A healthy market opportunity

I was interviewed recently on the latest developments in digital pharma marketing. Here’s an excerpt of the story from the HotHouse blog:

The rise of digital in all its forms – Internet, mobile, social media, online video – has fuelled the shift from selling and marketing products to selling and marketing services, as consumers have replaced manufacturers at the centre of the marketing universe.

Everything from product development to promotion to post-purchase evaluation is today built around understanding and meeting customer needs.”

This is abundantly apparent in an area like healthcare. From a product-focused sector based solely on convincing doctors to prescribe medications based on scientific evidence (and a few educational dinners), drugmakers are building portfolios of services aimed at patients and doctors around their brands, helping healthcare professionals tackle issues like patient compliance and health education as direct promotion takes a back seat.

Big numbers

I discussed the implications of these trends with healthcare digital strategist (and HotHouse content producer) Ray Welling in this month’sHotHouse podcast. And while the growth of online generally as a medium and a marketing tool has been impressive, the numbers for healthcare are truly staggering.

Read the full story

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An e-health model for Australia?

CNET has published a long analysis of Google and Microsoft’s efforts at dominating the e-health market in the US. Apparently, the two technology giants, at war on so many fronts, are having a love fest when it comes to e-health.

An excerpt from the article: “‘I love Google Health,’ said Sean Nolan, the chief architect of Microsoft’s HealthVault service. ‘What they are trying to do is a good thing…We are in the same boat. We’re not really fighting with these guys. We’re all trying to make it work.’

“The love, apparently, is mutual. ‘I think it is critically important that there is more than one company trying to do this. (Personal health records) are very hard to get right,’ Google Health product manager Roni Zeiger said. ‘We certainly haven’t done so yet.'”

Hunh? What’s this about? Apparently they have a few common enemies in this territory. “Perhaps mutual interest comes before brass-knuckled competition. Google and Microsoft face many of the same issues–privacy, bureaucracy, and technological intransigence in the health industry–as they attempt to put their own spin on e-health.”

Read the full article for a detailed look at all the issues raised by Health Vault, Google Health and all their competitors.

E-health in a tangle

Excerpted from Australian Doctor, 20 March 2009:

With so much reform in the offing, does the Rudd Government have the political will to finally make e-health a reality? Ray Welling investigates.

Ordinary Australians can use their bank cards all over the world or seamlessly connect their laptop to a wireless net work from Broome to Berlin, yet their critical health data can’t be shared with their local hospital or even the pharma cist down the road.

This is despite extensive international and Australian research pointing to significant savings in lives as well as public health expense when health IT innovation is applied.

This year researchers in Texas reported in the Archives of Internal Medicine that increasing the automation of hospital notes and records led to a substantial decline in mor tality rates for all conditions studied. An author of the study said that by computeris ing health records, more than 100,000 lives a year could be saved in the US alone.

Closer to home, a 2002 Australian Institute of Health and Welfare study found that up to 18% of medical errors — many of them fatal — were due to inadequate availability of patient information.

According to the study, these adverse events account for as much as 3% of the gov ernment’s total cost of care — $3 billion a year in avoidable cost.

A business case for a national electronic health record program was published last year by the National E- Health Transition Authority (NEHTA), which suggested a net benefit to the Australian economy of between $7.5 billion and $8.7 billion over the first 10 years.

Australia is not the only late adopter of e-health. In the US, just 1.7% of hospitals sur veyed in 2008 had fully imple mented a comprehensive patient e-health records system across all units of their hospi tals and only 7.9% had imple mented a basic system.

However, the US is much closer to fully sharing health data. Electronic health initia tives were specifically men tioned in former US President Mr George W Bush’s last four State of the Union addresses, and USPresident Mr Barack Obama announced shortly before his inauguration that he was dedicated to making 100% of personal health records available electroni cally within five years. He backed that up by allocating $US20 billion in his initial economic stimulus bill to the task. Electronic health records were specifically mentioned in his maiden speech to the US Congress in February.

SO what’s happening in Australia? It’s not that we’ve been ignoring e- health. It is estimated that more than $5 billion has been spent by state and territory governments, GP divisions, and others on e-health devel opment activities in the past 10 years.

Those initiatives include a program by General Practice Network NT to have the entire NT population regis tered for shared electronic health records by 2010, bed side electronic records and clinical decision support tools being trialled in SA hospitals, a $250 million Enterprise Information Repository in Queensland, and a hospital- based electronic health record system deployed in the South Eastern Sydney and Illawarra Area Health Service in NSW, which is soon to be rolled out across the state.

But for e-health to make a real difference, national co- ordination is needed. On a national level, NEHTA was set up with Commonwealth funding in 2005 to develop core technical foundations for e-health in Australia, such as clinical terminologies, infor mation messaging standards and designing unique con sumer and care provider iden tifiers.

Other than this, however, none of the local or state groups developing e-health systems are talking to each other or working to create sys tems that can be integrated across borders. Some can’t even be integrated across hos pitals or surgeries in the same state. It’s a situation that brings to mind the 19th cen tury, when each colony built its railway systems using incompatible rail gauges.

