Paul Levy is CEO at Beth-Israel Deaconess Medical Center in Boston. Paul was one of the  first CEOs to embrace blogging and continues to use his popular online column as a forum to express his views on the business of healthcare, public policy in Massachusetts and the challenges of being a manager in a very challenging field.  In this latest post he addresses a problem you wouldn’t think would be problem for a top manager at a facility affiliated with Harvard Medical School:  The very real risk to his health his job poses. He blogs at Running a Hospital. 

Two stories about being a patient in my own hospital.

(1)
I am really lucky to have a primary care doctor who knows how to
protect me, as president of our hospital, from our well meaning
doctors. Why do I need protection? Well, because the specialists are
really proud of their work and want to use any malady that I have to
show me their stuff. My doctor knows how dangerous this can be!

A
few years ago, I signed up for an ocean kayaking trip in Patagonia.
This was to entail pretty strenuous outdoor living and paddling all day
long for two weeks. The program therefore required a physical exam and
recommended a stress test for those over a "certain age." So I asked my
PCP to order one.

She says, "No.  I refuse to order a stress test for you."

"Huh?", I reply intelligently.

"Here’s
the deal," she says. "If I order the stress test, our especially
attentive (knowing who you are) cardiologist will note some odd
peculiarity about your heartbeat. He will then feel the need, because
you are president of the hospital, to do a diagnostic catheterization.
Then, there will be some kind of complication during the
catheterization, and you will end up being harmed by the experience."

Continue reading…

Consumers want;* On-line appointment scheduling* Web messaging with physician and support staff* Access to lab and radiology reports* On-line prescription refills* Reminders and "information therapy"* Access to personal medical records* Outcomes and disease management tools

Or so says Bill. As Bill is a Director in Microsoft’s healthcare group and their most exposed presence online and probably in RL too, it’s a pretty good bet that this is the eco-system that Microsoft is looking to build around HealthVault.

The
Health 2.0 team converged in NYC this week for a day of
meetings with the New York Times, Digitas Health and a host of our favorite
Health 2.0 companies based in the Big Apple.  First it was lunch with
Carly Kuper and VP Patrick Denton of Digitas at the Gramercy Tavern. Among other things, we
discussed the regulatory and legal challenges that hamstring many
pharma companies from becoming full-fledged Health 2.0 players, despite
the many progressive people within their walls. 

Next, we caught up
with Sarah Greene,  Director of Health coverage for the New York Times to talk about some
exciting new online features at the Times. Sarah told us she is ecstatic about the reception so far for "Well"" the new blog by ex-WSJ’er Tara Parker-Pope.  The Times obviously doesn’t share metrics, but she could tell us that  Tara is moving up swiftly in the rankings of their in-house blogs.  We were thrilled  to meet science editor Laura Chang. (Matthew is a huge fan!) And also had a chance to meet with NYT.com Health section editor Michael Mason.

Unity Stoakes from Organized Wisdom helped organize our happy
hour at the Swift Hibernian lounge.  He and partner Steven Krein (Promotions.com, Law.com) are pushing full
steam ahead building out the new face of Organized Wisdom on a
wikimedia platform, hiring for a bunch of new positions and getting all
sorts of attention from the investment community.Continue reading this post …

Phew! What a week on THCB. This week’s posts included: The Grand Opening of the Health 2.0 Blog, The VA – Cerner Deal,  The Sparse Information Model, Humana’s Change Now 4 Health Campaign, Why Aren’t More Students Applying to Medical School?,  Woodstock of the Wonks , Man Bites Dog. Candor in Washington. Plus updates on Health 2.0 San Diego.

Veteran IT insider Robert X. Cringley seems to think so, and worse he compares its behavior in dealings with smaller competitors to you know who in this article, The Next Microsoft.

Cringley’s other concern is, though, much more serious about a big company behaving badly towards the little guys. It’s that click fraud is a big deal that is going to hurt Google’s main model of making money, Adsense, because fairly soon advertisers will be throwing too great a proportion of their ad budgets down click-fraud ratholes, and not getting enough back from their ads.

Why is this a real concern for the Health 2.0 crowd? Because, most Health 2.0 consumer companies are basing their model on ad revenue one way or another. Most of that revenue will probably come from some kind of broker-based model, and if the main broker (which is Google) loses credibility with customers, that will doubtless have two ripple-on effects.

First, there may not be enough revenue around to justify those ad based business models. Second, if there’s a serious downturn in Google fortunes, that will hit the whole software/Web services sector before it’s really taken off in health care.

So overall, I’m hoping Cringley’s wrong. Thus far I think he is. The cost of click-fraud is not enough to kill the overall high ROI of search-based advertising. But it needs to be watched.