Tuesday, July 10, 2012

Armani Suits, Digital Health, and Where the VCs Roam

Research has told us that men don’t like to visit the doctor.  That might be true for the rest of the country, but certainly not in New York.  I welcome visits to the specialists that have carved my body into special interest sectors, not because they are particularly good at their trade, but because when in their offices I get to see the latest Armani fashions worn by the young and the beautiful who might have just stepped off Project Runway.  These beauties are the well-groomed, iPad-laden, pharmaceutical representatives who drag suitcases-on-rollers that are stuffed with drugs for the physician to hand out to patients as if the gifts were Halloween candy.  I have been caught with my hand out more than once.

Because I leave the office with expensive goodies, I don’t mind waiting that extra thirty minutes so my doctor can partake of the latest windfall from GlaxoSmithKlein, the pharmaceutical giant that probably won’t be slowed down by the recent $3 billion fine from the DOJ for inappropriate promotion of certain drugs.  The company will just hire more runway models.  Or perhaps sign up another television celebrity like Dr. Drew, who reportedly got a cool $275,000 for promoting Glaxo products to his afternoon audience a few years ago.  Thank goodness for Dr. Oz.

The Affordable Healthcare Act, recently upheld as constitutional by the Supreme Court, probably won’t get Armani suits out of the doctor’s waiting room and therefore can already be considered a success.  Perhaps more interesting than the 2,000-plus page tome that describes in numbing detail this Healthcare Act is the wonderful work ProPublica is doing tracking this beautiful but dark underside of medical marketing.  We owe a debt of gratitude to ProPublica reporters Charles Orstein and TracyWeber, who have exposed the financial ties between doctors and drug and device makers.

ProPublica.org offers a data base through which you can check and see whether your doctor is receiving money from pharmaceutical companies.  Through this data base, I learned that my favorite urologist in 2010 received $6860 from Pfizer for consulting.  I’ll give him a pass on the $165 for meals.  The reporters note that in 2011 a dozen drug companies spent $761 million for doctor speaking fees and consulting, with speaking fees comprising a large percentage of this total number.  Weber and Orstein encourage consumers to do the research and have this conversation with their doctors.  A speaking fee doesn’t necessarily mean a doctor is in the pocket of a drug company.  But they are very large pockets.

I read a Reuters blog by Ezekiel Emanuel stated that, in 2008, 17% of office-based physicians and 9% of hospitals had electronic health records (EHRs) and few than 10% used electronic prescriptions.  Then came the little known Health Information Technology provision in the 2009 Economic Recovery Act. This basically gave physicians and hospitals financial incentives for adopting EHRs.  If they didn’t, Medicare payments would be reduced starting in 2015.  There were the usual protests, but by December 2011, EHR use among office-based physicians nearly doubled to 34% with e-prescribing exceeding 40%. Hospitals responded just as positively with 35% adopting EHRs.

Emanuel writes that “going electronic will allows physicians to more closely track patients, especially the chronically ill, enabling a seamless exchange of data across multiple physicians, hospitals and other providers.”  The writer observes that this initiative has taken the focus away from developing new forms of coding and ways to bill the patient and placed it on improved patient care and enhanced coordination among physicians.

I have written in previous blogs about Qualcomm Life’s efforts to place the smartphone at the center of patient care, christening it the “Pocket Doctor.”  This has huge implications for health care because the company has the capability and partners to build a vast wireless health ecosystem.  Entrepreneur and medical doctor Peter Diamandis, chairman of the X Prize Foundation, designed to stimulate competition in health care,  is eloquent about how technology has finally made is possible for individuals to truly take responsibility for their own health.  That day might come sooner than we think.

While the chatter around the Healthcare Act was at full pitch, I was paying more attention to what is happening in the Venture Capital space that might impact the industry.  Gigamon points to recent and ongoing investments in digital health as worthy of serious attention because health care is ripe for massive disruption and democratization.  C. Steven Burrill, CEO, Burrill & Co., suggests that “the increased funding in digital health reflects the growing awareness of the transformative power their technologies bring to health care.”

And these technologies are small, large and numerous, including: wearable body monitoring products, personalized therapies via mobile devices, software that turns a smartphone into a clinical-quality ECG-reader, platforms for healthcare cost comparisons, wireless sensors that track activities, digestible tracking sensors, HIPAA-compliant and secure mobile messages, management software for home health care, and numerous EHR platforms.  Full details are available at Rockhealth.com.

It’s interesting that, with all the bombast about the Health Care Act, technology offers enormous promise to change the field, one doctor, hospital and patient at a time.

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