Through a public records request to the state of Ohio, MedCity News obtained a list of investments made through the state’s Technology Investment Tax Credit (TITC) program. Under the tax credit program, investors who put money in approved companies are eligible for a tax credit of up to 25 percent of the amount they invest, with a maximum of $250,000 per investment per company eligible for the credit. The list from the state includes names of investors and the companies they’ve invested in, but omits the amounts.

Download this excel spreadsheet and you can review these investment by investor or by company. Below is the list of every investor (ranked by how many investments they’ve made through the state. And be sure to read the story that outlines what Ohio’s top angel investors are looking for in a company.

Obtaining that initial investment is often a huge hurdle for startups, but once the cash comes in, it provides a critical source of early funding — lifeblood for young, hungry companies. And as the traditional model of venture capital increasingly appears to be broken, angels have often stepped up to fill the void in early stage funding.

In Ohio, in particular, angel funding has taken on an important role for startups. The state boasts two of the five-largest angel groups in the country — Ohio TechAngel Fund in Columbus and North Coast Angel Fund in Cleveland — plus numerous wealthy individual investors. But the thing about angels is that they generally don’t want anyone besides other insiders to know that they’re angels, so they aren’t easy to find. And finding them is only the beginning of the journey.

Three healthcare entrepreneurs have been among the most adept at raising angel funding in the state. Biomarker company Cleveland HeartLab, medical device firm  Thermedx and health IT firm Within3 have done a nice job leveraging Ohio’s investment tax credit and have raised additional millions from high net-worth individuals.

Conversations with Jake Orville (CEO of Cleveland HeartLab), Mike Haritakis (executive vice president with Thermedx) and Lance Hill (CEO of Within3) yielded the following tips for healthcare startups on how to land angel funding.

Network, network, network. Angels aren’t going to take cold calls. The only way you’re going to get in front of them is through an introduction from a trusted colleague. A great place to start is by working your contacts in the professional services industry — lawyers, accountants, bankers and the like, Haritakis said.

Don’t focus on the money first. It’s a mistake to view angels simply as a source of funding, Hill said. Before you even think about the money, consider who could help your company the most — whether that help comes in the form of coaching, introductions to key contacts or business development advice. If you can get those people to contribute something besides money, that’ll make them more likely to take an interest in your company and eventually become investors.

Target first- and second-generation money. Of course it’s a broad statement, so of course it doesn’t always hold true, but it’s pretty safe to say that people who’ve acquired wealth through their own business ventures will probably have more appetite for the uncertainty that comes with early stage investing than those who came into it through their own bloodlines.

“People who earned [their] own money instead of inheriting it are more likely to embrace risk,” Hill said.

Realize that many angels won’t initially understand much about your business. Many angels who invest in med-tech startups didn’t make their money in the healthcare industry. So you’ll need to be patient, slowly walk them through the landscape of the market you’re playing in, take them out to see your customers and find a way to relate your business to the success they’ve experienced in theirs.

“Overcommunicate,” Orville advised. “Understand they’re not experts in your business.”

Trust is the key to whole process. Create trust with angels by meeting them through their own trusted colleagues, earn it by relating to them and seeking their advice, and keep it by frequently updating them on your company’s successes and challenges, Orville said.

Using the investor tax credit? That’s different.

A total of 590 companies have been approved for Ohio’s Technology Investment Tax Credit, a program in which investors who put money in approved companies are eligible for a tax credit of up to 25 percent of the amount they invest. But less than half  (291) have actually raised any money through the tax credit, according to data from the state’s Department of Development.

What’s more, while $1.5 million is the maximum investment amount that can be raised with the tax credit, only 80 companies have even raised $750,000 in equity toward the credit. Only 11 companies have raised essentially the maximum.

In life-science hungry Ohio, med-tech companies in general seem like they could take much better advantage of the tax credit. Of the 11 companies to max out on tax-credit-eligible investments, four are involved in healthcare, which isn’t bad. But less than a quarter of all companies that actually raised money with the tax credit are connected to the life sciences and healthcare.

