E-cigarettes: the California Cooler of the 21st century

Just a harmless, tasty treat?

Just a harmless, tasty treat?

If like me you came of age in the 1980s you remember the California Cooler, a sweet wine/juice combo that made it easy for kids to start drinking alcohol even if they couldn’t handle the “adult” taste of beer, wine or liquor. They were very popular at the time but I don’t recall anyone ever saying they were a healthy alternative to anything.

Fast forward 30 years to the e-cigarette era. New data show 13 percent of high school students use e-cigarettes. From the Boston Globe (E-cigarette use spikes among American teens)

In interviews, teenagers said that e-cigarettes had become almost as common at school as laptops, a change from several years ago, when few had seen the gadgets… A significant share said they were using the devices to quit smoking cigarettes or marijuana, while others said they had never smoked but liked being part of the trend and enjoyed the taste — two favorite flavors were Sweet Tart and Unicorn Puke, which one student described as “every flavor Skittle compressed into one.”

Policymakers are confused. E-cigarettes seem safer than smoking, and at least some people must be using them to try to quit. But my view is that at least for kids they lower the barriers to unhealthy behaviors by making drug use more like having a candy or soft drink. The FDA banned nicotine lollipops. Why is this different?

I’m concerned about this delivery method for nicotine, but I’m also worried about marijuana. E-cig entrepreneurs have been busy finding ways to use the devices to deliver THC, and there is a big rise in marijuana laced foods, so-called edibles or medibles. Let’s not fool ourselves and our kids by pretending these drugs are harmless treats.

Image courtesy of patrisyu at FreeDigitalPhotos.net

By healthcare business consultant David E. Williams, president of Health Business Group.

Care transitions: Interview with Curaspan CEO Tom Ferry

Tom Ferry, Curaspan co-founder and CEO

Tom Ferry, Curaspan co-founder and CEO

When Tom Ferry co-founded Curaspan back in 1999, discharge planning wasn’t the sexiest arena for a Harvard MBA to jump into. But he was on to something because 15 years later “transitions of care” is a mainstream term, there is a major focus on readmissions prevention, and post-acute care is universally recognized as the greatest opportunity for cost savings. Curaspan is right in the thick of it.

Though we both live in Boston, I met up with Tom at the #HIMSS15 conference in Chicago. Curaspan is exhibiting at HIMSS for the first time, and its booth is seeing a steady stream of traffic. In this podcast interview, Tom discusses the importance of care transitions and how Curaspan plays a role in addressing the challenges.

  1. Why are transitions of care important? (0:08)
  2. How does the hospital discharge process typically work? How should it work? (0:42)
  3. There is tremendous variation in cost and quality in post acute care. Why? (1:23)
  4. What role are new payment arrangements such as ACOs and bundled payments having on the discharge process? (1:53)
  5. Hospitals are typically paid on a DRG basis for what happens in the hospital. If we move to an episode based system what will happen to post-acute providers such as skilled nursing facilities? (2:41)
  6. Do you plan to incorporate data and analytics to determine where a patient should go based on their individual characteristics? (3:42)
  7. How do patient and family engagement play into the discharge process? (5:16)
  8. Why did you start Curaspan? How has the concept evolved since then? (6:25)
  9. What products and services do you offer on the Curaspan platform? (7:23)
  10. What are your objectives for the HIMSS conference? (8:42)

By healthcare business consultant David E. Williams, president of Health Business Group.

See you at #HIMSS15

I’m packing my bags and heading to #HIMSS15 in Chicago as a Social Media Ambassador. I look forward to seeing everyone there.

I’ve been enjoying reading Scott Tharler’s HealthcareIT News profiles of the various social media ambassadors. The post about me went up Friday.

You can also read about:

By healthcare business consultant David E. Williams, president of Health Business Group.


Tufts and Boston Medical Center merger: Why not?

The Boston Globe (Boston Medical Center, Tufts in merger talks) shares the not-very-surprising story of two teaching hospitals thinking about teaming up.

Partners HealthCare and Beth Israel Deaconess (BIDMC) are the leading academic medical centers in town, with Tufts and Boston Medical Center (BMC) both struggling to compete. The financial challenges of Tufts and especially BMC are evidence of their positions in the food chain and the serious challenges of subsisting on government payments from Medicaid and Medicare, rather than the more lucrative commercial market.

Tufts and BMC are close together physically, so it should be reasonably straightforward to combine programs, build scale, and generate savings. The harder challenge will be to determine how to position the combined entity in the market. Partners is the big gorilla, with high spending and two famous hospitals. BIDMC is positioned as the somewhat less expensive, high end Harvard-affiliated choice.

Tufts has a good reputation, too, but has a hard time standing out. BMC is well respected, but the large safety net population makes it hard to invest to compete effectively. And these academic centers will never be as cost-effective as community-based players like Steward.

Let’s see what they come up with.

By healthcare business consultant David E. Williams, president of Health Business Group.

Cancer drugs: Why the high and rising prices?

