Like many of the big ideas that catch on in business, patient engagement is an elusive idea – too often used without much thought and wheeled out at meetings as the dramatic conclusion of a Powerpoint presentation. Too bad most of the people talking about patient engagement don’t have the first idea what they’re talking about. Dr. Rob Lamberts offers us all a little remedial patient engagement training.
“You have to pass the bill so we can find out what’s in it,” Nancy Pelosi once famously remarked. Now that Obamacare implementation is officially underway, it’s become clear that lawmakers may have been – shall we say – a little optimistic about some key assumptions behind the law. Analyst Dan Diamond talked to five health care visionaries, including former CMS head Don Berwick and Washington and Lee professor Timothy Jost, about what they think Obamacare got right and what might need a little gentle tweaking.
A new study published last month finds that misdiagnosis is a serious problem in American hospitals. Could electronic medical records help remedy the situation? Writing from Boston, Evan Falchuck argues that the key to dealing with this problem may be a rethink of how we do medicine in the age of digital health.
Steven Brill’s epic 24,105 word Time cover story on the dark side of hospital charges captured the insanity of the dark side of hospital charges. But are government price controls really the answer? Not so fast, argues Carnegie Mellon healthcare economist Martin Gaynor.
Open source software is everywhere we look. From the hands-free image editor on your desktop to the web-based content management system your IT department uses to manage your website, open source technology is everywhere. It has advantages. It’s cheap. It’s web-based and it’s usually reliable. Shouldn’t open source be radically transforming healthcare in the way it’s saving other industries? Maybe so. Edmund Billings weighs in the reasons open source may turn out to be the HIT giant killer after all.
You’ve seen the chart so many times that your brain no longer even registers it when you see it. Red and blue squiggles trending to infinity. If you’ve opened a textbook or heard a presentation in the last ten years, you’ve seen the infamous health care costs growth chart. A fresh look by data statistician Frank de Libero suggests the messy red and blue squiggles on those charts we were looking at may have been misleading us.
Recent reports that oncologists are denying treatment to Medicare patients are probably just the tip of the iceberg, argues THCB contributing editor Michael Millenson. If past cuts are any guide, we’ll only know how bad things really are years from now, he writes. And that should be cause for real concern.
The new thinking among many experts is that nurse practitioners and physicians assistants should take over many mundane day-to-day tasks to free up doctors for more important work. But many doctors remain violently opposed to the idea. Dinosaur MD offers a cautionary tale.
Steve’s death was a hard one. Facing Stage 2 Hodgkin’s Lymphoma he fought for life using every weapon he could lay his hands on. Herbal teas. Acupuncture. Mysterious elixirs. The one thing he didn’t try? Chemotherapy. With a growing number of patients choosing alternative therapies, the story is a familiar one.
One of the big stories coming out of HIMSS this year is a new star alliance featuring some of the biggest names in health IT. Adrian Gropper argues the effort misses the mark. And that’s a damn pity when real innovation is desperately needed.
The news of a controversial wellness program at CVS led to a media storm with reports accusing the chain of discriminating against employees. Unfortunately, the media got it exactly backwards, argues Greg Juhn. The drug chain has exactly the right idea. So, what’s really going on?
Wisconsin senator Paul Ryan has built a career by standing next to Medicare spending charts and waving a pointer telegenically. When Ryan released his latest plan to save the country by saving Medicare last weekend, the critics were lit. The issue? Parts of the proposal rely on the administration’s approach to insurance exchanges to keep costs down. Which makes sense, argues economist JD Kleinke, after all the whole idea was a Republican idea. But don’t quote us on that.
The current thinking is that new technologies, better information and a more scientific approach to the practice of medicine will let doctors do more than ever before, allowing them to leap tall buildings at a single bound, see record numbers of patients and improve their patient satisfaction scores. And that may well turn out to be true, argues the University of Virigina’s Jeff Goldsmith, but we’re still faced with a problem that is not going to go away until we come up with a solution: a shortage of living, breathing human beings with medical degrees going into primary care.
The Affordable Care Act is now the law of land. Looking for ways to obstruct implementation of the new healthcare law is becoming a cottage industry in some circles. And that’s a crying shame.
Sorry. The real scandal is the healthcare industry’s continued refusal to adopt electronic medical records and other new technologies that could revolutionize care and save tens thousands of lives every year. What’s really going on here? It turns out that the answer isn’t as straightforward as one might think.
The HIT Job (44)
The New York Times investigation on the sketchy influence of federal money in health IT was inevitable from the moment Washington announced it would be paying incentives to drive electronic medical record adoption. Unfortunately, the newspaper’s hard-hitting reporting almost entirely misses the point, argues UCSF’s Bob Wachter.
An early adopter of electronic medical records says enough already. This has gone on long enough. Better technology is indeed the answer. But we have just isn’t good enough. It’s time to roll up our shirt sleeves and get to work, argues Rob Lamberts.
If you want to repair a seriously broken healthcare system, the thinking goes, you need to get at the root of the problem. And chronic disease is one of the best places to start. Convince people to take the steps that can help prevent chronic conditions like diabetes, high blood pressure and stroke and you’re on your way to a solution. There’s only one problem with that, argues Al Lewis. It’s a lot more complicated than they told you.
With frustrated physicians leaving primary care for higher ground in record numbers there are alarming signs that the primary care system as we know it may be about to implode. How can we encourage docs to stay in the primary care game? THCB contributor Dr. Leslie Kernisan has a controversial idea: limit the number of hours that physicians work each week.
Do wellness programs work? Recently, the heretical idea that they might not actually be all they’re cracked up to be has been gaining ground. Faced by mounting evidence that much of what we’re doing in wellness isn’t working very well, a lot of people are sitting down to work on the problem. How to build new programs that do better? Simple technologies and the right data are the answer, argues THCB contributor Mike Miesen.
