Tag: Startups

Interview with Trizetto & Eliza

Jul 16, 2008

By Matthew Holt

Due to poor planning on my part, this morning I was up scandalously early to talk with Gene Drabinksi, who runs the CareAdvance unit of Trizetto, and Alexandra Drane, President of Eliza.

Last week they announced a partnership that integrates the care management aspects of Trizetto’s services with the automated phone outreach provided by Eliza. It’s another step in the evolution of phone-based contact and personalization in health care — which, the careful THCB reader will have noted, I think is an important channel for delivering and capturing health information.

Of particular importance, is making useful that vast glob of data stored within a health plan by communicating about it with the members. It’s also always good to hear from some experienced and passionate players, and Alex and Gene certainly fit that bill. As I hadn’t had any coffee, I wouldn’t claim the same for myself!

Here’s the interview.

Health IT supporting our troops

Jul 16, 2008

By John Halamka Coin

I spent yesterday in Washington with Major General Elder Granger, Deputy Director in the Office of the Assistant Secretary of Defense for Health Affairs.

We discussed electronic health records, personal health records, decision support, and interoperability. Here’s a brief overview of the electronic systems supporting our troops. Go here for additional details.

AHLTA-T is a PDA version of the Department of Defense Health Record running on Windows CE devices. The DOD tests all of its battlefield technology at Fort Detrick for ruggedness in battlefield conditions — heat, sand, ice, water, and physical abuse. A shock resistant enclosure keeps the PDAs safe. The AHLTA-T record itself has an iPhone-like interface with radio buttons and touchable graphics to rapidly record a battlefield assessment. It generates a structured history and physical, then creates a care plan based on triage rules and best practice protocols. The user interface is designed to be easy to navigate in high stress conditions. Given the lack of WiFi and reliable cellular in battlefield conditions, cradle sync is used to transfer all the medical records to AHLTA system.

Once in AHLTA, battlefield data joins the patient’s lifetime health record and is available worldwide for clinical care. Patients may be evacuated to Germany and upon arrival, their entire updated record is available to the care team.

AHLTA data is transferred to a Clinical Data Repository where it is available for institutional review board approved clinical research, surveillance, and quality reporting. DOD leadership has real-time dashboards showing injury, biosurveillance, and medical supply data.

The DOD also has an integrated pharmaceutical repository with over 1 billion records from pharmacies and pharmacy benefit managers which dispense medications to the armed forces and their families.

When a patient leaves the armed forces and becomes a Veteran, their lifetime medical record is available in the Veteran’s Administration VISTA system via the Bidirectional Health Information Exchange (BHIE) built to connect the DOD and VA systems.

It’s an impressive system, incorporating national standards, serving our troops throughout their lifetime.

As I left, General Granger shook my hand and passed along his personal coin (photo above), just as Dr. Koop had done with me a few months ago.

I look forward to a productive collaboration between the DOD and the non-profit health care world I live in everyday. I’m confident there are decision support alerts/reminders, mobile device implementations, and data exchange experiences that we’ll be able to share for our mutual benefit.

State telemedicine networks: a modern anachronism

Jul 15, 2008• 2

By Scott Shreeve

I continue to read with interest articles describing new telemedicine projects. I just don’t get it.

What are these guys doing? You don’t need a telemedicine network fraught with complicated hookups, poor screen quality, and difficult communication interfaces. The new telemedicine network is called the I-N-T-E-R-N-E-T (invented by Al Gore in 1994) which in case you didn’t know obviates your “telemedicine initiatives”. I mean seriously, who is sponsoring all these things anyway? Oh, it must be the really efficient guys who you want to sponsor your health care.

There are hundreds of services popping up that do this stuff all day long – American Well, TeleDoc, Consult-A-Doc, Myca, etc. The only thing encouraging I saw in this article is that they actually believe they can have a 100 clinics up the first year. That will be great so that the millions of people who have been doing eConferencing via the internet for the last five years can have some medical people to talk to. Cool.

Oh, and by the way, congratulations on the concept of a broadband connection. Maybe you can download some Seinfeld re-runs to celebrate the glory days of 1998.

My Health Direct

Jul 14, 2008• 3

Nearly two years ago Jay Mason called me telling me about his plan to create an appointment system whereby hospitals in Wisconsin could re-route their Medicaid patients to community and safety-net clinics. He told me that not only would it relieve ED overcrowding but that it would also allow providers to more efficiently deliver pro-bono care. I didn’t exactly rate highly his chances of success in creating a calendar referral system for Medicaid and uninsured patients, but I suggested that he check in with me when it was up and running. Here’s Jay on what My Health Direct is doing now, and it indeed sounds encouraging. Matthew Holt

By Jay Mason Jay_mason

The problems of emergency department overcrowding and increased bad debt affect nearly every urban acute care hospital in the country. Patients who seek care at an ED are four times more likely to be covered under Medicaid or twice as likely to be uninsured than their privately insured counterparts.

