Categories

Above the Fold

Best of: The AMA goes 2.0

Most of you reading about Health2.0 will be bored by now of me talking about Sermo and how they’ve become the quickest growing physician online community in well under a year–although there’s now competition in that space from the  likes of Within3. You’ve also probably got bored of me saying that the big question about Health2.0 technologies is whether "the health care establishment" is going to adopt them.

However, you’d probably be a little surprised to find that one of the bastions of America’s health care establishment–and one that doesn’t get much good press on THCB–has decided that it needs to jump on board the Health2.0 bandwagon. Today Sermo announces a deal with the AMA that allows the AMA to see what doctors are talking about on Sermo, and gets its user docs free access to all the AMA’s journals, as well as starts making Sermo’s ranking and discussion tools part of those journals.

This is a coup for Sermo and a big move for the AMA. Not to mention a validation of the impact of at least one part of the Health2.0 movement. Want to know more? I thought you did–which is why I interviewed Sermo CEO Daniel Palestrant about the deal yesterday. Listen to the interview.

And yes, Daniel and Sermo (and the Within3 folks) will all be at the Health2.0-User Generated Healthcare conference. But you all knew that too!

BEST OF: JD Kleinke talks about PHRs, Omnimedix and the Dossia controversy

JD Kleinke is always one of the more controversial and fun people in health care policy and health care IT. He doesn’t just write about stuff–he also gets really involved. From his early days at HCIA to his more recent roles at Healthgrades. And now of course he’s the head of Omnimedix — which was developing the technology for the employer based PHR Dossia, funded by WalMart, Intel et al. But apparently not funded enough.

I had a wide-ranging discussion with JD about his policy work, his career, what he thinks about health plans, and what went wrong with Dossia. The interview is of course well worth a listen.

HEALTH2.0/TECH: Way too much going on!

I’m trying to organize a conference with everyone and their brother claiming that they need the last seat and that the dog ate their mouse so they couldn’t register. And we’ve been coaxing our demo panelists through their demos–which are all going to be really great, other than no one believes you when you tell them that four minutes went by in just 240 seconds.

And Tuesday was just one of those days…

Perennial THCB Health2.0 favorites Sermo are cooking up some fun stuff for the wine and cheese reception they’re sponsoring to close the Health2.0 Conference. But they’ve had a huge few days. Last week they announced that the FDA will be using Sermo to monitor potential new adverse drug events and much more. Initially FDA staff will be looking at what docs are talking about online, later they’ll be posing questions. Then Tuesday Sermo announced a $27m Series C Round, which should just about cover the cost of the cocktails….

Meanwhile, Kosmix has taken the beta tag off its RightHealth stealth search engine site. You can hear far more about this from my interview with Venky a month or two back. But they’ve announced that they got 2.5 million visits and 9 million searches generated a month and are in the top 12 health search sites measured by Hitwise. The concept is to extend the "home age for a search" to let people explore topics in context, while still making those top 10 search results visible.

Speaking of searches, OrganizedWisdom is changing its spots and moving from being a user-generated content site, to being a community search site that integrates user-generated content from all over.  More details here and to be revealed at the conference next week. CEO Steven Krein tried to explain this to me at lunch a while back but I didn’t understand what he was talking about. Now I do and it’s really very interesting.

Finally, we’ll have more to say about how the news that Adam Bosworth is leaving Google health will impact Health2.0 shortly. But rest assured that Google is still participating in the conference and that they remain committed to health care.

HEALTH PLANS/TECH: Selling out a name–et tu Harvard?

Over at HISTalk there’s frequent criticism of "awards" that are handed out by analysts to vendors, and frequent assessment of which consultants can be trusted as independent, as opposed to which ones will "sell" an award. Frost and Sullivan gets a particularly bad rap over there on the latter issue.

Which all struck me as a little strange when I saw this press release. South Carolina Blues has won an award for its pre-certification technology. Who bestowed this honor?  Harvard School of Public Health’s Dept of Health Care Policy.

BlueWorks is a partnership between the Blue Cross and Blue Shield
Association and Harvard’s Department of Health Care Policy that recognizes
innovative Blue Cross and Blue Shield companies working with doctors and
hospitals to increase the efficiency and consistency of care delivery
nationwide. <SNIP> Since 2004, Harvard Medical School’s Department of Health Care
Policy has named 35 Blue Cross and Blue Shield programs as BlueWorks winners.

