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Glen McDaniel, President and Chief Executive Officer

Glen McDanielPresident and Chief Executive OfficerGM Global What is a GLG Leader?|GLG Leaders are a separate tier of Council Members with a Council Rank in the top 5%. These GLG Member Program participants are eligible for ongoing, in-depth consultative relationships with GLG clients.

Health middlemen can be good for consumers

January 4, 2007

As Health Middlemen Thrive, Employers Try to Tame Them | online.wsj.com

-  It is always good business to use the bargaining power of a huge group of constituents to get discounted prices for goods and services

-  Middlemen need to be prompted to continue to add value after initially courting the companies/employers/healthplans they represent

- Payers must continue to hold middlemen accountable. It is easy to let them run on auto-pilot and call the shots after a while.

Glen McDaniel, President and Chief Executive Officer

Glen McDanielPresident and Chief Executive OfficerGM Global What is a GLG Leader?|GLG Leaders are a separate tier of Council Members with a Council Rank in the top 5%. These GLG Member Program participants are eligible for ongoing, in-depth consultative relationships with GLG clients.

Outsourcing of Medications to Asia Good and Bad

January 3, 2007

U.S. Taps Sleeping Giant in Asia’s Life Sciences Realm | www.sdbj.com

1. The process of getting drugs to market could be speeded up
2. Because of labor and other cost efficiencies resulting from outsourcing, savings could be passed on to the consumer.
3. The manufacturer with the most efficient operation could capture significant market share.
4. It's important to consider local issues -heterogeneity/homogeneity of test subjects, differences from the US population, cultural issues, clinical standards and protocols used, meeting FDA/GMP standards etc.
5. Will competition cause a race to the bottom??

Glen McDaniel, President and Chief Executive Officer

Glen McDanielPresident and Chief Executive OfficerGM Global What is a GLG Leader?|GLG Leaders are a separate tier of Council Members with a Council Rank in the top 5%. These GLG Member Program participants are eligible for ongoing, in-depth consultative relationships with GLG clients.

TRIAD Hospitals Slowing Down

January 3, 2007

TRIAD Tug of war | www.thestreet.com

 Triad has been known in the hospital industry for its rapid growth and healthy margins. Recently several joint ventures have been nixed and third quarter earnings (Q3 2006) has been less than expected. Combined, these events will adversely affect Triad stock and may portend more problems in the near future.

Glen McDaniel, President and Chief Executive Officer

Glen McDanielPresident and Chief Executive OfficerGM Global What is a GLG Leader?|GLG Leaders are a separate tier of Council Members with a Council Rank in the top 5%. These GLG Member Program participants are eligible for ongoing, in-depth consultative relationships with GLG clients.

JCAHO Patient Safety Goal to Reduce Medication Errors

December 27, 2006

1.5 million Americans a year affected by medication errors | seattletimes.nwsource.com

There are many approaches to reducing medication errors. JCAHO's Medication Reconciliation Patient Safety Goal is among the latest formal initiatives to reduce medication errors

Poor communication is responsible for up 50% of all medication errors and almost 1 in 4 of adverse drug events (ADEs) in hospitals.  ADEs cost hospitals about $3.5 billion each year, according to the Institute of Medicine. Medication reconciliation improves communication among caregivers.

This is a complex, significant issue that requires  a multi-pronged approach; medication reconciliation is just one more tool in the arsenal

Glen McDaniel, President and Chief Executive Officer

Glen McDanielPresident and Chief Executive OfficerGM Global What is a GLG Leader?|GLG Leaders are a separate tier of Council Members with a Council Rank in the top 5%. These GLG Member Program participants are eligible for ongoing, in-depth consultative relationships with GLG clients.

Retail medical clinics-an inevitable development

December 19, 2006

Retail Medical Clinics Draw Patients & Payers | www.managedcaremag.com

Between the long waiting period to get in to see the typical physician and the log-jam in EDs, patients have been looking and hoping for medical care delivered in a reasonable time.
Retail medical clinics are the current (inevitable) solution to that quest. The implications are

- Fast, affordable, convenient care
- Reduced misuse of the ED for routine or non-emergent care
- Massive growth in this industry sector in the years to come
- Increased revenues for host-stores
- It is important- but might be difficult- to educate patients that these clinics are not a substitute for a family physician or an ED

Glen McDaniel, President and Chief Executive Officer

Glen McDanielPresident and Chief Executive OfficerGM Global What is a GLG Leader?|GLG Leaders are a separate tier of Council Members with a Council Rank in the top 5%. These GLG Member Program participants are eligible for ongoing, in-depth consultative relationships with GLG clients.

