FastCompany had a naturally insightful article on the virtual global infrastructure. Read the BUSINESS360° entry on Knowledge Process Outsourcing.

During our meeting with Dr. Bart Romanek, an established physician working in the outskirts of Austin, the veteran practitioner takes head-on the country’s current hospital building boom with specific opinions on the needs of a rural and suburban town. We discuss whether the sprouting of small-town hospitals are helping the local communities or actually creating a disservice in the flawed models it oftentimes becomes victim to. He is not embarrassed or hesitant to point out the drastic financial differences of the predominantly hometown doctor to the faithful disciples of the “Dr. 90210″ and “nip/ tuck” generations.

His idealistic outlook is peppered by bits of wisdom borne from practicing medicine for over 28 years in this country and abroad. His first-hand experience of a centralized, government controlled national healthcare system – commenting on the good and the bad – shapes his advocacy of continued reform for the US while balancing the strengths of the private and governmental sectors.

This conversational thread leads our discussion to the practice of “concierge” or private physicians and the growing need of local doctors to develop additional revenue streams to stay afloat. The tangential topic of retail sales of vitamin supplements from multi-level marketing firms through physician partners was brought up but runs counter to Dr. Romanek’s vigilant “traditional” philosophy that he’s “a doctor – not a vitamin salesman”. Reflective of his cool-headed diplomacy, he acknowledges that physicians these days are strapped for cash. He prefers though continued advocacy on the Hill or within the market for fair compensation for doctors. He shares with us a personal campaign he is waging to dramatically improve the local health-system in partnership with a collaborative group of physicians in the adjacent metro area (a separate potential topic touching on our hospital building research series).

We wrap up our brief meeting with the physician only to realize that he had already invested almost an hour for our “short” preliminary interview. As one discovers that the coffee has gone cold, that the afternoon has slipped away and that one is late for their Biology lab- our conversation with the professor had to come to an end. As he shows us out through the office, he shares with us the difference of his experience with his community-base as compared to his perspective of new physicians these days. He rarely gets to breeze through a grocery store, unable to just breeze into a store or coffee shop without bumping into a child of a child that he has brought onto this earth. People happen to always see Dr. Romanek walking around town, they get into a conversation, and soon realize that they have been with their family doctor in deep conversation and are both now running late from where they should be. And with that, we departed to our next meeting.

In the heart of rural Texas – just in the fringes of the state capitol – the HEALTH360 team conducted preliminary interviews with a range of pediatricians and general practitioners to get a gauge on industry positions on the current climate of healthcare reform, emergence of new technologies, and evolving operational paradigms.

The purpose of the information gathering campaign is to perform a market audit on what the technology providers are currently offering physicians and how it has been received by the healthcare community. We wanted to connect the venture capital buzz in Woodside, CA or Waltham, MA to the reality on the ground – specifically with the neighborhood doctors.

We visited Dr. Romanek during a lunch-break at his office – just in the outskirts of the main town center outside of Austin. A classic family physician who evokes of a Brooks Brothers intellectual patriarch, Dr. Romanek discussed his specific experience with national healthcare, the market pressures of managed health companies on the local solo-practitioner, and the best practices he adopts to survive in this taxing climate of regulation and lacking resources allotted to community health.

The shock of silver hair and silver-rimmed glasses emphasize the socio-political and real-world finance undertones of our conversation while an academic, philosophical aura exudes from his smart blue striped shirt, red conservative tie and crisp Khaki pants. We chat casually – as one does with a mentor professor – about the spate of the industry and his own personal thoughts on how to move forward in dealing with the daily pressures of the local doctor.

A particularly unique exchange from our other interviews was Dr. Romanek’s recently bringing on board a new practitioner to his clinic. Beaming pride towards the daughter who went back to small-town America after achieving accolades from prestigious medical academic institutions and residencies, he goes on to detail his daughter’s lifestyle and professional decision to serve and care for the community she grew up with – hard-working people not able to even afford the co-pay of their visits. Yet this small office is equipped with the latest Practice Management (PMS) technology and much needed medical equipment – oftentimes the critical factor that helps Dr. Romanek safeguard patient safety and quality care.

He proudly showcases the latest PMS platform he brought on-board for his staff of 5 last season. We discuss the hefty cash outlay that the office made, and I try to clarify what his longer-term strategy was for his practice as the ROI forecast he had mentioned for the technology upgrade seemed to overlap with what he was mentioning as his estimates on how much longer he will personally practice.

Another reason why he must be so relieved to have his daughter finally join the practice.

In that emergency state conference with over 30 hospital CEOs from across the state, I came upon the idea on how to change the country’s ailing health system.

