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Consequences of Market Concentration in Healthcare
- Posted August 26th 2010
- Comments (4)
- by Janice
Paul Levy, CEO of Beth Israel Deaconess Medical Center in Boston, wrote in his blog about dangers of market concentration in the provider segment earlier this week. Levy’s main point is that large provider groups can negotiate better rates from payer organizations and put smaller provider organizations at a disadvantage and that the accountable care organization (ACO) model could exacerbate the negotiating power. Furthermore, there are consequences to consumers when market power is highly concentrated. Also this week, John Moore of Chilmark Research wrote about the recent acquisition of Axolotl by Ingenix, a healthcare data analytics company. In this post, I connect and extend these two topics and address issues related to vertical market concentration in healthcare with Ingenix as the example.
Ingenix is a wholly-owned subsidiary of UnitedHealth Group, an $87 billion (2009 revenue) company with approximately 80,000 employees in its four major divisions: health benefits, benefits management, data and information services, and pharmacy benefits management (PBM). The health benefits (insurance) segment is the largest by far with 2009 revenue of $81.3 billion, and Ingenix (the data and information services segment) is the smallest with 2009 revenue of $1.8 billion.
However, Ingenix has an operating margin of 13.5% vs. the health benefits margin of 5.9% and Ingenix’s recent top line growth is stronger than the other segments. Considering the number of acquisitions made by Ingenix, it’s not a surprise that revenue is growing. According to Ingenix’s careers page, the group has acquired over 50 companies in the past 10 years. See Alacra’s headlines and timeline of the Ingenix acquisitions since 1998 (as well as their offer to sell you more information).
A few notable acquisitions include The Lewin Group, a healthcare consulting company, QualityMetric, a health outcomes measurement company, and PICIS, a clinical workflow IT vendor to hospital emergency departments. I find these deals of note because they clearly extend Ingenix’s purview beyond the payer and pharma analytics segment into the clinical analytics segment.
The Lewin Group, for instance, received a contract from HHS last year to develop the framework for comparative effectiveness research.
Lewin describes how the resources of its sister companies within Ingenix position it well to develop the framework that will be used to determine the relative effectiveness of treatments on its own site as follows (emphasis mine):
The Lewin Group Center for Comparative Effectiveness Research has unique capabilities for conducting and supporting CER, combining The Lewin Group’s broad and widely recognized record of independent analysis of health information technology, evidence-based medicine, health care policy and other issues; affiliate company i3’s expertise in clinical trials and study design, drug safety, health economics and outcomes research; and Ingenix data. Through Ingenix, the Center will have access to robust longitudinal de-identified patient data sets including integrated medical, disability, laboratory results and pharmacy claims data. The staff available to the Center includes more than 1200 health services researchers, clinicians, clinical trial design experts, epidemiologists, biostatisticians, health data experts, health economists, and others.
In John Moore’s post, Ingenix’s EVP for provider solutions states that he “sees a convergence of administrative and clinical processes”. I agree that analytic processes and platforms that have been developed for the payer market are being adapted for use in clinical settings, and I’d add that the same type of convergence is occurring between life science research analytic platforms and clinical platforms. In fact, I’ve drawn a 3 circle Venn diagram illustrating the convergence in healthcare data analytics between these three domains in recent client reports.
Should we be concerned that a large payer analytics company (Ingenix), owned by one of the largest health insurance providers, is on a path toward becoming a dominant clinical data analytics company? I think so. There are so many reasons to be optimistic about the benefits of data analytics in healthcare applications that can lead to improved personalized care and drug treatments. But, like Levy, I have concerns about the concentration of power in large organizations and the implications of such market power on the future of clinical decision support systems.
Today’s Health Content Headlines
- Posted August 26th 2010
- Comments (0)
- by Janice
Please scroll down if the story you are looking for is not the first headline. New stories are added throughout the day and I may have provided a link to the most current story that is now lower down on the page. Follow me on Twitter @janicemccallum.
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.
Changing the Healthcare Story
- Posted May 26th 2010
- Comments (0)
- by Janice
“The world view is a narrative - it’s a narrative we got from our parents, our teachers, our employers and our culture, and to change that narrative with good data and good statistics takes more than numbers. But it can’t be done without the good numbers.”[1]Hans Rosling, Director, Gapminder Foundation.
Last week, I attended Patient-Centered IT ‘10 produced by the health and wellness team of Capstone Partners, an investment bank that serves middle market companies. The quality of speakers and the interesting mix of health IT and health content start-ups combined to make it one of the better healthcare conferences I’ve attended in a while.
Among the highlights:
Jim Champy-of Reenginering the Corporation fame–opened the meeting with a preview of his new book, Reengineering Health Care, co-authored by Harry Greenspun, MD, CMO of Dell. Available in June, it is targeted to clinicians and exhorts them to take a stronger role in calling for improvements in our healthcare delivery system. In Champy’s words, we “need proof to convince clinicians” of the benefits of changing and automating processes in healthcare provider institutions.
Toward of the end of his talk, Champy expressed surprise that more consumers are not clamoring for change in our healthcare delivery system. Why aren’t they? I think it’s because they don’t have enough information about the often dangerous flaws in our current system or enough knowledge of how much better the system could be with improvements that are eminently doable with existing information sources and IT resources.
