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Above the Fold

Global 2.0: A lesson from Indian pharmacies

Sep 6, 2008• 4

By Sarah Arnquist

MedPlus Pharmacies is arguably one of India’s fastest growing health companies. Since its launch in 2006, the retail pharmacy chain has opened 500 stores in several Indian cities and serves roughly 25,000 customers daily.

Medplus In a space no larger than a walk-in closet tucked into neighborhoods, local MedPlus pharmacists dispense low-cost but guaranteed high quality medications and track customer orders with a sophisticated electronic record system.

In many respects, the MedPlus business model could not be more different than that of U.S. retail pharmacy chains. I spoke recently with Apu Gupta, MedPlus COO, who explained to me that the business’ success is rooted in its uniquely Indian model developed by founder and CEO Dr. Madhukar Gangadi while he was a student at Penn’s Wharton School of Business.

MedPlus’ business model would likely not work outside India, and the Walgreens or CVS model would likely not work in India, Gupta said. This got me to thinking about a term I first heard last spring: Global 2.0.

Sarah Palin’s limited health care record staunchly free market

Sep 5, 2008• 30

By Robert Laszewski

Republican vice-presidential candidate Sarah Palin has very little on her health care
policy resume from her short time in office as Alaska’s Governor but what she does have fits right in with Senator McCain’s strategy to use the market more effectively in bringing down America’s health care costs and improving access to the system. Palin

Her health care efforts have focused on two things in Alaska:

Eliminating the 1970s era strategy of requiring providers to file Certificate of Need (CON) applications before being able to build more health care facilities.

Providing consumers with more information.

An international perspective on Medicine 2.0

Sep 5, 2008• 3

By Neil Versel

I’m here at the Medicine 2.0 Congress, a very international meeting put on by Dr. Gunther Eysenbach of the Centre for Global eHealth Innovation, a project of the University Health Network and the University of Toronto.

The meeting is in a place called the MaRS Centre, in the heart of what’s being called the Discovery District. It’s at the corner of College and University, right around the corner from several major hospitals, including Toronto General, Princess Margaret Hospital and Mount Sinai Hospital The conference even has its own blog so I shall try to come up with something original.

Eysenbach opened the proceedings Thursday morning with a discussion about what health 2.0 and medicine 2.0 really mean. I’ll just link to an article that appeared in Eysenbach’s Journal of Medical Internet Research earlier this year.

Don’t believe the hype? Peter Murray, the International Medical Informatics Association‘s VP for strategic planning, just put up a slide of this graphic:

Patients lost in the maze

Sep 5, 2008• 8

By Sarah Arnquist

Millions of patients are paying medical bills they don’t actually
owe after being confused about the practices of "balanced billing," according to a recent Business Week report.

The story goes onto discuss how it’s illegal for doctors, hospitals or labs to bill patients for the difference if they deem the insurance payment too low, but that it happens routinely to the tune of $1 billion each year.

Around the time that story first ran, THCB received this email from distraught reader, Paul Evans of Arizona:

I recently went into an emergency room at a local hospital in Scottsdale, Ariz. The doctor asked several questions and diagnosed kidney stones. To confirm this, he ordered a Cat scan and X-rays. While there I was given morphine for the pain. Two hours later, I was discharge with a prescription for pain pills and a strainer to examine my urine for the stone I would pass. I am insured by Aetna. Aetna received a bill for $6,000 and paid $4,000. I am now receiving bills for the remaining $2,000. All this for two hours in the emergency. Do I have to pay these bills? This is balance billing I think. What are my rights? Help!!

Complex HIT issues lack absolute answers

Sep 4, 2008• 2

By John Halamka

Halamka Listening to Obama and McCain you realize that some issues have no absolute right
answer. Pro-Life v. Pro-Choice, Pro-Gun v. Anti-Gun, Less Government v. More Government etc. Everyone has an opinion and often the emotions run high.

The same thing is true about health care data standards and interoperability, although the stakes are a bit lower than life and death issues.

Recently folks have asked me to comment about Carol Diamond and Clay Shirky’s article in Health Affairs which contains potentially controversial statements such as:

Yet after three years of standards documentation and the resolution of several standards ‘disputes,’ we remain a long way from seeing these standards used and implemented to enable health information sharing. As Sam Karp of the California HealthCare Foundation stated in his testimony to the Institute of Medicine Board on Health Care Services and National Research Council Computer Science and Telecommunications Board, ‘Not a single data element has been exchanged in real world health care systems using standards this process has developed or deployed.’

