Sunday, December 26, 2010

Physicians must ride the third great wave

Physicians Must Ride the Third Great Wave...

 

Here we are ready to say goodbye to 2010 and usher in 2011.  This year has been a massive year for the tech world. The Consumer Internet reigns.   Start-ups are providing incredible services for both consumers and businesses to gain feedback on their application and use of their sites.  Lean start-ups which start first with customers and then create products out of nothing are the norm.  Cost of business creation is at an all time low.   Free and freemium models abound.   Our social graphs have deepened and have new-found importance.  As of November 2010 Apple is activating 275,000 ios devices a DAY.  Consumers have chosen the mobile as their device of choice.  E commerce reins as the consumer’s choice and has decimated almost every brick and mortar industry.  

 

Now let’s reflect on the year of 2010 in health care.   There is a lot going on.  Hospitals and physician practices are hard at work.  The focus is on reform and meaningful use implementation, as well as the acquisition of government funding to keep floating our ailing hospitals and broken fee for service business models.   Primary Care continues to lose ground, as hoards of physicians flock to retirement, better opportunities in health care consulting and health IT sales, as predicted in this Physician’s Foundation Study from 2008.  Physicians in private practice are leaving contracts with medicare in a variety of states, notably, Texas. Innovative products and services do help our hospitals and physician practices improve, with improved billing platforms, portals, and the like. These are all forms of incremental innovation. Yet, the focus for both  hospitals and physician practices remains the third party payer, with most of our products in Health IT laser focused on revenue cycle management.  They focus on the  improvements in the work-flow of the physician office that must implement the excruciating and time consuming details of third party payer practice.  There are certainly opportunities for improved contracting, process, revenue cycle and acquisition of HHS funding for Medical Home projects.  These are the domain of consultants in the industry.  Christensen notes that industries in decline always have the most robust consulting opportunities.

 

I want to take a minute to warn all of us entrenched in the above considerations, that we  have missed the boat, my friends.   Meaningful use and specifically the Patient Health Record has a far more significant importance.  Clay Christensen writes in Innovator’s Prescription that the only chance of saving healthcare is through disruption.  Disruptive Innovation that is.  Disruption is all around us in 2010. Both hospital and physician practice models are being massively disrupted already, by companies harnessing the third great wave of innovation that John Doerr of Seqoiua Capital predicts.  We have been disrupted by a long list of emerging business models that have taken marketshare, accentuating the financial woes of the typical physician practice.  Clay C. and Jason Hwang discusses a long list of these in his book.   Coming from the experience of building a health service organization and cloud platform that helps doc’s go mobile, I have spoken at conferences and Health IT panels with the founders of these emerging businesses that focus on consumers, self tracking, social contagion, and croudsourcing.  There are even new professional organizations that have grown out of this refreshing consumer interest in creation of health WITH their physician. that are growing as a result.  They focus on consumer’s interest to improve the physician patient relationship utilizing high tech tools in some instances, specifically the PHR.  Yes, the group of us doctors who use social media to improve health all agree that 2010 is the “ Year of the Patient”, with epatient dave leading the charge.  

 

The growing success in these emerging business can be attributed to new business model creation which validates pricing directly with customers.  They utilize a host of high tech tools to rapidly gather feedback and iterate their product offerings.  They are creating something out of nothing, what Eric Ries from Lean Startup calls, a “ Miminum Viable Product” and then selling it.  They then build the business around customers with an ongoing process of customer development.  They build out process and corporate culture that revolves around customers. This is disruptive innovation.  As the existing business models in healthcare continue to struggle with distractions like meaningful use, government, reform and revenue cycle management, the new value network in health care is DISRUPTING you.  The disruption will continue, Clay says, until within 5 years we will have a new value network, the center of which is the Patient Health Record.  (Not hospitals and physician offices as in 2010)  In order to stay in the game, primary care physicians MUST implement the principles of disruptive innovation alongside the continued incremental changes that you are implementing in practice.  

