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.
Share this: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.
Share this: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?
Share this: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.
Share this: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?
Share this: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.
Share this: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.
Share this: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.
Share this: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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