Sunday, September 23, 2007

PeerClip: physician social bookmarking and collaboration

I got the opportunity at Health 2.0 to learn about peerclip, a new social bookmarking tool, information rating and peer collaboration tool exclusively for physicians. I've not personally used the tool but saw this recent review by Shahid Shah, the Healthcare IT Guy. Here is ConnectivHealth's official press release on the new product.

Read the "about us" section for more about peerclip and how you might use the tool if you are an MD, DO, physician assistant or nurse practitioner. I plan to pass along some information about peerclip to my physician clients to gain further insight into the tool and its value. I'd be interested to hear from anyone out there using the tool - feel free to post your thoughts in the comments.

Hospital Mashup: Google and HHS Hospital Data

NetDoc now as a mashup of Google Maps and HHS hospital data. As Shahid Shah says, these types of tools takes mountains of data and makes it more accessible and easier to digest by the average public health consumer. Here is the view/data of hospitals that are 100 miles from Charleston, West Virginia.

Here is the summary of what the tool provides:

When it comes to treating heart attacks, pneumonia, surgery and other emergencies, you want to find the best medical care available.

To help you make these decisions, visit the Hospital Rankings tool and enter your ZIP code to see how hospitals in your neighborhood rank on benchmarks set out by the U.S. Department of Health and Human Services in four categories: Heart Attack, Heart Failure, Pneumonia and Surgical Care Improvement/Surgical Infection Prevention.

Thanks to Shahid for the tip on this new tool.

Saturday, September 22, 2007

Health 2.0 Physician Model: House Calls and FICO

Just back from Health 2.0 and was reading about Dr. Parkinson who demonstrates his new (disruptive) model changing the way health care is provided. Don't miss the great discussion in the comments. Check out Dr. Parkinson's website Jay Parkinson, MD + MPH (and his blog).

Dr. Parkinson's approach also highlights something of value that I think has been missing from health care for years -- house calls. I had the chance to watch and go on house calls with my dad, a retired rural physician. There is incredible value in seeing the patient in his/her own environment.

Dr. Parkinson's response in the comments is a concrete example of Scott Shreeve's FICO concept discussed at Health 2.0. Dr. Parkinson comment:
"I’m also toying with the possibility of lowering the following year’s fee for each individual who utilizes my services less often than average. We’ll see."

Update: Catch an interview with Dr. Parkinson who explains his business mode on ABC News.

Thursday, September 20, 2007

Health 2.0: User-Generated Healthcare Conference 2007

The Health 2.0: User-Generated Healthcare Conference officially gets underway today but the pre-conference gathering was a great time last evening. We started out at the Hilton San Francisco lobby bar and then moved down to Johnny Foley's Irish Pub just down O'Farrell Street.

I had the opportunity to talk with Chris Sparks and Robert Hendrick of MedBillManager, Michael Markus with Within3, Daerick Lanakila with SugarStats, Joel Selzer with Ozmosis, Ash Damle with MEDgle, Daniel Kogan with Health WorldWeb, Laird Kelly with RSi Focal Search, Fred Eberlein with ReliefInsite and others.

Clear to me was that there was an incredible amount of excitement and enthusiasm around what is happening as this group tries to figure out how best to position themselves and their companies in this new non-traditional health sector. I was also struck by the fact that many of those who have jumped in with new ventures have done so as a result of a personal family health story or a frustration with how they were treated by the current health care system.

Some thoughts by others covering the Health 2.0 Conference and some of the afterglow:

I'm going to attempt to do some live blogging during todays sessions depending on availability of wireless access and available time. Below is speaker panel agenda for the day which I will use to post comments and questions on during the day.

Conference Agenda (live blogging notes are in italics)

Cool opening video on Health 2.0 called "A Brief History of Medicine . . ." created by guys at Scribe Media and inspired by the Web 2.0 . . . The Machine is Us/ing Us, video that I've posted about before.

8:00-8:30 INTRO Health2.0: User-Generated Healthcare
Matthew Holt/Indu Subaiya

Covered some background for the crowd on "what the hell is Web 2.0/Health2.0?" Used the O'Reilly definition including lightweight business models.

What is Health 2.0 (personalized search that finds the right answer for the long tail, better presentation of integrated data, communities, etc.) Consumerism is a great force - how will it impact health care? Transparency and consumerism.

