Health 2.0 is working on a new documentary focusing on the experience and outcomes of patients using Health 2.0 tools and technologies to manage their health. We are currently looking for both enthusiastic users of online services and innovative Health 2.0 companies to participate in this exciting project.
Healogica was one of the companies that presented at Launch! at the Health 2.0 Meets Ix conference in Boston in April. I felt that the quality of the Launch! companies as so strong that they all deserved to be featured to more than the 200 people in the room who saw it. So on the spur of the moment I offered all of them a spot on THCB to get them a little more visibility. And now there’s a flood of three minute videos headed our way.
First up is an innovative clinical trial recruitment service called Healogica. And yes it’s new (which is the point of Launch). Watch the short video below to get an idea and investigate further over at Healogica
Our friends over at American Well have two announcements today. First, they’re releasing what they call Online Care Insight, which is essentially the integration of care guidelines into their online care system. We saw a glimpse into this at the Health 2.0 Hawaii chapter meeting last March (sorry if you weren’t there!). Essentially this is a decision support service that helps physicians figure out if the online visit in front of them is appropriate for online care, and then offers clinical decision support during the visit (such as medication reminders, gaps in care, and other alerts)
The second piece of news is that American Well and Optum Health will be combining the American Well online visit service with Optum’s eSync care management platform. eSync basically integrates the data analytics portion with care management, so that a plan or employer can figure out who’s got what dread disease and reach out to them using a series of different contacts. Usually this means email, or nurse or health coach call. Now an online physician visit is part of that continuum.
(Optum Health is a subsidiary of United HealthGroup, and eSync was introduced at a sponsored Deep Dive at the recent Health 2.0 Meets Ix conference. FD Both American Well and Optum have sponsored the Health 2.0 Conference).
Obviously given United’s scale & Optum’s reach into the self-funded employer market this is big news for American Well and online care. The press release also says that the service will be available to individual consumers. I assume that this means that some part of United’s multi-state physician network will be on the system, and that there’ll be an option for consumers who are not in a United plan to access it. If it does mean that, then when this is launched the American Well service will essentially be available nationwide. But that’s my early morning speculation. I’ll try to track down someone from American Well to get more accurate details.
In this final, thought-provoking panel discussion, pioneers in the development of Online Care gazed far into the future. Where might Online Care be in 2020? How will it fit into the evolving healthcare landscape and patient-physician relationship? By taking the long view, panelists offered insights that can inform the actions all of us take to shape Online Care today.
Dr. Indu Subaiya, Matthew Holt, and Dr. David Kibbe offered some final thoughts after a day of intense discussion, and inspired attendees to continue the conversation even after the conclusion of the Symposium.
Panelists: Jay H. Sanders, MD, FACP, FACAAI, CEO, The Global Telemedicine Group, David C. Kibbe, MD, MBA, Senior Advisor, AAFP, Roy Schoenberg, MD, MPH, CEO, American Well Systems
Moderators: Indu Subaiya, MD and Matthew Holt, Co-Founders, Health 2.0
Each moderator shared and discussed key viewpoints from their table’s discussion with other moderators.
Panelists: Margaret Laws, Director, California HealthCare Foundation, Della Lin, MD, Anesthesiologist, Honolulu, Hawaii, Alfred J. Fortin, PhD, Senior Vice President, HMSA/Blue Cross Blue Shield of Hawaii, Peter Kennedy, Physician Liaison, Hawaii Independent Physicians Association
Each moderator shared and discussed key viewpoints from their table’s discussion with other moderators.
Panelists: Roy Schoenberg, MD, MPH, CEO, American Well Systems, Ronald Dixon, MD, MA, Massachusetts General Hospital, Harvard Medical School, Gary Okamoto, MD, Medical Director and Senior Vice-President, Rehabilitation Hospital of the Pacific, Arthur L. Wilmes, FSA, MAAA, Principal & Consulting Actuary, Milliman, Inc.
The rise of social computing a few years back led to an explosion of community-oriented Health 2.0 ventures. Many of these innovations included sites that helped patients to share information with other patients (e.g., PatientsLikeMe) and doctors to share information with other doctors (e.g., Sermo).More recently, a new class of technologies is enabling those patients and doctors to connect. In this session, Matthew and Indu presented the landscape of Online Care technologies, including American Well’s Online Care, Kaiser KP HealthConnect, and others. They examined what’s drawing patients to these innovative services, and what their experiences have been so far.
