The Week in Review

New York attorney general Andrew M. Cuomo sent a letter to UnitedHealthCare demanding that the insurer cancel the launch of an online service that would rate doctors by the quality of care they provide and the cost of their services. Linda Lacewell, an attorney on Cuomo's staff, noted that the program could be used to push patients toward selected doctors. “To compound the situation, we understand that employers may act on these ‘ratings’ to offer financial inducements such as lower co-payments or deductibles to promote ‘cost-effective’ doctors to their employees."

The Wall Street Journal reports that state and federal officials are continuing to ask tough questions about the status of non-profit hospitals. Yesterday, the IRS released a study that notes that "many" hospitals spend less than three percent of revenues on charitable care. The analysis is based on a survey of  500 non-profit hospitals. Meanwhile, Senator Charles Grassley released a memorandum in response that suggests that Congress may set new rules governing how much charity care non-profits are required to provide. 

Dr. Anna Pou, the New Orleans surgeon charged with second degree homicide in the deaths of four patients in her care in the days after Hurricane Katrina, filed a lawsuit accusing Louisiana attorney general Charles Foti of using the case against her to "advance his political career." The suit argues that Foti would better serve the state's residents by investigating the inept official response to the disaster."The real cause of loss of life is the government's abandonment of the patients and the doctors," the lawsuit notes. "There can be no doubt that this will be the central issue in the defense of this matter."

The thread on Dr. Pou and her case, which began more than a year ago when we ran a brief item about the defense fund set up to help pay her legal expenses, has been surprisingly active for a long time. Various posters and acquaintances -- including many doctors and other healthcare workers who have worked with her - have left messages of support, encouragement and criticism. Many have had nasty things to say about Charles Foti.  Bill writes in claiming to have an inside angle the case. (Note: These claims have not been verified.) He says:         

"Anna is also my friend and I promised her I would not talk about the things we have talked about. I wish I could tell you more, but I made a promise and I am therefore bound to keep it. What I can tell you is this: Foti was not the principle in the original investigation.  Instead Jullie Cullen, Director of the Criminal Division of the Attorney General's Office spearheaded the original investigation. The case against Anna will not go further than the Grand Jury. There will be no court case and the charges will be dropped. I wish I could tell you more, but I cannot. But please know this: what happened on the seventh floor was done out of love."

Val responds: "First of all I am an MD and I did go through Katrina and I do know Anna Pou. But trying to be objective and somewhat logical here no one is allowed or justified to "play God" and decide when another's life should end. However, we are bound to reduce suffering whenever possible. It is completely bogus to say that you cannot give versed and morphine together-- we do it all the time in ICU or the OR etc."

Jonathen sounds more Perry Mason-like. "The charges were based not just on the eye witness statements that indicated Dr. Pou, in her own words, told them she was going to administer lethal doses but on the original autopsy reports which showed high levels of morphine, including a morphine overdose test, and Versed and Ativan. Mr. Foti was doing his job. And as for Anna, this case is not about whether she is a nice or not nice person, whether she is a competent or incompetent doctor.This is a case about a doctor who told multiple eye witnesses that lethal injections where going to be administered to the remaining patients on the seventh floor."

The Center for Science in the Public Interest's Merrill Goozner drew attention to a post last week by Beth Israel Deaconess Medical Center CEO Paul Levy discussing a new treatment for severe asthma. Goozner noted that that BDMIC is both a clinical trial site for the procedure and a consultant to the device's maker, Ashtmatx of Mountain View California. Levy mentioned neither fact in his post. 

Medical journals have rules that disclosure of potential conflicts. So do newspapers. Yet "the blogosphere operates without rules, even when the blogger runs one of the nation's leading teaching hospitals," Goozner writes. Levy says he was "unaware of the relationship" at the time he wrote about the treatment.

Two years ago, the University of Pittsburgh Medical Center ignored the advice of consultants and pushed ahead with an ambitious $402 million IT services contract with IBM. The deal was one of the most talked about of the year. Did it pay off? UPMC CIO Daniel Drawbaugh says yes.

In Vermont, government officials think "socialized data" could help develop a new model for fighting chronic diseases. Government Health IT News examines the ways that the Vermont Information Technology Leaders program, a public/private partnership, is combining the regional health information organization with traditional disease management methods. The article examines similar efforts around the country, noting projects in Kentucky and Calgary. Orion Health's Dr. Chris Hobson, the star of a recent THCB podcast, makes an appearance to talk about the company's technology, which is being used in both Calgary and Vermont.  [Full disclosure Orion is a THCB sponsor.]