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Archive for the ‘Elsevier’ Category
Final Meaningful Use Rule Provides Boost to Publishers
- Posted July 22nd 2010
- Comments (0)
- by Janice
The final rule for meaningful use of electronic health records was provided by the HHS Office of the National Coordinator (ONC) last week. The rule spells out the minimum requirements that EHR implementations must meet in order for the provider to be eligible for incentive payments.
I’m pleased to see that objectives related to patient access to information from his/her record are emphasized in the final rule. Offering incentives for doctors to provide patients with a clinical summary at each visit will improve doctor-patient relationships and help patients become more involved in their own health care and almost certainly will improve patient compliance with care instructions. But what really caught my attention is the rule that relates to using “certified EHR technology to identify patient-specific education resources and provide those resources to the patient if appropriate” [i.] This objective wasn’t included in the interim certification criteria, so its addition to Stage 1 of the final rule was a pleasant surprise.
The rule only requires that >10% of patients receive patient-specific education resources. Still, it is a start and will provide encouragement to more healthcare publishers to invest in creating high quality timely information for patients that can be incorporated into EHRs.
Already, clinical information publishers including EBSCO, Thomson Reuters Healthcare, Elsevier and Wolters Kluwer are in various stages of customizing patient education information for use within electronic records via Infobuttons.[ii] The new meaningful use rule will be a boost to all publishers of evidence-based medicine to continue to fund expansion of their information sources and clinical decision tools for patients. And, once consumers get a taste for the personally relevant education materials that help them understand their conditions and their care plans, I predict that demand for more patient education resources will skyrocket.
i Full text of the patient education section from the final rule is appended below.
ii For more on Infobuttons, see: http://www.informatics-review.com/wiki/index.php/Infobuttons .
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Full text of the section of the meaningful use final rule from the CFR.
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
42 CFR Parts 412, 413, 422, and 495
NPRM EP/Eligible Hospital Objective: “Provide access to patient-specific education resources upon request.”
In the proposed rule, we discussed this objective, but did not propose it. We stated that there was a paucity of knowledge resources that are integrated with EHR, and that also are widely available. We also noted that the ability to provide education resources in multiple languages CMS-0033-F 182 might be limited. We stated our intent to further explore the objective in subsequent stages of meaningful use.
Comment: We received many comments, including comments from both the HIT Policy Committee and MedPAC, to include this measure in the final rule. These commenters disagreed with our assertion in the proposed rule that “there is currently a paucity of knowledge resources that are integrated within EHRs, that are widely available, and that meet these criteria, particularly in multiple languages.” Specific examples of the availability of knowledge resources integrated with current EHRs were provided. The HIT Policy Committee amended their recommendation in their comments on the proposed rule to:
- EPs and hospitals should report on the percentage of patients for whom they use the EHR to suggest patient-specific education resources.
Other recommended language for the objective includes
- Provide patients educational information that is specific to their health needs as identified by information contained in their EHR technology such as diagnoses and demographic data, and
- The original HIT Policy Committee objective of “Provide access to patient-specific education resources upon request.”
Response: We are convinced by commenters that the availability of education resources linked to EHRs is more widely available than we had indicated in the proposed rule. Therefore, for the final rule we will include this objective for the Stage 1 of meaningful use.
We note that the new recommendation of the HIT Policy Committee is a hybrid of a measure and an objective, whereas in developing the meaningful use criteria we consistently identify both an objective and associated measure. However, we agree with the HIT Policy Committee and others CMS-0033-F 183 that the objective and associated measure should make clear that the EP, eligible hospital or CAH should utilize certified EHR technology in a manner where the technology suggests patient-specific educational resources based on the information stored in the certified EHR technology. Therefore, we are including a revised version of this objective in the final rule for Stage 1 of meaningful use.
We also believe it is necessary to state what level of EP, eligible hospital and CAH discretion is available when deciding whether to provide education resources identified by certified EHR technology to the patient. Therefore, we include the phrase “if appropriate”, which allows the EP or the authorized provider in the eligible hospital or CAH final decision on whether the education resource is useful and relevant to a specific patient.
After consideration of the public comments received, we are including this meaningful use objective for EPs at §495.6(e)(6)(i) and eligible hospitals and CAHs at §495.6(g)(5)(i) of our regulations as “Use certified EHR technology to identify patient-specific education resources and provide those resources to the patient if appropriate”.
NPRM EP/Eligible Hospital Measure: Not applicable
Comment: CMS received a comment requesting an 80 percent threshold of appropriate patients and/or caregivers receiving patient-specific educational materials. In addition, the HIT Policy Committee’s revised objective suggests a patient based percentage.
Response: As with the addition of the recording of advance directives, we are able to relate this measure to one that is based on patients and can be accomplished solely using certified EHR technology. As this objective requires more than just the recording of information in certified EHR technology, we adopt a lower threshold of 10 percent.
CMS-0033-F 184
After consideration of the public comments received, we are including this meaningful use measure for EPs at §495.6(e)(6)(ii) and eligible hospitals at §495.6(g)(5)(ii) of our regulations as “More than 10 percent of all unique patients seen by the EP or admitted to the eligible hospital’s or CAH’s inpatient or emergency department (POS 21 or 23) are provided patient-specific education resources”.
