,000.
The Health Design Challenge supports ONC’s efforts to engage consumers in their health through the use of technology, including the Blue Button, and is part of ONC’s Investing in Innovation (i2) Initiative. The i2 Initiative holds competitions to accelerate development and adoption of technology solutions that enhance quality and outcomes.
"This challenge was unique because it engaged professionals and students inside and outside of the health care industry to participate and propose real solutions," said Ryan Panchadsaram, presidential innovation fellow for ONC." We’ve assembled a showcase of top entries that challenged the status quo and inspired the health community."
More information about the winning submissions and other top entries can be viewed in the online gallery at http://healthdesignchallenge.com . For more information about health information technology, visit: www.healthit.gov.
The release was posted here.
Sunday, January 27, 2013
Details on suicide among US physicians: data from the National Violent Death Reporting System
By Karen Gold, Ananda Sen, and Thomas Schwenk
General Hospital Psychiatry
Volume 35, Issue 1 , Pages 45-49, January 2013
Abstract
Objective
Physician suicide is an important public health problem as the rate of suicide is higher among physicians than the general population. Unfortunately, few studies have evaluated information about mental health comorbidities and psychosocial stressors which may contribute to physician suicide. We sought to evaluate these factors among physicians versus non-physician suicide victims.
Methods
We used data from the United States National Violent Death Reporting System to evaluate demographics, mental health variables, recent stressors and suicide methods among physician versus non-physician suicide victims in 17 states.
Results
The data set included 31,636 suicide victims of whom 203 were identified as physicians. Multivariable logistic regression found that having a known mental health disorder or a job problem which contributed to the suicide significantly predicted being a physician. Physicians were significantly more likely than non-physicians to have antipsychotics, benzodiazepines and barbiturates present on toxicology testing but not antidepressants.
Conclusions
Mental illness is an important comorbidity for physicians who complete a suicide but postmortem toxicology data shows low rates of medication treatment. Inadequate treatment and increased problems related to job stress may be potentially modifiable risk factors to reduce suicidal death among physicians.
The entire article is here.
Thanks to Ed Zuckerman for this article.
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