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Archive for the ‘Physicians’ Category
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 Nov 9-22
- Posted November 22nd 2009
- Comments (0)
- by Janice
Very good article by Linda Peitzman, MD, CMO (Medical) of Wolters Kluwer Health on benefits of order sets. Article provides some detail on how to implement order sets to ensure everyone receives latest most current version. Note, hour long interview with Linda, Nancy Greengold (of Hearst Business Media and co-founder of Zynx Health), Sundeep Karnik (fmr VP Strategy Elsevier Health) and Gary Kennedy, CEO of Remedy MD can be found here: http://www.berkerynoyes.com/pages/innovations_in_evidence_based_medicine.aspx
InformationWeek profiles Transparent health Network, which is compiling prices for direct purchases of healthcare services by patients.
IL launches its hospital compare site. Article points out that public ratings rarely reflect quality of care.
Flybridge invests in woman-owned pilates equipment seller, which has sold over $500M in equip on QVC over the past 12 years.
WSJ writes about new x-discipline collaboration among research scientists. Key point relates to how these scientists are creating their own databases. No mention of third party publishers in this new world of data-driven research.
Workflow study that follows patient through hospital identifies areas for improvement.
Jane Sarasohn-Kahn reviews recent study by Buck Consultants on growth of wellness programs in a variety of countries and compares the priorities of each country’s wellness programs. US is only one where cost-saving is key objective.
Brian Ahier writes about recent developments in electronic healthcare records with a focus on Practice Fusion and GoogleHealth’s attempts to offer patient info that is consistent with physician info.
Matt Holt comments on Practice Fusion’s announcement of patient portal to coincide with their free EHR s/w.
John Moore of Chilmark Research, who moderated closing panel, recaps the day’s highlights. I’ll add that John did a very good job on the last panel, which included Esther Dyson, Steve Munini COO Dossia, Fred Smith of CDC, and George Willock, CEO of HealthString. Audience appreciated the focus on the patient (Adam Bosworth did focus on patient, too). I believe it was Esther who said: “the patient is the most important input into health decisions”. She mentioned the “quantified self” movement and Society for Participatory Medicine also got a plug. This was the most forward-looking session that addressed social media and the exploding amount of new data that will be available for analysis.
Very good video by Nobel laureate in biochemistry, Paul Nurse, who makes the point of the importance of recording healthcare outcomes and analyzing data to prevent misunderstandings based on false correlations. He uses the vaccination scare as an example.
DataONE (Data Observation Network for Earth) is one of two $20 million awards made this year as part of the National Science Foundation’s (NSF) DataNet program. The collaboration of universities and government agencies coalesced to address the mounting need for organizing and serving up vast amounts of highly diverse and inter-related but often incompatible scientific data. Resulting studies will range from research that illuminates fundamental environmental processes to identifying environmental problems and potential solutions.
Good balanced view of response to recent breast cancer screening guidelines.
Center for Ix Therapy, which was represented at our first Health Content07 conference, to shut down Nov 30, 2009. The Center was small organization with limited resources, and suffered from trying to define a space that already existed and was far more widespread and diverse than their definition of Ix Therapy.
Lois Wingerson writes about Healthcamp NYC and ePatients.
Wonder what Lexis and Westlaw will say about this?
HR and billing IT apps are helping hospitals save money that can be applied to clinical improvements.
Makes sense. FDA and other govt sources are not best at marketing and distribution. Everyday Health (Waterfront Media) can take on that role to extend reach of FDA info.
Latest version of Allscripts (version 11) was launched before it was debugged. HDM asks if Allscripts has overreached its grasp since its merger with Misys. Note also the prices for the KLAS reports: $980 for providers; $11,850 for others!
Grove, former CEO of Intel, promotes concept of new degree to help accelerate the cycle from medical research discoveries to mass production of new treatments. Essentially, Grove wants to combine skills of researchers and engineers to disrupt current cycle that can take many years from bench research to broad availability.
ModernMed, a concierge medical service in Milwaukee, launches with 2 primary care MDs. Founder believes healthcare costs can be controlled via effective primary care.
Physician posits that dependence on checklists may not be to the benefit of good patient care if insufficient attention to individual patients is paid.
CambridgeSoft, which provides IT solutions for pharma BI (esp R&D), receives funding from Health Evolution Partner (David Brailer’s PE company). CambridgeSoft is touting its SaaS solution for pharma & chemical research.
Gary slams the morning TV shows for their promotion of junk information about weight-loss and other health issues. I agree that for the most part, TV news health info is superficial and very seldom put in context. Wouldn’t it be great if the money were spent on disseminating helpful information and pointing people to more trustsworthy sources?
“The Centers for Medicare and Medicaid Services plans to boost data sharing among its various programs that have common functions using the Medicaid Information Technology Architecture (MITA) and the nationwide health information network (NHIN).” Sounds reasonable…
How much information is optimal to share between patients & doctors? Great comments here.
Good article that points out the importance of system change (behavior change) for checklists and the like to be effective.
Article makes the point that it’s great that gov’t agencies are providing more open data, but that data needs to be put in context and displayed in an engaging manner to really have full impact. And that, dear publishers, is what you should be doing…
Another outstanding post by DC patient, who writes that een though she is an engaged patient, she never would have thought to file reports of adverse effects (AE) via FDA’s MedWatch. Her comments make it pretty clear that the MedWatch channel is not effective for monitoring Rx AEs. Patients consider many factors before they single out any particular cause.
Excellent round-up of Day 1 of FDA hearings on social media use by Pharma.
Another story on the funding for Caring.com which recently acquired the Gilbert Guide.
CVS sees value in studying interaction between genes and medication for its PBM business and for its end-customers.
Google’s proposed ad format for Pharma ads. Presented at FDA’s hearing on social media.
