flying cadeuciiCall it a tale of two infections. It’s the story of how hospitals have blocked transmission of a dangerous infection that patients can give doctors, while a hospital-caused infection that can kill patients continues to be widely tolerated. It involves saved lives and endangered ones ­– and also of billions of dollars spent needlessly due to unsafe care.

The infection that’s been conquered is occupational transmission to doctors and other health care workers of HIV, the virus that causes AIDS. When AIDS first burst on the scene in the early 1980s, it was “disfiguring, debilitating, stigmatizing and inevitably fatal,” in the words of Dr. Paul Volberding, a treatment pioneer. With the disease’s spread poorly understood, “the fear of contagion [was] hanging over our heads,” Volberding recalled.

However, once the mode of transmission was identified– exposure to HIV-infected blood or other bodily fluids – precautions were rapidly put into place. From 1985 through 2013, there were just 58 confirmed cases of occupationally acquired HIV infection reported to the Centers for Disease Control and Prevention (CDC), according to a Jan. 9 CDC report. Since 1999, there’s been only one confirmed case of occupational transmission, involving a lab tech infected via a needle puncture in 2008.

Reported occupational infection “has become rare,” the CDC concluded, likely due to prevention strategies and “improved technologies and training.” Continue reading “Safe Doctors, Unsafe Patients: A Tale of Two Infections”

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Screen Shot 2015-01-23 at 9.33.17 PMOf the many hidden gems in the Affordable Care Act, one of my favorites is Physician Compare.  This website could end up being a game changer—holding doctors accountable for their care and giving consumers a new way to compare and choose doctors.  Or it could end up a dud.

The outcome depends on how brave and resolute the Centers for Medicare and Medicaid Services (CMS) is over the next few years.  That’s because the physician lobby has been less than thrilled with Physician Compare, and, for that matter, with every other effort to publically report measures of physician performance and quality.

I’d give CMS a C+ to date.   Not bad considering it’s the tough task.  The agency has been cautious and deliberate.  But after the many problems with Hospital Compare, Nursing Home Compare, Home Health Compare, and Dialysis Facility Compare—not to mention the shadow of healthcare.gov’s initial rollout—that’s understandable.  They want, I hope, to get this one right from the get-go.  And competition from the private sector looms.

Continue reading “What’s Next For Physician Compare?”

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Don’t get lost amongst the 1,200+ exhibitors that will be fighting for the attention of 38,000 or so health IT professionals at next spring’s HIMSS conference. Make sure your brand is top-of-mind before the attendees descend on Chicago April 12-16.

THCB  understands that exhibiting at HIMSS requires a significant financial and time commitment for participating vendors. Our goal is to help organizations maximize their marketing success by sharing their message with the 6,000 THCB readers who visit our site each day.

HIMSS exhibitors wishing to connect with our highly healthcare-centric audience are encouraged to take advantage of one of our HIMSS Specials.

Our sweet marketing packages include:

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For details contact Michelle Noteboom for details on available options and to reserve your spot.

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flying cadeuciiThere are no winners in the fee-for-service game.

It’s time to toss the whole business-as-usual model — for your own good and the good of your customers.

The emerging Default Model of health care — the “consumer-directed” insured fee-for-service model in which health plans compete to lower premiums by bargaining providers into narrow networks — not only does not work for health care’s customers, it cannot work. This is not because we are doing it wrong or being sloppy. By its very nature the Default Model must continually fail to bring our customers what they want and desperately need. Ultimately it cannot bring you, the providers, what you want and need.

Take a dive with me into the real-world game-theory mechanics of the health care economy, and you will see why. It’s time to rebuild the fundamental business models of health care.

Continue reading “Dump the Business Model”

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Jacob RiderI started my blog over 15 years ago.  Yes – it’s been less active in recent years, and as I reflect on why I’ve been less active – only part of the reason is that I was working for a publicly traded company from 2008-2011 .. and a federal agency from 2011 – 2014.  Both of these organizations have reasons to control the messages of their employees.  I needed to be cautious about what I blogged.  So I didn’t blog publicly very much. 

But since November, I’ve had no excuse.  And yet nothing much flowed from these fingertips.  

It should have.  Back in the day – THCB and Docnotes – and a handful of other sites offered bookmarks and observations on health care delivery, the convergence of health care and IT, and random observations.  These days – there is a tidal wave of these things on the Internet. I sometimes question whether MY contributions are of any value now that there is so much out there.  I remember when Dave Winer toyed with killing his blog.  He didn’t.  Nor should I.  This post celebrates the not-killing of my new blog, and the beginning of the NEXT 15 years of my public observations.

Here goes ..

