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Archive for the ‘Clinical tools’ Category

Consequences of Market Concentration in Healthcare

Paul Levy, CEO of Beth Israel Deaconess Medical Center in Boston, wrote in his blog about dangers of market concentration in the provider segment earlier this week.   Levy’s main point is that large provider groups can negotiate better rates from payer organizations and put smaller provider organizations at a disadvantage and that the accountable care organization (ACO) model could exacerbate the negotiating power.  Furthermore, there are consequences to consumers when market power is highly concentrated.  Also this week, John Moore of Chilmark Research wrote about the recent acquisition of Axolotl by Ingenix, a healthcare data analytics company.  In this post, I connect and extend these two topics and address issues related to vertical market concentration in healthcare with Ingenix as the example.

Ingenix is a wholly-owned subsidiary of UnitedHealth Group, an $87 billion (2009 revenue) company with approximately 80,000 employees in its four major divisions:  health benefits, benefits management, data and information services, and pharmacy benefits management (PBM).   The health benefits (insurance) segment is the largest by far with 2009 revenue of $81.3 billion, and Ingenix (the data and information services segment) is the smallest with 2009 revenue of $1.8 billion.

However, Ingenix has an operating margin of 13.5% vs. the health benefits margin of 5.9% and Ingenix’s recent top line growth is stronger than the other segments.  Considering the number of acquisitions made by Ingenix, it’s not a surprise that revenue is growing.  According to Ingenix’s careers page, the group has acquired over 50 companies in the past 10 years.  See Alacra’s headlines and timeline of the Ingenix acquisitions since 1998 (as well as their offer to sell you more information).

A few notable acquisitions include The Lewin Group, a healthcare consulting company, QualityMetric, a health outcomes measurement company, and PICIS, a clinical workflow IT vendor to hospital emergency departments.  I find these deals of note because they clearly extend Ingenix’s purview beyond the payer and pharma analytics segment into the clinical analytics segment. 

The Lewin Group, for instance, received a contract from HHS last year to develop the framework for comparative effectiveness research.

Lewin describes how the resources of its sister companies within Ingenix position it well to develop the framework that will be used to determine the relative effectiveness of treatments on its own site as follows (emphasis mine):

The Lewin Group Center for Comparative Effectiveness Research has unique capabilities for conducting and supporting CER, combining The Lewin Group’s broad and widely recognized record of independent analysis of health information technology, evidence-based medicine, health care policy and other issues; affiliate company i3’s expertise in clinical trials and study design, drug safety, health economics and outcomes research; and Ingenix data.  Through Ingenix, the Center will have access to robust longitudinal de-identified patient data sets including integrated medical, disability, laboratory results and pharmacy claims data.  The staff available to the Center includes more than 1200 health services researchers, clinicians, clinical trial design experts, epidemiologists, biostatisticians, health data experts, health economists, and others.

In John Moore’s post, Ingenix’s EVP for provider solutions states that he “sees a convergence of administrative and clinical processes”.  I agree that analytic processes and platforms that have been developed for the payer market are being adapted for use in clinical settings, and I’d add that the same type of convergence is occurring between life science research analytic platforms and clinical platforms.  In fact, I’ve drawn a 3 circle Venn diagram illustrating the convergence in healthcare data analytics between these three domains in recent client reports.  

Should we be concerned that a large payer analytics company (Ingenix), owned by one of the largest health insurance providers, is on a path toward becoming a dominant clinical data analytics company?  I think so.  There are so many reasons to be optimistic about the benefits of data analytics in healthcare applications that can lead to improved personalized care and drug treatments.  But, like Levy, I have concerns about the concentration of power in large organizations and the implications of such market power on the future of clinical decision support systems.

 

Health Content: There’s an App for That in EHRs

Approximately 30,000 people convened in Atlanta last week for the HIMSS conference. HIMSS stands for Health Information Management Systems Society, and its annual event has become the meeting place for vendors and users of electronic medical and electronic health records systems (EMR/EHR). This year’s conference program had a major focus on the impact of the ARRA HITECH[1] funding and incentives for adoption of new EHR systems. One of the most common topics of discussion at the event was “meaningful use” of EHRs.

I’ll reveal my bias upfront. My background is in digital information services, and I’ve always viewed information management systems as tools for increasing the utility of the content that flows through these systems. An information system that doesn’t optimize the utility of the content in a way that adds efficiency to a process or leads to better outcomes is not all that compelling to a user.

With EHR systems, it has been long apparent to me that their value would be far higher to the clinicians who use them if the knowledge embedded in medical textbooks, scholarly research publications, and other reference sources were incorporated into the EHR systems at or near the point of care. Over the past 10-15 years, we’ve witnessed the gradual migration of information that had been stored in separate online reference systems to systems that physicians and other clinicians can access on their handheld devices or EHR/EMR screens. Epocrates for drug reference information on early PDA devices was a pioneer. Now, nearly all the reference and research content is digitized, but most of it hasn’t been incorporated into EHRs in a manner that maximizes its utility for clinicians. 

At this year’s HIMSS conference, there were myriad signs of accelerating convergence of EHR systems and health content. EHR vendors are eager to embed clinical information into their systems to demonstrate the value of incorporating accepted clinical guidelines, procedures, lab values, drug dosing suggestions, regulatory benchmarks and any other useful clinical reference content that would save the clinician’s time and lead to improved outcomes. Embedding the accepted rules and guidelines into an EHR system also provides the ability to customize recommendations based on the patient’s characteristics (sex, weight, other drugs being taken, allergies, and increasingly personal genome). The advantages of having the appropriate rules and guidelines embedded in the software are obvious. Just think TurboTax. [Note, I am focusing on clinical content in this post; benefits for administrative/performance improvement applications are equally compelling.]

Granted, medicine is more complex than the tax code. (It may be hard to believe anything is more complex than the tax code, even taking into account the state-wide variations, but it’s true!). Hospitals will continue to follow different procedures, guidelines will remain suggested guidelines to allow for individual variations, and new medical knowledge will be acquired daily. Nonetheless, the value of automating the practice of applying widely accepted medical rules and guidelines is immense-for practitioners and patients.

Medical publishers have been slow to adapt their content for usage in EHR/EMRs. Zynx Health, a Hearst Business company, was a leader in providing order set workflow systems that incorporate content. Their sister company, First DataBank, also proved the ground for transforming drug information to medication management systems. Based on my discussions at HIMSS, other medical publishers are accelerating their efforts to create clinical decision support systems from their collections of content that can be embedded in EHR/EMR systems. Elsevier, Thomson Reuters, and Wolters Kluwer, the big 3, have made great strides.

HIMSS is still a very technology-centric event with limited focus on health content and relatively few publishers exhibiting. Along with the big 3, a handful of other publishers, including EBSCO/DynaMed, Lexi-Comp, PEPID, and several patient education publishers (ExitCare, Healthwise, Patientedu.com) were present. And, of course, MedTech, the publisher of Healthcare IT New and Healthcare Finance News, which also publishes the Exhibit Guide and the daily HIMSS10 Guide, was there. BNA, a publisher of regulatory information, had a booth, too.

However, I see 2010 as a turning point for health content publishers. They have to learn to adapt their information for inclusion in EHRs. A digital version of a reference work is no longer good enough. The content has to become an “app” that can be incorporated into electronic systems.[2] Standalone content that doesn’t plug in to a user’s system or get embedded into clinical decision support systems will be left on the sidelines. By the time HIMSS11 rolls around next year, expect to see more health content publishers among the exhibitors and more clinical decision applications that can be integrated into healthcare information systems on display. Soon it will be difficult to identify where the content ends and the technology begins.

______________________

1 Health Information Technology for Economic and Clinical Health Act (HITECH Act) is part of the American Recovery and Reinvestment Act (ARRA) bill of 2009 (aka, the Stimulus Bill). For details see: http://healthit.hhs.gov/.
2 Official standards for Meaningful Use that include use of evidence-based order sets and other clinical decision support systems by 2012-2015 will fuel this trend. 

 

Headline Commentary Mar 1- Mar 19

  • » Microsoft Connected Health Conference 2010

    RT @HealthVault: Register today for the Microsoft Connected Health Conf May 19-20. https://www.msconnectedhealth.com/SiteLogin.aspx

  • » MediaPost Publications IVillage Looks To Chief Healthcare Decision-Makers 03/19/2010

    iVillage’s new Health site w/ content from Healthwise & Cleveland Clinic: http://bit.ly/ciOVt9 /Still looks like woman’s magazine 2 me

  • » Vanguard Health intends to buy Detroit hospital system | tennessean.com | The Tennessean

    Detrioit’s largest nonprofit hospital 2 B acquired by for-profit Vanguard Health: http://bit.ly/aDIKjS /more consolidation amg providers

  • » Health Reform Galaxy Blog: The Galaxy Welcomes the Wonk Review

    RT @HealthBizBlog: Health Wonk Review blog carnival at RWJFs Health Reform blog http://tinyurl.com/ybq6ow7

  • » Recent Events

    RT @SusanCarr @ctorgan: e-patient conference April 6-7, in DC. By NLM, at NIH http://www.fnlm.org/Events-2010-Conf.html

  • » Cleveland Clinic Project Finds Benefits in Linking Devices With Physicians - iHealthBeat

    RT @iHealthBeat: Cleveland Clinic Project Finds Benefits in Linking Devices With Physicians - http://bit.ly/9vYBOb

  • » Testimony–Creating the Framework for High Performing Health Care Organizations - The Commonwealth Fund

    Stephen Schoenbaum, MD, MPH’s testimony to Mass. Division of Health Care Finance & Policy on costs of healthcare in MA. Slidedeck links included. Thanks to Paul Levy for pointing to this info.

  • » NIH Announces Genetic Testing Registry, March 18, 2010 News Release - National Institutes of Health (NIH)

    NIH creates public database, Genetic Testing Registry (GTR)that will help consumers and providers determine best options for genetic testing. Goal of GTR is to have providers of genetic test enter info on the tests and identify laboratories that perform the tests.

  • » Private-Payer Profits Can Induce Negative Medicare Margins — Stensland et al., 10.1377/hlthaff.2009.0599 — Health Affairs

    Study by MedPAC reports that hospitals that lose money on Medicare/Medicaid reimbursements have higher fees and higher profit margins and represent large hospitals with strong negotiating power. They charge commercially insured patients higher fees to compensate for losses on CMS patients. But, majority of hospitals have incentive to keep fees lowers and manage to make money on Medicaid/Medicare patients. Consistent with Paul Levy’s post today.

  • » Vida y Salud – One Million Unique Users in Under 10 Months

    Very nice case study of how Vida y Salud has grown their brand and achieved substantial audience growth in under a year. Emphasizes importance of quality unique data and a cross-media marketing campaign.

  • » Interview with Glen Tullman, CEO of Allscripts | EMR and EHR

    Matt Holt interviews Glen Tullman at HIMSS10. Glen does nice job of describing how Allscripts have some footprint with 1/3 of US doctors and is working toward interoperability and connected care. Slams Epic.

  • » HealthBlawg: Massachusetts health care cost trends hearings yield data, stir heated debate

    RT @healthblawg: RT @Paulflevy: Cost Driver Hearings in MA are worth viewing: http://bit.ly/a8M7FN ^ cf background http://bit.ly/9JC7Qx

  • » Running a hospital: Health Care Cost Trend Hearings

    Massachusetts is holding hearings on drivers of healthcare costs. Paul Levy, CEO of Beth Israel/DMC, provides links to prepared statements & points out that higher costs are correlated with market power/negotiating strength of hospitals and not to type of payment system (global payments vs. fee-for-service).

  • » Coca-Cola retools wellness strategy - Articles - Employee Benefit News

    Coke tries for compatibility between its health insurance plans and its wellness programs–with some success. Hm, wonder if cutting out sugary softdrinks buys points in wellness programs.

  • » Emdeon Acquires HTMS to Extend Services to Insurers

    Emdeon, a large revenue cycle management (RCM) company, acquires Healthcare Technical Management Services, a health IT consulting fimr that assists insurers in purchasing and implementing IT. Services to aid in transitioning to ICD-10 seem to be the major attraction in this acquisition. Emdeon to pay $11M with additional cash payments of up to $14M based on financial performance.

