Friend and fellow health care blogger, Fard Johnmar, today officially announced the launch of The Digital Health Revolution. A project he has been working on with the folks at Scribe Media since meeting them at the fHealthcare Blogging Summit in Las Vegas.
Fard has great insight into the health care industry and I look forward to great content coming out of DHR. Check out the show here, including a very interesting interview with Susannah Fox, Associate Director with the Pew Internet and American Life Project on the topic of empowerment/revolution of the e-patient.
Enoch Choi, MD and I were lucky enough to be Fard's guinea pigs in his first (impromtu) interview for Scribe Media.
HealthVault: Adding Structure (Interoperability) to the Health Information Ecosystem
Last week (October 4) Microsoft rolled out a brand new vehicle that should help accelerate the growing consumer driven health care movement and creation of a national interoperable health information system. HealthVault is a new personal health record (PHR) platform that allows the user to gather, store and share health information online.
There has been a lot written about the roll out of HealthVault over the last week. I've read numerous articles and blog posts to try to get a better grasp of what it is (and what it is not). Over the weekend I ran across Vince Kuraitis' post at his e-CareManagement Blog which I found to have provided some good insight. Not until reading Kuraitis' post did I actually understand that HealthVault is not a PHR but a PHR platform.
In particular I like this quote by Kuraitis and his comparison of the pre-fax world:
HealthVault is setting out the same architecture, transportation and storage device for health information. The natural gas (health information) is very valuable and the system of moving it around is incredibly complex with multiple players and competitors. You have individuals and companies constantly adding natural gas (health information) to the system and end users who need natual gas (health information) at the opposite end. To date the health care industry does not have such a structured, standardized system of pipelines to protect and transport health information. We are largely still living in a paper world with systems that don't have the capability to talk to each other.
As I step back and take a look -- I see an industry in the midst of a tidal shift regarding the control of personal health information and maybe the bigger question of who wants (and can safely) control health information. Microsoft's HealthVault appears to be laying down more planks to create the platform for an interoperable system that will allow for health information to become more transportable, transparent and standardized. Ultimately, the question in my mind remains whether this will help to improve care and help each of us become better stewards of our own health?
Stay tune . . .
There has been a lot written about the roll out of HealthVault over the last week. I've read numerous articles and blog posts to try to get a better grasp of what it is (and what it is not). Over the weekend I ran across Vince Kuraitis' post at his e-CareManagement Blog which I found to have provided some good insight. Not until reading Kuraitis' post did I actually understand that HealthVault is not a PHR but a PHR platform.
In particular I like this quote by Kuraitis and his comparison of the pre-fax world:
" . . . this really isn’t about Microsoft vs. Google . . . It’s about creating a new business ecosystem based on the appropriate (honoring privacy and security) free flow of interoperable and transportable personal health information (PHI) — something that doesn’t exist today."I'll throw out another comparison that I thought about as I read his post -- the natural gas transportation and storage industry. West Virginia is home to some large underground gas storage facilities. Basically, natural gas is pumped during off season to West Virginia from the Gulf Coast via large transmission lines or is gathered from small wells through gathering facilities and lines. The gas is then pumped and stored in previously depleted underground wells. In doing so, the natural gas can be stored safely and moved quickly to market in the northeast during the cold months.
HealthVault is setting out the same architecture, transportation and storage device for health information. The natural gas (health information) is very valuable and the system of moving it around is incredibly complex with multiple players and competitors. You have individuals and companies constantly adding natural gas (health information) to the system and end users who need natual gas (health information) at the opposite end. To date the health care industry does not have such a structured, standardized system of pipelines to protect and transport health information. We are largely still living in a paper world with systems that don't have the capability to talk to each other.
As I step back and take a look -- I see an industry in the midst of a tidal shift regarding the control of personal health information and maybe the bigger question of who wants (and can safely) control health information. Microsoft's HealthVault appears to be laying down more planks to create the platform for an interoperable system that will allow for health information to become more transportable, transparent and standardized. Ultimately, the question in my mind remains whether this will help to improve care and help each of us become better stewards of our own health?
Stay tune . . .
HealthBlawg Explores This Weeks Best Law Posts At Blawg Review #129
David Harlow of HealthBlawg takes to the keyboard like Columbus took to the seas and explores the world of law in Blawg Review #129. Don't miss this edition by one of my fellow health law bloggers.
