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Health 2.0: Live from Healthcare Unbound

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Today
I’m at the HealthCare Unbound conference in San Francisco, where
I’m on a panel on PHRs at the end of the day. Tomorrow morning
I’m presenting at the Silverlink/HealthWise session on Information
Therapy in Boston. You do the math and figure out where I’m spending
the night! Funnily enough as I type I’m sitting next to Josh Seidman,
the President of the Center for Information Therapy, who’s on a panel
here later today. Tomorrow I’ll be seeing his colleague Dorothy
Jeffress. At least those two have figured out the divide and
conquer thing.

First
up was Vince Kuratis. He told us the DM world was
ending (otherwise known as Medicare Health Support crapping
out).

Liz
Boehm, Forrester was looking at tech adoption among
seniors and trying to do it by same store growth versus new growth in
tech use by seniors as they age over time. Most growth in familiar
technologies; (e.g. replacement technologies like cell phones, DVD,
etc) was dominated by real growth BUT going online regularly and having a
computer at home are primarily from people aging in (new growth rather than
same store growth). And that means the adoption will take much longer.

Why
is this adoption rate so slow? Seniors have trouble seeing. Seriously. She
showed a cool slide that showed problems with vision that more seniors have
(focus, seeing at night, etc, etc). And hearing, and using the mouse and
interacting with websites, etc, etc, etc. And there are problems with cognition
(as you age your short term memory falls apart, as we all know!). Liz tried to
get the crowd to follow some basic instructions like standing up, sitting down,
hopping up on one foot; she said that most seniors have trouble
following those instructions quickly. I noticed that most people were too lazy
to get up and follow along (Josh and I did of course). So motivation is a
problem too (after all if a good looking blonde woman can’t persuade
a room full of geeky men to do anything, what hope do the rest of us have!).
Liz then gave a whole list of things that companies targeting them should do to
change behavior. Looks like Forrester is having trouble get its clients to
figure this out, and is having to go back to real basics on the whole matter.
To me that’s not particularly good news, as if they have to be
helping them with that. Here’s the data from Forrester.

Continue reading…

TECH: Problems for Employer-backed PHR

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The Dossia Project, the sweeping personal health record (PHR) initiative backed by Wal Mart, Cardinal Health, Pitney Bowes, Intel, BP and other major employers, looks as though it is running into serious problems. The consortium is suing JD Kleinke’s Omnimedix Institute, the non-profit group which was hired to develop the system seven months ago. "They went ahead to file
a restraining order to prevent us from suing them," Ominmedix chairman
and CEO J.D. Kleinke said in an interview. "They’ve gone ahead and
filed a restraining order against us, a 13-employee, 501-C."

HEALTH2.0/TECH: Big day for Healthline

It’s a big day for Healthline Networks. The health “search and much more service” (if I call them “search only”, President Dean Stephens gets grumpy with me!) has raised another $21m in venture funding and announced deals with several customers—including some who have put money in as part of the round. Those on the funding and client side include NBC (which owns iVillage), Aetna, & US News & World Report. Also putting money in was Kaiser Permanente’s venture arm, so it’s reasonable speculation (if not announced yet) that KP is thinking of using Healthline too. In addition AOL and Ask.com are also going to use Healthline for search on their properties.

Given that vertical search is becoming a big deal in health care, this is some of the biggest news yet. So lots of activity! Healia was bought last month, Kosmix has been announcing deals, Medstory was sold to Microsoft, and some small company beginning withe letter G apparently is doing something in search too.

Of course, if you really want to know more you should consider coming to the Health2.0 Conference to hear from all of those companies and many more….

THCB Reader Mail

SeekCEO wonders whether there are any ex-WebMD/ex-Healtheon folks who would like to lead a new Healthcare Web 2.0 startup in Southern California? If you’re qualified email for details.

The Robert Wood Johnson Foundation’s Susan Promislo writes in with this to say about the "Disruptive Innovations in Health and Health Care" competition we wrote about last week.  

"Thanks for the note about the Robert Wood Johnson
Foundation/Changemakers competition to identify disruptive innovations
in health and health care. I also wanted to add that the $5,000
Changemakers cash awards are an important component of the competition,
but they are not where the action ends.  All entries will be reviewed
by RWJF’s Pioneer Portfolio, which has made available up to $5 million
to support innovative, disruptive approaches that come in through this
competition.  Once the competition closes, promising projects may be
invited to submit proposals to Pioneer for possible future funding.
More info. is available at
http://rwjfblogs.typepad.com/pioneer/2007/04/back_in_january.html

The deadline is July 18, which means you’ve basically got all weekend to get your entry in to win a grant!

Unity Stoakes of Organized Wisdom responds to concerns on the part of privacy advocates that the military-industrial Google complex
may pose a threat to consumer privacy. "Google already has all of our
data. They know more about me than I do.  May as well give them all the
rest and see how (on an aggregate level) this type of data can
collectively help us improve our health. For better or worse the age of
privacy is quickly being replaced by what I call THE AGE OF
TRANSPARENCY. Whether we want to or not, not only is the world flat
again, it’s also OPENING UP and AGGREGATING."

