Patient-centered Medical Home

The health care system of today is based on an entitlement-oriented fee for services model. Providers feel entitled to be reimbursed for the services they provide. The more services they provide, the more reimbursement they receive. The payers–both government and insurance companies–have not yet provided sufficient incentive to providers to shift the focus to health instead of treatment. A new model is emerging rapidly that will cause a shift to an accountability-oriented fee for value model. The intention of the new model is to increase quality and patient safety and improve outcomes while reducing cost.

A major systemic change to the health care model is arising because of the shift from volume to value. The change is the emergence of the patient-centered medical home (PCMH). The home in PCMH is not a place; it is a concept. The concept is for the primary care physician to coordinate the care of a population of people and recommend the care that is needed to keep that population healthy. Dr. Paul Grundy at IBM describes the primary care physician’s role as the “systems integrator”.  Under the PCMH, the primary care physician will focus on health instead of treatments and will use a full range of procedures and providers to achieve improved health including alternative medicine, home health care, follow-up calls to ensure medication compliance, and follow-up appointments to monitor progress. IBM is encouraging the use of email communications between doctors and patients to supplement the standard waiting room interval before being able to ask the doctor a question. The focus on health is more likely to keep patients out of the hospital where costs are significantly higher. Dr. Grundy has been aggressively pushing on the PCMH concept for more than five years and for obvious reasons–IBM has hundreds of thousands of employees and pays the bill for a lot of health care.  A healthier workforce is good for employees and shareholders alike. If you want to get some further insight about the PCMH, I highly recommend listening to a 21 minute video of Dr. Grundy’s recent talk.

Tags: health care, Healthcare, ibm health care, patient centered medical home, pcmh

Genesys XVIII

The 18th Annual Genesys Partners Venture Dinner — Gen XVIII– Monday night at the Union League Club in New York attracted more than 100 venture capitalists, investors, journalists, entrepreneurs, and industry executives. As always, Jim Kollegger — CEO of Genesys Partners and one of the pioneers of the information industry — was an elegant master of ceremonies. He introduced the various sponsors, next day panelists for the SIIA Conference, several startup CEO’s, and a few of us who have been around the block a few times, each to make some comments.

Like a broken record, I offered the normal upbeat view of the future of the Internet but prefaced my remarks by asserting that we are only 10% of the way there. In other words, of all the things that could be done on the Internet that would save us time and make our lives better, only 10% of them are there. It may sound low but consider retail e-commerce. Although there has been continuous and steady growth of retail e-commerce it still represents just 4% of total retail (as of the end of October). Why isn’t it 25% or more? Much is written about that here at patrickWeb but the short version is that there are still a lot of lame web sites. “Click here for the location of our nearest dealer where you can visit” or “call to buy the product you just found” or “Click here to download this form and fax it to us”. And of course there are the ubiquitous clipboards at doctor offices where we take a pen and provide a lot of information information that they already have.

I described one man’s view of the evolution of the Internet including the seven characteristics below. This parsed way of looking at the Internet has served me well for quite a few years. The things going on under each area continuously change and Jim asks me once a year to do a thumbnail sketch of my latest thinking.

Fast
Broadband in the U.S. is not a pretty story compared to other parts of the world. We are second after China in number of broadband users, but 28th in the world in number of broadband users as a percentage of our population. The problem is that there are too many lobbyists and the FCC is a political organization. The new FCC head is a very smart guy with venture and business experience. He totally gets it. The only problem is that AT&T, Comcast, and Verizon have more lawyers than he does. Meanwhile France is offering 100 megabit access for $90 per month and WiFi throughout the country. Thanks to the telco lobby, many states have banned the offering of WiFi by municipal entities. Every citizen in Greenland has Internet access. We have 31,000 post offices.

