Tweets from Boston meeting on health, the Internet and mobile communication

Check out #chs11 f for tweet from the Connected Health Symposium in Boston. Each year, Partners sponsors this meeting to look at how the Internet and mobile communication are changing the health care system.  Here’s a link to the Tweetstream and a few samples below from a session on social networking and health.

RT @MGHDiabetesEd: “online patient communities can increase engagement, decrease isolation.” #chs11
jillplev
October 20, 2011
@taracousphd at #SoMe panel at #chs11: 35% of young people search for #healthcare informaton online
sonnyvu
October 20, 2011
Giving patients the choice to use an alias-based identity on social networks is a key way to address privacy concerns #chs11
dsgold
October 20, 2011
@dsgold How so? Alias identity does not equal unidentifiable, does it? I’d be concerned this is a false sense of security. #chs11
Dermdoc
October 20, 2011
Facebooking health @taracousphd facebook campaigns have huge opportunity for reaching teens, can use it for health literacy #chs11
connectedhealth
October 20, 2011
@lisagualtieri : There are credit #literacy programs for teenagers, why not more health literacy ones? #chs11
sonnyvu
October 20, 2011
We need to be inter-generational in our social media “prescription” including seniors as well as youth #chs11
pamressler
October 20, 2011
Social media can help make a disease more than just a disease for teens @drjosephkim #chs11
connectedhealth
October 20, 2011
@drdannysands telling about how he prescribed acor to @epatientdave & it save his life #chs11 #s4pm
pjmachado
October 20, 2011
Next up, Facebooking Health moderated by my wonderful #TUSM colleague @lisagualtieri #chs11
pamressler
October 20, 2011
@meyouhealth Chris Catter shows first ever social graph to visually render well-being among participants in social networks #chs11
dsgold
October 20, 2011
CDC traditional data tracked same as social media during H1N1 #chs11
pamressler
October 20, 2011
should MDs, nurses, etc recommend online pt communities? -yes! #chs11
ICherryBlsm
October 20, 2011

Get healthier with web games

Beyond exergaming.

The Institute of Medicine anbd HHS will host a public forum today: The Community Health Data Forum: Harnessing the Power of Information to Improve Health in Washington, DC. The morning session will debut a number of recently developed applications that use community health data before an audience of highly influential policymakers and all attendees.

Watch it online.

This Boston-based project will be there: Community Clash is“a Web-based game that allows players to compare their community’s health to other cities.”  

The Institute of Medicine and HHS will host a public forum, The Community Health Data Forum: Harnessing the Power of Information to Improve Health, in Washington, DC. The morning session will debut a number of recently developed applications that use community health data before an audience of highly influential policymakers and all attendees.

The afternoon session includes a series of working groups that will begin at 12:15 p.m. and adjourn at 2:00 p.m. During this session, smaller groups will discuss additional ideas and the needs of various stakeholders with respect to the Community Health Data Initiative and how to translate these opportunities into functioning applications by the end of 2010.

Boston conference on technology and global health.

The World Health Medical Technology Conference, was a “workshop dedicated to exploring the opportunities and challenges of designing, building and funding medical technologies for the developing world.”

In other words, trying to find inexpensive tests and treatments that are simple to use and don’t require a lot of infrastructure, like labs and clean water.  

BHN sat in on the morning sessions at BU, which features presentations from local groups, including Cambridge’s “Diagnostics for All.”  Una Ryan, the group’s CEO, said: “We have all this advanced and innovative technology and we don’t know how to get it to the people who need it the most.”

So, the non-profit has created a tiny, paper diagnostic tool that works like a home pregnancy test.  Imagine a miniature game of Twister. Instead of a foot, health care worker can put a drop of blood on one of the dots. The dot then changes color based on, say, how well the patient’s liver is functioning.

 Since hepatitis and drugs for HIV and TB can cause liver damage, this simple, inexpensive test will allow docs to monitor patients even if in remote villages with no roads and a couple of generators for electricity.  The costs – ten cents. The group plans to use the technology to give rural health workers tools to test for and monitor TB, malaria, HIV/AIDS, and diabetes.