Ginger B comments on the thread about the reasons doctors don’t like to use email to correspond with patients. "I have Kaiser and I like the email feature. I have many other things to do besides sit next to my telephone waiting for a phone call from a Doctor. It’s one of those things where if you have one meeting that day, that will be when they try to call you. I’ll also add that when I emailed about my PCP ordering a lab test for me she emailed back and informed me that she was also ordering blood lipids to be done because I was due for those, and she wanted me to come in and get the results so we could review them."

Anonymous writes in to comment on the same thread.  "If our patients want to contact us, they must use email, we don’t use the phone.  For three days after an appointment and for special circumstances determined at the time of the visit (for which they are given a code) they may email us for free.  After that, it is $25, refunded if I can’t answer their concerns satisfactorily. Questions are answered within 24 business hours. I haven’t had one complaint and though my practice is closed, I have requests daily to take patients.

POLICY: Debating SICKO’s Impact by John Irvine

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Since opening a week ago, Michael Moore’s latest documentary has focused unprecedented attention on the U.S. healthcare system. The film has brought angry protests outside movie theaters. Standing ovations from audiences. And provoked angry debate in the nation’s editorial pages. It has also done fairly well at the box office, drawing far more viewers to theaters than many experts had predicted.  According to the Hollywood Reporter, the film finished second in per-theater gross last weekend, bringing in $11.3 million at 700 screens across the country — rather a respectable showing for a movie that specializes in disturbing subjects that Americans would generally rather not talk about. So far, Sicko has generated exactly the kind of controversy that the critics predicted it would.  Moore has  already had to deny that he is planning a trip to Iran next month to view the film at an Islamic film festival. (The story turned out to be a rumor spread by conservative opponents.  The filmmaker says he received an invitation from the Iranians but declined to accept.) This week he was on CNN, lambasting the network for its healthcare coverage and getting into a near shouting match on The Larry King Show with medical correspondent Dr. Sanjay Gupta over some of the stats used in the film.

Moore went on to accuse the network of colluding with the film’s
opponents, pointing out that one of Gupta’s researchers, Paul Keckley,
the former head of Vanderbilt’s Center for Evidence Based Medicine and
a current Deloitte consultant, has done a lot of work for big health
insurers and pharma companies. (Something that could be said of a fair number of people working in the field, as THCB readers know all too well.) Could Keckley be censoring the network’s coverage?  Moore wondered out loud to himself and not-very-subtly. 

The theatrics aren’t a surprise to anyone who has followed Moore throughout his
career. Not surprisingly, the attack drew a rather hurt denial from Gupta on his
CNN blog.

Meanwhile, Moore is living up to his reputation for drawing attention to himself. Earlier this week, the filmmaker published a leaked internal memo on his web site allegedly authored by
the Blue Cross communications department.  The document reviewed the film – acknowledging that the documentary is a slickly done piece of work. [Follow the link and scroll down to read the whole thing.] The review begins as follows:

"You would have to be dead to be unaffected by Moore’s movie, he is an effective
storyteller. In Sicko Moore presents a collage of injustices by selecting
stories, no matter how exceptional to the norm, that present the health
insurance industry as a set of organizations and people dedicated to denying
claims in the name of profit. Denial for treatments that are considered
"experimental" is a common story, along with denial for previous conditions, and
denial for application errors or omissions. Individual employees from Humana and
other insurers are interviewed who claim to have actively pursued claim denial
as an institutionalized goal in the name of profit. While Humana and Kaiser
Permanente are demonized, the BlueCross and BlueShield brands appear, separately
and together, visually and verbally, with such frequency that there should be no
doubt that whatever visceral reaction his movie stirs will spill over onto the
Blues brands in every market."

Will the public hold health care providers and insurers accountable for the lapses Moore documents in his film? That remains to be seen. For many Americans who haven’t been paying attention, the documentary is undoubtedly a wake up call. There seems little doubt that people will start to ask more questions when they walk into their doctor’s office or when they sit down to pick an insurer, which is certainly enough to make some people uncomfortable. There is also little doubt that the film has added to the already fiercely burning debate between supporters of a free market based system and a government run universal healthcare system.

PODCAST REVIEW: Here’s THCB contributor Dr. Eric Novack’s take on the film from his radio show last Sunday. Two thumbs up? Er, No. Here’s Part 1 and Part 2. Eric and I will get into this a little later on, we hope!RELATED: "Sicko and Healthcare Reform", Maggie Mahar’s piece on THCB drew thousands of readers  and led to excellent discussion.

POLICY: Finally, the review– It’s A Sicko World

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I know you’ve all been dying for this. It’s my review of Sicko, up over at Spot-On.

There’s so much wrong with Michael Moore’s Sicko that it’s embarrassing, especially for a health care pundit, to reveal the emotional punch it gives you. You know that your head is being bowled over by your heart, and you also know that it’s very, very cleverly done. But that doesn’t make the message any less powerful. MORE

POLICY/POLITICS: Susan Blumenthal review of the Presidential Candidates’ health care policy

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Susan Blumenthal, M.D. has created a side-By-side Comparison of all the Presidential candidates’ health care proposals. What does it tell you? None of the Republicans have a real proposal–Rudy Guliani has made some big statements about turning the system over to consumers but no one else — including Romney — has dared say much. While Edwards has a convoluted plan (courtesy of Jonathan Gruber) and Obama has been standing far too close to David Cutler, Hillary Clinton has only announced half of hers.

Of course none of it matters too much. The journey between here and real health care reform is a long, long one. But good job by Susan and her team to put it all together.

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