Category: Uncategorized

A Dream of Reason

Jun 22, 2009• 9

By BRIAN KLEPPER and DAVID KIBBE

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The dream of reason did not take power into account…Modern medicine is one of those extraordinary works of reason…But medicine is also a world of power.

-Paul Starr, The Social Transformation of American Medicine, 1984

Today’s unveiling of a Declaration of Health Data Rights is an important action, long overdue, that represents a collaborative effort by a group of health care professionals – activists, entrepreneurs, technologists and clinicians – all colleagues we hold in high esteem.

The Declaration’s several points arise from a single, simple premise: that patients own their own data, and that that ownership cannot be pre-empted by a professional or an institution. And there lies its power, especially in the context of early 21st Century health care. It is a transformative ideal that currently is not the norm. But we join our colleagues in declaring that it should be.Continue reading…

Time to Revisit Wyden-Bennett?

Jun 22, 2009• 8

By ROGER COLLIER

With the Washington insiders at politico.com
reporting this weekend that health care reform appears to be in “real
jeopardy,” and the Senate Finance Committee so uneasy that they have
decided to delay reform bill markup until after the July Fourth recess,
it’s increasingly clear that an approach of layering more and more
fixes onto the present system isn’t going to work.

Opening Physicians’ Notes to Patients

Jun 21, 2009• 22

By STEVE DOWNS

Steve Downs Today’s Boston Globe ran a story (page one, no less!) announcing our grant to Beth Israel Deaconess Medical Center to run a three-site demonstration of opening up physicians’ notes to patients. That’s not just making labs, drugs, allergies, etc. available to patients – it’s giving them access to the actual notes that the physician records about a visit. Now these notes are technically available now – under HIPAA each of us has a right to our full medical records (of which physician notes are a part), but the process for obtaining them is often slow, cumbersome and even expensive in some cases. Under this project, called Open Notes, patients will receive a secure email after the note has been completed and they can see it right away. They’ll also be prompted to review the note prior to their next visit. So instead of limiting access to the very determined, access will be easy for anyone who’s mildly interested.

Why would we fund this? Several reasons, really. First, is that at the Pioneer Portfolio, we’re very interested in patient-centered innovation. Let’s face it: virtually every trend suggests that people are going to have to become much more engaged in their care and in taking care of themselves. And, as the pioneers of shared decision-making, patient centeredness, patient activation, online support groups and the health 2.0 community have shown us, real benefits come from this engagement. So much of the energy and excitement in health care today is coming from the patient/consumer side of the equation. So it’s a space where we believe we will find many innovations that can ultimately transform health.Continue reading…

Your AHIP Quiz Question of the Day

Jun 21, 2009• 20

By Matthew Holt

This is something that’s been puzzling me for a few weeks. We all know that insurers are very good at making sure that they insure healthier risks than average. In the individual market they do this openly, by underwriting against poorer risks. Those “risks” (who are most of the people with the really tragic stories) end up uninsured or in massively over-stretched state major risk pools.

Eight Signs that Wellness and Prevention have become Health Reform Priorities

Jun 20, 2009• 9

By DAVID R. WILLIAMS

Health care reform alone won’t make
America healthier. We’ve seen this basic message as recently as yesterday,
in Ezra Klein’s piece for the American Prospect, “Wealth-Care Reform.” At the Robert
Wood Johnson Foundation Commission to Build a Healthier America, we’ve been studying prevention, wellness,
and the broader factors that influence good health for nearly two years.
And as the health care reform debate has heated up over the last few
weeks, we’ve seen eight signs that health reformers and leaders from
all sectors are starting to get the message that there’s more to health
than health care.

How Relevant is the American Medical Association?

Jun 20, 2009• 23

By RAHUL PARIKH, MD

Like most doctors, I was busy seeing a full schedule of patients when President Obama addressed members of the American Medical Association at their annual meeting in Chicago. The speech was billed as a crucial confrontation over health reform, and anticipation had been building for quite some time. So I was too busy to learn anything about his remarks and the response until I got home.

Then again, I’m not a member of the AMA. I never have been. Neither are very many of my physician friends and colleagues. In fact, the odds are that your doctor isn’t a member of the AMA, because at best, only between 25-30% of the approximately 800,000 doctors in country belong to it. And a good percentage (up to half of members according to one report) of those include residents and medical students, who get big discounts on membership and a free subscription to a journal when they join.Continue reading…

The Dumbest Thing I Have Ever Seen An Insurance Company Do

Jun 20, 2009• 28

By ROBERT LASZEWSKI

And, I’ve been in the business for 37 years.First, let me
stipulate we really need a system of universal care where everyone gets
to have insurance. But we don’t yet so certain rules are unavoidable
until we do.

The State of Meaningful Use

Jun 19, 2009• 2

By MICHAEL PAINTER

Is it possible that the State Department is technologically bolder than the HIT Policy Committee? On Tuesday, that committee convened by the Office of the National Coordinator as required by the American Recovery and Reinvestment Act released some initial recommendations on the definition of meaningful use of HIT. Then yesterday the New York Times in an above the front page fold article reported that the State Department recognized an internet blogging service could change history–right now.

Compare that report about the State Department to the HIT Policy Committee’s recommended vision for the role of patients and families. The committee envisions that someone would eventually “provide access for all patients” to populated personal health records and some self-management tools by 2015–about six years from now. It’s not that this vision is bad; it’s just so underwhelming. Let’s see–the State Department thinks that the Iranian people might be using Twitter today to regain control of their nation–and in our multi-billion dollar ultimate vision for the patient’s role with health information technology we’re still talking about “providing” a couple of interesting tools to patients by 2015. Is it me, or are we possibly missing a powerful health reform player here–the consumer?

So, as you can see, I listened to this meeting on “meaningful use” and came away with some distinctly mixed impressions.Continue reading…

Back to the Drawing Board?

Jun 19, 2009• 4

By ROGER COLLIER

The current congressional approach
to health care reform of adding ever more fixes without changing the
underlying system looks increasingly shaky.

What are the some of the indications?

The public plan has generated
enormous opposition—and not just from insurers. Whether anyone believes
that a Medicare clone would reduce under-65 health care costs or not,
it is unlikely that a final reform bill will include anything other
than a weak compromise.

Op-Ed: On Health Reform, Obama Faces a New Foe: Other Democrats

Jun 17, 2009• 4

By HARRIS MEYER

Democratic Senator Maria Cantwell of Washington is a prime reason President Obama will have a hard time getting health care reform passed this year. Let me explain this seeming oddity. At a news conference on May 27 in Yakima, Wa., the purportedly liberal Cantwell, who represents a state that voted 58 percent for Obama, announced her support for two new, bipartisan bills that would advance a key goal of Obama’s reforms — increasing access to primary care physicians and other doctors who are in short supply. As Massachusetts has discovered, making sure nearly everyone has health insurance doesn’t help if there aren’t enough doctors to take care of them.

The two bills Cantwell endorsed feature provisions that would cost the federal government billions of dollars a year — scholarships and loan forgiveness for medical students who serve in shortage areas, increased funding for the National Health Service Corps, higher Medicare payments to primary care doctors, more Medicare funding for resident physician training, interest-free loans for hospitals starting new residency training programs, etc.Continue reading…