HealthContentAdvisors

AHRQ proposes expanding CAHPS surveys to include patient attitudes about health It. Harvard & Rand will conduct a field test in 2009.

ContentNext, the parent company of PaidContent.org, which is now owned by the Guardian, confirms recent layoffs and realignment.

Anas Younes, MD on why he Tweets.

Jay Parkinson’s Hello Health healthcare model is highlighted. Hello Health offers a model for providers of health care that utlizes technology to improve efficiency and communication between patients & doctors. For now, Hello Health requires direct payment from patients, although patients can seek reimbursement.

Glaxo’s CEO, Andrew Witty, discusses changes in R&D organization, which has moved from “industrial-scale drug discovery processes” of the past 15 years that relied on “an industrial process based on large-scale applications of technologies like genomics, proteomics and combinatorial chemistry” which didn’t deliver on their promise, to more focused research that is “more of an art than a science”.

Discussion draft of House’s health reform bill “To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes.” 852 page pdf doc.

Nice to see that Els has iPhone apps for popular medical info products from Mosby/Saunders, including Mosby’s iTerms Flash Cards, Saunder’s Q&A Review for th NCLEX-RN Exam and many more.

Nice piece by Ellen Goodman on the importance of helping doctors focus on providing healthcare, not reimbursement rates and other business issues.

Good recap of Google Book Settlement, Book Rights Registry, and orphan works rights proferred to Google under the settlement. Interesting that Google, the company that champions free content, is now being feared for possibly planning to charge “exorbitant” rates once they get near-monopoly rights over orphan works.

Great post by Richard Scoville on how some community health centers are relying on registries of patient records & outcomes to improve overall care. Unfortunately, most EHR systems aren’t set up to interoperate with registries, which nixes the whole idea of meaningful use!

RWJF launches consumer health care confidence index in partnership with Survey Research Center at U. Michigan, which conducts the “Surveys of Consumers” monthly survey of 500 households.

Dan Clancy responds to Bezos’ comments about Google Books. All publishers–in all platforms & for all audiences–should be following Google Books Settlement and the G Books program!

Merger, which was called off last fall due to market conditions and lack of buyer for Porex, is back on. HLTH still seeking buyer for Porex. WebMD will be surviving company with Wygod as Chair and Gattinella as Pres/CEO. All stock transaction. WebMD has been a publicly traded sub. of HLTH.

Sponsored by CTIA (wireless ind assoc), Congress, administration officials, & experts to meet to discuss “mHealth solutions to America’s chronic care crisis”. Good quote from Obama at end of article. “We need to explore a range of ideas about how to put patient safety first, let doctors focus on practicing medicine, and encourage broader use of evidence-based guidelines”.

IBM bets on mobile tech to reach parts of pop that don’t use pcs–and of course those who use both.

The Healthcare Financial Mgmt Assoc will publish a detailed report this fall on how to implement best practices in revenue cycle mgmt (RCM). Preliminary results given at HFMA’s annual meeting in Seattle. Bullet point results listed in article.

Good article on recent research by TNS Healthcare on shifting relationships between Pharma and doctors. No major revelations, but some good data.

Round 1 research reports from Robert Wood Johnson Foundation’s Project HealthDesign available via this link.

Esther Dyson on the importance of genetic research, includes transcript and video.

I think they mean “mnemonic” not pneumonic! Articles lays out mnemonic checklist for effective patient discharge information that is in compliance with JCAHO guidelines.

In fact, The Economist benefited by refusing to give its content away on the Web. Audience for the Economist is smaller than that of Time or Newsweek because of its higher quality global analysis focus (remember that People magazine has the highest circulation). Added analysis in Economist differentiates it from commodity news articles that just summarize week’s news stories.

Full text of article referenced earlier. Provided doctors follow accepted clinical guidelines and fall below average error rates, this model (PROMETHEUS) proposes a risk-adjusted payment model.

Initial recommendations includes 22 objectives, but no official definition of meaningful use. Note, incorporating access to medical research info or existing clinical decision support systems is not among the objectives. Too much focus on technology, barely any focus on research content!

WaPo covers some recent social media ad campaigns by Pharma.

Thomson Reuters offers special edition of ISI WoK to developing countries in partnership with Reseach4Life.

Yahoo adds 5 new papers, even in face of possible shutdown of HotJobs, which is a major source of job classified rev. for consortium papers.

