MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'agents'. Sat, 03 Sep 2011 02:01:12 +0100 http://www.medworm.com/index.php?rid=5139735&cid=t_107445_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcould-your-swimming-pool-give-you-a-rash%2F2011.08.18 Allergic to Swimming? We’re in the dog days of August and summer continues to hold on. What better way is there to relax than in your nice, cool pool? Unless you’re allergic to it, of course. I had a patient this summer who developed an itchy rash all over. He thought it might be due to his pool, but insisted that he kept it immaculately clean. Ironically, that might have been the trouble. Some people are allergic to (more…) *This blog post was originally published at The Dermatology Blog* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=5139735 Thu, 18 Aug 2011 12:00:39 +0100 5139735 http://www.medworm.com/index.php?rid=5107898&cid=t_107445_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2FjT4ncXm_IJU%2F The group of drugs known as ESAs are apparently being used inappropriately in cancer patients, suggesting that the expensive treatments are being wasted and exposing patients unnecessarily to serious side effects, according to a new study in the Journal of Clinical Oncology. Specifically, the meds were administered for no more than one week in 24 percent of patients, which is an insufficient amount of time to offer a useful benefit, according to the researchers (read the abstract). Moreover, nearly eight percent of the patients received one of the drugs for more than 14 weeks, while almost 14 percent were getting the drugs when they weren’t on chemotherapy.” The meds are approved for cancer patients who are getting chemotherapy, and recommended treatment is between two and 14 w... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=5107898 Mon, 08 Aug 2011 12:55:04 +0100 5107898 http://www.medworm.com/index.php?rid=4960347&cid=t_107445_160_f&fid=36190&url=http%3A%2F%2Fwww.skincareblog.org%2F Sonal Bahuguna: SunscreenApplying sunscreen helps to protect the skin from the harmful sun rays. Are you afraid of stepping out in sunlight and feel that sunscreen is not working for you. The problem is not sunscreen that shields you from sun but the way to apply it. Maximum damage to skin is caused by ultra violet rays coming from the sun. To deal with it you should know how sunscreen can work efficiently on your skin. Follow the simple steps whenever you step out in sun as they will definitely help you to protect your skin: 1. Always select a sunscreen with SPF 15 or above as it helps to protect your skin from sunburn. Choose one which can block both UVA and UVB rays.2. Shake the bottle well before use, as it will ensure proper mixing of the content in the bottle.3. Apply a larger am... Skin Care blogs http://www.medworm.com/rss/comments.php?id=4960347 Wed, 22 Jun 2011 12:52:41 +0100 4960347 http://www.medworm.com/index.php?rid=4876385&cid=t_107445_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmyth-buster-seafood-allergies-do-not-increase-risk-of-allergies-to-ct-contrast-dyes%2F2011.05.28 It is a prevalent belief out in the medical (and lay public) community that patients with iodine or seafood allergy can not receive contrast when undergoing certain radiological tests like CT or MRI scans. The concern is that contrast contains minute amounts of free iodide and as such, IV administration of this material puts the patient at risk of a life-threatening anaphylactic reaction. Contrast is often given in these tests as it traces out bloodflow enabling the physician to see organ and mass architecture much more clearly allowing for improved accuracy in seeing anything abnormal. Well… rest assured that patients with iodine and seafood allergy CAN receive contrast without any significant increased risk of an allergic reaction as compared to other allergies. In a large study en... Better Health blogs http://www.medworm.com/rss/comments.php?id=4876385 Sat, 28 May 2011 18:00:00 +0100 4876385 http://www.medworm.com/index.php?rid=4733993&cid=t_107445_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F04%2Fkhadafys-academic-mercenaries-health.html We just discussed Henry Kissinger as an early example of the intellectual mercenary, and recent striking examples of academic mercenaries,particularly the Harvard University-derived Monitor Group's academically disguised public relations work for Libyan tyrant Moammar Khadafy.We concluded that academic mercenaries help foster the corporate culture in which health care is now immersed.  However, it also appears they may have direct influence on health care.  Monitor Group LeadershipConsider for example the main figure in the Monitor Group - Khadafy scandal.  According to a Boston Globe article, Michael Porter developed the Monitor-Khadafy connection: Monitor’s work in Libya began when Michael Porter, a Harvard Business School professor who is a... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4733993 Tue, 19 Apr 2011 19:54:00 +0100 4733993 http://www.medworm.com/index.php?rid=4653332&cid=t_107445_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fphysicians-as-conversation-agents-in-new-media%2F2011.03.29 I frequently talk about the visibility of doctors in the online space. How can doctors make content, contribute to the broader dialog, and be more visible? Maybe I need to spend less time pushing the idea that every doctor needs to create. Most doctors, after all, just want to listen and watch. Maybe we need to be cultivating dedicated communicators. There’s a role evolving where physicians are formally involved in the creation of content and the maintenance of dialog. Wendy Swanson at Seattle Children’s Hospital and Claire McCarthy at Boston Children’s Hospital come to mind as good examples. Both serve as models for how institutions can leverage the voice of an individual for a branded online identity while contributing to the common good. Both are evolving as conversation agents on... Better Health blogs http://www.medworm.com/rss/comments.php?id=4653332 Tue, 29 Mar 2011 17:00:29 +0100 4653332 http://www.medworm.com/index.php?rid=4294806&cid=t_107445_113_f&fid=39278&url=http%3A%2F%2Fblogsite.mdbuyline.com%2F%3Fp%3D127 Ultrasound contrast first appeared in the 1990s and now, evolving microbubble contrast agents, which are relatively low-cost and safe, are expanding the role of ultrasounds in diagnostic medicine. Microbubbles consist of shells ranging from 1-4 micrometers in diameter that are injected with a gas and have the ability to reflect ultrasound waves.  Because microbubbles reflect ultrasound waves differently than tissue, a unique sonogram is produced with these contrast agents.  Currently, their primary focus is in echocardiography for the diagnosis of cardiac conditions but they are evolving to other applications, such as tumor identification and liver diseases.  Additionally, microbubbles can be used to deliver drug therapy to a specific site. I spoke to Roy Filly, MD, professor emeritus, ... MD Buyline blogs http://www.medworm.com/rss/comments.php?id=4294806 Mon, 27 Dec 2010 14:35:55 +0100 4294806 http://www.medworm.com/index.php?rid=4214277&cid=t_107445_113_f&fid=39278&url=http%3A%2F%2Fblogsite.mdbuyline.com%2F%3Fp%3D105 According to a recent article, more than half ($15 billion) of the $21 billion U.S. Medical Imaging Market is spent on contrast agents. In fact, most hospitals spend as much on contrast agents as they do on new imaging equipment.  But with discounting ranging from 20 to 65%, this is an area that should not stay hidden.  On average, imaging dyes range from $20 to $150 per procedure and can make up 10 to 60% of a study’s costs.  When I spoke to Dr. Alexander R. Margulis, MD, clinical professor of radiology, Weil Medical College at Cornell University New York, he put it into perspective, stating, “Considering the overall expenses of a study, including hospital and doctors’ fees, the contrast is not much more.  If you address cost from just the technology side, it can start to add up... MD Buyline blogs http://www.medworm.com/rss/comments.php?id=4214277 Tue, 30 Nov 2010 14:16:29 +0100 4214277 http://www.medworm.com/index.php?rid=4159241&cid=t_107445_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmore-doctors-are-refusing-industry-perks-and-gifts%2F2010.11.12 Physicians and particularly primary care doctors are reporting fewer industry ties than five years ago, according to a survey. While 94% of doctors reported some type of perk from a drug or device maker in 2004, 83.8% did in 2009, researchers reported in the Nov. 8 Archives of Internal Medicine. Researchers surveyed a stratified random sample of 2,938 primary care physicians (internal medicine, family practice, and pediatrics) and specialists (cardiology, general surgery, psychiatry and anesthesiology) with a 64.4% response rate. (more…) *This blog post was originally published at ACP Internist* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=4159241 Fri, 12 Nov 2010 15:00:00 +0100 4159241 http://www.medworm.com/index.php?rid=4151976&cid=t_107445_113_f&fid=39278&url=http%3A%2F%2Fblogsite.mdbuyline.com%2F%3Fp%3D86 How do you visualize a tumor the size of a pinhead or a critical structure without radiation or patient contact?  