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More accolades for Topol as ‘connected health’ gains

I’m convinced that Dr. Eric Topol is one of those rare people, like Dr. John Halamka, who can function on minimal sleep, perhaps four hours a night. He just gets that much done.

Yesterday, AT&T named Topol chief medical advisor. As such, the company says, Topol will “impact the design, development and delivery” of connected health products and services for the AT&T ForHealth business. This is on top of his appointment last year as editor-in-chief of Medscape, his many speaking engagements and TV appearances and, lest we forget, his day job as cardiologist, geneticist and chief academic officer at Scripps Health in San Diego and leader of the Scripps Translational Science Institute.

Topol will not, however, be replacing Dr. Geeta Nayyar, who was full-time CMIO at AT&T until September.

This news comes a couple weeks after CBS News ran a segment on the possible demise of the stethoscope at the hands of the portable ultrasound.


This is not the first time we have heard this idea. Yes, it was Topol who dropped his stethoscope in the trash on stage at TEDMED 2009 and suggested that the handheld ultrasound should become the standard of care by the time the 200th anniversary of the stethoscope rolled around in 2016.

Given how slowly medicine moves, I wouldn’t bet on the stethoscope being extinct in the next two years; the cost of the GE Healthcare Vscan ultrasound, the one Topol demonstrated in 2009, hasn’t really budged since then. A new one will still set you back $7,900. I can’t see primary care physicians shelling out that kind of cash when the old technology is $200 or less.

Meanwhile, this week we get more evidence that “connected health” may be winning the terminology battle over mobile, wireless and digital health. The February edition of Health Affairs examines this field, which the policy journal says encompasses telemedicine, telehealth and mobile health. On the other hand, the lead author of one of the overview articles is Dr. Joseph Kvedar, founder and director of the Center for Connected Health at Partners HealthCare in Boston. He is the champion of the term, and possibly the creator of it.



February 4, 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.

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.

Dentzer leaves Health Affairs, replaced by founding editor Iglehart

Susan Dentzer has stepped down as editor of influential policy journal Health Affairs and will be replaced on an interim basis by Founding Editor John Iglehart.

In a press release issued Friday, Health Affairs gave the usual, vague reason: Dentzer is “leaving to pursue a new opportunity.” Her brief Wikipedia entry says Dentzer “stepped down abruptly on April 11, 2013.”

I know no more than that, though the press release suggests it wasn’t acrimonious.”We thank Susan Dentzer for her contributions and wish her well in her new endeavor,” Project HOPE President and CEO Dr. John P. Howe III said in the release. Project HOPE publishes Health Affairs.

Iglehart returns after a nearly six-year absence. He retired in 2007 after leading the editorial side of Health Affairs since its inception in 1981. The journal says he will be working with Executive Editor Donald Metz and Executive Publisher Jane Hiebert-White to find a new editor.



April 14, 2013 I Written By

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

Health Wonk Review gets hung up on insurance

The last edition of Health Wonk Review prior to the Nov. 6 presidential election falls into the familiar big-media trap of portraying the Patient Protection and Affordable Care Act, a.k.a. Obamacare, as being only about health insurance and of effectively equating health insurance to healthcare. Let me repeat: insurance is not the same thing as care, and having “good” insurance does not guarantee good care.

This installment of HWR is awfully heavy on the insurance aspects of the ACA in the context of politics the election, which is not surprising, though host Maggie Mahar of the HealthBeat blog does at least consider comparative-effectiveness research, thanks to a contribution on the esteemed Health Affairs Blog.

My post, which includes the infographic from the movie “Escape Fire” showing how medical harm essentially is the No. 3 cause of death in the U.S., is almost an afterthought, but at least Mahar also includes an entry from Dr. Roy Poses about medical harm in clinical trials.

There’s nary a word on health IT, which really is a shame in the context of the election, especially given that several Republican members of Congress, including Sen. Tom Coburn, M.D. (R-Okla.), have publicly questioned whether “meaningful use” so far has led to higher utilization of diagnostic testing and thus higher Medicare expenses.

