Healthcare Innovations

Government Funded Research is for the People

Matthew Holt, in the Fierce Healthcare newsletter, points out that research publications and sponsors are concerned this will reduce their financial return on research.

WSJ.com - Most Americans Back Online Access To Federally Funded Research, 2006-May-31 (via Fierce Healthcare)

A majority of U.S. adults say federally funded research findings on health issues and other topics should be available for free to doctors and the general public, according to a recent Harris Interactive poll.

In an online survey of 2,501 U.S. adults, more than 80% of Americans say they agree strongly or somewhat that research should be available for free via the Internet because the research is paid for with U.S. tax dollars.

In addition, 81% of Americans say they agree strongly or somewhat that access to such research data will help those living with a chronic illness or disability to get the latest information that might assist them.

And 62% of Americans say they agree strongly or somewhat that making the information available online and for free "will help speed up finding potential cures for diseases," compared to 10% who disagree somewhat or strongly.

Struggling to Keep Up with a Patient's Drug History

An excellent round-up article in the Wall St. Journal makes it clear that hospitals and doctors struggle to stay informed about what patients are taking, including over-the-counter supplements. The problem is magnified with geriatric patients.

WSJ.com - The Informed Patient, 2006-May-23, by Laura Landro

According to the nonprofit Institute for Healthcare Improvement, which is helping thousands of hospitals develop patient-safety programs, poor communication as patients move through the hospital is responsible for as many as 50% of all medication errors and up to 20% of adverse drug events. By developing rigorous medication-reconciliation systems, though, such errors can be cut by 75% to 80%.

Inventing is Fun

Richard Ivey WW VP of R&D for BD Diagnostics: Forging weapons to fight disease - baltimoresun.com by Nancy Jones-Bonbrest, 2006-May-24

Typical day // He works 50 to 55 hours a week, leading the research and development team of about 200 people. The majority of his time is spent monitoring progress on product development, hiring technical talent, doing research and designing products. He works with engineers and scientists as often as possible. "I do get my hands dirty a lot, trying to separate good technology from not so good technology. I'm accountable at the end of the day for that." Ivey is also on the road about 25 percent of the time developing relationships and brokering technology deals.

Company's area of focus // Infectious disease.

How R&D works // Ivey says it's often referred to as "connect and develop" instead of "research and develop" because a lot of the new research is now done out of small laboratories at universities and startup companies.

What people don't know about R&D // "It's a lot of fun. It's rewarding. You get to learn about medical care and human health, while working in science and making a difference."

The good // "Watching our teams succeed in developing great products that make a difference in the health care setting."

 

The bad // "It's science and we are inventing new things. There is a lot of uncertainty and risk. That's what gives me the gray hair. It's exciting, but at the same time there is a certain amount of risk."

 

Philosophy on the job // "Build good teams and let people create and be innovators."

Virutal Nursing Homes, courtesy Andy Grove

USATODAY.com - Grove revels in throwing 'barbed wires', 2006-May-23, by Kevin Maney

Grove's post-retirement activities branch into health care — another aspect of American life that concerns him. Health care is, he says, "the bulk of my productive work at Intel."

His title at Intel is senior adviser, reporting to CEO Paul Otellini. Grove is driving an Intel research project to create technology that can help the aging live independently as long as possible. "That's a (expletive) need!" Grove says — one of many times he adds some sea salt to a remark. "I think we can do a virtual nursing home with technology." But he's not forthcoming with details.

Internet Investors Like Healthcare

Link: WSJ.com - Prognosis Positive: Web Health Ventures.

This is the hottest space in the Internet," said West Shell, chairman and chief executive of Healthline Networks Inc., which runs health-care search engine healthline.com. The San Francisco company raised $14 million in financing this year from VantagePoint and others. [Web Health]

Another company attracting investors is Healthia Inc., a "comparison-shopping" company for health-care products and services.

Overall, the commitments remain relatively modest -- roughly $41 million has been spread over five companies in a little more than a year, according to industry tracker VentureOne, a unit of Dow Jones & Co., publisher of The Wall Street Journal. But technology investors see health care as a huge opportunity for Internet-based businesses.

IT Innovation in Hospitals

Issue Brief from Mathematica Policy Research, Inc. May 2006, Number 3:  New Hospital Information Technology: Is It Helping to Improve Quality.

