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Let’s see a show of hands. Who among us, doctor, nurse, patient, family member, wants to give or get health care inspired by a factory—Cheesecake or any other?


I didn’t think so.

True confession: I have never actually eaten at a Cheesecake Factory (hereinafter referred to as the Factory). My wife, Mary, and I did enter one once. We were returning from a summer driving vacation. Dinnertime arrived, and we found ourselves at a mall walking into a busy Factory.

It seemed popular. The wait was long—really long. We got our light-up-wait-for-your-table device. We perused the menu. There was a lot there. Portions seemed gigantic. We looked at each other and, almost without speaking, walked back to the hostess, returned our waiting device and left.

You got me—I cannot say 100 percent that I wouldn’t love Factory food. We were so close that one time!

A young woman in our small New Jersey town recently opened a new restaurant here. We tried it the other night. She and her business partner tended us and all the other patrons with such attention and care. We waited some, true, but she seated us near the bar while we waited—brought over pieces of cheese (no light-up device) for us to enjoy. The menu was ample and varied—not enormous. It’s also true that two items on the menu—including my first choice—were no longer available that evening. The chef however crafted the dishes that we did select with flare and pride. Dinner was a delicious, wonderful, relaxing experience—made better because of the human touch.

It’s probably not fair to contrast my one near-Factory dining experience with this other. Big chain restaurants have clearly figured out a way to provide a consistent meal for millions of satisfied customers. But the Factory way is not for everyone. People, I think, crave customized, attention-to-detail service experiences—in their dining choices. And—I’ll go out on a limb—in their health care too.

Continue reading “Big (Box) Medicine”

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Ceci Connolly

If you’re wearing a wristband that counts your steps, a patch that monitors your vital signs or a watch that tracks your heart rate, you are in the minority. And if you paid $300 or more for any of those items, you are among the nation’s quantified self-health elites.

Judging by the chatter streaming across our social media feeds, one would think every man, woman, child is sporting a health “wearable.” But in reality, these are the early days of the devices that promise to help us live longer, healthier, more active lives.

Despite the buzz, just 21% of Americans own a health wearable, according to a new consumer survey by PwC’s Health Research Institute, and only 10% of them use it daily. Even fewer consumers – 5% of respondents — expressed a willingness to spend at least $300 for a device. Many wearables today are a passing fancy – worn for a few months then tucked away in a drawer awaiting a battery charge or fresh inspiration to get up and get moving again.

As Genentech CEO Ian Clark recently put it, health wearables are “a bit trivial right now.”[1] And it seems even the folks claiming to be wearing the devices can’t be trusted – reports have begun circulating of employees enlisting their more active coworkers to wear the device and collect fitness points on their behalf.

Yet wearables present remarkable opportunities for a nation and industry grappling with the twin challenges of improving health and controlling healthcare spending. Across the board, consumers, clinicians, insurers and employers express high hopes for the power of these new devices.

Continue reading “The Self-Health Era”

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Screen Shot 2014-10-29 at 10.05.05 AMHealth 2.0 announces the inaugural event, WinterTech: The New Consumer Health Landscape on January 15th, 2015 during JP Morgan Week in San Francisco, CA. Industry leaders Walmart, Samsung, Target, Qualcomm Life, MyFitnessPal and many others will discuss major digital health themes in the marketplace such as: investing in consumer health, the new role of retail environments in health care, new platforms and interfaces for personal health, the informed health care consumer, and how consumer data is contributing to new clinical insights.

Participating organizations and speakers at WinterTech include:

Ben Wanamaker (Walmart)
Bakul Patel (United States Food and Drug Administration)
Rick Valencia (Qualcomm Life)
Tara Montgomery (Consumer Reports)
Karan Singh (

Agenda highlights include:

Consumer Data Powering Clinical Insight: The tools and services that are shaking up data collection and analysis to provide actionable insights and more personalized health care. With Rick Valencia (Qualcomm), Bakul Patel (FDA), Karan Singh (, and Amanda Cashin (Illumina).