Another speaker, Katrina Firlik, MD, CMO of HealthPrize, brought up the point that “data can drive better behavior“. Her company uses techniques from human behavior studies to create engaging programs to improve patient adherence to prescription drug treatments.
Both speakers emphasized the role of “evidence-based narratives” in changing human behavior. We are producing and collecting increasing amounts of health-related data, and we’re making good progress in introducing standards and improving the interoperability between currently fragmented data sets, though the need for aggregators and consolidators will remain strong for the foreseeable future.
What is needed are compelling stories based on the data-stories that link back to the source data and exhibit a solid understanding of it. But Rosling warns that misrepresentations will be rampant as access to data becomes more open. I recommend watching Rosling’s presentation that is referenced below–especially the first 20 minutes–for an entertaining and inspiring view of the power of data to change the healthcare story.
[1] Hans Rosling from the Gapminder Foundation in a presentation at World Bank, May 24, 2010. Rosling uses examples from public health, but his descriptions of building narrative from data bases, especially using graphics, equally applies to other situations.
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 Mar 1- Mar 19
- Posted March 19th 2010
- Comments (0)
- by Janice
RT @HealthVault: Register today for the Microsoft Connected Health Conf May 19-20. https://www.msconnectedhealth.com/SiteLogin.aspx
iVillage’s new Health site w/ content from Healthwise & Cleveland Clinic: http://bit.ly/ciOVt9 /Still looks like woman’s magazine 2 me
Detrioit’s largest nonprofit hospital 2 B acquired by for-profit Vanguard Health: http://bit.ly/aDIKjS /more consolidation amg providers
RT @HealthBizBlog: Health Wonk Review blog carnival at RWJFs Health Reform blog http://tinyurl.com/ybq6ow7
RT @SusanCarr @ctorgan: e-patient conference April 6-7, in DC. By NLM, at NIH http://www.fnlm.org/Events-2010-Conf.html
RT @iHealthBeat: Cleveland Clinic Project Finds Benefits in Linking Devices With Physicians - http://bit.ly/9vYBOb
Stephen Schoenbaum, MD, MPH’s testimony to Mass. Division of Health Care Finance & Policy on costs of healthcare in MA. Slidedeck links included. Thanks to Paul Levy for pointing to this info.
NIH creates public database, Genetic Testing Registry (GTR)that will help consumers and providers determine best options for genetic testing. Goal of GTR is to have providers of genetic test enter info on the tests and identify laboratories that perform the tests.
Study by MedPAC reports that hospitals that lose money on Medicare/Medicaid reimbursements have higher fees and higher profit margins and represent large hospitals with strong negotiating power. They charge commercially insured patients higher fees to compensate for losses on CMS patients. But, majority of hospitals have incentive to keep fees lowers and manage to make money on Medicaid/Medicare patients. Consistent with Paul Levy’s post today.
Very nice case study of how Vida y Salud has grown their brand and achieved substantial audience growth in under a year. Emphasizes importance of quality unique data and a cross-media marketing campaign.
Matt Holt interviews Glen Tullman at HIMSS10. Glen does nice job of describing how Allscripts have some footprint with 1/3 of US doctors and is working toward interoperability and connected care. Slams Epic.
RT @healthblawg: RT @Paulflevy: Cost Driver Hearings in MA are worth viewing: http://bit.ly/a8M7FN ^ cf background http://bit.ly/9JC7Qx
Massachusetts is holding hearings on drivers of healthcare costs. Paul Levy, CEO of Beth Israel/DMC, provides links to prepared statements & points out that higher costs are correlated with market power/negotiating strength of hospitals and not to type of payment system (global payments vs. fee-for-service).
Coke tries for compatibility between its health insurance plans and its wellness programs–with some success. Hm, wonder if cutting out sugary softdrinks buys points in wellness programs.
Emdeon, a large revenue cycle management (RCM) company, acquires Healthcare Technical Management Services, a health IT consulting fimr that assists insurers in purchasing and implementing IT. Services to aid in transitioning to ICD-10 seem to be the major attraction in this acquisition. Emdeon to pay $11M with additional cash payments of up to $14M based on financial performance.
RT @roskadigital: Text4Baby surpasses 22,000 users, 500k msgs sent http://ow.ly/1nqbW #hcsm CDC, J&J backed
RT @wroush: Top national players in #healthIT (Sebelius, Blumenthal) coming to Boston next month for conference. http://bit.ly/9EyvQg
RT @tgoetz: why does technology drive costs UP in medicine? @huffpo http://bit.ly/ayMAtt /I agree w/ lack of transparency, but not scale
Interesting counterpoint — or complement– to my latest blog post about how healthcare content is being transformed into apps for integrated systems. Guerra questions whether the healthcare sector will accept a plug-and-play environment. I’m a bit more optimistic than he, based on external incentives.
Official gov’t site with summaries of recent HIT Standards Committee meetings.
RT @VinceKuraitis: Here’s the health care chapter of the FCC Broadband expansion report! http://bit.ly/92hv61 #healthit via @mobilehealth
Lates recommendations from HIT Policy Committee to the ONC re: meaningful use, certification/adoption of EHRs, and privacy & security.
RT @HITNewsTweet: Professional registration at #HIMSS10 saw an increase of 9 percent http://ow.ly/1lccO #healthIT
More evidence that the health IT sector is healthy. Registrations were up 9% in 2010 for a total of 27,855.