Check out the upcoming editions at Blawg Review. If you are a new law blogger -- sign up to host or submit your favorite law related post.
Check out the upcoming editions at Blawg Review. If you are a new law blogger -- sign up to host or submit your favorite law related post.
PeerClip: physician social bookmarking and collaboration
Sunday, 23 September 2007
I got the opportunity at Health 2.0 to learn about peerclip, a new social bookmarking tool, information rating and peer collaboration tool exclusively for physicians. I've not personally used the tool but saw this recent review by Shahid Shah, the Healthcare IT Guy. Here is ConnectivHealth's official press release on the new product.Read the "about us" section for more about peerclip and how you might use the tool if you are an MD, DO, physician assistant or nurse practitioner. I plan to pass along some information about peerclip to my physician clients to gain further insight into the tool and its value. I'd be interested to hear from anyone out there using the tool - feel free to post your thoughts in the comments.
Hospital Mashup: Google and HHS Hospital Data
NetDoc now as a mashup of Google Maps and HHS hospital data. As Shahid Shah says, these types of tools takes mountains of data and makes it more accessible and easier to digest by the average public health consumer. Here is the view/data of hospitals that are 100 miles from Charleston, West Virginia.
Here is the summary of what the tool provides:
Here is the summary of what the tool provides:
When it comes to treating heart attacks, pneumonia, surgery and other emergencies, you want to find the best medical care available.
To help you make these decisions, visit the NetDoc.com Hospital Rankings tool and enter your ZIP code to see how hospitals in your neighborhood rank on benchmarks set out by the U.S. Department of Health and Human Services in four categories: Heart Attack, Heart Failure, Pneumonia and Surgical Care Improvement/Surgical Infection Prevention.
Thanks to Shahid for the tip on this new tool.
Health 2.0 Physician Model: House Calls and FICO
Saturday, 22 September 2007
Just back from Health 2.0 and was reading about Dr. Parkinson who demonstrates his new (disruptive) model changing the way health care is provided. Don't miss the great discussion in the comments. Check out Dr. Parkinson's website Jay Parkinson, MD + MPH (and his blog).
Dr. Parkinson's approach also highlights something of value that I think has been missing from health care for years -- house calls. I had the chance to watch and go on house calls with my dad, a retired rural physician. There is incredible value in seeing the patient in his/her own environment.
Dr. Parkinson's response in the comments is a concrete example of Scott Shreeve's FICO concept discussed at Health 2.0. Dr. Parkinson comment:
Update: Catch an interview with Dr. Parkinson who explains his business mode on ABC News.
Dr. Parkinson's approach also highlights something of value that I think has been missing from health care for years -- house calls. I had the chance to watch and go on house calls with my dad, a retired rural physician. There is incredible value in seeing the patient in his/her own environment.
Dr. Parkinson's response in the comments is a concrete example of Scott Shreeve's FICO concept discussed at Health 2.0. Dr. Parkinson comment:
"I’m also toying with the possibility of lowering the following year’s fee for each individual who utilizes my services less often than average. We’ll see."
Update: Catch an interview with Dr. Parkinson who explains his business mode on ABC News.
Health 2.0: User-Generated Healthcare Conference 2007
Thursday, 20 September 2007
The Health 2.0: User-Generated Healthcare Conference officially gets underway today but the pre-conference gathering was a great time last evening. We started out at the Hilton San Francisco lobby bar and then moved down to Johnny Foley's Irish Pub just down O'Farrell Street.
I had the opportunity to talk with Chris Sparks and Robert Hendrick of MedBillManager, Michael Markus with Within3, Daerick Lanakila with SugarStats, Joel Selzer with Ozmosis, Ash Damle with MEDgle, Daniel Kogan with Health WorldWeb, Laird Kelly with RSi Focal Search, Fred Eberlein with ReliefInsite and others.
Clear to me was that there was an incredible amount of excitement and enthusiasm around what is happening as this group tries to figure out how best to position themselves and their companies in this new non-traditional health sector. I was also struck by the fact that many of those who have jumped in with new ventures have done so as a result of a personal family health story or a frustration with how they were treated by the current health care system.
Some thoughts by others covering the Health 2.0 Conference and some of the afterglow:
I'm going to attempt to do some live blogging during todays sessions depending on availability of wireless access and available time. Below is speaker panel agenda for the day which I will use to post comments and questions on during the day.
