The Health Care Blog – Page 1042 – Everything you always wanted to know about the Health Care system. But were afraid to ask.

Above the Fold

QUALITY: Stents cannot be killed, well perhaps not

Oct 26, 2007• 3

So in the latest of the stent wars a new study suggests that Medicare has been saving money as drug-eluting stents have replaced by-passes. This of course is music to the ears of J’n’J & Boston Scientific — not to mention the odd invasive cardiologist. And they’ve been getting, shall we say, a touch aggressive about marketing their product–here’s JSK’s great entry on DTC stent marketing at Health Populi. (By the way, Jane’s blog is really good. and is keeping those old veterans of the HC blogging world amongst us on our toes!)

However, it’s not clear to me whether the interpretation of this study hasn’t ignored two things in the context of the stent world.

The first is that earlier this year COURAGE essentially showed that medical management is better than stenting (or at least no worse). The other issues is the timing. What we really need to know is the value over the long-term. The data in this study is not old enough to know what happens in the long term–and of course in Medicare we’re all paying over the long term.

But of course four years ago in what is still one of my favorite posts on THCB, a Stanford study showed that in the long-run stents ended up costing considerably more than CABG’s — which is why I said then that we should dump the stent and have a by-pass!

X2HN, Women’s Executive Networking Conference

Oct 26, 2007

Want to go to a conference where there’s no chance that you have to meet Matthew? Gale Wilson-Steele (founder of MedSeek & CareSeek and one of my favorite people in healthcare) wrote to THCB about the conference that she co-founded last year. Apparently because men haven’t got X2 but a spare Y instead, they can’t come! Here’s why you should go if you don’t have a dangling Y!

X2HN was founded to accelerate the pace of healthcare improvement by providing the top-level women in all sectors of healthcare a venue for exchanging ideas, knowledge, and resources. Each year we host a space-limited 2-day Xscape where our members are recharged and inspired by learning from each other and experiencing the nation’s best programs and products.

This year we will convene January 30 – February 1, 2008 at the legendary La Valencia Hotel in the heart of La Jolla, California—a village known for its beauty, beaches, and boutiques.

The rejuvenating agenda for this remarkable event includes:

An Inspiring Evening with Darlene Price – Darlene, is one of America’s finest executive communications trainers. No wonder she is retained by many of the world’s top corporations. Darlene is President of WellSaid! and has received numerous honors including nine Telly Awards for outstanding corporate communications. Listen to the life-altering tale of her own healthcare experience, as Darlene sets the tone for the 2008 Xscape and focuses our hearts and minds on leading a much needed healthcare revolution—one communication at a time.
Pearl Sessions—X2HN-member presentations provide illumination on the numerous, interconnected facets of our healthcare system. In a few moments you will learn how your executive peers use their competencies and connections to drive important healthcare objectives.
Life Lesson —"Constructing a Business Plan for Life”—a female executive’s guide to applying business mindedness to the personal pursuit of meaning and happiness.
Workshop—Darlene Price will share the secrets to effective executive communication in an interactive training workshop.
Trends for 2008—A panel discussion of the top trends in healthcare improvement.

PharmaSURVEYOR in a capsule By Erick Von Schweber

Oct 25, 2007• 1

THCB frequently spotlights Health 2.0 startups that are using Web 2.0 technology in new and innovative ways to solve healthcare challenges. Today we feature Erick and Linda Von Schweber, the developers of a new web-based system that allows consumers to better manage their drug regimens, allowing users to understand the trade offs involved with different drugs and reduce the odds of a potentially serious interaction. Look for more profiles of up and coming Health 2.0 startups and posts by Health 2.0 developers and entrepreneurs in the weeks to come.

Americans are worried; millions visit web sites multiple times each month looking for information on drug side effects, interactions and efficacy, but they say their needs are not being met by the simplistic data they find. This community-in-the-making is not paranoid; adverse drug effects (ADEs) are the 3rd leading cause of death in the US, killing 218,000 people a year, yet 150,000 of those deaths are deemed avoidable if only available knowledge could be identified and effectively applied.The barrier is complexity: the typical senior, on a regimen of eight drugs, can have as many as 40 trillion alternate regimens to choose from that vary widely on ADEs, efficacy and cost. Even the typical baby boomer, on a regimen of four to six drugs, faces a trade space of millions of choices. The only recourse is reading drug information sheets and using a drug interaction checker. But these only flag problems; they don’t offer solutions.

Fire Burns Away the Fog of Ideology: Can Humane Health Care Reform Rise from the Ashes? – Michael Millenson

Oct 24, 2007• 13

THCB welcomes back our solid pal, the erudite Michael Millenson, for whom the sun doesn’t shine if there’s no wisecrack in the wings. Now leading a consulting firm specializing in health care quality projects, Michael is a former Chicago Trib reporter with 3 Pulitzer nominations to his credit. Michael’s groundbreaking 1997 book Demanding Medical Excellence was one of the first to call attention to the problems addressed by the Quality and Safety movements. Enjoy.

As wildfires sweep Southern California, I have been surprised that homeowners in some of the most affluent and staunchly Republican enclaves in the state have not protested the widespread deployment of government workers bearing fire hoses and driving ambulances. The pain of watching one’s life possessions burn to a crisp must almost be matched by the pain of watching tax dollars wasted on a task that private, for-profit firefighters could surely perform more cheaply and more effectively. Yet not even the richest of the fire-torn refugees has expressed regret over government intervention in their rescue.

