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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.
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 Jan 23-Jan 31
- Posted February 1st 2010
- Comments (0)
- by Janice
Good article on Endeca, a widely used search engine on shopping sites. Endeca’s “guided navigation” (also referred to as “faceted search”) works very well on structured information. Could it be adapted for less-formally structured info?
McKesson & HP partner to provide EHR s/w and hardware for physician practices.
Article questions the role of employers in sponsoring wellness programs that tie participation to financial incentives such as reduced premiums.
Interesting. Wolters Kluwer has set up a system whereby doctors will receive CME credit for clinical research done via their mobile phone.
Time covers e-Patient Dave’s story and writes about e-patient movement under the moniker “patient 2.0″. Provides a somewhat jaded view of non-medical specialist patients’ ability to understand medical info and make judgements. Suggests “rapid-learning” program for e-patients.
Very thorough review of MSFT-Siemens deal to introduce MS HealthVault to German market and make it the system through which patients are provided medical info. HL7 is more widely used in Europe and Infobutton apps will likely catch on more quickly.
Els adds SNIP and SJR to Scopus to provide more complete citation metrics.
Julie Deardorff of Chicago Tribune writes about my recent blog on the AAFP’s FamilyDoctor.org site’s advertising high salt foods. Quotes me, AAFP VP Publishing, and Dr. John Spangler.
Prof. Robert Fogel, U. Chicago, contends that healthcare costs are high because consumers demand the high-cost extras and innovation.
Good interview with David Blumenthal, Director, ONC, on meaningful use of EHRs and plans for national health data exchange.
John Halamka’s brief description of the breakout of grant funding plans by ONC.
Whole Foods to offer up to an additional 10% discount for employees who meet wellness measures that include nicotine use, cholesteral, and BMI targets.
good piece on why healthcare sector could be big market for Apple’s forthcoming tablet. The fact that iPhones are popular among MDs is one big reason.
Good short piece on why publishers are distributing content via Kindles even though there are business considerations.
Filing to Office of Science and Technology Policy from Elsevier regarding proposed regulations to offer more open access to scholarly publishing that is funded by US tax dollars.
Kent Bottles brings together topics from current books by Atul Gawande, Timothy Goetz, and an article by Jerome Groopman to consider the merits of checklists and use of decision trees in medicine. He also covers behavioral economics and choice and mentions the Thaler-Sunstein approach to offering nudges (libertarian paternalism) to guide healthful behavior. Conclusion: medicine and health are complicated. Seems to me that since computers are useful for dealing with complex calculations (even under stress) that it makes sense to use automated checklists and decision support systems to guide complex processes. Provided we can avoid GIGO (garbage in, garbage out) situations.
Thomson Healthcare acquires ProfSoft-Health, a Needham, MA-based healthcare data analytics company. ““ProfSoft’s solutions will enhance the clinical performance measurement capabilities we provide to our healthcare payer customers,” said Jon Newpol, executive vice president of the Healthcare & Science business of Thomson Reuters.”
Interesting article on how Conde Nast is seeking to leverage brand value of Gourmet, Domino, and Cookie (defunct magazines) as well as current titles Wired and Lucky. Compares CN to Meredith, whose Better Homes & Gardens has used its brand to provide quality seals to products. CN-selected content (tested by Gourmet kitchens?) is one idea they should consider, IMO.
David Williams interviews Bob Wachter of UCSF. Haven’t listened to it yet, but I have no doubt that it is a worthwhile use of time.
IUD manufacturer, Mirena (part of Bayer Pharmaceutical) has been using home parties, a la Tupperware, to spread word about benefits of Mirena IUD. FDC has sent warning letter to Bayer.
Good analysis of what the implications are of NY Times stated plans to allow inbound links to have access for free, but to charge metered access to direct users after an initial allotment of free pageviews.
Everyday Health, the consumer health portal owned by Waterfront Media, files for $100M IPO. Positive sign for consumer health publishers. Everyday is one of the largest consumer health portals that relies on online advertising for most of its revenue.
Brigham and Women’s and Harvard Med School Professor Lawrence DeBuske decides to keep paid speaking role and gives up practicing & teaching. New limitations on accepting pay for for delivering canned presentations played role. Dr. DeBuske apparently gives several talks on behalf of multiple pharma companies each week.
Home page of Jan 2010 report from RWJF on PHRs.
John Sharp’s overview of Robt Wood Johnson Foundation’s new report on PHRs.
ZocDoc, a online directory of doctors that has focused on NY and DC, is expanding to cover SF. Note, a key differentiator of ZocDoc (from the slew of other doctor ratings sites) is its integration with practice management systems for scheduling appointments so that users can find doctors with available appts. ZocDoc says they have integrated with close to 1400 PMS companies. Note, ZocDoc also encourages patient reviews of doctors, but only from ZocDoc users. Reviews of doctors remains a sticky wicket for all of the doc review sites.
Commentary on why it is a positive sign that an MD is now leading Navigenics, a personalized genomics company.
Susannah Fox from Pew Internet started the conversation with her post about Google Health OneBox that lists results from Mayo Clinic, WebMD, ADAM, and MedlinePlus in a special position at top of search results. Great discussion in the comments ensued, including a couple from me.
