As a first time author and publisher it’s been an interesting road from drafting, writing, and editing to finally publishing Pharmaplasia™. Fortunately I had some fantastic professional help putting it all together.
My intent was to call out the historical missteps of the pharmaceutical industry, provide some deeper organizational and business insight (rather than superficial sensationalized hype) as to why they happened, and identify a better path forward for pharmaceutical companies, especially in light of the evolving new healthcare market. After a year and a half of grueling long hours of writing and editing I was told the work really begins after you have your book written and published. I was stunned but can now tell you they were absolutely correct. Marketing and selling books is challenging and time consuming.
Recently, a customer who was interested in purchasing a bulk supply for their pharmaceutical company alerted me to the fact that my book cost $49.99 on Amazon. At the time I only had the Kindle e-book version available on Amazon for $9.99, so I was totally confused.
So I searched Amazon.com and to my surprise, in addition to my Kindle version, Pharmaplasia™ was listed as a “Collectable” (presumably because it was a signed paperback copy) and it was (and as of today, still is) priced at $49.99. Anybody who wants a signed paperback copy can send me a check for $49.99 and I’ll be happy to send you a signed paperback copy.
So last week I put the paperback copy up for sale at Amazon for $19.95 (plus shipping and handling) and unintentionally started a price war with my own book. Within days, somebody decided to offer “new”, “never opened” paperback copies for $19.90. This is really interesting because I have the inventory in my house except for those that I have sold (mostly through my website) or provided for review purposes or to friends and family.
So you don’t have to spend $49. Pharmaplasia™ only costs $19.95 (plus shipping and handling) for the paperback and $24.95 (plus shipping and handling) for the hardcover. Both are available by clicking on the Buy Now button to the right on this website. The paperback and Kindle version are also available at Amazon.com. And for those interested in discount pricing for bulk purchases for your group or company, please shoot me a note email@example.com and I’d be happy to work with you on pricing and delivery.
The US government driven (CMS, Centers for Medicare & Medicaid Services) incentivized push for electronic health records (EHRs) has mostly focused on the business logistics of tracking healthcare delivery and associated costs. And while the proposed Accountable Care Organization concept deepens the utility of EHRs to include quality and clinical outcome performance metrics they also have implicit goals for managing and controlling costs. Under the guise of better healthcare at lower cost, my impression is that most healthcare systems are probably looking at this more in the context of making sure CMS or insurers are comprehensively billed and that they have a way to verify billing accuracy and any incentive payments have been rightfully earned.
I wonder if we will ever get to a point of exploiting the clinical information hidden in these electronic data files. Could EHRs ever lead to better real world data to support evidence based medicine? With millions of patients in the “real world” data sets over an extended period of time you would think that figuring out “best practice treatment guidelines” would be better served than by a couple of clinical trials with a few hundred or even a couple thousand carefully selected patients studied over a relatively short period of time. Want comparative effectiveness? You would think this could be determined with the electronic data on thousands if not millions of patients rather than a small statistically designed trial in a single institution or small number of sites. EHRs could also be useful for identifying treatment trends or determining where companion diagnostics might be most helpful.
The challenges of HIPAA compliance, research regulations, and bioethical considerations are beyond my area of expertise but I feel it would be a unfortunate if they stood in the way of being able to use this valuable information. There must be ways to design and execute this type of research without compromising patient confidentiality and ensuring patient safety. I also appreciate the pitfalls, limitations, and scientific critiques of retrospectively data mining to assess and evaluate clinical data.
The value of EHRs goes well beyond the financial implications and benefits. To realize their clinical potential the data must be accessible; it must be analyzed and accurately interpreted. This will require a new breed of clinicians with specialization in the design, execution, and reporting of EHR clinical study data. Clinical interpretation of the data will require therapeutic area expertise, an appreciation for statistics, and a comprehensive understanding of the data set and the nuances of the data limitations. These are not part-time jobs but rather new job functions (staffed with expertise) that add cost to healthcare initially with cost benefits coming in the form of more cost effective, better treatment outcomes in the future.
The danger will be in executing poorly designed, “quick and dirty” reviews and clinical assessments without expertise which can lead to misleading or wrong conclusions and potentially adverse or costly recommendations … purportedly supported by data. firstname.lastname@example.org