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Study objective: To measure the effect of an altered process of care, directed by a computerized reminder system, on rates of symptomatic postoperative venous thromboembolism.

Design: Comparisons of preintervention and postintervention measurements.

Setting: A university-affiliated community hospital in Utah.

Patients: Two-thousand seventy-seven consecutive patients who underwent major operations in four surgical divisions between January 1, 1997, and October 31, 1997 (preintervention), and 2,093 consecutive patients who underwent the same procedures between January 1, 1998, and October 31,1998 (postintervention).

Intervention: A program to prevent venous thromboembolism developed from American College of Chest Physicians guidelines, and an altered work process directed by a computerized reminder system.

Measurements: Rates of symptomatic, objectively confirmed deep vein thrombosis (DVT), pulmonary embolism (PE), and death attributable to venous thromboembolism occurring within 90 days of the date of surgery.

Results: The preintervention and postintervention cohorts did not differ with respect to age, severity of illness, number of risk factors for venous thromboembolism, or individual risk factors for venous thromboembolism. The overall prophylaxis rate increased from 89.9% before implementation of the computerized reminder system to 95.0% after implementation (p <>

Conclusions: Computerized reminder systems combined with altered care procedures increase the rate of prophylaxis against venous thromboembolism without decreasing the rate of symptomatic venous thromboembolism when the baseline rate of prophylaxis is high. A population of surgical patients exists who are resistant to American College of Chest Physicians-recommended prophylactic measures against venous thromboembolism. New strategies are needed to address prophylaxis-resistant venous thromboembolism.

Key words: computer reminders; deep vein thrombosis; prevention; prophylaxis; pulmonary, embolism

Abbreviations: DVT deep vein thrombosis; EDW = Enterprise Data Warehouse; HELP = Health Evaluation Through Logical Processing; PE = pulmonary embolism

Placing patients in isolation provides an effective method of limiting transmission of communicable diseases, a technique that has proven key in staunching the spread of severe acute respiratory syndrome in 2003. But patients often feel cut off from communication and a recent study indicated they also suffer from more adverse events.

"Isolation is, unfortunately, a necessity in hospitals to protect the common good," said Terri Rearick, RN, BS, CIC, administrator of safety services at Children's Memorial Hospital in Chicago. "Make those decisions so the appropriate patients are isolated, they are isolated at the appropriate category of isolation and they are taken out of isolation as soon as appropriate. That makes a difference. It sounds like an easy thing to do, but it's not always so simple."

Clinicians tailor the level of transmission-based precautions to the type of infection and causative organism.

For instance, a methicillin-resistant Staphylococcus aureus (MRSA)-infected wound requires contact precautions, gowns and gloves, but no mask, while a patient with influenza should be placed on droplet precautions. Nurses should wear a mask and eye protection whenever coming within three feet of the patient. Airborne precautions, such as those for tuberculosis, require a private room with negative air pressure and wearing of N95 respirators.

Patients in isolation often feel neglected, lonely and stigmatized. Even the word isolation has a negative connotation for patients, said Lynette Tellefsen, RN, CIC, assistant director of infection control at Florida Hospital in Orlando. The gowns, gloves and masks form a barrier to the traditional sense of healing and touch associated with nursing.

Now a study reported in the Journal of the American Medical Association shows that isolation also might lead to poorer quality of care and adverse events.

The authors of "Safety of Patients Isolated for Jnfection Control" evaluated records of patients with MRSA colonization or infection admitted to two North American general-teaching hospitals and compared their stays with that of patients in the same bed just before or after the study subjects' admission to ensure the two cohorts would receive care from the same team of caregivers, in the same room and at the same time of the year.

Patients in isolation were more likely than controls to have vital signs incompletely recorded, days with no vital signs and days with no nursing or physician progress note in the chart. Isolated patients were twice as likely to experience adverse events. But investigators found no difference in hospital mortality. Patients also expressed more formal and informal complaints about their care, including negative perceptions of treatment, access to staff, communication, humaneness, cleanliness of the environment and billing problems.

Although the time required for gowning up to enter a room and peeling off after delivering care forces nurses to limit trips into and out of isolation rooms, it should not preclude meeting clinical standards. Batching tasks with medication administration saves time, but nurses still need to check on patients regularly, even if it is just a quick "hello" from the door for patients on droplet or contact precautions.