Easy, in theory; you make it glow.  Near-infrared (NIR) fluorescence first appeared in the laboratory, but it has now become an effective, real-time intraoperative instrument.  Dr. John Frangioni, MD, PhD, associate professor of medicine and radiology at Harvard Medical School in Boston, MA, is a leading scientist whose lab is focused on developing NIR technology.  He explained the technology’s applications and stated, “Near-infrared technology is a platform that can be used with any type of surgery and is limited only by the contrast agents used.  In the morning, it could be used for cardiac surgery; in the afternoon, cancer surgery.”  NIR fluorescence consists of ... MD Buyline blogs http://www.medworm.com/rss/comments.php?id=4151976 Wed, 10 Nov 2010 14:27:50 +0100 4151976 http://www.medworm.com/index.php?rid=4031177&cid=t_107445_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F10%2F04%2Fbritish-journal-of-general-practice-2010-vol-60-no-579%2F This article looks at the temporal pattern between antipsychotic prescriptions and pneumonia in terms of age, type of pneumonia and other chest infections, and antipsychotic class. (Print subscription held at Fade Library) Filed under: Currently Watching, Journals Tagged: Aged, Antipsychotic Agents, Computerised Medical Records Systems, Pneumonia (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=4031177 Mon, 04 Oct 2010 13:47:13 +0100 4031177 http://www.medworm.com/index.php?rid=4023006&cid=t_107445_113_f&fid=36694&url=http%3A%2F%2Fblog.crossoverhealth.com%2F2010%2F10%2F01%2Fcrossover-health-welcome-to-next-generation-health-care%2F FOR IMMEDIATE RELEASE Crossover Health Launches New Model of Primary Care in South Orange County Innovative membership service delivers Urgent, Primary, and Online Care Aliso Viejo, CA (PRWEB) October 1, 2010 Crossover Health Medical Group announced today the launch of their flagship membership-based, primary care practice in Aliso Viejo, California. The new clinic will offer urgent, primary, and online care services directly to individual members, families, and employer groups. Membership based health care is a new health care finance and delivery innovation that has gained widespread popularity as the cost of health insurance and ongoing service deficiencies have plagued the current health care delivery system. The Crossover membership model decouples health care from health insurance, a... Crossover Healthcare blogs http://www.medworm.com/rss/comments.php?id=4023006 Fri, 01 Oct 2010 15:46:58 +0100 4023006 http://www.medworm.com/index.php?rid=4013318&cid=t_107445_113_f&fid=39278&url=http%3A%2F%2Fblogsite.mdbuyline.com%2F%3Fp%3D34 Wow, what a leap in technology.  When I have discussions with administrators on what’s up and coming in imaging technology, the first thing that comes to mind is big boxes that cost millions.  In the world of imaging, not a whole lot of discussions at this level are directed to contrast agents.  I have been following nano-based contrast agents since my first evolving technology conference years ago and am pretty excited about what’s in store. For example, a recent MIT technology review article has stated that researchers have developed nano-based agents that are 15 times more sensitive than existing compounds.  A nanoparticle is a molecule that ranges from 1 nm to 100 nm in length and, because of their size, can also reach multiple areas of the body.  This sounds exciting, but how... MD Buyline blogs http://www.medworm.com/rss/comments.php?id=4013318 Fri, 17 Sep 2010 15:07:07 +0100 4013318 http://www.medworm.com/index.php?rid=3776379&cid=t_107445_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fprimary-care-conference-moves-industry-support-off-site%2F2010.07.21 Harvard’s annual primary medicine conference, Pri-Med East 2010, will move the industry-supported portion of the program off-site, and marketing will be further restricted (advertisements had been allowed in bathrooms, for example.) A Harvard official said the new rules are meant to keep doctors from becoming or appearing as industry marketing agents. (The Boston Globe) *This blog post was originally published at ACP Internist* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=3776379 Wed, 21 Jul 2010 21:00:00 +0100 3776379 http://www.medworm.com/index.php?rid=3610315&cid=t_107445_87_f&fid=36050&url=http%3A%2F%2Fblisstree.com%2Flive%2Fpvc-free-21-companies-that-dont-use-the-toxic-plastic%2F photo: Thinkstock Polyvinyl Chloride (PVC) is found in an astonishing array of everyday items – home siding, school supplies, car interiors, medical tubing, and many more common products – but when PVC production produces dioxins, the most toxic substances in the world and a known cause of cancer. The Greenpeace Guide to Greener Electronics singles out companies, like Nokia, that have stopped using PVC in the production of their goods, but it’s not only electronics producers that are moving away from the deadly plastic. Microsoft, Honda, Walmart, Target and Nike have all started shifting production away from PVC. A representative from the Vinyl Institute, an industry trade group, thinks that the move away from PVC is a mistake, and that no one will find a plastic better than P... Breastfeeding 1-2-3 blogs http://www.medworm.com/rss/comments.php?id=3610315 Fri, 28 May 2010 16:09:17 +0100 3610315 http://www.medworm.com/index.php?rid=3573791&cid=t_107445_113_f&fid=36694&url=http%3A%2F%2Fblog.crossoverhealth.com%2F2010%2F05%2F18%2Fday-73-demolition-weekend%2F Demolition (dĕm’ə-lĭsh’ən) n. The act or process of wrecking or destroying, especially destruction by explosives. Explosives, especially when designed or used as weapons. We are having a blast on our march toward revolutionizing the way that medicine is practiced, delivered, and experienced. In fact, we feel so strongly about it that we are literally busting down walls, bashing in doors, breaking windows, ripping up the carpet, smashing mirrors, and throwing away all the trash of our current health care system. And this is just the build out phase: The above is a very cool timelapse video showing Large Construction leading a team of 35 volunteers, who donated more than 150 hours, over an intense two day period to completely demolish our current 4,000 square foot space. ... Crossover Healthcare blogs http://www.medworm.com/rss/comments.php?id=3573791 Tue, 18 May 2010 07:39:50 +0100 3573791 http://www.medworm.com/index.php?rid=3391053&cid=t_107445_180_f&fid=38619&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FALifeCoachsBlog%2F%7E3%2Fga4KJanbgzI%2F I love Amazon, I really do. I have no idea how much I spend there in a year, but it’s a lot. I love the fact that I can read reviews on books before I buy, that when I do buy they’ll turn up on time thanks to the awesome Amazon Prime. That I can buy a gift and have it delivered directly to the person, gift wrapped if necessary, and that I can send stuff back without any quibbling whatsoever. I hate Amazon, I really do. I hate the fact they take such a large percentage off authors for their books, that they pay pitiful levels of commission to their affiliates and they charge me $79 for Amazon Prime, a service that has me buying books on a whim when before I’d wait until I got up to the free order threshold by which time I’d often changed my mind. Most of all though I hate the f... Life Coach Blog: The Discomfort Zone : blogs http://www.medworm.com/rss/comments.php?id=3391053 Mon, 22 Mar 2010 12:22:33 +0100 3391053 http://www.medworm.com/index.php?rid=3298424&cid=t_107445_113_f&fid=36694&url=http%3A%2F%2Fblog.crossoverhealth.com%2F2010%2F02%2F22%2Fcareer-walkabout-going-on-and-off-the-grid%2F Walkabout (wôk’ə-bout’) n. A temporary return to traditional Aboriginal life, taken especially between periods of work or residence in modern society and usually involving a period of travel through the bush. A public stroll taken by an important person, such as a monarch, among a group of people for greeting and conversation. I have been off the grid for the last several months heads down on a project which is the cumulative result of my last three year walkabout. Each of the experiences I had along the way provided a stepping stone and preparation for the path that I have recently embarked on. After a couple of years of talking about health deliver reform (starting with Redefining Health Care), health care financing (Health Equity), health plan innovation (Lemhi Ventures)... Crossover Healthcare blogs http://www.medworm.com/rss/comments.php?id=3298424 Mon, 22 Feb 2010 22:49:34 +0100 3298424 http://www.medworm.com/index.php?rid=3172203&cid=t_107445_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2F79WEYfGWBKA%2F Another day, another deadline. But this is a busy world, after all. And what better way to prepare than to keep up with events. So, as you gird for the challenges ahead, here are a few items to help you along. As for us, we will reach for our usual cup of stimulation. Have a good day, everyone… FDA Issues New Guidance To IRBs On Multi-Site Trials (OutsourcingPharma) US Pharmacopeia Recalls New Edition Of USP-NF (statement) Glaxo Forms Global Media Team (PR Week) Blood Pressure Drugs May Cut Dementia Risk (Bloomberg News) Glaxo Sees Little Generic Threat To