 

See, disruption starts and ends with consumers.  If you listen to your patients carefully, they will tell you exactly what they want.  Consumers and businesses are willing to pay for services.  I want physicians in primary care to remember they need us now more than ever.   We are focused at Personal Medicine on service line strategy of disruption and new business model creation for physicians.  Our legacy and vision is a global mobile primary care workforce who rides the third great wave of innovation, the mobile, social, e-commerce revolution.  

 

Feedback?

 

Natalie Hodge MD FAAP

Chief Health Officer Personal Medicine

www.personalmedicine.com

Posted via email from Personal Medicine

Physician's Ride the Third Great Wave

Click to open:

Physicians Must Ride the Third Great Wave...

 

Here we are ready to say goodbye to 2010 and usher in 2011.  This year has been a massive year for the tech world. The Consumer Internet reigns.   Start-ups are providing incredible services for both consumers and businesses to gain feedback on their application and use of their sites.  Lean start-ups which start first with customers and then create products out of nothing are the norm.  Cost of business creation is at an all time low.   Free and freemium models abound.   Our social graphs have deepened and have new-found importance.  As of November 2010 Apple is activating 275,000 ios devices a DAY.  Consumers have chosen the mobile as their device of choice.  E commerce reins as the consumer’s choice and has decimated almost every brick and mortar industry.  

 

Now let’s reflect on the year of 2010 in health care.   There is a lot going on.  Hospitals and physician practices are hard at work.  The focus is on reform and meaningful use implementation, as well as the acquisition of government funding to keep floating our ailing hospitals and broken fee for service business models.   Primary Care continues to lose ground, as hoards of physicians flock to retirement, better opportunities in health care consulting and health IT sales, as predicted in this Physician’s Foundation Study from 2008.  Physicians in private practice are leaving contracts with medicare in a variety of states, notably, Texas. Innovative products and services do help our hospitals and physician practices improve, with improved billing platforms, portals, and the like. These are all forms of incremental innovation. Yet, the focus for both  hospitals and physician practices remains the third party payer, with most of our products in Health IT laser focused on revenue cycle management.  They focus on the  improvements in the work-flow of the physician office that must implement the excruciating and time consuming details of third party payer practice.  There are certainly opportunities for improved contracting, process, revenue cycle and acquisition of HHS funding for Medical Home projects.  These are the domain of consultants in the industry.  Christensen notes that industries in decline always have the most robust consulting opportunities.

 

I want to take a minute to warn all of us entrenched in the above considerations, that we  have missed the boat, my friends.   Meaningful use and specifically the Patient Health Record has a far more significant importance.  Clay Christensen writes in Innovator’s Prescription that the only chance of saving healthcare is through disruption.  Disruptive Innovation that is.  Disruption is all around us in 2010. Both hospital and physician practice models are being massively disrupted already, by companies harnessing the third great wave of innovation that John Doerr of Seqoiua Capital predicts.  We have been disrupted by a long list of emerging business models that have taken marketshare, accentuating the financial woes of the typical physician practice.  Clay C. and Jason Hwang discusses a long list of these in his book.   Coming from the experience of building a health service organization and cloud platform that helps doc’s go mobile, I have spoken at conferences and Health IT panels with the founders of these emerging businesses that focus on consumers, self tracking, social contagion, and croudsourcing.  There are even new professional organizations that have grown out of this refreshing consumer interest in creation of health WITH their physician. that are growing as a result.  They focus on consumer’s interest to improve the physician patient relationship utilizing high tech tools in some instances, specifically the PHR.  Yes, the group of us doctors who use social media to improve health all agree that 2010 is the “ Year of the Patient”, with epatient dave leading the charge.  

