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Keep wasting your money, Silicon Valley venture capitalists

Silicon Valley is at it again.

Last week, digital health accelerator Rock Health unveiled its new offices, and from the news coverage, it seems as if it’s creating an image as much as incubating startup companies.

According to Xconomy, “a big crowd of investors, executives, and other life science industry insiders took time away from JP Morgan to attend the grand opening of Rock Health’s stylish new headquarters in the Mission Bay neighborhood of San Francisco.” And stylish it is.

“Rock Health’s kitchen and community gathering space includes a Cirque-du-Soleil-style swing,” Xconomy reported. Because, you know, incubating companies that will fix a broken $2.8 trillion industry with their “solutions” requires a little avant-garde spectacle à la Québécoise — or perhaps Las Vegas. Having been at the Digital Health Summit at International CES in Sin City myself a week earlier, I was happy to see more focus on substance than style in the meeting room, if not in the exhibit hall.

© Bruce Damonte/Studios Architecture

I bet that swing cost a lot of money. So did the design, since Xconomy saw fit to identify the architecture firm. (For that matter, so did I, but only to give proper credit for the photo.) In an industry where a third or more of spending is wasteful — completely irrelevant to care and probably preventable — according to a 2012 report in Health Affairs, are such frills really necessary? I’m certainly not blaming Rock Health here. It’s the investors who are throwing away their money.

In opening the center, Rock Health reportedly dubbed Mission Bay the ‘United States’ New Digital Health Hub.'” That’s a bold statement. There certainly is a lot of potential there, but, as the person who identified San Diego as “a leader in mobile healthcare” back in January 2010, I still see more substance and tangible results in Southern California than in Northern California. For that matter, the Boston area could make a strong case, as could New York City. Smaller but healthy communities have popped up in places like Madison, Wis. That’s fine, competition is good.

However, I’ve seen more failures in Silicon Valley than anywhere else. But does that stop Silicon Valley’s No. 1 media cheerleader, TechCrunch, from declaring, “VC’s Investing To Heal U.S. Healthcare”? No, it does not.

No flame-out has been as spectacular as that overhyped vaporware known as Google Health. Google is back at it again with its VC arm, but this time the Internet giant seems to have a direction and a clue. Maybe.

As TechCrunch reported, “Google Ventures is addressing the nation’s healthcare dilemma with investments in companies like the physicians’ office and network One Medical Group, which raised a later stage $30 million last March. At the opposite end of the spectrum in December 2013 Google invested in the $3 million seed financing of Doctor on Demand, which sells a service enabling users to video chat with doctors.”

Google appears to be scrapping the torturous direct-to-consumer route in favor of going where the money actually is, from third-party payers and from providers, newly incented under the Patient Protection and Affordable Care Act and private reform efforts to work more efficiently and better coordinate care.

On the other hand, it’s been less than two weeks since Stephen Colbert made fun of Doctor on Demand. (Health 2.0 boss Matthew Holt commented on that post that it was “Kind of unfair that Doctor on Demand get the publicity when American Well and a [scad] of others have been doing this at scale for years.” He was right, but, hey, Google.)

Google Venture General Partner Dr. Krishna Yeshwant told TechCrunch the real motive behind all the VC money flooding into healthcare. “As an entity it is where we’re spending 17 percent to 18 percent of GDP, so any one segment is tens of billions of dollars,” Yeshwant is quoted as saying. “Increasingly you’re seeing IT investors who have a fine sense of disruptive opportunities enter the market.” In other words, it’s all about the Benjamins.

But do they understand that healthcare doesn’t work like any other industry? I’m not so sure. And I haven’t even addressed the bigger questions of privacy, data stewardship, interoperability and workflow.

As you prepare your hate mail for me, check out this site, “What the F*** Is My Wearable Strategy?” (NSFW). Refresh the page for more hilarity, but be forewarned: some of the ideas may hit close to home.