Of course all major Universities collaborate with business, but I’m not sure I recall one going into the "handing out prizes" part of consulting. Anyone know any more?

HEALTH 2.0: It’s a sell out!

I remember first discussing the Health2.0 Conference with my partner Indu Subaiya and saying, "do you think we can get 100 people to come?" Well apparently we misunderestimated ourselves. As of yesterday the Health2.0 Conference has sold out. There’s a waiting list and some final adjustments to be done, but we’re expecting 400 people plus to be there on September 20th.

Thanks to all the speakers, advisory board members, moderators, sponsors, and of course my colleagues Indu, John and Sara, Patrick and Adrienne who have been working their tails off.

If you’re coming we’re really looking forward to seeing you. And if you can’t make this one, we’re already planning the next one in 2008.

POLICY/INTERNATIONAL: The Dutch–Better than the US at football, drug-laws and health care organization

The Netherlands is a small nation of only 16 million, and yet they have a record in International soccer that’s better than many three times their size. laws about drugs and prostitution that reduce crime, violence and embody toleration, and now they probably have the most advanced health care financing system in the world.

How so? It’s essentially Enthoven’s original managed competition idea in action (circa 1987). Even the Wall Street Journal thinks good things. The key is you need to ban underwriting, and implement risk adjustment (not that it’s easy but it is doable) between plans. Then you have to give the insurer and the insured incentives to realize that the way that population health is managed has ramifications for both the population’s health and its wealth. Then you get rational trade-offs made at a population level.

Can it happen here? I think so, unless you think that Americans cannot handle rational choice. Of course the people who claim to value choice in health care here can’t abide by the concept of the rational structure that the Dutch have put in place which allows choice to be made about the right things. So "choice" here in health care financing means, as the WSJ put it:

In the U.S., competition among insurers often means competition to find
the healthiest customers, especially in the individual market.

But of course if you don’t allow individuals to make the choice of what they spend collectively on a monthly basis to be the point of decision on how much is spent on health care (and put those intermediaries in the middle in the position of benefiting from lowering that amount in the "right" way), then the only other rational allocation is to have the government do it via the tax system.

CODA: I wrote extensively earlier this year on my comparison between the two and how different they both are from typical American notions of competition.

BLOGS: Health Wonk Review up

Brain Klepper has defected back to Pat Salber’s blog to host a great edition of Health Wonk Review. But don’t worry Klepper fans….we’ll have him back here shortly. In fact he’ll be running THCB during the Health2.0 Conference. But if you’re a Pat Salber fan (and why wouldn’t you be?) don’t fret. She’ll be blogging from Health2.0 too.

POLICY: What the lumenati are saying may surprise you

Forbes has one of those “pics and words” articles about healthcare, with quotes from lots of smart and not-so-smart commenters. But I just thought it would be fun for you to read the quotes and then play the “who really said that” game.  Here are some quotes I picked, not quite at random. After the jump, I reveal who said them with a little commentary

1) We want to get to 100% insurance coverage so the whole country is in the risk pool, which eliminates cherry picking.

2) The old managed competition idea from the Clinton years is still a pretty good one. The idea was to have some entity–employer, private or possibly a public sponsor–set up a menu of choices for people and give them a lot of information about each choice. Then give people a set of choices that range from basic coverage to highly generous, expensive coverage and let them decide how much money they want to spend. Subsidize lower-income people in some way, like refundable tax credits, to ensure people have money to buy good basic coverage, but then they’d have to add their own money if they wanted something more extravagant.

3) We have turned over $2.2 trillion of our money to those who manage our health care, without holding them accountable. Not surprisingly, these folks–hospitals, insurers, governments–used the money to benefit themselves

4) All of the incentives are pointed in the wrong direction.

5) The Medicare program needs to focus on being a more active purchaser. We need to consider an entire episode of care from start to finish to ensure a patient gets care in the most appropriate location … We don’t, at the moment, have a rational reimbursement structure for health care. You may pay more for a procedure at one location, and the quality of care may not be higher. Part of fixing that will take legislation.

6) Spend money on an information infrastructure. Then it would technically be quite possible to track what different hospitals actually spend on health care and what happens to these patients that get treated. Put that information on the web and let people see it to hold doctors and hospitals accountable for how they practice.

7) You need to have a private marketplace rather than have government control in the health care sector, and that means fixing the federal tax code.

You want to know who really said that? Read on:

Continue reading…

assetto corsa mods