Advair (Reuters) (Source: Pharmalot) Pharmalot blogs http://www.medworm.com/rss/comments.php?id=3172203 Thu, 14 Jan 2010 12:01:24 +0100 3172203 http://www.medworm.com/index.php?rid=3056584&cid=t_107445_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F12%2F03%2Fnew-england-journal-of-medicine-2009-vol-361-no-22%2F This article provides a review of thiazide diuretics which were introduced in the late 1950s as the first effective oral antihypertensive agent with acceptable side-effects. This article focuses on the diuretics most often indicated for long-term therapy of hypertension. (Print subscription held at Fade Library) Posted in Journals Tagged: Anti Hypertensive Agents, Diuretics, Hypertension (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3056584 Thu, 03 Dec 2009 16:47:43 +0100 3056584 http://www.medworm.com/index.php?rid=2868675&cid=t_107445_77_f&fid=37259&url=http%3A%2F%2Fwww.horizonpress.com%2Fblogger%2F2009%2F10%2Frnai-to-treat-chronic-hepatitis-b-virus.html Chronic infection with the hepatitis B virus (HBV) occurs in approximately 6% of the world's population and carriers of the virus are at risk for complicating hepatocellular carcinoma (HCC) and cirrhosis. Although effective vaccination is available, it is prophylactic and of little use to individuals who are already infected with the virus. Furthermore, current treatment options have limited efficacy and chronic HBV infection is likely to be a significant global medical problem for many years to come. Silencing HBV gene expression by harnessing RNA interference (RNAi) presents an attractive option for development of novel and effective anti HBV agents. Numerous studies have reported highly successful suppression of viral replication, which bodes well for employing this approach to counter ... Microbiology Blog: The weblog for microbiologists. blogs http://www.medworm.com/rss/comments.php?id=2868675 Wed, 07 Oct 2009 15:27:00 +0100 2868675 http://www.medworm.com/index.php?rid=2584237&cid=t_107445_113_f&fid=36694&url=http%3A%2F%2Fblog.crossoverhealth.com%2F2009%2F07%2F08%2Fcode-red-why-proprietary-hit-vendors%2F CODE RED (kōd rĕd) n. A system of hospital codes used world wide to alert staff to emergency conditions Codes intended to convey essential information quickly with minimal understanding “Code Red” typically implies catastrophic, life threatening emergency I had the privilege to meet with Phil Longman several years back at a cafe in Washington DC when he was researching out information for his landmark piece on the Vista EHR developed by the VA. The report was so successful that Phil ultimately turned it into a book. I was interviewed at length for the book and was able to provide some of the good source material on the history of Vista from some of its luminary developers. Phil recently contacted me for his most recent bombshell, “CODE RED – How Software Compani... Crossover Healthcare blogs http://www.medworm.com/rss/comments.php?id=2584237 Wed, 08 Jul 2009 13:32:05 +0100 2584237 http://www.medworm.com/index.php?rid=2570675&cid=t_107445_113_f&fid=36694&url=http%3A%2F%2Fblog.crossoverhealth.com%2F2009%2F07%2F02%2Fwhats-the-new-spelling-for-the-ama-s-e-r-m-o%2F Spelling (spĕl’ĭng) n. The forming of words with letters in an accepted order; orthography. The art or study of orthography or the way in which a word is spelled. Whoa . . . just ahead of a 21% cut in physician salaries we have an epic battle shaping up within the physician community. The AMA, long the Godfather and voice of physicians around the country, apparently is feeling the heat from a younger, more svelt upstart from across (cyber)town. I have just received back to back emails from Sermo CEO Daniel Palestrant essentially declaring his succession from the physician union. This comes at a critical time when further fracturing of physician leadership and political strength put in jeopardy the opportunity for the physicians to have a unified voice (or is it because the stakes... Crossover Healthcare blogs http://www.medworm.com/rss/comments.php?id=2570675 Thu, 02 Jul 2009 18:58:50 +0100 2570675 http://www.medworm.com/index.php?rid=2266685&cid=t_107445_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2009%2F03%2F13%2Ffriday-flashback-for-march-13-2009%2F Well, one day last week it was 60 degrees here in New England, and then a few days later it’s snowing. It must be March. And if it’s Friday, it must be time for another Friday Flashback while I’m attending the annual SXSW conference in Austin, Texas. Yes, I’ll eat some BBQ for you. 10 Years Ago on Psych Central Detecting Deception A decade ago, I wrote about the research to-date that demonstrated how lousy human beings are in detecting deception in others — to catch another person in a lie. “The conclusions from this research are obvious — trained professionals and untrained laypeople, in general, cannot tell when a person is lying.” A decade later, our ability to detect deception has increased slightly and 4 years ago, we noted Paul Ekma... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=2266685 Fri, 13 Mar 2009 16:50:09 +0100 2266685 http://www.medworm.com/index.php?rid=2258289&cid=t_107445_113_f&fid=36694&url=http%3A%2F%2Fblog.crossoverhealth.com%2F2009%2F03%2F12%2Fprimary-care-possibilities-kaiser-leads-the-way-again%2F Leadership (lē’dər-shĭp’) n. The position or office of a leader Capacity or ability to lead Guidance; direction I have written extensively about Kaiser Permanente in the recent past (here, here, and here) - not only for their notable achievements but even more impressive to me is their genuine interest to share their results with others as model for global health improvement. The recent issue of Health Affairs has two impressive articles from Kaiser regarding their EHR implementation as well as their Online Portal efforts. Great material. As part of the same issue, Health Affairs newest contibutor Carleen Hawn highlighted the work of Ted Eytan in an article discussing the new social media delivery model. The article was a campy, highly conversational piece introducing som... Crossover Healthcare blogs http://www.medworm.com/rss/comments.php?id=2258289 Thu, 12 Mar 2009 14:28:17 +0100 2258289 http://www.medworm.com/index.php?rid=2234316&cid=t_107445_113_f&fid=36694&url=http%3A%2F%2Fblog.crossoverhealth.com%2F2009%2F03%2F02%2Fhealth-care-moonshot-the-health-care-x-prize-development-project%2F Moonshot (mūn shŏt) n. Description of the audacious attempt and the subsequent race to place a man on the moon Used as an analogy to describe similarly gigantic challenges under competitive influence The best health care book I have ever read, is ironically the first one I was fortunate to pick up. “Redefining Health: Creating Value Based Competition on Results” literally became a life altering experience for me as I read it at a time when I was seeking to redefine my career path. The notions of health care value (outcomes/price), the organizational principles engendered by this approach (focus on the medical condition across the full cycle of care), the competitive forces that this framework unleashes (virtuous cycles of innovation), and the overall promise for improving our deliv... Crossover Healthcare blogs http://www.medworm.com/rss/comments.php?id=2234316 Mon, 02 Mar 2009 11:59:42 +0100 2234316 http://www.medworm.com/index.php?rid=2234317&cid=t_107445_113_f&fid=36694&url=http%3A%2F%2Fblog.crossoverhealth.com%2F2009%2F03%2F02%2Fdartmouth-atlas-elliot-fisher-for-hhs-secretary%2F Atlas (ăt‘ləs) n. A book or bound collection of maps, sometimes with supplementary illustrations and graphic analyses. A volume of tables, charts, or plates that systematically illustrates a particular subject I have some reservations about Kathleen Sebelius being appointed to the new role of HHS Secretary. She certainly possess the requisite leadership, experience, and other criteria that would appear on paper to make her an excellent candidate. But I am not worried about whats on her resume, I am worried about what’s in her head.  