Miami medicine goes digital




















About 10 years ago, Dr. Fleur Sack quit her practice as a family physician to become a hospital department head. Spurring her decision was the need to switch from paper records to electronic ones to keep her private practice profitable. “At that time, it would have cost about $50,000,” Dr. Sack recalled. “It was too expensive and it was too overwhelming.”

But times and technologies changed, and last year, Dr. Sack left her hospital job to restart her medical practice with an affordable system for managing electronic patient records. She agreed to a $5,000 setup fee and a subscription fee of $500 per month for the system. Her investment also qualified her for subsidy money, which the federal government pays in installments, and to date, her subsidy income has paid for the setup fee and about two years of monthly fees. “So far, I’ve got my check for $18,000,” she said. “There’s a total of $44,000 that I can get.”

That kind of cash flow is one reason why so-called EHR software systems for electronic health records have been among the hottest-selling commercial products in the world of information technology. EHR system development is a growth industry in South Florida, too. Life sciences and biotechnology are among the high growth-potential sectors identified by the Beacon Council-led One Community One Goal economic development initiative unveiled in 2012; already, the University of Miami has opened a Health Science Technology Park while Florida International University has launched a program in its graduate school of business oriented toward biotechnology businesses.





For many young businesses in the area’s IT industry, government incentives are paving the way. The federal government is pushing doctors and hospitals to use electronic health records to cut wasteful spending and improve patient care while protecting patient privacy — sending digital information via encrypted systems, for example, rather than regular email.

Under a 2009 federal law known as the HITECH Act, maximum incentive payments for buying such systems range up to $44,000 for doctors with Medicare patients and up to $63,750 for doctors with Medicaid patients. Hospitals are eligible for larger incentive payments for becoming more paperless. The subsidy program isn’t permanent; eligible professionals must begin receiving payments by 2016. But by then, the federal government will be penalizing doctors and hospitals that take Medicare or Medicaid money without making meaningful use of electronic health records.

“What the government did is, they incentivized, and now they’re going to penalize,” said Andrew Carricarte, president and CEO of IOS Health Systems in Miami, one of the largest South Florida-based vendors of online software service for physician practices. He said insurance companies also may start penalizing physicians for failing to adopt electronic health records because “the commercial payers always follow Medicare and Medicaid.”

It’s all part of the growth story at IOS Health Systems, which has more than 2,000 physicians across the nation using its online EHR system. Carricarte said many of the company’s customers buy their second EHR system from IOS after their first one flopped. “Almost 40 percent of our sales come from customers who had systems and are now switching over to something else,” he said.





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Miami Dolphins hopeful on stadium referendum date




















The Miami Dolphins are hopeful the Miami-Dade County Commission will approve a May 14 date for a referendum on the $400 rehabilitation of their stadium, time enough to get South Florida in play for Super Bowl 50, a Dolphins spokesman said Saturday.

Spokesman Ric Katz said the language of the proposed referendum has yet to be decided, and ultimately the commission decides the date.

But, he said, “we’d be very happy with” May 14 because “that gives us a week to communicate to the NFL before they make the important decision of Super Bowl 50.”





NFL owners are slated to meet on May 22 to pick the site of the 2016 Super Bowl — seen as a tourist revenue prize for whichever host city gets the 50th anniversary contest.

Mayor Carlos Gimenez met Friday with Dolphins owner Stephen Ross and CEO Mike Dee to discuss the proposed stadium rehabilitation.

From the mayor’s side, there has been no agreement on a date and Gimenez does not plan to bring the proposed May 14 referendum to the commission at this time, said spokeswoman Suzy Trutie.

Friday’s was a “first meeting” at which “many things were discussed,” including the Dolphin’s preference for May 14.

But, “We continue negotiating with the Dolphins with regards to finances.”