Presenters: Indu Subaiya, MD and Matthew Holt, Co-Founders, Health 2.0
Indu Subaiya, MD and Matthew Holt - The Integration of Social Media and Online Care [Presentation in pdf format]
David C. Kibbe, MD, MBA, Senior Advisor, AAFP
Margaret Laws, Director, California HealthCare Foundation
Michele Shimizu, MD, Family Physician, Kamuela, Hawaii
Arthur L. Wilmes, FSA, MAAA, Principal & Consulting Actuary, Milliman, Inc.
Indu Subaiya, MD and Matthew Holt, Co-Founders, Health 2.0
The concept of telehealth has been around for decades. Traditionally, this model has employed technology to bring providers together across geographic divides, improving collaboration on patient care. Now, with Online Care, the promise of “telehealth for the masses” has arrived. The difference: patients can now access providers directly and immediately, from wherever they are, and receive affordable, quality care. In this keynote, Dr. Sanders traced the origins and evolution of telehealth and telemedicine up to the emergence of Online Care. He then looked closely at Online Care’s role in the health landscape today and in the months and years ahead – as well as the lessons that can be applied from his prior experiences.
Opening Remarks: David C. Kibbe, MD, MBA, Senior Advisor, AAFP
Keynote Presenter: Jay H. Sanders, MD, FACP, FACAAI, CEO, The Global Telemedicine Group
Jay Sanders, MD - Where We Are and Where We Need to Be [Presentation in pdf format]
Milliman’s Care Guidelines® are familiar to us all. These annually updated, evidence-based clinical guidelines span the continuum of care, including chronic care and behavioral health management. Following the arrival of Online Care, Milliman began enhancing and expanding its guidelines to support physicians in a variety of Online Care encounters, including both acute and chronic scenarios. In this presentation, Milliman unveiled its work to date and discussed how the Guidelines will continue evolving as Online Care grows.
Presenters: Arthur L. Wilmes, FSA, MAAA, Principal & Consulting Actuary, Milliman, Inc., W. John Semmens, MD, Healthcare Management Consultant, Milliman, Inc.
Milliman, Inc. - Guidelines for Online Care Encounters [Presentation in pdf format]
Online Care is about bringing patients and physicians together, but its success requires the advocacy and support of the health plan. In this session, Hawaii’s two largest health plans shared their perspectives on Online Care – including their motivations for introducing it, experiences so far, and hopes for its future role in improving the health of Hawaii residents.
Presenters: Michael Cheng, SVP, External Operations Division, HMSA/Blue Cross Blue Shield of Hawaii, Suzanne Fields, MSPH, Sales Manager, Kaiser Permanente, Hawaii Region
Mike Cheng - Online Care Case Study [Presentation in pdf format]
Suzanne Fields, MSPH - Using Online Tools to Improve Employee Health and Productivity [Presentation in pdf format]
As the US healthcare system confronts the challenge of making quality, affordable care available to everyone, all eyes are on Hawaii’s adoption of Online Care. This panel discussion included leading policy-makers and influencers from Hawaii and the mainland. They discussed the motivations, steps, and lessons learned in crafting a policy approach to using technology to increase access to care. The panel also addressed what needs to change in health policy so that patients and physicians can make the most of Online Care technologies.
Panelists: Sen. Rosalyn H. Baker, Hawaii’s 5th Senate District, Margaret Laws, Director, California HealthCare Foundation, and H. Roger Netzer, MD, Chair, Hawaii Medical Board
Moderator: David C. Kibbe, MD, MBA, Senior Advisor, AAFP
In this session, a group of leading Online Care practitioners shared their personal insights, opinions, and real-world experiences caring for patients using technologies, including HMSA’s Online Care and Kaiser’s KP HealthConnect. Physicians discussed why they adopted Online Care, and how it fits into their practice (and life). Personal insights were complemented by findings from Dr. Dixon’s clinical research on Online Care.
Panelists: Ronald Dixon, MD, MA, Massachusetts General Hospital, Harvard Medical School, Peggy Latare, MD, Chief of Family Medicine, Hawaii Permanente Medical Group, Michele Shimizu, MD, Family Physician, Kamuela, Hawaii
Moderator: Indu Subaiya, MD, Co-Founder, Health 2.0
And part two:
Ronald Dixon - Virtual Visits in General Medical Practice [Presentation in pdf format]
Craig Stoltz finds the funny side of Twitter for IBS patients. You can guess the name....