Conference Agenda (live blogging notes are in italics)
Cool opening video on Health 2.0 called "A Brief History of Medicine . . ." created by guys at Scribe Media and inspired by the Web 2.0 . . . The Machine is Us/ing Us, video that I've posted about before.
Yahoo groups on health are happening organically. Talked about the emotional side of online health communication by patients for patients. Individuals want to get information from other individuals -- not necessarily from their health care provider.
5:30 - 5:45 Wrap-up - Matthew Holt /Indu Subaiya
I had the opportunity to talk with Chris Sparks and Robert Hendrick of MedBillManager, Michael Markus with Within3, Daerick Lanakila with SugarStats, Joel Selzer with Ozmosis, Ash Damle with MEDgle, Daniel Kogan with Health WorldWeb, Laird Kelly with RSi Focal Search, Fred Eberlein with ReliefInsite and others.
Clear to me was that there was an incredible amount of excitement and enthusiasm around what is happening as this group tries to figure out how best to position themselves and their companies in this new non-traditional health sector. I was also struck by the fact that many of those who have jumped in with new ventures have done so as a result of a personal family health story or a frustration with how they were treated by the current health care system.
Some thoughts by others covering the Health 2.0 Conference and some of the afterglow:
- Brian Klepper blogged the days sessions over at The Health Care Blog while Matthew was busy playing host for the event. Brian has his initial thoughts on the conference over at The Doctor Weighs In. Brian does a great job capturing the day's sessions (Introductions, Opening Panel - Consumer Aggregators, David Brailer, Search Panel, Social Media for Patients Panel, Reactor Panel - Payor, Provider, Pharma, Closing Reactor Panel.
- Scott Shreeve is blogging over at Scott Shreeve, MD. Here is his take on the opening session.
- Jane Sarasohn-Kahn provides the quotable "gems" from the conference at Health Populi.
- Rock'n Roll perspective from the HealthcareITBlog, including the central theme of "you need to have a community, and you need to have a business model."
- Esther Dyson summarized her experience and perspective as a part of the reactor panel, including her discussion of how Health 2.0 can become a catalyst for real(age) change at The Huffington Post. Engaging the public in their own health care has to be at the heart of real change for the industry and the only way that the future costs of health care can truly be controlled.
- PointClear Blog highlights one of the practical issues (and problems) with health search - whether the everyday user can interpret the complex and specialized search results. The demos by the search panel using the term "diabetes" were overwhelming to me and probably to most average health consumers. This is is something that the health search engines are going to have to address. PointClear also discussed data liquidity, another theme of the day.
- Arizona Health Futures captures the essence of what we all have to strive to change with the Health 2.0 movement and does a nice job of summarizing the closing panel's discussion. Also, an interesting post on what came out of the unconference group covering liquidity of data vs. privacy (wish I could have participated in the discussion - I totally agree that traditional providers view their control of the health data as incredibly powerful. We are going to continue to see the struggle as individual patients try to wrestle away the control of this data).
- Podcast with Dr. Brailer at Neil Versel's Healthcare IT Blog.
- Check out the video interviews from the conference being produced and posted by ICYou including a short interview that I was privileged to get to do with ICYou.
I'm going to attempt to do some live blogging during todays sessions depending on availability of wireless access and available time. Below is speaker panel agenda for the day which I will use to post comments and questions on during the day.
Conference Agenda (live blogging notes are in italics)
Cool opening video on Health 2.0 called "A Brief History of Medicine . . ." created by guys at Scribe Media and inspired by the Web 2.0 . . . The Machine is Us/ing Us, video that I've posted about before.
Covered some background for the crowd on "what the hell is Web 2.0/Health2.0?" Used the O'Reilly definition including lightweight business models.
What is Health 2.0 (personalized search that finds the right answer for the long tail, better presentation of integrated data, communities, etc.) Consumerism is a great force - how will it impact health care? Transparency and consumerism.
Search is the largest area with social network and tools linked in. Good graphic with interlinking circles and content --- transaction. Also put up a slide graphic of Scott Shreeve's definition of Health 2.0 a much broader definition.
Matthew's continuum of Health 2.0?
User generated health care -- user connect to providers -- partnership to reform delivery -- data drives discovery.
Missy Krasner, Product Marketing Manager, Google
Question of whether consumers/patients are really ready to put all their personal information online. Search needs to continue to be refined in the health search field.