Coming from an insurance background, I am concerned that she will be mired in the managed care thinking of the insurance world she grew up in, the bureacratic complexities of the CPT/ICD-9 coding world, and the perverse incentives and lack of sy... Crossover Healthcare blogs http://www.medworm.com/rss/comments.php?id=2234317 Mon, 02 Mar 2009 11:45:48 +0100 2234317 http://www.medworm.com/index.php?rid=2201334&cid=t_107445_113_f&fid=36694&url=http%3A%2F%2Fblog.crossoverhealth.com%2F2009%2F02%2F20%2Finterview-with-jason-hwang%2F Interview (ĭn‘tər-vyū) n. A conversation, such as one conducted by a reporter, in which facts or statements are elicited from another. An account or a reproduction of such a conversation. I have long been a fan of Clay Christensen and his concepts of Disruptive Innovation (DI). I devoured the book and the subsequent follow on books. It resonated with me because of what we were doing at Medsphere so closely aligned with what the principles and concepts in the book. As I have now transitioned more into the personal health space, and begun dabbling in health policy and systematic reform by default, I have come to further appreciate how the notions of DI can and should be applied to health care. I believe by so doing we can harvest the DI fruits of increased access, lowered costs, ... Crossover Healthcare blogs http://www.medworm.com/rss/comments.php?id=2201334 Fri, 20 Feb 2009 17:40:26 +0100 2201334 http://www.medworm.com/index.php?rid=2195389&cid=t_107445_113_f&fid=36694&url=http%3A%2F%2Fblog.crossoverhealth.com%2F2009%2F02%2F18%2Fcuomo-bully-pulpit-all-payers-database-to-be-a-reality%2F Bully pulpit (bʊl’ē pʊl’pĭt) n. Public Office of sufficiently high rank that provides the holder with an opportunity to speak out and be listened to on any matter. An effective mechanism to bring issues to the fore that were not initially in debate, due to the office’s stature and publicity. I never knew that Andrew Cuomo had such a swing. One by one he is knocking ‘em down in NY - United, Cigna, Aetna, and now Wellpoint have succumbed to Gotham’s keeper of the peace (and highly effective health care reformer). Several more payers are in his sites and given the domino effect it is only a matter of time before we hear the announcements regarding other health plans abandoning their current pricing opacity strategies. And the price of that strategy just kee... Crossover Healthcare blogs http://www.medworm.com/rss/comments.php?id=2195389 Wed, 18 Feb 2009 19:27:15 +0100 2195389 http://www.medworm.com/index.php?rid=2138331&cid=t_107445_113_f&fid=36694&url=http%3A%2F%2Fblog.crossoverhealth.com%2F2009%2F01%2F27%2Fcognitive-surplus-collective-intelligence-or-organizing-wisdom%2F Cognitive Surplus (kŏg’nĭ-tĭv sûr’pləs) n. The surplus brain power available as a result of the free time made possible through  technology advances, cultural changes, and new politico-social arrangements I have had this blog queued up for a long time and an article describing Yahoo’s renewed focus on improving the search experience tweaked me to get this out there. While I will leave the “search” technical details to others, I am most interested in the notion of “human powered” applications. You see, the human mind is truly a beautiful thing - in fact it is so beautiful that it is a terrible thing to waste. I am not talking about the “wasting” in the context of drugs, but wasting in terms of potential CPU cycles. There is a not... Crossover Healthcare blogs http://www.medworm.com/rss/comments.php?id=2138331 Tue, 27 Jan 2009 23:05:10 +0100 2138331 http://www.medworm.com/index.php?rid=2108072&cid=t_107445_113_f&fid=36694&url=http%3A%2F%2Fblog.crossoverhealth.com%2F2009%2F01%2F15%2Flaunch-personal-health-advisory-services%2F Crossover (krôs’ō‘vər) n. The adaptation of a musical style, as by blending elements of two or more styles or categories, to appeal to a wider audience. A recording designed to appeal to wide or diverse audience I have been blogging for just over two years at Crossover Health while also working as a strategic consultant in the area of health care innovation.  I have had the privilege to work with some promising companies, some great people, and some excellent ideas during that time. However, I have also been working on some of my own concepts based on the things that I have been observing. Crossover Health recently launched its beta version of personal health advisory service to South Orange County residents and employers. Crossover Health provides a new category of hea... Crossover Healthcare blogs http://www.medworm.com/rss/comments.php?id=2108072 Thu, 15 Jan 2009 15:20:08 +0100 2108072 http://www.medworm.com/index.php?rid=2104897&cid=t_107445_113_f&fid=36694&url=http%3A%2F%2Fwww.moviesoundclips.net%2Fmovies1%2Ffindingnemo%2Ffish.mp3 Scheme (skēm) n. A systematic plan of action A secret or devious plan An orderly combination of related parts “Usual and customary” just became “Transparency and consistency” The United Health Group, in what will become a sweeping decision (interesting interview with author here) within the Health Insurance industry, was just levied a $50M wrist slap by New York Attorney General Andrew Cuomo for their participation in “a scheme to defraud consumers by systematically underpaying the nation’s patients by hundreds of millions of dollars over the last decade.” While United denied any wrong doing and continues to stand by the database their subsidiary Ingenix developed to determine what appropriate reimbursement rates should be, they appear to be on the... Crossover Healthcare blogs http://www.medworm.com/rss/comments.php?id=2104897 Wed, 14 Jan 2009 09:40:48 +0100 2104897 http://www.medworm.com/index.php?rid=2093076&cid=t_107445_113_f&fid=36694&url=http%3A%2F%2Fblog.crossoverhealth.com%2F2009%2F01%2F09%2Ftransparency-trek-the-million-eob-march%2F Trek (Trĕk) n. A journey or leg of a journey, especially when slow or difficult. A journey by ox wagon, especially a migration I have been thinking alot about EOB’s. How did these anomolies of reason, this perversions of clarity, and obfuscators of objectivity come into existence? To what intent are they provided to the “beneficiary”.  Every single person I have ever spoken to goes through the same five step process when they receive an EOB: “What the heck is this?” “That office visit or procedure costs what?!” “Wait, this isn’t a bill? Why are they sending me this?” “So, how much do I owe? Doesn’t my insurance cover this? I can’t figure this out. I’ll just wait till I get the letter from collections... Crossover Healthcare blogs http://www.medworm.com/rss/comments.php?id=2093076 Fri, 09 Jan 2009 23:49:30 +0100 2093076 http://www.medworm.com/index.php?rid=2090319&cid=t_107445_113_f&fid=36694&url=http%3A%2F%2Fblog.crossoverhealth.com%2F2009%2F01%2F08%2Fpart-ii-innovators-prescription-health-care-business-models%2F This is Part II of a recap of the The Innovators Prescription: A Disruptive Solution for Health Care. It is the third installment by Clayton Christensen in his innovations series where he collaborates with the esteemed Jerome Grossman, MD and newcomer Jason Hwang, MD. This segment lays some additional foundation for understanding the general disruptive innovation framework prior to jumping into how to specifically disrupt the current hospital business model in Part III, physician clinic model (IV), Chronic Care (V), Reimbursement (VI), and Policy/Regulation (VII) BUSINESS MODEL - an interdependent system of four components: Value Proposition - helps targeted customers do more effectively, conveniently, or affordably a “job” they are trying to do Resources - the “inputs&#... Crossover Healthcare blogs http://www.medworm.com/rss/comments.php?id=2090319 Fri, 09 Jan 2009 07:01:58 +0100 2090319 http://www.medworm.com/index.php?rid=2090320&cid=t_107445_113_f&fid=36694&url=http%3A%2F%2Fblog.crossoverhealth.com%2F2009%2F01%2F08%2Finnovation-stewardship-the-kaiser-garfield-innovation-center%2F Steward (stū‘ərd) n. One who manages another’s property, finances, or other affairs. One who is in charge of the household affairs of a large estate, club, hotel, or resort. An official who supervises or helps to manage an event. I have written a few notes (here and here) regarding Kaiser Permanente (KP), including their continuing rise to lead the next wave of health care organizations creatively adopting and successfully implementing disruptive innovations. They have all the requisite features of disruption - the adoption of technology enablers, new business models of care, and due to their vertical integration value networks that reinforce one another through virtuous cycles. While KP is clearly not perfect, the scale and scope of KP is now allowing them to do things ... Crossover Healthcare blogs http://www.medworm.com/rss/comments.php?id=2090320 Thu, 08 Jan 2009 14:37:11 +0100 2090320 http://www.medworm.com/index.php?rid=2084438&cid=t_107445_113_f&fid=36694&url=http%3A%2F%2Fblog.crossoverhealth.com%2F2009%2F01%2F06%2Fnon-consumers-why-american-well-will-do-well%2F Consumer (kən-sū’mər) n. . Ultimate user of a product or service. One that consumes, especially one that acquires goods or services for direct use or ownership rather than for resale or use in production and manufacturing. HI consumers set to say HI! to physicians online January 15. I have been following American Well for the last year and have spoken at several conferences with CEO Roy Schoenberg. American Well is Act II for the Schoenberg brothers who had a successful sale of their first company CareKey to Trizetto for $100M dollars (imagine Dr. Evil saying that!) back in 2005.  