The session also featured a presentation on a Seattle group called PATH, which describes itself as an international nonprofit organization that creates sustainable, culturally relevant solutions, enabling communities worldwide to break longstanding cycles of poor health.” Among other projects, PATH is   working with a Cambridge start up called Daktari on an inexpensive hand-held device that can perform key blood tests on patients with HIV/AID.

Daktari was founded in 2008 by Bill Rodriguez, who has worked at both Harvard and at the Clinton Foundation, and Mehmet Toner, a Harvard/MIT engineer.

Innovation was the theme, as the morning speakers said many existing devices simply can’t be adapted to work in communities without water, doctors, or electricity.

“The technologies we use to diagnose diseases are way too complex,” Rodriguez said. “They were never designed to work in these settings.”

So for details, check out the Mass Device blog.

 

Support solid, local reporting on medical devices

A plug today.  

Mass Device  — officially called the The Massachusetts Medical Devices Journal —  is a web site that reports on the business of medical device industry.  Like pharma, the medical device industry develops products that create jobs and cure people. 

Both also make TONS of money off the way the health care system works now.  

 So, it is key to know how the industry operates and where it is heading. This is daily business reporting — you’re not likely to see investigative stories unearthing misdeeds. (Correct me if I’m wrong B or B.) But we need industry focused reporting on who is winning and who is losing and how these folks do business.

 Pharma gets a lot of coverage. But you usually have to get fairly deep into the business section for news on devices. Mass Device does it for you with blogs, Q&As, staff written stories and conferences.

 Here’s how they describe themselves.  The Massachusetts Medical Devices Journal is the online journal of the medical devices industry in the Commonwealth and New England, providing day-to-day coverage of the devices that save lives, the people behind them, and the burgeoning trends and developments within the industry.

 But the fact that everyone gets their news for free doesn’t change another fact – it costs money to produce the news. And all of us are looking for new ways to do that. So, consider buying a premium services at Mass Device. You get something for your money.  For $60 a year and up, you’ll get access to conference calls and business intelligence reports and more.  

 Disclosure. I wrote for Mass Device for a bit last year.  You can still find my week in review blog posts on their site.

  For a taste of what these folks do besides the blog, see the site for the upcoming conference on medical devices and the developing world.

Innovative medical technologies are changing the face of patient care in the developing world.  New low cost point-of-care diagnostics, patient monitoring systems, neo-natal and emergency care, and hand-held imaging probes are just a few of the products that are saving lives and improving care in emerging markets around the world.

Hear from leading providers of global health care, innovative medical technologies, and global investment funds who will direct panels on:

  • How innovative medical technologies are changing the quality of care in global health settings
  • How innovative distribution channels are opening new global markets for medical technologies
  • How global medical technology companies are attracting traditional venture capital investments
  • How cooperative partnerships are changing the medical technology global landscape
  • How to conduct successful clinical research and new product trials in global health settings
  • How to achieve design innovation for advancing patient care

 Coming up soon and not to be buried,  another plug, this one for a book on disease detectives by Vermont-based writer Mark Pedergrast. We’re not talking about a novel, Inside the Outbreaks is a true story about the teams that investigate fast spreading diseases like H1N1 for the CDC. It’s getting great reviews and BHN will add one when we finish.

Privacy, profiteering and other perils of computerized health records

BHN finally caught up on the ongoing series on health information technology, or HIT, running on The Huffington Post. Some of this ground has been covered elsewhere – privacy, issues with patient access and conflict of interest for former senator and quasi-lobbyist Tom Daschle.

Still, take note of the recent report on the digital divide. And when the Huff Po team started following the money, they produced a solid piece on the feeding frenzy for federal stimulus money.

The competition among companies has spawned a wealth of sales gimmicks. One firm offers a “cash-for-clunkers”-inspired deal that gives doctors $3,000 in rebates if they junk their current system for a new model.  Another has announced interest-free loans to doctors that won’t come due until their stimulus checks arrive. Even Wal-Mart has begun selling a “turnkey” digital health records system through Sam’s Club.

