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Archive for the ‘Wolters-Kluwer’ 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 .
—————
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 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 Nov 9-22
- Posted November 22nd 2009
- Comments (0)
- by Janice
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
InformationWeek profiles Transparent health Network, which is compiling prices for direct purchases of healthcare services by patients.
IL launches its hospital compare site. Article points out that public ratings rarely reflect quality of care.
Flybridge invests in woman-owned pilates equipment seller, which has sold over $500M in equip on QVC over the past 12 years.
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.
Workflow study that follows patient through hospital identifies areas for improvement.
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.
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.
Matt Holt comments on Practice Fusion’s announcement of patient portal to coincide with their free EHR s/w.
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.
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 (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.
Good balanced view of response to recent breast cancer screening guidelines.
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.
Lois Wingerson writes about Healthcamp NYC and ePatients.
Wonder what Lexis and Westlaw will say about this?
HR and billing IT apps are helping hospitals save money that can be applied to clinical improvements.
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.
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!
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.
ModernMed, a concierge medical service in Milwaukee, launches with 2 primary care MDs. Founder believes healthcare costs can be controlled via effective primary care.
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, 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.
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?
“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…
How much information is optimal to share between patients & doctors? Great comments here.
Good article that points out the importance of system change (behavior change) for checklists and the like to be effective.
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…
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.
Excellent round-up of Day 1 of FDA hearings on social media use by Pharma.
Another story on the funding for Caring.com which recently acquired the Gilbert Guide.
CVS sees value in studying interaction between genes and medication for its PBM business and for its end-customers.
Google’s proposed ad format for Pharma ads. Presented at FDA’s hearing on social media.
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.
Forrester’s CEO on how old media needs to reinvent itself for digital world where customers decide what is valuable.
Nice rundown of vetted sources of online health information from medical librarians.
Explorys, a start-up search engine, partners with Cleveland Clinic to develop search/analytics tool for patient records.
David Blumenthal’s latest statement on goals of the ONC for interoperability of electronic health records.
Chris Truelove’s review of 1st morning of #FDASM
linking patient data and related information
Very good article and great comments on hurdles that impede implementation of electronic health records/electronic medical records.
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.
Geonetric survey lists top objectives of patient portals created by hospitals.
More outlets for distributing health and fitness gear as focus on wellness and prevention increases.
Pretty interesting application. Not as far-fetched as it seems.
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.
Lots of info on various IT standards for EMR/EHRs
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.
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.
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.
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.
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.
SDI Health, a PA company that provides healthcare data analytics services, receives funding from Tailwind Capital.
FastIgnite site offers tools for start-up companies to calculate pre-money valuation, vesting, and more.
Article on lack of transparency in reporting health research and health statistics.
CareFocus, parat of the Clinical Xpert suite of CDS workflow solutions from Thomson Reuters (fmly Mercury MD) extends functionality of product line.
Narrated slide slow illustrating new features of reports on Patients Like Me. Impressive.
Dr. Danny Sands on why he believes in participatory medicine and informed patients.
PhRMA proposes methods for verifying FDA-approved data in health info provided to consumers. FDA logo on sites?
Good concise review of Merck Manual Professional Ed. for iPhone
Excellent slide deck that describes influence of social media in healthcare: pharma, med school, epatients, doctors, nurses.
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.
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.
Merck offers iPhone app that allows chemo patients to track symptons, etc.
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.
Chief scientist at Endeca, a specialist in faceted search, joins Google.
Microsoft will launch a video web series on health IT beginning Nov 11, 2009.
Review of data.gov with emphasis on healthcare data.
Long interview with David Brailer, now a PE exec, fmly Director ONC.
Emap titles Health Servie Journal and Nursing Times partners with Doctors.net.uk to share content and conduct research.
Anne Woods promoted to CNO (Chief Nursing Officer) at WK Health. She’s responsible for nursing strategy across Medical Research & journals publishing businesses.
Hope Leman’s interview w/ John Sharp of Cleveland Clinic.
