Category: Uncategorized

Forcing the candidates to get real on health care change

Sep 16, 2008• 9

By Robert Laszewski

Let’s pretend that either Senator Obama or Senator McCain will be able to implement their respective health care reform plans if elected. This exercise should be easy. We’ve been doing it for months now.

Or, we can get real and expect them to do the same.

For all the arguments both candidates are making that they are change agents, including over their competing health care reform proposals, this dirty little secret remains –– neither Senator’s health care plan has a chance of being implemented.

Adding layers to Health 2.0

Sep 16, 2008• 5

By Susannah Fox

Jen McCabe Gorman drew a picture at HealthCampDC last that I really liked. Luckily, I found this image of her Medicine 2.0 presentation, so nobody has to decipher my sketch.

The one difference is that, on Friday, Jen pointed out that the outer square ("content") is Health 1.0 and Health 2.0 begins with the "community" square. After reading her research paper, I now understand that the next inner square is Health 3.0, or content + community + commerce and the final, innermost square is Health 4.0, which would add coherence to the equation. Health 4.0 in this model is the "evolutionary stage connect[ing] the real world of brick-and-mortar systems with the virtual world of online services."

The paper is well worth a read, whether you agree with this model or not. I’m going to have to think about the following points, for example:

Another weakness of current Health 2.0 initiatives is the tendency of communities to attract similar people. Many focus on connecting "like-minds," relatively homogeneous groups such as patients with the same diagnosis or physicians in the same subspecialty. Similar groups then generate very similar content. Users become settled and ‘comfortable’ and thus less inclined to venture out and advocate for other consumer groups and sytemic change.

Around the Web in 60 Seconds (Or Less)

Sep 16, 2008• 1

The majority of ER patients leave confused and with unanswered questions, which can contribute to medication errors and return visits, the New York Times reports. And the study published in the Annals of Emergency Medicine was among English speakers! Imagine the confusion among those with limited or no English.

Illinois is debating its certificate of need laws, following a decision by the US Department of Justice and Federal Trade Commission that it hampers competition and weakens the market’s ability to contain costs, the Chicago Tribune reports. The Illinois Hospital Association president defended the law: "The state has a legitimate interest … in preventing the proliferation
of profit-seeking enterprises that seek to cherry-pick well-paying
patients or those who have good insurance coverage, leaving
full-service community hospitals to provide vitally needed but
money-losing services, such as emergency and trauma care and care for
the uninsured, that are poorly reimbursed or not reimbursed at all."

Pennsylvania politics over medical malpractice insurance subsidies threaten the existence of the state agency that monitors hospital finances, occupancy, procedures and infection rates, the Pittsburgh Tribune-Review reports.

Health Affairs has critiques of McCain and Obama’s health plans, along with a proposed comprimise by Wharton professor Mark Pauly.

Golden Rule Founder dies

Sep 16, 2008

By Matthew Holt

It is not seemly to speak ill of the dead so this is all you’ll hear from me about the passing of Patrick Rooney, founder of Golden Rule. An obituary is here.

Health 2.0–time to make a move

Sep 15, 2008• 3

The Health 2.0 Conference is a scant 5 & 1/2 weeks away, and as of Monday midnight on the west coast the rate for attending goes up $300 to the full rack rate. So please visit www.health2con.com and get your pass today.

The health search future

Sep 15, 2008• 5

By Jane Sarasohn-Kahn

Over the past couple of weeks, the eHealth world learned that RevolutionHealth engaged Morgan Stanley, the investment bank, to help assess the company’s ‘alternatives.’ The early talk was to raise capital, but the tenor seems to have switched to sales or merging. One talked-about suitor for Steve Case’s start-up is Everyday Health.

This news comes on the heels of a new comScore report that reports 21% growth in the "health information" site category, from 57 million visitors in July 2007 to 69 million in July 2008.

The No. 1 in health search portals continues to be WebMD, which grew by 3 percent year on year. WebMD was also top in display ads versus other health sites. WebMD had 290 million display ad views in July 2008.

What’s on the horizon of Medicine 2.0

Sep 15, 2008

By Neil Versel

Travel and deadlines got in the way of me posting about the second day of the recent Medicine 2.0 Congress in Toronto, but I saved my notes.

Something super-cool I saw there: Medting.com, a "global" repository of medical images, developed in Spain and soon to branch out to the U.S. Is it another YouTube for medicine? Not exactly. Miguel Cabrer, president of the company, sees it as more like a Snomed for multimedia.

In Canada, they’re getting interactive with physicians.

Late last month, the Canadian Medical Association launched a social networking portal called Asklepios—named after the Greek god of medicine—on its site. Access is limited to physicians, but CMA online content director Pat Rich says it’s partially in response to doctors who bemoan the demise of the staff lounge.

In the spirit of Facebook and MySpace, it is more than just a professional site; physicians can use Asklepios for blogging, discussing hobbies, posting photos and even, theoretically, dating.

Perils of Pay for Performance

Sep 12, 2008• 4

By Josh Siedman

Dr. Sandeep Jauhar wrote an essay this week in the New York Times about the perils of pay-for-performance (P4P). Specifically, Dr. Jauhar discusses how P4P may have unintended consequences and create perverse incentives due to poorly designed performance measures. The point is well taken, but it’s important not to confuse the merits of P4P with the measurement issues that exist.

With respect to the latter, back in my days as Director of Measure Development for the National Committee for Quality Assurance (NCQA), I co-authored a paper with Partners’ cardiologist Tom Lee, Jim Cleeman from NHLBI, and others working with us at NCQA on the development of new HEDIS cholesterol management performance measures. In the JAMA article, “Clinical Goals and Performance Measures for Cholesterol Management in Secondary Prevention of Coronary Heart Disease,” we tried (among other things) to communicate the difference between quality improvement measures and comparative performance measures.

Wonder if your doctor is laughing at you?

Sep 12, 2008• 3

By Sarah Arnquist

That CNN headline grabbed my attention and got me to read a column that basically chastises the 17 percent of internal medicine residents who reported they had laughed at patient in a survey published in JAMA.

The author then goes on to express great relief that 94 percent of those who find humor in their patients considered it unprofessional behavior.

Lighten up! Of course, no doctor — or any professional for that matter — should laugh in a patient or client’s face or use humor maliciously. That’s basic human decency.

But humor is a release, and in a work environment as stressful as a
hospital, people need a release. Maybe that release should occur
outside the hospital walls, but funny things occur in stressful
environments and people do strange things that often merit a chuckle or
two.

Remember pensions? The big differences between Obama & McCain’s health care plans

Sep 11, 2008• 8

By Robert Laszewski Politics

This election is different than any other on the issue of health care because both candidates are giving us serious blueprints to reorganize America’s health care system and those blueprints are very very different.

As voters, you have a huge and critically important choice on health care.

There are dozens of details upon which they differ and for those I would point you to my comprehensive posts on the McCain Health Care Plan and the Obama Health Care Plan.

But to understand their big idea differences, I would point you to our pension system to better understand where McCain and Obama are going on health care. Back in the 1960s and 1970s, it was common for workers to have what is called a defined benefit pension plan.The worker got a promise from the employer that when retirement came he’d get a certain monthly benefit — often about 60 percent of his final average earnings. That might be $2,000 a month — every month for the rest of his life. Therefore, a defined benefit.