I’ll be up with reflections on an action packed Health 2.0 Meets Ix conference later, but for now is you want to see the 1500+ tweets from Thursday alone, Gilles Frydman has figured out how to get them all in one long long list here http://healthbirds.com/tagsearch.html?hid=233
I’ll be up with reflections on an action packed Health 2.0 Meets Ix conference later, but for now is you want to see the 1500+ tweets from Tursday alone, Gilles Frydman has figured out how to get them all in one long long list here http://healthbirds.com/tagsearch.html?hid=233
Have fuel, will accelerate! In the months leading up to the Fall Health 2.0 Conference, the Accelerator wiki membership grew from a few to over a hundred individuals and companies with increasingly diverse members, from serious technologists to product and strategy managers and company executives, representing tiny start-ups and billion dollar health care enterprises. The Health 2.0 Accelerator also facilitated its first collaborative: the Drug Profile Interoperability (“DPI”) project. Thanks to this effort, users of DestinationRx’s Medicine Cabinet or PharmaSURVEYOR’s web application can now access a valuable combination of drug safety and cost information that is not otherwise available from any single company. Then, at the Conference, Julie Murchinson announced an exciting and important step in the Accelerator’s evolution: the creation of a formal non-profit organization to advance consumer-centric health care by driving integration of technology and the consumer experience.
With an important seed contribution from the Health 2.0 Conference, the Health 2.0 Accelerator (H2A) is off and running (www.Health2Accelerator.org), creating opportunities to accelerate progress among its members and the Health 2.0 community!
Why Now? Why H2A?
We think the space is approaching a critical stage in its evolution where an increasing number of consumers will seek comprehensive solutions, not fragmented tools and services.
For you iPhone-ers (and there are lots and of you--30 million plus was the last number I heard) there's some exciting news (that actually concerns Health 2.0 and THCB too). A.D.A.M has launched a new platform on the iPhone. It’s called the Medzio Mobile Health Network and (of course as it’s promo Health 2.0 Meets Ix week on THCB) it will be launching officially in Boston on Thursday. (FD A.D.A.M is a Health 2.0 Conference Sponsor, and Health 2.0 & THCB will be providing content to the network).
I got in a little (friendly) trouble with the folks at A.D.A.M last year for mentioning that they’d been around a while in the eHealth space, but they are not resting on their laurels. They’ve seized on the iPhone as a platform and now are adding information from a host of partners—not to mention taking their own content and converting it for the iPhone and adding more new features for searching health services to it. And then they’re creating a platform that others can join onto.
This is a really interesting way for health information, and increasingly services, to be delivered where people are. And it gives a strong hint about how people will be accessing health care in the future. All a click away on iTunes. We’ll be bullying one of the Health 2.0 iPhone contingent to write a review shortly….
MyCa/Hello Health is launching it's new platform in a special Deep Dive at Health 2.0 Meets Ix tomorrow, Weds 22nd at 12 noon. Sean Khozin will also be demoing it as part of the "Building Health 2.0 into the Delivery System" panel.
What's so intriguing about what Jay Parkinson has been dong with Myca and Hello Health? Jay's been holding himself (and Hello Health) up as a new alternative to the current broken primary care model. So is this really a revolutionary platform? Or are they just tilting at the windmills of America's broken primary care system?
I visited Jay for a chat last week at Hello Health's first outpost in Williamsburg, Brooklyn.
The Health 2.0 team is in Boston, and we’ve been prepping with our friends from Information Therapy. The Health 2.0 Meets Ix conference is coming up on Wednesday and Thursday 22nd & 23rd April. We have a really fantastic agenda, including several exciting new product launches, and a fantastic “Night Out” Reception, sponsored by Kaiser Permanente. There are a few spots left at the conference, although we’re likely to post the “sold-out” notice in the next 24 hours or so, so if you still want to come you can register here. But hurry…
In addition there are some related meetings happening around Health 2.0 Meets Ix. The Health 2.0 Accelerator is having a meeting immediately before the main conference in the Park Plaza Hotel. More details are here but it’ll include a presentation from Matt Quinn of AHRQ who’ll be talking about all that lovely new Federal money for comparative effectiveness research.
The day before (Tuesday April 21) there’s a Social Pharmer & HealthCamp Boston meeting at Microsoft’s Cambridge campus, and there’s drinks after that
Meanwhile the Economist has a second article about Health 2.0, following one from about 18 months ago.
e-Patient Dave on the real world issues of moving data around in health care. The punchline—claims-based data without dates is not very useful, which requires those using the aggregators (Google health et al) to do a whole lot more work.
A really, really important article. Go read.
Health 2.0’s NYC chapter is having a meeting this Thursday 4/2–-around 50 people are due to attend and it’s set to be a great session.
There is one minor problem though. Due to a last minute cancellation by the existing conference room sponsor the meeting needs a new venue. Please contact eugeneATnyhto.org if you can fit ~40-50 people for tomorrow evening from 6.30pm.
(Eugene does have a back up, but it’s not ideal! And no this is not an April Fool’s joke)
Indu & Matthew traveled to Hawaii (tough gig but someone’s got to do it) to take part in the Hawaii Health 2.0 chapter on Online Care, held on Thursday March 26. The chapter meeting was rather more fancy than the average Health 2.0 local meeting, with the dolphins in their own lagoon at the Kahala resort being a few steps away from the meeting.