Todd Federman, executive director with Cleveland-area angel investment group North Coast Angel Fund, said he wasn’t surprised that less than half of the companies approved for the tax credit have been able to cash in. It’s a given that many of the early-stage businesses looking to raise money through the tax credit are small, risky and fraught with uncertainty – not exactly thrilling prospects for even the bravest of angel investors.

“This may just be evidence of how challenging it can be to raise capital from private investors,” Federman said.

You can see every company that’s raised money with the tax credit since 1996. Following is list of all the healthcare companies that have been approved for — and actually used — the credit. Some are well-known, some are obscure, some no longer exist.

1. Cleveland HeartLab, $1.5 million

1. Imalux, $1.5 million

1. Rhino Systems, $1.5 million

1. Thermedx, $1.5 million

5. Percuvision, $1.45 million

6. Charles H. Mack & Associates, $1.42 million

7. Minimally Invasive Devices, $1.41 million

8. Workflow.com, $1.4 million

9. Synapse Biomedical, $1.39 million

10. Within3, $1.35 million

11. AssureRx, $1.34 million

12. Ogenix, $1.24 million

13. Monarch Teaching Technologies, $1.23 million

14. PeriTec Biosciences, $1.2 million

15. DIRAmed, $1.19 million

16. NDI Medical, $1.12 million

17. SecuReach Systems, $1.09 million

18. Endosphere, $1.05 million

19. SpineForm, $1.02 million

20. PocketScript, $1 million

21. InfraRed Imaging Systems, $959,900

22. Neuros Medical, $890,520

23. Cardio Energetics, $870,000

24 Thermalin Diabetes, $867,000

25. AcelleRX Therapeutics (now Juventas Therapeutics), $858,333

26. Noteworthy Medical Systems, $828,049

27. Great Lakes Pharmaceuticals, $793,935

28. Copernicus Therapeutics, $734,376

29. TheraVasc, $724,139

30. LifeHealth Science, $710,000

31. CleveX, $707,931

32. NeoMed Technologies, $635,182

33. Nanostatistics, $588,172

34. CardiOx, $577,031

35. Future Path Medical, $575,000

36. Allostatix, $480,000

37. Physician Technology of Ohio, $421,428

38. Checkpoint Surgical, $374,994

39. Paraspinal Diagnostic, $363,332

40. Cervilenz, $273,333

41. Gerard Ventures, $260,000

42. Joint Vue, $250,000

43. Radar Medical Systems, $222,000

44. OtoSonics, $215,000

45. Verterbration, $175,000

46. iMedd, $150,000

47. Intelecare, $150,000

48. Phylatron, $150,000

49. Updox, $143,750

50. Athersys, $143,013

51. NCRx Optical Solutions, $120,000

52. YourQuest Personal Health Solutions, $120,000

53. Aria Analytics, $100,000

54. Advanced BioSensors, $80,000

55. Freedom Meditech, $75,000

56. Genomatix, $74,000

57. Xanthostat Diagnostics, $60,000

58. Boundaryless Health, $50,000

59. SironRx Therapeutics, $50,000

The Cleveland-based company has communities in about 10 countries, including  Australia, Brazil, China and Germany, CEO Lance Hill said. “Global business will be an increasing part of our mix over the next few years,” he said. “That’s something we didn’t fully appreciate in the early days, but we’re definitely trying to capitalize on it now.”

Founded in 2004, Within3 has enjoyed what Hill called “rapid growth” recently, having doubled its employee numbers over the last year to more than 50. And like Cleveland Clinic spinoff Explorys, another of the luminaries of Cleveland’s health IT scene, Within3 may double its employee numbers yet again over the next year or so.

Hill also foresees adding new Within3 locations, in what would be the company’s first offices outside Cleveland, within the next year or two. Candidates would be East and West Coast locations in the U.S. or in Europe.

Within3′s business model is to build online “communities” that enable collaboration within healthcare organizations, similar to groups  on LinkedIn. The company’s “40-plus” clients include drug companies, medical device firms, hospitals and professional organizations, Hill said.

“Think of it as a very secure, customized LinkedIn for doctors surrounded by a set of communities,” Hill said.