One proposed financing plan would increase the bed tax in mainland Miami-Dade by 1 percent and increase the sales tax rebate the team already gets at the stadium in Miami Gardens. Ross had initially offered to pay at least $201 million in his financing plan. But Katz, a Miami publicist representing the team in the stadium campaign, said the two sides were still in negotiation on what the mayor would ask the commission to put to taxpayers in a referendum.

Trutie said the proposed referendum would gauge public opinion on increasing hotel taxes from 6 to 7 percent to fund the stadium renovations.

Of the commission, Katz said, “We do not take them for granted. They have the prerogative.”

Attorney Kendall Coffey did not return calls asking whether the Dolphins had hired him to write the ballot language.

Dolphins lobbyist Marcelo Llorente had said in recent weeks that the team was considering May 7 and 14 as possible referendum dates.

Any activity by the Florida Legislature would likely have to be undertaken before then. The regular session is slated to end May 3.

Miami Herald staff writers Patricia Mazzei and Doug Hanks contributed to this report.





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Independent Spirit Award Winners 2013

The 2013 Film Independent Spirits Awards were handed out in Santa Monica, CA today and lots of Oscar frontrunners cemented their status by dominating in their categories once more.

Check out all the winners below:


Best Feature


Beasts of the Southern Wild

Bernie

Keep the Lights On

Moonrise Kingdom

Silver Linings Playbook


BEST FEMALE LEAD


Linda Cardellini, Return

Emayatzy Corinealdi, Middle of Nowhere

Jennifer Lawrence, Silver Linings Playbook


Quvenzhane Wallis, Beasts of the Southern Wild

Mary Elizabeth Winstead, Smashed


BEST MALE LEAD


Jack Black, Bernie

Bradley Cooper, Silver Linings Playbook

John Hawkes, The Sessions


Thure Lindhardt, Keep the Lights On

Matthew McConaughey, Killer Joe

Wendell Pierce, Four


BEST SUPPORTING FEMALE


Rosemarie DeWitt, Your Sister's Sister

Ann Dowd, Compliance

Helen Hunt, The Sessions


Brit Marling, Sound of My Voice

Lorraine Toussaint, Middle of Nowhere


BEST SUPPORTING MALE


Matthew McConaughey, Magic Mike


David Oyelowo, Middle of Nowhere

Michael Pena, End of Watch

Sam Rockwell, Seven Psychopaths

Bruce Willis, Moonrise Kingdom


BEST DIRECTOR


Wes Anderson, Moonrise Kingdom

Julia Loktev, The Loneliest Planet

David O. Russell, Silver Linings Playbook


Ira Sachs, Keep the Lights On

Benh Zeitlin, Beasts of the Southern Wild


BEST SCREENPLAY


Wes Anderson & Roman Coppola, Moonrise Kingdom

Zoe Kazan, Ruby Sparks

Martin McDonagh, Seven Psychopaths

David O. Russell, Silver Linings Playbook


Ira Sachs, Keep the Lights On

For the full list of winners, click here.

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Man's legs sliced off after he falls into the path of subway train








Twitter.com/joeyboots


Emergency crews help a man who fell into the path of a D train in The Bronx Saturday.



A drunken man’s legs were sliced off last night when he fell into the path of a D train at a Bronx subway station, authorities said.

The man, whose name was not released, got up from a bench, staggered across the platform, and fell to the track bed at the 161st Street-Yankee Stadium stop at 9:30 p.m., said sources.

“He was drunk, he was intoxicated,” said one MTA worker. “He was sitting here and he fell down.”

Before the man could get up, a D train rushed into the station, crushing and severing both of his legs.



An ambulance rushed the man to a nearby hospital. He was expected to survive, despite his horrific injury, police said.

Subway riders captured pictures and video of the frantic scene.










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The faces of Florida’s Medicaid system




















MEDICAID

MiamiHerald.com/healthcare

The tea party governor now says he wants to expand Medicaid. The Republican Legislature isn’t so sure.





Hanging in the balance?

Access to healthcare for 1 million or more poor Floridians.

