If you’re a healthcare entrepreneur, it probably doesn’t get much better than getting encouragement from Eric Topol. It’s a bit like a celebrity endorsement. Suffice it to say, Clinton Phillips, the CEO and founder of 2nd.MD, a telehealth service that seeks to cut the time it takes to offer second opinions to self-insured company employees from a group of more than 300 specialists from Massachusetts General to the Mayo Clinic, was thrilled when he spoke with Topol a few weeks ago.

In a phone interview with MedCity News, Phillips said: “He told me he loved this idea and tried to do something like it at the Cleveland Clinic. I have a huge amount of respect for him.”

The keys to its service are speed, access and reducing healthcare costs. Here’s how it works. Users request a second opinion, usually when they have received a diagnosis or recommendation for a medical procedure. They are typically asked ahead of time to provide lab and test results, a physician’s assessment or recommendation for treatment for the patient’s condition. Within a few days, users can speak with two to five specialists, depending on their condition, through a 20-minute phone or video conference session. They can also access a summary of the opinions.

“We have taken these very hard-to-reach people and made them available to a [wide range of employees] and helped them save a ton of money.”

A former chiropractor turned entrepreneur, Phillips previously founded Aspen Back and Body, which was sold to Laser Spine Institute in 2009.

The 14 companies 2nd.MD currently works with represent a wide range of areas but tend to employ technology-savvy people who think nothing of searching for medical information online. It’s in talks with some big U.S. companies and particularly likes those with offices across the country and outside the U.S..

“70 percent of the time medicine can be handled remotely or virtually, provided you have a good set of clinical information,” said Phillips.

Asked what the limits of the service are, Phillips points out that physicians don’t provide prescriptions or order procedures and it won’t work if you need to be evaluated. More often than not, the specialists will advise a less invasive course of action than what the user’s physician might recommend. Philips says that’s because they are specialists and are not being incentivized to order more invasive procedures. He said the speed and convenience of its service combined with the less invasive approach and having the flexibility to choose the physicians they want has led to strong patient satisfaction.

“More often than not the diagnosis may be correct, but the treatment may be wrong — maybe the [user's] doctor has not seen as many cases of this condition as another doctor.”

It’s looking to raise $1 million to boost its technology team to help realize its goal of 2 million users in its network. It’s also poised to release a smartphone app to help users review physicians on its team, schedule appointments, note they want to conference in a loved one on a call for support and upload images they’ve taken with their camera. It will also help users get a translation of second opinion summaries into other languages.

NEW YORK (Reuters Health) - In a new study, people with high blood pressure who could communicate with their pharmacists online had better blood pressure control a year after that service ended.

Previously researchers had found that patients randomly assigned to the web-based pharmacy care did better than those who used a patient website but had no extra help or were only trained to monitor their blood pressure at home.

The new findings suggest some of those benefits may hold up over the long run - even after patients stop messaging with their pharmacists, researchers said.

Hayden Bosworth, who studies treatment adherence at Duke University Medical Center in Durham, North Carolina, said there's been a lot of interest in how to help patients stick more closely to their blood pressure and cholesterol medications, for example.

"From a health care plan perspective, these interventions are expensive and we need to look more at the sustainability of the effects and look at it long term," said Bosworth, who wasn't involved in the new research.

"We need to look at it from a (return on investment) perspective."

The new study took place at Group Health, a Seattle-based health care system. Patients there already had online access to parts of their medical records and could email with their doctors through a secure website.

Researchers led by Dr. Beverly Green randomly assigned 778 people in the system with high blood pressure to one of three groups.

One group received usual care, a second was trained in how to monitor blood pressure at home and a third received the monitoring instruction and was able to communicate online with pharmacists.

A year after the intervention ended, 618 patients remained in the study. Blood pressure was controlled - meaning less than 140/90 milliliters of mercury (mm/Hg) - for 60 percent of people who had online access to pharmacists, compared to 48 to 52 percent of those in the other groups.

Average systolic blood pressure - the top number - was 134 in the pharmacy group versus 138 among usual care participants and 141 for the blood pressure monitoring only group. There was no difference between groups when it came to diastolic blood pressure, the study team reported in JAMA Internal Medicine.

"We thought that since the patients were used to taking care of their blood pressure and communicating with their pharmacists, now they would do that with their provider," Green told Reuters Health.

She said a formal cost analysis of the program is in the works, but that online pharmacist access cost about $400 per patient.

Given the improvement in blood pressure, "I believe it is very inexpensive," Green said.

But current reimbursement plans make it difficult to make these types of programs work, she said. For example, doctors typically don't get paid for communicating with patients online or over the phone - only in person.

Bosworth said online access to pharmacists is just one way to improve adherence to blood pressure medicines. Texts and emails from case managers are other strategies, he said.

"These kinds of interventions - patients are extremely satisfied with them," Green said.

"They really appreciate being able to get a hold of their provider when they need it. And they also like that they can get their questions answered when they need it and they don't have to come in," she added.

"I think we're at a point where we can do these self-management programs relatively well for at least med adherence," Bosworth told Reuters Health.

"The important part now is how do we take these, package them, and implement them in the real world?"

SOURCE: http://bit.ly/10lllFn JAMA Internal Medicine, online May 20, 2013.

“We have reached a tipping point in adoption of electronic health records,” said Secretary Kathleen Sebelius in a statement.

About 191,305 Medicare eligible professionals — a group that’s dominated by physicians but also includes dentists, optometrists, podiatrists and chiropractors — have received $3.7 billion in Medicare incentive payments for meeting Meaningful Use requirements since 2011, according to a Department of Health and Human Services report.. More than 88,903 Medicaid-eligible professionals for received  nearly $2 billion. About 3,880 hospitals to date have received $8.7 billion through Medicaid only, Medicare only and a combination of Medicare and Medicaid programs.

To demonstrate the first stage of Meaningful Use, eligible professionals had to order prescriptions electronically, send appointment reminders to patients for preventive or follow up care, and display lab results in the EHR. One of the key things hospitals must provide to comply with Meaningful Use Stage 2 is a discharge summary that includes, among other things: admit and discharge date and location; reason for hospitalization; care team including the attending of record as well as other providers of care; procedures performed during admission; current and past problem list; summary of care record for transitions of care or referrals to another provider.

Some challenges to providers expanding electronic medical records across their systems include the variety of systems that differ from one practice to another. And the standardization issue isn’t confined to providers. Last month, the ONC marked a different milestone of sorts when it withdrew EHR certification for health IT vendor EHRMagic for two electronic health record systems that failed to demonstrate meaningful use. It came as a surprise when ONC officials concluded that surveillance activities varied across its authorized certification bodies, highlighting a need for consistency. It also sparked debate about what the consequences would be for any providers that used a system that loses certification.