A super group of major tech firms has banded together and hit the road with what they call a “stimulus tour” to boost sales. So far, the tour, which includes officials from Microsoft, Dell and Allscripts-Misys Healthcare Solutions, has played in more than 30 cities. It stops at local convention centers and hotels, where it holds seminars for doctors. Those who attend receive a “customized stimulus analysis of how much money your practice could earn in federal incentives.”

The marketing blitz comes amid a simmering debate over how closely government should keep watch over the young, but fast-galloping industry. Officials expect electronic health records to transform the practice of medicine by greatly improving the quality of care and sharply cutting costs

Yet federal officials don’t require the same degree of testing, safety inspections or marketing oversight for electronic records systems as for many types of medical devices. While tech firms believe strict regulation of the industry would stifle innovation, critics want to clamp down.

Critics got their wish in the form of that defender of government oversight, Republican Chuck Grassley.

Sen. Charles E. Grassley (R-Iowa), ranking member of the Senate Finance Committee, has asked 31 hospitals and health systems across the country in a  Jan. 19 letter to advise him of any problems with their computer systems and any “issues or concerns that have been raised by your health care providers” over the past two years.

“Hospitals are on the front lines and their perspective will be very valuable in this effort, so I look forward to hearing what they have to say about expanded use of health care information technology,” Grassley said Wednesday in a statement.

Mass General and the Brigham got the letter, according to the story.  Oddly, Tufts also got the letter but Beth Israel – which has a very active HIT program – did not.

Keep an eye on the site for more. It seems some of the key players didn’t want to talk to the Huff Po team. BHN would like to see a few more comments from the Office of the National Coordinator, the federal agency running the operation.

Also, since this work is a product of the Huff Po Investigative FUND, we’re hoping that means that –unlike many other contributors to the liberal-leaning web site — these folks got paid for their work.

Finally, for more on how this is playing out here in Massachusetts,  check out this radio piece on wiring health care in Newburyport, Mass. by BHN senior writer Tinker Ready.

UCSF v. Beth Israel on FDA on heart device safety

Docs from BI, working with the Food and Drug Administration, released a study this week suggesting that medical device makers are providing weak evidence to support the efficacy and safety of products, in particular cardiovascular devices like stents and implanted defibrillators.

The study was release earlier to counter a similar study in the Journal of the American Medical Association that faulted the agency for approving devices based on limited and potentially biased data.

Just prior to the release of the new study, FDA officials announced that they would strengthen the device review process.

The New York Times reported that the BIDMC “study found that more than 40 percent of the studies used to approve cardiovascular devices had lacked high-quality data about either the treatment or safety goals of the study.”Researchers also concluded that 25 percent of trials had failed to adequately follow patients enrolled in studies.”

Dr. William H. Maisel, a cardiologist at the Beth Israel Deaconess Medical Center who was involved in the study, said the review did not find a correlation between lower-quality data and problems related to the devices. However, he said he thought the potential for such links existed.

But, the JAMA study out of the University of California faulted the FDA review process and “concluded that the F.D.A. had approved cardiovascular devices based on data that ‘lacked adequate strength.’”

Their conclusion Premarket approval of cardiovascular devices by the FDA is often based on studies that lack adequate strength and may be prone to bias.

According to AP: The new studies, published in separate medical journals, cap a year of scrutiny and criticism for the FDA’s medical devices division. In August, the head of that division resigned, months after scientists under his leadership alleged they were pressured to approve certain products. The year began with congressional investigators saying the FDA should take immediate steps to make sure the riskiest devices are approved through the most stringent process.

Docs from BI, working with the Food and Drug Administration, released a study this week suggesting that medical device makers are providing weak evidence to support the efficacy and safety of products, in particular cardiovascular devices like stents and implanted defibrillators.

The study was release earlier to counter a similar study in the Journal of the American Medical Association that faulted the agency for approving devices based on limited and potentially biased data.

Just prior to the release of the new study, FDA officials announced that they would strengthen the device review process.

The New York Times reported that the BIDMC “study found that more than 40 percent of the studies used to approve cardiovascular devices had lacked high-quality data about either the treatment or safety goals of the study.”Researchers also concluded that 25 percent of trials had failed to adequately follow patients enrolled in studies.”