RT @healthcentral: Google allegedly polling AdSense sites on showing pharmacy + liquor ads http://bit.ly/axCicw
Reviews recent survey by Surescripts, the largest e-prescribing network, on adoption of e-prescribing by physicians. Even with $$ incentives from CMS that started in Jan 2009, uptake has been slow. Combo of CMS incentives and inclusion of e-Rx app in an EMR seems to be biggest driver of growth.
Dr. Kevin Pho addresses some of the drawbacks of tying physician compensation to patient satisfaction survey scores. Hospitals do receive incentives from CMS to report survey results. But there are other measures that should help balance the issues raised in Dr. Pho’s article. But I agree that assessing quality of care of a physician by averaging patient satisfaction scores is dicey.
RT @ahier: Premier comments on #MeaningfulUse (pdf) http://bit.ly/aTRj4z /Long…but enjoyed the section on Problem lists & codes.
Finally posted my comments on #HIMSS10 from my “health content” perspective: http://bit.ly/9CVkjo #in
RT @robertloakes: RT @jimmyweeks: Thoughts on #HIMSS10 http://post.ly/S9Kv /thx for the notes, Jim. Wish I had seen Thurs keynotes.
RT @SusannahFox: What if food inspection results were searchable? Drug approvals? http://bit.ly/9Qk6zb (via @nwatzman) #gov20 #datacontent
RT @ClinicalCafe: CMS orders UC Irvine Medical Center 2 improve medication mgmt (Via @PSeditor @AbbieCitron) http://bit.ly/9fFQOh #ptsafety
RT @ePatientDave: Beth Israel Deaconess “learned from implementing EHR as a service” http://is.gd/afFCK
WebMD launches core community feature, WebMD Health Exchange with group of medical experts who will provide info on a range of topics. But, primary purpose is to encourage peer-to-peer patient/consumer sharing. It will be interesting to see how successful WebMD is in building patient communities. Most patient community sites started small with tight focus.
RT @Health_IT: From MicrosoftMD, Crushing Complexity from Healthcare, http://bit.ly/bR1LJv #healthIT
RT @healthblawg: Patient safety not taught in medical school? Lucian Leape Institute releases report… http://bit.ly/94R424
RT @knowledgevision: Gr8 use-case: Emerson Hospital using KnowledgeVision 4 Dr. briefings http://ow.ly/1gP4B /Fmr colleagues lead new MA co
RT @Eclipsys: Video of Eclipsys’ Phil Pead on CNBC to discuss the benefits of electronic medical records. http://bit.ly/c0HHKA
RT @KentBottles: RT @iHealthBeat: British Medical Group Calls for NHS To Halt EHR Database Project - http://bit.ly/bTD1M8
RT @john_chilmark: Why I’m not crazy about the WebMD Exchange http://wp.me/p6shx-CC Poor SM execution
RT @GlobeHealth: Few drug studies meet comparative effectiveness definition - http://b.globe.com/co6JTr ;yea but it’s f(RCT) process.
» Survey shows nurses spend most of their time on paperwork | Healthcare IT News
RT @ahier: Survey shows #nurse’s spend most of their time on paperwork | http://bit.ly/asw1Vq (via @HITNewsTweet) /Need workflow apps
RT @PracticeFusion: Use of e-prescribing nearly tripled in 2009 http://tinyurl.com/yzjex4b /Driven by Gov’t incentives; will it work for #MU
RT @patientslikeme: PLM & Novartis launch free online community 4 organ transplant recipients: http://bit.ly/cZyqNo
RT @vaibhavb: “Checklists” and Rapid Innovation with Amalga http://bit.ly/cjpwyT #HIMSS10 #HIT /Nice video demo.
Recent Harvard School of Public Health study points to increased risk of heart disease & diabetes from eating processed meats. Unprocessed meats didn’t have same association to heart disease. This was meta-analysis of previous studies. Wonder if AAFP still advertises Buddig & Boar’s Head on their Healthy Living pages.
RT @healthblawg: Dr. John Glaser, CIO Partners Health Care, speaks w/ David Harlow about health. http://bit.ly/bgcetK /Look fwd to reading.
Headline Commentary Feb 14 - Feb 28
- Posted February 28th 2010
- Comments (0)
- by Janice
GE’s press release for HIMSS. Includes debut of clinical knowledge platform that helps providers with quality improvement initiatives, expanded HIE services, a clinical portal and a patient health management system.
FDA charges Guidant (a Boston Scientific company) with failure to report safety problems with some of its implantable defibrillators.
BU School of Medicine creates RED (Re-Engineered Discharge), a checklist that helps reduce readmissions. Other examples of application of health IT in this article.
Eclipsys Sunrise Enterprise suite of health IT software applications to integrate with Microsoft’s Amalga UIS platform.
Earnings in health and pharma division down sharply–from 29M Euros in 2008 to a loss of 79M Euros in 2009. WK says pharma communications, advertising and book sales biggest factors. McKinstry says they are changing portfolio of WKHealth to focus on “clinical decision support areas”.
Athenahealth to delay its Q4 SEC filing so that it can audit its revenue recognition practices. Has to do with how Athenahealth amortizes implementation fees that are deferred until implementation is completed; they are considering extending the period of amortization beyond the current 1 year.
