HealthContentAdvisors

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

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

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.

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.

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

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

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.

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.

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.

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.

Home page of Jan 2010 report from RWJF 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.

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.

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

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

“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.

“Press Ganey Associates, Inc. today announced the addition of Philip Marshall, MD, MPH, as senior vice president, clinical products. Dr. Marshall joins the company at a time of continued growth and will be responsible for expanding the clinical product lines for the company.” Dr. Marshall was most recently VP Product Strategy at WebMD Health.

Superb analysis of impact of Scott Brown’s win to fill Ted Kennedy’s seat in the Senate on health reform. David Harlow (whom I finally got to meet yesterday) and Joseph Kvedar offer insightful quotes. Kvedar suggests that if health reform legislation doesn’t pass, we still have raised awareness of need for change to control costs and that some changes will occur even w/o legislation. Harlow says that costs and quality will continue to decline w/o legislation and could lead to a stronger bill with some form of a public option down the road.

Good article from former HBS professor on how companies can mine their own propriety data about customers and partners to their advantage. Lays out the 5 keys to doing it right: 1) create a network to collect proprietary data; 2) use best technology; 3)analyze with insight & precision; 4) figure out how to act on info to your advantage; 5) be lucky enough to have good timing.

Nuval, a Boston-area company that provides numeric ratings that reflect nutritional value of foods, gets official endorsement from American College of Preventive Medicine.

Very good commentary about shortcomings of continued medical education (CME) from a Canadian physician’s perspective. In Canada, CME (called CPD in Canada) is more structured and reporting is more detailed. Dr. Rob is very critical of US system that relies primarily on attendance at medical conferences.

Highlights IdeaBounty and InnoCentive as examples of companies that facilitate crowdsourced innovations. In these two cases, winning participants are paid for their ideas/solutions. Good article that describes how 1 company replaced their ad agency with IdeaBounty for creative.

Pearson FT is apparently shopping Interactive Data.

DeepDyve makes another move toward making scholarly journal articles more accessible. The partnership with CiteULike expands the utility of DeepDyve to knowledge workers who don’t have high-priced subscriptions through their corporate or academic library. CiteULike is a “delicious”-type bookmarking service popular in the scholarly community. DeepDyve also announced partnership with publisher De Gruyter. I am impressed with the pace of innovation and content deals carried out at DeepDyve. Their $0.99 rental price for journal articles is an important step toward opening up access to scholarly research on a much wider scale.

Good article and comments about expectations of enhanced ebooks. Key themes IMO: 1) publishers have to understand the technology platform/distribution platform that is appropriate for their audience; 2) pricing plays a role in selecting the right platform (CD-ROM allowed fixed pricing at a time when online access charged per second); trying to use new technology as a guise for increasing prices is a risky move.

Poll of 800 physicians on Sermo indicate that large percentage feel current Medicare policies are out of sync with market needs. “[O]ver 40% of the physicians polled feel the US government “never will” understand how declining reimbursement rates from Medicare negatively affect the care patients receive from their physicians. They fear reimbursements will continue to decline in the coming years, reducing patient access to physicians.”

Nice article that describes some reliable sources of health info for consumers from a Minnesota pub. Note, they still have PDR listed as owned by Thomson Healthcare, even though it’s a winter 2010 article.

Good overview of the two companies and the impact of the acquisition. John Moore of Chilmark views the acquisition as a long-term investment since he doesn’t see much life in the PHR segment at this time.

Adams replaces Carl Byers, athena’s initial CFO, who last June said he wanted to live abroad.

Credit rating firm TransUnion has acquired MedData LLC, a Charlotte, N.C.-based health care transactions processing firm, for an undisclosed sum.

Healthcare IT News reviews Allscripts/Misys Q2 results. Rev. up 30% yoy. Allscripts CEO, Glen Tullman, calls 2010 “year of the EHR” due to stimulus funds.

Origin, a CT-based provider of RCM and clinical and BI analytics, gets growth equity funding from TCV. Previous investors include Beecken, Petty & O’Keefe & Company (“BPOC”), an investor since 2006, and management as investors in Origin.

Not enough info is provided in blog entry to make much sense of the results. Asking people what general categories of content they would pay for isn’t very telling; better research methods are needed. Plus, there’s such a range of content in each type that results aren’t very valuable.

Good article on outlook for Informa. Author indicates that asset sales are likely in 2010 and points to Performance Improvement as a top candidate, since it doesn’t fit with other Informa assets. However, Informa’s CEO, Peter Rigby, is against divestments and would prefer to grow through more acquisitions, according to article. Also, academic/scholary publishing division is called out as their best performer (due to high margins). Given pressures on this segment and lack of innovation from Informa, I would be worried if I were a shareholder.

Harvard Pilgrim Health Care Inc. has won a $72 Million grant from the FDA to build a system to monitor the safety of drugs and medical devices after they have gone on the market.

