If you read this headline, what would you think was going on?

Perot Systems Walks Off With Indiana Hospital’s Patient Data

The story is that an employee of Perot which runs the IT systems for Sisters of St. Francis (a hospital chain in Indiana and Illinois) took patient data on CDs home (or somewhere) and left them in the bag when s/he changed their stuff into another bag. It’s unclear as to where or for how long the CDs sat in the employee’s original bag, but it was later returned to the hospital.

It looks like just another “IT guy goes home with data, mislays it” story.  So why the headline that suggests that one of the nations biggest outsourcers is stealing its clients’ data — which it’s already got on its servers anyway? Sloppy reporting or not, the guys at Perot will want to clarify this ASAP!

I wrote a brief piece for the newly renamed Digital Healthcare and Productivity on ePrescribing. Don’t get too carried away by the headline in the piece—I did know about Surescripts before this week! But while the dog-food has now been put into a can with an easy release top (eRx apps connected to pharmacies), it’s still not clear how fast the dogs are going to eat it.

Those of you in the tech world might want to come back here to comment.

In the late 1990s several companies promised to
bring handheld ePrescribing to America’s physicians. ePrescribing was
supposed to improve efficiency for doctors, particularly by reducing
calls from pharmacies to their offices. But most savings from
ePrescribing go to pharmacies, whose employees spend less time entering
data, and to health plans because ePrescribing helps increases generic
substitution. In addition, many early systems ended up generating a fax
from office to pharmacy becausethere was no easy way to transmit those
prescriptions electronically. Continue …

I have been struggling with the new attention on online virtual worlds like Second Life, World of Warcraft, etc, etc. I think that there’s something here that’s more than games. But I can’t quite tell what yet. And if it’s just games, well I don’t want to get sucked into this, as I waste enough time on the Internet already.

Here’s an article by a tech veteran suggesting that this is The Next Big Thing. The question is, what moves to virtual worlds? If it’s just games, then it’s self limiting as only some people have that much time on their hands and they’re not the ones with the money. There are obviously options for moving community online to virtual worlds, but community per se doesn’t have that much economic value. However in some aspects of health care, like patient groups, there is real value from community.

The web though is most important for moving commerce and information online. It’s not clear to me how you put that into a virtual world, other than advertising to those who are playing games or otherwise spending time there which is the TV/newspaper model. Any ideas?

(Note: Slight edits made to clarify)

Here’s the article from the NY Times confirming that drug-eluting stents are being used less since the recent findings of increased risk over bare-metal stents.

But now stent sales are falling and some doctors are rethinking their faith in the devices, driven by emerging evidence that the newest and most common type — drug-coated stents — can sometimes cause potentially fatal blood clots months or even years after they are implanted.

SNIP

There is no question that stents have saved countless lives in the short term by preventing impending heart attacks or opening arteries while an attack is being treated. But neither type of stent, no matter how much better it may make a patient feel, has been shown in rigorous clinical trials to improve long-term survival compared with other forms of treatment.

SNIP

Drug-coated stents cost an average of about $2,200 each in the United States, nearly three times the price of bare-metal ones. Despite the higher price, they quickly captured more than 85 percent of the United States market after their introduction in this country two years ago. Overseas, where national health insurers have been more reluctant to pay the higher prices, drug-coated stents have caught on more slowly.

SNIP

But other doctors’ uncertainty is starting to show in the declining sales of stents. Just this week, Boston Scientific said that its third-quarter stent sales, $572 million, were 4.8 percent lower than a year earlier.  Johnson & Johnson, whose Cypher is the only other drug-coated stent currently sold in this country, said this week that its worldwide stent sales of $627 million in the quarter included a 6 percent decline from a year earlier in the United States. Its sales in Europe were down 3 percent.

And showing what’s going to replace these drug-eluting stents—more CABGs? more drugs? diet and exercise? Dean Ornish’s program (still waiting for Medicare reimbursement 15 years after it’s been more or less proven to work? Unlikely.

Several competitors are still anxious to enter the domestic market, including medical giants like Medtronic and Abbott Laboratories and smaller players like Conor Medsystems whose products are already on the market overseas. Some have claimed that results to date suggest their products have little or none of the clotting risks. Because none of them plan to apply for F.D.A. approval before next year, it is unclear whether or how the agency’s new scrutiny of stent safety will affect their prospects. New stents will not address the issue of whether too many patients get stents instead of first trying therapy with drugs, including statins, that might improve their condition.

Newer Stents Pose Dangers, 2 Doctors Say. That would be the drug eluting stents, now racking up a $6bn odd in US revenue for their manufacturers.

Well what did you expect? Oh, and by the way, still no evidence that stents are better than CABGs for the payer or the patient, in fact it’s still probably the other way around —as THCB has been saying for a while. But don’t expect much to change. After all you need more than evidence to stop this ball rolling downhill.

For example, I met someone with a new and better drug-eluting stent (from ex-BSX but now with Abbott) only last week, so if we decide that Cypher and Taxus aren’t the best answer, I’m sure the real answer will be something new—not something old.

Aetna introduces a PHR for its members, only 5 1/2 years after sending me the funniest email of all time, which said that they were spending all their time fixing their IT system and even if the solution (a PHR) that we had for them would fix all their problems, they still couldn’t buy it for 2 more years. Well I guess they meant 5 more!  Sadly we were out of business well before the 2 years expired!

Their PHR is an off shoot of Active Care Management’s Care Engine. Aetna bought ACT last year. At that point Empire Blues was the biggest user of Care Engine. They didn’t go with it for their PHR though—they’re using WebMD’s version. Which makes me wonder how good Active Care’s version is. Perhaps I’ll be able to check into it soon and tell you.

Meanwhile all care will soon be delivered at home by clever in-home dialysis and monitored by Health Buddies. It must be true because it says so in Business2.0. Yes I know that’s an unfair slam on Health Hero Network (who I know and love), but their new direct to consumer model is, shall we say, a brave business innovation, given that it demands $50 a month from the chronically ill.

Good luck to them and I’m sure they’ll keep me appraised on the models success while the rest of us are waiting for Medicare funding for remote monitoring.

Yesterday I had two articles in the former Health IT World, which is changing its name to Digital Healthcare and Productivity. The first for you Googleheads is about Vertical search in health getting sexy, but it doesn’t say much about U no Hu. The second is rather more complex and is about Enterprise data warehousing and Business Intelligence.

Please feel free to comment back here.