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Healthwise Adds Informed Medical Decisions: Don Kemper Interview

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By Matthew Holt

Today venerable health content creator Healthwise merged with the Informed Medical Decisions Foundation which was previously funded by (and had an exclusive relationship up until last month with) Health Dialog. I asked Healthwise CEO–and old friend of Health 2.0–Don Kemper what was happening and what it meant. I also snuck in a smidgen of snark about a conference we worked on together five years ago.–Matthew Holt

Matthew: Don, you’re merging Healthwise with the Informed Medical Decisions Foundation. So I know the two organizations are both non-profits but as a poorly informed outsider I always thought of you as rival content creators, with Healthwise selling your content and services to insurers and providers and Informed Medical Decisions being funded by Health Dialog which then got to use and sell the content and decision support aids it created to its customers. Am I wrong?

Don: You aren’t completely wrong—but then not overly well informed either. We have always thought of ourselves as sister organizations rather than rivals. We have collaborated well in advocacy efforts to promote the role of the patient. Health Dialog has had a near exclusive relationship with the Foundation until recently. Health Dialog has been a long-term client of Healthwise, too—just not an exclusive one. When the restructured Health Dialog-Foundation relationship dropped the exclusivity requirement it allowed us to proceed with the merger discussions.

Matthew: Now that change occurred for Informed Medical Decisions and you two can merge, what do they have that Healthwise hasn’t got, and vice versa?

Don: The Foundation has three things that will add greatly to the Healthwise mission:

1. Medical Evidence—Their assessment of medical evidence in key areas goes deeper than we have been able to go. Whereas we have often waited for treatment guidelines to change before reflecting the changes in our content, their medical editors are often involved in making the guideline changes. Getting that information into the patient’s hands six months earlier could make a life or death difference.

2. Value Demonstration—The Foundation has developed research relationships with many health services researchers around the country. By setting up and evaluating demonstration sites for shared decision making (SDM) they have proven how SDM improves decision quality and reduces the use of expensive but preference-sensitive treatments.

3. Practice Change Management—The Foundation has gained a great deal of experience in helping clinicians build SDM into their workflow. Those learnings will help as we integrate patient engagement into the mainstream of care.

What they get from us is “reach.” People now turn to our information, tools and solutions over 340 times a minute. (180 million times a year). Fifteen percent of US physicians can now prescribe Healthwise patient instructions through their EMRs.

Healthwise has invested heavily in the technology needed to integrate into EMRs and has excelled at building broad-based solutions that fit within a health plan’s or health system’s workflow. It would have been hard for the Foundation to have matched that without us.

Matthew: So how will this actually work. How many people do you have, how many do they? Who gets to keep their jobs? Is this a real merger or a takeover?

Don: This is a merger made in heaven. No one will be out of work. Continue reading…

A Global Movement Prepping For Lift Off

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By MATTHEW HOLT

I’ve been a busy world traveler lately. The focus of the health care tech and policy crowd in the US has been on the fix to one high visibility website. Before I talk about the rest of the world it’s worth noting that the Administration painted itself into a corner here.

When healthcare.gov failed on take-off they didn’t make the obvious choice of letting other brokers and plans enroll people directly–and worry about correcting subsidies on the back end. I spoke with one big online broker this week who told me that his company still couldn’t get reliable access to the subsidy calculator API, and so can’t enroll people. I suggested the solution to that back in October but apparently no one is listening at HHS–although Sen Mary Landrieu was. The White House was however listening to the Fox news crowd ranting about cancelled insurance policies and made the bad policy (if necessary political) call to allow current individual market policies to continue–even if they are rightly now illegal under the ACA.

But elsewhere the impetus that the US has been seeing on the health technology side–with over $2 billion in venture funding this year–is spreading. The UK just confirmed that it’s releasing the equivalent of $800 million for new health technology, and we just returned from a very successful Health 2.0 Europe conference. All kinds of activity is going on over there–did you know there were over 100 digital health start-ups in Finland & the Baltics alone? Well, you do now.

Today the Health 2.0 international roadshow is in Sao Paulo, Brazil–a city that has the size and energy of New York–albeit before Guliani cleaned up the graffiti. And yes, even in Latin America, there’s lots of activity in using technology to change health care. I’ll tell you more next time, but it’s clear that there’s way more than one website in healthcare.
Hope to see you in Brazil or at at our Health 2.0 at the mhealth Summit Session in DC on Monday.
–
-Matthew Holt

We Love to Talk About Our Lives. What About Our Deaths?

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By Alexandra Drane, Leigh Calabrese-Eck & Matthew Holt

Most of us find ourselves pretty fascinating… flipping through photos and slowing down for the ones where we’re included, tweeting our favorite tidbits of information, facebook-ing progress on this or that…

We find other people captivating as well. In fact, there’s a meme going around on facebook where people share a handful of things that most people don’t know about them – and there’s a great joy in learning these tidbits about the friends and family we think we know so well.