Transparency may be one the most used buzzwords of our generation. But are new transparency initiatives really making a difference? Should we even be talking about transparency at all? Should we be talking about something else? Carnegie Mellon economist Martin Gaynor explains what’s going on.
With consumers hungry for information on pricing for medical services and politicians writing the T-word into every piece of legislation they can think, we’re asking a lot of transparency. The release of a new report card rating state transparency laws suggests we have a long way to go.
Much has been written about how doctors think. But how do they think about technology? Why do some promising new ideas catch on and others disappear from the scene without a trace? The answer tells us a lot.
As his mother lay dying Journalist Charles Ornstein faced a terrible decision. The experience helped shape his ideas about one of the most controversial areas in health care today.
Glen Tullman’s ouster this past December made headlines and was one of the first signs that the future might not be smooth sailing for the electronic medical record vendors. The critics are being critics. There are still reasons for encouragement, the ex-Allscripts CEO writes in an opinion piece.
Administration Could Do (18)
With millions of Americans nearing retirement age, the healthcare system is ill-prepared with another influx of patients, some critics argue. Throw in a healthcare system in transition, an uncertain economy and a deteriorating safety net and you have downright scary situation. Faced with this crisis, writes Janice Lynn Schuster, the administration should create a national caregiver corps similar to the Peace Corps or Americorps, enlisting Americans to help protect the well being of vulnerable generations. Add technology to the mix and you just might have something. We urge you to sign her petition.
Amazon. ITunes. EBay. Priceline. Welcome to the Golden Age of The Internet Consumer. But plans to market insurance to consumers online as if health insurance coverage were a movie download or a airline ticket to Florida make a flawed assumption, writes James Wilson. Consumers will always make decisions on the basis of cost. The implication? Many of the most vulnerable will remain underinsured.
What skills will doctors need to survive and succeed in the future? At this point pretty much everybody gets that they’ll need to be good with technology. But beyond that? This is what we know: tomorrow’s doctor will need to be comfortable dealing with e-patients armed with information. They’ll need to efficiently communicate and coordinate care with colleagues using new-fangled means. And oh yeah, lest we forget: they’ll need to adapt quickly and to a changing world on a regular basis. Just like everybody else.
What will your doctor look like 50 years from now? We’re hearing some pretty futuristic answers. A robot? An algorithm? A warm and compassionate human being as capable of a group hug as coming up with a data-driven treatment plan? How can med schools and medical educators prepare students for an uncertain future? Jacob Scott, Ali Ansary, and Sandeep Kishore offer a little advice to get started.
Earlier this month Walgreens became the latest retailer to announce that it will be opening in-store clinics where consumers will be able to find services that once upon a time could only be found at their local doctors office. Critics – including your aforementioned local doctor – are wondering about the impact on care. Other analysts see a logical response to the current system’s inefficiencies that might well reduce pressure on an overworked system. Ishani Ganguli, MD walks us through the story.
Why Become A Doctor? (14)
Confronted with stories of burnout, liability issues, student debt and an uncertain forecast for many popular specialties, many young medical school candidates are looking elsewhere. The rules of the game are changing and changing quickly argues the University of Chicago’s Vineet Arora, but the argument for going into medicine is still compelling.
Faced with reports questioning Washington’s support for EMR vendors and suggestions that a lack of regulation may hurt the industry, some critics have called for a rethink of federal support for the electronic medical record industry. But is a time out really the answer? The answer isn’t killing technology. It’s coming up with better technology, respond supporters.
Supporters argue the current generation of electronic medical records only begins to tap the potential of this much-touted and talked-about technology. Doing electronic medical records right may involve taking a new look at how information is structured, argues THCB contributor Leslie Kernisan.
Guess what? It’s not rocket science. The key to building HIT applications that talk to each other may be a bit like working on the relationships in your real life, argues Rob Lamberts. The key to building better healthcare tools may be talking to the people they’re really meant to serve.
Early adopters are high on the data driven-potential of tracking devices and gizmos that let users collect and interpret personal health data. New products are popping up everywhere, from the Apple store to the pages of health magazines. But how many people are really using these technologies? Quantified Selfers argue the numbers are higher. Wired Editor Gary Wolf responds to Pew research on the latest statistics.
HIPAA was supposed to fix a glaring problem. Unfortunately, it created a new glaring problem that may be worse than the one we started out with. Instead of protecting patient privacy and access to care, the law is being used as a weapon. Predictably, some businesses are using the privacy law to deny patients access to their own medical information, stifle competition and control data for their own commercial purposes. Time to figure out what the law is supposed to do and get it right, writes Rob Lamberts.
Under the new health law, the Patient Centered Outcomes Institute – better known by it’s government-issued acronym PCORI – will play a leading role in setting the nation’s research agenda. PCORI’s four advisory panels (patient engagement, disparities, improving healthcare systems and assessment of treatment options) will vote on research priorities in key areas to make sure patient interests are protected, theoretically influencing billions of dollars of government spending. That makes it all the more important that we know who is serving on the panels. The early signs suggest that the institute will need to do more if transparency is the goal argues Michael Millenson.
You actually thought reinventing healthcare was going to be easy? You thought all you were going to need were some cool ideas, better technologies and supportive patients? My friend, allow us to introduce you to the cold hard brick wall of reality. A couple of things you may have neglected to consider. What happens when your cool new technology doesn’t work the way it’s supposed to? What happens when the builder calls to say they’re a month behind schedule? It turns out that reinventing your world can be surprisingly stressful. A progress report from Rob Lamberts.