Andrew Spong’s analysis of Twitter followers/followings of pharma companies.
Brief article describing MedeAnalytics revenue cycle management solution being adopted by St. Joseph’s Hospital in Maryland.
Great news for data geeks and data content enthusiasts! Following up on their promise to add transparency to the federal government, Obama admin posts new data sources from all cabinet departments. I’m going to go download the Medicare data set now.
Info on work Tim Berners-Lee is doing for UK govenment to make sources of gov’t data more available and meaningful.
“Syed Tirmizi, MD, a longtime clinician and medical informatics leader at the US Department of Veterans Affairs, joined Quantros today as Vice President of International Business Development and Government Relations. Tirmizi helped lead the VA into its position as a pioneer in the use of electronic medical records (EMR) for point of care service delivery, enabling meaningful use of data to further patient safety and quality initiatives.”
“Pfizer increased its spending on online professional promotion by more than 90% last year, according to a study, a sign the drugmaker is emphasizing alternatives to live sales reps for detailing certain products.” Study by SDI.
TOC and abstract of just published study on significant benefits of reducing sodium intake for improving cardiovascular disease. See my notes in item below (third item) on same subject.
Headline Commentary Jan 1 - Jan 22
- Posted January 22nd 2010
- Comments (0)
- by Janice
“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.
New Study in NEJM points to benefits of reducing salt intake in american diet. See my article on NY’s planned program to reduce salt and my criticism of AAFP for promoting salty foods in advertisements on their site. Note, a recheck of the AAFP FamilyDoctor.org site indicates that fewer packaged foods are advertised today. My blog appears to have been influential!
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.
UMass Medical selects NDoc to automate home health services care. NDoc provides billing and operational s/w for use at pointofcare for home health services.
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.
Trish (about.com) recounts story of pediatrician who molested patients and how comments on doctor rating sites prior to his conviction were positive. She suggests that the current array of ratings sites all share weaknesses. I tend to agree. Comments can be useful, but there need to be a large number and attributes of the people providing the ratings are needed. Plus, multiple criteria from formally reported and collected info need to form the basis. I’d want to know about outcomes, not just opinions.
Nuval, a Boston-area company that provides numeric ratings that reflect nutritional value of foods, gets official endorsement from American College of Preventive Medicine.
Martin Fenner in Nature’s Nature Network on growing options for reading scholarly articles. Covers various devices as well as the concept of using connected information to provide context. No clear-cut perfect solution yet.
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.
Excellent overview of trends in healthcare research being influenced by patient particpation via Internet channels. Specific focus on last October’s ePatient Connections conference. David Ellis and Julian Bond of HFD conclude that healthcare data analytics will become increasingly important in divining patterns from all the data being generated by epatients and even diagnosing for individual patients. They also point to the importance of mobile computing in healthcare.
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.
Boston company that repurposes discarded specimens and matches basic EHR data to allow for additional medical research studies to be carried out on the specimens. iSpecimen then aggregates and uses datamining techniques to analyze patterns in the data.
Pearson FT is apparently shopping Interactive Data.
Insititute for Safe Medication Practices reports results of recent survey about impact of recession on hospital staffing, capital expenses, patient acuity, and medication safety.
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.
MedScape article that explores the value of online searching for patients. Shallow article with no conclusions, but it does offer some good criticism of existing options.
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.
HubSpot marketing director explains why they have chosen to drop trade show exhibiting from their marketing mix. They still will attend events and seek speaking slots and will sponsor some events, but they don’t find the process of shipping booth & collateral and several sales people to be as worthwhile as other marketing options. Very good comments and responses.
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.”
MSNBC story that picks up on recent article in NEJM about pros and cons of sites that provide patient comments and ratings of doctors. Hook in this article is how some of the ratings sites, including Angie’s List, now flag doctors who are part of the Medical Justice Services group that require patients to sign contract that prohibits them from posting comments online. I agree that anonymous comments are a problem, and I’ve written before that a single numeric rating is insufficient, but it’s short-sighted of doctors to try to prohibit patients from expressing their opinions online.
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.
Quidel, a San-Diego point-of-care diagnostic testing company, buys Diagnostic Hybrids, an Athens, Ohio company for $130 Million in cash. Acquisition expands the range of tests provided by the combined company, and should provide some economies in R&D.
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.
Quest offers new test for early detection of colorectal cancer.
Adams replaces Carl Byers, athena’s initial CFO, who last June said he wanted to live abroad.
Cegedim Dendrite, the life sciences group of Cegedim, Paris-based CRM solutions provider, acquires SK&A, the leading US healthcare professionals directory. According to press release, revenues of SK&A are about $15 M.
Credit rating firm TransUnion has acquired MedData LLC, a Charlotte, N.C.-based health care transactions processing firm, for an undisclosed sum.
Pfizer provides $3m in funding to Stanford to develop CME framework that incorporates a more participatory learning environment. Can it be donew/o industry influence given the source of the funding? Stanford says “yes”….
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.
Another content + IT deal that will help hospitals/providers achieve meangingful use of EHRs. Zynx Health provides order sets; Meditech will integrate order sets from Zynx into EHR–press release doesn’t provide much detail on how they will integrate the info.
