Archive for March, 2011
March 24, 2011
One addition to my post on this book is the final chapter on trends – 20 in all.
- Hospitals are no longer buildings
- Patient Safety Focus
- Information is everywhere
- Evidenced-based Management
- Healthcare can’t keep up with the rate of scientific discovery
- “Not being sick” to “Being Well”
- Shortage of Professionals
- The information hight gains more and more influence
- Concepts such as P2P and Web 2.0 arrive at the health sector
- Social entrepreneurs take the lead
- Consumer-driven healthcare
- Electronic medical records
- Cost containment will become more and more critical in healthcare
- New actors will appear in the healthcare value chain
- Healthcare will become more and more “vertical”
- Personalize medicine drives the agenda
- Bioinformatics emerge
- Bioconnectivity is the next big thing
- Electronic signature is everywhere
- The triple helix is becoming real – administration, hospitals and universities, venture capital.
Some of these are obvious, others provocative. Are there more to add to the list?Share this:
March 22, 2011
Just returned from live tweeting of Atul Gawande at Cleveland Clinic Ideas and full of quotes and ideas. For instance, the evidence is building for use of checklists showing significant reduction in mortality and complications so that he states that if there was a drug that showed this kind of effect it would be adopted immediately, even faster than Viagra. Gawande also discussed two of his well known New Yorker articles:
- The Cost Conundrum - What a Texas town can teach us about health care
- The Hot Spotters: Can we lower medical costs by giving the neediest patients better care?
In the end, he challenged the audience and the country to find one hospital which could reduce costs while not causing harm to set a model. He predicted that in the coming hospital wars, the ones which reduced cost while maintaining quality would win and others would lose (close).
Within the provocative statements was the voice of compassion and rediscovering the soul of medicine in the complex, competitive healthcare environment of today.
Final thought – why are hospitals not advertising that they endorse and complete adopt checklists? And why would anyone not have surgery in a hospital that does not use checklists? Why take the risk when the evidence is there?Share this:
March 21, 2011
This volume by Luis Pareras, MD, published by Greenbranch Press, is one of the most comprehensive works on the topic to date. The book is filled with tables and diagrams on a range of topics covering innovation and bringing innovations to market. The eight sections cover: principles, the healthcare sector, structuring the idea, pushing our idea forward, creating a stratup, venture capital, basic skills, and trends. By beginning with the healthcare value chain, the author lays the basis for innovation and identifying the rich opportunities in this market. Information is covered along with drugs, devices and biotech. Healthcare IT is also put in the context of the value chain with such categories as, reducing friction in transactions, extracting the knowledge component from the system and extending the scope of the relationship between physician and patient, also known as participatory medicine. The concepts of ehealth and Web 2.0 are addressed avoiding the more specific terms, Medicine 2.0 and Health 2.0 and the book stays true to covering topics in an objective, business oriented approach without making claims about where these areas should go. Providing a “Framework for Analysis” puts the health IT initiatives in context of the value chain.
The sections on creating a startup and venture capital could be true for any entrepreneur but do give specific advice to the healthcare entrepreneur, such as, knowing the audience you are addressing and if it is venture capitalist, do not assume they will know the details of your medical intervention or product. Discussing skills like negotiation help lay out specific steps in knowing and enhancing your position whether negotiating a partnership or a buyout.
The book can be used for many audiences – obviously the healthcare entrepreneur would benefit from this book as a reference volume to go to at specific stages of building a startup. The book could easily be the basis of an MBA course on the topic. Those considering moving an innovation into the healthcare market should read it with an understanding of what they are venturing into. Venture capitalist could benefit from understanding the healthcare value chain and how specific innovations target specific steps in that chain. Healthcare executives should consider reviewing this book for understanding the how innovations impact their day-to-day operations and better evaluate the innovations and new products presented to them.
Innovation in healthcare is pervasive, the opportunities are broad. Participating in this innovation needs a toolkit like this book. Is it worth the cost – to many of the groups mentioned above, definitely.Share this:
March 12, 2011
The first speaker I heard at the American Medical Informatics Joint Summit was Kenneth Buetow from the National Cancer Institute. In his typical provocative manner, he challenged the audience on the transition day from the Translational Bioinformatics to the Clinical Research Informatics Summits. He began with promoting the P4 Medicine as the new model for healthcare: personalized, predictive, preemptive, participatory. Although throughout the conference little was articulated on the participatory aspects with one exception. More on that later.
Buetow talked about defining cancer on the molecular level and the challenge of the exponential number of patients required to do genetic screening for a single disease. He referred to Pharma 3.0 from the Ernst and Young report on Progressions 2011 where patient engagement through social media as necessary in this new age of medicine. It is here that he stated, “All diseases will become orphans” meaning that as we understand more about genomics and are able to combine these findings with clinical data, we will understand each disease process on a truly personalized level and hopefully treat it as such.
As part of Pharma 3.0 and a new model for medicine, he did note some encouraging trends in volunteers for clinical trials, true patient activism in a full participatory sense. Specifically, he reported some recent statistics from Army of Women, a joint project of Avon and Susan Love to recruit an army of those willing to volunteer for research studies. Rapid recruitment occurred consistently for studies through this resource while traditional clinical trials continue to suffer from lack of full enrollment. He also referred to adaptive clinical trials as part of this new model. Finally, he discussed the Translatable Informatics Ecosystem as a way of describing how informatics will be key in this new paradigm using Services-Aware Interoperability Framework (SAIF) as one technology to reach that goal.
Many of the presentations at this year’s conference were focussed on data warehouses of clinical and genomic data and ontology development and application include many efforts in the semantic space.
Several speakers referred to Evidence Based Medicine, Personalized Medicine and the Learning Healthcare System implying if not explicitly stating that there is a convergence of the future of medicine and that medical informatics and clinical research informatics are at the center of this convergence. Bill Hersch, noting the explosion of data both in journals and through EHRs and others sources, citing Stead on the need for “Systems of Brains” to manage the amount of information now available
All agreed that Medical Informatics is at a crossroads and has the opportunity to take leadership in the future of medicine, managing the data explosion and making it managable in the personalized medicine era we are entering.Share this:
March 7, 2011
Heading to San Francisco for this AMIA meeting. Looking forward to the opportunity to present from the podium and poster session. Topics include:
- Development and Sustainability of an EHR-based Chronic Kidney Disease Registry
- REDCap – Characterizing the Rapid Adoption at a large Academic Health Center
- Design of a Registry Management Tool for EMR Data
- Research Recruitment in Anesthesia Using EMR Data
There will be many opportunities for networking. Hope to come home with lots of ideas.
Hash tag is #TBICRI11Share this:
March 6, 2011
A nice interview with Dr. Harris, CIO of the Cleveland Clinic and President of the HIMSS board on following the spirit of meaningful use, not just the letter of the regulation to create a real sea change in health care.
From Hospital and Health Networks Daily blog.