A new form of E.coli (Escherichia coli-STEC) is causing lot of trouble in Germany, so far 17 people have died and several got infected.   It is causing bloody diarrhea and affecting Kidneys and considered to be “highly infectious and toxic”

As recorded by BBC, Dr Dilys Morgan from the Health Protection Agency says the E. coli outbreak is “alarming, it mainly affects young children and older adults, but what we’ve seen is predominantly young females getting this condition. It’s a very rare organism that’s causing this and it’s thought it has particular properties where the toxin it produces is particularly virulent and therefore is affecting this population more than we would normally expect.”

Professor Hugh Pennington, a microbiologist from the University of Aberdeen, said: “This outbreak is unusual in that it doesn’t seem to be targeting young children, usually children under five have had a very hard time with this kind of bug in the past, they seem to be escaping it, maybe just due to the nature of the food that’s causing the problem.”

According to the Centers for Disease Control and Prevention, to prevent Shiga toxin-producing E. coli (STEC) infection, you should just follow these simple things:

• Wash your hands thoroughly after going to the bathroom or changing diapers
• Wash your hands thoroughly after handling animals, animal bedding, or any material contaminated with animal fecal matter
• Eat only thoroughly cooked ground beef, pork, sheep meat, or sausage.
• Cook ground meat products to an internal temperature of 160ºF
• Avoid drinking unpasteurized milk and juices
• Wash fresh fruits and vegetables thoroughly before eating raw
• Prevent cross contamination in food preparation areas by washing hands, counters, cutting boards, and utensils after they touch raw meat.
• Keep raw meat separate from ready-to-eat foods

As long as you are doing aforementioned, you shouldn’t worry too much.  Ask your physician if you have any more concerns around this.  Just remember prevention is the key to a good health!

Use DocAsap for timely appointments. 

Dr. Jamo Rubin, the founder and president of Medical Present Value and chairman of PTRX, spoke in my Wharton eHealth class last night, and led an interesting talk about medical claims and entrepreneurship.  In talking about the “black box” that doctors face when submitting claims to insurance companies, he told a story about how twenty years ago when he was practicing, he tried to find out why a major insurance company only paid back $980 of a $3000 surgery bill.  After asking around the hospital, someone told him that the $980 was 120% of Medicare’s reimbursement for the surgery, but not being satisfied with that answer he tried to look up the Medicare payment formulation.  However, after realizing the 65-variable formulation model for allowable Medicare reimbursements was also a mystery to the public, he began to doubt that the private insurers could have figured out all the Medicare variables.  He came to realize that almost all doctors have no idea what their claims reimbursement will eventually be, leaving the doctors to send patients bills saying “Do Not Pay” until insurance companies pay a portion of their claim months later and to collect money from patients later if the claim is rejected.  All of this opaqueness and delay in private insurance reimbursement created a huge opportunity for MPV to create rule-based software that checked actual payments against the contract that the doctor signed with the insurer, helping doctors attain 4-7% more revenue on average from private payers as Dr. Rubin stated.

So why has this system persisted, where doctors are underpaid by private insurers by an average of 7%, according to Dr. Rubin’s experience?  First, the incentives for private insurance companies to underpay or delay payment are high, considering they audit, decide and pay claims.  Second, insurer contracts are often too complex, vague, or non-standard by region for them to even process properly (though he mentioned that insurers like UnitedHealthcare are standardizing their contracts now).  And last, private insurers themselves often only process claims, with self-insuring employers often being the reason for underpayment.  Dr. Rubin ultimately stated that the need for determining reimbursements more precisely will take center stage for doctors in the coming years, which should be good for MPV’s business.

At the end of the class, Dr. Rubin shared his experiences on the three usual failures and successes of startups:
Three failures
1) Judgment, in terms of failing to be brutally realistic about one’s business
2) Foresight, in terms of failing to see where trends are headed
3) People, in terms of becoming siloed from fellow employees

Three successes
1) Perseverance, in terms of sticking to a good idea even if others denigrate it
2) Focus, in terms of solving one key problem first instead of getting distracted on numerous other opportunities
3) Good investors, in terms of getting investors that know one’s business

I agree that start-ups that don’t address the three failures don’t ultimately last long, though I do believe that companies with strong products and market leads can afford short-term mistakes as long as they correct them in the long-term.  Regardless, I found Dr. Rubin’s presentation insightful, and appreciate him flying from Texas to visit Wharton.

Today’s beta launch of Medpedia, a wiki joint initiative by various prestigious global institutions (e.g., Harvard Medical School) that only lets pre-screened physicians and PhDs post, raises interesting questions about letting the public post about their conditions and health experiences.  Certainly, the content-rich site will supplement existing health info sites and provide confidence to consumers in the reliability of its information in light of Wikipedia’s medical inaccuracies, and I hope the site builds an active community of physicians to post and moderate.  We definitely like Medpedia’s focus on controlling the quality of content regarding conditions and treatments, categories where users assume advice is coming from authoritative and objective sources and not from those whose accuracy might be suspect (e.g., advertisers or lay people).

Crowd-sourced medical content can at times be useful to the public, such as for doctor reviews (e.g., Vitals.com or RateMDs) and social networking (e.g., PatientslikeMe).  However, in these categories, there have been allegations of misleading doctor reviews on Yelp, and this recent NYT article on Zagat for Doctors seems to dismiss the concept of crowd-sourced doctor reviews entirely, quoting one doctor as stating the Zagat-Wellpoint initiative was “treating medical care provided by dedicated and caring physicians as if we were preparing a meal.”   Our opinion is that while crowd-sourced medical content definitely has a place among screened or expert content to provide consumers with comprehensive info, medical websites should take more effort than, say, restaurant or product review sites to make sure that the public is not provided with misleading information.