"Man's Best Hospital," Run by the Boss of a MECC (Medical Education and Communications Company)?

In January, 2009 we <a href="http://hcrenewal.blogspot.com/2009/01/to-whom-did-scorpions-in-bottle-owe.html">posted</a> about how the CEO of Blue Cross Blue Shield (BCBS) of Massachusetts and of Partners HealthCare, made a secret oral agreement that BCBS would pay Partners at a higher rate than that given to other hospitals.<br /><br />Why BCBS would want to pay so much to this one hospital system was never clear. Partners does include some extremely prestigious hospitals, including the Brigham and Womens Hospital, and the Massachusetts General Hospital, ("Man's Best Hospital" in the House of God), but there are some other very prestigious teaching hospitals in Boston that were not blessed by BCBS' largess.<br /><br />We speculated about one possible cause: the leadership of the two organizations may have felt they had more in common with each other than with the constituencies of their own organizations. A few leaders of each organization had direct ties to the other. Many leaders of both organizations were simultaneously leaders of finance, the same sector that has brought us what is now called the Great Recession. Leadership of both organizations had conflicted loyalties. The organizations' CEOs at the time, and many members of their boards had divided loyalties and apparent conflicts of interest. For example, Jack Connors, the chair of the Partners HealthCare board, <a href="http://www.adclub.org/2008_Legends/jack.html">is also </a>the Chairman Emeritus of marketing communications company Hill, Holliday, Connors, Cosmopoulos Inc, whose clients include pharmaceutical and pharmacy benefits manager CVS / Caremark, and is also a member of the board of directors of Covidien, a medical device company.<br /><br />The Boston Globe just published <a href="http://www.boston.com/business/healthcare/articles/2009/05/31/partners_leader_questioned_on_outside_ties/">a report </a>that Mr Connors had even more intense conflicts that had not heretofore been made public.<br /><blockquote>He's chairman of New England's largest healthcare company, and that position atop Partners HealthCare has tested the limits of Jack Connors's considerable corporate dexterity.<br /><br />Though he has no background in medicine, Connors has been Partners' chief overseer, champion, and its most public face for 13 years.<br /><br />[One board member] is the cofounder and chairman emeritus of Partners' advertising firm. That would be Jack Connors. And that potential point of conflict has been disclosed....<br /><br />But to the chagrin of some former board members, <em><strong>never brought up for board review was Connors's stake in a leading medical education firm whose sale in 2004 made Connors a very wealthy man.<br /></strong></em><br /><em><strong>Nor has the board notified public officials of Connors's ownership of a fledgling home healthcare firm that has directly solicited Partners' hospitals for business.</strong></em><br /><br />Connors and top Partners officials defended the decision not to publicly disclose Connors's potential conflicts, saying that because Partners did not directly contract with either of Connors's firms there were no conflicts to report. Connors also defended his right to be an entrepreneur in the healthcare business while also chairing Partners' board, and strongly denied ever using his position for personal or financial advantage.<br /><br />The larger company, <em>M/C Communications, grew to become the biggest commercial provider of continuing education to physicians in the decade between its inception in 1994 and when Connors sold it in 2004. It profited hugely from <strong>an exclusive commercial relationship it maintained with Harvard Medical School, whose faculty teach at seminars the company holds.</strong> Partners' signature institutions, Massachusetts General Hospital and Brigham and Women's Hospital, are major teaching affiliates of Harvard Medical School.<br /></em><br />In addition, <em>M/C Communications benefited financially from <strong>millions of dollars in sponsorship revenue paid it from major pharmaceutical firms</strong> eager to play to this professional audience</em>.<br /><br />Connors said he was under no obligation to disclose his ownership of M/C Communications to the Partners board. He said that <em>while there is an 'affiliation' between Harvard Medical School and the two Partners hospitals, there is no formal contract between them.<br /></em><br />Connors said he informed Partners executives of his ownership of M/C Communications, and that they determined it did not warrant disclosure to the full Partners board.<br /><br />'There is no contract between Partners and Harvard,' Partners said in a statement to the Globe.<br /><br />Connors made a name for himself as an executive with Hill, Holliday, Connors, Cosmopulos, the Boston advertising company that he helped found and guided throughout a long career. <em><strong>Less well known is that he made most of his fortune from M/C Communications, which he sold to Bain Capital for $450 million in 2004.</strong></em><br /><br /><em>The sale was the largest of a private healthcare-related company in Massachusetts that year</em>, according to TM Capital Corp., an investment banking company. <em><strong>Connors, who led an investor group that bought the firm outright for $13 million in 2000, made about $250 million from its sale.<br /></strong></em><br /><em>After his 2004 windfall, he founded a company that helps elderly patients readjust to life at home after a hospitalization.<br /><br />That company, Dovetail Health, has - Connors acknowledged - <strong>solicited business from hospitals owned by Partners</strong></em>. And <em>Connors confirmed that after Dovetail executives failed to convince Blue Cross Blue Shield of Massachusetts to contract with the firm,<strong> he personally spoke to the giant insurer's president, Cleve L. Killingsworth, on Dovetail's behalf</strong>. Partners and Blue Cross Blue Shield regularly negotiate over $2.5 billion worth of medical business a year</em>.<br /><br /><em>Connors acknowledged in an interview that it might have appeared 'inappropriate' to some for him to pitch Killingsworth. But he said the conversation stemmed from a shared belief that new ways must be found to reduce frequent return trips of elderly patients to the hospital.