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Tag: Startups

Best of: AthenaHealth’s Jonathan Bush on the end of software

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AthenaHealth’s Jonathan Bush was patient enough to talk through two interviews with me. The first died in a software flameout–the second crashed my computer, but thankfully the recording was still there after my very fearful restart! Jonathan explains AthenaHealth’s business model, why software is "nearly dead", and why he might just send a detective to your house if you want a job with him!

The rumors are true–he’s entertaining and "provocative". And he’ll be coming (assuming his schedule clears up) to the Health2.0 conference. So take a listen to the interview

BEST OF: JD Kleinke talks about PHRs, Omnimedix and the Dossia controversy

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JD Kleinke is always one of the more controversial and fun people in health care policy and health care IT. He doesn’t just write about stuff–he also gets really involved. From his early days at HCIA to his more recent roles at Healthgrades. And now of course he’s the head of Omnimedix — which was developing the technology for the employer based PHR Dossia, funded by WalMart, Intel et al. But apparently not funded enough.

I had a wide-ranging discussion with JD about his policy work, his career, what he thinks about health plans, and what went wrong with Dossia. The interview is of course well worth a listen.

HEALTH2.0/TECH: Way too much going on!

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I’m trying to organize a conference with everyone and their brother claiming that they need the last seat and that the dog ate their mouse so they couldn’t register. And we’ve been coaxing our demo panelists through their demos–which are all going to be really great, other than no one believes you when you tell them that four minutes went by in just 240 seconds.

And Tuesday was just one of those days…

Perennial THCB Health2.0 favorites Sermo are cooking up some fun stuff for the wine and cheese reception they’re sponsoring to close the Health2.0 Conference. But they’ve had a huge few days. Last week they announced that the FDA will be using Sermo to monitor potential new adverse drug events and much more. Initially FDA staff will be looking at what docs are talking about online, later they’ll be posing questions. Then Tuesday Sermo announced a $27m Series C Round, which should just about cover the cost of the cocktails….

Meanwhile, Kosmix has taken the beta tag off its RightHealth stealth search engine site. You can hear far more about this from my interview with Venky a month or two back. But they’ve announced that they got 2.5 million visits and 9 million searches generated a month and are in the top 12 health search sites measured by Hitwise. The concept is to extend the "home age for a search" to let people explore topics in context, while still making those top 10 search results visible.

Speaking of searches, OrganizedWisdom is changing its spots and moving from being a user-generated content site, to being a community search site that integrates user-generated content from all over.  More details here and to be revealed at the conference next week. CEO Steven Krein tried to explain this to me at lunch a while back but I didn’t understand what he was talking about. Now I do and it’s really very interesting.

Finally, we’ll have more to say about how the news that Adam Bosworth is leaving Google health will impact Health2.0 shortly. But rest assured that Google is still participating in the conference and that they remain committed to health care.

HEALTH PLANS/TECH: Selling out a name–et tu Harvard?

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Over at HISTalk there’s frequent criticism of "awards" that are handed out by analysts to vendors, and frequent assessment of which consultants can be trusted as independent, as opposed to which ones will "sell" an award. Frost and Sullivan gets a particularly bad rap over there on the latter issue.

Which all struck me as a little strange when I saw this press release. South Carolina Blues has won an award for its pre-certification technology. Who bestowed this honor?  Harvard School of Public Health’s Dept of Health Care Policy.

BlueWorks is a partnership between the Blue Cross and Blue Shield
Association and Harvard’s Department of Health Care Policy that recognizes
innovative Blue Cross and Blue Shield companies working with doctors and
hospitals to increase the efficiency and consistency of care delivery
nationwide. <SNIP> Since 2004, Harvard Medical School’s Department of Health Care
Policy has named 35 Blue Cross and Blue Shield programs as BlueWorks winners.

Of course all major Universities collaborate with business, but I’m not sure I recall one going into the "handing out prizes" part of consulting. Anyone know any more?

BEST OF: Interview with Shawn Jenkins, CEO BenefitFocus

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When I was contacted by the PR folks representing BenefitFocus I found out that they’d quietly put into place the original 1995 business plan of Healtheon–connecting employers and health plans electronically around enrollment and billing. (Remember The New New Thing?) Ironically enough some of the plans that announced that Healtheon was going to do that with them in 1996 are just getting online with BenefitFocus now! So I thought that it would be pretty interesting to talk with Shawn Jenkins, BenefitFocus’ CEO about their core business, which has been growing like crazy in the last couple of years.

Then I found out that they were also launching a Web2.0 media group including a new health care YouTube-type video site called ICYou (get it?), hiring a star local news anchor from Charleston SC, Nina Sossaman-Pogue, and creating a PHR, and that they also wanted to come sponsor and video the Health2.0 Conference. So then I really wanted to talk with Shawn!

Here’s the interview. (We had a slight technical hitch in the middle but I think my editing skills have overcome it!).

What Are They Thinking: ONCHIT and RTI – Brian Klepper

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I’m sure I don’t really get the deeper issues involved here, but sometimes its hard to not have your breath taken away by some people’s notion of a good idea. Maybe its because I’m not a true geek, but what I’m about to describe strikes me about the same way I feel as when I see a young adult with multiple facial piercings and hear her/him say "Aren’t these great!?"

Modern Healthcare has an interesting piece on a report that was developed by RTI, a contractor to HHS’ Office of the National Coordinator for Health Information Technology (ONCHIT). The report urges revising Electronic Medical Records (EMR) standards to make it easier for payers and the feds to access the records and spot  fraud.

Now I’m as big a transparency advocate as the next guy, and I routinely explain to doctors how claims or clinical encounter data can be used to accurately rate their pricing and performance relative to peers within specialty. I believe we should use performance ratings to reward the high performers and to incent the poor ones to do better.