  • » http://mobihealthnews.com/6957/text4baby-now-has-more-than-22000-users/

    RT @roskadigital: Text4Baby surpasses 22,000 users, 500k msgs sent http://ow.ly/1nqbW #hcsm CDC, J&J backed

  • » Obama’s Health IT Chiefs on Tap for Governor Patrick’s Big Health Technology Ball | Xconomy

    RT @wroush: Top national players in #healthIT (Sebelius, Blumenthal) coming to Boston next month for conference. http://bit.ly/9EyvQg

  • » Thomas Goetz: The Dark Side of Healthcare Technology

    RT @tgoetz: why does technology drive costs UP in medicine? @huffpo http://bit.ly/ayMAtt /I agree w/ lack of transparency, but not scale

  • » Guerra On Healthcare: Will Future Clinical Systems Be Modules Or Monoliths? — InformationWeek

    Interesting counterpoint — or complement– to my latest blog post about how healthcare content is being transformed into apps for integrated systems. Guerra questions whether the healthcare sector will accept a plug-and-play environment. I’m a bit more optimistic than he, based on external incentives.

  • » HIT Meeting Summary « Federal Advisory Committee Blog

    Official gov’t site with summaries of recent HIT Standards Committee meetings.

  • » RT @VinceKuraitis: Here’s the health care chapter of the FCC Broadband expansion report! http://bit.ly/92hv61 #healthit via @mobilehealth

    RT @VinceKuraitis: Here’s the health care chapter of the FCC Broadband expansion report! http://bit.ly/92hv61 #healthit via @mobilehealth

  • » HealthIT.hhs.gov: Policy Recommendations

    Lates recommendations from HIT Policy Committee to the ONC re: meaningful use, certification/adoption of EHRs, and privacy & security.

  • » http://www.healthcareitnews.com/news/himss10-registration-figures-all-counts

    RT @HITNewsTweet: Professional registration at #HIMSS10 saw an increase of 9 percent http://ow.ly/1lccO #healthIT

  • » HIMSS10 registration figures up on all counts | Healthcare IT News

    More evidence that the health IT sector is healthy. Registrations were up 9% in 2010 for a total of 27,855.

  • » Google Polling AdSense Publishers on Showing Pharmacy Ads

    RT @healthcentral: Google allegedly polling AdSense sites on showing pharmacy + liquor ads http://bit.ly/axCicw

  • » amednews: E-prescribing growing, but most practices still don’t use it :: March 15, 2010 … American Medical News

    Reviews recent survey by Surescripts, the largest e-prescribing network, on adoption of e-prescribing by physicians. Even with $$ incentives from CMS that started in Jan 2009, uptake has been slow. Combo of CMS incentives and inclusion of e-Rx app in an EMR seems to be biggest driver of growth.

  • » Patient-satisfaction surveys have drawbacks - Opinion - USATODAY.com

    Dr. Kevin Pho addresses some of the drawbacks of tying physician compensation to patient satisfaction survey scores. Hospitals do receive incentives from CMS to report survey results. But there are other measures that should help balance the issues raised in Dr. Pho’s article. But I agree that assessing quality of care of a physician by averaging patient satisfaction scores is dicey.

  • » RT @ahier: Premier comments on #MeaningfulUse (pdf) http://bit.ly/aTRj4z /Long…but enjoyed the section on Problem lists & codes.

  • RT @ahier: Premier comments on #MeaningfulUse (pdf) http://bit.ly/aTRj4z /Long…but enjoyed the section on Problem lists & codes.

  • » Health Content: There’s an App for That in EHRs | Health Content Advisors

    Finally posted my comments on #HIMSS10 from my “health content” perspective: http://bit.ly/9CVkjo #in

  • » Thoughts on HIMSS10 - jimmyweeks’s posterous

    RT @robertloakes: RT @jimmyweeks: Thoughts on #HIMSS10 http://post.ly/S9Kv /thx for the notes, Jim. Wish I had seen Thurs keynotes.

  • » Sunlight Foundation Reporting Group

    RT @SusannahFox: What if food inspection results were searchable? Drug approvals? http://bit.ly/9Qk6zb (via @nwatzman) #gov20 #datacontent

  • » UC Irvine Medical Center ordered to improve ‘medication management’ - latimes.com

    RT @ClinicalCafe: CMS orders UC Irvine Medical Center 2 improve medication mgmt (Via @PSeditor @AbbieCitron) http://bit.ly/9fFQOh #ptsafety

  • » What I’ve Learned About Implementing EHR as a Service | ITworld

    RT @ePatientDave: Beth Israel Deaconess “learned from implementing EHR as a service” http://is.gd/afFCK

  • » WebMD launches social media | Healthcare IT News

  • WebMD launches core community feature, WebMD Health Exchange with group of medical experts who will provide info on a range of topics. But, primary purpose is to encourage peer-to-peer patient/consumer sharing. It will be interesting to see how successful WebMD is in building patient communities. Most patient community sites started small with tight focus.

  • » HealthBlog : Crushing Complexity from Healthcare

    RT @Health_IT: From MicrosoftMD, Crushing Complexity from Healthcare, http://bit.ly/bR1LJv #healthIT

  • » HealthBlawg: Patient safety not taught in medical school? Lucian Leape Institute releases Unmet Needs: Teaching Physicians to Provide Safe Patient Care

    RT @healthblawg: Patient safety not taught in medical school? Lucian Leape Institute releases report… http://bit.ly/94R424

  • » http://diginovations.bizland.com/sandbox/clients/demo/emerson/player.html

    RT @knowledgevision: Gr8 use-case: Emerson Hospital using KnowledgeVision 4 Dr. briefings http://ow.ly/1gP4B /Fmr colleagues lead new MA co

  • » News Headlines

    RT @Eclipsys: Video of Eclipsys’ Phil Pead on CNBC to discuss the benefits of electronic medical records. http://bit.ly/c0HHKA

  • » British Medical Group Calls for NHS To Halt EHR Database Project - iHealthBeat

    RT @KentBottles: RT @iHealthBeat: British Medical Group Calls for NHS To Halt EHR Database Project - http://bit.ly/bTD1M8

  • » WebMD + Social Media, NOT! « Chilmark Research

  • RT @john_chilmark: Why I’m not crazy about the WebMD Exchange http://wp.me/p6shx-CC Poor SM execution

  • » Few drug studies meet comparative effectiveness definition - White Coat Notes - Boston.com
  • RT @GlobeHealth: Few drug studies meet comparative effectiveness definition - http://b.globe.com/co6JTr ;yea but it’s f(RCT) process.

  • » Survey shows nurses spend most of their time on paperwork | Healthcare IT News

  • RT @ahier: Survey shows #nurse’s spend most of their time on paperwork | http://bit.ly/asw1Vq (via @HITNewsTweet) /Need workflow apps

  • » Use of Electronic Prescribing Nearly Tripled in 2009

    RT @PracticeFusion: Use of e-prescribing nearly tripled in 2009 http://tinyurl.com/yzjex4b /Driven by Gov’t incentives; will it work for #MU

  • » PatientsLikeMe Collaborates With Novartis to Create an Open Online Community for Organ Transplant Recipients

  • RT @patientslikeme: PLM & Novartis launch free online community 4 organ transplant recipients: http://bit.ly/cZyqNo

  • » Family Health Guy

    RT @vaibhavb: “Checklists” and Rapid Innovation with Amalga http://bit.ly/cjpwyT #HIMSS10 #HIT /Nice video demo.

  • » Processed Meats Linked to Heart Disease Risk

  • Recent Harvard School of Public Health study points to increased risk of heart disease & diabetes from eating processed meats. Unprocessed meats didn’t have same association to heart disease. This was meta-analysis of previous studies. Wonder if AAFP still advertises Buddig & Boar’s Head on their Healthy Living pages.

  • » HealthBlawg: John Glaser, CIO of Partners Health Care, speaks with David Harlow about health IT and meaningful use in a $7.9 billion health system

    RT @healthblawg: Dr. John Glaser, CIO Partners Health Care, speaks w/ David Harlow about health. http://bit.ly/bgcetK /Look fwd to reading.

  •  

    Headline Commentary Feb 14 - Feb 28

  • » GE Healthcare Unveils Future of Healthcare IT at HIMSS10 - MarketWatch

    GE’s press release for HIMSS. Includes debut of clinical knowledge platform that helps providers with quality improvement initiatives, expanded HIE services, a clinical portal and a patient health management system.

  • » Guidant Charged with Failure to Report Defibrillator Safety Problem

    FDA charges Guidant (a Boston Scientific company) with failure to report safety problems with some of its implantable defibrillators.

  • » AHRQ: Health IT could be disruptive while reducing rehospitalization rates, costs

    BU School of Medicine creates RED (Re-Engineered Discharge), a checklist that helps reduce readmissions. Other examples of application of health IT in this article.

  • » Eclipsys, Microsoft partnership looks to open platforms, interoperability | Healthcare IT News

    Eclipsys Sunrise Enterprise suite of health IT software applications to integrate with Microsoft’s Amalga UIS platform.

  • » FT.com / Media - Wolters Kluwer results disappoint

    Earnings in health and pharma division down sharply–from 29M Euros in 2008 to a loss of 79M Euros in 2009. WK says pharma communications, advertising and book sales biggest factors. McKinstry says they are changing portfolio of WKHealth to focus on “clinical decision support areas”.

  • » Athenahealth delays quarterly report - The Boston Globe

    Athenahealth to delay its Q4 SEC filing so that it can audit its revenue recognition practices. Has to do with how Athenahealth amortizes implementation fees that are deferred until implementation is completed; they are considering extending the period of amortization beyond the current 1 year.

  • » Technology Review: Briefings: Personalized Medicine

    MIT Technology Review feature series on personalized medicine. Haven’t taken good look at the articles yet, but will return to explore.

  • » Doctors group to focus on 1 hospital - The Boston Globe

    Important story about how Harvard Vanguard/Atrius physician group is making Beth Israel/Deaconess Medical Center (BIDMC) a priority hospital because of coordination of care between the two institutions.

  • » NEJM — Serving Two Masters — Conflicts of Interest in Academic Medicine

    Sponsorship and payments from device and pharma companies to fund research and for board representation introduce conflicts of interest for academic health centers. No news there, but some good insight into recent developments in this article.

  • » Mayo Clinic partners with GE, Intel for home-based monitoring study | Healthcare IT News

    Mayo, GE Healthcare & Intel partner on year-long study of effects of monitoring seniors & people w/ chronic illnesses with home monitoring devices.

  • » The Migration to Modular HIT Apps « Chilmark Research

    John Moore at Chilmark provides insightful analysis of today’s announced alliance between Microsoft Amalga and Eclipsys.

  • » Eclipsys and Microsoft form alliance in Health IT

    “”Blending Eclipsys’ leadership in physician adoption and sophisticated clinical and decision-support workflows with Microsoft’s leadership in interoperability, data extraction, authentication and context management will open up new choices and opportunities for healthcare organizations needing to make the most from their existing IT infrastructure.”- Peter Neupert, Corporate VP, HSG, Microsoft.

  • » Adopting electronic health records will cut costs - TheHill.com

    Google and Microsoft Health execs address benefits of health IT on healthcare in short article published in The Hill. Two key points: 1) focus on the patient and 2) focus on the performance improvement (”improved outcomes we want to achieve”) with health IT, not just IT for IT’s sake.

  • » Macmillan’s DynamicBooks Lets Professors Rewrite E-Textbooks - NYTimes.com

    Interesting. DyanamicBooks allow professors to customize textbooks with their own modifications. Prices will be lower for e-books, but print on demand versions will cost about the same as traditional print version. What about copyright for new version? It probably remains with Macmillan, which means professors don’t get to copyright their contributions?

  • » Obama Administration Details Healthy Food Financing Initiative

    Primarily via financing initiatives from Treasury, HHS, and Dept. of Agriculture will fund programs that improve the availability of fresh foods and more healthy alternative foods in communities that currently lack access to large grocery stores. These initiatives are closely tied to first lady Michelle Obama’s Let’s Move initiative that aims to decrease childhood obesity.