</em> More recently, however, he said he does not believe his approach to Killingsworth was inappropriate.<br /></blockquote>So let's try to recap this.<br /><br />While Jack Connors has been chairman of the board of Partners HealthCare, the largest and most prestigious hospital system in Massachusetts, he also ran an advertising agency that did business with Partners, and has been on the board of Covidien, a medical device company. Both of these relationships he disclosed to his fellow board members, although no one seemed troubled by them.<br /><br />However, while a Partners board member, Connors was also the founder, and ultimately profited very handsomely from the sale of M/C Communications. M/C Communications apparently begat <a href="http://www.mc-comm.com/live/MCHCGateway.html">M/C Holding Corporation</a>, which in turn owns M/C Communications and Pri-Med Institute LLC. M/C Communications now <a href="http://www.mc-comm.com/live/MC/">describes itself </a>as " established in 1994 and has become a leading provider of medical education event management solutions for health care professionals and others around the globe." M/C Communications runs <a href="http://www.pri-med.com/pmo/Home.aspx">Pri-Med</a>, which is <a href="http://www.pri-med.com/industry/">described</a> thus: "Pri-Med is a platform for science and medicine that includes meetings, resources, online, and new media tools designed to meet the information and education needs of today’s practicing physician." Pri-Med <a href="http://www.pri-med.com/industry/conference.htm">markets itself to industry</a>, presumably the pharmaceutical, biotechnology, and device industry, "Sixty percent of doctors’ offices restrict rep access, making it more challenging than ever to get in front of your customers. But with Pri-Med, you get to meet clinicians in a professional environment where they seek you out. More than 66% of attendees say they come to Pri-Med events to meet you, industry representatives." So Connors' company was a medical education and communication company (MECC), which provided what appeared to be educational programs to physicians that in fact were also sold to the health care industry as marketing opportunities.<br /><br />So Partners HealthCare, which includes two of the world's most prestigious teaching hospitals, has been run by the boss of a MECC? Say it ain't so.<br /><br />Not only did Connors own a company that had an exclusive contractual relationship (as described above) with the Harvard faculty who staff the main Partners HealthCare hospitals, that company was engaged in marketing the products of sponsoring drug and device companies disguised as education. Finally, Connors denied that this presented any kind of conflict of interest, because Partners HealthCare has no explicit contract, just an "affiliation" with Harvard Medical School.<br /><br />Finally, just to ice the cake, Connors' latest venture is a home health care company that did business with Partners, and tried to do business with BCBS, spearheaded by Connors' direct conversations with the BCBS CEO.<br /><br />Jack Connors thus seems to have just become the latest poster boy for leaders of health care organizations who put their personal financial interests ahead of their responsibilities to those organizations, and function as a power elite whose collective interests trump those of the constituents of the organizations they run.<br /><br />Quoting <a href="http://www.boardsource.org/Knowledge.asp?ID=3.364">from BoardSource</a>, the main duties of the leader of any US not-for-profit are:<br /><br /><blockquote><br />Duty of Care<br /><br />The duty of care describes the level of competence that is expected of a board member, and is commonly expressed as the duty of 'care that an ordinarily prudent person would exercise in a like position and under similar circumstances.' This means that a board member owes the duty to exercise reasonable care when he or she makes a decision as a steward of the organization.<br /><br />Duty of Loyalty<br /><br />The duty of loyalty is a standard of faithfulness; a board member must give undivided allegiance when making decisions affecting the organization. This means that a board member can never use information obtained as a member for personal gain, but must act in the best interests of the organization.<br /><br />Duty of Obedience<br /><br />The duty of obedience requires board members to be faithful to the organization's mission. They are not permitted to act in a way that is inconsistent with the central goals of the organization. A basis for this rule lies in the public's trust that the organization will manage donated funds to fulfill the organization's mission.<br /></blockquote><br />By leading companies that did direct business with Partners and its staff, and failing to disclose that he was doing so to his fellow Partners board members, Connors appeared to have violated the Duty of Loyalty.<br /><br />By running a MECC that helps drug and device companies market to physicians in the guise of education, using faculty from the academic teaching hospitals that he lead, Connors seems to have mocked the mission of the academic hospitals within Partners, and thus appeared to violate the Duty of Obedience.<br /><br />This episode certainly does suggest that health care, and the organizations involved in this case, are lead by an "old-boy network," as one person interviewed for the Globe article suggested. More than just an old-boy network, they seem to be lead by chummy members of the power elite whose collective personal interests supersede the missions of the organizations they are supposed to steward. When this happens, is it any surprise that health care becomes less accessible, more expensive, and of lower quality?<br /><br />Yet challenging the power elite that are increasingly revealed as controlling much of health care seems to be something that one cannot talk about when discussing health care reform. However, failing to address this problem will likely doom any effort, no matter how well intentioned, to improve health care.<br /><br />Hat tip to and see <a href="http://alison-bass.blogspot.com/2009/06/fish-rots-from-top-conflicts-of.html">comments</a> by Alison Bass on the Alison Bass Blog.<br /><br />ADDENDUM (3 June, 2009) - See also <a href="http://carlatpsychiatry.blogspot.com/2009/06/harvard-med-school-jack-connors-and.html">comments</a> by Dr Daniel Carlat on the Carlat Psychiatry Blog.

