November 12th, 2009

What Intel wants in health care

Posted by Dana Blankenhorn @ 6:10 am

Categories: Aging, Assistive Technology, Gadgets, General, Home Health Care, Home Health Care Equipment, Medical Equipment, Rehabilitation

Tags: Health Care, Intel Corp., Venturebeat, Vertical Industries, Benefits, Healthcare, Sales Strategy, Human Resources, Sales, Dana Blankenhorn

Our Tom Foremski is shocked, shocked that Intel is launching a camera that reads.

What’s going on, he asks? Intel is terrible at consumer products. (Picture from Intel.)

But the Intel Digital Health Group is as serious as a heart attack, and the Intel Reader is part of it. The device is actually a specialized computer, combining a camera, optical character recognition, and a voice chip.

I have a stake in this, because my daughter is dyslexic and my mother blind. I appreciate the hard work that went into this. The $1,500 price tag is off-putting, but Moore’s Law tells me that in time it should come down.

And therein hangs our tale.

Intel produces what is now a commodity. It is the dominant supplier of chips but margins are thin. It needs higher margins to thrive.

Health care offers those higher margins. Health care and assistive technologies offer humongous margins because production runs are often small and sales channels thin. Venturebeat says the Intel Reader, for instance, will be going to CTL, Don Johnston, GTSI, Howard Technology Solutions and Human Ware.

None are exactly Best Buy. These are specialty resellers. Johnston, for instance, specializes in technology for dyslexic and autistic kids.

Still, these are growing markets. The Intel Health Guide, for instance, is aimed at the business of aging in place. There are 76 million of us baby boomers and we’re not getting any younger — ka-ching.

And let’s look again at the Reader. Products for the blind, for the autistic, and for the dyslexic are traditionally seen as separate markets. Here we have one product that addresses all of them. That means more sales which can drive down costs. In this business that’s an innovation.

So there is potential here for the perfect marketing storm. A company that can drive down costs enters a market with enormous margins. It can get fat on slimmer margins than those it finds in the market. As it drives down prices it expands the market — I might get that Reader for my daughter when it comes in at $400 (and in time it will).

This can truly be a win-win-win. The assistive technology and health care markets want lower prices, which Intel can deliver. Lower prices will expand the reach of things like aging in place technologies and readers for the dyslexic. Intel can build a highly-profitable business that in time delivers top line growth as well as bottom line growth.

Sure, there are specialty channels to figure out. Sure there are new marketing skills here Intel has not yet mastered. But price can cover that up while those skills are learned. This is the lesson Japanese and Chinese producers have been teaching us for decades.

And if they want to offer a review unit, I’ve got some good testers coming in for Christmas.

November 11th, 2009

Why not pay for what works?

Posted by Dana Blankenhorn @ 11:44 am

Categories: Drugs, Gadgets, General, Government, Home Health Care Equipment, Hospital Equipment, Insurance IT, Medical Equipment, Medical IT, Medical Office Equipment, Rehabilitation, U.S., state government

Tags: Patient, Health Care, McCaughey, Insurance, Financial Planning, Vertical Industries, Benefits, Healthcare, Business Operations, Corporate Insurance

In all the hullabaloo over health reform, Charles Silver and David Hyman write at The Health Care Blog, a key point of cost control has been lost.

Paying only for what works.

Silver and Hyman are law professors, not doctors. They point to a RAND Corp. study saying that “one-third or more of all procedures performed in the United States are of questionable benefit.” (The illustration is from the study.)

What happened to this simple idea?

The way to enforce it is through comparative effectiveness. Analyze data from millions of patients, develop best practices, and move physicians toward the most cost-effective solution.

This is what every other country does, regardless of how they pay for care. Formularies drive care, based on cost effectiveness. Anyone who wants to go outside what works had better have a good explanation. Often, going outside what works is simply forbidden, or patients are told to buy it with their own money.

Isn’t that how you set priorities? Why should governments or insurance companies act differently?

Unfortunately this was one of the first dominoes to fall in the debate. Reform opponents like Betsy McCaughey called this “getting between a patient and their doctor.”

This happened in conjunction with the debate over the Obama stimulus, and the subject was health IT. The purpose of the HITECH Act’s $19.2 billion in stimulus was to collect the data that would drive decisions on what to pay for.

McCaughey’s scare worked. Explicit promises were made not to use comparative effectiveness in any way to deny care, not to use evidence to decide what we should pay for.