Always On

WiFi is part of the fabric of the world. The big shift is streaming of data — not just tweets, but data from *things*. Bridges, toll booths, traffic lights, buildings, cars, and health monitoring devices attached to people. Hospital physicians will soon be adjusting the drip rate on infusion pumps in the hospital from their office based on real-time data from the patient. The WiFi infusion pumps enable hospital administrators to know where the pumps are (they never have enough of them) and which ones need maintenance. The creation of data is staggering. Of all the data in the world, 90% of it was created in the last two years. YouTube receives 60 hours of new video every hour. Wikipedia has 4 million articles and 8,000 editors.

Everywhere
There are one billion computers (including tablets), one billion cars, 1.5 billion televisions, and 2 billion Internet users. Small numbers compared to cell phones — 5.2 billion paid subscribers. The Internet used to be where your PC is, now it is where you are.  Most of the cell phones are dumb but soon most of them will be smart and they will all have Internet access. The mobile web is unfolding and is taking part in creating data in addition to consuming it through streaming. When you take a picture on your iPhone, it goes into the photostream and from there to iCloud and from there to all of your other devices.  

Natural
Social networking has become fundamental to all aspects of our economy and society. Integration of social networking with a full range of web applications will evolve to become the primary means of collaboration. The emerging issue is that many people are a bit liberal with sharing their every movement — what they are eating, listening to, where they are headed, their current latitude and longitude, and where they slept last night. They are not thinking that some day they may run for office or interview for a job. OpenSocial is an important new standard that will enable social media apps that work across all of the social media sites. The Europeans may legislate it, but regardless, a capability is needed to be able to remove things from the social media.

Intelligent
The Semantic Web is the next big turn of the crank but the crank is moving slowly. Most web pages have links but do not have context. In other words the words on the page do not necessarily mean anything — but they could. If a web page said “Join us for a concert by The Eagles at Kimmel Center in Philadelphia next Tuesday” that set of words could have a lot of context. Clicking on it could add the concert to your calendar, knowing what “next Tuesday” means. It would also know exactly where the Kimmel Center is and that The Eagles is a performing group that performs a particular genre and your music player would receive a list of suggestions of music they have recorded or links to live concerts under way at the moment. This is the tip of the iceberg. The semantic web will lead us to a point where most of the interactions of web pages will be between computers not between computers and people. The biggest growth of intelligence is occurring in the field of analytics. Exabytes of data are being stored. Analytics will enable businesses to make sense of it, model their business and continuously adapt to what is going on. IBM’s Watson took on humans on the Jeopardy Show, but what is more interesting is the ability for a primary care physician to call and get a recomendation based on patient data they describe to Watson. Within a couple of seconds Watson will be able to review all medical information in the world and make a useful suggestion. Business Intelligence and analytics are poised to enable new insight into the mounds of data that are being accumulated.

Easy
Technology isn’t the easiest thing at times. There are many dimensions to “easy” but one good example is the Nintendo Wii. At a local senior center, members find the Wii to be their exercise coach. It is not just for kids! The iPhone and iPad have shown how easy it can be to get applications on a handheld computer. Amazon has done the same with the Kindle. Most companies still don’t get the idea that the Internet is about power to the people. If you can’t make it simple, people won’t buy it. Cloud computing has become the mainstay for me and for millions. The convenience and reliability of the clouds is compelling. Add Dropbox and you have a completely replicated set of data, wherever you are and with whatever device you may be using. How about TV? Three remotes — BlueRay, Cable box, and TV — include 151 buttons. Even a savvy child could not possibly master this impossible user interface. Boxee TV has produced a good model of the future of TV, but I suspect that an upcoming Apple TV will be what finally provides the needed regime change.

Trusted
This is the big one. Will we trust the Internet? Security technology is available to achieve much higher levels of security than presently deployed both at enterprise and consumer levels. It is a constant battle and requires significant budgets and a lot of talented people to maintain the needed security. The bigger issue will be privacy. (Stay tuned for the Firefox “do not track” feature). Banks have our personal information and they are using it. Healthcare insurers have more information about our health than our doctors do. Nevertheless, there is much to be optimistic about when it comes to electronic medical records. Perhaps 25% of doctors and hospitals use them but they are not easily interchangeable and accessible. This will change over the next few years as the government adds dollar incentives to make it happen. The result will be better quality of care, better outcomes, and fewer errors. And, fewer clipboards.

