The Health Care Blog

TECHNOLOGY: Dan Weintraub on the HIT world

If you want a slightly more thoughtful commentary than I provided live blogging the HIT conference, whip over to this column by Dan Weintraub on Technology and Health. Although he doesn't come out and say it directly, Dan notes that...

QUALITY: Millenson on Pay For Perfomance

Michael Millenson week continues here at THCB! Despite giving my team at IFTF almost no credit for inventing the phrase (oh, I can be as petty as any academic!) Michael has written a pretty good article called Pay for Performance:...

HEALTH PLANS: United swallows Definity

Possibly also to be headlined, Dotcom survives and makes good! For a mere $300m UnitedHealth Group has bought CDHP player Definity Health which gives United a platform into the self-directed consumer plan world. Hard to tell exactly how much cash...

QUALITY: Five years on from To Err Is Human

Nov 29, 1999 saw the release of possibly the most famous report in health care since the Flexner report excoriated the medical school system in the early 1900s. The report was called To Err is Human and it was created...

HAPPY THANKSGIVING

THCB will return on Monday 29th.

TECHNOLOGY: The UK's EMR project is not apples to apples, with UPDATE

As we go into this most uniquely American holiday, here's a story or two about the place the pilgrims were thankful to get away from. Of course my British friends tell me that Thanksgiving is really on July 4th for...

BLOGS: Grand rounds

This week's Grand Rounds are up at Shrinkette's place.

PHARMA/POLICY/QUALITY: A deluge, sorry

I said a while back that I wouldn't do just tell you to go read other stuff, but there's a deluge that you just must pay attention to--all out in the last 24 hours. 1) Kaiser Family Foundation is out...

PHARMA: The Industry Veteran on drug patents and who pays for research

Last week the NY Times had an NY article about drug pricing that suggested a new approach for keeping innovation while controlling prices. In particular it suggested changes to the way the patent system works, and how the Federal government...

POLICY: A Blue state Republican talks about expanding healthcare access

One of the great ironies of American political life is that three of the biggest Blue states have Republican Governors. One of those governors (and of course it's not Arnie or Pati-Pati-Aki) has developed a plan for universal health care,...

TECHNOLOGY: Molly Coye's call for action

Molly Coye Molly is the CEO of HealthTech a research organization that looks at this introduction of new medical technologies, mostly from a provider point of view. She was asked how IT is changing health care in California. The answer...

Sam Karp, CIO California Health

Sam Karp, CIO California Health Care Foundation

TECHNOLGY/QUALITY: Carolyn Clancy says DSM works; Sam Ho agrees; Arnie Milstein says that we'll cut costs just in time

No cats for Friday blogging, but people blogging instead, as I went to the ballpark witha camera today. Here are some of the people I've been watching and chatting with. Carolyn Clancy, Head of AHQR Shorter Clancy: AHQR is bought...

Suneel Rattan, Health Hero Network

Suneel Rattan, Health Hero Network

Laura Jantos, EMR implementation whiz

Laura Jantos, EMR implementation whiz from ECG and cool snowboarder

QUALITY: More from HIT conference (Friday)

Today we're going to tour the ballpark and have a go in the batting cage. But first... Shorter Bob Pearl, CEO Permanente Medical Group: Our docs are convinced we care about outcomes. Other people's docs (other IPA and med groups)...

POLICY: What will turn the tide? by Atlas

Correspondent Atlas (who you may recall is the token right-winger on THCB) writes regarding my question as to what will turn the tide regarding reform:The pondering of what might start a proletarian revolution in health care sounds jarringly reminiscent of...

PHARMA: Is Crestor the next Vioxx?

Five drugs are in risk of being the next Vioxx, the Senate panel looking at Vioxx was told this morning. The remark was made by the US FDA reviewer who is not allowed on the Bextra review panel as he's...

TECHNOLOGY/QUALITY: A quickie on the DSM companies panel

This'll be the last one today but it's been an interesting conference. Some quick ones from the panel of DSM companies. Carter Coberley from American Healthways likes neural nets to predict cost and therefore go for intervention early. Frank Martin...

