By ANDY DeLaO

Back in August, 2015 IBM announced their bid to acquire Merge Healthcare for $1B dollars. (Forbes article here) Merge is a product that helps to manage, store, report, and bill for the medical images of patients as read by Radiologists.   (More here) Today between the 7500 Merge customers they have access to roughly 30 billion images.

The promise for Watson Health is to learn how to “see” through machine learning from the vast amount of medical images that Merge Healthcare manages. Currently, Watson reads 66 million pages a second. It is predicted by IBM researchers that 90% of all “Big Data” stored by healthcare systems is related to medical imaging.

The offer to hospitals, healthcare systems, Radiologists, and ultimately patients is that Watson will be able to have information, including medical images, uploaded to the cloud for analysis. Based on the symptoms and a cross referencing of medical images against images of previously diagnosed medical conditions and diseases, Watson would be able to provide an initial recommendation. (supporting article)

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By BLAKE McKINNEY, MD

There has been at least one report that the Federal Trade Commission (“FTC”) is looking into anti-competitive practices based on the Texas Medical Board’s telemedicine regulations.

As a telemedicine company operating in Texas, we maintain that the rules put in place by the Texas Medical Board are by no means insurmountable and do not seriously limit competition. The rules merely allow better integration of telemedicine offerings with existing medical services and help ensure a better patient experience.

Telemedicine is possible in Texas as defined by the guidelines of The Texas Medical Board (TMB), but it has to be telemedicine done right. Telemedicine must be provided in a way which conforms with modern clinical safety standards, including ensuring continuity between traditional care encounters and telemedicine encounters.

The TMB regulations mandate that:

1. An individual must have a face-to-face visit with the provider group providing virtual care to establish a doctor/patient relationship;

2. Doctors treating a panel of patients virtually must have reciprocity (communication, accountability) with each other and should be under common medical direction; and

3. Physicians engaging in telemedicine must be able to follow-up with patients and vice versa.

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By MICHAEL PAINTER, MD

For more on this session at Health 2. 0 on Monday October 5, see the agenda here.

I’m reading the morning news on my iPad at 32,000 feet en route from New Jersey to Silicon Valley for the annual fall Health 2.0 meeting. I love coming to this place with its promise and hope pushing us toward better futures.

Of course, much of that hope is hitched to faster, smaller, cheaper driven by trusty Moore’s Law. Just when it seemed our Moore’s Law golden goose would soon be waddling a little more slowly, the New York Times reports today that IBM scientists may have found a way to keep the eggs coming. Apparently, they’ve discovered a chip manufacturing approach that may get around the looming laws of physics by using transistors with parallel rows of carbon nanotubes separated by a distance of just a few atoms. Whew.

In another Times article, Apple’s CEO, Tim Cook, takes us from that atomic level way up here to the macro where most of us live, work, learn and play. Business, Cook says—presumably especially the dynamic technology sector—has civic responsibilities beyond pushing profit.He and Apple, for instance, have made recent stands about equity, and he noted Apple would “continue to evangelize” about it.

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By NIAM YARAGHI

When President George W. Bush issued an executive order in April 2004 to establish the Office of the National Coordinator for Health IT, he had a clear vision in mind: to create a secure, nationwide interoperable network that allows authorized users to access medical records of anyone at anytime and anywhere in the U.S. President Barack Obama knew very well that his plan for providing health insurance to all Americans would not be successful unless it was paired with a plan for controlling the quality and cost of health care services.

Ironically, Bush’s health IT network was (and remains) the instrumental element that guarantees the financial sustainability of Obamacare. It was no surprise that the economic stimulus package of 2009 allocated $25.9 billion for promoting the adoption and use of electronic health records systems among American physicians and hospitals. But a decade and $30 billion later, only half of the U.S. office-based physicians have adopted a basic electronic health records system and a mere 20 percent of them use such software, according to the latest statistics by Robert Wood Johnson Foundation.Continue reading…

By JK Wall

Even before the first date, Anthem Inc. CEO Joe Swedish was smitten with Cigna Corp.

But as in any love story, there would be plenty of drama between then and the July 24 announcement of the two health insurance giants’ $54 billion engagement.

At one point, the Anthem board made Swedish break up with Cigna, but then three months later sent Swedish swooping back in with pleasantries and ultimately a bear hug that Cigna couldn’t refuse.

And along the way, both Anthem and Cigna flirted with Humana Inc., causing everyone to get jealous. And it appears that Cigna even entertained secret overtures from Minnesota-based UnitedHealth Group.Continue reading…

BY SAURABH JHA, MD

Once, a farmer from a village in Bihar was diagnosed with colon cancer. He came to Patna, the capital city, to have the tumor removed. Because he was poor, my father recommended a young surgeon who trained in the UK. The surgeon was competent and idealistic. He was a Fellow of the Royal College of Surgeons. His charges were the lowest. He did not charge the extremely poor.

The farmer declined, saying “if this babu is treating patients for free, he can’t be a good surgeon.” The farmer chose the most famous surgeon in the city, whose charges were not astronomical in comparison, but certainly higher. The farmer paid full fare – there were no discounts for poverty. The practice accepted credit cards. He paid cash. Once the surgeon received half the payment, he made the incision. The surgery was uneventful. The farmer was cured.

This was a voluntary contract between surgeon and farmer. No middle man. No forms to submit. Cash for scalpel and the skill of its bearer. There is a resurgence of this model in the US, known as Direct Pay Medicine. Despite India’s socialist roots, paradoxically, much of medicine has always been direct pay, or private.Continue reading…

By MICHEL ACCAD, MD

On the surface, the proposition that medical care in India is a free market seems plausible.

Setting aside the perennially underfunded public healthcare system, there is a large second tier system where patients get care without any apparent oversight. Sure, laws and rules abound, but these are easily overcome with bribes paid to bureaucrats. A “cost of doing business,” you might say.

In that private system, the care rendered is up to the doctor and patient, and the terms of the transaction are simply decided on the basis of cash exchanging hands. What could be more free market than that? A libertarian paradise!

But Voltaire wisely advised debaters to define their terms, or else engage in fruitless conversations. So perhaps we should make it clear that a free market is not solely defined on the basis of voluntary exchanges, although I recognize the prevalence of that unfortunate misconception.

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