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Monday, February 1, 2016


I heard an NPR segment while driving last week, featuring someone from this organization. I forget the topic, but I did shout a note in my iPhone while stopped at a red light to look them up. Check them out. their tagline -- "reporting from the frontiers of health and medicine" -- seems rather spot on. I've been reading through various articles and watching some of their videos. A lot of nice content, pretty much spanning the gamut.

Topically, first, "The Regulars."
  • Morning Rounds: Your daily dose of news in health and medicine 
  • Pharmalot: Taking stock of the drug industry, from the lab to the medicine chest 
  • Gut Check: Going beyond the headlines to make sense of scientific claims
  • Science Happens! A video series that takes you inside labs to see discoveries in action
  • The Watchdogs: Keeping an eye on misconduct, fraud, and scientific integrity
  • Signal Podcast: A biweekly podcast that explores how your medicines get made
  • Kendall Squared: Dispatches from the world’s epicenter for biotechnology and drug discovery
  • Pulse of Longwood: Inside one of the nation’s largest hubs of hospitals and biomedical research
  • Endnotes: Stories about people living with limited time, their caregivers, and issues they face
  • So Tell Me: A weekly conversation with people driving today’s insights and advances
Then, other topical headings.
  • In the Lab: Putting the latest scientific research under the microscope
  • Money: The business behind science, medicine, and the drug industry
  • Politics: Tracking how politics and policy intersect with science and health care
  • Health: The latest developments affecting patients and practitioners
  • First Opinion: Perspective and commentary from experts around the world
I also signed up here for their daily notices:

One more routine stop for me, in addition to my daily inbox feeds, ad hoc keyword searches, and routine first-cup-of-coffee health-related destinations such as Science Based Medicine, The Incidental Economist, The Neurologica Blog, THCB, and EHR Science, to cite just a few.

Recall my reporting in my recent WinterTech post on the startup now underway in Michigan by my Niece and her husband Jeff ("Neuro Trainer™"). Interesting STATnews video, "Could playing a dolpin in a video game help stroke patients recover?"

Not sure why this embedded so small. No adjustable H/W parameters in the iFrame code. Watch it here at the source if you wish.

Below: This was interesting in particular as well:
Updated: Experts argue the benefits, pitfalls of a unique patient identifier

Your medical records probably bear different numbers — one for your primary care physician and his or her medical group, one for each hospital you’ve been treated in, different ones for different specialists. This can make it difficult to retrieve your medical information.A common way to match and collect health records is by using a person’s name and birthdate. But consider this: In a health database of 3.5 million Houston-area residents, about 70,000 share the same first name, last name, and birthdate.

When the Health Insurance Portability and Accountability Act was signed into law in 1996, it called for creating “a standard unique health identifier for each individual” to make it easier to link a person with all of his or her health information, no matter where it was stored. In 1998, Congress eliminated that requirement and even prohibited the use of federal funds to develop a unique identifier.Twenty years later, the issue is still very much alive. STAT asked experts to offer their perspectives on why the United States should, or should not, create a unique health identifier for each of us.Tommy G. Thompson: Test identifier to fight medical fraud

Michael D. Greenberg: Unique identifier could protect privacy
Adrian Gropper: Identifier adds nothing beyond “coercive surveillance”
Douglas Fridsma: Make the conversation about patient benefits
Twila Brase: Block the identifier, block national health care
Stephen Smith: Unique identifiers work in the UK...
I follow Dr. Gropper a lot, and have seen him at various conferences I cover.
By Adrian Gropper: Implementing a unique patient identifier would add nothing to our health care system beyond coercive surveillance. It would collect information about us without our consent or even our knowledge, much as the National Security Agency has been doing with telephone records.

Patients are just people. Why bother with a number when scanning the iris of the eye is arguably a perfect way to identify each of us. The technology for doing this is becoming almost as inexpensive as that needed to read a credit card. It’s not a stretch to imagine iris scanners appearing in doctors’ offices, hospitals, ambulances, and the like to match individuals with their health records.

That might be efficient, but it isn’t voluntary and offers us no say about what information is matched and who has access to it, nor does it offer any transparency into the process.

There are other ways to accurately match individuals with information about them. The Internal Revenue Service, for example, is quite good at matching people with their financial information by asking for their name, date of birth, and Social Security number the first time they register at a bank or employer. For health, we could ask individuals to supply their name and an email address, cellphone number, or other familiar unique identifier. Then, whenever an entity wants to access an individual’s data, be it a physician, lab, pharmacy, insurer, or someone else, a notification would automatically be sent to the person by email or text asking if that’s what they intended. This kind of familiar opt-in system gives the individual control over his or her data and the ability to see who is looking at it.

