Category: Uncategorized

Speak Softly and Carry (Good) Data

Oct 1, 2015• 8

By DALE SANDERS

After a recent talk, a client came up to me with a puzzled expression.

We made small talk. We talked about the weather. We talked about sports. Finally, he got to the point.

“When are you going to talk about Big Data?” he asked somewhat impatiently.

“I’m not,” I responded.

It transpired that he was expecting to hear about all of the miraculous things Big Data was going to do for his healthcare system. He had come expecting to hear my Big Data talk.

Apparently, this was something he had been looking forward to all week. He was to be disappointed.

As a matter of fact, I almost never talk about Big Data.

And for the most part, nobody at my company, HealthCatalyst, does either.

Which might seem a little strange for a company in the data and analytics business. You’d think we’d be singing the praises of Big Data from morning till night. But we aren’t. There’s a reason for that, which I think is important.

Private Medicine in India is a Free Market

Oct 1, 2015• 10

BY SAURABH JHA, MD

Once, a farmer from a village in Bihar was diagnosed with colon cancer. He came to Patna, the capital city, to have the tumor removed. Because he was poor, my father recommended a young surgeon who trained in the UK. The surgeon was competent and idealistic. He was a Fellow of the Royal College of Surgeons. His charges were the lowest. He did not charge the extremely poor.

The farmer declined, saying “if this babu is treating patients for free, he can’t be a good surgeon.” The farmer chose the most famous surgeon in the city, whose charges were not astronomical in comparison, but certainly higher. The farmer paid full fare – there were no discounts for poverty. The practice accepted credit cards. He paid cash. Once the surgeon received half the payment, he made the incision. The surgery was uneventful. The farmer was cured.

This was a voluntary contract between surgeon and farmer. No middle man. No forms to submit. Cash for scalpel and the skill of its bearer. There is a resurgence of this model in the US, known as Direct Pay Medicine. Despite India’s socialist roots, paradoxically, much of medicine has always been direct pay, or private.Continue reading…

Private Medicine in India is No Free Market

Oct 1, 2015• 2

By MICHEL ACCAD, MD

On the surface, the proposition that medical care in India is a free market seems plausible.

Setting aside the perennially underfunded public healthcare system, there is a large second tier system where patients get care without any apparent oversight. Sure, laws and rules abound, but these are easily overcome with bribes paid to bureaucrats. A “cost of doing business,” you might say.

In that private system, the care rendered is up to the doctor and patient, and the terms of the transaction are simply decided on the basis of cash exchanging hands. What could be more free market than that? A libertarian paradise!

But Voltaire wisely advised debaters to define their terms, or else engage in fruitless conversations. So perhaps we should make it clear that a free market is not solely defined on the basis of voluntary exchanges, although I recognize the prevalence of that unfortunate misconception.

Welcome to ICD-10

Oct 1, 2015

By SEAN CAVANAUGH

Today, the U.S. health care system moves to the International Classification of Diseases, 10th Revision – ICD-10. We’ve tested and retested our systems in anticipation of this day, and we’re ready to accept properly coded ICD-10 claims.

The change to ICD-10 allows you to capture more details about the health status of your patients and sets the stage for improved patient care and public health surveillance across our country. ICD-10 will help move the nation’s health care system to better, smarter care.

You may wonder when we’ll know how the transition is going. It will take a couple of weeks before we have the full picture of ICD-10 implementation because very few health care providers file claims on the same day a medical service is given. Most providers batch their claims and submit them every few days.

Even after submission, Medicare claims take several days to be processed, and Medicare – by law – must wait two weeks before issuing payment. Medicaid claims can take up to 30 days to be submitted and processed by states. Because of these timeframes, we expect to know more about the transition to ICD-10 after completion of a full billing cycle.

Getting the Real Story: Valid Performance Measures

Oct 1, 2015

By LINDA RIDDELL

If you want the real story about whether a wellness program or health product worked, you want valid, accurate measures. Getting the real story is the topic of our lively panel discussion at Health 2.0 hosted by the Validation Institute. By adhering to principles of objectivity and stringent validation processes, the Validation Institute provides healthcare industry consumers with sound and valid information, allowing them to evaluate companies with confidence.

I am a population health scientist with training in epidemiology, biostatistics, quality measures, and risk finance and I run Health Economy LLC.