On Wednesday I gave a talk about the Future of the Internet and Healthcare at the SIIA Conference. The presentation can be found here.

Other patrickWeb conference related stories

Tags: broadband, fcc, future, health, health care, Healthcare, IBM, internet, ipad, iPhone, jeopardy, john patrick, Mobile, opera, siia, social media, supercomputer, union league, WiFi

EMRs — The Time is Now

Electronic medical records (EMRs) are on the way, and not any too soon. The government is offering large incentives to healthcare providers to start using EMRs and for those who skip the incentive, there will be penalties to follow. Whatever you may think of the EMR, it is at our doorstep. I am not making a political statement about this – to me it is common sense and a technological imperative that will reduce costs, enhance healthcare quality, and improve patient safety. A reader sent me an account of what he and his family experienced two weeks ago and, with his permission, I am sharing this true story because I think it is one of millions of examples that justify the move to EMRs.

The reader is from California and I will call him Frank for purposes of this post. Frank’s 15-year-old son Alex was scheduled for non-emergency pulmonary valve replacement surgery on Friday afternoon. He was born with a number of congenital heart defects and had open-heart surgery at 30 days old 15 years ago. A recent MRI showed his pulmonary valve to be leaking extensively so it was recommended it be replaced with a new adult-sized pig valve. Before leaving for the hospital Friday morning, Frank received a phone call saying that Alex had been bumped from the schedule due to a critical newborn with heart problems.

Although Frank understood the bump, Alex took it extremely hard. As the day wore on, he got more and more upset and stressed out. Around 9 PM he mentioned that he was having shortness of breath and was having pains around his heart. Since he had a full pre-op earlier that week, Frank’s immediate thoughts were that this was a combination of extreme stress and possibly indigestion, but he decided to take Alex to the local hospital emergency room (ER). Once there, clinicians checked Alex’s vital signs and ran an EKG. The ER doctor did a quick echocardiogram. After reviewing the test results, the ER Doctor asked if Frank had any historical EKG’s so that a comparison could be made to Alex’s abnormal EKG.

Around 11 PM Frank signed the paperwork to authorize a search for the EKG — the nursing staff started calling hospitals where Alex had been a patient to see if they could obtain EKG data. They hit a brick wall. The large hospital where Alex had the pre-op wanted to help but had no access to data. A call to the cardiology specialist’s office got a recording — they were closed.

As Frank reflected on the data void, he realized that he can download an obscure piece of music from multiple sources on the web, but in spite of valiant efforts, he could not get a copy of Alex’s EKG. Isn’t it a collection of ones and zeroes, just like music? Although it was a stressful weekend for Frank, Alex began to feel better and was able to go back to school the next day.

On Saturday morning Frank did an extensive web search, and found that Medic Alert provides emergency information to caregivers if a physician sends them data. This is a great service, but shouldn’t it be an automatic by-product of healthcare by any caregiver? From Frank’s perspective, having access to someone’s past EKG could either save a life, prevent misdiagnosis or save time and money. To Frank, it seems like a basic for anyone with an affected child or if they themselves have a potentially serious ailment. Frank’s perception is that EKGs for the most part are still “paper driven” and nobody is thinking about getting them on the web as a standard practice.

Alex has a new surgery date in early November. Hopefully, Alex will be feeling better, and with the surgery delay he should get to finish his soccer season.

It is time for healthcare to catch up to banking, e-shopping, e-music, YouTube, and social networking. What could be more important that the health of our families? Privacy is a valid and important concern, but it can and is being addressed as part of the rollout of EMR systems.

Alex’s privacy was intact – his EKG results were in a manila folder somewhere – private, secure, and unavailable when needed.