"Man's Best Hospital," Run by the Boss of a MECC (Medical Education and Communications Company)?

In January, 2009 we posted about how the CEO of Blue Cross Blue Shield (BCBS) of Massachusetts and of Partners HealthCare, made a secret or...

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Search billions of documents with the Google Search Appliance 6.0

It's hard to conceptualize the number 1,000,000,000. One billion sheets of paper could circle the earth at the equator well over five times. Counting to one billion would take about 30 years of your life, even if you never stop to sleep. And if you had to find a single piece of information by sorting through a billion documents it would take you, on average, about 2000 years. Businesses and large organizations have tons of documents and other types of data — some even have a billion documents that need searching, and it's unlikely that employees have 2000 years to dedicate to the hunt.<br /><br />Figuring out how to navigate the complex content systems of large organizations is a tough problem, one we've dedicated years to solving. Today we're releasing the newest version of our solution, the <a href="http://google.com/gsa">Google Search Appliance 6.0 (GSA)</a>, which has the capacity to search billions of documents. So whether you own a small business with a few thousand docs or belong to a huge organization with a billion, the GSA can search them all. Even if the content you need lives in a bunch of different departments or locations, in all kinds of formats, languages and repositories, the GSA makes searching within your organization as simple as searching on Google.com. It also has helpful features like user-added results and query suggestions, so over time your coworkers' input improves search results. The GSA 6.0 also is full of customization features, as well as flexible security policies so that each enterprise or large organizations can tweak the settings to suit its needs. We believe that setting your enterprise up with the GSA can save you tons of employee hours spent looking for data — letting you focus on the actual work to be done.<br /><br />We demonstrated the infrastructure you'd actually need to search a billion docs — check it out in the video below. To learn more about the GSA 6.0 or our search solutions for businesses, check out the <a href="http://googleenterprise.blogspot.com/2009/06/introducing-google-search-appliance-60.html">Google Enterprise Blog</a> or our <a href="http://www.google.com/enterprise/search.html">website</a>.<br /><br /><br /><object height="340" width="560"><param name="movie" value="http://www.youtube.com/v/rE0KNvECG2s&hl=en&fs=1"><param name="allowFullScreen" value="true"><param name="allowscriptaccess" value="always"><embed src="http://www.youtube.com/v/rE0KNvECG2s&hl=en&fs=1" type="application/x-shockwave-flash" allowscriptaccess="always" allowfullscreen="true" width="560" height="340"></embed></object><br /><br /><span class="byline-author">Posted by Cyrus Mistry, Product Manager</span>

Search billions of documents with the Google Search Appliance 6.0

It's hard to conceptualize the number 1,000,000,000. One billion sheets of paper could circle the earth at the equator well over five ti...

