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Archive for the ‘Physicians’ Category

Healthcare 3R’s Bring Pain and Gain

• Posted May 23rd 2008
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• by Janice

 Arguably the most powerful and actionable of all consumer health information, ratings, rankings ad recommendations (the 3R’s), present both opportunities and minefields, as the Massachusetts Group Insurance Commission (GIC) found out this week when a lawsuit was filed against them by the Massachusetts Medical Society (MMS).   

GIC ranks physicians using cost and quality measures, and its rankings are used for  cost containment; patients have to pay higher copayments for doctors who rank in the lower tiers.  MMS, which has more than 20,000 physicians and student members, alleges that GIC’s system, called Clinical Performance Improvement Initiative (CPI), uses “inaccurate, unreliable and invalid tools and data”.  In particular, the complaint cites miscoding of procedures and inaccurate assignment of patients to physicians who were not responsible for their care. 

A different ratings approach is practiced by the department of Health and Human Services’ (HHS). Its CAHPS program  centers its rankings on patient satisfaction measures.   HHS was also in the news this week with a near-full-page ad in local papers in all 50 states promoting the use of the Hospital Compare site (http://www.hospitalcompare.hhs.gov/). As reported by AP, “the ads reflect an emphasis by the Bush administration to increase transparency in the health care system. Officials say greater public disclosure of costs and quality will drive providers to improve on both fronts.”

Currently, hospitals are penalized with a reduction in their reimbursement rates from CMS if they do not participate in the CAHPS program.  It is expected that HHS will continue down the path of pay-for-performance (P4P) as the CAHPS program develops.  

The 3R’s are shaping up to be a lively and controversial business, and Health Content Advisors and our parent company, InfoCommerce Group, will continue to monitor closely those information products that offer ratings, rankings, and recommendations, and you can look for them to continue to play a prominent role in this year’s Health Content08 conference.

 

Monetizing Online Health Communities

• Posted May 16th 2008
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• by Janice

 My colleague, Russell Perkins, writes this week about how a partnership between Gerson Lehrman Group (GLG) and iGuard.org is selling access to the information collected in patient community sites to investors, pharmaceutical companies, and other healthcare industry stakeholders.   

Sermo, one of the participants in our Health Content07 conference last fall, is now providing paid access to market researchers in the medical field who want to poll Sermo’s communities of experts.    

The Wall St. Journal reported earlier this week about another company, EmergingMed, that is leveraging its online patient communities by playing matchmaker between existing patient community sites and the medical research teams that are seeking recruits to test cutting-edge treatments in clinical trials.  According to the WSJ article, one survey by Harris Interactive revealed that 75% of cancer patients would have been willing to enroll in a relevant clinical trial “had they known it was possible”. 

These are all great examples of market-driven information products and show how social networking sites can broaden their revenue base beyond online advertising.

 

Medical Tourism Site Launches

• Posted May 14th 2008
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• by Marji

CPR Communications, a healthcare marketing and communications company, has launched YourMedicalTravel.com, a web site that provides information about medical tourism to consumers.

Specific information accessible on the site includes travel tips, cost comparisons for various procedures, legal data and insurance facts. Site visitors can also find information about treatments as well as particular regions (from India to Singapore and Thailand).

The new site complements another CPR Communications offering, MedicalTravelToday.com, a site for businesses that participate in the medical tourism industry.

CPR has launched this latest site to capitalize on a trend of individuals traveling abroad to find more affordable medical treatment. However, recent media reports suggest that the market for such content is not as large as previously thought. A recent article in The Wall Street Journal cites a McKinsey & Co. study that revealed that not as many people are interested in traveling abroad for medical treatment as was assumed. Yet, the study does note that the industry is still poised for strong growth.

In addition, the article notes that the Medical Tourism Association doesn’t size the medical tourism market because there is no firm definition of the market.

Still, for CPR Communications, the launch makes sense. It really does fit nicely with the company’s MedicalTravelToday.com offering, and the organization is certainly on its way to creating a solid portfolio for the medical tourism market. Although the McKinsey study found the market to be smaller than originally thought, it is still predicting growth; and CPR Communications is extremely well-positioned to capitalize on that growth.

 

Consumer-Driven Health Care Drives Demand for Ratings

• Posted May 8th 2008
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• by Janice

The proliferation of doctor ratings sites continues unabated and is likely to continue. The two main drivers of growth are both related to the consumer-directed healthcare movement: 1) the demand for information about healthcare providers from consumers/patients and 2) the focus on measuring quality and satisfaction in healthcare. 

