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Access to Your Medication's Track Record


WASHINGTON — A wealthy 76-year-old businessman from Century City is looking to apply his golden touch to the nation's health care system.

Joseph H. Kanter, who made his first fortune in real estate and then launched a successful banking career, wants to work with the federal government to establish a national health outcomes database.

The idea, he says, is to help patients and their doctors make decisions by establishing a computerized record of how various drugs and treatments have worked in similar cases in the past.

"You wouldn't buy a stock unless you had 10 years' earnings, 10 years' dividends, 10 years' sales and 10 years of what the stock price was," Kanter says. "[So why] accept from a doctor a treatment that may or may not save your life or even kill you without the relevant information?"

Kanter has trod an unlikely path to his current role as populist health care crusader. He and his wife decamped from their home in Miami to California when Kanter decided he wanted to be in the movie business.

As a newcomer in Hollywood, Kanter says, he did reasonably well. He produced several films, including the Academy Award-nominated "Ironweed" starring Jack Nicholson and Meryl Streep.

Kanter has always taken a hands-on role in the treatment of his own medical problems, and three years ago decided to commit his time and money to making health care data widely available to other patients.

He is working with a branch of the U.S. Department of Health and Human Services to develop the database. On Capitol Hill, he has the backing of Sen. Bill Frist (R-Tenn.), the only practicing surgeon in the Senate.

Frist says the database would be the "fruition" of federal efforts to improve the quality of health care in the United States.

Dr. John M. Eisenberg, director of the health department's Agency for Healthcare Research and Quality, recently announced his agency's support for the project. He and Kanter have invited representatives of the largest health and disease-related organizations to attend an Oct. 30 planning conference in Washington.

Kanter says the project is unprecedented because it would cater to patients, not just clinicians.

"It will not be written in medicalese," he says, "[but rather] in language that can be understood by an average patient," whom Kanter identifies as someone with a seventh-grade education.

The Chicago-based American Medical Assn. offers its own "national guidelines" data on the AMA's Internet site, says Yank Coble, the group's secretary-treasurer. This professional resource, he says, incorporates submissions from medical specialty groups based on their experiences in practice.

But Kanter says the AMA data is targeted at professionals, not health care consumers.

Though Kanter believes his database would help physicians prescribe the most effective courses of treatment, he concedes that some doctors oppose the plan on the grounds that it would eliminate the "placebo phenomenon."

"If you combine the natural tendency of the body to heal with the placebo effect of people thinking their doctor is God, you get patients recovering without treatment about 20% of the time," Kanter says. "So the medical profession is saying, 'We don't want to cause the public to lose faith in us.' "

The issue of protecting patients' privacy presents another complication. Kanter says many people would be very nervous about having their treatment records stored on a widely accessible database.

The key to allaying privacy concerns, he suggests, would be to ensure anonymity.

Twice in the past year, Kanter and the Healthcare Research agency have convened panels of medical and technical experts to assess the feasibility of constructing a workable database.

Researchers at these meetings, he says, have concluded that the technology exists to build a compendium of treatment results indexed by age, sex and other patient variables.

"If someone has a secondary condition, like diabetes, for instance, that [fact] may affect the treatment, so the case would go in its own special category," Kanter says.

Other major challenges include figuring out how to translate medical jargon into patient-friendly terms, and establishing standard recording procedures.

Eisenberg suggests funding could be another stumbling block. Although his office has established that there is public interest in health outcomes information, he is not sure the agency has enough cash to help Kanter finance the database.

For now, Kanter says, he will concentrate on raising awareness of the project.

"Not many people outside the field know about it," Kanter says. "Everybody knows about clinical research, which produces treatments and vaccines, but very few know about outcomes research."

Betsy Zeidman of the Fair Care Foundation, a national patient advocacy group, believes the outcomes database will prove a boon to health care consumers.

"The Kanter partnership with the federal government is vital," she says. "Obviously, evidence-based medicine is the key to saving both lives and money, and the digital age finally allows everyone to know what works."

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