The way that providers implement new systems and upgrades is also a critical factor. There are trails of medical errors caused by rapid implementation or inadequate training for staff — an issue the Pennsylvania Patient Safety Authority has highlighted.

Now that next-generation DNA sequencing is fast enough, cheap enough and commercially available, the next challenging for innovators is finding ways to effectively apply it to everyday medicine outside of the research lab.

Mayo Clinic and personalized medicine firm Cancer Genetics Inc. (NASDAQ:CGIX) have formed a new company to do just that. OncoSpire Genomics, announced today, will discover and commercialize diagnostic products using next-generation DNA sequencing, starting in cancer.

OncoSpire will leverage clinical and research expertise from the Biomarker Discovery Program at Mayo’s Center for Individualized Medicine along with operating capital and commercial expertise from Cancer Genetics, a reference lab that offers products and services to enable development of cancer diagnostics and personalized treatments. Initially, it will focus on developing diagnostics for hematological and urogenital cancers.

The joint venture is another example of how hospitals, in search of fresh revenue streams, are increasingly turning to partners to commercialize the innovation they’re doing in-house. Mayo, in fact, has done this before in the form of mRemedy, a mobile health company created with DoApp Inc. to provide a patient engagement app.

Mayo also made a push to improve its approach to genome interpretation earlier this year when it initiated a strategic partnership with California diagnostics company Silicon Valley Biosystems.

The hospital and publicly traded Cancer Genetics will have equal ownership of the new Rochester-based venture, but other financial details were not disclosed.

Cancer Genetics CEO Panna Sharma said in a statement that the company wanted to work with Mayo because of its talented clinicians and thought leaders, who would help driving clinical value and adoption of products developed by OncoSpire. “We expect this will add value to our commercial offerings as next-generation sequencing becomes more widely accepted by the clinical community.”

[Photo from Flickr user andylepp]

The panel, which advises the U.S. Food and Drug Administration on matters related to central nervous system disorders, voted 13-3, with one abstention, that the drug, suvorexant, is safe for elderly patients at 15 milligrams a day, and is safe for non-elderly adults at 20 milligrams.

The panel voted 8-7, with two abstentions, that the drug is not safe when given to elderly patients at 30 milligrams or non-elderly adults at 40 milligrams.

NEW YORK (Reuters Health) - More than one quarter of people being treated for non-melanoma skin cancer in their doctor's office reported some type of complication after surgery, in a new study.

About half of those complications were medical problems related to the cancer-removing procedure, including pain, infections and slow wound healing.

But just 3 percent of doctors noted a complication in the same patients' medical records, researchers reported this week in JAMA Internal Medicine.

"It's important, in order to improve care and improve quality of care, to be aware of what our weaknesses are as physicians," said Dr. Eleni Linos, who led the new study at the University of California, San Francisco.

"If a quarter of Toyota customers were unhappy after service, they would take that very seriously," she said - the same as if a quarter of Apple product buyers didn't like their purchases.

The researchers followed 866 people - mostly older men - being treated for non-melanoma skin cancer, which includes basal and squamous cell cancers.

About 2.2 million people are diagnosed with those cancers every year in the U.S., but only 2,000 or so die, according to the American Cancer Society.

One recent report, also from Linos and her colleagues, found most people with non-melanoma skin cancer undergo surgery to treat it - even though for some elderly or ill patients, benefits are unlikely (see Reuters Health story of April 29, 2013 here: http://reut.rs/11RhiQn).

This time, the researchers sent questionnaires to patients who had undergone some type of in-office skin cancer procedure for up to five years after their surgery.

Thirteen percent of them reported a non-medical problem, such as issues with their scar or appearance or difficulty getting to appointments. Another 14 percent said they had a medical complication - most commonly pain, numbness or itching, problems with wound healing or infections.

One in ten people reported a moderate or severe complication on a post-surgery questionnaire.

In contrast, Linos and her colleagues found doctors noted a complication in the medical charts of just 22 of those patients, or 3 percent.

She said the proportion of patients who reported a complication was "sky high" compared to what the researchers were expecting.

WHAT'S A COMPLICATION?

Patients might have a broader view of what counts as a complication, she said, such as disliking bandages or scars. Or, doctors may simply not ask patients about their post-surgery problems often enough - and may miss chances to address treatable issues.

Complications can be subjective for patients, and even scarring can be "life-altering" for certain people, according to Anthony Simon Bates, who has studied how patients are asked about complications of skin cancer surgery at the UK's University of Bristol.

"There's a real need to manage patient expectations and for doctors to provide adequate pre-operative advice and information to patients," Bates, a medical student who wasn't involved in the new research, told Reuters Health.

According to Linos, the same patterns have been suggested for hospital care, as well as medication side effects: what patients experience can be very different from what doctors expect.

"The bottom line is, it's worth asking patients what they're experiencing directly," she said. "We're all on the same team, but often we may not be as aware as the patient is about their own experience."

SOURCE: http://bit.ly/14xz8Ji JAMA Internal Medicine, online May 20, 2013.

NEW YORK (Reuters) - Little known biotechnology company Merrimack Pharmaceuticals Inc has quietly built a large pipeline of experimental cancer treatments that it aims to deliver at a fraction of the cost spent by larger rivals.

That could translate into lower-cost treatments for large unmet needs, such as pancreatic cancer, at precisely the time when pressure is mounting to reduce runaway healthcare spending.

Despite six drugs in clinical development - one of them in late-stage trials - and two more about to advance to human testing, Merrimack is burning only about $20 million a quarter.

"For the size and scale of what we do, that's eye poppingly low," Merrimack Chief Executive Robert Mulroy told Reuters.

"Our cost structure is orders of magnitude lower than anybody to date in this business. Our cost from starting a discovery program to getting into the clinic is less than $20 million, and the industry average is close to half a billion per molecule," he said in an interview this week.

"Hopefully, we're going to get to less expensive drugs because our capital costs to be successful with them will be so much lower."

That would be music to the ears of payers and the overtaxed U.S. Medicare system contending with new cancer treatments that can exceed $100,000 per patient.

Started by six professors from Harvard and the Massachusetts Institute of Technology in 2000, Merrimack is nearing the finish line with what could be its first commercial product, a nanotherapeutic treatment for pancreatic cancer - a disease for which patients currently have few options.

Shares of Merrimack, which has a market value of about $500 million, are down nearly 16 percent this year, while the biotech sector overall has been on the rise.

Brean Capital analyst Gene Mack said investors have been wary about the prospects for the company's lead drug because the failure rate for pancreatic cancer drugs has been high and Merrimack is testing its drug in patients that have failed prior treatment - a population with a very poor prognosis.