Tags: cardiac, ekg, emr, health care, Healthcare, heart, heart surgery, phr, surgery

DEMO in Santa Clara – 2011

Demo has always been my favorite conference, and this past week in Santa Clara proved valuable once again. I believe this was the twenty-first year I have attended Demo. The Demo conference allows entrepreneurs to show off new gadgets, software, hardware and business ideas and enables the press, analysts, investors, key influencers and technology enthusiasts to assess what they see. The product introductions that take place reveal key technology trends over the coming 12 to 18 months. There were excellent speakers, as always. Take a look at the list.

Eighty companies were launched in two days. I view Demo as a barometer of what lies ahead and each year I comment not just on the companies but on the key trends I observed. Last year it was mobile, social media, and cloud. This year it was mobile, cloud, social media, and HTML5. There are now 5 billion cell phones in use around the world. In the U.S., 96% of people have one, and half of them are now smartphones. That is a big shift and it validates that the moible Internet is here. Cloud computing was as clear as a bell. Nobody wants to buy an application that requires having a server, as has been required in the past. Everything is in the cloud. Dropbox continues to be the best way to get an understanding of what cloud means. If you don’t have Dropbox yet, I highly recommend it. Social media is here to stay and most of the startups were offering some new way to exploit it — collaborative shopping and sharing content continue to loom large. The biggest shift is HTML5. I try to keep technical jargon out of patrickWeb, so sorry for the technical term. HTML is what makes the Web work. It is a protocol that makes Web pages accessible and useful. What is new is that HTML5 takes the Web to a much higher level than before. It means that a Web page can now be much more intelligent and, most importantly, the page can be truly cross-platform. That means that a page can be rendered on your PC, Mac, iPhone, Android, Tv, or anything that uses a standards-based browser. It is going to revolutionize the Web. To get a taste of this, get the Amazon Cloud Reader. HTML5 also means that–once fully adopted–you will never see a message that says “You need the latest version of Flash” or “You need the latest Real player” or “You need the latest Windows Media Player”. Audio and video will be able to be embedded in any page and enjoyed on any device. I love it!

Only six of the 80 companies were of special interest to me, although all of them were interesting. Three of them were related to healthcare. Here is my list — the links from them will tell you more. You can get a complete rundown on all 80 at the Demo Alumni Page.

LumoBack has a bandaid-like patch that you put on your back and it sends data to your iPhone about your posture.
Oh my meds provides a way to keep a track of a lot of meds in one convenient place–even if they were fulfilled at multiple pharmacies–and provides a lot of useful information about the medications.
SenseAide monitors what is going on at the residence of a senior. If the door has not opened for a long period of time or there is a fall, a call to a wall-mounted video phone is placed and automatically answered so a caregiver can ask if everything is ok.
Iconfinder has a slick model for selecting an image for use in your blog or website.
Upverter is a cloud-based electronic design tool. It breaks a lot of new ground and it is quite impressive what it can do without any desktop software.
Zirtu Virtual desktop takes virtualization to a new level. It does not virtualize the operating system — just all the desktop apps. It provides a virtual desktop even if the network connection is lost.

See the rest at demo.com, or better yet, head out to Silicon Valley in April for DemoSpring2012 and see the next batch of startups.

Tags: ethanol, find a doctor, health care, Healthcare, mac, vmware, windows

Strawberries

There are a lot of subjects I do not know much about. One of them is genomics. I moderated a panel at a technology conference a few years ago that included three PhDs in bioinformatics and I learned enough to confirm how little I knew. I asked the three experts what book would enlighten me. They unanimously recommended Genome: The Autobiography of a Species in 23 Chapters by Matt Ridley. After reading the book I was convinced that the amount I did not know was orders of magnitude greater than I had thought. One thing I do know is that genomics is going to have a very major impact on healthcare in the years ahead — more like months than decades.