This Thanksgiving, we’re asking our friends and family to try this exercise, but with a twist – we want to know how they’d answer just five questions on their end-of-life preferences.

What? Are you CRAZY? Talk about how you’d want to die over Thanksgiving? Yup – that’s exactly what we’re suggesting. You know why? Because this is a conversation you absolutely want to have exactly when you DON’T need to have it… and it’s a conversation you need to have with your loved ones. Our hope for you this Thanksgiving is that you’ll have the luxury of checking both those boxes.

Continue reading…

A Pragmatic Fix for Healthcare.gov & the HIXs

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By Matthew Holt

By now even those of us who originally thought that we were seeing minor teething troubles are no longer deluding ourselves. Healthcare.gov, the federal health insurance exchanges (HIXs), and many of the state HIXs are in deep trouble.

One summary of many articles about this is up at ProPublica. But now that the House Republicans have stopped trying to destroy the country and themselves, attention will turn quickly to this problem, and–much worse–beyond the politics, there is now only eight or so weeks to get ready for actual enrollments for Jan 1, once you take out Thanksgiving and the Christmas holiday. Getting ten or twenty million new customers on board, not to mention the small businesses who want to move from their current insurance onto the exchanges, seems like an impossible task.

But, if we can muster the will, there may be a solution. (And yes, I want it to work, faut de mieux). Quietly last summer two private online insurance brokers, eHealth which runs the eHealthInsurance.com site, and GetInsured, struck deals with HHS which allowed them to enroll individuals in plans that qualify for the mandate under the ACA, and more importantly, connect with the “Health Exchange Data Hub” that figures out whether the enrollee qualifies for a subsidy (theoretically by connecting to the IRS).

That part of the transaction, though, could be done by attestation and dealt with later. In other words, someone buying health insurance could state what their income will be in 2014 (or was in 2013) and if it ends up varying dramatically on their 1040 then in 2015 they will pay or receive the difference. Essentially this is something all Americans recognize–the IRS asks you for more or gives you a tax refund well after the fact, and H&R Block and their competitors make a business of giving you the refund right away (and of course charge you for the privilege).

That is important because what seems to be crippling the HIXs right now is not the back end, it’s the front end. (Go to this Reddit thread for lots more deeply technical conversation about that). Showing people options, comparing plans, setting up accounts–that’s all standard web stuff and most of the HIXs can’t do it. Those private brokers have both smoothly done this for years and at least the two I mentioned have built comparative tools for the new insurance plans. (Both were demoed at Health 2.0 on October 1).

So why can’t we put prominent links to eHealthInsurance.com and GetInsured on the Healthcare.gov site and move people over there? Continue reading…

Moving Beyond the Sick Care Model

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By Lori Houston

How does a corporate behemoth heavily invested in the transaction-based health care system of today make the shift to engaging with its 20 million+ customers about their health in new and deeper ways? Humana’s new CEO Bruce Broussard sees technology as key to successfully meeting this challenge.

The company does a good part of its $39 million annual business in one of the health system’s status quo areas: providing medical benefit plans to employer groups.

In his October 1st keynote at the Seventh Annual Health 2.0 2013 Fall Conference, Broussard will share some thoughts from the executive suite about the role Humana envisions for itself as part of health care’s future. Health 2.0 co-founder Matthew Holt recently chatted with Broussard about Humana’s plans.

Matthew Holt: Humana has been looking to get involved in the new changes in health care as a whole. I know you’ve been surveying the role of new information technologies and tools in recent months.

What kinds of things are you seeing? What has most surprised you about the possibilities?

Bruce Broussard: The informational tools that are coming out are pretty powerful. I’d categorize them as allowing individuals and companies like Humana to educate and motivate individuals, and to gain easier access to providers and to more timely treatments.

When we look at the new tools coming out, I think these are going to greatly improve health care in multiple ways.

Continue reading…

Top Twelve Reasons to be at Health 2.0 Next Week

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By Matthew Holt

And now, for your crassly commercial consideration, I am emerging from my bunker/email queue and relentless rehearsing of 150+ demos to tell you the Top Twelve reasons why you need to join over 1,600 others at the 7th Annual Health 2.0 Fall Conference which starts with pre-conferences on Sunday 29th and kicks off officially on Monday 30th September:

Twelve Teams creating new on-body laboratory grade sensors competing for $2.25 million in prizes in the Nokia Sensing XCHALLENGE

Eleven Pre-conference sessions including International Health 2.0, a design workshop from Mad*Pow on behavior change, Patients 2.0, Doctors 2.0, Employers 2.0 and more!

Ten New Companies introducing their brand new products to the market in Launch!

Nine Developer Challenge Competitions with winners & new challenge announcements on stage!