We further specify that in order to meet this objective and measure, an EP, eligible hospital, or CAH must use the capabilities Certified EHR Technology includes as specified and standards at 45 CFR 170.302(m). The ability to calculate the measure is included in certified EHR technology.
To calculate the percentage, CMS and ONC have worked together to define the following for this objective:
* Denominator: Number of unique patients seen by the EP or admitted to the eligible hospital’s or CAH’s inpatient or emergency department (POS 21 or 23) during the EHR reporting period. A unique patient is discussed under the CPOE objective.
* Numerator: Number of patients in the denominator who are provided patient education specific resources
* Threshold: The resulting percentage must be more than 10 percent in order for an EP, eligible hospital, or CAH to meet this measure.
We do not believe that any EP, eligible hospital, or CAH will not have more than 10 percent of their patients eligible to receive patient specific education resources and therefore do not believe an exclusion is necessary for this objective.
Health Content: There’s an App for That in EHRs
- Posted March 20th 2010
- Comments (0)
- by Janice
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 Jan 23-Jan 31
- Posted February 1st 2010
- Comments (0)
- by Janice
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 & HP partner to provide EHR s/w and hardware for physician practices.
Article questions the role of employers in sponsoring wellness programs that tie participation to financial incentives such as reduced premiums.
Interesting. Wolters Kluwer has set up a system whereby doctors will receive CME credit for clinical research done via their mobile phone.
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.
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.
Els adds SNIP and SJR to Scopus to provide more complete citation metrics.
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.
Prof. Robert Fogel, U. Chicago, contends that healthcare costs are high because consumers demand the high-cost extras and innovation.
Good interview with David Blumenthal, Director, ONC, on meaningful use of EHRs and plans for national health data exchange.
John Halamka’s brief description of the breakout of grant funding plans by ONC.
Whole Foods to offer up to an additional 10% discount for employees who meet wellness measures that include nicotine use, cholesteral, and BMI targets.
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.
Good short piece on why publishers are distributing content via Kindles even though there are business considerations.
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.
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 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.”
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.
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.
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.
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, 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.
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.
Home page of Jan 2010 report from RWJF on PHRs.
John Sharp’s overview of Robt Wood Johnson Foundation’s new report on PHRs.
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.
Commentary on why it is a positive sign that an MD is now leading Navigenics, a personalized genomics company.
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.
Andrew Spong’s analysis of Twitter followers/followings of pharma companies.
Brief article describing MedeAnalytics revenue cycle management solution being adopted by St. Joseph’s Hospital in Maryland.
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.
Info on work Tim Berners-Lee is doing for UK govenment to make sources of gov’t data more available and meaningful.
“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 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.
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
- Posted December 31st 2009
- Comments (0)
- by Janice
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.
Thomas Goetz, exec editor of Wired, on why personalized medicine is really about personal data.
Mentions Polka, an iPhone app, that allows remote monitoring.
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.
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 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 (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’ underperforming PBM unit names Lofberg new CEO. Lofberg is currently CEO of Generation Health, a genetic PBM.
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.
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”?
Jane Sarasohn-Kahn on PWC’s new report on 10 top trends in healthcare in 2010. Link to full report included.
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.
More on HHS grant for designing db for comparative effective research.
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).
Nice comparison table of existing e-book readers.
Health Data Management reports that Thomson Reuters Healthcare (Ann Arbor) is entering the HIE market with a data analytics platform.
Good article that describes how electronic laboratory notebooks (ELN) could become the foundation for effective data management in R&D enterprises.
Healthcare IT News briefly reviews the top 20 list from KLAS.
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!
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., 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.
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!
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.”
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.
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
- Posted December 13th 2009
- Comments (0)
- by Janice
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
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.
No doubt CME needs a redesign to change the current heavy subsidies by Pharma.
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”.
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.
An indictment of doctors and drug companies that promote drug interventions for preventive care. Uses example of hormone drug replacement for women.
Ad Age lists top magazines that have ceased publishing in 2009.
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.
EBSCO’s DynaMed write-up on breast cancer screening. I don’t find their analysis and coverage very helpful.
Conversation between Milken and Pfizer CEO Kindler
Reports of small survey of device manufacturers; results show that social media isn’t yet part of the marketing mix for device companies.
John Moore writes a brief post about MSFT’s announcement of long-term care provider Golden Living’s adoption of Amalga & HealthVault.
Some commentary on benefits of move to ICD10 codes.
McClellan, former CMS adminstrator, MD, and PhD economist, will keynote Advanstar’s Center for Business Intelligence (CBI)’s Annual Strategic Medicare Policy Summit.
Good overview with links to other stories about Pharma’s slowness in developing mobile apps.
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.
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 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 to announce Universal Search, which allows clients to search across Ovid and client’s other internal databases in single search. Nice development.
WebMD, HealthVault (MSFT) and GoogleHealth comprise the panel moderated by Jane Sarasohn-Kahn. About 50 minutes long. Worth a look.
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.
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.
Dow Jones Venturesource reports Q2 2009 VC investments by industry. Healthcare the best performer and it outpaces IT for first time on record.
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.