"Investors don't realize how much progress has been made in the last year," Mack said. "Fundamentally, this is my favorite company (worth) under a billion dollars."

Late-stage trial data on the lead drug candidate, known as MM-398, is expected the second half of this year. If the study succeeds, the company could file for approval late this year or early in 2014.

MM-398 is designed to treat a particular type of tumor - hypoxic tumors - that tend to be resistant to standard therapies because of poor blood flow to the tumor.

"You don't have a lot of highways to the tumor so you don't get a lot of drug there," Mulroy explained.

The Merrimack technology is designed to deliver cancer-killing therapy directly into the tumor and have it work for far longer than other new medicines that directly target tumors.

"Our technology keeps the drug in the tumor for over a week as opposed to just a few hours," Mulroy said.

Hypoxic tumors are very common in pancreatic cancer, making it notoriously difficult to treat, but are also present in many other types of solid tumors.

Merrimack is developing a companion diagnostic test that uses a radioactive imaging agent to identify hypoxic tumors. If the test works as intended, MM-398 could also eventually treat lung, breast, colon and other cancers if patients are found to have the right type of tumor, giving it a huge potential market. The company plans to test MM-398 in combination with chemotherapies and targeted biotech medicines.

Merrimack also has a drug, MM-111, in Phase II testing for gastric cancer, for which there is an enormous unmet need, particularly in China and Asia.

The company has enough cash to fund its numerous clinical trials for the rest of this year and take MM-398 through to approval and commercialization, Mulroy said.

The company has full rights to seven of the eight drugs in clinical development and hopes to retain them for the U.S. and European markets while looking for partners to sell the medicines in other parts of the world, the CEO said.

French drugmaker Sanofi acquired global rights to the Merrimack drug MM-121, being tested in lung, breast and ovarian cancer. Merrimack, which will get milestone payments and royalties on future sales of the medicine, expects data from four Phase II trials of MM-121 later this year.

In another vote of confidence, Sanofi is the company's second-largest shareholder with more than a 5 percent stake, according to Thomson Reuters data.

Merrimack's share performance over the second half of the year will hinge on a steady flow of clinical data, with four Phase II studies and the pivotal Phase III on MM-398 expected to be reported in the coming months.

"There will be plenty of opportunities to show that the technology works," Mulroy said. "We're in a big transition year for us."

(Reporting by Bill Berkrot; editing by Ed Tobin and John Wallace)

FRANKFURT (Reuters) - German software company SAP is looking to recruit people with autism as programmers and product testers, drawing on skills that can include a close attention to detail and an ability to solve complex problems.

SAP has asked start-up Danish recruitment company Specialisterne to help it find, train and manage employees diagnosed with the disability.

"They bring a special set of skills to the table, which fits with SAP," said a spokesman for the company, which has already hired people with autism in India and Ireland.

Specialisterne Chief Executive Steen Thygesen said the partnership was his first with a multinational company to help with its worldwide recruitment.

The Danish company says it has already helped several hundred autistic people to find a job. Sufferers often find it harder to communicate and some have lifelong learning disabilities.

Those with a form of autism known as Asperger syndrome can sometimes have above-average intelligence. As children, they may prefer mathematics and other subjects rooted in logic and systems, according to Britain's National Autistic Society.

"People with autism have some unique abilities to really focus on their task and stay focused for long periods of time. They are also good at spotting discrepancies in data," said Thygesen, a former manager with Microsoft and Nokia whose 14-year-old son has Asperger syndrome.

According to the U.S. Centers for Disease Control and Prevention, 1 in every 88 children in the United States and almost 1 in 54 boys are diagnosed with autism.

The SAP spokesman said the company aimed to reflect the proportion of people diagnosed as autistic in society within its 65,000-strong workforce - or about 1 percent.

A Berlin-based company, Auticon, already exclusively employs autistic people as software testers. It has a team analyzing data for Vodafone Germany, an Auticon spokesman said.

(Reporting by Harro ten Wolde; Editing by Tom Pfeiffer)

At one point during my trip to FutureMed earlier this year, I found myself seated next to a young man — noticeably younger than many of the entrepreneurs and doctors-in-training who were attending. Shaggy haircut, jeans, smartphone always in hand. Must be a local high schooler who had won some kind of contest to attend, or was getting school credit for being there, I thought.

It turns out, he was a high schooler and he had won a contest, but it was the Intel Science Fair, and he was actually a faculty member for FutureMed. It was Jack Andraka, one many young scientists and entrepreneurs who have set their sights on solving some of medicine’s big problems.

Here are a few of these budding scientists and entrepreneurs to watch:

Last year, at age 15, Andraka won the Intel Science Fair for developing a sensor strip for detecting a pancreatic cancer biomarker that he says is faster, cheaper and more sensitive than existing diagnostics. Now, he has assembled a team of teenagers to develop a diagnostic sensor device for the Qualcomm Tricorder X Prize.

Fred Turner won the title of UK Young Engineer of the Year earlier this year for building his own polymerase chain reaction machine, which he uses in his at-home laboratory to study DNA. His first project? Determining why his brother has ginger hair and he doesn’t. The 17-year-old will reportedly attend Oxford University in the fall to study biochemistry.

High school senior Brittany Wenger is combining medicine and data science to create an “artificial neural network” to improve breast cancer diagnosis. She won the 2012 Google Science Fair and created Cloud4Cancer, a project that collects data from biopsies done with the fine-needle aspiration process, with the goal of helping doctors better assess whether breast tumors are malignant or benign.

A finalist in the 2013 Intel Science Talent Search and the winner of NPR’s Big Idea contest, 17-year-old Catherine Wong took on a digital health challenge of her own when she developed a low-cost, smartphone-based electrocardiogram (a la AliveCor) for the developing world. Her device uses off-the-shelf electronic components to pick up the heart’s electrical signals, and sends them via cellphone to a physician.

After his mother broke her leg and refused to take pain medication for fear of becoming dependent, Oregon high schooler Raghav Tripathi began researching a potential non-addictive painkiller. His research, which landed him a spot as a finalist in the 2012 Siemens Competition in Math, Science and Technology, focused on anandamide, a compound produced by the body that has painkilling effects at elevated levels. He told ABC News he hopes his work will lead to a medicine or vaccine.

[Screen cap from BBC]

Leaders from UnitedHealth Group, Blue Cross Blue Shield Minnesota and Aetna explained how they decide what treatments to cover and calculate the ROI of preventive care at the recent Medtech Investing conference in Minneapolis. The panel included Dr. Richard Migliori, chief of medical affairs for UnitedHealth Group; Jim Epple, former chief operating officer of Blue Cross Blue Shield Minnesota; and Dr. Edmund Pezalla, the national medical director of pharmacy policy and strategy at Aetna,

Early in the discussion, Migliori said that payers have moved beyond the cost of the device. Now administrators consider a treatment’s cost impact on the entire episode of care. When UnitedHealthcare calculated the annual cost of care for patients who need Gleevec, this analysis convinced the insurer to cover the drug.

