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WellNet launches social networking site for healthcare providers


WellNet Healthcare this month will launch a test version of Point to Point Healthcare, a social network linking users’ physicians, pharmacists and insurance benefit managers, the Washington Post reports. The online tool will allow employees of companies who use the program to connect their health care providers to facilitate treatments. The tool will also feature an online concierge that can assist employees in finding new specialists and a message system that issues reminders to pick up prescriptions.

WellNet, which helps employers evaluate their corporate health plans by collecting anonymous data on employee’s medical and pharmacy activity, will be able to monitor the social network to track such data in real time, the Post reports. WellNet will initially offer the program at no cost if clients transfer their pharmacy benefits to WellNet. WellNet plans in early 2009 to open the services to other companies for a licensing fee. Success, Concerns
The success of the program is dependent on whether WellNet is able to get its network of 300,000 primary care physicians to use it, according to the Post. Joseph Heyman, board chair for the American Medical Association, said, “It depends how simple it is to use these online tools” adding, “If it means extra work, and it’s not a time-saver, [physicians are] generally not interested.”

According to the Post, privacy advocates are concerned about the security of Web-based medical records. Deborah Peel, founder of the Patient Privacy Rights Foundation, said, “There isn’t any way to fix a violation of your sensitive health records.” In addition, some are worried that the identities of the employees could be discovered because WellNet typically deals with small and mid-sized companies, where it could be easier to identify an employee.

WellNet officials said Point to Point, developed by software company Healthcare Interactive, will use the same security used by online banking systems and will be guarded by the legal protections specified by the Health Insurance Portability and Accountability Act. In addition, company officials said users of Point to Point can control access to different parts of their medical profile (Marr, Washington Post, 8/16).

Major Medical Schools limiting pharmaceutical funding

Stanford University officials on Tuesday plan to announce a new policy under which pharmaceutical and medical device companies no longer will have the ability to select continuing medical education courses that they seek to finance for physicians at the university’s School of Medicine, the New York Times reports. Under the policy, Stanford will ask the companies to contribute to a pool of funds that the university can use to finance any CME courses, regardless of whether those courses mention products marketed by the companies.

According to the Prescription Project, Stanford will become the sixth major U.S. medical school to establish such a pool as part of an effort to limit the influence of the companies on CME courses. Pharmaceutical and medical device companies have “long paid” for CME courses, and, although the “industry says its money is intended solely to keep doctors up to date, critics charge that companies agree to support only classes that promote their products,” the Times reports.

Stanford School of Medicine Dean Philip Pizzo said, “I want to make sure we’re not marketing for industry or being influenced by their marketing.”

Reaction
David Korn — chief scientific officer of the Association of American Medical Colleges, which in June recommended that medical schools establish policies to limit the influence of pharmaceutical and medical device companies on CME courses — called the new policy at Stanford “an extremely important step forward.”

Murray Kopelow, CEO of the Accreditation Council for Continuing Medical Education, said, “It’s a good plan, and it’s a big deal that a place like Stanford has adopted it,” adding, “When this is all over, medical education will not be the same as what it’s been.”

In a statement, Sen. Chuck Grassley (R-Iowa), who in April 2007 issued a report that examined how companies have used CME courses to promote their products, said, “Reforms based on transparency can foster accountability and build confidence in medical education and, in turn, the practice of medicine.”

Ken Johnson, a spokesperson for the Pharmaceutical Research and Manufacturers of America, said, “America’s pharmaceutical research companies have taken positive steps to help ensure they provide nothing but accurate and balanced information to health care providers” (Harris, New York Times, 8/26).

newspapers examine presidential health care plans

A number of newspapers have recently looked at the presidential candidates’ positions on health and economic issues, and how new figures on the number of uninsured Americans may play in the campaign. Summaries of the articles appear below.

Presidential Agenda
The Wall Street Journal on Monday published a special section titled “Shaping the New Agenda” that examined the positions of Obama and presumptive Republican presidential nominee Sen. John McCain (Ariz.) on health care and three other economic issues. The section focused on the results of online debates hosted by the Journal that included representatives from the campaigns of the candidates. Summaries of some of the articles that appeared in the section appear below.

* Health care in 2000 election: The article examined comments from the major presidential candidates in the 2000 election on health care and other issues for “some perspective on the policy arguments between the McCain and Obama camps.” During debates in 2000, then-Democratic presidential nominee Al Gore cited the need to “move step by step toward universal health coverage” through a “hybrid system — partly private, partly public.” He proposed expansion of health insurance to all U.S. children within four years, expansion of coverage to lower-income parents, tax credits to help residents purchase individual coverage and tax credits to encourage small businesses to offer coverage to employees. Then-Republican presidential nominee George W. Bush said that he “absolutely opposed … a national health care plan” because he did not “want the federal government making decisions for consumers or for providers.” He proposed a health care safety net for low-income residents, tax credits to help residents purchase individual coverage and a plan to allow small businesses to join together to purchase coverage across state lines (Wall Street Journal, 8/25).