 

The growing success in these emerging business can be attributed to new business model creation which validates pricing directly with customers.  They utilize a host of high tech tools to rapidly gather feedback and iterate their product offerings.  They are creating something out of nothing, what Eric Ries from Lean Startup calls, a “ Miminum Viable Product” and then selling it.  They then build the business around customers with an ongoing process of customer development.  They build out process and corporate culture that revolves around customers. This is disruptive innovation.  As the existing business models in healthcare continue to struggle with distractions like meaningful use, government, reform and revenue cycle management, the new value network in health care is DISRUPTING you.  The disruption will continue, Clay says, until within 5 years we will have a new value network, the center of which is the Patient Health Record.  (Not hospitals and physician offices as in 2010)  In order to stay in the game, primary care physicians MUST implement the principles of disruptive innovation alongside the continued incremental changes that you are implementing in practice.  

 

See, disruption starts and ends with consumers.  If you listen to your patients carefully, they will tell you exactly what they want.  Consumers and businesses are willing to pay for services.  I want physicians in primary care to remember they need us now more than ever.   We are focused at Personal Medicine on service line strategy of disruption and new business model creation for physicians.  Our legacy and vision is a global mobile primary care workforce who rides the third great wave of innovation, the mobile, social, e-commerce revolution.  

 

Feedback?

 

Natalie Hodge MD FAAP

Chief Health Officer Personal Medicine

www.personalmedicine.com

 

 


Google Docs makes it easy to create, store and share online documents, spreadsheets and presentations.
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Posted via email from Personal Medicine

Sunday, December 19, 2010

Knowledge Centers for Your Child's Health

Check out this website I found at paducahpediatrics.snappages.com

Here is a list we put together of great knowledge centers on the web for Pediatric health! The better information you have the more prepared you are to parent!

To Your Best Health,

The Personal Medicine Team

Posted via email from Personal Medicine

Sunday, December 12, 2010

Regulation of genetic tests unnecessary, government says -- Webster 182 (16): 1715 -- Canadian Medical Association Journal

From the standpoint of a mother, having had the experience myself of holding down my children in a chair for a venous stick, consumers will be demanding this...

Posted via email from Personal Medicine

Friday, December 10, 2010

Computing in the Age of the $1,000 Genome: Xconomy to Convene Leaders of New Era in Personalized Medicine | Xconomy

We are looking down the barrel of having the answers to our patients personal genomes. These are companies primarily going direct to consumers. I have had the experience of parents requesting genetic testing OVER our current lab technologies and have been recommending 23and me and or Bayor screen here. So we are primed for a MASSIVE shift in the way that consumers view our current blood chemistry industry and how we as physicians use that information. We are entering a new era of " prediagnosis" and consumers are on board with it. Payors as usual will not be, but it is understood by consumers that this testing will be out of pocket. Furthermore, consumers are NOT willing to share this private genetic data with payors. Get on board doc's the future is coming, well, no, it is here.

To Your Best Health,

The Personal Medicine Team

Posted via email from Personal Medicine

Thursday, December 09, 2010

SIDS may be related to deficits in Seratonin

Serotonin May Be the Key to SIDS

Lack of biochemical causes baby's alarm system to fail if breathing problems develop, experts say

By Dennis Thompson
HealthDay Reporter

WEDNESDAY, Dec. 8 (HealthDay News) -- Sudden infant death syndrome, or SIDS, has for years had a reputation as a mysterious and terrifying killer of newborns.

But medical researchers now think they have cracked the secret of what causes babies to die of SIDS, an advance that could save hundreds of lives each year.

Doctors have found that babies who die of SIDS tend to have significantly lower amounts of serotonin than babies who die of other causes. Serotonin is a hormonal neurotransmitter closely linked to many of the body's vital functions, including the sleeping cycle.

A lack of serotonin is suspected to hamper a sleeping baby's ability to wake up when its safety is threatened by a lack of oxygen or some other health hazard, said Dr. Rachel Y. Moon, a pediatrician, SIDS researcher and associate chief of the division of general pediatrics and community health at the Goldberg Center for Community Pediatric Health at Children's National Medical Center in Washington, D.C.