QUALITY/TECHNOLOGY: Pay for performance in California

Next session is on P4P in California, where 6 health plans are busy running a P4P program via the Integrated Healthcare Association. (Presentations are linked) At the moment (Lance Lang, HealthNet) it's only 0.5% of the dollars for those participating...

TECHNOLOGY/QUALITY: DSM and IT at the HIT meeting

Shorter Sam Nussbaum (CMO Anthem) "DSM does work, really. But the baseline changes (sick people are not homogenous or constant--they also get better (or die). It's worth about 14% on a PMPM basis across populations, but has an ROI of...

TECHNOLOGY: More HIT notes -- barriers to EHR acquisition session

Brad Holmes from Forrester breaks up docs by age (under 44 makes them much more accepting of technology). Breaks up demand for software based on what docs want. Want ePresribing and charting, get Medicalogic (GE). Want diagnosis, use Next Gen....

TECHNOLOGY: More on HIT

In the response and Q&A to Brailer, we're told that adoption can happen in small offices and by PCPs. But CMS in California has been handing out some incentives for smaller groups (something called the Docket program) and only 256...

TECHNOLOGY: Live blogging from HIT conference

I'm at SBC Park in the bar (really!), the Wi-Fi is free and my lap top is propped on one of those big barrels of Coke cans and somewhere in the distance David Brailer is telling us that the US...

POLICY: Bush Plans Tax Code Overhaul, with UPDATE

Look at this trial balloon--Bush Plans Tax Code Overhaul. Getting rid of tax deductibility of health insureance as a business expense!! Are they serious? If so that really would put the cat amongst the pigeons! UPDATE: Ross works out the...

TECHNOLOGY: HIT meeting today

Thursday (Pacific time) I'll be at the HIT meeting in San Francisco, held at PacBell SBC Park so that we don't have to cross a picket line at the downtown hotels. I'm informed Barry Bonds won't be there but current...

POLICY: Jonathan Cohn on the politics of real reform

Jonathan Cohn, who besides being a deliriously happy Red Sox fan is a health care journalist and a senior editor at the moderately liberal New Republic, has been corresponding with me a while. (Does it bug anyone else having to...

QUALITY: Holding the line on 5 year anniversaries!

Like a bunch of kids sneaking downstairs to open their Christmas presents before the day comes, journalists and pundits across health care are "celebrating" the 5 year anniversary of To Err is Human, weeks before the actual day. Don't worry....

BLOGGING: BloggerCon session on Medblogging is up

In yet more shamelss self-promotion, a session that I participated in at BloggerCon III is up online. You can download a 33 Mb MP3 here or you can go here to find this stream in Windows Media Player or Real...

POLICY/POLITICS: What might turn the tide?

I just got back from a rather frustrating talk by veteran liberal investigative journalists Barlett and Steele, on their new book Critical Condition. These geezers have just discovered that the health care system is in a bit of a mess,...

PHARMA: Viagra wild thing ad no-noed

The Viagra "wild thing" ad was adjudged by the FDA to be too hot for prime time (or something) and has now been pulled. Over at Pharma-Mkting list serv John Mack notes: The FDA pulled the ads because they crossed...

BLOGS: Grand Rounds

The medical bloggers Grand Rounds is up at DB's MedRants.

QUALITY: Which parts of DSM do make sense, by Gordon Norman

My piece yesterday on the apparent inability of DSM to prove its value got some very pointed feedback. Gordon Norman, the V.P of Disease Management at PacifiCare, wrote this response. He suggests that there are real world answers to the...

PHARMA: 60 Minutes piles in more on Vioxx

60 Minutes had a second (or third) to market piece on Vioxx on Sunday night. It's about time CBS had a fish in a barrel to shoot, given their complete horlicks they made of the "Bush desertion to rehab in...

QUALITY: DSM-- Convincing anyone? Maybe. Improving health? Probably. Saving money? Probably not. (with clarifying UPDATE)

The Wall Street Journal (from which this is stolen in its entirety as most of you can't get to it) basically advocates Pfizer's claim that their DSM process in Florida works and saves money; $41.9 Million to be exact: Pfizer...

