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DNADirect bought by Medco: Consumer genomic counselling goes mainstream?

Ryan Phelan started DNADirect to expand the power of genetic testing to everyone, using the Web. She’s been ploughing a tough furrow but been making some real progress in the last few years, including getting an investment from Lemhi Ventures and working with Humana to provide genetic testing to its members (and the utilization management going along with it), to go along with their initial DTC approach.

Late last week DNADirect was purchased by Medco. I spoke with Ryan and Robert Epstein, Chief Medical Officer of Medco to get just a taste of what this will mean for the future of DNA testing within Medco.

Here's the interview.

The Point of Health 2.0. Yes There is One

The (not huge) world of Health 2.0, participatory medicine and ePatients has been fretting itself about a comment Susannah Fox (all hail) elevated into a post called “What’s the Point of Health 2.0”.

Here’s an excerpt from the comment from DarthMed,

The remaining 95% of “patients” out there are not motivated to become informed, or invest the time/energy/money in using any of these tools. These are the folks that know that fast food isn’t healthy, but are just too tired to choose differently. Some (emphasis on some) will do a standard Google search when they receive a new diagnosis at best. Yet these are the folks – often folks with multiple chronic (often preventable) health problems, many overweight, on multiple medications, sometimes social problems – that have the real issue that needs fixing.

So we can all sit and perfect the tools for a few folks that never needed them anyway, or we can recognize that the kinds of solutions required for healthcare in the US today have nothing to do with fancy IT, or prioritization on search engines, and everything to do with low-tech, unsexy approaches toward grass-roots public health. Sorry to be the voice of reality guys.Continue reading…

Todd Park speaks: Free the data!

Todd Park is definitely one of health care IT’s good guys. Todd was the brains (though not the mouth!) behind athenahealth. After he left athenahealth, he spent a year back in California doing angel investing (Ventana among others) and being a dad. But despite his desire to stay on the west coast, he was dragged into the vortex known as Washington DC, and for the last 5 months he’s been the (first) CTO of HHS. (By the way, he cashed out his investments, and politely turned down my proposal to “care for” his cash while he was being a public servant!)

Todd gave the keynote yesterday at the Health IT Summit for Government Leaders. He describes his job as unlocking HHS’ “inner mojo” in terms of data use and technology innovation. So what are the big deals he sees? These are my notes on his fast talking!

1) HITECH/ARRA is not about for paying for software. Its purpose is to incentivize “meaningful use”. He wants to make sure that people understand that the NHIN (National Health Information Network) is not a thing. It’s a set of policies and services that people can use to make health data work over the Internet. It is NOT a parallel network. And at the end of the day, what’s going to make this work is the private sector — including vendors modifying their products to match these policies.

2) Leveraging the power of HHS data for public good. The amount of data HHS has is “ridiculous”. It has a set of sets of data. Todd is a paid up member of Tim Berners-Lee “free the data” club. They’re adding all kinds of data sets to data.gov including every grant, patent et al licensed/paid for by HHS. Todd calls this “data liberation”. They’re also creating community health maps where data on community health performance can be mashed up with other types of maps (real estate, job listings, et al). In addition, they’re doing “smart targeting” — an attempt to combine findings from different/disparate data sets without waiting to do the big database integration. He’s hoping to use techniques that the intelligence community uses to link, say, emails and bank wires, to similarly track, say, disease outbreaks, drug interactions, etc.

Continue reading…

PharmaSecure using SMS to detect counterfeit drugs

In developing countries, (and here too) counterfeit drugs are a mega-big problem. Essentially fraudulently labeled drugs in the supply chain are often not what they say they are, with potentially devastating consequences. But there’s no really easy way for companies to monitor their supply chain. We ran into PharmaSecure as they were getting off the ground last year, and yesterday I met CEO Sarah Hine who showed me how their technology allows the consumer to directly connect with the manufacturer using SMS.

A very innovative use of technology and a very interesting brief interview (complete with demo!). They’ve also just raised a $2m series A round.

MS-HUG Awards; let’s see you, Health 2.0 gang!

Last year I was a judge in the MS-HUG award for the HealthVault applications category. The quantity and standard of the entries was pitiful. I think that a few sales reps rounded up a few entries at the last minute

Given that many if not most Health 2.0 applications now link to HealthVault I really hope that the entries this year are way better. Here’s the blurb but if you are a cool Health 2.0 company linked to HealthVault, please enter. You have a week or so (and no Microsoft is not paying me to write this! In fact I didn’t even get paid to be a judge!)

Nominations are accepted in the following categories: 

Clinical Records – Inpatient
Clinical Records – Ambulatory
HIE and Interoperability
Microsoft HealthVault Applications
The nominations have been open since mid-December and will close on January 22 at 5:00 pm Central Standard Time. All of this year’s awards information is on the Microsoft HUG website at:
www.mshug.org/awards.

Welcoming immigrants and robots to fill the nursing shortage

David E Williams

In a report this week, Nursing crisis looms as baby boomers age, CNN Money repeats a well-known story:   there are unlikely to be enough nurses to take care of people as they age. Nursing schools can’t keep up with the demand and trouble awaits. We’ll face a shortage of 260,000 RNs by 2025, we’re told.

I don’t really believe it’s such a big deal.

There are two good solutions to the problem, and they aren’t mutually exclusive:

  1. Increase the recruitment of nurses from abroad
  2. Substitute technology for laborContinue reading…

Virtual Medicine: The Lever That Just Might Save Independent Practice

Reece

Give me a lever long enough, and a prop strong enough, I can single-handedly move the world.

