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Matthew Holt

HEALTH PLANS: Ron Wyden on Health plans

Just for Friday, no Health 2.0 stuff. Instead two speeches, one by Oregon Senator Ron Wyden (D) last week to AHIP. The other from me to the Western Blues meeting late last year. This is Wyden’s

In less than a year, America will watch a new president be sworn into office, and exactly one year from now that new president will be on day 44 of his/her first 100 days – their so-called “honeymoon” with the public.  I don’t think that I have to tell you, that for the cause of health care reform, those 100 day will be very important. I believe, however, that the success of health care reform hinges to a great extent on how your profession responds to the efforts of a new president and a new Congress.

If your profession decides – as it did in 1993 and 1994 – to go out and spend millions of dollars fighting to preserve the status quo, you may delay reform for awhile but you will increase the likelihood of a government run health system with no role for the private sector.

So, this morning, I’m going to make the case for your taking a different approach.  I’m going to make the case why a fundamentally different private health insurance market would be good not only for the American people but also for the many responsible persons who work in the private health insurance industry.  Many of whom are in this room today.

I don’t have to remind you what the public opinion is of the private health insurance industry.  It’s not just “Sicko,” Denzel Washington movies and Los Angeles Times investigative reports.   Lots of presidential candidates can tell you that the easiest way to win applause is to “go negative” on private health insurance.

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HEALTH 2.0/CONSUMERS: Susannah Fox on e-Patients and Health 2.0

Two fantastic video clips from a fantastic researcher. (Susannah runs the health research program at the Pew Internet and American Life program.

Susannah’s (brief) keynote including the seven word meme that dominated the day!

Her interview afterwards:

TECH: Scott & me on Google and Microsoft

Scott Shreeve is blogging up a storm these days. Where he finds the time I don’t know. Today he has an excellent piece called Getting Giga Over Google (Again) which compares the Silicon Valley giant’s strategy with that of its northern competitor. Yesterday I put one up on the Health 2.0 Blog on the same topic but from a different angle. Both well worth a read. I absolutely welcome the market entrants

However, Scott says “enough” with the privacy debate. But somehow I can’t quite get there yet. Every single journalist who ever writes about this leads and ends with privacy—and appears to have no other lens through which to view this issue.

I really have something to get off my chest about that. So stay tuned.

HEALTH 2.0: Indu Subaiya’s take

Thanks to Michael for his article and thanks to everyone for participating in such a fantastic day and a half. We’re just getting the first round up of coverage (here’s the San Diego Union-Tribune’s piece which was on the Front Page! (The O’Reilly conference down the street was only in the business section!!). And here’s my Health 2.0 Co-Founder Indu Subaiya telling icyou about the conference:

The rest of the many icyou videos are here. Many thanks to Nina and the gang from icyou! (We’ll be posting the "star wars" video they made for parent company Benefitfocus soon too!)

Health 2.0 – An Uncompleted Van Gogh

Imagine today’s presentations at Health 2.0: User-Generated Healthcare, as looking the way a painting by Vincent Van Gogh might look if he had not yet stepped back from the canvas.

In our painting, there is genius at work — each splotch of paint, each dab of color makes a statement, much as each Health 2.0 company presents its vision and its product. But somehow, despite all the individual needles, the haystacks are lost. Where is the vision that helps us see the health care system as a whole in a new light? Is it just too early in the process – with a little more pointillism, the point of it all will become clear — or is the problem that we are waiting for Van Gogh?

Health 2.0 companies, it seems, are addressing specific and limited problems – albeit quite important ones — with gusto. Putting it all together and transforming health care is nobody’s business plan.

Over the past 24 hours, Matthew and Indu put on an intense and fascinating meeting. Since they could not simultaneously “do” and write about the “doing,” they have asked Your Correspondent to do the latter. After nearly 10 hours of content bombardment, I can tell you there are some gung-ho entrepreneurs ready to drag consumerism into health care. Empowerment! Flexibility! Personalization! Wellness! Choice! Value! I and the rest of the under-65 (mostly well under 65), upper-middle-class (and not a few lower upper class) crowd are ready to throw our Power Bars into the air and cheer aerobically.

