Category: Uncategorized

A Response to Steven Brill

Jan 20, 2015• 51

By ROBERT PEARL, MD

As CEO and Executive Director of The Permanente Medical Group at Kaiser Permanente, I have been following with interest the exchange between Malcolm Gladwell and Steven Brill, prompted by Gladwell’s critique of Brill’s book (America’s Bitter Pill). Gladwell accurately points out that the solution to the problems of the American health care system that Brill puts forth in the book are very close to the structure of Kaiser Permanente. We provide world class hospital and ambulatory care to millions of Americans through our dedicated, physician-led Permanente medical groups, and pay for it through the not-for-profit Kaiser Foundation Health Plan.

Brill dismisses Gladwell’s criticism explaining that “Kaiser Permanente is not the same because it doesn’t have a monopoly, or oligopoly power, in any of its communities. It’s not a teaching hospital. It doesn’t have the network of high-quality doctors, or isn’t perceived to, like New York Presbyterian has in New York or the Cleveland Clinic has in Cleveland.”Continue reading…

My Health Data Is Killing Me

Jan 20, 2015• 9

By TOM GREENE

We are still in the dark ages when it comes to health and fitness data. It reminds me of the early 1990s when I had a paper day planner for a calendar, a business card holder for contacts, and a map.

Then along came the Microsoft Outlook and LotusNotes platform. These two platforms slugged it out like Uber verses Lyft. Then Microsoft integrated MS Office with MS Outlook and it was “game over.” I finally had one place to find everything I needed to do 90% of my job.

I’m waiting for that moment to come to the realm of my fitness data. It’s extremely difficult for me to access my medical and fitness data as it is, and yet the recent CES conference presented hundreds of new ways to collect more of my data. There will be wearables, scales, patches, contact lenses, smartphones, watches, etc. Maybe even a drone to fly overhead and watch what I eat for lunch. It is overwhelming. How overwhelming, you ask?

Let’s start with AppleHealth (HealthKit).

There is a reason Apple gave this app out for free on iOS 8.0. I recall getting the Brickbreaker game for free on my Blackberry in 2004. I played it once on a long flight and never used it again.

HIT Newser: The Flex-IT Bill, Take 2 + Dr. Google In EHR Bid

Jan 20, 2015• 3

By MICHELLE RONAN NOTEBOOM

Flex-IT Bill, Take 2

Lawmakers re-introduce the Flexibility in Health IT Reporting Act of 2015, which would shorten the 2015 MU reporting period from one year to 90 days. The bi-partisan-supported bill earned quick support from HIMSS, CHIME, the AMA, MGMA, and other professional organizations. The bill was originally introduced in September but it failed to pass.

Given the growing disenchantment with the MU program, look for this bill to pass – and hopefully give a boost to attestation numbers.

Dr. Google Joins DoD EHR Bid

Google teams up with PwC, General Dynamics, and Medsphere in their bid for the Department of Defense’s $11 billion EHR bid.

Google brings name recognition and a reputation for innovation and data security. While the Epic/IBM team has been looking like the front-runner, Google puts the PwC/Medsphere/GD team back in the hunt. For those keeping score at home, other vendors in the mix include Cerner/Leidos/Accenture Federal and HP/CSC/Allscripts. A June decision is expected.

The American Healthcare Consumer

Jan 16, 2015• 32

By IAN MORRISON

When you hear the word “empowerment,” it’s code for “You’re on your own, pal.”

Health care leaders are starting to recognize that consumers are becoming a major decision-making force. Let’s be clear at the outset: The rise of the consumer is not the panacea that will solve all our problems. It is a reality that hospitals and health systems must respond to. For the foreseeable future, consumers will pay more for health care and be more involved in picking plans, providers and individual treatment options. This development means significant financial consequences for consumers (unlike almost any other developed country).

Providers need to understand the financial predicament of the typical American health consumer and the responses consumers are making in this changing environment. At the same time, with a new congress and a political season of primaries and posturing just around the corner, pundits, politicians and plutocrats need to recognize where consumers are as voters, plan members, employees, patients and family members.

Will There Be a Sony For Healthcare in 2015?