Good commonsense views on what will and will not change in 2010.

Short but insightful article that reports some interaction between Google’s CEO Eric Schmidt and Atul Gawande, MD, author of new book The Checklist Manifesto. Key point, workflow or “clinical encounter” is not understood by the computer scientists who create EMR systems. Also, systems analysis and performance improvement (my terms) are not respected uses of time for MDs.

Dr. Fabius, among other things, served as president and chief medical officer for i-TRAX, which was acquired by Walgreens in 2008. “I-TRAX was the parent company of CHD Meridian Healthcare, a leading provider of worksite healthcare centers for large employers.”

Inside Out provides interactive training on the human body for K-12 market.

Brian Ahier summarizes Sec’y HHS Sebelius’ Health Security program.

Kaiser and VA (Veteran’s Affairs) will use NHIN to exchange patient data (with permission) in pilot program in San Diego area.

Some good insight here. E.g., 6)PMS vendors will acquire RCM companies (didn’t I just write that yesterday?),8) Payers, PBMs and Pharmacies will use EHRs to deliver information (add publishers to that list).

Kevin Noland resigns to make way for former CFO Mark Adams to take helm. Could this be result of change in strategy to focus more on benefits management services than content?

TabSafe, an Indiannapolis company, showcases its medication management system at CES.

“23andMe has completed a $27.8 million second round of funding. In addition to funding from Google and Google founder Sergey Brin (husband of 23andMe founder Anne Wojcicki), 23andMe has been funded by Genentech and New Enterprise Associates.”

As my colleague Russell Perkins said, “betcha thought there already was one”.

Dr. Carolyn Clancy, director of AHRQ, describes new report for consumers on anti-depressants. Includes link to full report.

“Atenda is one of the largest home health benefit management companies, providing care and exclusively managing more than 1.3 million lives. Atenda is used by major health plans as a single point of contact for managing all home care services, resulting in improved care and cost savings to plans and their members.” Univita was established by Genstar Capital last year with its acquisition of Long Term Care Group, and subsequently acquired ENURGI.

HIMSS writes up new CDSC created by Blackford Middleton at Partners Healthcare.

“The National Association for Children’s Hospitals and Related Institutions (NACHRI), a non-profit organization dedicated to improving the operations and quality of care in its almost 200 member hospitals, is using a web-based research database and reporting system developed by IT Consulting Services of Quantros to report on quality improvement initiatives. Quantros is a leading software and services provider for the healthcare industry.”

Nice article on Google’s view of future of advertising. I agree with Arora from Google that online ads shouldn’t be an afterthought, but a critical part of overall advertising strategy.

Nice summary of major milestones in medical research in the last 10 years. Emphasizes the impact of the mapping of human genome a decade ago. Also points to advances in preventing disease. Note, although preventive medicine is a much better long-term goal than treating illness, based on my experience, funds tend to be focused on the crisis of the moment and savings of prevention often get forgotten over time (e.g., vaccinations). However, for the present time, there is likely to be renewed focus on prevention in medicine.

Good thought-provoking piece by Joe Esposito. He uses example of early enthusiasm from entrepreneurs and Wall St. to build broadband pipes to households, which puzzled the established RBOCs who couldn’t imagine why HHs would need such high bandwidth. Contrasts that situation with today’s need to radical change in scholarly publishing model to provide more direct interactive between researchers and scientists. Implication is that the needed change won’t come from traditional players. I agree.

Scott Kirsner, Boston Globe, on trio of young companies that provide outsourced R&D, using crowdsourcing. Innovcentive, Hypios and Yet2.com are highlighted. Innocentive & Yet2.com are Boston area companies; Hypios is in Paris.

Editor of Journal of Spinal Disorders & Techniques for past seven years receives royalty payments from certain Medtronic devices. “Studies involving Medtronic spinal products or that were funded by Medtronic appeared in the journal at least once per issue, on average.” And, are uniformly reviewed in a positive light. More trouble for scholarly publishing sector–fueled in part by Richard Smith, former editor of BMJ.

Nice post that focuses on improving access to healthcare data–by all stakeholders.

Interesting news about licensing deal between AllTheContent, a Geneva, Switz based content syndicator, and Pharma Channel, which provides info to pharmacies in Europe.

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

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.

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.

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

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”?

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.

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).

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

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

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.

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!

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.

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.

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”.

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

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.

Conversation between Milken and Pfizer CEO Kindler

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

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

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.

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.

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

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.

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.

Comprehensive article on HSAs and high-deductible health plans.

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

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.

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.

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

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.

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

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.

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.

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.

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.

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

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.

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

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

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

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

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.

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.

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.

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.

Wonder what Lexis and Westlaw will say about this?

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.

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.

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

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?

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

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…

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

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

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.

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

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

linking patient data and related information

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.

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

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.

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.

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.

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

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

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

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

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

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.

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.

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

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

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