MIT Technology Review feature series on personalized medicine. Haven’t taken good look at the articles yet, but will return to explore.
Important story about how Harvard Vanguard/Atrius physician group is making Beth Israel/Deaconess Medical Center (BIDMC) a priority hospital because of coordination of care between the two institutions.
Sponsorship and payments from device and pharma companies to fund research and for board representation introduce conflicts of interest for academic health centers. No news there, but some good insight into recent developments in this article.
Mayo, GE Healthcare & Intel partner on year-long study of effects of monitoring seniors & people w/ chronic illnesses with home monitoring devices.
John Moore at Chilmark provides insightful analysis of today’s announced alliance between Microsoft Amalga and Eclipsys.
“”Blending Eclipsys’ leadership in physician adoption and sophisticated clinical and decision-support workflows with Microsoft’s leadership in interoperability, data extraction, authentication and context management will open up new choices and opportunities for healthcare organizations needing to make the most from their existing IT infrastructure.”- Peter Neupert, Corporate VP, HSG, Microsoft.
Google and Microsoft Health execs address benefits of health IT on healthcare in short article published in The Hill. Two key points: 1) focus on the patient and 2) focus on the performance improvement (”improved outcomes we want to achieve”) with health IT, not just IT for IT’s sake.
Interesting. DyanamicBooks allow professors to customize textbooks with their own modifications. Prices will be lower for e-books, but print on demand versions will cost about the same as traditional print version. What about copyright for new version? It probably remains with Macmillan, which means professors don’t get to copyright their contributions?
Primarily via financing initiatives from Treasury, HHS, and Dept. of Agriculture will fund programs that improve the availability of fresh foods and more healthy alternative foods in communities that currently lack access to large grocery stores. These initiatives are closely tied to first lady Michelle Obama’s Let’s Move initiative that aims to decrease childhood obesity.
Obama’s healthcare proposal 2/22/10
CalTech is partnering with DeepDyve to provide discounted access to DeepDyve’s article rental service to alumni. DeepDyve’s Gold plan, which allows rental access to an unlimited number of articles included in DeepDyve’s collection of scholarly journals and other literature that sits behind paywalls. I continue to be impressed with DeepDyve’s initiatives to increase access to scholarly research that has been walled off to non-academics or those who don’t have a corporate subscription to commercial collections.
Missed this last week. PatientsLikeMe acquires ReliefInSite, based in Hungary. ReliefInSite helps patients track their pain levels; bus model relies on pharma and clinical researchers.
Transcript of Q4 2009 earnings call with Kerry Hicks and CFO Allen Dodge. Few tidbits: efforts to build risk management business line (Health Credit Solutions) have failed and Health Grades is winding down that business and focusing instead on ratings products. Advertising sales have grown nicely, esp. from AdSense and other networks. However, I still question how well the WrongDiagnosis.com product fits with HealthGrades.
IMS offers decision support service for regulatory compliance for Pharma and med device companies.
Some good points about quality of patient-reported data and implications for using data from patient community sites in research. I like the points about how some users enter dummy data just to test out a site and the importance of recognizing what data are missing. Both issues related to good data management.
National Center for Quality Assurance (NCQA) paper on evolving standards for Patient-Centered Medical Home metrics.
Summary of project funded by RWJF and carried out by IHI to study performance improvement initiatives in hospitals in the period 2001-2008. Link to report included.
Grassley questions Pharma sponsorship of content on WenMD
E-patients consult Web to find ratings on doctors and providers, but fewer post ratings themselves. Link to full report from Pew.
Eclipsys beat expectations in Q4 2009, with earnings of $3.8 Million, up 15% YoY. Rev. up 5% YoY.
John Mack on the role Pharma can plan in providing information directly to consumers via social media.
Good overview of ResearchGATE, a social networking site for scientists that allows users to set degree of privacy and facilitates collaboration. Bus model: jobs board for scientists.
Pathway Genomics, which provides genetic tests to consumers, licenses Staywell’s Harvard Health Content so that customers can access additional information about the conditions reported in the test results.
ONC’s Aneesh Chopra, who chairs the Implementation Workgroup, seeks feedback on how to build a starter-kit for EHR implementation. Specific categories of interest: Vocabularies; content exchange standards; communications exchange standards, and privacy.
Story of how Louisiana has seen improvements in rural health care through implementation of health info exchange.
AHRQ
Recent survey commissioned by Cleveland Clinic, GE Healthcare & Ochsner Health System indicates that 50% of Americans believe other people’s health “was going in the wrong direction” but only 17% said their own health was “going in the wrong direction”. 2000 people surveyed. Results are in line with my observations. Many people are in denial that their habits are unhealthy. Even when they get sick, they don’t believe their own health management was a factor.
Consistent with research by Tomas Philipson, U. Chicago. Healthcare innovation and IT saves lives, but it comes with a high cost. We can keep innovating, but we can’t afford to keep paying for the innovations in the current system.
TOC and links to full report from CDC on trends in health statistics.
“Must read” article in NEJM on creating national program for CER.
HHS Secretary Kathleen Sebelius releases report that includes info on requested premium increases by health insurers across the country. Link to full report included.
Description of study in Worcester, MA to implement evidence-based theraputic management guidelines for cardiac patients.