Headline Commentary July 7-13
- Posted July 13th 2009
- Comments (0)
- by Janice
Modern Healthcare’s analysis of recent IOM and Federal Coordinating Council reports on comparative effectiveness research (CER). Key finding: data infrastructure is need and investment in creasting databases is critical (and probably > total funds allocated for CER –$400 M–in ARRA).
Perhaps the UK will promote & accelerate adoption of Google & MSFT’s PHR platforms before they gain traction in US.
Pretty good list of useful purposes of Twitter–mostly business related.
Interesting new aggregator of top journal content (based on impact factor & google scholar rankings) in clear, attractive interface. Access to premium fulltext journals is limited to existing subscribers via Athens. [edited 7/15] Note, Clinical Reader has been called out by medical librarians because of sloppy copyright practices and use of false implied endorsements by NLM & others. To gain credibility as source of authoritative content, CR team needs to tread carefully!]
Decent article in Telegraph about Reed Elsevier’s need to focus on IT infrastructure to enhance value of content assets. Title a bit misleading, but it does mention specific title/markets where Reed might reconsider selling RBI assets: Construction, chemical, energy, XpertHR & Totaljobs.com.
I wouldn’t call it WebMD, but it includes health and wellness information and lots of information on the institution.
PhRMA site offers limited access to Adis’s R&D Insight drug pipeline db for no charge. Limited info on each drug is output, but list of drugs by phase is available. US only.
Beta version released; official release sched. for Q4 2009. Breakthrough sounds like an exaggeration, but it is a step forward for a traditional directory publisher who sells to libraries.
Tim Berners-Lee talks about data that do stuff (an ICG mantra): “And now there are lots of different ways that people need to be able to look at data. You need to be able to browse through it piece by piece, exploring the world of data. You need to be able to look for patterns of particular things that have happened. Because this is data, we need to be able to use all of the power that traditionally we’ve used for data. When I’ve pulled in my chosen data set, using a query, I want to be able to do [things like] maps, graphs, analysis, and statistical stuff.
SpringerImages, which includes over 1.5 million scientific images, tables, charts & graphs, to be officially launches at ALA in Chicago this week. Was originally planned for Q1 release.
Can’t resist tagging this article, since it intersects the key topics I follow & my interests (tennis). Serena Williams launches skincare line developed by chairman for American Academy of Dermatology Chair, Dr. Bryan Adams. Skincare line is targeted for those with “demanding and active lifestyles” like Serena.
Serials Solutions, a ProQuest company, expands the content indexed by its Summon Service. Summon aims to offer “Google-like” search interface across library’s holdings. For now, content from ProQuest, Gale, Springer, IEEE, Taylor& Francis and some other scholarly publishers and university presses participate. Summon is in beta at Dartmouth, Claremont Colleges, and 5 other universities in US, Canada, UK, and Australia.
Some good analysis of Amazon’s Kindle pricing strategy and why share to publishers may shrink. Quotes couple of analysts.
Kent Anderson of NEJM writes about Amazon’s growing role in book publishing, not just redistribution of books. How should publishers react? Comments as of 7/9 suggest scholarly publishers stick to their knitting of creating content and build their own open repositories– and be more aggressive with digital distributors. Granted, scholarly publishers should take more control of digital distribution, but in order to do that, they have to invest in digital infrastructure & know-how.
Monster cuts 160 jobs; will add 80 in new technology innovation center. New focus on long-term strategic planning and customer engagement. Evidence of need to add layers of analytic and other value to core content.
Good dialogue about social media’s relevance to clinical practice.
Healthcare reform may include tax credits for employer-sponsored wellness programs.
Good write-up of interview with Berners-Lee by ReadWriteWeb’s founder, Richard MacManus. W3C’s focus on data content is exciting development for us at InfoCommerce Group, where the role data in publishing businesses has been a central focus on ours from day 1. s
Survey conducted by Rodale on behalf of FDA DTC division provides data that show that almost 50% of consumers rate online health videos information websites as top resource when searching for medical conditions and prescription drug info online. Next in line were pharma websites, video sharing sites, and social networking sites.
