We're finally at Stage 3; NYT: Kaiser-Permanente caves
Mort Zuckerman
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Subject: We're finally at Stage 3; NYT: Kaiser-Permanente caves
Date: May 23, 2010 7:23 PM
All truth passes through three stages: First, it is ridiculed; Second,
it is violently opposed; and Third, it is accepted as self-evident.
-- Arthur Schopenhauer, 1788-1860 (attrib)
====================================
New Rules:
http://www.actionlyme.org/DEFENSIVE_PATIENTING.htm
"You will state that 'Lyme is simply Relapsing fever with the HIV
gp120 vaccine hoax (Dearborn)' and that you're 'not interested in
their fairy-*ss politics, one way or the other.'"
============================================
Previous to this article/statemenet below, Kaiser,
et al, said they "were just taking over medicine and
the MD groupsn has better just get used to the idea"--
--John J. Connolly of the ALDF.com and CastleConnolly.com
Now Kaiser says this Stage is self-evident
and common knowledge beacuse they,themselves
were responsible for the Lyme/LYMErix fiasco
because they inststed on a vaccine, setting
up the monopoly with the local morons at
Yale and NYMC:
http://www.actionlyme.org/CRYME_DISEASE.htm
http://www.nytimes.com/2010/05/23/business/23unboxed.html?hpw
May 21, 2010
High-Tech Alternatives to High-Cost Care
By STEVE LOHR
MENTION health care reform and the image that instantly comes to mind
is a big government program. But there is another broad transformation
in health care under way, a powerful force for decentralized
innovation. It is fueled in good part by technology — low-cost
computing devices, digital sensors and the Web.
The trend promises to shift a lot of the diagnosis, monitoring and
treatment of disease from hospitals and specialized clinics, where
treatment is expensive, to primary care physicians and patients
themselves — at far less cost.
The new models emphasize early detection of health problems,
prevention and management of chronic disease. The approaches have
adopted a range of labels including “wellness,” “consumer-directed
health care” and the “medical home.”
The potential transformation faces formidable obstacles, to be sure.
Some of those hurdles include getting patients to embrace healthier
lifestyles and persuading the government and insurers to reimburse at-
home testing and monitoring devices.
Yet the promise, according to Dr. David M. Lawrence, the former chief
executive of Kaiser Permanente, the nation’s largest private health
care provider, is “an array of technology-enabled, consumer-based
services that constitute a new form of primary health care.”
To glimpse the business opportunity — and the challenge — at the
forefront of this emerging, decentralized health care market, let’s
look at a start-up in the field of sleep medicine.
The start-up, Watermark Medical, offers an at-home device and a Web-
based service for diagnosing sleep apnea. Characterized by snoring and
pauses in breathing, sleep apnea is a serious health problem that
often goes undiagnosed.
Typically caused by tissue in the back of the throat obstructing the
airway to the lungs, it contributes to the severity of chronic
conditions including diabetes, heart disease, obesity, hypertension
and depression, adding an estimated $3.4 billion to the nation’s
health costs.
Sufferers battle chronic fatigue, and sleep experts suspect that apnea
is the cause of many workplace and car accidents. Treatments include a
masklike apparatus that pumps air to keep the patient’s airway open;
an oral appliance, resembling an orthodontic retainer, that helps open
the throat; and surgery to shave tissue that blocks the air passage.
Today, sleep apnea diagnoses are mainly done in specialized sleep
clinics, where the patient sleeps under observation for a night or
two, at a cost of up $4,000 — with the expense usually shared by
insurers and patients. Given the cost and inconvenience, physicians
say, patients often do not go to a clinic and seek treatment until
their sleep troubles are severe.
Watermark Medical traces its technical origins to the work of Dr.
Philip Westbrook, a Stanford-educated sleep expert who led the sleep
disorder centers at the Mayo Clinic in Rochester, Minn., and at Cedars-
Sinai Medical Center in Los Angeles. But during a brief period in
private practice in California, seeing the expense and trouble sleep-
testing was for patients, Dr. Westbrook decided there had to be a
simpler, more efficient way.
He teamed up with a pair of medical-device technologists and won an
innovation grant from the National Institutes of Health to finance a
prototype. They came up with a headband that holds a blue plastic
device — smaller than a deck of cards and resting on the forehead —
equipped with a microprocessor and sensors, and a tube that fits into
a patient’s nose. If the tube falls out, the patient hears a voice
prompt.
In 2004, the device was approved for use by the Food and Drug
Administration. “We had a better mousetrap, but no business or
marketing expertise,” Dr. Westbrook said.
But there also wasn’t a real market, until the Centers for Medicare
and Medicaid Services approved reimbursement for home sleep-testing in
2008. That was when two young entrepreneurs, Sean Heyniger and Charles
Alvarez, who had recently sold PDSHeart, a remote heart-monitoring
company, to a larger corporation, were looking for another
opportunity. They researched the sleep market and found Dr. Westbrook,
who is now Watermark’s chief medical officer.
They founded Watermark in March 2008, tweaked Dr. Westbrook’s device,
produced a business model and conducted pilot projects. Watermark
began introducing its testing device last September. Its sensor-
equipped headband, powered by Intel’s Atom microprocessor, measures 10
things, including blood-oxygen saturation, air flow, pulse rate and
snoring levels.
The patient wears the device for a night or two, then returns the
device to the doctor’s office. The data is downloaded to a personal
computer, then sent on the Web to a network of sleep professionals,
one of whom delivers a report to the physician within 48 hours, with a
diagnosis and suggested treatment. The physicians typically charge
from $250 to $450 a test, and a doctor collects $100 to $150 of that.
“It’s a new revenue stream for the physician,” said Mr. Alvarez,
Watermark’s president.
Watermark also charges the physicians $4,000 for each digital
headband.
So far, 35,000 patients have been tested using the Watermark device,
with more than 1,000 doctors prescribing about 4,000 tests a month.
DR. LEE SURKIN, a sole practitioner in Greenville, N.C., is one of
them. He has three Waterman devices and has done at-home tests on 50
patients so far.
Owning his own sleep lab, Dr. Surkin said, would be far more lucrative
under current insurer reimbursement rates, but he prefers the at-home
tests as a low-cost way to diagnose and treat far more patients. “This
is a tool that moves health care toward where it has to go,” he said.
If successful with sleep, Watermark plans to branch out to other kinds
of Web-based personal devices to monitor chronic conditions like heart
disease and diabetes. The company’s executives talk of their
technology as a platform that can add many other services someday, a
bit like Apple’s applications store for its consumer devices.
Indeed, Watermark’s co-chairman and a major financial backer is John
Sculley, the former chief executive of Apple. “We’re starting with
sleep, but the model can extend to many other diagnostic services,” he
said.
"[Real] scientists are *fiercely* independent. That's the good
news."-- NIH's Top Fool, Anthony Fauci