Within3 makes its money by charging an annual software license fee for a community site as well as ongoing service costs associated with maintaining it.

One recent customer is the National Association of Public Hospitals and Health Systems  (NAPH). Leadership from the group’s member hospitals will use the community setup by Within3 to network and collaborate on best practices, said Maya Linson, NAPH’s web coordinator. By giving member hospitals the ability to make connections among themselves, the community will free up NAPH staff to work on other issues.

“Previously, an NAPH employee would get a question from a member via email or the phone,” Linson said. “Then that staff member would have to go out and find another NAPH member with the answer and connect those two individuals. Now members can “crowd source” the entire NAPH membership and staff for answers on their own.”

More than 3,000 employees at NAPH member hospitals have been invited to join the network, with their job titles ranging from C-level executives to medical directors to communications officers, Linson said.

While Hill was happy to discuss most examples of Within3′s impressive growth and success, there was one topic on which he grew silent: fundraising. He declined to discuss the company’s investment funding and wouldn’t confirm the accuracy of a 2009 MedCity News report  that the company had raised $7 million over its lifetime up until that point.

“Ask me about it in about four weeks and it might be very different,” he said, perhaps hinting that a big funding announcement is in the offing.

Ohio Gov. Ted Strickland called financially troubled Forum Health in Youngstown “a critically urgent situation,” while three federal legislators appealed to President Obama for financial assistance for the bankrupt health-care agency, according to the Youngstown Vindicator. In a letter to the president, the legislators revealed for the first time that Forum Health received interest from four bidders should it decide to sell some or all of its assets while reorganizing under Chapter 11 bankruptcy protection. Forum has “three viable bidders for the entire system plus one bidder interested only in the Hillside Rehabilitation Hospital facility” in Howland, they wrote. Forum also owns Northside Medical Center in Youngstown and Trumbull Memorial Hospital in Warren.

Ohio is receiving $173,000 as part of a $3 million settlement with supermarket operator Meijer Inc. linked to the grocer’s employment of pharmacists who were blocked from federal benefit programs, according to Business First of Columbus. The settlement that involves federal agencies along with state attorneys for Ohio and Michigan stems from a voluntary disclosure Grand Rapids, Mich.-based Meijermade to the government stating that it employed pharmacists between 1997 and 2006 who were barred from participating in Medicaid, Medicare or the U.S. military’s Tricare programs. The Ohio attorney general’s office said Meijer cooperated in an investigation tied to the disclosure.

Within3, the provider of online communities for health professionals in Cleveland, announced the release of mobile applications for both the Blackberry and iPhone. A surge of customer requests fueled the need for a handheld solution that integrated with the communities on the Within3 platform. “It became apparent the health professionals we serve were looking for alternative channels to access the activity and discussions occurring within their communities, in a format most convenient in their daily lives,” said Lance Hill, CEO of Within3, in a PRNewswire release. Within3 is working with early customers to introduce these mobile applications into their online communities.

The government agency that oversees Medicare suggested Friday that some small employers would find it cheaper to drop health insurance and pay small fines under a Senate bill designed to extend health coverage to millions more Americans, according to the Cleveland Plain Dealer. Meanwhile, a segment of hospitals getting less Medicare money might suffer financially, which could jeopardize access to care, according to the analysis by Richard S. Foster (pdf), chief actuary for the Centers for Medicare and Medicaid Services, or CMS.

Hitachi Medical Systems America Inc. in Twinsburg has been awarded a contract for open MRI products by MedAssets Supply Chain Systems in Alpharetta, Ga. Terms of the contract were not disclosed. The contract features Hitachi’s Oasis1.2T High-Field Bore-less MRI. “Hitachi’s Oasis is a unique product that combines high-field image clinical capability, image quality and throughput demanded by physicians with a superior experience and comfort demanded by patients, which only a truly open MRI environment enables,” said Sheldon Schaffer, vice president and general manager of MR/CT for Hitachi, in a BusinessWire release.