Good article on the under-tapped value of customer lists held by publishers. As author points out, many print publishers seem to miss the connection between their ability to build communities of interest for publications and adapting that ability to web-based communities. Instead, too many publishers are letting upstarts replace them online.
Candover & Cinven (current PE owners) ask bidders to resubmit bids for up to 49% of Springer. Initial bids from TPG, EQT and consortium of Carlyle & Providence did not meet current owners’ expectation. Owners asked for 500M Euros for up to 49% of Springer; 2 sources said 350-380 Euros was a more reasonable valuation.
The concepts of EBM and Comparative Effectiveness Research are reaching consumer-focused publications. IMO, considerable education via general press and other venues will be necessary to help consumers/patients understand EBM and CER.
Interesting partnership between Mayo Clinic and Winn-Dixie grocery chain, whereby Mayo provides info related to nutrition and conditions including cold & flu, heart disease, digestion, asthma and allergy (most of which have OTC products sold in grocery stores to help manage these conditions).
SDI, which acquired Verispan last year, releases results of most respected pharma companies by pediatricians.
CDC launched a web-based public health tracking interface that includes state-by-state data through 2006 on air & water quality, lead paint, and other public health measures. My first attempt to extract data for air quality in MA led to an error message. It’s likely that no data were available for the query I entered through the menu-based system, but a better-designed faceted search would have alerted me to this fact. In sum, it’s great that CDC is providing more data in easy-to-use formats, but there’s lots of room for improvement by commercial information services that can add value by aggregating data and improving the search experience.
Thomson Reuters, already one of the biggest webcast providers, acquires Toronto-based webcasting s/w firm Streamlogics.
Emdeon, a RCM vendor, buys eRX Network, a vendor of epharmacy solutions. eRx has established base in government, providing claims-processing services for CMS.
A medical librarian’s comparison of DynaMed and UptoDate
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.
Headline Commentary May 31-June 7
- Posted June 7th 2009
- Comments (0)
- by Janice
A rundown of a handful of online physician ratings sites. Also mentions pushback by physicians who can’t respond to reviews. Mentions RateMDs.com, DrScore.com, AngiesList, Heatlhgrades and some state-specific sites.
Good series on how the Google algorithm has evolved and how human reviewers have been added to the formula.
IAB PWC research shows that online ad spend declined in Q1 2009 YoY for the 1st time in years.
The Open Access Scholarly Publishers Assos. and DOAJ/Lund University LIbraries will hole 1st conf. on Open Access in Sweden Sept. 14-16.
E-patient Dave’s slides from presentation at National eHealth Collaborative last week.
Good overview of Data.gov by Info Today.
David E. Williams provides a very nice summary of Michael Porter’s excellent article in NEJM (available for free): A Strategy for Health Care Reform — Toward a Value-Based System.
The participatory medicine/epatient pioneers have formed a society, the Society of Participatory Medicine, and will publish a journal called Jounral of Participatory Medicine. Dr. Alan Green, MD is the first president. Journal will be open access, of course!
Some background on why drug companies aren’t flocking to Twitter.
This story supports theme of the June 4 blog on Health Data Analytics and the bounty of new data streams that will be available from digitized records of all sorts. Cerner’s data warehouse includes 1.2 billion lab results, as well as medication orders and other data.
Good post that expands on theme that EHRs (EMRs) should be designed with patient needs in mind and that simply automated current procedures in hospitals won’t likely lead to an improved experience for patients who want to participate in their health care decisions.
Commonwealth Fund study on Comparative Effectiveness Research from 4 other countries. In my reading pile.
Healthcare a bright spot in employement trends: health care jobs grew >23,000 in May, while overall nonfarm payrolls shrank by 345,000.
Dr. Val discusses the “workflow interruption” aspect of most EHR systems. The “workflow interruption” is my term. She describes more elegantly, but I am putting it in context of good marketing practices in IT and publishing, where product developers spend time shadowing prospective customers and get a deep understanding of their workflow in order to design information tools that increase efficiency and try to improve outcomes, not just add a layer of technology in order to record data.