Good article with data and charts on changes in pharma sales & marketing over time and expected effects of health reform on pharma sales techniques.
Comprehensive article on HSAs and high-deductible health plans.
Perspective on whether use of EMRs reduce liability for physicians. Focuses on discounts offered by insurance cos to doctors and practices that use EMRs.
Schein will merge its animal health business with Butler; Schein to own 50.1%.
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.
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.
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.
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.
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.
Excellent post and comments. I just added my own comment (7th in list).
Article mentions strong interest in healthcare sector by PE. Do PE professionals smell, taste and feel an opportunity in healthcare, too?
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.
Excellent video presentation by Peter Norvig of Google. Data, semantics, search and much more.
IDC Health Insights report on EHR vendors ($4,500)
Interesting article and site (which I just discovered) about opportunities in scientific/medical writing and journalism. Site focuses on female scientists.
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.
Money-Driven Medicine site with free streaming version of the movie. Nice example of offering free streaming with promo for the paid DVD.
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.
More on Informa bid for Springer from FT, which quotes analyts.
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.
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?
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’s order sets will be integrated with Keane’s Optimum EHR system thru this partership. Another example of embedding EBM info into EHRs.
Article describes how students are sharing for-fee medical articles in a Napster-type environment.
“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.
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 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.
MD who wrote this post suggests that Kolata’s article is biased toward the big pharma position, since her only sources were from pharma.
Headline Commentary October 19-31
- Posted October 31st 2009
- Comments (0)
- by Janice
Usage of free PHR services hasn’t yet taken off. Peter Neupert of MSFT hints that wider adoption of IT by physicians and better connectedness between the stakeholders are needed before the value of using PHRs is obvious enough to incent consumers to adopt them.
Does technology interrupt the communication between doctors & patients? That’s the question posed by this book. Sounds interesting.
Short article on health IT with focus on MSFT. Quotes Peter Neupert, MSFT Health head.
New site that compiles info about neuroscience research.
Nice brief overview of EHR solutions for smaller practices with a description of some of the vendors.
Great example of the how new sources of data will transform medical research.
AMedNews writes up the recent PWC report on secondary data from EMRs. This is a major focus of ours at Health Content Advisors.
Jay Parkinson on specialized providers v. general hospitals.
Keas expands through partnership programs with CVS Caremark (MinuteClinics), Quest, and now Partners Healthcare.
Review of Adam Bosworth’s company, Keas, which uses custom “care plans” that collect personal data - directly or indirectly.
Bob Stern, founder of MedPage Today, delivers his perspective on how medical societies that publish research and organize medical conferences inhibit distribution of research information, much of which is funded by tax dollars via NIH, HHS, NSF, etc. The current model is undergoing a slow but steady transformation, which I think is accelerating.
Consumer Watchdog wants change to HHS ruling that gives providers the authority to decide if/when a patient’s healthcare information security has been breached.
CVS Caremark offers mobile site that includes access to medication history, drug info, special offers, and driving directions/phone numbers of CVS pharmacies or MinuteClinics.
Karen Overstreet, named executive director of Lippincott CME unit. Interesting that she’ll report to the Medical Research division, not education. Has there been a re-org?
Hope Leman writes an enthusiastic review of American Well, the online healthcare service that provides access to medical professionals from home and handles billing, too.
FDA will use data from Wolters Kluwer’s Pharma Solutions Source Lx Patient Studies Suite that captures patient-level Rx data and Pharmaceutical Audit Suite (PHAST) that captures Rx transactions to follow trends in flu medication prescribing activity by region and other patient demographics.
Good overview of status of standards for ensuring that secondary data produced by EHRs will be useful for research purposes.
American Academy of Professional Coders offers free app to help convert ICD-9 to ICD-10 codes. See aapc.com.
New edition will include feeds from Factiva and use Factiva Smart Search. Need to check on pricing.
long article on why “lifestyle” medicine is needed to reduce costs and improve outcomes. Note, focus on healthy behavior is gaining traction in large part because of the research that can be conducted on electronic health records of patients.
HealthPort Inc., an Alpharetta, Ga.-based provider of healthcare IT solutions to hospitals and health systems, has set its IPO terms to six million common shares being offered at between $14 and $16 per share. It would have an initial market cap of approximately $360 million, were it to price at the high end of its range. HealthPort is owned by ABRY Partners. www.healthport.com
HealthGuru Media raises additional $3.2 M from Castile Ventures and Village Ventures. VV’s Po Beabody is co-founder/Chairman
New study in The Journal of the American Medical Association, estimates that there are 67,000 fewer active physicians than calculations have suggested. The physician work force is also younger than previously estimated, with a greater proportion of doctors in their 20s and 30s and fewer who are 65 and older. By 2020, there will be 957,000 physicians, according to the new estimates, rather than the 1.05 million previously projected. Only 9 percent will be 65 or older, or half as many as had been predicted.
Due to “operating” costs (and debt loads from med school) MDs less likely to go into solo practices.
Team that developed InnovationRx at the Innovation Company bought the rights to the company and relaunched it as Aprexis Health Solutions. Aprexis focuses on patient adherence, with adherence to prescription drugs the focus.