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The Local Business Center dashboard opens its doors

If you're a local business owner, it's likely that Google plays a role in helping customers find you. And we're not just talking about your website — thanks to <a href="http://maps.google.com/">Google Maps</a> and <a href="http://www.google.com/">Google Search</a>, you may also be getting a lot of online traffic to your business listing. You've probably seen one of these listings before:<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjaVd0nTAs4MV9X_IWq-gCms_NL2adm9aLYX1HxrIJqzFv2zNFsHgzo6R2i6hpCyHWtYVg2rvSl5S2Qq112W6TngtZcOeObDYiK4mGapkcR-E1yNZ-zPeexR48A30tgY7cg9K2WO5G-i45g/s1600-h/OGB+post.jpg"><img alt="" border="0" id="BLOGGER_PHOTO_ID_5342583973125746738" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjaVd0nTAs4MV9X_IWq-gCms_NL2adm9aLYX1HxrIJqzFv2zNFsHgzo6R2i6hpCyHWtYVg2rvSl5S2Qq112W6TngtZcOeObDYiK4mGapkcR-E1yNZ-zPeexR48A30tgY7cg9K2WO5G-i45g/s400/OGB+post.jpg" style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 400px; height: 395px;" /></a>You also probably know how they tend to work: A potential customer does a search on Google.com or in Google Maps, comes across your listing, clicks on it to see your reviews and details, and then gets directions to your location.<br /><br />Now, imagine if there were a way for you to get a better understanding of how those customers are finding you. Did they search for "pizza" or "pasta" to get to the listing for your Italian restaurant? Do they live across town, but drive miles for your great selection of camping gear? What happens to traffic to your new dental practice when you start advertising in the local paper? With information like that, you'd be able to make better informed decisions on how to drive more traffic to your listing and attract more customers.<br /><br />Later today, you'll be able to do just that, thanks to a new dashboard feature we're launching in the Local Business Center (<a href="http://www.google.com/local/add/businessCenter?gl=US&hl=en-US&service=lbc&hl=en-US&gl=US&utm_campaign=en&utm_source=OGblog&utm_medium=et&utm_term=%7Bkeyword%7D">www.google.com/lbc</a>). The LBC is a free tool that enables business owners to control the content of their business listings as they appear in Google Search and Google Maps. All you have to do is <a href="http://maps.google.com/support/bin/answer.py?hl=en&answer=15391">claim your listing</a> in the LBC and go through a quick verification process to get access to the following kinds of data:<br /><ul><li><span style="font-weight: bold;">Impressions</span>: The number of times the business listing appeared as a result on a Google.com search or Google Maps search in a given period.</li><li><span style="font-weight: bold;">Actions</span>: The number of times people interacted with the listing; for example, the number of times they clicked through to the business' website or requested driving directions to the business.</li><li><span style="font-weight: bold;">Top search queries</span>: Which queries led customers to the business listing; for example, are they finding the listing for a cafe by searching for "tea" or "coffee"?</li><li><span style="font-weight: bold;">Zip codes where driving directions come from</span>: Which zip codes customers are coming from when they request directions to your location.</li></ul>The new dashboard will also let you dig into that data using all kinds of lists, maps, and graphs like this one, which measures impressions and actions for a hotel's business listing:<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgtlL6Vziv_XkaAYges4l9VXlwdyoMM04dBizmUvq3suk9aFW38ESD77up4ioHJWYpLQmmt9KvtibBmxGz57JT5ql7wZiWnShU0B9vX-aE8L2AaqdHukaRaCzPx6EpKvzwCZe3MW3mGFmvf/s1600-h/OGB+Graph.jpg"><img alt="" border="0" id="BLOGGER_PHOTO_ID_5342583771477620370" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgtlL6Vziv_XkaAYges4l9VXlwdyoMM04dBizmUvq3suk9aFW38ESD77up4ioHJWYpLQmmt9KvtibBmxGz57JT5ql7wZiWnShU0B9vX-aE8L2AaqdHukaRaCzPx6EpKvzwCZe3MW3mGFmvf/s400/OGB+Graph.jpg" style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 400px; height: 178px;" /></a><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg1TXJls_4HAEkEAxwRwkD_C7zmquF7elVV25sh-SIjgohWVLh0vSUWG7ckUm2XQOI9FbukdhVgLfNwJD6WmEU7gIsjp747fkWmW06kImlJpmE1j6LdMwMAU1aKD8Z4wo7adUIsUj7xP7RN/s1600-h/totals.png"><img alt="" border="0" id="BLOGGER_PHOTO_ID_5342733529161453554" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg1TXJls_4HAEkEAxwRwkD_C7zmquF7elVV25sh-SIjgohWVLh0vSUWG7ckUm2XQOI9FbukdhVgLfNwJD6WmEU7gIsjp747fkWmW06kImlJpmE1j6LdMwMAU1aKD8Z4wo7adUIsUj7xP7RN/s400/totals.png" style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 400px; height: 110px;" /></a><br />When you sign in to the LBC today, you'll find that we've already populated the dashboards for claimed listings with data from the last 30 days. After that, new information will be added every day, so you can check in often to see how things are going. We're also working hard to add more historical information, and to make this available for businesses outside the U.S. All the data we share through the dashboard will be anonymous and aggregated, to protect the privacy of Google users.<br /><br />We're really excited to be able to open up this data to local business owners. Before now, you could track usage metrics on your website using a tool like <a href="http://www.google.com/analytics/">Google Analytics</a>, but data about how customers found you in other ways never got back to you. That all changes today, and we think business owners will really get a lot out of this new information. So if you're a local business owner and you feel the same way, be sure to check out this new dashboard.<br /><br />To learn more about accessing and using the dashboard, take a look at the video below and then visit the <a href="http://google-latlong.blogspot.com/2009/06/bringing-power-of-googles-data-to-local_02.html">Lat Long Blog</a> for a more in-depth overview.<br /><br /><object height="340" width="560"><param name="movie" value="http://www.youtube.com/v/hjeCmHwqVpU&hl=en&fs=1&rel=0&hd=1"><param name="allowFullScreen" value="true"><param name="allowscriptaccess" value="always"><embed src="http://www.youtube.com/v/hjeCmHwqVpU&hl=en&fs=1&rel=0&hd=1" type="application/x-shockwave-flash" allowscriptaccess="always" allowfullscreen="true" height="340" width="560"></embed></object><br /><br /><span class="byline-author">Posted by Amer Shahnawaz, Software Engineer, Local Business Center </span>