Dr. William H. Maisel, a cardiologist at the Beth Israel Deaconess Medical Center who was involved in the study, said the review did not find a correlation between lower-quality data and problems related to the devices. However, he said he thought the potential for such links existed.

But, the JAMA study out of the University of California faulted the FDA review process and “concluded that the F.D.A. had approved cardiovascular devices based on data that ‘lacked adequate strength.’”

Their conclusion Premarket approval of cardiovascular devices by the FDA is often based on studies that lack adequate strength and may be prone to bias.

According to AP: The new studies, published in separate medical journals, cap a year of scrutiny and criticism for the FDA’s medical devices division. In August, the head of that division resigned, months after scientists under his leadership alleged they were pressured to approve certain products. The year began with congressional investigators saying the FDA should take immediate steps to make sure the riskiest devices are approved through the most stringent process.

Academics, industry, health reform and medical devices

The NYTimes business section has an update on academic/industry partnerships and explains new transparency rules in the Senate reform bill. Massachusetts has had a state law on this but it’s only been in effect for a few months. A group of doctors who oppose the law held a meeting in Boston this summer.

Also, read on and find that for first time I my career, I found a device (or drug) maker list payments to med school docs, In this case Mass General.

From the NYTimes:

 Health Bills Aim a Light on Doctors’ Conflicts 

As part of the health care overhaul under consideration by Congress, lawmakers have included so-called sunshine provisions intended to shed light on the financial relationships between the medical industry and doctors.

The targets are common business practices like drug company payments to doctors for speeches and consulting services, which have the potential to influence patient care and drive up the nation’s medical bills.

For more about industry sponsorship of academic research, see the article in the latest issue of Health Affairs. where a group of Boston area researchers found that “52.8 percent have some form of relationship with industry.”

There are many potential impacts of these data. First, given that industry relationships are frequent and diverse, close scrutiny of researchers’ industry relationships is likely to be a major undertaking for institutions—especially among those with large numbers of researchers. Second, relationships are most common among productive, senior faculty members who contribute substantially to their research community. This finding supports the belief that it is difficult, but not impossible, to find academic scientists without industry relationships to serve in advisory roles for organizations such as the Food and Drug Administration, the NIH, or the Institute of Medicine. Third, the widespread nature of these relationships will raise serious concerns regarding the integrity of the academic research enterprise (either rightly or wrongly) on the part of elected officials, university officials, and perhaps the American public.

In a related story, James Ridgeway comments on a Mother Jones story on medical devices on his excellent “Unsilent Generation” blog. Read both. THe MJ story mentions two companies with ties to the state and, in one case, to Mass General doctors.

These companies makes things like artificial joints and heart valves, which are often needed by older people—and paid for by Medicare.

In recent months, these companies have launched a huge lobbying blitz  in response to provisions in the health care reform bills that would levy fees on their high-profit enterprise. The efforts apparently have not been wasted: In the latest versions of the legislation, the level of fees has dropped considerably (though that hasn’t stopped the manufacturers’ whining).

In the Mother Jones story,  DePuy, is based in Raynham, is one of four companies that in 2007 “said they would pay $311 million to settle federal charges that they gave doctors millions of dollars in kickbacks, often in the guise of consulting fees. The government deferred prosecution of the four companies so long as they complied with the settlement terms.

Another company settling was Indiana-based  Zimmer, which has been a player  at Mass General. On the company website , they list more than $9 million in consulting fees paid to eight doctors at Mass General Hospital since 2007 and another $19 million to some of those docs and others for a total of 14 who  listed under MGH Corporation.  More on MGH’s role in licensing right to material to the company that was used for orthopedic implants.

 For news about the medical device industry, see Mass Device, a website devoted to news about local companies and national trends.

More on journalist Gary Schwitzer’s Health News blog.

Meantime, it doesn’t take the NY Times to dig into conflict of interest issues. A student journalist with the Minnesota Daily points out how medical students receive free textbooks from drug companies promoting their products. Case in point: an otolaryngology text given out by a company making an ear infection drug – with the company’s logo on it, and with the beginning of each chapter crediting the drug company.