Dr. Pauline Chen’s column about the decline in # docs who want to go into primary care. In large part, it’s due to large number of routine cases they deal with and the amount of paperwork and coordination required. Of course, pay is an issue too. This ties with articles I’ve published about the commodization of routine health care enabled by health IT. Programming routine tasks and allowing nurses and other clinicians to take over these tasks should relieve primary care physicians of the “burden” of routine tasks.
Forrester’s CEO on how old media needs to reinvent itself for digital world where customers decide what is valuable.
Nice rundown of vetted sources of online health information from medical librarians.
Explorys, a start-up search engine, partners with Cleveland Clinic to develop search/analytics tool for patient records.
David Blumenthal’s latest statement on goals of the ONC for interoperability of electronic health records.
Chris Truelove’s review of 1st morning of #FDASM
linking patient data and related information
Very good article and great comments on hurdles that impede implementation of electronic health records/electronic medical records.
Live webcast of FDA’s hearing on use of Internet and Social Media Tools by FDA-regulated Medical Products, Nov. 12-13. Much anticipated meeting on topic of use of online media by Pharma and other FDA-regulated companies.
Geonetric survey lists top objectives of patient portals created by hospitals.
More outlets for distributing health and fitness gear as focus on wellness and prevention increases.
Pretty interesting application. Not as far-fetched as it seems.
No matter the outcome on ONC pronouncements about meaningful use, CCHIT, the certifying board for EMR/EHR systems, is continuing to play its previous role. CCHIT describes itself as a “community” and believes they offer meaningful services to small hospitals and group practices.
Lots of info on various IT standards for EMR/EHRs
Comments on Erik Engstrom’s new position as CEO of parent company Reed Elsevier. Engstrom has been CEO of Elsevier, the STM group of RE, for some time. Smart and analytical, I think he’s a good choice.
CareMedic, a Florida revenue cycle management (RCM) company, to be acquired by UnitedHealth’s Ingenix group. Ingenix now has near end-to-end platform for managing every step of the revenue cycle, from patient registration to reimbursement.
Well, even though someone’s gotta pay for the production and dissemination of information, I don’t like this alliance and don’t believe AAFP can be objective in its research on effect of sugary soft drinks if Coke is the sponsor.
WaPo on how some people may overreact to info they find on online health sites. Writer overreacts a bit herself in implying that online resources shouldn’t be used to help diagnose one’s condition. Agree that health literacy is needed; that is, consumers need better training to vet health resources. But, we’ll have hypochondriacs in the real and virtual worlds. Not everyone will gain the same benefits from online health resources.
Google now incorporating dat aon flu shot availability and mashing it up with Google Maps to illustrate where flu shots are currently available. Note, Google is compiling info provided by clinics. More proof positive that Goog is a content publisher.
SDI Health, a PA company that provides healthcare data analytics services, receives funding from Tailwind Capital.
FastIgnite site offers tools for start-up companies to calculate pre-money valuation, vesting, and more.
Article on lack of transparency in reporting health research and health statistics.
CareFocus, parat of the Clinical Xpert suite of CDS workflow solutions from Thomson Reuters (fmly Mercury MD) extends functionality of product line.
Narrated slide slow illustrating new features of reports on Patients Like Me. Impressive.
Dr. Danny Sands on why he believes in participatory medicine and informed patients.
PhRMA proposes methods for verifying FDA-approved data in health info provided to consumers. FDA logo on sites?
Good concise review of Merck Manual Professional Ed. for iPhone
Excellent slide deck that describes influence of social media in healthcare: pharma, med school, epatients, doctors, nurses.
Describes use of mobile devices to monitor steadiness of eldery to prevent falls. Good descriptions of how data from monitoring devices can be used in research to vastly improved current snapshot approach of medical research.
Focus on shortage of primary care doc and how nurses will take on more resposibility. Agree, but shortage isn’t the source of problem. Rather, commoditization of basic medical care & procedures due to digitization of health care info is source of change. See piece on “heatlh content is rapidly becoming a commoditiy” in my blog at Health Content Advisors.
Merck offers iPhone app that allows chemo patients to track symptons, etc.
Sermo creates community on practice management topics for docs to share info about healthIT and the business issues of running a practice. There are even CME activities with 8 module curriculum titled: The New Business of Medicine.
Chief scientist at Endeca, a specialist in faceted search, joins Google.
Microsoft will launch a video web series on health IT beginning Nov 11, 2009.
Review of data.gov with emphasis on healthcare data.
Long interview with David Brailer, now a PE exec, fmly Director ONC.
Emap titles Health Servie Journal and Nursing Times partners with Doctors.net.uk to share content and conduct research.
Anne Woods promoted to CNO (Chief Nursing Officer) at WK Health. She’s responsible for nursing strategy across Medical Research & journals publishing businesses.
Hope Leman’s interview w/ John Sharp of Cleveland Clinic.
Headline Commentary October 19-31
- Posted October 31st 2009
- Comments (0)
- by Janice
Usage of free PHR services hasn’t yet taken off. Peter Neupert of MSFT hints that wider adoption of IT by physicians and better connectedness between the stakeholders are needed before the value of using PHRs is obvious enough to incent consumers to adopt them.
Does technology interrupt the communication between doctors & patients? That’s the question posed by this book. Sounds interesting.
Short article on health IT with focus on MSFT. Quotes Peter Neupert, MSFT Health head.
New site that compiles info about neuroscience research.
Nice brief overview of EHR solutions for smaller practices with a description of some of the vendors.
Great example of the how new sources of data will transform medical research.
AMedNews writes up the recent PWC report on secondary data from EMRs. This is a major focus of ours at Health Content Advisors.
Jay Parkinson on specialized providers v. general hospitals.
Keas expands through partnership programs with CVS Caremark (MinuteClinics), Quest, and now Partners Healthcare.