“You’re the one from New York, aren’t you?” a woman in her mid-fifties asked me at the table. “Is it that obvious?” I asked. “Not really, it wasn’t the pin-stripe suit, darlin’. We just now all these fools, love.” she smiled back.

She asked me where I lived and I told her that the family lived in Houston to enable Kelly’s treatment at MD Anderson. She and I would end up talking for the next 3 hours. A 15-year survivor from metastatic breast and lung cancer and also a former MD Anderson patient, she would demonstrate the immediate bond that all people whom the disease has affected. “Friends for Life” Kelly and I would say of the bond cancer fighters share.

As I headed west back to Houston that night, I can see all the debris from Katrina still lining the sides of I-10 connecting Louisiana and Texas. I kept thinking to myself how that lady showing up in my table was a godsend. It would have been a very un-productive trip had she not appeared. She had personally introduced me to all the CEOs she knew at the conference. I tried to remember our last conversation as I drove home nearing midnight.

“I’m glad you’re doing what you plan of doing, Kyle. The country doesn’t understand how many people died here, how Katrina brought this region’s health system in shambles. For crying out loud, one of the association executives basically hijacked a group of Apache helicopters just to get patients off rooftops after waiting there for hours. You have to do this. We all need to scrap what we have and start over in how this country cares for its sick.

Your wife needs this system to change.”

- – -

If you have 4 minutes, watch the clip below. It’s one of the most representative pieces I have seen on prime-time TV on the dramatic tragedy brought upon by Katrina.

The real-life physician was acquitted as well.

James Spader | Hurricane Katrina

“So you’ve found the Holy Grail of healthcare.” Sean (an alias as well) leans back and clasps his hands around the back of his blonde head.

I lean over the conference table of the venture capital firm overlooking the picturesque waterside view of Hobbs Brook Basin twenty minutes west of Boston. I had driven from Manhattan just 3 hours ago at 85-mph across 3 states, picked up my partner who flew in from Houston, and is now trying to convince the head of an investment group to believe in my concept on how to change the medical community as we knew it – all this with only a maxxed-out credit card on my wallet after not having earned a salary in the last 2 years.

“This is what can help turn our country’s healthcare system around, Sean. There is no excuse that 56% of all diagnoses are wrong. That 1 out of 3 treatments are incorrect.

We can change this now, right here.”

—

Everything is moving like wildfire. Too fast, I thought. I recount just 3 weeks ago meeting up with one of the largest hospital design firms in the world.

“I’m telling you, Kyle, if we get this rolled out, it will be bigger than e-mail.” The managing partner was on fire. “Our firm works with someone that has been able to get us face-time with the President. We should plan on when would be best to set that up for the White House.”

I quickly glance out of his 29th floor office window and look at the rest of the Houston skyline. This is surreal, the kid that used to sell sausage door-to-door in Manila to help pay for his books at the Jesuit school in the Philippines. Times were tough while my parents were abroad.

—

Vincent interrupted my daydreaming, “I think we went too low. The starting point should have been at $5M rather than 2.” We were heading back to Logan Airport so he can head fly to Washington DC.

“I know. It’s just too much money to put to work. Maybe we should have just pitched the engine. Well, he said to regroup and re-present. Let’s connect in Houston. I know we can resurrect this thing. Thanks Vincent.”

I was seated across a CIO for a major hospital network after work picking his brains on his hospital’s on-going EMR ramp-up. In the heart of the world’s largest medical center in Houston, this fellow New Yorker and I were sharing stories of the old neighborhood. While talking about the Sopranos and the challenge of finding a good pizza in town, he was talking about the extensive travelling he has been doing lately, getting his over 100+ hospitals connected to their new EMR system.

After the 3rd beer – in what was pegged as Houston’s brewery with the largest beer selection – I decided to throw a feeler on some highly disruptive technology being introduced in the CIO-circles as an EMR alternative. The buzz he was in the fringes on quickly dissipated. I was now seated across one of the hand-picked officers designated by the governor post Hurricane Katrina and Rita to help get the area’s RHIO (Regional health Information Organizations) up and running.

A few more beers later and a blistering cross-examination on the assumptions and concepts shared, the result was an relenting openness in learning more of the alternative EMR strategy. But he was unconvinced, at the moment. Considering that what he and I talked about didn’t advocate the increased introduction of new wireless devices and increased usage of TabletPCs, I knew moving forward that it wasn’t going to be an easy-sell – despite the fact that we both were Yankee die-hard fans even during the Don Mattingly/ pre-Derek Jeter era.

But in dealing with enough CIOs and IT Directors outside of the healthcare space as well, one thing I have grown to appreciate is the non-layman’s acknowledgement that these *techies* value the creativity of a solution first and foremost to the hardware/software a system would bring on-board. EMR has been talked about since 1973, and every single decade the market advocates keep proclaiming that the tides are now coming in.