  • » The President’s Proposal puts American families and small business owners in control of their own health care. | The White House

    Obama’s healthcare proposal 2/22/10

  • » DeepDyve Offered to CalTech Alumni

    CalTech is partnering with DeepDyve to provide discounted access to DeepDyve’s article rental service to alumni. DeepDyve’s Gold plan, which allows rental access to an unlimited number of articles included in DeepDyve’s collection of scholarly journals and other literature that sits behind paywalls. I continue to be impressed with DeepDyve’s initiatives to increase access to scholarly research that has been walled off to non-academics or those who don’t have a corporate subscription to commercial collections.

  • » PatientsLikeMe Buys ReliefInsite to Help Patients Track Their Pain Online | Xconomy

    Missed this last week. PatientsLikeMe acquires ReliefInSite, based in Hungary. ReliefInSite helps patients track their pain levels; bus model relies on pharma and clinical researchers.

  • » Health Grades Inc. Q4 2009 Earnings Call Transcript — Seeking Alpha

    Transcript of Q4 2009 earnings call with Kerry Hicks and CFO Allen Dodge. Few tidbits: efforts to build risk management business line (Health Credit Solutions) have failed and Health Grades is winding down that business and focusing instead on ratings products. Advertising sales have grown nicely, esp. from AdSense and other networks. However, I still question how well the WrongDiagnosis.com product fits with HealthGrades.

  • » IMS Launches Integrated Regulatory Compliance Solution for Pharmaceutical and Medical Device Companies - MarketWatch

    IMS offers decision support service for regulatory compliance for Pharma and med device companies.

  • » Health data quality – a two-edged sword « Archetypical

    Some good points about quality of patient-reported data and implications for using data from patient community sites in research. I like the points about how some users enter dummy data just to test out a site and the importance of recognizing what data are missing. Both issues related to good data management.

  • » Ideal Medical Practices: NCQA explores patients as valuable resource for information to add to their unworkable metric set

    National Center for Quality Assurance (NCQA) paper on evolving standards for Patient-Centered Medical Home metrics.

  • » Pursuing Perfection: Raising the Bar for Health Care Performance - RWJF

    Summary of project funded by RWJF and carried out by IHI to study performance improvement initiatives in hospitals in the period 2001-2008. Link to report included.

  • » Grassley Probes WebMd Ties To Eli Lilly // Pharmalot

    Grassley questions Pharma sponsorship of content on WenMD

  • » Many seek a “just-in-time someone-like-me” but few post their own stories. | Pew Internet & American Life Project

    E-patients consult Web to find ratings on doctors and providers, but fewer post ratings themselves. Link to full report from Pew.

  • » Eclipsys posts good fourth quarter earnings, builds new EHR | Healthcare IT News

    Eclipsys beat expectations in Q4 2009, with earnings of $3.8 Million, up 15% YoY. Rev. up 5% YoY.

  • » Pharma Marketing Blog: Can Pharma Fill the HCP-to-Patient Social Media Vacuum?

    John Mack on the role Pharma can plan in providing information directly to consumers via social media.

  • » Researcher creates ‘Facebook for Scientists’ | VentureBeat

    Good overview of ResearchGATE, a social networking site for scientists that allows users to set degree of privacy and facilitates collaboration. Bus model: jobs board for scientists.

  • » Pathway Genomics Licenses Harvard Health Content for Personalized Genetic Test Reports

    Pathway Genomics, which provides genetic tests to consumers, licenses Staywell’s Harvard Health Content so that customers can access additional information about the conditions reported in the test results.

  • » Aneesh Chopra Invites You to Tell Us About Opportunities and Challenges facing HIT Implementation « Federal Advisory Committee Blog

    ONC’s Aneesh Chopra, who chairs the Implementation Workgroup, seeks feedback on how to build a starter-kit for EHR implementation. Specific categories of interest: Vocabularies; content exchange standards; communications exchange standards, and privacy.

  • » Serving the Underserved: Exchanging Information to Improve Rural Health Care | Mastering Data Management

    Story of how Louisiana has seen improvements in rural health care through implementation of health info exchange.

  • » Patient Safety and Quality: An Evidence-based Handbook for Nurses

    AHRQ

  • » Most Americans Think It’s Others Who Are Unhealthy - Yahoo! News

    Recent survey commissioned by Cleveland Clinic, GE Healthcare & Ochsner Health System indicates that 50% of Americans believe other people’s health “was going in the wrong direction” but only 17% said their own health was “going in the wrong direction”. 2000 people surveyed. Results are in line with my observations. Many people are in denial that their habits are unhealthy. Even when they get sick, they don’t believe their own health management was a factor.

  • » Rising Use of Medical Technologies Extending Americans’ Lives: MedlinePlus

    Consistent with research by Tomas Philipson, U. Chicago. Healthcare innovation and IT saves lives, but it comes with a high cost. We can keep innovating, but we can’t afford to keep paying for the innovations in the current system.

  • » CDC annual report, Health United States, 2009

    TOC and links to full report from CDC on trends in health statistics.

  • » Five Next Steps for a New National Program for Comparative-Effectiveness Research | Health Care Reform Center

    “Must read” article in NEJM on creating national program for CER.

  • » Sebelius Unveils New Report on Requested Premium Increases in States Across the Country

    HHS Secretary Kathleen Sebelius releases report that includes info on requested premium increases by health insurers across the country. Link to full report included.

  • » Contemporary Trends in Evidence-based Treatment for Acute Myocardial Infarction

    Description of study in Worcester, MA to implement evidence-based theraputic management guidelines for cardiac patients.

  • » MEDai and Shared Health(R) Partner to Offer Tennessee Robust Health Information Exchange Platform

    Shared Health Clinical Xchange, the largest HIE in Tennessee, has partnered with Elsevier’s MEDai to provide clinically-relevant HIE.

  • » Cholesterol drugs up diabetes risk slightly: study | Reuters

    Meta-analysis indicates that use of statins to control cholesterol is correlated with higher risk of type 2 diabetes.

  • » VA to study doctor’s reactions to e-alerts

    Veteran’s Admin to monitor how doctors respond to e-alerts sent via the agency’s computerized patient record system (CPRS). Currently, they only tract if doc acknowledges receipt of an alert, not whether the doc takes follow-up action.

  • » Teenagers Science Project Leads To Simple Concussion Test - Shots - Health News Blog : NPR - StumbleUpon

    Simple “hockey-puck on a stick” test easier to implement in real-world situations: “There are computer algorithms to measure reaction time, using game-like programs. But they’re not so good for use at the sidelines, and they involve licensing fees.”

  • » Health Care Reform and Comparative Effectiveness: Implications for Surgeons — Urbach and Morris 145 (2): 120 — Arch Surg
  • » Data-Driven, Patient-Centered Health Care: A #WhyPM Video | e-Patients.net

    Excellent presentation of text/audio content–and the info provided is excellent, too. Good points about data alone not being sufficient; data must be put in context and must be shared to be helpful. Read Susannah Fox’s comment to learn more about the people behind the voices in the video.

  • » NaviNet Multi-Payer Portal Selected for Initiative to Increase Healthcare Efficiencies and Reduce Costs | Business Wire

    NaviNet chosen as communications network in pilot intended to document benefits of provider-payer health info exchange in NJ.

  • » Mind Hacks: The draft of the new ‘psychiatric bible’ is published

    Fascinating overview of changes to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)currently in draft form. Along with the info about specific disorders, I find the new approach toward categorizing disorders along a spectrum of severity very interesting. The degree to which someone has a disorder is considered, rather than placing each level of severity in a separate category. Aspergers as part of the autism spectrum is the example that is getting a lot of press.

  • » Advertising - G.E. Ad Campaign Aims to Put a Human Face on Its Role in Health Care - NYTimes.com

    GE producing TV ads for Healthymagination campaign during Olympics. Also sponsoring content online. Good to see someone beside Pharma sponsoring content!

  • » Beyond Meaningful Use

    Excellent lead article on need for automated data input (from devices, exchange from other systems, etc), better clinical decision support systems, and process change to make use of EHRs “meaningful” in improving health care.

  • » DeepDyve Does It Again: Fascinating Developments in Scholarly Publishing and Scientific Communication « Significant Science

    Hope Leman’s long, but very entertaining, comments about DeepDyve’s specialty search and article rental model for scholarly journals articles. Access to much of the scholarly journal content isn’t available to non-subscribers and even discovering the existence of this body of content is difficult, which means the publishers are not reaching growth markets. DeepDyve offers a solution with minimal risk to publishers, yet the buzz for DD hasn’t grown as much as Hope (or I) would have expected. Worth reading — and it’s worth checking out DeepDyve.

  •  

    Headline Commentary Feb 1 - Feb 13

  • » HealthLeaders Interstudy offers PatientFinder Healthcare Analytics Tool to Pharma

    PatientFinder, which estimates # of insured patients in region that have specific diseases but are untreated, to be offered by HealthLeaders Interstudy. 

  • The Health Care Blog: Rating or Narrating, that is the question.

    Denise Silber writes about provider ratings sites in Europe (France and UK) and how the survey-based rating sites differ from the “narrative” sites that allow patients to describe their experience in their own words. Combination would be better, wouldn’t it?

  • » KLAS questions vendor claims on HIEs | Healthcare IT News

    KLAS on current state of HIEs–vendors “pass around packets of information without necessarily taking ownership of what is in the packet”.

  • » PatientsLikeMe Growing as Pharma Customers Boost Focus on Patients | Xconomy

    Xconomy on PatientsLikeMe, the Cambridge-based patient community site that leads in this space in collecting data. Also mentions Keas and its recent deal with Pfizer.

  • » Microsoft e-health research taps Xbox, mobile phones ( - Software - Industry Verticals )

    More on MSFT MyLife health project that utilizes Windows mobile phones to capture and transmit health-related data. Talks about accelerometers in phones and how they could be used to monitor movement.

  • » Microsoft looks at health potential of Xbox, apps | Health Tech - CNET News

    MSFT research at conference in Beijing talks about using XBox as part of a total health care system. Also refers to MSFT MyLife for Windows mobile phones, which uses mobile phones to capture and transmit data relevant to a EHR/PHR.

  • » The opportunity in B2B social media » 16th letter » Blog Archive

    Melissa Chang comments on projections from AMR Research on increased spending by B2B marketers on social media and questions where the projected 21% growth in social media spend will be focused. Note, lead-gen sites marketing is projected to increase 17% and online directories -2%.

  • » Press Releases | Pfizer: the world’s largest research-based pharmaceutical company

    Interesting. Pfizer in alliance with Keas to enable health & wellness experts to produce and distribute online care plans directly to patients. My take: Pfizer and other pharma companies already subsidize the publication of a great deal of health care information. With this deal, they’re extending their reach into new channels.

  • » Procter & Gamble buys full stake in MDVIP - Business Courier of Cincinnati:

    P&G completes its acq. of MDVIP, a concierge medical practice based in Boca Raton, FL.

  • » CenterWatch: Content Feeds on Clinical Trials

    Nice. CenterWatch now provides feeds by therapeutic area, disease category, FDA approved drugs and more that can be added to a website–for Free!

  • » HealthBlawg: Medical Apologies: Do right and do well

    David Harlow’s insightful commentary on why medical apologies–accompanied by a commitment to investigate root cause–may reduce malpractice suits. And could lead to performance improvement, too….

  • » PatientSafe Solutions - Gets new funding

    Patient Safety and workflow solutions company raises $30M led by TPG Biotechnology Partners.

  • » Decisions, Decisions - Can Financial planning learn from healthcare?

    Why communicating absolute vs. relative probabilities is important in healthcare–and in fin’l planning.

  • » More on Calculators: Harvard Does the Math | The Decision Tree

    Harvard Med School’s Laboratory for Quantitative Medicine has created personalized risk assessment tools based on “binary biology”. Interesting.

  • » The Health Care Blog: Why Calculators Are the Future of Healthcare

    Thomas Goetz on nomograms, or clinical decision tools, that help calculate risk of specific diseases on a personalized basis.

  • » Weighing in on Amazon/Macmillan Pricing Debate « Pakman’s Blog: Disruption

    Really good analysis and commentary about ebook pricing and the recent controversy between Macmillan and Amazon about books on Kindle prices. I agree with author that the market should determine the value of the content. Market structure in book publishing industry inhibits market forces to apply. I like 4th paragraph that addresses fact that not all song tracks–or all books–have same value, so why are they priced nearly the same? In book publishing, the bizarre returns policy does provide mechanism to sell less popular books for very low prices, but authors receive no royalties. I also agree that far more ebooks would sell if prices were lower.

