A.D.A.M.
(Nasdaq: ADAM) is a leading provider of online consumer health
information solutions to healthcare organizations, employers,
consumers, and educational institutions. A.D.A.M.’s goal is to empower
consumers to get smart about their health and wellness, while reducing
the costs of healthcare and benefits administration. This position is based in Atlanta, Georgia.
Above the Fold
JOB POST: National Guidelines Project Manager
Kaiser Permanente’s Care Management Institute (CMI) is a unique,
pioneering institution with a mandate to drive, fund, and catalyze care
management activities throughout our non-profit HMO. CMI strives "to
make the right thing easier to do. The Center for Health Care Delivery is creating a new Knowledge Service/Evidence unit. The National Guidelines Project Manager is responsible for leading and
making significant contributions, and/organizes the development, revisions,
production and dissemination of National, evidence-based guidelines
and practice resources across the organization. Responsibilities include
all aspects of project management. Interfaces regularly with management
to produce timely and valuable results. Responses to: Ca**********@**.org.
PLEASE remember to include THCB JOB BOARD in the subject of your email.
TECH/HEALTH2.0: Vince Kuratis Connecting the Dots…on Google Health
Vince Kuratis, who knows rather more than he should about DM and eHealth, and maybe knows rather too much to be as optimistic as he is—given all that he knows—has a long and excellent article on Connecting the Dots…Google Health Promises to Create AND Dominate Next Generation PHRs.
Briefly Vince’s analysis is that Google Health will allow a personal URL that will be a place that a consumer can store data from all over the health system and link it to their own “soft” data such as Google searches, and then run applications over the top—presumably to do things like diagnose diseases.
You should go read Vince’s analysis, which is pretty close to my own, and irons out a lot of the details.
The only way that I’d differ from Vince (other than I was too lazy to write mine out fully) is that that I’d add in the one interesting VC investment Google has made. It’s in 23andme. Aside from the fact that the CEO is Larry or Sergey (I can’t tell those two apart)’s wife—bet that made the pitch easier!— and that Esther Dyson has her hooks into it as well, the interesting thing about 23andme is that it’s a genetic testing company. And it seems pretty logical that genetic information is going to be mixed into PHRs in the near future….so it doesn’t take a rocket genome scientist to make the link between 23andme and the not yet unveiled Google PHR/personal health URL.
They key question is whether Google (and more importantly American consumers using Google as a vehicle) has the clout to make the health care system willingly and easily give up its data….
We shall see.
POLICY: Tom Tomorrow disses the conservative straw men
The best political cartoonist in America is at it again–This Modern World
PHYSICIANS: Medicare and the AMA–here we go again
Physician fees would be cut by 9.9 percent in the coming year under a payment plan proposed Monday by Medicare <SNIP> Congress has stepped in to prevent similar cuts in the past, and doctors’ groups are urging lawmakers to intervene once again this year.
Not very likely….
HEALTH PLANS: From the AHIP fields (Ignagni loves Shalala and vice versa–Newt’s just watching!)
AHIP’s annual conference last week, and Karen Ignagni was recently spotted in USA Today slagging off Michael Moore as part of that newspaper’s “fair and balanced” look at the topic, and telling yet more lies about “Canadians coming to the US for health care.” Apparently her research team doesn’t subscribe to Health Affairs. I meanwhile was at Meditech having way more fun (more about that anon). But an anonymous THCB reader did indeed make it to Vegas. And considering AHIP’s somewhat risky current political tactics, I’d think Vegas was an appropriate place for them to have the show! Here’s his report:
The AHIP (America’s Health Insurance Plans) conference was everything that you would expect from a group of health insurance executives and the people who want to sell them stuff. Held at the posh Wynn resort in Las Vegas, it brought together the who’s who in health insurance, although fewer CEO-level folks than the World Health Care Congress. Unlike HIMSS, which is both much larger and pushing to include payers, purchasers and health information exchanges, AHIP doesn’t seem to be pushing such democratization. This is the business of health insurance.
Of course the triple 800-pound-gorillas in the room were the release of Michael Moore’s “Sicko,” the public awareness that CDHP wasn’t panning out to be the panacea that it was positioned to be, and the Democratic takeover of Congress.