Birmingham, AL based MEDSEEK listed 455 in Deloitte’s Technology Fast 500. MEDSEEK provides patient portals for hospitals and claims >650 hospital clients.
WK Health announces new customer who will use Provation, now branded as Provation Order Sets, powered by UpToDate Decision Support.
PEHub reports that IMS Health is in talks with PE firms to sell the company. IMS shares surged almost 22% yesterday (10/19)
UnitedHealth exceed analyst estimates despite declines in #insured, due to increases at drug unit.
Prof Teisberg on why gov’ts shouldn’t legislate comparative effectiveness requirements. Essentially because of variation in outcomes. Focus should be on value for each patient.
Argentina the latest country to launch medical tourism program to encourage visitors to plan vacations centered around medical procedures (cosmetic and fertility are top treatments for medical tourists in Arg).
With goal of trimming 100 positions in newsroom, NY Times editor Bill Keller offers buyout to entire newsroom staff. If fewer than 100 respond, they’ll have layoffs.
MVP Health, a regional health insurer in upstate NY, VT, and NH, will reimburse physicians for using RelayHealth’s WebVisit (TM) for patient consultations. MVP is partnering with Mohawk Valley Medical Associate (MVMA) to offer physician’s immediate reimbursement for implementing Relay’s webVisit.
CDW Healthcare, Vernon Hills, IL, partners with Cerner to market EHR solutions to physician practices.
presentation materials from Sept 24, 2009 webcasts on CAHPS Clinician and Group Survey
Wow! AstraZeneca seeks 5,000+ sales people to “self identify” their interest in taking buyout.
Concerns about patient privacy loom over electronic health records segment. George Hill of Leerink Swann estimates that by 2020, data mining could represent a $5 Billion industry.
Epic and Apple working together on Mobile EHR project.
Preview of next week’s Connected Health 09 conference in Boston. Focus: new devices and communications tools will help patients take more control of their health and leave hospital visits for severe events.
Great review of new iPhone version of Merck Manual Home Health Handbook.
New device from Fitbit that tracks exercise & sleep & can be used to monitor calorie intake, too. Fitbit is joining a fast-growing segment of devices that help monitor healthy behavior & can be used by payer segment to evaluate lifestyle of insured populations.
Akaza Research, provider of OpenClinica 3.0 open source s/w for clinical trials, adds electronic data capture features.
Dr. Rob on medical costs and medical codes–and plug for his interview with Ira Glass for This American Life’s series on medical costs to be aired weekend of 10/17-18, 2009.
More proof that medical apps are far ahead of any other professional (b2b) mobile apps.
Quest Diagnostics’ MedPlus group, launches its Care360 ambulatory EHR on Oct.24. MedPlus will market the EHR to teh 150,000 physicians that already use its other Care360 apps and will offer hosted solutions for smaller practices. Quest’s MedPlus has the advantage of having existing relationships with these practices who use their other Care360 apps.
Although there’s resistance, trend toward incentives for following healthy behavior is on the increase.
Developed in collaboration with the Allen Institute for Brain Science, Elsevier’s Brain Navigator tool, a “GPS system” that provides 3-D software to navigate the brain, adds new features for visualizing injection pathways and printing and exporting images. Interesting to note that this collaboration is with Elsevier’s Science and Technology Books division. Great example of how STM publishers can leverage their content through IT/R&D partnerships.
Halamka reports on latest HIT standards Committee meeting.
According to 2006 Kaiser Foundation study, nearly 1/3 of US companies that offer health insurance also offer some sort of wellness program. And, the focus on wellness has increased since then. This article describes some of the programs and $$ incentives for reaching wellness goals.
Quantified Self, group that advocates and facilitates patients to track health and wellness data about themselves, names impressive advisory board.
Very interesting. Healthy Advice Networks, which markets health info to physician practices with content sponsored by pharma and health and wellness brands, partners with HealthScape Consumer, a joint WK Health and Nielsen longitudinal panel to provide data on the effectiveness of sponsoring/promoting in Healthy Advice Network.
iTriage, an iPhone app from Healthagen, offers info on wait times at ERs and info about providers (hospitals). Providers pay to be listed with marketing info.
RightHealth is dba name of Kosmix, a Mt. View California search technology company that initially focused on the health space.
MedSeek announces recent deals for installations of their consumer information portals in hospitals.
Digitas Health lists 140 possible uses of Twitter in healthcare. Nice.
Review of recent conference on Personalized Health at Ohio State.
Florida-based video sharing site that posts videos for docs to use for patient education.
Deloitte offers database and analytic tools on pharma/biosciences alliances.
e-Patients: A New Market for Health Content
- Posted October 12th 2009
- Comments (0)
- by Janice
The last week of this month (Oct 2009) I will give a presentation on the e-patient market at the first e-Patient Connections 2009 conference. E-Patients are highly motivated, energized, educated and online-savvy patients and patient advocates that are organizing to share experiences and to dig deeply into health information sources and medical research studies to find information about specific diseases and health conditions. Some of the leading organizers of the e-Patient movement have also formed a new association, the Society for Participatory Medicine, which publishes its first journal issue this month in the Journal of Participatory Medicine
Patient-driven healthcare is transforming our current healthcare system at a rapid rate. Patients are expected to make choices about providers, healthcare treatment options, drug choices, insurance plans, and more, but information is needed to power this trend. That means huge opportunities for publishers that can provide the right information in the appropriate format for the e-Patient segment.