  • » Patient 2.0 empowers patients, worries doctors : Covering Health

    Good review of recent Time article, Patients 2.0, and differing attitudes about the effectiveness of patient-reported data in medical research. Article points to concern on part of doctors of reliability of patient-reported outcomes data. My view: methods need to be developed for incorporating patient-reported or patient-recorded outcomes data into medical research methods, but these data are too important to ignore!

  • » FDA’s issues guidance on Bayesian statistical methods in medical device clinical trials

    Very cool. FDA allows Bayesian analysis for studies of effectiveness in medical device clinical trials. Bayesian analysis allows use of results from previous studies to serve as prior distribution and may allow for results from smaller or shorter new studies to provide sufficient evidence of effectiveness.

  • » Patient Driven Research

    Or outcomes-based research. By Gilles Frydman, founder of ACOR.org and co-founder of e-Patients.net, a pioneer in participatory medicine. Good introduction to potential benefits of PDR and the need for guidelines on how to conduct PDR, since no accepted structure and review processes currently exist.

  • » Medicare and Medical Technology — The Growing Demand for Relevant Outcomes | Health Care Reform Center

    Article describes how CMS is becoming more specific in requiring proof that treatments produce improved outcomes, not just evidence of their safety and short-term efficacy.

  • » Have a Medical Question? Text a Group of Doctors - Bits Blog - NYTimes.com

    Start-up, Truth on Call, offers system for posing questions via Twitter to a group of doctors, for $10 per response. Target audience is fin’l, pharma, research, but will be offered to patients, too.

  • » http://www.jnj.com/connect/caring/patient-stories/reaching-moms-one-text-at-a-time/

    More on the Text4baby partnership btwn HHS, other fed agencies, industry (Pharma, telecom carriers) and insurance plans.

  • » HHS Coordinates Program to send Health Reminders via Text to Pregnant Women

    Text4baby is a program managed by HHS that includes mobile telecom carriers, federal agencies, insurance plans and other healthcare industry reps. 3,400 women have signed up so far.

  • » Doctor and Patient - When the Patient Can’t Afford the Care - NYTimes.com

    Important points about need for care providers to understand the effect of healthcare costs on patients who can’t afford expensive treatments. Cost factors must be considered when addressing compliance issues.

  • » Pending lab tests are not in hospitalist discharge summaries | KevinMD.com

    Article states that pending lab tests are only included on hospitalist discharge summaries 16% of the time. Incredible. Follow-up visits aren’t very useful when docs don’t even know what to check. Inadequate discharge summaries are core problem. IT systems that don’t communicate are equally critical problem.

  • » A Doctor’s Take on Participatory Medicine, Health IT and the E-Patient: A Talk With Daniel Sands of Cisco Systems « Significant Science

    Hope Leman hits one out of the park with a fantastic interview with Danny Sands, MD at BIDMC and well-known in participatory medicine circle (also e-Patient Dave’s doctor).

  • » Harvard-Based Crowdsource Project Seeks New Diabetes Answers — & Questions | Epicenter | Wired.com

    Rewards for posing good questions and providing best answers about Diabetes 1. Program sponsored by Harvard Clinical and Translational Science Center and uses the InnoCentive platform to manage the competition/collaboration.

  • » Wolters Kluwer Health Unveils Facts & Comparisons® eAnswers Drug Information Reference | Press Releases @ Your Story

    WK Health updates Facts& Comparisons and rebrands it as (drumroll please…) Facts & Comparisons eAnswers. Drug info resource.

  • » A special report on social networking: A world of connections | The Economist

    Good overview of why social networking sites are flourishing. I like comments about how sites are more welcoming now and how sites serve as tools for users–not just discussion boards. LinkedIn is great example. Same applies to patient communities and PatientsLikeMe and CareTogether are good examples of increased utility of online communities.

  • » The End of a Paper That Linked Autism to a Vaccine - Health Blog - WSJ

    Astonishing. I finally read more details of the retraction and the original study. Only 12 children were studied and they were paid 5 pounds each to give blood at a child’s birthday party. Researcher had claimed that they were all referred to physicians, which was not true. Parents who suspected link helped raise funds for the researcher via their lawyers. So, Lancet finally retracts article, but what about the 10-years worth of fallout from the falsified research that has rippled across official and unofficial research sites and commentary on the Web?

  • » The Twitter Train Has Left the Station - Bits Blog - NYTimes.com

    Nice counter to Twitter naysayers who address only the downside of Twitter (time sink) — without ever having used it. Writer emphasizes how critical Twitter is to the online news business for generating links and being part of the conversation.

  • » Google Pours “Incredible” Computing Power into Antibody Drug Discovery With Adimab | Xconomy

    Google Ventures has invested in Adimab, a New Hampshire biopharma company and is providing computing power to handle the heavy lifting of computer search work of matching candidate antibodies and targets to speed up the current process used by most biopharma labs.

  • » IBM to Acquire Initiate Systems — ARMONK, N.Y., Feb. 3 /PRNewswire-FirstCall/ –

    Initiate Systems, a master data management company that specializes in healthcare data, is acquired by IBM. Initiate clients include payers, providers, and PBMs. Terms not disclosed; Initiate had raised over $67M in VC funding from Apex Venture Partners, First Analysis Group, Sigma Partners, BC/BS Venture Partners and Paladin Capital.

  • » DeepDyve Continues To Add Sources at Rapid Rate

    DeepDyve, the specialty search service with features that simplify finding related information, adds 6 new publishing partners. ACM, AIP, MIT Press, and UC Press among them. All 6 will join the DeepDyve article rental system that was introduced last year, which allows users access to premium subscription content for $0.99 per article (with volume discounts). More details in press release.

  • » Guerra On Healthcare: Meaningful Objections To Meaningful Use — Meaningful Use — InformationWeek

    Anthony Guerra provides commentary on inadequacies of MU guidelines and reimbursement requirements.

  • » Getting Personal - Personalized Medicine getting closer

    Good article that describes how quickly move toward personalized medicine–based on an individual’s genetic data–is occurring.

  • » U.S. Healthy Eating Trends Part 5: Nielsen Healthy Eating Index Debuts | Nielsen Wire

    Good idea, but it looks as though Nielsen chooses healthy foods based on manufacturer claims.

  • » » Rudiments of EBM concepts for librarians The Search Principle blog

    Cute: a Jeopardy quiz for the rudiments of EBM for medical librarians.

  • » Wait another year for patient safety data, GAO says — Federal Computer Week

    Patient Safety Act of 2005 scheduled to yield database in 2011. 65 Patient Safety Organizations have been set up, but few are collecting data yet. No plans set to collect from other providers beyond hospitals.

  • » HealthTrans, a Pharmacy Benefit Manager, Completes a Private Equity Financing | Business Wire

    ABRY provides funding to HealthTrans to support organic growth and acquisitions.

  • » Glam Media On A Roll: Raises $50 Million In Private Equity At $750 Million Valuation

    Wow! Glam raises another $50 M at a rumored valuation of $750M. Glam is an ad network with focus on health & beauty sites. Many of the sites tend toward the trashy end of beauty sites, not reputable healthcare info. See comments. Notwithstanding previous 2 sentences, Glam sure is good at fundraising!

  • » The Problem with the Data-Information-Knowledge-Wisdom Hierarchy - The Conversation - Harvard Business Review

    David Weinberger on flaws in the data-information-knowledge-wisdom hierarchy model. Hierarchy is too limited–one way progression, when gaining knowledge is more of a system that requires observation, hypothesis building, and testing.

  • » Patients Value Personal Recommendation Over Online Doctor Ratings - Better Health

    Comments about online sites that offer ratings of doctors. Points out weaknesses of current info, esp. fact that ratings aren’t based on outcomes. Hints at other problems: most patients choose docs based on info from referring physician. Docs in network are critical. I’d add: trustworthiness of online ratings sites is not clear.

  • » BBC News - Journal stem cell work ‘blocked’

    Long article that provides some evidence that breakthrough research is not getting sufficient coverage in top journals. Theory is that peer reviewers are protecting their own group and making it too difficult for innovative researchers to break through. I think there’s some credibility to the theory that innovations are more likely to occur outside of the traditional circles of scholarly publishing, since researchers are increasingly making source data available. New metrics that incorporate real-time online measures are needed.

  • » Calculating the Risks of Surgery - WSJ.com

    The main article (see previous entry) about risk calculators to help surgeions communicate risks of surgery to patients.

  • » Why Don’t More Hospitals Calculate the Risks of Surgery? - Health Blog - WSJ

    Addresses issue of why hospitals don’t track and use data to help them reduce risk in surgery. Mentions NSQUIP from ACS.

  • » eCliniqua Healogica to Exit Difficult Market for Online Trial Matchmakers

    Healogica, a site that connects potential candidates to clinical trials to shut down. They had about 2,000 registered users but couldn’t get enough CROs and pharma companies to pay for access to the leads they generated.

  • » iChange Names Stuart MacFarlane as CEO | Business Wire

    Social networking for weight loss site, iChange, gets funding from Momentum Venture Managment(MVM) and names MVM principal Stuart MacFarlane CEO. MacFarlane fmly of Insider Pages.

  • » Graphic display of Tweets by Disease/condition

    Great display of information on # tweets by disease type/condition.

  • » How e-prescribing stops doctor shopping | ZDNet Healthcare | ZDNet.com

    Good description of how the use of e-prescribing systems (in this case Kryptic) can alert doctors & pharmacists of “doctor shoppers” who go from doctor to doctor to get multiple prescriptions for pain medications and other drugs.

  • » Promoting Healthy Skepticism in the News: Helping Journalists Get It Right — Woloshin et al. 101 (23): 1596 — JNCI Journal of the National Cancer Institute

    Excellent article that proposes ways to improve how medical research is communicated by consumer media. In lecture I gave last week at Simmons College School of Health Sciences, I emphasized the importance of communicating medical research and other healthcare information clearly, especially risk information.

  • » Physician Wellness Services targets burned out/problem docs : MedCity News

    Reports on programs that provide behavioral counseling to MDs that have depression, substance abuse and stress problems.

  •  

    Headline Commentary Jan 23-Jan 31

  • » Endeca founders steering search firm toward ‘business intelligence’ market - The Boston Globe

    Good article on Endeca, a widely used search engine on shopping sites. Endeca’s “guided navigation” (also referred to as “faceted search”) works very well on structured information. Could it be adapted for less-formally structured info?

  • » McKesson and HP to Help Physician Practices Speed Electronic Health Record Adoption for Better, Safer Patient Care

    McKesson & HP partner to provide EHR s/w and hardware for physician practices.

  • » Workplace Wellness Programs

    Article questions the role of employers in sponsoring wellness programs that tie participation to financial incentives such as reduced premiums.

  • » New Smartphone Application Rewards Physicians with CME Credit for Online Medical Research

    Interesting. Wolters Kluwer has set up a system whereby doctors will receive CME credit for clinical research done via their mobile phone.

  • » Patients 2.0 - Time on e-Patient Movement

    Time covers e-Patient Dave’s story and writes about e-patient movement under the moniker “patient 2.0″. Provides a somewhat jaded view of non-medical specialist patients’ ability to understand medical info and make judgements. Suggests “rapid-learning” program for e-patients.

  • » Update: Siemens Brings HealthVault to Europe « Chilmark Research

    Very thorough review of MSFT-Siemens deal to introduce MS HealthVault to German market and make it the system through which patients are provided medical info. HL7 is more widely used in Europe and Infobutton apps will likely catch on more quickly.

  • » Elsevier incorporates additional citation metrics into Scopus

    Els adds SNIP and SJR to Scopus to provide more complete citation metrics.

  • » Doctors Question Ads on Health Web Site

    Julie Deardorff of Chicago Tribune writes about my recent blog on the AAFP’s FamilyDoctor.org site’s advertising high salt foods. Quotes me, AAFP VP Publishing, and Dr. John Spangler.

  • » Learning to Love Healthcare Spending?

