In this interview captured at the Health 2.0 Goes to Washington on June 10, 2010 David Hale, project manager at the National Library of Medicine and National Institutes of Health talks about his vision for the future of Health IT and their upcoming Hackathon focused on challenges related to drugs and lactation in nursing mothers.
Above the Fold
WEGOHealth provides solution for that Ning premium charge
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Ever since the “build your own network” company Ning moved to a pay model for its networks, there’s been some browbeating on the blogosphere about what to do with those communities which had created traction on Ning, but didn’t have a way to pay.
For the next year at least that little problem is over. The sugar daddy here is WEGOhealth, which has positioned itself in an unusual niche—the place where people leading online patient communities can go to learn from each other. WEGOHealth is run by former Yahoo Health leader (from a few years back) Jack Barrette. Jack is a hell of a nice guy but I suspect that this deal wasn’t just about being nice. The WEGOhealth business model is about convincing advertisers that they can get in front of influential patients, and anyone running a Ning network for a health condition is likely to be (as Edelman call it) a health infoential.
So if you have a NING network that might qualify, here’s how to apply. And I suspect that Jack would appreciate it if you also paid a visit or two to WEGOhealth as well.
Guidelines for the Perplexed
There has been much progress in the understanding of the biology of Alzheimer’s disease. Chemicals detected in the blood and spinal fluid of patients with Alzheimer’s and findings with new brain imaging techniques are the long sought after “biomarkers” of the disease. They are clues to its cause that are already targets for drug development. But there is a great public health danger in jumping the gun and prematurely using biomarkers in clinical practice for diagnosis or prognosis. It is for this reason that I have serious reservations about the new diagnostic guidelines proposed for the diagnosis of Alzheimer’s disease.
The current guidelines, which have served as well as possible for 26 years are based entirely on the patient’s narrative. The diagnostic label is applied when there is no better explanation for a severe and global compromise in cognition that developed insidiously. The diagnosis of Alzheimer’s when it is full blown is not a challenge. The challenge is in making the diagnosis when it is less obvious, when it is but “Possible” or “Probable.” These categories are confronted in the old criteria by considering the degree to which elements of cognition are compromised. The application of these qualified diagnostic labels provokes as much anxiety in the clinician as it does angst in the patient and foreboding in the patient’s intimate community. Maybe the fact that grandpa occasionally forgets his keys or his neighbor’s name is all there is to it; “grandpa’s losing it” or has a touch of “senility”. That would call for a supportive community, and not the specter of a slide to a dreadful fate denoted by Alzheimer’s.
Failure
I went to a patient’s funeral this past weekend. I generally don’t do that for people whose relationship I’ve built in the exam room. It’s a complex set of emotions, but invariably some family member will start telling others what a nice doctor I am and how much the person had liked me as a doctor. It’s awkward getting a eulogy (literally: good words) spoken about me at someone else’s funeral. This patient I had known prior to them becoming my patient, and his wife had been very nice to us when we first moved here from up north.
But that’s not why I am writing this. As I was sitting in the service, the thought occurred to me that a patient’s funeral would be considered by many to be a failure for a doctor. Certainly there are times when that is the case – when the doctor could have intervened and didn’t, or intervened incorrectly, causing the person to die earlier than they could have. Every doctor has some moments where regrets over missed or incorrect diagnosis take their toll. We are imperfect humans, we have bad days, and we don’t always give our patients our best. We have limits.
Sermo: The latest from Dan Palestrant
Over the weekend I caught up with Dan Palestrant, the CEO of Sermo–still the largest US based physician online community. Sermo opted not to raise new VC recently (unlike say Phreesia and ZocDoc) and actually reduced headcount in early 2009. Meanwhile during 2009 Daniel got his 15 minutes of fame debating the likes of Howard Dean on cable news and the site became a haven for lots of (grumpy) political talk, But while that may have captured the headlines, Sermo has done a major technology upgrade and redesigned both its user and its client interface. That re-design went live last week and Daniel spoke to me about what they did, what the discussion on the site is about (think clinical and business, less politics than last year), which clients they’re working with (think big Pharma) and how they’re doing financially and business-wise (better than you might have heard).