Billions of dollars in federal money.

The state budget, which already pumps $21 billion a year into care.

Florida’s Medicaid system today serves more than 3 million people, about one in every six Floridians. The decision whether to expand the system by a full third will be made by men and women in suits in Tallahassee’s mural-filled chambers this spring.

But the impact is elsewhere, in children’s hospitals in Tampa and Miami, in doctors’ offices in New Port Richey and in the home of a woman who recently lost her full-time teaching job.

The Suddenly uninsured

This was not how she envisioned her 60s.

Jean Vincent dreamed of turning her five-bedroom home into a bed and breakfast. She painted murals on walls, created mosaics on floors and let her imagination guide the interior decorating. There is a “garden” room, a “bamboo” room and a “canopy” room.

In 2010, Vincent lost her full-time job teaching in Citra north of Ocala. Her mother became sick with cancer and needed around-the-clock care before dying in August. Then, doctors began prescribing Vincent costly medications to treat osteoporosis and early-onset diabetes.

“I started getting a little behind with my mortgage,” said Vincent, 61. “All of a sudden, I found out I had to have an emergency retina eye surgery.”

Today, Vincent is searching for roommates to move into her home and help pay the bills. She begs Gainesville’s Sante Fe Community College and City College to schedule her for as many classes as she can handle as an adjunct geography professor; this semester’s four is the most she’s ever had.

But her biggest worry? Not having comprehensive healthcare.

Vincent — who is too young for Medicare — is enrolled in CHOICES, a health services program the Alachua County government created for the uninsured. It covers preventative care like her flu shots and helps with her drug therapy. But if Vincent ever got so sick she needed to go to the hospital, she’d be on her own.

Under current Florida law, adults with no dependents are not eligible to participate in Medicaid no matter how little they make. Vincent’s four children are all grown, which means even as her income has dwindled she can’t become eligible for the health insurance program run jointly by the federal and state governments.

If Florida decides to expand the Medicaid system, people in Vincent’s position for the first time could be covered.

The expansion would allow any single adult making about $16,000 a year eligible for Medicaid.

On the matter, Vincent has become an activist. She joined with patient rights group Florida CHAIN and traveled to Tallahassee to lobby lawmakers.

“When I gave my testimony, that’s all I wanted them to do was see there were people out there that weren’t just trying to take advantage of the system,” she said.

This summer, she expects to only be assigned one class at Sante Fe. That will provide about $2,000 for her to live on for three months. Meanwhile, her retirement dreams are put on hold.





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Miami police union challenges officer’s firing for fatal shooting




















The Fraternal Order of Police filed a lawsuit against the city of Miami on Friday, asserting that an officer who fatally shot an unarmed motorist in 2011 was improperly fired from the police department.

Officer Reynaldo Goyos shot and killed Travis McNeil as he sat in a car at a Little Haiti intersection. It was one of a string of seven deadly shootings of black men in the inner city by Miami police officers in 2010 and 2011.

Goyos was cleared of criminal wrongdoing by prosecutors in 2012. But he was terminated last month after the department’s Firearms Review Board concluded that the shooting was unjustified.





The police union lawsuit claims that the board violated state open-government laws by failing to open its meetings to the public.

Goyos “was improperly terminated by the city of Miami Police Department by a review board that violates the law,” union President Javier Ortiz wrote in a statement.

The lawsuit contends that Goyos should be reinstated.

City Attorney Julie O. Bru declined to discuss the specifics of the case. “We reviewed the allegations, and the city maintains that the board has operated consistent with the requirements of law,” she said.





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Diogo Morgado as Jesus in 'The Bible'

Producer Mark Burnett and his wife Roma Downey are bringing The Bible to television with an epic, 10-hour, five-part miniseries, and ET's Nancy O'Dell is with the man who portrays Jesus, Diogo Morgado, and the actor who embodies St. Peter, Darwin Shaw.

