Brown2020

Emerging infectious diseases that start with a fever or a rash can pose a risk to public health because they might not be recognized at the early stages when containment or treatment is possible. After September 11, our fears were stoked by anthrax. Then came SARS, and we still wait anxiously for bird flu.

A patent recently issued to Health Hero Network describes a simple but powerful idea that addresses the pandemic challenge by enabling near-real-time syndromic surveillance that can be adapted on the fly. Easy-to-navigate survey devices collect data from hospital waiting rooms, school nurses, and other points of care. The survey script can be changed and updated remotely by public health authorities based on the latest information. The devices report data to central computers that look for any unusual patterns and then alert public health authorities immediately so that they can investigate further.

Disease outbreaks that look like the flu at the beginning can be hard to detect early because flu-like symptoms are common and are not always reported. The first cases of an outbreak may be spread out over many different clinics, hospitals, and schools in a metropolitan area. Unusual patterns might emerge only when looking at a broader cross section of a region. The other challenge is that we may not know what data is relevant and important at the beginning stages of an outbreak. Where it might have been fever, rash, and working in a mail room for one threat, it might be diarrhea and travel to a specific region or eating a particular food in another threat.

While many efforts have been discussed and may even be underway to facilitate early detection of outbreaks by sifting through electronic medical records and pharmacy data, the most important information might be missed because no one knew to ask the right question. When we do figure out what question to ask, we won’t have time to add fields to medical records or change forms. Our public health authorities need the ability to change the script as soon as they learn new information.

Despite the simplicity of the approach, it is not easy to organize health systems around new ways of doing things. On the other hand, maybe we won’t need to. Public health surveys could be pushed to iPhone users, for example. There just might be enough iPhones out there by now to provide a statistically significant sample size enabling highly sensitive early detection of potential public health emergencies. If you want to read the patent, you can find the full text here.

Gastric bypass surgery is a rapidly growing procedure in which the stomach is reduced from its normal football-size to something between the size of a thumb and a hardboiled egg. In each case, the stomach itself is healthy: the purpose of the surgery is to force the patient to change behaviors that are leading to obesity.

The images above came from a live Webcast of a gastric bypass surgery performed at Tufts-New England Medical Center in Boston by Dr. Scott Shikora, Chief of Bariatric Surgery at Tufts-NEMC, along with bariatric surgeons Dr. Michael Tarnoff and Dr. Julie Kim. Click on the images to watch the complete video on YouTube.

You also can watch Dr. Stan Hoehn perform a minimally invasive gastric bypass at Shawnee Mission Medical Center in Kansas by clicking on the image below.

A Consensus Panel convened by the National Institutes of Health (NIH) indicates bariatric surgery for people with a body mass index (BMI) of 40 or higher, or people with a BMI of 35 or higher with one or more related comorbid conditions such as diabetes, hypertension, and cardiovascular disease.

Bariatric surgery is regarded by leading physicians on the panel as a lifesaving tool that enables, or in fact forces, the patient to change lifestyle and eating habits. Check out the BMI calculator below to see if you should be changing your behavior.

BMI Calculator (C) 2008 Brown2020.com

With 100 million Americans struggling with at least one chronic condition, and over 60 million Americans considered to be clinically obese, we can expect a lot of bariatric surgery ahead. Can we really address the issue of obesity by forcing ourselves to change behavior under the knife, or are there other ways to address this epidemic?

Stay tuned to this blog for an ongoing discussion of obesity and of new approaches to improving health behavior.

Flip through these slides from the CDC to see a dramatic portrayal of the obesity epidemic in the U.S. The map shows the increasing prevalence of obesity over the past 20 years.

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It looks like Health Buddy is getting traction in the Netherlands, thanks to Sananet.

“Telebegeleiding thuis geeft mensen met chronische ziekte meer veiligheid en zelfvertrouwen.”

Today I had the opportunity to participate in Health 2.0 User Generated Healthcare Conference. The one-day conference in San Francisco was fabulously organized by Matthew Holt of The Healthcare Blog and Indu Subaiya of Etude Scientific.

Indu and Matthew managed to assemble a stellar collection of entrepreneurs, movers, shakers, and creators of the next generation of the eHealth field. A full house discussed search engines that learn from personal health records, social networks that support patients, and how the wisdom of crowds is transforming medical knowledge.

We all know that the current way we organize and manage healthcare is dysfunctional and unsustainable. How else could we find a way to spend $2 trillion per year and leave 45 million people uninsured? How else could we spend so much and still have such mediocre outcomes compared to the rest of the world?

