HealthVault Express

I was planning a post this AM, and my internet is flaky, fortunately I use Live writer from Microsoft. It's a simple task to write off line and then save a draft and/or upload to the blog.

The internet is a complex "spider" of networks and supposed redundancy. This morning I only have access to google, and whatever is on their servers. The rest of the bilions of sites are unavailable.  I guess Google will save the world. I wonder if HealthVault is up.

This brings to mind the fallibility of all things electronic. Imagine you are at your docs office and he want to pull up your PHR which is stored in Healthvault and/or Google Health. What now?

Or how about your front or back office running an EMR on as asp solution?  Nada!!  Although not requiring much hardware investment and offering 24/7 maintenance .asp solutions are not as cheap as you might think.

That's the downside....

The upside is that my internet has never has gone down for more than an hour or so.  But never say never...I live in a fairly metropolitan area of Southern California.

With a client-server configuration, I have personally been the victim of servers, client work stations fizzle out and be down for a day or even up to a week while a part or major component is replaced, along with the software that may have been lost. Not a happy situation either.

More bad news....I called my ISP to see just how long the outage will  be.  I received one of those messages. "We are experiencing an outage in your area"  (how do they know  where I am...must be one of those caller ID thingys.  The voicemail was upgraded to

"If you would like a call when the technical difficulty is fixed, push one.  (how do they know I don't have a rotary phone?_) For you late season "boomers" go to wikipedia or google....  "we will call you back between the hours of blah blah blah...  This does not sound good.  How will they voicemail blast this message?  

BuzzNet Tags: isp,google,boomer,web 2.0,internet,server,client,voicemail

 

Health Train Billboards

Obama Has Spent $113 Million on Health-Themed Ads

My initial reaction was how many uninsured children would benefit from money thrown at TV ads.

PEOPLE WANT MORE PERSONAL, EXPERT “HEALTH ENGAGEMENT,” GLOBAL STUDY REVEALS

October 16, 2008, — New York – A 5,000-person, five-country study released today by Edelman shows that people want more active, trusted, and personal health interaction with companies, organizations and brands, effectively rewriting the “rules of engagement” in health.

 

Health Populi  Jane Sarasohn-Kahn

A majority of employers who don't sponsor health would be unwilling to contribute over $50 per employee per month for coverage

U.S. employer sponsored health system is experiencing some bipolar behavior: there is a cadre of large employers who want to continue sponsoring health benefits as part of overall compensation. But, for at least one in 3 employers, most would not be willing to pay $50 more.......................

 

BuzzNet Tags: campaign ads,politics and healthcare.global,rules of engagement

Health Train Billboards

Obama Has Spent $113 Million on Health-Themed Ads

My initial reaction was how many uninsured children would benefit from money thrown at TV ads.

BuzzNet Tags: campaign ads,politics and healthcare

Gene Train Express

 

Quote of the day:
The effort to understand the universe is one of the very few things that lifts human life a little above the level of farce, and gives it some of the grace of tragedy. - Steven Weinberg

*************************************************

The rapid scientific progress in genomics is now translating into almost everyday clinical applications. It becomes obvious,although expensive at this time, that DNA analysis will cause a revolutionary catalytic disruption in how medicine will be practiced.

One-stop' embryo test unveiled

A gene mapping test could tell parents-to-be if embryos are affected by almost any inherited disease, UK scientists have claimed.

The team from London's Bridge Centre say the £1,500 test could detect any of the 15,000 inherited diseases in weeks.  The claims for this new technique, called karyomapping which analyses chromosomes, is that it is a universal 'one size fits all' test. The human genome project has allowed mapping our DNA.

The economics of genetic testing is a double edged sword. Initially this testing will be expensive. Most payers will not pay for this testing, at first.  As the early testing translates into "assembly line" techniques the cost will diminish exponentially.  The upside is that proper testing will allow forecasting and accurate diagnosis of genetic conditions, allowing for targeted specific conditions.  Patients will benefit from designer drugs modeled to prevent allergic and cross reactions in some patients. It may become possible to design antibiotics against drug resistant organisms. 

Health Train at San Francisco

By now those of you who read my blog regularly realize that I did not go on a media fast.  It didn't seem quite right in the middle of the Health 2.0 ver 3.0 in San Francisco. If Matt, Sarah, Michael are working, who am I  to be a slack? So I am monitoring Health 2.0 from afar.

I received an email from Wellsphere asking if they could link to my blog here at Health Train Express.  The "train" is getting new routes.