New Platforms and Interfaces for Personal Health: Samsung, Nick Crocker (MyFitnessPal), Jim Taschetta (iHealthLabs), David Donovick (Pivotal Living), and Lena Cheng (Doctors on Demand) discuss and analyze the newest tools and platforms in health and wellness as both familiar favorites and new players make ventures into this exploding market.

Investing in Consumer Health Care: An indepth discussion with health care investors including Lisa Suennen (Venture Valkyrie Consulting) and Casper deClercq (Norwest Venture Partners).

Revolutionizing Retail for Better Health Care Experiences: Ben Wanamaker (Walmart), Joshua Riff (Optum), and Target discuss the integration of health care into the retail environment both online and in person.

The Informed Health Consumer: The tools and resources educating and empowering consumer health care decision making. Hear from Tara Montgomery (Consumer Reports), Heather White (Environmental Working Group), Alex Postman (SELF Magazine), Thomas Goetz (Iodine), Ari Tulla (BetterDoctor) and moderator Dr. Robin Berzin.

“It’s impossible to understand the impact of this new class of consumer health technologies without understanding the larger economic and demographic shifts affecting the nation at large” said Health 2.0 CEO, Indu Subaiya. “From retail and media, to employers and consumer associations, WinterTech will examine the opportunities that arise from new distribution channels and business models that can take this innovation mainstream.”

Most details, including the agenda and registration can be found on the WinterTech website.

About WinterTech
WinterTech focuses exclusively on the consumer health tech landscape from the perspective of leading tech companies, retailers, investors, and the media. As new partnerships and opportunities emerge across many different sectors during a changing era of digital health and wellness, WinterTech aims to gather the industry leaders and consumers to facilitate impactful change.


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Screen Shot 2014-10-28 at 9.34.48 AMThe Ebola crisis in Texas has tested our nation’s health care system in many ways, exposing weaknesses and potential breakdowns. In particular, the incident with the first diagnosed Ebola patient at Texas Health Presbyterian underscores a fundamental issue with information liquidity between providers, their care teams, and across the continuum of care. The ability to share information effectively is critical not just in responding to health care crises like Ebola — but also in delivering great, cost-effective care.

As athenahealth CEO Jonathan Bush said in an interview with CNBC earlier this month: 

“The worst supply chain in our society is the health information supply chain. It’s just a wonderfully poignant example, [a] reminder of how disconnected our health care system is. … The hyperbole should not be directed at Epic or those guys at Health Texas. The hyperbole has to be directed at the fact that health care is islands of information trying to separately manage a massively complex network.”

Continue reading “Ebola and the Information Flow Challenge”

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IntersystemsLike far too many women, I know what it means to confront the prospect of breast cancer. I spent the better part of a year in watchful waiting for what eventually proved to be a benign lump. Some of my friends participate in randomized clinical trials in hopes of being among the first to benefit from a promising new therapy. Some have passed away.

All have faced agonizing challenges sorting through options and confusing medical jargon, poring over statistical data they may or may not understand, and trying to reach a treatment decision in the midst of their fear.

A recent observational study reported in The Journal of the American Medical Association (JAMA) compared survival rates for several different treatment approaches to breast cancer. The primary finding picked up in the press was that the long-term survival rate for women undergoing bilateral mastectomy was not statistically different than that for women who chose lumpectomy and radiation.

I’m not going to outline the entire study – there are a number of good summaries available elsewhere. What particularly caught my interest was the way the study was conducted.

What excited me about the new study is that it is a terrific example of the secondary use of data for informatics-based clinical research. That is, information captured as part of the normal care process for a single patient is combined with information from an entire population segment in order to compare clinical alternatives. Continue reading “The Promise of Informatics-Enabled Research: The California Mastectomy Study”

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flying cadeuciiThe recent Ebola cases and fatality have triggered a collective process of finger pointing as we struggle to understand events and hold someone accountable.

