Reputations are like food. Some are organically grown. Others are highly processed.
Two contrasting examples are sweeping the media.
Jeremy Lin, the Harvard player turned Knicks sensation, has inspired "Linsanity" by his recent streak of phenomenal performance. The media coined the phrase. Lin earned it on the court.
In his recent Wall Street Journal article, Jason Gay insightful observed that "...'Linsanity' also feels like an organic, emphatic reversal of the contrived way stars have been packaged and processed, in sports and beyond."
I can't help but compare "Linsanity" to the Republican presidential candidates who are jockeying for their party's nomination. Every nuance of reputation is genetically engineered in spin-doctor laboratories. Any wholesome natural goodness or inspiration is removed by excessive processing.
In your media diet, which would you rather consume?
With no artificial ingredients, additives, re-engineering or continual processing, organically grown reputations seem to be a healthy alternative. They're also less likely to leave a bitter aftertaste.
Organically grown reputations inspire us.
As we work in health care, maybe we can use our own home-grown reputations to inspire others.
— Tom DeSanto
Image: Google Images
Healthy Reputations
Komen's Branding Nightmare
Two health issues that reach deep into the heart and soul of every woman are reproduction and breast cancer.
Two philanthropic brands that immediately evoke those issues are Planned Parenthood® and Susan G. Komen for the Cure.®
When Komen withdrew funding, loyal Planned Parenthood supporters expressed their outrage by demonstrating on the streets and blasting Komen in social media. Others immediately contributed toward replacing the lost funding.
Komen supporters also have intense brand loyalty. Where were they?
Even in the face of an epic error, Komen has earned enough goodwill to assuage disappointment and anger among its supporters. What Komen didn't generate was an acceptable answer for its actions. The inability to defend the decision seems to indicate that its leaders did not reach a solid consensus on how their decision might affect their supporters.
Many women were forced to choose between two impassioned issues and the brands that reflect them.
Planned Parenthood started out $680,000 in the hole from Komen funding cuts. Intense brand loyalty turned Planned Parenthood into a big winner with many new contributions and pressure that lead to the restoration of Komen funding.
An important lesson for all of us is to remember that brand loyalty is a powerful force. We must always remember to very carefully consider our supporters when making decisions.
—Tom DeSanto
Health Care: More Challenges, More Consolidation
In 2011, consolidations continued to climb, up nine percent over 2010. According to Irving Levin Associates, 980 healthcare-related mergers and acquisitions with a total value of $227.4 billion occurred in 2011. Consolidations reached their last peak of $268.4 billion in 2006.
Hospitals reflected the same trend. The value of the top ten hospital mergers and acquisitions for 2011 increased from $3.8 billion in 2010 to $5.6 billion. For all hospital consolidations, the value was approximately $7.3 billion.
As financial pressures continue to grow, more hospitals are likely to join forces to meet challenges such as decreased Medicare reimbursement, cuts in state Medicaid spending, investment in electronic medical records, movement toward forming accountable care organizations, increases in uncompensated care and uncertainty about health care reform.
According to Moody's Investor Services, hospital consolidations have a positive effect because they increase competition in local markets, improve efficiencies and provide added leverage with payers. Conventional wisdom about economies of scale supports their conclusion.
As hospitals join forces to meet challenges, they face an entirely new set of challenges. Researchers at Boston University identified eight factors that are essential to successful integration: strategic vision, governance, leadership, organizational culture/values, financial systems, clinical services, information systems and support functions. Hopefully, hospital leaders can learn from the past and reap greater benefits from consolidation.
— Tom DeSanto
Sources: American Hospital Association data; , "How has hospital consolidation affected the price and quality of hospital care?", Research Synthesis Report No. 9, Willian B. Vogt, PhD and Robert Town, PhD, 2006; "A Conceptual Framework for Successful Hospital Mergers,"Alan Cohen, ScD, Boston University. Image: Google Images
Improving Chronic Disease Outcomes with mHealth
More than 100 million people in the U.S. have at least one chronic condition, and the number is growing.
More than 270 million people in the U.S. subscribe to wireless services, and the number is growing.
What if wireless technology could be used to remotely monitor chronic conditions and to remind patients to manage them effectively?
People with chronic conditions could enjoy better health and avoid preventable medical and hospital visits. And, because chronic diseases account for 75 percent the $2.3 trillion America spends on health care, we could begin to control runaway costs.
That's just one of the many possibilities of mHealth — the use of mobile technology to support health outcomes.
A widely cited study by Myer, Kobb and Ryan reported that home telemontoring, video visits and coordinated care helped reduce emergency room visits by 40 percent and hospital admissions by 63 percent among elderly veterans with a variety of chronic diseases.
It is estimated that if patients with congestive heart failure, diabetes, chronic obstructive pulmonary disease and other chronic conditions agreed to have their doctors monitor them remotely and guide their self-care via mobile wireless applications, the result would be a $21.1 billion annual reduction in costs for emergency care, hospitalization and nursing home care.