HMSA, American Well and Kaiser Permanente hosted the meeting which focused on online care. David Kibbe kicked off the meeting with a little reprise of the Great American Health 2.0 Motorcycle Tour. Jay Sanders “father of telemedicine” gave a great presentation going back to future showing the “radio doctor” in a picture from 1924, which looked pretty much like what online care looks like now! Jay was very provocative about the potential of telemedicine and the role of physicians in the future—for example, if you have a physical and you don't check the doctor's hearing first, how do you know that they’re reporting is correct? Indu & Matthew followed with the introduction to Health 2.0 and putting online care in place within the wider technology change….but you’ve all heard way too much about that (slides below)
The morning had two great panels. For the physician panel, Ron Dixon showed some of this data from his clinic at Mass General showing that patient and physician satisfaction with asynchronous & video-conference (via skype web cam) was very good. Michele Shimizu is a community doctor in Hawaii on the big island who is now seeing patients online using the HMSA/American Well system—she’s been seeing both HMSA members and uninsured people online. Peggy Latare, the chief of family medicine at Kaiser Permanente, explained the roll-out of HealthConnect in Hawaii—the setting where they’ve shown that the introduction of asynchronous care has resulted in a 25% drop in office visits. All three physicians are tremendous advocates for online care, and all had great stories of really advancing patient outcomes from both synchronous and asynchronous online care.
The other panel moderated by David Kibbe looked at policy. Roger Netzer, the Chair of the Hawaii Medical board was admittedly skeptical. He wanted to make sure that online care was safe, and challenged the group to consider whether it was as effective as physical examination. But he also said that he was learning about these new possibilities. State Senator Rosalyn Baker has been the champion of remote health & telemedicine in Hawaii—not least because her constituency in Maui is a plane ride away from the specialists in Honolulu. Margaret Laws (from CHCF) explained her vision of how innovative technology could deal with access disparities.
The last burning question was about how online care & telehealth relates to “meaningful use” of an EHR as defined in the HITECH act. David left us with an appeal that we all make sure that the monies in the act are used to improve outcomes, rather than just be used to buy technology—and that should include online care as part of that definition of meaningful use. Rosalyn Baker also said that one concern was how quickly the money in HITECH had to be spent—which was a real challenge to get anything new considered.
After lunch Art Wilmes and John Semmens from actuarial firm Milliman introduced some new data about online care. It included an estimate that using online care to replace some ER visits and other routine care could save overall about 1% of total medical costs. They also developed some guidelines for what care was safe to deliver online, and what needed to be re-routed to in-person.
Mike Cheng from HMSA told us that they got the online care process with American Well up and running in 7 months, including syncing members claims data with system. The system’s up and running since 15 January. Suzanne Fields from Kaiser Permanente described how the HealthConnect system is now a basis for “9 cool tools” which help Hawaii employers (who all have to provide insurance) improve their employees health. Interestingly their outreach via newsletters cause big bumps in online enquires on that topic. In addition, now they have HealthConnect, NPs can visit the workplace and take their laptops can have all the information about the members from the system.
The session ended with some work groups considering several different aspects of online care, and reporting back. Inevitably issues of licensure come up, not that they were resolved. Finally, Drs Kibbe, Schoenberg & Sanders took part in a looking ahead panel. Roy Schoenberg stressed that this was about convenience, and that it was demanded by the consumers—which is why it would happen quickly. Jay Sanders agreed. David Kibbe was also optimistic, but continued to appeal for recognizing that a combination of patient registries, ePrescribing & online care might be better than simply spending the $40,000 on an EMR—and ought to cost a whole lot less.
At the end of the day many many physicians and other attendees came to comment to me about how valuable the information had been for them. But everyone was very cognizant that for online care, this is a beginning.
Chris Lawton has an article in Thursday’s Wall Street Journal called (wait for it) Cough, Cough. Is There a Doctor in the Mouse?
It’s a good general run down of American Well, TelaDoc & SwiftMD, which are the leaders in synchronous web-based care. Of course there’s also lots of asynchronous care going on online. In particular Kaiser Permanente has shown a huge amount of online communication between its clinicians and members, and RelayHealth has a similar service in which several health plans are paying doctors to communicate online with patients.
And this is all starting to come together and have an impact. The Health 2.0 Hawaii chapter will be having a meeting about this very topic on March 26.