The Local Business Center dashboard opens its doors

If you're a local business owner, it's likely that Google plays a role in helping customers find you. And we're not just talking...

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Blog search and beyond

Since <a href="http://bloggerindraft.blogspot.com/2007/07/new-feature-search-box.html">we launched</a> the Custom Search AJAX gadget for Blogger on our <a href="http://draft.blogger.com/">experimental site</a>, we've gotten some great feedback. Now, the tuned-up search gadget is available to all <a href="http://buzz.blogger.com/2009/06/search-box-gadget-available-to-all.html">Blogger users</a>. You can configure this gadget to help your readers search all the information that's relevant to your blog — your posts, webpages that you link to, and sites that you link to from the sidebar — all in one shot. When your readers search using this gadget, the results are displayed with the look and feel of your blog. And they show up inline, so readers don't have to leave your blog. After they're done, they can quickly dismiss the results and go back to reading your blog posts. Take a look at how <a href="http://www.skrishnasbooks.com/">S. Krishna's Books</a> uses the gadget.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgRqlT5-6b4bE1AkOLI6xuvg3NKQvMYq0iwkoqESZiUM-U04FDMrPBOC01qGwIeBlObBTVfRxtjW4den9gD-KIa3xOo1KaaDjiQDfF7mpCP0gyyyijHR9VnqCkM27r5Hzo1H6AX8UmonWoc/s1600-h/Books.gif"><img alt="" border="0" id="BLOGGER_PHOTO_ID_5342405162847376402" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgRqlT5-6b4bE1AkOLI6xuvg3NKQvMYq0iwkoqESZiUM-U04FDMrPBOC01qGwIeBlObBTVfRxtjW4den9gD-KIa3xOo1KaaDjiQDfF7mpCP0gyyyijHR9VnqCkM27r5Hzo1H6AX8UmonWoc/s400/Books.gif" style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 400px; height: 343px;" /></a><br />You can configure the gadget on your blog with just a few clicks:<br /><ul><li>Edit your blog's layout, and click "Add a Gadget"</li><li>Select and configure the search box gadget</li></ul>The search box will then show up on the sidebar on your blog.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgOrbH_pLmDEtke2p3q15DiX9Vi6mOjwgpj5WVOtWLXmCn6xD6-9QHUSfd18gz09ZJAKnATvxDvaPTefDVOKxdKMcDcWJuBAIVX0tovY1huxYa5KK0gEqNafEdzOIkinctFXvBA9uN4KmqL/s1600-h/blogger_gadget_add.gif"><img alt="" border="0" id="BLOGGER_PHOTO_ID_5342404152935327858" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgOrbH_pLmDEtke2p3q15DiX9Vi6mOjwgpj5WVOtWLXmCn6xD6-9QHUSfd18gz09ZJAKnATvxDvaPTefDVOKxdKMcDcWJuBAIVX0tovY1huxYa5KK0gEqNafEdzOIkinctFXvBA9uN4KmqL/s400/blogger_gadget_add.gif" style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 400px; height: 225px;" /></a><br />By default, the following 3 search tabs are configured:<br /><ul><li><span style="font-weight: bold;">This blog</span>: searches across your blog posts</li><li><span style="font-weight: bold;">Linked from here</span>: searches blog posts, webpages linked from your posts, blog lists, and link lists</li><li><span style="font-weight: bold;">The web</span>: searches across all pages on the web</li></ul>The gadget also provides an option that lets you restrict search results to pages linked from a specific blog list or link list. For example, if you have many link lists on your sidebar, you can choose to surface only the most important ones in specific search tabs. "Linked from here" includes pages from all of them.<br /><br />The goal of this gadget is to expand the search capabilities of your blog and give your readers a better search experience. If you're using it, we'd love to hear your <a href="http://groups.google.com/group/blogger-help?pli=1">feedback</a> on other improvements we can make. Learn more at the <a href="http://googlecustomsearch.blogspot.com/2009/05/search-box-for-blogger.html">Custom Search Blog</a>.<br /><br /><span class="byline-author">Posted by Rajat Mukherjee, Group Product Manager</span>