Developing a specific action plan for each patient in isolation helps Florida Hospital ensure nurses follow the same precautions, something patients find important and reassuring.

"It takes a lot of planning. There is a lot that can be done for the person in isolation, but it can't be hit or miss," said Rearick, at Children's Memorial. Rearick suggests, when possible, that nurses time their care around family visits, so professional interactions fill the greatest voids in time. Families can bring books or games from home to provide distractions.

Tellefsen said Florida Hospital's policy Of allowing, patients with MRSA wound infections to go outside, as long as they wash their hands and change into a clean gown and robe before leaving their rooms, has helped patients' ability to cope with the precautions.

Children's Memorial has trained volunteers how to safely use personal protective equipment and allows those proficient at it enter the rooms and interact with patients. While volunteers do not provide nursing care, the visits help patients pass the time. And as a representative from the facility, the volunteer helps show concern for the patient's emotional well being.

Nurses should explain to patients and families the reason for the precautions, how long the patient will need to stay isolated and how to properly apply protective equipment, so they can visit. Renee Patterson, CSP, infection control manager at Ingham Regional Medical Center in Lansing, Michigan, developed fact sheets about MRSA and other infection diseases with details about precautions, which nurses can leave with family members.

Another tip from Tellefsen: Keep gowns and gloves by the door to make it easier for staff to comply with precautions and provide care. Post the type of precautions and what must be worn and remind people about hand washing.

The New York City Department of Health and Mental Hygiene has established a syndromic surveillance system that monitors emergency department visits to detect disease outbreaks early. Routinely collected chief complaint information is transmitted electronically to the health department daily and analyzed for temporal and spatial aberrations. Respiratory, fever, diarrhea, and vomiting are the key syndromes analyzed. Statistically significant aberrations or "signals" are investigated to determine their public health importance. In the first year of operation (November 15, 2001, to November 14, 2002), 2.5 million visits were reported from 39 participating emergency departments, covering an estimated 75% of annual visits. Most signals for the respiratory and fever syndromes (64% and 95%, respectively) occurred during periods of peak influenza A and B activity. Eighty-three percent of the signals for diarrhea and 88% of the signals for vomiting occurred during periods of suspected norovirus and rotavirus transmission.

Two recent phenomena have contributed to widespread interest in monitoring nonspecific health indicator data to detect disease outbreaks early. The first is heightened concern about bioterrorism, particularly the ability of public health agencies to detect a large-scale bioterrorist attack in its early stages. The second is the proliferation of electronic databases in healthcare settings. Initially designed to facilitate billing, health information systems capture an increasingly rich array of clinical detail. Recent advances in information technology make extracting, transmitting, processing, and analyzing these data feasible for public health purposes. The emergency department surveillance system we describe is an early prototype of what may become a standard component of modern public health surveillance.

In New York City, emergency department chief complaint surveillance evolved out of the public health response to the September 11, 2001, World Trade Center attacks (1). When this labor-intensive effort ended, the New York City Department of Health and Mental Hygiene (DOHMH) began intensively recruiting hospitals capable of providing emergency department visit data in electronic formats. We describe the methods and chief results from the first 12 months of experience with this electronic system.

Materials and Methods

Data Transmission and Processing

Data files are transmitted to DOHMH 7 days per week, either as attachments to electronic mail messages or through direct file transfer protocol (FTP). Half of participating hospitals have automated the transmission process. Data processing and analysis are carried out on a laptop computer that can be operated either through the DOHMH local area network or through remote dial-up, which facilitates weekend and holiday analysis. Each morning, an analyst retrieves the files, inspects them for quality and completeness, and saves them for processing and analysis in SAS (version 8, SAS Institute Inc., Cary, NC). If a file is not received by 10:00 a.m., the analyst contacts hospitals to obtain missing data. The analysis is typically completed by 1 p.m.

Data files contain the following information for all emergency department patient visits logged during the previous midnight-to-midnight 24-hour period: date and time of visit, age in years, sex, home zip code, and free-text chief complaint. Additionally, some hospitals provide either a visit or medical record number. No other personal identifiers are included. Files arrive in several formats, most commonly as fixed-column or delimited ASCII text. Data are read and translated into a standard format, concatenated into a single SAS dataset, verified for completeness and accuracy, and appended to a master archive.