You’re welcome.

January 20, 2014 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Google vs. Bin Laden?

How’s this for a headline? “Entrust my medical records to Google? I’d rather give them to Bin Laden.”

That was the headline accompanying a column in Tuesday’s London Daily Mail. Columnist Stephen Glover (no, not Steve-O of “Jackass” and “Dancing With The Stars” fame/infamy–and I only know his real name because his sister is an old friend of mine) is scared to death by the prospect of a company like Google storing medical records.

“People who deposited their medical records with Google would no doubt be given assurances that they would not be passed on to third parties. But Google would not go to the trouble and expense of storing such information unless it hoped to benefit from it in some way,” Glover writes.

“Here is a company which, through a variety of means, is building up a profile of each of us – or at any rate those of us who use computers. I understand, of course, that it has no over-arching intention of ordering or controlling our lives, and that the information it holds about us is used for its own commercial gain. But it would be absolutely the last company in the world to which I would entrust my medical records. I would far rather stick them in an envelope and send them to Osama Bin Laden or Vladimir Putin,” he continues.

Wow, I know I’ve been harsh on Google in the past, but never like that.

July 6, 2009 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Google listens

As promised, I have written something about Google‘s reaction to the inaccurate information that got into cancer survivor Dave deBronkart‘s personal health record, as chronicled in the Boston Globe. It’s over on the BNET Healthcare Blog.

Thanks to Enoch Choi for alerting me to the happenings at the Health 2.0 Meets Information Therapy conference, which I was unable to attend.

April 23, 2009 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Microsoft’s answer: No

I mentioned Wednesday morning that Microsoft and the Mayo Clinic launched their trial with HealthVault. “Left unanswered so far is whether Mayo convinced Microsoft to sign a HIPAA business associate agreement,” is what I wrote.

I then posed this question in an e-mail to Microsoft, and got a response from a publicist: “No, Microsoft did not sign a HIPAA business associate agreement with Mayo. I can tell you that Microsoft is committed to complying with applicable laws and currently complies with existing State breach notification laws. They are also committed to complying with ARRA statutes on their effective dates.”

So there’s the answer.

Meanwhile, Google seems to be taking the recent criticism about the accuracy of claims data in Google Health PHRs seriously and constructively. More on that later, as I may actually write something that I’ll get paid for. You might want to keep an eye on Dave DeBronkart’s blog, too. There’s nothing up there yet, but I imagine there will be soon. John Halamka posted his thoughts last Friday.

April 22, 2009 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Google Health and claims data

I’ve suspected for a while that one reason why personal health records haven’t taken off was because the “untethered” kind that are not tied to a specific provider organization’s electronic medical record or portal tend to be built with claims data. That is, an insurer or employer combs through billing codes to piece together records that ostensibly contain clinical records.

There are numerous problems with this, of course. First off is the workflow issue. If the doctor doesn’t have an EMR to import PHR data, then the PHR represents an extra step that the typical physician isn’t willing to take.

Then there is the reputation of managed care. Health insurers often are just slightly above oil companies, politicians and Bernie Madoff on the public’s trustworthiness scale. I imagine they’re even lower from the perspective of doctors who are asked to accept these claims-based records and use them in the practice of medicine. I’m sure there are some payer-sponsored PHRs that are fairly accurate, but they don’t ever get much of a chance because of this perception.

That said, claims-derived PHRs can never be fully accurate representation of health status because the ICD-9 (and soon, ICD-10) billing codes are completely different than CPT diagnosis codes. Don’t believe me? Ask Dave deBronkart, aka E-Patient Dave.

DeBronkart’s story is widely known among health IT types, but he was featured Monday in the Boston Globe. That article tells something I didn’t know, that there was inaccurate data in a Google Health PHR that had suggested cancer had spread to his brain or spine, as well as a few other false alarms.

