Category: Uncategorized

Health Hack the Planet: Japan’s Upcoming Code-a-thon

Feb 8, 2012

By Deb Linton

Health 2.0 and the Health 2.0 Fukushima Chapter are proud to announce the next competition in the Developers World Cup series: The Health 2.0 JAPAN Hackathon. On February 21st and 22nd, Health 2.0 will host this inaugural event at Nihon University in the Fukushima prefecture (map) in conjunction with Medical Creation Fukushima Exhibition and the Health 2.0 Fukushima Chapter Meeting.

The Health 2.0 Developers World Cup is an international innovation competition to improve the technology supporting our world’s healthcare systems. Through our local chapters, Health 2.0 invites teams to use the growing number of open health datasets and APIs now being made available to rapidly prototype health related applications for the chance to win prize money and international visibility. The first place winners of each local code-a-thon will be flown to San Francisco to face-off against other finalist teams at the 6th Annual Fall Health 2.0 Conference for the Developers World Cup title. Regional competitions are being held in New Delhi, New York, Amsterdam, Austin, Boston, Russia, China and Washington DC.

We’re particularly excited to see the results of this regional competition given the increasing popularity of hacking events in Japan. Hack For JAPAN, a series targeting solutions for disaster recovery after earthquakes, has established a strong community of developers ready to tackle big problems. With its more experienced teams, it will be interesting to see who Japan sends to the international finals in the Fall.

The competition has been divided into 3 categories because of the large number of innovators expected to attend. There will be a traditional Code-a-thon, a Design-a-thon, and an Ideathon. The Code-a-thon will center around disaster recovery services, smartphone use and Osirix applications. The Design-a-thon will focus on improving breast cancer exams and 3D virtual animations to improve patient-doctor communication. Finally, the Ideathon will look at how to improve healthcare for disaster victims, remote populations and healthcare recovery in Fukushima.

Registration is filling up quickly and there are only a few more days left to sign up. You can learn more about the event and register HERE but we recommend that you first fire-up Google Translate if your kanji is a little rusty.

Should Sugar Be Controlled Like Alcohol? Part II

Feb 7, 2012• 16

By Aaron Carroll MD

Lots of interesting feedback on my post on sugar regulation. Some of you have accused me of making straw man arguments; others have used straw man arguments to question my post. So let me take a few minutes to be clear about what I was saying. The article I referenced specifically questioned whether sugar should be regulated like alcohol and tobacco.

We regulate alcohol by making it illegal to use it before the age of 21. Period. We regulate alcohol by making businesses get a specific, and often hard-to-get, license to sell it. Where I live, it’s illegal to sell it on Sunday. We don’t regulate alcohol by limiting the amount you can put in a drink. Any bar can make any drink they like, with as much or as little alcohol as they want.

We regulate tobacco by making it illegal to use it before the age of 18. Period. We regulate it by making businesses sell it in specific areas, often hard-to-get at. It’s illegal to put it in vending machines. But we don’t regulate tobacco by limiting the amount you can put in a cigar. Any cigar maker can put as much or as little tobacco in as they want.

So when someone says that they want to regulate sugar like alcohol or tobacco, that’s what I think of. And it was what they meant, according to reports:

Sugar is so toxic it should be controlled like alcohol, according to new report that goes so far as to suggest setting an age limit of 17 years to buy soda pop.

A Better Way to Avoid Pregnancy

Feb 6, 2012• 86

By John Goodman

You know we have entered the silly season when a major national debate gets underway over whether people should be given something for free that they could easily pay for out-of-pocket. Take the decision of the Obama administration to force Catholic universities, hospitals and charities to provide health insurance that includes free contraceptives. The reaction was poignant and hyperbolic, but (what can I say?) completely deserved:

“An edict delivered with a sneer,” wrote Michael Gerson in The Washington Post.
“An attack on Christianity so severe that every single church in Florida had a letter read from the bishops,” said Newt Gingrich.
“We can’t just lie down and die and let religious freedom go,” said a spokeswoman for the Conference of Catholic Bishops.
“We do not happen to think pregnancy is a disease,” said the president of the Association of Catholic Colleges and Universities.
People who postpone conception with “chemicals and latex” are part of the “culture of death,” said Archbishop Timothy Dolan.