Hence, the television footage of health officials hauled off to Congress, accusatory headlines (“Alarming stumbles by the C.D.C.”) and appointment of czars. In the desire to pin the blame somewhere, notably the Centers for Disease Control and Prevention (CDC), we overlook the essential fact that in the United States public health responsibilities are fragmented among federal agencies, and decentralized throughout state and local government. The laws and regulations governing public health activities at federal, state and local levels is truly wonky terrain, but understanding these details is critical to being able to improve our response to public health emergencies. We need to know who actually has the authority to deal with specific public health functions and who should be held accountable (spoiler alert – it is not the Czar, nor the Secretary at DHHS, nor the Surgeon General, nor the Director of CDC). Often, it is a state health official, local health official or professional organization. Continue reading “Who Do We Blame Now?”

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flying cadeuciiWith ICD-10 still looming and value-based payments and penalties on the horizon, U.S. hospitals need strategies to tackle the “triple threat” of financial, operational and clinical challenges these transitions present. Summit Health implemented an end-to-end clinical documentation improvement process to address all three main challenges holistically.

In healthcare, we know it’s better to be proactive. Reducing stress, watching your diet and exercising to prevent a heart attack is a proactive approach instead of undergoing a triple bypass after the attack hits. Doctors see warning signs, like high cholesterol and blood pressure, take proactive measures and put patients on a care plan to prevent a cardiac event. For Summit Health, the ICD-10 requirement was our warning sign and the reason we took proactive measures early on. We knew we had to take dramatic steps to not just meet ICD-10 requirements, but to also prepare for the inevitable and much-needed transition to a value-based system that could significantly impact our bottom line. To stay ahead of the game, we charged forward with a vigorous, preemptive strike to ensure our clinical documentation process set up to succeed in any payment model and any number of coding changes.

Continue reading “The Rx for ICD-10 and the Threat of Inaccurate Documentation”

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Screen Shot 2014-10-27 at 3.03.00 PMThe American Heart Association is constantly looking for new ways to improve upon our scientific conferences. So, we are proud to announce the new AHA Scientific Meeting tagline: Expect big things from YOUR AHA Scientific Events. You Ask. We Listen. We Deliver.

What does this new tagline mean to the thousands of healthcare professionals who attend our AHA scientific events? It is our promise to the global cardiovascular healthcare community that we are listening to what you have to say. We promise to deliver enhancements that will make our scientific meetings convenient and mobile-friendly, while offering what the American Heart Association has always been known for: presentation and discussion of the very best in cardiovascular science.

So I encourage you to comment on our scientific meetings and we will continue to deliver results. I look forward to seeing you all at Scientific Sessions 2014 in Chicago, from November 15th-19th.

Learn more and register at

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If First You Don’t Succeed

Amidst recent criticism that ACOs are failing to control costs, HHS announces an $840 million initiative designed to improve patient care and lower costs. The Transforming Clinical Practice Initiative will provide 150,000 clinicians with incentives and tools to “encourage doctors to team with their peers and others to move from volume-driven systems to value-based, patient-centered, and coordinated health care services.” Sounds a lot like the goal for ACOs, which HHS hoped would help providers to “work together to provide higher-quality coordinated care to their patients, while helping to slow health care cost growth.”

DeSalvo and Reider exit the ONC

Karen DeSalvo, MD, the national coordinator for health information technology for HHS, steps down from her post just 10 months into her job to assume the role of Acting Assistant Secretary of Health to address “pressing public health issues,” including the Ebola outbreak. The same day Deputy National Coordinator Jacob Reider, MD announced that he would also leave the ONC at the end of November. The ONC’s COO Lisa Lewis will serve as Acting National Coordinator. The changes comes at a time when critics are asking tough questions about the government’s Meaningful Use program and providers’ lackluster progress qualifying for Stage 2.

Epic, Ebola, and (legal) Payola

Epic President Carl Dvorak stands behind his company’s EMR and blames Texas Health Presbyterian clinicians for the mishandling of the country’s first Ebola patient. Meanwhile, the health system’s Chief Clinical Officer Daniel Varga, MD tells a Congressional committee that his organization is “deeply sorry” for “mistakes.” In unrelated Epic news, the company discloses it spent $24,000 over the last two months lobbying Congress. Epic is in the running for the Pentagon’s $11 billion EMR contract and fighting criticisms that its platform lacks interoperability.

Continue reading “Health IT Highlights from the Past Week”

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