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.
Quantros, a health IT company that helps hospitals with patient safety and risk assessment, names Gerard Livaudais, MD, MPH, as EVP Product Management.
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.
athenahealth’s athenaClinicals was rated highly in recent KLAS ambulatory EMR report on confidence that athenaClinicals will meet meaningful use criteria.
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.
SF-based Practice Fusion raises $5m of anticipated $7.1 round for it’s EHR software. Practice Fusion offers s/w for no charge and makes money with advertising–and has plans to sell data mined from customers.
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.
Adidas introduce miCoach at CES. Similar to Nike’s popular Nike+.
Good commonsense views on what will and will not change in 2010.
David Walt, professor of chemistry at Tufts and chairman of Illumina, provides his top 5 trends to watch in biotech. Optimistic outlook for advances in curing cancer, but thinks that the data management and analysis issues will be a challenge due to the magnitude of data (”Moore’s Law just can’t keep up”).
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.
Interesting example of how incentives from CMS can trickle down to specific programs within hospitals. In this case, residents can earn up to $1200 per year in incentive pay for reaching 3 goals related to patient satisfication–two from Press Ganey survey results and 1 from UCSF Medical Center compliance audits. Results are measured for a team and each teammember receives payment.
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.”
AHA endorses Surgical Info Systems for its scheduling, reporting and analytics modules.
Inside Out provides interactive training on the human body for K-12 market.
Nice overview of Cell Press’s (Elsevier) new beta of their planned “article of the future”. Good features for zooming in on charts and link to more data and references. I need to do a more thorough review and hope to see it in action at Cell Press in Cambridge soon.
Brian Ahier summarizes Sec’y HHS Sebelius’ Health Security program.
I’ve mentioned NuVal before. Intriguing company that provides single numeric rating of the nutritional value of foods and works with grocery stores to put labels on shelves. Concept is good, but like the writer, I think the single digit is insufficient. Good for shelf; but maybe more detail could be available via mobile device?
Kaiser and VA (Veteran’s Affairs) will use NHIN to exchange patient data (with permission) in pilot program in San Diego area.
A physician reviews online doctor rating sites. Slams Vitals, in large part because only single numeric rating is available w/o paying. I’ve commented before that single number is ineffective for rating doctors–or most any other item. The reviewing physician likes the comments, however. Note, as list of comments gets larger, some kind of summary indicators become more necessary to annotate and summarize the long comments.
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).
Nice article from Ingenix analytics on employer wellness programs.
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?
Commonwealth Club program on medicine. Video.
TabSafe, an Indiannapolis company, showcases its medication management system at CES.
AdvancedMD, which provides practice management and RCM solutions to medical practices, acquires PracticeOne, an EHR vendor. Interesting that the vertical integration is occurring in this direction–the vendors of admin/financial systems acquiring the EHR vendors. There’s lots of room for more consolidation in both markets.
“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.”
“Krames has partnered with eClinicalWorks to provide consumer-friendly patient education to physicians using the electronic medical records system, eClinicalWorks 8.0.” Makes good sense.
As my colleague Russell Perkins said, “betcha thought there already was one”.
Sramana Mitra interviews co-founders of NaviNet, a real-time health info exchange based in Boston area. 5-part interview with lots of good stats and info.
Dr. Carolyn Clancy, director of AHRQ, describes new report for consumers on anti-depressants. Includes link to full report.
Gawande speaks about his new book, Checklist Manifesto, and the benefits of checklists in medical settings. Specifically mentions how checklists improve teamwork to the benefit of patients, and addresses the issue of physician resistance (20% of those surveyed after trying out checklists said they didn’t think they were useful; however >90% of that 20% group would want checklists to be used if they were the patient!).
“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.
Infotrends broad multi-client study on changing communications needs of small-to-medium sized businesses. TOC and list of tables only. Complete study >$10K
HIMSS writes up new CDSC created by Blackford Middleton at Partners Healthcare.
Caritas hospital group in Boston expands their relationship with athenahealth to include athenaClinicals. They already used athena’s revenue cycle management (RCM) s/w.
“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.”
Lots of reaction to ONC’s release of MU requirements. This article highlights a few key concerns, including lack of focus on patient’s rights and support for outdated technology that will not provide advancements that are needed.
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.
Article in NEJM questions equity of wellness program incentives in health reform package.
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.
One of the questions posed by David Carr in this column about the reports of a new tablet device from Apple (rumored to be announced later this month (jan 2010)). If Apple can produce an e-reader/tablet that considerably improves the user experience over the Kindle, it could take off even at $800-$1000 per device. Publishers of all types–B2C and B2B–should be planning bus models (mostly advertising) around tablet devices.
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.
Like this list, esp. the top 3.
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.
Interesting comments from former insiders and analysts on what made Dow Jones vulnerable and changes under Murdoch. Note, I didn’t see any mention of the enterprise division of Dow Jones (there may be some comments, but most focus in on WSJ and the Telerate mess).
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.
Mitch Wagner’s last article for InformationWeek w/ 2 examples of hospitals with successful implementation of business intelligence (document management, integration, analytics, dashboards) software.