The alternative to evidence is politics. Silver and Hyman note that millions of insurance dollars are spent annually on entirely non-medical treatments like Christian Science, but there’s more:

Lobbying from providers and supportive patients explains why many states already mandate coverage of elective services like in-vitro fertilization, massage therapy, and visits to athletic trainers. Concerns about the efficacy and cost-effectiveness of treatments are washed away by a stream of campaign contributions, and sad stories about patients who can only obtain the “necessary” services if the insurer will pay for them.

This is what is wrong with the present system. State regulation of insurance is based on politics, so your coverage includes any procedure that becomes politically powerful in your state. That’s why insurance costs are rising through the roof.

There is nothing wrong with paying for prayer but it’s not medicine, they write. There’s nothing wrong with in-vitro fertilization but it’s optional, not something everyone should have to cover.

Thus, by tossing away evidence as a way to rule-out certain coverages, you pay for a lot of stuff you don’t need.

Silver and Hyman wrote to argue against a politically-motivated individual mandate. Any mandate should be based on science, not politics, and by giving up on comparative effectiveness early in the process, it became impossible to set that standard, either through the federal government or through the states.

If this was Betsy McCaughey’s intent, she is fiendishly clever. Health care will remain a growth industry, because Americans will keep having to pay for stuff that doesn’t work, regardless of whether reform passes or fails.

November 10th, 2009

What's up with the rabbit penis, doc?

Posted by Dana Blankenhorn @ 8:57 am

Categories: Consumer Information, Curioisities, General, Rehabilitation, Research

Tags: Technique, Organ, Rabbit, Productivity, Dana Blankenhorn

News that the Wake Forest Institute for Regenerative Medicine (yep, WFIRM) has successfully grown rabbit penises in a lab set off a media feeding frenzy.

These are fully-functioning organs. The rabbit recipients went at it like, well, rabbits.

But there is more to this story than meets the snark.

This is an important proof-of-concept test for Dr. Anthony Atala (right), the center’s director.

The concept is that cells from a reduced organ are sprayed onto a collagen matrix, then bathed with compounds that stimulate cell growth and left in kept in an environment that duplicates the temperature and chemical makeup of living tissue.

The success of the technique means Dr. Atala could also grow new noses, new ears, perhaps even new fingers that are fully compatible with, and in many cases nearly identical to, the originals. This is not a fancy “stem cell” technique but a more straightforward one with wide application.

The news comes just months after Dr. Atala formed an Alliance for Regenerative Medicine that not only includes other colleges like Stanford and Georgia Tech but corporations like Geron and Johnson & Johnson, along with venture capitalists like Kleiner Perkins.

The aim of the group is to maintain political support for research and for the technique itself, said Geron CEO Thomas Okarma in the group’s initial press release.

The apparent success of the technique may be the best advertisement of all.

Although we know what Jay Leno will say about it. “Does this mean Cher can finally become a grandmother?” Rimshot optional.

May 20th, 2009

More good design in medicine please

Posted by Dana Blankenhorn @ 8:58 am

Categories: Assistive Technology, Curioisities, General, Hospital Equipment, Medical Equipment, Rehabilitation

Tags: Pole, Core77, Healthcare, Dana Blankenhorn

In the rush to produce and distribute medical products efficiently good design is often ignored.

(Picture from Core77 design magazine.)

It should not be. Good design can make anything more personal.

Even an IV pole.

Modo, a Beaverton, Oregon producer of medical carts, many of them made for Cardinal Health has just won a design award for its new IV pole.

Core77 has published a case study of the design process. There were many things to consider. Most poles ride low on the ground and get filthy. They lack identification and become commodities.

Goo Sung described the “ah-ha” moment. “The father had his arm on his son’s shoulder. The boy had his arm on his IV pole. It was as though three people were walking together. I saw the IV pole as the boy’s companion.”

The result was a pole with cup holders and a tray for people to use, a ring with room for a photograph of loved ones, and a wheel base a few inches off the ground for cleanliness.

The design should give Cardinal a temporary boost in the pole business, but it also holds important lessons for the rest of the medical industry.

1. Good design is worth the money.
2. Design from the user’s point of view, not just the customer’s.
3. Humanize.

What other lessons do you have?

April 2nd, 2009

Intel and GE put $25 million per year each into monitors

Posted by Dana Blankenhorn @ 8:04 am

Categories: Aging, Always On, Assistive Technology, Gadgets, General, Home Health Care, Medical Equipment, Networking, Rehabilitation

Tags: Monitor, General Electric Co., Health Care, Intel Corp., Vertical Industries, Benefits, Healthcare, Wi-Fi, Wireless And Mobility, Enterprise Software

Intel and General Electric have signed a co-marketing agreement covering their wireless monitoring systems.