The digital age is also turning patients into suppliers of information via the digitization of clinical and administrative health records. Also, e-Patients directly produce information by sharing data in online social networks, which are becoming better organized and structured to create data that can mined for research purposes.
My presentation, The Future of Health Content Publishing, will highlight:
1) e-Patients as a market for new health care products that extend beyond current patient education products to provide deeper clinical information.
2) e-Patients as suppliers of health content via social media (e.g., Cure Together and Patients Like Me) and as a by-product of digitized records and transactions (e.g., outcomes data, cost-analysis).
See e-Patient Connections 2009 for more information about this event; use promo code Info500 to receive a $500 discount on the registration fee.
e-Patients as suppliers of health content data fits into the theme of our Data Content09 conference, too. Data Content09 immediately follows the e-Patient event in Philadelphia this year. At Data Content09, I will lead a roundtable discussion on healthcare data analytics that will delve into the surging amount of data being produced directly and indirectly by all healthcare industry stakeholders (patients, physicians, providers, payers, pharma, policymakers). The emphasis will be on information sourced from patient records, transactions, and self-reported data. We’ll discuss how health content publishers can exploit these sources of data to offer richer healthcare analytics tools and stay a step ahead of new competition they face from EMR/EHR vendors, large health insurance companies and others that are building repositories of data as a by-product of the transactions they record and the information they collect digitally.
Note, some innovative health content companies are participating in Data Content09. Will Passano, VP of Skyscape is on our program and John McKinley, CEO of OurParents.com, is attending as a Models of Excellence award finalist. If you are interested in attending Data Content09, please contact me at:jmccallum@infocommercegroup.com or call me at 781.356.1766. I hope to see you in Philadelphia in a couple of weeks.
Headline Commentary Sept 21-26
- Posted September 26th 2009
- Comments (0)
- by Janice
Halamka names Quest’s Care360 e-prescribing solution as the “cool technology of the week”. Quest is offering a free six-month trial of the service.
Good examples of employers (Pitney Bowes) that are saving $$ on health insurance by offering incentives for healthy behavior. Employers may be the key reforming health care–with or without policy reform. But, they are awfully quiet in the policy debate.
Focuses on overpayment to Medicare Advantage providers.
Teamsters protest Whole Foods at Penton’s Natural Products Expo in Boston.
Video to promote upcoming conference on media convergence. Clever and entertaining presentation of info about media trends.
The future of cardiovascular medicine is here. It combines top-notch clinical resources with robust, future-oriented IT infrastructure and digital image management technology.
Uwe Reinhardt offers a primer on how to read health insurer’s 10-Ks.
2-day event sponsored by IOM about using evidence from medical practice to improve learnings about cancer treatment. Includes sessions related to outcomes data and patient-generated data on social networks.
Peter Jasco, who has written several previous in-depth reviews of Google Scholar, provides an update and describes why GS won’t serve as a citation analysis tool. Hmm, what does that say for “infodemiology” results mined from Google?
How doctors are adapting to growing number of e-patients who research their conditions and are well-read in medical matters.
FDA to hold hearings on use of social media by pharma.
New app converts ICD-9 codes to ICD-10 codes and has an iPhone version.
Quest Diagnostics, known primarily for its lab testing business, offers its Care360 e-prescribing s/w for free during a 6-month test. Quest is also beta-testing a Care360 EHR for small to midsize practices.
Short-term ROI horizon for health insurers hampers their investment in wellness and education programs with long term results.
Cogent opinion piece with good comments about future of scholarly publishing. Theme: journals as brand, not necessarily as primary distribution vehicle. Also, journals as just one component of scientific research content assets.
Elsevier’s Procedures Consult Online Training suite is now available for iPhone & iPod touch through partnership with Modality, which distributes mobile learning apps for several medical publishers.
NEJM series on health reform; this time why Accountable Care Organization (ACO) model could rein in costs.
Gawande, Gruber, and others on health care costs.
Great piece on Dave DeBronkart, aka e-Patient Dave, who is a founder of the new Journal of Participatory Medicine. Journal and its community aspire to change the culture of medicine so that patients have a more active role in all aspects of their healthcare and most of all, so that patients have full access to their medical records.
Very interesting: Humedica, a Boston area start-up, launches with $30M in 1st round funding from Bain, General Catalyst, NorthBridge and Leerink Swann. Several Leerink folks are on management team. Humedica plans national healthcare analytics business based on data from EMRs.
WK’s Adis R&D Insight adds “intelligent forecasting” from its pharma research service inThought to its drug pipeline info service.
Elsevier to award CEUs to reviewers of its Journal of EB Dental Practice.
Zagat tool for rating/recommending doctors incorporated into BCBS of Georgia’s online site for members. Makes sense to offer recommendations within a system.
Bids for 49% didn’t meet company’s target, so entire company may be for sale. There should be more interest for majority ownership, but expected price is probably still too high.
Good post on how the proliferation of ratings and awards for hospitals is diluting the effect. Also, high ratings doesn’t always equate with a good match for a specific patient.
