Archive for January, 2008

Future of Medical Imaging: Podcast & Video

January 15, 2008

Mayo Clinic and IBM are teaming up in a new center for medical imaging. A video and podcast are available here on the Healthnex blog. More information is available in the IBM Press Room including  a white paper (“Real-Time Mutual-Information-Based Linear Registration on the Cell Broadband Engine Processor”) and PowerPoint presentations.
What is the future of medical imaging? With lower cost storage, more robust networks in hospitals and faster processors, many of the previous barriers are being broken down. This is confirmed by the growth of remote radiology. But the Mayo Clinic/IBM initiative demonstrates an innovation at another level with future real-time imaging which may benefit transplant or interoperative interventions.

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The Future of Primary Care

January 13, 2008

In an extended article on The Healthcare Blog, Brian Klepper writes on “ Bad Medicine: How The AMA Undermined Primary Care in America“. In a reaction to a Wall Street Journal article on the 10% cut in Medicare physician payments, he explains how the across the board cut changes nothing in terms on the erosion of primary care and family practice physicians in practice.  He  goes on to detail the failure of RVUs in balancing payments.

Although not related to ehealth, this is an important policy issue especially in an election season. Worth the read.

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Update on AskDrWiki

January 9, 2008

After beginning in some controversy, AskDrWiki.com, one of the first wikis on the internet used as a medical reference is getting a good review. Started by cardiology fellows at the Cleveland Clinic, the wiki has grown to have 19 specialty areas, 400 credentialed users and 1000 articles. Not to mention 65,000 unique visitors. This report in the local Cleveland paper notes the editorial policy and board is now posted which has calmed some of the initial criticism. Congratulations to Kevin Civello and Brian Jefferson for their persistence in making this tool a reality.

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Medicine 2.0 Blog Carnival is now up

January 7, 2008

The blog carnival includes a broad range of contributors. This issue has my 2008 predictions and citations of Medicine 2.0 in various blogs and web announcements including Mike Leavitt and JAMA.

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Consumerism in Health Care – Future Directions

January 4, 2008

In doing some digging on this topic, I found an article from Health Affairs from 2005 which calls for a new direction.
“Consumerism appeals to the widespread and legitimate desire for a more transparent, flexible, and personal system and provides a salutary counterbalance to the organizational hypertrophy and opaque administrative mechanisms of the managed care era.” The article goes on to recommend marrying the best of supply-side and demand side competition in health care to produce a new model.

“Different consumer-centric benefit designs and provider-centric network designs will be appropriate for different health services, depending on whether utilization is strongly consumer preference–sensitive, provider supply–sensitive, both, or neither.”

“Different forms of organization may offer the best combination of cost, quality, and convenience for different services depending on their clinical and technological characteristics.”

Check out the charts which describe some of these models: Benefit and Network Designs , Alternative Forms Of Provider Organization.

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Web 2.0 comes to the Lab

January 3, 2008

myMedLab.com is a newish Web 2.0 venture which sells personal lab testing online. Described as “an innovative approach that dramatically lowered cost and gave consumers direct access to the same health information once only available to doctors”, the site offers lab tests in several categories.  These include: basic, male and female wellness (metabolic and lipid profile among others), weight loss (bariatric panel), and individual tests (DNA and drug tests, for instance). The business model includes agreements with local labs and a zip code search to find them. Finally, there is a PHR to securely store your records of testing.

Overall, a comprehensive solution for direct-to-consumer lab testing. This could be a resource for those with health savings accounts to save some money provided that their doctor does not want a test repeated. The controversy about this kind of testing will continue, especially whether testing should only be ordered by those who can interpret the results. Or is this one of the last hold outs of paternalistic medicine?

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eHealth 2008

January 1, 2008

What does 2008 hold for eHealth? Here is my take on some trends to anticipate

  • Announcement of Google Health – will the much anticipated personal health tool be rolled out?
  • PHR market consolidation – there are more than 100, but adoption is slow. With HL7 standards and a HIMSS position statement, will the market thin out and more robust tools prevails?
  • RHIOs – will continue to struggle with a few exceptions until after the 2008 elections allow some movement on health care reform which will support IHE.
  • Telemedicine and eMonitoring will show increased growth both in rural health and other areas where incentives are made available.
  • Consumer-Directed Health Care and Health Savings Accounts will see gradual growth. Many consumers will  stick with traditional health plans when possible rather than opting  for high-deductible plans
  • Health 2.0 tools and networks will also expand although there will also be some companies which will be acquired or go out of business
  • Consumerism in  health care will  continue to expand  with  consumers demanding more access to information about their health care, providers and outcomes

Looks to be an exciting year. The Year of the Consumer in Health Care.

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European “Consumer Report-like” Ratings for Health Care

January 1, 2008

eHealth in Austria pointed to the European consumer health rating matrix for 2007.  Indicators include everything from

  • Patient  Rights (percent of  GPs using  EMRs,  no fault  malpractice insurance, etc.),
  • wait times (cancer  treatment  in less than 21 days – would the US patients tolerate this?),
  • Outcomes (heart infarct mortality),
  • Generosity of public health systems (cataract operations per 100,000)
  • Pharmaceuticals (Rx subsidy percent).

These few examples are very clear indicators which could easily be applied to the US and in some cases to health care systems themselves. Can anyone point to similar measures here?

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