Month: September 2008

Complex HIT issues lack absolute answers

Sep 4, 2008• 2

By John Halamka

Halamka Listening to Obama and McCain you realize that some issues have no absolute right
answer. Pro-Life v. Pro-Choice, Pro-Gun v. Anti-Gun, Less Government v. More Government etc. Everyone has an opinion and often the emotions run high.

The same thing is true about health care data standards and interoperability, although the stakes are a bit lower than life and death issues.

Recently folks have asked me to comment about Carol Diamond and Clay Shirky’s article in Health Affairs which contains potentially controversial statements such as:

Yet after three years of standards documentation and the resolution of several standards ‘disputes,’ we remain a long way from seeing these standards used and implemented to enable health information sharing. As Sam Karp of the California HealthCare Foundation stated in his testimony to the Institute of Medicine Board on Health Care Services and National Research Council Computer Science and Telecommunications Board, ‘Not a single data element has been exchanged in real world health care systems using standards this process has developed or deployed.’

I did not find Carol and Clay’s article controversial. Both are good friends of mine and I agree with their thesis that technology is not enough to ensure successful interoperability. We need to agree on appropriate policies to protect privacy, incentives for implementation, and justifications for continued use of technologies to ensure widespread adoption.

Another state gov’t. misses the boat on patient-centered care and HIT

Sep 4, 2008• 2

By Joshua Seidman

Amid more data released that consumers are not using personal health records (PHRs) or don’t even know what they are, the state of West Virginia has launched a Web site designed to convince consumers of the merits of health information technology (HIT).

As best I can tell from eHealthWV Web site, here’s the plan: “To ensure consumer input and involvement in the process of health information exchange and electronic health records, WVMI and its partners launched a new phase to the project in mid 2007. It involves educating consumers about electronic health records and health information exchange.”I’m sure they mean well, but it would be helpful if one of these state efforts “ensured consumer input and involvement” by actually soliciting their input before designing their outreach. Right now, most states and health information exchange activities are focused on addressing consumers’ fears about data rather than their needs about health care.

Health Wonk Review

Sep 4, 2008

Insureblog hosted the latest compilation of the best from the health blogosphere. Check it out.

Where does Sarah Palin stand on children’s health coverage?

Sep 4, 2008• 24

By Jocelyn Guyer

The entire country now has heard about how Sarah Palin and her husband knew in advance that their son, Trig Palin, would be born with Down Syndrome. The Palins also must have known that they would have health insurance and the financial resources needed to pay for the extensive medical care Trig is likely to need throughout his life.

Here is 3-year old Emily Demko, another child with Down Syndrome, who lives with her
family in Ohio. The family has given permission to share this photo of their beautiful daughter and the story (details here) of their trials securing health coverage for Emily.

As of this spring, Emily was uninsured. Due to her Down Syndrome, the family could not find a private insurer willing to offer them affordable coverage for Emily. If the Bush Administration had not shut down Ohio’s efforts to expand its State Children’s Health Insurance Program (SCHIP), Emily would have been able to continue to secure decent, affordable public coverage. But the Bush Administration in August of 2007 issued a controversial ban on coverage of children in moderate-income families and twice vetoed bills to reauthorize and expand the SCHIP program.SCHIP is a popular, bi-partisan program. Sixty-eight Senators, including 18 Republicans, voted for the SCHIP reauthorization bill that President Bush vetoed (Senate vote). John McCain, however, stood with the President.So, along with knowing about Sarah Palin’s personal decision to have a child with Down Syndrome, it also would be good know if she agrees with her candidate’s decision to stand with President Bush against expanding the State Children’s Health Insurance Program. Right call or wrong call?

Jocelyn Guyer is the deputy executive director at the Center for Children and Families (CCF) and a senior researcher at the Georgetown University Health Policy Institute. This post represents her personal opinion not that of the Institute.

Adam Bosworth speaks about Google Health, Keas and everything

Sep 3, 2008• 2

By Matthew Holt

Adam_bosworth After a long period of time I’ve finally wrestled Adam Bosworth to the floor and forced
the microphone to his mouth. Adam of course is the software guru (he’s one of the originators of XML) who went to Google to start Google Health, and spent much of 2007 talking about how he hoped Google Health would change health care. He then left Google Health (several months before it launched in March 2008) and at the very end of 2007 founded Keas. Adam will be at the Health 2.0 Conference and while Keas is in stealth mode at the moment, he may just be ready to show us all a bit of Keas’ technology by then.

But he also has very strong views on health technology, data, PHRs. HealthVault & Google Health, and much much more. Listen to the interview.

New report shows health blogosphere going strong

Sep 3, 2008• 7

By Fard Johnmar

It started as a whisper and then grew to a roar. Last year, the Detroit Free Press wrote the first in what would become series of articles questioning the wisdom of medical blogging. In 2007 and 2008, USA Today and National Public Radio featured stories that noted the benefits of physician blogging, but also highlighted patient privacy and legal concerns associated with this activity. Finally, early last month, the Los Angeles Times and other publications featured a study that has generated a lot of heated commentary in the blogosphere and beyond.