Syndrome Coding

Emergency department patient visits are categorized into exclusive syndromes based on the patient's chief complaint, a free-text field that captures the patient's own description of his/her illness. We developed a SAS algorithm that scans the chief complaint field for character strings assigned to a syndrome. The coding algorithm is designed to capture the wide variety of misspellings and abbreviations in the chief complaint field. If the chief complaint was blank or uninformative (e.g., "EVAL," "TRIAGE") the record was omitted. If it contained a word or phrase from a single category it was coded for that syndrome, i.e., "SHORTNESS OF BREATH" or "SOB" appearing alone would indicate the respiratory syndrome. If the chief complaint contained words or phrases from multiple categories, it was coded according to the following hierarchy: common cold > sepsis/dead on arrival > respiratory > diarrhea > fever > rash > asthma > vomiting > other visits. The hierarchy attempts to place each chief complaint into a single, specific syndrome (Table 1). Chief complaints containing text strings such as, "cold," "sneeze," "stuffy," or "nasal" are coded as cold and excluded to increase the specificity of the respiratory category for illnesses other than viral rhinitis. The two syndromes of particular interest for bioterrorism surveillance are the respiratory and fever syndromes in persons [greater than or equal to] 13 years of age. Children are excluded due to their high rates of febrile and respiratory illnesses and to limit the number of false signals generated. Respiratory and fever syndromes in children are examined by graphic and CUSUM analyses with SaTScan performed on an ad hoc basis. We monitor the diarrhea and vomiting syndromes in all ages in an effort to detect gastrointestinal outbreaks that may be due to contamination of food or water.

The March 18, 2004 release of Producer Price Index (PPI) data for January 2004 contained erroneous January index levels for four commodity index series: All commodities, farm products and processed foods and feeds, industrial commodities, and all commodities except farm products. These index series appear in table 3 of the PPI news release and in tables 6 and 8 of the PPI Detailed Report. They also are available on the BLS Web site.

The error in calculating January index levels was made in a step that is unique to these four series. The correct preliminary values for January 2004 are 141.0 for all commodities, 136.4 for farm products and processed foods and feeds, 141.9 for industrial commodities, and 142.6 for all commodities except farm products. The published index values for all series other than the four listed above, and for all months other than January 2004, were not affected.

The original January 2004 index values for the four affected series were removed from the time series database and were not available in the January and February issues of the PPI Detailed Report. In addition, the originally released values for any percent changes involving January 2004 were incorrect for those four series. Those percent change values also were not available.

The Materials Management department at St. Anthony's Health Care, a 395-bed acute care hospital in St. Petersburg, FL, that is part of the BayCare Health System of not-for-profit hospitals, reviewed its automated inventory system in January 2003 with the goal of identifying areas for improvement. Since then it has expanded its use of the system.

Five years ago, St. Anthony's turned to PAR Excellence Systems, a Cincinnati-based manufacturer, to automate the hospital's inventory system. PAR Excellence provides a complete line of products that use a point-of-use data collection system to automatically track supplies and charges to patient accounts. The system supports bar-coding or "iButton" technology. St. Anthony's uses the iButton technology which uses a hand-held, battery-powered probe that can sense an "iButton" used to store supply-chain information. When the probe touches the button, the information is transferred to the probe. When the probe is placed in its storage cradle, that information is downloaded to the hospital's computers in a process that eliminates keyboard entry.

In its review of the system, the Materials Management department began by assessing the storage rooms of different floors and hospital units and studying inventory reports to determine which supplies were being used the most. The department also asked the nursing staff and other departments for their input on how to improve the process. The department immediately found ways to further streamline the process. For example, the department removed the bulky sliding shelves in the supply room for the Intensive Care Unit. Those shelves were replaced with a wall hanging, panel and plastic bin system that give nurses a better view of the supply room. Those improvements freed up enough space to add about 50 different items to the supply room. The department also made sure that storage bins were used to capacity. Doing that eliminated the number of weekly trips to refill those bins. "We reduced the amount of labor it took to replenish the inventory," said Victor Celiberti, St. Anthony's director of materials management.

When Beth Hart, of Princeton's Family Guidance Center Corporation says, "We do a lot of things," it seems like an understatement.

This agency brings together many diverse services. Among them are outpatient mental health and substance abuse treatment, after-school programs for children who are dealing with emotional difficulties, a day school for children with emotional and behavioral problems, a consumer credit counseling service, and family preservation services.