Jan 16, 2015• 2

By INDUSTRY SKEPTIC

In 2015 I think there is a good chance we’ll see a major security incident along the lines of this month’s Sony hack. This event will be like 9/11, in the sense that there will be a before and an after, and life as we know it will change forever. This has been coming for a long time. We’ll finally see how vulnerable we are and there will be a public outcry, most likely leading to some kind of government action. Up until now, most incidents have been security breaches of the disgruntled employee and clueless user variety, which are a huge big deal as far as HIPAA lawyers and privacy advocates are concerned, but not a very real threat to anybody.

This will be the real thing, with potentially disastrous results. I don’t know if this will be an attack on Healthcare.gov by a politically-motivated hacker group. (I’m surprised it hasn’t happened already. ) Or an attack on a academic hospital system designed to acquire potentially valuable patient and research data. Or a hack of a health insurance company, intended to Wikileak financial and (possibly damaging) patient claims data. For an insurer with a poor track record, this could cause serious problems.

2015: The Year We Finally Meet The Triple A

Jan 15, 2015• 2

By CYNDY NAYER

Since 2002, and possibly before, there have been moments of clarity and innovation in the health care sphere, from patient-centered to consumer-driven to value-based to outcomes design, from iPhone texts to wellness to electronic medical records to blue buttons and transparency. Yet the year 2015 will certainly be the standout year of transformation, most noted for the interstellar collision of all of these siloed ideas into the supernova Triple-A.

This is the year that the person reclaims his or her health.

The Triple A is not exactly the Triple AIM of Dr. Don Berwick (his is patient-centeredness, cost effectiveness and positive patient experience). Instead, this Triple A happens within and is directed by the person, whom we will identify as over age 18 and able to make decisions for him/her self.

The Triple A is marked by the following dimensions: Awareness, Activation and Accountability.

Invaders from Mars with Commentary from Robert Burns

Jan 15, 2015• 2

BY MARTY SAMUELS, MD

Just over a half-century ago, in the mid-50s, at the height of our paranoia about communists and the Soviet Union, a boy sees a flying saucer land in the distance. No one else sees the event. The occupants of the mysterious spacecraft prove to be invaders from Mars. Their strategy is to capture people, one-by-one, and to perform brain surgery on them whereby an electrode controlling device is placed in the victims’ brains rendering them pawn
s of the invaders, though they retain the superficial appearance of human beings. The only clue to recognizing one of these unfortunate robots is to look for the telltale antenna at the base of the hairline in the back of the neck.

In order to understand the profound meaning of the Invaders from Mars, you have to know a little neurology.

There are really two people within each of us, a fact that reflects the two almost mirror image cerebral hemispheres, each responsible for the opposite side of the body and extra-personal space. Put simply, damage to the left hemisphere will cause paralysis and loss of sensation on the right side of the body, including loss of perception from the right side of the world.

This loss of perception is more profound than simple blindness. If reflects the fact that anything that the brain does not record is actually not there. We live, after all, in virtual reality. What our brains do not sense is, for us, not there. Do the following experiment. What is behind your head? Not what you imagine might be there or what you think you remember is there. What is actually there? Is it black, white, striped? Try to describe it. You don’t have the words, because what is there is nothing, and nothing has no color, texture or shape. Is there an antenna at the base of your hairline? You couldn’t possible know, could you?

Healthcare and the Second Machine Age: An Interview with Andy McAfee

Jan 15, 2015• 5

By ROBERT WACHTER, MD

Andy McAfee is the associate director of the Center for Digital Business at MIT’s Sloan School of Management. He is also coauthor (with his MIT colleague Erik Brynjolfsson) of the 2014 book, The Second Machine Age: Work, Progress, and Prosperity in a Time of Brilliant Technologies, one of my favorite books on technology. While he sits squarely in the camp of “technology optimists,” he is thoughtful, appreciates the downsides of IT, and isn’t overawed by the hype. In the continuing series of interviews I conducted for my forthcoming book on health IT, The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age, I spoke to McAfee on August 13, 2014 in a restaurant in Cambridge, Massachusetts. I began by asking about some of the general lessons from today’s world of technology and business that have implications for healthcare.