Nice post that focuses on improving access to healthcare data–by all stakeholders.
“URAC, the nation’s leading health care accreditation and education organization, today announced its new Consumer Education Initiative, which teaches consumers about health insurance and identifies ways they can make more informed decisions about their health care.”
Interesting news about licensing deal between AllTheContent, a Geneva, Switz based content syndicator, and Pharma Channel, which provides info to pharmacies in Europe.
Nice video explanation of HL7 and how the standard facilitates sharing info between various IT systems in hospitals.
Headline Commentary Dec 6-13
- Posted December 13th 2009
- Comments (0)
- by Janice
Press Ganey acquires Patient Impact, announced 12/6/09. Patient Impact to become the unit specializing in physician practice & outpatient surveys. More details to come. Note, Patient Impact was a Health Content Innovator and presented at our Health Content08 conference: http://www.infocommercegroup.com/healthcontent/index.html
Headline says it all. Gary dissects an actual memo used with TV journalists that promotes tying recent medical research to exaggerated claims of short-term benefits–and the specifically recommends against mentioning research labs or clinical work.
No doubt CME needs a redesign to change the current heavy subsidies by Pharma.
Article on the new building extension of MIT’s media lab designed by Japanese architect Fumihiko Maki. Contrasts Maki’s style of open space with lots of glass to original IM Pei buildling with limited windows. Interesting metaphor for move of technology from “black box” to enabling and thriving on “transparency”.
Article questions the affordability of new cancer drug, Folotyn, produced by Allos Therapeutics. Allos says price is in line with other specialty treatments and so far health insurers have agreed to cover it to treat aggressive tumors. Shines light on problem of high cost of developing drugs, but doesn’t offer any solutions.
An indictment of doctors and drug companies that promote drug interventions for preventive care. Uses example of hormone drug replacement for women.
Ad Age lists top magazines that have ceased publishing in 2009.
References CBO study (with link) that describes the allocation of marketing $$ to detailing, CME support, DTC and a measly $400 M in professional journals. Journals publishers need to reinvent themselves as a vehicle for reaching doctors/clinicians.
EBSCO’s DynaMed write-up on breast cancer screening. I don’t find their analysis and coverage very helpful.
Conversation between Milken and Pfizer CEO Kindler
Reports of small survey of device manufacturers; results show that social media isn’t yet part of the marketing mix for device companies.
John Moore writes a brief post about MSFT’s announcement of long-term care provider Golden Living’s adoption of Amalga & HealthVault.
Some commentary on benefits of move to ICD10 codes.
McClellan, former CMS adminstrator, MD, and PhD economist, will keynote Advanstar’s Center for Business Intelligence (CBI)’s Annual Strategic Medicare Policy Summit.
Good overview with links to other stories about Pharma’s slowness in developing mobile apps.
Nancy McKinstry interview: journals renewals are strong even with price increases; hospitals are spending more capital in 2009 than 2008 in anticipation of ARRA funds to come in 2010.
Note, this is the first I’ve heard of ebizMBA, who writes on their site that ebizMBA is “an eBusiness knowledgebase that helps you find the webs best ansers to your online business questions on topics ranging from online marketing and analytics to website development and venture capital”. To their credit, they offer some indication of the parameters they use to measure popularity.
Humana will establish MinuteClinic for its own employees and will encourage all members to use MinuteClinic for basic screening tests for cholesterol, blood pressure, bmi–and will couple basic screenings with its own LifeSynch health coaching.
Ovid to announce Universal Search, which allows clients to search across Ovid and client’s other internal databases in single search. Nice development.
WebMD, HealthVault (MSFT) and GoogleHealth comprise the panel moderated by Jane Sarasohn-Kahn. About 50 minutes long. Worth a look.
Not surprising to hear that Informa has decided against going forward with bid for Springer. Debt levels of Springer make the deal hard to digest and current Springer owners PE firms Candover and Cinven want a sale to conclude quickly. If PE company acquires Springer, perhaps they would sell off pieces.
Very good analysis of trends in IT research. Essentially says that high priced IT research reports are becoming commoditized and used for lead gen that is paid for by vendors. Analysts can still make money consulting, firms can put on events, and carry out customized research. Totally in line with my writings and demonstrated in the content value pyramid in my Publishing for e-Patients preso (on Slideshare/janicemc). Like comment about individual analysts becoming branded more so than firms. Agree there, too.
Dow Jones Venturesource reports Q2 2009 VC investments by industry. Healthcare the best performer and it outpaces IT for first time on record.
Kent Bottles provides excellent summary of recent lecture by David Eddy, MD (the “founder” of EBM) who has consistently challenged the robustness of existing methods of clinical decision guidelines. Dr. Eddy believes the future requires more complex models that consider a larger number of factors and interactions that in effect provide more personalized medical treatment. Eddy’s own company, Archimedes, builds “virtual patients” that can be used for complex modeling of probable outcomes. I don’t know enough about Archimedes to judge its efficacy, but I think Eddy has the right approach. We know that more data are available about patients and outcomes and will accelerating adoption of EHRs, the amount of data will expand rapidly. Along with the improved data sources, there is clearly a need for more complex models to analyze the data and test the benefits of medical treatments.