    Prof. Robert Fogel, U. Chicago, contends that healthcare costs are high because consumers demand the high-cost extras and innovation.

  • » ONC Reconsiders National Health Data Exchange

    Good interview with David Blumenthal, Director, ONC, on meaningful use of EHRs and plans for national health data exchange.

  • » Breakout of Grant Programs from ONC

    John Halamka’s brief description of the breakout of grant funding plans by ONC.

  • » Whole Foods Employees to Get Deeper Discount If They Meet Health Incentives

    Whole Foods to offer up to an additional 10% discount for employees who meet wellness measures that include nicotine use, cholesteral, and BMI targets.

  • » Healthcare System: Biggest Market for Apple’s Tablet?

    good piece on why healthcare sector could be big market for Apple’s forthcoming tablet. The fact that iPhones are popular among MDs is one big reason.

  • » Publishers Flirt With Amazon Kindle Despite Business Model …

    Good short piece on why publishers are distributing content via Kindles even though there are business considerations.

  • » Elsevier submission to Office of Science and Technology Policy public …

    Filing to Office of Science and Technology Policy from Elsevier regarding proposed regulations to offer more open access to scholarly publishing that is funded by US tax dollars.

  • » Checklists and Decision Trees Vs. Spontaneity and Imagination

    Kent Bottles brings together topics from current books by Atul Gawande, Timothy Goetz, and an article by Jerome Groopman to consider the merits of checklists and use of decision trees in medicine. He also covers behavioral economics and choice and mentions the Thaler-Sunstein approach to offering nudges (libertarian paternalism) to guide healthful behavior. Conclusion: medicine and health are complicated. Seems to me that since computers are useful for dealing with complex calculations (even under stress) that it makes sense to use automated checklists and decision support systems to guide complex processes. Provided we can avoid GIGO (garbage in, garbage out) situations.

  • » Thomson Reuters Acquires ProfSoft

    Thomson Healthcare acquires ProfSoft-Health, a Needham, MA-based healthcare data analytics company. ““ProfSoft’s solutions will enhance the clinical performance measurement capabilities we provide to our healthcare payer customers,” said Jon Newpol, executive vice president of the Healthcare & Science business of Thomson Reuters.”

  • » Conde Nast looks for new ways to leverage its brands

    Interesting article on how Conde Nast is seeking to leverage brand value of Gourmet, Domino, and Cookie (defunct magazines) as well as current titles Wired and Lucky. Compares CN to Meredith, whose Better Homes & Gardens has used its brand to provide quality seals to products. CN-selected content (tested by Gourmet kitchens?) is one idea they should consider, IMO.

  • » Health Business Blog ” Blog Archive ” Podcast interview with Dr. Robert …

    David Williams interviews Bob Wachter of UCSF. Haven’t listened to it yet, but I have no doubt that it is a worthwhile use of time.

  • » DTC Device Marketing Meets Social Media

    IUD manufacturer, Mirena (part of Bayer Pharmaceutical) has been using home parties, a la Tupperware, to spread word about benefits of Mirena IUD. FDC has sent warning letter to Bayer.

  • » Felix Salmon on NYTimes paywall plans

    Good analysis of what the implications are of NY Times stated plans to allow inbound links to have access for free, but to charge metered access to direct users after an initial allotment of free pageviews.

  • » Everyday Health files for $100M IPO

    Everyday Health, the consumer health portal owned by Waterfront Media, files for $100M IPO. Positive sign for consumer health publishers. Everyday is one of the largest consumer health portals that relies on online advertising for most of its revenue.

  • » Doctor Quits Brigham to Speak for Pay

    Brigham and Women’s and Harvard Med School Professor Lawrence DeBuske decides to keep paid speaking role and gives up practicing & teaching. New limitations on accepting pay for for delivering canned presentations played role. Dr. DeBuske apparently gives several talks on behalf of multiple pharma companies each week.

  • » Feature: The Power and Potential of Personal Health Records - RWJF

    Home page of Jan 2010 report from RWJF on PHRs.

  • » eHealth ” John W. Sharp on eHealth and Health IT ” Major Robert Wood …

    John Sharp’s overview of Robt Wood Johnson Foundation’s new report on PHRs.

  • » ZocDoc Launches in San Francisco

    ZocDoc, a online directory of doctors that has focused on NY and DC, is expanding to cover SF. Note, a key differentiator of ZocDoc (from the slew of other doctor ratings sites) is its integration with practice management systems for scheduling appointments so that users can find doctors with available appts. ZocDoc says they have integrated with close to 1400 PMS companies. Note, ZocDoc also encourages patient reviews of doctors, but only from ZocDoc users. Reviews of doctors remains a sticky wicket for all of the doc review sites.

  • » Why Dr. Vanier’s Appointment as CEO of Navigenics is Good Thing

    Commentary on why it is a positive sign that an MD is now leading Navigenics, a personalized genomics company.

  • » Health Sites - Some Are More Equal Than Others

    Susannah Fox from Pew Internet started the conversation with her post about Google Health OneBox that lists results from Mayo Clinic, WebMD, ADAM, and MedlinePlus in a special position at top of search results. Great discussion in the comments ensued, including a couple from me.

  • » Twitter awareness/engagement ratio: a pillory or a pedestal for pharma …

    Andrew Spong’s analysis of Twitter followers/followings of pharma companies.

  • » Maryland Hospital Adopts MedeAnalytics Performace Improvement Solution

    Brief article describing MedeAnalytics revenue cycle management solution being adopted by St. Joseph’s Hospital in Maryland.

  • » Obama Admin posting new sources of gov data including Medicare data

    Great news for data geeks and data content enthusiasts! Following up on their promise to add transparency to the federal government, Obama admin posts new data sources from all cabinet departments. I’m going to go download the Medicare data set now.

  • » BBC News - Tim Berners-Lee unveils government data project

    Info on work Tim Berners-Lee is doing for UK govenment to make sources of gov’t data more available and meaningful.

  • » Quantros Hires International Bus Dev VP

    “Syed Tirmizi, MD, a longtime clinician and medical informatics leader at the US Department of Veterans Affairs, joined Quantros today as Vice President of International Business Development and Government Relations. Tirmizi helped lead the VA into its position as a pioneer in the use of electronic medical records (EMR) for point of care service delivery, enabling meaningful use of data to further patient safety and quality initiatives.”

  • » Pfizer nearly doubles amount spent on e-detailing

    “Pfizer increased its spending on online professional promotion by more than 90% last year, according to a study, a sign the drugmaker is emphasizing alternatives to live sales reps for detailing certain products.” Study by SDI.

  • » NEJM article on benefits of salt reduction in cardiovascular disease

    TOC and abstract of just published study on significant benefits of reducing sodium intake for improving cardiovascular disease. See my notes in item below (third item) on same subject.

  •  

    Headline Commentary Dec 14-31

  • » Lebhar-Friedman sells Healthcare Pubs to Quandrant Health

    Quadrant HealthCom, publisher of The Female Patient, announced Tuesday that it has acquired Dowden Professional Publications from Lebhar-Friedman.With the deal, Quadrant takes control of four medical journals and an events group. The journals are: OBG Management, Current Psychiatry, The Journal of Family Practice and Mayo Clinic Proceedings. Financial terms of the deal were not disclosed.

  • » Personalized Medicine is About Data

    Thomas Goetz, exec editor of Wired, on why personalized medicine is really about personal data.

  • » Tracking Vital Signs with a SmartPhone

    Mentions Polka, an iPhone app, that allows remote monitoring.

  • » Interview with John Gomez of Eclipsys

    Really good interview, where Gomez talks frankly about outdated tech in hospitals/health IT (e.g., MUMPS) and talks about making CPOE easier to reap benefits of healthcare data-analytics.

  • » iGuard.org drug safety system registers 2 million users

    From press release: “iGuard is a free, personal drug safety monitoring service that now provides 2 million consumers and caregivers with timely, personalized information about drug-drug interactions, drug-disease interactions, medication safety warnings, breaking safety news and medication recalls that may affect their health. In return, patients provide feedback on their medications to help researchers learn how to treat diseases better and minimize medication side effects. In 2009 alone, iGuard users have contributed toward 92 medical research studies – helping to develop new drugs for such diseases as multiple sclerosis, epilepsy and diabetes.”

  • » HealthGrades (HGRD) Provides 2010 Guidance

    HealthGrades announces new org structure and provides improved guidance for 2010. I just have to add that this may be the most poorly written press release I have ever seen.

  • » Healthy Humans Receives 2009 Life Sciences Start-up Company of Year from Eastern Technology Council

    Healthy Humans (www.healthyhumans.com), an online wellness solutions company, received the 2009 Life Sciences Startup Company of the Year award from the Eastern Technology Council. The award, sponsored by the University of Sciences in Philadelphia, recognizes the company’s business and technology achievements. Healthy Humans provides online wellness programs that address the underlying causes of chronic disease and encourage prevention through personalized solutions and self-care methodologies. The company’s proprietary portal technology combines state-of-the-art medical protocols with evidence-based therapies. Note, Healthy Humans was highlighted as a Health Content08 Innovator at our HC08 conference.

  • » CVS names Per Lofberg CEO of PBM Unit

    CVS’ underperforming PBM unit names Lofberg new CEO. Lofberg is currently CEO of Generation Health, a genetic PBM.

  • » Cerner acquisition to expand its employer health centers | Healthcare …

    Cerner acquires IMC Health Care, a provider of on-site health clinics for employers. Cerner established its own subsidiary to handle its self-insured and health & wellness needs. With acq. of IMC, Cerner is expanding to serve other self-insured employers.

  • » Scholars Seek Better Metrics

    Choronicle of Higher Ed describes some alternatives to impact factors. I agree that empirical data should be used in measuring importance, but a single # is not likely to be sufficient. Wouldn’t that strengthen the “Britney effect”?

  • » Consumer Healthcare trends from PWC

    Jane Sarasohn-Kahn on PWC’s new report on 10 top trends in healthcare in 2010. Link to full report included.

  • » Are Medical Conferences Becoming Obsolete?

    At least one doctor thinks they are. Dr. Wes Fisher writes that the rise of social media and the cost of travel (and reduction of sponsorship by pharma and device companies) spells the end of the medical conference business. I think he’s right that there will be a reduction in live events, but I don’t expect them to disappear.

  • » RFA-HS-10-005: ARRA-AHRQ Recovery Act 2009 Limited Competition …

    More on HHS grant for designing db for comparative effective research.

  • » HHS to Build Comprehensive Claims Database to Support CER

    HHS has an RFP for study on how to build claims db that will include payer records beyond CMS data. DB will be used for comparative effectiveness research (CER).

  • » The Ebook Reader site

    Nice comparison table of existing e-book readers.

  • » Thomson Reuters Healthcare Gets in the HIE Game

    Health Data Management reports that Thomson Reuters Healthcare (Ann Arbor) is entering the HIE market with a data analytics platform.

  • » Electronic Laboratory Notebooks Enter Mainstream Informatics

    Good article that describes how electronic laboratory notebooks (ELN) could become the foundation for effective data management in R&D enterprises.

  • » KLAS Releases 20 Best Software Vendors for 2009 (Healthcare)

    Healthcare IT News briefly reviews the top 20 list from KLAS.

  • » Pfizer Adds New Type of Tablet to Sales Calls - WSJ.com

    Pfizer is equipping detailers with tablet computers that limit what samples can be provided to physicians based on their specialty and record the amount and type of samples. Doctors have to sign for receipt. It’s astonishing that sampels given to doctors in the past were not recorded!

  • » AdWeek Names Nike Fit Digital Campaign of the Decade

    A must-read for every publisher to gain an understanding of the convergence of publishing, marketing/advertising and the blurring of the roles between publishers and vendors. Nike’s online campaign was much more than advertising, it included tools for fitness programs and for exchanging data. Or as AdWeek says, “a product experience”. Traditional publications and ads can’t deliver a “product experience” in print of online.

  • » A.D.A.M. Launches Consumer Site for Medical Images

    A.D.A.M., long-known for its collection of anatomy images for medical education, launches an e-commerce enabled website that sells individual images. Prices seem to depend on the image and use. An graphic with multiple images related to carpal tunnel is priced at $39.95 for use in PPT; a simple image of the eye related to radial keratomy appears to be free, but site asked user to indicate how the image will be used.