Cancer drugs. Good stuff cheap?

Cancer drugs. Good stuff cheap?

When Americans talk, pharmaceutical companies listen. And what they’ve heard is that initiatives to contain or regulate medical costs get labeled as “rationing,” a word with very un-American connotations.

While politicians wring their hands, pricing strategists at pharma and biotech companies take action by charging high and rising prices for products for life-threatening illnesses. Cancer is Exhibit A, with many drugs costing more than $100,000 per year of treatment. A JAMA Oncology paper reviewed wholesale prices for cancer drugs approved over the past five years and found that prices are not correlated with a drug’s novelty or efficacy.

The authors conclude:

“Our results suggest that current pricing models are not rational but simply reflect what the market will bear.”

Now it’s possible that there is a greater correlation between actual negotiated prices and novelty or efficacy that isn’t showing up in the researchers’ data on wholesale prices. Still, the main conclusions are likely to stand, and spending on cancer drugs is sure to grow as more drug developers respond to market signals and develop new products.

If those who pay the bills, including private insurers, employers, and the government want to do something about cancer drug prices, they’ll need to embrace objective ways to measure cost effectiveness, and not be afraid of an opponent throwing around the “rationing” word. They’ll have to couple that approach with a commitment to personalized (or “precision”) medicine so that individuals get the specific drugs that are most effective for them, even if they don’t work as well for the general population.

The outcry over Sovaldi pricing for Hepatitis C has shown that there is at least some appetite to take on drug prices, but I don’t expect any dramatic clampdown on cancer drug prices in the near term.

Image courtesy of Stuart Miles at FreeDigitalPhotos.net

By healthcare business consultant David E. Williams, president of Health Business Group.

Heading to #HIMSS15? Share your story with the Health Business Blog

I’ll be covering the Healthcare Information and Management Systems Society (HIMSS) conference #HIMSS15 for the Health Business Blog again this year. I’m interested in interviewing and writing about innovative companies, so if you have something exciting to share feel free to use the contact form to get in touch, or mention me on Twitter @HealthBizBlog. I’ll be in Chicago Monday through Wednesday of the show.

Topics I’m most interested in are:

  • Remote patient monitoring and communications
  • Clinical decision support
  • Patient engagement
  • Interoperability

By healthcare business consultant David E. Williams, president of Health Business Group.

Why I drink Samuel Adams beer

Good... and good for you?

Good… and good for you?

When I worked at the Boston Consulting Group in the 1990s, the firm held internal quarterly conferences to present new insights and build a common culture among consultants. One of the best guest speakers was Jim Koch, a former BCG consultant who founded Boston Beer Company, maker of Samuel Adams. Jim’s insight was that there was room  in the market for a fresh beer made with premium ingredients. He converted that insight into a company that has been a driving force in the craft beer industry. Unlike any of our other speakers, he advertised his product by popping open a beer and drinking it while giving his talk!

Recently I’ve become alarmed at the use of certain food additives, especially artificial emulsifiers, but also others such as preservatives and clarifying agents. I’m worried that some of these products may be contributing to inflammatory bowel disease, metabolic syndrome and other health problems.

Two important components of my diet are ice cream and beer, so I wrote to my favorite companies to find out what they put in their products. Sadly, JP Licks includes artificial emulsifiers in their ice cream –although they are looking for alternatives.

But Sam Adams, did not let me down. Here’s what I received from them:

Dear David,

Thank you for your question regarding the ingredients in our Samuel Adams beer. When a drinker contacts us, we take their words as seriously as we take our beer. 

We do not add any coloring or preservatives to our Samuel Adams beer, nor do we use any adjuncts, which lighten and cheapen it. Our beers are made with all-natural, high-quality ingredients. Samuel Adams Boston Lager was the first American beer to pass the German Beer Purity Law also known as the Reinheitsgebot. The Reinheitsgebot requires German brewers to only use the traditional ingredients found in beer: water, malt, hops and yeast. Samuel Adams Boston Lager consists of 4 ingredients: Water, a special Samuel Adams blend of two-row malted barley, Bavarian hops, Hallertau Mittelfrueh and Tettnanger, and proprietary Samuel Adams lager yeast. To add additional complexity to our brews, some of our other recipes use spices or fruit (not to be confused with adjuncts) including vanilla, grains of paradise, cinnamon, chocolate, rose hips, and fruits like lemon zest, cherries, and orange peel.

Because we do not use any preservatives, we strive for freshness at Samuel Adams. This is why all of our beers have a freshness dating that gives a recommended date to consume by. Although beer doesn’t go bad in the sense that milk does, we believe freshness is a fundamental component of any quality beer.

We hope this answers your question. Thanks again for contacting us, and please continue to enjoy Samuel Adams beer knowing we use only the finest quality ingredients!


[Name redacted]
Consumer Response Representative

Image courtesy of nongpimmy at FreeDigitalPhotos.net

By healthcare business consultant David E. Williams, president of Health Business Group.