Good article with data and charts on changes in pharma sales & marketing over time and expected effects of health reform on pharma sales techniques.
Comprehensive article on HSAs and high-deductible health plans.
Perspective on whether use of EMRs reduce liability for physicians. Focuses on discounts offered by insurance cos to doctors and practices that use EMRs.
Schein will merge its animal health business with Butler; Schein to own 50.1%.
Press releases doesn’t provide many details; I will look at Elsevier site soon. Embase is an index to biomedical research; relaunching as standalone product seems old-world.
Good article that mentiones pricedoc.com, healthcarebluebook.com, and outofpocket.com, sites that provide info on prices for various procedures or office visits by doctor.
Story about Full Yield, a wellness program for employers that provides its own food & nutrition programs. Story describes how Safeway, IBM, Pitney Bowes and others have saved money on health care costs via wellness programs. Major issue, however, is that these are companies that self-insure.
Another story that critiques overly simple health care rating schemes. IMO, ratings needs to be based on analysis of outcomes, using real data, not observations from a third-party, which are subject to error.
A one-sided critique of the shortcomings of EHR/EMR systems from Huffington Post. Whereas I agree that there are shortcomings, a more balanced report would have more credibility. Still, it offers some good basic info on what the feds are trying to do with ARRA funding.
Excellent post and comments. I just added my own comment (7th in list).
Article mentions strong interest in healthcare sector by PE. Do PE professionals smell, taste and feel an opportunity in healthcare, too?
Good commentary on public reaction to public health announcements and EBM. More “infodemiology”, that is, providing trustworthy information and monitoring public response to epidemics, is needed.
Excellent video presentation by Peter Norvig of Google. Data, semantics, search and much more.
IDC Health Insights report on EHR vendors ($4,500)
Interesting article and site (which I just discovered) about opportunities in scientific/medical writing and journalism. Site focuses on female scientists.
Sponsored by Google, survey lists most popular resources used to find medical info. Surprise! Search engine/Google is at the top, followed by peer-reviewed journals. No category for online clinical information resources, such as UpToDate, MDConsult, DynaMed, as far as I can see. If no breakout were given on survey, Search Engine category may incorporate these resources too.
Money-Driven Medicine site with free streaming version of the movie. Nice example of offering free streaming with promo for the paid DVD.
FDA would need legislative action to approve new db, but given the ability to track more data from electronic records and online user-input, federal db makes sense.
More on Informa bid for Springer from FT, which quotes analyts.
Study of search behavior indicates that online search is often used to confirm or refute one’s internal knowledge. Hm, sounds rather Bayesian to me.
With over 2.1B Euros in debt (8X EBITA), Springer is a loaded target. Bids are expected to be under 400M Euros. But bigger question is: is there sustained value in publishers of scholarly research, an sector that is being disrupted by new models of scholarly communication and research?
Good review of press related to new mammogram guidelines. Interesting that so many who say they want EBM, object when they don’t like the data. “Don’t like” often means they stand to lose business or stature.
Zynx Health’s order sets will be integrated with Keane’s Optimum EHR system thru this partership. Another example of embedding EBM info into EHRs.
Article describes how students are sharing for-fee medical articles in a Napster-type environment.
“It” in this case, is the information in medical journal articles. Really good article about what could be done to help add context to each medical journal article that reports on new research so that journalists, patients, and even doctors can better understand the implications.
With pressure from patient groups and regulators, hospitals have make significant progress in reducing hospital-acquired patient infections. Checklists and focus on solving the problem (using best practices from other institutions as one means) are noted as key to changing the procedures and culture at hospitals.
Study performed by Prof. Ashish Jha at HSPH and Catherine DesRoches at MGH indicates that using EHRs makes little difference in outcomes. This article goes on to point out that researchers also focus on the importance of changing processes & culture in hospitals to benefit from positive effects of using EMRs/EHRs. I’d add that hospitals and hospital systems that incorporate clinical information systems (order sets, point-of-care CDS) are more likely tho demonstrate improved outcomes. At this stage, not enough evidence-based content has been incorporated into EMR/EHRs.
MD who wrote this post suggests that Kolata’s article is biased toward the big pharma position, since her only sources were from pharma.
Headline Commentary Sept 14-20
- Posted September 20th 2009
- Comments (0)
- by Janice
Good article about lack of transparency in pricing for medical services–and how health reform could help change the current system. Also mentions a company called NewChoiceHealth.com that estimates cost of procedures from Medicare data.
Brief review of Health IT Stimulus Summit sponsored by Health Data Management.
Sweden’s EQT now frontrunner; TPQ is out; Carlyle & Providence Equity still in but have taken a back seat.
Review of Dr. Margaret Hamburg’s remarks from a recent speech where she emphasized need for more resources for regulating drugs to keep up with growth in research activity.
Good notes on Medicine 2.0 meeting in Toronto on PHRs.
Good profile of Innocentive, a Boston area company headed by former Hoover’s CEO Dwayne Spradlin. Innocentive provides marketplace to bring together inventors and companies that seek solutions (largely life science companies). Companies post challenges they want solved; inventors post their fees for executing. Company’s goal is to improve the research process.
