It’s up over at Healthcare Economist. Go check it out. It’s filled with thoughful commentary about the economy, bailout and health care.
Above the Fold
X2HN event calling for speakers
What do high stakes poker, smart women and health care have to do with each other? The Third Annual Xscape conference coming up in February will combine all three in Las Vegas to promote and support women health care executives.
The conference is put on by the X2 healthcare network, and they’re looking for additional speakers.
Indu Subaiya, co-founder of the Health 2.0 Conference and Accelerator, will give the keynote address, bringing attendees up to speed on new health care players in technology and how Health 2.0 is empowering consumers.
KevinMD turns into raving socialist…
Well not quite, but in his op-ed at USA Today Kevin talks about why it’s a problem for the US not to have wide deployment of EMRs, and notes that it’s the wrong incentives that are to blame—docs have to pay but others reap the rewards. So in Kevin’s words:
One needs to look at the Department of Veterans Affairs for an optimal model. All of the VA’s primary care physicians, specialists and hospital-based doctors across the country use the same electronic record system. It has played a significant role in the reduction of medical errors, optimization of cost efficiency, and attainment of high scores in preventive care measures.
Kevin’s usually criticizing me for being the wooly lefty, but I could be pardoned for thinking that he’s suggesting that we junk the current US system in favor of rolling all docs and patients into the VA. I wouldn’t suggest that but far be it from me to tell Kev that he’s wrong!
Will tighter credit slow medical technology innovation?
Medical technology is one of the most innovative sectors in the U.S. economy. The market is fueled by aging populations, expanding chronic conditions, and a forecasted growth in demand for companion diagnostics to use in concert with personalized, targeted therapies.
In its detailed update, Pulse of the industry: US medical technology report 2008, Ernst & Young describes the industry, its opportunities and challenges.
In summary: U.S. med-tech still leads the world, but the larger economy could compromise both the U.S. lead in the sector as well as health innovations.
Do gamers make better surgeons?
By 
Something I had not seen before coming to the U.S. was robotic surgery, even though some UK centres do offer it.
Leonardo da Vinci has had many attributes associated with his name, but what would he think of being eponymously associated with prostate surgery?
da Vinci surgery uses advanced invasive robotics to perform procedures such as hysterectomies, prostatectomies and even mitral valve surgery. The manufacturers claim many advantages from decreased blood loss to the sparing of nerves. It is a shock to walk into a room where the patient appears to have been grasped by a giant mechanical spider, with the legs moving within the patient’s abdomen. The surgeon is nowhere to be seen and if you ask the nurse she will point to a figure hunched behind a box in the corner of the room. Peak behind and you will see a magnificently magnified view from within the patient abdomen from positions you would never see in an open procedure. The surgeon appears to be playing an advanced musical device as the instruments are directed from within.
If you watch a game junky play on their PC, PlayStation or Xbox, the manual dexterity and eye-hand co-ordination is something to behold. So will the next generation of gaming computer nerds be the da Vinci surgeons of the future. A study in 2007 suggests that this may be so. Researchers found that doctors who spent at least three hours a week playing video games made about 37 percent fewer mistakes in laparoscopic surgery and performed the task 27 percent faster than their counterparts who did not play video games.
Even though I am not a surgeon will this evidence be enough to convince my wife of our latest purchase?
Sean Neill is a South African-born, British-trained anesthesiologist, who
recently relocated to Midwestern USA. He blogs regularly at OnMedica about his cross-cultural experience, frequently pointing out oddities of American health care.
Matthew gets the kicker quote
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A New York times special section today includes a story about going online for health information. John Schwartz quotes all of our favorites, including Susannah Fox, Clay Shirky, Benjamin Heywood of Patients Like Me, Trusera and ACOR.
The article mentions Matthew, Indu and the upcoming Health 2.0 conference. And ends with this kicker quote from Matthew, "In the end, the more people you have in the conversation,
the better information drives out the worse information."
Busines ties and MRIs — it’s not rocket science
The Health and Human Secretary Inspector General’s office concluded last week that doctors are likely to order more MRIs if they have business ties with the imaging provider.
Shocking, isn’t it?
Modern Healthcare reports that inspector general’s report was a follow-up to a previous finding that MRI claims paid under Medicare’s physician fee schedule increased fourfold from 1995 to 2005.
“The complexity and limited transparency with which these services are provided warrants continued attention to ensure that services are reasonable, necessary and compliant with Medicare statutes and regulations,” the report states.
Too much data but not enough information
By John Halamka
During the decade I’ve been CIO, IT operating budgets have been 2 percent of my organization’s total budget, which is typical for the health care industry.
During the same period, IT budgets for the financial services industry have averaged 10 percent or higher.
Since 1998, I’ve often been told that Healthcare IT needs to take a lesson from the financial folks about doing IT right.
Judging personal health records by their usefulness
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It appears that at least the first phase of personal health record (PHR) certification from CCHIT (Certification Commission on Health Information Technology) will focus on a narrow set of attributes. CCHIT Chairman Mark Leavitt told a group earlier this month that the first set of PHR standards will focus primarily on privacy, security and interoperability.
Leavitt indicated that functionality standards would initially only address what functions are needed to support privacy, security and interoperability. I asked him the following question: Given that what many consumers need to know is how useful would different PHRs be to helping them and their families manage their health, wouldn’t it make sense to include a broader assessment of functionality in CCHIT’s PHR certification?
Will We Need a Bailout of the Health Care System, Too?
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A huge bailout is being planned in Washington to avert a calamity that was brought about, in large measure, by the financial system operating the way financial operators told us it was supposed to function. The money is needed, we are told, to bail out the financiers who assured us — up until just a couple of weeks ago — that the system they operated was sound and would need no rescue.
What is the likely spill over to health care from the misbehavior of the financial system’s owners, operators, and managers? I’m going to suggest there are likely to be both direct and indirect effects. One of the indirect effects is that we may lose faith in doctors, nurses, and hospitals, or at least come to suspect that the practice of their craft and trade is not aligned with their espoused principles of "doing no harm" and acting in our best interests.
