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TECH: WorldDoc CEO Rahul Singal transcript

This is the transcript from my recent podcast with WorldDoc CEO Rahul Singal transcript.

Matthew Holt: Hi. It’s Matthew Holt, at The Health Care Blog, and we’re back with another podcast. This time, I’m talking with the C.E.O. of a very interesting company, which has its fingers in multiple pieces of the health-care system. I’m talking today to Rahul Singal, M.D., who is the president and C.E.O. of WorldDoc. Rahul, how are you today?
Rahul Singal: Doing fine. Thanks, Matt. Good afternoon.

Matthew: WorldDoc is based in Las Vegas, just to let the people listening know. I saw Rahul there at a conference a week or so ago. I’d kept tabs on WorldDoc a little bit in the last couple of years, but I wanted to find out a bit more about what was going on. But a number of interesting health care stories are coming out of Las Vegas. I suspect that both those stories and the roles of WorldDoc are not so well known. Anybody going to your website would see that you’re involved in a bunch of different things: strategy analysis, software, personal health records, pharmacy benefits management. To tell the people listening, what does WorldDoc do and what are your main lines of business?

Rahul: WorldDoc is in its seventh year of operations. We started with 14 board certified specialists. We now have 20. We have the single vision of trying to educate and empower consumer end users about their health before seeing a doctor. So we created a web based software system that helps people understand their acute care problems, things like a cough or red eye or stomach pain, "What’s wrong with me? What can I do to make myself better?" Acute care is one of the things. Preventive health. "Hey, I just turned 40 years old. What tests do I need? How can I maintain a healthy lifestyle? Am I at risk for a heart attack?" Then chronic conditions, things like when you know you have high blood pressure or diabetes or high cholesterol. We teach people about their goals, how to talk to their doctors, how to get to their goal.

We do this all in a software based system, created by the 20 board certified specialists.

Matthew: That’s one part of your business. As you know, there have been plenty of companies over the last decade or so who have created software programs to do some parts of some of that, but you guys seem to have made a real business of it. So what have you been selling, who are your customers, and what kind of services are you selling?

Rahul: Our core customers are self insured employers and their payers. The self insured employers are the true purchasers of health care. Their payers are independent third party administrators or regional health plans, which market to these entities, and then their consumers and end users use them.

Our core web based system comes with a 24 hour nurse line. One of the things that we’ve been able to do is import pharmacy and medical claims into our care engine, so that the pharmacy claims can be done within 24 hours of a claim fill. That means that, if I have diabetes and you have high blood pressure, and we each fill a prescription, then, the next day, the WorldDoc system might message you and say "Hey, for your high blood pressure, do you know what your goals are? Here’s the medication. You may want to talk to your doctor about this alternative, which will save you $1,000 a year."

Matthew: Let’s get down to a more granular example. Let’s say I’m one of your customers who is an employer, and I’m working with a TPA to administer a regional health plan or a TPA to administer my employee benefits. Maybe you want to pick a real example, of one of your employer customers. How does it actually work? What are the pieces that you’re supplying to them? What are the pieces that they’re really looking for?

I understand that a smaller TPA may not have done what some of the larger health plans have done and created their own online consumer health experience, as it were. Perhaps they’re looking to you to provide that. What is the value proposition? What are the reasons for which they will engage WorldDoc?

Rahul: On the health risk assessment side, where organizations profile a population’s risk, there’s a lot of examples in the industry in which an employer or a health plan will incentivize a population to fill out a health risk assessment. We do that as well, it works great.

However, we go a few steps further, so that, if, on the basis of pharmacy claims, we know that 500 people may have diabetes, and we’ve done this with Coast Resorts, a casino here in Las Vegas. These 500 people that were on a diabetes claim file, out of a total population of about 7,000, were sent one letter, which invited them to come to the WorldDoc website and fill out a diabetes report card. About 150 people did that.

