Tag: Startups

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.

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.

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.

Cisco’s Frances Dare talks about Congressional action on health IT

Aug 26, 2008

By Matthew Holt Frances_dare_2

Frances Dare is someone I’ve know for a long time in the health care IT world (sorry, Frances!). That means that she’s seen the painfully slow developments in many aspects of health IT since the 1990s, and has an experienced view of what’s coming along at what pace. These days Frances is a Director at Cisco focusing on health care, and more recently she’s taken an active role in Cisco’s health care lobbying efforts on Capitol Hill.

Given that we don’t spend much time on THCB talking about the impact of the Federal sausage-making process on health care IT, telemedicine, et al, I thought that getting the view of a major IT vendor about what they expect to come out of the current Congress would be pretty interesting. And it was. Here’s the Interview.

BTW, in the interview I get the name of Frances’ division at Cisco wrong, Frances is a Director in the ISBG which stands for Internet Business Solutions Group. (FD, I have done consulting work for Cisco in the past, even if I didn’t know the name of the group I was working for!).

Hello Health open for business

Aug 25, 2008• 13

By Matthew Holt

Hello Health, the clinic that Jay Parkinson has been promoting for a while, is open for business. If all the patients are as happy as the first patient, success is assured!

The deal is that they’ve gone with mid-range concierge fee ($35 a month—around the cost of a low cost cell phone plan or high-end Netflix?) for patients to get access/membership and then have fixed charges thereafter. That amount is about three times what I pay for very basic low-end concierge services (basically email) at Tom Lee’s Metropolitan Medical Group in San Francisco, but way less than the typical $150–200 a month fee for high-end concierge practices.

What remains to me the tricky factor in their vision is how they’ll make this work with the bureaucracy & accounting behind high deductible plans (without taking on a ton of staff). But however that piece works out, someone needs to shake up primary care. Jay and his 2 colleagues are young entrepreneurial docs giving it a shake.

Health 2.0 had a film crew there with David Kibbe acting as roving reporter at the launch party. Much more on both these topics to come, but remember that Hello Health is also working with MyCa on a very interesting new interface to the EMR and much more.

Yes, you’ll see much more about the Health 2.0 Across America video starring David Kibbe and the MyCa interface at the Health 2.0 Conference.

Who’d be a pollster, eh

Aug 22, 2008• 4

By Matthew Holt

HSC says that the number of Americans going online for healthcare goes way up:

In 2007, 56 percent of American adults—more than 122 million people—sought information about a personal health concern from a source other than their doctor, up from 38 percent, or 72 million people, in 2001, according to a national study released today by the Center for Studying Health System Change (HSC).

Harris Interactive says it’s gone down ;

Ten years ago, in 1998, the Harris Poll began measuring the number of people going online for health care information. At that time we reported that 54 million people had done so at least once. Since then the number of those people, whom we labeled “cyberchondriacs,” have increased almost every year, reaching 110 million in 2002, and 160 million in 2007.

This year, the Harris Poll finds only 150 million who claim to have gone online to obtain health care information. Of course, 150 million is still a huge number and includes 66 percent of all adults and 81 percent of those who are online.

Extra points if you can spot the flaw in my reasoning. (Yes, it’s easy but I’ve been up late watching the Olympics….even though I said I wouldn’t)

Health IT policy: the fur is flying

Aug 19, 2008• 11

By Matthew Holt

Some fur is flying in the rarefied world of health IT policy geeks this morning. Health Affairs has three articles. The first from Markle’s Carol Diamond, writing with Here Comes Everybody author and Internet guru Clay Shirky, more or less says that obsessive attention to rigid standards is not helping and actually may be hindering the IT adoption process. And yes, in case you were wondering they do mean CCHIT and ONCHIT’s current policies and agenda which has been going for four years and which they’re accusing of “magical thinking.” Instead, we need new policies which target desired outcomes measured in improved patient care, instead of assuming that creating new technology standards will get us there. And by policies I think they mean money, and its redirection by current payers. After all, if putting in a RHIO costs hospitals operating revenue in reducing admissions and tests, why would they do it?

Omnimedix still fighting Dossia owners

Aug 13, 2008• 1

By Matthew Holt

Kleinke JD Kleinke and Omnimedix are still in business and still fighting a pretty serious lawsuit
about the Dossia breakup. I talked with JD yesterday. The team is working on several super secret client projects, but it’s tough to run a small consulting shop and keep a protracted lawsuit open, so they’re passing the hat! Why keep the lawsuit going?

Well, there’s obviously stuff that JD couldn’t tell me, so this is speculation but it’s clear that this is much more than an a “vendor didn’t deliver/client didn’t pay” dispute. JD was always very vocal about an open nonprofit being the protector of the Dossia members’ employees’ data, so I surmise that contractual disputes about who got access to what data are at the root of this. It would be interesting (if practicably impossible) to compare Dossia’s contact with Omnimedix in their contract with Indivo.

More generally, JD and I talked about whether there’s a need for a Dossia-type entity when there’s Google Health and HealthVault. Here’s what JD said about Microsoft and Google’s privacy stance.

“In both cases they’ve violated their own operating principles as businesses to do the right thing.”

Viagra prescribed more safely online than in regular practice?

Aug 8, 2008• 9

By Matthew Holt

Really? Can this be true? Well so says a bunch of academics writing in the Mayo Clinic’s journal.

They looked at records of questionnaires taken and prescribing decisions made by a licensed, regulated online pharmacy called KwikMed — that is trying very hard to establish itself as ethically and legally different from those fly by night guys whose spam comments will rapidly attach to this post! They looked at the various outcomes and end points including safety and level of counseling and found that the online system produced results as good as or better as those found from a big records review in an unnamed (not surprisingly!) large multi-specialty clinic in Salt Lake City, UT.

Now obviously the ability to create an online questionnaire for specific conditions with clear inclusion/exclusion criteria (like ED or hair loss) means that as clear a picture can be gained in most cases from a good history taken online–and probably the history will be given more honestly by the patient. Plus the rigor of the history is probably better than one taken in a rushed office visit. And then it gets reviewed by a doctor who may recommend another approach but most times agrees and sends the Rx on to be filled.

David Hamilton is very smart

Aug 7, 2008• 2

By Matthew Holt

In his piece he suggests that data portability will lead to a clash as consumers figure out that it’s not privacy of this data that’s the problem, it’s what insurers do to people they already know information about. And that behavior is inevitable in the absence of political reforms which said clash will cause….at some point.

Of course I think he’s smart because I agreed with him here!