"We think a lot of it has to do with arousal, and how babies can wake up when they are asleep," Moon said. "If you have a baby who gets into a compromised situation and they are becoming hypoxic, there are some babies who are sleeping so deeply or have an arousal defect that they can't wake up."

SIDS is the leading cause of death for babies between 1 month and 1 year of age, according to the U.S. National Institutes of Health. Most SIDS deaths occur between the ages of 2 months and 4 months, and more than 2,200 U.S. infants die of SIDS every year.

These deaths are sudden and unexplained, even after doctors perform an autopsy and review the infants' health. Since most of these deaths happen when the babies are sleeping, SIDS is known to many as "crib death."

Researchers believe that some sort of birth defect leads to the serotonin deficit in some babies, said Laura Reno, vice president of public affairs for First Candle, a nonprofit organization dedicated to the study and prevention of SIDS.

Some of the most recent research came from work headed by Dr. Hannah C. Kinney, a neuropathologist at Children's Hospital Boston and a professor of pathology at Harvard Medical School. Kinney, a leading SIDS researcher, and her colleagues found that serotonin levels of 35 babies who died of SIDS were 26 percent lower than those of babies who died of known causes. The SIDS infants also had 22 percent lower levels of tryptophan hydroxylase, an enzyme that helps make serotonin.

Serotonin is suspected to be crucial to a baby's arousal system, which Reno likened to an "alarm" that wakes a baby up when the infant's health is compromised.

"In these babies, the alarm doesn't sound," Reno said. "They continue to sleep even if there is a challenge in their environment, which then causes them to die."

Environmental hazards that could lead to a SIDS death, Reno said, include:

  • Belly sleeping. Infants allowed to sleep on their stomachs end up rebreathing their own exhaled air rather than fresh air. "They are taking in carbon dioxide instead of oxygen," which creates an oxygen deficiency that can result in death, Reno said.
  • Overheating. Babies dressed too warmly or swaddled in thick blankets can become too warm for their own health. "These babies get too heated and, again, the alarm doesn't sound," she said.
  • Too much soft and fluffy bedding and pillows in a crib also can cause a baby to smother. Babies who sleep in the same bed as their parents also are more likely to die of SIDS, Reno said.
  • Smoking. Cigarette smoke robs sleeping babies of needed oxygen. Secondhand smoke, she said, is "really dangerous for these babies."

The next step in research would be to find a way to identify babies who suffer from a natural lack of serotonin. "That would be the goal, because then we would be better able to target messaging," Moon said.

In the meantime, parents are urged to follow the recommendations that doctors have been issuing for years to limit SIDS deaths:

  • Always place babies on their backs to sleep. Since the American Academy of Pediatrics issued this recommendation in 1992, SIDS deaths have dropped by more than half, according to the Nemours Foundation.
  • Place babies on a firm sleeping surface with a tightly fitted sheet. Don't allow a baby to sleep on a pillow, quilt or other soft surface.
  • Dress babies in light clothing for sleep, and keep the room at a temperature that adults would find comfortable.
  • Give babies a pacifier when putting them down to sleep. Studies have found that babies who use pacifiers are less likely to die of SIDS. "We think it may change the baby's arousal threshold, or the way the baby breathes," Moon said.

These are guidelines that parents should follow regardless of whether they believe their child may suffer from a serotonin deficiency, Moon added.

"Babies do suffocate," she said. "Babies do get trapped between mattresses and other things. So these safe-sleep recommendations will help protect against those things as well."

More information

The U.S. National Institute of Child Health and Human Development has more on SIDS.

For more on SIDS, read about one mother's experience.

SOURCES: Rachel Y. Moon, M.D., associate chief, division of general pediatrics and community health, Goldberg Center for Community Pediatric Health, Children's National Medical Center, Washington, D.C.; Laura Reno, vice president, public affairs, First Candle, Baltimore

Last Updated: Dec. 08, 2010

Copyright © 2010 HealthDay. All rights reserved.

