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Above the Fold

TECH: Andy Grove ‘s Prescription By John Irvine

May 3, 2007• 10

Former Intel Chairman and CEO Andy Grove is in the latest issue of WIRED talking about the paradoxical relationship between healthcare and technology. “We have the Human Genome Project, personalized medicine, war on
cancer, CyberKnife, stem cell research on one hand — no doctor to be
found or to take care of your sore throat on the other," Grove says. "That’s a pretty
ugly picture. It’s pretty ugly today but it’s going to get uglier."

WIRED’s Kristen Philipkoski interviewed Grove after a recent talk he gave at Berkeley. (Watch the webcast here.) The Silicon Valley legend, who Harvard Business School biographer Richard Tedlow thinks "could [probably] hold his own against Benjamin Franklin," argues that part of the answer lies in less complicated solutions than the industry is currently pursuing. "Altogether," Grove tells the magazine, "I am obsessed with doability as opposed to desirability."

Like other tech executives who have been drawn to healthcare as both a business and social issue, Grove has been thinking and talking publicly about the problem for years. Philipkoski writes that Grove’s current thinking focuses on three general areas where he thinks quick improvements might be possible:

First: Keep elderly people at home as long as possible (an idea he
calls "shift left"). Use high-tech gadgets to help them remember to
take their medicine and monitor their health. In one year, if a quarter
of the people now living in nursing homes went home, it would save more than $12 billion, Grove says.

Second, Grove advocates addressing the uninsured by building more
"retail clinics" — basic health care centers in drugstores and other
outlets that can take care of problems that are presently, and
expensively, addressed in emergency rooms.

Lastly, unify medical records using the internet. In his vision, every
patient carries a USB drive containing his or her medical records,
which any doctor can download.

POLICY: Slagging off Philip Longman, defending Jon Cohn

May 3, 2007• 3

Up at Spot-on I’m defending Jon Cohn from a way-off topic review of his book from Philip Longman in the Washington Monthly. This is an important topic because Longman is in the “we can’t afford universal health insurance because the delivery system is inefficient” camp. He’s way wrong about that and he’s not alone. In fact his logic is backwards. We need to sort that out quickly, and I have a go at doing so in a piece called New America? Old Excuses. (The “New America” is the Foundation Longman is from which for some reason has teed off my editor over at Spot-on in the past). Here’s the intro:

Last week, I came to criticize Jonathan Cohn (for being too nice). Today, I come to defend him. Phillip Longman who hails from the New America Foundation complains in the Washington Monthly that Cohn’s new book Sick is Misdiagnosed because Cohn concentrates on the financial consequences of living without health insurance and not on the overall problems with inefficient and ineffective care in the U.S. system. He doesn’t exactly get off to a roaring start, taking Cohn to task and getting it totally wrong in the process.

Read the rest and come back here to comment

TECH: KP promoting EHRs

May 2, 2007• 1

Kaiser Permanente is trying to shift the focus on its EHR programs back to the good things about it (and we’ve heard plenty about the controversy). They are having a conference today in DC with big guns like Carolyn Clancy and have put out a survey. Their spin on the survey is that Americans Want to Go Digital When it Comes to Their Health Care.

And while approximately one in ten (12%) of Americans currently review their personal medical records on their health insurance company’s Web site, over half say they would like to be able to check claims and coverage (56%) or access personal records (51%) electronically in the future.

It’s not all sweetness and light, but there clearly is more interest in accessing information that’s pertinent and personalized about health care from health plans, and of course KP is not the only one making steps in that direction. So they’re roughly right. As for HealthConnect, as I’ve been saying for a while, the proof of the pudding will be in the actual use when fully rolled out in California. And for that you’re going to have to wait.

TECH: Medecision launches blog

May 2, 2007

There’s lots of blogs about health care IT, but not too many from health care IT companies themselves. Today Medecision launches one. For more on Medecision and what it does see my interview with President John Copabianco

PHYSICIANS/PHARMA: Fool me once-shame on you. Fool me twice…..er won’t get fooled again? by The Industry Veteran

May 1, 2007• 3

So there’s been a fair amount of fuss about a new paper by two academics, one a former drug rep, about the tricks big Pharma uses to “fool” physicians when it details them. You may not be impressed and may be willing to blame Pharma with its cheerleader sales reps and beauty queen detailers. The Industry Veteran, in his usual gentle style, assigns blame elsewhere. You have, as usual, been warned!

This newswires and every health care site in the blogosphere carried a story about a former Lilly rep who published an article about the sales tactics that pharma reps use to influence physicians’ prescribing. I’m shocked and horrified — NOT! So pharma reps have been taught Sales Skills 101. What the hell, are physicians such delicate flowers that they must not be subjected to the lures of salesmanship? Sorry if I appear obtuse, but I don’t see anything disreputable if a rep assesses the type of physician he’s seeing and tailors a pitch to that type.

JOB POST: Blue Shield of California

May 1, 2007

Blue Shield of California is a long-established health
care firm which is embarking on a major program to reengineer its core business
and to modernize the technology that supports it. The Legacy Modernization
program will provide the key technology and business processes which are
fundamental to delivering on the firm’s strategies for future growth. Under the
umbrella of the LM project, there, are a number of critical business
opportunities which have become available. These opportunities are available in
both San Francisco and Sacramento, CA and are as follows:

Business Architects
Director of Business Architecture
Senior Project Managers -PMO Office
Sr. Systems EngineerSenior Performance Engineer
Director of Finance-PMO
Director of Package Configuration
IT Product Configuration Lead
Senior Business Analyst
Please send all responses to: ca************@**********ca.com. When responding please include THCB job board in your subject line.

Blue Shield of California is an equal opportunity employer.

– Go read more job listings on the THCB job board. (BETA)

HOSPITALS: AHA declares war on DRG changes

May 1, 2007• 1

Meanwhile, in the real business of health care, hospitals are gearing up to stop reimbursement cuts. Just wait till they find out the real end game of pay for performance.

POLICY: Local health reform doesn’t work

May 1, 2007

Incremental health reform doesn’t work. Not even in Maine which is learning an "Expensive Lesson as Health Plan Stalls."

HEALTH PLANS: Last ditch defense of MA extra payments

May 1, 2007

I saw this letter in the NY Times from some NAACP types defending Medicare Advantage’s advantages over Medicare FFS—the advantages being extra money from the taxpayer. I was going to comment but Bob Laszewski said it for me:

The Health Insurance Industry Employs Minority Groups to Protect Medicare Advantage Payments–Could They Have Sunk Any Lower?

PODCAST/CONSUMERS/TECH: Interview with Joseph Kvedar, Partners’ Connected Health guru

Apr 30, 2007

Joseph Kvedar wrote a piece for THCB a couple of weeks back on Connected Health and its potential. As I’m in Boston I dropped in on him in his office at the center of the world’s greatest collection of medical ivory towers in downtown Boston, just near Mass General. What he’s doing is preparing for a world in which doing more of the same may not be an option, and his employer is at least thinking about what it’s role might look like in that future.

But Joseph isn’t some other start-up whiz-kid with a few ideas. He’s the Director of the Center for Connected Health at Partners, and he has some very interesting things to say in depth about the promise of using technology to improve health and reduce costs of the very sickest patients–and the roadblocks and incentives along the way. And he’s, just perhaps, threatening to radically disrupt his own organization from the inside.

Here’s the interview.