Tag: The Insider’s Guide To Health Care

Engage With Grace

If there was something you could do to improve end-of-life-care in the United States, and it only took two minutes, and everybody did it, would there be a transformation?

Alexandra Drane, president of Eliza Corp., and Matthew Holt think so. That’s why
they’ve created "Engage With Grace" the one-slide project. Theoneslide

They believe that if everyone took two minutes at the end of every presentation to show this slide that asks five basic — but critical — questions transformation could occur. In times of tragedy, families would experience less anxiety, knowing their loved one’s wishes are being met.

Matthew and Alexandra ask that you download the slide, start a viral movement, have these conversations and transform end-of-life care. To learn more visit Engage with Grace, where you can download the one slde, register for free, learn how to start the conversation and store your answers to the questions.

MRIS: The good, the bad and the useless

Note: This post first appeared at

Gina Kolata’s must-read article in last week’s Science Times points out vast differences in the quality of MRI’s as well as vast differences in the expertise of the radiologists who interpret them.

Patients need to understand this, because physicians sure as Hades aren’t going to tell you.

Kolata uses sports injuries as example. With suspected cancers, the stakes are life and death. A poor MRI was part of the reason my daughter nearly failed to get a proper diagnosis of a malignant sarcoma in her arm, and then nearly failed to get the proper treatment.

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23andMe punk rock partying, price cuts and on vid on D

23andme is having a gobbing party in NYC tonight—presumably at the Roxie. You didn’t know punk was back, did ya? 

Indu will be there (sadly I had to stay chained to the computer). But there’s a little more 23andme news today in that they’ve dropped their core price to $399 and have inked a deal to get access to’s database of users. Not quite an impulse purchase yet, but still getting down there.

And if you want to know what 23andme is up to, you can see Linda & Ann’s interview/demo at All things D last May. Of course you can see Linda at Health 2.0 next month, but I’m not sure we’ll be quite the pushovers Mossberg & Swisher are…at least we’ll keep them to 3.5 minutes! 

I’m still trying to figure out whether the DTC genomic market is a gimmick or actually has some value (and I don’t mean value the way a VC does! I mean whether society should be spending health care dollars on genomics when we do such a shitty job treating diseases we do understand). But it’s good to see some real activity in at least postulating the concept.

An international perspective on Medicine 2.0

I’m here at the Medicine 2.0 Congress, a very international meeting put on by Dr. Gunther Eysenbach of the Centre for Global eHealth Innovation, a project of the University Health Network and the University of Toronto.

The meeting is in a place called the MaRS Centre, in the heart of what’s being called the Discovery District. It’s at the corner of College and University, right around the corner from several major hospitals, including Toronto General, Princess Margaret Hospital and Mount Sinai Hospital The conference even has its own blog so I shall try to come up with something original.

Eysenbach opened the proceedings Thursday morning with a discussion about what health 2.0 and medicine 2.0 really mean. I’ll just link to an article that appeared in Eysenbach’s Journal of Medical Internet Research earlier this year.

Don’t believe the hype? Peter Murray, the International Medical Informatics Association‘s VP for strategic planning, just put up a slide of this graphic:


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Patients lost in the maze

Millions of patients are paying medical bills they don’t actually
owe after being confused about the practices of "balanced billing," according to a recent Business Week report.

The story goes onto discuss how it’s illegal for doctors, hospitals or labs to bill patients for the difference if they deem the insurance payment too low, but that it happens routinely to the tune of $1 billion each year.

Around the time that story first ran, THCB received this email from distraught reader, Paul Evans of Arizona:

I recently went into an emergency room at a local hospital in Scottsdale, Ariz. The doctor asked several questions and diagnosed kidney stones. To confirm this, he ordered a Cat scan and X-rays. While there I was given morphine for the pain. Two hours later, I was discharge with a prescription for pain pills and a strainer to examine my urine for the stone I would pass. I am insured by Aetna. Aetna received a bill for $6,000 and paid $4,000. I am now receiving bills for the remaining $2,000. All this for two hours in the emergency. Do I have to pay these bills? This is balance billing I think. What are my rights?  Help!!

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Another state gov’t. misses the boat on patient-centered care and HIT

Amid more data released that consumers are not using personal health records (PHRs) or don’t even know what they are, the state of West Virginia has launched a Web site designed to convince consumers of the merits of health information technology (HIT).

As best I can tell from eHealthWV Web site, here’s the plan: “To ensure consumer input and involvement in the process of health information exchange and electronic health records, WVMI and its partners launched a new phase to the project in mid 2007.  It involves educating consumers about electronic health records and health information exchange.”I’m sure they mean well, but it would be helpful if one of these state efforts “ensured consumer input and involvement” by actually soliciting their input before designing their outreach. Right now, most states and health information exchange activities are focused on addressing consumers’ fears about data rather than their needs about health care.

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Adam Bosworth speaks about Google Health, Keas and everything

Adam_bosworthAfter a long period of time I’ve finally wrestled Adam Bosworth to the floor and forced
the microphone to his mouth. Adam of course is the software guru (he’s one of the originators of XML) who went to Google to start Google Health, and spent much of 2007 talking about how he hoped Google Health would change health care. He then left Google Health (several months before it launched in March 2008) and at the very end of 2007 founded Keas. Adam will be at the Health 2.0 Conference and while Keas is in stealth mode at the moment, he may just be ready to show us all a bit of Keas’ technology by then.

But he also has very strong views on health technology, data, PHRs. HealthVault & Google Health, and much much more. Listen to the interview.

Do membership practices offer privileges or just reserved for the privileged?

Scott_shreeveI have watched the meteoric rise of popular term “Medical Home.” While I personally dislike this phrase, it has caught on in the popular vernacular and looks like it is here to stay. In conjunction with the rise of the term is the growing popularity of a practice model that includes a higher level of service on a membership basis. It is essentially, next-generation concierge medicine, but now being promoted under the more politically correct banner of “direct practice.” Multiple variations of the model exist, from an all-inclusive single fee to a membership structure that retains a fee for service financial arrangement.

So discerning patients evaluating these practices are forced to determine the relative value of this new direct practice concept, and having passed that test, determine which type of practice model actually makes sense to them (All inclusive or Fee-for-Service). Lets look at these questions using a traditional four-person family with an annual all-in health care spending of $15,000 (consistent with Milliman’s 2008 numbers).

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Keep tabs on your digital footprint

Is it "disordered" behavior to Google your doctor? An article in JAMA suggests that doctors should be on their guard.

The Journal of the American Medical Association recently published an article about how doctors should be aware of how they are portrayed online and consider taking steps to manage their digital identities.

It is an article that, for the most part, could have been written about any profession with its warnings about “slanderous information published about someone with the same name” or “by a vengeful…colleague or ex-lover.” And the advice given is also familiar: create your own Web page to be sure correct information is available about you and use appropriate privacy settings on social network sites.

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In Online Health Content We Trust?

Late last week, Susannah Fox of the Pew Internet & American Life project announced
that the nonprofit had updated its statistics on the number of adult Americans using the Internet. Currently, 73 percent are Web users.  Of this group, three-quarters have looked for health or medical information online. Fox notes that regardless of whether the number of online health searchers increases or decreases from year to year, “Internet users are doing something [and] the horse is out of the barn.”  The growing power of the Internet has generated enthusiasm in some and dismay in others. It has also exacerbated long-standing tensions between patients and medical professionals –- especially physicians. For example, in a famous Time magazine essay, Dr. Scott Haig admonished some medical “Googlers” for possessing a wealth of information, but lacking the expertise to interpret it correctly.   

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