Facebook and Electronic Medical Records

Posted by AMS at 7 DEC 6:57 am

The Landscape of Pharma Information & EMR

Posted by AMS at 15 NOV 8:01 am

The Changing Landscape of Pharmaceutical Information & EMR – Changes in the next 10 years.

While recently attending a biotechnology forum, I found myself considering the pharmaceutical landscape and some of the ways it may be changing. The event was Boston’s War on Cancer, organized by Xconomy, during which a number of corporate presentations and discussion sections examined the state and direction of research into effective cancer therapeutics. The pharmaceutical industry is a regulated one, as it should be in my opinion, but the framework imposed by the regulatory process can often make innovative business models and development paradigms difficult to explore.

In the development of cancer therapeutics, companion diagnostic tests that assist in directing preferred treatments are taking on an ever more important role. Even here, regulatory uncertainty has likely hindered development. These tests are often developed by agents outside the pharmaceutical company, though they are often synergistically partnered. In 2004, the FDA identified companion diagnostics as an area of interest as part of its Critical Path Initiative. It followed up in 2005 by offering a concept paper for industry discussion, but actual draft guidance is still not expected until the end of this year at the earliest. I don’t envy the agency and its difficult responsibility of both insuring scientific vigor and maintaining a level of flexibility.

Entering the 21st century
Social media is another arena in which the pharmaceutical companies have been hesitant to venture due to unclear regulatory guidance. Concerns over how pharmaceutical products may be marketed over such venues concerns the FDA, which has yet to issue guidance despite the demand.

Unwilling to wait, pharmaceutical firm Roche has issued its own set of guidelines on how it plans on using the new media. Outside the pharmaceutical companies, there is no restriction. During a socializing break at the Xconomy forum, I learned of Sermo, a social group established and restricted to practicing physicians. Here, doctors can confer with their peers on patient specific topics and treatment options. Social support groups for patients are available and only passively supported by pharmaceutical firms.

What seems to be occurring is a change in the direction of information flow. Companies in the past have had a degree of control over how information on their drug products was distributed, largely through their sales force armies. Now these firms are being forced to become observers as information related to their products, often anecdotal, is distributed and discussed by outside agents that they don’t control.

The advent of widespread electronic medical records is going to accelerate the flow reversal of drug information. A recent study serves as a key example here. In late 2009, the label for the Bristol-Myers Squibb (NYSE: BMY) and Sanofi-Aventis (NYSE: SNY) drug Plavix (clopidogrel) was changed based on concerns that co-use of proton pump inhibitors could affect drug metabolism and efficacy. The study was based on claims data gathered by insurance companies Aetna (NYSE: AET) and Medco Health (NYSE: MHS).

Claims records may be mined, but the process will be far easier once the systems are fully electronic. In 10 years, a good deal of the medical literature may be published by insurers and based on data mining of real patient records. The result will be some real-world comparisons to drug efficacies seen in more controlled clinical settings. The result may indicate efficacy in treating conditions (off-label use), better information on how pharmaceuticals help save over more expensive forms of care (such as repeat hospitalization), but there will also likely be an increase observance of low-level adverse events, resulting in more situations of post market withdrawals, perhaps analogous to what happened to Merck’s (NYSE: MRK) Vioxx (rofecoxib).

As an investor, I want to consider what these possible changes in information sources may mean to industry players. I think it will continue to make pharmaceutical development and marketing a challenge, and perhaps continue to keep pharmaceutical firms relatively cheap in comparison to their historical norms. The loss of control over the pharmaceutical data will make drug marketing more difficult, though I am not sure it will make it more clear to consumers, who are increasingly involved in the decision process themselves.

I’m still content to own a few pharmaceutical firms, because of their enticing valuations and generally good dividend yields, but I prefer the more diversified companies. I also believe that insurers should find themselves gaining a valuable new asset that can be used for the more effective delivery of care services. I’m inclined to be bullish on insurers, but also inclined to continue to wait until there is more visibility resulting from the health-care reform legislation.