* Role of government in health care: The article examined the debate over the role that government should have in efforts to improve access to health care and reduce costs. The article featured a transcript of a recent online debate hosted by Laura Meckler of the Journal in which McCain campaign representative Jay Khosla, a former health care adviser to the Senate Budget Committee and former Senate Majority Leader Bill Frist (R-Tenn.), and Obama campaign representative David Cutler — an Otto Eckstein professor of applied economics at Harvard University, who served with the Council of Economic Advisers and the National Economic Council during the Clinton administration — addressed the issue (Meckler, Wall Street Journal, 8/25).

Economic Policies
The New York Times Magazine on Sunday examined the “vast disagreement about just how liberal” Obama is on economic issues, which “are going to be hugely important,” as the next president will have to address the “slow unraveling of the employer-based health insurance system,” the long-term financial stability of entitlement programs and other major concerns.

According to the Times Magazine, Obama has some “market friendliness” in his economic proposals, such as his health care plan, which would not require all residents to obtain health insurance. “Like other Democrats, he was pushing for a big government program to deal with what he saw as market failures in health care and to bring down the price of insurance,” but after the “program was in place, though, he trusted a market of individuals to make its own decisions; once the government had subsidized health insurance, he thought the vast majority of the uninsured would sign up,” the Times Magazine reports (Leonhardt, New York Times Magazine, 8/24).

Census Report
The Census Bureau on Tuesday plans to release two reports, one of which will address the number of uninsured U.S. residents and likely will “find traction in the presidential race, where health care remains a large issue,” the Journal reports.

According to the Journal, the release of the report, which “will almost certainly show” an increase the estimate of the number of uninsured residents, will “give both candidates a spring board to tout their very different health care plans” and “would seem to benefit Sen. Obama over Sen. McCain” (Dougherty, Wall Street Journal, 8/25).

Editorial, Opinion Pieces
Summaries of recent opinion pieces and an editorial that address health care issues in the presidential election appear below.

* Steve Jacob, Fort Worth Star-Telegram: Obama is the latest politician who has said that the U.S. can “move some money from here to there, cut some government waste no one apparently ever noticed and then fund an unattainable promise with an outlandish price tag” to address problems with the health care system, Star-Telegram columnist Jacob writes. According to Jacob, Obama “bundles three evergreen feel-good concepts” — electronic health records, disease prevention and chronic disease management — and “totes up dubious savings to fund his ultimate goal of making health insurance affordable to everyone.” Jacob adds that Obama has promised to reduce annual health insurance premiums by $2,500 per family — an “unbelievably tall order” and an “increasingly elusive target,” as “Obama’s own Web site points out that health insurance premiums have risen six times faster than wages in the last four years.” He writes, “To be sure, there are many laudable goals in Obama’s plan,” and investment in EHRs, disease prevention and chronic disease management will “improve the nation’s health and may moderate — if not lower — long-term health care costs.” However, Jacob writes, the “near-term price tag is clearly being underestimated to make the medicine go down a little easier” (Jacob, Fort Worth Star-Telegram, 8/24).

* Debra Saunders, San Francisco Chronicle: The Democratic National Committee this week will release a platform that is “all goodies” on health care and other issues, Chronicle columnist Saunders writes. For example, the platform “promises to provide every American access to ‘affordable, comprehensive health care’ and to achieve ‘long-overdue mental health and addiction treatment parity,'” Saunders writes, adding, “That’s right: The Dems will expand the number of people who receive subsidized health care, provide better benefits, and you apparently don’t have to worry about costs going up.” According to Saunders, because the “Dems are going to eliminate waste in the medical system, they ‘will save the typical family up to $2,500 per year.'” She writes, “How to pay for all these bright packages? Chances are that you won’t have to give, but only will get, get, get.” Saunders adds, “Then the platform promises a return to fiscal responsibility. Really” (Saunders, San Francisco Chronicle, 8/24).

* Washington Post: The “suggestion that Mr. Obama is all rhetorical fluff is mistaken,” as he has proposed several detailed plans on health care and other issues, a Post editorial states. Obama has taken positions on health care and other issues that “place him at almost any point on the Democratic political spectrum,” the editorial states. According to the editorial, during the Democratic presidential primary campaign, Obama “was to the right” of others on the question of whether U.S. residents should have to obtain health insurance. However, because Obama is “clearly less concerned about cutting the deficit” than former President Bill Clinton, the “era of big government would not be over in an Obama administration,” the editorial states (Washington Post, 8/25).