What makes this so amazing is that it is déjà vu all over again, as Yogi Berra might say. Do you remember the death knell for HillaryCare? I bet you can’t.

Mammograms and Pap smears. Hard to believe, isn’t it?

[Yes, I know. There were many things that helped derail HillaryCare. The biggest mistake was the White House’s failure to throw everything aside and endorse the Senate Republican health plan, which was about as close to HillaryCare as RomneyCare is to ObamaCare. Hillary would have ended up with about 90% of everything she wanted. More about that, perhaps, in a future Alert.]

The Perfect Storm For Innovation

Feb 6, 2012• 7

By JOHN HALAMKA

In my career, there have been a few perfect storms, defined as “a confluence, resulting in an event of unusual magnitude”.

When I was an undergraduate at Stanford University in 1980, two geeky guys named Jobs and Wozniak dropped by the Homebrew Computer Club to demonstrate a kit designed in their garage. IBM introduced the Personal Computer and MSDOS 1.0. I purchased an early copy of Microsoft Basic and began creating software in my dorm room including early versions of tax calculation software, an econometric modeling language, and electronic data interchange tools. Every day brought a new opportunity. The energies of hundreds of entrepreneurs created an industry in a few intensely creative months that laid the foundation for the architecture and tools still in use today. A guy named Gates offered me a job and I decided to stay in school instead.

In 2001 when I was first hired at Harvard, a visionary Dean for Medical Education, a supportive Dean of the Medical School, talented new development staff, and a sleepless MD/Phd student came together to create one of the first Learning Management Systems in the country, Mycourses. Robust web technologies, voice recognition, search engines, early mobile devices, and new multi-media streaming standards coincided with resources, strong governance, and a sense of urgency. Magic happened and in a matter of months, an entire platform was created that is still powering the medical school today.

The Journey We Take Alone.

Feb 6, 2012• 4

By Alexander Prisant

You start coming out from under the deep anesthesia. First your eyes start to open. They work. Then you haphazardly try to move an arm, your head, and your lips to speak. And none of that works at all.

You’re strapped in and breathing through a machine and taped up 32 ways against Tuesday. So you go back to your eyes, which work. Mounted over the foot of the bed is a clock. Those big, easy-to-read hospital clocks. You’re a little dopey, but you slowly realize it says three minutes to six. The last time you were conscious, you think, was about 8:45 in the morning.

What??

Now you’re not dopey; you’re stunned and scared and reflexively lurch to get up. But all the medical machinery holding you down keeps you down.

And for some reason there is no pain at all, even though you are already suspecting you’ve been filleted like a flounder.

Does Obamacare Limit Profits for Health Insurance Companies in Your State?

Feb 4, 2012• 84

By Jason Shafrin

One of the provisions in the Patient Protection and Affordable Care Act (a.k.a ACA, a.k.a. Health Reform, a.k.a. Obamacare) is that it limits the profits of health insurance companies. The ACA imposes a minimum medical loss ratio (MLR) on all insurers. The MLR is the amount of money spent on covered person medical care divided by the total revenue received through premiums. There is some debate of what constitutes ‘medical care’ (e.g., do investments in electronic health records count as medical care?), but insurer profits certainly are non-medical.

The ACA requires health insurers in the individual and small group market to spend 80 percent of their premiums (after subtracting taxes and regulatory fees) on medical costs. The corresponding figure for large groups is 85 percent. According to a recent Kaiser tracking poll, 60 percent of the public views the MLR concept favorably, although only 38 percent was aware that the provision is in the ACA. Insurance brokers may be getting squeezed for insurers to meet this amount.

