Eric Topol, Robert Wachter have a patient-centered conversation

Ostensibly an interview about Dr Topol’s book ‘The Patient Will See You Now,’ it is more a discussion of Dr Topol’s thesis that patients in control of their data are upending the relationship between doctor (as authority) and patient. What Dr Wachter questions– is the lack of analytics to turn this into useful information for both doctor and patient. Dr Topol agrees that the data is outstripping the analytics:

The field has not been developed nearly the way it should be to get us to the virtual medical assistant, which integrates all relevant data about an individual and provides great data visualization back to that person. Once it does, we have a tremendous opportunity to help people, even to preempt illness.

Dr Topol is also widely depicted as an advocate of ‘DIY’ (do it yourself) medicine, but he is not; “This is more about acquiring diagnostic or monitoring data and still having an intimate relationship with a doctor to help guide the appropriate treatment.” Doctors will have to change their methods too. A worthy Weekend Read (and audio excerpt 08:05) in this month’s AHRQ WebM&M.

Previously in TTA: Dr Topol on his book at last year’s NYeC Digital Health Conference (contrasting with the central control-stop medical intervention at 75 advocacy of Ezekiel Emanuel); Dr Wachter on The Overdose (excerpted from his ‘Digital Doctor’ book)

Integrating inexpensive lab testing, imaging to EHR–and vice versa

In the Dr Eric Topol patient-driven world, personal lab testing would be walk in, keep retail hours and not even need a doctor’s order. That is the model for Theranos, a well-funded low cost blood testing company operating 43 centers in California, Arizona (no doctor order needed) and one Pennsylvania Walgreens. Their latest alliance is with EHR physician practice giant Practice Fusion, which claims about 112,000 doctors actively using its cloud-based, ad supported platform, claims to be the fastest growing US EHR with at present 100 million patient records. The Theranos reporting app, which also connects patients with doctors who can help interpret the results (MD Connect) integrates with other EHRs (though not listed) and now the results will also show in their Practice Fusion patient record. Practice Fusion is also integrating imaging center RadNet‘s results.

Since the late 2000s, Practice Fusion has historically been the game changer in cost (one of the first in the cloud) and in catering to smaller practices. They are good at managing their hype, but as Neil Versel points out, there’s been a CEO ‘change-lobsters-and-dance’, there are questions about revenue and their awaited IPO seems far away, especially given the recent market upset. Hospital EHRs Cerner, Epic and NextGen now all have lower-cost practice versions that integrate with hospital versions. An American College of Physicians (ACP) 2014 survey identified that Practice Fusion is third (and tied with others) among most used practice EHRs behind Epic and eClinical Works, though strongest in solo practices. On the polar opposite of Mr Versel’s skeptical article is this breathless Forbes piece which confuses partnerships with acquisitions. Perhaps self-made billionaire Theranos CEO Elizabeth Holmes may decide to buy Practice Fusion!

A tale of two chessboards

Things happen ever faster on the second half of the chessboard. No sooner had the ink dried on our predictions for 2015, and Dr Eric Topol told the story of the first patient to call him with a smartphone diagnosis than Alivecor announced that they now have CE certification for their AF-diagnosing app.

Mind you, whilst Dr Topol might welcome this, it seems that others are still on a different chessboard: under the heading “Doctors fear that new health tech is turning UK into a nation of “worried well””, a recent survey of UK doctors showed that “Seven out of ten (76%) GPs said they had noticed a marked increase in number of patients “self-diagnosing” from the internet over the past twelve months” suggesting, in the words of 1066 & all that, that technology is a Bad Thing. What, this reviewer wonders, will be the reaction to (more…)

Looking back over Telehealth & Telecare Aware’s predictions for 2014, part II

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2015/01/magic-8-ball.jpg” thumb_width=”150″ /]Editor Charles has treated you to a look back on his 2014 predictions, daring Editor Donna to look back on hers. Were they ‘Decidedly so’, ‘Yes’, ‘Reply hazy, try again’ or ‘My sources say no’? Read on…

On New Year’s Day 2014, it looked like “the year of reckoning for the ‘better mousetraps’”? But the reckoning wasn’t quite as dramatic as this Editor thought.

We are whipping past the 2012-13 Peak of Inflated Expectations in health tech, diving into the Trough of Disillusionment in 2014.

There surely were companies which turned up ‘Insolvent with a great idea’ in Joe Hage’s (LinkedIn’s huge Medical Devices Group) terms, but it was more a year of Big Ideas Going Sideways than Crash and Burns.

Some formerly Great Ideas may have a future, just not the one originally envisioned. (more…)

2014: a few quotes

As a coda to yesterday’s review of our predictions for 2014, here are a few quotes that particularly struck this editor as of interest in 2014, sometimes because of what was said and sometimes because of who was saying it – it’s left to the reader to decide which.

Arthur L. Caplan, Director of Medical Ethics at the New York University Langone Medical Center at the end of an interesting piece in the New York Times on the finer points of genetic testing said:

If you want to spend wisely to protect your health and you have a few hundred dollars to spare, buy a scale, stand on it, and act accordingly.

Three months later, Anne Wojcicki, the founder of 23andme – one of the genetic testing organisations mentioned in the last clip – was quoted in this Medcity News piece as saying: (more…)

Dr. Topol in the AT&T house: a reboot of ForHealth?

HIMSS14 will tell. The big news that kicked off this snow-bound week in large parts of the US was Dr. Eric Topol joining Dallas, Texas-based AT&T ForHealth as Chief Medical Advisor. Well-known for his personality and evangelism of all things mHealthy, certainly Dr. Topol lends a certain star power to Big Blue’s efforts in this area–a shine that went completely dark in 2013 after a promising start in 2011 and strong partnering moves in 2012 (Alere and WellDoc diabetes management TTA 10 Aug 12VRI monitoring in May). The quietude of 2013 deserves a closer look. Dr. Geeta Nayyar joined with fanfare in September 2011 as Chief Medical Information Officer and departed exactly two years later to join engagement company PatientPoint with the same title. ForHealth made no waves at International CES save for being an example in the controversial ‘sponsored data’ plan announcement (GeekWire). Even finding ForHealth on the AT&T website is not easy. It is buried under ‘Business>>Enterprise Business‘ and then in a dogpile of footer links as ‘Healthcare Solutions‘–not ForHealth. In marketing, this is a state usually termed ‘dead in the water.’ The fact that Dr. Topol is remaining as Chief Academic Officer at Scripps Health also indicates that he is no direct replacement for Dr. Nayyar, despite being cited by AT&T SVP Chris Hill as a “change agent” who will help “drive our competitive strategy”. We’ll see if HIMSS14 on 23-27 February where AT&T will be exhibiting and their subsequent activity marks a genuine reboot for ForHealth, putting Dr. Topol’s impressive abilities to work beyond a twinkle. AT&T press release, MedCityNews article