Tweeting Their Way For New Patients – Social Media

Posted by AMS at 17 AUG 7:32 am

Hospitals are turning to social networking in an effort to market themselves to new patients who seem to be looking more to social media to choose the kinds of products and services they use.

Earlier this year, a Baltimore television station incorrectly reported that Greater Baltimore Medical Center had been invaded by an armed robber. Naturally, the Twitter-verse was aflutter.

After the news broadcast, Michael Schwartzberg, media relations manager of GBMC, sent out a slew of tweets correcting the misinformation.

This is new territory for medical marketing. Ten years ago, it was innovative if hospitals had websites. Now, medical institutions are tweeting, creating Facebook pages, making videos for YouTube, and posting photos to Flickr.

In this technology-driven age, consumers are relying less on word-of-mouth referrals and looking more to social-media outlets to choose the kinds of products and services they use—including health care. In response, hospitals have ramped up their online marketing campaigns.

“I think the amount of competition in this direct area affects a lot of the things we do [in social media],” said Betsey Haley, communications and social-media manager for LifeBridge Health.

LifeBridge spreads its online presence throughout five different social-media platforms plus its website.

The LifeBridge Twitter account and Blogspot blog is updated regularly and provides health care information to patients, while its Facebook page is used as a job and career board. LifeBridge also has its own channels on YouTube and ICYou, an online health video source.

“We look at social media as a new and interesting way to communicate with people,” Haley said.

Federal health reform is helping to put patients at the center of their care too, which means consumers will have more options.

“With or without health care reform, social media has a relevant place in our landscape of navigating health information and health care decisions,” said Kathy Smith, director of market development for Johns Hopkins Medicine.

Hopkins has social-media communities on Facebook, Twitter, and YouTube.

“By actively engaging in social media, we have the opportunity to reach audiences on a platform where they feel comfortable,” Smith said.

She said patients are definitely paying attention to different social-media avenues as a way to connect with health care professionals and get health information at the click of a mouse.

“Today’s health consumer is much more mobile than they once were,” Schwartzberg said.

Schwartzberg said GBMC uses its social-media platform for media relations, customer service, crisis communication—such as H1N1 updates, community relations, and human resources.

Kevin Cservek, a spokesman for Baltimore Washington Medical Center, said the hospital has a Facebook page and Twitter account that are updated daily. Cservek also runs a YouTube channel, which so far features interviews with physicians about heart disease. A Flickr site boasts photos from various events.

Cservek said social media won’t replace traditional marketing, but it is another avenue hospitals can use to reach patients.

At a recent free screening for prostate cancer, Cservek said that out of 100 people that attended, about a handful of men said they found out about the screening on Facebook.

“For commercial brands like an energy drink or a new line of clothing, I think social media has a lot of value,” said Vivienne Stearns-Elliott, media relations officer for St. Joseph Medical Center in Towson, Maryland.

But she is still skeptical of the value of social media for hospitals, especially since many elderly and low-income patients do not have regular access to a computer.

By Emily Mullin Aug 12 2010

Portfolio.com/industry-news/health-care

Social Media in Health Care: Barriers and Future Trends

Posted by AMS at 6 JUL 7:00 am

Social media has invaded health care from at least three fronts: innovative startups, patient communities and medical centers. The Health 2.0 movement has nurtured dozens of startups with creative concepts to revolutionize health care: tools from vertical search and social networks to health content aggregators and wellness tools.

Patient communities are flourishing in an environment rich with social networks, both through mainline social communities and condition-specific communities. Meanwhile, hospitals and academic medical centers are diving into the social media mix with more than 300 YouTube channels and 500 Twitter accounts. Hospitals are moving from experimentation (Twittering from the OR to Flipcam videos) to strategic use of social media to enhance brand loyalty and recruit new patients. They are taking on monitoring and monetization of social media.

At the same time, health care organizations find challenges in adopting social media. Hospitals and medical practices are risk adverse and generally cautious about new technology trends without clear value. There are questions about whether social media use by hospital employees is a waste of time, or even worse, presents risks of violating HIPAA or leaking proprietary information. Hospital IT departments are concerned about security risks, such as the use of tinyurl.com, which can mask malicious Web sites. Privacy concerns, particularly the vulnerability of social media accounts, are also cited as a reason to avoid social media.