Search is the largest area with social network and tools linked in. Good graphic with interlinking circles and content --- transaction. Also put up a slide graphic of Scott Shreeve's definition of Health 2.0 a much broader definition.

Matthew's continuum of Health 2.0?
User generated health care -- user connect to providers -- partnership to reform delivery -- data drives discovery.

8:30-9:30 OPENING PANEL: The Role of the Consumer Aggregators

Missy Krasner, Product Marketing Manager, Google

Question of whether consumers/patients are really ready to put all their personal information online. Search needs to continue to be refined in the health search field.

Wayne T. Gattinella, CEO, WebMD

The number of people searching for information online has doubled recently. People/patients now go online first for health information then to family and health care providers. This same trend is occurring with new doctors coming out of med school - they are going online instead of looking at text books.

Peter Neupert, VP Health Solutions Group, Microsoft

The challenge for those in the room that want to disrupt the health care industry is finding the business model that works. Cited stats on the revenue generated by health search -- big number and will continue to trend upward.

Bonnie Becker, Director, Health Category, Yahoo!

Yahoo groups on health are happening organically. Talked about the emotional side of online health communication by patients for patients. Individuals want to get information from other individuals -- not necessarily from their health care provider.

Moderator: Jane Sarasohn-Kahn, THINK-Health

Q/A from the crowd:
  • Trust lies in the individual user. Google's experiment with "passionate experts" who go out and label good/trustworthy content on the web. People want a trusted coach to help them weed through the data.
  • How do we mesh search and ads (revenue)? Good discussion on the topic from the panel.
  • Will search marginalize the need for physicians? Doctors are feeling alienated by some of what search brings to the table. Will the patient arrive in the office better prepared to discuss their health condition. One problem is that the traditional model of care (read: payment/reimbursement model) requires doctors to quickly move patients through the office - patients who arrive better prepared to discuss their health condition take more time (not less). Can we empower physicians and other care providers with information rather than alienate them from the process.
  • Question on what is your business model Google, Yahoo and Microsoft? Google response - we are not a health care company, trying to get better at health care, taking it slowly, very small team making quick decisions working bottom up, team is small, business model - free service for health user/put out a product that will help people/ads that help with discovery of information. Microsoft response - sell enterprise software to hospitals, working on consumer ideas (MedStory), fragmentation in the industy is a big problem in the hospital space - no work flow of data, wants to help guide in a connected way to improve connection of data. Yahoo response - goal of creating a good user experience, Yahoo health groups, search and answers, model is search advertising.
  • Data liquidity. How do health care data standards get in the way? "health care is a hairball" - Wayne at WebMD. Discussed the behavioral changes that have to occur - the technology has been out there for use in the industry.
  • How do we help users ask smarter health questions?
  • How do we pull folks into the Health 2.0 revolution for their own benefit, as well as society's? Great question - this is the one I have thought a lot about. How does all this actually improve patient behavior? What will drive people to care about their health? Patients with chronic disease have a direct stake in taking care of themselves. The more difficult question is how do we engage the masses to take care of preventable disease - obesity, cardic, etc.

Special Perspective from: David J. Brailer Former National Health IT Coordinator & Founder, Health Evolution Partners

Will web/health 2.0 become a catalyst to accelerate traditional models of health care to change. The future health of the health care industry needs health 2.0 . Many of the traditional models of communication and collaboration among providers, patient to provider, insurer to provider, etc. will be changed by health 2.0. Relationships in health care can be redefined by the health 2.0 movement. Need to bring/create sustainable business models - you can't just drop technology in (not passive role - must actively change the culture/process).

9.30-9.40 STRETCH BREAK, Bio Break & Coffee refill

9.40-10.40 DEMO PANEL & Discussion: Search in Healthcare

Each of the panel members did a quick demo of their individual search product focused on diabetes information. Interesting to see the various search engines search results for the same topic. I was overwhelmed by the information and can't imagine an ordinary consumer of health care (especially one who is poor, uneducated and otherwise unsophisticated) being able to grasp this much information.

Alain Rappaport, CEO, Medstory/Microsoft

Very good graphic showing a long tail like list of content sources in the "Information that Matters" section. Here is the search for diabetes.

Venky Harinarayan, Co-Founder, Kosmix

Tom Eng, President & Founder, Healia/Meredith

Working to refine health search. Recently released a new clinical study search feature.