Billing itself as a "non-profit consortium of behavioral health care services," the Family Guidance Center was created in 1993, following the merger of the Community Guidance Center of Mercer County, and the Family Service Association of Trenton/Hopewell Valley, both of which had served the area for many years.

Its professional staff includes teachers, social workers, psychologists, nurses, counselors, and a full-time medical director. Adapting itself to the changing needs of the community it serves, the agency purchased the Lanning School in Ewing as the site for both its Children's Day School and Children's Day Treatment. Almost 150 students ages six through 14 are served by these programs.

Those attending the day school participate in academic and therapeutic programs designed to meet their specific needs. These students may be autistic, or suffer from behavior disorders or multiple handicaps, that have made them unsuccessful within standard classroom settings. The goal is to eventually return them to their local school systems, after their particular problems are addressed, a process that takes on average two to three years. "Local school districts from all over Mercer County are the sending districts, and they pay the tuition," explains Hart, the agency's director of grants and development.

Family Preservation Services provides intensive in-home family education and crisis intervention, noted Hart. A counselor goes into the home for up to six weeks, and tries to maintain its continuity while attempting to avoid placement of the children in foster care or institutional settings.

Problems addressed within this program may involve child abuse and neglect, developmental- disabilities, substance abuse, mental illness, and delinquency.

Mental health and substance abuse are treated under the program called Behavioral Healthcare, which provides mental health and psychiatric care to children and adults through individual, family and group counseling services. There are also psychiatric evaluations and medication for such problems as clinical depression, schizophrenia, and bipolar disorder.

The agency's Consumer Credit Counseling Service recently became HUD certified,

Hart noted. This program's goal is to help individuals and families attain financial self-sufficiency, through the teaching of money management skills, and by encouraging responsible use of credit. Another focus, Hart adds, is offering financial education for first time home buyers.

The Substance Abuse Treatment Services, with locations in Hamilton and Trenton, provides outpatient drug and alcohol treatment for young people and adults. Components include weekly outpatient counseling sessions, an adolescent recovery program, a 16-week drug awareness and education group for DWI offenders, drug testing, and HIV testing services.

The Family Guidance Center, working with the New Jersey Department of Health and Senior Services, developed the Mercer County HIV Consortium, a state and federally funded program serving those suffering from HIV/AIDS.

Through its work with Trenton's Henry J. Austin Health Center, the agency provides behavioral healthcare services at the Austin facility for low income and underinsured clients.

Following 9-11, the Center was chosen by United Way to distribute financial assistance, and provide counseling services to individuals and families affected by the attacks, as well as for victims of the anthrax crisis.

The mission of the Family Guidance Center is to provide every client with high quality services in the areas of mental health, addictions, education, and financial and family counseling, according to their individual needs, and to ensure that these services are delivered in a way that is both fair, and compassionate.

"There are clearly hospitals that manage actual high-cost cases, and they should be properly reimbursed However we also need to be certain that other hospitals are not inappropriately gaming the system. Any hospital billing very high outlier rates better be absolutely sure that they are right, or they are likely to be very sorry."

--CMS administrator Tom Scully announcing new steps CMS is taking to protect Medicare from abusive billing practices by hospitals.

Under Medicare's prospective payment system (PPS), CMS makes outlier payments to hospitals. These outlier payments supplement the standard payment under PPS when the costs of furnishing care to a particular patient are significantly greater than the prospective rate that is established for that patient's DRG. In recent years, hospitals have become eligible for outlier payments when their charges for the services, adjusted to costs, exceed the PPS rate by a specified amount.

Outlier payments generally are based on a hospital's own pricing policies and on the services it furnished to patients. Recently, when CMS discovered that outlier payments exceeded projected budget levels, it initiated an investigation of certain hospital practices that generated significant outlier payments. First, CMS is evaluating whether hospitals that have received high outlier payments have adopted pricing policies that are inconsistent with Medicare requirements. Second, CMS is investigating whether hospitals receiving high outlier payments have provided medically unnecessary services to outlier patients.

Background

Medicare regulations have established several steps to determine whether a hospital is entitled to receive an outlier payment for services it furnishes to a Medicare patient and how much the outlier payment will be (see generally 42 C.F.R. [sections] 412.84).

First, the hospital's charges for the services furnished to the Medicare patient are adjusted to reflect the hospital's own costs of those services. To do this, a hospital generally must use its own ratio of costs to charges (RCC). The hospital's charges, adjusted to costs, are the product of the hospital's charges for the services furnished to the Medicare patient multiplied by the hospital-specific RCC.

