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HEALTH2.0: Sermo, Pfizer: Big Pharma puts big toe in social networking waters

You can’t trust those Brits. I get a super exclusive on the Sermo-Pfizer deal and those damn Brits at the FT break the press embargo. So much for “honour” amongst journalists!

This is the latest version of Big Pharma’s experiment to figure out how to replace the incredibly inefficient way it researches, sells to and communicates with doctors. The very baby steps of starting to cut those detail forces are just starting to be taken, but while those empires slowly get dismantled over the coming decade(s), something needs to be put into its place. eDetailing via video has been a bust so far, and putting those hot cheerleaders into the doctor’s office is getting more and more expensive.

So the deal is that Pfizer (and of course soon other pharmas) will be able to put information into the social networking site. This has great opportunity and great peril for big Pharma. Of course there’s lots of information that they can contribute, and lots of contacts that they can make. But on the other hand, they are definitely losing control over the message.

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POLICY: While Politicians Battle Over Expanding SCHIP, Children Are Dropped From the Program by Maggie Mahar

At the moment, nearly everyone interested in the S-CHIP debate is focusing on October 18,  the
day the US House of Representatives will try to override the President’s veto of an expanded State Children’s Health Insurance Program (SCHIP).

Unlike many of the critics, I favor the expanded program.  Briefly, here are a few things to
keep in mind: 

First, under the proposal, 70%  to 80% of children in the program would be from
families earning less than twice the poverty level ($20,650 for a family
of four).   

Granted families
of four earning  up to $60,000 a year would qualify for the program
in most states. But given the fact that the average annual premium for
family coverage is now pushing $13,000, it is not at all unreasonable
to suggest that families earning $$60,000 before taxes cannot
afford private insurance.

In theory,
maybe these families could buy private insurance just for their children,
but it’s hard enough to buy individual coverage (when you don’t
belong to a group) –try finding individual insurance that covers
children only.

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A Broad Vision of Health 2.0: Reformulating Data for Transparency, Decision Support & Revitalized Health Care Markets – Brian Klepper and Jane Sarasohn-Kahn

Download health20_1011.ppt

Before you start reading, download the document above. It’s a single PowerPoint slide that’s animated to build. Go into presentation mode, then read along with the narrative below.

The term Health 2.0 refers to the concept, described by O’Reilly in September of 2005, of Web-based platforms that allow users to reformulate data for their own purposes. The Health 2.0 movement is rapidly gaining steam and traction, propelled by established and startup firms. The efforts displayed at the recent Health 2.0 meeting in San Francisco, convened by Matthew Holt and Indu Sabaiya, were both wide-ranging and narrowly focused. Even so, several end-of-day panelists noted that, at this early stage, Health 2.0’s definitions and translations into practice remain murky and fragmented.

We thought it might be useful to try to develop an image of how Health 2.0 MIGHT develop: what its working parts were, what kinds of information it would receive and generate, who its users would be and what its impacts might be. The image that has resulted is simplistic; it doesn’t try to explore any of the underlying mechanisms necessary to pull this off. But it does try to convey a vision of how innovators might come together to aggregate and reformulate large data sets from disparate sources to create tremendous new utility in the marketplace for patients, clinicians and purchasers of all types.

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POLICY: Michelle Malkin is really dumb

Yes, that headline is a blatant attempt to get some of the opprobrium Malkin and her nutty commenters are venting on Jon Cohn and Erza Klein.

A little background. Jon, being the sensible moderate, wrote a good article on why the SCHIP veto helps Universal Health Care, and then pointed out that the smearing of the kid from Baltimore whom the Dems put up to support S-CHIP was a dumb idea with lots on the far right failing to do basic fact checking. In fact the family in question was exactly the type that S-CHIP needs to help

In the NY Times today Paul Krugman puts this all into a little more narrow perspective. Suggesting that sliming Graeme Frost–the 12 year old kid in question, is just standard operating procedure for the Rush Limbaugh-types on the right, who have a pretty direct line into the Republican machine.

