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6 posts from October 2009

10/29/2009

Ethics in Computing

Ethics in Computing. During a class discussion in our Information Technology (CS-250) course at The University of the Sciences in Philadelphia we were examining the ethics of computing. History has shown us that the use of technology can be for good or for bad intentions. For example, nuclear technology provides us with medical therapies and clean energy but has also been used as a weapon of war. The automobile has provided society with an easily accessible travel vehicle but also results in many deaths each year and degrades the environment. Computers and the Internet have had profound impacts on society.  Many positive changes to business, entertainment, and social networking have been due to computer technology.  But there are also negative aspects to the computer revolution. As a professional computer scientist or computer engineer, you should help advance the field of study by adhering to a set of ethical standards that illustrate the positive aspects of modern computer technology.  Computer scientists need to be at the forefront of identifying unethical uses of computer technology. We came up with the following list of intentional unethical uses of computers. Can you identify any others?

1. Hacking

2. Spam

3. Phishing

4. Pirating 

5. Stealing Data

6. Identity Theft

7. Cyber Bullying

8. Spreading Viruses

9. Cyber Snooping

10. Online Gambling

11. Online Illegal Solicitation

12. Cyber Squatting 

10/16/2009

The Senate Bill: Access But What About Costs and Quality?

An expert commentary from Richard G. Stefanacci, DO, MGH, MBA, AGSF, CMD

 

Under the recently passed Senate Finance Committee, access for health insurance would be advanced for both the insured and uninsured. Of course, this bill still has a long way to go before being signed into law. While the Senate bill focuses on access it pays, much less attention on cost and quality improvement.

 

For the insured there is the promise of more security and stability through:
• regulations against denial of coverage because of a pre-existing condition
• elimination of arbitrary caps on the amount of coverage over ones lifetime
• limits on out-of-pocket expenses
• required to cover, with no extra charge for routine checkups and preventive care

 

For the some 36 million uninsured Americans there is a requirement to obtain insurance, and they will be aided by insurance available through a Consumer Operated and Oriented Plan or CO-OP. These CO-OPs will be non-profit, member-run health insurance companies in all 50 states and District of Columbia that is different in scope and oversight from the government run national public option being proposed by the House. This CO-OP will be available with other plans through state-based exchanges.

 

To further assist the uninsured gain coverage, tax subsidies will be made available to individuals and small businesses and penalties will be levied against those forgoing this mandate. The penalty will be phased-in according to the following schedule: $0 in 2013; $200 in 2014; $400 in 2015; $600 in 2016; and $750 in 2017. It’s not clear whether or not these penalties will be sufficient to force healthy individuals into the insurance pool.

 

COSTS
Costs are consider in the Senate bill although it is not clear how these provisions would change the slope of the climbing cost curve. Instead these cost reductions are mostly one time events more focused on funding the access expansion. These cost provisions focus on:

  • Fraud & Abuse
  • CMS Innovation Center
  • Medicare Cuts ($404B)
  • Excise tax on high cost insurance plans ($201B)
  • Malpractice Reform ($54B)
  • Administrative simplification
  • Medicare Prescription Drug Coverage

In actuality, the main reason that the Senate bill was so significantly below the $1 trillion is that unlike the House bill which includes some $228 billion to solve the longstanding problem of Medicare physician reimbursement, the Senate bill choose not to address this issue. The House bill assumes that Congress will continue preventing the provider cuts which have been set to go into affect for the last several years but instead been simply postponed in favor of slight reimbursement increases. As a result, the 22 percent reduction set for 2010 has once again been postponed.

 

QUALITY
Quality is also included in the bill with some continued focus on value based purchasing and bundling of payments to provide incentive for efficient and effective care. There is also creation of new delivery groups under the title of Accountable Care Organizations (ACO). These are similar to the PHOs (Physician Hospital Organizations) of years ago that were supposed to deliver better care without the administrative overhead of a traditional managed care organization.

 

The concern is that this bill misses the opportunity to decrease health care costs. Instead, it may actually accelerate costs through the significant increase of coverage. Real cost reduction can only come from promotion of a healthier population cared through a system delivering PCP dominion patient centered coordinated care.

 

If we do not achieve significant cost reductions now, we will in the future have costs reduced through rationing both on demand and supply side of health care delivery. On the demand side, the rationing will be forced meaning that patients will see a decrease in available benefits. On the supply side, if the significant provider reimbursement reductions eventually go through such many will likely opt out of the insurance system, the result of this large decrease in providers will be a forced rationing because patients will be unable to find the help they need.

 

This scenario can only be averted if health care reform is comprehensive covering not only access but cost and quality improvements.


 

Dr. Richard G. Stefanacci is the executive director of the Institute for Geriatric Studies at Mayes College of Healthcare Business & Policy at University of the Sciences in Philadelphia.