Review of Adam Bosworth’s company, Keas, which uses custom “care plans” that collect personal data - directly or indirectly.
Bob Stern, founder of MedPage Today, delivers his perspective on how medical societies that publish research and organize medical conferences inhibit distribution of research information, much of which is funded by tax dollars via NIH, HHS, NSF, etc. The current model is undergoing a slow but steady transformation, which I think is accelerating.
Consumer Watchdog wants change to HHS ruling that gives providers the authority to decide if/when a patient’s healthcare information security has been breached.
CVS Caremark offers mobile site that includes access to medication history, drug info, special offers, and driving directions/phone numbers of CVS pharmacies or MinuteClinics.
Karen Overstreet, named executive director of Lippincott CME unit. Interesting that she’ll report to the Medical Research division, not education. Has there been a re-org?
Hope Leman writes an enthusiastic review of American Well, the online healthcare service that provides access to medical professionals from home and handles billing, too.
FDA will use data from Wolters Kluwer’s Pharma Solutions Source Lx Patient Studies Suite that captures patient-level Rx data and Pharmaceutical Audit Suite (PHAST) that captures Rx transactions to follow trends in flu medication prescribing activity by region and other patient demographics.
Good overview of status of standards for ensuring that secondary data produced by EHRs will be useful for research purposes.
American Academy of Professional Coders offers free app to help convert ICD-9 to ICD-10 codes. See aapc.com.
New edition will include feeds from Factiva and use Factiva Smart Search. Need to check on pricing.
long article on why “lifestyle” medicine is needed to reduce costs and improve outcomes. Note, focus on healthy behavior is gaining traction in large part because of the research that can be conducted on electronic health records of patients.
HealthPort Inc., an Alpharetta, Ga.-based provider of healthcare IT solutions to hospitals and health systems, has set its IPO terms to six million common shares being offered at between $14 and $16 per share. It would have an initial market cap of approximately $360 million, were it to price at the high end of its range. HealthPort is owned by ABRY Partners. www.healthport.com
HealthGuru Media raises additional $3.2 M from Castile Ventures and Village Ventures. VV’s Po Beabody is co-founder/Chairman
New study in The Journal of the American Medical Association, estimates that there are 67,000 fewer active physicians than calculations have suggested. The physician work force is also younger than previously estimated, with a greater proportion of doctors in their 20s and 30s and fewer who are 65 and older. By 2020, there will be 957,000 physicians, according to the new estimates, rather than the 1.05 million previously projected. Only 9 percent will be 65 or older, or half as many as had been predicted.
Due to “operating” costs (and debt loads from med school) MDs less likely to go into solo practices.
Team that developed InnovationRx at the Innovation Company bought the rights to the company and relaunched it as Aprexis Health Solutions. Aprexis focuses on patient adherence, with adherence to prescription drugs the focus.
Birmingham, AL based MEDSEEK listed 455 in Deloitte’s Technology Fast 500. MEDSEEK provides patient portals for hospitals and claims >650 hospital clients.
WK Health announces new customer who will use Provation, now branded as Provation Order Sets, powered by UpToDate Decision Support.
PEHub reports that IMS Health is in talks with PE firms to sell the company. IMS shares surged almost 22% yesterday (10/19)
UnitedHealth exceed analyst estimates despite declines in #insured, due to increases at drug unit.
Prof Teisberg on why gov’ts shouldn’t legislate comparative effectiveness requirements. Essentially because of variation in outcomes. Focus should be on value for each patient.
Argentina the latest country to launch medical tourism program to encourage visitors to plan vacations centered around medical procedures (cosmetic and fertility are top treatments for medical tourists in Arg).
With goal of trimming 100 positions in newsroom, NY Times editor Bill Keller offers buyout to entire newsroom staff. If fewer than 100 respond, they’ll have layoffs.
MVP Health, a regional health insurer in upstate NY, VT, and NH, will reimburse physicians for using RelayHealth’s WebVisit (TM) for patient consultations. MVP is partnering with Mohawk Valley Medical Associate (MVMA) to offer physician’s immediate reimbursement for implementing Relay’s webVisit.
CDW Healthcare, Vernon Hills, IL, partners with Cerner to market EHR solutions to physician practices.
presentation materials from Sept 24, 2009 webcasts on CAHPS Clinician and Group Survey
Wow! AstraZeneca seeks 5,000+ sales people to “self identify” their interest in taking buyout.
Concerns about patient privacy loom over electronic health records segment. George Hill of Leerink Swann estimates that by 2020, data mining could represent a $5 Billion industry.
Epic and Apple working together on Mobile EHR project.
Preview of next week’s Connected Health 09 conference in Boston. Focus: new devices and communications tools will help patients take more control of their health and leave hospital visits for severe events.
Great review of new iPhone version of Merck Manual Home Health Handbook.
New device from Fitbit that tracks exercise & sleep & can be used to monitor calorie intake, too. Fitbit is joining a fast-growing segment of devices that help monitor healthy behavior & can be used by payer segment to evaluate lifestyle of insured populations.
Akaza Research, provider of OpenClinica 3.0 open source s/w for clinical trials, adds electronic data capture features.
Dr. Rob on medical costs and medical codes–and plug for his interview with Ira Glass for This American Life’s series on medical costs to be aired weekend of 10/17-18, 2009.
More proof that medical apps are far ahead of any other professional (b2b) mobile apps.
Quest Diagnostics’ MedPlus group, launches its Care360 ambulatory EHR on Oct.24. MedPlus will market the EHR to teh 150,000 physicians that already use its other Care360 apps and will offer hosted solutions for smaller practices. Quest’s MedPlus has the advantage of having existing relationships with these practices who use their other Care360 apps.
Although there’s resistance, trend toward incentives for following healthy behavior is on the increase.