Interesting post that provides insight into pharma marketing practices and suggests that physician & patient education advocates learn from some of the practices of pharma in getting out their message.

Person who stole patient record information at Cedars Sinai Medical in LA & used info to defraud insurance companies sentenced to 4yrs 8 mos. in prison.

Experiment shows that author pays model could lead to inappropriate acceptances of papers. In this case, a computer generated article was accepted for publication by an open access/author pays publisher.

Forbes on Obama’s speech to AMA & the reaction.

Ascend Media, fmly owned by PE companies CCMP and VSS & mgmt, now owned by lenders, is for sale. Assets include B2B magazines for medical imagin, hearing, respiratory care, PT, plastic surgery & other professionals, as well as event media and medical education products. Drop in pharma advertising likely a major driver for declines in sales for all properties.

Not surprisingly, AHA is against cutting payments to hospitals, esp. before coverage is expanded to more uninsured.

HITSP, a public/private partnership that works on interoperability of EHRs in US, has begun work to identify standards to support “core research data element exchange”.

WSJ speaks with David Blumentional, head of ONC. “There’s no way to transform the healthcare system without information technology.”

HealthLeaders publishes data from Thomson Reuters on hospital expenses per adjusted discharge for 2008 and 2005.

John Mack offers addt’l insight into FDA warning letters to pharma about paid search ads.

Write-up of last week’s (June 11-12,2009) Games for Health conference in Boston.

Obama administration says it can find $313 B in healthcare savings to help pay for reforms.

John Moore summarizes his thoughts on the recent Microsoft Connected Health conf. Key point: MSFT has shifted some focus from consumer apps to enterprise apps, in large part because of the faster uptake & more clear business models.

Allhealthcarejobs.com, which was launched in 2006 and is reported to have sales <$1M, is acquired by jobs site Dice Holdings for $2.8 million.

Sramana Mitra on some well-positioned health IT and health content companies. Mostly focused on IT companies that help to save costs.

AMA & Covisint are working together to build a portfolio of Web-bases services to physicians and on June 11, announced that the portal will be launched nationally in early 2010 and will provide a link to Microsoft’s HealthVault PHR platform.

Thomas H. Lee, MD writes about effect of IT on role of physician. Comparing what IT has done to publishing (and journalists), Dr. Lee posits that some basic functions of doctors can indeed be automated. This is an important theme and I will write more on this topic soon.

LifeShirt,a wearable remote patient monitoring system, completes prototype of next-gen shirt. Current version embeds sensors to collect respiratory, cardiopulmonary, & other data from patient. Can also connect to peripheral devices and transmit data to vendor’s db for analysis. New version will integrate all sensors, extend battery life, & make upgrades easier. Sounds cool, but what about washability?

Ed Felten’s suggestions for data.gov & general role of feds in serving as info provider. Great points: “Private actors….are better suited to deliver govt info to citizens and can constatnly create and reshape the tools individuals use to find and leverage public data.”

The government says sipping red wine improves the benefits. Glad to know I’m doing it right!

Steve Outing provides a list of suggestions for newspaper company executives. Food for thought for publishers in other segments, too!

Class action settlement against First DataBank (Hearst) that publishes benchmark drug prices and McKesson, a drug wholesaler, will result in some payments to consumers who bought these drugs, along with some price rollbacks, but not a significant change.

Healthcare Informatics’ June issue with HCI 100 list of top health IT vendors.

Drug interaction/adverse effects info tool added to MSFT’s HealthVault.

A rundown of a handful of online physician ratings sites. Also mentions pushback by physicians who can’t respond to reviews. Mentions RateMDs.com, DrScore.com, AngiesList, Heatlhgrades and some state-specific sites.

IAB PWC research shows that online ad spend declined in Q1 2009 YoY for the 1st time in years.

E-patient Dave’s slides from presentation at National eHealth Collaborative last week.

David E. Williams provides a very nice summary of Michael Porter’s excellent article in NEJM (available for free): A Strategy for Health Care Reform — Toward a Value-Based System.

Some background on why drug companies aren’t flocking to Twitter.

Good post that expands on theme that EHRs (EMRs) should be designed with patient needs in mind and that simply automated current procedures in hospitals won’t likely lead to an improved experience for patients who want to participate in their health care decisions.

Healthcare a bright spot in employement trends: health care jobs grew >23,000 in May, while overall nonfarm payrolls shrank by 345,000.