By the way, Healthcare IT News is currently running a poll that asks: “With four GOP senators calling on HHS to suspend MU payments, would health IT remain bipartisan if Romney became president?” The poll is on the home page, but even after voting, I couldn’t find the results. In any case, I personally believe health IT has enough bipartisan support for MU to continue.

I also believe that no matter who wins the presidency, Congress probably will remain divided for the next two years, with Democrats holding onto the Senate and the GOP retaining control of the House, so I don’t expect any controversial legislation to pass. A Romney administration possibly could put a hold on future MU payments or revise the Stage 2 rules, but never underestimate the power of the hospital  and physician lobby.


October 28, 2012 I Written By

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

Health Wonk Review, unadorned but chock full of health IT

In the latest edition of Health Wonk Review, hosted by Chris Fleming on the estimable Health Affairs blog, there’s not much in the way of a fun theme, but that’s OK. It’s still full of some good perspectives, including more than the usual share of health IT.

My post that aggregated a bunch of tweets from the Health 2.0 Conference made the biweekly blog carnival, as did a much longer-form way of covering the event, David Harlow’s series of video interviews. Harlow got 18 different people on camera, including HHS gurus Todd Park and Dr. Farzad Mostashari.

Elsewhere, patient advocate Jessie Gruman,  president and founder of the Center for Advancing Health, took on mobile apps as a means of changing patient behavior, Tom Lynch of the Workers’ Comp Insider blog discussed predictive modeling in healthcare claims administration and Healthcare Economist blog author Jason Shafrin wonders why patients don’t seem to care much about healthcare quality.

In particular, I invite you to share Shafrin’s short post, if for nothing more than a conversation starter.

October 13, 2011 I Written By

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

10 years later, there’s still a quality chasm, and Senate Dems are wusses

It’s been a full decade since the Institute of Medicine published the second volume in its landmark series on patient safety and quality of care, Crossing the Quality Chasm. We appear to be not much closer to achieving a high-quality health system as we were 10 years ago.

Last week, as you may have already heard, a paper in Health Affairs from researchers at the University of Utah concluded that adverse events may be 10 times more prevalent than previously believed and that errors may occur in an astounding one-third of all hospital admissions. The research team, which included such luminaries as Dr. David Classen, Dr. Brent James and the Institute for Healthcare Improvement‘s Frank Federico, also said that their estimates probably were on the conservative side.

Patient-safety advocate Regina Holliday finagled her way into the Health Affairs briefing on the subject on Thursday, and was disappointed by her observation that patients were almost an “afterthought” in a discussion on how to close the gaping chasm. Holliday, a sometimes painter, expresses her frustration in words in this interesting blog post and on canvas. Note that she depicts Accountable Care Organizations as a unicorn.

Do I have to remind you of who used to be the driving force behind the IHI? That of course would be Dr. Donald M. Berwick, the administrator of CMS that Republicans want to kick to the curb because they think they can score political points against the Obama administration. For that matter, the Obama administration and Democrats in the Senate are willing to sacrifice Berwick because they clearly lack the cojones to stand up for better healthcare. Yes, I said cojones. Sue me.

Please read and share my series of posts on Berwick if you haven’t done so already.

Berwick political saga is a tragic attack on better healthcare (March 14)

More reasons why CMS needs Berwick (March 20)

Slams on Berwick getting pathetic (March 23)


April 10, 2011 I Written By

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

Opening Day for Health Wonk Review

It’s time for another baseball season, and Health Wonk Review is ready to go. as with the Spring Training Edition two weeks ago, optimism reigns. (Host Jason Shafrin of the Healthcare Economist blog proves it by calling for the Milwaukee Brewers to win the World Series this year. I guess cheeseheads are still giddy from the Green Bay Packers’ victory in the Super Bowl two months ago.)

I didn’t make the starting lineup, but am an early choice from the bullpen for my “Slams on Berwick are getting pathetic” post. Curiously, Shafrin wades away from the controversy a bit by highlighting something said by a person I’m critiquing, namely that comparative effectiveness research “doesn’t work in the real world.”

