Month: July 2015

Xerox is extending to consumers & communities

Jul 31, 2015• 1

By MATTHEW HOLT

I’m steadily getting all those interviews I did 3+ months ago at HIMSS up onto THCB. (For those of you not paying attention we had a bunch of tech issues at THCB needing a big change and had to forswear videos for a while. But we’re baaack…)

This interview is with Xerox’s Tamara StClaire (Chief Innovation Officer, Commercial Healthcare) and Gail Croall, Chief Medical Officer, Healthspot.

Xerox has a big business in inpatient analytics–I interviewed Justin Lanning who runs their Midas+ Division back in 2012, and does lots of government based claims-processing (especially for Medicaid) and customer service centers. It even was one of the many companies building health exchanges (and struggled like many others!). In May this year (after this interview was shot) Xerox bought a community based visualization company called the Healthy Communities Institute which sells dashboards about public health issues to towns and counties–and has been a big player both at Health 2.0’s Healthy Communities Data Summit but also winning a couple of our challenges.

In late 2014 Xerox invested in Healthspot a telehealth company that builds kiosks. That partnership is the main focus of this interview. Below the fold there’s another video which is a tour of the Healthspot hub that you can expect to see cropping up in RiteAid pharmacies across Ohio and later the nation.

Of PCPs and THC

Jul 29, 2015• 6

By ROB LAMBERTS, MD

The drug test came back abnormal. There was THC present. I walked back to Mrs. Johnson and raised my eyebrows.

“What’s wrong?” she asked, not used to whatever kind of look I was giving her.

“Uh, you forgot to mention to me that you smoke weed.”

She blushed and then smirked. “Well, yes, I guess I forgot to put that down on the sheet. I don’t do it real often, but sometimes it takes mind off of things. I just get real anxious about my kids, my husband…and my heart problems. I only smoke one or two a night”

She’s not your usual picture of a pot-head. She’s in her sixties, has coronary heart disease, irritable bowel, hypertension, is on Medicaid, and is the essential caricature of the the poor white folk who live in the deep south. And she smokes weed.

I was doing drug testing on her as part of my office policy. Mrs. Johnson gets 30 Percocet per month, and so clearly poses a high risk of drug trafficking, escalation to PCP, crystal meth, and LSD, and ending up behind bars for the rest of her life. That’s why I had to test her. And now I caught her in a lie, trying to cover-up her use of illegal drugs.Continue reading…

The reboot for Care Innovations: Interview

Jul 28, 2015

By MATTHEW HOLT

This interview is with Karissa Price, chief marketing officer, and Kumar Subramanian, CTO of of Care Innovations. This is the GE/Intel JV which was originally a devices and perpiherals company that has recast itself as a software and data analytics company–in the business of remote patient management–just in time for population health to get serious. When Sean Slovenski (ex-Humana) took over as CEO at Care Innovations he not only wanted to recast the company but he also wanted to impact the way the industry positioned itself, so he set up the Validation Institute (FD: I’m on the Advisory Board for the Validation Institute). You can hear more about what Care Innovations is up to in the video below.

The ProPublica Report Card: A Step In the Right Direction

Jul 24, 2015• 2

By ASHISH JHA, MD

Last week, Marshall Allan and Olga Pierce, two journalists at ProPublica, published a surgeon report card detailing complication rates of 17,000 individual surgeons from across the nation. A product of many years of work, it benefitted from the input of a large number of experts (as well as folks like me). The report card has received a lot of attention … and a lot of criticism. Why the attention? Because people want information about how to pick a good surgeon. Why the criticism? Because the report card has plenty of limitations.

As soon as the report was out, so were the scalpels. Smart people on Twitter and blogs took the ProPublica team to task for all sorts of reasonable and even necessary concerns. For example, it only covered Medicare beneficiaries, which means that for many surgeries, it missed a large chunk of patients. Worse, it failed to examine many surgeries altogether. But there was more.

The report card used readmissions as a marker of complications, which has important limitations. The best data suggest that while a large proportion of surgical readmissions are due to a complication, readmissions are also affected by other factors, such as how sick the patient was prior to surgery (the ProPublica team tried to account for this), his or her race, ethnicity, social supports—and even the education and poverty level of their community.

Calendar: Powering Medical Research With Data: The Research Analytics Adoption Model

Jul 22, 2015

By HEALTH CATALYST

TODAY JULY 22/ 1 PM EST Analytics are becoming imperative to researchers in recruiting patients into studies, making breakthrough discoveries, as well as monitoring the clinical implementation of these discoveries.

This webinar will be for organizations that want to leverage their enterprise data to power more effective research.

THCB’s MATTHEW HOLT SAYS: “HealthCatalyst are a highly interesting and fast-growing database company not to mention a THCB supporter. This webinar should be required for anyone interested in how healthcare organizations can leverage their existing data to power medical research and build strong clinical trial programs. Check it out.“

It’s “Slack for Health Care”- athenaText

Jul 22, 2015• 2

By MATTHEW HOLT

By now it’s not a secret that EMRs are “records” and yet we’ve been trying to cram communication functions down their throat. Meanwhile the hottest tools in enterprise tech are souped up versions of AIM (remember that, you AOL fans?)– with companies like Slack & HipChat providing group-based instant messaging and changing the way teams work. As health care becomes a team sport, you’re going to see many approaches from the major EMR vendors and new entrants in the coming months to fix the communication problem. And yes at Health 2.0 this Fall I’ll be running a full panel on the topic that the Clinical User Experience Sucks–how do we fix it?