Developed in collaboration with the Allen Institute for Brain Science, Elsevier’s Brain Navigator tool, a “GPS system” that provides 3-D software to navigate the brain, adds new features for visualizing injection pathways and printing and exporting images. Interesting to note that this collaboration is with Elsevier’s Science and Technology Books division. Great example of how STM publishers can leverage their content through IT/R&D partnerships.
Halamka reports on latest HIT standards Committee meeting.
According to 2006 Kaiser Foundation study, nearly 1/3 of US companies that offer health insurance also offer some sort of wellness program. And, the focus on wellness has increased since then. This article describes some of the programs and $$ incentives for reaching wellness goals.
Quantified Self, group that advocates and facilitates patients to track health and wellness data about themselves, names impressive advisory board.
Very interesting. Healthy Advice Networks, which markets health info to physician practices with content sponsored by pharma and health and wellness brands, partners with HealthScape Consumer, a joint WK Health and Nielsen longitudinal panel to provide data on the effectiveness of sponsoring/promoting in Healthy Advice Network.
iTriage, an iPhone app from Healthagen, offers info on wait times at ERs and info about providers (hospitals). Providers pay to be listed with marketing info.
RightHealth is dba name of Kosmix, a Mt. View California search technology company that initially focused on the health space.
MedSeek announces recent deals for installations of their consumer information portals in hospitals.
Digitas Health lists 140 possible uses of Twitter in healthcare. Nice.
Review of recent conference on Personalized Health at Ohio State.
Florida-based video sharing site that posts videos for docs to use for patient education.
Deloitte offers database and analytic tools on pharma/biosciences alliances.
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.
Emdeon Delivers RCM Efficiency and Gathers Intelligence
- Posted August 13th 2009
- Comment (1)
- by Janice
The healthcare debate tends to focus on, well, healthcare—interactions between doctors and patients. Obama has recently tried to reposition healthcare reform as “health insurance reform”. But, given the realities of where the biggest inefficiencies exist, perhaps the focus should be on health insurance payment processing reform. Emdeon, which went public Wednesday, August 12, estimates that about 17% of our total healthcare expenditures in 2008, or $360 billion, is spent on administrative costs. Further, they estimate that $150 billion of the $360 billion is spent by payers and providers on billing and insurance claims processing. This segment is referred to as revenue cycle management or RCM. Core RCM services involve:
o Verifying eligibility ahead of time
o Submitting claims to clearinghouse according to each payer’s requirements
o Tracking claims in process and fixing denied claims
o Handling payment from payer to provider
o Sending explanation of benefits (EOB) to patients
o Submitting secondary claims if appropriate.
With many providers still using outdated paper processing and limited-functionality automated processes, there is much room for improvement and cost savings in this market.
Emdeon provides services to help medical providers, payers and pharmacy benefits managers (PBMs). Their largest segment is medical providers (hospitals and medical practices), where they supply revenue cycle management (RCM) services and patient billing statement services and had 2008 revenues of $444.8 million in this segment, of which $144.9 derived from RCM and $266.2 from patient statement production and mailing (total 2008 Emdeon revenue: $853.6 million). Emdeon processed over 4 billion health-related transactions in the US in 2008 and accounts for almost ½ of all such transactions. As the largest provider of RCM services, Emdeon’s stock price represents to a large degree the overall market’s sentiment of this segment. Emdeon priced its IPO at the top of the planned range at $15.50 and the stock (NYSE: EM) is up 11.3% as of late-afternoon today (Thursday) at $17.25. A good, if not great, reception.
In its registration statement (Form 424B4) Emdeon describes the fragmented provider landscape (see p. 84) that it says has “historically under-invested in administrative and clinical systems”, in part because of the 560,000 office-based doctors, approximately 74% of which are in small practices with six or fewer physicians. Even these small practices may have relationships with over 50 individual payers. These small to mid-sized practices need RCM solutions that don’t require substantial investment in IT knowledge or equipment.
The market for RCM solutions is fragmented, too. Emdeon has the largest share and there are a handful of other smaller RCM vendors with comparable (or better) claims processing features. But there is also a large group of small billing management companies that either specialize in a type of provider (e.g., emergency care - see recent story about HRA) or focus on a region.
The RCM segment of healthcare has been receiving substantial attention from investors, large consulting companies, and big health IT vendors that recognize the opportunities that exist to improve efficiency in medical billing and related administrative functions. We anticipate accelerated activity in this segment, with both horizontal and vertical consolidation’s occurring. We’ll continue to post updates and commentary about the RCM segment and adjacent segments on this blog.
And for those who think that we’re veering away from health content with this post, let me leave you with this outtake from Emdeon’s Prospectus:
“Our access to vast amounts of healthcare data positions us to develop business intelligence solutions that provide our customers with valuable information, reporting capabilities and related data analytics to support our customers’ core business decision making.”
Health data analytics reside at the pinnacle of our definition of health content!
Follow me on Twitter @janicemccallum
Headline Commentary Aug 9-Aug 13
- Posted August 13th 2009
- Comments (0)
- by Janice
Sales of ebooks grow rapidly, but not exponentially.
Esther Dyson speculates on how Internet could radically change the way patients are involved in their healthcare. Like the way she stresses the important role of information and info tools in changing behavior.
Sony will adopt ePub format, an open standard developed by group that includes some large publishers (Random House, HarperCollins) and use Adobe anti-piracy s/w for their Reader, which allows limited sharing & copying, dropping their own proprietary closed systems with very restricted anticopying s/w.
David Rothman gives a brief overview of TrialX, a clinical trials search tool for patients that can incorporate diagnosis and demographic info from Google Health and Microsoft HealthVault.
FDA clarifies rules for providing access to investigational drugs for patients. Some could be available as early as end of Phase I. Link to FDA rules in article.
