Friday, January 22, 2010
Why Dr. Vanier's Navigenics appointment is good for PM
Posted by Steve Murphy MD at 5:08 AM 3 comments
Friday, January 15, 2010
Enter the "Not" DTC Genomics Rep
An attractive male/female (depending on doctor) walks into the office.
In order to gain the state license, Navigenics had to meet several requirements, including hire a doctoral-level scientist with expertise in genetic molecular testing, pay a $1,100 fee, and respond to deficiencies cited by inspectors with a plan of correction.
Most important, however, was Navigenics' conceding to not market its services directly to consumers, as clinical labs are forbidden from doing under state regulations. "They have acknowledged that DTC will not work for them" in New York, Kusel said. "They can only operate through physicians' orders."
Posted by Steve Murphy MD at 7:38 AM 10 comments
Thursday, January 14, 2010
CETP, Jewish Centenarians and Alzheimers
2005, I am at a lecture in a small conference room in the Annenberg building at Mount Sinai. You know the building, the huge black imposing tower at 101st and Madison Ave.
Posted by Steve Murphy MD at 4:43 AM 0 comments
Tuesday, January 12, 2010
Congratulations Navigenics. You ARE a clinical lab! Uh-Oh...
So like I have said multiple times. Navigenics is AT LEAST a clinical laboratory if not a healthcare provider.
Posted by Steve Murphy MD at 8:11 AM 7 comments
Monday, January 11, 2010
Gotta Love It. Even the daycare.......
So the other day I go to pick up my oldest and the businesswoman who runs the show said to me "I have a question" I quickly see her Time Magazine with the cover which asks "Can we change our genes"
Posted by Steve Murphy MD at 4:40 AM 2 comments
Labels: epigenetic changes, epigenetics, medgadger, methylation, time magazine
Thursday, January 7, 2010
Personal Genomics Flop.....big Belly Flop!
Daniel and Dan get quoted in an article in the Times yesterday and I am happy for them. It just goes to show how bloggers in this space ultimately shape the space.
That being said, everyone is left wondering "Where in the hell do we go from here in Personal Genomics?"
Well, I know where we are going in Personalized Medicine. PGx.
But as for personal genomics, the path is less clear. First we have to be honest about a few things.
1. Your genome is essentially worthless right now
2. We don't understand what the hell most of the SNPs and CNVs mean in the genome
3. In an economic downturn, very few people will buy this, no matter how cool it looks.
4. Don't believe me? How does Time's Invention of the Year ONLY GET 30,000 (if you believe) customers. How many iPhones sold after the listing in 2008?
5. Things we are certain of in the genome add very little to life planning or healthcare.
Now, if we can overcome those things we have to ask ourselves. Is this a software play or a genome database play. If this is a software investment......
1. Is the software being created that valuable?
2. Can you patent or create a moat around the analytical tools that were created by these companies, or are the tools just rehashing of other tools that exist
3. Does Prometheus ruin the ability to patent these tools?
4. Are these tools accurate and valuable? Ask J Craig fellas....
5. Will the lessons learned justify the investment? At least a few hundred million USD people!
Well, let's say it is NOT a software play, it is a genome database play.
1. How many people does it take to have a valuable database.
2. Is the database a legal liability worth the risk?
3. Will anyone want to buy the database?
4. Can there be a free database which will be more valuable than the "for sale" database
5. Can the database be curated and annotated easily?
So, after the million dollar open bars and zeppelins and celebs we are left with some real hard questions. Which is why I am very unclear as to the future of this "industry"
Is this really an industry all of its own? Or is this just a rehash of facebook?
Do you remember that fat kid? You know the one who said "Hey look at me! I am gonna make a HUGE SPLASH!"
Well, guess what porky, huge splash made..........
Now how in the hell does that SORE RED BELLY FEEL?
The Sherpa Says: A lot of pain and suffering may ultimately in the end prove worthless and the ripples may die.......Only to have some other fatso cause waves later on........
Posted by Steve Murphy MD at 5:02 PM 0 comments
Hackers, HITECH and HIPAA in DTC Genomics, Oh My!
At our practice we run a pretty tight ship when it comes to security of patient records. Why do we do this? Well there are 2 big reasons.
Sec. 1320d-6. Wrongful disclosure of individually identifiable health information (a) Offense A person who knowingly and in violation of this part-- (1) uses or causes to be used a unique health identifier; (2) obtains individually identifiable health information relating to an individual; or (3) discloses individually identifiable health information to another person, shall be punished as provided in subsection (b) of this section. (b) Penalties A person described in subsection (a) of this section shall-- (1) be fined not more than $50,000, imprisoned not more than 1 year, or both; (2) if the offense is committed under false pretenses, be fined not more than $100,000, imprisoned not more than 5 years, or both; and (3) if the offense is committed with intent to sell, transfer, or use individually identifiable health information for commercial advantage, personal gain, or malicious harm, be fined not more than $250,000, imprisoned not more than 10 years, or both.
So let's say someone hacked a record to get the one up on you, maybe you are a political candidate or maybe a business competitor, or maybe they want to sue you.......
If this rogue hacker performs an act of this on genomic information ordered by a doctor or that can be defined as PHI, these are the penalties. If it is not considered PHI, it is a far lesser offense.......
So the question is, do you want these protections if you are a customer/patient? I would say Hell Yeah.
But do you want them as a covered entity? Uhhhhh.....Ahem.......Well........
As a doctor we have to follow these. Why shouldn't anyone else who has been given the responsibility of handling human samples?
The Sherpa Says: As a consumer HITECH is great. But as a start up company it can prove to be a nightmare. But those who have to risk the most are the huge companies making millions of dollars....can you say class action lawsuit for millions? I know a few lawyers who would be interested in that! I wonder if the DTC Genomics investors thought of that
Posted by Steve Murphy MD at 5:45 AM 3 comments
Labels: 23 and me, dtc genomics, HIPAA, HITECH, illumina, navigenics
Wednesday, January 6, 2010
5 Technologies going bye bye in this decade?
I read with interest a twitter post by @Blaine_5 @Genomicslawyer and a few other of my friends.....
Posted by Steve Murphy MD at 5:15 AM 1 comments