The Globe quotes many of the usual suspects, notably deBronkart’s personal physician, Danny Sands, as well as Drs. Paul Tang, David Kibbe and John Halamka. While this may not be news for those in health IT, I think this story should be required reading for anyone considering a personal health record.

April 13, 2009 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

My BNET commentary on the Google-HIPAA issue

I’ve got a new outlet for my work, namely the BNET Healthcare Blog. My first post went up today after a couple of weeks of refining and editing—worth it only because the faster I get the hang of BNET’s style, the more I get to post on this big stage.

The subject is the denials by Google and Microsoft that their PHR offerings are not subject to the new HIPAA requirements, even though the language seems clear to me and to several experts I’ve talked to. I specifically quoted Dr. David Brailer in this post, from a conversation we had a couple of weeks ago for a story I wrote on the stimulus bill. Brailer consulted extensively with congressional staff during the legislative process.

I expect BNET to put up another post of mine on Wednesday, hopefully before HIMSS09 ends at 2:30 p.m. CDT.

April 7, 2009 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Does HITECH have teeth? Google may not think so

I was astounded today to read in Modern Healthcare (the fact that I apparently was blacklisted from writing there for reasons never explained to me makes me reluctant to link to the story) that Google says the new privacy and security rules won’t change its PHR plans.

The Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted last month as Title XIII of the American Recovery and Reinvestment Act of 2009, strengthens much of the privacy and security language of HIPAA. Some of the language effectively gives business associates the same responsibilities as covered entities when it comes to protecting patient data. Section 13408 specifically includes personal health records.

Reporter Joe Conn, my former boss and an all-round good guy (rare at MHC these days), quotes Google Health Product Manager Roni Zeiger, M.D., as saying the new legislation has no effect on the company’s offering. Zeiger actually said that Google Health, as a service offered directly to consumers, is neither a covered entity nor a business associate under the new law.

Excuse me? I’ve been struck since Day 1 with the arrogance Google seems to be exhibiting with its entry into healthcare (actually, since before Day 1, since Google says CEO Eric Schmidt’s speech to the 2008 HIMSS conference was not technically a product introduction), but it seems to me Zeiger is intimating that the law doesn’t apply to Google.

This is almost as ludicrous as former Vice President Dick Cheney suggesting in 2007 that he was a fourth branch of government.

March 4, 2009 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Google denies lobbying to kill privacy provision

Google today denied a claim by a group called Consumer Watchdog that it was lobbying to kill consumer privacy protections in proposed health IT legislation.

From the Google Public Policy Blog:

Consumer Watchdog wrong on medical records claim
Tuesday, January 27, 2009 at 3:12 PM
Posted by Pablo Chavez, Senior Policy Counsel

Earlier today a group called Consumer Watchdog put out a press release alleging a “rumored lobbying effort” by Google “aimed at allowing the sale of electronic medical records.”

This claim — based on no evidence whatsoever — is 100 percent false and unfounded.

Google does not sell health data. In fact, one of our most steadfast privacy principles is that we don’t sell our users’ personal data, whether it’s stored in Google Health, Gmail, or in any of our products. And from a policy perspective, we oppose the sale of medical information in the health care industry.

We are supportive of strong privacy protections for medical records. Consumers own their electronic medical data and should have the right to easily access their information and control who gets to see it. We also believe in data portability, and we support open standards that enable consumers to control their data and take it wherever they’d like.

We have corresponded with Consumer Watchdog several times over the past few months to hear and address their concerns. It’s unfortunate that they did not contact us before making today’s unfounded statements, because we could have told them that their claims were patently false.

At last year’s HIMSS conference, Google CEO Eric Schmidt said that the company would not attempt to monetize its health product, other than by driving people to the company’s regular search engine.

January 27, 2009 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

‘Today’ and Redbook notice mobile PHRs

Regular readers know about my skepticism toward personal health records, given the minuscule level of consumer acceptance. Manhattan Research highlighted the low uptake of PHRs in a study released Jan. 15.