Karen Ignagni, AHIP’s fearless leader, opened the conference with a less than rousing invitation for the assembled attendees to pat themselves on the back for all of the good work that they are doing to improve healthcare…and to consider themselves among “the patriots” on July 4. Maybe it was the early hour, but I believe that I counted exactly twelve people clapping.
Ignagni introduced her “close personal friend” former Secretary of Health and Human Services Donna Shalala (under President Clinton) and current president of University of Miami. I think that Shalala was chosen as a way of demonstrating that AHIP has connections with Democrats as well as Republicans. Shalala told the audience to support AHIP because Ignagni is among the most connected people in Washington on health issues…and – again to a smattering of applause – echoed the sentiment that those in the audience were somehow “patriots” in the cause of improving healthcare. Shalala continued about her co-chairmanship (with Senator Bob Dole) of the commission looking into the mistreatment of troops at Walter Reed. It’s a very difficult problem because there are very few experts on the military health system. But, she told us, that it was an example of a single payer, government run system…and look, look…at all of the problems, especially in transitions of care (that I’m sure have nothing to do with the rivalries that exist between military branches and are all about the MHS being “single payer” and government run). She went on to speak about how unlikely it was that there would be transformational change anytime soon because while there is widespread agreement that healthcare needs reform that there is not widespread agreement on how to fix it. We could expect incrementalism or worse, and that she (and the Clintons) had mis-read the public’s desire for change in 1993. (Ed’s note: It appears that the time and options Shalala has acquired on the United HealthGroup board have softened her liberal credentials somewhat!)
Next up was Newt Gingrich, who began by recommending Nicholas Sarcozy’s new book and focused on the new French President’s admission that the French people need to “work harder”. He said that he might run for President but was waiting for the current group of those “interviewing” for the position to narrow a bit. He declared the Medicare drug benefit and the sign-up process a success because of the power of consumer choice. Using a metaphor he dubbed “Medi-Cruise” for government run or single payer healthcare, he likened the ability of senior citizens to navigate the complexities of choosing vacation cruises with their abilities to choose optimal drug benefits. Seniors – according to Newt – did a much better job of choosing a benefit than if the government had chosen a one-size-fits-all benefit: Just imagine if the government chose your cruise for you – “Medi-Cruise”…and if everyone was forced to have the same-type room! As if a cruise – paid for on a voluntary basis by people themselves and health benefits – necessary and paid for by the government – are the same thing. Gingrich – on a positive note – said that the National Health Information Network (including digitization of individual providers) should be viewed on the same importance and scale as the national highway projects under Eisenhower. He rationalized this huge government project because it was for national security. He also focused on ferreting out fraud and abuse instead of making wholesale rate cuts. Ultimately, Gingrich is among those who believe that transparency of cost and quality information and consumer incentives will make healthcare a functioning market. He expects consumers to lead transformative changes in healthcare. There was no mention of the recent CDHP story in the WSJ.
Possibly fearing disruption or protest, Q&A at both sessions was short, seemed tense, and required clear identification by name and affiliation…not unreasonable…I had the feeling that any overtly accusatory questioner would be cut off, ushered out, and pilloried by the crowd. Ignagni seemed loaded for bear.
HEALTH2.0/PHARMA:Drug Companies & Social Media
The ever wonderful Jane Sarasohn Kahn has a great article up at IHealthbeat on the use of Social Media and Health2.0 by drug companies. Her conclusion is that Drug Companies Lag in Adopting Social Media To Communicate With Consumers but that there’s great opportunity to go after compliance and adherence via social media. These BTW are good things for drug companies and patients. Read her article.
And if you can’t get enough JSK (and who can?) Jane will be moderating the kick-off panel with the likes of Google, Yahoo, WebMD and Microsoft explaining their take on Health2.0 at the conference of the same name on September 20th. But she’ll also be talking about social media (along with another "veteran" of that world Joyce Flory) at Dimtriy’s Blogging & Social Networking track in the Marketing to the Health Care Consumer Summit in Chicago earlier that same week.
TECH: Why physicians don’t want email from patients
Headline: Patient-Doctor E-mail Could Cut Income for Physician Practices. Kaiser Permanente Northwest’s Clinical Systems Planning and Consulting group did a study on its patient-physician email use in its NorthWest region and found that it worked as it was supposed to. Visits down 7-10%. Phone calls down 15%.