Pics: Adorable Tots: Celebs and Their Cute Kids!

"Jesus is definitely the most complete and complex figure of mankind; he's just someone who belongs to millions and billions of families all around the world," says Portuguese star Morgado, a religious man himself. "Just [given] the chance [to play him], I'm like, 'Okay, I'm going to try to just give an example of my Jesus.'"

Premiering Sunday, March 3 at 8 p.m. on History, The Bible brings to life some of the more well-known tales from the ancient tome from Genesis through Revelation, including David and Goliath, Noah's Ark, the Exodus, Daniel in the Lion's Den and the crucifixion/resurrection of Jesus. Shot in Morocco, the series is narrated by Emmy winner Keith David with a musical score by Oscar winner Hans Zimmer, also stars Downey as Mother Mary and includes Paul Brightwell, Greg Hicks, Sebastian Knapp, Amber Rose Revah, Greg Hicks and Simon Kunz.

Related: First Look at Russell Crowe as 'Noah' 

Watch the video for the actors' take on tackling such iconic figures – and see the amusing moment after Nancy sneezes in front of Morgado!

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Hey, I’m a dude, Lucille








The women-only Lucille Roberts health club cluelessly peppered Alex Shiyan with text messages about a sweetheart membership deal.

Just one problem — he’s a man.

The Brooklyn resident became so fed up with the useless offer that he fired back at the fitness giant with a class-action lawsuit filed yesterday in Manhattan federal court.

“1 Day Sale @ Lucille Roberts. just $5 to register and $15 a month NO CONTRACT,” read the message, according to the suit.

It also urged him to call the franchise operation’s Irvington, NJ, branch, adding, “Ask for Jessica and get a free gift when you join today!”




Shiyan’s suit cited some serious problems with the offer — most notably his gender.

He said the texts have been arriving for several months on a phone he got from the New Jersey law firm where he works in client relations.

“It’s a little funny,” Shiyan said. “I mean, I’m definitely not the target market audience, so what are you going to do? I reached out to an attorney.”

Shiyan’s proposed class-action complaint seeks damages of up to $2,000 “for each and every text” received by him and potentially “thousands” of others, along with a court order barring Lucille Roberts from sending out future unsolicited spam directly to people’s smartphones.

Shiyan, 25, and his lawyer said that they didn’t know how many texts have been sent in total and that they were still in the discovery process.

Lucille Roberts “knowingly and/or willfully” violated the Telephone Consumer Protection Act by using an “automatic telephone dialing system” to contact him without his permission, the suit says.

Shiyan’s lawyer, Sergei Lemberg, who runs the “Sue Spam Texters” Web site, said he was baffled by the texts.

“It’s hard to know why Lucille Roberts texted my guy. He certainly has no need for women’s fitness,” Lemberg explained.

Kevin Roberts, acting president of Lucille Roberts and a son of the late fitness guru, insisted that the company doesn’t use a mass- texting machine and texts only women “who have come in as guests” or been referred by members.

“It seems very strange,” Roberts said. “It has to be an error because we really don’t text-message men.”










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South Florida hospitals could lose $368 million from sequestration




















A detailed survey shows that South Florida hospitals could lose $368 million over 10 years in federal budget cuts starting next Friday, if the sequestration program kicks in as scheduled.

The Florida Hospital Association, using data from the American Hospital Association, estimates that over the next decade, sequestration would cause Miami-Dade hospitals to lose $223.9 million and Broward facilities $144.4 million under the Congress-mandated budget cuts that hit virtually all federal programs unless Republicans and Democrats can work out a compromise.

The New York Times and other national news organizations are reporting that sequestration, unlike the New Year’s fiscal cliff, seems virtually certain to take place.





The law requires across-the-board spending cuts in domestic and defense programs, with certain exceptions. Because healthcare represents more than one in five dollars of the federal budget, it will be a huge target for cuts.