#1 health care blogger Amy Tenderich has prodded us to remind you that the second annual Diabetes Design Challenge is now open! And this year there are real & large cash prizes, funded by CHCF—Grand prize $10,000, and support from IDEO and MedGadget! Here’s what Amy tells us: 21m Americans live with diabetes, yet the devices we rely on generally don’t hold a candle to the sleek design of consumer electronics (think iPod)... So patients are going "grassroots" to improve the design of tools for treating diabetes. On Monday morning, we’ll be announcing opening of the 2009 DiabetesMine Design Challenge, a blog-based competition calling for innovative design concepts (devices or web applications) that will improve life with diabetes. The competition is open to ANYONE with a good idea: patients, parents, startup companies, design & medical students, developers, engineers, etc.
Today late afternoon PST Google flipped the switch on an important change/add to Google Health. Recently they’ve been adding more and more little features, such as printing & graphing, and in the last month getting CVS retail pharmacies on the network (to join Walgreens), and sucking up device data. But this new one may be the most interesting, as Google Health has added the ability for users to invite others to see their records.
Anyone who’s used Google Docs (and that includes all of us working at Health 2.0) immediately gets addicted to sharing those spreadsheets and text documents with a wider team. It’s so easy, you just invite them to it, and then one day you wake up and you’re sharing hundreds of documents with everyone you work with and cannot imagine how you did it before.
For Google Health (and the details got a mention on the main Google blog today) they’re starting sharing relatively slow. Up until now they haven’t had any ability for one person to see into another record unless they know that user name and password. (Do you trust your husband/wife that much? 
)
Now you can invite anyone to a “read only” view. It’s all or nothing sharing, so they get to see for now everything in your record. Presumably there’ll be changes to that in a later version.
But for now it looks and works just like sharing in Google Docs, in that you can invite anyone. There are some slight differences, in that the receiver cannot edit and cannot re-share, and they have to accept the link from the email (it doesn’t just show up automatically in their Google Health account)
So now people will be able to share Google Health with their families and caregivers. But obviously the big next phase is people offering to share these records with their physicians. We’ll see but this may well be the killer app the PHR has been looking for—after all now a doctor just needs one Google sign-in which they almost certainly have anyway, and they can see all the Google Health PHRs of the patients who start sharing their records with them. And they will. This has the potential to be really disruptive.
There's a pretty serious article about Yelp, which has become the dominant player in restaurant and service reviews in the SF Bay Area, in a local alternative weekly The East Bay Express called Yelp and the Business of Extortion 2.0.
Now recently Yelp has seen a couple of its reviewers sued for reviews about health care providers (both chiropractors), and the issue about what reviewers can say online is probably still to be worked out.
But this article is about something much worse. It accuses Yelp of changing reviews, eliminating them, and generally breaching the church/state line between community and sponsorship. And it goes both ways. Businesses that advertise get bad reviews “disappeared” and those who don’t find their good reviews are vanishing.
Reading between the lines, it’s probably true that pushy commissioned sales people have been suggesting that good things will happen to those businesses that sponsor/advertise, and that the reverse is true to those who don’t. The question is, have they actually been given the keys to the car to make that happen? If so, it’ll probably kill Yelp’s business. But if it doesn’t then lawsuits and regulation are likely to follow.
This already matters for health care reviews. Yelp has far more doctor reviews (in terms of number of reviews per physician) than any other review site I’m aware of in the SF Bay Area. But of course, the same issue is potentially true for any review site that focuses on doctors and is searching for a business model.
The only issue as of now is that, as Michael Millenson pointed out this week on THCB, the healthcare review sites out there now can only hope for a fraction of Yelp’s reach and power.
Health 2.0 is working on a new documentary focusing on the next generation of physicians and healthcare professionals.
We are looking to cast 3-5 medical students who are willing to share their perspectives on how the field of medicine is changing, how they expect to be practicing when they're out in the world, and how Health 2.0 technologies factor into their lives.
Are you (or can you recommend) a dynamic and engaging medical student or health professional in training who is currently working to bring the medical profession/healthcare system into the 21st century? Are you working on projects that relate to social media/the web/mobile/ changing the world with technology? Then we want to talk to you!
The short film will debut at the Health 2.0 conference in Boston in April and be distributed online through various partner organizations.
Please send all recommendations and references to Lizzie Dunklee, Executive Producer at Health 2.0 at lizzie@health2con.com.
I’ve been following Phreesia since it was two guys in an apartment trying to figure out how to make the patient check-in at the doctors office a better and more useful experience. Today they announced an $11m series C round with new investor BCBS Ventures, a new-ish fund backed by 11 Blues plans. (FD: Phreesia has presented and exhibited at Health 2.0, and I think they’re a great example of using light-weight web technology to solve a messy process problem)
I spoke to Chaim Indig, CEO & President of Phreesia, and new investor Paul Brown, Managing Director of BCBS Ventures Inc this morning. Here’s the interview.