Blog search and beyond

Since we launched the Custom Search AJAX gadget for Blogger on our experimental site , we've gotten some great feedback. Now, the tuned...

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The Day in the Cloud Challenge featuring Google Apps on June 24th

<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiZUXnbLKmon5FnhTlyMCUpqtVV8zldj7cwWpM8Q1mym32Gqx8t_8YY8dsd2l7uol_OWOvi3zfvCyko5VLnHKcwLhdlKQF3Ljeu-Zk6hf2QUZ_zRZqw4UQwr0VhDTmZ84mzLPq2jWitw_qL/s1600-h/DIC_Logo.jpg"><img alt="" border="0" id="BLOGGER_PHOTO_ID_5342371620736381266" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiZUXnbLKmon5FnhTlyMCUpqtVV8zldj7cwWpM8Q1mym32Gqx8t_8YY8dsd2l7uol_OWOvi3zfvCyko5VLnHKcwLhdlKQF3Ljeu-Zk6hf2QUZ_zRZqw4UQwr0VhDTmZ84mzLPq2jWitw_qL/s200/DIC_Logo.jpg" style="margin: 0pt 0pt 10px 10px; float: right; cursor: pointer; width: 200px; height: 200px;" /></a>You're invited to take the <a href="http://www.dayinthecloud.com/?utm_source=google&utm_medium=blog&utm_campaign=ogb">Day in the Cloud Challenge</a>, the first-ever online scavenger hunt to be played simultaneously in the air and on the ground. We've teamed up with <a href="http://www.virginamerica.com/">Virgin America</a> to sponsor this challenge on June 24, 2009, the "Day in the Cloud." At Google, we've gathered a small group of gamers extraordinaire to come up with unique puzzles, trivia, and brain teasers, many of which use Google Apps. So if you're game, get ready for the Day in the Cloud Challenge.<br /><br />More and more people are storing their data (such as documents, calendars, email, and photos) online "in the cloud" with services like <a href="http://www.google.com/apps/">Google Apps</a>. All that you need is an Internet connection to access and share that information with friends, family, and co-workers. With airlines like Virgin America offering in-flight Wi-Fi, it's now even easier to stay connected while you travel, even when you're flying through the sky.<br /><br />Those of you paying close attention might remember that we've held a <a href="http://googleblog.blogspot.com/2006/04/can-you-crack-code.html">puzzle extravaganza</a> in the past. The Day in the Cloud Challenge will be different in that each contestant will have just <span style="font-weight: bold;">one hour</span> to play the game. Everyone is encouraged to take on the challenge between 12:00am and 11:59pm PDT on Wed, June 24, 2009. And if you happen to be flying on Virgin America, in-flight Wi-Fi service will be complimentary on June 24th so that you can play during your flight.<br /><br />The top five scorers in the challenge will receive a "Year in the Cloud" <a href="http://www.dayinthecloud.com/challenge/?utm_source=google&utm_medium=blog&utm_campaign=ogb">prize package</a>, which includes a year of free flights and free in-flight Wi-Fi from Virgin America, an HP netbook computer, and 1 terabyte of Google account storage for all of your photos and email. Not a puzzle fanatic? Don't worry. The questions come in various difficulty levels so there will be some easy puzzles and others that might drive even the most experienced competitors crazy. A final note on eligibility: You must be a legal resident of the U.S. and at least 18 years of age to be eligible for a prize.<br /><br />Check out <a href="http://www.dayinthecloud.com/?utm_source=google&utm_medium=blog&utm_campaign=ogb">www.dayinthecloud.com</a> for more information. While you're there, sign up for an email reminder to receive practice clues and tips.<br /><br />We'll see you in the cloud.<br /><br /><span class="byline-author">Posted by Boris Debic, Physicist and Google Software Engineer (and puzzle creator)</span>

The Day in the Cloud Challenge featuring Google Apps on June 24th

You're invited to take the Day in the Cloud Challenge , the first-ever online scavenger hunt to be played simultaneously in the air and ...

