The Health Care Blog – Page 1045 – Everything you always wanted to know about the Health Care system. But were afraid to ask.

Above the Fold

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

Oct 15, 2007• 2

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.

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

Oct 15, 2007• 9

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.

BLOGS: Looking for a potential TV star?

Oct 15, 2007

I had a note from a producer at Discovery looking for someone aged 18-29, who was/is ill/injured while uninsured or on an inadequate plan. This person would need to be a Maryland resident and willing to share their story on camera. Any takers? Email ***************@*******ry.com“>Kristen

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

Oct 14, 2007• 1

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.”

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

Oct 13, 2007• 10

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.

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

Oct 12, 2007• 8

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.

POLITICS: Forgotten children and unopened bills By Eric Novack

Oct 12, 2007• 8

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.

POLICY: Michelle Malkin is really dumb

Oct 12, 2007

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.

INTERNATIONAL: SWF seeking Canadian M

Oct 12, 2007• 1

A SWF, that’s a sick white female, is looking for a husband with Canadian health coverage.

Hospitals: Firing doctors by Paul Levy

Oct 10, 2007• 7

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.