Continue reading “My World in 2015″

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Robert PearlAs CEO and Executive Director of The Permanente Medical Group at Kaiser Permanente, I have been following with interest the exchange between Malcolm Gladwell and Steven Brill, prompted by Gladwell’s critique of Brill’s book (America’s Bitter Pill).  Gladwell accurately points out that the solution to the problems of the American health care system that Brill puts forth in the book are very close to the structure of Kaiser Permanente.  We provide world class hospital and ambulatory care to millions of Americans through our dedicated, physician-led Permanente medical groups, and pay for it through the not-for-profit Kaiser Foundation Health Plan.

Brill dismisses Gladwell’s criticism explaining that “Kaiser Permanente is not the same because it doesn’t have a monopoly, or oligopoly power, in any of its communities. It’s not a teaching hospital. It doesn’t have the network of high-quality doctors, or isn’t perceived to, like New York Presbyterian has in New York or the Cleveland Clinic has in Cleveland.” Continue reading “A Response to Steven Brill”

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AppleHealth

We are still in the dark ages when it comes to health and fitness data. It reminds me of the early 1990s when I had a paper day planner for a calendar, a business card holder for contacts, and a map.

Then along came the Microsoft Outlook and LotusNotes platform. These two platforms slugged it out like Uber verses Lyft. Then Microsoft integrated MS Office with MS Outlook and it was “game over.” I finally had one place to find everything I needed to do 90% of my job.

I’m waiting for that moment to come to the realm of my fitness data. It’s extremely difficult for me to access my medical and fitness data as it is, and yet the recent CES conference presented hundreds of new ways to collect more of my data. There will be wearables, scales, patches, contact lenses, smartphones, watches, etc. Maybe even a drone to fly overhead and watch what I eat for lunch. It is overwhelming. How overwhelming, you ask?

Let’s start with AppleHealth (HealthKit).

There is a reason Apple gave this app out for free on iOS 8.0. I recall getting the Brickbreaker game for free on my Blackberry in 2004. I played it once on a long flight and never used it again.

Continue reading “My Health Data Is Killing Me”

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Flex-IT Bill, Take 2

flying cadeuciiLawmakers re-introduce the Flexibility in Health IT Reporting Act of 2015, which would shorten the 2015 MU reporting period from one year to 90 days. The bi-partisan-supported bill earned quick support from HIMSS, CHIME, the AMA, MGMA, and other professional organizations. The bill was originally introduced in September but it failed to pass.

Given the growing disenchantment with the MU program, look for this bill to pass – and hopefully give a boost to attestation numbers.

Dr. Google Joins DoD EHR Bid

Google teams up with PwC, General Dynamics, and Medsphere in their bid for the Department of Defense’s $11 billion EHR bid.

Google brings name recognition and a reputation for innovation and data security. While the Epic/IBM team has been looking like the front-runner, Google puts the PwC/Medsphere/GD team back in the hunt. For those keeping score at home, other vendors in the mix include Cerner/Leidos/Accenture Federal and HP/CSC/Allscripts.  A June decision is expected.

Continue reading “HIT Newser: The Flex-IT Bill, Take 2 + Dr. Google In EHR Bid”

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Ian MorrisonWhen you hear the word “empowerment,” it’s code for “You’re on your own, pal.”

Health care leaders are starting to recognize that consumers are becoming a major decision-making force. Let’s be clear at the outset: The rise of the consumer is not the panacea that will solve all our problems. It is a reality that hospitals and health systems must respond to. For the foreseeable future, consumers will pay more for health care and be more involved in picking plans, providers and individual treatment options. This development means significant financial consequences for consumers (unlike almost any other developed country).

Providers need to understand the financial predicament of the typical American health consumer and the responses consumers are making in this changing environment. At the same time, with a new congress and a political season of primaries and posturing just around the corner, pundits, politicians and plutocrats need to recognize where consumers are as voters, plan members, employees, patients and family members.

Continue reading “The American Healthcare Consumer”

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flying cadeuciiIn 2015 I think there is a good chance we’ll see a major security incident along the lines of this month’s Sony hack.  This event will be like 9/11, in the sense that there will be a before and an after, and life as we know it will change forever. This has been coming for a long time. We’ll finally see how vulnerable we are and there will be a public outcry, most likely leading to some kind of government action.  Up until now, most incidents have been security breaches of the disgruntled employee and clueless user variety,  which are a huge big deal as far as HIPAA lawyers and privacy advocates are concerned, but not a very real threat to anybody.

This will be the real thing, with potentially disastrous results. I don’t know if this will be an attack on Healthcare.gov by a politically-motivated hacker group. (I’m surprised it hasn’t happened already. ) Or an attack on a academic hospital system designed to acquire potentially valuable patient and research data.  Or a hack of a health insurance company, intended to Wikileak financial and (possibly damaging) patient claims data. For an insurer with a poor track record, this could cause serious problems.

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