There have been many promising ideas proven futile and many vain attempts at healthcare transformation. What is different this time around? Finally the ecosystems are in place, the tools of production are widely accessible and development costs are so low that citizens do not need to wait for the institutions to be the deciders.

We have entered a new phase of rapid innovation and experimentation that is producing a wave of brave new ideas, some of which will be disruptive to current ways of doing things and some of which will be revolutionary. Pay attention to the list below, because you will be seeing these people in headlines for years to come.

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Steve Brown Joins MDV Focused on Internet and Healthcare
Brings Media and Systems Experience Aimed at Promoting Healthier Behavior

MENLO PARK, Calif., July 19 /PRNewswire/ — MDV-Mohr Davidow Ventures, (http://www.mdv.com), a leading Silicon Valley venture capital firm, today announced the addition of Steve Brown as an Entrepreneur in Residence. He will work with MDV to pursue opportunities that apply Internet technologies and services to empower consumers and to encourage healthier lifestyles.
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I had the opportunity to visit the district health center in Rwinkwavu, Rwanda, where Dr. Michael Rich explained why the Partners in Health model of care is able to achieve better medication adherence in Rwanda than even our best practices in the United States.

It is not just the fact that Bill Clinton and The Clinton Foundation negotiated a deal on antiretroviral (ARV) drugs. It’s not just the fact that the once complex cocktail regimen of pills can be combined into one generic pill. It is because an army of community health workers visit patients in their villages every day, checking in to make sure everything is OK, and to make sure that everyone is taking their medicine.

Daily support and monitoring at home, working with informal caregivers in the community to surface problems early so that bigger problems can be prevented: That is the key to improving quality of care with limited resources.

Dr. Paul Farmer, as chronicled in the book “Mountains Beyond Mountains” by Tracy Kidder, realized this in Haiti a decade ago, and now the Partners in Health “accompagnateur” system is being rolled out in developing countries around the world. Is there something we might learn from Rwanda?

This is Bill Clinton’s speech from the TED conference in Monterrey, California. He won the TED Prize, and his wish was that the TED community would join with him in supporting Partners in Health to establish a new model of care in Rwanda that could deliver quality care with limited resources.

This is my presentation from the plenary session of Silver Economy, a conference held in Maastricht, Netherlands in November 2006.

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Redwood City, CA - June 26, 2006 - Health Hero Network, Inc. announces that it received the “Innovative Approach to the Delivery of Health Care” award given by the California-based Adaptive Business Leaders Organization (ABL) during its eighth annual Innovations in Health CareSM awards event. The “ABBY” award, among the most prestigious recognitions in California bestowed on health care and life science companies, is awarded to organizations whose products and services are judged to be the most innovative, with proven metrics that assure their cost-effective quality. Health Hero Network was honored for its Health Buddy® system of care that enables people afflicted with chronic illnesses to manage their conditions from home.

“Health Hero Network’s Health Buddy system represents the very best of innovations in health care. It’s an elegant solution that truly makes the timely delivery of quality, cost-effective health care a reality,” said ABL President, Mimi Grant.

In bestowing the award, the ABL noted that the Health Buddy system, currently used by over 12,000 patients, has delivered significant clinical outcomes including reduced hospital admissions, reduced inpatient bed days, increased medication compliance, and reduced costs. The Health Buddy system is also recognized as the leading telehealth solution in use by the Veterans Affairs Administration (VA), deployed in over 100 of its clinical sites across the country. Coincidently, Kenneth Kizer, MD, former head of the Veterans Health System, was honored by the ABL for his leadership while he was at the helm of the VA, where he was the principal architect of the largest transformation in the organization’s history.

“Health Hero Network was founded on the vision that health care can be transformed to provide better service to people who struggle with complex chronic conditions while substantially reducing medical costs,” said Steve Brown, CEO of Health Hero Network. “To be recognized alongside other outstanding health care CEOs and business leaders in California is a great honor. Recognition of our Health Buddy system and its proven effectiveness in organizations such as the VA, our nation’s largest health care delivery system, is validation for us that the time has come for a better system of care,” added Brown.

About Health Hero Network
Health Hero Network develops and markets the Health Buddy system for health improvement. The system serves as the interface between patients at home and care providers, facilitating patient education and monitoring of chronic conditions. The system includes monitoring technologies, clinical information databases, Internet-enabled decision support tools, health management programs and content development tools. Through increased communication, behavior modification, and prevention, the Health Buddy system improves patients’ quality of care. Based in Redwood City, California, Health Hero Network’s systems are protected by over 57 patents. http://www.healthhero.com