“What we found out is that one pill a day is $36,000 per year, but we spend $110,000 per year on these people on treatment, so the total cost of care went down,” he said. “Now we have four nurses in Chicago who spend all their time calling patients to make sure they are taking this drug.”

Pezalla said Aetna tends to be more generous in covering treatment for stroke patients.

“We decided to cover new treatments even though they don’t have a big ROI because they improve quality of life,” he said.

Pezalla said Aetna only pays for certain surgeries in certain centers where they do lots of the particular procedures.

“We are doing this with transplants and oncology groups, now using predetermined protocols so they don’t have to go through preapprovals,” he said.

The group also discussed the acceptable timeline for ROI on wellness programs or preventive care.

Migliori used the example of laparoscopic surgery for gastric bypass. UnitedHealthcare did a long-term study and found that the breakeven point was about 36 months out.

“When you start using laparospic methodology versus not doing laparo at all,  people who did not have the surgery had higher claims later on,” he said.

Pezalla said Aetna covers screenings and the HPV vaccine because it’s the right thing to do. He also predicted that accountable care organizations will create a more stable population for insurance companies in the long-term.

Epple said one of the most encouraging industry trends is the evolution to longer-term contracts.

“Moving to three-, four-, five-year contracts gets people out of negotiation mentality and into investment mode,” he said. “Let’s get to the point where we’re willing to invest in the long-term health of a population.”

Eppel predicted that some health systems will disappear and that the key to survival is reengineering the process of providing care to get to high-quality and low-cost results.

“The key is taking an episode of care and picking it apart,” he said, adding that hospitals will have to start standing up to doctors.

“Hospitals hear a lot of, ‘If you don’t get me this and you don’t get me that, I’ll leave,’” he said. “The brave and the bold who will survive will say, ‘No, we can’t do that.’”

Photo from Scanadu

Scanadu, one of the most high profile participants vying for the $10 million Qualcomm Tricorder X PRIZE, today lifted the veil on the design of its medical scanner via an Indiegogo campaign. And in a matter of a few hours, it’s exceeded its goal of $100,000.

The device, called Scout, is placed on the forehead for 10 seconds and measures a person’s heart rate, temperature, oxymetry, respiratory rate, blood pressure, ECG and emotional stress. Readings are sent via Bluetooth to a smartphone, where an app tracks those stats over time.

It’s built on the Micrium platform, the same operating system used in NASA’s Sample Analysis at Mars suite, and was designed by Yves Behar, who also designed Jawbone. For early bird buyers, Scout runs $149.

The startup, which came out out of Singularity University and is based at NASA Ames Research Park, launched the crowdfunding campaign to raise money and collect data for FDA clearance via clinical studies, which buyers can opt in to. First shipments of the device will go out in Q1 2014, it says.

More than 200 other companies and teams are expected to participate in the X Prize competition.

Shares of the Calgary-based company rose as much as 11 percent to C$3.14 on the Toronto Stock Exchange on Wednesday. Its Nasdaq-listed shares were up 10 percent.

Reolysin was administered intravenously along with chemotherapy drugs carboplatin and paclitaxel to patients who either failed to respond to prior therapies or were not considered for standard first-line cancer treatment.

"These preliminary results are very encouraging and support progressing to subsequent studies," said Chief Executive Brad Thompson.

Oncolytics said it will not proceed with the second stage of the trial at this time as it try the drug in combination with other emerging treatments.

(Reporting by Bhaswati Mukhopadhyay in Bangalore; Editing by Roshni Menon)

LONDON (Reuters) - For a pathogen with such a short history, the mysterious new virus killing people in the Middle East and Europe has already had an amazing array of names.

It first surfaced last year as "human betacoronavirus 2c EMC", but the suffixes "2c England-Qatar, "2C Jordan-N3", "England 1" have also appeared and many scientists have resorted to "novel coronavirus" - new crown-shaped virus - instead.

While the World Health Organization (WHO) says the virus and the severe infections and deaths it has caused are "alarming" and need to be tracked, none of its names is especially helpful.

"A virus is only 'novel' until the next one comes around," Raoul de Groot, head of the Coronavirus Study Group (CSG), said of the catchiest of the titles it has acquired so far.

So with the death toll from the 42 cases identified at 21 and expected to rise - de Groot's group has come up with a new name: "Middle East Respiratory Syndrome" or MERS, since all the cases have had a direct or indirect connection to the region.

The CSG, which published the name in the Journal of Virology last week, said it had been endorsed by the Saudi, Dutch and British scientists who discovered it, the WHO's European office and the Saudi health ministry.

But naming deadly new viruses is fraught with sensitivity, and the signs are this matter has yet to settle.

DIFFICULT HISTORY

Human disease is littered with examples of fractious, sometimes furious rows over what emerging pathogens are called.

Some 30 years ago, when the human immunodeficiency virus, or HIV, was discovered, it was named "GRID", or "gay-related immune deficiency", helping to spread the slur "the gay plague".

It was not until it became clear the sexually transmitted virus was also infecting heterosexuals and haemophiliacs, that GRID was replaced with the more accurate HIV.

More recently, the scientific "H1N1" was the name that stuck for the pandemic flu strain that swept the world in 2009/2010 after earlier suggestions proved too sensitive.

An Israeli health minister objected to "swine flu" on religious grounds and "Mexican flu" caused offence to a nation.

When scientists called a "superbug" enzyme that makes bacteria resistant to almost all known antibiotics "New Delhi metallo beta lactamase", or NDM-1, the Indian health ministry called it "malicious propaganda" to put India in the name.

"Clearly, naming viruses and diseases after ethnicity, religion, gender and lifestyle is potentially stigmatizing and offensive, and thus unacceptable," de Groot said.

"All parties involved were acutely aware of sensitivities around geographic naming and the issue has been weighed very carefully," he told Reuters via email.

The MERS decision involved Ron Fouchier of the Erasmus Medical Center in the Netherlands, Maria Zambon of the UK Health Protection Agency and Ali Mohamed Zaki, an Egyptian microbiologist working at the Dr Soliman Fakeeh Hospital in Jeddah, Saudi Arabia, among others.

All of them played key roles in discovering the new virus.

According to a source close to the discussions, who declined to be identified due to sensitivities surrounding the issue, one suggestion was to name the virus after Zaki as a tribute to his work; he lost his job after going public with his findings.

It is early days, but so far, MERS has not caught on, despite the WHO's European branch saying "the WHO and other committee members strongly urge the use of this name in scientific and other communications".

