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Archive for April, 2009
Headlines for April 19-25
- Posted April 25th 2009
- Comments (0)
- by Janice
HealthBirds, tool provider and aggregator of health-related tweets.
Good post about experience on an “e-patient” who sought out additional options after being told she needed surgery. Point to keep in mind: it takes some work and luck to find an MD or advocate who can help. Patients need more guidance. “a wealth of information is available on the web, but patients often need encouragement to seek it, and help interpreting it and applying it to their own situations. Peer support groups on line are one way to accomplish this and finding an interested, available physician to serve as an “e-patient advisor” is another way.”
Harvard School of Public Health newsletter article that reviews some examples of employer-sponsored wellness programs. Compares carrot & stick approach.
Post by Partners clinical informatics R&D group on meeting in DC of new Clinical Interoperability Council. “CIC may help establish essential clinical governance mechanisms for defining & optimizing the implementation of HL7 standards, … and the clinical content that is used in healthcare information technology for clinical decision support.
FDA held meeting on Wed 4/22 to discuss strategic direction of the device center, which has been criticized for approving devices despite objections from scientific reviewers.
Q1 2009 earnings results for Healthgrades. net income $1.64 B met consensus estimates. Rev. grew 35.6%. Internet Business Group rev. grew 124%, mostly ad & sponsorship rev.
Medical Present Value Inc. has integrated its patient cost estimator with insurance eligibility/benefits calculation s/w. Based in Austin, TX. mpv.com
AHRQ contracted with Rand Corp to develop ‘how-to’ toolset for implementing e-prescribing systems. Notice in today’s Fed Register.
Not sure if I already tagged this story yet.
Example of new payment models in pharma sales. In this case, Merck provides discount to Cigna if Cigna helps promote compliance.
Great example of a Twitter Poll: Are Cochrane reviews too long, short, or just right.
ABC news writes about open access movement in scholarly pubishing and the importance of broader access to medical research. Also, article points to provisions in stimulus bill for continuing to require posting to PubMed, and describes the Conyers bill that takes the opposing view of diminishing open access.
Thomson Reuters’ NexCura Cancer Profiler Tools to be incorporated into National Foundation for Cancer Research (NFCR)’s website for cancer patients. Good example of medical society’s sponsoring commercial content for patients.
John Moore from Chilmark provides a quick comparison of growth in unique visitors to WebMD, Healthline & Healia.
Lowers forecast made in October by 2 %. Emerging markets capture higher % growth; US market to decline in 2009.
Revenue declines 8% to $526.0M (3% constant currency); Operating income also down, but net income up.
John Glaser, VP & CIO Partners Healthcare in Boston has accepted a 6 month stint as adviser to David Blumenthal, the recently appointed national coordinator for healthcare IT. Glaser will spend 4 days/week for 6 months working with ONC.
Agents from Defense Criminal Investigations Service raided offices of Siemens Medical Solutions in Malvern seeking documents related to company’s military contracts.
O’Reilly Radar reports that medical apps for iPhones are the 3rd fastest growing category. Medical still only 1.1% of all apps, but growing. Note, healthcare & fitness is separate category with 2.5% share.
American Medical Assoc. plans to launch health info exchange platform for physicians. AMA has contracted with Covisint (sub. of Compuware) to build the platform. Will likely include practice mgmt tools, CME and other content, clinical mgmt tools and networking. DrFirst has already announced its plans to offer its e-prescribing s/w via the platform.
Microsoft’s Tim Smokoff, genl manager MSFT’s worldwide public sector health division, on state of health IT and MSFT’s role.
Good post on “ebb and flow” but steady progress being made in determining clinical quality guidelines.
Good article on well-publicized deal between Microsoft & Mayo Clinic to offer PHR free service.
ADAM releases a consumer health app for iPhone with content from ADAM, Healthcare Blue Book, video from HealthiNation, and some blogs/social networking sites.
From Healthline, post that provides the “pro” point of view on patients doing online research prior to office visits–despite some possible drawbacks.
Story in FT that suggests that new CEO of Reed Elsevier, Ian Smith, may be interested in talking with WoltersKluwer about a merger. Also reports on new chairman, Anthony Habgood.
Searchable transcript of UnitedHealth, parent of Ingenix and OptumHealth, latest earnings call.
UK’s NHS on DNA tests.
