“is about using technology to bring health care information together to reduce medical error, reduce the need for testing, put information in front of patients, and put information in front of researchers.”
A FierceHealthIT story reported on an initiative by the American Telemedicine Association, which is running a demonstration program with DocTalker Family Medicine. DocTalker, founded by Dr. Alan Dappen (partnered with @drval) is providing remote health services to Association members and employees. It’s being pitched as an employee benefit that can promote worker health and productivity by reducing the need for office visits and providing round-the-clock responsiveness.
David Pogue waded into the EMR narrative this week, with a piece on CBS News that took a look at the U.S. efforts with an interesting focus on Kaiser’s EMR efforts. Pogue follows up with a blog post containing a transcript of his full interview with David Blumenthal. Interestingly, the main negative angle in his CBS piece is cost; but as we’ve noted, many providers are offering loans or guarantees or both to cover the cost until the federal payments kick in.
The company is planning to use the proceeds to buy late-stage or approved therapies for acute care and gastroenterology to go along with their existing approved products — Caldolor, an IV form of ibuprofen, and Acetadote, which treats acetaminophen overdose.
The President’s Council of Advisors on Science and Technology is meeting now. The meeting is broadcast live online at http://tr.im/vK3G.
They just finished introductions. Eric Schimidt, Eric Lander and Harold Varmus are there, among other luminaries. 100% in-person attendance.
“21 members include 4 winners of MacArthur ‘genius’ awards, 3 Nobel laureates, 2 university presidents, as well as 16 members of one or more of the U.S. national academies of science, engineering, and medicine.”
The WSJ Health Blog notes today that Salesforce.com’s investment in Practice Fusion, though not a large financial investment, follows an appealing trend in the EMR space. Both Salesforce.com and Practice Fusion are cloud computing plays (aka hosted services / ASP) where software and data live on company servers rather than on local PCs in doctors’ offices. This will be particularly attractive for smaller practices without their own IT capabilities.
GE has put $100 million — the first installment of a promised $6 billion commitment to its “healthymagination” goals — into funding zero-interest loans to physicians’ offices, hospitals, clinics, etc. to support the purchase of (GE’s own) electronic medical records (EMR) systems.
The program is called “Stimulus Simplicity” and it has a couple of very smart features:
GE will include a “certification warranty” that will ensure the systems qualify for the stimulus funding.
Highly Ymaginitive, GE!
[A side note for the lawyers in the audience: GE says Stimulus Simplicity contracts feature “extremely simple language.” Truly plain language contracts … that could be a $6 billion benefit right off the bat.]
Nearly 60% [of internet users] said they have consulted blog comments, hospital reviews and doctor reviews, listened to podcasts about health care and signed up to receive updates about health or medical issues. And 20% have posted comments, reviews, photos, audio or video online related to health care, such as participating in an online group forum.
GE is devoting $6 billion over the next 6 years to meet three goals by 2015: reduce the cost of healthcare by 15% (focusing on procedures and processes); increase access by 15% (to services, technologies and health education); and improve quality by 15% (partner with physicians and stakeholders to simplify procedures and accelerate adoption of standards of care).
The initiative was introduced in Toronto by Elyse Allan, President & CEO of GE Canada, and by Peter Robertson, General Manager of GE Healthcare Canada, who did a good job of speaking to Canadian-specific issues. One program that was heavily discussed was the Pan Northern Ontario PACS Project (PNOP) agreement with GE Healthcare for the creation of a Diagnostic Imaging Repository (DI-r) and longitudinal patient records across northern Ontario. The program is being funded in part by Canada Health Infoway and the Ministry of Health and Long Term Care’s eHealth Program.
Dr. Suzanne Strasberg took over as the incoming president of the Ontario Medical Association (OMA) Saturday night at their annual gala. The OMA press release headlines Dr. Strasberg’s call for access to family physicians, but health IT also figures prominently. Dr. Strasberg indicated that she would focus on a number of initiatives, including “expansion of the use of IT and eHealth” and cited support for “Electronic Medical Records, which have enhanced patient safety and improved the quality and continuity of care, as examples of where further expansions should be made immediately.”
the nature of entities to which its proposed rule would apply;
the particular products and services they offer;
the extent to which vendors of personal health records, PHR related entities, and third party service providers may be HIPAA-covered entities or business associates of HIPAA-covered entities;
whether some vendors of personal health records may have dual roles as a business associate of a HIPAA-covered entity and a direct provider of personal health records to the public; and
circumstances in which such a dual role might lead to consumers’ receiving multiple breach notices or receiving breach notices from an unexpected entity, and whether and how the rule should address such circumstances.