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More Documents About the Selling of Seroquel Show How Research Was "Subordinated to Commercial Goals"

We<a href="http://hcrenewal.blogspot.com/2009/02/buried-data-smoke-and-mirrors-job-and.html"> posted </a>earlier this year about how documents produced on discovery and recently unsealed during litigation suggested how <a href="http://www.astrazeneca-us.com/">AstraZeneca</a> handled clinical research data in the marketing of its atypical anti-psychotic drug <a href="http://www.seroquel.com/">Seroquel </a>(quetiapine). A new crop of documents has just been released, providing yet more insights, as <a href="http://www.tampabay.com/news/business/article1002805.ece">reported by the St Petersburg (Florida) Times</a>:<br /><blockquote><br />Behind the scenes at the global pharmaceutical company AstraZeneca, the team in charge of the blockbuster antipsychotic Seroquel had one mission: make the multibillion-dollar seller even bigger.<br /><br />To that end, internal company documents released Wednesday show <em>how the British drugmaker hid unfavorable study results, promoted unapproved uses</em> and even considered pitching the drug as less likely to lead to suicidal thinking than competitors'.<br /></blockquote><br />In particular,<br /><blockquote><br />Documents suggest Seroquel studies were repeatedly <em>subordinated to commercial goals.<br /></em><br />When a study in 2002 failed to show that Seroquel's sustained release formula was any more effective than a placebo in treating schizophrenia, orders from the top were to <em>keep the results 'in strictest confidence.'</em><br /><br />When a scientist in England wanted to study the weight gain in rats on Seroquel, AstraZeneca <em>declined to fund the research, saying 'we could wind up with results that are not clearly advantageous.'<br /></em><br />In one discussion, it was suggested that <em>authors of potentially helpful research reports who raised too many questions, slowing publication, should be asked to step down.<br /></em><br />A researcher who pressed for results of an unfavorable trial was rebuffed for weeks before being given 'three or four sentences describing high-level results.'<br /><br />AstraZeneca marketers were <em>jealous of what they saw as competitor Lilly's ability to cast questionable study results in a positive light. 'They (Lilly) are able to spin the same data in many different ways</em> through an effective publications team,' according to a 2003 memo. <em>'Negative data usually remains well hidden</em>.'<br /><br />As Seroquel's sales soared, documents reflect <em>an ongoing struggle between the safety and marketing teams</em> over the potentially damaging issue of weight gain. In 2000, the company's scientists said data did not support the marketing claim that Seroquel resulted in only 'limited' weight gain. Close to 23 percent of the people who took the drug gained more than 7 percent.<br /><br />Despite the safety team's objections, the word 'limited' remained on Seroquel's label for two more years.<br /></blockquote><br /><br />This is a reminder how beleaguered we advocates of evidence-based health care (EBHC) have become. The idea of EBHC was that health care decisions for individual patients, and policies for groups of patients ought to be guided by critical review of the best available evidence from clinical research, guided by knowledge of biology and the biopsychosocial context of health, and informed by patients' values and preferences. The idea still makes sense to me, but it only works if physicians, patients and policy-makers have access to an unbiased sample of clinical research studies, so that studies with are not selectively suppressed to support vested interests. Although critical review can account for inevitable trade-offs, compromises, and errors in how studies are designed, implemented, and analyzed, the clinical epidemiological methods it uses are really not designed to root out falsehoods and deliberate deception.<br /><br />However, the ongoing story of Seroquel, and many other cases discussed on Health Care Renewal suggest that when clinical research is sponsored by those who can profit from the product or service it evaluates, that research is prone to suppression and manipulation. Although I believe there are many honest scientists who work for pharmaceutical, biotechnology, device, health information technology and other health care corporations, it seems they often have to answer to marketers whose only goal is to sell more product. <br /><br />As long as clinical research is sponsored and run by the people who can profit directly from selling the products and services the research is meant to evaluate, the ideal of evidence-based health care becomes less attainable. <br /><br />As we have said before, suppression and manipulation of research amounts to post-hoc abuse of research subjects who volunteered their participation believing that it would advance science and health care.<br /><br />Furthermore, suppression and manipulation of research can deceive physicians into prescribing tests and treatments that will fail to help, or even harm patients, and deceive patients into thinking that they are getting the best possible tests and treatments, when, again what they are getting is ineffective or even harmful.<br /><br />In my humble opinion, there is an increasingly strong argument that clinical research should not be controlled, and probably should not be done at all by organizations with vested interests in the research producing results favorable to their products.

More Documents About the Selling of Seroquel Show How Research Was "Subordinated to Commercial Goals"

We posted earlier this year about how documents produced on discovery and recently unsealed during litigation suggested how AstraZeneca ha...

