Tag: The Insider’s Guide To Health Care

Viagra prescribed more safely online than in regular practice?

Aug 8, 2008• 9

By Matthew Holt

Really? Can this be true? Well so says a bunch of academics writing in the Mayo Clinic’s journal.

They looked at records of questionnaires taken and prescribing decisions made by a licensed, regulated online pharmacy called KwikMed — that is trying very hard to establish itself as ethically and legally different from those fly by night guys whose spam comments will rapidly attach to this post! They looked at the various outcomes and end points including safety and level of counseling and found that the online system produced results as good as or better as those found from a big records review in an unnamed (not surprisingly!) large multi-specialty clinic in Salt Lake City, UT.

Now obviously the ability to create an online questionnaire for specific conditions with clear inclusion/exclusion criteria (like ED or hair loss) means that as clear a picture can be gained in most cases from a good history taken online–and probably the history will be given more honestly by the patient. Plus the rigor of the history is probably better than one taken in a rushed office visit. And then it gets reviewed by a doctor who may recommend another approach but most times agrees and sends the Rx on to be filled.

Information therapy goes beyond evidenced-based info

Jul 23, 2008• 1

Siedman_2

By Joshua Seidman

Joshua Seidman is the president of of the Center for Information Therapy
that aims to provide the timely prescription and availability of evidence-based health information to meet individuals’ specific needs and support sound decision making.

I had a fun meeting recently with some smart folks from the Robert Wood Johnson
Foundation that raised questions about Ix that could use some clarification. When we talk about information therapy (Ix), we often drift into “evidence-based information” to help with some specific health condition.

That certainly is an important component of Ix, but it’s too limiting in many circumstances. When we talk about the “proactive delivery of the right information to the right person at the right time,” that has to encompass whatever the information needs of the consumer are.

Using professional societies to advance participatory medicine

Jul 22, 2008• 6

By Daniel Hoch Epatients

Dan Hoch is a neurologist based at Massachusetts General Hospital
and an assistant professor at Harvard Medical School. An early
developer of online resources for patients, Dan helped found Braintalk.

Professional medical societies are not quite like the secret society Skull and Bones at
Yale University, but they may well look that way to many patients.

In most cases, their sole reason for being is to serve their members in a pretty narrowly defined way. These services generally include continuing medical education programs, an annual meeting, promoting research, advocating for public and political awareness of the value of the specialty, providing resources to support clinical practice, and more mundane perks like access to group insurance (malpractice and otherwise).

If you define the mission of the society a little less narrowly, and it’s not hard to see how that mission can be aligned with that of participatory medicine. We often argue on the e-patients blog that full participation of all parties in health care will yield better, more efficient care. Such care will benefit the members of a professional society. Further, patients are taking part in research not just as guinea pigs, but as organizers and directors. This benefits the societies’ research missions. But, are medical societies poised to understand this, and if so, how do we guide them?

People with high-deductible plans make riskier decisions

Jul 14, 2008• 5

By Jane Sarasohn-Kahn

Healthaffairs People enrolled in high-deductible health plans tend to make more risky health
decisions than those enrolled in lower-deductible plans, according to a study published in the July/August issue of Health Affairs.

In Do Consumer-Directed Health Plans Drive Change In Enrollees’ Health Care Behavior? the authors find the answer is, "yes," probably.

Enrollees in the high-deductible CDHP were more likely to forgo medical care to save money.

Health care financing confuses consumers

Jul 9, 2008• 3

By Jane Sarasohn-Kahn

Consumers are interested in a variety of financial instruments to help them purchase health care. However, even when given a choice to shop for and eventual purchase insurance, millions of people don’t.

Consumers are confused about health plan choices and need help in financial decision making. Data from McKinsey presented in an essay, "What consumers want in health care," analyzes results from a survey of about 3,000 retail health consumers. According to McKinsey, "many consumers aren’t accustomed to shopping for health insurance, so they are not prepared for this additional responsibility."

One of the most surprising, sobering findings is that people were more concerned about the cost of illness than about the illness itself.

If California can’t protect consumers, who can?

