Harvard’s Blumenthal gets HHS HIT post

David Blumenthal
David Blumenthal

What did I tell you?

 Dr. Blumenthal has already been working with the White House and you can see his hand in Obama’s health plan. 

The Department of Health and Human Services today announced the selection of David Blumenthal, M.D., M.P.P. as the Obama Administration’s choice for National Coordinator for Health Information Technology.  As the National Coordinator, Dr. Blumenthal will lead the implementation of a nationwide interoperable, privacy-protected health information technology infrastructure as called for in the American Recovery and Reinvestment Act. 

“I am humbled and honored to have the opportunity to serve President Obama and the American people in the effort to harness the power of health information technology to modernize our health care system,” said Dr. Blumenthal. “As a primary care physician who has used an electronic record to care for patients every day for 10 years, I understand the enormous potential of this technology. President Obama has laid out a vision of health reform that is both inspiring and long overdue. We cannot make that vision a reality without the help of our most advanced computer technology.”  

Dr. B has been researching HIT lately, but  I got to to know his work through his research on industry/academic relationships. Much of that research is being carried on now by Eric Campbell at Harvard IHP.  They have contributed much quantitative work on the subject.

For an anecdote, they could just wander over to Fruit Street, where more details are emerging about Harvard child psychiatrist Dr. Joseph Biederman and his relationships with drug makers. Liz Kowalczyk  of the Globe reports:

The expanded inquiry is based in part on slide presentations that summarize projects at the Johnson & Johnson Center for Pediatric Psychopathology Research, a center at Massachusetts General Hospital that was funded by Johnson & Johnson and headed by Biederman from 2002 to 2005.

Under the heading “Key Projects for 2005,” one slide promises to provide a J&J subsidiary, Janssen, “with critical competitive data on safety and efficacy of risperidone (an antipsychotic) in children” under age 10, while another talks about expanding use of the drug Concerta for teenagers with attention-deficit hyperactivity disorder.

Another slide indicates that a benefit of the center is to help J&J develop new uses for its drugs.

In a seven-page letter sent yesterday to Harvard University president Drew Gilpin Faust and Mass. General president Dr. Peter Slavin, Grassley, a Republican, said he is concerned about the implications of the slides and asks why they “suggest an expectation of positive outcomes” prior to the clinical trials.

Oops. Click here for Harvard IHT on COI.

Click here for more Harvard IHT on HIT.

(I tell my writing students not to use too many acronyms. I couldn’t  resist.)

For more on Partners and HIT check out an excerpt of my interview with John Glaser, HIT point man at Partners.

 For some of my work  on conflicts of interest for some industry sponsored docs, take your pick :

January 7, 2006, The Washington Post:” Divided Loyalties? Nonprofit Health Advocacy Groups Like to Portray Themselves as Patients’ Allies. Can They Serve Corporate Benefactors at the Same Time?” Lead story, “Health” section.

November 2003, Nature Medicine: The color of money: As the line between academia and industry blurs, conflict-of-interest issues have gone from black and white to all shades in between.

Science for Sale : A Harvard researcher could profit from a product he “independently” reviewed for the National Institutes of Health. The scientific community, dependent on corporate money, has no clear way to handle such conflicts. The Boston Phoenix, April 29, 1999.

The doctor and his implants: Can doctors with financial ties to medical products put a patient’s best interests ahead of their own? Or do potential payoffs cloud their medical judgment? The News & Observer, March 31,1994

Hanging with the Health Wonks

masthead-hwrToday I defer to the New England links on The Health Wonk Review, a biweekly collection of the best in health policy blogs. Every two weeks, a different blogger hosts this blawg digest — I mean, blog… no,  I mean the current host, Health Blawg. Newton lawyer David Harlow hosts this health policy and law site and he’s on wonk review duty.  

 He links to the Health Beat Blog, which offers comments and links to the written version of Congressional testimony delivered last week by Harvard doc and New Yorker writer Atul A. Gawande.

 As a clinician, public health researcher, and medical-watcher, this is what I see: our health system is failing-on cost, coverage, safety, and value-because the complexity of health care itself has exceeded our abilities as individual clinicians.

 He also links to his own piece on medical tourism, my piece on HIT and a Mass Hospital Association bit on unions. Other items cover primary care in Mass. and a piece from Health Care Renewal on how Harvard pays its docs. Finds links to all of the above here.

Did Shepard Fairey design the new Caritas ad campaign?

The Caritas hospital group launched a new ad campaign today with the slogan “Quality to the People.” The logo looks like a Soviet-era propaganda poster or something from the artist behind the ubiquitous blue and red Obama poster– a clenched power fist holding a stethoscope.

In a direct shot at Boston teaching hospitals, the ad suggests that medical research gets in the way of good care. 

“Quality should not be compromised with the distractions of basic research demands.” 

Vermont health summit and BIDMC Levy as hero

Two Items of note.

 Globe columnist Kevin Cullen’s piece on BIDMC CEO Paul Levy generates half of the letters page in the Globe today. The rest of the page was filled with outrage over the AIG bonuses.

 In the column, Cullen describes Levy asking hospitals nurses and techs to accept salary and benefits cuts.

He looked out into a sea of people and recognized faces: technicians, secretaries, administrators, therapists, nurses, the people who are the heart and soul of any hospital. People who knew that Beth Israel had hired about a quarter of its 8,000 staff over the last six years and that the chances that they could all keep their jobs and benefits in an economy in freefall ranged between slim and none.