New site includes ability to upload and share personal protocols.
Cignamakes Quicken Health Expense Tracker available to those enrolled in most of its health plans, via myCigna.com.
SureScripts releases report and PR that announces growth in e-prescribers in US from 19K to 103K in past 2 years. Q1 2009 growth especially high due to new incentives from CMS.
The result of consumers’ bearing more of the costs of healthcare: fewer doctor visits & reduction in other care. Especially acute in recessionary times with loss of employer-paid care.
Developing countries adopting telemedicine & use of mobile phones for medical records transfer more rapidly than in US.
Healthline adds suite of tools & enhancements to help patients research treatments & costs.
Zynx Health (a Hearst Bus. Info company) contracts with Scope e-Knowledge for medical terminology mapping project.
More on FDA warnings to 14 pharma companies about lack of compliance of short online paid search ads. Prior to recent warning, pharma companies thought a “one-click” rule existed, which allowed for brief ad as long as a click on the ad led directly to more info.
Good piece on PaidContent about FDA warnings to Pharma about use paid search ads, which the FDA says are misleading because they don’t include risk info. In early April, FDA asked pharma companies to remove ads that contain violations and respond to the agency by mid-April. Health in one of largest verticals for Google, and pharma ads make up the largest component of ads in the category, so Google has big incentive to find a solution, even though SVP Rosenberg says it may not be easy.
American Psychiatric Assoc votes to phase out pharma-sponsored symposia at APA annual meetings.
Good article in NY Times on state of personal health record (PHR) systems. Key point, for most patients, their provider(s) are not using effective EHR systems that can interact with PHR s/w. PHRs can still be a useful tool for record-keeping for individuals, although the patient will have to input all data manually. My comment: with more patients on high-deductible plans with HSAs, there is more incentive to track medical expenses. Intuit’s tools may be good solution.
Follow-up to Google Health story about e-Patient Dave. BIDMC’s CIO Halamka has decided to halt transmission of medical billing codes to PHR vendors. Instead, they’ll send info from clinical records, which include a mix of textual descriptions and some codes.
Dr. Roni Zeiger, product mgr for Google Health, writes that patients should ask about risk/benefit profile of all treatments their doctors suggest. Good goal in an ideal world, but we have a way to go before we have sufficient data to provide the statistical evidence. The greater issue is improving health literacy, ie., educating patients about medical research and basic statistics.
FTC files propsed privacy requirements for PHR vendors and organizations that send data to PHR vendors. ARRA requires FTC to work with HHS to prepare a report to Congress by Feb. 2010; for now, FTC is proposing “interim final regulations” covering breach notifications for PHR vendors.
Follow-on from John Halamka, CIO of BIDMC, re: the Google Health brouhaha this week. They’ve learned from experience that medical billing codes shouldn’t be tranferred to Google Health. Overall, post supports my point that health literacy & patient education experts not involved in plans for Google Health PHR.
Thomson Reuters Healthcare’s Medstat Advantage Suite and APS Healthcare are chosen by NY State’s Medicaid office to provide analytic/predictive modeling services to study usage patterns in provision of Medicaid services. “APS, which operates 41 Medicaid programs in 26 states and Puerto Rico, focuses on improving overall health and wellness through education and interventions that promote behavior change, improve health outcomes and reduce long-term healthcare costs. Thomson Reuters’ Advantage Suite® is currently used for data analytics and decision support by Medicaid and other government agencies in 28 states. Thomson Reuters will deploy its Medstat Advantage Suite® solution, which combines a customized repository of healthcare data with a comprehensive set of analytic tools. The system generates intelligence and benchmarks that governmental agencies use to analyze and manage the cost and quality of healthcare delivered to their beneficiaries.”
Debate about usefulness/value of genomewide studies for predicting likelihood of disease in individuals, based on currently available genomic testing services. Full genomic profile of individual appears to be more useful.
Headlines for April 7-18
- Posted April 18th 2009
- Comments (0)
- by Janice
Slide presentation by Andre Blackman on mobile health applications. Lots of good data on usage of mobile phones by consumers.
Dr. Val posts on the emerging category of medical bloggers in the health content economy. “Watch for a fundamental shift in the way health information is reported”, she says. Especially info from medical conferences.
Text from Medlink’s 10-K for 2008. MedLink’s EHR received CCHIT certification in 2008.