Dean Stephens, President & COO, Healthline Networks


Somewhat unique in that it uses natural language search.

Moderator: Jack Barrette, CEO WeGoHealth (ex-Yahoo)

10.40-11.15 NETWORKING Break with Demonstrations

11.15- 12.15 DEMO PANEL & Discussion: Social Media for Patients

Ben Heywood, CEO, Patients Like Me

Doug Hirsch, CEO, Daily Strength

Steve Krein, CEO, OrganizedWisdom

Karen Herzog, Founder, Sophia's Garden

John de Souza, CEO, MedHelp International

Brian Loew, CEO, Inspire

Moderator: Amy Tenderich, Blogger/Journalist DiabetesMine

Like my discussion last night, this panel again brought out the personal side of Health 2.0. Most of the panel members had a personal experience that lead to their passion to want to create something new to address or supplement something that the traditional health care system was failing to provide them or their family members. For example, Patients Like Me grew out of a desire to Ben Heywood to want to create something to help his brother who was diagnosed with ALS.

Steven Krein stood out on the panel and suggested that Organized Wisdom was positioning itself to be the aggregator of consumer created health information from the likes of those on the panel. He talked a bit about Organized Wisdom's new roll out as a people driven search engine and coined the phrase, "people are the new algorithm."

12:15-1:00 REACTOR PANEL Payers, Providers, & Pharma….and Health2.0

Paul Wallace, Senior Advisor & Medical Director, Kaiser Permanente

Joe Gifford, Chief Medical Officer, Regence BCBS

Jeff Rideout, Managing Partner, Ziegler HealthVest Fund

Bruce Grant, SVP, Digitas Health

Ted von Glahn, Director, Performance Information and Consumer Engagement, PBGH
Moderator: Doug Goldstein, eFuturist

1:00-2:00 LUNCH with "Unconference" issue tables & more demonstrations

During the unconference I hosted a group on law/privacy issues and Health 2.0. We had some really great discussion including a brainstorming session on what changes to HIPAA privacy law need to occur to better accommodate the Health 2.0 companies. We also discussed most of the companies participating in the conference are likely not required to comply with HIPAA (although many do because they want to move toward the industry standard) because they don't fall into definition of a covered entity under HIPAA (a health care provider, health care plans or health care clearinghouse). The knee jerk reaction from those who don't understand HIPAA is to overreact by ratcheting down on privacy. We also got into the "flip side of the rock" on data aggregation. Most of the talk all morning focused on the positive aspects of health data aggregation. However, there are downsides to data aggregation including those who might want to use the data improperly for financial gain.

2:00-3:00 DEMO PANEL & Discussion: Tools for Consumer Health

Mike Battaglia, VP Healthcare Strategy, Intuit - Quicken Health

Marlene Beggelman, CEO, Enhanced Medical Decisions

Dave Hall, VP of Innovations, HealthEquity

Joseph Villa, COO Employer Division, Revolution Health

Ryan Phelan, CEO, DNADirect

Moderator: Scott Shreeve, CrossOver Healthcare (founder Medsphere)

3:00-3:30 NETWORKING Break with Demonstrations

3:30-4:30 DEMO PANEL & Discussion: Providers and social networks

Daniel Palestrant, CEO, Sermo

Effective presentation by Daniel who used the "saw blade" example as a way to show the value and positive impact of sharing/collaborating among physicians. Creative suggestion by a physician to use a straw to help remove a saw tooth blade from a patient presenting in the ER with a saw blade through the finger. Money is not a motivator of physicians. They have found that the physicians on Sermo are motivated more by the need to collaborate.

Lance Hill, CEO, Within3

Chini Krishnan, CEO, Vimo

Gale Wilson Steele, Founder/CEO, Careseek

Patricia Ball, VP Product Development Consumer Aware/BCBS Minnesota

Doug Goldstein, eFuturist & President, Medical Alliances

Moderator - Enoch Choi MD, MedHelp/PAMF

Q/A from the crowd:

  • How do the companies moderate the comments made by consumers about providers and what are the legal ramifications?
  • What are the panel members doing to protect/address protecting privacy within their business model? Will they make the data anonymous before reporting that out to other groups? Sermo will be making the aggregated data available to track trends and be analyzed by others.
  • What is your business model? Most rely on value of the data aggregated and advertising. Daniel at Sermo indicated that Sermo does not rely on advertising but instead talked about value in information arbitrage (taking advantage of the information created through the system).