Univita is a new play from a strong executive team led by former Anthem CEO Ben Lytle. Post Anthem, Lytle and his son Hugh founded Axia, a wellness company, and sold it to DM industry giant (albeit a small giant among dwarves), Healthways.
Now they’ve bought Enurgi which has established a platform for caregivers to manage in-home care over the web. (FD, Enurgi was founded by my friend Chiara Bell and Health 2.0 has a teeny, teeny stock position). Scraped straight from Univita’s website, here’s what they say they’re going to do:
Previously Univita bought a long term care insurer (the imaginatively titled Long Term Care Group), and now with Enurgi they have the platform.
Now of course despite being well financed and putting the initial pieces in place, there’s a long way to go for this start-up.
But it’s an indication that even in the depths of the recession we appear to be spiraling into, smart business people are seeing that the care of the baby boomers’ parents is going to need different tools and a different approach than is available in the market today. Watch this space.
In this piece I’m slightly pulling CEO Rajiv Metha’s chain (but he’s an Arsenal fan so he can take it). At any rate the Zume Life beta program is open and it works on the iPhone (as previewed at Health 2.0 in October.
Zume has received the kind of publicity that tiny starts-up dream about (articles in the WSJ, NY Times et al) while only having a tiny number of people in pilots actually using the service. So it’’s good to know that the rest of us can actually use it and see what the fuss is about.
Meanwhile Zume is by no means alone in the market for lightweight trackers of health, diet and everyday activities.
Health 2.0 “Launch” star thecarrot.com has a nifty interface to the iPhone designed in from the start, and has been adding different trackers to its platform at a ripping rate. For a pure platform approach that you can track basically anything at all on, it’s really neat
Sensei is a subsidiary of Humana that focuses on weight loss and has some really interesting features allowing you to customize a diet plan to yourself & take it mobile.
Purpleteal is focusing on drugs and medication adherence (and isn’t quite in public beta yet).
And Adam Bosworth’s Keas has some very interesting combinations of all of the above—again going into beta soon (although you may have seen the preview at Health 2.0)
This is an unscientific smattering, but there’s certainly something stirring and it’ll be interesting to see if trackers/reminders and “life managers” take off in health care.
In one of the first articles of this type I've seen published in a mainstream medical journal, in this case the Archives of Dermatology, there's some evidence that being in an online community helps patients. This study is from our friends at the Partners Center for Connected Health which is run by Joe Kvedar, himself a dermatologist. (No I haven't spoken to Joe about it and I don't know if his specialty is why they picked on psoriasis—other than it’s a very nasty condition.
Anyway, the key take-away from an attitudinal study of over 200 patients in five online communities is that:
Almost half (49.5 percent) of participants perceived improvements in their quality of life and 41 percent perceived improvements in psoriasis severity since joining an online support community.
And all this from a treatment with no costs and no side effects. Even Syd Wolfe (new head of drug safety at the FDA much to Forbes dismay—yes it is that Sydney Wolfe) would approve!
I expect that as Health 2.0 tactics go mainstream we’ll hear a lot more about these types of cases.
It’s possible that you were distracted by certain events happening yesterday. But it’s time to focus on the job at hand, and in the world of Health 2.0 that means the upcoming Health 2.0 Meets Ix Conference.
Today is the last day to get earlybird pricing at $1,299 for regular and $1,099 for academic/foundation/government—that earlybird pricing expires at midnight tonight.
Here’s the agenda, and here’s where to sign up.
In the middle of a ho-hum article about Health 2.0 in the Jacksonville Business Journal, there's this somewhat unfortunate and untrue sentence!
Then there’s Medscape, a social network for doctors that has a format similar to MySpace or Facebook and includes 100,000 physicians. It’s similar to its predecessor, Sermo, and both are exclusive to verified physicians.
Sermo is the predecessor of Medscape? Oops. In the tone of the article Medscape is the 1.0 company (now owned by WebMD), Sermo the 2.0 company and unless the reporter knows something most of us don’t, they’re separate companies and pretty big rivals!
Calling all Chicagoans – Some attendees of the Health 2.0 Conference would like to create a regional Health 2.0 group in your area—FIRST MEETING IS TOMORROW!
The Purpose: To form a group within the greater Chicagoland area to connect, to discuss, and to inform on all things health and technology.