Eight Start-Ups Competing in the DC to VC start-up showcase from Morgenthaler Ventures with 8 VCs as team captains

Seven Sponsored Deep Dive Sessions from leaders Janssen,  United Healthcare, Cigna, Airstrip, Health Dialog, NaviNet &  The Iron Yard (featuring 10 startups from the South)!

Six Demos showing the latest tools for and about health consumers on our panel called Big Data: Tools & Applications for Individuals

Five Networking Parties for attendees, sponsors, and exhibitors!

Four Cutting-Edge Revolutionary Demos on the Frontier of Health 2.0 panel including Syapse, BrainControl and from the labs of Adam Gazzaley at UCSF and Louis-Philippe Morency at USC.

Three Female Health 2.0 Rising Stars: Akhila Satish, CyberDoctor; Hind Hobeika, InstaBeat; Julia Winn, BetterFit Technologies.

Two Engaging Keynotes by movers and shakers –Bruce Broussard, CEO of Humana, and Gavin Newsom, Lt. Governor of California.

One Revolutionary Health Technology Conference you don’t want to miss!

And honestly we could have done a top 100! You can find out more and sign up here! And, to quote a recently late Silicon Valley legend, it will be insanely great.

Glen Tullman–The Teaser

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By Matthew Holt

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Allscripts is one of the biggest companies in Health IT. Glen Tullman built it from almost nowhere and then last year after one bad quarter and a power struggle in the boardroom (which he initially won), he left–and he stresses it was his decision. Along the way there were lots of interesting choices made, and he and Allscripts ended up with a sweep of all the negative awards at this years HISSIES (including his first time as “Industry figure in who’s face you’d most like to throw a pie”).

But despite all the abuse, what Glen did over the past 15 years is pretty remarkable given the stagnant state of the enterprise HIT market. I’ve interviewed him almost every year since THCB started and he was never shy in giving his opinions. Last month I got him for a long retrospective. THCB will be running that in parts over the next week or so, and he dishes on the Allscripts’ record, on Epic, on the future of health IT and more.

But here’s a teaser…

It Was the Best of Times, it Was the Worst of Times

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By Matthew Holt

Optimized-EdisonAt Health 2.0 we have a natural bias toward the innovator, the entrepreneur, and the developer. Health care is largely broken, and those upstarts have the potential to fix it. But it’s by no means easy. Part of what we’re doing at our upcoming Health:Refactored conference is helping developers get access to APIs and other technical entrees into health care data (such as the SHIN-NY or HealthVault).

But as Paul Levy pointed out in a recent post about Epic’s domination of the large hospital system EMR market, and as Jonathan Bush hilariously detailed in a talk at last week’s TEDMED, health care’s money and data and power are still locked up in huge institutions that don’t have it in their business plans to give up that position — whatever their mission statements might say.

Francois de Brantes’ book The Incentive Cure details in a fun way how hard it is for providers to do the right thing, and how in the absence of changing incentives, most of the things that seem to make sense for better health (like holistic patient management, care variation reduction, better informed patients and providers) actually make worse sense for health care institutions. Which means that the dam is still holding back the torrent of ideas and solutions from innovators, entrepreneurs and developers. We know (broadly) what to do but we can’t do it. It’s the worst of times.

But two things are changing. One is that we at least recognize the problem. The system may be an addict, but it knows it’s one, and so does the taxpayer and the patient. So that first step has been taken. The second change is the flood of new technologies outside of, and now inside of health care, that can help us get through the next 11 steps. Todd Park says this is the best time ever to be a tech entrepreneur in health care. So is this the best of times? Eventually it’s up to all of us to make it so.

Naked political plug: Aneesh Chopra in California this week

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While my politics are well known to THCB readers, I rarely encourage people to do anything about it–especially in a state where I don’t get to vote, but today is different. Aneesh Chopra is running for Lt Gov in Virgina. He’s the former CTO of the US and a really good guy–who is running based on improving science and technology in a vital state, where the Republicans are literally into trans-vaginal ultrasounds & creationism. To my SF and LA-based friends, you can meet Aneesh at Cigar Bar & Grill on Mon 18th 5.30-7 in downtown SF and in in 1240 Shadow Hill Way, Beverly Hills on Tuesday 19th 7-9pm. This is a chance for the tech community to support one of its own, so I encourage you to go along and write a check. For more information or to RSVP please contact Caitlin Blair at Caitlin@chopraforva.com or (703) 468-1456, or I’m sure if you show up Aneesh will be happy to see you!–Matthew Holt

Matthew Holt on HIBC.tv from HIMSS 2013

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THCB founder Matthew Holt is reporting live from HIMSS 2013 in New Orleans. Matthew’s first guest is Ben Chodor of Happtique. We’ll then hear from Matthew on his walking tour of the floor as he drops in on a few companies, including Kareo, CareCloud, Wellness Layers, and more…

Watch the live stream here: http://www.livestream.com/hibc.