4:30- 5:30 CLOSING REACTOR PANEL: Health2.0 - Looking Ahead

Marty lead off with setting the stage by asking the panel to look back and reflect on the day and then give some perspective on where they see this headed in the future. The discussion and thinking by this group was superb. There was recognition of fragmentation but also reflection that similar fragmentation existed in the early days of the technology/online revolution. Great concept of the calcified ball at the center of current health care model and that this group was working to eat away at the fringes.

Lee Shapiro, President, Allscripts

Referred to the use of EMR as subsituted service from paper records. The new feature is connectivity. This connectivity is what will really change the way the data collected in the EMR is used -- sharing information with practitioners to add greater value.

David Kibbe, American Academy of Family Physicians

Bob Katter, Senior VP, Relay Health (McKesson subsidiary)

Pioneered the idea of reimbursed e-visits.

Jay Silverstein, Chief Imagineer, Revolution Health

He recognized the creativity in the room on ideas to create better community in health care. Also intrigued by the idea of improving practice patterns across the county. Downsides he sees from the day is still the fragmentation of health business. Very insightful thoughts.

Steve Brown, Founder Health Hero Network, Entrepreneur in Residence, Mohr Davidow Ventures

Esther Dyson, EDventure

Moderator: Marty Tenenbaum, Commercenet

5:30- 5:45 Wrap-up - Matthew Holt/Indu Subaiya

Tuesday, September 18, 2007

FSB Best Lawyers in America 2008

Last week I learned that I was selected by my peers for inclusion in The Best Lawyers in America® 2008 in the field of "Health Care Law". This is the first year that I have been selected for the honor.

In all, six lawyers from Flaherty, Sensabaugh & Bonasso, PLLC were selected for inclusion in The Best Lawyers in America® 2008. Congratulations go out to the other honorees:

Below is background information about Best Lawyers and the process used to select attorneys for inclusion:
Since its inception in 1983, Best Lawyers has become universally regarded as the definitive guide to legal excellence. Because Best Lawyers is based on an exhaustive peer-review survey in which more than 25,000 leading attorneys cast almost two million votes on the legal abilities of other lawyers in their specialties, and because lawyers are not required or allowed to pay a fee to be listed, inclusion in Best Lawyers is considered a singular honor. Corporate Counsel magazine has called Best Lawyers “the most respected referral list of attorneys in practice.”

Saturday, September 15, 2007

2007 Healthcare Blogospere Survey

A few weeks ago my fellow blogging colleague, Fard Johnmar, announced the second edition of Taking The Pulse Of The Healthcare Blogosphere (2007 Survey). A survey co-produced by Johnmar's Envision Solutions and Trusted.MD Network.

The survey was first conducted last year (read the highlights). The survey will again look at the trends of health care bloggers so that we can all better understand why people blog about health and medical topics.

Today I finally got around to taking the survey and am passing along a recommendation to others health and medical bloggers to take a few minutes out of your busy schedule to add to the survey data. Deadline to take the survey is October 15.

Also check out Fard's interesting post from today covering the relaunch of Organized Wisdom at Healthcare Vox.

Friday, September 14, 2007

Calling All Creative West Virginians!

If you are creative and living in West Virginia (or a West Virginia expatriate) check out the upcoming Create West Virginia Conference set for November 12-14 at Stonewall Resort. More from the Create West Virginia Blog.

Medicare Physician Data: Transparency vs. Privacy

iHealthBeat provides commentary and an update on the outcome of the Consumers' Checkbook v. HHS matter involving whether or not Medicare physicians claims data should be made publicly available.

The United States District Court for the District of Columbia ruled in favor of Consumers' Checkbook on August 22 requiring that HHS release the physician data requested under FOIA to Consumers' Checkbook. So far HHS has not appealed the decision and the data is required to by produced by September 21.

It will be interesting to see if HHS appeals the decision. Classic example of transparency vs. privacy. Brian Kleppner has more over at that The Health Care Blog.

UPDATE (10/22/07): The WSJ Health Blog reports that HHS has decided to appeal the decision requiring that HHS release data under FOIA to Consumers' Checkbook. The decision initially required production of the data by September 21 which was then extended until October 22.