A new condition of interest to data publishers: Database Hugging Disorder (DBHD). Humor aside, this post addresses trend toward allowing access to the databases that were used in medical and other studies. In line with the Open Access movement in scholarly publishing that campaigns for free access to research articles where the research was funded with public funds, the open database movement seems to be growing very quickly. Oddly enough, even though the databases hold more value than individual articles (especially when data can be combined from multiple databases), the fact that they haven’t been monetized in most cases may lead research organizations to be more willing to make them freely available while still charging for published articles based on the data.

J&J said “pipeline productivity is on track” and outlined growth strategies: -greater marekt penetration, new commercial models, exapnded geographic presence.

Good piece from Michael Porter on key changes required to reform our healthcare system. Porter emphasizes the need to align incentives for insurers, providers, employers, and patients with health of the patients/consumers as the objective. I’ve only skimmed the article, but it looks spot on.

Only PE companies left in bidding. Interesting twist: Springer’s current owners, Candover & Cinven are looking to raise a specific amount (500M Euros) and are asking interested parties to bid on share they are willing to accept for that amount. Springer has large number of scholarly journals & books, and has done well selling ebook versions in the past couple of years, but has lagged behind in creating decision tool applications based on their content. Heavily focused on academic market.

Great post on the potential value of the huge amount of data that are being collected as more info on individual patients is recorded in digital form. Effects of drug interactions across a broad population is key example given here.

Medidata, which provides s/w for managing clinical trials and for managing clinical research data (Rave), sets terms for IPO. S1 was filed in January 09. Insight Ventures key investor. Market cap at expected $11-13 range to be up to $290. See: http://www.mdsol.com/products/rave_overview.htm

Good overview of Google Wave by folks at ReadWriteWeb.

More on Google’s plans to sell ebooks. Even though publishers get to set price, Google retains right to discount at its own expense.

CMPMedica announces new online healthcare education program for patients & their caregivers. Health Empowerment Initiative targets “knowledge gaps” in patient understanding to improve compliance with prescriptions and healthful behavior. Sounds interesting & I’ll check it out, but they should have come up with a better name for the program!

From Mark Logic User conference #MLUC09, write-up of Webmedx, a company that provides transcription s/w to convert dictation to coded XML documents. Notes that approx. 60% of physician-created documentation is dictated & transcribed. Note section on CDA: Clinical Data Architecture & link to this open source standard.

Dr. Thomas Frieden, NY City’s health commissioner, will be announced today as Obama’s pick for director of Center for Disease Control & Prevention (CDC).

Google is experimenting with asking users who search for health-related topics why they are searching, e.g, looking to diagnose, find treatment, etc.

Elizabeth Satin, who has focused on healthcare industry in her investment banking career, joins Wolters Kluwer as SVP & head of Corporate Development & M&A for N. America.

Ad Age nicely surveys the state of digital marketing & social media usage by Big Pharma and their agencies. Highlights J&J, GSK, AstraZeneca, Novartis, Sanofi & Boehringer Ingelheim. Good quotes from top digital agencies, too.

Dr. Gwenn interview Denise Basow, MD, editor-in-chief of UptoDate, to discuss appropriateness of patient site on UTD for spectrum of patients.

NIH is seeking comments on possible changes to fed. regulations regarding potential conflicts of financial interest on part of researcher that could affect objectivity in design, conduct, or reporting of research fundeed under PHS grants. Note, transparency of researchers’ financial interests will be increasingly important as more medical & other scientifc research is made for widely available via the Web and other vehicles. Related to Open Access themes, too.

Some ideas for searching and mining info in Twitter.

Extended list of academic, industry, and consultants who will advise on implementation of ARRA funds for health IT.

BreastCancer.org partners with HealthCentral.com for sponsorship ads. Is this a sign of new type of partnerships between online consumer health portals and non-profit consumer healthcare online communities. Can HealthCentral serve as effective ad/sponsorship agency for such sites? How will sponsoring social media healthcare sites like BreastCancer.org compare with Pharma’s direct development of community sites around a specific drug (e.g., Alli)?

Health insurers, PhRMA, AMA, AHA, and SEIU say they will work to contain cost future increases in health care. Comments from readers reflect skepticism of pledge.

MobihealthNews interviews Roni Zeiger, product manager of Google Health.