An early indicator of what lies ahead might be what is going on with fruits and vegetables. Elizabeth Weise, Science writer at USA Today, just did a nice summary of the latest genomic breakthrough with strawberries. Her story, Woodland strawberry genome sequenced, is about the genome of the woodland strawberry, a “cousin” to today’s cultivated strawberry, that has now been sequenced by an international research consortium.

The strawberry is the second smallest plant genome to be sequenced, with just 14 chromosomes. What sequencing means in layman terms is that the researchers have been able to construct a “parts list” of the strawberry. (See the actual gene mapping in Nature Genetics if you are curious about the details). Weise reports that as a result of the sequencing, breeders may be able to create tastier and hardier varieties of the popular berry as well as for other crops in its family, including almonds, apples, peaches, cherries and raspberries. The researchers are optimistic that they will also find new “parts” that will provide resistance to strawberry wilt, a common, soil-borne pathogen that spoils cultivated strawberries.

The consequences for humans are mind boggling. Gene hunters are finding more genes and linking them to diseases and predispositions to diseases. The next phase will be developing methods of prevention and cures. We may see more breakthroughs in the next ten years than we have seen in the last 100 years. If you want to get an idea of the scope of the human genome project, I recommend reading Medical and Societal Consequences of the Human Genome Project by Francis S. Collins.

Tags: bioinformatics, francis collins, gene mapping, genome, Genomics, health care, Healthcare, john patrick, matt ridley, strawberry

Health Discussions Forum

I am grateful to the readers of patrickWeb for years of visits to the blog and providing excellent feedback to me. I especially appreicate hearing about a typo or bad link or something that improves the site for everyone. As you may have detected, I have developed a strong interest in healthcare.  The interest in healthcare is not new — there are currently 54 posts in patrickWeb that are healthcare related. The involvement on the board and committees of Western Connecticut Healthcare has intensified the interest. I am also working on a doctorate in health administration.

About six months ago I learned about Dr. Eric Lutker, a retired psychologist who is my neighbor in Florida. Eric developed a learning institute at the club we belong to where he invites various resident speakers to make a presentation. I was one of his invited speakers and on election day last month I gave a talk about, guess what, the Future of the Internet. Much of my view about the future of the Internet correlates strongly with the future of healthcare, and my talks have gravitated toward the intersection of information technology and clinical technology. The Q&A session after the talk was 75% healthcare related, and afterward Eric suggested we start a blog on the subject. Hence, the Health Discussions Forum was born. Our goal is simple. We plan to post short healthcare related stories about things we read or opinions and reflections we may have. We have opened up the commenting feature of the blog to allow others to comment on what we write or on the comments other readers have written. We are not sure where it will lead but hopefully, it will be the beginning of a dialog on the important issues and innovations emerging in a very important part of all of our lives.

Now for the true confessions part of this posting. Most readers of patrickWeb visit the blog with Google Reader or other blog readers but there are approximately 300 readers who subscribe via email, receiving the entire post by email whenever a new story is created. I outsource this service through a provider called Feedblitz. In my enthusiasm for the new healthcare blog, I configured Feedblitz to send Health Discussion Forum postings to the patrickWeb subscribers. Less than 5% have unsubscribed so I hope that is because the posts were appreciated or at least tolerated. If you are a subscriber and prefer not to get the healthcare posts, you can unsubscribe at the bottom of one of the emails or if you prefer, just let me know and I will take care of it for you. I apologize to anyone that feels they got opted in unknowingly. If you are not a subscriber to Health Discussions Forum and want to give it a try, feel free to subscribe using the form below.

Tags: blogging, forum, health, health care, health discussions, Healthcare, patrickWeb

Home Monitoring

My mother lived to just weeks short of 90. During the first 89 1/2 years she had a good quality of life, but during the last six months it was very difficult for her and her family. Having spent a lot of time with her between the assisted living home and the hospital, I learned a lot about healthcare for patients with chronic heart failure.  For those over 65, somewhere between 6 and 10% have CHF and the estimated annual expenditure for their care and treatment is $35 billion.