Shared Health Clinical Xchange, the largest HIE in Tennessee, has partnered with Elsevier’s MEDai to provide clinically-relevant HIE.
Meta-analysis indicates that use of statins to control cholesterol is correlated with higher risk of type 2 diabetes.
Veteran’s Admin to monitor how doctors respond to e-alerts sent via the agency’s computerized patient record system (CPRS). Currently, they only tract if doc acknowledges receipt of an alert, not whether the doc takes follow-up action.
Simple “hockey-puck on a stick” test easier to implement in real-world situations: “There are computer algorithms to measure reaction time, using game-like programs. But they’re not so good for use at the sidelines, and they involve licensing fees.”
Excellent presentation of text/audio content–and the info provided is excellent, too. Good points about data alone not being sufficient; data must be put in context and must be shared to be helpful. Read Susannah Fox’s comment to learn more about the people behind the voices in the video.
NaviNet chosen as communications network in pilot intended to document benefits of provider-payer health info exchange in NJ.
Fascinating overview of changes to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)currently in draft form. Along with the info about specific disorders, I find the new approach toward categorizing disorders along a spectrum of severity very interesting. The degree to which someone has a disorder is considered, rather than placing each level of severity in a separate category. Aspergers as part of the autism spectrum is the example that is getting a lot of press.
GE producing TV ads for Healthymagination campaign during Olympics. Also sponsoring content online. Good to see someone beside Pharma sponsoring content!
Excellent lead article on need for automated data input (from devices, exchange from other systems, etc), better clinical decision support systems, and process change to make use of EHRs “meaningful” in improving health care.
Hope Leman’s long, but very entertaining, comments about DeepDyve’s specialty search and article rental model for scholarly journals articles. Access to much of the scholarly journal content isn’t available to non-subscribers and even discovering the existence of this body of content is difficult, which means the publishers are not reaching growth markets. DeepDyve offers a solution with minimal risk to publishers, yet the buzz for DD hasn’t grown as much as Hope (or I) would have expected. Worth reading — and it’s worth checking out DeepDyve.
Headline Commentary Feb 1 - Feb 13
- Posted February 13th 2010
- Comments (0)
- by Janice
PatientFinder, which estimates # of insured patients in region that have specific diseases but are untreated, to be offered by HealthLeaders Interstudy.
Denise Silber writes about provider ratings sites in Europe (France and UK) and how the survey-based rating sites differ from the “narrative” sites that allow patients to describe their experience in their own words. Combination would be better, wouldn’t it?
KLAS on current state of HIEs–vendors “pass around packets of information without necessarily taking ownership of what is in the packet”.
Xconomy on PatientsLikeMe, the Cambridge-based patient community site that leads in this space in collecting data. Also mentions Keas and its recent deal with Pfizer.
More on MSFT MyLife health project that utilizes Windows mobile phones to capture and transmit health-related data. Talks about accelerometers in phones and how they could be used to monitor movement.
MSFT research at conference in Beijing talks about using XBox as part of a total health care system. Also refers to MSFT MyLife for Windows mobile phones, which uses mobile phones to capture and transmit data relevant to a EHR/PHR.
Melissa Chang comments on projections from AMR Research on increased spending by B2B marketers on social media and questions where the projected 21% growth in social media spend will be focused. Note, lead-gen sites marketing is projected to increase 17% and online directories -2%.
Interesting. Pfizer in alliance with Keas to enable health & wellness experts to produce and distribute online care plans directly to patients. My take: Pfizer and other pharma companies already subsidize the publication of a great deal of health care information. With this deal, they’re extending their reach into new channels.
P&G completes its acq. of MDVIP, a concierge medical practice based in Boca Raton, FL.
Nice. CenterWatch now provides feeds by therapeutic area, disease category, FDA approved drugs and more that can be added to a website–for Free!
David Harlow’s insightful commentary on why medical apologies–accompanied by a commitment to investigate root cause–may reduce malpractice suits. And could lead to performance improvement, too….
Patient Safety and workflow solutions company raises $30M led by TPG Biotechnology Partners.
Why communicating absolute vs. relative probabilities is important in healthcare–and in fin’l planning.
Harvard Med School’s Laboratory for Quantitative Medicine has created personalized risk assessment tools based on “binary biology”. Interesting.
Thomas Goetz on nomograms, or clinical decision tools, that help calculate risk of specific diseases on a personalized basis.
Really good analysis and commentary about ebook pricing and the recent controversy between Macmillan and Amazon about books on Kindle prices. I agree with author that the market should determine the value of the content. Market structure in book publishing industry inhibits market forces to apply. I like 4th paragraph that addresses fact that not all song tracks–or all books–have same value, so why are they priced nearly the same? In book publishing, the bizarre returns policy does provide mechanism to sell less popular books for very low prices, but authors receive no royalties. I also agree that far more ebooks would sell if prices were lower.
Good review of recent Time article, Patients 2.0, and differing attitudes about the effectiveness of patient-reported data in medical research. Article points to concern on part of doctors of reliability of patient-reported outcomes data. My view: methods need to be developed for incorporating patient-reported or patient-recorded outcomes data into medical research methods, but these data are too important to ignore!
Very cool. FDA allows Bayesian analysis for studies of effectiveness in medical device clinical trials. Bayesian analysis allows use of results from previous studies to serve as prior distribution and may allow for results from smaller or shorter new studies to provide sufficient evidence of effectiveness.
