Category: Uncategorized

What Can Meaningful Use Learn From Healthcare.gov?

Mar 2, 2015• 18

By FRED TROTTER

The US has spent several billion dollars on medical records, as part of the HITECH program. The goal of that spend was simple: portable medical records for patients. On our current path, we will have medical records, but without that magic word: “portable.” Ironically, the reason for this is identical to the root-cause of the problems with healthcare.gov

The root-cause of the initial failure of healthcare.gov was a lack of accountability and empowerment. There was no one person who was in charge of the operation, and those who were presumed to be in charge did not have the skill-set or political clout needed to make decisions about the project.

The result was the healthcare.gov train wreck. Thankfully, healthcare.gov was turned around.

That turn-around was the result of decisively fixing these exact issues.

Accountability restored, disaster averted.

You would think that the Obama administration and HHS would have learned the “accountability with empowerment” lesson well, if not for IT projects generally, then at least for projects involving Health IT.

Yet we are repeating this mistake with Meaningful Use. For those who are living in a cave with regards to healthcare reform, Meaningful Use is a set of standards designed to ensure that the money that the federal government spends on Electronic Healthcare Records (EHRs) for doctors results in clinically productive outcomes.

What’s wrong with Cannon, Halbig & King in 5 tweets

Mar 2, 2015• 28

By MATTHEW HOLT

When the latest post from Michael Cannon–he who seeks to sink the subsidies attached to the Federal exchange–hit my inbox, I wondered, “Why don’t his opponents stop arguing the specifics, and instead explain what the Supreme Court ought to do. I also don’t see why Mark Andreeseen (@pmarca) should have all the fun with long Twitter essays. So in only 5 tweets complete with misspellings and other contortions to get my thoughts into 140 characters, this is what I sent back

1/ I might be prepared to concede that @mfcannon is right on the facts of what the wording of the law says (King vs Burwell)

— Matthew Holt (@boltyboy) March 2, 2015

2/ might also concede that @mfcannon is right that the real @JonathanGruber & Senate HELP staffers meant to punish non-excange states

— Matthew Holt (@boltyboy) March 2, 2015

3/ But that doesn't mean that the language would have survived in committee. More likely we'd have House version = one national exchange

— Matthew Holt (@boltyboy) March 2, 2015

4/ And, sorry @mfcannon, the job of SCOTUS is to fix bad laws NOT perpatuate them (Brown vs Bd eductaion. Lawrence vs texas)

— Matthew Holt (@boltyboy) March 2, 2015

5/ Removing the subsidies in King vs Burwell would simply be punishing low inc. people on basis of geography. Is that what @mfcannon wants?

— Matthew Holt (@boltyboy) March 2, 2015

Value-Based Reform

Mar 2, 2015• 31

By JACK COCHRAN, MD and CHARLES KENNEY

The U.S. Department of Health and Human Services’ recent announcement to move the Medicare program toward value-based payments is among the most promising recent developments in health care.

While changing the way we pay for care will not be easy, we believe that shifting away from fee-for-service to value-based payments could be a catalyst to a better, more affordable health care system in our country.

Three Benefits of Paying for Quality
There are numerous potential benefits to paying for quality rather than quantity, including the three we want to focus on today.

We believe this payment shift has the potential to accelerate progress toward achieving the Triple Aim – defined as better individual care, better population care, and lower cost.
We believe the payment shift by Medicare will accelerate the transition to value-based payments among commercial insurers – a major benefit to employers in terms of improved health for employees and greater affordability.
We believe value-based payments have the potential to help slow – and possibly reverse – the epidemic of physician burnout in the United States, particularly among primary care doctors.Continue reading…

THCB E-mail Notifications Are Back!

Mar 2, 2015

THCB Tech Desk

Never miss an important post again. Sign up here.

King v Burwell: Three Scenarios

Mar 2, 2015• 15

By ROGER COLLIER

By now, every reader of THCB must be aware the Supreme Court is hearing arguments this week in a case that could undermine much of Obamacare. Simplifying somewhat, the plaintiffs in King versus Burwell argue that the phrase “exchange established by the state” in the Affordable Care Act’s section 1311 dealing with tax subsidies precludes making such subsidies available to those who enroll through the federal exchange(s). The government argues (a) that other sections of the law make it apparent that all exchange enrollees are potentially eligible for subsidies, and (b) that language in section 1321 providing that HHS shall “establish and operate such exchange within the state,” where a state is unable or unwilling to create their own exchange, essentially establishes a state exchange.

As many media articles have commented, the implications of a SCOTUS ruling for the plaintiffs are huge. Some five to eight million enrollees in the 34 federal exchange states would lose their subsidies, making insurance unaffordable for many of them, and premiums in these states would skyrocket—all while leaving the existing tax fines for being uninsured in place.

