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Tag: Startups

Health care information technology in an early Obama Administration

When Obama takes office in January, the economy will be his first
priority, followed by the war in Iraq. Health care will follow as his
next major issue to address.

What will he do?

I imagine
he’ll take a phased approach to ensuring all Americans have access to
health care. Given the change management needed to accomplish this, it
will take a while.

However, Health care Information Technology
has broad bipartisan support and is his best strategy to reduce
health care costs, reimburse providers for quality instead of quantity,
and to ensure coordination of care. Here are my predictions for
health care IT in the first year of the Obama administration:

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At Kaiser, “The EMR is the Foundation of Everything We Do”

Continuing his series of interviews about the business care for Health 2.0, here Scott Shreeve interviews Anna-Lisa Silvestre, the VP of Online Services for Kaiser Permanente.

SS: Anna-Lisa, nice to meet you. Tell me a little about your background?

AL: I started out with Kaiser Permanente 23 years
ago as a health educator. I was fortunate to be able to transition into
the interactive technology unit that was created in the mid 1990’s. We
had a singular focus on developing online capabilities back in the good
old HTML days. However, things have dramatically changed since then and
we now have over 2.5M members who have activated an online account; 60%
of those users signed on two or more times last year.

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Daniel Palestrant, CEO, Sermo at Health 2.0

Sermo has very quickly become the big Kahuna in the physician social network space. So big in fact that its rivals trumpet how different they are from it in their models and approach. Yet it was only two years ago that Sermo was still putting a little votive candle in a net for every doctor who signed up—and the major problem it was facing was corralling the packs of dogs charging around its office in a basement in Cambridge, MA. A lot has happened in under two years, but I understand animal control is still a major function! So we thought that having Daniel Palestrant tell us where Sermo is now would be a great way to kick off day two at Health 2.0 and to talk about the new deal with Bloomberg. (The net broke at around 12,000 candles I believe, and no dogs were mentioned in the making of this video, sadly!)

Confessions of a Physician EMR Champion

Starting this month and continuing for the next year or so, I’ll be presenting a standard talk to physician audiences entitled “Confessions of a Physician EMR Champion,” subtitled “A Conversation with American Physicians About How to Save Medicine in the Age of Information.”

The broad message is that, to be successful, the adoption of health IT by physicians, nurses, and staff must extend communication and health data exchange beyond the narrow confines inside the four walls of their practice. Health IT needs to empower all providers to act as effective members of a team which includes the patient, medical home, specialists, and ancillary service providers such as pharmacists and lab technicians.

My “confession” is that for several years I led a team effort by the American Academy of Family Physicians, its state chapters, and its members, to promote adoption of electronic medical records, or EMR software systems. Between 2003 and 2007, the percentage of the AAFP’s active membership of 60,000 doctors who utilize an EMR from a commercial vendor in their practices jumped from about 10 percent to almost 50 percent. The overwhelming majority of the doctors in these practices consider this a good thing, and would never go back to paper systems. The accumulated knowledge and experience about EMRs among the AAFP’s membership is unparalleled.Continue reading…

Microsoft Healthvault: Coke, Pepsi or Intel Inside

This post appeared originally on DiabetesMine.

When Microsoft launched its HealthVault application last year — the first major commercial Personal Health Record (PHR) system on the open web — the Wall Street Journal reported that
“Consumers are just not that excited about these services.”  A year
later, I’m wondering: have they given us reason to be more excited
now?  Last week, I grilled HealthVault’s rival Google Health
about the progress they are making.  Keithtoussaintmsft1

Are these big players trying too
hard to be all things to all people?  Or, with their rather generic
“personal health platforms,” do they end up offering nothing much of
value, especially to people living with chronic illness?

This week, DiabetesMine caught up with Keith Toussaint, Senior Program Manager with Microsoft HealthVault, for a perspective from inside the Microsoft dynasty.

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Moving forward on genetic testing

Scott_shreeveThree months ago,
there was a huge hubbub about genetic testing in California. In a
dramatic effort, albeit totally misguided, the California Department of
Health sent “cease and desist
letters to multiple vendors who were offering genetic testing services
directly to the consumers. They were concerned by the cost, the
accuracy, the ability for medical professionals to interpret the
results, and the potential for harm to the consumers. However, with
many technology advances that outpace the regulatory apparatus, this
one was well ahead of its time and when the dusts settles, this type of
testing will become a normal part of your health portfolio.

Need proof?

This week Microsoft, Scripps Health (based in San Diego), Affymetrix and Navigenics
announced they are launching a research study to evaluate the impact of
personal genetic testing. The study will offer genetic scans to up to
10,000 employees, family and friends of Scripps Health system and will
measure changes in participants’ behaviors over a 20-year period.
Participants will be able to save a copy of their genetic information
and analysis in HealthVault, enabling them to retain it for future use
as they continue to manage their health and wellness, whether it is for
preventative or treatment purposes.

From Cease and Desist, to a public announcement from all California
based companies on a landmark longitudinal study with 10,000 people
validating the use of personal genetic information in just over three
months?

Stylin’ and profilin’ Cali Style.

Subliminal health education

You’ve heard of subliminal advertising, but what about subliminal educating for health?