A "disease outbreak update" issued from the WHO's global headquarters in Geneva on Wednesday referred to the "novel coronavirus" or "nCoV" throughout. MERS did not get a mention.

A WHO spokesman said he was unable to comment on the discrepancy but added that from now on "we are going to be using the new name in all our updates".

(Editing by Philippa Fletcher)

Pfizer, the largest drugmaker, sold Zoetis shares in an initial public offering in February that raised $2.2 billion. Pfizer retained an 80 percent stake in Zoetis after the IPO and now plans to unwind that, starting with this offer.

The offer would allow shareholders to exchange $100 worth of Pfizer stock for $107.52 worth of Zoetis stock.

Pfizer said the offer is expected to add to its earnings starting in 2014.

Zoetis shares were priced at $26 in the IPO and closed their first day of trading at $31.01. On Tuesday they finished at $33.04.

Pfizer owns 400,985,000 shares of Zoetis Class B common stock that it will convert to Class A shares for the exchange.

Pfizer shares were trading at $29.45 in premarket activity, up from a Tuesday close at $28.78.

(Reporting by Caroline Humer; Editing by Gerald E. McCormick and John Wallace)

The pharmaceutical company’s Discovery Fast Track program is designed to identify and collaborate with academic researchers developing novel therapeutics and help advance their work.

Applicants submit a therapeutic hypothesis and target information and the status of the biological screen. Judging criteria for the submissions, according to the contest website, includes:

• Strength of the therapeutic hypothesis
• The degree of originality of the work presented
• Level of completeness of the target/screening assay
• Potential impact or benefit of the target to medicine (unmet medical need)
• Investigator’s and institution’s capabilities to support entry into the Discovery Fast Track Competition and for joint execution of a DPAc project

In August 2013, an expert panel of judges will select up to 20 finalists, who will then submit an expanded application including confidential supporting data and present their proposal to GSK. Winners will be selected in October 2013.

Those academic researchers who are chosen will get access to some of the vast resources of the big pharma business, such as high throughput screening. That means that they can test millions of pure compounds (1.8 million to be exact) using a diverse set of technologies in biochemical and cellular assays of different complexity. It also has proprietary software for validation.

The deadline for submissions is July 19. Applicants can apply here.

Winning researchers will partner with investigators on GSK’s Discovery Partnerships with Academia team to develop viable, research-stage drug candidates into innovative medicines, according to a company statement. The three year old Discovery Partnerships program got its start in the UK and to date has led GSK to initiate nine collaborations, including two in the U.S. — one with Vanderbilt University to deveop a group of drugs to treat severe obesity and the other with the Fred Hutchinson Cancer Research Center to develop muscular dystrophy therapeutics.

Other drug developers have used innovation challenges to crowdsource ways to improve chronic conditions and help solve painpoints in healthcare like Sanofi with its Data Design Diabetes challenge and Janssen’s Connected Care challenge.

And technology has certainly gotten us far. So far, that nowadays we can use our own smartphones to check whether there are specialized restaurants in the area that serve the type of food that we might need (if we’re suffering from some particular disease or intolerance), what kind of foods we should evade if we or our children have allergies. Apps that help us deal with the challenges which diabetes presents and even apps that consult us what to do if we’re suffering from cardiovascular complications. Here are a number of these, in each of the above category, that you can use to prevent or cope with already existing complaints.

Find Me Gluten-Free

Find Me Gluten-Free  connects customers with gluten-free restaurants and other eating places. According to statistics, 1 in 133 people suffers from Celiac disease, an autoimmune disorder of the small intestine caused by a reaction to gliadin. The app is meant to both raise awareness and help educate people, as well as make it easier for people to eat out, without having to worry about what they will be eating. (iPhone and Android compatible)

Is That Gluten Free?

Is That Gluten Free   is another useful tool for managing one’s gluten-intolerance. Apart from also providing information about food chains, it features a large database of gluten-free menu items and ingredients which are safe to be consumed. These are sorted by category, brand or product name. It also provides users with advice on how to make their menu gluten-free. (iPhone compatible)

Cook IT Allergy Free

Cook IT Allergy Free  is quite useful for anyone who suffers from some form of allergy. It contains all major food allergen categories, such as gluten, dairy, nuts and eggs. If any of the recipes you want to cook feature a product which you are allergic to, the app can offer suggestions for an allergen safe substitution option. It also includes over 200 recipes, all of which have beautiful images attached to them. (iPhone compatible)

Foodditive

Foodditive  offers a comprehensive look at E-numbered food additives that are present in more or less all of the foods we buy at the supermarket. It is directed at people who are sensitive or allergic to one substance or another but may lack information about which foods feature such an additive. It permits for additives to be marked in different ways, so as to distinguish whether they are ok to be consumed or are to be avoided. (iPhone compatible)

dLife Diabetes Companion

dLife Diabetes Companion  is one of the best apps around, designed to help people understand and learn to live with diabetes. It features a huge database of information, answers to questions by experts, recipe and food lists. Users are also able to keep track of their blood sugar levels as well as watch educational videos from by dLifeTV. (iPhone compatible)

Glucose Buddy

Glucose Buddy  is another great tool which diabetics can use when monitoring how their blood sugar levels are doing and how they are generally coping with the illness. The app is meant mostly as a data storage utility where one can log one’s glucose numbers, food intake, insulin dosage, etc. The app can display data in graphs and also has an a1c (hemoglobin) calculator. (iPhone compatible)

Lose It!

Though  Lose It!  is not specifically designed as an app to prevent cardiovascular disease it actually does just that. The app helps users keep track of calories (a calory budget) and exercise in order for them to achieve weight-loss in an easy and balanced way. Obesity being one of the main reasons for cardiovascular complications, the app is very suitable for people who wish to avoid heart disease by simply losing the surplus pounds. (iPhone compatible)

iEat For Life: Heart Disease

iEat For Life, devised by Nutritionist Approved Inc, provides a long list of foods which are advisable in the prevention or treatment of heart disease. It features detailed information about each food and in what way it is beneficial for cardiovascular conditions. It also contains information on how to prepare foods, as well as which foods are to be avoided. Very good resource! (iPhone compatible)

Make sure to check out these apps if you’re suffering from or wanting to prevent any of the above diseases. These apps are sure to provide you with good advice and are generally meant to help you on your way to a healthy lifestyle without undue complexity.

Author:  Bianca Banova,  writing for  AIMS Education  and  Culinary Depot

LONDON, May 22 (Reuters) - The U.S. government has signed an antibiotics development deal worth up to $200 million with GlaxoSmithKline to tackle the dual threats of drug resistance and bioterrorism.

The collaboration, the first of its kind between Washington and a drug company, will allow funding to move around GSK's antibiotics portfolio rather than focusing on a single drug candidate.