This is of course great news. Productivity goes up, patients are happier and their care is probably better. Of course in the bizzaro world of health care that we live in, this would translate into a 7–10% decline in primary care physicians’ incomes. Which is why RelayHealth et al raise suspicion of their potential customers, and why we have to get them off the fee-for-service treadmill ASAP.
POLICY/HEALTH PLAN: Karen Ignagni lie of the day
AHIP’s response to Sicko. Lined up in “cut to” style with answers but no questions so that it can be dropped into local news (check out the weird “B-roll” at the end). And again some of what she says is reasonable, if not a real reflection of what most of her members have been doing for the last 7 years.
But always the lie, always. She just can’t help it! Go to minute 1.00 of the video. Note what she says about Canada. And then take a look at the data.
POLICY: Jonathan Weiner, pulling no punches on what’s wrong
Jonathan Weiner, Professor of Health Policy and Management at Johns Hopkins, tells it like it is in a great interview at Managed Care magazine. It’s so good I’ve extracted several real zingers. I particularly love the last one about “getting the government out of the way of the market.” Here’s a selection:
“Other developed countries have come to two realizations that we have not come to. One is that it is immoral — or at best, amoral — not to provide health care to everybody if we believe that basic health care is a sign of a developed country.”
“The second realization is that other countries acknowledge that the collective — social insurance programs like the sickness funds of Germany, government agencies, or third parties that look very much like our insurance or managed care companies — cannot provide everything for everybody.”
“When managed care plans, working mainly as agents for employers and government, tried to make some necessary changes and do the right thing, nobody would let them. We shot the messenger. We’re lousy at doing what’s necessary in our health care system. Tightly controlled managed care as envisioned in the ’90’s in the Clinton reform plan is not managed care today. I’m a big supporter of good forward-thinking managed care on the part of executives and clinicians, and I definitely support the appropriate role of the market and consumerism. But we can’t lose sight of population-based care and public policy issues that don’t come naturally to managed care organizations facing pressure every quarter to make a profit and keep investors happy.”
“Within a generation or two, we’ll see the positive side of health information technology. Health care will actually get more humane, with more human interaction and more communication, because the technical side of what doctors do now will be handled by the electronic box. Things like figuring out what tests should be ordered, what drugs should be used, looking at an EKG and comparing it to the evidence will all be done better by electronic systems, using algorithms developed by doctors at places like Cleveland Clinic and Johns Hopkins. Doctors will need to be communicators, facilitators, coordinators, and coaches. I believe that model will favor women doctors, because they happen to be better at those skills.”
“Every advanced HIT system I’ve studied — the British, Hong Kong, Kaiser Permanente, and Geisinger Health System in the U.S. — has a centralized rational entity that looks at the big picture and sees itself as being in this for the long haul.”
“Our health care system is the most expensive in the world by a factor of two, and the most inefficient probably by a factor of three. Yes, we pay our doctors and administrators more and patients who get care get a lot more, but a lot of the cost difference is due to waste. We need clinical research of the type funded by NIH, and we need more operational population-based research. The Agency for Health Care Research and Quality is terribly underfunded now, and once genomics come more fully on line, research into cost effectiveness will become even more important”
“I serve on the Medicare Coverage Advisory Committee, an academic group, and I can tell you that Medicare has nowhere close to the authority it needs. There’s a lot of good people at CMS trying to do a good job, but their hands are tied by legislation. In most cases, they are not allowed to look at cost-benefit issues.”
“Q: Who’s persuading Congress to maintain the status quo? WEINER: Device manufacturers, pharmaceutical companies, everybody and their mother. God bless Big Pharma for keeping the new technology coming out. We may all need it one day, but it doesn’t all work equally well, and it certainly isn’t all cost effective. We cannot as a society pay for everything for everybody. That is absolutely impossible and totally unethical as long as we have 18,000 people a year dying — the equivalent of fifty 747’s going down — because they lack health insurance. My tone and tune will change once we have basic health care for all. We are a rich country and we absolutely can afford it, as long as we operate within a budget.”
“When a young doctor or medical school dean tells me that in this country the market does what the market should do, and government should keep out of it, I tell them that’s fine, as long as they’re willing to return the million and a half dollars in federal and state subsidies for each doctor trained. A plastic surgeon practicing in the fanciest suburb in any city gets more of a subsidy than the family doctor practicing in an inner city or rural area, and that’s not right. Moreover, the plastic surgeon can make a half million dollars a year, while the inner city doctor is making a hundred thousand.”