Intel delivered its Health Guide to the market a year ago, and went through a product launch in October. But within the health care space it does not have a big brand name.

GE does. It also has a system it calls QuietCare which also does wireless monitoring and is sold to nursing homes.

Under the agreement, announced with some fanfare by CEOs Paul Otellini of Intel and Jeff Immelt of GE, each company will put $25 million per year, over five years, into the joint venture. This led them to trumpet a $250 million investment.

The two companies will do research jointly, but GE Healthcare will handle the marketing, which takes that hassle off Intel’s plate. The two companies think the telehealth market will be worth $3 billion this year and $7.7 billion by 2012.

When I first started writing about the idea of such monitors, linked to wireless broadband, in 2003, I referred to it as “Always-On” technology. The applications live on the network and the collection points are interfaces between sensors and the Internet, with some intelligence for preliminary analysis.

February 18th, 2009

Disease management becoming a consumer market

Posted by Dana Blankenhorn @ 8:37 am

Categories: Aging, Always On, Assistive Technology, Consumer Information, General, Home Health Care, Internet, Networking, Rehabilitation, Research, Sports Medicine, Wellness

Tags: Blood Pressure, Network, Parks Associates, Healthcare, Dana Blankenhorn

My blood pressure cuff now has a hockey stick graph.

It’s from Parks Associates, best known for its work in networking, and it shows personal disease management becoming a $460 million consumer market in four years, up from $100 million last year.

This must be true. They put it on their blog. (That’s where the illustration comes from.) Notice how the numbers go up from left-to-right? Draw a line across those bars and you get the hockey stick.

We’re talking here of Personal Health Records (PHR) and devices tied to them through digital recording and wireless networking.

I have written about this since 2003, calling it Always On, but Parks’ point is that computer networking makes the underlying devices far more attractive consumer products.

We are talking about things like blood pressure monitors, blood sugar devices, heart rate monitors, anything that gives you a regular reading on what you have.

When you can save the data or (better yet) transfer it to a scaled system which can analyze it and deliver alerts when needed, then you’ve got something immensely valuable.

And it’s finally about to happen.

January 26th, 2009

Stem cell dam broken?

Posted by Dana Blankenhorn @ 10:24 am

Categories: Ethics, General, Rehabilitation, Research, U.S., genetics

Tags: Stem-cell, Geron Corp., Dana Blankenhorn

 
News that Geron Corp. can move to human trials of its paralysis treatment based on embryonic stem cells sent the stock skyrocketing today and led some to believe the war over stem cells is over.

Some analysts are quick to note that President Obama has not yet lifted the Bush Administration bans on most stem cell research.  But stock touts are now bullish on the sector.

Geron’s work was actually ready for trial in 2005, and CEO Thomas Okarma has stated in a video that a lot of efforts have been stopped over the years. But that’s only in the U.S. — many patents have already been issued for use of stem cells in East Asia.

The actual impact of the therapy on the body is unknown. Its goal is to have the body produce myelin, the “insulation” around nerves that allows them to become useful. But all the company has said that in rats it worked better than a placebo.

But opponents are not going away. And the Geron approval doesn’t directly address the Bush bans on use of stem cells, since the work was done with cells created before the ban took effect.

So advocates still have hurdles to cross. Are approvals of stem cells now just benefitting our global competitors? Will President Obama formally change course? And do these therapies work?

December 26th, 2008

Insuring what cannot be assured

Posted by Dana Blankenhorn @ 8:11 am

Categories: 2009 Preview, Finance, General, Government, Mental Health, Payment Processing, Rehabilitation, Research, U.S., state government

Tags: Approach, Health Care, Insurance, Vertical Industries, Financial Planning, Government, Benefits, Healthcare, Business Operations, Corporate Insurance

Now comes the downside of mental health parity.

(Making Mandated Addiction Treatment Work, by Barbara Wallace, was published in 2005 and is available from Amazon.com.)

Substance abuse. Recovery is very possible when the patient is committed to making a change. It does not even have to be costly.

If they’re pretending, if they’re in self-denial, however, billions of dollars can be wasted. And are wasted, on treatments that can’t prove they work.

The problem is not unique to substance abuse. The mind remains the most mysterious organ we have. Our sub-conscious desires can override our most conscious thoughts.

So how do you insure that risk? How does a business limit its exposure?