Medical Mutual of Ohio, one of the state’s largest health insurers, said it caught a record $7 million in fraudulent health-care claims during 2009, up from $6.2 million last year, according to the Plain Dealer. The privately owned Cleveland insurer, which serves about 1.6 million customers, probes an estimated 120 cases of potential fraud each year and produced more than 700 indictments since its inception in 1983.

The health care industry was well-represented in the Business Courier of Cincinnati’s Business Courier Fast 55 list of fast-growing local companies, according to Dialed-In. Of five category leaders, four were in the health care industry. Medpace, a clinical research organization in Norwood, finished on top in the $200 million or higher category. KeySource Medical, a generic pharmaceuticals wholesaler in Sycamore Township, finished first in the $50 to $199 million category while CH Mack, a provider of health care management systems in Blue Ash topped the $1 million to $4.9 million category.

• Cleveland Clinic Innovation Summit highlights. This year it included a speech by the FDA commissioner,  the prediction for next year’s 10 medical innovations and a little bit a breaking news: Schering-Plough’s pre-announcement of its schizophrenia and bipolar drug treatment Saphris.
• More change at Cleveland Clinic. The Clinic’s plans for its big-ticket reference lab has changed. It’s lost its leader and revised other plans, including building a larger lab on its main campus but scaling back potential future employment by 20 percent to 30 percent.
  
• Doctors and insurance companies, working together. Ohio joins New Jersey in a pilot project to streamline administrivia and provide one portal for doctors to manage insurance claims. What’s driving the change? High deductibles and wasted time (read: money) in administrative costs.
• What is Within3? Within3 has a new Web site, new customers, a new identity and new funding — and also thinks it’s solved the riddle of social networking in health care. But will people see the Cleveland company as a social networking business or niche Web designers?
• Scut is good. Cleveland surgeon Dr. Jeffrey Parks gets sentimental over scut work and wishes residents had more time to do it. “You find yourself seeing things and experiencing events that change you fundamentally. Little things like chatting with an elderly man while you wheel him down to CT scan, making small talk, learning about him as a human being, rather than simply a name on the list.”

Have a great weekend.

Within3's GI Circle

CLEVELAND, Ohio — The medical social network Within3 has a new Web site, new customers and new plans to expand.

The company unveiled its redesigned site last week, which highlights Within3′s transformation from creating a LinkedIn for doctors to Nings focused on health-care interests. Instead of building a physicians-only social network for all doctors to commiserate around any subject, Within3 now creates customized members-only social networks on specific subjects such as clinical trials, hospital alumni or medical specialties.

Within3 made the switch sometime ago and has recently announced deals to match the model. Earlier this year it launched an online community around head-and-neck cancer research at the National Comprehensive Cancer Network, and another for physicians at Children’s Hospital Boston. This week the company said it’s created a network for the American College of Gastroenterology which will open at the group’s annual meeting in late October.

“This ends the speculation about will social media take off in health care,” said Lance Hill, president and chief executive officer at Within3. “This is a broad, marquee and highly visible example.”

Within3 is named after the idea that most people are connected to one another within three individuals. That concept, the success of broader social networks like Facebook, and the potential to tap into pharmaceutical marketing dollars spurred several companies to create online social networks for physicians. The biggest online network is Sermo, which has more than 100,000 members. Many of these companies sell to pharmaceutical companies and other interest groups access to observe the interactions of the doctors.

But here’s the rub with physicians. They may be within three connections of you, but there’s a good chance they may not care and likely won’t have the time to to talk with you, anyway. None of the online social networks — Within3 included — can claim they’ve figured out how to serve doctors in the way Facebook, LinkedIn and other social networks connect with their communities.

If Within3′s name changed to reflect its new philosophy, the company would likely be called Within1 — connecting doctors who are connected to other doctors by one very intense, vested interest. Hill said the doctors are too busy and too focused to gather for broader purposes.

The American College of Gastroenterology (ACG) will use Within3 to create GI Circle: a virtual, interactive and year-round version of its annual conference. Members can post research, which can be updated and commented on by other members. Members can also connect Facebook style for either social or professional purposes.

