Tag: The Insider’s Guide To Health Care

The AMA Wins a Round Against Accountability and Patient Information

On January 30th, a 3-judge DC appeals court overturned a lower court decision that would have forced public release of Medicare physician data. Writing for the majority in a split 2-1 judgment, Circuit Judge Karen LeCraft Henderson declared that

“The requested data does not serve any (freedom-of-information-related) public interest in disclosure. Accordingly, we need not balance the nonexistent public interest against every physician's substantial privacy interest in the Medicare payments he receives.”

But in a strongly worded dissent, Judge Judith Rogers, the third member of the ruling panel, found that the request by the consumer group, Consumer Checkbook, represented “a commanding and important public interest in disclosure of the data.”

Continue reading…

The anti-Dimitriy!

Certain people have accused Health 2.0 of being a bubble. Others of us have responded that it’s not. I don’t think either side in that argument has claimed that health care needs a bubble. But Forbes columnist Sramana Mitra thinks that a tech bubble in health care would be a great thing. In particular it would produce many more AthenaHealths and PatientsLikeMes

Certainly a provocative read!

Interview with Fred Goldstein, US Preventive Medicine

Last year US Preventive  Medicine (USPM) caused a little splash with some full page ads in the Wall Street Journal proclaiming itself the future of preventative care. Since then the company, which has raised a significant chunk of private capital, has been diversifying into various aspects of prevention–including what looks more like disease management.

About a year ago USPM acquired Fred Goldstein’s company Specialty Disease Management Services. And since then it’s been marketing The Prevention Plan to employers–including a recent deal with AON–and also putting out a very neat online service that was shown at Health 2.0 in October.

Prevention is getting some lofty rhetoric, including Prez2Be Obama suggesting that it’s a major key to cutting health care costs. But many people in health care think that it doesn’t have an ROI. Fred disagrees and told me why in a wide-ranging conversation about the company, the concept of prevention and whether it’s really the wave of the future. Click here to listen

ePatient Dave & his doc Danny Sands speak out

One of the most remarkable people I’ve met this year is Dave deBronkart, better
known as ePatient Dave (fourth from left on top of the blog). Dave has had a remarkable recovery from cancer and has probably used as many Health 2.0 tools as any patient.His blog is here.

I got the chance this week to talk at length with Dave and his GP Danny Sands. Danny is not only a practicing doctor in the BIDMC system in (Boston, yes that one with the blogging CEO and blogging CIO!) but also the Director of Medical Informatics for Cisco (FD, Cisco is a Health 2.0 sponsor and I’ve done consulting work for them in the past).

We covered a lot of ground in this conversation—starting with Dave’s illness, Danny’s role as a physician working with a very savvy patient, and the role of ACOR. But then we moved onto some critical questions about who will control the patient experience in the future in a world of Health 2.0 and what providers, patients and physicians need to do to prepare for it.

A fascinating conversation recorded via Cisco’s Webex technology that you can listen to here.

PS Dave asked me, what the most important issue raised in this interview was. I said "who is going to perform the function you performed for yourself for people who
don’t grab the bull by the horns the way you did? Because apparently it won’t be the Danny’s or
the BIDMCs of the world"

PatientsLikeMe keeps getting more famous

Here’s the CBS News clip that ran about PatientsLikeMe last week

Of course you’ve probably already seen the Business Week article about Health 2.0 which quotes Jane Sarasohn-Kahn and little ol’ me. Cathy Arnst did a nice job, including referring people back to Jane’s most excellent piece on the Wisdom of Patients

Moving up the health care value chain

Last week, I participated in a very cool live podcast with the ReadWriteWeb editor Richard Macmanus. While I am finishing up my commentary based on that experience, I did want to comment on another post by Richard who is one year into his diagnosis of Type I Diabetes. He mentioned that his favorite Health 2.0 application was MyMedLab.

In full disclosure, I serve as an advisor to
the company as well as a participant on the call that was conducted. I
became involved with MyMedLab while conducting my own survey of
promising Health 2.0 companies, tools, and technology. I was intrigued
by their Health 2.0 delivery model of leveraging the internet to remove
inefficiencies of time, location, and physician approval for routine
wellness laboratory testing.

I became convinced after using the service for myself. Since I
hadn’t ordered lab test since my medical school entrance physical exam,
and I was preparing for an upcoming physical, I ordered the baseline
wellness tests I knew my primary care provider would want (conveniently
organized by “profiles” – individual tests that are grouped together to
provide disease or organ system specific information
). I wanted to
maximize my time with my doctor and come prepared with as much
information to review during our appointment as I could.

Continue reading…

Patients still choose docs based on word of mouth

Patients still choose where they receive care based on good old word of mouth and referrals from their doctors, despite numerous Web sites and initiatives aimed at giving them information to compare the cost and quality of doctors and hospitals.

That’s the finding of a new national study released today by the Center for Studying Health System Change (HSC) and funded by the California HealthCare Foundation.

The key findings were:

  • In 2007, only 11 percent of American adults looked for a new primary care physician. In doing so, half relied on recommendations from friends and relatives, 38 percent relied on physician recommendations, and another 35 percent used health plan information.
  • When choosing specialists, nearly all consumers relied exclusively on physician referrals.
  • Use of online provider information ranged from 3 percent for consumers undergoing procedures to 7 percent for consumers choosing new specialists to 11 percent for consumers choosing new primary care physicians.
  • Very few of the 35 million adults who underwent a medical procedure used information other than the doctor’s referral in deciding where to seek care.

The bottom line: All the hoopla about consumer shopping and seeking out the bargains and best value for themselves, may be just that – hoopla.

How do all the Health 2.0 platforms launching into this area plan to change this ingrained consumer behavior?

Extracting more value from the health care dollar

Americans spend more money on health care than any other nation, but get far less in return, say multiple health care executives in Sunday’s  Washington Post.

That’s not news to readers of this blog, but probably is not yet common knowledge among the general American taxpayer. That might change. The news media seems to be writing about this "value gap" more frequently, particularly in citing the growing momentum behind creating a center for comparative effectiveness research to evaluate drugs, devices and treatments to find out what works best.

Defining and measuring value is not easy, but increasingly public and
private health care purchasers are using their market power to demand higher quality care. Whether the science is
ready to support this "value-based purchasing" is the topic at the ECRI Institute’s annual conference today and tomorrow. (I’m attending the conference and will report on it tomorrow.)

Continue reading…

e-Patient Dave tells his story


In the Connected Health conference at Partners I sat in on a great session in which e-Patient Dave (Dave deBronkart) and his physician, Danny Sands described his use of listservs, the Internet, email and BIMDC’s PatientSite and other tools in his (successful!) battle with renal cancer—after being told median survival was 24 weeks. I won’t tell the whole story as they’re trying to get it published in an authoritative journal—so that physicians will pay attention and promote this use of technology by patients.

Danny Sands says most patients with his condition feel incredibly alone. but "Dave told me he didn’t think he was isolated. He felt

Dave said, “Reading and connecting online makes me a better patient. But it doesn’t make me an oncologist.” But doing all these things via ACOR and the use of CaringBridge and PatientSite did, he believe, increase his hope & outlook, and helped make his treatment successful.

A remarkable story and one that we’ll tell more about later.

(Note: I made a minor edit as my original note got garbled between my ears and my fingers!)



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