  • » Top analyst blogs ” Technobabble 2.0

    Health Content Advisors ranks #136 out of 400 top blogs on IT. Interesting that my writings about health content, which is inextricably connected to health IT, rates so highly. It’s an honor to be placed in the immediate neighborhood of top analysts from top IT research firms, considering that my blog is secondary to the consulting work I do. Must be my analytical nature!

  • » LWW partners with ProtoMED to Build Student Version of PMS and RCM Solutions

    Very interesting. “December 14, 2009 — Lippincott Williams & Wilkins (LWW), a leading international publisher for healthcare professionals and students, and part of Wolters Kluwer Health, has partnered with ProtoMED Medical Management Corporation (PMMC) to build a student version of its ProtoMED medical practice management software and its ProtoCHART electronic medical record (EMR) software.”

  • » Nobel Laureate Paul Samuelson, Eminent Economist, Dead at 94

    Nice tribute to Paul Samuelson in the Boston Globe. Samuelson taught at MIT since 1940 and every student of economics has been touched by Dr. Samuelson. I honor him as a fellow U. Chicago alum, but also for negotiating one of the best textbook contracts ever.

  • » Legal Battle over E-Book Rights to Older Books

    NY Times highlights the conundrum of Wm Styron’s estate where Random House and Styron’s family both claim ownership of e-book rights. I was involved in licensing books for an early e-book reader (SoftBook Press) in the late ’90s and met with all of the major NY & Boston publishing houses, including Random House. At that time, the majority of recent contracts with authors included incomplete clauses that essentially wrote that the publisher had rights to new electronic formats for the content licensed in the contract with terms to be negotiated. It was a terrible situation where rights were tied up but terms and conditions weren’t defined. It seems as though these same publishers have done very little in the past decade to update the terms of contracts that existed at that time, at least with terms that are fair to authors. As in the B2B publishing world,B2C publishers (and authors and agents) have to recognize that the digital version of the work is now the primary work.

  •  

    Headline Commentary Dec 6-13

  • » Patient Satisfaction Surveys, Patient Experience | PatientImpact

    Press Ganey acquires Patient Impact, announced 12/6/09. Patient Impact to become the unit specializing in physician practice & outpatient surveys. More details to come. Note, Patient Impact was a Health Content Innovator and presented at our Health Content08 conference: http://www.infocommercegroup.com/healthcontent/index.html

  • » Gary Schwitzer on how TV news over-promotes medical research via teasers

    Headline says it all. Gary dissects an actual memo used with TV journalists that promotes tying recent medical research to exaggerated claims of short-term benefits–and the specifically recommends against mentioning research labs or clinical work.

  • » IOM report on Redesigning Continuting Education in Health Professions

    No doubt CME needs a redesign to change the current heavy subsidies by Pharma.

  • » MIT’s Media Lab elevates transparency

    Article on the new building extension of MIT’s media lab designed by Japanese architect Fumihiko Maki. Contrasts Maki’s style of open space with lots of glass to original IM Pei buildling with limited windows. Interesting metaphor for move of technology from “black box” to enabling and thriving on “transparency”.

  • » New cancer treatment costs $30,000 a month

    Article questions the affordability of new cancer drug, Folotyn, produced by Allos Therapeutics. Allos says price is in line with other specialty treatments and so far health insurers have agreed to cover it to treat aggressive tumors. Shines light on problem of high cost of developing drugs, but doesn’t offer any solutions.

  • » The arrogance of preventive medicine — Sackett 167 (4): 363 …

    An indictment of doctors and drug companies that promote drug interventions for preventive care. Uses example of hormone drug replacement for women.

  • » A Guide to Magazines That Have Ceased Publication - Advertising Age …

    Ad Age lists top magazines that have ceased publishing in 2009.

  • » Drug Industry Spends $20B/yr on Marketing

    References CBO study (with link) that describes the allocation of marketing $$ to detailing, CME support, DTC and a measly $400 M in professional journals. Journals publishers need to reinvent themselves as a vehicle for reaching doctors/clinicians.

  • » Breast Cancer Screening: Research and Guidelines - HealthLibrary

    EBSCO’s DynaMed write-up on breast cancer screening. I don’t find their analysis and coverage very helpful.

  • » December 2009 conference: Partnering For Cures; int with Michael Milken

    Conversation between Milken and Pfizer CEO Kindler

  • » Medical Device Companies Slow to Adopt Social Media

    Reports of small survey of device manufacturers; results show that social media isn’t yet part of the marketing mix for device companies.

  • » Microsoft announces Amalga and HealthVault adopted by Golden Living

    John Moore writes a brief post about MSFT’s announcement of long-term care provider Golden Living’s adoption of Amalga & HealthVault.

  • » ICD-10 a Win for Physicians, Care Management, and Patient-centered Medical Home

    Some commentary on benefits of move to ICD10 codes.

  • » CBI, an Advanstar healthcare conference, announces Mark McClellan as keynoter

    McClellan, former CMS adminstrator, MD, and PhD economist, will keynote Advanstar’s Center for Business Intelligence (CBI)’s Annual Strategic Medicare Policy Summit.

  • » Pharma’s missed opportunity: phone apps

    Good overview with links to other stories about Pharma’s slowness in developing mobile apps.

  • » Wolters’ subscription renewals resilient | Industry Summits | Reuters

    Nancy McKinstry interview: journals renewals are strong even with price increases; hospitals are spending more capital in 2009 than 2008 in anticipation of ARRA funds to come in 2010.

  • » Some company called ebizMBA lists 20 most popular online health info sites

    Note, this is the first I’ve heard of ebizMBA, who writes on their site that ebizMBA is “an eBusiness knowledgebase that helps you find the webs best ansers to your online business questions on topics ranging from online marketing and analytics to website development and venture capital”. To their credit, they offer some indication of the parameters they use to measure popularity.

  • » Humana expands its relationship with CVS MinuteClinic

    Humana will establish MinuteClinic for its own employees and will encourage all members to use MinuteClinic for basic screening tests for cholesterol, blood pressure, bmi–and will couple basic screenings with its own LifeSynch health coaching.

  • » Ovid announces Universal Search

    Ovid to announce Universal Search, which allows clients to search across Ovid and client’s other internal databases in single search. Nice development.

  • » Consumer Aggregator Panel from Health 2.0 2009

    WebMD, HealthVault (MSFT) and GoogleHealth comprise the panel moderated by Jane Sarasohn-Kahn. About 50 minutes long. Worth a look.

  • » Informa Backs Off From Springer Bid

    Not surprising to hear that Informa has decided against going forward with bid for Springer. Debt levels of Springer make the deal hard to digest and current Springer owners PE firms Candover and Cinven want a sale to conclude quickly. If PE company acquires Springer, perhaps they would sell off pieces.

  • » Gartner/AMR Deal and the Future of Indusry Analyst Research

    Very good analysis of trends in IT research. Essentially says that high priced IT research reports are becoming commoditized and used for lead gen that is paid for by vendors. Analysts can still make money consulting, firms can put on events, and carry out customized research. Totally in line with my writings and demonstrated in the content value pyramid in my Publishing for e-Patients preso (on Slideshare/janicemc). Like comment about individual analysts becoming branded more so than firms. Agree there, too.

  • » VC Investments in Healthcare outpace IT for First Time

    Dow Jones Venturesource reports Q2 2009 VC investments by industry. Healthcare the best performer and it outpaces IT for first time on record.

  • » David Eddy Lecture on Future of Evidence-Based Medicine at ICSI

    Kent Bottles provides excellent summary of recent lecture by David Eddy, MD (the “founder” of EBM) who has consistently challenged the robustness of existing methods of clinical decision guidelines. Dr. Eddy believes the future requires more complex models that consider a larger number of factors and interactions that in effect provide more personalized medical treatment. Eddy’s own company, Archimedes, builds “virtual patients” that can be used for complex modeling of probable outcomes. I don’t know enough about Archimedes to judge its efficacy, but I think Eddy has the right approach. We know that more data are available about patients and outcomes and will accelerating adoption of EHRs, the amount of data will expand rapidly. Along with the improved data sources, there is clearly a need for more complex models to analyze the data and test the benefits of medical treatments.

  • » Healthcare Reform’s Impact on Pharma Sales

    Good article with data and charts on changes in pharma sales & marketing over time and expected effects of health reform on pharma sales techniques.

  • » Guide to Health Savings Accounts

    Comprehensive article on HSAs and high-deductible health plans.

  • » amednews: Do EMRs cut liability risk? Insurers want evidence before …

    Perspective on whether use of EMRs reduce liability for physicians. Focuses on discounts offered by insurance cos to doctors and practices that use EMRs.

  • » Henry Schein and Butler Animal Health to Merge

    Schein will merge its animal health business with Butler; Schein to own 50.1%.

  • » Elsevier relaunches Embase

    Press releases doesn’t provide many details; I will look at Elsevier site soon. Embase is an index to biomedical research; relaunching as standalone product seems old-world.

  • » Shopping for Healthcare - NY times

    Good article that mentiones pricedoc.com, healthcarebluebook.com, and outofpocket.com, sites that provide info on prices for various procedures or office visits by doctor.

  • » Health Care Savings May Start in the Cafeteria

    Story about Full Yield, a wellness program for employers that provides its own food & nutrition programs. Story describes how Safeway, IBM, Pitney Bowes and others have saved money on health care costs via wellness programs. Major issue, however, is that these are companies that self-insure.

  • » Failing hospital: NHS rating system should be scrapped, says inspection …

    Another story that critiques overly simple health care rating schemes. IMO, ratings needs to be based on analysis of outcomes, using real data, not observations from a third-party, which are subject to error.

  • » Switch to Electronic Records Getting Mixed Reviews at Hospitals and …

    A one-sided critique of the shortcomings of EHR/EMR systems from Huffington Post. Whereas I agree that there are shortcomings, a more balanced report would have more credibility. Still, it offers some good basic info on what the feds are trying to do with ARRA funding.

  • » Gary Schwitzer: more on USPTF’s mammogram guidelines

    Excellent post and comments. I just added my own comment (7th in list).

  • » PE Eyes Siemens Hearing Aid Unit

    Article mentions strong interest in healthcare sector by PE. Do PE professionals smell, taste and feel an opportunity in healthcare, too?

  • » The Emotional Epidemiology of H1N1

    Good commentary on public reaction to public health announcements and EBM. More “infodemiology”, that is, providing trustworthy information and monitoring public response to epidemics, is needed.

  • » Statistical Learning as the Ultimate Agile Development Tool

    Excellent video presentation by Peter Norvig of Google. Data, semantics, search and much more.

  • » Reports Rate Ambulatory EHR Software

    IDC Health Insights report on EHR vendors ($4,500)

  • » Careers in Scientific Writing

    Interesting article and site (which I just discovered) about opportunities in scientific/medical writing and journalism. Site focuses on female scientists.

  • » Survey of Where Doctors Find Medical or Rx Information

    Sponsored by Google, survey lists most popular resources used to find medical info. Surprise! Search engine/Google is at the top, followed by peer-reviewed journals. No category for online clinical information resources, such as UpToDate, MDConsult, DynaMed, as far as I can see. If no breakout were given on survey, Search Engine category may incorporate these resources too.

  • » WATCH MONEY-DRIVEN MEDICINE - HERE

    Money-Driven Medicine site with free streaming version of the movie. Nice example of offering free streaming with promo for the paid DVD.

  • » Researchers Urge FDA to Create Drug Monitoring Database

    FDA would need legislative action to approve new db, but given the ability to track more data from electronic records and online user-input, federal db makes sense.

  • » FACTBOX-Informa takeover of Springer risky but appealing | Industries …

    More on Informa bid for Springer from FT, which quotes analyts.

  • » Futurity.org – Learning powered by search engines

    Study of search behavior indicates that online search is often used to confirm or refute one’s internal knowledge. Hm, sounds rather Bayesian to me.

  • » Informa Eyes Deal for Springer

    With over 2.1B Euros in debt (8X EBITA), Springer is a loaded target. Bids are expected to be under 400M Euros. But bigger question is: is there sustained value in publishers of scholarly research, an sector that is being disrupted by new models of scholarly communication and research?

