Category: Uncategorized

Checklists save money but adopted at glacial pace

Aug 29, 2008

By Charlie Baker

For the past year or so, I’ve been listening to and participating in a conversation in New England and nationally about the rising cost of health care. It’s a sticky wicket, to be sure, with no obvious, simple solutions. But I must say, I’ve been surprised that at least one pretty good idea hasn’t generated more traction. Intensive Care Unit checklists — which I’ve written about before — have already demonstrated that they can save lives, money and time, reduce variation, and improve quality, but they remain the exception instead of the rule in ICU care.

In June, the World Health Organization shared preliminary data on a demonstration it’s running using a “Safe Surgery Checklist” that showed reductions in deaths, complications and infections, along with significant improvements across many care standards for a wide range of surgeries that were done using the tool. And yet the take-up rate on this tool — which is so simple it fits on one single sheet of paper — is very slow to occur.

Balloon Mania: Happy Birthday Health 2.0

Aug 28, 2008• 2

By Scott Shreve

Having been around for the beginning of the Health 2.0 movement, it is good to see the conference continuing into its sophomore year. A lot has and continues to happen regarding the ongoing health care innovations that collectively make up Health 2.0.

An ongoing criticism and source of frustration for me has been the banter of those who continue to regard the entire space as a “farce.” People who demand the “proof”, demand unwarranted standards of outcome/impact prior to experimental implementation, and dismiss the space because current business models have yet to produce multiple exits (although there have been a few notables, including AthenaHealth, Medstory, HealthCentral, etc).

So at the infancy of this movement, all I can share with those doubters is an anecdote from the life of one the most famous tinkerers of all time — Benjamin Franklin (just finishing up his biography). In describing the distinctively French invention and subsequent “hype” associated with hot air balloons:

Stanford Med School rejects industry funding for continuing education

Aug 28, 2008• 4

By Sarah Arnquist

Stanford University’s medical school announced this week new restrictions on educational contributions by drug and medical device companies, which turn out to be among the strictest in the nation.

The rules are an effort to limit industry influence on physician practice. Currently, the continuing education programs tend to follow the market’s needs and not necessarily the best advancements for optimal patient care.

"The school will no longer accept funds from pharmaceutical or device companies that are targeted to specific programs, as industry-directed
funding may compromise the integrity of these education programs for
practicing physicians," a press release states.

SiliconValley.com reported that "Drug and medical-device company
contributions for continuing medical education have surged nationwide
from $302 million in 1998 to $1.2 billion in 2006, according to the
Accreditation Council for Continuing Medical Education. Stanford
officials said about $1.87 million — or 38 percent — of the medical
school’s budget for continuing education came from industry sources in
fiscal 2006-07."

Cost-containment missing piece of Mass. health reform

Aug 28, 2008• 5

By Niko Karvounis

Niko Karvounis tracks the health care system for the Century Foundation. This post first appeared on the HealthBeat blog, one of our favorite health care reads.

The Massachusetts experiment in health care reform is all about expanding access. But it doesn’t try to control costs. This, in a nutshell, is why it’s running into trouble.

The plan didn’t reform health care delivery, just coverage. Granted, in terms of bringing more people in under the tent, it’s been a success: Since the plan went into effect in 2006, 439,000 people have signed up for insurance — a number that represents more than two-thirds of the estimated 600,000 people uninsured in the state two years ago. This surge in coverage has reduced use of emergency rooms for routine care by 37 percent, which has saved the state about $68 million. (Going to the ER for routine care drives up health care costs by creating longer wait times and tying up resources that can be used to help patients who are critically ill).

Health Reform Prospects Fade as Presidential Campaign Enters Homestretch

Aug 27, 2008• 13

By Jeff Goldsmith Ijeff

Jeff Goldsmith is President of Health Futures, Inc, and a professor of public health sciences at the University of Virginia.

As presidential aspirants geared up their issue analyses last fall, health reform ranked as the number one domestic policy item the next President should address in many national public opinion polls. As the campaign season draws to a close, however, health reform has virtually disappeared from the headlines, supplanted by concern about gas prices, home mortgage foreclosures, soaring food costs and, most recently, the "Soviet" invasion of Georgia. Though you will hear campaign rhetoric from both parties at their upcoming conventions, health reform has been demoted to the second tier of campaign issues. Their platforms and campaign pledges on health reform seem increasingly unlikely to decide who is the next president of the United States.

