Posted 2/25/12 on the Hospitalist Leader
If you have not heard, the NYC Dept. of Education released a report card assessing all of its 18,000 teachers. It is making a lot of noise, particularly here in the city. Read the story, regardless of where you live–it is interesting and a policy exercise that is no doubt, coming to a theater near you.
What is striking, and I allude to it in my title, is the resemblance of the arguments here, as compared to those made by the physician community. The CMS ratings site will ramp up with substantive data in the upcoming decade, and the same fears of inadequate adjustment, sample size, and inaccurate information are front and center:
Continue reading “Swap “Doctor” for “Teacher””
Posted 2/21/12 on Health Populi
IBM is celebrating the first birthday of Watson this week. I had the opportunity to brainstorm some of the short- and long-term meanings of Watson in health care this week at HIMSS 2012 in Las Vegas.
When most people think of Watson, an image of the Jeopardy! game featuring the technology versus the legendary player Ken Jennings comes to mind. However, Watson has the potential to play a transformational role in health care, globally – for population health, and for the patient N=1.
Continue reading “Happy Birthday Watson”
Posted 2/20/12 on the Disease Management Care Blog
As population health providers such as care management vendors, home health agencies, medical homes, accountable care organizations and pharmacy benefit managers strive to increase both the quantity and quality of interactions with their patients, one thing is certain: traditional snail mail and phone calls are no longer equal to the task.
E-mail is an option (even as the lawyers worry about HIPAA and the CIO insists that it happens in a “walled garden“) and then there’s the emerging potential of social media (precontemplation in 140 characters or less?).
But how about cell phone texting?
Continue reading “How Texting Would Work In A Real World Disease Management Program”
Posted 2/21/12 on Health Populi
With $3.1 billion awarded to doctors who are buying and learning how to use electronic health records (EHRs), Secretary of Health and Human Services Kathleeen Sebelius told a Kansas City community college that 41,000 doctors and 2,000 hospitals were on the road to meaningfully using the technology — double the number of EHR users in 2 years.
Continue reading “Glasses Half Full and Empty: EHR Use Has Doubled, But…”
Posted 2/10/12 on Kent Bottles Private Views
Speaker after speaker at the January 26, 2012 Care Innovations Summit in Washington, DC concluded that increasing the quality and decreasing the per-capita cost of health care is the dominant political, social, and economic issue of our time. More than one expert called for a “jailbreak.” Before January 26, “jailbreak” for me meant either an obscure English reality television show or an expression applied to overriding the software limitations deliberately placed on computer systems for security or administrative reasons. The speakers in DC seemed to be calling for a jailbreak out of the prison of the status quo of the American health care delivery system and into an era of digital medicine and understanding the ill patient as a complex emergent system that does not need to be fully understood to be cared for.
Two new books make the case that American medicine is at an inflection point and about to undergo “its biggest shakeup in history.” Eric Topol, MD in The Creative Destruction of Medicine:How the Digital Revolution Will Create Better Health Care (New York: Basic Books, 2012) is no fan of the traditional approach which he labels as “conservative to the point of being properly characterized as sclerotic, even ossified.” David B. Agus, MD in The End of Illness (New York: Free Press, 2011) applies systems biology to his field of oncology and concludes: “Cancer is not something the body has or gets; it’s something the body does.”
Continue reading “Topol & Agus on the Future of Medicine”
Posted 2/9/12 on The Doctor Weighs In
Last fall, I decided to splurge on tuition for FutureMed (FM), Singularity University’s week long celebration of all things cutting edge in healthcare and bioscience. It is only day four of the six day course and already my brain is stuffed with enough info on innovation to last a life time. Just when I think it can’t get any better, FM rolls out a new speaker on yet another mind-boggling topic: cancer genomics, synthetic biology, robotics, the impact of virtual reality on behavior, exponential thinking, and more. Unbelievable…and fun.