A typical scenario would be for an 89 year old person to enter the emergency department with shortness of breath. After a few hours or more in the ED the patient is admitted to the cardiac care unit. The patient is taking a dozen or so medications which are changed by the hospitalist to conform to the hospital formulary. After a week of tests, fluid infusion, and monitoring, the patient is ready to be discharged back to a nursing or assisted living home. The goal is to have the primary care physician see the patient within a week to make sure he or she is on track to stable health. The patient is confused about the new medications they have been discharged with and the appointment with the PCP may or may not happen in a week. Things go fine for a few weeks and then it is back to the ED and a readmission to the hospital. Repeat.

There are many long term solutions involving diet, exercise, and medications, but in the meantime there are millions of people with CHF who will likely follow the scenario above. Is it possible that using home monitoring can have a positive impact on quality of life and reduced healthcare expenditures? The jury is out. Research studies are underway at distinguished medical centers around the country. The idea is that by monitoring weight, blood oxygen, blood pressure and some basic questions like “How do you feel today?”, “Did you take your medications?”, etc., a stream of data is created every day that may be predictive of what is ahead. A recent study by Yale and reviewed in the New England Journal of Medicine concluded there was no difference in outcomes between those under monitoring and those not. I read the study and found that my idea of “monitoring” is different than what their study used. Although many experts were involved in the study, the data collection was done by the patients calling an automated telephone service and entering data. That is not monitoring from my perspective. Apparently it wasn’t for some of the patients in the study either because many did not enter their data.

Major companies including GE, Intel, IBM, and others are putting millions of dollars into research and development in the telemedicine market. I visited a lady in Connecticut that was being monitored by equipment provided by the Visiting Nurses Association. It was basically a PC with plug-in measuring devices. Each day the patient interacts with the PC and answers a couple of dozen questions in addition to providing weight O2, and blood pressure measurements. What struck me about the visit was not the technology but the social aspects of the process. The lady was “attached” to the PC — not technically but emotionally. She was taking responsibility for her health. She had previously been called a “frequent flier” by people at the ED. Now she doesn’t visit so often. Maybe she fears being away from her PC? The PC had become her buddy. It was Facebook to her. Some studies have shown that a person being monitored will fess up to having had a fall which they would not have told a nurse about for fear of being told they would have to go to the ED to be checked.

The data collected by the PC is sent through a dial-up telephone connection to a monitoring center, much like an alarm center. I can envision vast improviements to the system being used today. Instead of a big clunky PC how about something the size of an iPhone? O2, blood pressure cuff, and scale all connected by wireless. Data transmitted via broadband in realtime. Data going to a patient-centered medical home facility where a resident scans the data rather it going to an alarm center. Supercomputer analytics being applied to the data to look for patterns between weight, O2, blood pressure, and answers to various questions with the result being a prediction of fluid buildup that will lead to problems in 6 days unless the intake of diuretics is increased by 50% for ten days. Compared to the monitoring and predictions that are made by NASA for a spacecraft, the monitoring and predictions made for CHF patients is archaic. Skeptics say that there are too many factors involved and that only a doctor can make sense of them. I have the utmost respect for physicians but I also know, as sure as I can spell my name, that a few years from now we will be asking why it took so many years to realize that complications of various chronic diseases are in fact related to data that is collectible and very nicely subject to sophisticated analytics which can improve the quality of life and dramatically lower cost.

Milt Freudenheim at the New York Times summarizes many of the issues with home monitoring in his story Wired Up at Home to Monitor Illnesses. It is an excellent story that I can highly recommend reading.