Bank set up by Blue Cross/Blue Shield to manage HSA accounts to fold. Started in 2007; only achieved 2% of expected volume. I didn’t even know it existed.
Clinical Site Services, a service provider to CROs and service companies to help them with their site performance, launches its own site that provides health info with the goal of attracting users who may be prospects for clinical trials. Bus model rests on selling ads/sponsorships to CROs, etc. Interesting; will check it out later today.
Excellent points about how paying for routine care via insurance distorts market mechanisms (I’m applying my own analysis and terminology). But, having an intermediary that blocks and distorts price and cost information prohibits rational market mechanisms from working. See this article for an alternative model.
Uses MarkLogic for QualityAnalytics product that facilitates reporting quality measures and adds search features.
Good article that describes UK site that focuses on helping consumers interpret health articles. Mentions Bazian.com.
Thomson Scientific launches upgrade to TPharma that includes consensus analyst forecasts for strategic drugs across major pharma therapy areas & combines the forecasts w/ downloadable revenue models for drugs in over 100 indications.
John Halamka discusses the question of whether to wait until more details have been worked out about meaningful use of EHRs before moving forward with implementation plans. He suggests getting started early in order to meet requirements when they come due.
Inverness Medical Innovations to buy Free & Clear, a regional health services provider focusing on wellness and prevention.
Reports on how NPDB is used and indicates that most hospitals don’t report errors or misconduct by the doctors practicing there.
Post about new feed that aggregates tweets from 25 patient safety experts on Twitter.
Dell joins other computer hardware firms in expanding into bus. services with planned acq. of Perot Systems. Will help Dell in healthcare market. Expect more M&A activity with other firms involved (or trying to buy their way into) health IT.
More on FDA’s social media & pharma developments.
FDA to publish a survey on usage of social media by Pharm. Notice will be published today in Fed. Register. Here is an overview of what to expect by John Mack.
change:healthcare, a HC08 innovator, launches ability to post questions on Twitter about healthcare price info (e.g., Rx drugs) and other health issues — with focus on helping people save money.
Good points made about EBM. As I like to say, we have some work to do in improving state of EBM, but it beats the alternative of not basing diagnoses and treatments on available evidence…
Headline Commentary July 20-26
- Posted July 26th 2009
- Comments (0)
- by Janice
HHS considering notification requirements for cases when the security of de-identified patient data used in research is breached.
Jeff Jarvis’ ideas for building new revenue streams for online news companies by leveraging the network effect and sharing ad revenes between the original site and the sites that prive traffice through links.
Advertising may help increase book publishers’ profits, but it is unlikely that books will become less expensive: they are already inexpensive. Readers are unlikely to invite advertising, unless books become totally free.
Interesting new program at U. Rhode Island, a pharma science, which goes beyond basic understanding of the existing drugs on the market into study of how drugs work and interact. “Starting this fall, the school will introduce a pharmaceutical sciences major, a four-year degree program that focuses on the science of drug development, manufacturing, and delivery.” Sounds like a good idea & will be helpful for pharma BI function.
Good review of why there is skepticism among doctors & others (including me) about how investment in EHRs will provide “magic bullet”. Key issue is the quality of the EHR systems being sold by many of the big health IT vendors. Key quality factors include: ease of use, interoperability, low downtime.
Examples of Cleveland Clinic & Bassett Health where coordinated care and salaried doctors contribute to better & more cost-effective care.
Dr. Denis Cortese, CEO Mayo Clinic, interviewed on Charlie Rose week of July 20 2009.
Good example of the complexity of calculating out-of-pocket healthcare purchases. In this case, hearing aids are used as the example, and most expensive hearing aids are not covered by insurance. But, the need to understand initial & follow-up treatment, as well as costs for supplementary tests and devices, is valid for all health-care purchases. In short, in the current system, increasing out-of-pocket expenditures for patients primarily causes confusion, leads to higher costs (since consumers don’t know how to fight the charges–or don’t have time), and does nothing to improve care or wellness.
Obama visits Cleveland Clinic on July 23, 2009. This is the press release from CC.
Healthcare.com, a Miami, FL based health directory company, launches new site: InsuranceAgenFinders.com for consumers to find health insurance brokers. Site also provides info for brokers and agents. Healthcare.com also has sites: HealthInsurancePlan.us, LifeInsurance.org.
Dr. Sidney Wolfe describes why the current system for reporting doctors in the NPDB isn’t working.
Good overview of EBM — what it is and what it is not– and some cautions about Obama’s zeal for EBM and Health IT.
Jbat puts Twitter’s emergence in the context of Google in 2004 and suggests that small-to-medium sized businesses will be the lifeblood of Twitter. These SMBs need to continously find better/faster/cheaper ways of marketing their goods & services and Twitter can help. I like the comment from a reader that describes Twitter as a new “marketplace” for buyers & sellers. That’s what I said of online directories 5-6 years ago.
PLoS is working toward new measurements of “impact” for scholarly research, based on ind. articles and including measures of web-based linkages.
AP creates new technology for tracking usage of articles and wrapping reuse rights into code in each article. In principle, the concept could work; in practice it may flop due to too many restrictions on links.
