A healthcare organization's logo represents the all-important first impression, since that is often the first interaction a patient has with a brand. The logo is often a brand's most visible and memorable element, at least at first. After interacting with any business, healthcare or otherwise, all the attributes of that organization are then assigned to the logo, which may or may not reinforce what that visual mark says.
Advertising agencies that used Flash to build deep, immersive sites with intricate animation have in some cases been embracing a low-fi, low-cost approach by tapping out-of-the-box Web software and free tools and platforms. The trend signifies a shift in strategy from the wowing of consumers with an experience driven by tech wizardry to the weaving of brands into the fabric of the Web and an emphasis on content. This means putting a premium on sharing, flexibility and speed.
The new 15-member Federal Coordinating Council for Comparative Effectiveness Research, authorized under the American Recovery and Reinvestment Act (ARRA) to assist federal agencies in coordinating and comparing the effectiveness of health services research, heard suggestions from the public April 14 in Washington on where to focus its efforts.
The goal of comparative effectiveness research (CER) is to provide information on the relative strengths and weakness of various medical interventions. Individuals participating in the listening session—representing provider, patient, research, medical education and other healthcare organizations—urged the panel to consider a variety of options.
John Martin, director of Premier Research Services, a research group owned by nearly 200 not-for-profit hospitals and healthcare organizations, urged the council to make sure that CER be aimed at "true research"—not administrative activities—and that the research be patient-focused.
Rather than just rely on findings from clinical trials, attention should be focused on whether a treatment "provides the greatest benefit to the patient in a real-world healthcare environment," Martin said. To that end, he suggested that results for CER "should be used as a guide for the best available treatment based on quality, safety, and efficiency—but not as a substitute for provider judgment."
"The care provider and the patient should have the opportunity to fully weigh each measure in selecting the best pathway for care," Martin added.
Collaboration also will be important. "Our experience has shown that involvement of stakeholders such as hospitals and healthcare systems early in the process—if it's considered in the development of research priorities—more likely will lead to the transition from research practice to use in acute healthcare facilities."
Harold Miller, president and CEO of the Network for Regional Healthcare Improvement (NRHI), a nationwide coalition of regional collaboratives, said it is difficult to "do good comparative effectiveness research if you don't have good data on the use of treatments and outcomes that result."
"Moreover, what matters is the effectiveness of treatments in the real world—not in the laboratory," Miller said. The "fastest and most cost effective way to get real world data" is to build on the "extensive quality measurement and data collection" that are already being developed around the country—such as through the health collaboratives, he said.
Jeff Allen, executive director of Friends of Cancer Research, noted that CER historically has used data and evidence obtained through literature reviews of individual trials. These reviews generally cannot "create new knowledge" and "provide little insight into the effectiveness of healthcare interventions outside of clinical trials," he said.
Instead, he called for new ways of thinking—such as linking public and private healthcare databases (such as insurance claims)—which would have the potential to "generate an unprecedented amount of information for a variety of research activities."
Myrl Weinberg, president of the National Health Council, which represents the interests of individuals with chronic diseases and disabilities, noted that efforts should be made to "disentangle the findings of good comparative effectiveness research" from insurance coverage and reimbursement decisions.
"We need to break the immediacy of that relationship in order to avoid denial of appropriate care," Weinberg said. Weinberg noted that patients' greatest concern was that CER will be used "inappropriately to deny access or to funnel them into a one-size-fits-all mode of care."
Elena Rios, MD, president and CEO of the National Hispanic Medical Association, which represents Hispanic physicians, said that CER could add to the body of knowledge to assist in reducing healthcare disparities. It also could help promoting effective ways of communicating with Hispanic patients and their families.
Earlier this year, the Recovery Act appropriated $300 million for the Agency for Healthcare Research and Quality, $400 million for the National Institutes of Health, and $400 million for allocation at the discretion of the Secretary of Health and Human Services to support CER. The council will make its recommendations in June.
Janice Simmons is a senior editor and Washington, DC, correspondent for HealthLeaders Media Online. She can be reached atjsimmons@healthleadersmedia.com.