Here’s the apprx.10 minunte interview: Dan Palestrant
Interview with Farzad Mosashari
On June 7, 2010 senior advisor at the Office of the National Coordinator, Farzad Mosashari, gave an interview at the Health 2.0 Goes to Washington conference. These are his thoughts on the conference, meaningful use and the focus his office has on watching out for the little guy.
Beacon Communities: Webinar with EVERYTHING You Ever Wanted to Know!
HIE, SHARP, RECs, and now… Beacons?
What does it all mean?
With the passage of HITECH in 2009, we’ve seen a series of coordinated grant programs from HHS – and if you’re not confused with all of the acronyms, you’re probably not paying attention. But never fear, in the latest of our series of FREE webinars, Health 2.0 has teamed up with the Health 2.0 Accelerator to bring you a conversation with Aaron McKethan, Program Director for the Beacon Communities Program in ONC to explain what the Beacon communities are, give some details about the types of programs and opportunities that they are providing, and to help answer all of your questions!
Wednesday, July 21, 2010
1pm ET / 10am PT
Register today at: http://www.health2con.com/webinars!
Checking in with BenefitFocus
It's been a little while since I checked in with the folks at BenefitFocus. They essentially create a system that allows employees to sign up for benefits all at once. They market it via a lead health plan in each area, and then give the employer HR department the ability to glom their other benefits plans onto it, saving lots of time and trees during open enrollment and for new employee hires. (The really old reader may remember that this was the very first business model of Healtheon in 1996 and funnily enough Healtheon's first "client" for that version of their business model, Blue Shield of California, is a decade and a half later using BenefitFocus for the same thing).
They also have an interesting side business making videos and selling that service to HR departments for internal education, and have a public side to their video business, a sort of Youtube for health called ICYOU, who of course come to every Health 2.0 Conference (Hi, Nina & crew!)
Last week I caught up with Shawn Jenkins, the CEO of BenefitFocus. This is a guy who started a business in the middle of the dotcom bust in the technology backwater of South Carolina (cue abusive emails!), and now has 500 employees, lots of clients and a very profitable company. And of course they are well positioned to be at the hub of the forthcoming exchanges–the state of Maryland has already signed on the dotted line. And now they're moving into analytics.
Interested in what they're up to? Listen in.
Kenneth Buetow and caBIG
SUBTEXTAt Health 2.0 Goes to Washington on June 7, 2010, Kenneth
Buetow, Associate Director of BioInformatics for the National
Cancer
Institute and Founder of caBIG, talked about the launching of a large
scale effort called Cancer Biomedical Informatics Grid (caBIG).
Open access scheduling at the doctor’s office
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I’m quoted in the Boston Globe today (A new practice: The doctor will see you today) on open access scheduling. (I’m all the way down at the bottom of the article.)
Open access is one of my favorite innovations because it improves customer service and quality levels. As we add patients to the system open access provides a way to preserve or improve access to the physician. It’s better—in my view—than other solutions such as using more mid-level practitioners and trying to boost the total number of doctors.
Open access means seeing today’s patients today rather than forcing them into a slot far in the future or trying to squeeze them in to a crammed schedule. The example given in the Globe article is a more extreme version than what I’m used to. I’m not sure such a radical shift to open access is optimal. It might be best to preserve a lower percentage of slots for same-day access rather than forcing folks in today who’d prefer to wait a bit!
What’s required to make open access work?
- Working overtime to chip away at the existing backlog (otherwise there’s no free time to offer up)
- Varying number of hours worked per day to accommodate fluctuating demand
- Having the right sized patient panel—something that’s somewhat hard to assess in advance, since the true demand is unknown (offices usually just know how far out they are scheduling)
Why does it work?
- There’s a high no-show rate from appointments made weeks or months in advance
David E. Williams is co-founder of MedPharma Partners LLC, strategy consultant in technology enabled health care services, pharma, biotech, and medical devices. Formerly with BCG and LEK. He blogs regularly at Health Business Blog, where this post first appeared.