Thought-provoking article by CEO of Daylife, Upendra Shardanand. Addresses the need for content publishers/journalists to start thinking like data publishers so that pieces of the story can be reorganized in multiple ways with additional media included to enrichen the story, if desired. With XML-based CMS tools increasingly in use, we should be seeing more creative expositions of content. What’s holding back progress, I believe, is the economics of publishing. How will pieces of stories be monetized? With shopping sites, the content is advertising; with journalism, the content is the product. Does content only have value if it drives the purchase of something?

WebMD to launch Medscape iPhone app in May/June. Article also discusses the success of ReachMD’s recently launched CME app on the iPhone. More evidence of the popularity of the iPhone platform with doctors.

David Kibbe, MD, entry on CCR standard in Medpedia.

Shrinking library budgets and weakened pound are affecting the ability of academic & non-profit libraries in the UK to subscribe to scholarly journals & texts.

GE unveils “Healthymagination” initiative to produce “low cost products” for organizations with limited access to health IT. Early word is that the news release & Webcase was splashy but with very little substance.

Reponse from Elsevier about Merck-sponsored “fake journal”.

More on Kindle DX and how newspapers will subsidize for customers in areas that do not get home delivery currently. That will miss the group with greatest interest.

Print ad rev. down 18.4%. Online ad revenues down 2.6%. In line with other magazines; health sector no help in this case. E-Commerce revs up, book sales up for “Flat Belly Diet” and “Eat This, Not That” for which Rodale is planning a reality TV show.

Article describes how AmeriHealth implemented NaviNet, an info messaging service that alerts clinicians to unment healthcare services for a patient and the patient’s eligibility for coverage of the services. NaviMedix, Cambridge, MA, develops NaviNet.

New Kindle DX announced for pre-order at $489; available in Summer. Looks very cool, but price is high. Will newspapers or other publishers subsidize the cost to keep subscribers?

Pfizer agrees to cover publication costs for articles by its researchers on BioMed Central (now part of Springer). Is this the unintended consequence of “author pays” model: Big Pharma-backed research will be fully-supported b/c Pharma can cover the costs. But what about research that isn’t related to something that Pharma wants to promote? As with the Els/Merck “journal”, transparency is key.

Some explanation of the Elsevier-produced “complimentary” journal that consisted of reprints about Fosomax & Vioxx that was paid for by Merck. Journal issues in question were produced between 2003-2005.

Halamka’s summary of Micky Tripathi’s (Mass eHealth Collaborative) presentation on “Meaningful Use”. Lots of good material in the preso, but it all seems so hospital/current vendor-focused to me.

I’ve been lax in reporting on the Merck-sponsored journal that Elsevier produced without full disclosure. Here’s a perspective.

Good article that describes lessons from UK’s NICE (National Institute of Clinical Excellence) that could be put to use by US for the comparative effectives research efforts.

Washington state’s governor has signed bills that will allow health regulators to conduct surprise inspections of hospitals beginning in August, which changes the current policy of 4-months of advance notice; second bill tightens standards for screening for MRSA.

Not health related–just to the health of newspaper companies…. Great, easy-to-follow post on how to use Calibre to download and organize newspaper content on a Kindle.

Governor John Baldacci of Maine unveils “Maine HealthCost”, which allows users to enter their insurance info and find estimated out-of-pocket costs by providers across the state.

Describes Caterpillar’s testing of a program with Wal-Mart where Wal-Mart essentially serves as the PBM for CAT.

Eric Schonfeld presents good trend data on online ads from Google, Yahoo, MSN, and AOL. Q109 first qtr that showed decline since dotcom bust. Google only company that saw modest growth.

Dr. Val speaks with CEO of AllOne Health, which provides a mobile phone app for practitioners and patients.

Warburg has invested more than $65M in Archimedes Pharma, which is seeking approval for its nasal spray pain reliever for cancer sufferers.

ClearHealth creates a iPhone app that allows doctors to view patient records on their iPhones.

Rodale & Reveille, who brought us “The Biggest Loser” are teaming up for new reality TV program based on Rodale’s “Eat This, Not That”.

J&J achieves top ranking in Harris survey on company reputation. Pharma industry was only sector to “register a significan tpositive change from 2007″. Financial services now at bottom with Tobacco industry.

Statement by PhRMA on IOM’s report with recommendations to curb detailing/gift/etc to physicians & medical institutions. Includes some data on R&D spend v. marketing spend by Pharma.