Two R&D Heads! The combined Pfizer-Wyeth will have Mikael Dolsten heading up the newly created BioTherapeutics Research Group and Martin Mackay heading up the small molecule PharmaTherapeutics Research Group. (Two CapitalLetters!) The In Vivo Blog has a podcast interviewing both.
Two VA Initiatives! In addition to the electronic medical records initiative we mentioned earlier this week, the Department of Veterans Affairs is also setting up a large cohort genetic study that will establish a database of genetic information from patients that will be linked to the participants’ electronic health records. This is great news for personalized medicine because it will ensure that the EHR standard that comes out of the VA project will accomodate and utilize individualized genotypic data.
Two R’s, Two L’s, Two B’s! G. Steven Burrill (two r’s, two l’s, one b) says he’s confident he can raise $1 billion (there it is!) to develop the Pine Island biotechnology project and a private equity/venture capital fund, which will support development of new technologies out of the Mayo Clinic and the University of Minnesota, among others.
Two Border Crossings! Simponi, a biologic developed by Johnson & Johnson and Schering-Plough, crossed the border Northbound — gaining approval from Health Canada before the FDA; and Molecular Templates Inc. crossed the border Southbound — leaving Ontario for the Texas Life-Sciences Collaboration Center.
Any large-scale government implementation like this is bound to help set standards and encourage adoption by other providers. With luck it will also, over time, provide data on cost-savings and care improvements.
The Biotechnology Initiative (TBI) would like to credit Premier Dalton McGunity and Minister of Research and Innovation John Wilkinson for their quick response to the looming economic uncertainty by the creation of the Emerging Technologies Fund… The life sciences community in Ontario is greatly encouraged as a result of the creation of this Fund.
Canada’s Research-Based Pharmaceutical Companies (Rx&D) is encouraged by initiatives in the Ontario Government’s 2009 budget designed to fuel innovation and growth in Ontario’s biopharmaceutical and life sciences industry…
“The support in the budget for research infrastructure, genomics, tax incentives for innovation and the increased funding for the Ministry of Research and Innovation demonstrate that the McGuinty Government is strengthening its commitment to make science and innovation a priority.”
The McGuinty government has made encouraging policy initiatives that help bring innovative high-tech applications to market more efficiently… The Ontario Budget released today contained far-reaching initiatives that will help the province’s entrepreneurs, scientists and researchers develop and market new technology here instead of other jurisdictions.
encouraged that the government is investing $2-billion into eHealth, which is playing an increasingly important role in improving patient safety and efficiency of our health care system. Electronic Medical Records (EMRs) have had a tremendous impact on patient safety, continuity of care, and quality of care. To date, over 3,000 physicians have made the transition to EMRs and by the end of 2009, over 4 million patients will have an electronic health record.
This week, Walmart announced that it will be offering an EMR solution through Sam’s Club, using Dell for computers and eClinicalWorks for software. Walmart says it has been considering the move long before the stimulus announcement, but the pricing — under $25,000 for the first physician in a practice, about $10,000 for each additional doctor with annual maintenance and support costs around $4,000 to $6,500 a year — matches the $40,000 per physician in the stimulus quite well for practices with 2+ physicians.
The U.S., Canada and the UK have all acknowledged the central importance of R&D even in these recessionary times. However, the three national governments have decided to focus their spending on different steps of the R&D equation:
Education: UK Takes the Long View
British PM Gordon Brown, in a speech this week, identified three priorities: research, education and training, and public discourse. However, only one of the three, education, was the subject of specific increased targets and spending: retraining to increase the number of science teachers, a goal to double the number of pupils in state schools taking ‘triple science’, and a new Diploma program. The U.S. and Canada have increased funding for graduate studies, but the UK effort is focused at an earlier stage, to rebuild the interest and capabilities of domestic graduates.
Publicly-Funded Research:U.S. Takes the Lead
The focus of the U.S. R&D spending increases has absolutely been on research. The increases for the NIH and NSF in the stimulus and the budget will go largely to increasing the volume of publicly-funded research. PM Brown’s speech also vowed to protect funding for science from competing demands for Government support during the downturn, but did not propose increases over the existing 10-year plan. Canada’s budget actually cut research funding across the three main granting agencies.