Alliance Health, which builds platforms for health-related social networks, raises and additional $3.3 M for a total of $6.6M in VC from EPIC Ventures,Highway 12 Ventures and angels. DiabeticConnect.com was its 1st site, which has >50,000 registered memebers.
This is a very interesting move. Scientific news feed direct from major universities. See: www.futurity.org.
Good commentary about disconnect between focusing on improving HCAHPS scores and patient safety. When too tightly focused on score improvement, real chances to improve quality often get overlooked.
MDVIP respresents one of the new breed of physician practices that charge fixed fees for primary care, wellness & preventive care and offer more access to patients. Fees are far lower than typical high-deductible insurance premiums, but patients still need catastrophic coverage and have to pay for lab fees, etc. This new model of primary care, along with retail clinics, will be the major disrupters in healthcare delivery in US. Note, key reason cited for creating the new model: admin o/h expense of insurance claims processing.
Slides, recordings and transcripts from August 27, 2009 Web conference sponsored by AHRQ.
Darin Steward of Oregon Health & Sciences Univ. writes very good overview of PHRs and coves the concept of “infodemiology” without using the term!
Check out this cool app for reading, searching & Tweeting the just-released Baucus hc bill — from Tizra a search tech company.
Librarian Loren MccRory questions the longevity of current for-fee subscription databases sold to public and academic libraries. With more good info available for free, why should libraries continue to buy “big deal” subscriptions of unknown value to their audience?
Good balanced piece on FDA’s cancer drug director, Dr. Richard Pazdur.
Atty General Jerry Brown unveils site that tracks prescription drug use to help physicians with durg interractions and to spot possible illegal drug abuse.
MedAssurant, based in Bowie, MD, acquired Atlanta-based Catalyst Info Technologies, which provides s/w to manage collecting & reporting quality data (HEDIS). MedAssurant focuses on analytics for disease management, clinical & quality outcomes, and financial performance and is gaining market share in healthcare data analytics through acquisitions as well as organic growth. Article also points out other recent acq: Verisk Health (based in Waltham, MA) acquired TierMed Systems LLC (Chanhassen, MN) earlier in the week.
Dirk Stanley, MD, writes of his hospital’s experience with “Jedi Informaticists”, a special breed of clinical specialist who has crossover skills in health IT, healthcare analytics, and a workflow process mindset. Sounds like a systems analysts with subject specialty to me. He’s right that individuals with these crossovers skills are critical to successful EMR/EHR implementation and adoption. The right “Jedis” will see the big picture and focus on key success factors.
Ted Eytan, MD’s (Kaiser Foundation) presentation on PHRs as used at Kaiser & plans for the future. Outstanding slides (see esp. slide 16).
Published by Wiley with support from Aetna, Navigating Your Health Benefits is available for free.
Apple invites vendors to meeting to discuss healthcare apps. As author says, they’d be idiots to ignore the billions in ARRA funds!
Very helpful presentation by John Moore of Chilmark Research on state of personal health records (PHRs).
Weems named SVP Health Strategy at Vangent. Govt & Health are key markets for Vangent.
Malamud’s preso was a big hit; here’s the video.
OurParents, a central source of information on eldercare services and related information, introduces user forums.
MD describes why current system with 3rd party payers doesn’t lend itself to price transparency. Dr. Jindal suggests patients examine their EOB statements and note how much goes to doc v. insurance co. IMO, EOB statements are purposely designed to confuse, not explain and they impede transparency in pricing.
Nice marketing move to encourage sales of its EHR systems for physician practices.
HealthLeaders writes about Data Advantage’s Hospital Value Index and suggests that hospitals have to adapt to increased scrutiny and pay-for-performance measures.
Recent national survey of almost 1,000 physicians by Mayo Clinic reveals that 78% agree that physicians have moral obligation to address societal health policy issues and 73% agreed that physicians are obligated to care or uninsured or underinsured. Other questions reveal attitudes toward using cost as a consideration in determining treatment. Data tables available.
Just learned about Harvard’s suspension of funding for its Div. of Primary Care. Wow!
Bedside patient portals help patients keep in touch with doctors. good idea.
JAMA now requires independent review of data analysis in industry-sponsored research and has seen a dramatic drop in commercially-funded submissions.
Video Screencapture.
Good comments on security as process not product.
Profile of John Brownstein, an epidemiologist at Children’s Hosp in Boston. Browstein developed HealthMap.org, which culls online reports of infectious diseases and maps them in real time. A great example of infodemiology.
Headline Commentary Aug 24-30
- Posted August 30th 2009
- Comments (0)
- by Janice
Excellent article that emphasizes that providing information to stakeholders (esp. patients and doctors) is the best approach to assuring optimal decisionmaking.
ER MD writes about loss of relationships between doctors & patients & how increased use of hospitalists may have contributed.
Market forecast for medical device segment in France.
Good article that describe recent instances of data center projects by providers.
More examples of how Pharma is using social media.
Good news for PE companies.
New book forthcoming from Sage Publications, Encylopedia of Medical Decision Making. Seems like an obvious good online reference work.
