Wednesday, February 4, 2009

Conflicts of Interest 2009

It's time for my annual post of my conflicts of interest.

Many of my regional and national activities are volunteer positions that require me to be a non-voting facilitator, so openly publishing my possible conflicts of interest is important.

1. My W2 is issued by Beth Israel Deaconess Medical Center, which invoices Harvard Medical School for the time I spend there. BIDMC and HMS are my only two paying jobs. I consolidated them into one W2 (BIDMC chargeback to Harvard) to avoid having two paychecks and double FICA.

2. In 1993, I created a family trust and all my savings/investments are managed in that trust by an independent third party. In the 15 year lifespan of this trust, I have not made a single investment decision to buy or sell any particular stock, bond, or fund.

3. Harvard has very strict rules about working with for-profit companies. No Harvard logos can be used in association with a commercial product. No organizational endorsements are permitted i.e. "Harvard thinks this is the best product on the market!". Case studies are fine and objective comments about functionality are permissible i.e. "I tested 5 products and found product x met my specific functional criteria." Whenever I do case studies, they are reviewed by Public Affairs at Harvard Medical School for appropriateness.

Whenever I have a question about serving as an adviser or board member, I inform Corporate Compliance at BIDMC and seek permission. Here are the roles I serve in for-profit companies and the financial arrangements:

Healthline Medical Advisory Board - Healthline has a built a search engine that uses controlled vocabularies/ontologies in an attempt to deliver more specific search results to users i.e. it knows that brains contain neurons and thus a search on neurons also looks at diseases of the brain. I serve on their advisory board to offer suggestions about how to incorporate medical knowledge in the search process. I have not accepted any compensation. I was asked to serve as an adviser by one of my former professors, who leads the Medical Advisory Board.

Anvita Health (formerly SafeMed) Board of Directors - I rarely serve on the Boards of companies, but I made an exception with Anvita because I so strongly believe in their mission - to provide healthcare analytics and actionable health intelligence to doctors, patients and payers using a web-services architecture. They are the decision support behind Google Health, informing patients about medication interactions. I have not received any cash compensation for my Board service and but have stock options (as is typical for Board members) which I have not exercised. Thus I own no stock. My options have been declared with Harvard and BIDMC and I have recused myself from any decisions regarding purchasing of Anvita products. At present, BIDMC uses Anvita as part of our Blue Cross and Harvard Pilgrim Healthcare radiology cost control initiatives.

ePocrates Board of Directors - ePocrates is handheld prescribing software that runs on Treos, Blackberries and the iPhone. Many attending physicians, residents, and medical students at Harvard download the free version of ePocrates. Since it is the most popular mobile software used by clinicians at BIDMC and Harvard, I agreed to serve on the Board of Directors. I have not received any cash compensation for my Board service and did receive stock options, as is typical for Board members. These options were purchased by an investor in the company in 2008, so I do not currently own any ePocrates stock. I have recused myself from any purchasing decisions regarding ePocrates products.

These are all my for-profit company activities. I have no pharmaceutical company sponsorships, no lobbying activities, and no non-cash perks provided by anyone.

If there is anything I can do to adhere to other best practices, ensuring my objectivity, let me know!


Ahier said...

You are a fine example of transparency and ethical behavior.
If only our leaders in Washington would follow your lead!

willrice said...

I enjoy reading about your technology at home configurations. One recent post entitled “Technology I Own” does not list some of the other technologies that you have indicated in other posting that you have at home for evaluation purposes (Cicso CTS 500 Telepresence). This leads me to understand that you do not own these devices; rather they are donated from the manufacturers to you as evaluation in hopes to highlight its use resulting in an implied endorsement.

Should you also consider conflict of interest with "donated" technology that you receive as demo or evaluation trials? Endorsing and promoting technologies that you receive for evaluation.

John Halamka said...

Great point! The Cisco CTS 500 will be in my home for 60 days then removed. I've not received any hardware or software donations for my ongoing personal use in 2008 or 2009.

Unknown said...

As a fellow Healthcare IT professional, I enjoy reading the post on your blog and your enthusiasm for Web 2.0 technologies.

Jim Graham said...

If only the voters would be so demanding of those that run our towns, county's, states and nations - we would be in a better place