But wait: will these models work when “consumers” become “sick people,” and these sick people – old, with poor reading skills, not that well-educated, a little bit cowed by the men in the white coat — need not health care but “medical treatment”? It’s a question that nags throughout the day. This is a crowd that wants to both do well and do good, gosh darn it. We are a movement we are told – but, really, with Matthew and Indu mandating 8-minute bio breaks for a crowd of 300, is anyone having a movement? – but we are also a dog-and-pony stage set for new business concepts. Elevator pitches and elevated sentiments happily co-existing.

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The Unconference LiveBlog, cont’d

More from the Unconference floor:

How can doctors get more involved in using technology in patient care? One point relative to doctor/hospital blogging: "Medical institutions have to get used to the fact that people know they are not infallible."

Doctor ratings? The methodology is too messy.

The CEO of Trusera is at the table, and casually announces that his company is launching this weekend. It’s a patient social networking site. Nice clean interface!

*************Randomly overheard: "I’ve never seen a healhcare conference that’s so full of men. Usually it’s at least half and half women."

*************

Well, the groups are breaking up. I’m seeing a lot of people excusing themselves like they do at cocktail parties–"I’m going to catch up with some other folks," "I’m going to see what’s going on over there," etc. Or it may be the cookies and coffee in the hallway.

I think the Unconference was a big hit–lots of people got to know each other, exchange ideas (and cards). Also some interesting sociology–who dominates a table, the funniest, most serious, the one with the CEO nametag?

All in all, a good start. Let’s hope the Real Conference is just as good.

Diving Deep with American Well by Craig Stoltz

American Well, an ambitious startup designed to provide virtual health/medical transactions between patients and doctors, has been invited to present its product overview in a thoroughgoing way–a deep dive, in Health 2.0 patois.

In this liveblog, I need to control the depth, of course. I’ll try to boil this into five (5) key points about American Well:

1. Unlike other industries, health so far hasn’t succeeded in doing transactions (Amazon, Expedia, eBay, etc.) on line. Imagine Expedia if, instead of buying a ticket, all you got was a picture of your plane. What’s missing? In health, it’s the real care transaction.

2. American Wellness is essentially a brokerage system for online wellness services–real services, not just information. Connecting consumers with providers and, as important, the money–which is to say insurance reimbursement systems. Patients, docs, money, all tied together.

3. Consumers can access specialists, from anywhere, for a fee. Their calls, e-mails, etc. are aggregated and distributed to the appropriate specialists in real time.

[The liveblogger anticipates the big question: How does this provide continuity of care?

And the answer comes immediately–the AW marketplace delivers only specialists, not a primary care doctor. The tradeoff of getting someone with whom there is no existing relationship to have immediate access to care. ]

4. What’s the transaction like? The demo shows a consumer’s entry into the system. [The interface is very clean–you can tell they usability tested this really well.] First, consumer looks for a doctor. [PowerPoint slide joke: Doctor profile that comes up is an OB whose name is given as Otto Matic.]

Doctors presented with bios, videos, etc. Ratings? Yes, but not clinical ratings. Just consumer satisfaction ratings. [Needless to say, this is one of many services attempting to aggregate patient evaluations of doctors.]

Part of summary is–price transparency! The cost of the anticipated consult is listed. Patients can fill in their health background to let docs understand the situation more fully. Then doctors, in real time, review request and decide if it’s appropriate that they take it on.

Then: When patient and doctor both agree to a clinical encounter online, an interactive console pops up –the interaction can be live video via webcam, live  audio or typing chat, on-screen notes and documents, etc. Lab information, with patient permission, can be added. While it’s a virtual interaction, it’s a rich-media virtual encounter.

5. And the consumer’s regular doctor? Patient can send doctor report of entire transaction.

[The liveblogger’s question: What will the patients’ internists have to say about this?]

Other point: Insurer AIG has developed a new malpractice insurance product–per transaction, not annual. It’s embedded in the service.

Will this save money in healthcare? AW argues that by providing some care in the home, and keeping some transactions at lower cost, insurers, payers and patients can save money. This can keep people out of the ER, maybe.