The hospital's charges, adjusted to costs, then are compared with an outlier threshold for the patient's DRG. The outlier threshold is an estimate of the minimum costs that a hospital should incur in treating a patient before it is entitled to any supplemental payments for that patient in addition to the fixed rate set under PPS. The outlier threshold is the sum of the PPS rate for the DRG, payments (if any) to the hospital for either graduate medical education programs or for the disproportionate share of low-income patients, and a stop-loss fixed dollar amount.

To calculate the actual outlier payment to a hospital, CMS has adopted a formula to estimate the marginal cost of the care furnished to the patient in excess of the outlier threshold, Specifically Medicare pays the hospital 80 percent of the difference between the hospital's charges, adjusted to costs of the services furnished to the patient, minus the outlier threshold for the patient's DRG.

An important exception to this general formula is that if the hospital's own RCC is significantly more or less than the national RCC, the hospital must use a statewide average RCC for the state in which it is located, rather than its own RCC. The hospital's charges for services furnished to the Medicare patient are multiplied by the statewide RCC to determine the hospital's estimated costs of furnishing care to that patient.

This exception can yield significant advantages for a hospital with an inflated charge schedule. If the standard formula were used, a hospital with inflated charges would have a very low hospital-specific ratio of costs to charges, and its charges adjusted to costs would be relatively low. However, when the hospital applies the higher, statewide RCC to its high charges, the hospital's charges, adjusted to costs, are correspondingly higher.

As a result, a hospital with a high charge schedule that uses the statewide RCC increases its PPS outlier payment in two ways. First, the hospital will qualify for outlier payments more frequently than it would otherwise. Second, when the hospital is entitled to an outlier payment for an individual patient, it will receive a greater outlier payment than it would otherwise.

Source Medical Solutions, a leading provider of outpatient information management solutions, today announced that the company has received nine new orders for its SourceRad(TM) Web-based radiology information system (RIS).

The New Centers Include:

--Advanced Imaging Center of Pocatello, ID

--Hallmark Standup MRI of San Bernardino, CA has added 4 additional centers

--Advanced Medical Imaging Center of Chicago, IL has added a 2nd center

--U.S. PET/Imaging for Life of St. Petersburg, FL has added a 4th center in Chicago

--Florida Radiology Consultants of Ft. Myers, FL has added 2 additional centers for a total of 5 centers on SourceRad

SourceRad(TM) is a unique, Web-based RIS with comprehensive functionality that enables imaging centers to increase efficiency and profitability while enhancing the quality of care they deliver. The system's affordable price point and rapid deployment model allow imaging centers to enjoy the benefits of clinical and financial automation while realizing an immediate return on their investment. SourceRad(TM) also interfaces seamlessly with other systems, including practice management, PACS and billing services, to facilitate enterprise-wide secure information sharing.

"We're excited to offer an affordable full-featured RIS that leverages ASP technology to meet the dynamic needs of diagnostic imaging centers. The addition of nine new sites is further validation that SourceRad(TM) fills a unique need in the marketplace," said Ralph Riccardi, Source Medical EVP & COO.

Omni Medical Holdings Inc. (OTCBB:ONMH) provides a turn key back office suite of products and services to healthcare practitioners and facilities throughout the United States and today announced financial results for the quarter ending June 30, 2005 that included a 375% increase in revenues to $1,493,604.

Omni Medical CEO Arthur Lyons commented on the company's recent 10Q filing:

"The quarter ending June 30 showed dramatic improvement in many areas for Omni Medical, beginning with a 375% increase in revenue growth. While it's true that expenses grew at a 453% rate, much of that increase is due to a conservative depreciation schedule and added interest expense for DataFuzion. We expect interest expense to decline over the coming twelve months, as debt is either retired, renegotiated or converted to equity. It should be noted that DataFuzion worked hard to cut expenses this past quarter and that impact should be seen in next quarter's performance.

"We also experienced an 19% increase in shareholder's equity, due principally to the acquisition of Plum Creek Outpatient and assets of Stat Anesthesia, which have already shown themselves to be excellent additions to the company.

"The Plum Creek acquisition and Stat Anesthesia services agreement closed in mid April, so Omni didn't receive a full quarter's benefit from the transaction. Given the continued strong demand for their services, our shareholders could see further increases in revenue, cash flow and equity through calendar year end as the full financial impact of that transaction takes effect. Recently signed new accounts will also increase our margins and validate the expenditures for existing infrastructure."

