To Gather Drug Data, a Health Start-Up Turns to Consumers
By STEVE LOHR
SAN FRANCISCO — For years, Thomas Goetz had been a spirited armchair advocate of the use of digital technology and data to improve health care.
At Wired magazine, where he was executive editor, Mr. Goetz assigned and wrote articles on the subject. He organized conferences, lectured and wrote a book in 2010, “The Decision Tree,” which hailed a technology-led path toward personalized health care and better treatment decisions.
In early 2013, just as he was leaving Wired, Mr. Goetz met Matt Mohebbi, a Google engineer who shared his interest in technology and health. Their conversations continued for months, and prompted an epiphany.
“It struck me that I could help make it happen, not just write about using data to personalize and improve health care,” said Mr. Goetz, who has a master’s in public health from the University of California, Berkeley.
And so the two men founded a company, Iodine, in July 2013. Its offering, an online service for tailored drug-taking information and advice, is being introduced on Wednesday at the Health 2.0 conference here.
Iodine reflects sharply increasing interest and investment in digital health companies. Venture investment in digital health start-ups in the first half of 2014 surged to $2.3 billion, surpassing the total for all of last year, according to Rock Health, which conducts research and provides seed funding for start-ups.
The investor enthusiasm for health ventures, said Halle Tecco, managing director of Rock Health, is fueled by the belief that the health care industry is both huge and technologically backward, and thus ripe for an assault with clever software and data-driven decision-making.
Iodine joins a growing collection of health start-ups using data analysis in innovative ways, including Omada Health, Ginger.io and Propeller Health, sometimes employing sensors and smartphones to provide early warning signals about conditions like diabetes, depression and asthma.
Iodine is charting new territory with its ambitious use of Google Consumer Surveys as a research tool. With 100,000 surveys completed and more added daily, Mr. Goetz said that Iodine was building the largest survey ever taken of Americans’ drug experience, intended to help consumers and perhaps guide policy. Clinical trials to determine drug approval, by contrast, routinely involve a couple of hundred people.
Google Consumer Surveys, begun in 2012, is best known for its performance in the presidential campaign that year, being the most accurate of the Internet polls and second-most-accurate of the polls tracked by Nate Silver, editor in chief of the website FiveThirtyEight.
A Health Care Success Story
By BOB KOCHER and FARZAD MOSTASHARI
IT may have been the most influential magazine article of the past decade. In June of 2009, the doctor and writer Atul Gawande published a piece in The New Yorker called “The Cost Conundrum,” which examined why the small border city of McAllen, Tex., was the most expensive place for health care in the United States.
The article became mandatory readingin the White House. President Obama convened an Oval Office meeting to discuss its key finding that the high cost of health care in the country was directly tied to a system that rewarded the overuse of care. The president also brought up the article at a meeting with Democratic senators, emphasizing that McAllen represented the problem that needed to be fixed.
Five years later, the situation has changed. Where McAllen once illustrated the problem of American health care, the city is now showing us how the problem can be solved, largely because of the Affordable Care Act that Mr. Obama signed into law in 2010.
In his article, Dr. Gawande cited studies showing that patients in high-cost areas like the Rio Grande Valley, which includes McAllen, were much less likely to receive preventive services like cancer screenings or vaccines, but far more likely to be prescribed costly drugs, invasive procedures and expensive diagnostic tests. And they were not any healthier for it: Compared with places like El Paso, McAllen had worse health outcomes, despite spending twice as much per capita onMedicare.
The problem was that doctors in McAllen were responding to reimbursement incentives in the American health care system that rewarded activity rather than value. The more procedures and visits a doctor billed, the more he got paid.
The Affordable Care Act was designed to change that. One of its provisions created the Medicare Shared Savings Program, which rewards doctors for keeping their patients healthy. Participation in the program requires primary care doctors to create networks, called accountable care organizations, or A.C.O.s, to better coordinate patient care. These networks are reimbursed for delivering high-quality care below a baseline of historical Medicare costs.