More on the theme of pharma companies’ reducing spend on consumer ads (DTC). Some attribute reduction on slowdown in new product introductions, but there is also a shift away from traditional advertising to production of informational websites by Pharma.
Good review of Zenith’s latest forecast of advertising growth worldwide. Breakdown of advertising spend by medium. Internet advtsg gains share, but still will account for only 14.6% total advtsg in 2011.
Pfizer & Glaxo collaborating to develop & market HIV & AIDS drugs. Glaxo has stronger position now in this therapy, so has 85% stake in jv to begin. Stakes subject to change based on future sales & drug development.
J&J pulls back on plan to create a 4th division focused on wellness & instead groups HealthMedia & Human Performance Institute with consumer business. This a significant change & a sign that it may be difficult for pharma companies to lead growth in developing wellness programs.
According to new research from Manhattan Research, 64% of physicians now use smartphones–doubling YoY 2009/2008. Further, the phone usage is additive to computer online usage with physicians spending more time online overall.
Boston area health content events, posted by Steve Wardell.
A write-up from a data quality perspective of this week’s focus on e-Patient Dave’s experience with Google Health.
Jonathan (Jack) Lord named CEO and President of Navigenics following departure of Mari Baker to lead video game company PalyFirst 6 weeks ago. Navigenics has been building partnerships with leading medical centers, including Mayo Clinic 7 Scripps Research Inst, as well as concierge medical organizations like MDVIP.
InformationWeek’s perspective on state of EMR software. Again, point that systems developed without keen understanding of clinician’s workflow and decision processes–along with added dose of flexibility to fit demand profile of health care practitioners–are not going to be warmly welcomed by physicians or patients.
NYC tries sending “detailers” to visit doctors to offer patient education materials & marketing materials to support campaigns to stem domestic abuse, STDs, and promote healthy eating. While pharma companies are curtailing detailing, NYC is picking up some of the slack!
International Medical Solutions introduces wireless kiosks for patient use at provider facilities. Patients can register, update medical histories, read & sign consent forms, & view educational videos.
e-Patient Dave provides good intro to medical billing codes, which he points out in today’s Boston Globe are currently used by Google Health to infer a user’s medical conditions. We have a long way to go before we have a coding systems that works well in faciliating the transfer of data between all the stakeholders in the heatlhcare economy. Tranferring (and translating) info between patients and the other stakeholders will likely prove to be the most difficult task.
Missed this last week. Steve Case’s Revolution LLC receives $42M from Goldman Sachs, Citigroup, Morgan Stanley and David Pottruck (former Schwab CEO), David Golden (former JP Morgan), Ted Leonsis (Chairman, Rev. Money) and Case. It looks as though Case believes there’s greater profit in pursuing online payment processing than online health services!
Longer article on Express Scripts acq. of WellPoints PBM unit.
Express Scripts, based in St. Louis, is buying the PBM business of Wellpoint for $4.68 B.
E-patient Dave’s experiences with Google Health are highlighted. Prognosis is not very positive wrt how GHealth integrates and uses data from providers’ records. Big problem relates to relying on imperfect codes used for medical billing. Beth Israel, Dave’s provider, recommends using their own PHR system.
Describes burgeoning field of medical informatics, which ideally combines clinical, IT, and knowledge of workflow processes at provider institutions. Article focuses on “data” content that is stored in and produced by medical records systems; integration of other health content, including research studies and clinical decision resources from medical publishers, must be part of the equation, too.
Wes Crews, previously with onTargetjobs, Gale Group (now Cengage) and InfoTrieve, named COO of HealthGrades. Crews will be responsible for operational and strategic leadership of sales, marketing and service professionals at HealthGrades.
An interesting analysis of WalMart’s deal with eClinical Works and Dell to sell EMR systems at Sam’s Club. My argument with the views expressed is that they focus on WalMart’s current business strengths and don’t allow for the fact that WalMart understands that selling healthcare s/w and services requires a new appraoch. But, WalMart recognizes the major shifts occurring in healthcare & they are a major player in accelerating some shifts (e.g., $4 generics, low-price services in WalMart clinics). It’s important to note that WalMart uses the same eClinicalWorks EMR s/w in its clinics. In short, this early effort to sell bundled EMR s/w, hardware, and service may not be a huge success, but it should be viewed as just one step in WalMart’s plan to become a major player in the next generation healthcare economy.