It Costs Nothing to Care: Why We Need to Provide Health Insurance for Undocumented US Residents

Sep 30, 2015• 5

By ABRAAR KARAN, MD

The cost of medical service provision in the United States is one of the most palpable strains on the healthcare system, but we must not forget that cost is the sibling of quality and access—without considering the three as such, we will undoubtedly fail to navigate our country’s healthcare quandary. Low quality care inevitably results in the need for more care in the form of readmissions, while lack of access to primary care leads to increases in the utilization of expensive, emergency services. Of particular concern in our country, a growing contributor to cost, and driven by low quality care and even less access to that care, is the systematic exclusion of undocumented patients. This was made very clear to me through the example of a single suffering patient, Mr. Gomez.Continue reading…

Is Obamacare Working? Show us the Data

Sep 30, 2015• 13

By FRED and ALMA TROTTER

As President Obama’s healthcare reform unfolds in the last years of his administration, critics and supporters alike are looking for objective data. Meaningful Use is a funding program designed to create health IT systems that, when used in combination, are capable of reporting objective data about the healthcare system as a whole. But the program is floundering. The digital systems created by Meaningful Use are mostly incompatible, and it is unclear whether they will be able to provide the needed insights to evaluate Obamacare.

Recent data releases from HHS, however, have made it possible to objectively evaluate the overall performance of Meaningful Use itself. In turn we can better evaluate whether the Meaningful Use program is providing the needed structure to Obamacare. This article seeks to make the current state of the Meaningful Use program clear. Subsequent articles will consider what the newly released data implies about Meaningful Use specifically, and about Obamacare generally.

Should the Government Provide Infrastructure For a Health Data Highway?

Sep 29, 2015

By ADRIAN MEYER

Susannah Fox, the CTO of HHS was talking at the AcademyHealth Concordium 2015 conference this week. Her energetic call for innovation got me thinking:

Should the government be in the business of funding infrastructure for healthcare communication?

Comparable infrastructures

The governments on local, state and federal level have deployed comparable infrastructures and licensing in the interest of public health and safety:

1. Licensing of car tags while providing infrastructure for roads

2. Licensing of planes and pilots while providing infrastructure for air traffic control

3. Licensing post office locations while providing infrastructure for moving mail

How about: Licensing providers (NPI) while providing infrastructure for health data exchange “highway”?

The communicating health professional

What if providers could communicate in a secure “healthcare highway” or cloud system?

Dr. Specialist: “Hey @npi.1234567890 attached a consult note.”

Dr. Primary: “Thanks @npi.0987654321, sending 3 more pts your way with similar symptoms. (attached)”

Healthcare’s Perpetual War

Sep 28, 2015• 14

By MARGALIT GUR-ARIE

There are three visions of peace in the seemingly never ending, but really rather brief, Israeli-Palestinian perpetual crisis. One peace features two independent countries living in collaborative harmony on a piece of land approximately the size of New Jersey. Another peace yearns for a messianic Jewish state stretching from the blue Mediterranean shores to the Jordan River, and possibly beyond. The third and final peace is expected to materialize after the Zionist entity has been permanently erased from the face of this earth, or at least from the face of that New Jersey size holy piece of land. Each definition is amenable to slight compromises in form, but not at all in substance.

There are three visions for the future of medicine in the seemingly insurmountable, but really rather minor, perpetual health care crisis in America. One future of medicine sees physicians unencumbered by useless administrative tasks, wielding sleek and useful technology tools, offering the best medical care to all patients who need and want attention. Another future is yearning for the revival of chickens and charity as bona fide methods of payment for whatever medical care the free market wishes to bestow on the less fortunate. The third and final future is one devoid of most middling and often faulty doctors, where the health of the nation is enforced by constant computerized surveillance with fully automated preemptive interventions. Each definition is amenable to slight compromises in form, but not at all in substance.Continue reading…

Health 2.0: Exclusive Interview with Susannah Fox, CTO of HHS

Sep 28, 2015

By DEEPA MISTRY

Susannah Fox, CTO of HHS, shares how she is fostering patient empowerment and engagement through technology. Matthew Holt, Co-Chairman of Health 2.0, had the opportunity to personally chat with Susannah and learn more about the democratization of healthcare!

Don’t miss Susannah Fox at the 9th Annual Health 2.0 Fall Conference. Purchase your tickets here!

Matthew Holt: Matthew Holt here, delighted to be on with a really wonderful amazing person in healthcare who is not only my friend but also the CTO of HHS, Susannah Fox. Susannah, thanks so much for joining us.

Susannah Fox: I am thrilled to be talking with you.

Matthew Holt: Well, so those of you who don’t know — Susannah originally was a journalist at U.S. News and World Report and spent many, many years at Pew Research, and is basically leading the survey research understanding the patient experience — probably in healthcare as a whole but studying the patient experience with the use of technology. She happens to be the first proper keynote speaker we ever had at a Health 2.0 conference back in 2008, attended Health 2.0 in many different places with us, and has been a great friend and colleague.