Hmmm this is interesting, from the team at Boston Children's regarding SIDS causes... Bottom line is put your baby on their back to sleep to minimize risk.

To Your Best Health,

The Personal Medicine Team

Posted via email from Personal Medicine

Wednesday, December 08, 2010

The Superfoods Rx

Here is an excellent book I suggest for everyone who wants to keep their family healthy... Tonight I'm making the Turkey Pumpkin chili on page 291

To Your Best Health,

The Personal Medicine Team

Posted via email from Personal Medicine

Saturday, December 04, 2010

Your Diet: Eat More, Weigh Less, Pt. 2 | The Dr. Oz Show

Here is a great video from Dr Oz on how to eat MORE!

To Your Best Health,

The Personal Medicine Team

Posted via email from Personal Medicine

Friday, December 03, 2010

Home

Wow just got asked to speak at this cool conference in Singapore, Asian wireless Summit about Personal Medicine care delivery model and Panel with other wireless leaders... Asia... big market, huh?

Posted via email from Personal Medicine

Thursday, December 02, 2010

Obesity Bill Shot Down...

Republicans block child nutrition bill

So sad... if everyone will just read this post on superfoods and go out and buy them and EAT them... we won't have to worry about this anymore...

http://paducahpediatrics.snappages.com/blog.htm

WASHINGTON (AP) — House Republicans have temporarily blocked legislation to feed school meals to thousands more hungry children.

Republicans used a procedural maneuver Wednesday to try to amend the $4.5 billion bill, which would give more needy children the opportunity to eat free lunches at school and make those lunches healthier. First lady Michelle Obama has lobbied for the bill as part of her "Let's Move" campaign to combat childhood obesity.

House Democrats said the GOP amendment, which would have required background checks for child care workers, was an effort to kill the bill and delayed a final vote on the legislation rather than vote on the amendment.

Because the nutrition bill is identical to legislation passed by the Senate in August, passage would send it to the White House for President Barack Obama's signature. If the bill were amended, it would be sent back to the Senate with little time left in the legislative session.

House Majority Leader Steny Hoyer, D-Md. said the House would hold separate votes on Thursday on the amendment and the bill.

Republicans say the nutrition bill is too costly and an example of government overreach.

"It's not about making our children healthy and active," said Rep. John Kline, R-Minn., the top Republican on the House Education and Labor Committee. "We all want to see our children healthy and active. This is about spending and the role of government and the size of government — a debate about whether we're listening to our constituents or not."

Former Alaska Gov. Sarah Palin has also taken a swipe at the first lady's campaign, bringing cookies to a speech at a Pennsylvania school last month and calling the campaign a "school cookie ban debate" and "nanny state run amok" on her Twitter feed.

The legislation would give the government the power to decide what kinds of foods could be sold and what ingredients may be limited in school lunch lines and vending machines.

The Agriculture Department would create the standards, which would likely keep popular foods like hamburgers and pizza in school cafeterias but make them healthier, using leaner meat or whole wheat crust, for example. Vending machines could be stocked with less candy and fewer high-calorie drinks.

The bill would provide money to serve more than 20 million additional after-school meals annually to children in all 50 states. Many of those children now only receive after-school snacks. It would also increase the number of children eligible for school meals programs by at least 115,000, using Medicaid and census data to identify them.

The legislation would increase the amount of money schools are reimbursed by 6 cents a meal, a priority for schools that say they don't have the dollars to feed needy kids.

(This version CORRECTS that Palin is a former, not current, Alaska governor.)

Copyright © 2010 The Associated Press. All rights reserved.

Related articles

The Associated Press

Posted via email from Personal Medicine

Wednesday, December 01, 2010

Disruptive Innovation in Primary Care

Here is a 35 minute clip from Medfusion on the emerging technologies that enable physicians to go mobile and connect online and in the homes of patients.

To Your Best health,
The Personal Medicine Team

Posted via email from Personal Medicine