What’s fascinating is that these 150 people, whom we taught to know their numbers, put in their cholesterol levels, their hemoglobin A1c, and blood pressures, and we created a profile of "Hey, am I at goal?" Simultaneously, we sent this to the employees’ doctors, and we had that in our database. What we showed, within six months, was that these people that participated, that their blood sugars improved to the same degree as they would have if a nurse had phoned them at home. So, we believe, for working age people, commercial people, "Get on the same page with your doctor, reach your goal." This study was published in the Journal of Managed Care about a year ago, and really empowered end users to take better care of themselves.

Continue reading…

TECH: The Magic Ingredient for E-Prescribing? And a trademark grumble

At iHealthbeat, the ever wonderful Jane Sarasohn Kahn tells you more than probably ever needed to know about NEPSI–the Allscripts et al backed free ePrescribing initiative.

BTW, if you use the words eRx apparently you don’t mean ePrescribing but you mean this company instead. Or at least that’s what their lawyer Mr Swindle (I shit you not) said in his letter to me. Pity that said word has been used to mean ePrescribing since well, well before the foundation of said company, and certainly before it got a trademark on it in 2001. But it’s good that said company is rich enough to pay high-priced lawyers to write stupid letters. I suspect that they’re not so pissed with me, as with these companies and government agencies—whom people have actually heard of—using the term!

Talk about fleas claiming that they own the dog! I’m thinking of trade-marking the term eIdiot.

TECH/HOSPITALS: Cisco healthcare briefing

The video of the briefing on health care hosted by Cisco is up here. To get an idea of what it was about take a look at this agenda. Then go take a look at my little part of the action, which is a discussion forum about issues raised. You’re welcome (and encouraged!) to come ask a question and make a comment.

Obviously Cisco hopes that by getting everyone smarter about healthcare it’ll sell more networking equipment. But their goal in hosting this seminar is to raise the level of the conversation, and I think that this is pretty interesting stuff if you care about health care IT — particularly in hospitals. There’ll also be a transcript up soon.

TECH/PODCAST: interview with Rahul Singal, CEO of WorldDoc

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WorldDoc is a company that sells an interesting mix of a consumer web tools based on PHRs, care management software and transparent PBM services. Its current customers are employers and regional TPAs & HMOs. I spoke with CEO Rahul Singal about the company, their business, and what he thought about the future of consumer services in health care. And to find out, you can listen to this podcast.

TECH: Cisco Innovations in Healthcare IT Discussion Forum

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I am the host for a Q&A forum hosted by Cisco. It’s a follow up to this video discussion about the use of IT in health care. Like most tech companies, Cisco is increasingly targeting health care as an industry where its networking technology can make a real difference—and of course where it can sell more of it! As you know I’m in general an advocate of more IT use in health care, and I think that they’re showcasing some interesting innovations.

So please come over to the discussion forum to join in the conversation. I’ll be referencing some of the more interesting things that I saw at Cisco there and here next week.

TECH: Health plan uses novel security solution

A smaller Pennsylvania Blues seems to think that it’s going to be providing access to their data to its members everywhere. It’s using some interesting security tools to do it.

Diversinet Corp. (OTCBB: DVNTF), a leading provider of mobile authentication security and access solutions, today introduced MobiSecure™ Wallet and Vault, new solutions that give users secure and immediate access to a host of personal, financial, and insurance identity information, as well as other critical, privileged data. Offering both convenience and security, the new MobiSecure products give banks and other financial institutions, insurance companies, and health care providers a unique and easy-to-use solution they can use to provide individuals with fast, convenient and secure access to new applications and services via mobile phone, PDA or PC browser. Diversinet also announced today it has signed a licensing agreement with Blue Cross of Northeastern Pennsylvania (BCNEPA) for the MobiSecure Wallet and Vault.

TECH: PHR talk

Those of you who couldn’t get into the live version of the PHR webinar I was on the other day can now go to the Center for Information Therapy events web page and listen and watch for yourself. (Or I suppose if you did see it but thought it was so good you wanted to see it again, you can do that too!) It’s the first in the list of “past events.”