HealthGrades study of AHRQ patient safety indicator show reduction in medical errors, but large disparities continue to exist.
Key issue related to point of care devices in clinical settings is contamination. This keyboard from Medigenic can be cleaned with hospital-grade disinfectants.
Google Health: PHRs Still Need Human Touch
- Posted April 16th 2009
- Comment (1)
- by Janice
Google has been very good at establishing a broad-based platform for search and search advertising . However, they’ve always taken a “hands-off” approach when it comes to content. Google doesn’t get involved in the dirty work of “data cleansing”, especially when it requires domain-specific knowledge and human intervention. Instead, Google focuses its resources where they can rely on existing metadata to fuel their engineering powerhouse.
Therein lies the problem that came to light this week when the Boston Globe ran an article that detailed the experience of e-Patient Dave (Dave deBronkart) in transferring his medical record info from Boston’s Beth Israel Deaconess Medical Center (BIDMC) hospital to Google Health, the highly anticipated personal health record (PHR) utility from Google. Dave described in the Globe article and on the E-Patient.net blog some of the unacceptable outcomes that occurred when Google inferred information from content that was imported into his Google Health PHR from electronic records at BIDMC. For instance, dates did not accompany most of the information, so Google Health issued alerts that assumed all of the conditions and meds listed in his record were occurring simultaneously.
The article also highlights serious flaws in using medical billing codes to infer information about medical conditions. E-Patient Dave delves more deeply into the medical coding issue on his blog and offers a good round-up of the various codes used by medical providers. These billing codes are imperfect for their primary purpose; using them as the primary metadata to infer a patient’s medical history is a fatal flaw.
So, should we conclude that Google Health is DOA as some have suggested? Not necessarily. But, it’s fair to say that Google Health isn’t ready for the average patient/consumer and won’t be until more progress is made in harmonizing the codes and terminology used by various stakeholders in the healthcare economy. One conclusion is clear: given the current stage of development of PHRs, there are opportunities for content intermediaries in healthcare to solve some of the data inconsistency problems. One new company, Zweena Health, added its voice to the Google Health bashing to promote its own service that creates PHRs for individuals. According to their site, they “do all the work” to convert information from providers into a usable information resource.
Traditional healthcare publishers represent another group that is well-positioned to help solve the data translation and transfer problem for patient records. Healthcare publishers like Elsevier, ThomsonReuters, and Wolters Kluwer have been combining content with technology to create clinical and workflow tools for years. Their expertise in understanding content, technology and workflow of healthcare professionals should be included in efforts to develop electronic records for providers and patients.
Finally, medical librarians have expertise and hands-on experience in translating medical information for consumer audiences. Perhaps it is time for Google to fund medical librarians to take on the work of creating taxonomies and harmonization schemes that would better serve multiple stakeholders. I’ll forward this post to David Rothman and other medical librarians who blog to get their feedback.
One final thought. Google likes to aim high and target projects that reach large numbers of people where Google can add value through low-touch high-tech projects that leverage their computing and coding resources. In the case of digital health records, perhaps Google should take the approach that CMS (Centers for Medicare & Medicaid Services) has used and tackle a smaller piece of the puzzle first, starting with drug information. Digital drug databases have evolved to a state where they are more reliable, and CMS is advancing e-prescribing by providers through financial incentives and promotions. This week’s announcement that Express Scripts is acquiring Wellpoint’s NextRx pharmacy benefits management (PBM) unit for $4.68 billion is another sign of progress in this arena. The market apparently approves of the acquisition: Express Scripts’ stock price has risen since the announcement and has been upgraded to a buy by UBS.
As we wrote last month on the subject of health IT, it is imperative that architects of the health IT software systems understand the content that will flow through their systems and how it will be used. The same imperative applies to developers of PHR software and tools to an even greater extent.
Blog Rally to Save the Boston Globe
- Posted April 6th 2009
- Comments (2)
- by Janice
Paul Levy, CEO of Beth Israel Deaconess Medical Center in Boston, organized a “blog rally” to save the Boston Globe newspaper. Health Content Advisors is pleased to participate. Here is the statement that is being published simulateously at 10 pm on Monday, April 6:
We have all read recently about the threat of possible closure faced by the Boston Globe. A number of Boston-based bloggers who care about the continued existence of the Globe have banded together in conducting a blog rally. We are simultaneously posting this paragraph to solicit your ideas of steps the Globe could take to improve its financial picture.
