Dr. Simon Kos had big shoes to fill when he took over the role of Microsoft Chief Medical Officer from Dr. Bill Crounse last year. Dr. Kos said himself that they were some “big scrubs to fill”. However, at the time he had already been with Microsoft for six years and in Health IT for more than a decade before that, so he was no doubt up to the challenge.
As Chief Medical Officer, Dr. Kos is responsible for providing clinical guidance, worldwide thought leadership, vision and strategy for Microsoft technologies and solutions in the healthcare industries. He made the move to Health IT after working a few years as a Medical Officer in Sydney, Australia. It was then that Kos decided to go back to school to study software engineering, and later his MBA. He then worked with InterSystems and Cerner and helped them to implement e-Health initiatives in Australia. In 2010 he joined Microsoft as a Health Industry Manager “with the appreciation that improving health and healthcare was about more than just putting in EMRs.” Even back then Dr. Kos had the vision to know that the future of healthcare would be in the data analytics and the AI applications that Microsoft would eventually release.
In a recent conversation, with the team here at Health 2.0, Dr. Kos talked about Microsoft’s current framework of digital transformation and highlighted their four pillars; Patient Engagement, Clinician Empowerment, Advanced Analytics, and New Models of Care. As a once practicing doc, he knows that technology needs to help not hinder the healthcare workforce and that AI will be able to improve diagnosis speed and accuracy without replacing or interfering with the clinician. He is a fervent believer that it is important to be constantly evaluating the tech models that may not be viable today but will be in the future. He is excited about Microsoft’s work on patient chatbots and VR/Mixed reality physician education platforms and will be demoing that technology on the Health 2.0 Stage on Monday, October 2nd.
The integration of behavioral health into the primary care setting has resulted in a number of benefits. Traditionally, behavioral health and medical health operated separately, but in recent years, the integration of these two systems has improved access to care, ensured continuity of care, reduced stigma associated with seeking care and allowed for earlier detection and treatment of mental health and substance abuse issues. By bringing behavioral health specialists into primary care facilities, healthcare systems have streamlined care and brought down costs, working collaboratively and reducing the number of appointments and hospital visits.
At Carolinas HealthCare System, we use technology to take behavioral health integration one step further. A robust behavioral health integration project was developed through myStrength, using virtual and telehealth technology to ensure that every primary care practice has the capabilities for early detection of mental illness and substance abuse and upstream intervention, easing the connection between behavior health specialists and patients who might otherwise be averse to seeking professional help.
Mental illness touches each of us personally: one in five individuals struggles with mental health issues, yet access to care is one of the biggest issues facing North Carolina residents today.Continue reading…
Value-based healthcare initiatives are great, but on their own won’t be enough to bend the healthcare cost curve.
The focus must move—and move quickly—from treating people who are sick to helping them get and stay healthy. The only way that’s going to happen is by getting patients and populations motivated to do the right things early instead of desperate things late.
The New Consumer World of Tools and Health Models
Health plans, in particular, have shifted responsibility onto consumers.
At this session you’ll also check out a demo from health optimization platform Welltok. Through population health management we are learning more about how to create wellness strategies and to stratify patient populations based on their conditions and adjust for nuances in age, race, diagnostic groups, and the like.
Any backpacker travelling on a shoestring budget in Thailand knows not to blow their entire budget on premium whiskey in a premium hotel on the first night in Bangkok. Rather, you need to skip the occasional meal, stay in a cheap dorm with random strangers, and drink cheap beer on Khao San Road if you wish to see the country and return home without having to wash dishes in a restaurant in Bangkok to repay the loans. Both Democrats and Republicans seem impervious to a simple wisdom that I learnt when backpacking – you save money if you go for cheap stuff. The operative word here is “cheap.”
Both the Affordable Care Act (ACA) and the Better Care Reconciliation Act (BCRA) impose cost sharing, such as deductibles. Deductibles lower premiums by cost shifting. Because the sick, for obvious reasons, are more likely to meet their deductibles sooner than the healthy, deductibles shift costs from the healthy to the sick, or are a “tax on the sick.” Deductibles also reduce premiums by reducing the administrative loading of insurance – because insurers have fewer small claims to process, administrative costs reduce.
