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Month: September 2010

Health 2.0 Europe: Seach and Content

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At the Health 2.0 Europe Conference, April 6-7, 2010, in Paris France, a number of panelists gave live demonstrations in regards to search and content. They discussed the question of how to make content on the internet useful and personalized for patients and consumers. The panelists showed different ways for finding information, finding the right information, and finding good quality information. On the panel were Segolène Ayme from Orphanet, Frankie Dolan from MedWorm, Célia Boyer from Health On the Net Foundation, West Shell from Healthline Networks, Steven Krein from Organized Wisdom, and Berci Mesko from Webicina.

Independent Advisors Prove Independent

Reasons for the tougher regulatory environment, according to Baghdadi? “First, the FDA is bringing more drugs in front of advisory panels due to changes in FDA law that require most new drugs to be reviewed by outside experts,” the article notes. “Second, stricter conflict of interest rules implemented by FDA (in the wake of the 2007 reform law) have made it more difficult for the agency to recruit experienced panel members.”

If inexperienced members without conflicts of interest are more prone to voting no, how does that explain 2007, when the current rules weren’t in place and there were still 50 percent “no” votes?Continue reading…

Beyond Meaningful Use: Three Five-Year Trends in the Uses of Patient Health Data and Clinical IT

Finally, we have a Final Rule on the Medicare and Medicaid EHR incentive programs. The rules and criteria are simpler and more flexible, and the measures easier to compute. But they are still an “all or nothing” proposition for physicians, who will have to meet all of the objectives and measures to receive any incentive payment. Doctors who get three-quarters of the way there won’t receive a dime. And a lot of uncertainty remains about dependent processes that CMS and ONC must quickly put in place, like accreditation of “testing and certifying bodies,” and the testing schemas for certification. All in all, we expect most physicians in small practices to sit on the sidelines until the dust settles, likely in 2012 or 2013.

Nevertheless, while it is good to get Meaningful Use behind us, it may be better still seeing beyond it. After all, the incentive payments for becoming a “meaningful user of certified EHR technology” are merely a small down payment on the savings that could be realized if health care supply, delivery and payment are affected by the changing policy and market environments over the next 5 years. The EHR incentive programs are meant to prime the pump by putting approximately $25 billion, give or take a few billion, into the hands of physicians and hospitals who adopt EHR technology during the 5 years between 2011 and 2016.

During that same time, by comparison, reductions in waste, duplication, and unnecessary procedures might mean savings of $100 billion to Medicare alone,# depending on whose estimate you believe and how effective you think the reforms will be in replacing payment for volume with payment for value. It might be a lot more. Conservative estimates are that 30% of our total national health care expenditure of $2.5 trillion, or over $800 million, is unnecessary and could be eliminated through real reforms. Some authoritative estimates argue that half or more of care costs are unnecessary, so the target jumps to $1.25 trillion a year.

Continue reading…

Remembering the Tonsillectomy Riots

Picture 7The humble tonsillectomy has been at the center of controversies over practice variation, inappropriate surgery and avoidable harm for decades; indeed, well before the terms to describe those problems were formally articulated.  Now, thanks to the recently unearthedTonsillectomy Riots of 1906, you can add “patient empowerment” and “informed consent” to that list.

Tablet, an online magazine of Jewish news and culture, rescued theTonsillectomy Riots from historical obscurity. Piecing together old newspaper accounts in English and Yiddish, the magazine told what happened on New York’s heavily Jewish Lower East Side on a steamy day in June when “50,000 immigrant mothers descended on their local public schools demanding to see their children, having heard that there was a Board of Health-sanctioned child slaughter taking place.”Continue reading…

Getting Social

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Moving to the south is an eye-opening experience.  First, there’s the friendliness of everyone; I remember the first time a stranger talked to me in the grocery store, it made me nervous.  In Philadelphia, where I went to med school, anyone talking to you in the grocery store was either hitting on you or crazy.  Add to that list: “or from the south.”

Then there’s the politeness factor.  Kids are expected to say “yes sir” and “yes ma’am” when answering questions asked by adults.  Most northern-bred transplants to the south that I’ve talked to think this is a good thing – a refreshing change from the rudeness you often get from kids.