“I don’t know if it will be a Facebook kind of thing, but it will allow people to socialize,” said Dr. Philip Katz, president-elect of the ACG and chairman of gastroenterology at Albert Einstein Medical Center in Philadelphia.

“What’s out there now does work,” Katz said, referring to conferences, journals, e-mails and other outreach efforts. “But they’re not as optimal for the free and instant access people like.”

For Katz, like many of his colleagues, this will be his first try at social networking. “I do nothing,” he said. And the AGC doesn’t yet know how they’ll judge whether the investment was worth it; they’ll largely rely on feedback from members.

Within3 is five years old, and Hill said the company is “flirting with profitability.” Whether it reaches profitability sooner rather than later will depend on how quickly it wants to expand, he said.

Overall, Within3 has raised $7 million and recently completed a round of fund-raising, though Hill declined to say much the company raised. Hill said the business could double in size from 25 employees to 50 by the end of next year. Within3 would likely have to take on more capital if it opted for a faster expansion.

Within3 makes its money by charging an annual software license fee for the site as well as ongoing service costs associated with maintaining it. Within3 doesn’t sell access to the site to pharmaceutical companies, but it does get a piece of pharma money. For example, the ACG paid for its Within3 site with the help of AstraZeneca, which will get some acknowledgement on GI Circle, ACG officials said.

Hill is used to answering questions about whether doctors will ever engage in social media. The new question for Within3 is whether it’s even a social networking company or, instead, simply a highly specialized Web design company building stand-alone sites. Attendees at this week’s Health 2.0 conference in California were asking the company that very question, said Kathy Ruggeri, Within3′s director of marketing.

Comparisons to Ning are common, but problematic. Ning is a free Web-based service that lets anyone create their own social network around any topic — albeit much sloppier than Within3′s sites. Yet Ning does offer forums, restricts access to only the people you want and other features Within3 charges for.

Ruggeri said the company offers much more than free services or what a Web design firm can. It has technology to create a social network, expertise in everything from regulatory and privacy standards in health care, and services to make sure the community participates once it’s up and running.

Also, Within3 members can also join multiple Within3 communities. For example, a gastroenterologist could be in both GI Circle and, if they’re an employee at Boston Children’s, join the hospital’s Within3 site, too. That would create a social networking “ecosystem,” but it hasn’t happened much yet.

So far, 26 teams — including companies like Within3 and Steris, organizations like BioEnterprise and institutions including Cleveland Clinic — have signed on. This is one-part cornhole (known as bean-bag toss to those outside Ohio) and one-part networking event, and it’s free to both watch and to participate in the event. The only cost is for onlookers who would want some of the hot dogs, hamburgers and other picnic food available. It costs $15 to eat.

Attendees will start to gather at 4 p.m. and we’ll start the tournament around 4:30 p.m.

This week was “Selection Tuesday,” as teams were paired off in their first-round match ups. You can see the full bracket below or download and print it (pdf), but the most interesting match up of Round One seems pretty obvious, pitting “David” — MetroHealth Medical Center — against “Goliath:” Cleveland Clinic Innovations.

There are other good first-round pairings. Cleveland economic cheerleader TeamNEO will try to defeat a company they love: Cleveland’s Steris Corp. The Ghannoum Law Firm, which would probably like to do more business with health-care spinoffs out of Case Western Reserve University, will face a team from the university’s technology transfer office.

We could still squeeze in six more two-member teams. If you are a business involved with the health-care industry contact MedCity News to grab one of the final spots.

MedCity News First Annual Cornhole Tournament bracket (click image to print)

Word of a good cornhole game spreads fast.

Staff of TechFlash, a Seattle-based news organization covering the region’s technology industry, told their online friends about MedCity News’ Medical Cornhole Tournament (TechFlash just hosted Seattle’s version of a medical cornhole tournament: ping pong for the tech industry).

And nothing goes viral without video, so we’ve added some online video to spread the word.

So mark your calendars for Cornhole: The Ultimate Medical Challenge from 4 to 8 p.m. Aug. 27 around the pavilions in upper Edgewater Park.