A new condition of interest to data publishers: Database Hugging Disorder (DBHD). Humor aside, this post addresses trend toward allowing access to the databases that were used in medical and other studies. In line with the Open Access movement in scholarly publishing that campaigns for free access to research articles where the research was funded with public funds, the open database movement seems to be growing very quickly. Oddly enough, even though the databases hold more value than individual articles (especially when data can be combined from multiple databases), the fact that they haven’t been monetized in most cases may lead research organizations to be more willing to make them freely available while still charging for published articles based on the data.
Good post that includes links to top ideas for Pharma in social media, as well as John Mack’s thoughts on the need for Pharma companies to create “corporate” blogs or websites that serve as central resources on diseases, conditions, or other topics that are more broad than a marketing site for a drug. Points to importance of providing links and information from other sources. This is a theme I think is important and publishers should take note. Pharma websites are now prospective buyers of authoritative content for their websites.
J&J said “pipeline productivity is on track” and outlined growth strategies: -greater marekt penetration, new commercial models, exapnded geographic presence.
Elsevier to publish guidelines for sponsored reprints.
Good piece from Michael Porter on key changes required to reform our healthcare system. Porter emphasizes the need to align incentives for insurers, providers, employers, and patients with health of the patients/consumers as the objective. I’ve only skimmed the article, but it looks spot on.
Stunning numbers from new study that says 62% of all bankruptices filed in 2007 were in part due to medical expenses–and 78% of those individuals had health insurance.
Only PE companies left in bidding. Interesting twist: Springer’s current owners, Candover & Cinven are looking to raise a specific amount (500M Euros) and are asking interested parties to bid on share they are willing to accept for that amount. Springer has large number of scholarly journals & books, and has done well selling ebook versions in the past couple of years, but has lagged behind in creating decision tool applications based on their content. Heavily focused on academic market.
Anthem Blue Cross, the BC provider in California, announces wide availability of its cost comparison data to members in CA. The transparency tool provides access to costs associatied with all aspects of a medical procedure, from lat tests to recovery room charges & physician costs for specific facilites. Eventually, BC/BS plans to make similar info available countrywide. A big move in the right direction to support consumer driven health plans with high deductibles & copays.
Great post on the potential value of the huge amount of data that are being collected as more info on individual patients is recorded in digital form. Effects of drug interactions across a broad population is key example given here.
Modern Healthcare reports that GetWellNetwork, which provides bedside computer apps for “patient engagement” is “promoting the use of its own and similar products by creating and helping fund a not-for-profit institute devoted to researching patient-engagement effectiveness”. GetWellNetwork calls their applications “interactive patient care”. My comment: it gets confusing when there are so many fragmented terms for improving patient care & safety, some that involve patient participation, some that don’t. Rationalizing the health IT market, esp for vendors to hospitals, and incorporating patient education providers would add efficiency and perhaps even make sense to the patients. Relationship of GetWell and the insitutute also raises doubts on transparency. Parallels relationship between Healthwise & Center for Ix Therapy, although at least both are non-profits in this case.
Medidata, which provides s/w for managing clinical trials and for managing clinical research data (Rave), sets terms for IPO. S1 was filed in January 09. Insight Ventures key investor. Market cap at expected $11-13 range to be up to $290. See: http://www.mdsol.com/products/rave_overview.htm
Medsphere, a San Diego company, has raised $1.0M of a $15M funding round. Medsphere is commercializing an open source version of the EHR system developed for Veterans Affairs. Backers include Thomas Weisel, Azure Capital Partners, & Epic Ventures.
Good overview of Google Wave by folks at ReadWriteWeb.
Posts by pharma sales reps on site: CafePharma allowed in lawsuit that claims Schering hid study results on Vytorin.
More on Google’s plans to sell ebooks. Even though publishers get to set price, Google retains right to discount at its own expense.
Previously announced collaboration between Nature Publishing and InnoCentive launches. Innocentives provides platform for problem “Seekers” to solicit solutions from problem “Solvers”–all with a life sciences focus.