I did not find Carol and Clay’s article controversial. Both are good friends of mine and I agree with their thesis that technology is not enough to ensure successful interoperability. We need to agree on appropriate policies to protect privacy, incentives for implementation, and justifications for continued use of technologies to ensure widespread adoption.

Another state gov’t. misses the boat on patient-centered care and HIT

Sep 4, 2008• 2

By Joshua Seidman

Amid more data released that consumers are not using personal health records (PHRs) or don’t even know what they are, the state of West Virginia has launched a Web site designed to convince consumers of the merits of health information technology (HIT).

As best I can tell from eHealthWV Web site, here’s the plan: “To ensure consumer input and involvement in the process of health information exchange and electronic health records, WVMI and its partners launched a new phase to the project in mid 2007. It involves educating consumers about electronic health records and health information exchange.”I’m sure they mean well, but it would be helpful if one of these state efforts “ensured consumer input and involvement” by actually soliciting their input before designing their outreach. Right now, most states and health information exchange activities are focused on addressing consumers’ fears about data rather than their needs about health care.

Health Wonk Review

Sep 4, 2008

Insureblog hosted the latest compilation of the best from the health blogosphere. Check it out.

Where does Sarah Palin stand on children’s health coverage?

Sep 4, 2008• 24

By Jocelyn Guyer

The entire country now has heard about how Sarah Palin and her husband knew in advance that their son, Trig Palin, would be born with Down Syndrome. The Palins also must have known that they would have health insurance and the financial resources needed to pay for the extensive medical care Trig is likely to need throughout his life.

Here is 3-year old Emily Demko, another child with Down Syndrome, who lives with her
family in Ohio. The family has given permission to share this photo of their beautiful daughter and the story (details here) of their trials securing health coverage for Emily.

As of this spring, Emily was uninsured. Due to her Down Syndrome, the family could not find a private insurer willing to offer them affordable coverage for Emily. If the Bush Administration had not shut down Ohio’s efforts to expand its State Children’s Health Insurance Program (SCHIP), Emily would have been able to continue to secure decent, affordable public coverage. But the Bush Administration in August of 2007 issued a controversial ban on coverage of children in moderate-income families and twice vetoed bills to reauthorize and expand the SCHIP program.SCHIP is a popular, bi-partisan program. Sixty-eight Senators, including 18 Republicans, voted for the SCHIP reauthorization bill that President Bush vetoed (Senate vote). John McCain, however, stood with the President.So, along with knowing about Sarah Palin’s personal decision to have a child with Down Syndrome, it also would be good know if she agrees with her candidate’s decision to stand with President Bush against expanding the State Children’s Health Insurance Program. Right call or wrong call?

Jocelyn Guyer is the deputy executive director at the Center for Children and Families (CCF) and a senior researcher at the Georgetown University Health Policy Institute. This post represents her personal opinion not that of the Institute.

Adam Bosworth speaks about Google Health, Keas and everything

Sep 3, 2008• 2

By Matthew Holt

Adam_bosworth After a long period of time I’ve finally wrestled Adam Bosworth to the floor and forced
the microphone to his mouth. Adam of course is the software guru (he’s one of the originators of XML) who went to Google to start Google Health, and spent much of 2007 talking about how he hoped Google Health would change health care. He then left Google Health (several months before it launched in March 2008) and at the very end of 2007 founded Keas. Adam will be at the Health 2.0 Conference and while Keas is in stealth mode at the moment, he may just be ready to show us all a bit of Keas’ technology by then.

But he also has very strong views on health technology, data, PHRs. HealthVault & Google Health, and much much more. Listen to the interview.

New report shows health blogosphere going strong

Sep 3, 2008• 7

By Fard Johnmar

It started as a whisper and then grew to a roar. Last year, the Detroit Free Press wrote the first in what would become series of articles questioning the wisdom of medical blogging. In 2007 and 2008, USA Today and National Public Radio featured stories that noted the benefits of physician blogging, but also highlighted patient privacy and legal concerns associated with this activity. Finally, early last month, the Los Angeles Times and other publications featured a study that has generated a lot of heated commentary in the blogosphere and beyond.

In an analysis of medical blogs published in the July 23rd edition of the Journal of General Internal Medicine, Dr. Tara Lagu suggested that some doctor bloggers are painting an unflattering picture of the medical profession and fail to disclose financial conflicts. Lagu cited a 2006 poll produced by my firm Envision Solutions and the social network Trusted.MD indicating that public relations professionals approached nearly one-third of health bloggers responding to the survey. Lagu recently told American Medical News that she believes medical associations should “adopt policies explicitly addressing blogging ethics.”