The rise of antibiotic resistance is causing alarm among governments worldwide, leading to warnings from officials such as England's chief medical officer Sally Davies that the issue is a "ticking time bomb" threatening public health.

Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention, recently called for an urgent fight-back against "nightmare bacteria".

The collaboration between GSK and the Biomedical Advanced Research and Development Authority (BARDA), part of the U.S. Department of Health and Human Services, will study potential new drugs to treat conventional pathogens and those that might be developed as bioterrorism weapons.

Britain's biggest drugmaker said on Wednesday it would receive $40 million for an initial 18 months and up to a total of $200 million if the agreement is renewed over five years.

The problem of antibiotic resistance and the rise of so-called "superbugs" that cannot be treated with traditional medicines has been growing for years, but drug companies have been reluctant to invest in new medicines because of poor returns.

Patients tend to take antibiotics for only a short period, prices are traditionally low and any new antibiotics are likely to be reserved for serious infections - once again minimising the sales opportunity.

David Payne, head of GSK's antibacterial discovery unit, said public-private partnerships, like the one with BARDA, were a key part to solving the problem.

GSK is one of relatively few large pharmaceutical companies still pursuing research into new antibiotics.

LONDON, May 22 (Reuters) - A new wave of medicines that tap the power of the immune system to fight cancer could become the biggest drug class in history, with potential sales of $35 billion a year.

That bullish sales forecast by analysts at U.S. bank Citigroup highlights the growing excitement surrounding so-called immunotherapy after positive results from clinical trials conducted by companies such as Bristol-Myers Squibb and Roche Holding.

"We believe this market will generate sales of up to $35 billion (a year) over the next 10 years and be used in some way in the management of up to 60 percent of all cancers," Citi analyst Andrew Baum said on Wednesday.

Citi's forecast is considerably higher than current market consensus, but if it proves correct, then cancer immunotherapy would exceed the peak market value of top blockbuster drug classes such as statins for high cholesterol.

After years of puzzling over how to get the body's immune system to respond more effectively against tumour cells, scientists are now finding a number of promising avenues.

The new drugs are designed to target areas that act as brakes on the immune system. By interfering with these brakes, the drugs free the immune system to attack and kill cancer cells.

Bristol-Myers Squibb's nivolumab and Roche's MPDL3280A are two leading contenders in the field. Both had an impressive effect against a variety of cancers, according to preliminary trial results released last week.

Further details of the studies will be presented at a meeting of the American Society of Clinical Oncology in Chicago early next month.

MANAGEABLE CANCER

Conventional chemotherapy and other cancer drugs often have a powerful effect in shrinking tumours, but the effect is typically short-lived. The effect of immunotherapy can last much longer because the immune system has effectively been reset to remember how to keep fighting cancer cells.

Citigroup said that immunotherapy has the potential to transform a significant percentage of cancers into something akin to a chronic disease, in a similar way to how HIV drugs have made the viral disease a manageable condition.

On the back of its upbeat prediction for the immunotherapy market, Citigroup has upgraded shares in Bristol-Myers Squibb and Roche to "buy" from "neutral".

Roche stock was trading 1.7 percent higher by 0914 GMT, outperforming a flat European drugs sector.

Other leading players with a range of drugs, vaccines and cell therapy treatments in the cancer immunotherapy field include GlaxoSmithKline, AstraZeneca, Novartis , Merck & Co and Amgen.

In addition to the progress being made in research, analysts believe that the immunotherapy field could also benefit from a new U.S. Food and Drug Administration initiative to speed approval of important and innovative drugs.

The U.S. watchdog recently started a scheme to allow quicker studies of life-saving therapies designated as a "breakthrough", provided that clinical data is compelling. (Editing by David Goodman)

That what’s-next approach drives MedCity ENGAGE, MedCityNews.com’s executive summit on patient engagement and healthcare delivery on June 5-6 in Washington, D.C. We’re just a few weeks away from the event. Nearly 300 leaders from the federal government, health systems, insurance companies and other sectors are already registered to join us.

I want to make sure you get the chance to be a part of the event too. Here’s why you should come.

ENGAGE will have constant #realtalk conversations on everything from using data and managing accountable care organizations to implementing gamification and adopting a retail approach to healthcare.

The agenda will be set by the likes of Mayo Clinic, members of Congress, Walgreens, Pfizer, Health and Human Services, UnitedHealth, Humana, Partners HealthCare, Angie’s List, the U.S. Department of Veteran’s Affairs, Cleveland Clinic and beyond. Those established groups will be coupled by fresh voices — whether they are consumers or new thinkers within the medical industry — who have been regularly working to empower underserved patients; create new, tech-driven solutions to help foster patient engagement; or make policy mandates work at the grassroots level.

Plus, nearly two dozen innovative companies will be part of an Innovation Showcase full of unique solutions to create better patient engagement.

Those who come will be actively joining the discussion. Your ideas will be recorded so we can continue the conversation about what should be done around patient engagement. ENGAGE attendees will take part in an on-site poll answering key questions around patient engagement. Meanwhile, a video booth will capture attendees’ points of view on what’s working and needs to be done to better engage patients.

All those thoughts — along with other aspects of the conference — will be shared and kept on MedCityNews.com to embolden the rest of the healthcare industry.

It’s not too late to take part. Buy your tickets and join in a chorus of those dedicated to acting now to improve healthcare.

Florida's hospitals, like those across the rest of the nation, have received their spring report cards and more than a third earned an A, according to a nonprofit organization that advocates for safer health-care delivery.

In the Sunshine State, 37 percent of all hospitals scored an A, allowing Florida to retain its 10th-place ranking among states. Florida also ranked 10th when the last report from The Leapfrog Group was issued in November.

Locally, Orlando Regional Medical Center earned its second consecutive A, while Florida Hospital Orlando maintained its B, according to Leapfrog.

In addition to ORMC, other Orlando Health hospitals earning A grades were Dr. P. Phillips Hospital, in Orlando; Health Central, in Ocoee; and Orlando Regional South Seminole Hospital, in Longwood.

"We are extremely proud of our performance," said Dr. Thomas Kelley, chief quality officer for South Seminole Hospital. "It did not happen by chance, but as a result of a great deal of thoughtful energy, and great teamwork at every level of the organization."

Each of the four Orlando Health hospitals that earned A's on this report card had received C's on Leapfrog's first state-by-state hospital-safety report, which came out last June.

Since then, the hospitals have developed teams of doctors and nurses focusing on quality, safety and enlisting patients' families for help.

Florida Hospital DeLand and Florida Hospital Waterman in Tavares moved up from B's to A's and joined Florida Hospital Memorial Medical Center in Daytona Beach, which maintained its A from November.