Beside the immaculate dress and German accented baritone voice that had a couple of my conference colleagues swooning, Roy has a clear and compelling business proposition with American Well: utilize ... Crossover Healthcare blogs http://www.medworm.com/rss/comments.php?id=2084438 Tue, 06 Jan 2009 22:12:53 +0100 2084438 http://www.medworm.com/index.php?rid=2075474&cid=t_107445_113_f&fid=36694&url=http%3A%2F%2Fblog.crossoverhealth.com%2F2008%2F12%2F29%2Fthe-googlers-dilemma-the-stupidiest-generation%2F Stupidiest (stū’pĭd est) adj. Being the most slow to learn or understand. Tending to make poor decisions or careless mistakes. Characterized by a lack of intelligence or care; foolish or careless. I am a huge fan of the “Greatest Generation” as described by Tom Brokaw and cinematically iconized by “Band of Brothers“, “Saving Private Ryan“, “The War” by Ken Burns, and countless other films showing valiant, heroic, and sheer willpower of the era. It was a heady time of American idealism, where shared sacrifice was required for the epic battle of good versus evil. We now face challenges of similar proportions, with the global economic meltdown, intractable global terrorism, looming health care crisis and political unrest throughout... Crossover Healthcare blogs http://www.medworm.com/rss/comments.php?id=2075474 Fri, 02 Jan 2009 18:56:04 +0100 2075474 http://www.medworm.com/index.php?rid=2022026&cid=t_107445_113_f&fid=36694&url=http%3A%2F%2Fblog.crossoverhealth.com%2F2008%2F12%2F08%2Fdemocratizing-concierge-medicine-first-look-at-current-health%2F Current Health (kûr‘ənt helth) n. Membership based, comprehensive primary care practice based in San Francisco area with plans to spread branded clinics throughout the West. Millennial version of the classic vision of a trusted physician who makes house calls. As I have mentioned previously, I have been involved in some really cool projects recently that I believe are at the forefront of the wave of change that will soon wash over the health care industry as the “time for change” appears to be now. Current Health - Guardians of Your Health With that preamble, I am thrilled to introduce you to Current Health (formerly San Francisco On Call) - The Primary Care Specialists. I have had the privilege to work with Dr. Jordan Shlain, David McKie, Vy Le, and the excellent t... Crossover Healthcare blogs http://www.medworm.com/rss/comments.php?id=2022026 Mon, 08 Dec 2008 23:06:57 +0100 2022026 http://www.medworm.com/index.php?rid=2022027&cid=t_107445_113_f&fid=36694&url=http%3A%2F%2Fblog.crossoverhealth.com%2F2008%2F12%2F08%2Fmymedlab-evolution-of-dtc-lab-testing%2F Evolution (ĕv‘ə-lū’shən) n. A gradual process in which something changes into a different and usually more complex or better form. Change in the genetic composition of a population during successive generations resulting in the development of new species. In addition to my work with Current Health, I have been actively involved as a Chief Medical Advisor to leading direct to consumer laboratory testing service MyMedLab. They have developed a cost-effective, convenient, compliant, and confidential way to obtain laboratory testing results. Their model is simple, efficient, and has been found to be effective in getting people the information they need to manage their health in concert with their trusted physician advisors. However, as everyone knows, going Direct to Consume... Crossover Healthcare blogs http://www.medworm.com/rss/comments.php?id=2022027 Mon, 08 Dec 2008 02:35:43 +0100 2022027 http://www.medworm.com/index.php?rid=1999467&cid=t_107445_113_f&fid=36694&url=http%3A%2F%2Fblog.crossoverhealth.com%2F2008%2F12%2F01%2Fhealth-care-value-chain-moving-on-up%2F Value Chain (văl’yū chān) n. 1. A sequence of value-enhancing activities 2. A chain of activities that gives the products more added value than the sum of added values of all the activities. Last week I was able to participate in a very cool live podcast with the ReadWriteWeb editor Richard Macmanus. While I am still finishing up my commentary based on that experience, I did want to comment on another post by Richard who is one year into his diagnosis of Type I Diabetes. He mentioned that his favorite Health 2.0 application was MyMedLab. In full disclosure, I serve as an advisor to the company as well as a participant on the call that was conducted. I became involved with MyMedLab while conducting my own survey of promising Health 2.0 companies, tools, and technology. I was intrig... Crossover Healthcare blogs http://www.medworm.com/rss/comments.php?id=1999467 Mon, 01 Dec 2008 06:01:30 +0100 1999467 http://www.medworm.com/index.php?rid=1981466&cid=t_107445_113_f&fid=36694&url=http%3A%2F%2Fblog.crossoverhealth.com%2F2008%2F11%2F22%2Felectronic-health-record-foundation-for-excellence%2F Excellence (ĕk’sə-ləns) n. A special feature or quality that confers superiority The quality of being exceptionally good I have mentioned this many times but it bears repeating with three recent news articles - the electronic health record itself is not a game changer but it is a powerful information gathering tool. However, by gathering information in a single collaborative place, EHR technology allows all clinical providers to measure, monitor, and begin to improve the way the provide care. It is this later part, which is part of the overall organizational transformation enabled by the technology (not solely because of it), that allows an organization to achieve the promised high performance results of an often painful EHR implementation. Kaiser achieves top ranking among Cal... Crossover Healthcare blogs http://www.medworm.com/rss/comments.php?id=1981466 Sat, 22 Nov 2008 17:39:44 +0100 1981466 http://www.medworm.com/index.php?rid=1968957&cid=t_107445_133_f&fid=35096&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FAutismVox%2F%7E3%2FcS4aI67rjkI%2F While studying drug abuse and addiction, researchers at the Ohio State University College of Medicine have found a link between nicotine addiction and autism. Neurexins are proteins that, along with neurologins, are thought to play a key role in the formation and functioning of synapses, of connections between nerve cells. In the new study, a protein made by the neurexin-1 gene was found to have a very particular role, as noted in today’s Science Daily: The discovery identified a defining role for a protein made by the neurexin-1 gene, which is located in brain cells and assists in connecting neurons as part of the brain’s chemical communication system. The neurexin-1 beta protein’s job is to lure another protein, a specific type of nicotinic acetylcholine receptor, to the synaps... Autism Vox blogs http://www.medworm.com/rss/comments.php?id=1968957 Mon, 17 Nov 2008 21:20:37 +0100 1968957 http://www.medworm.com/index.php?rid=1739643&cid=t_107445_113_f&fid=36694&url=http%3A%2F%2Fcrossoverhealth.wordpress.com%2F2008%2F08%2F27%2Fballoon-mania-happy-birthday-health-20%2F Balloon Mania (bə-lūn mā’nē-ə) n. An excessively intense enthusiasm, interest, or desire over balloons; a craze of interest of the same; A focus on all aspects of balloons that inspires lively interest. Having been around for the beginning of the Health 2.0 movement, it is good to see the conference continuing into its sophomore year. Alot has and continues to happen regarding the ongoing health care innovations that collectively make up Health 2.0. An ongoing criticism and source of frustration for me has been the banter of those who continue to regard the entire space as a “farce”. People who demand the “proof”, demand unwarranted standards of outcome/impact prior to experimental implementation, and dismiss the space because current business models have ye... Crossover Healthcare blogs http://www.medworm.com/rss/comments.php?id=1739643 Wed, 27 Aug 2008 08:17:51 +0100 1739643 http://www.medworm.com/index.php?rid=1683615&cid=t_107445_136_f&fid=36162&url=http%3A%2F%2Fwww.myelomablog.com%2F2008%2F08%2F05%2Ftreatment-with-anti-anemia-drugs-may-not-be-safe-for-multiple-myeloma-patients%2F How will this affect the treatment of anemia? Will it mean more transfusions and less ESAs? I’ve only ever had a few shots of Procrit, and have never had red blood cells (just platelets). What I’m afraid will happen is that people will be afraid of ESAs. If you think about it, the statement at the end of the summary makes a lot of sense. Were the patients in the group who were given the ESAs just more sick, with a poorer prognosis? Public release date: 4-Aug-2008 Contact: Sean Wagner swagner@wiley.com 781-388-8550 Wiley-Blackwell Treatment with anti-anemia drugs may not be safe for multiple myeloma patients Thessaloniki, Greece - August 4, 2008 - A recent study published in American Journal of Hematology demonstrated that Erythropoiesis-stimulating agents (ESAs), a widely used ... beth's myeloma blog blogs http://www.medworm.com/rss/comments.php?id=1683615 Tue, 05 Aug 2008 15:44:45 +0100 1683615 http://www.medworm.com/index.php?rid=1475587&cid=t_107445_113_f&fid=36694&url=http%3A%2F%2Fcrossoverhealth.wordpress.com%2F2008%2F05%2F28%2Fmamma-mea-culpa-ingenix-goes-open-source%2F Mea Culpa (mā‘ə kŭl‘pə) n. 1. An acknowledgment of a personal error or fault 2. A statement of acknowledgment expressing regret or asking pardon I have long been a big fan of Ingenix and their mission of using information analytics to help create value. They are an impressive organization with a plethora of technology, products, and services designed to unlock the hidden value of information. They are huge, pervasive, and can be found in nearly every health plan portfolio or health care infomediary arsenal. They have an impressive vision, strong financial backing and performance (have created an additional $1B to bottom line the last five years), and are poised to lead the information age in health care. They are also controversial because to date they have been solely foc... Crossover Healthcare blogs http://www.medworm.com/rss/comments.php?id=1475587 Thu, 29 May 2008 02:51:55 +0100 1475587 