For hospitals and doctors, the major impact will be felt in Medicare cuts, which according to the budget law are limited to 2 percent of Medicare payments. Medicaid, food stamps and Social Security are exempted from cuts, according to the Bipartisan Policy Center.

The FHA study calculates that over 10 years, Jackson Memorial Hospital stands to lose $30.6 million, Mount Sinai Medical Center on Miami Beach $27.3 million, Holy Cross in Fort Lauderdale $23.8 million and Memorial Regional Hospital in Hollywood $21.4 million.

“The problem with sequestration is that it just makes broad cuts across the board,” said Linda Quick, president of the South Florida Hospital and Healthcare Association. “The Affordable Care Act is looking at all sorts of intelligent ways to reduce costs,” including coordinated care that will stop duplicated tests and reduce hospital readmissions. “But sequestration takes an ax, and that doesn’t make any sense.”

FierceHealthcare, which produces trade publications, says sequestration cuts over the next decade will include $591 million from prescription drug benefits for seniors, $318 million from the Food and Drug Administration, $2.5 billion from the National Institutes of Health, $490 million from the Centers for Disease Control and $365 million from Indian Health Services.

The National Association of Community Health Centers estimates that 900,000 of its patients nationwide could lose care because of the cuts. The group said the cuts were “penny wise and pound foolish” because they would mean less preventive care while more and sicker patients would end up in emergency rooms.

Like the fiscal cliff, Republicans and Democrats agreed on a sequestration strategy, with the idea that the drastic measure would force the two sides to reach agreement on more deliberative budget adjustments. That hasn’t happened.

The White House reports that the law will mean that nondefense programs will be cut by 5 percent, defense programs by 8 percent. But since the first year’s cuts must be done over seven months, that means in 2013, nondefense programs need to be cut by 9 percent, defense programs by 13 percent.





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Bill to ban smoking on some public land advances




















Cities and counties could bar smokers from beaches, parks, and other publicly owned outdoor areas under a proposal that passed an early Florida Senate test Thursday, despite concerns from restaurateurs.

By unanimous vote, the Senate Regulated Industries Committee approved the measure (SB 258), which expands the state’s clear indoor air restrictions to more outdoor venues.

Voters approved the Florida Indoor Clean Air Act a decade ago.





The proposal would allow local governments to create smoke-free areas on publicly owned land as long as smoking sections are also available.

A similar bill stalled last year after concerns over smoking on sidewalks.

The current version of the bill prohibits smoking only on sidewalks in public parks, on public beaches, or in recreations areas while continuing to allow smoking on regular street-side sidewalks.

The bill would also allow cities and counties to extend smoke-free zones from public buildings to 75 feet from the entrance, or the same distance from a ventilation system or windows.

Law-enforcement officials would be required to first alert violators of the no-smoking restrictions and ask them to leave before they can issue a citation.

“Nobody wants to put anyone in jail for doing these things but it does send a signal,” said Sen. John Thrasher, R-St. Augustine.

“This state wants to be smoke free, eventually. . . . This is just one incremental step toward getting there.”

Rep. Bill Hager, R-Delray Beach, filed a House version of the bill this week.

In December, Sarasota County Judge Maryann Boehm ruled that Sarasota’s ordinance banning smoking in public parks was unenforceable, arguing that regulating smoking was a task left to the Legislature.

Thursday’s vote came after representatives of the state’s restaurant industry expressed concerns about the potential of unintended consequences but said they hoped to work with the sponsors to work out problems as the bills progress.

“When the smoking ban was passed, many businesses spent hundreds of millions of dollars to reconfigure their properties to accommodate both the new law and our customers,” said Richard Turner, of the Florida Restaurant and Lodging Association.

“At the moment, we are concerned that some of these ordinances could impact the investments that have been made.”

Some panelists also expressed concerns, saying they want assurances that beaches and public parks will not be totally off limits to smokers.

“The beach belongs to everybody,” said Rep Audrey Gibson, D-Jacksonville. “And people are different.”





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