But who’s tried selling health to us where we live, work, and play? What about using ‘mainstream’ TV shows as a public health education tool?

Kaiser Family Foundation’s seeding of Grey’s Anatomy produced some surprising results.

Kaiser worked with the show’s Director of Medical Research to pick health topics based on 3 criteria:

  1. Appropriate for the show
  2. Not well understood by the American public
  3. Topic where learning could be "measured in a straightforward way" in a survey

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Shout out to Adam Singer, physician entrepreneur of the year

Adamsinger

Modern Physician just named Adam Singer, the founder of IPC — The Hospitalist Company, its first annual Physician Entrepreneur of the Year. Adam and I don’t always see eye to eye, but I want to congratulate him and highlight some of his contributions.

When the hospitalist field launched in the mid-1990s, Adam was there – I recall seeing him at virtually every hospitalist-related meeting during the early years. He struck me as a bit awkward – maybe a tad insecure – but he was brimming with passion and a near-religious fervor for the hospitalist concept. He had just started his company, whose business was to organize hospitalist programs and place them in hospitals, first in So Cal, and later in other regions. In essence, IPC was really the first “rent” (vs. buy) hospitalist solution, and it quickly found a market niche.

Adam’s vision was unique and deeply held. He frequently scolded me for what he called an overly traditional and “academic” view of what a “real hospitalist” should be. To his way of thinking, hospitalists should be relentless managers of the inpatient stay, less about traditional views of physicianship and more about driving teams and technology to make hospitalizations more efficient and increase adherence to practice standards.

The use of technology was critical to Adam’s ability to bring his vision to fruition. Adam had a fundamental problem to solve: he needed data to run his business, but getting information from all of his client hospitals was nearly impossible. As Adam once told me, “if I need to get clinical and billing data from each hospital, I’d be spending all my time in hospital IT meetings.” So he built IPC’s infrastructure around home-grown handheld devices that allowed his hospitalists to collect detailed patient data; the devices synced up with a central data repository daily. Not only did this give IPC the ability to measure and articulate their value to client hospitals, but it gave Adam – a self-described control freak – a detailed window into the daily practice of dozens, later hundreds, of his hospitalists without having to leave his North Hollywood office. I remember him demonstrating the system to me one day, including the tough, sometimes boorish notes he would tear off to those docs who seemed to be underperforming. It wasn’t my idea of an attractive management style, but one couldn’t doubt his commitment to his vision and his ability to disseminate this vision across an increasingly vast enterprise.

Perhaps most impressively, Adam focused like a laser on post-discharge care, well before it was fashionable. At a time when few saw the business case to do this, Adam developed a sophisticated (and expensive) system of post-discharge follow-up phone calls, aided by his handheld technology system. He found that, by calling every patient soon after discharge, his nurses were often able to troubleshoot and avoid unnecessary re-hospitalizations or harm. “All part of our value equation,” he told me when I asked him how he could afford to do this, and there was no doubt that it was a marketplace differentiator for IPC. Today, everybody is thinking about readmission rates and filling the post-discharge black hole. Adam was all over it a decade ago.

I’ve had my disagreements with Adam over the years, and continue to harbor concerns about some aspects of IPC’s clinical and business model. I also wondered whether he would suffer “Founder’s Syndrome” – he has the kind of high energy, confrontational personality that is perfect for the early, free-wheeling days of a start-up, but sometimes gets shoved aside when the company matures, replaced by a smoother consensus-builder. To Adam’s credit, that hasn’t happened, in part because he is a great judge of talent, bringing in others who have played Robert Gates to Adam’s Rumsfeld.

And you can’t argue with success. IPC’s net revenue now exceeds $200M/year. And last year his company became the first hospitalist enterprise to go public, earning he and his shareholders considerable wealth (which they have retained, despite the market conditions). Others will doubtless follow, but this event was external validation of Adam’s leadership and, more broadly, the hospitalist idea.

So hats off to Dr. Adam Singer, Physician Entrepreneur of the Year. Whatever one thinks of his unusual style, there is little doubt that Adam has been as responsible for the growth of the hospitalist field as anyone.

Google Health: Is It Good For You?

By AMY TENDERICHAmy_small

Note: Amy Tenderich, who writes and maintains the wonderful Diabetes Mine,
just did this very illuminating interview with Google Health’s Missy
Krassner.  As you’ll see, she doesn’t slow-pitch to Missy. This is a
sure-footed, tough-minded exchange about the real issues that are on
the table now in Health 2.0. – Brian Klepper

Slowly but surely, using the Internet for your health needs is
becoming as mainstream as shopping on the web: no longer futuristic,
but is it for everyone?  And perhaps more importantly, are mainstream
commercial health platforms from companies like Google and Microsoft
really useful for people with specific chronic illnesses?  I thought it
would be interesting to hear their side of the story.

Missykrasner_3
So please welcome Missy Krasner, Product Marketing Manager for Google Health, whom I was lucky enough to catch up with for an interview last week.

Missy, shortly after Google Health launched last Spring, David Kibbe, former Director of Health IT for the AAFP, noted
that most of its services were “only mildly useful and sort of
‘toyish.’” How have these services evolved to be more useful to people
with health conditions?

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