Caution or stubbornness? Boston docs shun new heart procedure

longwood mapBoston-area docs are known for their reluctance to adopt new procedures. The Washington Post reports that holds true for a new approach to angioplasty. Instead of steering the catheter into the coronary arteries through the groin, some docs go through the wrist.

Questions about the best method of performing cardiac catheterizations, one of the most common procedures in medicine and among the most profitable for hospitals — Medicare reimburses (George Washington University) GWU about $10,600 for an angioplasty involving one stent — reflect some of the issues in the roiling health-care debate. Is the radial approach, which has a steep learning curve, actually superior or largely a fad? Can it cut costs by reducing hospital stays? And if patients are given a choice of catheterization sites, what factors should they consider? …

In Boston, a city brimming with teaching hospitals and interventional cardiologists — heart specialists with advanced training who perform procedures — only a handful of physicians specialize in radial catheterization, said Pinak B. Shah, director of interventional cardiology training at Brigham and Women’s Hospital.

“There’s no data out there to suggest it is worse and growing evidence that it may be better,” said Shah, an assistant professor of medicine at Harvard Medical School, who performs 60 to 70 percent of procedures through the wrist.

Shah said he believes a combination of financial self-interest, the relative paucity of medical devices designed for radial access, resistance by older physicians and the general tendency of doctors to regard patient discomfort as secondary have contributed to under-use of the approach. 

 

Masschusetts to set up statewide electronic health information exchange

June 2009 dump 190

The idea that computers can cut health care costs seems pretty abstract at times. But, if you think of all the money wasted on claims processing, prescribing errors and questionable care, it makes sense. Computers could get at the cost of administration, medical errors and unnecessary testing and treatment. 

Massachusetts is setting up a health information exchange that could serve as a national model, according to the self described geek doctor, John Halamka, Chief Information Officer of Beth Israel Deaconess Medical Center.  He’s also co-chair of the federal health information technology (HIT) Standards Committee. That means he’s deep into the federal effort to wire the health care system or according to the Globe he is “cochair of a committee that will help…determine a sort of Good Housekeeping Seal of Approval for electronic medical records – essentially, what features do they need in order to be government-certified.”

So, when he couldn’t makes it to a recent meeting of like CIOs, he put together a video to fill them in on how to get in on the $1.2 billion in federal funding set aside for HIT.

Look to the Bay State, he said. In the video, he said Massachusetts has a plan to bring local and regional health information programs into a statewide system. Here’s a draft plan for eastern Mass.

“Think of it as leveraging the work of the past by providing a governance layer,” he said in the video.”

This will position the state to qualify for one of the proposed federal  Health Information Exchange Cooperative Agreement grants.

The grants are designed to: reach all health care providers in an effort to improve the quality and efficiency of health care. Cooperative agreement recipients will evolve and advance the necessary governance, policies, technical services, business operations and financing mechanisms for HIE over a four year performance period. This program will build off of existing efforts to advance regional and state level HIE while moving towards nationwide interoperability

On the video, Halamka also talked about “meaningful use,” a key concept for docs and hospitals seeking federal HIT funding. The federal government isn’t interested in buying new Macs for doc to process claims.  Successful applicants will have to offer systems that collect data, handle prescriptions and provide patient portals.   

 “It’s not just about buying software. It’s about really using it to improve quality, coordinate care, empower the patients…offer educational material and access to the record of the patient,”  he said in the video.

For more, see the video, via Healthcare IT news, or the latest missive from Dr. David Blumenthal, head of HIT for the feds.

CORRECTION: This post was updated at 4:30 pm from an earlier version, which listed a different federal HIT program.

Week in review and accessible hospitals

Check out my Week in Review and the rest of Mass Device. This business news site covers a key part of the health care industry —   everything from computers to catheters to scanners. The device industry faces many of the same issues as pharma – safety, financing, high prices and the uncertainty of health reform. 

My review covers Kennedy, Dodd, overtired surgeons and more.

Also, the Globe reports that the Brigham and Mass General “are pledging to spend millions of dollars to resolve complaints that ill-suited equipment and sometimes-indifferent medical workers make disabled patients feel unwelcome.”

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