Or outcomes-based research. By Gilles Frydman, founder of ACOR.org and co-founder of e-Patients.net, a pioneer in participatory medicine. Good introduction to potential benefits of PDR and the need for guidelines on how to conduct PDR, since no accepted structure and review processes currently exist.
Article describes how CMS is becoming more specific in requiring proof that treatments produce improved outcomes, not just evidence of their safety and short-term efficacy.
Start-up, Truth on Call, offers system for posing questions via Twitter to a group of doctors, for $10 per response. Target audience is fin’l, pharma, research, but will be offered to patients, too.
More on the Text4baby partnership btwn HHS, other fed agencies, industry (Pharma, telecom carriers) and insurance plans.
Text4baby is a program managed by HHS that includes mobile telecom carriers, federal agencies, insurance plans and other healthcare industry reps. 3,400 women have signed up so far.
Important points about need for care providers to understand the effect of healthcare costs on patients who can’t afford expensive treatments. Cost factors must be considered when addressing compliance issues.
Article states that pending lab tests are only included on hospitalist discharge summaries 16% of the time. Incredible. Follow-up visits aren’t very useful when docs don’t even know what to check. Inadequate discharge summaries are core problem. IT systems that don’t communicate are equally critical problem.
Hope Leman hits one out of the park with a fantastic interview with Danny Sands, MD at BIDMC and well-known in participatory medicine circle (also e-Patient Dave’s doctor).
Rewards for posing good questions and providing best answers about Diabetes 1. Program sponsored by Harvard Clinical and Translational Science Center and uses the InnoCentive platform to manage the competition/collaboration.
WK Health updates Facts& Comparisons and rebrands it as (drumroll please…) Facts & Comparisons eAnswers. Drug info resource.
Good overview of why social networking sites are flourishing. I like comments about how sites are more welcoming now and how sites serve as tools for users–not just discussion boards. LinkedIn is great example. Same applies to patient communities and PatientsLikeMe and CareTogether are good examples of increased utility of online communities.
Astonishing. I finally read more details of the retraction and the original study. Only 12 children were studied and they were paid 5 pounds each to give blood at a child’s birthday party. Researcher had claimed that they were all referred to physicians, which was not true. Parents who suspected link helped raise funds for the researcher via their lawyers. So, Lancet finally retracts article, but what about the 10-years worth of fallout from the falsified research that has rippled across official and unofficial research sites and commentary on the Web?
Nice counter to Twitter naysayers who address only the downside of Twitter (time sink) — without ever having used it. Writer emphasizes how critical Twitter is to the online news business for generating links and being part of the conversation.
Google Ventures has invested in Adimab, a New Hampshire biopharma company and is providing computing power to handle the heavy lifting of computer search work of matching candidate antibodies and targets to speed up the current process used by most biopharma labs.
Initiate Systems, a master data management company that specializes in healthcare data, is acquired by IBM. Initiate clients include payers, providers, and PBMs. Terms not disclosed; Initiate had raised over $67M in VC funding from Apex Venture Partners, First Analysis Group, Sigma Partners, BC/BS Venture Partners and Paladin Capital.
DeepDyve, the specialty search service with features that simplify finding related information, adds 6 new publishing partners. ACM, AIP, MIT Press, and UC Press among them. All 6 will join the DeepDyve article rental system that was introduced last year, which allows users access to premium subscription content for $0.99 per article (with volume discounts). More details in press release.
Anthony Guerra provides commentary on inadequacies of MU guidelines and reimbursement requirements.
Good article that describes how quickly move toward personalized medicine–based on an individual’s genetic data–is occurring.
Good idea, but it looks as though Nielsen chooses healthy foods based on manufacturer claims.
Cute: a Jeopardy quiz for the rudiments of EBM for medical librarians.
Patient Safety Act of 2005 scheduled to yield database in 2011. 65 Patient Safety Organizations have been set up, but few are collecting data yet. No plans set to collect from other providers beyond hospitals.
ABRY provides funding to HealthTrans to support organic growth and acquisitions.
Wow! Glam raises another $50 M at a rumored valuation of $750M. Glam is an ad network with focus on health & beauty sites. Many of the sites tend toward the trashy end of beauty sites, not reputable healthcare info. See comments. Notwithstanding previous 2 sentences, Glam sure is good at fundraising!
David Weinberger on flaws in the data-information-knowledge-wisdom hierarchy model. Hierarchy is too limited–one way progression, when gaining knowledge is more of a system that requires observation, hypothesis building, and testing.
Comments about online sites that offer ratings of doctors. Points out weaknesses of current info, esp. fact that ratings aren’t based on outcomes. Hints at other problems: most patients choose docs based on info from referring physician. Docs in network are critical. I’d add: trustworthiness of online ratings sites is not clear.
Long article that provides some evidence that breakthrough research is not getting sufficient coverage in top journals. Theory is that peer reviewers are protecting their own group and making it too difficult for innovative researchers to break through. I think there’s some credibility to the theory that innovations are more likely to occur outside of the traditional circles of scholarly publishing, since researchers are increasingly making source data available. New metrics that incorporate real-time online measures are needed.
The main article (see previous entry) about risk calculators to help surgeions communicate risks of surgery to patients.