The AW plan–essentially disconnecting care from a physical location–raises all kinds of questions not dealt with, even in this deep dive: Privacy? Coordination of care? How to deliver service of real value without risking misdiagnosis, etc. How will insurers ultimately reimburse this care? How different/better/worse will this be compared to in-store retail clinics? What conditions or situations is this kind of virtual care best suited to?

And finally, when will this launch? In 2008, CEO Roy Schoenberg, MD assures us.

Liveblogging the Health 2.0 “Unconference” by Craig Stoltz

So Indu is on stage, introducing the Health 2.0 "Unconference"–user-led
discussions around tables, all happening at the same time. Whoever
submitted a topic gets to "hold court" at a table.

So you are reading The Health Care Blog’s liveblog of an Unconference. This is so front-edge, high-wire techno-virtual I think I may get a nosebleed. 

Enoch Choi, a very 2.0 physician and veteran leader of
unconferences, is leading the show. "Very reality TV"–if you’re bored,
pick up and go to a table that’s more interesting. Topics are being
submitted as we speak.

  • Enoch is giving out topics
  • Social media and pharma!
  • Genomics!
  • Extending patient-physician relationship!
  • The future of alternative sales channels in pharma!
  • Increasing patient engagement!

I’m using exclamation points, but we’ll see how exciting these topics
actually turn out to be. People are finding tables now. We’ll see how
many wind up bolting–and what precisely the I’m-leaving-your-table
etiquette is.

***********

The biggest crowd, curiously enough, is at the table discussing "information overload." David Sobel holds court. Interesting point: More information actually "disempowers" people due to confusion and excess. Information is not always power. It’s often annoyance, noise, even harmful.

*********Over at the table of the estimable Esther Dyson, there’s a hand-written sign "The Impact of Genomics Info." This is heady stuff: one discussant talks about the sensitivity of an individual’s genomic information, and that the system isn’t prepared for dealing with that.

"And doctors," it’s pointed out, "are not trained in genetic medicine."

Benjain Heyward of PatientsLikeMe seconds the motion: Doctors aren’t set up to deal with the information that patients often want about their genetic risks, etc.

******

BIG crowd over at the Pharma-and-social-networking table. Great point made: "What would pharma have to gain from trying to create and own their own social network?"

If you’re a patient with Crohn’s, it’s asked, where are you going to go to find support? A forum run by a drug company? Or one with more independence and credibility.

Something called GroupLoop is mentioned. It’s described as a network that has the ability to become a "cross between MySpace and health." We’ll have to check that one out.

TECH/HEALTH 2.0: Eliza & Silverlink, strategic healthcom 2.0

So the gang is all in San Diego getting ready for the Health 2.0 conference which starts Monday (gulp, that’s today!) Feverish last minute preparations are apace. 

I spent some time on Saturday morning talking to two people at the forefront of the communications revolution on the telephone. Alex Drane, President of Eliza, and Stan Nowak, CEO of Silverlink.  We had a fascinating
interview. See if you can spot the moment when Stan invented a new term which Alex trademarked before he’d finished speaking. (Hey at least the lawyers are making money!)

TECH: Drugs & technology–Allscripts and SafeMed

To finish off the last but not least of my HIMSS interviews, here are two companies that both announced being part of the Google ecosystem on the Thursday of HIMSS. One is well known and a leader in ePrescribing and EHRs (even though it’s had a tough year on Wall Street and won the HISSIE for most likely to be acquired!) That’s Allscripts of course, and I was able to grab a quick chat with head marketing honcho Dan Michelson and Jamie Stick, IS Director from one of their star clients, Central Utah Clinic in Provo, Utah.

They also have a very cool video called Paper Free health care (I spot some inspiration from the Health 2.0 video!)

I also got the chance to meet a much smaller company called SafeMed. Rich Nossfinger & Ahmed Ghouri hasve built a very very sophisticated rules and processing engine which can interpret drug data and embed that decision support into patient specific indications. Very intriguing stuff and you can learn more by listening to this interview (although they weren’t allowed to let me tell the world in advance that they are one of the first partners in the Google ecosystem. Here’s the SafeMed interview.

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