Dave deBronkar, a kidney cancer survivor (full article), found that after data had been imported in to Google Health it said his cancer “…had spread to either his brain or spine…” which was not the truth.

As Bob Evans from Information Week (full article) explains:

Google Health users are finding stunning inaccuracies in medical records imported from primary-care physicians and hospitals because Google takes some information from insurance billing records that use broad and imprecise codes to describe patient treatment.The codes that Bob Evans is referring to are what is known as ICD-9 codes and they are used in the billing context to indicate the symptom of the diagnosis for the treatment rendered.

When coding the diagnosis for a diagnostic study, one will first code the finding and then the symptom (or complaint) from the patient. If the finding is negative, then only the symptom (or complaint) will be coded. In this case, if the data were to be imported into Google Health or any other Personal Health Record (PHR) it would show inaccurate information for this patient.

For example, a patient comes into the ER and complains of pain in the chest. A chest x-ray would be performed. If the result of the x-ray is found to be normal, the ICD-9 code for chest pain would be used for reimbursement purposes. In this case, this is a symptom not a finding. If this data was imported into a PHR it would be misleading.

The chest pain could have been caused by a case of excessive “flatulence” which would not have been captured in the PHR, if only billing data was used.

In addition, as John Chilmark points out ICD-9 is “limited” (full article).

Problem is, claims data is based on limited code sets (ICD-9) that physicians use for reimbursement. This can lead to inaccurate entries/codes as physicians struggle to fit a diagnosis to a given code or possibly prescribe a drug for off-label use, or even “game” the reimbursement system. Either way, end result is an inaccurate picture of the consumer’s health.

If claims data is bad, what is the best way to seed a PHR? In my opinion, there is no existing source we can take data from to create a baseline for a PHR. Billing data is currently being used because it is already electronic (meaning cheap), and insurance companies want to make sure they continue to wedge themselves between the doctor and the patient.

The first step in building an accurate electronic view of a person’s health is to strengthen the direct relationship between the doctor and the patient. This goal can be catalyzed through the use of Internet communication/networking tools. Simultaneously, we need to create open systems that are interoperable, which are built on existing standards. Together through direct communication and sharing the data population of PHR systems will be at the point where they only have accurate and meaningful data.

I received a tweet about this from Andre Blackman (http://www.pulseandsignal.com).
This is something that will actually turn a Wii into something more than just entertainment.

http://www.engadget.com/2009/01/27/wii-check-up-channel-will-link-you-to-health-professionals-dr/

This past October, my brother Naveen and I had the privilege of attending the Health 2.0 conference in San Francisco. For those that are unaware, Health 2.0 is essentially the use of social media in health care. One example of a Health 2.0 application is www.patientslikeme.com. At patientslikeme, users are able to share their experiences with other patients in order to “…share information that can improve the lives of patients diagnosed with life-changing diseases”.

The conference was well run, organized and informative. However, it did not seem enough to meet twice a year then come home. We really wanted to continue the conversations we began in San Francisco. In December, we reached out to some of the Chicago-area people we met at Health 2.0 to gauge interest. We met just before the holidays to discuss how to create something on a local level to discuss, exchange ideas, and network. We had a great discussion

We are trying to organize another Health 2.0 Chicago meeting this Thursday (January 15, 2009) at 5:30 PM at Matilda (3101 N. Sheffeld, Chicago, IL). If you are on twitter you can RSVP at http://twtvite.com/p61cej. We hope that if you are interested Health 2.0 you will join us.

Thanks for the memories!

For the past year or so, I have suspected that as the Dollar gets weaker and the Euro gets stronger more athletes will go and play in Europe or other parts of the world. This is because with a weak dollar other countries can now afford American talent.

The only reason that America has attracted the best athletes in the world over the past 30-40 years is because we have been able to pay them higher salaries to create the best and most competitive leagues in the world (with exception of Soccer). As the rest of the world catches up, you will see more talented Americans leave the USA and play elsewhere around the globe.

What potentially is a bad thing for American sports leagues and franchises might end up being a good thing for American sport in general. Distributing American talent around the globe will help create stronger leagues in other countries. A stronger league is a more competitive league. When people “buy” sport they are in essence consumers of competition. This consumption of a higher level of competition will inspire kids who never would have otherwise thought to play sports. In the end, these kids might end up coming to America to play or may just strengthen the newer leagues at home.

Economics is an interesting force. Let’s see how it helps the spread of American sports and talent throughout the globe.

The full details of the announcement can be read here: http://www.engadget.com/2008/03/06/live-from-apples-iphone-press-conference/

What interests me most about today’s announcement is the iFund. With the launch of this $100 million fund, it appears that Apple is now trying to build a community of developers/users around the iPhone. This is a 180 degree turn from their original stance of web apps as the only method for developing applications for the iPhone.

It is possible that Google’s Android had something to do with this change of heart. The fact that the iPhone is already in the market will give Apple a jump on Google. What will be interesting is to see if Apple decides to license the use of the iPhone OS to other hardware manufactures. This would be another huge change in Apples philosophy, but one that I think can only help them and their new commitment to building a solid user/developer community around the iPhone.

I created my own test mash up app, which combines Chicago Yelp! reviews with Google maps. You can check it out at http://yelpmap.googlemashups.com. Click on the review on the left to see it on the map along with a summary and a link to the full review.

If you are familar with XML or HTML GoogleMashUps isn’t difficult to use. This app took me about 20 mins to build and publish.

GoogleMashUps is in a limited beta release. If interested in signing up visit this page.