Wednesday, February 20, 2019
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Innovation Amidst the Crisis: Health IT and the Opioid Abuse Epidemic | Part 4 – Resource Allocation and Access

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By COLIN KONSCHAK, FACHE and DAVE LEVIN, MD 

Dave Levin
Colin Konschak

The opioid crisis in the United States is having a devastating impact on individuals, their families, and the health care industry. This multi-part series will focus on the role technology can play in addressing this crisis. Part one of the series proposed a strategic framework for evaluating and pursuing technical solutions.

A Framework for Innovation

In part one of our series, we declared the opioid crisis an “All Hands-On Deck” moment and made the case that health IT (HIT) has a lot to offer. Given the many different possibilities, having a method for organizing and prioritizing potential IT innovations is an important starting point. We have proposed a framework that groups opportunities based on an abstract view of five types of functionality. In this article, with an assist from Dr. Marv Seppala, Chief Medical Officer at the Hazelden-Betty Ford Foundation and Dr. Krista Dobbie, Palliative Care physician at the Cleveland Clinic, we will explore allocation of resources and access to care and the role that technology can play.

Resource Allocation and Access for Opioid Management

Innovation Amidst the Crisis: Health IT and the Opioid Abuse Epidemic | Part 3 – Clinical Decision Support

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By COLIN KONSCHAK, FACHE and DAVE LEVIN, MD

Dave Levin
Colin Konschak

The opioid crisis in the United States is having a devastating impact on individuals, their families, and the health care industry. This multi-part series will focus on the role technology can play in addressing this crisis. Part one of the series proposed a strategic framework for evaluating and pursuing technical solutions.

A Framework for Innovation

As noted in part one of our series, we believe the opioid crisis is an “All Hands-On Deck” moment and health IT (HIT) has a lot to offer. Given the many different possibilities, having a method for organizing and prioritizing potential IT innovations is an important starting point. We have proposed a framework that groups opportunities based on an abstract view of five types of functionality. In this article we will explore the role of technologies that provide clinical decision support.

The Power & Perils of Unconventional Healthcare Partnerships

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By LYGEIA RICCIARDI Lygeia Ricciardi

Last week’s announcement by Aetna and Apple of their Attain “experience” designed to enable Aetna members to achieve better health using the Apple watch was the latest in a series of partnerships vying to shake up healthcare from an unconventional angle. Others include Amazon-Berkshire Hathaway-JP Morgan’s collaboration to reshape health insurance, and Uber and Lyft’s numerous partnerships with Sutter, CareMore Health, and other healthcare systems to address transportation challenges for patients.

The Heat is On

Big changes in healthcare—including the shift to value-based care, the growing influence of consumerism, and a recognition that health outcomes depend on a wide array of everyday life factors ranging from foods to moods—are forcing the old guard in healthcare to recalibrate. Healthcare provider organizations alone engaged in a record-breaking 115 mergers and acquisitions in 2017, and continued apace until now, with deals already announced in 2019 between Dignity Health and Catholic Health Initiatives (CHI), among others.   

The most interesting partnerships, from my perspective, pair traditional healthcare players with non-traditional ones: it’s a recognition that something fundamental has to change, a point which hasn’t been lost on the 84% of the Fortune 50 companies that are already in healthcare, up from 76% in 2013. Everyone from tech giants to car manufacturers seems to gambling to some extent on healthcare. And why not, when the potential jackpot just keeps growing?

Innovation Amidst Crisis: Health IT and the Opioid Abuse Epidemic | Part 2 – Fostering Situational Awareness

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By COLIN KONSCHAK, FACHE and DAVE LEVIN, MD

Dave Levin
Colin Konschak

The opioid crisis in the United States is having a devastating impact on individuals, their families, and the health care industry. This multi-part series will focus on the role technology can play in addressing this crisis. Part one of the series proposed a strategic framework for evaluating and pursuing technical solutions. 

A Framework for Innovation

Deaths from drug overdoses in the United States jumped nearly 10 percent last year, according to recent estimates by the Centers for Disease Control. One major reason for the increase: more Americans are misusing opioids.

Health IT (HIT) can play a pivotal role in addressing the opioid-abuse epidemic. To maximize impact, however, we believe it’s essential to organize and prioritize IT innovations and approaches. In part one of this series, we proposed a conceptual framework that sorts opportunities based on five types of functionality. In this article, we will explore one of these categories: technologies that enhance situational awareness.

Innovation Amidst the Crisis: Health IT and the Opioid Abuse Epidemic | Part 1 – A Strategic Framework

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Colin Konschak
Dave Levin

By COLIN KONSCHAK, FACHE and DAVE LEVIN, MD

The opioid crisis in the United States is having a devastating impact on individuals, their families, and the health care industry. This multi-part series will focus on the role technology can play in addressing this crisis. In this article, we propose a strategic framework for evaluating and pursuing technical solutions. Future articles will explore specific areas and solutions within this framework.

A Full-Blown Crisis

One of the authors recently had the opportunity to participate in a multi-stakeholder workshop in Cleveland, OH dedicated to finding new, collaborative approaches to addressing the nation’s opioid abuse epidemic. While Ohio might be considered ground zero for this epidemic, the evidence is clear that this is a national crisis and it is getting worse. The numbers are frightening, especially the 2016 estimate that 2.1 million people misused opioids for the first time.