Even though the MLR is a national law, it may not apply in your state. Continue reading…

Do Something Really Innovative In Health: Crowdsource Problems, Not (Just) Solutions

Feb 4, 2012

By David Shaywitz

Businesses exist to solve problems, right? Certainly, this is the heart of the classic entrepreneurial model: you become obsessed with a particular problem, and create a business to solve it. Example: eBay was created by Pierre Omidyar to solve a perceived problem with inefficient markets, and since its inception has generally focused on doing exactly this.

Most enterprises are not blessed by such a coherent focus, at least not for long. More often, organizations – including university research labs as well as for-profit businesses – have a point at which they realize that their challenge has changed, and the problem they thought there were going to solve has shifted or even completely disappeared. The team – often an impressive group of people representing a wide range of capabilities — is then left to figure out what to do.

While disbanding is always an option, it rarely seems to happen, at least volitionally. Businesses, projects, academic enterprises – all are obsessed with their own survival, which rapidly becomes the defining mission. As a result, the organization urgently tries to figure out a way to pivot, a way to apply established resources in a different, useful way as it searches for a purpose to justify its existence. Very often, the question becomes: what should we do – what problem should we solve?

Nimble Medicine

Feb 3, 2012• 9

By Dave Chase

In a piece for the New Yorker, Dr. Atul Gawande outlined how, early in the 1900s, more than forty per cent of household income went to paying for food and food production consumed roughly half the workforce. Beginning in Texas, a wide array of new methods of food production were tested. After many pilots, tests and information dissemination, food now accounts for 8% of household budgets and 2% of the workforce. As a wide array of small innovations ultimately led to the transformation of farming, so too is a rapidly building wave of innovative new care and payment models leading to similar breakthroughs in healthcare. I call this Nimble Medicine.

Until recently, attempting a new care or payment model meant long planning and development cycles. The cost and complexity of testing new models prevented many from being tried. Even today, the leading HealthIT vendor is known to charge $100 million and up for its software. Amazingly, they require three months of training before they even let people administer the software.

Genetic Testing and Insurance: One Datum

Feb 3, 2012• 4

By DAVID FRIEDMAN

Reductions in the cost of genetic testing and improvements in what we know about what it tells us produce obvious benefits; if you know you are likely to have some particular medical problem, you may be able to take precautions against it. But they also have at least one potential downside.

The more is known about the chance of bad things happening to us, the less able we will be to insure against them.

A solution to this problem that is sometimes proposed is to permit individuals to have their genes tested but forbid insurance companies to require testing as a condition of insurance or to use the information it produces. The problem with that is adverse selection. If the customer knows his risk and the insurance company doesn’t, high risk and low risk customers are charged the same price, making insurance a good deal for the former and a bad deal for the latter. Insurance companies, realizing that most of those who choose to buy their insurance are bad risks, will charge accordingly, driving more of the low or average risk customers out of the market. In the limiting case, insurance is bought only by high risk customers, at a high risk price. A famous description of the problem is Akerlof’s article “The Market for Lemons.”

If we allow both insurance companies and their customers to make use of genetic information, then both high risk and low risk customers can buy insurance, but at different prices. The risk of having genetic variants that make you more likely to suffer some expensive medical problem is uninsurable, although you can still insure against the risk that, given those genes, the problem will actually appear.

Thinking About the Bipartisan Policy Center Report on Health IT

Feb 3, 2012

By Jane Sarasohn-Kahn

There are few issue areas within the Beltway of Washington, DC, that have enjoyed more support across the political aisle than health care information technology. In 2004, George Bush asserted that every American would/should have an electronic medical record by 2014. Since then, Democrats and Republicans alike have supported the broad concept of wiring the U.S. health information infrastructure.

With the injection of ARRA stimulus funds earmarked in the HITECH Act to promote health providers’ adoption of electronic health records, we’re now on the road to Americans getting access to their health information electronically. It won’t be all or even most U.S. health citizens by 2014, but it will millions.

Just how solid is political support for health IT these days, then? An important report, Transforming Health Care: The Role of Health IT, from the Bipartisan Policy Center Task Froce on Delivery System Reform and Health IT published in January 2012, talks about the gaps and obstacles to achieving an interoperable, accessible health IT infrastructure.