We have had the privilege of being inspired by Peter Diamandis, founder of the X-Prize and co-founder (together with Ray Kurzweil) of Singularity University. Paul Yock, MD shared the experience of the Biodesign Department at Stanford and the work he has been doing with young innovators across the globe. Richard Satava blew our minds with health related technology developed at DARPA (unmanned rescue helicopters, unmanned ORs, and other aspects of the hospital of the future) and Amir Belson chatted about some of the 64 medical device companies he has founded, each one bringing to market innovations that change medical practice for the better (a modular endoscope that takes the curves with ease, a sure-fire catheter to get the IV in the first time).
Continue reading “FutureMed: Hanging Out With the Smartest People in Health Care”
Posted 1/08/12 on Forbes
You can’t get much cooler than HealthTap: slick Silicon Valley start-up, social media darling, savvy and successful backers. But when you closely examine the service HealthTap actually provides, the money and good looks fall away. Like in the fable about “the emperor’s new clothes,” behind the buzz, there’s nothing there.
OK, maybe one thing: a really risky way to get medical advice.
Here’s how a Feb. 4 New York Times article described the company’s website:
[U]sers post questions and doctors post brief answers. The service is free, and the doctors aren’t paid. Instead, they engage in gamelike competitions, earning points and climbing numbered levels. They can also receive nonmonetary awards — many of them whimsically named, like the “It’s Not Brain Surgery” prize, earned for answering 21 questions at the site.
Fellow physicians can show that they concur with the advice offered by clicking “Agree,” and users can show their appreciation with a “Thank” button.
Continue reading “HealthTap: The Emperor’s New Clothes of Social Sites”
David C. Kibbe and Brian Klepper
Posted 2/2/12 on the Health Affairs Blog
©2012 Health Affairs by Project HOPE – The People-to-People Health Foundation, Inc.
Americans increasingly distrust what they perceive as poorly run and conflicted government. Yet rarely can we see far enough inside the federal apparatus to examine what works and what doesn’t, or to inspect how good and bad decisions come to pass. Comparing the behaviors of two influential federal advisory bodies provides valuable lessons about how the mechanisms that drive government decisions can instill or diminish public trust.
Continue reading “Trusting Government: A Tale of Two Federal Advisory Groups”
Posted 1/19/12 on Forbes
Great post by Rick Ungar over on The Policy Page. Still, I’m left wondering. It’s an election year and given the stakes, I think we’ll look back on 2012 as the year of the great Healthcare Reform debate – Part 2. What we have today is really just the beginning of a long and winding investment in Healthcare Reform – Part 1. I think the question remains – have we tamed the cost beast with real legislation – or is it just legislation around the edges? Here’s why I’m wondering.
National Healthcare Expenditure – or NHE. Total agreement with Rick that costs are “out-of-control” because our NHE is really $3 trillion – this year. Actually, NHE for 2012 is probably closer to $2.7 trillion but there’s this nagging bookkeeping accrual of about $300 billion where we (narrowly) avoided those darn pesky SGR cuts to Medicare. It’s come to be known affectionately as “doc fix” – and we’ve kicked that can down the road for 9 consecutive years. Maybe we’ll just write it off – and maybe we should – but it’s actually on the books so we can’t just ignore it – can we? That puts the real NHE at about $3 trillion for 2012 (+ about 4% for each year forward – as far as the eye can see). As one economist said – we don’t have a debt problem in this country – we have a healthcare problem.
Continue reading “US Health Care Hits $3 Trillion”
Posted 1/18/12 on Health Policy and Marketplace Review
Insurance exchanges have to be up and running in all of the states by October 2013 in order to be able to cover people by January 1, 2014.
If the states don’t do it, the feds have to be ready with a fallback exchange. States have to tell HHS if they intend to be ready by January 1, 2013.
Continue reading “Will the Feds Be Ready With the Fallback Insurance Exchanges by October 2013?”