This week athenahealth, one of the few big cloud-based players in EMR-land introduced athenaText. (Don’t bother asking why there are no caps in the company name yet the simple word “text” gets a capital T in the middle of the product name! It’s as you’d expect an instant message product (rather than SMS one) but with some differences. For a start it integrates direct into the athenaClincals EMR, but it also pulls in both drug info and physician contacts from the Epocrates product that athenahealth owns (and which has several hundred thousand physicians on it). The goal is to spread the product virally (think Skype or Slack). But first things first. What is it and how does it work? I spoke with VP of UX at athenahealth, Abbe Don, to find out more and to get a demo, which you can see below.

Dean Stephens updates Healthline’s new entry into clinical world

Jul 20, 2015

By MATTHEW HOLT

A few weeks back I caught up with a Health 2.0 veteran Dean Stephens, CEO of Healthline. For those of you who’ve not been paying attention Healthline.com has become a very fast growing consumer site–now with over 30m visits a month. Meanwhile, Dean’s been incubating a provider-focused natural language search product called Coding InSight to extract information from EMRs, which will compete with the likes of Apixio, Clinithink and others. Many more details in the interview below!

Limelight Health raises $3m to automate insurance quotes

Jul 20, 2015

By MATTHEW HOLT

A while back Michael Lujan, who was one of the originals working at Covered California, came to see me at the Health 2.0 office. He and his colleagues realized that the workflow for small business health insurance quotations between the carriers and the agents was broken. Yet, despite the ACA (or maybe because of it!) agents are responsible for 90% of small business health quotes.

Any small business who’s ever got a health insurance quote from an agent has likely seen a relatively incomprehensible series of prices and benefits on a PDF. And if they want to see a change, the broker has to go back to the carrier/insurer and start again.

For the past year or so LimeLight Health (working at incubator Launchpad Health) has been trying to make that an interactive process, and the result is their product Quotepad. Another really interesting niche product in our convoluted health care mess.

Today Limelight announced a $3m series A funding round. I spoke to CEO Jason Andrew, who told me what they do and gave a demo.

https://youtu.be/Fky8br-AcmU

After Transparency: Morbidity Hunter MD joins Cherry Picker MD

Jul 17, 2015• 16

By SAURABH JHA, MD

When report cards of performance became available, cardiac surgeons in New York and Pennsylvania avoided high risk patients. Could something similar happen, nationally, after the forthcoming revolution in transparency inspired by Propublica’s data release?

Take two fictional orthopedic surgeons, Cherry Picker MD and Morbidity Hunter MD.

Cherry Picker lives in the Upper East Side of New York. His patients give him great reviews on Yelp. His patients read every comment on Yelp before making any decision. Cherry Picker has a beautiful family. When he smiles, light refracts from his shiny teeth.

Cherry regularly appears on TV. He writes for the sleek, metrosexual publication, FHM. Cherry specializes in knee injuries in weekend warriors. His patients often call him from the ski slopes in Colorado, Whistler and Zermatt. Cherry is good at his craft. But his patients are even better at their craft – post-operative recovery. Cherry doesn’t actively seek such patients. His patients are selected for him by his zip code, reputation, long waiting list and Yelp.

Morbidity Hunter’s real name is Harjinder Singh. He migrated from Punjab and works in a safety net hospital in North Philadelphia. Singh wanted to work in Beverley Hills, but to convert his J1-visa to a green card, he had to work in an area of need. Once he started working, he liked his job. His daughters liked their school and his wife liked the house they bought. Singh doesn’t have shiny teeth. He hasn’t appeared on TV, although his daughters tease that he can play Sonny from Exotic Marigold Hotel.

Singh’s colleagues named him Morbidity Hunter because he operates regardless of how sick his patients are. He never says no. Nearly all his patients are obese and diabetic. The School of Public Health sends students to shadow him to learn about polypharmacy. The hospital went on a spree of hiring hospitalists when Singh started. Continue reading…

How Is Health Reform Impacting Insurance Switching Patterns?

Jul 17, 2015• 6

By IYUE SUNG

Americans typically don’t switch health insurance, and that has not changed much with healthcare reform. Despite controversy with the converse scenario – the ability to keep the same insurance – and the introduction of health insurance marketplaces, data from ACAView suggests switching behavior has been modest.

For this latest ACAView research, our team set out to determine how the ACA’s insurance coverage expansion has influenced patient behavior in switching insurance coverage. We looked at patients’ switching patterns, and how those have shifted for a subset of patients who have visited primary care providers at the same practice at least once a year between 2013 and 2014 and/or between 2014 and 2015.

Our research revealed five key findings:

In Medicaid expansion states, over 40% of uninsured patients obtained insurance the following year, in both 2014 and 2015. In comparison, in non-Medicaid expansion states, about 25% of previously uninsured patients obtained insurance during the same time periods. Conclusion: Medicaid expansion has allowed a higher proportion of previously uninsured patients in continuous care to obtain insurance.

In Medicaid expansion states, the proportion of commercially insured patients switching to Medicaid coverage – though rare – has doubled. In 2014, 1.2% of commercially insured patients in continuous care switched to Medicaid coverage. Prior to coverage expansion, only 0.6% switched to Medicaid coverage in the subsequent year. (In 2015, this proportion increased to 1.6%.)

With coverage expansion, the percentage of commercially insured patients who switch coverage the subsequent year has increased: from 15.0% pre-expansion to 18.3% in 2014 and 17.3% in 2015. This may occur because some commercially insured patients switch to plans on the health insurance marketplaces because they are eligible for subsidies.

The switching behavior of people who changed plans or payers had no notable impact on utilization. Whether patients switched commercial insurance plans with the same payer, or they switched payers, there were no clear changes in either visit frequency or relative value units (RVUs) per visit.

Patients with a range of chronic conditions[1] (high cholesterol, hypertension, and diabetes) are less likely to switch insurance coverage. In contrast, patients diagnosed with mental disorders were more likely to receive insurance coverage.