DeepDyve (formerly Infovell) unveils a suite of tools for publishers that want to offer DeepDyve search and discovery tools for content via their own site. Tools include enhanced landing pages, customer search API, a “more like this” feature, and content highlight search capability. DeepDyve, a Health Content08 innovator, will provide these tools to publishers whose content is incorporated in the DeepDyve search index for a rev. share of advertising deal, or a fee that depends on volume. Note, DeepDyve’s current index is very strong in health content and other scholarly research information. PLoS is one of the first to implement the API.

Judge Chin issues a 4 month extension to the May 5 deadline for opting out of Google Book Search Settlement.

BW highlights concerns about suitability of largest entrenched health IT vendors to revitalize healthcare information systems and add efficiency to current manual processes, given their track record. Reaction to article is divided: some say BW is promoting the viewpoint that doctors dismiss the benefits of technology b/c they aren’t tech savvy *; others say the big vendors truly are not providing systems that add efficiency due to poor design. See our 4/16 blog on Google Health PHRs for a more balanced view: health IT vendors need to develop greater expertise about the data that will flow through their systems and the workflow of the clinicians who will be using the systems. With a dearth of standards for clinical data across health IT systems, interoperability and ease-of-use will continue to be curtailed. Information architects are desperately needed in healthcare.*NB, we don’t believe all doctors are luddites!

IOM proposes that pharma companies disclose payments to doctors, med schools, & professional groups in a centralized db, along with some other recommendations to curtail current practices.

Ken Doctor on continued decrease in print circulation for newspapers and Google’s plans to offer personalized online news. Ken lists reasons for print downturns and points out that the aggregator/distributor (Google) seems to be winning (or has already won) in the online news category. As he says, unless a “new, fairer, stable ecosystem emerge[s]”, “Who will pay journalists to create the news?”

NY Times writes about Johns Hopkins Drug Library, which maintains samples of largest collection of approved drug compounds. Researchers can order full set for about $5,000 and then carry out testing to find new applications. Article describes High Throughput Screening (HTS), which automates processes for testing and allows large-scale screening that wouldn’t have been economically feasible in past.

Roni Zeiger, MD, Google Health product manager, responds to flak over use of billing codes to exchange & interpret data from patient’s hospital medical records.

J&J’s McNeil Pediatrics launches new Facebook Page that provides online resources for adults with ADHD. Site aggregates info from group of ADHD experts and community leaders. This site follows other ADHD Facebook Pages from J&J, which is leading other pharma companies in experimenting with social media and web publishing.

New site from HHS that covers federal health IT programs and provides links to state-level initiatives and additional info.

NY-based Applied Informatics launches TrialX, a patient recruitment tool that facilitates recruitment for clinical trials via social networking sites. TrialX also allows subjects to upload data from PHR apps from Google Health and MSFT HealthVault for pre-screening. Recruitment for research studies is fast becoming the leading revenue model for social networking sites.

Good description of Mayo’s adaptation of MSFT’s HealthVault for their PHR application that is open to anyone.

Phase Forward, a leading provider of clinical trial management s/w acq. Waban Software,which provides platform solutions to automate clinical data analyis & reporting, for $14M in cash.

NY Times reports on spread of swine flu & public health emergency. Tracking usage of social media & Google Flu during this emergency will be interesting.

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.”

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.

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.

AHRQ contracted with Rand Corp to develop ‘how-to’ toolset for implementing e-prescribing systems. Notice in today’s Fed Register.

Example of new payment models in pharma sales. In this case, Merck provides discount to Cigna if Cigna helps promote compliance.

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.

John Moore from Chilmark provides a quick comparison of growth in unique visitors to WebMD, Healthline & Healia.

Revenue declines 8% to $526.0M (3% constant currency); Operating income also down, but net income up.

Agents from Defense Criminal Investigations Service raided offices of Siemens Medical Solutions in Malvern seeking documents related to company’s military contracts.

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.

Good post on “ebb and flow” but steady progress being made in determining clinical quality guidelines.

ADAM releases a consumer health app for iPhone with content from ADAM, Healthcare Blue Book, video from HealthiNation, and some blogs/social networking sites.

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.

UK’s NHS on DNA tests.

Cignamakes Quicken Health Expense Tracker available to those enrolled in most of its health plans, via myCigna.com.

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.

Healthline adds suite of tools & enhancements to help patients research treatments & costs.

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.

American Psychiatric Assoc votes to phase out pharma-sponsored symposia at APA annual meetings.

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.

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.

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.”