Using a Mobile App for Monitoring Post-Operative Quality of Recovery

Mar 2, 2015• 5

By JAAN SIDOROV, MD

While your correspondent is tantalized by the prospect of healthcare consumers using mHealth apps to lower costs, increase quality and improve care, he wanted to better understand their real-world value propositions.

Are app-empowered patients less likely to use the emergency room?

Do they have a higher survival rate?

Do they have higher levels of satisfaction?

In other words, where’s the beef?

That’s when this paper caught my search engine eye. It’s a report on using an app to monitor post-operative patients at home.Continue reading…

Shared Responsibility in the Affordable Care Act

Mar 1, 2015• 3

By DRANOVE AND GARTHWAITE

Recently we wrote that it was well past time to end the employer mandate in the Affordable Care Act. In light of some commentary, we thought it best to revisit this issue in more detail. It seems that most of the support for the employer mandate comes from a misguided understanding of why employers are currently the primary source of private health insurance. It is explicitly not because of a sense of “responsibility” to the employee, at least not any more responsibility than they feel when they pay employee wages for their work.

Here is a basic summary of how labor markets work, based on decades of very widely accepted academic research and practical experience. Employees receive compensation from their employers in return for their work product. In other words, employers aren’t running charities for their workers, but neither are workers volunteering their time at firms. Each expects something from the other. Some employee compensation comes in the form of cash wages and some in the form of fringe benefits such as health insurance, pensions, free coffee, parking, etc.Continue reading…

Feedback Loop

Feb 27, 2015• 14

By PHILIP ALLEN GREEN

Right now there are two patients in every room. One is made with flesh, bones, and blood. One is made with a monitor, a mouse, and a keyboard.

Both demand my time.

Both demand my concentration.

A little over two weeks ago I wrote the short story Please Choose One. I posted it online. The response it generated exceeded anything I could have ever imagined. It struck a nerve. People contacted me from all over the world, from all walks of life, about the story. Everyone, it seems, can relate to the challenge of having to choose between a person and a screen.

People sent me all kinds of suggestions and ideas. A few sent words of encouragement. Yet, what struck me the most about the people who contacted me was what they did not say. Not a single IT person argued the computer was more important than the patient. Not a single healthcare provider stated they wanted more time with the screen and less time with the patient. And finally, most importantly, not a single patient wrote me and said they wished their doctor or nurse spent more time typing and less time listening.

Medicine is the art of the subtle- the resentful glance from the mother of the newborn presenting with the suspicious bruise, the solitary bead of sweat running down the temple of the fifty three year old truck driver complaining of reflux, the slight flush on the face of the teenage girl when asked if she is having thoughts of hurting herself. These things matter. And these same things are missed when our eyes are on the screen instead of the patient.

Health 2.0 Asia: Japan Conference Partnership

Feb 27, 2015

By SOPHIE PARK

Tokyo, Japan – Health 2.0 announces the Health 2.0 Asia partnership with MedPeer, Inc. to showcase the Health 2.0 Asia conference Japan on November 4-5, 2015. The conference will be the first of a series of events expanding the global presence for Health 2.0 in Asia. This conference will feature ground-breaking insights and leadership within the global health care technology industry while showcasing cutting-edge technologies for user-generated health care. The conference will become a forum for attendees to build networks for exchanging innovative ideas and developing new business parternships, which will promote active inbound and outbound investment within the health-tech industry. MedPeer, Inc. will expand Health 2.0 activities across Japan in collaboration with local chapters by holding a series of health-tech hackathons.

About Health 2.0

Health 2.0 is the premiere showcase and catalyst for the advancement of new health technologies. Through a global series of conferences, thought leadership roundtables, developer competitions, pilot programs, and leading market intelligence, Health 2.0 drives the innovation and collaboration necessary to transform health and health care.

Media Contact
Sophie Park
so****@********on.com

The Facebook Model for Socialized Health Care

Feb 26, 2015• 5

By EDGAR T. WILSON

As government involvement in U.S. health care deepens—through the Affordable Care Act, Meaningful Use, and the continued revisions and expansions of Medicaid and Medicare—the politically electric watchword is “socialism.”

Online, of course, social media is not a latent communist threat, but rather the most popular destination for internet users around the world.

People, whether out of fear for being left behind, or simply tickled by the ease with which they can publicize their lives, have been sharing every element of their public (and very often, their private) lives with ever-increasing zeal. Pictures, videos, by-the-minute commentary and updates, idle musings, blogs—the means by which people broadcast themselves are as numerous and diverse as sites on the web itself.

Even as the public decries government spying programs and panics at the news of the latest massive data-breach, the daily traffic to sites like Facebook and Twitter—especially through mobile devices—not only stays high, but continues to grow. These sites are designed around users volunteering personal information, from work and education information, to preferences in music, movies, politics, and even romantic partners.

So why not health data?