In an analysis of medical blogs published in the July 23rd edition of the Journal of General Internal Medicine, Dr. Tara Lagu suggested that some doctor bloggers are painting an unflattering picture of the medical profession and fail to disclose financial conflicts. Lagu cited a 2006 poll produced by my firm Envision Solutions and the social network Trusted.MD indicating that public relations professionals approached nearly one-third of health bloggers responding to the survey. Lagu recently told American Medical News that she believes medical associations should “adopt policies explicitly addressing blogging ethics.”

Health care lessons from the Titanic

Sep 3, 2008• 4

By Sarah Arnquist

The U.S. Health Care system is like the Titanic — a big, fancy,
expensive ship that unequally doles out limited resources depending on class
status and is destined to hit an iceberg and sink.

A professor used this analogy recently to provoke students to look
more deeply into the complex and intractable factors that determine health status. Biology
and genetics surely are important, he said, but one cannot ignore the environmental,
social and economic factors that influence an individual’s
susceptibility to disease.

Comparing the U.S. health care system to the Titanic is an analogy as hackneyed as saying the system is in crisis. Yet, it remains useful.

Google’s strategy (mostly outside of health care)

Sep 3, 2008

By Matthew Holt

VC Fred Wilson explains where he thinks Google is going in Chrome, Android, and The Cloud. The Health 2.0 team is about 3 months into using Google Docs (especially the spreadsheet) and although Docs continues to have its teething troubles, like Fred we are hooked. I suspect we and Fred’s shop are not alone

BTW, I read the Chrome comic book today and it is a thing of beauty — taking really tough technical concepts and explaining them simply and not condescendingly. I’ll for sure be downloading Chrome when I get the chance.

Meanwhile, in health care last week David Kibbe interviewed Ronnie Zeiger at Google as part of the Great American Health 2.0 Tour. The Googleplex was a little empty as half the employees seemed to be at Burning Man. But a little way into the public release of Google Health, it does seem as they’re happy with what’s happening so far, and they remain committed to taking it seriously. (I sense a bottle of fine wine coming my way ).

On the other hand, I know for sure that Microsoft continues to take its health care business very seriously too. And yes, you’ll be able to see both of them at Health 2.0.

Around the Web in 60 Seconds (Or Less)

Sep 3, 2008• 1

By Sarah Arnquist

A clinic in Minnesota is routinely dropping patients with high-deductible health plans who aren’t paying their bills, the Star Tribune reports. "For the most part, these are college-educated and middle-class folks," Dr. Rochelle Taube told the Tribune. "We send them a letter and say unfortunately, we’re not able to care for you." Some clinics and doctors’ offices that aren’t dropping patients have had to exert more effort or new approaches to getting paid, "such as swiping a credit card at check-in just like at a hotel."

Sicker patients are better off getting bypass surgery than medicated coronary stents, according to the Wall Street Journal. Boston Scientific funded the study using its own stents. It’s the first head-to-head study of its kind, but hopefully not the last if analysts’ predictions are accurate that the failure to show stents as the obvious treatment of choice for complicated heart patients will lead to a drop in sales. The BSX stock price increased 1 percent Tuesday.

In 2006, U.S. pharmaceutical companies spent about $5 billion on consumer marketing campaigns, but the Washington Post reports a Harvard Medical School study in the British Medical Journal found the spending may have less impact on consumer behavior than previously assumed.

Also in BMJ, a review of Britain’s National Health Services records shows that patients undergoing a hip or knee joint replacement using the new resurfacing technique are more than three times as likely to need a replacement than if the joint were fully replaced and cemented. The study tracked more than 150 000 people who underwent a hip or knee replacement between April 2003 and September 2006. To learn more about the U.S. failure to track the safety of joint replacements, read this New York Times article.

Health 2.0 User-Generated Healthcare

Sep 2, 2008

How are Web 2.0
technologies like social networks, wikis and online communities
changing the face of the health care industry? How are hospital systems
and physician practices evolving as a result of rapid technological
change? How can health plans evolve in
the face of emerging challenges with the help of new technologies and
new thinking? What will come of the recent controversies over genetic
testing and the privacy of patient data? Where does the hype over social networks and
user-generated content end and the reality begin? H20logo

Come learn more about these questions and many more at Health 2.0 on October 22nd – 23rd at the San Francisco Marriott.
You’ll meet industry insiders and new players entering the field. You’ll see
rapid-fire demos of new technologies and hear both expert reaction from
established players in the field and fresh perspectives from newcomers.
You’ll also get critical insight from industry observers as well as practical,
common-sense advice on employing these new technologies in your own
business or organization.

Confirmed speakers include: Google Health, Microsoft, Yahoo Health, Healthline, Cisco, Eliza, Silverlink, DestinationRX, AthenaHealth CEO Jonathan Bush, Sermo CEO Daniel Palestrant, HealthGrades CEO Kerry Hicks, WebMD CEO Wayne Gatinella, Clay Shirky, author of "Here Comes Everybody: Organizing Without Organizations." Dr. David Kibbe, Jay Parkinson, M.D., Jane Sarasohn-Kahn, THCB’s Matthew Holt, Health 2.0’s Indu Subaiya, CrossoverHealth founder Scott Shreeve, 23andMe and many, many more.