FDA new regulations on Pharmaceuticals and Medical Devices

FDA last week issued new rules that aim to ensure medication warning labels provide clear and concise information to consumers, the AP/Denver Post reports. The new rule, which will take effect next month, states that pharmaceutical and medical device companies must rush out safety updates on products only if there is clear evidence of a risk not yet reviewed by FDA. The Pharmaceutical Research and Manufacturers of America supported FDA’s actions, saying the new rules provide clarity about drug warning labels, the AP/Post reports. However, consumer advocacy lawyers said the new rules provide legal protection to companies that withhold information on risks associated with their products. In addition, the American Association of Justice said the new rules require an unnecessary standard of scientific evidence before companies must update their labels (Perrone, AP/Denver Post, 8/24).

Editorial Addresses NEJM Commentary on Pre-Emption
A Las Vegas Sun editorial agrees with the editors of the New England Journal of Medicine “who say that taking away consumers’ right to sue would also take away a strong incentive for the FDA and the pharmaceutical industry to be open about a drug’s potential for causing harm.” According to the editorial, the NEJM editors “state the obvious” that FDA and the pharmaceutical companies “haven’t always been completely open or correct in their labeling, even when the risk of lawsuits has been present.” The editorial concludes, “Preserving the right of consumers to sue will keep federal agencies and manufacturers more honest — and the public more protected” (Las Vegas Sun, 8/23).

controlling your in box

Technology is supposed to make life easier, but it doesn’t seem that way when you’re struggling to wrangle 289 new e-mail messages, dealing with a hard-drive crash, or suddenly realizing that you left an important file on the office computer. Thankfully, plenty of tools can help. We’ll tell you which ones are worth trying, and we’ll also suggest some practices that you can incorporate into your workday to use tech tools more effectively and efficiently.

Beat e-mail overload once and for all by emptying your inbox completely–and keeping it that way. The “Inbox Zero” philosophy says that e-mail messages are just calls to action–not clutter that we need to hang on to. Create three folders or labels in your e-mail client: Action, Later, and Archive. Each day when you check your e-mail, make a decision and do something with every new message you’ve received until you’ve moved them all out of your inbox and reduced your message count down to zero. Ruthlessly delete the messages you don’t need, on the spot. Respond to the ones that will take under 2 minutes. File messages that you want to keep for future reference in the Archive folder, those that will take longer than 2 minutes to reply to in Action (and add those to-do items to your list), and messages you need to follow up on at a subsequent date (such as Amazon shipment notifications) in Later. Then breathe a sigh of relief when you see that glorious declaration: ‘You have no new mail.’

hospitals requiring payment upfront

The South Florida Sun-Sentinel on Tuesday examined how across the U.S., “some insured patients are being asked by hospitals to pay larger portions of their bills upfront — and sometimes hospitals will not do the procedures until they get their copayments.” Although hospitals must provide emergency treatment without receiving upfront payment, elective or scheduled procedures, such as angioplasty or chemotherapy, “can be withheld depending on a patient’s ability to pay,” according to the Sun-Sentinel.

A voluntary survey conducted by the Internal Revenue Service in 2006 found that 14% of 481 not-for-profit hospitals nationwide required an upfront payment or payment plan before a patient was admitted. Hospitals maintain that the slow economy and rising health care costs have resulted in many unpaid medical bills and the practice is needed to offset such costs. However, patient advocates contend that requiring payment before services are delivered can cause stress on already vulnerable patients who might have life-threatening illnesses.

Hospital officials in Florida say that patients are being asked to pay larger amounts upfront as insurance companies require patients to make higher out-of-pocket contributions to their care. David Smith, CFO for Memorial Regional Hospital in Florida, said, “As the economy worsens, employers are having a harder time affording insurance for their employees, they’re increasing the patient portions, and patients’ benefits actually decrease”

increase drug prices

Drug makers increased the average wholesale price of 26 brand-name drugs by 100% or more in a single cost adjustment last year, compared with comparable price increases for 15 drugs in 2004, according to University of Minnesota researchers, USA Today reports. In the first half of 2008, the average wholesale prices of 17 drugs have increased by at least 100%. According to USA Today, many of the prices that are “quietly” being raised are for older products used to treat rare but often serious conditions.

Alan Goldbloom, president of Children’s Hospitals and Clinics in Minnesota, said, “This does drive up the price of health care,” adding, “Hospitals are either eating the cost or passing it along to insurers, so you and I are paying it in increased premiums.”

According to pharmacy benefits manager Express Scripts, the average wholesale prices of 1,344 brand-name drugs increased by an average of 7.4% last year. Stephen Schondelmeyer, director the PRIME Institute at the University of Minnesota, said, “There is no simple explanation” for why certain drugs experienced the larger increase. “Some companies seem to figure no one is watching so they can get away with it,” Schondelmeyer said. “Drug companies say the price hikes cover the costs of keeping the drugs on the market,” USA Today reports.

Sens. Amy Klobuchar (D-Minn.) and Charles Schumer (D-N.Y.) last week asked the Government Accountability Office to investigate cases of large price increases. Klobuchar earlier this year also asked the Federal Trade Commission to investigate a company that had increased the average wholesale prices of four drugs by up to 3,436% in 2006 (Appleby, USA Today, 8/8).