CMPMedica announces new online healthcare education program for patients & their caregivers. Health Empowerment Initiative targets “knowledge gaps” in patient understanding to improve compliance with prescriptions and healthful behavior. Sounds interesting & I’ll check it out, but they should have come up with a better name for the program!
Headlines for May 9 - May 14
- Posted May 15th 2009
- Comments (0)
- by Janice
From Mark Logic User conference #MLUC09, write-up of Webmedx, a company that provides transcription s/w to convert dictation to coded XML documents. Notes that approx. 60% of physician-created documentation is dictated & transcribed. Note section on CDA: Clinical Data Architecture & link to this open source standard.
Kevin MD on whether doctors who follow EBM should be protected against malpractice. Short answer, yes.
Dr. Thomas Frieden, NY City’s health commissioner, will be announced today as Obama’s pick for director of Center for Disease Control & Prevention (CDC).
Mark Leavitt, MD, CEO of CCHIT, says “meaningful use” of EHRs = “a certified EHR, it has to include e-prescribing, it has to be able to exchange information and it has to be able to report quality data.” I’ll add: to exchange information and report quality data, common standards for coding information are needed between the senders & recipients of info, and quality info must be input into the system before quality data can be reported. GIGO.
Google is experimenting with asking users who search for health-related topics why they are searching, e.g, looking to diagnose, find treatment, etc.
Philip Pead, former CEO of Per-Se Technology, is named successor to Andrew Eckert as CEO of Eclipsys.
Elizabeth Satin, who has focused on healthcare industry in her investment banking career, joins Wolters Kluwer as SVP & head of Corporate Development & M&A for N. America.
John Goodman raises issue of poorly-designed healthIT systems that in some circumstances increase the likelihood of error & cites a 2005 study.
Ad Age nicely surveys the state of digital marketing & social media usage by Big Pharma and their agencies. Highlights J&J, GSK, AstraZeneca, Novartis, Sanofi & Boehringer Ingelheim. Good quotes from top digital agencies, too.
Qforma, a healthcare-analytics company launches new directory for Most Influential Doctors in conjunction with USA Today. At launch, coverage will be national with doctors in these specialties: diabetes, high blood pressure, high cholesterol and asthma. QForma partnered with Wolters Kluwer Health for info on “millions of data points that reflect important collaborative indicators such as referral networks, practice patterns, publication history and leadership positions in professional associations.”
Dr. Gwenn interview Denise Basow, MD, editor-in-chief of UptoDate, to discuss appropriateness of patient site on UTD for spectrum of patients.
Pharma lobbying up 36% in Q1 2008, whereas most industries are down significantly. Pharma clearly wants active role in health reform.
NIH is seeking comments on possible changes to fed. regulations regarding potential conflicts of financial interest on part of researcher that could affect objectivity in design, conduct, or reporting of research fundeed under PHS grants. Note, transparency of researchers’ financial interests will be increasingly important as more medical & other scientifc research is made for widely available via the Web and other vehicles. Related to Open Access themes, too.
Intel-sponsored site on mobile healthcare
Some ideas for searching and mining info in Twitter.
Wal-Mart ready to expand onsite health clinics in partnership with hospitals. Initial partnership with Revolution’s RediClinics didn’t work out.
Extended list of academic, industry, and consultants who will advise on implementation of ARRA funds for health IT.
Brief summary of recent Forrester Research study on usage of social media in pharma marketing. Includes link to slides Josh Bernoff (author of the study) used at Social Pharmer, which I attended,. Note, many pharma marketers & agencies in the room didn’t agree with Forrester’s conclusions about target markets.
BreastCancer.org partners with HealthCentral.com for sponsorship ads. Is this a sign of new type of partnerships between online consumer health portals and non-profit consumer healthcare online communities. Can HealthCentral serve as effective ad/sponsorship agency for such sites? How will sponsoring social media healthcare sites like BreastCancer.org compare with Pharma’s direct development of community sites around a specific drug (e.g., Alli)?