Tags: chf, chronic heart failure, ge, health care, Healthcare, home monitoring, hospital, IBM, intel, telemedecine

The Future of the Web

The Demo conference two weeks ago was in Santa Clara, not San Diego. Sorry for the error — Demo has often been in San Diego, but not this time. My last posting summarized what the event is all about and mentioned a few companies that launched there. In addition to the excitement of seeing so many enthusiastic start-ups I gained some new insight at the conference as well. Executive Producer Matt Marshall made some brief but profound comments in his opening talk. The content was not really new but he pulled together and nicely summarized the big picture of where things are headed (See more about his talk at DemoBeat. In a nutshell Matt said the future of the web is evolving around social networking, mobile, and cloud computing.

All three of these topics are written about throughout this blog but I truly gained some new perspective on them at Demo. I have often said that social networking is not about eleven-year old kids on MySpace. It is more about grown-ups looking for jobs, hunting for people to hire, or collaborating on a new venture. The new ingredient is e-commerce integrated with social networking. People can buy what their friends are buying and can offer help to a colleague who wants to know how a particular product works or might fit into their environment. More broadly speaking, social networking is finding its way into every web application, not just a separate application of its own.

The mobile Internet is booming as we can all witness from the massive press coverage about every new phone, phone rumor and network pricing change. The new trend I observed at Demo is that startup companies showed off their new application and pointed out that in addition to the mobile app, the data from it can also be viewed from a PC or Mac. That is a 180 degree flip since a year ago. The iphone and Android phones have the power and speed and graphics to make e-commerce, business apps, video conferencing, and other sophisticated apps practical on the handheld devices. The iPad and coming tablets take things to the next level. The PC and Mac become secondary.

Every start-up at Demo either offered some form of cloud computing service or had it built in to whatever they were offering. While there are still skeptics about cloud computing it is clear to me that it has evolved to where the Internet was ten years ago. Cloud is a natural evolution of the Internet. What makes cloud computing so powerful is actually what is on our computers and devices — the browser. Browsers are getting very sophisticated and able to execute javascript incredibly fast. The result is that apps in the browser have the look and feel of what we expect from a desktop computer or better.

When you combine all three of these market factors — social networking, mobile, and cloud computing — you get a new generation of capability. It takes things up a notch in terms of power, flexibility, convenience and ease of use. I no longer say we are just 5% of the way there. I revise that to 10-15% overall but still 5% in healthcare.

Tags: ethanol, find a doctor, health care, Healthcare, mac, vmware, windows

DEMO in Santa Clara

Demo has always been my favorite conference and this past week in Santa Clara proved valuable once again. This was the twentieth year I have been attending. The Demo conference allows entrepreneurs to show off new gadgets, software, hardware and business ideas and enables the press, analysts, investors, and technology enthusiasts to assess what they see. The product introductions that take place reveal key technology trends over the coming 12 to 18 months.

Sxity-six companies were launched in two days. Only one was healthcare related but I was quite impressed with it. The site, healthinreach.com, is designed to make it easy for patients to find a doctor that meets their criteria — based on ailment, cost, location, speciality, rating, bedside manner, and a host of other things. They get data from state medical boards. How does it know about bedside manner? Crowdsourcing, of course.  HealthInReach is free for patients but doctors pay a fee; in effect a finders fee.  The site is very user friendly. They even provide scheduling of appointments. The company is focused on the west coast now but plans to go national.

There were many other start-ups of interest but I will mention just a few that I found of interest. See the complete list and details at demo.com.

MicroFueler – a portable organic waste conversion ethanol system. Looks like a gas station pump, complete with nozzle. Converts grass clippings to fuel for your car.

Footfeed – the first dedicated location-based check-in aggregation platform. Check-in to Brightkite, Foursquare, Gowalla, Facebook, and Twitter simultaneously.

Parallels – runs on the Mac and lets you run Windows apps side by side with Apple apps. No dual boot required.

VoiceBase.com – brings storage, search and sharing to voice communications just like email did for text. Very handy idea for conferences, presentations, meetings, and negotiations.

See the rest at demo.com.

Tags: ethanol, find a doctor, health care, Healthcare, mac, vmware, windows