Not surprisingly, no post related to health IT cracks the starting nine at all. Even something from the Health Affairs blog by Vanderbilt medical informaticist Dr. Mark Frisse is relegated to the bullpen. Yeah, we know we’re underdogs, but take a look at the NCAA Final Four, which includes under-respected teams from Butler and Virginia Commonwealth. Actually, look at last year’s World Series, featuring the star-crossed San Francisco Giants and the unheralded Texas Rangers. Is this the year health IT surprises all the doubters by riding its strengths to a championship season?

Hope springs eternal, especially here on the North Side of Chicago. It’s time to play ball!


RIP, Steve Goodman (1948-1984). You’ll get your wish someday.

April 1, 2011 I Written By

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

Bellagio follow-up in ‘Health Affairs’

There’s been a lot of work done in the field of global e-health since the Rockefeller Foundation‘s series of conferences in Bellagio, Italy, in July and August 2008. I had the distinct honor of attending for the third of four weeks, which focused on electronic health records and on mobile healthcare, two subjects that even more up my alley now then they were a year and a half ago.

I’ve had intermittent contact with some of the participants in those conferences since then, most recently at the AMIA annual symposium last month, and I’ve tried to report on progress from those meetings toward applying information technology to addressing health issues in developing countries. A wider audience will get a chance to read more about some of the projects in an upcoming issue of Health Affairs.

From what I understand, in mid-February, Health Affairs will publish nine papers on global e-health issues related to the work done at and as a result of Bellagio. I’m not privy to any further details, though.

December 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.

Health Affairs on Obama HIT plans

We don’t know all the details yet, but a lot of people are excited about the fact that President-elect Barack Obama has made a point of including health IT in his forthcoming economic agenda. He did this as recently as Saturday.

Yesterday, in a Health Affairs blog post, Health Affairs Executive Publisher Jane Hiebert-White summarized Obama’s statements and other various reactions to his plans. She also indicated that the venerable policy journal will devote its March issue to health IT.

I’m reserving judgment until Obama not only fills in some of the details, but also chooses the new heads of CMS and the Veterans Health Administration.

January 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.

Dentzer named ‘Health Affairs’ editor

You heard it here first, only because I happen to be up way too late on a Friday evening, working on a huge project due in just over two weeks: Susan Dentzer, chief health correspondent for the “NewsHour with Jim Lehrer,” is the new editor-in-chief of Health Affairs, effective May 1.

You heard it here first because the folks at Project HOPE decided to send out the press release well after hours, just as it did a couple of weeks ago when the previous editor, Jamie Robinson, decided to leave after just a few months on the job.

Robinson is returning to his previous job as Kaiser Permanente Distinguished Professor of Health Economics at the School of Public Health at the University of California, Berkeley. He took over at Health Affairs last September, when founding editor John Iglehart retired.

Perhaps I should have taken the hint when Dentzer emceed the Health Affairs 25th anniversary summit last November. Or not. The only other time I had met her was at the 2007 AHIP Institute, when I mistook her for AHIP boss Karen Ignani. I do know that she knows the business, and she was gracious enough to take my call last year and chat for a few minutes, even after telling me that “NewsHour” didn’t have a freelance budget.

According to Health Affairs:

“Dentzer also serves on the Kaiser Commission on the Future of Medicaid and the Uninsured, and she is a member of the national advisory committee for the Robert Wood Johnson Foundation’s Investigator Awards in Health Policy Research. From 1993 to 2004, Dentzer was a member of the board of trustees for her alma mater, Dartmouth College, and she chaired the board from 2001 through 2004. As a Nieman Fellow at Harvard University in 1986 and 1987, Dentzer studied political economy, health economics, and business at the John F. Kennedy School of Government, Harvard Business School, and the Harvard School of Public Health.”

That’s quite a CV.

This might be my last post for a while, since my Doctor’s Digest tome, all 30,000 words of it, is due April 14. I may or may not hit the World Health Care Congress in Washington April 21-23, before going on a much-needed vacation on April 26, and I may or may not blog again before then.

March 28, 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.