And the answer is not the quality of the model! In the comments please!
The trifecta: Reform idiocy, Hospital CEOs and the Obesity Problem
It’s rare that you get such a delicious health care story combining human frailty, blindness and multiple stereotypes, but Julie Rovner of NPR found it. In fact I literally thought she’d been set up but she confirmed to me that it was true and put me in touch with the CMS spokesman who confirmed it. So remember, this really happened.—Matthew
An interim hospital CEO in Ohio Valley Medical Center, in West Virginia “found out” “advanced intelligence” from “word of mouth” sources in Washington DC that the “High Commissioners of the Healthcare Reform Bill” were going deny Medicare payments to any hospital of which than 5% of employees were 25% overweight.
This rumor prompted the said CEO to panic. Now before I tell you what he did, let me tell you a little of his story. To quote the CEO as he tells it:
I am five feet, 10 inches tall. The guidelines (he’s referring to standard BMI guidelines) suggest that I should weigh between 151 and 163 for my medium frame. If you add 25 percent to the upper limit, I would need to be no heavier than 204 pounds. I currently weigh 272 pounds, down from 335. I would have three years to lose 68 pounds
That is indeed some challenge. Not to mention that the hospital is in West Virginia (albeit the northern sliver between Ohio & Pennsylvania) where the obesity rate is among the nations highest—there’s a reason that Jamie Oliver took his childhood obesity crusade there. In fact Ohio County, WV’s obesity rate is 32% according to the rather fun County Sin Rankings site. And as obesity tends to mean a BMI of roughly 25% more than the outer band of the guidelines, it’s a fair bet that somewhere close to 32% of the workforce is obese. So getting that number down to 5% would be a major struggle.
The interim CEO also wanted to promote not only his own weight loss story but the laudable activities of his hospital’s dietitians and its weight-loss programs. Here’s his counsel to hospital employees.
I strongly urge you to take advantage of the programs OVMC and EORH are currently offering employees who are battling with excess weight. Mary Velez is doing a fabulous job with Weight Watchers programs, and in addition, I have also been offering a program known as “Diet and Fitness for Love.”
And who could be against that advice?
Aneesh Chopra talking Health IT and innovation, SF 12 noon today
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Today at 12 noon PST Aneesh Chopra, Federal CTO will be at the Commonwealth Club in San Francisco talking about health care and health care IT. Indu and I saw him last night talking about technology before a big crowd at the Silicon Valley Computer History Museum.
In today’s talk he’s going to be focused exclusively on health care, which means he won’t have to dodge the question on Net Neutrality that he got last night. And even better, if you don’t have a ticket yet you can get one free thanks to the California Health Care Foundation,
I’ve seen Aneesh talk several times. Last night was particularly good in that he really responded well in the Q&A session. Plus he gave several shout-outs to the Health 2.0 Developer Challenge even if he made Indu embarrassed,
So if you care at all about health care and IT, you should come to the Commonwealth Club in downtown San Francisco today. And as an added bonus the entire health 2.0 team down to the Norwegian interns will be there – except for Lizzie who is up at the Health 2.0 NorthWest Chapter Kick off meeting.
Diversinet: a backbone for unplatforms?
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Unplatforms is the term I’ve been using to describe the multitude of devices that people are using to collect and receive information. And also to cover the different channels they are using often on the same device (e.g. text, voice and web on one smart phone). Application developers are having to come up with strategies for connecting with people and moving and integrating their data in a world of multiple unplatforms, Diversinet has been focusing on creating a turnkey system for moving health data securely to patients–here’s a demo you can play around with to see how it works. It might be one solution for health care organizations to deal with all those unplatforms over which they need to reach consumers.
The company has recently changed its business strategy–it was working with a subsidiary of a Penn Blues plan to distribute its services, but following a protracted legal dispute, it’s now going direct to health care plans and providers who want to move data between multiple devices, and has hired McKesson veteran Mark Trigsted to run its new health care group. First customer is Minnesota integrated systems HealthPartners, with a pilot for pregnant women underway already. I spoke with Diversinet’s SVP of sales Jay Couse to find out more about the technology and the business strategy.
Ingenix buys Axolotl (with minor Update)
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Ingenix, the arms dealer that’s been supplying all sides in the health care information war for the past decade or so, built itself up by buying lots of little companies in the data analytics space. Now it’s repeating the effort in the Health Information tools space. First it bought Caretracker (actually the company may have had a different name when it bought it, but that’s the name now). It’s a Web-based EMR for smaller practices (a sector with lots of Federal dollars attached). Then it bought Picis, a company that offers software that runs ORs, EDs and other high acuity inpatient sites (another recipient of lots of Medicare dollars).
Today it bought Axolotl, one of the vendors that’s biggest in the emerging (and constantly confusing) Health Information Exchange marketplace. Yet another place that lots of Federal dollars via ONC are going.