  • » Gary Schwitzer on fallout from USPTF’s mammogram guidelines

    Good review of press related to new mammogram guidelines. Interesting that so many who say they want EBM, object when they don’t like the data. “Don’t like” often means they stand to lose business or stature.

  • » Zynx Health partners with Keane’s EHR

    Zynx Health’s order sets will be integrated with Keane’s Optimum EHR system thru this partership. Another example of embedding EBM info into EHRs.

  • » ISPUB - Opening the non-open access medical journals: Internet-based …

    Article describes how students are sharing for-fee medical articles in a Napster-type environment.

  • » Promoting Healthy Skeptism in the News: Helping Journalists Get it Right

    “It” in this case, is the information in medical journal articles. Really good article about what could be done to help add context to each medical journal article that reports on new research so that journalists, patients, and even doctors can better understand the implications.

  • » Mass. hospitals make headway on patient infections

    With pressure from patient groups and regulators, hospitals have make significant progress in reducing hospital-acquired patient infections. Checklists and focus on solving the problem (using best practices from other institutions as one means) are noted as key to changing the procedures and culture at hospitals.

  • » Study Shows EHRs Make Little Difference in Cost/Quality

    Study performed by Prof. Ashish Jha at HSPH and Catherine DesRoches at MGH indicates that using EHRs makes little difference in outcomes. This article goes on to point out that researchers also focus on the importance of changing processes & culture in hospitals to benefit from positive effects of using EMRs/EHRs. I’d add that hospitals and hospital systems that incorporate clinical information systems (order sets, point-of-care CDS) are more likely tho demonstrate improved outcomes. At this stage, not enough evidence-based content has been incorporated into EMR/EHRs.

  • » Dr weighs in on Gina Kolata’s article on drugs used to prevent breast cancer

    MD who wrote this post suggests that Kolata’s article is biased toward the big pharma position, since her only sources were from pharma.

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    Headline Commentary Nov 9-22

  • » Linda Peitzman, CMO of Wolters Kluwer Health, on Practicing EBM with Order Sets

    Very good article by Linda Peitzman, MD, CMO (Medical) of Wolters Kluwer Health on benefits of order sets. Article provides some detail on how to implement order sets to ensure everyone receives latest most current version. Note, hour long interview with Linda, Nancy Greengold (of Hearst Business Media and co-founder of Zynx Health), Sundeep Karnik (fmr VP Strategy Elsevier Health) and Gary Kennedy, CEO of Remedy MD can be found here: http://www.berkerynoyes.com/pages/innovations_in_evidence_based_medicine.aspx

  • » Transparent Health Network provides pricing for direct patient-provider transactions

    InformationWeek profiles Transparent health Network, which is compiling prices for direct purchases of healthcare services by patients.

  • » Illinois launches hospital compare site

    IL launches its hospital compare site. Article points out that public ratings rarely reflect quality of care.

  • » Flybridge invests $3M in pilates ecommerce business

    Flybridge invests in woman-owned pilates equipment seller, which has sold over $500M in equip on QVC over the past 12 years.

  • » Experiments Treated as Teamwork

    WSJ writes about new x-discipline collaboration among research scientists. Key point relates to how these scientists are creating their own databases. No mention of third party publishers in this new world of data-driven research.

  • » Following Patient to Improve medicines management and reduce errors

    Workflow study that follows patient through hospital identifies areas for improvement.

  • » Global Wellness Program Strategies

    Jane Sarasohn-Kahn reviews recent study by Buck Consultants on growth of wellness programs in a variety of countries and compares the priorities of each country’s wellness programs. US is only one where cost-saving is key objective.

  • » Health gets personal in the cloud - O’Reilly Radar

    Brian Ahier writes about recent developments in electronic healthcare records with a focus on Practice Fusion and GoogleHealth’s attempts to offer patient info that is consistent with physician info.

  • » Practice Fusion adds patient portal

    Matt Holt comments on Practice Fusion’s announcement of patient portal to coincide with their free EHR s/w.

  • » Wrap-up of Public Health and Technology (PHAT) event at Harvard School Public Health

    John Moore of Chilmark Research, who moderated closing panel, recaps the day’s highlights. I’ll add that John did a very good job on the last panel, which included Esther Dyson, Steve Munini COO Dossia, Fred Smith of CDC, and George Willock, CEO of HealthString. Audience appreciated the focus on the patient (Adam Bosworth did focus on patient, too). I believe it was Esther who said: “the patient is the most important input into health decisions”. She mentioned the “quantified self” movement and Society for Participatory Medicine also got a plug. This was the most forward-looking session that addressed social media and the exploding amount of new data that will be available for analysis.

  • » Diagnosis is Not Enough, Measuring Medical Outcomes is Critical — Big Think

    Very good video by Nobel laureate in biochemistry, Paul Nurse, who makes the point of the importance of recording healthcare outcomes and analyzing data to prevent misunderstandings based on false correlations. He uses the vaccination scare as an example.

  • » DataONE, a collaboration between university and govt earth scientists to build common database

    DataONE (Data Observation Network for Earth) is one of two $20 million awards made this year as part of the National Science Foundation’s (NSF) DataNet program. The collaboration of universities and government agencies coalesced to address the mounting need for organizing and serving up vast amounts of highly diverse and inter-related but often incompatible scientific data. Resulting studies will range from research that illuminates fundamental environmental processes to identifying environmental problems and potential solutions.

  • » Kevin MD on Breast Cancer Screening Guidelines Backlash

    Good balanced view of response to recent breast cancer screening guidelines.

  • » Center for Ix Therapy to Shut Down

    Center for Ix Therapy, which was represented at our first Health Content07 conference, to shut down Nov 30, 2009. The Center was small organization with limited resources, and suffered from trying to define a space that already existed and was far more widespread and diverse than their definition of Ix Therapy.

  • » E-Patients: E is for energized and engaged

    Lois Wingerson writes about Healthcamp NYC and ePatients.

  • » Google Scholar now offers limit by legal opinion

    Wonder what Lexis and Westlaw will say about this?

  • » Hospitals Increasing Rev through Business IT apps

    HR and billing IT apps are helping hospitals save money that can be applied to clinical improvements.

  • » FDA collaborates with Everyday Health to distribute consumer health info

    Makes sense. FDA and other govt sources are not best at marketing and distribution. Everyday Health (Waterfront Media) can take on that role to extend reach of FDA info.

  • » Has Allscripts Overplayed its Hand?

    Latest version of Allscripts (version 11) was launched before it was debugged. HDM asks if Allscripts has overreached its grasp since its merger with Misys. Note also the prices for the KLAS reports: $980 for providers; $11,850 for others!

  • » Andy Grove Promotes Translational Medicine Degree

    Grove, former CEO of Intel, promotes concept of new degree to help accelerate the cycle from medical research discoveries to mass production of new treatments. Essentially, Grove wants to combine skills of researchers and engineers to disrupt current cycle that can take many years from bench research to broad availability.

  • » Medical start-up puts faith in primary, preventive care - JSOnline

    ModernMed, a concierge medical service in Milwaukee, launches with 2 primary care MDs. Founder believes healthcare costs can be controlled via effective primary care.

  • » Checking the right boxes, but failing the patient

    Physician posits that dependence on checklists may not be to the benefit of good patient care if insufficient attention to individual patients is paid.

  • » CambridgeSoft Announces Investment by Health Evolution Partners and …

    CambridgeSoft, which provides IT solutions for pharma BI (esp R&D), receives funding from Health Evolution Partner (David Brailer’s PE company). CambridgeSoft is touting its SaaS solution for pharma & chemical research.

  • » NPR’s OnTheMedia interviews Gary Schwitzer about Health Info on Morning TV programs

    Gary slams the morning TV shows for their promotion of junk information about weight-loss and other health issues. I agree that for the most part, TV news health info is superficial and very seldom put in context. Wouldn’t it be great if the money were spent on disseminating helpful information and pointing people to more trustsworthy sources?

  • » CMS plans to share more data between agencies

    “The Centers for Medicare and Medicaid Services plans to boost data sharing among its various programs that have common functions using the Medicaid Information Technology Architecture (MITA) and the nationwide health information network (NHIN).” Sounds reasonable…

  • » Great Graphic Depiction of a Common Doctors Dilemma #hcsm #pm #hcr …

    How much information is optimal to share between patients & doctors? Great comments here.

  • » Reality check for checklists (reg req)

    Good article that points out the importance of system change (behavior change) for checklists and the like to be effective.

  • » When it comes to making data sexy, you can’t be too graphic - CNN.com

    Article makes the point that it’s great that gov’t agencies are providing more open data, but that data needs to be put in context and displayed in an engaging manner to really have full impact. And that, dear publishers, is what you should be doing…

  • » Commentary from Patient who attended FDA Social Media hearings

    Another outstanding post by DC patient, who writes that een though she is an engaged patient, she never would have thought to file reports of adverse effects (AE) via FDA’s MedWatch. Her comments make it pretty clear that the MedWatch channel is not effective for monitoring Rx AEs. Patients consider many factors before they single out any particular cause.

  • » A Patient’s Perspective on Day 1 of the FDA Public Hearing on Social Media | DCPatient

    Excellent round-up of Day 1 of FDA hearings on social media use by Pharma.

  • » Caring.com raises $10 million - San Francisco Business Times:

    Another story on the funding for Caring.com which recently acquired the Gilbert Guide.

  • » CVS Caremark takes stake in pharmacogenomics company

    CVS sees value in studying interaction between genes and medication for its PBM business and for its end-customers.

  • » Google Public Policy Blog: Making health-related ads more useful

    Google’s proposed ad format for Pharma ads. Presented at FDA’s hearing on social media.

  • » Doctor and Patient - Primary Care’s Image Problem - NYTimes.com

    Dr. Pauline Chen’s column about the decline in # docs who want to go into primary care. In large part, it’s due to large number of routine cases they deal with and the amount of paperwork and coordination required. Of course, pay is an issue too. This ties with articles I’ve published about the commodization of routine health care enabled by health IT. Programming routine tasks and allowing nurses and other clinicians to take over these tasks should relieve primary care physicians of the “burden” of routine tasks.

  • » George F. Colony’s Blog: The Counterintuitive CEO: How CEOs Can Rebuild Media Companies

    Forrester’s CEO on how old media needs to reinvent itself for digital world where customers decide what is valuable.

  • » Finding Credible Health Information Online: MedLibs Round 1.8 | Highlight HEALTH

    Nice rundown of vetted sources of online health information from medical librarians.

  • » Startup, Cleveland Clinic Partnering on Patient Records Search Engine - iHealthBeat

    Explorys, a start-up search engine, partners with Cleveland Clinic to develop search/analytics tool for patient records.

  • » Brian Ahier - Health IT & Healthcare Reform: The HITECH Foundation for Information Exchange

    David Blumenthal’s latest statement on goals of the ONC for interoperability of electronic health records.

  • » Medad Blog » Blog Archive » Day 1 of pharma social media hearings, after the morning

    Chris Truelove’s review of 1st morning of #FDASM

  • » Research (Ylabz) Google Health and Wave Mashup

    linking patient data and related information

  • » Converting to Electronic Health Records: fits and starts - O’Reilly Radar

    Very good article and great comments on hurdles that impede implementation of electronic health records/electronic medical records.

  • » FDA Webcast of Social Media hearings

    Live webcast of FDA’s hearing on use of Internet and Social Media Tools by FDA-regulated Medical Products, Nov. 12-13. Much anticipated meeting on topic of use of online media by Pharma and other FDA-regulated companies.

  • » Health Populi: Hospitals focus on quality, experience, and empowerment in patient portals

    Geonetric survey lists top objectives of patient portals created by hospitals.

  • » Consuming Interests: Best Buy to start selling health and fitness gear - News and tips for consumers on shopping, saving money, deals and credit - baltimoresun.com

    More outlets for distributing health and fitness gear as focus on wellness and prevention increases.

  • » Cough into your mobile phone for instant diagnosis - Telegraph

    Pretty interesting application. Not as far-fetched as it seems.