Teams with a connection to the health-care industry can sign up by e-mailing MedCity News or calling (216) 453-2662 Ext. 107. It’s free to play and watch the tournament, and we’ll provide a picnic-style barbecue. Non-participants who also want to eat will need to RSVP by Aug. 17 and pay $15.

Perhaps because of the viral nature of good ideas, the tournament has grown. We expected a quaint 16-team gathering, but now we’re planning on 32. We currently have more than two-dozen registered teams including from hospital systems like Cleveland Clinic, MetroHealth Medical Center and University Hospitals; organizations like BioEnterprise, TeamNEO and the Ohio State Medical Association; medical companies like Steris, NDI Medical and Within3; as well as medical venture capitalists and media participants.

Keep checking the site for updates. The tournament seeding will be announced Aug. 18.

And that thing is cornhole.

MedCity News is proud to host an end-of-the-summer cornhole tournament and picnic.

Cornhole: The Ultimate Medical Challenge
4 to 8 p.m. Aug. 27 at Edgewater Park
Free to play. Free to watch. Onlookers pay $15 to eat.

Tournament teams already include members of Cleveland Clinic Innovations, Within3, MetroHealth Medical Center, Invacare, Calfee Halter & Griswold, BioEnterprise, Medical Mutual and Arteriocyte, but we are looking for more members of the medical industry to participate. Interested?  Contact us ASAP!

Winners get their very own MedCity News cornhole set and bragging rights as the best cornhole players in Ohio’s health-care industry.

We’ll post a tournament bracket and other details as the date draws closer.

And since he’s arriving in Cleveland on Thursday, we extend a special open invitation to you, Mr. President, to return to Cleveland on Aug. 27 and participate in cornhole. Depending on the mood of Congress, it could be the most notable health-care accomplishment this year.

The Sermo business model

A recent dust up between the American Medical Association and the physician network Sermo has provided online medical networks with something they haven’t found themselves: purpose.

Scattered from Cleveland and Seattle to Virginia and Massachusetts are companies still trying to prove out a winning model to gather physicians in a Facebook — or is it a LinkedIn, or is it a Ning? — type of environment reserved solely for the medical community.

The perceived reward is worth the pursuit, though. The leaders of these medical social networks say that their sites, if done right, are the new place pharmaceutical companies can come (and spend their marketing dollars) to connect with doctors now that ethics policies and gift bans are keeping drug representatives away.

But a central problem remains largely unsolved: what is compelling enough to convince a significant number of time-crunched and inward-looking physicians to seriously embrace an online network?

“Think about how difficult it is to reach out and touch a doctor,” said Joel Selzer, the co-founder and chief executive officer at Ozmosis. “The money that’s being spent to reach out and engage physicians: it’s billion with a B. And that’s just pharma.”

Sermo, based in Cambridge, Mass., has the lead and the industry’s attention — particularly after making a public break earlier this month from the AMA. The AMA has said their members weren’t getting value in the partnership. Sermo has said the AMA no longer represents most doctors.

Since the split Sermo has published the results of a series of unscientific polls of Sermo members showing they clash with the AMA on issues including health-care reform.

“Sermo’s goal has never been to supplant the AMA,” said Dr. Daniel Palestrant, Sermo’s chief executive officer. “Our interest was our constituency.”

Palestrant said online networks like Sermo help drive a new kind of “radical transparency” that delivers a voice and a vote to each member. But that’s not just in the political arena. Palestrant points out that while health-care reform and the clash with the AMA have brought new attention to Sermo, physicians there largely discuss clinical topics — and that has been good enough for his membership.

“Medicine is an intrinsically social pursuit,” Palestrant said. “Doctors do a better job with patients if they can speak with one another.”

Sermo’s 100,000 members put it at or near the top in terms of memberships (alongside WebMD’s Medscape Physician Connect). Sermo makes money by allowing third parties — pharmaceutical companies, government agencies and the like — observe what its members discuss.

But — when thinking about membership numbers — consider that the AMA’s membership is about 200,000, and that Sermo will not say how many of its members are “active:” meaning they check their accounts at least once a month.