Access to our health information is a first-order privacy issue. Most of the matching and access is done for purposes that don’t benefit the patient. Some access is done for risk adjustment, some for marketing services, and some for setting prices while effectively keeping cost and quality in medicine a secret. Take a look at TheDataMap, developed by Latanya Sweeney of Harvard University’s Data Privacy Lab, to see the types of organizations that routinely tap into our health information.

Americans need a health care system that encourages trust in our doctors, labs, pharmacies, hospitals, and more. You don’t build trust in a system by introducing involuntary and coercive practices like a unique patient identifier just because they are efficient.

Adrian Gropper, MD, is chief technology officer for Patient Privacy Rights.
I've been hip to Dr. Latanya Sweeney for years, I cited her on this blog back in 2011.

So, given that my interests on this blog extend out from its onset core of Health IT per se to overlapping and interweaving topics such as HIT "UX," informatics/"data" issues more broadly (including the misnomer "interoperability"), process QI, applied clinical science (inclusive of "the Omics"), medical pedagogy and clinical cognition (and the so-called "Art of Medicine"), HIT privacy, health care economics (including IP, VC investing, and the impacts of AI) and public policy, and organizational dynamics, etc., -- and, of course, the "caregiver" and "patient experience," -- will surely keep me even busier.



My friend Joe Flower has a new post up on LinkedIn:

Who Is The Real Customer In Healthcare?

Almost none of the buy or pricing decisions involve people "playing" with their own money and their own health. The buying decisions are mostly made by the medical practitioners themselves, and the pricing decisions are mostly made in negotiations between each medical organization and the insurance companies, or between the whole industry and the government, for Medicare and Medicaid.

A real customer is the person who gets the benefit of the product, who can choose it, who pays enough of the cost for it to make a difference in their choice—and who can walk away from the deal, shop elsewhere, buy an alternative way to solve the problem, or even buy nothing. None of that is true of the patient in the traditional healthcare setup...
Tell me about it.

Below, more shots at MU:
How has meaningful use really affected healthcare providers?

We praised the inclusion of HITECH in the American Recovery and Reinvestment Act of 2009 as a stimulus to expand EHR adoption and improve the quality and effectiveness of patient care for all time. Today, many respected healthcare leaders argue that it is time to declare victory and move on.

Those leaders were recently encouraged by CMS leader Andy Slavitt’s announcement that Meaningful Use would end soon and be replaced by something better. Unfortunately, “April Fools” was declared only two days later, when CMS administrators, including Karen DeSalvo, MD, National Coordinator for Health Information Technology, said the program was going to be with us for the foreseeable future. Now, we can look forward to more good ideas from our government.

It is time to consider the impact of Meaningful Use. How has it affected the provider community? How has it accelerated, or retarded, the innovation of healthcare practice? How has it influenced the economics of healthcare? What has it done for the most important stakeholder, the patient? If it has not achieved the full potential ascribed to HITECH, what are the causes and what are the best next steps?...
Well, HITECH was the source of my REC job. Not that I didn't take my own shots at it. Now, with the bulk of the MU money all essentially out the door (~$32 billion), it should be a relatively easy kill -- though, with this being an election year, we may not see a lot done on The Hill across a breadth of legislative areas (with the likely exception of several more Quixotic bills declaring ObamaCare repealed for the umptie-dozenth time).


I've had my recent observations regarding the travails of Theranos, here, here, and here. STATnews is on it today.

Is Theranos done?

The Silicon Valley upstart wowed the medical world with a whopping $9 billion valuation, a supremely media-savvy CEO and the promise that it could revolutionize health care by using just a few drops of blood to run scores of lab tests at a fraction of the current cost.

But these days, Theranos is sinking deeper and deeper into a quagmire. Regulators keep issuing sharp warnings about its lab practices. Pharmacies keep pulling back from its partnerships. The Wall Street Journal keeps raising questions about its technology.

Does Theranos have a chance to regain the confidence of potential investors, partners, and patients — or is it on an irreversible decline? For clues, keep an eye in the coming months on these five bellwethers...
Good piece. Read all of it.


Looks like Theranos is back actively and adversely in the news. Daily Beast:
Theranos Sounded Too Good to Be True—and It Is

...“Is Theranos Finished?” asked health and medicine outlet STAT, which noted that the company “didn’t respond to questions about how it’s doing financially.” Between the government regulation and the rocky business deals, those are reasonable questions to ponder....

More to come...

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