http://www.medworm.com/index.php?rid=1446628&cid=t_107445_113_f&fid=36694&url=http%3A%2F%2Fcrossoverhealth.wordpress.com%2F2008%2F05%2F15%2Fgoing-off-the-grid-the-rise-of-direct-practice-medicine%2F Grid (grĭd) n. Something resembling a framework of crisscrossed parallel bars, as in rigidity or organization An interconnected system for the distribution of electricity or electromagnetic signals over a wide area, especially a network of high-tension cables and power stations. The interconnected system employed by the Medico-Industrial complex to create a third party payment systems which artificially creates complexity, increases costs, reduces quality, eliminates accountability, and destroys the patient-physican relationship. As has been documented in this blog, I have been on a health care finance reform journey the last six months. I was fortunate to be given the opportunity to work with Lemhi Ventures (outstanding group of health care innovators) on looking at new models of heal... Crossover Healthcare blogs http://www.medworm.com/rss/comments.php?id=1446628 Fri, 16 May 2008 05:57:11 +0100 1446628 http://www.medworm.com/index.php?rid=1280821&cid=t_107445_10_f&fid=35345&url=http%3A%2F%2Fwww.gideononline.com%2Fblog%2F2008%2F03%2F05%2Femergence-of-infectious-diseases-in-the-21st-century%2F As of 2008, mankind is confronted by 346 generic infectious diseases, distributed in a seemingly haphazard fashion across 220 countries. An average of three new diseases are described every two years - and a new infecting organism is published every week ! Over 1,600 human pathogens have been reported, each with a specific set of phenotypic, genomic and susceptibility characteristics which must be confronted by diagnostic laboratories and clinicians. The pathogens are in turn confronted by 276 generic anti-infective agents and 67 vaccines - marketed under 10,493 proprietary names. Table 1, below, lists the major infectious diseases and pathogens which have been reported since 1972. Many conditions on this list (ie, Lyme disease, Legionellosis, Cyclosporiasis) are in fact old diseases whic... GIDEON blog blogs http://www.medworm.com/rss/comments.php?id=1280821 Wed, 05 Mar 2008 15:33:39 +0100 1280821 http://www.medworm.com/index.php?rid=1184792&cid=t_107445_113_f&fid=36694&url=http%3A%2F%2Fcrossoverhealth.wordpress.com%2F2008%2F01%2F28%2Fcollective-intelligence-the-network-is-nirvana%2F Collective Intelligence (kə-lĕk’tĭv ĭn-tĕl’ə-jəns) n. 1. Collective intelligence is a form of intelligence that emerges from the collaboration and competition of many individuals. 2. Collective intelligence appears in a wide variety of forms of consensus decision making in bacteria, animals, humans, and computers. 3. The study of collective intelligence may properly be considered a subfield of sociology, of business, of computer science. The basis of this blog is a grossly misinformed comment I read on the January 24, 2008 HIStalk update: From Cady Heron: “Re: Misys. Misys will have a big roll-out of an SaaS solution. athenahealth may start feeling some heat if Misys can overcome its current dismal perception in the market. As my contact stated, athenahealth is nothi... Crossover Healthcare blogs http://www.medworm.com/rss/comments.php?id=1184792 Tue, 29 Jan 2008 02:56:20 +0100 1184792 http://www.medworm.com/index.php?rid=1184793&cid=t_107445_113_f&fid=36694&url=http%3A%2F%2Fcrossoverhealth.wordpress.com%2F2008%2F01%2F28%2Fthe-new-network-hello-carol%2F Medical Network (mĕd’ĭ-kəl nĕt’wûrk‘) 1. A group of health care providers who have organized themselves to provide care 2. Provider organizations who voluntarily group together and are utilized by insurance companies to seek discounted pricing in exchange for additional volume of patients for the provider. I am pleased to comment on the “grand opening” of Carol - “The (first ever) Health Care Market Place.” As I have commented before here and here, Carol represents a major innovation within healthcare at several levels: First, Carol is truly creating a centralized health care market place for consumers within a given regional community. A market place as defined by a centralized place where by consumers can shop, compare, and purchase health... Crossover Healthcare blogs http://www.medworm.com/rss/comments.php?id=1184793 Mon, 28 Jan 2008 10:57:30 +0100 1184793 http://www.medworm.com/index.php?rid=1147496&cid=t_107445_113_f&fid=36694&url=http%3A%2F%2Fcrossoverhealth.wordpress.com%2F2007%2F12%2F17%2Freality-check-from-headlines-to-prime-tap%2F Reality Check (rē-ăl’ĭ-tē chĕk) n. 1. An assessment to determine if one’s circumstances or expectations conform to reality. 2. The act of letting a real user try out prototype software. 3. Conversationally, saying “sanity check” means you are requesting a check of your assumptions. My wife recently notified me that one of my sons was going to need to have bilateral myringotomy with Tympanostomy tube placement. Apparently the persistence of fluide behind his ear drum was beginning to have an impact on his hearing. So, trying to be true to the new paradigm of health, I wanted to see if I could leverage some of the new Health 2.0 consumer tools to help me make better choices about the care that I needed for my family. So here is what I did: Review Indications for Proced... Crossover Healthcare blogs http://www.medworm.com/rss/comments.php?id=1147496 Mon, 17 Dec 2007 15:07:50 +0100 1147496 http://www.medworm.com/index.php?rid=1064203&cid=t_107445_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2007%2F12%2F01%2Flearning-about-psychiatric-advance-directives%2F Last week the topic of a psychiatric advance directive, or PAD, came up in the Wall Street Journal in an article entitled, Helping Mental Patients Gain Some Control Over Treatment. A psychiatric advance directive allows a person with a mental illness to state preferences for, or dislikes of, specific treatments, designate a proxy decision-maker or make other advance decisions about their mental health care and treatment. For instance, if you know you have a bad reaction to Haldol, but may not be believed when you’re in a manic or delusional state, a psychiatric advance directive helps communicate that vital information to a treatment team. Why wouldn’t a doc just consult your medical chart for such information? Well, largely because charts are still paper and institutional or ... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=1064203 Sun, 02 Dec 2007 00:42:06 +0100 1064203 http://www.medworm.com/index.php?rid=1147501&cid=t_107445_113_f&fid=36694&url=http%3A%2F%2Fcrossoverhealth.wordpress.com%2F2007%2F11%2F28%2Fgenomics-vs-proteonomics-accessorizing-your-genes%2F Accessorize (ăk-sĕs’ə-rīz‘) v.   1. To furnish with accessories: accessorized my outfit with a matching watch. 2. To wear or select accessories: accessorizes according to the latest fashions. I had the occasion this past weekend to be out with my wife doing some shopping. Apparently, I have been too busy of late to notice that my wardrobe had been in some decline. My wife therefore drug me out on grey Saturday (which follows Black Friday) to hit the local Nordstrom Rack. I was shamed into trying on jeans formerly priced at over $200 (who pay sthis kind of money for a pair of jeans?), gigolo bling-bling shoes (are pointy toes really appropriate for male shoes?) , and a variety of belts and watches (how does wearing a watch “change” my outfit) required to p... Crossover Healthcare blogs http://www.medworm.com/rss/comments.php?id=1147501 Wed, 28 Nov 2007 00:47:10 +0100 1147501 http://www.medworm.com/index.php?rid=1147502&cid=t_107445_113_f&fid=36694&url=http%3A%2F%2Fcrossoverhealth.wordpress.com%2F2007%2F11%2F27%2Fconsumer-enlightment-the-power-of-personalized-health%2F Enlightenment (ĕn-līt’n-mənt) n. The act or a means of enlightening; state of being enlightened. A philosophical movement of the 18th century that emphasized the use of reason to scrutinize previously accepted doctrines and traditions and that brought about many humanitarian reforms. I have been a little quite lately, for which I apologize, but have been busy with a few things that are starting to heat up. First, and foremost, I am excited to be a part of the announcement today regarding the re-introduction of MyMedLab into the ongoing wave of consumerism within healthcare. MyMedLab is yet another example of how the direct empowerment of users (ie, engaged consumers formerly known as passive patients) is enabling the transformational crossover between the traditional delivery ... Crossover Healthcare blogs http://www.medworm.com/rss/comments.php?id=1147502 Tue, 27 Nov 2007 10:21:50 +0100 1147502 http://www.medworm.com/index.php?rid=994946&cid=t_107445_113_f&fid=34657&url=http%3A%2F%2Fscottshreeve.blogspot.com%2F2007%2F10%2Fcrossover-health-next-generation.html • Crossover [’kros ‘ovr] n. 1. The appropriation of a new style by combining elements from different industries in order to appeal to a wider audience Now that the bizarro is over, I am ready to re-engage in the enterpreneurial bizarre . . . that frightful, yet exhilirating plunge into the unknown, and often deep waters, of a big blue ocean. Having sailed these waters once before, I pay no attention to the landlocked doubters who smugly gawk from the shores while secretly wishing they had the