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Hospitals: Firing doctors by Paul Levy

As one of the first CEOs in healthcare to author his own blog, Paul Levy of Beth Israel Deaconess Medical Center has established a cult following with outspoken posts tackling the issues he faces as the top manager at one of the most influential hospitals in the country, writing on everything from insider debates over the publication of hospital mortality and infection rates to negotiations with labor organizers and the wise use of information technology. Today he tackles a delicate subject sure to provoke debate – and enthusiasm – on the THCB discussion boards …

Several years ago, before taking this job, I was asked to turn around a
relatively small clinical trials data processing company. I had to lay
off a number of people who were not critical to the company’s success,
and one of these included a doctor who had been hired to expand the
business into a certain area that we determined was no longer
appropriate. This was not a case of incompetence or lack of energy or
enthusiasm. He was great guy with terrific credentials, but we just
could not afford his particular expertise in that troubled little
company.Recently, we had a chance to meet, and he confessed to
me that my decision to lay him off had caused him to have a real crisis
of confidence. He had never been fired before and, as he put it, his
view of himself as a person and the job he did was one and inseparable.
Here, I had torn them apart, and it took him a while to remember and feel
that he was still as adept and valuable a physician as he had been
before he was fired. Indeed, he was able to thank me, years later, for
teaching him the important lesson that a particular job does not define
who he is.I replied to him that I thought that his initial
reaction explained to me why doctor-managers often find it difficult to
fire other doctors. They too quickly internalize how it would feel to
themselves to be fired, and they project this onto others. They
conclude that they cannot devalue the professional abilities of a
fellow physician by terminating his or her employment. They have
difficulty separating the business imperative from the degradation of
one’s self esteem.

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TECH: Big deal in the RF location tracking world

I haven’t spent much time recently on the location tracking tools that I think will be a big part of hospital efficiency improvement in the future. The folks I met this weekend at LA County are thinking about them for next year when they move to a huge new emergency room, but the big fuss at HIMSS in 2006 around the asset and people location tracking has yet to really pan out.

But maybe the market is starting to take off. Yesterday one of the companies I’ve been following for a while, Ekahau, announced a big sale to big public hospital system Carolinas HealthCare System. Given that the inherent chaos that most hospitals appear to live with (to the uneducated eye—yes, I’m picking on LA County, but you know there’s some truth in that!), the potential for efficiency improvements from asset tracking and improved communications are very real.

JOB POST: Software architect

Phreesia is a
fast growing venture backed start up company looking for an experienced Software Architect.Phreesia is free to physicians in participating practices. The
Phreesia solution includes the leading edge PhreesiaPad™ which adds immediate value to the
physician’s practice by gathering comprehensive intake information and chief
complaints, decreasing the time spent asking basic questions, improving patient
flow and reducing administrative time. Based on the patient’s responses they
are automatically taken to a customized portal with relevant health and
lifestyle information. Phreesia is sponsored by pharmaceutical and healthcare
companies with relevant educational communications to patients at
the point of care.

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Are We Willing to Accept a Two-Tier Hospital System? By Maggie Mahar

Frequent THCB contributor Maggie Mahar returns today with another of her "Inside Baseball" posts on the healthcare industry. Is the recent boom in hospital construction a sign of a healthy and vibrant industry as many prognosticators have argued, or a symptom that something is going very wrong beneath the surface. This piece first appeared at Healthbeat, Maggie’s blog at the Century Foundation.    

Yesterday, I wrote about the hospital-building boom and suggested
that we may not need it—and more to the point, we may not be able to
afford it.

In my description of how hospitals are adding costly amenities like
waterfalls and all-private-rooms in order to woo well-heeled,
well-insured patients, I suggested that the money might be better
invested in computerized medical records or Level I trauma units. (In
some parts of the country, trauma units are spaced so far apart that if
you are in a car accident, there is a real danger that the unit will be
too far away to be of any help.)

Barry Carol responded, agreeing that safety should come first, but
also arguing that the private rooms help prevent infections. As for the
waterfalls, he noted that “while they may make good journalistic copy
as illustrative of frills,” given the high cost of hospital
construction “they probably get lost in the rounding as a cost factor.”
See his comment here.

Because Barry had raised a number of good points, and because the
hospital boom is such a large and crucial subject, I decided to return
to it today while responding to his comment.

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