In 2006, several hospitals sought a new approach to address some of their most entrenched challenges – overcrowded emergency departments, increasing levels of uncompensated care, and an ongoing imperative to maximize use of its clinical resources. They soon gravitated to a web-based solution called My Health Direct, which was created by start-up Global Health Direct for use in settings with a highly disproportionate share of the Medicaid and uninsured population.

How patients get the best care

Jul 11, 2008• 3

By Susannah Fox Epatients

What are the social and psychological factors that affect how people are treated — or
even their health outcomes? This question has popped up in my reading and in my work quite a bit this week, and so I wanted to share what I have learned from three leading thinkers: Peggy Orenstein, Dr. Jeffrey Lin, and Dr. M. Chris Gibbons.

Interview with Sandeep Agate, REACH Call

Jul 8, 2008

By Matthew Holt

We don’t talk much about traditional telemedicine at THCB, but remote care is not just for consumers. There’s also huge possibilities for clinicians to use these technologies to tap into expertise that can make specialty care more available and improve care in dramatic ways.

REACH call, which is a 2-year-old company from Georgia has an interesting and relatively cheap technology that gets vital expert specialty opinion to emergency rooms and enables stroke care to be significantly improved. I spoke to Sandeep Agate, REACH’s CEO last week and it’s a pretty interesting interview.

Health 2.0 Accelerator — The waiting is over….

Jul 4, 2008• 5

By Matthew Holt & Indu Subaiya

For several months there has been discussion amongst Health 2.0 companies about the concept of a Health 2.0 Accelerator. It started with Marty Tenenbaum’s introduction of the concept in September 2007. It continued with the discussion at the San Diego meeting in March 2008. Since then conversations and meetings among a small group have continued to define a first cut at what the Health 2.0 Accelerator should be.

The basic idea is for organizations to collaborate to create “public goods” —frameworks and strategies that will help all concerned to advance the industry. The way to do this is via projects that tackle particular problems, and leave behind frameworks and utilities that all can use.

The reality is of course going to be more complex, but we’re delighted to announce that the first project concerning moving pharmaceutical data has been announced, and the first principles and statements about the future of the Accelerator are now up at its own wiki at Health2Accelerator.org.

We are now asking for everyone in the Health 2.0 Community to become members, suggest projects, and contribute to the wiki. This is very much a work in progress, but we believe that the potential is huge. Please go to the new site, and contribute by giving us your comments.

Mitigating interference between electronic medical devices

Jul 3, 2008• 1

By John Halamka

Last week, JAMA published an article about the risks of active and passive radio frequency identification to other hospital equipment.

The Associated Press and ABC News issued major stories about it.

Although the study focused on RFID tags, the issue is more generic. Electronic Magnetic Interference (EMI) is generated by many devices including cell phones, laptops, and microwave ovens. Such devices emit RF energy which may interfere with the operation of sensitive electronic components used in medical equipment. The interference may be frequency related (signal jamming) or cause the device to fail because a chip or wire is exposed to too much energy from an emitting device. The very best defense is to have adequate shielding for medical equipment. It’s inconceivable that hospitals can keep patient care areas free of RF emitters. Thus, it is important for hospital clinical engineering departments to be vigilant in identifying potentially unsafe devices.

Matthew’s top podcasts this year

Jul 1, 2008• 3

By THCB STAFF Ipod

The Health Care Blog is working hard to bring readers more excellent content, but
the downside of that is great posts and podcasts quickly get buried. Here’s a quick list of Matthew’s top podcasts this year.

Adam Bosworth speaks about Google Health, Keas and everything By Matthew Holt

Adam_bosworth

After a long period of time I’ve finally wrestled Adam Bosworth to
the floor and forced the microphone to his mouth. Adam of course is the
software guru (he’s one of the originators of XML) who went to Google
to start Google Health,
and spent much of 2007 talking about how he hoped Google Health would
change health care. He then left Google Health (several months before
it launched in March 2008) and at the very end of 2007 founded Keas. Adam has very strong views on health technology, data, PHRs.
HealthVault & Google Health, and much much more. Listen to the podcast.

