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Above the Fold

HEALTH2.0/CONSUMERS/TECH: Patient groups online are a source and a force

We know that patients have been organizing online and Laura Landro (who’s been there herself) confirms it in a fascinating article. Go read it. Of course this is making some people nervous.

Of course, the rush to link communities and researchers and the move by patient groups to conduct their own research raises some thorny new issues. While the nonprofit, patient-run online groups have no financial interest in research or recruiting for trials, some for-profit health Web sites see their online communities as a way to make money. Such sites, supported by drug-company advertising, may seek to recruit patients for drug-company clinical trials, often without going through physicians who may advise patients about the pros and cons of such trials. Also, the research organized by online patient communities makes some scientists nervous because such efforts don’t use the gold standard of randomized controlled clinical trials.

So you might argue that the for-profit status of Yahoo or DailyStrength raise that thorny issue. But of course the non-profit groups are starting to use for-profit start-ups like Clinicahealth and Solos to supply their online services. And the mix between patient groups, disease groups and big Pharma continues to be a matter of controversy. Meanwhile there’s plenty of evidence that clinical trials per se are not that helpful, and all the data generated online will be very important no matter what the nervous scientists think.

We are on the cusp of a big change here, and everyone’s roles are changing in uncertain ways.

POLICY/HEALTH PLANS: More communism at the Wall Street Journal

More radical Bolshevism at the Wall Street Journal. Venessa Furhmans is now saying that Health Savings Plans (are) Start(ing) to Falter. How dare she!  She’s going to get it when Rupert takes over!

On the other hand, just dumping people into HSA and CDHPs was always going to raise dissatisfaction, and people, in general, do not want to shop at the point of care for medical treatment because it’s really, really hard.

In a survey published last month by Towers Perrin, an employee-benefits firm, employees enrolled in them said they felt less capable of finding a quality doctor or hospital, though they often were in the same network as colleagues in other plans. Only 29% said they tried to save money in their accounts for future medical expenses. Though the consulting firm says consumer-directed plans have much potential, its executives were surprised consumer responses were so negative. "If I were a product manager in any other industry and saw scores this low in customer satisfaction and understanding, I’d be thinking of pulling that product from the shelves or retooling it," says David Guilmette, managing director of Towers Perrin’s health-care consulting practice.

Still it’s a little ironic that a benefits guy is knocking CDHPs. After all, who the hell has been pushing them all this time?  And (to quote myself), remember kids, the CDHP is the bastard child of a one night stand between a benefits consultant with nothing to sell and a right-wing think tank that can’t do basic math.

THCB: Tech section with UPDATE

Over the next few weeks or so you’ll see some changes at
THCB. Most importantly, we’ll be launching the Tech Section, a new area of the site specifically focused on
healthcare and technology. Stories on healthcare, technology and IT subjects
will live here, as will archived podcasts and our rapidly expanding collection
of Health 2.0 focused content.
You’ll also find guest posts by special guest contributors working in the field,
ranging from execs at top hospital and health plan systems, to experts at the forefront of the industry.

Meanwhile, if you want to reach a monthly audience of tens of thousands
of healthcare industry observers interested in the intersection of technology
and healthcare and related stories, you may want to consider  sponsoring THCB or one of our sections. We’re read “religiously” throughout the
industry, by readers who like our “irreverent’ and “influential” coverage of trends and issues (Wall Street Journal.)  Monthly and longer term corporate sponsorships are available.  A limited number of Health 2.0 sponsorships remain
as well. Contact jo**@***************og.com
for rates, availability and other details.

PODCAST/TECH: HEALTH2.0/TECH/PODCAST: Interview with Venky Harinarayan, Founder Kosmix

Here’s this week’s interview is with Venky Harinarayan, Founder and (unofficial) CEO at Kosmix. Kosmix wants its new RightHealth site to be the "unofficial home page for health". He’ll tell you about categories and "broad" searching, the intricacies of the search ecosystem, and how Powerset will beat out Google. (OK he may not have said that, but it should get this entry lots of hits!).

This was the first interview when I could see my interviewee over Skype and I found it very unnerving, even though he couldn’t see me!  But you’ll only have to listen. You might well want to play with RightHealth while he’s describing it.

My take is that search is just starting in health care…and that in 2-3 years we won’t recognize it!

QUALITY/POLICYThe NY Times has licked its sore all better!

The New York Times is suddenly acting like Alain Enthoven and Jack Wennberg have taken over its health care reporting! This is the third article saying sensible things about the health care system in less than a week! Today, following the stories about practice variation in back surgery and Eliot Fisher’s work at Dartmouth, you wonks will all be amazed that Reed Abelson tells the public that In Health Care, Cost Isn’t Proof of High Quality.

They say that it takes about 17 years for a medical discovery to make it into general practice. Funnily enough I heard exactly the same stories about low quality hospitals and surgeons being the highest cost producers 17 years ago in Alain Enthoven’s class! How long before the Wennberg/Enthoven mantra make it into the public’s assessment of the health care system?

POLICY: Pandemic Flu Leadership Blog

I am supposed to be (but for reasons of schedule and health—I’ll explain later—failing to be) one of the participants in the Pandemic Flu Leadership Blog. But there are lots of great entries there and currently there is Live Blogging of the Influenza Leadership Forum in Washington, DC. Check it out and hopefully I’ll be able to join in later in the week.

POLICY: Jonathan Cohn, on film and in the studio

Up at WorldHealthCareBlog (eventually after some production delays) is the interview I did back in April with Jonathan Cohn, author of Sick.. That’s Sick the book as oppsed to the remarkably similar I guess (as I havent seen it yet) Sicko the movie.

And in an appalling sloppy piece of journalism or editing in the UK newspaper The Independent Andrew Gumble retells a seres of stories from Cohn’s book Sick and ascribes them to Moore’s movie, even though he mentions Cohn’s book later.

I guess Jon should scruff up and put on a few pounds….

PODCAST/TECH: Interview with Luis Machuca, CEO Kryptiq

We had Luis Machuca CEO of Kryptiq on a podcast from WHCC talking about his company’s health plan earlier in May. But he didn’t get to talk much about his company’s business or technology. This interview rectifies that, and it’s another in the series about how messaging and data exchange is arriving in health care. Take a listen to the interview.

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