In addition to Florida Hospital's main campus in Orlando, its sister hospitals in Altamonte, Apopka, Celebration, east Orlando, Kissimmee and Winter Park all kept their B's.

"Florida Hospital considers the safety of our patients to be our No. 1 priority, and our team is working diligently and is committed to providing the highest quality of care," said hospital spokeswoman Samantha O'Lenick.

"We appreciate the attention Leapfrog brings to these issues. We are working on a range of initiatives to increase safety and efficiency within our health-care processes," she said.

Leapfrog awarded Hospital Safety Scores of A, B, C, D or F grades to 2,514 general hospitals in the nation. It does not score children's or specialty hospitals. Grades reflect how well a hospital keeps patients safe from infections, injuries, medical errors and medication mix-ups.

Sixteen hospitals received F's, including one hospital in Florida: Wuestoff Medical Center, in Melbourne. Fourteen Florida hospitals got D grades, but none in Central Florida.

The state with the most grade-A hospitals was Maine, where 80 percent of the hospitals earned the top score. New Mexico had the fewest A hospitals, with only 6.7 percent earning the top score there.

To come up with the grades, health analysts looked at 26 measures of publicly available hospital-safety data and hospital-provided surveys.

About half of the measures were based on health outcomes, including facts such as how many patients died after surgery from preventable complications and how often foreign objects, such as surgical instruments, were left inside patients.

The other measures include procedures that hospitals have in place to prevent health mishaps. Such scores consider hand-washing processes and how well health workers pass along patients' medication information as they transition from one care level to the next, such as from home to hospital.

One in four patients admitted to a U.S. hospital suffers some kind of harm, said Leapfrog President Leah Binder.

The rankings "serve as a reminder that we are on an ongoing journey," Binder said. "Patient safety shouldn't be merely a concern; it should be a priority."

Despite several A's, Orlando Health hospitals are still working to improve, say administrators.

Last March, South Seminole Hospital began displaying its performance record on large video screens in patient-care areas around the hospital.

The digital monitors show the number of patients who have acquired blood infections, blood clots and urinary infections, as well as how many fell and got hurt or developed bed sores. The screens include ways family members and visitors can help.

"Some thought this would scare visitors, but it engages them," said Kelley. "This way they can be aware and can be part of the care team."

Consumers can find out how hospitals scored and see more details at hospitalsafetyscore.org.

mjameson@tribune.com or 407-420-5158

Hospitals' new grades

Here are the grades Central Florida hospitals earned this May compared with their scores last November. Health analysts for The Leapfrog Group based the grades on 26 variables, including rates of infections, medication mix-ups, acquired injuries (such as bedsores) and other sources of harm that can be fatal.

Hospital New / Old

Bert Fish Medical Center, New Smyrna Beach; C; C

Central Florida Regional Hospital, Sanford; C; C

Dr. P. Phillips Hospital, Orlando; A; A

Florida Hospital, Orlando; B; B

Florida Hospital Altamonte; B; B

Florida Hospital Apopka; B; B

Florida Hospital Celebration Health; B; B

Florida Hospital DeLand; A; B

Florida Hospital East Orlando; B; B

Florida Hospital Kissimmee; B; B

Florida Hospital Memorial Medical Center, Daytona Beach; A; A

Florida Hospital Waterman, Tavares; A; B

Halifax Medical Center, Daytona Beach; B; B

Health Central, Ocoee; A; A

Leesburg Regional Medical Center; C; C

Orlando Regional Medical Center; A; A

Orlando Regional South Seminole Hospital, Longwood; A; A

Osceola Regional Medical Center, Kissimmee; C; B

St. Cloud Regional Medical Center; B; B

The Villages Regional Hospital; B; B

Winter Park Memorial Hospital; B; B ___

(Reuters) - Merck & Co Inc said it has entered into a $5 billion share repurchase agreement with Goldman Sachs Group Inc, as the drug giant looks to prop up shareholder value in face of stiff competition from makers of less-costly generics.

Under the accelerated share repurchase agreement (ASR), Merck has agreed to repurchase about 99.5 million shares from Goldman Sachs based on current market prices.

"We don't have consensus share count post-Q1 earnings to quantify the impact of the accelerated repurchase, but we believe this is a positive sign of Merck attempting to create shareholder value," ISI Group analyst Mark Schoenebaum said in a note to clients.

Merck's board had authorized additional purchases of up to $15 billion of its common stock and said that it would buy back about $7.5 billion over the next 12 months.

Sales of Merck's asthma drug Singulair plunged 75 percent to $337 million in the first quarter. The pill was Merck's biggest product, with annual sales of $6 billion, before cheaper generics flooded the U.S. market last August.

More pain from generics is in store. Merck's Maxalt migraine drug recently lost patent protection and its Temodar brain cancer medicine will soon face cheaper copycats.

Merck aims to seek marketing approval this year for a handful of new drugs, including a sleep aid called suvorexant now before U.S. regulators. It is counting on these products to help offset plunging sales of Singulair, Maxalt and Temodar.

(Reporting by Sakthi Prasad in Bangalore; Editing by Chris Gallagher)

SAN FRANCISCO — Representatives from AARP and Geisinger Health System make no pretensions: They’re not into technology just because it’s cool.

While the 50+ population and doctors appear to be dissimilar markets, selling to either requires a deep understanding of customer needs rather than just a sense of having “the next big thing.”

If you’re a startup targeting either market, you need to wise up.

Here are a couple pointers from AARP and Geisinger, gleaned from a panel discussion at HealthBeat today.

How can entrepreneurs sell into a health system?

Geisinger Health System serves over 3 million people and is a premier case study in how to deliver effective care. Chanin Wendling leads their eHealth initiatives and gets so many calls each week from entrepreneurs that, she says, her “head is spinning.”

“Everyone has a cool new idea but no one has tested it,” Wendling says.

For startups that want to work with Geisinger, Wendling first wants to see a solid clinical business case where the technology solves a tangible problem faced by patients or physicians.

Once approved, her team will pilot the technology, sometimes three or four different ways, to figure out the right approach to product launch.

The technology must also integrate with their online medical records, and Wendling anticipates that the system will implement a data integration layer to facilitate more seamless deployment of technology in the future.

Understanding the 50+ market

The 100 million people who comprise the digital health market for 50+ is worth about $20 billion. Nice market, if you can get it.

Jody Holtzmann, a senior vice president at AARP, advocates that startups embrace the idea of “connected living,” which includes maintaining relationships with family, preserving autonomy, and enjoying life, rather than just connected health (focused on health maintenance.)

For the aging, adopting products in order to live life on their own terms is more appealing than using technology to assist with medication adherence. For example, the physical fitness market for 50+ is projected to reach $1.8 billion over the next five years.