I had some problems getting audio in my version, so let me know if that happens to you. But it’s a fairly nifty audio and slide integration.

And yes it’s very bizarre giving a speech into a telephone when you can’t hear anything on the other end at all!

TECH: Cisco’s briefing

A little about my day job today. I’m sitting in a video briefing hosted by Cisco for its provider clients being broadcast to 10 sites. I’m in the one in San Jose, where there are lots and lots of interested parties from a minor, local HMO which has its own small IT projects underway!

I’m telling you this because after the session is done it’ll be posted online, and then there’ll be an online discussion about the issues of installing IT in hospitals, and the possibilities of new technology.

More details later…

TECH/PHYSICIANS/INDUSTRY: Now the Communists have infiltrated the officer ranks!

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(Speaker adopts very pompous tone) You may remember a little while back that some left wing seditious journalist criticized the sanctity of our free and opaque market system. He claimed that a leading back surgeon at the Cleveland Clinic — the Cleveland Clinic, I say, yes, the very epitome of all that is good and great about American capitalist medicine — was somehow putting his own interests above that of his patients as he used a surgical device that he and the clinic both promoted.

Well this rabble rousing has got completely out of hand. Now a presumably Frenchy cheese-eating surrender monkey type who claims to be a surgeon also specializing in back surgery is also on the hunt. The "surgeon" in question, one Aaron Filler, makes outrageous claims about surgeons — including those who’ve been to medical school and therefore have unimpeachable ethics. He even suggests that those involved in developing and marketing devices claim that they get better results using them that are not replicable by other surgeons.

Nonetheless, concern about an ethical crisis affecting patients was
reinforced by discussions at various professional meetings during 2006.
Formal scientific publications on a new type of spinal device had
revealed extraordinarily high success rates and explicitly reported
“zero” device-related complications (Schnake et al Spine Journal 3:159S
2003). However, a separate study involving only surgeons with no
financial interest revealed an unusually high rate of “device related”
complications and failures (Grob et al, Spine 30:234, 2005). <SNIP>Differences in reported scientific results seemed to reflect the
difference between conflicted versus non-conflicted investigators.

He also casts aspersions on the completely above-board and reputable relations between professional societies of surgeons and their respectable colleagues in the medical device industry.

Many surgeons receive manufacturer funds to attend training meetings in
places like Vail, Cancun and Las Vegas, advertised as academic medical
education events. I recently organized a session at one such meeting
that brought in several nationally respected neurosurgeons to teach new
diagnostic techniques and treatments to reduce the use of implants. Meeting sponsors from the device industry objected and the session was canceled.

Hang on a moment. He said "surgeonS". That means there’s an epidemic of Frenchies breaking out in the ranks.

But I’ve figured out this so-called surgeon’s motives! He’s too lazy to do any surgery! Instead he’s written a book called "Do You Really Need back Surgery". Well it’s not too hard to see his game! Instead of getting up early and cutting away in the great tradition of American capitalist physicians, he wants to sit on his rear and collect royalties. Well, that’s not the spirit of grit and true enterprise that this country’s medical care establishment was built on.

I suggest that the North American Spine Society quickly sets up a Committee on UnAmerican Spine Surgical Activities and drags this Filler, and his fellow travelers like Association of Ethical Spine Surgeons‘ President Dr. Charles Rosen, into hearings where their true Frenchy leanings can be exposed to the world. Then the real American back surgeons can thankfully go back, undisturbed, to operating on anyone who’ll lie down.

TECH/BLOGS: Case preaches open health care

This I like. Steve Case has his own blog at Revolution Health, called The Revolution Manifesto.

There was lots of interest about him on the Webinar I did this morning. And no, Indu, I’m not going to declare a winner between Revolution and Google Health right now. That’d be like saying who’s going to win the 2010 World Cup!

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