Addresses issue of why hospitals don’t track and use data to help them reduce risk in surgery. Mentions NSQUIP from ACS.
Healogica, a site that connects potential candidates to clinical trials to shut down. They had about 2,000 registered users but couldn’t get enough CROs and pharma companies to pay for access to the leads they generated.
Social networking for weight loss site, iChange, gets funding from Momentum Venture Managment(MVM) and names MVM principal Stuart MacFarlane CEO. MacFarlane fmly of Insider Pages.
Great display of information on # tweets by disease type/condition.
Good description of how the use of e-prescribing systems (in this case Kryptic) can alert doctors & pharmacists of “doctor shoppers” who go from doctor to doctor to get multiple prescriptions for pain medications and other drugs.
Excellent article that proposes ways to improve how medical research is communicated by consumer media. In lecture I gave last week at Simmons College School of Health Sciences, I emphasized the importance of communicating medical research and other healthcare information clearly, especially risk information.
Reports on programs that provide behavioral counseling to MDs that have depression, substance abuse and stress problems.
Needed: Guided Navigation for Health Information Search
- Posted February 3rd 2010
- Comments (0)
- by Janice
There has been a lively dialogue occurring on the e-patients.net site this past week about how Google and Microsoft Bing display search results for health care queries. Google recently introduced a special result listing that provides links to Mayo Clinic, ADAM, WebMD and MedlinePlus when users type in a common health condition as their search term. For example, type in “hypertension” in the Google search box and the first listing in the search results will look like this:
| Hypertension | |
| Google Health Mayo Clinic Medline Plus WebMD | |
| Hypertension is the term used to describe high blood pressure. Blood pressure readings are measured in millimeters of mercury (mmHg) and usually given as two numbers. For example, 120 over 80 (written as … www.google.com/health |
|
The thread on e-patients.net was initiated by Susannah Fox, Associate Director, Digital Strategy at Pew Internet Research and so far has elicited 73 comments about Google’s policy of providing special placement for these four specialty health sites. Further comments on the post focused on the inability of existing consumer health portals, aggregators, and search engines in guiding patients to information sources that may be more relevant to them. I highly recommend a thorough reading of Susannah’s post and the subsequent comments.
I contributed the following comments: “At this point, the big search engines focus on the broadest topics and Mayo, ADAM, WebMD and MedlinePlus are good sources for basic info on diseases and conditions. But, the common complaint I hear about these resources is that they are too broad, not deep enough, too removed from the current needs of the patient, and certainly not geographically specific.” Susannah wisely brought up the topic of how useful it would be to offer more guidance to people who are seeking more specific reliable information in their health-related query. She asks “I wonder if curated search results are the answer to the ongoing debate over information quality?”
It may be difficult to offer “pre-curated” health information that suits everyone’s needs because of the vast array of queries and the disparate number of sources that exists. The ‘big 3′ consumer health portals, WebMD, EveryDay Health[ii], and HealthCentral already serve as curators to the content they make available under their umbrellas. But, these sites share many of the same mile-wide, inch-deep characteristics of the previously mentioned sites. Even though there are some patient communities represented on these consumer health portals, it is often difficult to find the relevant community and relevant information buried in a post.
The discoverability problems in consumer health search relates to the early-stage of the health content product life cycle. Some online patient communities may have existed for a long time, but most are relatively new. Because many are small and specialized, it is unlikely they will ever achieve sufficient PageRank in Google’s relevancy algorithm to be listed on the first couple of search results pages on Google.
As social networking and other factors that drive the demand for healthcare information matures, there will be more demand for services that guide users through the process of researching, communicating, and recording health information. Who will be the likely winners in the race to provide guided navigation to health information? There are roles for EHR/PHR vendors, content companies (i.e., publishers), patient community sites, pharma and other vendors, providers, and payer organizations to create, distribute and sponsor health content. I expect to see a growing number of licensing and other content sharing deals between these health industry stakeholders in the coming years. And there will always be a role for aggregators and search engines that can improve the customer experience.
[i]Note, Google has changed the display to read “Google Health” instead of ADAM. Google licenses the content from ADAM.
[ii] Everday Health (the new parent company name for what was formerly Waterfront Media) filed to go public last week.
Headline Commentary Jan 23-Jan 31
- Posted February 1st 2010
- Comments (0)
- by Janice
Good article on Endeca, a widely used search engine on shopping sites. Endeca’s “guided navigation” (also referred to as “faceted search”) works very well on structured information. Could it be adapted for less-formally structured info?
McKesson & HP partner to provide EHR s/w and hardware for physician practices.
Article questions the role of employers in sponsoring wellness programs that tie participation to financial incentives such as reduced premiums.
Interesting. Wolters Kluwer has set up a system whereby doctors will receive CME credit for clinical research done via their mobile phone.
Time covers e-Patient Dave’s story and writes about e-patient movement under the moniker “patient 2.0″. Provides a somewhat jaded view of non-medical specialist patients’ ability to understand medical info and make judgements. Suggests “rapid-learning” program for e-patients.
Very thorough review of MSFT-Siemens deal to introduce MS HealthVault to German market and make it the system through which patients are provided medical info. HL7 is more widely used in Europe and Infobutton apps will likely catch on more quickly.
Els adds SNIP and SJR to Scopus to provide more complete citation metrics.