  • » CCHIT going on almost as if nothing happened | ZDNet Healthcare | ZDNet.com

    No matter the outcome on ONC pronouncements about meaningful use, CCHIT, the certifying board for EMR/EHR systems, is continuing to play its previous role. CCHIT describes itself as a “community” and believes they offer meaningful services to small hospitals and group practices.

  • » CCR and CCD - Google Health Developers | Google Groups

    Lots of info on various IT standards for EMR/EHRs

  • » FT Alphaville » Blog Archive » Boardoom execution at Reed

    Comments on Erik Engstrom’s new position as CEO of parent company Reed Elsevier. Engstrom has been CEO of Elsevier, the STM group of RE, for some time. Smart and analytical, I think he’s a good choice.

  • » Life as a Healthcare CIO: The Genius of the AND
  • » UnitedHealth Group’s Ingenix acquiring CareMedic - Minneapolis / St. Paul Business Journal:

    CareMedic, a Florida revenue cycle management (RCM) company, to be acquired by UnitedHealth’s Ingenix group. Ingenix now has near end-to-end platform for managing every step of the revenue cycle, from patient registration to reimbursement.

  • » Health Care Renewal: Paging (and Paying) “Dr Coca-Cola”

    Well, even though someone’s gotta pay for the production and dissemination of information, I don’t like this alliance and don’t believe AAFP can be objective in its research on effect of sugary soft drinks if Coke is the sponsor.

  • » Googling can mislead people seeking health information - washingtonpost.com

    WaPo on how some people may overreact to info they find on online health sites. Writer overreacts a bit herself in implying that online resources shouldn’t be used to help diagnose one’s condition. Agree that health literacy is needed; that is, consumers need better training to vet health resources. But, we’ll have hypochondriacs in the real and virtual worlds. Not everyone will gain the same benefits from online health resources.

  • » Official Google Blog: Finding flu vaccine information in one easy place

    Google now incorporating dat aon flu shot availability and mashing it up with Google Maps to illustrate where flu shots are currently available. Note, Google is compiling info provided by clinics. More proof positive that Goog is a content publisher.

  • » Tailwind Capital Invests in SDI Health LLC | Business Wire

    SDI Health, a PA company that provides healthcare data analytics services, receives funding from Tailwind Capital.

  • » FastIgnite, Inc. – Startup Tools

    FastIgnite site offers tools for start-up companies to calculate pre-money valuation, vesting, and more.

  • » Making sense of health statistics

    Article on lack of transparency in reporting health research and health statistics.

  • » Thomson Reuters Clinical Surveillance Solution Offers Powerful New Functionality to Improve Clinical Quality and Reduce Costs - Thomson Reuters

    CareFocus, parat of the Clinical Xpert suite of CDS workflow solutions from Thomson Reuters (fmly Mercury MD) extends functionality of product line.

  • » The Value of Openness: The PatientsLikeMe Blog » Redesigned Treatment Reports on PatientsLikeMe

    Narrated slide slow illustrating new features of reports on Patients Like Me. Impressive.

  • » Why Participatory Medicine? | e-Patients.net

    Dr. Danny Sands on why he believes in participatory medicine and informed patients.

  • » PHRMA - PhRMA Statement About Accessing Online Health Information

    PhRMA proposes methods for verifying FDA-approved data in health info provided to consumers. FDA logo on sites?

  • » iPhone Medical App Review: The Merck Manual Professional Edition Medical App is the First Encyclopedia of Medicine that Fits in Your Pocket

    Good concise review of Merck Manual Professional Ed. for iPhone

  • » How Facebook and Twitter are Changing Healthcare

    Excellent slide deck that describes influence of social media in healthcare: pharma, med school, epatients, doctors, nurses.

  • » Unboxed - Digitally Tracking the Elderly to Help Prevent Falls - NYTimes.com

    Describes use of mobile devices to monitor steadiness of eldery to prevent falls. Good descriptions of how data from monitoring devices can be used in research to vastly improved current snapshot approach of medical research.

  • » With Doctors in Short Supply, Responsibilities for Nurses May Expand - Prescriptions Blog - NYTimes.com#more-11897#more-11897#more-11897#more-11897

    Focus on shortage of primary care doc and how nurses will take on more resposibility. Agree, but shortage isn’t the source of problem. Rather, commoditization of basic medical care & procedures due to digitization of health care info is source of change. See piece on “heatlh content is rapidly becoming a commoditiy” in my blog at Health Content Advisors.

  • » iChemoTracker Keeps Tabs on Your Chemo Regimen

    Merck offers iPhone app that allows chemo patients to track symptons, etc.

  • » Practice management a hot topic for Sermo docs | Healthcare IT News

    Sermo creates community on practice management topics for docs to share info about healthIT and the business issues of running a practice. There are even CME activities with 8 module curriculum titled: The New Business of Medicine.

  • » Going (to) Google | The Noisy Channel

    Chief scientist at Endeca, a specialist in faceted search, joins Google.

  • » Microsoft to launch new healthcare IT Web series | Healthcare IT News

    Microsoft will launch a video web series on health IT beginning Nov 11, 2009.

  • » Data.gov linking to HHS healthcare data sets

    Review of data.gov with emphasis on healthcare data.

  • » Former Health IT Czar David Brailer, M.D. to Speak at WHIT v5.0 Conference on Modernizing Healthcare - ahier’s posterous

    Long interview with David Brailer, now a PE exec, fmly Director ONC.

  • » Emap taps Doctors.net for joint research and comms projects | News | Research

    Emap titles Health Servie Journal and Nursing Times partners with Doctors.net.uk to share content and conduct research.

  • » Wolters Kluwer Health Appoints Anne Woods to Chief Nursing Officer; Strengthens Its Commitment to the Nursing Market

    Anne Woods promoted to CNO (Chief Nursing Officer) at WK Health. She’s responsible for nursing strategy across Medical Research & journals publishing businesses.

  • » Maneuvering Medical Institutions Through the Wild Waters of Social Media: A Talk With John Sharp of the Cleveland Clinic « Significant Science

    Hope Leman’s interview w/ John Sharp of Cleveland Clinic.

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    Headline Commentary Nov 1 - 8

  • » Magazine Preview - If Health Care Is Going to Change, Dr. Brent James’s Ideas Will Change It - NYTimes.com

    NYTimes on how InterMountain Healthcare is adapting EBM practices to improve outcomes.

  • » When Doctors Create Their Own Evidence-Based Medicine - Health Blog - WSJ

    Short article on Intermountain health and how it is adapting EBM to improve outcomes.

  • » Initiate Systems Acquires Accenx | Reuters

    Initiate Systems (healthcare data mgmt) acquire Accenx, a provider of health info exchange solutions.

  • » New partnership pushes PBM services to kiosks in doctors’ offices | Healthcare IT News

    Express Scripts partners with Greatwater S/w to provide PBM services to patients on kiosks in doctor’s offices.

  • » Overcoming Our Social Challenges - Getting Started with Social Media in Biotech/Pharma

    Shwen Gwee’s presentation on Social Media usage in pharma. Excellent presentation.

  • » FasterCures - Patients Helping Doctors

    Michael Milken’s FasterCures foundation site.

  • » Jeff Arnold launches ‘next generation WebMD’  | ajc.com

    Jeff Arnold, fmly of WebMD and more recently HowStuffWorks, to lauchn Sharecare, a consumer health info site supported by medical device from a group of physicians.

  • » Sermo Launches the Practice Management Exchange to Support the New Physician Practice in a Changing Healthcare World | Reuters

    Sermo, the online community for doctors, launches new community for exchanging info on practice management for small & individual practices. Seems like a better app than their original app.

  • » 75 hospitals recognized for their exceptional quality achievements - ahier’s posterous

    Data Advantage names to 75 hospitals in their value index.

  • » http://www.slideshare.net/timoreilly/state-of-the-internet-operating-system

    Tim O’Reilly’s preso from PayPal Innovate 11/3/09. Good focus on “sensor data”, that is data are generated from wireless devices. Esp. important in healthcare.

  • » Why Comparative Effectiveness Research is a market opportunity | eyeforpharma.com | Pharma strategy for the busy executive

    Interesting review of recent report from Quintiles with thesis that pharma should take lead in establishing valuation system for their products in line with the comparative effectiveness (CER) concept.

  • » A New Market Opportunity | DeepDyve Blog

    DeepDyve’s CEO, Bill Park, provides detailed analysis of the market opportunity for their new rental model of articles. Nice to see him sharing so much detail.

  • » 5min and HealthCentral Announce New Online Health Video Network | Reuters

    HealthCentral partners with 5min, an aggregator of health & wellness videos.

  • » Quintiles inks pharma deals

    Quintiles continues to build alliances with big pharma for CRO.

  • » Former Genzyme executive joins cancer diagnostic business - The Boston Globe

    Mara Aspinall joins On-Q-ity as CEO. On-Q-ity (could they have created a more difficult company name to type?) was created by combining two investments of Mohr Davidow (Cellective Diagnostics and the DNA Repair company). On-Q-ity will focus on “developing new, cheaper and more effective treatments for cancer by tracking suspicious cells in a patient’s blood stream that indicate resistance to treatment, Aspinall said. On-Q-ity will focus on breast and thoracic cancers first, then prostate and other solid tumor cancers. developing new, cheaper and more effective treatments for cancer by tracking suspicious cells in a patient’s blood stream that indicate resistance to treatment, Aspinall said. On-Q-ity will focus on breast and thoracic cancers first, then prostate and other solid tumor cancers” (from PE Hub).

  • » Qforma Appoints Erin McLaughlin as Director, Field Operations | Reuters

    Qforma, a predictive analytics company that has an app that rates doctors based on their published writings along with the usual critieria, hires former WK Health (NDC) exec.

  • » http://getbetterhealth.com/using-icd-9-codes-to-describe-your-morning/2009.11.02

    For medical coding geeks only; an MD applies ICD-9 codes to daily living….

  • » The New PubMed: Trick or Treat? « Laika’s MedLibLog

    Librarians are not pleased with redesigned PubMed, which may be fine for simple text searches, but not for complex targeted searches. My reaction: PubMed’s redesign opens the door wider for commercial publishers who can present better alternatives. Problem: they will pay for access.Need to find out what s/w PubMed is using.

  • » Diagnosis: What Doctors Are Missing - The New York Review of Books

    Dr. Jerome Groopman (author of How Doctor’s Think) writes on limitations of current diagnostic methods and EBM.

  • » Healthcare@Intel · Musings from TED MED So Far: The Medical Model is Hard to Move Past

    Good commentary on recent TEDMED event. Key issue in “mainframe” mentality of existing medical system. Need to move to “health” system.

  • » GE launches new eHealth business unit

    eHealth will focus on improving methods for sharing health info between patients and clinicians. Includes security features (patient ID, data privacy).

  • » Corporate Wellness Programs: Healthier Employees, Lower Costs - Kaiser Health News

    JNJ has launched project to market corporate wellness admin to other companies.

  • » Medpage Today BilPil Page

    Live (and archived) coverage of BilPil healthcare “unconference” in San Diego from MedPage Today.

  • » Angie Hicks ‘95 Receives McDermond Medal for Excellence in Entrepreneurship
  • » FDA meeting on social media usage by Pharma

    Some details on Nov 12-13 FDA public hearing on use of social media by pharma. list of speakers included

  • » Organization focused on improving understanding of health statistics

    For medical professionals and patients.

  • » Six Until Me.: ePatient2009: Voice of the Patient.

    Summary of SixUntilMe’s preso at epatient connections.

  • » Ghost-writers Hired by Drug Companies Write Journal Articles, Then Find the Medical Authors | InjuryBoard Virginia Beach

    Detailed explanation of the process used by many pharma companies to find academics to serve as lead author for scholarly journal articles that are “ghostwritten” by professional writers hired by pharma.

  • » DeepDyve’s Rent-to-Own Service

    MaryDee Ojala on DeepDyve’s new rental model for scholarly articles.

  • » Philips DirectLife Review: A Tamagotchi for Calorie Counters | Slipstream | Fast Company

    Philips introduces the Directlife device that calculates how many calories burned.

  • » Taking the Mystery Out of Health-Care Pricing - WSJ.com

    Report on some small steps taken by select providers to post prices of their services.

  • » Trends: The Social Life of Health Information | Pew Internet & American Life Project

    Susannah Fox’s preso from epatcon