BMJ article abstract highlights methods for reducing number of unnecessary (and expensive” interventions. Pts out that evidence is often not applied in deciding how to treat.
Article calls for comparative effectiveness info to be put on drug inserts.
Quotes David Brailer who says it’s important to consumers to have more control. Currently, hospitals are in the driver’s seat. Author suggests that protecting against fraud will be most important.
Rodale’s Prevention magazine’s annual survey of over 1,000 consumers indicates that consumers who are likely to respond to DTC ad by asking their physician about a drug is down >5% in 2009. Rodale analysts assumes economics and lower level of DTC print ads are the cause.
Articles describes several employer plans that offer $$ incentives to employees to practice healthy behavior (stop smoking, lose weight, go to the gym, etc). Mentions Tangerine Wellness, RedBrick Health, and quotes Yale economist Dean Karlan.
Survey by Medical Group Management Assoc. of CO reports that implementing an EHR was the 3rd highest challenge for physician group practices (62% consider selecting and implement EHR a major challenge). Note, revenue management or RCM rated 1st with 73% rating operating costs that are rising faster than rev. as a considerable or extreme challenge. Link to summary report included in article.
Article predicts that 85% of doctors will be employed by hospitals w/in next 10 year. Goes on to explain why (primarily reimbursement practices that favor hospitals). Worth a read.
Emdeon’s IPO raises $365.7 M, with shares priced at top of range & 10% more offered than originally planned. Sign of positive outlook for health IT providers, especially in the RCM/cost containment space.
Information Week covers range of doctors’ attitudes toward using social media to communicate with patients.
In response to the high-priced TEDMED event ($4,000), some folks created a sister conference called BIL:PIL. The BIL:PIL event will focus on innovations in social media and med technology. Oct. 30-31, San Diego State.
Article points out how little transparency or rationality there is in current health care pricing and reimbursement systems. AHIP apparently provided data to shore up support for their case, but the article doesn’t portray them in a very positive light. If insurance plans were so good, why would we have so many insured patients receiving outrageous bills?
Long article that describes slow progression toward cloud computing for healthcare providers. Some good examples and quotes.
Canopy Financial, the provider of the platform for the HSA system used by many of the top banks, announces that its statistics show that health savings account (HSA) balances increased in Q109.
Premier healthcare alliance, a consortium of 2,200 not-for-profit hospitals, will use 1SYNC for its standardized product identification network. Using 1SYNC will help standarized identification of all items purchased by healthcare proviers and improve efficiency of information exchange between supply-chain partners.
Article describes how doctors/surgeons have to make judgements about appropriate devices and treatment for infants (and other groups that weren’t part of the initial clinical trial study), since there often is no established evidence on which to base decisions.
Interesting app on Wolfram Alpha that helps patients understand medical lab tests/results.
Good brief article that describes 4 search engines that offer features and content that differ from Google or Bing. DeepDyve, which we’ve followed because of its excellent coverage of scholarly research and medical journals content, is one of the 4 mentioned in the article.
More activity in the “revenue cycle management” (RCM) aka claims processing segment of health IT. Intermedix (Ft. Lauderdale), which provides IT services to emergency providers has acquired HRA Medical Management (San Diego). HRA provides emergency physician and hospitalist billing services in Calif. and Nevada.
CNN lists top inefficiencies in US healthcare system. For example, they quote up to $210B wasted in inefficient medical claims processing that could be remedied through better systems and a simplification (rationalization) of claims used by different insurance companies.
More focus from NY Times on use of de-identified patient data–and in this case–identified patient data used for marketing. In this case, Rx data is the focus.
Emdeon, which processes nearly half of all medical payment claims in the US, to debut on NYSE Wednesday (Aug 12, 2009). Expects to raise as much as $333M. “Emdeon has picked a perfect time to test the public equity market. The entire health-care system in the US is in the state of flux, and advancement of health-care IT” is a strong focal point now, according to Alex morozov, Morningstar associate director in a recent research note.
Vince Kuraitis adds his voice to the MSFT HealthVault v. GoogleHealth comparison.
Merge Healthcare, a Wisconsin company, made its 2nd acquisition in past 2 months by acquiring Confirma, a Seattle-based copmuer assisted detection technology company, which specializes in CAD imaging tech for breast, liver, and prostate imaging.
Thomson Reuters Healthcare releases its latest (Aug 10, 2009) Top 100 Hospitals list. Fmly Solucient, which TR acq.
Datamonitor Group, part of Informa, to consolidate its IT research brands under the Ovum name. Datamonitor healthcare & pharma remains separate (as does energy, fin’l svcs, automotive, and consumer). New organization would make it easier to spin off the IT group.
Related to Dr. Seibel’s use of music in patient education, I found this home page from NIH for patient education for kids. Good uses of games, music, riddles, humor, art, etc. to engage kids.
Intriguing idea to use music as part of patient education. I’m a firm believer in using whatever medium is “appropriate” or useful. If music [and poetry] helps people remember key information, then I’m all for it. “The hip bone’s connected to the…”
Headline Commentary July 14-19
- Posted July 19th 2009
- Comments (0)
- by Janice
Netsmart, an enterprise software vendor to behavioral & public health providers, acquires Crown Software. Crown provides pharmacy management s/w that integrates with EHRs.
Article describes how sponsorship by pharma or other commercial entities leads to bias in clinical trial results and in published journal articles. An unintended consequence of open access, where research org funds publication?
A short, concise piece that provides some good examples of how newspaper/news publishers could create new revenue streams. Good examples, including some I’ve used in the past (post original documents & databases, better repurposing of archives, special editions, and more).
Big pharma is increasing subsidizing co-pays for their drugs in order to retain customer loyalty. Co-pays were put in place to help persuade consumers to focus on costs and compare drugs.
