By John Halamka
During the decade I’ve been CIO, IT operating budgets have been 2 percent of my organization’s total budget, which is typical for the health care industry.
During the same period, IT budgets for the financial services industry have averaged 10 percent or higher.
Since 1998, I’ve often been told that Healthcare IT needs to take a lesson from the financial folks about doing IT right.
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It appears that at least the first phase of personal health record (PHR) certification from CCHIT (Certification Commission on Health Information Technology) will focus on a narrow set of attributes. CCHIT Chairman Mark Leavitt told a group earlier this month that the first set of PHR standards will focus primarily on privacy, security and interoperability.
Leavitt indicated that functionality standards would initially only address what functions are needed to support privacy, security and interoperability. I asked him the following question: Given that what many consumers need to know is how useful would different PHRs be to helping them and their families manage their health, wouldn’t it make sense to include a broader assessment of functionality in CCHIT’s PHR certification?
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A huge bailout is being planned in Washington to avert a calamity that was brought about, in large measure, by the financial system operating the way financial operators told us it was supposed to function. The money is needed, we are told, to bail out the financiers who assured us — up until just a couple of weeks ago — that the system they operated was sound and would need no rescue.
What is the likely spill over to health care from the misbehavior of the financial system’s owners, operators, and managers? I’m going to suggest there are likely to be both direct and indirect effects. One of the indirect effects is that we may lose faith in doctors, nurses, and hospitals, or at least come to suspect that the practice of their craft and trade is not aligned with their espoused principles of "doing no harm" and acting in our best interests.
A heads up for THCB readers – if you’re thinking of attending Health 2.0 and still haven’t signed up for
your pass, you may want to think about acting now. Our last two events
sold out well in advance and we are again closing in on a sellout. Only
about 100 passes remain. Reserve yours today.
AGENDA ADDS:
Vita Cassese, VP, Worldwide Business Innovation, Pfizer
Scott Heimes SVP, Consumer Solutions, OptumHealth
Adam Bosworth, CEO, Keas
The WALL STREET JOURNAL’S Chris Lawton will interview athenahealth CEO
Jonathan Bush for the three Health 2.0 CEO’s panel on Tuesday. Brought to you by Johnson + Johnson.
Michael Millenson will interview Healthgrades CEO Kerry Hicks
Ex-WSj’er David Hamilton will interview Sermo CEO Daniel Palestrant.
EDELMAN will unveil the Edelman Health Engagement Barometer — new
findings from a landmark global study defining New Health Info-entials,
what their health hot buttons are, and how and where they want
companies and brands to engage with them.
UPDATES: We welcome
our latest sponsors – Medical Marketing & Media, RelayHealth,
Navigenics, Silverlink Communications and OptumHealth.
MEANWHILE: Esther Dyson talked recently to the Organized
Wisdom Blog about why she’s an active investor in Health 2.0
companies, including PatientsLikeMe, Organized Wisdom and 23andMe.
"The
thing that excites me the most." Dyson told OWB "is all the research
and discoveries that are being made around genetic information. That’s
just part of something even broader, which is – there’s gonna be a lot
more information available. We’ll be able to understand the impact of
treatments, and the relation between treatments, conditions,
environment…We’re gonna know a ton more."
Dyson had this to
say about the evolution of health search, considered by many observers to be the key economic driver of the online healthcare business … "right now you’re reading a
lot about behavioral targeting of advertising; the notion is: You track
someone’s behavior online, you collect a lot of data and you can show
them more relevant ads. Imagine if, instead of tracking someone online
without them necessarily knowing, you could ask someone, "Will you give
us your health information?"
"Then, instead of showing you more
relevant ads, we can also show you more relevant content. And ideally,
there’s a difference between, "Oh, this guy goes to the travel site,
let’s show him an airline ad,"…. and the guy who, in some form, tells
the system, "Oh, I’m traveling to Paris next week," and you can show
him an offer for 20 percent off on a flight to Paris. That is not
targeting, that’s actual personalization of the message to the person’s
specific circumstances…."
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A couple of weeks ago I did a post, The
Pretend Presidential Debate on Health Care–The Health Care
Press Needs
to Force the Presidential Candidates to Get Real on Health Care
"Change".In it I made the point that facing a $500 billion
budget deficit next year, the sunset of the Bush tax cuts in 2010,
fixing the alternative minimum tax problem once again, and the cost of
the Freddie and Fannie bailout, the presidential candidates needed to get real abouthealth care reform. Instead of giving us their rote health care talking points, I said they needed to start telling us how they were really going to deal with health care reform in the face of all of these challenges.Just when you think things can’t get any worse….Two
weeks later you can add the AIG bailout and as much as a $700 billion
bailout of the financial system now being considered by the Congress to
the reasons why the health care plans of both candidates are no longer relevant.