Jul 7, 2008• 1

By Robert Laszewski

Crazy as it sounds an Associated Press story from Thursday reported that the California Department of Managed Care "didn’t even try to enforce a million-dollar fine against health insurer Anthem Blue Cross because they feared they would be outgunned in court."

Last year, the department announced that it would fine the insurer for improperly rescinding individual heath insurance policies in the midst of the California rescission controversy. Since then, most insurers have announced policy changes in the way they rescind coverage.

Consumer genetic movement: Cease and desist? How about understand and resist!

Jul 2, 2008• 1

By Scott Shreeve

I have been following health care consumerism for several years now. Particularly, the “Direct Access” or “Direct To Consumer” laboratory testing market. While analytic lab testing has led out in this area, genetic testing has received all the regulatory attention, national press, and policy efforts (GINA).So it is no surprise that consumer genetic movement would be the first legal test of the Health 2.0 movement. As reported by Matthew Holt here on THCB, and a host of national outlets (Wired has had extensive coverage here, here, and here), there seems to be quite a hornets nest unleashed by our friends at the California and New York Departments of Health who are attempting to prevent consumers from accessing their own genetic information.

Thanks to some transparency efforts of the blogosphere, you can read the actual cease and desist letter written by Karen Nickels, the California Department of Pubic Health Chief of Laboratory Field Services. I actually know Karen Nickels personally. She has been a long time steward of ensuring regulatory exactness of all things laboratory within the State of California for 30+ years. She has a well deserved reputation as one tough cookie for the “precision” with which she carries out her dutiesUltimate Genetic Fighting – Which Genetic Variation Wins?

Google Health and the PHR: Do Consumers Care?

Jul 1, 2008• 28

By Keith Schorsch Keith_2

Google Health’s unveiling last week and Microsoft’s HealthVault launch last October
are important milestones in the evolution of Health 2.0. Both of these heavyweights have the resources and potential to improve the health consumer’s customer experience. I have followed the active (and important) conversations about privacy concerns, HIPAA, and Google Health’s terms of service, which are well represented by Erik Schonfeld’s post on Techcrunch and Larry Dignan’s post on ZDnet. And I read with interest Google’s rapid response offered by Google Senior Product Counsel Mark Yang.

What’s missing from all of these conversations is the elephant in the room: Do consumers really care about having online personal health records?

Dispatch from India: Private sector responding to new health care consumers

Jul 1, 2008• 5

By Jay Srinivasan

Editor’s note: The current issue of Health Affairs released next week
focuses on health care in India and China.

As with most parameters within the Indian economy these days, the health care industry is huge but that doesn’t tell you much.

The fact is that health care in India is a broken system whose fault lines are fast being papered over by the rapidity of change, influx of big capital, drive of entrepreneurship and the relative ease of staking positions and targeting opportunity in an economy on fire. Combine that with the government’s involuntary relinquishing of idealistic heights due to resource constraints and its abysmal record and you get an industry that is overwhelmingly in the hands of the private sector. Maybe the private sector can redeem the industry after six decades with little to show by the government.

Drug advertisements annoying and possibly misleading

Jun 30, 2008• 9

By Sean Neill

Sean Neill is a South African-born, British-trained anesthesiologist, who
recently relocated to Midwestern USA. He blogs regularly at OnMedica about his cross-cultural experience, frequently pointing out oddities of American health care.

Watching television in America takes some getting used to. Apart from the accent, it is strange to hear companies marketing drugs directly to the consumer. Not only do they sell their own brand, but they actively name and shame their competitors’ products. During a commercial break there may be two different brands of antihistamine telling you how bad the other is.

Direct-to-consumer advertising (DTCA) is the promotion of prescription drugs through newspaper, magazine, television and internet marketing. Although the drug industry is mounting major campaigns to have DTCA allowed in Europe and Canada, the only two developed countries where it is currently legal are the U.S. and New Zealand.

Studies have shown that increases in DTCA have contributed to overall
increases in spending on both the advertised drug itself and on other
drugs that treat the same conditions. For example, one study of 64
drugs found a median increase in sales of $2.20 for every $1 spent on
DTCA. It has been reported that 10 of the leading 12 brand-name drugs
with DTCA campaigns have sales in excess of $1 billion annually.