— Archimedes

Independent medical practice in America is in trouble. It is fragmented, with some 900,000 doctors – 300,000 primary care doctors and 600,000 specialists- practicing in disparate settings. These physicians are located in roughly 580, 000 locations. Some are solo, most are in small groups, and many are clustered around 125 academic medical centers, 100 integrated groups, and 5000 community hospitals.

Doctors are not unified – less than 20 percent belong to the AMA. Some 110,000 are members of Sermo – a social networking organization that tends to house dissident physicians. The MGMA is said to represent 300,000 doctors.Continue reading…

Health 2.0 Tools: The power of Twitter

Picture 31

The power of Twitter is real kids, and not for what you think. Used properly Twitter is an information filter. Exhibit A is what happened to the Von Schwebers who run PHARMASurveyor. They were a huge part of the Tools Panel which featured interoperation among 8 members of the Health 2.0 Accelerator at Health 2.0 a couple of weeks back. Then last week they were at an AHRQ conference on Drug Interactions when this happened. Erick von Schweber’s email picks up the story ..

The Chief Medical Officer of Express Scripts is doing his talk, about halfway through, and then tells this rather academic audience of scientists and researchers that there’s something new they need to attend to. It’s called Health 2.0, he says, and he puts up a PowerPoint slide with screen captures from WebMD, HealthVault, Healthline, DoubleCheckMD, etc. Then he tells the audience that the prior week he saw tweets about something new in the space, so he checked it out. He says this is the next major leap ahead in drug safety. So up comes a series of four slides, all screen grabs of PharmaSURVEYOR. And he calls us the Accelerator and explains what we do, disclaiming that he had no knowledge that we’d be there at the conference (I had moderated that morning’s session on making DDI evidence more relevant to patients and physicians; Hansten and Horn were my speakers, the guys who introduced the term “drug interaction” in the mid-sixties). He tells the audience that they must go to PharmaSURVEYOR as well as begin thinking in terms of consumer generated healthcare.

Now it just so happens that the Chief Scientist of Express Scripts but not the Chief Medical Officer had been to Health 2.0 and (I assume) seen the Tools panel demonstrations. But, and this will amaze no one, busy executives at big corporations don’t always immediately communicate all of their learnings with each other. So how did the Chief Medical Officer find out? He probably saw a re-tweet of the #health2con hash tag. That, ladies’n’genelmen, is how our kids is learning these days.

And do you want to see the incredible tools panel from Health 2.0 which contained both the accelerator integration project (in two parts), the debut of Keas, and Eliza showing the first Health 2.0 marriage? Funny you should ask.

On Stage at Health 2.0: The Cats and Dogs of Health IT

Here's the first in a series of videos from the Health 2.0 Conference a couple of weeks back that we're going to feature on THCB. This was the last panel of the day and it featured three leading health IT figures who've never been on a panel together before.

Following the passing of the stimulus and the debate over meaningful use, there’s been lots of tension between the “cats” (the major IT vendors) & “dogs” (the web-based “clinical groupware” vendors). (Here's the article I wrote about it last January). The real question is how the new wave of EMRs is going to integrate with the consumer facing and population management tools. Can there be unity around the common themes of better health outcomes through physician and patient use of technology? Or will the worlds of Health 2.0 and the EMR move down separate paths?

On the panel were Glen Tullman from Allscripts, Jonathan Bush from AthenaHealth (in his Apple 1984 runner shorts) and David Kibbe, from the AAFP. A feisty discussion about how IT for doctors and patients should play out.

Link to video

Why Standards Matter 2: Health IT Enters a New Era of Regulatory Control

David KibbeThe recent history of electronic medical records in ambulatory care, or what we now call EHR (electronic health record) technology, can be divided roughly into three phases. Phase I, which lasted approximately 20 years, from about 1980 to the early 2000’s, was an era of exploration and early adaptation of computers to outpatient medicine. It coincided with the availability of PCs that were cheap enough to be owned by many doctors, and with the increased capacity of off-the-shelf software programs, mainly spreadsheet and database management systems such as Lotus, Excel, Access, and Microsoft’s SQL, to lend themselves to computerized capture of health data and information. Phase II coincided roughly with the American Academy of Family Physician’s (AAFP’s) commitment to health IT as a core competency of the organization, and with its support/promotion of the early commercial vendors in the Partners for Patients program, a national educational campaign inaugurated in 2002 which involved joint venturing with vendors that included Practice Partners, MedicaLogic, eClinicalWorks, and eMDs, among others. Several other physician membership organizations joined this effort to popularize EMRs, or crafted their own education programs for their members based on the AAFP’s model. The most popular Phase II products were, and still are for the most part, client-server software applications that run on local networks and PCs within the four walls of a practice, and tend to use very similar programming development tools, back-end databases, and support for peripherals such as printers. The industry grew, albeit sluggishly, from roughly 2002-present in an unregulated environment, with increasing support from quasi-official industry groups like HIMSS and CCHIT, and with the blessing of many professional organizations, including the AAFP, ACP, AOA, and the AAP. Best estimates are that the numbers of physicians using EHR technology from a commercial vendor roughly tripled during this period, from about 5% of physicians to about 15%. The Bush administration gave moral support to the industry, but did not provide funding or payment incentives, and mostly left the industry to itself to sort out the rules, including certification. The industry is now entering a new phase, one we predict will significantly depart from the previous two eras.Continue reading…

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