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Last week, came the announcement that Suzanne Delbanco, founding director of the Leapfrog Group, has assumed the presidency of a company that tracks compliance with safety and quality practices via remote video. Big Brother, meet the Joint Commission.
The report, in Modern Healthcare, describes the process this way:
Video auditing refers to a system in which cameras are mounted in targeted locations to continuously capture specific clinical processes, such as observing handwashing and hand-sanitizing stations. [Using video] fed through a Web-based link, independent, third-party observers audit the recordings and provider reports on safety incidents.
Did you ever doubt this was coming? Virtually every other industry with compliance standards has long used video to monitor compliance and to goose workers into following the rules. If video surveillance is good enough for Vegas croupiers and Kansas meat packers, why wouldn’t it be good enough for neonatal nurses and ER docs?
Last week, Congress got a step closer to passing a Mental Health Parity bill after years of debating the issue. The bill would require insurance companies to provide the same coverage for physical and mental ailments.
For more than a decade, both houses have passed different versions of the legislation only to see it fall apart at the end. The biggest hiccup now seems to be that the bill doesn’t specify which mental disorders it will include.
The unintended consequences of fully covering services for autism, schizophrenia, bipolar and other mental disorders would be a skyrocket in the price of insurance premiums. That’s what critics warn.
Patient advocates argue that mental illness is as real as physical illness. Bipolar disorder is no different than diabetes in terms of its need for chronic, close management. So why should people with a mental disorder be discriminated against and forced to bear a heavier financial burden, which could derail any possibility of them leading a healthy and happy life?
The growth of the e-Patients movement may be experiencing surprising strength from a completely unexpected source, with many people growing the ranks of the movement because of the greatest motivator of all: saving money.
Clay Shirky’s cognitive surplus observation, made in April 2008, keeps on resonating as I see more and more evidence that, contrarily to what some naysayers would want us to think, the internet and social media are fundamentally important to a significant percentage of Americans looking for answers about wellness or sickness, health or disease.
In his speech Shirky noted :
"The value in media is no longer in sources but in flows; when we pool our cognitive surplus, it creates value that doesn’t exist when we operate in isolation. The displacement of TV watching is coming among people who are using more of their time to make things and do things, sometimes alone and sometimes together, and to share those things with others."
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A group of powerful women have joined forces to add their voices and shape the dialogue about health care issues through a new blog, Disruptive Women in health care.
The site is intended to be "a springboard for fresh ideas in health care," says Robin Strongin, president & CEO of Amplify Public Affairs in Washington, D.C.
The blog launched yesterday at the National Press Club, and today you can read posts by Google Health’s Missy Krasner about making health reform pertinent to the average person. Stephanie Mensh, co-founder of stroke survivor, writes about why Sarah Palin’s fake stance on supporting families with special needs makes her mad. And Glenna Crooks, president of Strategic Health Policy International, Inc. talks about why pharmacists need a larger role in health care delivery.
"My vision of a disruptive woman is someone who not only sees a problem, but jumps in to correct it. She does so with guts and spunk and is not afraid to shake up the status quo," said Strongin, a twenty-five year health care veteran, "Each of these women brings a unique perspective, years of hands on experience, and a track record of speaking up, speaking out and making change."
Esther Dyson explains why she believes Health 2.0 companies, such as Organized Wisdom are a great investment. Dyson has been an early investor and guiding influence on many technology start-ups, including including 23andMe, Medstory (which was acquired by
Microsoft), PatientsLikeMe, Meetup, and Flickr and Del.icio.us (which both
were acquired by Yahoo!)
UPI reports on a free online tool, the CaP Calculator, designed to help clinicians bring more personalized medicine regarding prostate cancer. Here’s the group’s missions statement: "The purpose of CaP Calculator is to provide a user-friendly resource that promotes thorough, educated discussion of prostate cancer risk and outcomes between health care professionals and patients."
Healthfinder.gov launched a redesign that aims to help consumers find better information faster. The site uses everyday language to explain maladies, and steps for prevention, as well as offering users the chance to personalize it for their needs.
MedHelp.org and Drugstore.com teamed up to launch a new online feature called Ask-a-Pharmacist and is the first to focus solely on medications. In the online forum, pharmacists will answer questions related to brand drugs, generic equivalents, common uses, drug
therapy, drug interactions, possible side effects and more.
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