“Despite significant interest in this type of service, only 7 million U.S. adults actually use PHRs,” the company said. “Compelling offerings from vendors ranging from Google, WebMD, and Microsoft to multiple insurers and employers have sparked buzz around PHR in the past year. But for average consumers not motivated by a serious illness, significant barriers such as privacy concerns, lack of understanding, and doubts to PHR efficiency hinder adoption”

At least one consumer publication thinks that might change this year. Last Friday on NBC’s “Today Show,” Redbook health editor Camille Chatterjee talked about the magazine’s 10 health trends for 2009.

Amongst such topics as the Wii Fit and, ahem, vaginal fitness, Chaterjee included online and mobile PHRs, specifically mentioning AllOne Mobile and Microsoft’s HealthVault.

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The PHR discussion starts at about 2:00. You can read the accompanying story here. Also, check out the podcast I did with AllOne Mobile’s Frank Avignone last year.

Meanwhile, HIMSS last week released a new book, “Personal Health Records: The Essential Missing Element in 21st Century Healthcare,” by Dr. Holly Miller, Dr. Bill Yasnoff and Howard Burde, all familiar names in health IT circles.

This follows on the heels of CMS launching a PHR pilot for Medicare beneficiaries in Arizona and Utah.

Are all these developments more hype or do they represent real progress?

January 26, 2009 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Greetings from MaRS

TORONTO—I’m here at the Medicine 2.0 Congress, a very international meeting put on by Dr. Gunther Eysenbach of the Centre for Global eHealth Innovation, a project of the University Health Network and the University of Toronto.

The meeting is in a place called the MaRS Centre, in the heart of what’s being called the Discovery District. It’s at the corner of College and University, right around the corner from several major hospitals, including Toronto General, Princess Margaret Hospital and Mount Sinai Hospital.

According to the Web site: “MaRS is not an acronym. It was originally a file name and the words “Medical and Related Sciences” were later attributed to it. Since we promote the convergence of a full range of science and technology disciplines, we’ve dropped ‘Medical and Related Sciences’ from our name and we’re back to just ‘MaRS.'”

So here we are in the fourth paragraph and I haven’t said a word about the conference itself. You’re going to have to wait a bit longer. I’m humbled to say that I am going to be cross-posting this week with the world-renowned Health Care Blog. It just so happens that at least two other contributors to that site are here: John Sharp and Jen McCabe Gorman—and the latter also blogs in Dutch. Rod Ward made the trip from the UK and is posting to his Informaticopia blog, Maarten den Braber from Amsterdam is Twittering and Denise Silber, who flew in from Paris, also has a blog—en français.

The conference even has its own blog: http://medicine20.crowdvine.com. So I shall try to come up with something original.

OK, paragraph six and we’re finally getting down to business. Eysenbach opened the proceedings this morning with a discussion about what health 2.0 and medicine 2.0 really mean. I’ll just link to an article that appeared in Eysenbach’s Journal of Medical Internet Research earlier this year.

Don’t believe the hype? Peter Murray, the International Medical Informatics Association‘s VP for strategic planning, just put up a slide of this graphic:

Moving along, Eysenbach suggested that Google Health and HealthVault are not personal health records but “personal health applications” or platforms. That should make the marketing folks in Mountain View and Redmond very happy, since they keep denying that they offer PHRs.

Speaking of which, even though PHRs haven’t exactly captured the public’s imagination, Eysenbach said we are moving into the realm of PHR 2.0, where people should be able to disclose information within their own PHR to others to form communities around commonalities. A prime example, he said, is Patients Like Me.

Anyway, there are 180 participants from 19 countries here, with a slant toward the academic side of medical informatics. In fact, there are proceedings of this conference that are freely available. There are some 67 poster presentations for me to peruse at some point.

More to come. If anything, I will lead in links per post.

September 4, 2008 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.