Twitter prepares materials for business use of its microblogging services. Lots of good tips for business use and examples from big companies.
Rand study analyzes effect of rising health care costs on employment, output, and value-add to GDP across 38 industries over the period 1987-2005. Concludes that HC costs had adverse effects on all 3 measures, esp. in industries w/ high % of employer-sponsored insurance.
With slump in pharma sales, sales reps (those who haven’t already lost their jobs) are seeing cuts to incentive pay (without comparable cuts in quotas).
Scribd succeeding where others have not by keeping it simple. Straightforward rev share (20% to Scribd; 80% to publisher/author) and easy to use platform. Let seller set terms.
Further info on cell phone with microscope attachment that is targeted for use in areas with limited access to health care. Link to PLoS full article included.
Physicians Interactive, owned by PE company Perseus, buys Skycape, the leading mobile platform for medical info delivered to physicians.
Fun interview with Pat Brown, an innovative researcher who thinks big and is not afraid to question status quo. One quote: “I want to literally overthrow the scientific publishing estabilshment” (thanks to Andrew Spong for link)
Assessment of the effectiveness of Pharma ads in medical journals. Haven’t read the article through yet, but looks to have good data.
New Deloitte study of >100 global life science companies, healthcare providers, and health insurance companies (abt 1/2 in US). Results indicate that thse companies are not sufficiently prepared to face security & regulatory requirements of managing their data. Further, they are not yet in a position to leverage IT efficiencies and the value of digital data due to the inadequate IT systems and know-how.
Jane Sarasohn-Kahn’s commentary on recent PWC report. She points to stats abt patient involvement that break down survey results by type of insured. Most notable stat: 61% of those covered by employer report their reason for lack of involvement: “I do not know where to go to find good information”.
Very good round-up of various community sites targeted to physicians, including Sermo, Ozmosis, iMedExchange, WebMD, and Within3.
WSJ points out key issue in using Cleveland Clinic, Mayo Clinic, or KP as models for health reform: these are integrated systems that facilitate sharing info, coordinating care, and can impose standards.
Good slide presentation on how Cochrane Collaboration uses Twitter, delicious, Facebook, etc.
Key median ratios for the 134 health systems rated by S&P declining in all categories in 2008.
Brian Ahier’s list of top 50 health info “heroes” on Twitter. Great list, even includes @janicemccallum!
WebMD launches Medscape Mobile for iPhone & iPod Touch. Free content includes: Drug db, drug interaction checker, Medscape medical news, CME from Medscape, & WebMD Health Dictionary.
2009 Edition of CMR International Pharmaceutical R&D Factbook, which provides stats on new molecular entities (NMEs), is now available. Published by the Centre for Medicines Research International, Ltd (CMR Intl), a Thomson Reuters business.
Boston area advertising firm, Pangea, uses QuizEngine, its content-focused advertising platform to engage readers.
John Mack summarizes the 2009 annual report from the Accreditation Council for Continuing Medical Education (ACCME) which shows that overall CME spending is down, and commercial CME sponsorship (ie., pharma) fell the most. However, pharma continues to sponsor CME indirectly.
DoD has successful pilot PHR program, MiCare, that uses GoogleHealth & MSFT HealthVault.
Fred Wilson on how “creative destruction” has changed the book publishing business. He quotes acceptance of Amazon’s Kindle, print of demand, and Google Books as key contributors. Print on demand & ebook readers have taken a long time to be accepted; I’d say the scale of Amazon & Google Books were key factors that drove changes that wouldn’t have come about w/o their outside intervention.
NPR story on Comparative Effectiveness (CER) of treatment for irregular heart beat. Quotes Carolyn Clancy of AHRQ, but doesn’t draw any conclusions.
Infectious diseases-focused organizations endorse adoption of HR3200, due to the inclusion of provision to create a database of hospital-acquired infections (HAI). HAI’s would be required to be reported to CDC, which would keep a database to track HAIs.
Good insight from John Moore at Chilmark on acquisition of Medem by Medfusion.
Martindale Hubbell’s community for legal professionals grows to 10K lawyers.
Zynx to provide order sets directly through eClinicalWorks EMR.
Entertaining grand rounds that provides a serious round-up of weekly healthcare stories. Demonstrates that design & writing ability really matter when it comes to conveying information!
Paul Levy shares some learnings from BIDMC’s performance improvement efforts.
Good overview article on various doctor ratings sites, including Angie’s List & RateMDs. There are many more that are not mentioned. Article focuses on the reliability of ratings, since individual preferences vary & the circumstances of doctor visits vary. Also mentions Medical Justice, the company that provides agreements that doctors use to require their patients to agree to NOT post on any review sites.
According to study conducted by AON, employers want enhancements to existing health insurance system rather than a complete overhaul. Key changes requested: more info on comparative effectiveness, more focus on wellness and preventive care, and changes to reimbursement policies.
WSJ columnists suggests some research studies be published in new journal named Duh!”, since finding seem so obvious, and other studies in “Huh?”, since connections aren’t always so obvious. Although it has catchy title, points made are valid–including need to study the “why” behind conventional wisdom and to put research in context.