HEALTH2.0: More doctor rating–this time it’s Wellpoint & Zagats

Oct 23, 2007• 10

So Zagats, which is the best known old world ratings guide in the restaurant business, is making a move into health care. And it’s doing it with the biggest blues plan Wellpoint.

So there’s likely to be quite a bit of cynicism about this. After all, why should anyone use a health plan site to rate doctors rather than an independent one, and for that matter is Wellpoint going to let its customers rate it? I can think of a few who won’t rate it so highly!

But beyond the cynicism, it’s clear that some form of ratings is coming fast. And plans might as well get into the game somehow, although given the lack of trust they have in the market, my guess is that an independent ratings company is more likely to succeed. And there are lots of those around. Perhaps the question is whether it’ll be a guide known best for restaurants like Yelp, a general health care site which allows ratings like Revolution or Vimo, or whether a specialist one that just rates doctors like RateMDs or CareSeek.

Quick add: On the panel at Connected Health, Henry DePhillips, ex MedDecision now with Medem says– consumers not going to
rate costs or quality—so that Wellpoint/Zagats are missing the point!

TECH: Fred Trotter–HealthVault: No privacy commitments

Oct 23, 2007• 1

I’m at the Partners Connected Health conference. Yesterday’s entry got killed by an overheating crash—but having blown the dust out of my heatsink, hopefully my Gateway is OK now.

Later today 5 cool Health2.0 companies are going to be showing their goodies on a panel I’m running. (WeGo Health, Enhanced Medical Decisions, DNADirect, PatientsLikeMe, and Praxeon)

I also heard an earlier panel talk from a next generation RelayHealth/online visit type company called American Well (not an oil company) which looks pretty interesting — real time video conf with docs “on call”, apparently some health plan will run it out next year)

Right now I’m at a panel on PHRs. We’re starting to talk about data privacy and trust. Funnily enough open source advocate Fred Trotter has today taken a broad swipe at Microsoft in an article called HealthVault: No Commitments and a Sleeping Watchdog in which he says that there’s no actual audit function and that privacy advocate Deborah Peel has been snowed.

So I asked….James Mault from Microsoft essentially said that they’ve done the best they can so far with a multitude of interested parties and that this is a continual work in process. He did say “ability or third party audits are built into the system” and that “at the end o the day the consumer will tell us what they want”. He didn’t mention the open source issue, and no, I’m sure Microsoft wont show him the code!

Massachusetts Health Care Reform : The Canary in the Coal Mine

Oct 23, 2007• 5

By MAGGIE MAHAR

Advocates for health care reform have been keeping an eye on Massachusetts, hopeful that its new health reform law will serve as a pilot program for the nation.

I’m much less hopeful than I was two days ago.

Yesterday I attended the Massachusetts Medical Society’s Eighth Annual Leadership Forum where I was one of four speakers. This year, the Society (which owns The New England Journal of Medicine) focused on the cost of health care –with a special emphasis on funding universal coverage in Massachusetts. The new was not good. While the citizens of Massachusetts believe that everyone has a right to health care (when polled 92% say “yes”), no one wants to pay for universal coverage. When asked “if the only way to make sure that everyone can get the health care services they need is to have a substantial increase in taxes [should we do it] 55% said “no.”

One speaker at the forum recalled a man who explained why taxpayers shouldn’t have to pick up the bill: “The government should pay for it.” (He didn’t disclose who he thinks “the government” is. )Continue reading…

Food Porn: Hardees and the 920 Calorie Burrito – Pat Salber

Oct 22, 2007• 31

Perhaps
the folks over at Hardee’s fast food haven’t heard the country is in
the midst of an obesity epidemic. They have just unveiled a new
breakfast offering, the Country Breakfast burrito. It consists of a
two egg omelet filled with bacon, sausage, diced ham, cheddar cheese,
hash browns and sausage gravy. Surrounding this protein load is a
flour tortilla. The burrito weighs in at 920 calories. That’s right,
920 calories, about half of what you should ingest in a day. This
little baby also has 60 grams of fat. All those calories and all that
fat will only set you back $2.69.

According to a story by the Associated Press,
Brad Haley, Hardees’ marketing chief, says that the burrito offers the
sort of big breakfast item normally found in sit-down restaurants with
an added advantage. “It makes this big country breakfast portable,” he
said.

Esther Dyson on Health 2.0

Oct 22, 2007

I hadn’t heard this quote from Esther Dyson describing Health 2.0 before. She puts it very well.

What we heard today was to me something like the mobile phone system;
it kind of snuck in quietly. It didn’t say it was going to replace the
landline phones. It just appeared.

HEALTH 2.0: Sssh. It’s a secret!

Oct 22, 2007

Pre-registration for the next Health 2.0 conference is now open. The exact location and date for this March event must remain a closely-guarded state secret for now, but expect an official announcement from the Health 2.o team soon. September’s conference sold out weeks before the event, so if you want the best odds of obtaining a pass, you probably should take the two minutes it takes to go sign up. If you attended the September 20th event in San Francisco, all you need do is email in**@********on.com with "I want to come to the next one" in the body of your email. Meanwhile, if you missed the September event in San Francisco, we will shortly be making an 8 DVD box with highlights of the Health 2.0 User-Generated Healthcare conference available for sale. Just send us an email with "I want the DVD in your subject line." We will provide details on pricing and shipping options when copies are available to ship.