courage to sail themselves. I firmly believe there is a new world to discover, fraught with difficult challenges but also abundant with limitless possibilities.I plan to sail on a new ship, Crossover Health, which will create the path for the mass migration to the new Health 2.0 world in the y... Scott Shreeve, MD blogs http://www.medworm.com/rss/comments.php?id=994946 Wed, 31 Oct 2007 21:57:00 +0100 994946 http://www.medworm.com/index.php?rid=989974&cid=t_107445_136_f&fid=36051&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FCancerCommentary%2F%7E3%2F177011659%2F Thallion Pharmaceuticals’ novel anti-cancer drug which offers two modes of action – ECO-4601 – showed positive results from its Phase I/II clinical trial. According to Pierre Falardeau, Ph.D., chief operating officer at Thallion Pharmaceuticals in Montreal, Canada: ”In 26 patients with advanced solid tumors, treatment with ECO-4601 is safe and well tolerated, including at doses yielding plasma concentrations above the expected therapeutic threshold. ECO-4601 has a unique mechanism of action comprising two distinct activities. It inhibits the RAS/MAPK intracellular signaling pathway, which is mutated in many cancer types, and which is the target of several approved cancer drugs such as Erbitux, Avastin, Tarceva, Nexavar, and Sutent. However, unlike these drugs, our preclinical exper... Cancer Commentary blogs http://www.medworm.com/rss/comments.php?id=989974 Tue, 30 Oct 2007 04:30:03 +0100 989974 http://www.medworm.com/index.php?rid=933229&cid=t_107445_150_f&fid=35777&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FPharmalot%2F%7E3%2F166716549%2F The agency has been “investigating reports of deaths and serious cardiopulmonary reactions” in patients given ultrasounds and, as early as this week, may issue Black Box warnings since docs use the imaging agents to enhance diagnosis of heart problems, The Wall Street Journal reports. The warnings are expected to be issued for Definity, which is made by Bristol-Myers Squibb, and Optison from General Electric. The drugs, known as contrast agents, sharpen the pictures of the heart during a procedure called echocardiography. The ultrasound exams help doctors diagnose heart defects and malfunctions. The FDA has also asked the drugmakers to update their product labeling, which they have agreed to do, the FDA spokeswoman tells the paper. The warnings will caution docs not to use the ... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=933229 Sun, 07 Oct 2007 23:49:16 +0100 933229 http://www.medworm.com/index.php?rid=945314&cid=t_107445_113_f&fid=34657&url=http%3A%2F%2Fscottshreeve.blogspot.com%2F2007%2F10%2Fknowledge-prostitution-enabling.html Voyeurism (voi-yûr' ĭz'əm) n. 1. The practice in which an individual derives pleasure from surreptitiously observing people.2. Derives from the French verb voir (to see); literal translation is "seer" but with perjorative connotations.I have recently written about the need to see some more compelling business models within the emerging Health 2.0 space. My contention is that many of the current models are weak and/or not sustainable, and that collectively we could, should, and must do much better. The most common business models currently out there focus on the first part of the Health 2.0 Triple A - a variation on the "aggregator model" theme. Within the aggregator theme, there are three distinct categories:Prostitution. Aggregate a uniquely "experienced" group (physicians, patients w... Scott Shreeve, MD blogs http://www.medworm.com/rss/comments.php?id=945314 Fri, 05 Oct 2007 07:08:00 +0100 945314 http://www.medworm.com/index.php?rid=928761&cid=t_107445_113_f&fid=34657&url=http%3A%2F%2Fscottshreeve.blogspot.com%2F2007%2F09%2Fhealth-20-business-model-payment.html Business Model (bĭz'nĭs mŏd'l) n. The plan implemented by a company to generate revenue and make a profit from operations. The model includes the components and functions of the business, as well as the revenues it generates and the expenses it incurs.A business model is a conceptual tool that contains a big set of elements and their relationships and allows expressing the business logic of a specific firm.It is a description of the value a company offers to one or several segments of customers and of the architecture of the firm and its network of partners for creating, marketing, and delivering this value and relationship capital, to generate profitable and sustainable revenue streams. My little daughter has a children's book wherein you have to try to find the baby. It cutely takes ... Scott Shreeve, MD blogs http://www.medworm.com/rss/comments.php?id=928761 Fri, 05 Oct 2007 06:49:00 +0100 928761 http://www.medworm.com/index.php?rid=921664&cid=t_107445_113_f&fid=34657&url=http%3A%2F%2Fscottshreeve.blogspot.com%2F2007%2F10%2Fpithy-party-histalk-turns-one-million.html Pithy (pĭth'ē) Precisely meaningful; forceful and brief. Consisting of or resembling pith (essential or central part or significance) As many of you know, the reigning czar of Health care IT Mr. HIStalk will soon celebrate his 1,000,000 visitor to his blog site. I was first made aware of his site when I was preparing to be interviewed by him in August of 2005. It was actually one of the first times I had ever paid attention to the blogging phenomenon and was surprised by the positive reaction and intense response to our interview there. It was clear that it was quite an influential place among the health care IT intelligentsia.Having now religiously read and followed the ongoing success and influence of HISTalk, I am pleased to see that Tim will have successfully completed his "million-p... Scott Shreeve, MD blogs http://www.medworm.com/rss/comments.php?id=921664 Tue, 02 Oct 2007 17:39:00 +0100 921664 http://www.medworm.com/index.php?rid=907013&cid=t_107445_113_f&fid=34657&url=http%3A%2F%2Fscottshreeve.blogspot.com%2F2007%2F09%2Fathena-health-history-of-first-health.html Initial Public Offering (ĭ-nĭsh'əl pŭb'lĭk ô'fər-ĭng) n.The first sale of stock by a private company to the public.Stock issued typically to raise capital and gain access to public marketsSale of stock typically handled by underwriters who determine type, quantity, and price of stock soldI have previously written on several occasions about one of my all-time favorite companies - Athena Health. It is appropriate to once again put finger to key to congratulate Jonathon Bush, Todd Park, Nancy Brown, Ed Park, Jon Hallock, and the rest of the Athenista's for their recent IPO (September 20, 2007). It was the largest IPO of 2007 and bodes well for the ongoing wave of investment in healthcare information technology.I find the history, growth, and now the prosperity of Athena to be fascinat... Scott Shreeve, MD blogs http://www.medworm.com/rss/comments.php?id=907013 Thu, 27 Sep 2007 04:45:00 +0100 907013 http://www.medworm.com/index.php?rid=822997&cid=t_107445_113_f&fid=34657&url=http%3A%2F%2Fscottshreeve.blogspot.com%2F2007%2F08%2Fdna-hucksters-future-of-snake-oil.html (snāk oil) n. 1. A worthless preparation fraudulently peddled as a cure for everything that ails a person.2. A product that has been proven to not live up to the vendor's marketing hype.3. Speech or writing intended to deceive; humbug.I am a big fan of Direct to Consumer (DTC) testing*, believing that allowing consumers the opportunity to have direct access to testing can be a positive step in empowering consumers to get involved with their healthcare. I believe that the DTC model can significantly increase the efficiency while dramatically reduce the cost of obtaining routine laboratory testing. I also believe that the DTC model can and should be consistent with the care being received under the direction of the "trusted advisorship" of a personal physician. Again, optimal care can be re... Scott Shreeve, MD blogs http://www.medworm.com/rss/comments.php?id=822997 Sun, 26 Aug 2007 14:42:00 +0100 822997 http://www.medworm.com/index.php?rid=803557&cid=t_107445_113_f&fid=34657&url=http%3A%2F%2Fscottshreeve.blogspot.com%2F2007%2F08%2Fginormous-going-gaga-over-google.html Gaga (gä'gä') adj. 1. Afflicted with or exhibiting irrationality and mental unsoundness 2. Completely absorbed, infatuated, or excitedOK, it was bound to happen. After more than a year of dithering, whispering, false (advertising) missteps, and hinting, it looks like we are going to get our first glimpse of "Google Health" (will the real Google Health please stand up). An article that appeared in the New York Times yesterday restoked the fires of possibility for Google's anticipated tour de force entry into healthcare. My Google Alerts picked up the story, which I then tracked on my Google Reader of top healthcare blogs, which I immediately forwarded to friends via Gmail, before settling in to write this on my Google Blogspot (I hope you are picking up on the theme; kinda scary isn't it)... Scott Shreeve, MD blogs http://www.medworm.com/rss/comments.php?id=803557 Wed, 15 Aug 2007 06:48:00 +0100 803557 http://www.medworm.com/index.php?rid=799201&cid=t_107445_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2Fbrokers-as-a-mirror-of-the-health-system.html Brian KlepperOver at The Health Care Blog, while my pal Matthew Holt is honeymooning with his lovely bride Amanda for the next week and a half, I've taken on a share of the guest cage-rattling responsibilities. Yesterday and today, I'm presenting the case against broker's excessive compensation and their financial conflicts with health plans. At the same time, though, I also point to their roles as sin-eater/intermediary in an increasingly contentious health plan - benefits manager/enrollee relationship.So its not either/or. Stop in here first and then visit there.  