Posted 1/17/11 on Disease Management Care Blog
In a yesterday’s post, the Disease Management Care Blog used Edie Weiner’s video presentation on digitization and commoditization to launch into its own version of health care futurism. While it struggled with notions of “opportunity costs,” it concluded that a) highly evolved patient data bases, b) biometric monitoring systems, c) artifical intelligence-based decision support and d) growing consumer acceptance of informatics will make the need for many traditional outpatient visits obsolete.
Thanks to inspiration from the movie Moneyball, the DMCB explains why. The movie chronicles the decision of the Oakland A’s General Manager (or “GM” played by Brad Pitt) to apply a more scientific approach to recruiting players. Eschewing the largely subjective evaluation process used by his veteran scouts, the GM decides to focus on a few key player statistics. As a result, he recruits players with high “on base” metrics and comparatively low salary demands. Success follows, and not only does he build a championship team, but he is offered a job with the legendary Red Sox. There is a telling scene filmed at Fenway Park in which the Sox owner salutes the new revolutionary approach to baseball by giving a small soliloquy on the merits of adapting or dying. Building a winning team is no longer a highly tailored and subjective approach to individual players, but data, information and insights.
Continue reading “The Digitization of Health Information: Why Primary Care Is At A Moneyball Moment”
Posted 1/15/12 on IBM Healthcare Perspectives
In the next 10 years, data and the ability to analyze it will do for the doctor’s mind what x-ray and medical imaging have done for their vision. How? By turning data into actionable information.
For instance, take Watson, IBM’s intelligent supercomputer application. Watson can analyze the meaning and context of human language, and quickly process vast amounts of information. With this information, it can suggest options targeted to a patient’s circumstances. This is an example of technology that can help physicians and nurses identify the most effective courses of treatment for their patients. And fast: in less than 3 seconds Watson can sift through the equivalent of about 200 million pages, evaluate the information, and provide precise responses. With medical information doubling every 5 years, advanced health analytic systems technologies can help improve patient care through the delivery of up- to-date, evidence-based health care.
Continue reading “Now You Have Health Care Data. So Where Does It Go?”
Posted 1/10/12 on MedInnovation Blog
Time is totally irreplaceable. Moreover, time is totally perishable and cannot be stored. Yesterday’s time is gone forever and will never come back.
Peter F. Drucker (1909-2005)
This blog’s genesis is three-fold: one, an article I read by Phillip Betbeze, “Telemedicine as Talent Strategy,” in today’s HealthLeadersmedia.com; 2) an interview I conducted in May, 2010 with Ron Pion, MD, chairman of Telemedicine Associates in Los Angeles , titled “The Internet Lifts All Boats”; and 3) frequent Skype conversations I’ve been having with my son, who lives in Madrid, Spain.
From these encounters, I predict: new sophisticated Internet technologies may be key to enhancing physician productivity.
Continue reading “The Time Has Come: Physician Productivity and Telemedicine”
Posted 1/10/12 on Health Populi
To doctors working in eight countries around the globe, the biggest benefit of health IT is better access to quality data for clinical access, followed by reducing medical errors, improving coordination of care across care settings, and improving cross-organizational workflow.
However, except for the issue of health IT’s potential to improve cross-organizational working processes, American doctors have lower expectations about these benefits than their peers who work in the 7 other nations polled in a global study from Accenture‘s Eight-Country Survey of Doctors Shows Agreement on Top Healthcare Information Technology Benefits, But a Generational Divide Exists. Accenture polled over 3,700 doctors working in Australia, Canada, England, France, Germany, Singapore, Spain and the US.
Continue reading “US Doctors Less Sanguine About Health IT’s Benefits”
If you have an hour to spare while exercising or traveling, make a point to listen to Mike Daisey’s fascinating and moving monologue on this week’s This American Life, describing his amateur investigations into the brutal working conditions in Shenzhen, China’s tech factories. While the focus is on Apple, the same plants make products for most major technology firms: Dell, HP, Samsung, Nokia and so on. It will give you pause about the real price of the tools and toys that we’ve come to rely on and obsess over.