Cisco’s Frances Dare talks about Congressional action on health IT By Matthew Holt

Frances_dare_2 Frances Dare has seen the painfully
slow developments in many aspects of health IT since the 1990s, and has
an experienced view of what’s coming along at what pace. These days
Frances is a Director at Cisco focusing on health care, and more
recently she’s taken an active role in Cisco’s health care lobbying
efforts on Capitol Hill. Here’s the podcast.

Interview with Trizetto & Eliza By Matthew Holt

I spoke this morning with Gene Drabinksi, who runs the CareAdvance unit of Trizetto, and Alexandra Drane, President of Eliza. They recently announced a partnership that integrates the care
management aspects of Trizetto’s services with the automated phone
outreach provided by Eliza. It’s another step in the evolution of
phone-based contact and personalization in health care — which, the
careful THCB reader will have noted, I think is an important channel
for delivering and capturing health information. Of particular importance, is making useful that vast glob of data
stored within a health plan by communicating about it with the members.
It’s also always good to hear from some experienced and passionate
players, and Alex and Gene certainly fit that bill. Here’s the podcast.

Interview with Kerry Hicks, HealthGrades CEO By Matthew Holt

HealthGrades has been busy. The publicly traded, pure-play provider
ratings company is changing the way it offers ratings, it’s publishing
a book, and it’s starting to rate drugs. It’s not alone. Last week,
Consumer Reports announced it also is getting into the business of
rating hospitals and using a model developed in conjunction with the
Dartmouth crowd. Plus, there’s the CMS effort. Given the way that
ratings are evolving and HealthGrades’ partnership with Google, (more
to come on Google from me separately soon) last week was a great time
to talk with HealthGrades Chairman & CEO Kerry Hicks. (Sadly it was before the Consumer Reports announcement but fascinating nonetheless). Listen to the podcast.

Kaiser tiptoes into HealthVault & tells THCB about it By Matthew Holt

Kaiser Permanente signed an extensive pilot with Microsoft, allowing
its 159,000 employees to copy their online health records into
HealthVault. This is a big coup for Microsoft and a fairly ambitious
move for KP which to this point hasn’t said much publicly about the
data transferability it was going to provide for its members. This is a
clear signal. Assuming that the pilot is a success, presumably all
Kaiser members using My Health Manager (over 2 million now and heading
to 3 million at years end) will soon be able to move their data to
HealthVault. We are potentially seeing the first real example of mass
scale data interoperability onto a platform not connected to a health
care organization. And obviously, Google is playing in this same space
too. Kaiser gave me a pre-release interview with with Peter Neupert, Corporate VP of Microsoft Health Solutions Group and Anne-Lisa Silvestre, VP of Online Services at KP. Listen to the Podcast.

The Long Baby Boom By Matthew Holt

I had a great chat with health care futurist Jeff Goldsmith
about his new book, the Long Baby Boom. We discussed the policy and
cultural issues of retirement, Medicare, Social Security, immigration,
end-of-life care and meaning… Listen to the podcast.

Caring.com & Trusera — two Health 2.0 newbies talk By Matthew Holt

Two of the more interesting newcomers in the Health 2.0 scene
gathered around the electronic water cooler, which is THCB’s podcast
series, to talk about what they’re up to and why they are worth looking
at. Andy Cohen is CEO of Caring.com and Keith Schorsch
is CEO of Trusera. Some of you may have seen Keith at the March 2008
Health 2.0 Conference. Andy is providing content checklists and much
more for those who have sick or frail parents, which will be most of
us. Keith is providing a sophisticated place for story telling and
information exchange for those facing serious health conditions. Both
have serious ambitions. Interesting stuff — listen to the podcast.

The Feds’ strange love-hate relationship with health IT policy

Jul 1, 2008• 5

By David Kibbe

With less than loud fanfare — barely a peep, really — the Office of the National Coordinator for Health IT (ONC) finally last week released its ONC-Coordinated Federal Health Information Technology Strategic Plan.

The plan is more than two years overdue and came only after scolding from a Government Accountability Office report in 2006 and an internal, semi-secret review of ONC’s doings by the Institute of Medicine late in 2007. The IOM criticized ONC for the lack of a viable strategic road map almost four years after President Bush’s call for interoperable health information technology and personal health records. A lot has happened since 2004 in this area, though you’d hardly know it reading the ONC Plan.

ONC is a top-down, heavily bureaucratic,
large-medical-enterprise-centric, and large-IT-vendor-led juggernaut
that has always been out of touch with what goes on down on the ground
where consumers, patients, nurses, and primary care doctors live and
work.