Investors are asked to visit http://www.agoracom.com/IR/OmniMedical and can e-mail correspondence to onmh@agoracom.com. Investors can also request to receive all future e-mail press releases and correspondence directly.

Omni Medical Holdings Inc. (OTCBB:ONMH) provides medical billing and a full range of information technology products to medical practitioners throughout the United States. For more information, please visit www.omnimedical.com and www.datafuzion.com.

This release contains forward-looking statements, which are made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995. We use words such as "anticipate," "believe," "expect," "future," "intend," "plan," and similar expressions to identify forward-looking statements. Forward-looking statements include, without limitation, our ability to increase income streams, to grow revenue and earnings, and to obtain additional cord blood banking revenue streams. These statements are only predictions and are subject to certain risks, uncertainties and assumptions, which are identified and described in the Company's public filings with the Securities and Exchange Commission.

As expected, the Department of Justice (DOJ) has begun notifying hospitals outside of Pennsylvania that they owe money to the government for Medicare billing errors involving the 72-hour payment window. At issue are costs billed to Medicare for outpatient services that should have been included in the inpatient bill because the services were rendered within 72 hours of an admission. DOJ considers the errors violations of the False Claims Act.

The settlement agreement that the DOJ is offering hospitals bases the amount of the fines on a formula in which the number of erroneous claims submitted by a hospital is compared with the number of erroneous claims submitted by all other hospitals in the same area. This comparison then is adjusted "to account for the effects that hospital size might have on the data utilized." The agreement also outlines the steps a hospital must take to avoid future billing error liability. A key component of the compliance program is that hospitals must create and offer an annual instruction program that all hospital billing office personnel must attend.

The U.S. Attorney's Office in the Middle District of Pennsylvania, which initiated the investigation of Pennsylvania hospitals, is attempting to retain jurisdiction for this issue throughout the country and is working with many other attorney's offices nationwide. Hospitals in Mississippi already have received letters from the U.S. Attorney's office for the Northern District of Mississippi informing them that the hospitals "will be contacted directly by representatives of the U.S. Attorney of the Middle District of Pennsylvania who will be supplying you with the details of the claim against you." In concluding, the letter states that both offices hope the hospital will agree to the settlement; "however, should court action be required, our two districts will cooperate in that undertaking."

Not all U.S. Attorney's offices are willing to give up control of the case, however. The U.S. Attorney in Massachusetts has decided to pursue the case independently and has not granted jurisdiction to the U.S. Attorney from the Middle District of Pennsylvania. The U.S. Attorney in Massachusetts acknowledges that some hospitals may have paid back some of the duplicate payments, but the repayment "has not extinguished the hospital's potential liability for damage and penalties under the False Claims Act."

A medical software development and hosting company, today debuted MDConnection, a platform independent, web-based patient management application that saves time and money on administrative tasks associated with running a practice.

Acting as a virtual assistant, MDConnection is HIPAA compliant, private, secure and is available online, any time of day, to help physicians and patients spend less time managing medical records, appointments, insurance and the billing process.

"Physicians across the country have told us they are always looking for ways to minimize time and money on administrative work involved with running their practice," says Peter Voutov, La Jolla Digital's chief technology officer. "We created MDConnection to revolutionize practice management software and bring the power of a large online community to the private practice."

MDConnection includes an advanced scheduling module -- an essential tool that lets patients schedule real-time appointments for themselves and family members with their physician's office, saving valuable time for both the patient and the medical practice. An intuitive step-by-step method guides the patient through the appointment booking, from choosing their physician to selecting a convenient time. The appointment is immediately reserved on the physician's schedule, and an automated confirmation email is sent to the patient.

MDConnection also features an online bill payment module that allows patients to pay medical bills using a credit card or an electronic check. The billing module keeps patients informed about the status of their medical bills, which aids in the practice's collection process.

Other time-saving features include an online patient medical record and administrative tools that allow patients to keep their personal contact information current. Since all of MDConnection's online tools directly interact with La Jolla Digital's Practice Management system, the medical practice benefits from the updates patients make to their current insurance, contact information and medical records.