Three-fourths of the hospital executives interviewed
reported that IT had been an important factor in
improving quality in their hospitals, a notable degree
of consensus given the range of IT functions covered
by the survey. In hospitals that were using some type
of IT, only 17 percent felt it had not been an important
contributor to higher quality.
In terms of what was viewed as most helpful in
enhancing quality, more timely clinical information,
diagnosis, and treatment was the greatest benefit
reported

Loyalty Reward for your own Health?

Link: Ivanhoe's Medical Breakthroughs - Marketing to Improve Health.

Health services should use social marketing ideas like large conglomerates such as Nike and Coca-Cola to improve people's health, say a group of international researchers.

In social marketing, commercial marketing strategies are applied to social good it has been shown to be effective in changing health behavior. Researchers say studies reveal social marketing campaigns are successful in tackling alcohol and tobacco use.

The United Kingdom government is embarking on its first social marketing strategy. Australia, New Zealand, Canada and the United States already have social marketing facilities embedded within their health services.

According to researchers, social marketing like commercial marketing should aim to build ongoing, mutually beneficial relationships. The study authors propose stop smoking services could offer grocery-store type loyalty cards to successful quitters, so they can influence friends and family to use services and be encouraged to think about their other health behaviors.

VA Leaps Ahead in Quality of Care

Link: FORTUNE: How the VA healed itself - May 15, 2006 by David Stires (via FierceHealthcare)

In the Tele-Health unit on the sixth floor, nurse Maggie Kong-Lopez is reading the vital statistics of a 57-year-old patient in Queens, sent to her computer via a Telebuddy that the VA has rigged at his home.

Today the news is worrisome: The patient, who is suffering from heart disease, has gained three pounds overnight, indicating that he's retaining fluids. After a few quick phone calls to the patient and his doctor, she tells him to double his diuretic medication today. "We caught him before his condition got worse," she says with satisfaction....

Tech is at the heart of the transformation. A networked software program - dubbed Vista - runs a powerful electronic medical record-keeping system that acts as the VA's brain. Through Vista, doctors submit prescriptions electronically, minimizing errors that stem from illegible handwriting. They are notified when their patient needs a flu shot, a chest X-ray, or other follow-up care. (In a pilot program, many vets also get reminders over home computers.)...

What's more, the VA has achieved all this while containing costs. As more vets have come in the door, the agency's overall budget has nearly doubled since 1996, to $30 billion. But the cost per patient has held steady at roughly $5,000. Over the same period, total health spending for the average American shot up more than 60 percent, to $6,300.

"We are providing veterans with more effective, more efficient, and more compassionate care," concludes Jonathan Perlin, undersecretary for health at the VA since April 2005.

Now the software is available for all hospitals.

The seamless integration of science, information, and compassion is the dream of modern health care. Scenes like these are not fantasies, however, but daily realities at the Veterans Health Administration, the federal agency that is the most wired and cost-effective health system in the land.

Hospital Talk about Pricing Transparency

Link: HCA to reveal costs of care - Nashville, Tennessee - Tuesday, 05/02/06 - Tennessean.com by Todd Pack

HCA Inc. says coming up with a plan to tell patients in advance how much they'll pay at its hospitals is "a top priority."

"We are committed to establishing a level of transparency," said Jack O. Bovender Jr., chairman and chief executive of the nation's largest for-profit hospital chain, which is based in Nashville.

Details of the planned transparency policy, including when it would be put into practice, haven't been worked out, a spokesman said.

But in a prepared statement, Bovender said it was crucial that patients be told how much services cost "so they can better understand their responsibilities and make more informed decisions about their health care."...

Price transparency is one of the items on the agenda of the American Hospital Association's annual meeting, which is under way in Washington. In a policy paper, the group said, "More can, and should, be done to share hospital pricing information with consumers."

President Bush told the hospital group on Monday that patients "need to know in advance what their medical options are, the quality and expertise of the docs and the hospitals in the area in which they live, and what their medical procedures will cost."...

Last month, Health and Human Services Secretary Michael Leavitt said in a speech in Nashville that the federal government would roll out a plan to help employers give workers basic information on the cost and quality of care at hospitals in key cities.

Cost information would be culled from insurance claims, while quality data would be based on standards such as those developed by the Hospital Quality Alliance, a public-private partnership involving the hospital association, the Centers for Medicare & Medicaid Services and the American Medical Association.