John Hussman, founder of Hussman Econometric Advisors, pledges $20M to U. Miami for genetic research. Genetics center has been renames John P. Hussman Institute for Human Genomics.
Profile of Gawande from Harvard Magazine.
Dana Blankenhorn on how Fast Forward (a medical foundation) uses SaaS computing.
James Murdoch lambasts publishing industry for resisting change.
Site with info on generic drug programs of various pharmacies.
A little counterpoint to all of the pharma industry bashing that’s been in the news recently. IMO, some incentives should be shifted to encourage development of needed drugs & not just me-too drugs.
Vendors of EHR systems for large hospitals are now targeting smaller providers, since 95% of large hospitals have already chosen EHR vendor. Cerner, Epic, Eclipsys, and Siemens are 4 big vendors singled out.
Deloitte’s whitepaper on how pharma could make use of data from EHRs to improve their research, clinical trials, and post-market surveillance processes.
Links to reports by Berkman Center on copyright policies at private foundations.
Heart monitor that detects, analyzes & stores info about patient’s heart. AngelMed Guardian. Smart devices are a growth segment.
Good evidence that healthcare analytics companies are well-positioned, with or without health reform. Private sector will increasingly study effectiveness of treatments using outcomes data & comparing them to costs.
WSJ points to Business Week article on biggest R&D spenders. Merck led the pharma cos, but much of their R&D expenses went to licensing, not internal drug discovery.
Editor & Publisher on ebooks and newspapers. To read.
Minnesota provides website with price info on primary care services, labs, etc for over 100 providers.
Good article on the placebo effect.
Interesting case where patient’s wife suggested experimental treatment that eventually was accepted. She wants $300M plus % of profits.
PharmaTimes reports that NEJM editor, Dr. Jeffrey Drazen and BMJ editor, Dr. Fiona Godlee, will argue next month at Oxford Union that clinical trials should not be conducted by the pharma companies that are developing the drugs due to conflict of interest.
United Health promotes compliance with Rx drugs with discount off next Rx. Negotiated lower prices with pharma companies, which will also benefit from long-term compliance.
American heatlh Care Association reports on letter sent by 31 state attys general to HHS sec’y Sebelius to critique CMS Nursing Home Five Star Rating System, which was put in place at the end of the last administration.
Experiment to charge minimal fee vs. free shows that far more will accept free than fee. But, isn’t segmenting the audience the right path?
Description of how Intuit’s QuickHeatlh helps consumers interpret medical expenses; esp. useful for high deductible plans with HSAs.
Hope Leman reviews the book Internet Cool Tools for Physicians, which I have been planning to read since it came out. Thanks Hope, I’ll do my best to remember to order it the next time I’m on Amazon.
Gary Price summarizes program for 8/28 conference at UC Berkeley about Google Books Settlement.
Free whitepaper from Manhattan Research on Pharma use of digital marketing.
iAtros introduces eRoentgen, an iPhone app that helps in choosing best imaging test.
Article includes comments from Susannah Fox of Pew & ePatient Dave (deBronkart) about finding experimental medicine and specialist doctors to combat fatal diagnoses.
More reason to combat obesity: the research shows it leads to shrinkage of the brain, esp. areas used for decisionmaking.
U. Washington dept that studies global healthcare, funded by Bill & Melinda Gates Foundation.
Cedars-Sinai Medical Center finds that “universal floor” where multiple patient types are grouped and care is coordinated by nurses. Sounds like the old model with a twist.
Dr. Vince Kuraitis describes the foundations of a “network economy” and asks if healthcare industry fits the bill.
EPub versions of 1 million books now available on Google. EPub offers some advantages over PDF versions.
Study attempts to measure level of empathy (or lack of empathy) in medical students. Thesis and conclusions are rather scary.
Long and quite detailed critique of WebMD the Magazine. Author criticizes the “woman’s magazine” nature of WebMD’s mag (and I would extend the comment to much of what is on the website for consumers). In efforts to make the information entertaining, author says that WebMD crosses the line by not providing scientific basis and important related information for much of the editorial info in the publication. Author also criticizes the acceptance of advertising by questionnable vendors. IMO, it is unfortunate that too much of the info provided on so-called consumer health portals is similar to the info that Dr. Atwood criticizes in this article. There’s a big gap between the scientific literature and the material produced for consumer audiences. Far too little info is published for intelligent motivated consumer/patients.
Interesting & worthwhile read about the future of scholarly publishing. Author posits that old model of journals publishing will be replaced by open model with actual usage metrics replacing journal impact factors.
From Medical Connectivity, brief article on how doctors are using Twitter to communicate with patients. Best for mass communication, such as public health alerts and distributing info on clinical trials.
Program for AHRQ’s upcoming conference (Sept. 13-16). Registration is closed; it’s a sellout.
MIT lab turns toys into med devices. Good use of design expertise.
US Bank offers HSA with access to WebMD Coverage Advisor, which helps consumers manage out of pocket costs.
manage out of pocket costs.
Some research on effectiveness of free text (fulltext) search v. search via taxonomies like MeSH in Medline. Results indicate that fulltext performs as well. My comment: combination is likely the most effective!