Wayne T. Gattinella, CEO, WebMD
The number of people searching for information online has doubled recently. People/patients now go online first for health information then to family and health care providers. This same trend is occurring with new doctors coming out of med school - they are going online instead of looking at text books.
Peter Neupert, VP Health Solutions Group, Microsoft
The challenge for those in the room that want to disrupt the health care industry is finding the business model that works. Cited stats on the revenue generated by health search -- big number and will continue to trend upward.
Yahoo groups on health are happening organically. Talked about the emotional side of online health communication by patients for patients. Individuals want to get information from other individuals -- not necessarily from their health care provider.
Moderator:
- Trust lies in the individual user. Google's experiment with "passionate experts" who go out and label good/trustworthy content on the web. People want a trusted coach to help them weed through the data.
- How do we mesh search and ads (revenue)? Good discussion on the topic from the panel.
- Will search marginalize the need for physicians? Doctors are feeling alienated by some of what search brings to the table. Will the patient arrive in the office better prepared to discuss their health condition. One problem is that the traditional model of care (read: payment/reimbursement model) requires doctors to quickly move patients through the office - patients who arrive better prepared to discuss their health condition take more time (not less). Can we empower physicians and other care providers with information rather than alienate them from the process.
- Question on what is your business model Google, Yahoo and Microsoft? Google response - we are not a health care company, trying to get better at health care, taking it slowly, very small team making quick decisions working bottom up, team is small, business model - free service for health user/put out a product that will help people/ads that help with discovery of information. Microsoft response - sell enterprise software to hospitals, working on consumer ideas (MedStory), fragmentation in the industy is a big problem in the hospital space - no work flow of data, wants to help guide in a connected way to improve connection of data. Yahoo response - goal of creating a good user experience, Yahoo health groups, search and answers, model is search advertising.
- Data liquidity. How do health care data standards get in the way? "health care is a hairball" - Wayne at WebMD. Discussed the behavioral changes that have to occur - the technology has been out there for use in the industry.
- How do we help users ask smarter health questions?
- How do we pull folks into the Health 2.0 revolution for their own benefit, as well as society's? Great question - this is the one I have thought a lot about. How does all this actually improve patient behavior? What will drive people to care about their health? Patients with chronic disease have a direct stake in taking care of themselves. The more difficult question is how do we engage the masses to take care of preventable disease - obesity, cardic, etc.
Will web/health 2.0 become a catalyst to accelerate traditional models of health care to change. The future health of the health care industry needs health 2.0 . Many of the traditional models of communication and collaboration among providers, patient to provider, insurer to provider, etc. will be changed by health 2.0. Relationships in health care can be redefined by the health 2.0 movement. Need to bring/create sustainable business models - you can't just drop technology in (not passive role - must actively change the culture/process).
9.30-9.40 STRETCH BREAK, Bio Break & Coffee refill
Each of the panel members did a quick demo of their individual search product focused on diabetes information. Interesting to see the various search engines search results for the same topic. I was overwhelmed by the information and can't imagine an ordinary consumer of health care (especially one who is poor, uneducated and otherwise unsophisticated) being able to grasp this much information.
Alain Rappaport, CEO, Medstory/Microsoft
Very good graphic showing a long tail like list of content sources in the "Information that Matters" section. Here is the search for diabetes.
Venky Harinarayan, Co-Founder, Kosmix
Tom Eng, President & Founder, Healia/Meredith
Working to refine health search. Recently released a new clinical study search feature.
Dean Stephens, President & COO, Healthline Networks
Praxeon/CurbsideMD
Somewhat unique in that it uses natural language search.
Moderator: Jack Barrette, CEO WeGoHealth (ex-Yahoo)
10.40-11.15 NETWORKING Break with Demonstrations
11.15- 12.15 DEMO PANEL & Discussion: Social Media for Patients
Ben Heywood, CEO, Patients Like Me
Doug Hirsch, CEO, Daily Strength
Steve Krein, CEO, OrganizedWisdom
Karen Herzog, Founder, Sophia's Garden
John de Souza, CEO, MedHelp International
Brian Loew, CEO, Inspire
Moderator: Amy Tenderich, Blogger/Journalist DiabetesMine
Like my discussion last night, this panel again brought out the personal side of Health 2.0. Most of the panel members had a personal experience that lead to their passion to want to create something new to address or supplement something that the traditional health care system was failing to provide them or their family members. For example, Patients Like Me grew out of a desire to Ben Heywood to want to create something to help his brother who was diagnosed with ALS.