10/08/2009

The Dark Side of the Universe

When we look up in the sky at night we see stars and other forms of visible matter.  Yet, as astronomers have discovered, more than 95% of the substance of the universe doesn't shine at all.  The invisible majority of the cosmos is made up of two mysterious entities, dubbed dark matter and dark energy.

On Thursday, October 22, from 1 PM to 2PM in Griffith Hall, Room C, the University of the Sciences Physics Program and The Harlow Shapley Visiting Lectureship Program of the American Astronomical Society are pleased to host:

Michael Turner
University of Chicago

An internationally recognized expert on cosmology (the science of the universe), Prof. Turner coined the phrase “dark energy” to describe the unknown force accelerating the universe. He is also a pioneer  in attempts to unravel the mystery of dark matter.

His lecture, "The Dark Side of the Universe:  Beyond Stars and the Starstuff We Are Made Of," will be free and open to the public.  The talk will be followed by a reception.  We greatly look forward to Prof. Turner's visit!


10/06/2009

H1N1 Flu – Understanding Your Treatment Options

- An Expert Commentary from University of the Sciences in Philadelphia -

By Daniel A. Hussar, PhD

While Americans wait for the H1N1 influenza vaccine, it’s important to know and understand the options for treatment for those who have been diagnosed and are ill.

Two antiviral medications, oseltamivir (Tamiflu) and zanamivir (Relenza) are active against the H1N1 strain of virus and can be used to treat those who have been diagnosed with (or are strongly suspected of having) this infection.  It is important that the use of these medications is started as soon as possible (within 48 hours of the onset of symptoms) if they are to be effective. When used for treating infection, these medications are usually administered twice a day for five days.

They do not immediately relieve symptoms, but may shorten the duration of symptoms by approximately one day, on average.

There has been some recent publicity that the intravenous administration of a single dose of another antiviral agent has been highly effective in treating H1N1 flu.  However, this drug is still being evaluated and is not commercially available.

·    Tamiflu is available in capsules and in a liquid formulation that are given by mouth and swallowed. It has been studied and approved for use in adults and children at least one year of age. Some patients experience nausea and vomiting, and there have been rare reports of neurologic/psychiatric adverse events (e.g., delirium) although it has not been proven that the drug was responsible for these effects. 

·    Relenza is administered by oral inhalation and its use in the treatment of influenza has been studied and approved in patients 7 years of age and older. It is generally recommended that Relenza not be used in patients with asthma, chronic obstructive pulmonary disease (COPD), or other conditions that may be associated with bronchospasm.

Individuals who experience symptoms such as sneezing, nasal congestion, or coughing that may be associated with the flu should speak with a pharmacist, physician, or other health professional. It may be that these symptoms are not due to a flu infection, but rather have developed because of an allergy or common cold, and can be effectively treated with a nonprescription product.


Daniel A. Hussar is the Remington Professor of Pharmacy at the Philadelphia College of Pharmacy at the University of the Sciences in Philadelphia. He serves as the author and editor of the Pharmacist Activist Newsletter (http://www.pharmacistactivist.com).  

10/02/2009

Commentary on the Healthcare Debate

Dr. Richard Stefanacci has provided his expert opinions to WHYY in relation to various elements of the healthcare debate.

 

Listen: 

Congress considers health insurance cooperatives

WHYY – Sept. 29

WHYY’s Taunya English spoke with Dr. Richard Stefanacci about the debate over health insurance cooperatives. Listen to the report here.

Paying docs to save costs
WHYY – Sept. 22
WHYY’s Kerry Grens spoke with Dr. Richard Stefanacci about several hospitals in New Jersey that are currently testing a program to save money by rewarding doctors for efficient care. To listen to the segment, click here.

October is Eat Better, Eat Healthier Month!

One way to eat healthier is to be prepared.  Pack a healthy lunch instead of relying on fast food.  Pack some healthy snacks instead of hitting the vending machine. A little thought and preparation goes along way to eating healthier AND saving some money!  Plan a week’s worth of healthy meals on Sunday.

Monday:       PB & J on whole wheat bread; banana; 8 ounces of skim milk

Tuesday:       Turkey, lettuce & tomato with fat free honey mustard on a small whole wheat tortilla; single container of sugar free Pomegranate applesauce; 20 small pretzels; Water with Crystal Light

Wednesday: Small whole wheat pita with lettuce & grilled chicken with light Caesar dressing; baby carrots; small apple, water with lemon

Thursday:        Canned salmon with fat free mayo and celery on small whole grain roll; 20 baked chips, orange, and small glass of milk

Friday:             Green salad loaded with canned chunk light tuna, carrot strips, pepper slices, tomato wedges, red beans, and dried cranberries. Balsamic vinaigrette on the side; cup of low fat chocolate milk.

Need something sweet after lunch? Try chewing a piece of sugarless fruit or mint flavored gum! Or better yet…just BRUSH YOUR TEETH! The smooth minty taste of the toothpaste is refreshing, gives you fresh breath and will stop you from nibbling.

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