POLICY/HEALTH PLANS/HOSPITALS/PHARMA: Wall Street roundtable on the industry

(Note: somehow this was written and not published 10 weeks ago in early September...showing both that I'm fallible and that not that much has changed in 10 weeks, apart from a little minor politicking. Given that Friday is the lighest...

QUALITY/POLICY: Paying people to stay thin? by Anonymous

Earlier this week THCB discussed the obesity problem in relation to personal health ecologies. It as pretty sobering stuff, but one anonymous correspondent has an out-of-left field suggestion:Your mention of pay-for-performance in relation to obesity management just gave me an...

PHARMA: Vioxx not an anomally, by John Abramson MD

Will Celebrex and the other Cox-2s follow the Vioxx path? Indications from Canada based on 14 reported deaths suggest that they might. Meanwhile Pfizer is initiating an ambitious and potentially risky clinical trial to try to prove that Celebrex is...

QUALITY: NEJM sneaks in early about "To Err is Human" plus 5

The NEJM has an article about the IOM patient safety report five years on. It's by by a pretty elite group; Drew Altman of Kaiser Family Foundation, Carolyn Clancy, head of AHQR, and Bob Blendon at Harvard. Basically they are...

QUALITY: Personal health ecologies as the future of DSM.

I spent a day last week at IFTF's meeting on Personal Health Ecologies. These are my notes, so use these as provocation material rather than a finished argument. But something important is slowly going on here, and health care wonks...

POLITICS: A reply to my wanted ad

Dear Sir Please consider me for the position outlined in your ad of 11/4/04. I believe I am eminently qualified for the position outlined in the job description. I have over 30 years experience the elimination of human rights, promote...

HEALTH PLANS: Looks like Anthem/Wellpoint has ground Garamendi down, with UPDATE

In the new political climate post election, it looks like John Garamendi (California Insurance Commisioner) has taken the latest bribe Wellpoint has put on the table and given his go ahead to its merger with Anthem. There'll be a press...

PHARMA/QUALITY: More in chemo sensitivity testing, by Larry Weisenthal

As I mentioned the other day, I have another article on oncology in the queue which got pressed for space as the election heated up. Larry Weisenthal, MD, is a board certified medical oncologist with a 25 year history of...

POLICY: The real costs of uninsurance, by Anonymous, with quick UPDATE

Every so often it's worth remembering the human and economic costs behind our uninsurance statistics. The following TCHB contributor was employed and insured until about a year ago, but like many with her health condition cannot afford insurance now she's...

PHARMA/PHYSICIANS: Changing the Identity of Medical Oncology Under Medicare, by Gregory D. Pawelski

Here's the first in a series of articles I have in the queue about the oncology market. The first is from Greg Pawelski:Under the new Medicare Prescription Bill (MMA) medical oncologists will be reimbursed for providing evaluation and management services,...

POLITICS: Election winners and losers

I wrote most of this yesterday, but Blogger was giving a lot of trouble, hence I only got to publish my cynical "help wanted" ad. But given that we have Bush in for four more years and at least two...

BLOGS: Blogger bloggered & quick Wanted ad

Yet again Blogger seems to be down. I'll leave you cynics with this thought and be back with my conclusions on the impact of the elction tomorrow. Wanted: 58 million people to support the elimination of human rights, promote torture,...

POLITICS: Wake me up in 4 years

I'm reminded of the scene in Citizen Kane, when Kane loses the election at the last minute and his editors pick between the two headlines. One reads "Victory" and the other says "Fraud at Polls!". The lefty blogs got very...

PHARMA: Merck knew more than it let on about Vioxx

A group of emails from within Merck show that the scientists were questioning the data and the marketing people were telling the sales reps to obfuscate. This is really ugly stuff. Taken on its own the views from the scientists...

POLITICS: After today, it may be over

The rumors I hear are that no-one will concede tonight and that the whole thing will go to appeal in Ohio, Florida and who knows where else. Four years ago a done-nothing Governor, who's only promise was to govern from...