Commercialization: Canada Takes Off
Canada’s focus was on commercialization. The 2009 budget included $200 million allocated to the National Research Council’s IRAP program — $170 million to double the program’s contributions to companies, and $30 million to help companies hire over 1,000 new post-secondary graduates. It also provided significant additional funding to BDC. The only comparable spending in the U.S. was the $400 million for ARPA-E, which is allocated to energy programs, and supports research as well as commercialization. PM Brown’s speech recognized the importance of maintaining the country’s struggling start-ups, and he has reached out to big pharma, but promised no specific action.
Nor have there been many changes that increase the value of outputs: in the bio/pharma area, the UK has probably moved farthest in this direction, with upcoming reforms of the National Institute on Comparative Effectiveness (NICE), while the U.S. has seen decreasing FDA approvals and is allocating new comparative effectiveness funds. On the other hand, approvals of GE animals, support for personalized medicine and big spending on electronic medical records will provide support to specific industry initiatives.
Graeme’s talk, as usual, was very interesting and not very print-able.
Carol’s talk was also great. Of course, Atlanta, Georgia is hosting BIO 2009, which is moving ahead full-steam. Georgia also has some interesting capabilities and initiatives
One focus in Georgia is on healthcare IT. Atlanta in particular has an extensive fibre optic infrastructure from having hosted the Olympics, and this will be a valuable asset as Electronic Medical Records are more widely adopted.
Most interestingly, the State has a “life sciences facilities fund“ that provides low interest loans secured by fixed assets to assist start-ups with finding appropriate space. Carol mentioned that the program just funded a 15-year loan with deferred interest at 60% of Prime.
Funding of $500 million announced today is in addition to $400 million in support provided to Canada Health Infoway in Budget 2007. This brings the Government of Canada’s total commitment to this initiative to $2.1 billion.
The Department of Energy’s Office of Science, which supports US physical science, will receive $1.6 billion.
$400 million will be provided to fund a new mini agency within DOE called the Advanced Research Project Agency-Energy. Obama’s energy secretary, Steve Chu, is a fan. Now congress has bestowed their blessing — and big money –on his dream energy program.
NASA will get $1 billion including $400 million for climate change research.
The National Institute of Standards and Technology will receive $580 million.
The National Science Foundation would receive the full $3 billion increase that the House had passed last month. That’s a 50% boost to its $6 billion budget. The breakdown of that number is not clear, but the House version contained $2 billion more for research grants; $900 million for three infrastructure programs, including a revived $200 million extramural facilities competition; and $100 million for two education programs.
The $3 billion in NSF funding breaks down as follows: $2.5 billion for research (peer-reviewed proposals); $100 million for the university research instrumentation program; and $400 million for national labs.
The NIST money is for infrastructure: $220 million for lab equipment and $360 million for facilities.
USDA gets $850 million for infrastructure.
NOAA gets $600 million for facilities and equipment.
…as the province moves toward electronic health records, Dr. Barbara Yaffe, Toronto’s associate medical officer of health, said she wants children’s immunization charts to be included.
…By law children in Ontario must be vaccinated against measles, mumps, rubella, diphtheria, tetanus and polio.
But in 2008 the city witnessed the largest outbreak of measles since the mid-1990s, as well as cases of mumps…
“[W]e would always be up-to-date on what every child has. We wouldn’t have to go through all this inefficient process of sending letters and bugging parents and even suspending some children, if we had that information.”
As a parent who is a recipient of those (many, many!) letters, I’m 100% in favour.
The views expressed here are solely the authors’ and should not be attributed to any of their firms or clients. The material and information provided on this website are for general information only and should not be relied on as legal or business advice or as a legal opinion. The authors make no claims, promises or guarantees about the accuracy, completeness, currency, or adequacy of any information linked or referred to or contained on this blog. No person should act or refrain from acting in reliance on any information found on this blog without first obtaining appropriate professional advice from a consultant or from a lawyer duly licensed to practise law in the relevant province, state, territory or country. These materials do not create a solicitor-client relationship between you and any author. Please note that the authors will not provide free legal, financial or other advice. Please don’t send us any confidential information or questions by email or otherwise because any information sent to us cannot be considered to be privileged or confidential.
Note that by accessing, commenting on or linking to the blog, you (like us) are subject to the WordPress Terms of Service. Most images are from Wikimedia Commons or from governments, others link back to commercial sources. If you want us to remove an image, just let us know.