So Sermo’s numbers make it interesting, but competitors (no surprise) dispute its formula. Sermo confirms whether a registered user is actually a physician, for example, but members also exist anonymously on its site.

Meanwhile Ozmosis, which started as an invitation only community, verifies and then identifies its physicians by name, which Selzer says allows for a more credible discussion that’s valuable for doctors.

Ozmosis plans to expand its membership in the next 12 months. It includes discussions and its own application to bookmark and discuss items found online. It recently made deals to add features including real-time health alerts and global disease surveillance, and intensified its focus on medical residents.

“In our view many of us forget that physicians are not a monolithic group,” Selzer said. The winning medical network will be capable to manage multiple, competing interests of physicians, he said.

Some have gone a different direction. Cleveland’s Within3 about two years ago abandoned these Facebook-like approaches as untenable. Instead it built a business around creating and maintaining online networks based on certain topics. The company will soon unveil a new Web site and marketing strategy promoting its approach.

This week, for example, Within3 announced it created an online network for the faculty, residents, fellows and alumni of Children’s Hospital Boston. In June it announced an online network for a study of head and neck cancer for the National Comprehensive Cancer Network. As a member of Within3, physicians can jump into any of these individual networks they’re interested in or allowed into.

Within3 Chief Executive Officer Lance Hill said the company is also building networks for drug companies where physicians could discuss issues around treatments and medications. The company makes money building and maintaining these networks it makes for organizations.

iMedExchange, the Seattle-based network, has a unique approach of its own. Its network will include a way to connect through multiple platforms including smart phones. It has also recruited organizations to provide information directly through their network (like its blog VitalSigns).

As the company unveils new applications, widgets and new platforms, it hopes to create an environment where a physician could sign on, ask a question and then receive answers through a phone or another platform.

“Our goal is to have physicians interacting seven days a week 24 hours a day,” Chief Executive Tobin Arthur said.

Arthur said features like messages boards and online polls, the promise of validating each member as a physician and focusing solely on the clinical aspects of a physician’s life aren’t good enough. In fact, they are a basic expectation for any medically oriented social network.

Many of the new applications in iMedExchange will focus on areas of business and finance, and allow physicians to customize the experience.

Palestrant points out none of the new models have been able to find the traction Sermo has. “I think it’s interesting perhaps what Within3 is doing,” he said. “This is their second re-invention. I hope this one will stick. Sermo has had the very same brand, same model and same message.”

Hill said they’ve learned what works. “For us, it’s a simple recognition that professional networking or social networking is nowhere near valuable enough to make difference to most health professionals,” Hill said. “The huge difference is that what we do embraces organizations and institutions in health care. We’re not trying to create applications or new networks and new work flows.”

Dr. Roger Macklis

CLEVELAND, Ohio — Dr. Roger Macklis’ radioactive mission could reach its half life later this year.

The Cleveland Clinic oncologist has long sought an expanded role for radioimmunotherapy – the directed delivery of radioisotopes into the body to target and kill tumor cells. For months now he’s championed that cause through the owners of the underachieving treatment Zevalin.

Their strategy: Doctors will warm to radioimmunotherapy if enabled to piggyback Zevalin on chemotherapy they’re already giving cancer patients to increase the effectiveness of initial lymphoma treatments.

The U.S. Food and Drug Administration will decide in July whether to allow Zevalinto expand its label to promote such use. This expansion could broaden its application beyond that of a second-line treatment, potentially adding 20,000 patients nationwide and fulfilling Macklis’ personal goal for a greater use of the treatment.

“For me, this is a case in which everything  is lined up for me,” Macklis said. “It’s the right thing to do. It’s a disruptive technology. And I think the medical data is in support of this.”

Disruptive. To understand Macklis’ feelings about this opportunity is to understand that word.

Disruptive technology is the promise of something that is new, cheaper and — eventually — better. It’s the Internet. The musket. Plastics. It’s Clayton Christensen, the Harvard Business School professor who wrote the book (several of them, in fact) on disruptive technologies and innovations — and a man who Macklis said he once approached about the disruptive potential of  radioimmunotherapy.

