Pagano Story Demonstrates That EMR is not the Only Privacy Concern

EMR gets slammed quite often as a potential privacy pitfall, but patient privacy-protected information is often unfortunately leaked whether the information is in an electronic record or not.  The story behind a major news story involving an NFL coach, broken today, demonstrates how, despite all the talk about electronic medical records as a privacy concern, there is just as much privacy danger from those old fashioned sources as well.

Word of mouth of healthcare providers can be just as effective in leaking details of a patient's conditions, despite privacy concerns.   Celebrities are often the victim of an anonymous nurse or lab technician handling HIPPA-protected information in an unprofessional manner.

Chuck Pagano, coach of the Indianapolis Colts was diagnosed with a treatable form of leukemia that will keep him off the sideline of his NFL team for a few months, according to media reports.    He is a popular coach and there are hopes for a fast recovery.

What we find interesting about the story, coming from a healthcare IT viewpoint, is that the reporter Bob Kravitz, the reporter at the Indianapolis Star  who broke the story, obtained the information through a privacy violation that had nothing to do with computers.  He told ESPN radio that he obtained the story when he went to buy a new car.  The salesman told him about it, saying he heard it from a friend who knew someone who treated him at the hospital.

Privacy is one of the concerns for EMR systems, but it is a broader issue that has many aspects to address.  Reports of violations, such as lost laptops or inappropriate access of records are commonly reported. Most hospitals, likely aware of extant potential for privacy violations with or without EMR, have not allowed concerns to reduce their enthusiasm for paperless medicine.   EMR systems continue to be expanded at major US healthcare systems.  .  EMR 2012 details the market for these systems and the reasons behind this growth.  

Vaccine Sales Drop For First Time in Over a Decade

At Kalorama we've sometimes been seen as promoters of the vaccine business, because we do yearly reports, and we have identified vaccines as the future growth area of pharmaceuticals in a time where 'blockbuster' single-molecule drugs are not plentiful.  We insist we call it like it is, and over the past decade it's simply the case that vaccines have been growing.  In 2011 however, given the over stockpiling of influenza vaccine in 2010, the market dropped about 30% according to our latest report.  So I suppose, we have a good objectivity test here.  When the market is down, as it now appears it was in 2011, we report that as well.   However, the interest, buzz and comparative growth prospects of vaccines have not declined.  R&D interest from top pharma presages a good future for these products.

In our report, Vaccines 2012, we demonstrate how the decline should be short lived, and what products are immune to the decline in the overall market.  

Good Viruses? Yes, Thanks to DNA Sequencing

Genetic Engineering News, one of Kalorama's favorite sources of information in the biopharma world, (and an avid user of Kalorama's Market Estimates) carries a story on the discovery of viruses that have a positive function.  In this case, they are referring to 'viruses that can zap zits.'  Which in practice means, isolated phages of virus have been found using heavy sequencers which can kill  P. acnes --  that elusive bacteria responsible for acne.

According to the article: 

After isolating, then sequencing the genomes of 11 Propionibacterium acnes phages, a team of researchers from the University of California (UCLA). and the University of Pittsburgh says it found similarities between the phages that may make them suitable against P. acnes, the bacterium believed responsible for the zits so many have long tried to zap.

What's significant about this article is that discovery of these type of treatments is only possible through DNA Sequencing.  The more research 'hits' that we see in the coming years, the more funding agencies will take an interest in sequencing research labs.  We needn't add that this is especially true where the target is one of heavy consumer interest.  These type of discoveries will increase the relevance of systems and drive the market for innovative, faster systems with more read length.  Kalorama's new report
http://www.kaloramainformation.com/DNA-Sequencing-Equipment-7118427/  details the current state of DNA Sequencing Equipment Markets.

Some Parts of Healthcare Reform Not Dependent on Election

Romney or Obama?   Well for a good deal of healthcare and the way it operates it may not matter.  Yes this runs against a lot of the conventional wisdom and certainly cable news talk.  As our Kalorama KeyPoint LinkedIn site article details, there are a number of provisions of healthcare reform that are already underway or will be underway shortly, and the take within the hospital community is that even a repeal would not 'change the changes' that hospitals are expected to face very much.   Besides since so many hospitals are making changes in the direction of the policies in healthcare reform such as population-based care and increased technology, repeal may not broadly change what some entities are doing.

The following parts of President Obama's healthcare reform legislation are likely to still be a component of Federal healthcare policy even if the act is repealed by a future Congress and President, though their presence may not be as obvious:

• Decreasing reimbursements for primary care 
• Transition to ICD 10
• IT incentives for EMR purchasing and requirements / penalties for non-compliance
• ACOs already likely underway are unlikely to be terminated.  While new ACOs may not form in a repeal, there is a likelhood of  move a pay-for-value system as opposed to strictly a pay-for-volume system
  

These are changes that while they are in the law and may be technically removed in a repeal, are likely to be parts of any President's healthcare policy anyway, unless an unexpectedly large amount of funding for healthcare is appropriated.  