Joint Commission Launches WikiHealthCare

iHealthBeat reports about the Joint Commission's new pilot wiki, WikiHealthCare. The pilot project is an effort by the Joint Commission to create a collaborative space for open exchange of information among health care professionals.

According to the article, the site now only has 1,500 registered users and only about 10 actively posting to the wiki. What's a wiki?

Modern Healthcare has more.

Thursday, September 13, 2007

Modern Day Rudy: Schmitt Happens

Who isn't inspired by a story like this (Washington Post version) about West Virginia University's starting fullback, Owen Schmitt. The story is one of determination, persistence, hard work, overcoming adversity and living out your dream. A lesson for us all.

My favorite quote from starting back and Heisman hopeful, Steve Slaton:

"He's like ‘Rudy' or something," Slaton said. "Everybody loves him."

And Schmitt's response:

"I don't understand why I get that attention. I mean, we have actual stars on this team."

Courtesy of the Daily Mail via the Washington Post.

Go Mountaineers!

Wednesday, September 12, 2007

Welcome Jane Sarasohn-Kahn: Health Populi

Today I received an email from my colleague, Jane Sarasohn-Kahn, a health economist and management consultant, announcing that she had joined the health care blogging world. Congrats Jane!

Jane will be blogging at Health Populi. Over the past year or so I have been reading Jane's thought provoking columns for iHealthBeat and have checked out her THINK-Health site. An example is today's post looking into the priorities (and shifting costs) of Americans on spending for health insurance and technology.

Here is her introductory post and why you should read her blog:
In this blog, I will share my multi-faceted perspectives on health care. In the new wave of transparency in American health care, I seek to shed light. I want to help move along the dialogue that Americans – not just politicians and pundits, but the bulk of Americans living and working outside of legislatures -- must have regarding how to honestly, openly and boldly confront the challenges facing U.S. health care.

Changing our behavior in this new world will involve re-engaging with the U.S. health system and our innermost motivations by

• understanding what health care costs,
• taking better care of ourselves,
• getting smarter about health and health care, and,
• voting in elections.

Along with education, no single domestic issue will affect every American more directly than health care will in the next years and decades to come. Now, read on. Get smart. Go health-shopping. Demand value from those who supply you with health goods and services. Vote. The health system is yours. Act like it.
I can't agree more Jane. Don't miss subscribing to the Health Populi RSS feed.

Monday, September 10, 2007

Butterfly in West Virginia

A butterfly we noticed just outside our front door this weekend. The kids loved watching them. Saw a couple of Monarchs and then this one. What is it? No I didn't photoshop to match the colors of the butterfly with the flowers. Rick Lee eat your heart out. By the way Rick, love your recent Chicago series, especially the Cloud Gate photos.

Sunday, September 09, 2007

The Economist and Health 2.0

The Economist takes a glimpse at Health 2.0.

Thanks to Scott Shreeve, MD for pointing out the article. Scott has great insight on what changes might be happening to health care as this new technology and social networking begins to invade traditional models of health care delivery. Scott is working on a white paper styled after Tim O'Reilly titled, What is Health 2.0? Enabling Technologies and Reform Initiatives for Next Generation Healthcare.

I'm looking forward to talking with Scott, Matthew, Indu and others who will be attending the Health 2.0 conference later this month. Congrats to Matthew and Indu Subyaiya, MD, co-organizers of the event, for their effort in putting together a fantastic agenda and selling the event out.

For a little more insight into the ideas behind the conference check out Indu's post from May 2007, Health 2.0: The Conference, the debate. Indu's vision for the conference:
If you don't come for Google, Esther Dyson, Revolution Health, Intuit, Sermo...come because this will be the most straight-up conversation on health care and technology you've participated in. No vested interests, no long-winded podium anesthetics, no oversized Vegas-style booths. Rather a close examination of organic and disruptive trends outside the top-down control of organizations, a reflective look at how each of us as interacts with various aspects of our health care and the demands we are going to increasingly place on the system to become more transparent, interactive and humane.
Note: If you are planning on attending the conference you may want to join the Facebook Group around the conference that hopefully others will use to generate discussion around the event. Also, if you plan to attend I would like to get together post a comment or send me an email. I will be arriving in the afternoon on the 19th.