As previously argued in this space, "health reform" really meant doing something about "health costs for my family" to most voters, not reducing inequity in access to coverage. Ninety-three percent of the voting public has health insurance of some kind. It is clear now that voter concern last fall about health reform was really a leading indicator of anxiety about the deteriorating economy and their own household economic insecurity. As Brian Klepper pointed out a few months ago in THCB, the purchasing power in real dollars of the American paycheck moved into negative territory last September, thanks to the rising price of energy, food and the resetting of home mortgages to higher rates. All these problems have worsened materially in the ensuing year

Two Blues, two different Health 2.0 approaches

Aug 26, 2008• 3

By Matthew Holt

Two of the better behaved and more innovative health plans (both non-profit regional Blues) have been taking different approaches to Health 2.0, user-generated content, communities and all that. BCBS Minnesota created a separate company called Consumer Aware which created HealthCare Facts, and the Healthcare Scoop. Now the Healthcare Scoop is going national. (You can hear more about that in the podcast I did with CEO MaryAnn Stump last year).

Meanwhile, in the Pacific Northwest Regence has been beavering away creating its own communities within its core web site — and has been making a pretty job of it, too. They’re theoretically for members only, but you can get a guest pass. And there’s a good deal of activity there. Which kind of answers the question, should health plans get involved in Health 2.0? These early adopters say, yes.

And, of course, I’d be remiss in my crass marketing duty if I didn’t tell you that Mary Ann Stump and Regence’s Joe Gifford will both be at the Health 2.0 Conference in October.

Comparing Biden’s health reform plan to Obama’s

Aug 25, 2008• 5

By Craig Stoltz Biden

It’s the time in the political season to make way too much of the impact a vice president can have on the presidential contest.

So I hope you don’t mind if I extend that amusing parlor sport into the arena of health care reform and consider how how Joe Biden’s original proposal for health care reform compares to Barack Obama’s.

If nothing else, it’s a good way to parse a few of the issues likely to be magnified when Obama and McCain yammer back and forth about their health care plans in the coming weeks.

In Online Health Content We Trust?

Aug 25, 2008• 5

By Fard Johnmar Fard

Late last week, Susannah Fox of the Pew Internet & American Life project announced
that the nonprofit had updated its statistics on the number of adult Americans using the Internet. Currently, 73 percent are Web users. Of this group, three-quarters have looked for health or medical information online. Fox notes that regardless of whether the number of online health searchers increases or decreases from year to year, “Internet users are doing something [and] the horse is out of the barn.” The growing power of the Internet has generated enthusiasm in some and dismay in others. It has also exacerbated long-standing tensions between patients and medical professionals –- especially physicians. For example, in a famous Time magazine essay, Dr. Scott Haig admonished some medical “Googlers” for possessing a wealth of information, but lacking the expertise to interpret it correctly.

Hello Health open for business

Aug 25, 2008• 13

By Matthew Holt

Hello Health, the clinic that Jay Parkinson has been promoting for a while, is open for business. If all the patients are as happy as the first patient, success is assured!

The deal is that they’ve gone with mid-range concierge fee ($35 a month—around the cost of a low cost cell phone plan or high-end Netflix?) for patients to get access/membership and then have fixed charges thereafter. That amount is about three times what I pay for very basic low-end concierge services (basically email) at Tom Lee’s Metropolitan Medical Group in San Francisco, but way less than the typical $150–200 a month fee for high-end concierge practices.

What remains to me the tricky factor in their vision is how they’ll make this work with the bureaucracy & accounting behind high deductible plans (without taking on a ton of staff). But however that piece works out, someone needs to shake up primary care. Jay and his 2 colleagues are young entrepreneurial docs giving it a shake.

Health 2.0 had a film crew there with David Kibbe acting as roving reporter at the launch party. Much more on both these topics to come, but remember that Hello Health is also working with MyCa on a very interesting new interface to the EMR and much more.

Yes, you’ll see much more about the Health 2.0 Across America video starring David Kibbe and the MyCa interface at the Health 2.0 Conference.

A few socialist musings for Monday

Aug 25, 2008• 1

By Matthew Holt

I just watched the closing ceremony of the Olympics, and the word is that state sponsorship of little known or cared about sports like swimming, gymnastics and cycling gets more medals and so should be encouraged. Bob Costas told me that China spent $40 billion on the games, even if London is going to spend less than half that. So it got me thinking about socialism.

Kevin Pho, blogger of KevinMD fame, and usually reliably anti-government in his views, asks for more socialism, at least directed in the direction of him and his fellow MDs. In this USA Today op-ed he suggests rightly that cutting doctors fees in itself saves little in health costs..