As wireless technology continues to advance and its application to mHealth grows, the U.S. has an enormous opportunity to help its citizens better manage chronic disease and improve the effectiveness of our health-care system.
— Tom DeSanto
Sources: Information Week, MobiHealthNews, homehealthnews.org, healthcarereformmagazine.com. Image: research2guidance
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| Immune system attacking a cancer cell |
Cancer cells have a stealth capability that enables them to avoid detection and destruction by the immune system. That's why cancer can sneak up on us and multiply unchecked.
In a study released this week in Science, researchers were able to reveal and reverse cancer's stealth capability.
Researchers hypothesized that stroma, the nonmalignant connective tissue that surrounds tumors, plays a role in helping cancer hide. They discovered that certain stroma cells express fibroblast activation protein (FAP), which is found in areas where the body needs to suppress the immune system (such as the uterus, placenta and areas of inflammation).
To study the possible stealth mechanism, researchers bred transgenic mice with a genetic switch to turn off FAP-expressing (FAP+) cells. They injected the mice with cancer and allowed tumors to become well established. When they turned off the FAP+ cells, 80 to 90 percent of the tumors died within 48 hours. In further study with a group of mice with no immune systems, turning off FAP+ cells had no effect—verifying that the mice's immune systems killed the cancer.
The study is a first step toward new therapies that could one day target FAP+ cells to unleash the immune system's ability to detect and destroy cancer cells.
— Tom DeSanto
Source: Kraman, M. et al., "Suppression of Antitumor Immunity by Stromal Cells Expressing Fibroblast Activation Protein-alpha," Science, 330:827-30, 2010. Image: Susan Arnold
A Major Reversal:
No Patents on Genes
Gene patents have been issued for decades. The Patent and Trademark Office has granted thousands of patents on genes from various organisms, including about 20 percent of human genes. This has enabled the biotechnology industry to drive remarkable advances in medicine.
In late October, the Department of Justice declared that human and other genes should not be eligible for patents because they are part of nature.
The road to reversal began when a lawsuit was filed challenging patents covering the BRCA1 and BRCA2 genes and patent-holder Myriad Genetics' screenings that determine predisposition to breast and ovarian cancers. A district court judge in Manhattan ruled the patents invalid because genes carry important information, whether in the body or isolated from it, that can't be patented. His ruling prompted the government to reconsider its policy.
A subsequent friend-of-the-court brief stated: "The chemical structure of native human genes is a product of nature, and it is no less a product of nature when that structure is 'isolated' from its natural environment than are cotton fibers that have been separated from cotton seeds or coal that has been extracted from the earth."
Such a reversal and adamant position could endanger the progress being made in diagnostic testing and in development of highly effective new drugs designed to work in conjunction with the patient's genetic makeup.
I often write about how this progress is already helping patients. BRCA2 screening provided early diagnosis to a cancer victim's children so they could avoid chemotherapy and invasive treatment. In clinical trials, patient-tailored cancer vaccines have brought remission in difficult cases. Extracted genes, and the potential they hold for improving people's lives, are not at all like the limited possibilities of extracted cotton fibers and coal.
The government's stand on patenting genes is not merely a matter of principle. It's a matter of life and death for current and future patients who depend upon the medical advances made possible through the development and delivery of gene therapies.
Appeals to the government's new stance are in progress. Let's hope they lead to a second reversal and further steps forward for biomedical science and the patients who benefit from it.
— Tom DeSanto
Trying a New Answer to Cancer Costs
The Problem
• Spending on cancer treatment is rising 15 to 18 percent annually, nearly double the rate of general health care costs.
• Drugs account for an estimated 65 percent of an oncologist's income.
• Customarily, doctors purchase cancer drugs, infuse them in their offices and then bill insurers for their cost plus a 15 percent profit margin.
How can cancer costs be reduced while ensuring that patients receive proper treatment and doctors are compensated fairly?
Their Answer is being tested in five cancer clinics for breast, colon and lung cancer. It works like this:
• Doctors decide in advance which drugs they would like to use in the patient's treatment plan, from generic chemotherapeutic agents to more costly branded drugs.
• UnitedHealth pays the doctors for whatever choice they make, but without the customary markup. Instead, the doctors receive a set fee that includes the profit they would have made, plus costs for managing patient care.
• If the doctors use a drug not in the treatment plan, United Health Group covers the cost of the drug, but will not increase the separate payment covering markup and patient management.
• In addition, treatment data would be shared among participating clinics to identify the most effective methods.
Reaction
Some groups argue that the plan could provide an incentive for doctors to withhold treatment from patients, especially if the separate payment doesn't cover enough costs.
I believe separating the ability to earn additional profit from prescribing more expensive drugs is a step in the right direction. We need to trust physicians to decide which drugs they prefer to use, cover the cost of those drugs and to provide them with collective data to support future decisions — without rewarding more expensive treatment options.
The outcome from the test program remains to be seen. In the meantime, UnitedHealth Group is to be applauded for seeking answers that respect physicians' judgment and support their financial success.
— Tom DeSanto
Source: Wall Street Journal, October 20, 2010. Graphic: Google Images
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