Chronicle of Higher Ed on Elsevier’s Cell Press’ beta site for “next gen” journal article. At first glance, I’m impressed by the added-value that Cell Press is providing to their users. I’m also a little (just a little) annoyed at the commenters who dismiss the efforts because of Elsevier’s high profits (estimates are inflated in one comment) in their journals business. STM publishing segment needs innovation to respond to needs of the scientist and researchers who use the info and data.
Carolyn Clancy writes about experience at Aurora Health Care, where they formed a patient safety advisory council to serve as bridge between hospitals and patients. The patient safety council led to: more accurate medicine lists for older patients, higher level of patient involvement, and increased involvement of health care professionals.
CHH Medical Supply convicted of Medicare Fraud for unneccessary power wheelchair prescriptions.
Elsevier’s Cell Press has beta site to explore “next generation journal article” (my words). Very cool.
GAO report (links to full report included) analyzing resource needs for FDA to manage growing responsibilities in medical device/product segment.
Good article that describes problems physicians/providers have in collecting from patients.
Headline Commentary June 29- July 6
- Posted July 6th 2009
- Comments (0)
- by Janice
Review of week’s top stories, including reactions to Chris Anderson’s new book, Free, video interview with Michael Hansen, new CEO of Elsevier Health Sciences, several articles about disruption in scholarly publishing, and other notable developments in health content publishing and health IT.
More on the “Free” as business model debate. See my comments on the post.
Walgreens may open several thousand work-site health clinics in coming years.
Using tag cloud to help understand key terms and contents of a book, Google Books now makes it easy to glean substance of books in seconds. Pretty cool.
List of open source resources that have gained traction in medicine in multiple categories, from EHRs to collaboration to publishing.
Connectyx’ MedFlash portable PHR enters sales agreement with Healthy Directions, a vendor of “science-based vitamin & nutritional supplement formulas” and other wellness products. By end of August 2009, Health Directions will offer the flash-drive MedFlash EPHR through its distibution channels. Comment: press release alludes to fact that the Healthy Directions’ audience, on average, is more interested in health & health-related products, than the general population and therefore is more likely to be interested in tracking their health-related behavior. Given the behavior of Healthy Directions’ audience, it makes sense for vendors of PHR technology to focus sales efforts on this group.
Apparently, a hospital is the worst place to be if one suffers cardiac arrest!
Massachusetts and Vermont ban on pharma and medical device companies’ giving gifts to doctors (anything from coffee mugs to trips) goes into effect today.
Wired lists new new entrants in search, including some vertical search engine–a couple focused on recipes!
Concerro, a vendor of SaaS workforce management s/w to hospitals acquires CommandAware, which provides hospitals a turn-key solution for emergency response.
Andrew Spong responds to Wiley-Blackwell’s recent press release that reports some results from recent survey of society publishers.
Very good article (although long) that lays out reasons why incumbents have difficulty adopting new technologies. I’d add that many large incumbent scientifc publishers have to innovate through acquistions because of the problems described in Nielsen’s article and because of constraints put on them by the financial markets (if they are public). Accounting for acquisitions allows them more freedom to “buy” vs. “make”. I totally agree about the need for scientific publishers (in fact, all publishers) to become proficient in IT. Technology is a key input to all content products & services; without constant innovation, publishers will get disrupted by new entrants. This relates to last week’s article, “Health Content is Rapidly Losing Its Value”.
Wolters Kluwer’s LWW partners with HealthStream, a leading e-learning and performance improvement provider to hospitals, to integrate Lippincott’s Nursing Procedures and Skills, into HealthStream’s Learning Center (HLC).
Using IVR technology, Doctors on Demand allows patients to call in and leave info, then get contacted by MD. Physical visits are required at least 1/year.
One doctor’s view of why tablet PCs work well in his environment.
UBM’s CMPMedica discontinues 2 print pubs and cuts unspecified # positions; some digital presence of pubs: Infections in Medicine and AIDS Reader will continue.
US Supreme Court declined to hear appeal from IMS and Verispan/SDI Health to overturn data privacy law in NH that prevents them from selling doctors’ prescribing behavior to drug marketers who use info to sell directly to doctors. VT & Maine have since enacted similar laws.
WK Health announces new research reports that incorporate data and analysis gleaned from their Adis R&D Insight, WK Healthcare Analytics (NDA), and other resources to suppy focused analysis on specific markets. inThought is targeted to financial analysts, health care suppliers and drug manufacturers. Seems like a logical extension to their data services.
Discussion about Chris Anderson’s new book, Free, and Gladwell’s critique of it in NewYorker. See my comments in the comment section.
Interview with new CEO of Elsevier Health Sciences, Michael Hansen. Describes EHS businesses and where they are focusing for growth (clinical decision support systems; outcomes analysis)
Outstanding presentation targeted to brand marketers/advertisers that presents variation on my thesis on convergence of publishing and advertising from the advertising agency perspective. As I wrote in 2003, “advertisers need to create more informational Web ads that will meet the standard of ‘related content’ rather than ‘vendor ad’”. In same paper, I wrote about how ad content is moving toward becoming ‘meaningful content’ and in some cases ‘entertaining’ content. See slides 5-60 in particular. Relevant to both publishers and marketers/advertisers.
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