But to really get to the system we need, doctors first have to implement and use EMRs. They’re key to making the health system as a whole work better. Fewer than a quarter of physicians currently use them at this point. While there are still some buggy whip advocates out there, a large and growing number of doctors get that. Young physicians take it for granted.

Still, there are a lot of hurdles to installing an EMR system. They’re expensive. They force you to change your practice’s work flows. Some of the designs aren’t all that friendly. They’re complicated. And who wants to learn a new system. Heck, I know I’d like what it can do for me, but I haven’t gotten up the nerve to tackle iMovie yet on my Mac, and that’s about a tenth as complicated as an EMR with embedded practice guidelines.

We KNOW EMRs are a good idea but there are lots of reasons for doctors to say NOT YET. This Administration, to its credit (he said, grudgingly) has gloried in their advocacy for these new
technologies, what they can do, and how they can help improve quality and cost. (Remember Newt’s
line, "Paper Kills?")

So WHY would the guys leading the charge on EMRs announce that one of the really great things to use EMRs for when doctors finally bring them online is to WATCH AND CONTROL THEM MORE EFFECTIVELY.

Dumb, dumb, dumb.

But I’m sure I don’t see the big picture here.

OMNI: The Oncology Metrics National Index – Brian Klepper

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An innovative Ft. Worth consulting firm comprised of experienced oncology professionals, Oncology Metrics, has linked private oncology practices throughout the country in a collaborative, knowledge-sharing enterprise, called the Oncology Circle. The first round of information brought together 22 practices containing 167 medical oncologists. Combined, the practices treated almost 63,000 patients annually, had $600 million in revenues and spent $375 million on drugs.

In a separate but related effort, Oncology Metrics has established a new national data aggregation effort, The Oncology Metrics National Index (OMNI), which brings together data from practices using electronic medical records (EMRs), mapping the data in each EMR to a standard template. Then those data are aggregated and mined to produce different cancer care-related clinical measures associated with procedures and processes: e.g., the administration of erythropoietin (anemia drugs), hemoglobin (Hgb) testing, and patient staging. A primary goal is to create a data mine that can allow each practice to see how it compares to others, and how they might improve. But a secondary and also very important objective is the development of transparency information that can help rationalize the practices and costs that have dominated oncology.

This is a leading edge project that leverages the data that is newly available through EMRs, and that is indicative of the kind of progress that we can anticipate throughout health care in the next few years. Clearly a company to watch.

PODCAST/QUALITY/TECH/HEALTH PLANS: Disease management, technolgy and the future of health care–Gordon Norman tells all

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Gordon Norman is Exec VP and Chief Science Officer at Alere Medical, formerly head of DM at Pacificare and a font of knowledge and opinion about disease management, technology, the role of health plans, and the chances for overall change in the  system. We agree much more than we disagree, but if you have any interest at all in the restructuring of health care, I’m sure that you will enjoy our conversation.

You’ll also enjoy Gordon’s recent talk at Healthcare Unbound–his slides are here

TECH/HEALTH2.0: Harris Shows Number of Cyberchondriacs increases to an Estimated 160 Million Nationwide

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Harris Shows Number of Cyberchondriacs increases to an Estimated 160 Million Nationwide

As you know I’ve been following this number for 10 years (not to mention working with and at Harris during part of that time), and  the increase in the last few years has been remarkable. After all the fast pace growth in the internet was in the 1990s not in the 2000s, yet its use for health care continues to increase.

And talking about cyberchondria, I had severe chest pain about a month ago that felt pretty bad while I was out of state. I searched on the web for chest pain, confirmed that I had 3 of 4 symptoms of a heart attack and got myself to a doctor rapidly. The EKG was negative, but of course had there been no Internet I might not have bothered and I might have ignored a heart attack or arrhythmia.  Presumably that’s not the preferred use of health online, but it really helped me.

PODCAST: Fine art and healthcare–a conversation with David St Clair, MeDecision

A while back I got a rather unusual email from MEDecision– an interesting tech company I’ve interviewed before on THCB. It was actually quoting their CEO David St Clair who’d just seen Malcom Gladwell and it said this:

Picasso was able to produce his greatest masterpieces by the time he was in his
mid-twenties. After that, it seems the quality of his output leveled off, or may
have even dipped a bit. Cezanne was kind of the opposite. He learned from
trial-and-error and leveraged a half-century of life experience, development and
growth to create his best art after the age of 50. I think Mr. Gladwell is dead-on in his assessment that
proposals to fix our health care system can be categorized as taking either
Picasso or Cezanne approaches. Like Picasso, a lot of folks are focused on
finding that one, major, “big bang” idea that will comprehensively solve every
problem. While this methodology may work in certain circumstances (it certainly
worked for Picasso for awhile), I have to agree with Mr. Gladwell that health
care is far too large and complex a system for us to realistically think that
some monumental “burst of innovation” is going to cure its every ill and set it
back on course. No, my money is on the Cezanne approach. After 20 years in the
health information technology business, I truly feel that there isn’t a single
magical solution – even if Michael Moore seems to think there is. It’s got to be
a lot of little solutions building momentum toward larger, system-wide reform.
And we need to engage as many people as we can in the process and give them the
means and resources they need to keep trying new approaches that might work.
Like Cezanne, we need to build on our experiences and develop and grow our ideas
before we can expect the masterpiece to emerge.

As you might imagine, I’m not a fan of incremental piecemeal change in health care, even though I’m not in complete agreement with Michael Moore–whatever certain of my readers might think. And it’s not often that a health care tech company CEO goes off the tech-only reservation (so to speak)  So yesterday I had a long chat with David. It certainly was spirited, and I hope you’ll be interested in the outcome!

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