But for now, Holtzmann asserts that the “quantified self” movement doesn’t reasonate with his target population: “You’re a fanatic and wearing a self-tracking device is a way to let everyone know what a fanatic you are,” he says.

Instead, he advocates that startups approach this group in a way that’s engaging, inviting, and, most importantly, fun.

Photo: Meghan Kelly, VentureBeat, moderator of the session. Photo credit: Michael O’Donnell/VentureBeat

This article originally appeared on VentureBeat

Commissioned by the Emergency Medicine Action Fund, the new analysis proposes that emergency physicians serve as the major decision makers for nearly half of all hospital admissions in the U.S. And when the average cost of a hospital stay is 10 times that of an ER visit, that puts those departments in the hot seat for deciding which patients need to be admitted and which can be cared for in other settings.

Office-based physicians are relying more on emergency departments too. Using public-access data from five nationally representative surveys, RAND researchers determined that the growth in inpatient hospital admissions between 2003 and 2009 was attributed to a 17 percent rise in unscheduled hospital admissions from emergency departments. On the other hand, admissions from referrals by an office-based physician dropped 10 percent and suggests that physicians are directing more patients to the emergency department instead of directly to the hospital.

“Whereas policymakers and third-party payers have largely focused on the cost of ED care relative to treatment in other outpatient settings, the role of EDs in either facilitating or preventing hospital admissions may be a bigger story,” the authors wrote.

So charging higher co-pays or turning away patients from the emergency department probably isn’t the best way to drive down costs. “Efforts to reduce non-urgent and non-emergency use of emergency departments oversimplify a complex problem, and should instead focus on increasing access to affordable options outside the emergency room,” said Dr. Andy Sama, president of the American College of Emergency Physicians, in a statement.

Other stakeholders seem to be catching on to that too. St. Luke’s Hospital in Iowa used a $50,000 grant from Transamerica to launch a popular Emergency Department Consistent Care Program that helps connect frequent ER visitors with primary care providers and coordinate visits with other health professionals. After one year, people who visited the ER 12 or more times in a year reduced their ER visits more than 60 percent.

Many payers take similar strategies. Optum Health, for example, has a decision support solution that engages with patients after every emergency room visit to reinforce the primary care provider relationship, educate ER users on alternatives and refer them to health management programs.

“Policymakers, third-party payers, and the public should be aware of the various ways EDs meet the healthcare needs of the communities they serve and support the efforts of ED providers to more effectively integrate ED operations into both inpatient and outpatient care,” the authors concluded.

NEW YORK (Reuters Health) - A new study has confirmed that removing the tonsils and adenoids of children with obstructive sleep apnea can reduce sleepiness and improve the quality of life, but putting off the surgery might not hurt either.

The study is the first controlled test to compare the operation with so-called watchful waiting as a strategy for stopping childhood obstructive sleep apnea syndrome, where the structures in the back of the mouth can temporarily block breathing during sleep.

The findings, released May 21 at an American Thoracic Society International Conference in Philadelphia, and appearing online in the New England Journal of Medicine, found that after seven months, surgery improved many gauges of everyday living.

"Improvements in emotional regulation, attention, organizational skills, reduced sleepiness, improved quality of life including socialization and physical and emotional wellbeing were quite large, larger than we anticipated," coauthor Dr. Susan Redline of Brigham and Women's Hospital in Boston told Reuters Health.

Yet when the children were formally tested, youngsters in both groups performed equally well, an indication that the sleep disturbance wasn't causing any measurable cognitive problems.

"Where you objectively measure these cognitive tasks, children can do fairly well in that motivated and structured environment" whether or not they have surgery, she said. "It shows that over a 7-month period of watchful waiting, cognition does not decline."

Nearly half the children who did not have the operation improved on their own, Redline said.

About 500,000 such operations are done in the U.S. each year, mostly to help children with apnea. It's the second most common pediatric surgical procedure after tubes in the ears, and costs about $2,850, according to the Healthcare Blue Book.

Redline and her colleagues took 464 children age 5 to 9 and randomly assigned them to surgery or observation at seven academic sleep centers. Nearly half were overweight or obese. The children with the most severe apnea were excluded.

Children with the surgery showed a large improvement on ratings of things such as impulsiveness, emotional control and quality of sleep that were assessed by parents and teachers.

"It really was across-the-board improvement in everyday life" for surgery patients, Redline said.

On the other hand, "almost half the children improved spontaneously over the 7-month period without surgery," she said.

Growth of the airway, a regression of the tissue blocking the airway at night, or routine medical care may have been some of the reasons, the researchers said.

Nonetheless, six of the 203 children in the watchful waiting group had an exacerbation of their symptoms. There was no worsening among the children who got surgery.

Three percent of the children who had surgery had some type of complication related to the surgery, but none was associated with death or disability.

The results also varied by weight, and the surgery was less effective among black children. The reason is unclear, the authors write.

SOURCE: http://bit.ly/165LeNT New England Journal of Medicine, online May 21, 2013.

CareCloud, which creates a fully-online management app for health care practices, surveyed over 5,000 doctors who say they are worried about their income in the next year.

“In the early 90s I saw healthcare for the first time and I was just blown away by how screwed up it was,” said chief executive Albert Santolo at VentureBeat’s HealthBeat conference today.

Despite attempts to modernize today’s practices in how they keep data and report revenue, the health care industry seems to be just as screwed up as it was 20 years ago, according to the survey, which CareCloud calls the Practice Profitability Index.

“You think about it very differently than you would 15 years ago in the early days of the web,” said Santolo. But, he said, “when you look at these systems, they date that far back.”

CareCloud is a platform-as-a-service (PaaS) that doctors can use to manage their finances. It also has a social layer to communicate with patients, as well as its own form of electronic health records (EHR). Indeed, it seems these EHRs are on of the main issues that make doctors worry about their profitability.

Santolo explained that EHRs are currently slowing doctors down, and he admitted that even CareCloud is a part of that problem. He predicts that 20 to 25 percent of doctors will be back in the market for better solutions surrounding EHRs.

There’s a lot of opportunity there, of course, for businesses to take up the challenge. (For instance, Practice Fusion has made great headway offering a free EHR now used by 150,000 doctors.)

CareCloud isn’t ignoring the issue and says it will release a new user interface for its EHRs next month.

Other than coding and documenting changes, doctors are also concerned about declining reimbursements, rising costs, and Affordable Care Act requirements, according to the survey. Nearly 50 percent of doctors are worried about using all this new technology to handle the flood of new patients that the ACA will bring to them.

“Doctors still care very much about their future, economics of their business, and what healthcare reform is imposing on them,” said Santolo. “They feel ill-equipped to handle the influx of 30 million new patients.”

This article originally appeared on VentureBeat