There's plenty of rabble rousing to go around.  (Source: The Doctor Weighs In) The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=799201 Tue, 14 Aug 2007 13:24:31 +0100 799201 http://www.medworm.com/index.php?rid=674870&cid=t_107445_113_f&fid=34657&url=http%3A%2F%2Fscottshreeve.blogspot.com%2F2007%2F06%2Fchange-agents-knowledge-prosititution.html Prostitution (prŏs'tĭ-tū'shən) n. The act or practice of engaging in questionable work for hire. The act or an instance of offering or devoting one's talent to an unworthy use or cause.I couldn't help the title - with all the Paris Hilton stuff in the news - you just have to wonder what people will really do for a buck. Therefore, it is with some surprise that I continue to learn about the questionable underbelly enabled by the Health 2.0 movement. Having already profiled Practice Fusion's business model (and the subsequent industry satire)I can't help but wonder about what Sermo is doing.First off, I want to congratulate Daniel Palestrant, MD for bailing out of his surgical residency to pursue the dream of aggregating physician conversation. I like what Sermo is trying to do: "challen... Scott Shreeve, MD blogs http://www.medworm.com/rss/comments.php?id=674870 Fri, 08 Jun 2007 18:48:00 +0100 674870 http://www.medworm.com/index.php?rid=594293&cid=t_107445_113_f&fid=34657&url=http%3A%2F%2Fscottshreeve.blogspot.com%2F2007%2F05%2Fred-hat-summit-sun-sand-and-health-20.html Summit (sŭm'ĭt) n. The highest point or part; the top. The highest level or degree that can be attained. A conference or meeting of high-level leaders, usually resulting in a call to actionAs mentioned previously, I was fortunate to visit with the Matthew Szulik, the CEO of Red Hat last fall. We discussed a wide range of topics, including how Red Hat could potentially get involved with the largest industry in the world - healthcare. Matthew was much taller than I expected (and I was much younger than he expected), and I was impressed with him on multiple levels, including his vision for what Red Hat was "really" about.I like to think I left him with a favorable impression as well, as both a huge healthcare initiative (beginning with the recent HIMSS announcement and webinar [no longer av... Scott Shreeve, MD blogs http://www.medworm.com/rss/comments.php?id=594293 Mon, 07 May 2007 04:32:00 +0100 594293 http://www.medworm.com/index.php?rid=574903&cid=t_107445_113_f&fid=34657&url=http%3A%2F%2Fscottshreeve.blogspot.com%2F2007%2F04%2Fjust-trust-me.html Trust (trŭst) n. Firm reliance on the integrity, ability, or character of a person or thing. The condition and resulting obligation of having confidence placed in one. Something committed into the care of another; custody or charge.With a small and growing family, I have had the privilege to see more Disney movies than should be humanly allowed. One of my favorite movies is the Jungle Book, and one of my favorite characters is Kaa, the snake with the kaleidoscope eyes. Kaa is constantly trying to lure Mowgli into his grasp by lulling him to sleep. You recall the gravely voiced crooning:Trussst in meJussst in MeSsshut your Eyesssand trussst in meSsslip in to sssilent ssslumberSssail on a sssilver missstSsslowly and sssurely your sssensssesssWill csseassse to resssissstI thought of Kaa as I... Scott Shreeve, MD blogs http://www.medworm.com/rss/comments.php?id=574903 Tue, 24 Apr 2007 22:25:00 +0100 574903 http://www.medworm.com/index.php?rid=552736&cid=t_107445_113_f&fid=34657&url=http%3A%2F%2Fscottshreeve.blogspot.com%2F2007%2F04%2Ftales-of-slacer_18.html Scapholunate Advanced Collapse (SLAC)1. Refers to a specific pattern of osteoarthritis and subluxation which results from untreated chronic scapholunate dissociation or from chronic scaphoid non-union;2. Degenerative changes occur most often in areas of abnormal loading; typically involves the radial-scaphoid joint initially, followed by degeneration in the unstable lunatocapitate joint, as capitate subluxates dorsally on lunate.OK, I admit it, I am a SLACer.After a 20 year career of serious hoops and football at the collegiate level, I was diagnosed with SLAC on my right wrist in November 2001. I had just finished competing in my first mini-triathlon and had noticed some increasing pain in my right wrist during training. I had noticed this pain on and off for several years, particularly a... Scott Shreeve, MD blogs http://www.medworm.com/rss/comments.php?id=552736 Wed, 18 Apr 2007 23:30:00 +0100 552736 http://www.medworm.com/index.php?rid=503968&cid=t_107445_87_f&fid=34865&url=http%3A%2F%2Fwww.thecancerblog.com%2F2007%2F03%2F27%2Fsunscreens-themselves-may-cause-skin-cancer%2F Filed under: Skin Cancer, Research, Daily newsThe skin cancer we so desperately try to avoid may be caused, in part, by the very thing we use to prevent the disease -- sunscreen.Scientists at the University of California report in the journal Free Radical Biology & Medicine that some of the chemicals found in sunscreen products can become cancer-causing agents once they are absorbed into the skin.And perhaps this is why more and more people are developing skin cancer, despite the increasing use of sun lotions."Sunscreens may be doing more harm than good," says lead researcher Dr. Kerry Hanson. May is the important word here. Sunscreens may contribute in some way to the incidence of skin cancer. But the jury is still out. And experts are not sure right now how significant this research ... The Cancer Blog blogs http://www.medworm.com/rss/comments.php?id=503968 Tue, 27 Mar 2007 04:00:00 +0100 503968 http://www.medworm.com/index.php?rid=463847&cid=t_107445_113_f&fid=34657&url=http%3A%2F%2Fscottshreeve.blogspot.com%2F2007%2F02%2Fhimss-iii-showing-your-underwear.html Underwear (ŭn'dər-wâr') n. Clothes worn next to the skin, beneath one's outer clothing.Clothes that typically cover private areas to avoid exposure. On Tuesday night, I had the distinct pleasure of attending the Athenahealth private party at Uptown Cajon in New Orleans. The restaurant is owned by a cousin (Vinny?) of one of the senior sales executives at Athena. I got to learn about the history of the restaurant, including how it was the realization of a life-long dream and a dying father to open the restaurant; that it was the first new restaurant to open up after Katrina; and that it was the first ever smoke-free restaurant in New Orleans. The food proved to be excellent and I recommend to anyone who visits NOLA (New Orleans, Louisiana - baby!). I had originally planned to attend a... Scott Shreeve, MD blogs http://www.medworm.com/rss/comments.php?id=463847 Thu, 01 Mar 2007 02:57:00 +0100 463847 http://www.medworm.com/index.php?rid=463855&cid=t_107445_113_f&fid=34657&url=http%3A%2F%2Fscottshreeve.blogspot.com%2F2007%2F02%2Fchange-agents-achieving-healthcare.html Equity (ĕk'wĭ-tē) n. 1.The state, quality, or ideal of being just, impartial, and fair.2. Justice applied in circumstances covered by law yet influenced by principles of ethics and fairness.The second profile in my ongoing review of vanguard Health 2.0 companies spotlights Utah-based HealthEquity. The company was founded in 2003 by my medical school classmate Steve Neeleman, a board certified general surgeon (we also both attended residency programs at the same school), and kid brother of Jet Blue founder David Neeleman. Rose and Gary should be proud of their boys, who have always sought to make the world a better place with their combination of insight, innovation, and intrepidness. While David is currently much more well known, Steve is an very successful entrepreneur in his own right... Scott Shreeve, MD blogs http://www.medworm.com/rss/comments.php?id=463855 Mon, 19 Feb 2007 19:49:00 +0100 463855 http://www.medworm.com/index.php?rid=463856&cid=t_107445_113_f&fid=34657&url=http%3A%2F%2Fscottshreeve.blogspot.com%2F2007%2F01%2Fhealthcare-20-prevention-experience.html Prevention (prĭ-věn'shən) n.1. The act of preventing or impeding2. A hindrance; an obstacle3. A "preventive"My tour of the Health 2.0 companies begins by focusing on the "Prevention Experience." Earlier this month, a new company with lots of big name healthcare people announced to world (via the Wall Street Journal) that they would like to engage the American public on a new model of healthcare - based on healthcare and NOT diseasecare (see previous post).That is an interesting concept, and something that I have seen repeatedly within the healthcare reform literature that is growing steadily larger. More impressive, it is part of the outcomes and results reporting movement where we are seeing showing that with appropriate "care models" (managing medical conditions over the complete cycl... Scott Shreeve, MD blogs http://www.medworm.com/rss/comments.php?id=463856 Wed, 24 Jan 2007 22:40:00 +0100 463856