University presses looking at forming consortium program to promote ebook sales.
ACS provides more detail about its new print format (landscape w/ 2 pages on each sheet) and changes to pricing, which eliminates print discount.
Good examples of how healthIT can add efficiency, but physician author cautions that entering data takes time. This doc is part of Kaiser Permanente, which is frequently held up as an example of effective use of electronic health records. Problem is, KP is an integrated system, which makes it much easier to enforce interoperability and usage.
Excellent article on how crowdsourcing to harness innovative ideas can work when there’s some structure and focus.
Good roundup of providers and related info about trend toward elderly staying in their homes and retrofitting with safety gear. Role of occupational therapist growing for this purpose, too.
Good commentary on top web sites for consumer health info.
Example of industry information company adding value through data-analytics.
Transcript and video interview with Obama, discussing evidence-based medicine & health reform.
Article provides breakdown of downloaded apps by category & within category, by free & paid.
Jim Clark, founder of SGI and Netscape, and later Healtheon (which merged with WebMD) speaks somewhat acerbicly about state of innovation & prospects for US in global business. Digs about lack of workable electronic health records, too.
Lewin Group, a health care policy research firm, launches new center for comparative effectiveness research (CER). note, Lewin won an HHS bid recently to construct CER framework. Lewin will incorporate longitudinal patient data (de-identified)from Ingenix, it’s parent company.
Pharma & biotech look to fare better than initially expected in health reform bill. Biotechs, as previously reported, will likely get 12 years exclusivity, vs. 7 originally proposed by Obama. Pharma wins on issues of drug importation & Medicare drug prices.
Josh Seidman’s very clear exposition of why needs of clinicians and patients have to be central to efforts to define meaningful use of electronic health records. Sadly, these voices are mostly absent from the discussions (apart from clinicians with IT roles in large provider organizations).
John Halamka provides concise update to meaningful use (MU) definition that came out of this week’s HIT Policy Committee meeting.
Robert Wood Johnson University Hospital (RWJ) loses motion to dismiss copyright & trademark infringement suit from HealthGrades for misuse of its ratings info, although RWF is mostly successful in motion to dismiss breach of contract claims. RWJ used copyrighted HealthGrades ratings in press releases & articles.
More concern about the ethics of folks behind Clinical Reader, a company that provides an interface to collections of clinically-relevant medical info.
Post provides some historical context on how medical research in academic settings has changed in age of Google. But, the adage “plus ca change, plus c’est la meme chose” almost always applies, esp. when it comes to business models/pricing models. Note, I worked at Dialog from ‘85-’95 during the time when CDRom was introduced.
Wow, when I have referred to “intermediaries” as a key category in the health content supply chain, entertainment companies weren’t top of mind. But, after reading the description of this program at the USC Annenberg Norman Lear Center, it makes sense. TV programs and movies have a lot of influence on the health literacy of our population. It’s important that the writers, editors & all parties in media understand where to find authoritative info & learn how to interpret it.
Princeton bioethicist, Peter Singer, writes on why we can’t afford to offer the most expensive new treatments to everyone. I’ve seen some strong reaction to his article, but to those who are “disturbed” by Singer’s premise, would you prefer involuntary bankruptcy and lifelong poverty to patients who are given treatements that they cannot afford? That’s what we have now–along with rampant price increases.
Jim Spanfeller resigns from Forbes, where he has led digital efforts for past 9 years, to start his own media management firm. Forbes had fared better than other business publications in part due to its more aggressive online strategies, but in my opinion, their online presense lacked cohesion and proper design. In print, Forbes remains a notch above most business pubs and can still leverage its readership.
Sagient Research will provide assessments, forecasts & approval timelines on clinical stage drugs for new “Forecast” module of Thomson Pharma Partnering. Sagient produces the BioMedTracker research service.
3 PE groups resubmitted bids for Springer at request of Candover & Cinven. New bids slightly higher (>400 M Euros vs. 350-380M Euros of 1st round), but still short of the hoped for 500 M Euro bid for up to 40% of Springer. PEHub rightly points out that Candover & Cinven recapitalized Springer 3 times and paid themselves healthy dividends each time.
Major insurers/payers are backing pilot medical home projects in NH, Maine, Colorado & NY. “Medical Home” is an awkward term for coordinated care that includes more focus on prevention.
Health Content is Rapidly Losing Its Value
- Posted June 22nd 2009
- Comment (1)
- by Janice
The dismal state of the news publishing business is well known. The competition in online news has become so intense that users now expect to receive general news for free. It’s not a stretch to say that news stories that report the latest medical research results fall in the same category (and constitute the majority of health stories in general news outlets).
This trend isn’t unique to news or health content. All digital content is becoming commoditized. Why? The answer is complex, driven mainly by technology. Good quality digital publishing systems are available for free (e.g., WordPess, open source CMS systems), thereby eliminating the cost of production and replication, and distribution costs have been driven down to near zero with Web distribution. These factors combine to reduce the barriers to entry, and as a result, the volume of digital content has exploded. Marketers are giving away content to promote their goods and services; citizen journalists are blogging, texting, and Tweeting; and social media tools have made it relatively easy to build an audience for content. Publishers, whose product is content, have to give away some of it to draw in users, but too often seem confused about what content to give away and what content to retain as premium content.
This commoditization phenomenon isn’t contained to publishers. As pointed out by Tom H. Lee, MD in a provocative article, “Commodifying Content Through IT: Could Physicians Be Next” in iHealthBeat last month, physicians are experiencing commoditization, too. Dr. Lee (who headed content development for Epocrates in its early days) posits that once the knowledge of doctors is encoded in computerized clinical decision support systems, the value of the physician who once had controlled access to the same information will decline.