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Sanofi-Aventis Settles

Here is another addition to the parade of multi-million dollar legal settlements by health care corporations. As <a href="http://www.google.com/hostednews/ap/article/ALeqM5iz-Iv0odwT89eHgHRlkwHSgLx5RwD98FB4T80">reported by the AP</a>:<br /><br /><blockquote><br /><span class="blsp-spelling-error" id="SPELLING_ERROR_0">Drugmaker</span> <span class="blsp-spelling-error" id="SPELLING_ERROR_1">Sanofi</span>-<span class="blsp-spelling-error" id="SPELLING_ERROR_2">Aventis</span> has agreed to pay nearly $100 million to settle allegations it cheated Medicaid on the cost of nasal sprays.<br /><br />The Justice Department said <span class="blsp-spelling-error" id="SPELLING_ERROR_3">Aventis</span> Pharmaceutical Inc., a wholly owned subsidiary of <span class="blsp-spelling-error" id="SPELLING_ERROR_4">Sanofi</span>-<span class="blsp-spelling-error" id="SPELLING_ERROR_5">Aventis</span> U.S. <span class="blsp-spelling-error" id="SPELLING_ERROR_6">LLC</span>, has agreed to pay the government $95.5 million to settle the charges.<br /><br />The government charged that between 1995 and 2000, <span class="blsp-spelling-error" id="SPELLING_ERROR_7">Aventis</span> and its corporate predecessors did not offer Medicaid the best prices for the sprays <span class="blsp-spelling-error" id="SPELLING_ERROR_8">Azmacort</span>, <span class="blsp-spelling-error" id="SPELLING_ERROR_9">Nasacort</span> and <span class="blsp-spelling-error" id="SPELLING_ERROR_10">Nasacort</span> <span class="blsp-spelling-error" id="SPELLING_ERROR_11">AQ</span>.<br /><br />In reaching the settlement, <span class="blsp-spelling-error" id="SPELLING_ERROR_12">Sanofi</span>-<span class="blsp-spelling-error" id="SPELLING_ERROR_13">Aventis</span> U.S. did not admit any wrongdoing. The company, based in <span class="blsp-spelling-error" id="SPELLING_ERROR_14">Bridgewater</span>, N.J., issued a statement saying it believed the old pricing system was legal.<br /><br />Under the law, the company was required to tell Medicaid the lowest price that it charged companies for those products, and offer state Medicaid programs rebates based on those prices.<br /><br />Prosecutors contend that in order to dodge that obligation, <span class="blsp-spelling-error" id="SPELLING_ERROR_15">Aventis</span> entered into a private deal with the HMO Kaiser <span class="blsp-spelling-error" id="SPELLING_ERROR_16">Permanente</span> that repackaged <span class="blsp-spelling-error" id="SPELLING_ERROR_17">Aventis</span> drugs under a new label, allowing them to overcharge Medicaid programs for the same product.<br /></blockquote><br /><br />It <span class="blsp-spelling-corrected" id="SPELLING_ERROR_18">seems</span> that scarcely a week goes by without a settlement of charges of unethical behavior by some major health care organization. The ongoing parade of such cases ought to inspire some worry about the ethics of the leaders of such organization. Given the current very public discussion of how expensive health care has become, one would think that there would be some discussion of how much of this expense is due to various kinds of deceptive and unethical behavior by some of the biggest, richest, and most powerful health care organizations. But perhaps that would be too upsetting for those who make so much money running these organizations.<br /><br />As we have <a href="http://hcrenewal.blogspot.com/2009/05/synthes-settles-agrees-to-stop-giving.html">said before</a>, most recently <a href="http://hcrenewal.blogspot.com/2009/05/novo-nordisk-accepts-deferred.html">here</a>, while human beings authorized or committed the acts that got the organization in trouble, rarely do these people seem to suffer any negative consequences. At most, the organization may pay a fine. In this case, the fine was, in corporate terms, of modest size. However, even a large fine, may come out of dividends or the stock price, dispersing the cost to stock-holders, or out of salaries across the board, dispersing the cost to all employees. Thus, those who got the organization into trouble are unlikely to feel pain from it. Perhaps because of reverence for all organizations related to health care, and fear that the bankruptcy of any health care organization will leave patients in the lurch, prosecutors do not seem inclined to actually prosecute such organizations. The net effect, though, seems to be that dishonest executives of health care organizations can continue to act with impunity.Until bad leadership of health care organizations leads to negative consequences for those practicing it, health care leadership can be expected to continuously degrade.<br /><br />ADDENDUM (2 June, 2009) - See <a href="http://scienceblogs.com/effectmeasure/2009/06/placing_a_vaccine_order_with_c.php#more">these comments </a>on the Effect Measure blog.

Sanofi-Aventis Settles

Here is another addition to the parade of multi-million dollar legal settlements by health care corporations. As reported by the AP : Drugma...

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