Author Archives

Matthew Holt

Virtual Medicine: The Lever That Just Might Save Independent Practice

Dec 21, 2009• 11

By RICHARD REECE, MD

Give me a lever long enough, and a prop strong enough, I can single-handedly move the world.

— Archimedes

Independent medical practice in America is in trouble. It is fragmented, with some 900,000 doctors – 300,000 primary care doctors and 600,000 specialists- practicing in disparate settings. These physicians are located in roughly 580, 000 locations. Some are solo, most are in small groups, and many are clustered around 125 academic medical centers, 100 integrated groups, and 5000 community hospitals.

Doctors are not unified – less than 20 percent belong to the AMA. Some 110,000 are members of Sermo – a social networking organization that tends to house dissident physicians. The MGMA is said to represent 300,000 doctors.Continue reading…

Interview with Alan Greene MD, author of “Raising Baby Green”

Dec 21, 2009• 1

One of the most remarkable talks I heard this year wasn’t about health care. It was about food. Of course, food is very, very closely related to health and health is at least tangentially related to health care.

So I invited Alan Greene of drgreene.com (who is a friend and has spoken at a couple of Health 2.0 Conferences) to tell me about the new book, Raising Baby Green. It really is a potential way to change how Americans (and everyone else) eat, and to use the most important years (the ones we can’t remember!) to do it.

Most importantly Alan is starting a viral campaign to get this information into the hands of expectant mothers. For anyone who knows an expectant mum or someone who might be one someday, this book is very important. And the message needs to get out and get mainstream quickly.

Here’s the interview in which Alan explains how to feed kids right, and we do a little plotting in how to get this into mainstream child-raising.

Cool Technology of the Week

Dec 19, 2009• 8

By JOHN HALAMKA

John Halamka is the CIO at Beth Israel Deconess Medical Center and the author of the popular “Life as a Healthcare CIO” blog, where he writes about technology, the business of healthcare and the issues he faces as the leader of the IT department of a major hospital system. He is a frequent contributor to THCB.

I recently wrote a Computerworld Column about Email Overload.

I’m a data oriented guy and was curious to learn detailed statistics about my own Blackberry use. I found a great Blackberry application called “I Love Blackberry” from EarlySail.Continue reading…

Senate Deal on Health Care Bill Done

Dec 19, 2009• 52

By Matthew Holt

As it's a work day for the Senate worth reporting here that Ben Nelson’s vote has been bought for more Medicaid spending for Nebraska and a complex formula for States to opt out of exchanges being able to fund abortions. So presuming there’s no problems in reconciliation we can expect the reform bill to be done relatively soon. Full details on what’s in the new bill on Think Progress’ The Wonk Room.

The netroots left has been complaining loudly over the last couple of days since Lieberman was bought off by dropping the public option and the Medicare buy-in. Howard Dean and Markos of Daily Kos both called for massive changes to the bill, or killing it and the debate between the “sensible left” and the “this is a sellout to insurers” has got a little silly. However, (unless Bernie Sanders pulls fast one) none of the more left wing Senators (Sherrod Brown et al) are going to vote against the bill, so what we see now is what we get.

The real issue will be when the voting public finds out that nothing happens for 3 years.

Kate’s Counterpane

Dec 19, 2009• 1

A wonderful sad and happy story about someone who never thought disease could happen to them. (It’s relatively long and plays in sections or you can go to the original site)

From a system/policy perspective, the role of complementary and allopathic medicine is pretty interesting. But this is a story about a fighter.

Interview with Paul Taylor, renegade hospital CEO

Dec 18, 2009• 4

By Matthew Holt

Paul Taylor is CEO of Ozarks Community Hospital, a teeny 2 hospital system catering to the poor and senior populations in rural Missouri and Arkansas. He thinks that he’s figured out a way to deliver health care at government rates and is incensed that every other hospital claims it can’t make it on what Medicare pays. (That’s they I call him a renegade–I don’t mean that his hospital is called “Renegade”!) He also gets much less from the local Blues than he does from Medicare for the same services.

I wrote about Paul a while back and he sounded like a guy with interesting ideas on how to fix health care. So I called him up to see if he would be a good interview–and he didn’t disappoint!

Paul Taylor

Health 2.0 Does Webinars

Dec 18, 2009• 2

By Matthew Holt

I'm excited to announce the latest program coming from Health 2.0 – The Health 2.0 Show with Indu & Matthew! This monthly webinar series will focus on news from the Health 2.0 community, a look at some cool new technologies, and interviews with industry leaders.