Take for example, the use of nurse practitioners and other non-physician clinicians for many relatively routine tasks previously carried out by doctors. Minute-Clinics and the like are prime examples where order sets are used to diagnose and treat common conditions. (See Harry Bliss cartoon: The doctor’s nurse’s nurse practitioner will see you now). Even self-diagnostic systems for patient use will become more commonplace over time as clinical decision support systems improve and gain acceptance as reliable diagnostic tools.
Okay, so let’s accept that health news content is a commodity. What about more specialized health content, such as fulltext journal articles, drug information, books, and other reference materials? The evidence indicates these categories are approaching commodity status, too. How fast they are de-valued depends on how easy it is to recreate or reproduce the information and other barriers to entry.
In today’s market we’re often willing to pay to find content, but not for the content itself. Rewards for creating content are declining relative to the rewards of creating new technology for processing content.
What should health content publishers — and healthcare professionals — be doing to maintain their value in the face of technology-driven commoditization? In short, they need to “move up the value chain”. Sometimes just aggregating related content and making it accessible at the point of need is sufficient added-value to extract a premium.[1] Other times, investing in creating sophisticated workflow tools or analytic engines that integrate content with IT to guide users to optimal solutions may be necessary to produce sufficient value in today’s market. So when it comes to technology, publishers need to embrace the opportunities to enhance their content and expertise with appropriate technology and make IT their friend before fear of technology defeats them.
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[1] Just today, I discovered that TauMed, a health news aggregator has shut down and its founder now works at EveryZing. Clearly, aggregation services that operate in a crowded space face commoditization as well.
Headline Commentary June 8-14
- Posted June 14th 2009
- Comments (0)
- by Janice
Obama administration says it can find $313 B in healthcare savings to help pay for reforms.
UK “Power of Information” taskforce invited Tim Berners-Lee to advise on opening access to UK govt data.
John Moore summarizes his thoughts on the recent Microsoft Connected Health conf. Key point: MSFT has shifted some focus from consumer apps to enterprise apps, in large part because of the faster uptake & more clear business models.
David E. Williams comments on the need to focus on the “content” or “information” side of the IT equation, not just the technology. In particular, he points to how clinical decision support systems (CDS) benefit from application of technology to info. This is the mantra of Health Content Advisors. We’re glad to see more industry analysts poiont out the need to put attention on the “I” in “IT” .
Allhealthcarejobs.com, which was launched in 2006 and is reported to have sales <$1M, is acquired by jobs site Dice Holdings for $2.8 million.
John Halamka’s post on first meeting of HIT Standards Committee on quality measures.
Sramana Mitra on some well-positioned health IT and health content companies. Mostly focused on IT companies that help to save costs.
Here’s an example of a publishing company’s looking at data it can extract from patterns of use of its content. Analysis doesn’t appear to have been done for purpose of creating a by-product, but online news sites should consider more offshoots from mining usage patterns on its sites.
AMA & Covisint are working together to build a portfolio of Web-bases services to physicians and on June 11, announced that the portal will be launched nationally in early 2010 and will provide a link to Microsoft’s HealthVault PHR platform.
Elsevier selects NextBio’s platform to enhance ScienceDirect, by allowing it to integrate search results from other online scientific data along with ScienceDirect results. NextBio is used by many top Pharma companies & research institutions.
Thomas H. Lee, MD writes about effect of IT on role of physician. Comparing what IT has done to publishing (and journalists), Dr. Lee posits that some basic functions of doctors can indeed be automated. This is an important theme and I will write more on this topic soon.
Dr. Chen writes about uses of social media (including Twitter) to motivate patients to comply with treatment and wellness plans.
LifeShirt,a wearable remote patient monitoring system, completes prototype of next-gen shirt. Current version embeds sensors to collect respiratory, cardiopulmonary, & other data from patient. Can also connect to peripheral devices and transmit data to vendor’s db for analysis. New version will integrate all sensors, extend battery life, & make upgrades easier. Sounds cool, but what about washability?
Varian says ’statisticians are sexy’ and ability to interpret and communicate trends from databases is critical skill in today’s business world.
Ed Felten’s suggestions for data.gov & general role of feds in serving as info provider. Great points: “Private actors….are better suited to deliver govt info to citizens and can constatnly create and reshape the tools individuals use to find and leverage public data.”
Lots of tips & references on using Twitter for HC journalists.
The government says sipping red wine improves the benefits. Glad to know I’m doing it right!
Single payer system = longer life expectancy?
Steve Outing provides a list of suggestions for newspaper company executives. Food for thought for publishers in other segments, too!
2nd in 3-part series on eprescribing.
Class action settlement against First DataBank (Hearst) that publishes benchmark drug prices and McKesson, a drug wholesaler, will result in some payments to consumers who bought these drugs, along with some price rollbacks, but not a significant change.
Good summary of new Pew reports with follow-up by Susanna Fox, Gilles Frydman, and more. I’ll dig into the report tomorrow.
Healthcare Informatics’ June issue with HCI 100 list of top health IT vendors.
Medseek, a provider of healthcare enterprise portals for hospitals, listed #72 in HCI 100 rankings.
Drug interaction/adverse effects info tool added to MSFT’s HealthVault.
Headline Commentary May 31-June 7
- Posted June 7th 2009
- Comment (1)
- by Janice
A rundown of a handful of online physician ratings sites. Also mentions pushback by physicians who can’t respond to reviews. Mentions RateMDs.com, DrScore.com, AngiesList, Heatlhgrades and some state-specific sites.
Good series on how the Google algorithm has evolved and how human reviewers have been added to the formula.
IAB PWC research shows that online ad spend declined in Q1 2009 YoY for the 1st time in years.
The Open Access Scholarly Publishers Assos. and DOAJ/Lund University LIbraries will hole 1st conf. on Open Access in Sweden Sept. 14-16.