Steven Krein stood out on the panel and suggested that Organized Wisdom was positioning itself to be the aggregator of consumer created health information from the likes of those on the panel. He talked a bit about Organized Wisdom's new roll out as a people driven search engine and coined the phrase, "people are the new algorithm."
12:15-1:00 REACTOR PANEL Payers, Providers, & Pharma….and Health2.0
Paul Wallace, Senior Advisor & Medical Director, Kaiser Permanente
Joe Gifford, Chief Medical Officer, Regence BCBS
Jeff Rideout, Managing Partner, Ziegler HealthVest Fund
Bruce Grant, SVP, Digitas Health
Ted von Glahn, Director, Performance Information and Consumer Engagement, PBGH
Moderator: Doug Goldstein, eFuturist
During the unconference I hosted a group on law/privacy issues and Health 2.0. We had some really great discussion including a brainstorming session on what changes to HIPAA privacy law need to occur to better accommodate the Health 2.0 companies. We also discussed most of the companies participating in the conference are likely not required to comply with HIPAA (although many do because they want to move toward the industry standard) because they don't fall into definition of a covered entity under HIPAA (a health care provider, health care plans or health care clearinghouse). The knee jerk reaction from those who don't understand HIPAA is to overreact by ratcheting down on privacy. We also got into the "flip side of the rock" on data aggregation. Most of the talk all morning focused on the positive aspects of health data aggregation. However, there are downsides to data aggregation including those who might want to use the data improperly for financial gain.
Mike Battaglia, VP Healthcare Strategy, Intuit - Quicken Health
Marlene Beggelman, CEO, Enhanced Medical Decisions
Dave Hall, VP of Innovations, HealthEquity
Joseph Villa, COO Employer Division, Revolution Health
Ryan Phelan, CEO, DNADirect
Moderator: Scott Shreeve, CrossOver Healthcare (founder Medsphere)
Daniel Palestrant, CEO, Sermo
Effective presentation by Daniel who used the "saw blade" example as a way to show the value and positive impact of sharing/collaborating among physicians. Creative suggestion by a physician to use a straw to help remove a saw tooth blade from a patient presenting in the ER with a saw blade through the finger. Money is not a motivator of physicians. They have found that the physicians on Sermo are motivated more by the need to collaborate.
Lance Hill, CEO, Within3
Chini Krishnan, CEO, Vimo
Gale Wilson Steele, Founder/CEO, Careseek
Patricia Ball, VP Product Development Consumer Aware/BCBS
Doug Goldstein, eFuturist & President, Medical Alliances
Moderator -
Q/A from the crowd:
- How do the companies moderate the comments made by consumers about providers and what are the legal ramifications?
- What are the panel members doing to protect/address protecting privacy within their business model? Will they make the data anonymous before reporting that out to other groups? Sermo will be making the aggregated data available to track trends and be analyzed by others.
- What is your business model? Most rely on value of the data aggregated and advertising. Daniel at Sermo indicated that Sermo does not rely on advertising but instead talked about value in information arbitrage (taking advantage of the information created through the system).
Marty lead off with setting the stage by asking the panel to look back and reflect on the day and then give some perspective on where they see this headed in the future. The discussion and thinking by this group was superb. There was recognition of fragmentation but also reflection that similar fragmentation existed in the early days of the technology/online revolution. Great concept of the calcified ball at the center of current health care model and that this group was working to eat away at the fringes.
Lee Shapiro, President, Allscripts
Referred to the use of EMR as subsituted service from paper records. The new feature is connectivity. This connectivity is what will really change the way the data collected in the EMR is used -- sharing information with practitioners to add greater value.
David Kibbe,
Bob Katter, Senior VP, Relay Health (McKesson subsidiary)
Pioneered the idea of reimbursed e-visits.
Jay Silverstein, Chief Imagineer, Revolution Health
He recognized the creativity in the room on ideas to create better community in health care. Also intrigued by the idea of improving practice patterns across the county. Downsides he sees from the day is still the fragmentation of health business. Very insightful thoughts.
Steve Brown, Founder Health Hero Network,
Esther Dyson, EDventure
Moderator: Marty Tenenbaum, Commercenet
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