Safer Hospitals Emerging

Link: WSJ.com - To Reduce Errors, Hospitals Prescribe Innovative Designs by Gautam Naik, May 8, 2006

Many hospitals aim to improve safety by focusing on ways to reduce human error. They encourage nurses to wash their hands more often to prevent the spread of infections and push doctors to write prescriptions more legibly in order to avoid mix-ups. A growing number of administrators are now factoring hospital layout and design into the patient-safety equation.

Traditionally, architects designed hospitals much like any other building -- making adjustments along the way for things like toilet location, medical equipment and ventilation. Mr. Reiling persuaded the facility's architects to draw up blueprints with specific medical benefits -- such as slip-proof floors and soundproof walls -- already built in.

The old St. Joseph's suffered from all the faults of a typical U.S. hospital. Lighting varied from one area to the next, making visual diagnoses inconsistent. Noise levels were higher than those recommended by health experts, making it harder for patients to rest.

At the new 80-bed facility, which opened its doors in August, the size and set-up of every room is identical. That means doctors and nurses quickly can find everything from syringes to emergency oxygen lines. Nurse stations are placed so that all patients are visible -- without pillars to block the view. Filters and ultraviolet devices trap and kill germs and other particles, making for healthier airflow throughout the hospital.

Though the changes are relatively new, the hospital says it is reaping benefits on both safety and financial fronts.

Doctors' Power Continues Decline

Link: Get What You Pay For — No One’s Listening Archive, March 25, 2006, by Yas

Since physicians seem powerless in the struggle to keep health care from becoming economically driven, the responsibility comes to rest on the patient — the new consumer. Health care in this country isn’t going to change unless patients start demanding better and more compassionate treatment. Salgo says it like it is:

    If you are unhappy with your doctor, fire him. If you cannot get more than a seven-minute face-to-face encounter with your doctor, he needs fewer patients. The true power in the health care economy rests not with the doctors and certainly not with the backroom business staff. It rests with you.

While it may seem ironic that Salgo argues against commercialism in medicine and then instructs you to fire your doctor if it’s not working out, he’s ultimately enforcing his belief that physicians are powerless to change the new paradigm of medicine. The fact is that whether we like it or not, health care now follows a customer-supplier business model. To keep our compassionate values, we’ll have to play by the new rules.

Book Review: The Business of Healthcare Innovation

Book Review of The Business of Healthcare Innovation: How New Products Come to Market by Lawton Robert Burns - Knowledge@Wharton, May 3, 2006

Burns says he hopes his book will be useful in both the classroom and the real world. Students in health administration need to be knowledgeable about the producer side of the healthcare equation, he notes, not just because of the growing reliance on medical technology but also because of the expense. "The fastest growing portion of hospital costs are these supplies," whether drugs or medical-surgical supplies, and hospital administrators should be savvy about the companies they deal with. "They need to take an active role. Hospitals need to understand what makes the companies tick."

At the same time, Burns adds, the different sectors, whether biotech or medical devices, must understand how each other operates, especially given a trend toward "convergence" of technology. "One of the reasons we wrote this book is that there is a slow but growing convergence of these products. One sector will increasingly rely on another sector for new product development." New drug-coated stents, which are part medical device and part pharmaceutical, are a good example.

Funding a Specific Innovation

The world is desperate for a flue vaccine production technology that can be ramped up very quickly in the case of a pandemic. So the federal government is handing out huge grants to the most likely players. Although a similar drive to achieve put a man on the moon, it remains to be seen whether we are currently on the right track and whether extra money will speed up the development process. The U.S. government would do well to cover the risk by spreading a little funding to alternative technologies.

Link: WSJ.com - U.S. Awards $1 Billion In Flu-Vaccine Contracts by Jennifer Corbett Dooren, May 4, 2006

Health and Human Services Secretary Mike Leavitt said the goal of the contracts would be to allow all Americans to receive a flu vaccine that could protect against a pandemic virus within six months of the time it appears a new flu virus is circulating among humans. Pandemic influenza occurs when a new virus emerges that humans have no natural immunity to and is a virus that can spread easily among humans.

The current chicken egg-based technology used to produce vaccines simply can't produce enough vaccines to protect nearly 300 million Americans in the event of a flu pandemic, Leavitt said. Cell-based technology would also allow for increased production of annual, seasonal influenza vaccines and would eliminate periodic shortages.