The Goals:
1. Stay in line with the Health 2.0 "mothers hip" vision
2. To be a referral network for both resources and ideas
3. A platform to direct you to a specific product of interest
4. To provide an audience to those interested in pitching a Health 2.0 product demo/idea/question
5. A forum for speakers to share current and relevant information pertaining to Health 2.0
6. An arena to discuss topics facing the Health 2.0 environment
7. A "jumping off" point to network with other Health 2.0 regional groups (Currently, LA, DC, Boston, NYC)
How this will be facilitated:
1. Meetings once a month (The Third Thursday of every month)
2. Rotating leadership - Will look to meeting participants to volunteer and take ownership to host/organize the monthly meetings.
3. Meetings to be held at an informal setting in the Chicagoland area
A small group met in December to discuss the high level information above. Based on some of the decisions made, the next meeting is scheduled to be held on January 15, 2008 at 5:30 am cst at Matilda's - 3101 N Sheffield Ave, Chicago, IL (Sheffield and Barry in Chicago). Below is an agenda to help the group get started:
Agenda
Additionally if you have interest in this group, please check out the Facebook Group “Health 2.0 – Chicago”, Facebook Event “Health 2.0 -- Chicago – Meetup”, and for all those on Twitter – a Twtvite: http://twtvite.com/p61cej.
If you have the opportunity and interest, please brave this blistery Chicago weather to make out to the second Health 2.0 Chicago Meetup. Thanks ! Kind Regards, Naveen Gidwani
By DAVID C. KIBBE, MD MBA
Like the Institute of Medicine's
(IOM) 2001 counterpart report, "Crossing the Quality Chasm," a new
report from the National Research Council of the National Academies
is complex, full of new ideas assembled from multiple disciplines, and
is likely to have seminal importance in framing public policy from now
on. "Computational Technology for Effective Health Care: Immediate Steps and Strategic Directions"
was released last Friday, January 9, 2009 in draft, but there is so
much to comment on that I think it's wise to begin with a quote from
the committee that sums up the central conclusion:
In short, the nation faces a health care IT chasm that is analogous to the quality chasm highlighted by the IOM over the past decade. In the quality domain, various improvement efforts have failed to improve health care outcomes, and sometimes even done more harm than good. Similarly, based on an examination of the multiple sources of evidence described above and viewing them through the lens of the committee’s judgment, the committee believes that the nation faces the same risk with health care IT—that current efforts aimed at the nationwide deployment of health care IT will not be sufficient to achieve the vision of 21st century health care, and may even set back the cause if these efforts continue wholly without change from their present course. Success in this regard will require greater emphasis on the goal of improving health care by providing cognitive support for health care providers and even for patients and family caregivers on the part of computer science and health/biomedical informatics researchers. Vendors, health care organizations, and government, too, will also have to pay greater attention to cognitive support. This point is the central conclusion articulated in this report. (emphasis added)
It would be difficult to find a more sober indictment of US health care IT policy
and implementation over the past decade than what is contained here.
The report is the result of many meetings and site visits beginning in
April 2007. It was written by a committee chaired by William W. Stead,
MD, Director of the prestigious Informatics Center at Vanderbilt
University Medical Center, and includes not only some of the nation's
top academic computer scientists and health IT engineers, but
representatives from the private sector (Google and Intel) as well.
The report recommends that governmental institutions - especially the
federal government - should explicitly embrace measurable health care
quality improvement as the driving rationale for its health care IT
adoption efforts, and should shun programs that promote specific
clinical applications or products.
Although the report's language
is sometimes almost impenetrable, the Committee's major criticism of
today's health IT is that the systems in use do not support the
clinical decision making processes that are foundational to the
practice of quality medicine, lacking what the authors refer to as
"cognitive support." Nor do they adequately support the data collection
and aggregation necessary to analyze, report, and improve care. Again,
in the words of the report:
by DAVID C. KIBBE and BRIAN KLEPPER
On December 19th, we published an Open Letter to the Obama Health Team, cautioning the incoming Administration against limiting its Health Information Technology (IT) investments to Electronic Health Records (EHRs). Instead, we recommended that their health IT plan be rethought to favor a large array of innovative applications that can be easily adopted to result in more effective, less expensive care.
The response to that post was vigorous - we received many comments and inquiries from the health care vendor, professional and policy communities - urging us to provide more clarity. One prominent commentator called to ask whether we, in fact, supported the use of EHRs. We both have been active EMR and health IT supporters for many years. Dr. Kibbe was a developer of the Continuity of Care Record (CCR), a de facto standard format for Electronic Medical Records (EMRs), and has assisted hundreds of medical practices to adopt EHRs. Dr. Klepper has been involved in EMR projects for the last 15 years, and the onsite clinic firm he works with provides every clinician with a range of health IT tools, including EMRs.
That said, we are realistic about the problems that exist with health information technologies as they are currently constituted. As we described in our previous post (and contrary to some recent claims), most products are NOT interoperable, meaning licensees of different commercial systems - each using different proprietary formats - often find it difficult to exchange even basic health care information.
