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We Are What We Eat: Where Is America’s Leadership? – Brian Klepper

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One of the attributes of a great image is its ability to convey vast amounts of information and meaning quickly and simply. Here’s a terrific example.

In one of his typically astute comments, Barry Carol alerted us to a wonderfully clever graphic by Wellington Gray – the image needs more space to be viewed properly than this blog allows, so you’ll have to click on the link – displaying the percentage of people older than 15 in different developed countries with a Body Mass Index greater than 30. In other words, the percentage of fat adults.

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What Obesity Really Costs – Brian Klepper

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Any
lingering doubts that America’s cavalier attitude toward lousy food and
obesity is draining the nation’s health and economic vitality should
have been laid to rest a couple weeks ago. Two important studies were released
that quantified just how much our inability to resist fast food is
costing us.

In Health Affairs, the premier journal of
health care market dynamics, economics and policy, Professor Ken Thorpe
and colleagues from Emory reported on a study comparing incidences of chronic disease in the US and in 10 European countries.
They found strong evidence that Americans have much higher levels of
lifestyle-related chronic disease than do Europeans – in other words,
we’re sicker – that American medicine tends to identify and treat
disease more aggressively than does European medicine, and that our
more excessive lifestyles and aggressive treatment patterns undoubtedly
contribute significantly to our much higher per capita health care
spending, which can be twice what Europeans pay.

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TECH: CCR Training Workshop

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The goal of the ASTM CCR Training Workshop is to give developers and
programmers in Health2.0, as well as traditional health IT, a "deep
dive" into the CCR standard, its schema, and current uses of the CCR
for portability and interoperability of health information exchange.
For those who don’t know about the CCR standard, it is an easily
implemented and widely adopted XML schema for capturing a "snapshot" of
a person’s most relevant health information, such as demographics,
diagnoses and problems, medications, allergies, immunizations, family
history, and care plans.   It is an open and royalty-free standard
sponsored by numerous physician and medical organizations, including
the American Medical Association and the American Academy of Family
Physicians.  Information on the next ASTM CCR Training Workshop can be
found on the home page of www.ccrstandard.com.  David C. Kibbe, MD MBA and Steven Waldren, MD are faculty for the one-day workshop.

Aspen Report 2 – Healing Unbound: The Promise of Advancing Computational Power, Brian Klepper

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Laptop-attached ultrasound units that produce startlingly clear internal images for five dollars in the field. Organs that re-generate inside scaffolds.  Drugs tailored to an individual’s biology. Micro-images of cancerous cells lit up by bio-chemical markers. Decision support tools that scan the physiological values in electronic health records for patterns too complex to be detected by an unaided clinician.

The advances available from dramatic improvements in computational capabilities were a recurring theme at the Aspen Health Forum, with experts from each discipline describing where the technology was leading us. I attended two sessions featuring Star Trek clips that predicted realities now within at least theoretical reach. (Prescient and corny, audiences nodded nostalgically.) Sessions on biotechnology, imaging, electronic health records (EHRs) and the hospital of the future highlighted the power that is being leveraged to improve care.

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

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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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Aspen Report 1 – A Rage To Know: A Few Days At The Aspen Health Forum, Brian Klepper

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At one of the opening sessions of the Aspen Health Forum, Peter Agre and Michael Bishop, both physician researchers and Nobel laureates, recounted their childhoods, their families, their likes and dislikes, their school experiences, and the barriers, successes and lucky breaks that led them into lives of discovery. Dr. Agre won the award for identifying the mechanisms that allow water to cross the cell membrane. Dr. Bishop won for discovering how certain defects in genes can lead to cancer.

Those of us in the audience were struck by the commonness and good humor of their stories, but also by these individuals’ profound humility and, most of all, their passion. What Neen Hunt, Director of the Lasker Foundation, the third speaker on that panel, in her description of Dr. Charles Kelman, an ophthalmologist who revolutionized the way cataract surgeries are performed (more on that in another post), called “a rage to know.”

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

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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

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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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POLITICS: Forgotten children and unopened bills By Eric Novack

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On October 18th, the US House of Representatives will try to override the President’s veto of a greatly expanded State Children’s Health Insurance Program (SCHIP).  As is so often the case, political rhetoric serves as a fog that obscures what the SCHIP legislation really is and who is most affected.

The Democrats believe that they win by losing. Republicans shout “socialized medicine”.

But the Democrats went even lower this past week by bringing out a 12 year old boy and his family to be the ‘poster child’ for SCHIP expansion.

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