You’re probably noticing a pattern by now…
Ingenix itself of course is owned by United Health Group, although its CEO Andy Slavitt will be at pains to tell you that United also just happens to own a health insurer or two, and that Ingenix is not the subsidiary of a health insurer. Of course, Congress doesn’t always agree…
Normally I’d do lots of in-depth analysis about this story, but I’m for now just rushing to for once beat HIStalk to the punch!
UPDATE: Inga at HISTalk won’t truck with my “I beat her” comment and notes that she posted the following tweet before me (even if I got my post up on THCB before her or MrHISTalk posted on HISTalk!)
Rumor from two good sources: Ingenix/UnitedHealth Group will announce its acquisition of Axolotl after the market…http://fb.me/ECtaUXRc
boltyboy2:56pm via TweetDeck
Ingenix (UHG) getting even more expansive in HIT, buys HIE vendor Axolotl
Interview with Geoff Hyatt, VP Business Development for Alere
At Health 2.0 Washington DC Conference, VP Business Development for Alere, Geoff Hyatt talked about collaboration and communication tools.
Beating up on ONC, mostly unjustified
Earlier this week there was a curious little hearing at Pete Stark’s committee. Much of the Q & A—mind you post the announcement of the final meaningful use rules—was (apparently, as I can’t find the transcript) a beating up on the poor folks at ONC for reducing the barriers towards meaningful use. Here’s Jonathan Hare of upstart privacy/identity/network vendor Resilient explaining that things are not tough enough.
While Jonathan is having a bit of fun here (and, oh by the way, he does actually have a solution for the inadequacies of current HIEs which we’ll be showing you more about in the world of Health 2.0), some of this and the other stuff the ONC folks had to deal with was a little tough. They got a fair amount of abuse from the committee.
Knee Trauma, again
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One of my favorite topics is back in the news. Apparently ACL repairs may be unnecessary. Here’s the WSJ Health Blog write up about the NEJM study. Two groups of active young people with torn ACLs were split. Half got immediate ACL repair, half got rehab and later repair if they needed it. Of the second group around 39% needed surgery but when the two groups (surg vs surg when rehab wasn’t enough) were assessed there was no difference.
Mostly this is a big duh! A simple ACL tear doesn’t need fixing unless you are going to go skiing, play soccer, volleyball or some other sport that needs it. I had a left knee simple ACL tear in my early 30s, had it fixed after 6 months wait & rehab and went back to all those sports. (Although I never seriously tested it in a twisting sport before repair).
Then several years later I had both a right knee ACL tear and a few weeks later multiple trauma to my left knee—3 ligament tears and other damage. (Advice to you all; snowboard around the tree not into it). My left knee has never recovered (nor will it) to take part in those twisting sports so I never had the right one fixed (I did get a new ACL & PCL in left knee as I need to be able to walk again!). But the right knee with no ACL is fine for walking, running, biking and even controlled pivoting for snowboarding—where the leg is locked in place vis a vis the other one.
But if I try to twist in a gentle soccer kickabout on my right knee I fall on my ass. So for my earlier ACL repair I suspect that I would have been in the group that needed surgery anyway (the 39%). So if you don’t want to or don’t need to play those sports OR if you do the rehab and are fine, you don’t need a repair, But if you do need to play those sports and rehab alone doesn’t work, then you do.
The question is how many people are getting the ACL repair but never gave rehab a try? Probably quite a few, and for them rehab with the option of surgery is a good idea.
But the real question is how many people are getting ACL repairs when they’re not participants in those sports? Anyone know?
So I’m on TV, unfortunately in piece of crappy reporting
So last month the nice people from KTVU (the local Fox affiliate in SF) came by to interview me and last night it aired. They’d been over at web-based EMR vendor Practice Fusion and had found out about EMRs. Then they came to interview me. I should probably have got the hint when reporter John Fowler kept on asking me about privacy concerns. I spent 20 minutes giving a balanced nuanced view about the advantages and problems of adopting medical records which is not exactly represented by the 6 second soundbite I get.
Unfortunately—despite the producer’s stated desire to use Bay Area people—Texan nut job Deborah Peel gets almost half the piece including almost all the interview content. (Apparently Deven McGraw couldn’t be tracked down? Maybe DC is too far away) And what does Deb Peel say? Well you know what she says…
Fantastic job: HHS ONC subject matter expert on consumer e-health
Josh Seidman has written from ONC telling us about a fantastic job opportunity. You get to work with the brilliant folks at ONC on fun stuff regarding consumer e-Health. What does that mean? From the posting.
- Forge alliances with consumer organizations, technology and care delivery innovators and consumer advocates to further the consumer e-health agenda.
- Develop consumer oriented strategies across the Office of the National Coordinator for Health Information Technology (ONC).
- Serve as Project Officer providing project management oversight for contracts, including designing, developing and coordinating project management plans for policy initiatives in conjunction with the Division Director and the Office of Policy and Planning Director.
We’ve been very impressed by everything we’ve seen about ONC’s commitment to patient communication—not least the “sneaking-in” to the meaningful use requirements in Phase 1 of patient education materials (what Don Kemper calls Christmas in July). I can’t think of a more fascinating job for anyone who cares about online health.
So if you’re interested here’s the link to apply.