We view the Globe as an important community resource, and we think that lots of people in the region agree and might have creative ideas that might help in this situation. So, here’s your chance. Please don’t write with nasty comments and sarcasm: Use this forum for thoughtful and interesting steps you would recommend to the management that would improve readership, enhance the Globe’s community presence, and make money. Who knows, someone here might come up with an idea that will work, or at least help. Thank you.
Note, I’ve written in the past with ideas on how newspapers should exploit the value in their archives. If they don’t, Google will (see: http://www.google.com/support/forum/p/news/thread?tid=1c47e6d29331dc2c&hl=en). Also, newspapers need to re-emphasize their value to their local communities by connecting readers with local vendors, event producers, and other local institutions in new ways, including using mobile e-reader technology.
Other ideas?
Headlines for Apr 2-6
- Posted April 6th 2009
- Comments (0)
- by Janice
Big news: Hearst’s Zynx Health and Elsevier partner to provide integrated evidence-based clinical info from ELS(FirstConsult) with Zynx’ order sets at point-of-care via ZynxOrder.
Matt Holt interviews Andy Slavitt, CEO of Ingenix. Slavitt provides an excellent overview of Ingenix’s health IT and EMR products (CareTracker).
NY Presbyterian hospital encourages patient use of personal health records via MSFT HealthVault. Hospital provides discharge info and report of care info to patient in PHR.
Good summary of conference at Columbia Law School on the Google Books Settlement. “The Google settlement may make the careful balances found in copyright law (as well as the public procedures to change it) moot, replacing them with private contractual arrangements instead.” “In the settlement agreement, only Google gets to make use of orphan works – those works whose rights holders do not announce themselves to the Registry.”
NY Times highlights Google’s far-reaching rights to orphan works granted in the Google Book Settlement. We will post more on settlement with links to key documents. NB: all publishers & authors of copyrighted books who want to opt out need to do so by May 5.
Richard Anders, a Boston-area entrepreneur, is forming an angel investment group to invest in life-science companies.
Harry Totonis, fmr MasterCard exec, named CEO of Surescripts, succeeding co-CEOs, JP Little and Rick Ratliff.
Elsevier’s MEDai healthcare analytics company launches patient-specific early warning system.
John Halamka lists the initial 13 members of HIT Policy Committee across differenct categories (Advocates for Patients; reps. of Providers, etc.)
Hank Asher, who sold his company Seisint to Reed Elsevier in 2004 for $775, is sued by RE for breach of non-compete because of reports of his plans to build data center in Boca Raton, FL.
Callanan will report to CEO Marty Kahn and will manage day-to-day operations for ProQuest publishing, marketing, customer care & content operations. She will continue to overall responsibility for Bowker, where she is currently Pres & CEO.
BMJ launches its BMJ Point of Care mobile product at HIMSS 09 in Chicago April 4-9. BMJ partnered with Epocrates to create Point of Care, which provides access to peer-reviewed diagnosis and treatment content from BMJ Clinical Evidence, as well as links to Epocrates’ drug databases.
Jane Sarasohn-Kahn on confusion that can arise from having too many different rating schemes for hospitals. Another point, how useful are hospital ratings if consumers don’t have meaningful choice in providers?
Merkle, a large database marketing agency, launches healthcare marketing practice & hires Jeff Wiltrout to lead.
Good comparison on search features of DeepDyve and Google for finding contextually relevant info. Describes how DeepDyve allows users to paste long paragraphs to find similar info vs. the keyword approach. Also hints that Google may be interested in acq. DeepDyve to counter MSFT’s move when they acq. Powerset.
Lippincott Williams & Wilkins, part of WK Health, adds behavioral health module to its online Nursing Procedures product.
Medicine and Mobile are a Perfect Match
- Posted April 3rd 2009
- Comment (1)
- by Janice
Mobile applications for medical professionals are hot! In the past two weeks, Business Week has run an article titled, Paging Dr. iPhone and PC Magazine ran another title, Meet Nurse iPhone. Other articles that have been posted to our headlines section include PDA Choices for Medical Students, 5-Minute Consult Now on iPhone, and most recently the Gary and Mary West Foundation announced $45 million in funding to create the Wireless Health Institute.