Read the full story here (password required – let me know if you’d like a full copy).

Electronic health records, brought to you by Wal-Mart

The Australian government doesn’t appear keen on consumer-led e-health solutions such as Google Health or Microsoft Health Vault. Well, it could be worse: here’s an excerpt from The New York Times this week:

Wal-Mart Stores is striding into the market for electronic health records, seeking to bring the technology into the mainstream for physicians in small offices, where most of America’s doctors practice medicine.

“Wal-Mart’s move comes as the Obama administration is trying to jump-start the adoption of digital medical records with $19 billion of incentives in the economic stimulus package.

“The company plans to team its Sam’s Club division with Dell for computers and eClinicalWorks, a fast-growing private company, for software. Wal-Mart says its package deal of hardware, software, installation, maintenance and training will make the technology more accessible and affordable, undercutting rival health information technology suppliers by as much as half.

“’We’re a high-volume, low-cost company,’ said Marcus Osborne, senior director for health care business development at Wal-Mart. ‘And I would argue that mentality is sorely lacking in the health care industry.’

“The Sam’s Club offering, to be made available this spring, will be under $25,000 for the first physician in a practice, and about $10,000 for each additional doctor. After the installation and training, continuing annual costs for maintenance and support will be $4,000 to $6,500 a year, the company estimates.”

Read the whole story here

Travelling down the health information highway

RJ Eskow has written a great article in the Huffington Post this week that explains in simple terms why electronic health records are a good thing. To wit:

“The digitizing of medical records could have a far more profound effect on health – and on our economy – than most people realize. The president said the recovery plan will ‘invest in electronic health records and new technology that will reduce errors, bring down costs, ensure privacy, and save lives.’ All that and much more is possible. With a new HHS Secretary and health czar, and a White House health care summit scheduled this week, this is the right time to act.

“‘Electronic health records’ don’t sound like a particularly exciting or innovative idea. But neither did ‘a network that could quickly reroute digital traffic around failed nodes’ in case of military attack, or ‘dynamic routing protocols to constantly adjust the flow of traffic’ between computers. Yet those were the modest original goals of ARPANET – which evolved into the Internet as we know it today.

“Paradoxically, computerizing the health system in this country could make it much more humane than it is today. But that calls for a broad vision of health IT as an ‘information highway’ that stores information, looks for problems, and eases the many routine interactions that make up the health system.”

The article concludes: “A comprehensive strategy should lay the foundation for a boom in private initiatives. If the Internet’s any example, people will meet these needs… and hundreds of others nobody’s thought of yet. That won’t just help us save money and improve healthcare. It could also create a new mini-boom in the technology and service sectors of our $2 trillion health economy.

“And that sounds a lot like a stimulus to me.”

Well said.

Big Pond content coup for West Australian portal

The Virtual Medical Centre has struck a deal with BigPond to provide health content for Australia’s biggest ISP.

The West Australian-based health site, which has been in operation for more than five years, operates websites for consumers and healthcare professionals across more than 20 therapy areas.

BigPond visitors can link through to the Virtual Medical Centre site, which provides information on diseases, pharmaceuticals and practical remedies, as well as healthy living and diet tips.

It also gives users access to a GP directory, educational videos and a medical dictionary, as well as interactive tools including a BMI calculator, a pregnancy calculator and a blood count evaluation tool.

Medical specialists who join the site are given access to “professional members only” tools which allow them to evaluate a patients’ health, including tools to calculate how many migraines a patient may suffer a month, a durogesic dose calculator and a body surface access calculator.

There are also separate sections for women, men and children, which group together relevant medical topics such as pregnancy, immunisations and prostate health.

More than 1000 medical specialists have contributed to the site.

E-consults begin trials in Queensland

From Medical Observer:

 A new Web portal allowing patients to consult their regular GP online could be a step forward in e-health for Queensland doctors.

GP Partners, one of the state’s biggest divisions, is currently trialling the Dr4U portal which, when fully operational, will provide an e-consultation service for routine matters such as repeat prescriptions or smoking cessation. Patients will also be able to submit results of self-monitoring for chronic conditions and can send a secure message to their regular doctor, who will respond within a few days.

A similar scheme, Ozdocsonline, was launched in NSW in 2002 by a group of Sydney GPs. Patients whose GPs are registered with this secure website can log on to discuss care plans, test results and management of chronic conditions.

Dr Dianne Chambers, a GP and one of the service founders, told MO last year that, since its launch, Ozdocsonline had generated the equivalent of $98,000 in MBS rebates. Dr4U is likely to bill upfront, however a payment system is still being devised.

AMA Queensland council member and GP Dr Richard Kidd said the system would free up face-to-face time for doctors. But he warned against patients expecting instant answers to queries. He said the Dr4U team was aware of the AMA’s position on e-consultations and was adamant any final product wouldn’t replace face-to-face consults.