The recent traffic records achieved by Castle Connolly, the publishers of the “Top Doctor” guides, during their promotion of “Long Island’s Top Doctors” on Newsday.com demonstrates the strong demand for the data.  Searches for doctors profiles in the database (accessible via Newsday) resulted in over 1.2 million profile views on just one day.   

On the quality and satisfaction front, the Centers for Medicare & Medicaid Services (CMS), a division of HHS, has led efforts to compile standardized ratings of healthcare providers and practitioners through their Consumers Assessment of Health Providers and Systems (CAHPS) program.  CAHPS originally measured satisfaction with health plans, but has branched out into measuring patient satisfaction with hospitals, and has begun  measuring satisfaction with physicians through the CAHPS Clinician and Group survey.  The availability of the CAHPS Clinician survey benchmark data (beginning Spring 2009) may spur even more entrants into the doctor ratings business, but it should also raise the bar for the quality of the ratings sites that survive in this competitive field.

 

Physician Transparency: Why the Angst?

• Posted April 24th 2008
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• by Russell

Last summer, a non-profit consumer advocacy group called Consumer’s Checkbook won a landmark victory in court: a U.S. federal court ordered the Department of Health and Human Services (HHS) to provide detailed Medicare claims data to the group. While containing no information that could identify individual patients, the data would allow a look at what types of procedures were being performed by individual physicians, and how often. In short, the data would provide an objective indicator of physician expertise. The reason Consumer’s Checkbook had to go to court for the information was that HHS had taken the stance that it couldn’t release this information because it would constitute an invasion of physicians’ privacy because it would indirectly allow anyone to calculate how much money a physician received from the government. The court shot down this argument and ordered release of the data.

One would expect that with HHS advocating at the highest levels for transparency in healthcare, and with a number of its own quality assessment and measurement initiatives, HHS might embrace this court ruling and get moving on this release of data. Instead, in a quiet court filing last week, HHS appealed this court decision. While HHS has publicly stated it is only seeking help from the court to reconcile several conflicting court decisions, published reports indicate its appeal filing with the court seeks to reverse the previous court decision, leaving restriction on disclosure of this information in place. Robert Krughoff, president of Consumer’s Checkbook, attributes this odd move by the government to pressure from the American Medical Association, stating “We regret that the AMA has pushed HHS so hard to hide this information.

Less than a month ago, the consumer ratings service Angie’s List announced that it would allow its consumer members to start rating physicians on everything from the cleanliness of waiting rooms to a physician’s bedside manner. The announcement immediately drew response from the physician community, including a fairly representative comment from Dr. Jon Marhenke, president of the Indiana State Medical Association, who said “doctors’ services to patients can’t be compared to the work of a skilled tradesman.”

All this points up an essential conundrum: physicians to a large extent seem to be resisting rating, evaluation and review at the exact same time that the move to consumer-driven healthcare is making this kind of information important if not essential. And this is not a new problem. For too long, patients have been selecting their physicians based on an awkward combination of word of mouth referrals, health plan participation and geographic proximity. That’s not good for patients, but what physicians apparently don’t see is that it’s not good for them either. By rejecting third party evaluation and review, physicians aren’t elevating themselves above the fray. Indeed, they are commoditizing themselves. By refusing to provide useful differentiation about their training, expertise, and yes, even their beside manner and office tidiness, physicians are telling patients “we’re pretty much interchangeable,” and leaving patient to select physicians based on criteria and information that can be highly subjective, biased, irrelevant and even inaccurate. There is a huge need for information to help differentiate physicians and this vacuum will be filled. And as every good marketer knows, if you don’t write your own story, others will write it for you, and you probably won’t like the results.

Physicians: market thyselves!

 

WebMD: No Immunity to Ad Pullback

• Posted April 24th 2008
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• by Janice

WebMD, the bellwether of the online health information sites, is suffering from ad pullback.  It was widely reported this week that WebMD has lowered its guidance for 2008 and its stock has been punished as a result.   S&P has downgraded the stock to a sell and cut its target price to $23.

Concern about lower-than-expected pharma advertising was a major factor in the downgrade.  But, WebMD is not entirely dependent on online ads for its revenue, which mitigates the financial picture. WebMD is also a leading provider of online continuing medical educations (CME) programs, and also provides private portals and custom publishing.

