Tweetcasting @2011 : Health Reform Implementation, Mobile Health and Patient Safety

My crystal ball is a little foggy so I decided to ask my Twitter followers (@HealthBizBlog) to help compile a list of health care predictions for 2011. I’ve integrated my thoughts with theirs and organized the predictions into four themes:

  1. Transparency will change from buzzword to reality
  2. Information technology progress will be uneven, with the biggest breakthroughs in mobile
  3. A culture of patient safety will begin to take root
  4. Health reform implementation will advance despite some ugly battles

Transparency will change from buzzword to reality.

The health care industry is tremendously opaque. Patients and doctors don’t know the price of medical services, while pharmaceutical and medical device makers maintain secret financial arrangements with physicians.

Much is likely to change for the better in 2011.

Giovanni Colella, CEO of health care transparency company Castlight Health (@CastlightHealth) predicts, “Consumers will increase their demands for personalized information about health care cost, quality and convenience and will turn to innovative applications to address these needs.”

Bright lights will be trained on the interaction between industry and physicians.

The Affordable Care Act requires pharmaceutical and device companies to report payments to physicians starting in 2013; voluntary reporting is likely to pick up next year. Beyond that, @PharmaGossip predicts, “PharmaWikiLeaks will become a force for good,” citing a recent leak about Pfizer in Nigeria as Exhibit A.

Information technology progress will be uneven, with the biggest breakthroughs in mobile.

AOL founder Steve Case (@SteveCase) tells me, “Mobile health will be a game changer in health and wellness.” I agree that mobile apps and devices present a big opportunity to prevent and manage chronic illness.

Thanks to advances in IT adoption by providers and patients, Kaiser’s Dr. Ted Eytan (@tedeytan) expresses confidence that, “The patient will finally become a customer of health care.”on

Meanwhile, physicians, hospitals and vendors will continue to make slow, uneven progress on electronic health record implementation in the quest to meet Meaningful Use requirements that qualify them for federal stimulus funds. Health IT expert David Ahern (@dahern1) says, “EHR vendor consolidation will be the order of the day, especially as companies discover how difficult it will be for them to reach Stages 2 and 3 of Meaningful Use on their own.”

A culture of patient safety will begin to take root.

Beth Israel Deaconess President and CEO Paul Levy (@Paulflevy) writes, “Too many people will still be harmed in clinical settings because of a lack of focus in redesigning the work done in hospitals.”

Dennis Ferrill (@DennisFerrill), CEO of eLearning company APS offers a path forward, “We will approach a tipping point in the culture of patient safety as institutions find that significant adverse events occur under their watch, while more of their peers take concrete steps forward.  Among the observable data points supporting this movement will be an increasing tendency to mandate key protocols and safety training for nursing and physician staff as hospitals gain confidence in their duty to control quality and outcomes.”

Since the Vioxx debacle, FDA and patients have sought reassurance on patient safety, a shift that will continue in 2011, according to iCardiac Technologies CEO Mike Totterman (@mtotterman). “Regulatory cardiac safety requirements will tighten, but emerging technologies will facilitate compliance with new standards to produce better, more reliable results in clinical trials.”

Health reform will prevail despite ugly battles.

“Always an optimist, I think 2011 is the year that economic recovery takes hold,” writes Dr. Bruce Siegel (@siegelmd), CEO of the National Association of Public Hospitals. “This changes the national health care debate dramatically as the Administration’s leverage is bolstered. There are some very ugly battles ahead, especially in the state houses, but overall it’s a year of consolidation.”  To demonstrate he’s a realist, he adds, “Also, the Redskins won’t go to the Superbowl!”

I’m a little less sanguine than Dr. Siegel about the prospects for the Accountable Care Act. I expect Republicans to make moderate progress chipping away at the law, even though repeal is not in the offing. The recent one-year Sustainable Growth Rate (SGR) fix, which halted the automatic cut to Medicare reimbursement rates, was financed by snatching a little bit from PPACA insurance subsidies. Expect more gambits like that, along with objections to proposed rules, attempts to defund or delay specific provisions, and continued court challenges to the law itself.

David E. Williams is co-founder of MedPharma Partners LLC, strategy consultant in technology enabled health care services, pharma,  biotech, and medical devices. Formerly with BCG and LEK. He blogs regularly at Health Business Blog, where this post first appeared.

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8 replies »

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  2. I agree that there needs to be transparency…people need to know what’s going on and trust the source.

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  4. “Hello, I’m in septic shock with total body failure. How much will you charge to treat me?”
    Sorry, but “price-competitive purchase decisions” only works for already inexpensive, intermittent, non-urgent care. It’s not relevant when the big bucks are spent.
    (Posting non-stop today while waiting for the computers to come back up at the nursing home!)

  5. David – you are right on target when it comes to the importance of transparency in healthcare costs, and the growing trend toward cost transparency in healthcare in the coming year. I believe the move toward Consumer-Driven Health Plans will accelerate in 2011 as well, but to be effective, consumers need three things – the freedom to negotiate, the economic imperative to negotiate, and accurate information on current, local healthcare costs.
    change:healthcare has developed a regularly-updated Healthcare Transparency Index (http://www.changehealthcare.com/hcti/index.html) that provides consumers with exactly this kind of trend information they can use to make more informed healthcare purchase decisions.
    With tools like this – along with both the freedom to negotiate and the economic incentive to negotiate – I feel that consumers in increasing numbers in 2011 will put economic pressure on physicians, pharmacies and other healthcare product/service providers to bring costs down by making price-competitive purchase decisions.
    Whether ACA moves forward, as you predict, or is revised or replaced as others predict, this mandate for cost-competitive change will continue to move forward. Either way, if consumer healthcare costs are to come under control, consumers themselves will have to use accurate local cost information to negotiate for the best healthcare services and products at the best costs. CDHP is one way this will happen, but even without such a plan, informed and motivated consumers will be at the forefront of system-wide cost containment.

  6. David – you’re right – but the key to this is consumers having access to accurate and local cost information; transparency has to be localized so people can act on it. Is there a source of local consumer cost information available?
    Ned Barnett
    Las Vegas