Yes, we are now in a political year once again. And the political environment is quite unique due to a multitude of factors. Is the paradigm shift around the corner? Will patients finally be able to actually get the ability to have access to their information – conveniently, affordably?

Having interviewed over 200 practicing physicians the last 2 years for our informational audit effort, time after time physicians have expressed their strong hesitancy towards EMR adoption. No one wants to end up holding a $100,000 Betamax (remember those?).

That being said – with uniformity/ standardization and inter-operability still being a present-day pipe dream – would it not behoove CIOs to honestly explore cheaper, low-tech, tried-and-true EMR solutions in the interim? Or do I need to bring my cassette tapes with me at my next meeting to prove my point?

But maybe next time, I should wait after the 5th beer instead. Then maybe the cassette tape would look like a brand new iPhone.

The objective of this national endeavor is to enable true information sharing between the research, practitioner, and patient communities – along with other stakeholders: governmental, pharmaceutical, etc. – our team will be able to address the true hindrances to collaborative information exchanges: Developing Incentives and Safeguarding Security for our HEALTH360° EMR platform. With the development of a consumer-driven (1) Media Network, supported by a (2) Secure Front-End database accessible to Patients and Practitioners, a (3) Sterilized Back-End database accessible only to researchers and other pre-approved stake-holders (NIH, CDC, etc.), and all enveloped in a HEALTH360° Business Model to establish sequential growth to promote the endeavor’s feasibility and sustainability.

Our multi-organization consortium is very aware of any hospital organization’s concerns for inter-operability when dealing with large-sized proprietary technology networks. Our Enterprise Application Integration (EAI) engine is currently utilized by the military, state/ county level agencies, and enterprise level Fortune 100 coporations. Our EAI and Business Process Management (BPM) infrastructure will enable access and seamless inter-operability for all organizations.

But what makes our HEALTH360° EMR strategy so unique will be the ability to bridge the patient to the information in their homes, at the Infusion therapy clinic(s), to the re-diagnostic facility – even at their neighborhood pharmacy. Anywhere, anytime – true Mobile Health. And we have the formula to actually have doctors want to adopt the system and to maintain it as well. And we will also lay the foundation for incentivizing end-users to blend in non-traditionally collected variables: daily nutrition, psycho-graphic, drug compliance, etc.  in an easy-to-use web interface, more secure than on-line banking or the premier email platforms.

The ability for a parent to have a pediatric cancer patient’s health information (medical record, prescription, nutrition, immunization, etc.) easily stored in a secure web repository that can be cost-effectively stored for the entire lifetime of the child – with the assistance of a dedicated Health Concierge – would be of tremendous benefit. This is the OnStar™ of Healthcare 2, 5, 10 years down the road – down to the regular check-ups, the ability for the oncological organization to see (and manipulate) the blue-print of the child’s health on a daily basis makes this information exchange invaluable.

HEALTH360° will further announce our specific local roll-out of community-based pilot programs offering patient advocacy and support organizations our FREE Health Information Portal and Media Network. For additional information, please contact awareness@fusiontv360.com. Thank you.

I myself have been exposed to governmentally mandated screenings right off the airport gate in Hong Kong en route to London during the peak of the SARS outbreak on my way back to New York a few years ago. To those who continue to cling on to a false sense of security – beware. Avian Flu is extremely real to the people that have already died from this evolving killer.

Bird flu could have become worldwide pandemic: study
By Jeff Waters (Aug 31, 2007 9:19pm AEST)

A new study by a US university has apparently confirmed for the first time that bird flu has been transmitted from human to human.

It is the nightmare possibility that health authorities have been fearing ever since the disease first appeared. It happened in Indonesia last year and reveals the world only narrowly avoided a global bird flu pandemic.

Researchers from the University of Washington have studied the case of a woman on the Indonesian island of Sumatra who caught the H5N1 bird flu virus from poultry in May last year.

Professor Ira Longini, who led the research, says they have confirmed that not only did she pass the virus on to her 10-year-old nephew, it was then transmitted to other relatives.

Seven of eight family members who caught the disease were soon dead.

—

WHO confirms five human bird flu cases in Vietnam
Sat Sep 1, 2007 4:20AM EDT

HANOI (Reuters) – The World Health Organization (WHO) has confirmed five human bird flu cases in Vietnam, four of them fatal, the U.N. agency said in a statement.

The four, including two women, died between June 21 and August 3 while a fifth person, a 29-year-old man, had recovered, it said.

All five cases, which had been confirmed earlier by Vietnam-based laboratory tests, were from the country’s north. They brought the total human infections in the Southeast Asian country since 2003 to 100 with 46 fatalities.