Current Trends in Social Media

Current trends to watch in social media in health care include:

Managing a conversation

Engaging e-patients

Convergence with personal health records

Social media for providers

An important distinction in this two-way conversation is between medical advice and medical information. Hospitals and providers need to walk a fine line between giving specific medical advice in the relatively public forums of social media and providing more generalized medical information.

At the same time, there are ways to create a conversation with health care consumers. Sites like Medhelp.org have provided this kind of information using medical experts to answer patient-submitted questions in general terms. For instance, promoting wellness is a win-win; medical information relevant to many is provided without specific medical advice for a patient’s medical condition.

The rise of e-Patients creates many opportunities for engagement. E-Patients are defined as those “who are equipped, enabled, empowered and engaged in their health and health care decisions.” E-patients can provide feedback not only on improving hospital Web sites but also as participants in quality improvement within the health system.

PHRs and Online Communities

A s the similarities between online patient communities (e.g., http://www.patientslikeme.com and http://curetogether.com) and PHRs begins to blur, will PHR information from providers be shared with online communities with the appropriate privacy settings so that the user can decide what to share?

Recording one’s medical condition online and abandoning privacy are part of the “Quantified Self” movement.  The Robert Wood Johnson Foundation’s Project Health Design uses the concept of “Observations of Daily Living,” which extends the quantified self to behavioral self-observations. The next step in quantified self is self-monitoring, also known as home monitoring and telemedicine. Being quantified in terms of one’s weight, blood pressure or blood glucose provides another way of self-monitoring and participatory medicine.

Some are predicting that in the near future, multiple monitoring devices will be phased out to give way to connections with smart phones that will record and transmit medical monitoring data directly to a PHR. Innovators, such as Google Health and Microsoft Health Vault, as well as edgy startups, will provide the conduit from smart phones to the cloud.

Finally, a relatively untapped resource is the use of social media among medical professionals. If anything, there have been negative stories about abuses and misuses of social media by health professionals and questions about the ethics of connecting with patients online.

Currently, few health care professionals see the value in social networking with other physicians, or they are not convinced that the benefits are worth the time. Although well over 90% of physicians use the Internet for continuing education, medical reference and e-mail with colleagues and a majority of doctors have a smart phone, taking the leap into online communities is less common.

Perhaps current business models dependent on financial incentives and industry sponsorship in exchange for private data have not engaged physicians. Could a different model that provides privacy and collaboration in the context of a community of similar interests demonstrate value and promote adoption?

Future Evolution of Social Media

Social media is here to stay in health care, but it will evolve quickly. Patient engagement will continue to characterize this change. Organizations will use social media tactically within their overall marketing and communications efforts — videos and mobile technology will likely dominate these approaches.

Online patient communities will expand and will become a rich source of information for others. Physicians and other health care providers will discover social media, which will have the potential of progressing medical research.

There may be regular news reports of privacy violations, dangerous misinformation and fraud promoted via social media, but these reports are not likely to stop a wave of innovation and conversation.

Thursday, May 06, 2010

by John Sharp

www.ihealthbeat.org

VA Looking To Add Social Medial Tools to EHR Portal

Posted by AMS at 11 APR 9:32 pm

The Department of Veterans Affairs is testing the use of various social media-style tools that would enhance the user experience and accessibility of VA’s electronic health record portal My HealtheVet, Federal Computer Week reports.

At the 2010 FOSE conference on Tuesday, Gail Graham, VA’s deputy chief officer of health care information management, said that younger VA members returning from deployment have been requesting more functionality and social media-like services in the EHR portal. Veterans use the portal to access their health records, maintain health diaries and order prescription refills.

She said that VA has been testing a secure message tool that would link patients to their health providers through My HealtheVet. The tool has been introduced in pilot projects at several VA hospitals, Graham said. However, she noted that HIPAA privacy rules prevent it from functioning as an instant messaging tool.

Graham said that additional features are being tested in focus groups with veterans (Beizer, Federal Computer Week, 3/23).