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Health 2.0 Fuels the Accelerator

Have fuel, will accelerate! In the months leading up to the Fall Health 2.0 Conference, the Accelerator wiki membership grew from a few to over a hundred individuals and companies with increasingly diverse members, from serious technologists to product and strategy managers and company executives, representing tiny start-ups and billion dollar health care enterprises. The Health 2.0 Accelerator also facilitated its first collaborative: the Drug Profile Interoperability (“DPI”) project. Thanks to this effort, users of DestinationRx’s Medicine Cabinet or PharmaSURVEYOR’s web application can now access a valuable combination of drug safety and cost information that is not otherwise available from any single company. Then, at the Conference, Julie Murchinson announced an exciting and important step in the Accelerator’s evolution: the creation of a formal non-profit organization to advance consumer-centric health care by driving integration of technology and the consumer experience.

With an important seed contribution from the Health 2.0 Conference, the Health 2.0 Accelerator (H2A) is off and running (www.Health2Accelerator.org), creating opportunities to accelerate progress among its members and the Health 2.0 community!

Why Now? Why H2A?

We think the space is approaching a critical stage in its evolution where an increasing number of consumers will seek comprehensive solutions, not fragmented tools and services.

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Mayo & Microsoft–a big name collaboration, with even more potential to come

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Mayo Clinic and Microsoft are today launching a combined product called the Mayo Clinic Health Manager (and they’ll be showing it Thursday 23rd at the Health 2.0 Meets Ix conference). What this product does is essentially combine the care guidelines and rules that Mayo has developed over the years with an individual’s data in their HealthVault account to trigger recommendations about care.

This might be a series of simple recommendations that someone of a particular age and race should get a particular diagnostic test (e.g. mammograms for women over 50). But the program can go suck up data from Microsoft Healthvault, so that includes device data that, say, a diabetic might have in that system. Which means that much more complicated guidelines and prompts can be delivered to patients based on exactly what’s known about their current status. The first ones include pediatric wellness (immunizations to you!), pregnancy and asthma, with diabetes coming soon.

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What is the Physician’s Role in a Web-based World?

With all of the super accessible health information now available, consumers have turned into the  equivalent of first year medical students, armed with too much information but not enough objective experience. The ideal doctor patient relationship is a partnership centered around facts and good communication that is based on our experience. The internet has enabled us to communicate in ways which are more and more interesting and, ultimately, more efficient. Except the online doctor, the curator of all these personalized facts, is nowhere to be found.

I spent a few sessions with a psychiatrist my first year of med school because I was convinced I had MS. Well, 11 years later I’m symptom-free and here to tell you all about how I beat that crippling disease called Medical Student Syndrome. But as health professionals all know, it’s the combination of facts, experience, and reason that enables us to do our jobs well.

Fortunately for our ability to earn a living, internet health information is just facts. So our jobs are still needed because, for the foreseeable future, we still offer experience and reason.

All jobs consist of executing the steps within a larger project. Most people have five or six projects at any one time that keep them busy for 40 hours a week. Web apps like Basecamp and Action Method were created to help people get these steps done. They help people organize with a team of people, delegate responsibility to any one of their teammates, and keep track of the project’s progress. They’re absolutely brilliant and a lifesaver for the modern workplace.

Doctors have about 2000 patient projects. And we get, on average, one hour with each patient per year to serve as their project leader, delegating the other 8,765 hours to our patient who manages their health on their own, disconnected from us and unable to receive personalized information or ask questions except during the occasional, all-too-short office visit.

Both Basecamp and Action Method were designed to share information and facilitate goal-oriented, efficient, online communication between teammates who aren’t working in the same geographic area. Awesome! Wouldn’t that be nice to have with our patients?

Ha, in an ideal world. We only get paid for office visits and procedures. We surely don’t get paid for communication and definitely not for prescribing links personalized to each patient. And there isn’t a single profession in the world that works for free.

The reality is this:

Percentage of people age 65 and over online today = 41%

Percentage of docs and hospitals who use computers = 9%

Percentage of people with home computers in 1985 = 15%

Even the elderly are more wired than doctors! And guess what they’re doing? They’re visiting Dr. Google. If their team leader isn’t accessible, well, folks, it looks like patients are on their own turning to really helpful resources like ACORMEDgle, other patients, Your Flowing Data, and rateadrug.com. Without a doctor on the other end of these links, even those cutting edge, senior netizens are leaving us behind blinded by their dust as we’re struggling to write our own chicken scratch paper notes.