Electronic Health Records: Great idea, difficult to implement

December 19, 2006

Goal Is Electronic Health Records. Path Is State by State. | www.nytimes.com

In today's mobile society, almost everyone agrees with the need for an electronic health record in order to ensure
•   Access across several geographical areas
•   Several caregivers can "use" the same chart at the same time
•   A complete, legible chart is available to a practitioner as needed
•   More security and privacy as access is restricted and password-controlled

Care would improve tremendously and medical errors can be significantly reduced through the adoption not just of electronic medical reords (EMR), but ensuring the information is accessible anywhere in a network that the patient presents for care.

Glen McDaniel, President and Chief Executive Officer

Glen McDanielPresident and Chief Executive OfficerGM Global What is a GLG Leader?|GLG Leaders are a separate tier of Council Members with a Council Rank in the top 5%. These GLG Member Program participants are eligible for ongoing, in-depth consultative relationships with GLG clients.

P4P IS HERE

December 18, 2006

Pay-for-Performance Plans Now Common Among HMOs | www.nlm.nih.gov

The recent legislation passed by Congress will affect most physicians who bill Medicare. Physicians participating in the Physician Voluntary Reporting Program (PVRP) will get a 1.5% incentive for reporting quality measures to CMS. Incentives will start in July 2007.

1. P4P is here in part and will only increase in scope in the years to come
2. Physicians should be prepared now- it's not "if", it's "when"
3. Physicians should be aware that there might be some hassles like change in staffing etc required
4. Patients will be the beneficiaries

Glen McDaniel, President and Chief Executive Officer

Glen McDanielPresident and Chief Executive OfficerGM Global What is a GLG Leader?|GLG Leaders are a separate tier of Council Members with a Council Rank in the top 5%. These GLG Member Program participants are eligible for ongoing, in-depth consultative relationships with GLG clients.

Caveat Emptor-Point of Care Testing

December 13, 2006

Demand For Rapid Diagnosis And Treatment Drives Point-Of-Care Testing Markets In The United States | www.medcompare.com

Point of care testing (POCT) has many advantages on the surface or when viewed theoretically. Shortened turnaround time (TAT) means a patient can be treated more expeditiously. This improves patient care as well as customer satisfaction.

As the technology advances and manufacturers push more aggressively, POCT will increase. Providers in some settings such as clinics and physicians' offices might find the performance of POC tests an additional source of revenue.

On the other side, POC testing is fraught with so many sources of error, that it could end up being a disservice to patients and even a source of liability in some cases.

Glen McDaniel, President and Chief Executive Officer

Glen McDanielPresident and Chief Executive OfficerGM Global What is a GLG Leader?|GLG Leaders are a separate tier of Council Members with a Council Rank in the top 5%. These GLG Member Program participants are eligible for ongoing, in-depth consultative relationships with GLG clients.

What we can do to reduce medication errors

December 11, 2006

1.5 million Americans a year affected by medication errors | seattletimes.nwsource.com

Medication errors are a huge source of harm including disability and death for patients. For hospitals and other providers they are a significant liability and risk factor that must be addressed more urgently.

In order to put a dent in this problem there must be commitment from caregivers, physicians and administrators alike.

Error reporting must be transparent and blame free

Technology must be utilized to its fullest to minimize human error

Physicians who are reluctant to accept CPOE and other time intensive "inconveniencies" will have to get onboard. This will entail the push and support of medical staff leadership and hospital administration.

Glen McDaniel, President and Chief Executive Officer

Glen McDanielPresident and Chief Executive OfficerGM Global What is a GLG Leader?|GLG Leaders are a separate tier of Council Members with a Council Rank in the top 5%. These GLG Member Program participants are eligible for ongoing, in-depth consultative relationships with GLG clients.

procrit and epogen-when marketing or good medicine

December 7, 2006

Anemia Drugs Procrit & Epogen May Do More Harm Than Good | www.newsinferno.com

1. Obvious need for a closer look at the use of epogen and procrit long-term safety, as well as guidelines for threshold use

2. Lowered medicare reimbursement as CMS tries to reign in Medicare spending

3. Decreased revenues for Amgen and Johnson & Johnson

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