Most EHRs are bloated with functions that often are turned off by practitioners, that are promoted politically through the current CCHIT certification process, and that drive up costs of purchase, implementation and maintenance. Despite moving toward Web-based delivery models that have MUCH lower transactional costs than old-fashioned client/server approaches, most commercial offerings are still extremely expensive, especially compared to the revenue flows of the relatively small operations they support. (John Halamka MD's recent recommendation that the Fed invest $50,000 per clinician for rapid implementation of "interoperable CCHIT certified electronic records with built in decision support, clinical data exchange, and quality reporting" provides an idea of the resource allocations that are on the table.) The very wide range of choices in the market currently raises the question of whether the implementation of a national EHR infrastructure MUST be so costly.
Many health care professionals still think of health IT as a compartmentalized function within health care organizations. But health IT has increasingly become the glue between and across all health care supply chain, care delivery and financing enterprises. In the past, it was enough for health IT to facilitate information exchange inside organizations - in which case a proprietary system would do - but we now expect information to be sent and received seamlessly, independent of platform, including over the Internet. Most of the currently dominant EHR technologies don't even begin to get us there.
Nor, despite the rampant optimism about its potential, can a focus on health IT alone - or even more emphatically, EHRs - resolve health care's deeper problems. As the noted health care economist Alain Enthoven wrote in a December 28 New York Times editorial:
In other words, as the recent reports from the Congressional Budget Office and the Dartmouth Atlas point out (yet again), real reforms will require an array of significant changes, many of which will face withering opposition from entrenched interests. One of those interests is the established health care information technology sector, which stands to finally win handsomely from huge Federal investment in their current products.
The good news is that this is the position held by Peter Orszag, the incoming Director of the Office of Management and Budget, the current Director of the Congressional Budget Office, an astute student of health care dynamics, and a key member of the Obama health team. In July 18, 2008 testimony before the Senate Finance Committee, he said:
In other words, it is fair to be skeptical about how we should proceed with a national health IT build-out effort. The health IT industry's current product/service offerings are analogous to the auto industry's obsession with SUVs, as much the problem as the solution. Just as the auto industry can be re-purposed to build lower-energy, less wasteful vehicles, so too should the health IT industry be encouraged to offer smarter products that serve the interests of an affordable, convenient, and evidence-based health care system.
A smorgasbord of Health Information Technologies is available to help us build a far better health system. Part 2 will describe some functions that a national health IT infrastructure renewal effort might consider.
David C. Kibbe MD MBA is a Family Physician and Senior Advisor to the American Academy of Family Physicians who consults on healthcare professional and consumer technologies. Brian Klepper PhD is a health care market analyst and a Founding Principal of Health 2.0 Advisors, Inc.
American Well's official opening in Hawaii is next week. In advance it gets a plug in the NY Times from Claire Miller.
It’s no secret that American Well are good friends of Health 2.0 (and, FD, have been sponsors of the last 2 conference). What we didn’t know but have suspected for a while is revealed in Roy Schoenberg’s comment:
Dr. Schoenberg, a physician, said that American Well had piqued the interest of policy makers in Washington who want to expand access to health care. Insurers in other states will soon offer the service, he said.
It’ll be interesting to see in particular whether the insurers that have rolled out asynchronous messaging (i.e. Relayhealth plus the KP HealthConnect system) feel the pressure to add a live synchronous video-link service too. Of course the main competitor to Hawaii Blues is Kaiser who so far believe that asynchronous secure email reduces office visits and saves them money. So my guess is we’ll find out pretty soon.
User-generated content 
Come join our active and growing Facebook group! Centering on the Health 2.0 Conference, it's one of the easiest ways to keep in touch, share content, and contribute to the discussion.
Subscribe!
Featured Posts
People Who Need People Use Social Media
By Jane Sarasohn Kahn
Health 2.0 and Identity
By David Kibbe MD MBA
Healthcare Open Source and Community
By Paul Biondich
38 sites....
By Matthew Holt
Consumer Access Practices for Networked Health Information
By David Kibbe MD MBA
More Featured Posts
UnitedHealth Customers Speak
By Miriam Bookey
Dyson, Kibbe Join Advisory Board
By Matthew Holt
Rating Doctors Like Restaurants
By Bob Wachter
Personal Genome Management
By Matthew Holt
The Sparse Information Model
By David Kibbe MD MBA
Health 2.0
a Broad Vision
By Brian Klepper and
Jane Sarason Kahn
Health 2.1
By Esther Dyson
Health 2.0 Note
By David Kibbe
An accelerator
for Health 2.0
By Marty Tenenbaum