Boston Heart Diagnostics Corp. questioned on doctor fees
By Robert Weisman
| GLOBE STAFF SEPTEMBER 23, 2014
A fast-growing Framingham company is responding to inquiries from federal investigators examining whether diagnostic firms improperly paid doctors who send them patients’ blood specimens to test their risk for cardiovascular disease.
Boston Heart Diagnostics Corp. said in a statement that it is “fully cooperating with the government’s information requests” in an investigation being conducted by the Department of Justice and the inspector general’s office of the Department of Health and Human Services.
The inquiry was first disclosed by The Wall Street Journal, which earlier this month reported that investigators were focusing on a Virginia company, Health Diagnostic Laboratory Inc., but also looking into a group of rival companies, including seven-year-old Boston Heart, as well as Quest’s Berkeley HeartLab, Singulex Inc., and Atherotech Diagnostics Lab.
Those companies have paid processing fees to the offices of physicians who send them blood samples that can be screened to identify patients vulnerable to conditions such as heart disease, stroke, or diabetes.
While the fees are considered reimbursement for packaging and labeling the specimens, investigators reportedly are trying to determine whether they are illegally designed to generate revenue by giving doctors incentives to order unnecessary tests.
Vermont Health Connect not single-payer
Health insurance exchange different from single-payer
The League of Women Voters of Vermont strongly supports universal, state-supported health care for Vermont.
There seems to be a misconception that because Vermont Health Connect is having technical difficulties, administering a single-payer system will somehow be worse. There's every reason in the world to believe the opposite is true.
Under single payer, there will be:
• No need to determine the best balance of deductibles vs. premiums vs. copays.
• No need to submit personal financial data, so a complicated algorithm can determine eligibility for subsidy and how much that subsidy will be.
• No need to update that information when your circumstances change, and go through the eligibility determination again.
Everybody in, nobody out. All you need is to be a resident of Vermont.
How can that possibly be harder to administer than the exchange?
JEAN HOPKINS
Burlington
Hopkins is a member of the League of Women Voters of Vermont.
A Doctor, a Rabbi and a Chicken
“Doctor, is it O.K. for our rabbi to visit my father?”
I was an intern on call in one of the internal medicine wards in an Israeli hospital just south of Tel Aviv. The first day of the Jewish holiday of Sukkot had just ended, and the ward was beginning to fill up with visitors who had been unable to drive until after sunset.
Looking up from what I was doing, I saw the son of one of my patients standing at the counter of the nursing station. He and I had already spoken several times that day about his 75-year-old father, who had been admitted the night before because of a stroke.
The father’s CT scan from the night before had been unremarkable, not unusual in patients whose strokes are caused by an interruption of blood flow to portions of the brain. I had explained this to the son, as well as what to expect over the next few days as his father would undergo further testing and then discharge to a rehabilitation facility. I told him that it was impossible at this early stage to predict how much function his father might recover, and cautioned against giving him anything to eat or drink until we were certain that his ability to swallow had not been affected. All of the son’s questions had been very appropriate and focused.
“Of course,” I responded, smiling and a little surprised that he had asked my permission. No one else had that evening.
Thanking me, he turned around towards the main door of the ward, located just beyond behind the nurses’ station. Bowing to the rabbi who was just out of sight, the son addressed him in the third person: “Please, may the honorable rabbi enter.” After kissing the rabbi’s hand, he straightened up and led the guest to his father’s room.
I followed them down the hall with my eyes. It was only as they were about to enter the room that I noticed that the rabbi was carrying a white chicken in his arms. Although quiet, the chicken was very much alive.
Billing dispute leaves Presque Isle clinic without access to electronic data on 3,500 patients
By Jackie Farwell, BDN Staff
Posted Sept. 24, 2014, at 6:15 p.m.
As the staff at a small Presque Isle health clinic prepared to see patients one day in July, they stopped short at their keyboards.