Julie Deardorff of Chicago Tribune writes about my recent blog on the AAFP’s FamilyDoctor.org site’s advertising high salt foods. Quotes me, AAFP VP Publishing, and Dr. John Spangler.
Prof. Robert Fogel, U. Chicago, contends that healthcare costs are high because consumers demand the high-cost extras and innovation.
Good interview with David Blumenthal, Director, ONC, on meaningful use of EHRs and plans for national health data exchange.
John Halamka’s brief description of the breakout of grant funding plans by ONC.
Whole Foods to offer up to an additional 10% discount for employees who meet wellness measures that include nicotine use, cholesteral, and BMI targets.
good piece on why healthcare sector could be big market for Apple’s forthcoming tablet. The fact that iPhones are popular among MDs is one big reason.
Good short piece on why publishers are distributing content via Kindles even though there are business considerations.
Filing to Office of Science and Technology Policy from Elsevier regarding proposed regulations to offer more open access to scholarly publishing that is funded by US tax dollars.
Kent Bottles brings together topics from current books by Atul Gawande, Timothy Goetz, and an article by Jerome Groopman to consider the merits of checklists and use of decision trees in medicine. He also covers behavioral economics and choice and mentions the Thaler-Sunstein approach to offering nudges (libertarian paternalism) to guide healthful behavior. Conclusion: medicine and health are complicated. Seems to me that since computers are useful for dealing with complex calculations (even under stress) that it makes sense to use automated checklists and decision support systems to guide complex processes. Provided we can avoid GIGO (garbage in, garbage out) situations.
Thomson Healthcare acquires ProfSoft-Health, a Needham, MA-based healthcare data analytics company. ““ProfSoft’s solutions will enhance the clinical performance measurement capabilities we provide to our healthcare payer customers,” said Jon Newpol, executive vice president of the Healthcare & Science business of Thomson Reuters.”
Interesting article on how Conde Nast is seeking to leverage brand value of Gourmet, Domino, and Cookie (defunct magazines) as well as current titles Wired and Lucky. Compares CN to Meredith, whose Better Homes & Gardens has used its brand to provide quality seals to products. CN-selected content (tested by Gourmet kitchens?) is one idea they should consider, IMO.
David Williams interviews Bob Wachter of UCSF. Haven’t listened to it yet, but I have no doubt that it is a worthwhile use of time.
IUD manufacturer, Mirena (part of Bayer Pharmaceutical) has been using home parties, a la Tupperware, to spread word about benefits of Mirena IUD. FDC has sent warning letter to Bayer.
Good analysis of what the implications are of NY Times stated plans to allow inbound links to have access for free, but to charge metered access to direct users after an initial allotment of free pageviews.
Everyday Health, the consumer health portal owned by Waterfront Media, files for $100M IPO. Positive sign for consumer health publishers. Everyday is one of the largest consumer health portals that relies on online advertising for most of its revenue.
Brigham and Women’s and Harvard Med School Professor Lawrence DeBuske decides to keep paid speaking role and gives up practicing & teaching. New limitations on accepting pay for for delivering canned presentations played role. Dr. DeBuske apparently gives several talks on behalf of multiple pharma companies each week.
Home page of Jan 2010 report from RWJF on PHRs.
John Sharp’s overview of Robt Wood Johnson Foundation’s new report on PHRs.
ZocDoc, a online directory of doctors that has focused on NY and DC, is expanding to cover SF. Note, a key differentiator of ZocDoc (from the slew of other doctor ratings sites) is its integration with practice management systems for scheduling appointments so that users can find doctors with available appts. ZocDoc says they have integrated with close to 1400 PMS companies. Note, ZocDoc also encourages patient reviews of doctors, but only from ZocDoc users. Reviews of doctors remains a sticky wicket for all of the doc review sites.
Commentary on why it is a positive sign that an MD is now leading Navigenics, a personalized genomics company.
Susannah Fox from Pew Internet started the conversation with her post about Google Health OneBox that lists results from Mayo Clinic, WebMD, ADAM, and MedlinePlus in a special position at top of search results. Great discussion in the comments ensued, including a couple from me.
Andrew Spong’s analysis of Twitter followers/followings of pharma companies.
Brief article describing MedeAnalytics revenue cycle management solution being adopted by St. Joseph’s Hospital in Maryland.
Great news for data geeks and data content enthusiasts! Following up on their promise to add transparency to the federal government, Obama admin posts new data sources from all cabinet departments. I’m going to go download the Medicare data set now.
Info on work Tim Berners-Lee is doing for UK govenment to make sources of gov’t data more available and meaningful.
“Syed Tirmizi, MD, a longtime clinician and medical informatics leader at the US Department of Veterans Affairs, joined Quantros today as Vice President of International Business Development and Government Relations. Tirmizi helped lead the VA into its position as a pioneer in the use of electronic medical records (EMR) for point of care service delivery, enabling meaningful use of data to further patient safety and quality initiatives.”
“Pfizer increased its spending on online professional promotion by more than 90% last year, according to a study, a sign the drugmaker is emphasizing alternatives to live sales reps for detailing certain products.” Study by SDI.
TOC and abstract of just published study on significant benefits of reducing sodium intake for improving cardiovascular disease. See my notes in item below (third item) on same subject.
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