New study on EMR adoption that surveyed Mass. doctors in 2005 and 2007 to be published in J. American Medical Informatics Assoc. cautions that inadequacies in most EMR systems lead doctors to only use pieces that work efficiently, e.g., e-prescribing. This confirms our view that lack of standards for data transfer and inadequate research in product design has resulted in EMR systems that do not improve efficiency of practitioners. Design that incorporates analysis of practitioner workflow and improved data standards are required before EMRs can be expected to improve productivity and lead to better patient outcomes. That’s what I think “meaningful use” should imply.
Health insurers, PhRMA, AMA, AHA, and SEIU say they will work to contain cost future increases in health care. Comments from readers reflect skepticism of pledge.
An essay from Times of London on future of printed books.
MobihealthNews interviews Roni Zeiger, product manager of Google Health.
HHS’s Federal Coordinating Council for Comparative Effectiveness Research (CER) is conducting “Listenning Sessions” for public to comment on CER. Upcoming sessions 5/13 in Chicago; 6/10 in DC.
Skyscape Sits Atop 2 Health Content Trends: Mobile Access and Pharma Marketing Shifts
- Posted May 5th 2009
- Comment (1)
- by Janice
Skyscape is well-positioned to benefit from two key health content trends. The first and most obvious is the rapid growth in usage of mobile applications for accessing health content. Manhattan Research published in its latest Taking the Pulse® v9.0 study that 64% of doctors are now using smartphones and that the number of physicians using iPhones more than doubled in the past year alone. Clinical and administrative content continues to be made available for mobile apps in response to the demand from doctors and other clinicians. Skyscape has seen its user-base nearly triple since the introduction of the iPhone.
The second trend relates to the increasing use of publishing as part of marketing and sales strategies by pharma companies. Pharma companies have a long tradition of subsidizing the distribution of authoritative medical content to physicians and other clinicians. Whether through reprints distributed by detailers or by providing access to content via sponsored CME and conference programs, pharma has served as an intermediary between commercial medical publishers and physicians for many years. A combination of factors, including tighter regulations on detailing and advances in digital publishing technology, is leading pharma companies to incorporate a more direct publishing component into their sales and marketing strategies. For example, social media marketing is gaining traction for use by pharma media agencies as part of cross-media marketing campaigns and in our view brings them ever closer to becoming “publishers”. With social media, the ad and media agencies are typically taking the lead in helping pharma companies to build communities of prospects around a drug or condition-related topic. For more on this topic, please see the accompanying blog post: Social Media Use by Pharma Blurs Lines Between Advertiser and Publisher.
Back to Skyscape. Last week, I met with the founders of Skyscape, Sandeep Shah and Kartik Shah (no relation), along with their new VP and investor, Will Passano, at their headquarters in Marlborough, MA.
Skyscape partners with leading medical publishers to distribute clinical content, mostly medical texts and other reference works, on the full range of mobile platforms. (Note, Skyscape got its start in 1994 creating content for Apple’s Newton.) The list of content partners is impressive and includes the top medical publishers (Wolters Kluwer, Springer, Elsevier, Wiley, McGraw Hill and many others) and drug reference sources; they claim to offer more than 500 reference works and offer them for download for fees similar to a print book, generally $50 - $100 for a reference work. They compare this to an iTunes model.
Their primary revenue model is selling content directly to doctors and other clinicians. Skyscape makes it easy to purchase and use clinical reference works with an intuitive interface and the addition of Smartlinks, their own technology that allow users to navigate directly to related information between applications.
But Skyscape’s business model extends beyond direct sales. They also offer programs for pharma companies to subsidize content, and offer the content to clinician customers as part of a marketing program that may also include alerts on brands news.
Skyscape also creates digital versions of conference programs. For multi-track events that take place over several days, the value add of a mobile application with digital search and linking features is obvious, especially when it replaces a 5 lb. conference book as was the case with the recent American College of Cardiology (ACC) conference guide. This allows the company to brand themselves with a “powered by Skyscape” logo.
We like their multi-faceted business model that includes direct sales and pharma channel sales. With over 650,000 active users and continued growth in adoption of smartphones by clinicians, Skyscape merits serious consideration from healthcare publishers as a mobile distribution partner.