When Massachusetts health system Partners Healthcare announced new industry interaction recommendations for doctors on Friday, it was just the latest piece of erosion in the changing landscape of the healthcare-pharma relationship. The recommendations came days after a similar announcement from Johns Hopkins and one month after Partner's home state set statewide rules limiting pharma gifts to physicians.
Although these new policies may seem like an onslaught on the pharmaceutical industry, Partners says they put their policy in place to make the symbiotic relationship stronger.
“I think there are many important aspects of the relationships between academia and industries that we need to preserve and protect," says Peter Slavin, MD, the president of Massachusetts General Hospital, who is leading the implementation efforts across Partners. “It's in our interest and in the public's interest that we focus our relationship with these issues and try to eliminated some of the noise that cause some people to call into question the value of the [pharma-healthcare] relationship. I think it will make the relationships stronger and by working together it will help the people we're trying to serve."
Extravagant dinners and ghostwritten articles are unnecessary distractions, while drug research and trials are paramount, he says.
Similarly, the Johns Hopkins policies were written to prevent any aspects of marketing from getting involved with drug research and physician interaction.
"This policy is designed to try to put the emphasis on relationship with industry—where many people believe it should be," says Julie Gottlieb, assistant dean for policy coordination at Johns Hopkins University School of Medicine. "That [focus] is on science and medicine exchanges that will advance patient care—and not on marketing."
Ideally, these conflict-of-interest policies will create strong ties that better facilitate the exchange of ideas between healthcare organizations and pharma researchers, she says.
“Ultimately none of us want to see a situation were our medical care is compromised because of a financial relationship between pharmaceutical company and that doctor," says Retta M. Riordan, president of Riordan Consulting in Mountainside, NJ and former compliance officer for Organon BioSciences. “Similarly we don't want to see the results of a research doctor being swayed as a result of the relationship. It would be horrendous from a research standpoint, a patient standpoint, and a company standpoint."
But the most recent regulations, like those implemented by Partners and Johns Hopkins, have gone too far, Riordan says.
“What has happened is these conflict-of-interest policies have been morphing into much more," she says. “They basically have been looking at every contact with pharma as being bad. I think these extremely restrictive policies don't benefit anyone, least of all the patient."
Slavin admits that the new Partners policy has caused dissent in the pharmaceutical industry and even within the organization itself, but they are prepared to deal with the consequences.
“We really feel very strongly that relationship between Partners and industry is critical to us achieving our mission," he says. “By restricting certain things they will liberate us to focus more energy on the important things between our organization and industry."
The next step for Partners will be to turn broad recommendations into specific policies ready for implementation.
“I hope by working together we can develop new agents that can help the lives of our patients and the public in general," he says. “I hope in five years from now this is less of a concern to public policy members, the media, and the public at large."
Johns Hopkins is less optimistic about the future of the healthcare-pharma relationship, and it will adjust its policies as the environment changes, Gottlieb says. "If industry decides to find new and different ways to market their products that also undermine independent decision making by physicians and researchers, then we have to address those," she says. "I hope that's not the case."
Riordan, too, is thinking about the future.
“We may see some more of these restrictive policies coming on board," she says. “What we don't want to see is a total restriction on interactions between physician and drug companies. I think people have stepped over a little too far in one direction, but I'm hoping that the pendulum will swing back."
Moses Cone Health System in Greensboro, NC, has sent letters offering free credit monitoring to 14,380 patients after a laptop computer containing confidential information was stolen from a vendor in Canton, GA. The health system said the information on the computer was not encrypted but was password-protected and contained a software program that requires training and expertise to use. Moses Cone said the health system does not know of any instance in which the information has been disclosed or misused or if the laptop was taken for that purpose.
Starting this year, New Jersey tax filers are being asked if they have uninsured children, and those who do are being directly sent a so-called "express" state child insurance application. The applications are for the state's FamilyCare program, which covers New Jersey children who fall in the gap between Medicaid and private insurance. The program provides free or low-cost medical exams, shots, hospitalization, lab tests, X-rays, prescription drugs, and dental and mental health services. It serves nearly 132,000 children and 128,000 adults.