Given the statistics, it is likely that many of you have been personally touched by the epidemic.

In our experience, successful improvement efforts in health care almost always address the role of people, process and technology. Strategic innovations aimed at the opioid abuse crisis should account for all three of these in a holistic manner. Innovation should be pursued as a series of practical experiments that address current gaps, result in near-term improvement, provide insights for future tests of change, and lead to a set of sustainable and scalable solutions that will be essential to ensuring long-term success in addressing this enormous problem.

Checking Boxes

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By HANS DUVEFELT MD Dr. Hans Duvefelt, A Country Doctor Writes, physician burnout

I pay $500 per year for UpToDate, the online reference that helps me stay current on diagnostic criteria and best treatment options for most diseases I might run into in my practice. They also have a rich library of patient information, which I often print out during office visits.

I don’t get any “credit” for doing that, but I do if I print the, often paltry, patient handouts built into my EMR. That was how the rules governing meaningful use of subsidized computer technology for medical offices were written.

If I describe in great detail in my office note how I motivated a patient to quit smoking but forgot to also check the box that smoking cessation education was provided, I look like a negligent doctor. My expensive EMR can’t extract that information from the text. Google, from my mobile device, can translate between languages and manages to send me ads based on words in my web searches.

When I do a diabetic foot exam, it doesn’t count for my quality metrics if I freetext it; I must use the right boxes. If I do it diligently on my iPad in eClinicalWorks, one of my EMRs, even if I use the clickboxes, it doesn’t carry over to the flowsheet or my report card.

Watch This Space: 3 Phenomena That Will Drive Health Care Innovation in 2019

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By REBECCA FOGG Rebecca Fogg

Back at their desks after the holidays, health care payers, providers and policymakers across the country are staring down their list of 2019 priorities, wondering which they can actually accomplish. Innovation to improve care quality and reduce costs will top many lists, and progress on this front depends, in no small part, on conditions for such innovation in the health care marketplace. Here are three phenomena unfolding there that I’ll be following closely this year to understand what innovators are up against, and how they’re responding.

  1. The legal battle over the Affordable Care Act (ACA). Over 20 million previously uninsured Americans acquired health insurance between 2010 and 2017, many due to the ACA’s premium subsidies, ban on pre-existing condition restrictions, and Medicaid expansion. At the most fundamental level, this coverage expansion has vastly improved one of the most important conditions for a healthy population—access to health care. But it also supports innovation toward better, more affordable care.Coverage expansion means providers get reimbursed for more of the care they deliver to patients who are unable to pay, which strengthens their financial position. It also enables some patients to maintain more continuous health insurance coverage, hence see a doctor more regularly over time. This, in turn, facilitates providers’ development of more effective approaches to management of long-term, chronic disease, which causes untold suffering and costs the U.S. hundreds of billions in direct medical costs.

Health in 2 Point 00, Episode 67 | uBiome, Planned Parenthood and Lively

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On Episode 67 of Health in 2 Point 00, Jess is appalled at the CDC’s salmonella warning for hedgehogs. But in other news, Jess asks me about uBiome, which has raised over $100 million, laying off over 50 people; Planned Parenthood’s new chatbot that helps answer teenagers’ questions about sexual health; and Lively’s recent $16 million raise for their telehealth hearing assessment platform. Don’t forget to stop by our booth at HIMSS in 2 weeks! —Matthew Holt 

Overprescribing Is a Key Component of the Opioid Crisis — Here’s How to Stop It

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By DAVE CHASE 

Today’s opioid crisis is one of the most dire side effects driven by our dysfunctional U.S. healthcare system. A recent JAMA Surgery report found that many surgeons prescribe four times more opioids than their patients use. This opens the door for misuse and abuse later on. In fact, the total combined cost of misuse, abuse, dependence and overdose is about $78.5 billion.

Unfortunately, there’s a direct connection between the low-quality care many patients receive, and the astounding rates of opioid addiction. Often, insurance plans offer access to high-cost, volume-centric physicians and include high deductibles — creating an expensive cycle that doesn’t focus on patient outcomes. Instead of taking the time to figure out what is actually ailing a patient, these overworked and nearly burnt-out doctors get them in and out the door with a referral and a prescription for more pills than they could ever need.

What may surprise you is that employers play a large part in setting the stage for addiction. Millions of Americans get their health insurance from their employer, and a majority of those plans are fully-insured. To determine what insurance plan they offer, employers work with a benefits broker to purchase one from a carrier like Aetna or Cigna. Each year, employers and their broker join together for an annual dance — the broker tells them that healthcare costs are rising so their insurance rates have gone up, usually by 5-20 percent. The employers don’t know better than to accept these increases, filtering them down to employees in the form of higher premiums. Despite costs constantly going up, the quality of care does not follow.

Radiology Firing Line | Meet the Patients

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By SAURABH JHA SAURABH JHA

Should Radiologists talk with Patients? In this episode of Radiology Firing Line Podcast, Ian Amber MD, assistant professor of radiology at Georgetown University advocates for patient interaction.

Listen to our conversation here.