I must admit as I have extracted myself from all the 'wonderful' things of patient care,

the only thing I miss is the personal  interactions between myself and patients.  I always aimed for the best outcomes, and was disappointed and somehow always felt guilty when the outcome of an eye surgery was not what I assumed to be perfect. I always had to go back and review what I might have done wrong, and discussed it with colleagues. I tried to keep my 'ego' out of the equation.

I am now a 'voyeur' enjoying academic discussions, patient care, and via several listservs, Sermo, iMedexchange focused on deep thought and practical questions with not only ophthalmologists from Brazil, Thailand, Hong Kong, Australia, Iceland and beyond. 

Nancy Turett in her blog shares her excitement about Health 2.0 and I can see why. These gatherings are educational but also are the physical manifestation of 'blogging'. It is the real world of virtual social blogging.  Friendships are made, and lost in a virtual world...a good deal like having a pen pal who sometimes answers your letter.  Putting a face and a voice on the blog seals the deal.

At Health 2.0  Gary Karr lists  Seven Great Health Care Policy  Blogs.

I expect to see some  updates on your flights back home.

gml

43 Things Tags: eye surgery,health 2.0,outcomes,pen pal,wellsphere

Health Train Genetic Transcription

John Hamlaka, M.D. the Chief Information Officer at Harvard Medical School and the Beth Israel Deaconess Hospital  has "donated"  his genome for the PGP (personal genome project.

It is now in a public space, accessible to anyone who can read AGTC code.

Audio transcript--John Hamlaka M.D.

Thought Leader #1

Thought Leader #2--David Altshuler

Thought Leader #3

I took a wrong turn surfing looking for blog material and happened upon these wonderfully informative daring innovators

Listen to the podcasts...you will need either iTune or Windows media player.

from Harvard Medical Labs

Episode 1- The Science of Social Networks--Audio

Episode 2- The Secrets of Aging--Audio

Episode 3- The Art of Perception--Audio

Episode 4-  And Coverage for all ? --Audio

Episode 5- Striving for Global Health--Audio

Episode 6-  Your Genome, Your Future--Audio

You may find the accompanying text from Harvard Medical Labs here.

Successful Health Train Reform

In many ways healthcare and education have taken a similar path. Education has endeavoured to equalize the playing field by increasing the number of pe0ple who are educated, thereby elevating them from impoverished lives, both economically and socially.

Despite increased spending in education, and a number of 'innovative' techniques' some of which have suceeded in their own relaively narrow segment, the effort has largely failed....left behind.

Max Ladner and Dan Lips write about the Heritage Foundation and about "A  successful model for education reform."

Parallels can certainly be drawn between our educational system and our health care non system.There  remains a large number of uninsured.

Obesity and dys nutrition abound fueling chronic diseases.

Florida has excelled in education outcomes. The tools have been a liberal use of charter schools, (300)......

— Standards and Accountability

— Ending Social Promotion

— Focusing on Reading

— Expanding School Choice Options

— Improving Teacher Quality

The Goldwater Institute elaborates further on the report from the Heritage Foundation.

Does this sound familiar?  Our government and payors have thrown more and more money at these issues in medicine, the underinsured, the medically indigent, the lack of physical fitness, and malnutrition without measurable success over the past ten years, except for some improvement in heart diseases. 

We physician leaders need to step back, out of the box, and ponder if some of education successes and failures apply to health care as well.

Health and wellness education and training needs to begin in elementary school.

M.D. O.D. also relates public education and public health issues in his recent blog, a guest editorial from ACEP by David Baehren M.D.

Evan Madianso likewise associates "affordable housing"  and "affordable health care  (brought to you by the feds. 

See   Freddie Mac  and    Fannie Mae. and yes they are still in business, have a web site and 'doing well' Thank you very much!!!

Health care needs a bailout, but we do not want it from the feds, for all the obvious reasons.

 

delicious Tags: affordable housing, affordable health, freddie mac, fannie mae, medically indigent, uninsured, heritage foundation, education reform, goldwater institute

Health Train Rest Stop

Well, frankly I need a break from blogging, healthcare and politics.  I am going on a  7 day media fast (not fest).

So you all enjoy Health 2.0, don't step on the homeless people, and use protection!!!

See you in a week.