MDConnection is an extension of the company's new and improved Web-based Practice Manager, a leading practice management system released by La Jolla Digital earlier this year. Both MDConnection and Practice Manager utilize the same architecture and intuitive user interface and work together to seamlessly manage a medical practice. This powerful combination creates the ultimate practice management solution for physicians with practices of any size.

WALTHAM, Mass. -- athenahealth, Inc., the premier provider of revenue cycle management services to medical group practices, announced that it has partnered with North Carolina Medical Society (NCMS), one of the nation's largest medical societies. NCMS is the sixth major medical society to select athenahealth as the preferred workflow, billing and collections solution for its membership.

Founded in 1849, NCMS is the oldest physician organization in the state and represents the interests of physicians while protecting the quality of patient care. Sensing the increasing financial pressures impacting its growing member base, the NCMS sought a new approach to medical practice management in order to help its members better manage their billing and claims.

"We went through an extensive evaluation to determine which revenue cycle management solution to recommend to our members, and athenahealth really provided everything we were looking for," explained Robert W. Seligson, executive vice president and CEO, North Carolina Medical Society. "athenahealth offers a unique and compelling service that no other vendor in the market came close to, and we feel confident that athenahealth programs and services will benefit our members. We field calls from our member physicians telling us how thrilled they are with athenahealth because they no longer have to spend countless hours on billing or filing claims - they can focus on spending quality time with their patients."

North Carolina joins a fast growing group of athenahealth partners, which already includes the Ohio State Medical Association, the Medical Society of the State of New York, the California Medical Association, the Massachusetts Medical Society, the Southern Medical Association, Siemens Medical Solutions Health Services Co., MedVirginia, and Memorial Hermann Health Network Providers, among others.

"We're thrilled to have the opportunity to partner with one of the oldest and most established medical societies in the nation," said Todd Park, chief development officer and co-founder of athenahealth. "It is very exciting for us to see the way state medical societies like NCMS really share our commitment to fixing what has become a chronic illness in the healthcare system. Together we are going to help physicians stop losing money they have earned, get back the huge portion of their time now spent on paperwork, and get back to doing what they became doctors for in the first place - delivering quality care to patients."

Group insurance billing for retirees and employees on leave can be an expensive and complex undertaking. Or it was up until now. The need to bill nonactive employees for insurance seems to grow each year. With more companies billing their retirees for insurance coverage and with ever increasing government legislation such as the Family and Medical Leave Act, companies of all sizes need a better way to process these payments. The proliferation of personal computers and the increase in their power now allow companies to administer third-party billing of insurance payments in-house. Keeping that in mind, Benefit Plan Systems Corp. developed its Group Insurance Billing System (GIBS) software package.

Insurance billing has become increasingly complex due to the multiple criteria used for calculating the insurance premiums. Age, years of service and tiered rate tables often must be reviewed together to determine the actual payment owed by a covered person. Add to this the myriad qualification criteria, staggered payment periods and dependent coverage, and it's no wonder companies have turned to usually expensive third-party administration to handle these billings. What GIBS has to offer

GIBS offers a relatively inexpensive alternative to process the group insurance billing needs for nonactive employees such as retirees and those on various leaves of absence that offer continued insurance coverage. All a company needs is a PC running DOS or OS/2 along with a letter-quality printer (preferably laser).

GIBS is complete in its coverage of insurance billing processes. The screens are clear and well-laid-out. The system enables the user to define an unlimited number of additional data elements to ease the customizing of each company's record keeping.

Setup is very straightforward. GIBS is installed from several floppy diskettes in a matter of minutes. The system, as delivered, is ready to go except for the data that define the participants and the rules for billing. These data components should not be minimized. The most time-consuming part of implementing any billing system is not installing it, but rather educating the system as to the data and processing rules for the covered groups. An experienced benefits administrator should be responsible for developing the codes and other information needed by the system.

Once the system is installed and the rules for processing are added to the systems tables, inputting the applicant and participant data can begin. Extensive tutorials are included with the system to allow for self-paced learning. A complete on-line help feature is part of the delivered system, and both screen- and field-level help are supported. The system also includes basic keyboard instructions.

GIBS refers to all participants newly added to the system as applicants, since it will use your user-defined criteria to determine whether coverage is warranted. Information can be entered using your PC or uploaded from other machine-readable sources that already contain your retiree/employee data. The upload feature is quite significant, since a user should take advantage of data contained in an automated system such as payroll or human resources to avoid manual input of data into a new system.