E-patient Dave’s slides from presentation at National eHealth Collaborative last week.
Good overview of Data.gov by Info Today.
David E. Williams provides a very nice summary of Michael Porter’s excellent article in NEJM (available for free): A Strategy for Health Care Reform — Toward a Value-Based System.
The participatory medicine/epatient pioneers have formed a society, the Society of Participatory Medicine, and will publish a journal called Jounral of Participatory Medicine. Dr. Alan Green, MD is the first president. Journal will be open access, of course!
Some background on why drug companies aren’t flocking to Twitter.
This story supports theme of the June 4 blog on Health Data Analytics and the bounty of new data streams that will be available from digitized records of all sorts. Cerner’s data warehouse includes 1.2 billion lab results, as well as medication orders and other data.
Good post that expands on theme that EHRs (EMRs) should be designed with patient needs in mind and that simply automated current procedures in hospitals won’t likely lead to an improved experience for patients who want to participate in their health care decisions.
Commonwealth Fund study on Comparative Effectiveness Research from 4 other countries. In my reading pile.
Healthcare a bright spot in employement trends: health care jobs grew >23,000 in May, while overall nonfarm payrolls shrank by 345,000.
Dr. Val discusses the “workflow interruption” aspect of most EHR systems. The “workflow interruption” is my term. She describes more elegantly, but I am putting it in context of good marketing practices in IT and publishing, where product developers spend time shadowing prospective customers and get a deep understanding of their workflow in order to design information tools that increase efficiency and try to improve outcomes, not just add a layer of technology in order to record data.
A new condition of interest to data publishers: Database Hugging Disorder (DBHD). Humor aside, this post addresses trend toward allowing access to the databases that were used in medical and other studies. In line with the Open Access movement in scholarly publishing that campaigns for free access to research articles where the research was funded with public funds, the open database movement seems to be growing very quickly. Oddly enough, even though the databases hold more value than individual articles (especially when data can be combined from multiple databases), the fact that they haven’t been monetized in most cases may lead research organizations to be more willing to make them freely available while still charging for published articles based on the data.
Good post that includes links to top ideas for Pharma in social media, as well as John Mack’s thoughts on the need for Pharma companies to create “corporate” blogs or websites that serve as central resources on diseases, conditions, or other topics that are more broad than a marketing site for a drug. Points to importance of providing links and information from other sources. This is a theme I think is important and publishers should take note. Pharma websites are now prospective buyers of authoritative content for their websites.
J&J said “pipeline productivity is on track” and outlined growth strategies: -greater marekt penetration, new commercial models, exapnded geographic presence.
Elsevier to publish guidelines for sponsored reprints.
Good piece from Michael Porter on key changes required to reform our healthcare system. Porter emphasizes the need to align incentives for insurers, providers, employers, and patients with health of the patients/consumers as the objective. I’ve only skimmed the article, but it looks spot on.
Stunning numbers from new study that says 62% of all bankruptices filed in 2007 were in part due to medical expenses–and 78% of those individuals had health insurance.
Only PE companies left in bidding. Interesting twist: Springer’s current owners, Candover & Cinven are looking to raise a specific amount (500M Euros) and are asking interested parties to bid on share they are willing to accept for that amount. Springer has large number of scholarly journals & books, and has done well selling ebook versions in the past couple of years, but has lagged behind in creating decision tool applications based on their content. Heavily focused on academic market.
Anthem Blue Cross, the BC provider in California, announces wide availability of its cost comparison data to members in CA. The transparency tool provides access to costs associatied with all aspects of a medical procedure, from lat tests to recovery room charges & physician costs for specific facilites. Eventually, BC/BS plans to make similar info available countrywide. A big move in the right direction to support consumer driven health plans with high deductibles & copays.
Great post on the potential value of the huge amount of data that are being collected as more info on individual patients is recorded in digital form. Effects of drug interactions across a broad population is key example given here.
Modern Healthcare reports that GetWellNetwork, which provides bedside computer apps for “patient engagement” is “promoting the use of its own and similar products by creating and helping fund a not-for-profit institute devoted to researching patient-engagement effectiveness”. GetWellNetwork calls their applications “interactive patient care”. My comment: it gets confusing when there are so many fragmented terms for improving patient care & safety, some that involve patient participation, some that don’t. Rationalizing the health IT market, esp for vendors to hospitals, and incorporating patient education providers would add efficiency and perhaps even make sense to the patients. Relationship of GetWell and the insitutute also raises doubts on transparency. Parallels relationship between Healthwise & Center for Ix Therapy, although at least both are non-profits in this case.
Medidata, which provides s/w for managing clinical trials and for managing clinical research data (Rave), sets terms for IPO. S1 was filed in January 09. Insight Ventures key investor. Market cap at expected $11-13 range to be up to $290. See: http://www.mdsol.com/products/rave_overview.htm
Medsphere, a San Diego company, has raised $1.0M of a $15M funding round. Medsphere is commercializing an open source version of the EHR system developed for Veterans Affairs. Backers include Thomas Weisel, Azure Capital Partners, & Epic Ventures.
Good overview of Google Wave by folks at ReadWriteWeb.
Posts by pharma sales reps on site: CafePharma allowed in lawsuit that claims Schering hid study results on Vytorin.
More on Google’s plans to sell ebooks. Even though publishers get to set price, Google retains right to discount at its own expense.
Previously announced collaboration between Nature Publishing and InnoCentive launches. Innocentives provides platform for problem “Seekers” to solicit solutions from problem “Solvers”–all with a life sciences focus.
CMPMedica announces new online healthcare education program for patients & their caregivers. Health Empowerment Initiative targets “knowledge gaps” in patient understanding to improve compliance with prescriptions and healthful behavior. Sounds interesting & I’ll check it out, but they should have come up with a better name for the program!
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