Health Financial Markets Impacted

iHealthbeat reported this morning that the merger between WEBMD and HLTH was cancelled due to current economic situation.  They cited several reasons for cancelling the merger which was announced in February 2008

In a statement, Martin Wygod, chair of HLTH and WebMD, said, "The boards of directors of HLTH and WebMD believe that, in the current economic environment, it is important for a growth company like WebMD not to be encumbered by $650 million in [HLTH's] long-term debt that would be coming due in 18 to 36 months" (Washington Post, 10/21).

Health IT experts tackle vendor collaboration

Dan Michelson -- chief marketing officer of physician software vendor AllscriptsMisys Healthcare Solutions -- recommended that physician group buyers "contractually obligate" their vendors to provide systems that can easily share data with other vendors.

del.icio.us Tags: webmd,hlth,health financial markets,allscripts,misys,mergers

Health Train 2008

Health 2.0's annual conference begins tomorrow in San Francisco. Although registration deadline has passed and there are over 900 attendees, an additional room has been opened across the hall from the main room.  There will be large screen presentations, and audio.  You will be able to attend the breakout sessions, and exhibit hall.

You can't go in the ballroom for the main sessions, but you can attend the breakout sessions, the exhibit hall, the "unconference" lunch, the IDEO session (there are actualy only limited spaces available anyway

HEALTH 2.0  REGISTER HERE MEETING OCTOBER 22,2008

Prognosticators are theorizing how our current economic crisit will affect health care reform and what the impact will be on Health 2.0, Web 2.0 and health information technology adoption.

HIT funding has been slow at the best....will this kill it?  Or will it drive Health IT due to the necessity of cost containment, and efficiency?

 

Richard Reece M.D. analyzes our current predicament(s) and gives a futuristic prediction for HealthCare 2020 at

Medinnovation 

Richard Reece, M.D. (photo from his blog)

del.icio.us Tags: health care,future health,health 2.0,web 2.0,medinnovation,san francisco

Economic Transformation

The real bad news

Always listen to your elders....the indians knew this.

Technorati Tags: reform,health crisis,financial crisis

Health Train Express International

 

Perhaps we should emulate the Chinese in revising our health care system.  Long considered primitive regarding health care, China is taking a bold step toward caring for it's billion or more people.

The Chinese however may have an advantage that much like building a home, it is much easier and less expensive to start from scratch.  The United States is faced with disassembling a system that has grown over the past 100 years or more and transitioning to a better means of financing health care.   We see that a large barrier to transitioning lies in the financing. Converting to a new system will be disruptive financially, and  old habits are difficult to break.

The Wall Street Journal reports that China is aiming for universal heatlh care.

The proposed plan would be quite a shift for China. The draft plan’s overall goal is to cover 90% of the population within two years and achieve universal care by 2020. It aims to return to non-profit national health care, an idea that was largely abandoned in the country 1980s.

This all stands in contrast to China’s current system, which provides little government funding to government hospitals and requires patients to pay heavy out-of-pocket expenses. The WSJ notes that out-of-pocket payments made up more than 60% of health spending in China at the end of the 1990s.

The plan — drafted in consultation with groups including the World Health Organization, the World Bank, consultant McKinsey & Co. and a few Chinese university-based public health experts —-----The government also aims to set pricing standards for medical services.

Other news about Chinese health care, Pharma,Western style hospitals is in the Wall Street Journal. And what does Heparin have to do with hot dogs?

In China as in the United States reform has it's skeptics.

Technorati Tags: china,healthcare reform,world health,pharma,public health

Health Train Express--Sunday Edition

On the heels of Colin Powell's endorsement of Senator Obama, we can begin to look at the options for health care reform that the two candidates espouse.

Before I talk about that I make the following observations.

Few if any Physicians have access to the national stage in a manner that prominent senators, governors, and other publicly elected officials enjoy.  We have relied on our national organizations, the AMA, specialty societies, lobbyists.

There are other major players and foundations ,fund policy analysts, and speakers on the national circuit of speakers that elaborate on options for health care reform. In fact there is an alphabet soup variety of publicly funded organizations active in these matters. Some are underwritten by non profit organizations that are actually underwritten by payers.

National Health Policy Resources

Kaiser Family Foundation

Robert Woods Johnson Foundation

The American Hospital Association

U.S. Non- Profits Health Data and Statistics

The following two interviews detail the essentials of  the two candidates platform for health care reform.

HEALTH TRAIN MEET THE PRESS FOR SENATOR OBAMA

HEALTH TRAIN MEET THE PRESS FOR SENATOR MCCAIN

Both interviews courtesy of the Kaiser Family Foudation