Dartmouth Hitchock's Director of Clinical Services sums it up pretty well.   "Organizational priorities will not be affected if health reform is repealed, which I do not believe will happen."

Beyond Nicoderm: Transdermal Patches See Growth

It is anticipated that the transdermal/transmucosal drug delivery market will  continue to grow beyond the smoking cessation technology that first brought them to the marketplace, according to Kalorama Information's just-published report on this topic.   The market for drugs that use technologies to deliver therapeutics through the skin is expected to be driven by various factors including the loss of patent protection for blockbuster drugs and the need to avoid the first pass effects  of oral drug delivery. 

Additionally, with an added focus on active transdermal technologies, new applications will likely cause a resurgence of interest in transdermal delivery of products. Recent advances in biotechnology and molecular biology have resulted in a large number of novel molecules with the potential to revolutionize the treatment and prevention of disease. However, such potential is severely compromised by significant obstacles to delivery these drugs into the body. These obstacles mean that drug delivery and targeting is now recognized as the key to effective development of many therapeutics. Transdermal and transmucosal drug delivery systems continue to gain market acceptance as a preferred method of administration.

 Interest in transdermal/transmucosal drug delivery dropped until the early 1970s. In 1981 the first dermal patches, Transderm-Scop for scopolamine (ALZA) and the Transderm-Nitro (ALZA), were launched on the market. Nitro-Dur (Key) and Nitro-Disc (Searle) followed in 1982, and in 1985, Boehringer Ingelheim released Catapress-TTS for clonidine, using ALZA’s drug delivery technology. This spurred a number of transdermal product offerings including::   Estraderm (CIBA) for estradiol, Duragesic (Janssen) for fentanyl, Testoderm (ALZA) for testosterone, Minitran (3M) for nitroglycerin.

These products and more are covered in The World Market for Transdermal Drugs, from Kalorama Information.  

ADME/Tox Services a Growing Market

Among the many services not commonly outsourced is early toxicology. While far from perfect, early ADME provides useful predictive information.  There are assays designed to show how cells and organ systems can deal with the absorption, distribution, metabolism and excretion of the compounds of interest. New assays are being introduced that are even more efficient predictors of compound performance.   It is in the toxicology stage of ADME/Tox – where the pitfalls lie. 

Unlike ADME (which describes how a compound will perform in an organism), toxicity deals with how that compound will damage or kill that organism. The downside of unfavorable toxicity is a lot more serious.  Unfortunately, pharmaceutical companies have found this out the hard way.  Several unfavorable events have emerged in the past few years which are largely attributed to the toxicity of a drug, including Vioxx and Baycol.

 At first glance, drug discovery can appear to be a straightforward process of screening compound candidates, optimizing leads, performing pre-clinical evaluations and then, with these steps completed, clinical trials can begin. The reality is not so neat. These activities often overlap, merge, and conflict with each other. So ADME (Absorption, Distribution, Metabolism, Excretion) and Toxicology are not simply a step in lead optimization, they are actually an integral part of an ongoing process, and increasingly the industry is seeing it that way.  

Kalorama's recent report, Early Toxicology Markets and Approaches, focuses on markets for early toxicology testing services. The objective of this report is to focus the reader’s attention on the issues and opportunities related to early toxicology testing in drug discovery. It begins with an overview of drug discovery, ADMET, and early toxicology testing. It continues with some of the ways big pharmaceutical developers dealwith early toxicology.  Several areas are covered, including:
For the purposes of reporting market size and growth forecasts, the report segments the market into the following:
In Silico Approaches
Databases
Data Mining Tools
Modeling
In Vitro Assays and Platforms
Biochemical Assays
Cellular Assays
Instruments & Platforms
In Vivo Testing
Mice & Traditional Animals
Zebrafish Models
Other Animals
Human Microdosing
Early Tox Services
In Silico Services
In Vitro Services
In Vivo Services

For information or to order: 
http://www.kaloramainformation.com/Early-Toxicology-Approaches-7123316/

Healthcare Finance News On Kalorama HAI Market Estimate

Healthcare Finance News has issued an article citing Kalorama's market estimate numbers  on hospital acquired infection testing.  Indeed, diagnostics is a big growth opportunity in this area as hospitals are under pressure to determine which patients have an HAI and isolate and or treat them.  

Five percent of admissions is a considerable incidence number, and we believe diagnostic companies will be busy working on innovative solutions which should keep growth strong in the next five years.  Top IVD companies are already involved in this area.  In our comments in the article, we addressed two of the most important HAIs that healthcare is facing.

“Some diseases are more of a priority. By and far, the most important of these are drug resistant tuberculosis (M. tuberculosis) and drug resistant S. aureus, which can also cause a deadly form of nosocomial pneumonia,” said Carlson. “These are the most serious and easily spread nosocomial infections. Therefore, the greatest amount of research and development effort is flowing toward the diagnosis and MDR differentiation of infections by these two bacteria…. Speed is essential in identifying these infections, and there are a host of tests out there, targeting specific infections and offering fast results,”