January 19, 2010
11 am PT / 2 pm ET
We’ll start the series off with a look at what lies in store for Health 2.0 in 2010 – including updates from the Advisors, the Accelerator and exciting new partnerships.

We’ll also chat with Thomas Goetz of Wired Magazine about his upcoming book,The Decision Tree: Taking Control of Your Health in the New Age of Personalized Medicine and his thoughts on technology, personalized medicine, and how it all relates to Health 2.0.

For more information and to register, check out: http://www.health2con.com/webinars.

Health Reform as Theater: Let Me Down Easy

Dec 16, 2009• 4

By MICHAEL L. MILLENSON

For a Broadway stage, the set is simple and spare – a long, white leather couch, a handful of wooden tables and chairs. No ornamentation is needed; the stories being told on the stage are what command the audience’s attention. Let Me Down Easy is health reform as poignant, funny and gripping theater.

A supermodel compares the high-powered physicians a cosmetics company gets her after she signs a lucrative contract to the doctors she had access to during her working-class childhood. A middle-aged woman emotionally refuses dialysis because of the terrible injuries her daughter sustained while undergoing dialysis when a hospital’s mistake left her covered in blood. And a cancer patient hospitalized with a post-chemotherapy fever describes being told not to take it personally that her chart has been lost: “that happens here quite a bit.”

Every word is true, every story describes a personal struggle with illness, dying and the medical care that sometimes happens in between. Twenty people speak, each in a separately titled vignette, but only one person appears on stage. That’s Anna Deavere Smith, who carefully selects verbatim excerpts from interviews she conducted and then meticulously mimics those interviewees’ body language and speech patterns in a manner so convincing that, in the miracle that is theater, she disappears into her characters. Some are well-known – Lance Armstrong, former Texas Gov. Ann Richards – others are not – a musicologist, a Buddhist monk, a rodeo bullrider.

Improving the Harvest: Farming and Health Care

Dec 16, 2009• 14

By BILL KRAMER

I love Atul Gawande’s writings on health care.

He has a rare talent for describing technical details of health care, insurance and finances in terms that most people can understand. His recent article in the New Yorker discussed the current health reform bills’ approach to curbing costs, using the agricultural industry as a potential model.

One of his basic points is similar to one I have made before. He describes two kinds of problems: “those which are amenable to a technical solution and those which are not. Universal health care coverage belongs to the first category . . . Problems of the second kind [referring to rising health care costs], by contrast, are never solved, exactly; they are managed.”

I would frame it somewhat differently. The two basic kinds of problems are those, which are amenable to a government solution, and those which are best addressed using decentralized market forces.

MedEncentive’s Five Year Report

Dec 15, 2009• 11

By Matthew Holt

As many involved in the worlds of Health 2.0 and Information Therapy know, some of the most interesting experiments in the world of patient-physician engagement have been happening in the somewhat unlikely environs of small town Oklahoma. There the City of Duncan has put its employees (and their providers) into a system that incents (but doesn’t mandate) physicians to practice according to accepted guidelines, and incents (but doesn’t mandate) patients to read information prescribed by their physicians about their treatments (and tests them about it). The system then asks each party to rate the other.

It sounds simple and frankly, compared to much in health care, it is. The system is supplied by MedEncentive, an Oklahoma City firm led by the charming and engaging Jeff Greene. While I remain fascinated by MedEncentive’s program (and FD MedEncentive has sponsored the Health 2.0 Conference in the past), it’s perhaps grown a little more slowly than Jeff and other fans might have liked—given the scope of the problem.

But the results have been impressive in reducing costs (mostly by reducing hospitalizations) and increasing patient involvement. Yesterday MedEncentive released a five year retrospective. The key finding?:

City of Duncan costs for the most recent year was 8.6% less than five years ago prior to implementing the Program, which is 34.9% less than the projected costs. The resultant four year savings equates to an 8:1 return on investment. (emphasis added)

Jeff abandoned a lucrative business in physician practice management to have a go at this intractable problem. Five years on he deserves plaudits for what he and his team have achieved, and hopefully we’ll see much more innovation like this mushrooming in the future.

Given the relatively lightweight nature of the intervention, I’m amazed that many much larger payers/employers haven’t given it a try. After all, whatever else they’re doing doesn’t seem to be exactly working too well!