Headlines for April 19-25
- Posted April 25th 2009
- Comments (0)
- by Janice
HealthBirds, tool provider and aggregator of health-related tweets.
Good post about experience on an “e-patient” who sought out additional options after being told she needed surgery. Point to keep in mind: it takes some work and luck to find an MD or advocate who can help. Patients need more guidance. “a wealth of information is available on the web, but patients often need encouragement to seek it, and help interpreting it and applying it to their own situations. Peer support groups on line are one way to accomplish this and finding an interested, available physician to serve as an “e-patient advisor” is another way.”
Harvard School of Public Health newsletter article that reviews some examples of employer-sponsored wellness programs. Compares carrot & stick approach.
Post by Partners clinical informatics R&D group on meeting in DC of new Clinical Interoperability Council. “CIC may help establish essential clinical governance mechanisms for defining & optimizing the implementation of HL7 standards, … and the clinical content that is used in healthcare information technology for clinical decision support.
FDA held meeting on Wed 4/22 to discuss strategic direction of the device center, which has been criticized for approving devices despite objections from scientific reviewers.
Q1 2009 earnings results for Healthgrades. net income $1.64 B met consensus estimates. Rev. grew 35.6%. Internet Business Group rev. grew 124%, mostly ad & sponsorship rev.
Medical Present Value Inc. has integrated its patient cost estimator with insurance eligibility/benefits calculation s/w. Based in Austin, TX. mpv.com
AHRQ contracted with Rand Corp to develop ‘how-to’ toolset for implementing e-prescribing systems. Notice in today’s Fed Register.
Not sure if I already tagged this story yet.
Example of new payment models in pharma sales. In this case, Merck provides discount to Cigna if Cigna helps promote compliance.
Great example of a Twitter Poll: Are Cochrane reviews too long, short, or just right.
ABC news writes about open access movement in scholarly pubishing and the importance of broader access to medical research. Also, article points to provisions in stimulus bill for continuing to require posting to PubMed, and describes the Conyers bill that takes the opposing view of diminishing open access.
Thomson Reuters’ NexCura Cancer Profiler Tools to be incorporated into National Foundation for Cancer Research (NFCR)’s website for cancer patients. Good example of medical society’s sponsoring commercial content for patients.
John Moore from Chilmark provides a quick comparison of growth in unique visitors to WebMD, Healthline & Healia.
Lowers forecast made in October by 2 %. Emerging markets capture higher % growth; US market to decline in 2009.
Revenue declines 8% to $526.0M (3% constant currency); Operating income also down, but net income up.
John Glaser, VP & CIO Partners Healthcare in Boston has accepted a 6 month stint as adviser to David Blumenthal, the recently appointed national coordinator for healthcare IT. Glaser will spend 4 days/week for 6 months working with ONC.
Agents from Defense Criminal Investigations Service raided offices of Siemens Medical Solutions in Malvern seeking documents related to company’s military contracts.
O’Reilly Radar reports that medical apps for iPhones are the 3rd fastest growing category. Medical still only 1.1% of all apps, but growing. Note, healthcare & fitness is separate category with 2.5% share.
American Medical Assoc. plans to launch health info exchange platform for physicians. AMA has contracted with Covisint (sub. of Compuware) to build the platform. Will likely include practice mgmt tools, CME and other content, clinical mgmt tools and networking. DrFirst has already announced its plans to offer its e-prescribing s/w via the platform.
Microsoft’s Tim Smokoff, genl manager MSFT’s worldwide public sector health division, on state of health IT and MSFT’s role.
Good post on “ebb and flow” but steady progress being made in determining clinical quality guidelines.
Good article on well-publicized deal between Microsoft & Mayo Clinic to offer PHR free service.
ADAM releases a consumer health app for iPhone with content from ADAM, Healthcare Blue Book, video from HealthiNation, and some blogs/social networking sites.
From Healthline, post that provides the “pro” point of view on patients doing online research prior to office visits–despite some possible drawbacks.
Story in FT that suggests that new CEO of Reed Elsevier, Ian Smith, may be interested in talking with WoltersKluwer about a merger. Also reports on new chairman, Anthony Habgood.