McAfee: Our devices are going to continue to amaze us. My iPhone – it’s a supercomputer by the standards of 20 or 30 years ago. Right now, hundreds of millions of people carry a device that is about this powerful. Wait a little while. That number will become billions. And those devices will spit out ridiculous amounts of data of all forms, so this big data world that we’re already in – that’s going to accelerate.

Since data is the lifeblood of science, we’re going to get a lot smarter about some pretty fundamental things, whether it’s genomics or self-diagnosis or how errors happen. Then, because we’re putting all this power into the hands of so many people all around the world, it seems certain that the scale, pace, and scope of innovation are going to increase.

So I’m truly optimistic for the medium- to long-term. But the short-term is going to be a really interesting, really rocky time.

RW: When you say medium- to long-term, how many years before we get to this wonderful place?

AM: Don’t hold me to it. But within a decade.

Rock Health and the Search for ‘Home Screen Health App’

Jan 14, 2015• 3

By KIM KRUEGER & MATTHEW HOLT

Rock Health has been around since 2011 first as an accelerator and now as an early stage venture fund. Matthew Holt had a chance to sit down with Rock Health’s Managing Director Malay Gandhi ahead of his appearance at WinterTech to discuss how Rock Health looks at the consumer side of digital health, and what developments Rock Health thinks we’ll see in the near future.

Matthew Holt: It’s Matthew Holt with Malay Gandhi. He is the managing director of Rock Health, and has been officially for what, nearly a year or so now, Malay? Is that right?

Malay Gandhi: Since June, June of this year.

MH: So about six months. Most of us know that Rock Health was founded by Halle Tecco and Nate Gross a few years back, 2011, and probably was the first and most influential of the incubators and accelerators that target health care specifically. Perhaps you can explain a little bit about how Rock Health works. Most people know that Rock Health is a nonprofit, and that you guys do a lot in terms of stimulating the ecosystem with small events, big events, and your reports on financing and so on. But you are mainly a fund and the amount of money that you invest in your companies has been increasing from I think $20,000 in the early days to $100,000 plus recently? Could you explain how that actually works compared to other accelerators or incubators?

MG: Yeah. Essentially, the way Rock Health works is there are three big things that we do, all under our mission to support and fund entrepreneurs. We have our venture arm, which does seed investments in the companies now. We’ll write checks up to $250,000 per company, really at the seed-stage. We conduct research which we release publicly. Let’s say about four reports or so a year, as you mentioned, tracking funding, but also doing deep diving in various topical areas.

Then our third area, we host a couple of events each year. Our signature events are the Health Innovation Summit, which is for everybody; the CEO Summit, which is an event for founders and CEOs of digital health companies; and then finally, the XX Retreat, which is a women’s professional leadership group for women who work in health care.Continue reading…

Thesis-Driven Investing in Digital Health: An Interview with Rebecca Lynn

Jan 14, 2015

By KIM KRUEGER & MATTHEW HOLT

These days, record amounts of venture funding is pouring into the digital health space. Yet, that hasn’t always been the case. Matthew Holt sat down with Rebecca Lynn, a General Partner with the Canvas Venture Fund, ahead of her appearance at WinterTech to discuss the quick and explosive growth in VC interest in digital health, as well what Canvas’ thesis-driven investment strategy means for its current and growing portfolio.

Matthew Holt: This is Matthew Holt. I’m talking to Rebecca Lynn. Rebecca is a General Partner at Canvas, which is a VC fund that came out of the better-known Morgenthaler fund about a year and a half ago. Is that right, Rebecca?

Rebecca Lynn: Yes. That’s right.

MH: Rebecca has done a number of things we were just talking about offline. Her very, very first deal was in the Lending Club, she has a background in personal finance, and the Lending Club just went public, so congratulations, Rebecca.

RL: Thank you.

MH: She’s also in the last four or five years been working hard on getting up to speed in health care and now you’re more than up to speed. You’re one of the leading venture capitalist experts in health technology. So that’s obviously what we are going to talk to you about and you’re going to be on the investor panel at Health 2.0’s WinterTech which is coming up on January the 15th. Also, you are the founder of something, which I was there at the start with you called, “DC to VC” which is a group putting together venture capitalists with government officials.Continue reading…