“This,” Macklis said of radioimmunotherapy, “is a classic disruptive technology.”

Radioimmunotherapies like Bexxar and Zevalin are only for non-Hodgkin’s lymphomas that have relapsed or not responded to other treatments. Macklis’ enthusiasm crystallized through the case of Betsy de Parry, a Michigan woman who in late 2002 used radioimmunotherapy after chemotherapy failed, fully recovered, and is alive today.

Macklis’ embrace of drugs like Zevalin and Bexxar are also based on his profession. He chaired the Clinic’s Department of Radiation Oncology for 12 years and still works in the department. He’s also served on the National Academ of Sciences’ Special Task Force on Radiopharmaceutical Sciences and Nuclear Medicine. (He has received no money or other reimbursement for his support of Zevalin.)

“I think he has a lot of intensity,” said Dr. Steven M. Larson, chief of nuclear medicine at Memorial Sloan Kettering Cancer Center in New York and the co-director of its Ludwig Center for Cancer Immunotherapy.

“I remember a guy who is very smart, intelligent and passionate about what he believes in. I think he’s willing to go to battle for his ideas, and I think that is the key to his success,” Larson said about Macklis.

But de Parry’s case was the anecdotal evidence to complement what Macklis thinks is clear research that shows radioimmunotherapy’s therapeutic advances.

Yet immunotherapy drugs have floundered. Zevalin was predicted to sell up to $200 million annually when it started almost eight years ago. But it hasn’t sold more than $20 million in the past several years, and sales last year declined to $11 million, according to its parent companies’ financial statements.

As a result, Zevalin has bounced from company to company. In February, Washington’s Cell Therapeutics Inc. sold its remaining stake in the drug to business partner Spectrum Pharmaceuticals.

“I don’t believe that this drug can substantially increase sales,” Morgan Joseph & Co. analyst Shiv Kapoor told Reuters after the Spectrum purchase.

Some blame the companies for not marketing their drugs effectively. Oncologists say that there is not enough evidence proving the effectiveness of radioimmunotherapy.

Some radioimmunologists and executives at Cell Therapeutics say oncologists are discouraged from using the drugs through a mix of poor insurance reimbursement, regulatory red-tape and training requirements. The label expansion sought for Zevalin would enable it to be used like similar therapies already are in Europe.

“Although Dr. Macklis and we believe that Zevlin has a major role, doctors had other options,” said Jack Singer, Cell Therapeutics chief medical officer. “This is certainly more difficult than [drugs] they can give in their office.”

So Macklis’ approach has been to campaign — online, with drug companies and with his peers — for a broader use of Zevalin with chemotherapy. He worked with Cell Therapeutics and urged the company to push for the label expansion, which was applied for in January.

Macklis has waged his own online campaign via Within3, a professional network for physicians, for which he works as an adviser and in which he owns an equity stake. Macklis built an online community there to promote the front-line approach to radioimmunotherapy with like-minded physicians.

He hopes to present research this fall at the American Society for Therapeutic Radiology and Oncology (ASTRO) that shows more success of radioimmunotherapy.

Radiation oncologists are a fragmented bunch, but Macklis’ approach has been part of a broader movement to unify them, said Larson of Sloan Kettering. Larson also said Macklis’ efforts could help bring about greater collaboration among oncologists.

But is Macklis — or radioimmunotherapy — truly disruptive? If the FDA’s approval were to move ahead, the procedure would likely be more costly than current therapies, not less, he admits. In time, he says, as more physicians use the approach, the costs could drop.

That’s why Macklis’ ASTRO presentation may be particularly important. He thinks there is enough evidence to show that mixing radioimmunologics with chemotherapies can extend the time between cancer recurrences – known as “remissions” – by up to two years.

But he thinks broader use of the radioimmunotherapy drugs is hindered by insufficient data for long periods of time that indicate dramatic improvements in results.

“It’s going to take awhile longer to show survival differences [that could] change many of the opinions that are on the fence,” he admits.

[Front-page photo courtesy of Flickr user wired.lain]