Doctors…eating the elderly’s dust isn’t your fault. You can’t work for free. And since the Feds define how we get paid (with this, not for this), we’re going to limp along, weighed down by our paper charts and federal bureaucratic initiatives that will soon face stiff resistance from the people who don’t kill golden geese, while society races past us in this era of profound changes in the way humans communicate. If only the way we get paid could be updated for the 21st Century, our patients wouldn’t be marginalizing our efforts. I can dream, can’t I?

Jay Parkinson, MD is a physician based in Williamsburg, Brooklyn. He works with Hello Health, an innovative healthcare start-up that matches online patient visits with convenient neighborhood locations. Jay will be a featured speaker at Health 2.0 Meets IX on April 22nd-23rd in Boston, where he will discuss the future of the physician practice in a Web 2.0 world and his firm’s vision for the future. Thinking of going? A limited number of passes are still available.

Surface–eye candy or really useful clinical tool?

Surface is relatively cheap for what appears to be a too-cool-for-school new technology. They quoted me about $12,000 for a unit. It may look like a huge immobile iPhone, but it has not only a wow factor, but now some clinical applications being built for it.

I took a look in the HIMSS booth at a couple of them, and ran into Microsoft’s leading physician spokesman Bill Crounse on the way.  Take a look, and at the least enjoy it whether or not you’ll see one in your doctors’ office any time soon.

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Like Us, Personalized Medicine is More than Its Genes

Millenson_122k_3 For those familiar with the famous Gartner Hype Cycle, the page one New York Times headline, “Genes Show Limited Value in Predicting Diseases spawned an uncontrollable urge to mark an “x” by the spot where the
Peak of Inflated Expectations starts its plunge into the Trough of
Disillusionment.

The Times’s curtain call for DNA cure-alls reported on a critical examination by the New England Journal of Medicine 
related to the strategy of comparing genomes of patients and healthy
people. So-called genomewide association studies, it turns out, have
not fulfilled their goal of discovering DNA changes responsible for
common ills. Instead, they “explain surprisingly little of the genetic
links to most diseases,” wrote the Times. “The era of personal genomic medicine may have to wait.”  
Note that the Times
carefully avoided the term “personalized medicine.” Despite the
tendency of drug and diagnostic firms to lay sole claim to that label,
molecular medicine comprises just one part of the personalized medicine
triad. Sickness and health are complex, and, like us, personalized
medicine is more than its genes. 

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Jay Parkinson, Hello Health & Myca, talks about the new release

Myca/Hello Health is launching it's new platform in a special Deep Dive at Health 2.0 Meets Ix, Weds 22nd at 12 noon. Sean Khozin will also be demoing it as part of the "Building Health 2.0 into the Delivery System" panel.

What's so intriguing about what Jay Parkinson has been dong with Myca and Hello Health? Jay's been holding himself (and Hello Health) up as a new alternative to the current broken primary care model. So is this really a revolutionary platform? Or are they just tilting at the windmills of America's broken primary care system?

I visited Jay for a chat last week at Hello Health's first outpost in Williamsburg, Brooklyn.

Health 2.0 Meets Ix, and other gossip

The Health 2.0 team is in Boston, and we’ve been prepping with our friends from Information Therapy. The Health 2.0 Meets Ix conference is coming up on Wednesday and Thursday 22nd & 23rd April. We have a really fantastic agenda, including several exciting new product launches, and a fantastic “Night Out” Reception, sponsored by Kaiser Permanente. There are a few spots left at the conference, although we’re likely to post the “sold-out” notice in the next 24 hours or so, so if you still want to come you can register here. But hurry…

In addition there are some related meetings happening around Health 2.0 Meets Ix.

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Social insurance is the key & h20tv.com

I'm recycling, but today someone asked me what I think we should do about health care reform. Funnily enough, we’re running a new(ish) series on h20tv.com in which anyone can give their 60–90 second view. Mine is here.

But the best thing I've ever written on the subject was put up 2 years ago on TMPcafe as part of a discussion series. I read it again today and it's still the clearest work I've done articulating my views on what reform should look like. Social insurance is the key–but it can handle competition, just not the type you're used to!.

The Public Plan–Mutual Assured Destruction?

6a00d8341c909d53ef01157023e340970b-piI typically don’t talk about my travels on this blog but something happened this week that bears reporting.

Whether
the federal government should or should not offer a public health plan
alternative to compete with private insurers in the under-age-65 market
is a hot topic in Washington and in the market.

I recently posted on it in detail: The Public Plan Option for the Under-Age-65 Market—The Biggest Health Care Controversy on the HillThis
past week I met separately with two health insurance CEOs—both
well-known leaders in the business and both from highly regarded
not-for-profit plans.

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