Searchable transcript of UnitedHealth, parent of Ingenix and OptumHealth, latest earnings call.
UK’s NHS on DNA tests.
New site includes ability to upload and share personal protocols.
Cignamakes Quicken Health Expense Tracker available to those enrolled in most of its health plans, via myCigna.com.
SureScripts releases report and PR that announces growth in e-prescribers in US from 19K to 103K in past 2 years. Q1 2009 growth especially high due to new incentives from CMS.
The result of consumers’ bearing more of the costs of healthcare: fewer doctor visits & reduction in other care. Especially acute in recessionary times with loss of employer-paid care.
Developing countries adopting telemedicine & use of mobile phones for medical records transfer more rapidly than in US.
Healthline adds suite of tools & enhancements to help patients research treatments & costs.
Zynx Health (a Hearst Bus. Info company) contracts with Scope e-Knowledge for medical terminology mapping project.
More on FDA warnings to 14 pharma companies about lack of compliance of short online paid search ads. Prior to recent warning, pharma companies thought a “one-click” rule existed, which allowed for brief ad as long as a click on the ad led directly to more info.
Good piece on PaidContent about FDA warnings to Pharma about use paid search ads, which the FDA says are misleading because they don’t include risk info. In early April, FDA asked pharma companies to remove ads that contain violations and respond to the agency by mid-April. Health in one of largest verticals for Google, and pharma ads make up the largest component of ads in the category, so Google has big incentive to find a solution, even though SVP Rosenberg says it may not be easy.
American Psychiatric Assoc votes to phase out pharma-sponsored symposia at APA annual meetings.
Good article in NY Times on state of personal health record (PHR) systems. Key point, for most patients, their provider(s) are not using effective EHR systems that can interact with PHR s/w. PHRs can still be a useful tool for record-keeping for individuals, although the patient will have to input all data manually. My comment: with more patients on high-deductible plans with HSAs, there is more incentive to track medical expenses. Intuit’s tools may be good solution.
Follow-up to Google Health story about e-Patient Dave. BIDMC’s CIO Halamka has decided to halt transmission of medical billing codes to PHR vendors. Instead, they’ll send info from clinical records, which include a mix of textual descriptions and some codes.
Dr. Roni Zeiger, product mgr for Google Health, writes that patients should ask about risk/benefit profile of all treatments their doctors suggest. Good goal in an ideal world, but we have a way to go before we have sufficient data to provide the statistical evidence. The greater issue is improving health literacy, ie., educating patients about medical research and basic statistics.
FTC files propsed privacy requirements for PHR vendors and organizations that send data to PHR vendors. ARRA requires FTC to work with HHS to prepare a report to Congress by Feb. 2010; for now, FTC is proposing “interim final regulations” covering breach notifications for PHR vendors.
Follow-on from John Halamka, CIO of BIDMC, re: the Google Health brouhaha this week. They’ve learned from experience that medical billing codes shouldn’t be tranferred to Google Health. Overall, post supports my point that health literacy & patient education experts not involved in plans for Google Health PHR.
Thomson Reuters Healthcare’s Medstat Advantage Suite and APS Healthcare are chosen by NY State’s Medicaid office to provide analytic/predictive modeling services to study usage patterns in provision of Medicaid services. “APS, which operates 41 Medicaid programs in 26 states and Puerto Rico, focuses on improving overall health and wellness through education and interventions that promote behavior change, improve health outcomes and reduce long-term healthcare costs. Thomson Reuters’ Advantage Suite® is currently used for data analytics and decision support by Medicaid and other government agencies in 28 states. Thomson Reuters will deploy its Medstat Advantage Suite® solution, which combines a customized repository of healthcare data with a comprehensive set of analytic tools. The system generates intelligence and benchmarks that governmental agencies use to analyze and manage the cost and quality of healthcare delivered to their beneficiaries.”
Debate about usefulness/value of genomewide studies for predicting likelihood of disease in individuals, based on currently available genomic testing services. Full genomic profile of individual appears to be more useful.
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