Hospitals are finding that reporting medical errors and making the info easily available helps reduce the number of malpractice lawsuits. Transparency helps!
BI lays off pharma sales reps and more layoffs are purportedly planned.
Important issues about how doctors communicate to patients risks & tradeoffs using statistics described in this paper.
High profile case where quality of life v. cost could be debated. Not everyone can afford the treatment Ted Kennedy received, nor will everyone want it.
Suggested reading from RWJF.
A group of predictions for the future; some health oriented, some not.
Interesting comparative study of using 3 different medical search platforms: Dialog (ProQuest), OVID (WK) and EBSCOhost. Same search gave different results, with Dialog returning more than twice as many results as others.
Embedded IT trainers to help with transition to Eclipsys was key.
Wired UK highlights how doctors & hospitals are using Twitter in UK & US.
Information Week lays out basics of enterprise business management that should be applied to health care IT.
Article provides good context for current activity in managing hospital supply chains. Several stories in past week about purchasing cooperatives to reduce cost of supplies.
Sec’y Health in MA writes about Rand report that provides analysis of 12 possible interventions with highest likelihood of reducing costs. Link to full report included.
Survey of medical students by Epocrates shows high usage of health IT, low confidence in info provided by pharma detailers.
Amer Assoc Family Physicians (AAFP) has launced Delta-Exchange, a social networking site for primary care physicians.
AMA uses Impelsys’ iPublishCentral s/w to publish frequently updated versions of its books in ebook format.
Forbes appears to be pro-public utility for healthcare info exchange in this article. Patrick Soon-Shiong describes reducing the gap between medical research and clinical use (translational medicine), a topic that I just noted in the post about the Army & Navy project at Walter Reed.
Army & Navy doctors collaborate real-time with medical researchers on wound care for injured soldiers–bridging the time gap in tradtional “translational medicine”.
Kodak partners with MMR (MyMedicalRecords.com) to resell Kodak scanning technology for digitizing and importing paper records into EHRs.
NaviNet, a Cambridge, MA claims clearinghouse vendor (RCM) (formerly known as NaviMedix), is promoting its clearninghouse services as preliminary health info exchange (HIE). Currently, EDI is limited to certain payment-related data types, but NaviNet suggests that scope could be increased. Their argument: Why recreate the EDI wheel if the basic network is already in place?
Article in chicago Sun Times says 28% of those seeking health insurance will look online to find providers. eHealthInsurance is profiled.
Informatics Corp. of America (ICA) partners with Mark Logic to offer OEM version of Mark Logic server to allow users to search across structured and unstructured data in EHR systems.
Wikimedia is testing a new policy that will insert an editorial review step before articles about living people are published or modified.
iMedX, a US-based EHR/ medical transcription outsourcing company, acquires Worldtech, Inc., a competing health IT/med transcription company that serves over 800 small physician practices in US and has global medical language specialists. Worldtech will become a division of iMedX.
Rx Ohio Collaborative (RxOC), a coop for group purchasing of Rx drugs, expands to include all Ohio public sector entities & now has about 12 participants. RxOC replaces independent PBMs and is expended to yield greater savings.
P&G to sell prescription drug businesses to Warner Chilcott for $3.1 B. Warner Chilcott, an Irish company that specializes in drugs for women’s health, has annual rev. of $938M. Deal will increase size of WC by huge percentage. P&G’s strategy is to sell off slower-growing units to focus on growth.
Aon survey shows that cost of claims paid in 2010 will increase 10.5% over 2009. Many employers say they won’t pass higher costs onto employees (and some employers won’t have higher premiums due to composition of their insured base) since employees have already taken so many hits in pay freezes & increased co-pays. I like this quote: “Employer contributions are not gifts, they’re part of total compensation. And if you end up having a more expensive health benefit that your employer pays most of, that means that your wages aren’t going up as fast as they would have” (Joseph Antos, AEI).
Healthland, a health IT solutions provider to small rural hospitals, acquires American Healthnet, an Omaha based health IT company to expand its customer base. Last year, Healthland acquired Advanced Professional Software.
Brief article on Microsoft’s increasing activity in health/biotech space.
Scary to read that many doctors don’t know when they are prescribing for off-label uses. David Williams suggests pharma detailing/marketing is cause.
Change:healthcare, a Health Content08 Innovator, is selected by Keystone Insititute for Translational Medicine as partner in consortium to help bridge gap between scientific discoveries in medicine and clinical practice. Congratulations Chris Parks, CEO, change:healthcare!
Good piece about using patient-generated data in medical research. Although not as controlled as clinical trials, certainly better reporting mechanisms can be created to increase the usefulness of real-world health conditions and outcomes data.
To read: article on Drupal, a popular open source CMS for Web publishers. Talks about their business model.
Excellent article that describes how iPhone and other wireless apps are being used by nurses in clinical settings.
NaturalNews.com has launched NaturalPedia.com, a wiki with contributions from hundreds of individual authors on topics related to natural health, wellness, and disease. Note, minimal testing of NaturalPedia indicates that it is primarily a shopping site with content used to refer readers to books and other content for sale. The wiki format is clever and the site seems very steeped in contextual advertising. Natural Health is headed by Mike Adams.
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