Archive for December, 2007

RHIOs struggle to Find Effective Business Models

December 29, 2007

In an article from Information Week, they review the report of the eHealth Initiative on “2007 Fourth Annual Survey of Health Information Exchange at the State, Regional, and Community Levels.” The analysis shows that the greatest barrier to health data exchange is finding sustainable business models. “

The survey found that reimbursement systems, which reward volume and fragmentation, also make it difficult for stakeholders to create sustainable business models.”

At the same time the RHIOs are successfully developing data exchanges for prescription information, lab results and outpatient information.

How will RHIOs fare in 2008?  Without healthcare reform, they will continue to struggle. Perhaps is CMS developed incentives within Medicare, that would set the stage for less fragmentation and reimbursement primarily based on volume rather than continuity of care models.

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Physician Internet Use – 39% Email Patients

December 18, 2007

In a survey by Jupiter Research reported by iHealthbeat, the range of Internet usage is reported with some changes since one year ago. 89% this year vs 75% the previous year reported using the Internet for researching clinical information. While this doesn’t imply diagnosis via Google, it does show a continued growth toward the physician not using the Internet as the exception.  Reading journals and communication with colleagues also showed increases – could this imply the future of the medical journal and hope for physician social networking, as in Sermo and Within3?

Finally, patient-oriented activities, while not scoring as high, had respectable increases – 69% searching for patient education materials and 39% (almost double in one year) emailing patients, we hope securely.

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Barriers to Health 2.0

December 13, 2007

According to part two of the series on Health 2.0 in Modern Healthcare, barrier to Health 2.0 include: an age gap (Health 2.0 appeals to a younger demographic) and privacy according to David Brailer. Privacy is a big concern because these sites are not covered by HIPAA and contain lots of private health information although one’s identity can be hidden. Even without creating an account in sites such as, PatientsLikeMe.com, one can view detail about symptom status and drugs for individuals with ALS, MS and Parkinsons. But this appears to be a trade off many patients are willing to take.
Can these site be hacked? Have they already? To what extent are they being using for targeted advertising?

One can only hope that users read the site usage policies before plunging into revealing their disease status.

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The Future: Consumer Health Information Technology

December 13, 2007

This is the title of a conference held by the National Cancer Institute at which Bill Crounse of Microsoft and Adam Boswoth presented. Crounse gave a vision of the future including wireless, seamless medical consultation while decrying underinvestment by US healthcare in IT. Bosworth sees impeded growth of research and evidence-based medicine as a result of not leveraging health IT to its fullest potential. Unfortunately, I could not find any report of this meeting on the NCI website.

Both also spoke at the World Health Care Congress. Crounse, in his blog, cites from the editor of WIRED magazine while  Bosworth  preached giving  consumers control of  their data.  Steve Case also spoke predicting more innovation in consumer health including personalization, more emphasis on healthy living and the killer app – community including IM, chat, facebook for medical conditions. (Thanks to Matthew Holt for the excellent reporting on the Congress).

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How Broad is Health 2.0?

December 12, 2007

In an article from Modern Healthcare, Matthew Holt and others are quoted on Health 2.0. Along the lines of Wireless Healthcare, Holt sees “medical care is an ongoing process rather than a series of episodic events.” He sees the patient-physician relationship as more of a team enabled by Web 2.0 technologies.

Scott Shreeve of Crossover Health takes a wider view as Health 2.0 addressing the crisis in health care today – “Health 2.0 has everything to do with outcomes, quality and healthcare reform.”

Health 2.0 has many facets and substantial potential for making changes in health care. Will it require market consolidation to have a real impact on healthcare reform? Or is it current volatile state how it will continue to manifest itself and still have an impact?

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Health Care Unplugged

December 11, 2007

There is an new report by the California Health Care Foundation with this title, Health Care Unplugged: The Evolving Role of Wireless Technology. Specifically, it points out the characteristics of cell phones: personal, ubiquitous, connected, increasingly intelligent. The convergence of cell phone technology with the increase in chronic conditions provides an opportunity or as they state it, “a demographic imperative.” Two categories of applications are noted: monitoring technologies and those that provide information or feedback on health issues. These categories are then matrixed with technology types, such as, implantable, wearable, portable, upstream and downstream communication, and multiple communication types – text, two way, data, multimedia, 2-way video. The report concludes with several predictions including the possibility of moving from episodic care to managing chronic conditions continuously.

Overall the report is worth reading to see the current technologies and to think about future innovation. I would add the capabilities of GPS as a potential technology/data for health care.

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More Acquisitions by Revolution Health

December 6, 2007

Revolution Health announced an acquisition and a financial investment. The purchase is HealthTalk, a Web-based vendor of chronic care information with a combination of ask our experts health content, blogs and podcasts.  The second is a strategic partnership with SparkPeople, a diet and fitness site. While they continue to enhance their content with more Web 2.0 features like these two, they have now become the second (to WebMD) health care property on the Internet. Pretty impressive considering how young the site is. Is this a testament to Health 2.0 taking on  the traditional Health 1.0 websites?

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Continuing Medical Education Through Video

December 5, 2007

There is a Spanish-language website, LiveMedWeb.tv serving Central and South America which is providing innovative CME using video interviews with medical experts. These short clips (longer than the typical YouTube) provide quick information to a large, otherwise untapped group of physicians. They also provide webinars through the site which are longer. The site is the product of LiveMed, a company from Mexico City which also provides live broadcasts of CME events.
Is there anyone in the US doing this?

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LinkedIn vs. Facebook

December 4, 2007

While not specifically related to ehealth, I came across several articles on the social networking in business controversy. Two articles from CIO magazine demonstrate this: first is” Why CIOs Should Be On Facebook“. The rationale is the amazing growth and reach in contrast with LinkedIn as just an online resume. He rightly notes the ability to integrate LinkedIn into Faceblook. His final argument, “your future workforce views Facebook as a staple in their daily lives.” Not a compelling case for business value. Meanwhile in “ A Proud Member of the LinkedIn Generation” sees this tool as a way to reconnect with old business associates and develop a powerful network of CIOs, CSO, etc.  I agree that the potential is there but perhaps yet to be realized.

Finally, the most negative article is from a Harvard Business Review blog where Tom Davenport says “ LinkedIn Is Not a Social Network“. He argues that since it is specifically for business it is not a social network and it is only useful in seeking jobs or favors. Granted, LinkedIn lacks the rich functionality or user interface that Facebook has but perhaps it has not reached its full potential because of the lack of tools.  Also, different businesses have a variety of types of human interactions – some are more formal or restricted by regulations or laws (lawyers, government, healthcare) while others are less formal (education, technology esp. developers). So one tool will not fit all. Is the solution somewhere in between – not too formal or informal?

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