One of the more interesting companies playing in the analytics space is Ayasdi. We’ve featured them at Health 2.0 a couple of times, but at HIMSS I got a chance to talk a little more in depth with chief medical officer Francis Campion about exactly how they parse apart huge numbers of data points, usually from EMRs, and then operationalize changes for their clients. The end result is more effective care and lower variability across different facilities, for example changing when drugs are delivered before surgery in order to improve outcomes. And increasingly their clients are doing this over multiple clinical pathways. They’re really on the cutting edge of how data will change care delivery (a tenet of our definition of Health 2.0) so watch the interview to hear and see more!
Bridget Duffy, the CMO of communications tech company Vocera & head of its Experience Innovation Network, is a national leader in the patient experience movement. And we all agree there are lots of improvements needed in the experience for both patients and front line clinicians. Anyone following the story about the death of my friend Jess Jacobs last year knows that there are problems a plenty in how patients are treated (pun intended). Bridget talked with me at HIMSS17 about how well we’ve done and how far we have to go.
A new report out from the American Health Policy Institute and Leavitt Partners further quantifies what we already know: a handful of employees are responsible for the bulk of employers’ health care spending. The new report documented that among 26 large employers, 1.2 percent of employees are high cost claimants who comprise 31 percent of total health care spending. Interestingly enough, the report was released on the heels of news yet again that high deductible health plans continue to be more popular than ever as a strategy for employers to control costs, with employee cost sharing expected to rise yet again this year.
And yet high deductible health plans may do more to bend the cost trend for healthy employees by reducing spending on items like pharmaceuticals and lab testing but not on inpatient care.
The least heathy employees quickly blow through their deductible, and their health issues are so acute and their bills so large, they don’t shop around for care. So what is a large employer or any purchaser concerned about these high cost claimants to do?
Customer centricity has been a mantra of managed care organizations for well over a decade. If you listen closely, you can hear plaintive cries of our care providers, lamenting the labyrinthine, almost Kafka-esque system of prior authorization, reimbursement, meaningful use, and near-real-time obsolescence of medical technology. The crushing weight of reform, the perverted incentives created by volume-based reimbursement, and the soaring costs of doing business have created a situation, much like in public education, where our system is fueled primarily by the power of a dedicated and passionate community whose members are motivated by their desire to care for other human beings.
“How can we possibly think about self-service websites when we are holding back an imploding healthcare delivery system”. Maybe we need to ask a more basic question…..is the U.S. healthcare system viable in the long-term? That question might simply be too hard to answer. So instead, we try to convince ourselves that, like educating our citizens, delivering medical care should be treated as a business. Innovation and value are fueled by financial incentives and healthcare is no different.
But it is different. It is very different.
In some particularly competitive/ wealthy markets, Providers are offering differentiated services….delivery rooms with hotel-style amenities, upgraded menus, concierge services, etc., usually available for an extra charge. But these services are not adding to anyone’s bottom line…they are just attracting those few patients who have the luxury of choice. Where is the value here?
The Affordable Care Act was intended to usher in a new era of competition and choice in health insurance, and at first it succeeded. But increasingly, provisions in the law are undermining competition and wiping out start-up after start-up. If something isn’t done soon, the vast majority of new insurers formed in the wake of the ACA will fail, and many old-line insurers that took the opportunity to expand and compete in the new markets will leave. It’s a classic story of unintended consequences and the difficulties of regulation.
Flush with optimism after the ACA passed, dozens of new insurers formed to take advantage of the environment created by the law. Twenty three of these were co-ops given start-up funding by the ACA. In most states the new plans only grabbed a small share of the market, but enough to put pricing pressure on larger incumbent plans. In a few states, like New York, the start-ups and other new entrants grabbed over half of the business on the exchanges.
To the surprise of many, price increases in health insurance remained low by US historical standards even as the recovery continued and people who had been without insurance were finally able to get it. How much of that modest cost trend is due to an improved competitive marketplace on the exchanges is speculation, but what is clear is that the doomsayers about the ACA were wrong. Costs did not explode, and even with higher 2016 rate increases we are not back to the bad old days (yet).