“I want to run an idea by you that I think is important, and I’d like to get your reaction to it,” Levy began. “I’d like to do what we can to protect the lower-wage earners – the transporters, the housekeepers, the food service people. A lot of these people work really hard, and I don’t want to put an additional burden on them.

“Now, if we protect these workers, it means the rest of us will have to make a bigger sacrifice,” he continued. “It means that others will have to give up more of their salary or benefits.”

He had barely gotten the words out of his mouth when Sherman Auditorium erupted in applause. Thunderous, heartfelt, sustained applause.

Also, both WBUR and the Globe had lengthy stories on the White House regional health forum in Vermont yesterday.  More on that coming up.


The business of Partners v. Partners as a group of non-profit teaching hospitals

Consider Monday’s Globe op-ed from Dr. James J. Mongan, CEO of Partners HealthCare, on how to cut costs.

…(W) e are not the only state experiencing healthcare cost increases; this is a national issue, and there are no villains or easy answers to the problem.


A recent Boston Globe series on pricing and Partners: ” A handshake that made healthcare history

Partners HealthCare was born in 1993, but its powerhouse potential didn’t fully hit home until 2000. That’s when the emerging giant cut a quiet deal with Blue Cross to ratchet up insurance costs across the state. Nothing in Massachusetts healthcare has been the same since.

In trying to figure whether there is contradiction or synergy between these two items, I came across NH-based Kevinmd.com. Kevin Pho, a Nashua blogging doc has his own ideas about the Partners and heatlh care costs.  

I don’t blame Partners for maximizing their revenue. They know that no other city in the country can boast two nationally ranked academic institutions, and take advantage of that fact to bully the insurance companies. It’s smart business.

Those that are unhappy with the situation – insurance companies, competing hospitals, and health policy wonks looking to control health care costs – need to rein in patient demand for their services. Educate the public that community hospitals can provide care equal to, or better than, MGH and the Brigham in routine cases.

Taxing health benefits?

The NY Times has a story about the Obama team considering some kind of tax on health benefits.

 The Obama administration is signaling to Congress that the president could support taxing some employee health benefits, as several influential lawmakers and many economists favor, to help pay for overhauling the health care system.

The proposal is politically problematic for President Obama, however, since it is similar to one he denounced in the presidential campaign as “the largest middle-class tax increase in history.” Most Americans with insurance get it from their employers, and taxing workers for the benefit is opposed by union leaders and some businesses.

 The reliable, D.C.-based Alliance for Health Reform tells you all about taxes and health insurance in this primer:

The United States tax system subsidizes the purchase of employer-sponsored health insurance for more than 160 million non-elderly people at a “cost” of approximately $200 billion a year. This tax subsidy is a major reason why most Americans have health insurance coverage through either their own employer or that of a family member. In recent months, the tax treatment of health insurance has gained a lot of attention – both during the presidential campaign and in health reform debates in Congress.

What is the current tax treatment of employer-sponsored health insurance? How does the tax treatment of health insurance impact employers? How does it impact employees? Do some workers benefit more than others from the current tax subsidies? Does altering the tax treatment of health insurance have the potential to expand or diminish coverage? Will cost containment efforts lead policy makers to consider altering the tax treatment of health insurance?

In addition to David Blumenthal of the MGH/Partners Institute for Health Policy, the group  takes note of the following local experts:

Two from Harvard

David Cutler

Professor Cutler served on the Council of Economic Advisers and the National Economic Council during the Clinton Administration and has advised the Presidential campaigns of Bill Bradley, John Kerry, and Barack Obama. Among other affiliations, Professor Cutler has held positions with the National Institutes of Health and the National Academy of Sciences. Currently, Professor Cutler is a Research Associate at the National Bureau of Economic Research and a member of the Institute of Medicine. NYTimes story featuring DC

Katherine Baicker, PhD

Professor of Health Economics in the Department of Health Policy and Management at the Harvard School of Public Health.  She is a research associate at the National Bureau of Economic Research. 


Jonathan Gruber, Massachusetts Institute of Technology.

Dr. Gruber’s research focuses on the areas of public finance and health economics.



Action for single payer advocates and money for young scientists

Money for scientists:    The Mass Life Sciences Center is giving away money — and not just to expanding biotech companies. The program is also trying to fill in some of the gaps left by flat NIH funding. So, young scientists should check out their latest “new investigator” offering – applications due April 17. The board approved a second round of funding for this program in late February.  

 The 2009 New Investigator Solicitation seeks to spur innovative new research and advance the careers of new investigators who are working on cutting-edge life sciences research at Massachusetts research institutions. A successful applicant will receive a grant of $100,000 per year for up to two years.

Single Payer update:  This came across my desk from single payer advocates at MassCare yesterday afternoon:

Next Tuesday in Burlington Vermont, Massachusetts Governor Deval Patrick and Vermont Governor Jim Douglas will convene a New England Health Summit as part of President Obama’s national push for health reform.

While Governor Douglas has now invited single payer advocacy groups from Vermont – including Physicians for a National Health Program and the Vermont Citizens Campaign for Health – Governor Patrick has not included any single payer groups on his invitation list from Massachusetts.

Please call and/or email the Governor’s office and ask them to include Mass-Care, Massachusetts Physicians for a National Health Program, and the Massachusetts Nurses Association in this important dialogue about the future of our health care system…

At the recent White House summit on health reform, no single payer advocate was invited until thousands of messages reached the White House, including word that doctors were going to protest on the sidewalk. At the last minute, two single payer supporters were invited…

 Two hours later, this arrived:

 At 5:30PM, we received an invitation from Governor Patrick’s Office of Government Affairs.