The approach gaining widest acceptance now is evidence-based practice. You do only what is proven to work. You do not provide coverage for other approaches.

Sounds simple and worthwhile, but there are two problems, as The New York Times makes clear in a recent article about Oregon’s experience.

1. There are not enough people with proper training and credentials in what works to meet the need.
2. Evidence-based payments deny support for approaches that may prove worthwhile, on which evidence is just now being collected.

At the heart of the best-known addiction process, Alcoholics Anonymous, is the idea that there is no “cure.” There is only the daily struggle to maintain sobriety, and the human connections which make that struggle bearable.

How do you put that into language an insurance policy can understand? How do you put that risk into a budget an employer, insurer or even the government can bank on?

Now that we have set a goal in law how do we meet it?

December 12th, 2008

MRI scans are too routine

Posted by Dana Blankenhorn @ 12:11 pm

Categories: Curioisities, Gadgets, General, Hospital Equipment, Medical Equipment, Medical Office Equipment, Rehabilitation, Research, Sports Medicine

Tags: Scan, Surgery, MRI, MRI Scan, Productivity, Dana Blankenhorn

It must be the most common sports story of all. An athlete hurts so they have an MRI diagnose what is wrong.

(Paul Lauterbur and Peter Mansfield shared the 2003 Nobel Prize in Medicine for their work with MRIs. From the Nobel Prize site.)

Just take a quick look at today’s sports headlines:

• An MRI confirmed Stephen Jackson of the Golden State Warriors has a sprained hand.
• Adam “Pacman” Jones of the Dallas Cowboys could play again this season despite a pain in the neck. His first statement after feeling the pain — I need an MRI.
• Josh Howard of the Dallas Mavericks doesn’t know when he will be back after repeated MRIs failed to find what is wrong with his foot.
• Duane Culpepper of the Detroit Lions had an MRI on his shoulder, and doesn’t know if he’ll be back this year.
• Cuttino Mobley of the New York Knicks retired after an MRI showed a thickening of his heart muscle. Subsequent exams revealed hypertrophic cardiomyopathy. “The MRI saved my life,” he said.

In all these cases MRIs were used for diagnosis. It’s routine.

Should it be?

In a September article in the New England Journal of Medicine, David Felson and others at the Boston University College of Medicine found MRIs on aging knees often diagnose minescus tears that are perfectly normal.

A study at the Cleveland Clinic found similar results regarding bad backs. Dr. Michael Modic, who heads the clinic’s Neurological Institute, concluded MRIs are pre-surgical tools, not diagnostic tools.

A single scan can cost $750-1,000 and if it turns up something wrong surgery is often ordered routinely. Diagnosing based on pain, and considering surgery only after a period of rest, can save both scans and surgical suites.

What about the jocks? Mobley was right to have an MRI and Pacman (as usual) was wrong. And if we stop making snap decisions based on MRIs we can save billions of dollars each year.

October 29th, 2008

Will MRSA change sport choices?

Posted by Dana Blankenhorn @ 6:47 am

Categories: Consumer Information, Drugs, Ethics, General, Rehabilitation, Research, Sports Medicine, Wellness

Tags: Dana Blankenhorn, Security, Strategy, Management, Treatment, Infection, MRSA, Games, Personal Technology

The NFL is going through a rash of rashes.

It’s serious. Bacteria resistant to antibiotics, new strains of Methicillin-Resistant Staphylococcus Aureus (MRSA) are hitting our favorite athletes.

Tom Brady (right), Peyton Manning and Kellen Winslow are just some of the stars laid low.

But this is not just about our Sunday heroes. It’s also about your kids and your choices for them. Are they still ready for some football?

MRSA is getting nastier because there are now multiple strains of it, and because football is a game where cuts are common. So-called community MRSA is caught in the locker room, then mixes with the nastier type in a hospital when you go in for treatment.

Treatment is very much part of the game. Surgery is common in a collision sport, with knees bent at impossible angles and arms ripped from their sockets.

The combination of bad infection treatment and a tough it out attitude can be deadly. Add the fact some teams can have as many as 100 athletes, and small wonder “football players have become the poster children for MRSA infections.”

There are things you can do to reduce the risk. Simple nose swabs can cut the infection rate 50%. Treating simple cuts more seriously will also help. New treatments, new drugs may be on the way.

But you can also cut your risk by choosing a different sport. Smaller teams have fewer paths to infection. Games with less contact leave you less prone to injuries requiring surgery.

Tennis, anyone?

 Loading ...