They soon realized they’d been locked out of the electronic health records for all of their 3,500 patients. Stuck behind a virtual wall, the records — digital medical histories detailing everything from blood pressure readings to medication lists and lab results — might as well have disappeared.
The vendor that maintained the records had taken the uncommon step of denying access because of a longstanding billing dispute with the practice, Full Circle Health Care.
CompuGroup Medical, a German firm with U.S. headquarters in Boston, showed no regard for the safety of the practice’s patients, said E. Victoria Grover, a physician assistant who runs the independent practice.
“They screwed us and I hope somehow they have to face the consequences,” said Grover, who first shared the story with The Boston Globe.
CompuGroup blocked the clinic’s 10 employees from a critical tool that medical providers rely on more than ever in treating patients. Electronic health records have been hailed as a way to improve health care by putting patient histories at clinicians’ fingertips, their adoption spurred by $30 billion in federal stimulus funds.
Doctors and nurses log nearly every interaction with patients in the records, aiming to prevent medical errors and dangerous drug interactions and better coordinate care.
Much of the debate around electronic health records has centered on their potential to improve care, patient privacy and the security of data. But possible pitfalls stemming from the legal relationships between vendors and health providers have gotten less attention.
In the wake of the rapid proliferation of electronic health records, similar disputes are likely to crop up, in Maine and across the country, according to Kate Healy, a partner in the health care group at the law firm Verrill Dana.
“I think this is probably the start of a new trend,” she said.
Eager to get the records online, vendors and providers signed contracts without always thinking far enough ahead, Healy said. Some overlooked how to proceed when things go south, she said, such as when a vendor or provider shuts down or a payment dispute arises. With more vendors jumping into the market, problems are bound to crop up, Healy said.
“When you switch vendors or terminate contracts, you’re going to have issues like those raised in this case,” she said.
At least one other health provider in Maine has been shut out of its patients’ electronic records. Earlier this year, a different vendor denied access to a small Freeport-area practice following a billing dispute, according to Gordon Smith of the Maine Medical Association. The vendor reportedly entered the practice’s office under the guise of updating or servicing the records system, then switched off the provider’s access, Smith said.
Healy said she’s working with a medical group in Massachusetts that encountered a situation similar to Full Circle’s.
It remains unclear how many health-care organizations CompuGroup serves in Maine. A company attorney didn’t respond to a request for comment from the Bangor Daily News.
Your medical record is worth more to hackers than your credit card
BY CAROLINE HUMER AND JIM FINKLE
NEW YORK/BOSTON Wed Sep 24, 2014 2:24pm EDT
(Reuters) - Your medical information is worth 10 times more than your credit card number on the black market.
Last month, the FBI warned healthcare providers to guard against cyber attacks after one of the largest U.S. hospital operators,Community Health Systems Inc, said Chinese hackers had broken into its computer network and stolen the personal information of 4.5 million patients.
Security experts say cyber criminals are increasingly targeting the $3 trillion U.S. healthcare industry, which has many companies still reliant on aging computer systems that do not use the latest security features.
"As attackers discover new methods to make money, the healthcare industry is becoming a much riper target because of the ability to sell large batches of personal data for profit," said Dave Kennedy, an expert on healthcare security and CEO of TrustedSEC LLC. "Hospitals have low security, so it's relatively easy for these hackers to get a large amount of personal data for medical fraud."
Interviews with nearly a dozen healthcare executives, cybersecurity investigators and fraud experts provide a detailed account of the underground market for stolen patient data.
The data for sale includes names, birth dates, policy numbers, diagnosis codes and billing information. Fraudsters use this data to create fake IDs to buy medical equipment or drugs that can be resold, or they combine a patient number with a false provider number and file made-up claims with insurers, according to experts who have investigated cyber attacks on healthcare organizations.
Medical identity theft is often not immediately identified by a patient or their provider, giving criminals years to milk such credentials. That makes medical data more valuable than credit cards, which tend to be quickly canceled by banks once fraud is detected.
No comments:
Post a Comment