But perhaps the most foreign thing in coming to the south is something called “Social.”  Social is a manners school where kids are not only taught how to eat right at the dinner table, but also how to address members of the
opposite sex and to perform various dances with a partner.  The formal training happens around 6th grade, but the talk of who will get partnered with whom is fodder for many parental discussions for several years leading up to the actual course. Parents arrange partnerships between their children – kind of like arranged marriages.  My two oldest kids participated in Social (which is run by a local family), and gave it mixed reviews.  We didn’t force it (although we did get calls regarding our kids’ availability), and one of them liked it enough to do it three years, while another barely tolerated one.

All of this came to mind because of a phone call I got this morning requesting an interview about social media and the medical field.  How are doctors handling blogs, Twitter, and Facebook?  What are the guidelines I abide by, and should the professional societies (AMA, ACP, etc)  be involved it directing their members on how to use social media? The interview was particularly timely because I was working on a post that quoted some funny patient/doctor interactions, but was having second-thoughts due to confidentiality concerns. How do I quote patient interactions without making it sound like I’m making fun of them?

Continue reading…

Dipping Into the Waters of Mobile Health

The concept of mobility in healthcare is nothing new to providers, vendors, and to Chilmark Research alike.  The current media and investor buzz surrounding mHealth stems from the belief that   1) mobile technology has finally matured to a point where age-old healthcare processes can finally be revamped; and 2) mobile technology has not only matured but has actually been adopted en-mass by physicians and shows no signs of abating.

Doctors Love Smartphones, but are GaGa over the iPad
Recent reports from SpyGlass Consulting and Manhattan Research show that the vast majority of physicians already use smartphones. Pamela Dolan at the AMA has a nice commentary on these latest numbers.   Chilmark Research’s recent talks with industry folks shows that the iPad is also gaining significant traction with physicians.  At a recent conference in Denver where Chilmark Research attended and spoke, the CIO of Catholic Health Initiative (CHI) sees providing their doctors with mobile apps (in CHI’s case on the iPad) as critical to the success of complying with meaningful use requirements.

mHealth Apps in Acute Care
Given that physicians have now ‘gone mobile’, does this imply that they will no longer be satisfied with computers-on-wheels (COWs), demanding mobile access to every piece of data buried in Health Information Systems (HIS)?   If so, providing doctors with mobile access to patient and hospital data could be just the perk needed to attract more affiliated physicians, satisfy existing ones and ultimately drive the adoption and use of HIT by clinicians.Continue reading…

Dipping Into the Waters of Mobile Health

Introductory Remarks: Chilmark Research is pleased to welcome a new addition to our staff, Cora Sharma.  Cora will be leading our research efforts in the mobile health app market (mHealth) and below is her first post on the subject. 

The concept of mobility in healthcare is nothing new to providers, vendors, and to Chilmark Research alike.  The current media and investor buzz surrounding mHealth stems from the belief that   1) mobile technology has finally matured to a point where age-old healthcare processes can finally be revamped; and 2) mobile technology has not only matured but has actually been adopted en-mass by physicians and shows no signs of abating.

Doctors Love Smartphones, but are GaGa over the iPad
Recent reports from SpyGlass Consulting and Manhattan Research show that the vast majority of physicians already use smartphones. Pamela Dolan at the AMA has a nice commentary on these latest numbers.   Chilmark Research’s recent talks with industry folks shows that the iPad is also gaining significant traction with physicians.  At a recent conference in Denver where Chilmark Research attended and spoke, the CIO of Catholic Health Initiative (CHI) sees providing their doctors with mobile apps (in CHI’s case on the iPad) as critical to the success of complying with meaningful use requirements.

mHealth Apps in Acute Care
Given that physicians have now ‘gone mobile’, does this imply that they will no longer be satisfied with computers-on-wheels (COWs), demanding mobile access to every piece of data buried in Health Information Systems (HIS)?   If so, providing doctors with mobile access to patient and hospital data could be just the perk needed to attract more affiliated physicians, satisfy existing ones and ultimately drive the adoption and use of HIT by clinicians.

Continue reading…

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