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Category: Health Tech

Not exactly health care, but follow the money…

400pxphotos_newyork1_032Michael Lewis has returned from writing about Jim Clark, technology, baseball and football to his first
topic; finance. (Liars Poker is still the best book about Wall Street ever) His two part piece with hedge fund manager David Einhorn this weekend in the NY Times is one of the best things I’ve seen on the current financial crisis and what to do about it.

It’s called The End of the Financial World as We Know It and How to Repair a Broken Financial World. (I recommend reading them both straight through). And yes, Lewis wants more transparency and more regulation.

Paul Krugman estimated last month that the share of GDP going to the financial sector increased from 5% of GDP to 8% of GDP over the past 30 years or so. What did exactly we get for the extra 3% of the economy that was extracted by Wall Street? The answer is pretty evident. And of course lots of other sectors of society, generally inhabited by people earning significantly less money, have suffered pretty directly as a result.

Of course, there’s another sector of the economy that’s increased its share of the GDP by an even greater amount in roughly the same time period (from about 9% to about 17%). No prizes for guessing which one.

Anyone care to justify what value that sector has provided?

Critical of Critical

Like legions of other wonks when I discovered that Tom Daschle was going to be Obama’s point guy on health care, I sent off for a copy of his book Critical. It’s a fast and easy read, but in its examination of the problem it doesn’t add much to superior books on what’s wrong with health care (much of the first section reads like an undergrad’s attempt to summarize Jonathan Cohn’s Sick) and there are some pretty weak logic flows and basic editing throughout (he refers to the book Uninsured in America on p155 as though it’s already been introduced before it actually gets introduced on p161). But ignoring all that, what does Daschle suggest we actually do?

First, he promotes himself as a scholar of failed attempts at health reform past, and of course a witness to the most recent attempt.

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Merry Christmas & Happy Hols

Thanks for reading THCB this year. Thanks to to all the authors who we’ve featured and thanks to John and Sarah for keeping the train on the tracks. And thanks to all who commented and made THCB a great place for educated debate about health care issues.

We’ll be posting a little over the next week with some forecasts for 2009–-which is shaping up to be an interesting year in health policy at least. And there’ll be a new look for THCB early in 2009 too.

But for now enjoy the holiday!

I’m in Tahoe where there was 2 foot of powder last night, which I’ll be heading out to enjoy on my snowboard soon!

Interview with Fred Goldstein, US Preventive Medicine

Last year US Preventive  Medicine (USPM) caused a little splash with some full page ads in the Wall Street Journal proclaiming itself the future of preventative care. Since then the company, which has raised a significant chunk of private capital, has been diversifying into various aspects of prevention–including what looks more like disease management.

About a year ago USPM acquired Fred Goldstein’s company Specialty Disease Management Services. And since then it’s been marketing The Prevention Plan to employers–including a recent deal with AON–and also putting out a very neat online service that was shown at Health 2.0 in October.

Prevention is getting some lofty rhetoric, including Prez2Be Obama suggesting that it’s a major key to cutting health care costs. But many people in health care think that it doesn’t have an ROI. Fred disagrees and told me why in a wide-ranging conversation about the company, the concept of prevention and whether it’s really the wave of the future. Click here to listen

ePatient Dave & his doc Danny Sands speak out

One of the most remarkable people I’ve met this year is Dave deBronkart, better
known as ePatient Dave (fourth from left on top of the e-Patients.net blog). Dave has had a remarkable recovery from cancer and has probably used as many Health 2.0 tools as any patient.His blog is here.

I got the chance this week to talk at length with Dave and his GP Danny Sands. Danny is not only a practicing doctor in the BIDMC system in (Boston, yes that one with the blogging CEO and blogging CIO!) but also the Director of Medical Informatics for Cisco (FD, Cisco is a Health 2.0 sponsor and I’ve done consulting work for them in the past).

We covered a lot of ground in this conversation—starting with Dave’s illness, Danny’s role as a physician working with a very savvy patient, and the role of ACOR. But then we moved onto some critical questions about who will control the patient experience in the future in a world of Health 2.0 and what providers, patients and physicians need to do to prepare for it.

A fascinating conversation recorded via Cisco’s Webex technology that you can listen to here.

PS Dave asked me, what the most important issue raised in this interview was. I said "who is going to perform the function you performed for yourself for people who
don’t grab the bull by the horns the way you did? Because apparently it won’t be the Danny’s or
the BIDMCs of the world"

EMR use: on the steep part of the S curve, or being replaced by a new idea?

Ten plus years ago, I was giving talks suggesting that at some point relatively soon the EMR was going to become a reality. In 1999, at Harris Interactive I actually got the chance to launch a study which I hoped was going to soon show a relatively steep growth in EMR use in physicians’ practices. (The study was called Computing in the Physician’s Practice). Sadly because the study wasn’t a huge financial success and because I wandered off to do other things, it was only fielded in late 1999 and early 2001.

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Management guru Tom Peters likes Health 2.0, Wennberg, PLM, Millenson, but not the medical establishement

I didn’t know that Tom Peters (the In Search of Excellence guy) knew or cared about health care, but he certainly does.

In just one blog posting he reveals his impatience (putting it mildly) with the general level of doctors skills, his approval of Michael Millenson’s and the Dartmouth group’s work on medical quality variation, and he shows that he likes Health 2.0 and PatientsLikeMe — not least because he thinks that the medical establishment is reacting negatively to them!

Now, Sleepless in San Francisco

Having returned from Seattle, the persistent itching from the sand-fly bites of Roatan has awakened me at 5 a.m. So I’m commenting on three pieces of news, which I’ve commented on before here and at Spot-On.

First, United HealthGroup has introduced two new things this week. One is is a consumer portal/WebMD competitor called myOptumHealth, which gave a sneak preview (and was a sponsor) at the Health 2.0 Conference in October.

At first blush I like the look of what they’ve pulled together, although the about us section doesn’t exactly tell you much about who owns Optum! But the really interesting product United launched this week was aimed right at me. It’s an option to repurchase your individual health insurance without being re-underwritten and rejected.

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Sleepless in Seattle

In a 36 hour span I left the mountains of Copa Ruinas in Western Honduras, had dinner in South Beach, Miami and after stopping off to see that Health 2.0 central in SF hadn’t collapsed, ended up in Seattle. I woke up early (had to get that in there to match the title) and hustled off to the main symphony hall because it’s the 25th anniversary of the Group Health Center for Health Studies. (The research arm of Group Health Cooperative of Puget Sound)

There the question of the day is, why haven’t integrated group practices (like Group Health & Kaiser) spread across the nation? And is there something that the new Administration can do to help make it so?

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