Some seem to relish bad news about WebMD and are quick to ascribe the slowdown in pharma advertising for WebMD to competition from newer players that offer less-costly ad alternatives. See, for instance, the comments in Silicon Alley Insider.  We firmly believe that ad dollars will continue to shift online.  However, the advertising sector is notoriously cyclical, and considering the current economic climate, the ad pullback is likely to prove contagious in the short term.

 

Medical Reality Shows for the Pros

• Posted April 23rd 2008
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• by Janice

I just took a look at the recently enhanced Procedures Consult, one of the online clinical reference products in Elsevier’s Consult line.  Procedures Consult builds on some of Elsevier’s medical reference texts and is supplemented with custom—produced animations and video content that enhance the textual and still-image content.

The videos offer step by step demonstrations on real patients of how to perform certain procedures, such as defibrillation or shoulder arthroscopy (the number of procedures continues to grow). Procedures Consult includes online testing that reinforces the understanding of the anesthesia, emergency medicine, orthopaedic and internal medicine procedures that are included in the reference tool.

This is a case where the addition of video content adds obvious value to the reference content, compared to some products where the video element consists of nothing more than talking heads. Even an amateur can appreciate how useful the video content will be to physicians and medical students who need to study new procedures or refresh their knowledge of infrequently used procedures.

Procedures Consult may not capture the imagination of the consumer-focused investment firms eager to pounce on ad-supported consumer-centric online health products, but it represents an intelligent application of technology that greatly enhances the value of information to the audience it serves. Furthermore, by virtue of highlighting industry-standard patient safety guidelines within the product, Procedures Consult becomes an important tool in the performance improvement efforts of hospitals. Performance improvement may not sound leading edge and exciting, but it represents real dollars to health care provider institutions and better outcomes for patients.

 

Epocrates Files for IPO

• Posted April 18th 2008
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• by Janice

Epocrates, best known for its mobile clinical information decision support tools for medical professionals, filed a registration statement with the SEC yesterday.  The filing didn’t disclose terms, but it estimates that the company will raise at least $75 million in the offering.  Revenues for 2007 were $65.6 million, which represents a 33% increase over 2006.  However, elsewhere in the filing the company reports that growth in  subscriptions to US physicians was flat in the period.

Subscription sales to physicians and other healthcare professionals do not represent the only revenue stream for Epocrates.  They also provide “interactive information services” to pharmaceutical and managed care companies and offer physician panels to market research companies.  These additional sources of revenue allow Epocrates to provide free access to core drug reference and decision support databases, which helps them build loyalty among their user base. 

Epocrates has been in the news recently for creating iPhone-compatible versions of  its drug and clinical information products.  This development should help Epocrates maintain its cool factor among medical students and younger healthcare professionals. 

In a related development, news that UpToDate, a competitor to Epocrates, is on the market has been circulating.  We’ll fill in more details in an upcoming post.

 

dCard: An Open Standard; A Needed Standard

• Posted March 7th 2008
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• by Russell

A consortium of nine healthcare technology companies and healthcare providers has unveiled a new standard for collecting, presenting and exchanging healthcare provider data. The new standard is called “dCard,” short for Doctor Card. It’s an important and needed initiative to be sure given the many tortured attempts over the years to organize basic provider information and keep it current.

We’ve spent many years in the area of claims data, thinking that the actual information used to cut checks to providers would be the key to building dependable provider databases. Not even close. It’s the same issue that has bedeviled the people behind the various physician identifiers that have been created: physicians tend to have multiple affiliations and even more addresses and phone numbers. They often have third parties involved in receiving payments. At any given time, many are not actively practicing medicine for various reasons. In short, it’s a case of volatility meets complexity.

This ongoing problem of getting control of even information this basic smacks right into two huge trends in healthcare: consumerism and improving care, while reducing the cost of care, through improved use of information technology.

How do you, for example, confidently rate the quality of a physician when you can’t even confidently supply that physician’s address and phone number?  How do you as an IT company develop an electronic health record when nobody can even organize and account for the people who will be entering data into your systems?

We wish dCard the best – we would all benefit from it success. And perhaps the standards that ultimately get traction will be based on open standards driven by voluntary consortiums – it almost has to, because other approaches haven’t advanced the ball very far.