Perhaps more than any occupation, healthcare is a perfect match for mobile. Physicians were early adopters of paging devices; it’s not a surprise that they are early adapters of multi-purpose networked mobile devices. Until recently, a limited amount of health content has been available for mobile devices. Epocrates for Palm devices was one of the first to catch on with doctors and med students and continues to expand its offerings. Skyscape has built itself a nice position as a converter and distributor of mobile device-enabled content and as a result has amassed an impressive collection of info resources for mobile applications, with a recent focus on iPhone applications. Other more complex point-of-care clinical decision tools for mobile devices are being launched by the larger medical publishers, including Elsevier, Wolters Kluwer, Thomson Reuters, and others. Just this week, BMJ launched its iPhone-ready BMJ Point of Care application, a joint-effort with Epocrates that provides mobile access to BMJ Clinical Evidence.
Potential uses for mobile device applications extend far beyond medical reference content. Doctor-to-patient communication via wireless devices, ie., telemedicine, is a growth area. An even larger market looms for two-way communication between doctors and patients and patient-to-patient communication.
The good news for publishers is that mobile devices offer a very large and growing market for their content. One word of caution: medical professionals and consumers will expect iPhone-like design, interoperability, and communications features. Expect to hear many announcements of iPhone-enabled content at HIMSS next week. Dr. and Nurse iPhone will be pleased.
Headlines for Mar 30-Apr 1
- Posted April 1st 2009
- Comments (0)
- by Janice
Physicians Interactive, which was acquired by Perseus last year from Allscripts, acquires MedManage, an e-sampling company that helps pharma and device companies market to doctors.
West Foundation, along with Scripps & Qualcomm create the West Wireless Health Institute in San Diego to invest in wireless/mobile health applications.
CareDataTrak launches kiosk system for self-screening of seniors.
Good interview with Linda Peitzman, Chief Medical Officer, Wolters Kluwer Health, that details how WK Health’s applications are being integrated into EMRs. Addresses clinical decision support tools (UptoDate), drug info tools (Medi-Span, Facts&Comparisons), and coding tools (ProVation).
Unbound Medicine’s 5 Minute Clinical Consult app now available for iPhone format.
AMA and Elsevier co-publish medical coding texts & websites by Carol Buck.
Thomson Reuters Healthcare launches campaign to save $4B in healthcare expenses by performance improvement practices. “The company’s Save $4 Billion campaign will offer U.S. hospital CEOs an analysis that shows how their hospitals compare to industry norms and benchmarks in clinical quality, patient safety, financial performance, and operational efficiency. Thomson Reuters will meet with hospital executives to discuss their results and where they should focus improvement efforts to have the greatest impact. There is no charge for these services.”
One medical librarian’s picks for online consumer health info sites. In her opinion, most of the big portals add little to the info that can be found on MedlinePlus and WebMD.
Post by physician in small practice about the process of moving to EMRs. Outcome was positive but it took time. Key objectives they kept in mind from start to finish: Simplify how things are done Always have the right information available Make communication clear and easy Achieve the highest quality possible
At a time when interest in wellness and preventive healthcare is rising rapidly, Prevention magazine’s circulation drops 15%. Article compares trend to some general interest pubs, but Prevention should be viewed alongside other health publications.
Bob Wachter details some shortcomings of rushing toward usage of clinical decision support tools & order sets that rely on inadequately examined results.
Run-down on best choices for a PDA device for med students. Covers iPod/iPhone, Palm, and HP.
Institutional review boards (IRBs) that oversee clinical trials on human subjects are in the spotlight after lax procedures found by congressional sting operation. Tougher regulations on pharma and device companies that sponsor trials may result.
New online journal, Database, from Oxford University Press is launched. “DATABASE: the Journal of Biological Databases and Curation will be a fully open access journal from launch. In addition, it will be a condition of publication that all databases and software described in DATABASE articles are made publicly available. The journal will be online-only, providing fast access of its full content to scientists worldwide.”
Dr. Val rants about Wellsphere’s recruitment practices for adding healthcare bloggers to their community. Wellsphere is now part of HealthCentral. It does seem that these bloggers should get a share of ad revenue generated by their content.
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