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Interview with Kerry Hicks, HealthGrades CEO

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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 Kerry Hicks interview.

CBO assesses return on investment of HIT

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By Jane Sarasohn-Kahn

The return on investment of health care information technology isn’t uniformly positive, according to a recent analysis from the Congressional Budget Office titled, Evidence on the Costs and Benefits of Health Information Technology.

The underlying rationale for the report, which was requested by the Senate Budget Committee, is to sort out the federal government’s role in health IT. The report asks, "Whether — and if the answer is yes, how — the federal government should stimulate and guide the adoption of health IT."

The federal government is already in the health care IT fray. President Bush set the goal in 2004 that every American have an electronic health record by 2014. This was a vision, however, without a funding source. There are also several proposals in Congress that would expand the federal government’s role in health IT by mandating the use of electronic prescribing, provide financial incentives to providers who use health IT, and offer grants to purchase systems for providers.

The CBO report points out a major benefit of health IT that has been largely overlooked: IT’s role in research on the comparative effectiveness of medical treatments and practices. When individuals’ health data is in electronic format, it can be depersonalized, aggregated, and analyzed for a range of uses, such as medical effectiveness, quality, and system efficiency, among other research questions.

One sentence in the 48-page report encapsulates the Mother of All Barriers to Health IT Adoption: "How well health IT lives up to its potential depends in part on how effectively financial incentives can be realigned to encourage the optimal use of the technology’s capabilities."

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Vision for hospital’s future HIT

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By John Halamka

Halamka_2
The role of the chief information officer is very operational — keeping the trains
running on time, ensuring budgets are sufficient and aligning IT resources with the needs of stakeholders.

One other important task of the CIO, however, is to market the work of the IT Department to internal and external audiences. Although IT staff and those involved in IT governance committees are interested in the granular details of projects and their time lines, many audiences want the vision – the big, audacious goals that are really transformational.

To ensure I target the right message to the right audience, I create two documents each year — an operating plan and an "elevator speech." I’m working with all our governance committees over the next few months to complete the details of the operating plan, but here’s my strawman elevator speech for 2009:

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Using studies to prove virtually anything

By Matthew Holt

This one is great. A British academic has shown that e-breaks — allowing workers to use the Internet for “personal” reasons — actually improve productivity.

A game company paid for the study, but then again the RAND study on EMR effectiveness was paid for by Cerner so caveat emptor. But I suspect that it might be true that 10 minutes playing Grand Theft Auto IV or trawling Match.com probably helps reduce stress and improve focus when back on the job. And, anyway, a more trusting work environment when the boss isn’t micromanaging every minute is probably a better and happier, and therefore, more productive environment.

But be honest. When you’re distracted by personal Internet use (think about the last time you got lost in YouTube), do you really spend just 10 minutes?

 

Athena announces payer rankings

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By Matthew Holt

AthenaHealth has announced its rankings on the best and worst payers in health care. Athena CEO Jon Bush discussed the PayerView rankings on the CNBC Squawkbox with Ron Williams, CEO of Aetna, the No. 1 ranked fastest payer. Williams pontificated about how great it will be when all the stuff Aetna is putting in motion is up and running.

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Then, he got a tough question about the pressure that high-deductible health plans have put on physicians by making them figure out payments from consumers and insurers. This is a real problem for doctors and getting worse. The amusing thing is that the question came not from the journalists but from Bush.

After Williams’ somewhat waffly answer, Bush said that he’s looking forward to announcing real-time claim adjudication with Aetna any time now. I’m not sure if Bush intended that as a slam or a promise (maybe both), but it seems AthenaHealth has had it with Humana and United Healthcare for a while.

Here’s the video and here’s the press release. New York’s Medicaid program is the worst payer, as if you were surprised.

 

 

Caring.com & Trusera — two Health 2.0 newbies talk

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By Matthew Holt

Two of the more interesting newcomers in the Health 2.0 scene gathered around the electronic watercooler, 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

Self diagnosis in military health care

By Matthew Holt

Given how much cool stuff comes out of the military and eventually has an impact in real life (not to mention the $800 billion a year we’re spending on it), the MC4 (Medical Communications for Combat Casualty Care) is worth a look. Unfortunately the sound on the video dies after a minute, but you’ll get the idea.

It appears that for those of you elitists with an iPhone ADAM is doing something similar (but of course I can’t tell, not having got one, n’all).

Microsoft Health Vault gearing up

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By Matthew Holt

Just a week after certain blogs (including this one) seem to have gone Google Health crazy, Microsoft gears up for its HealthVault Partners meeting next week in Seattle with both a $1.4- million  increase in its BeWell funding for HealthvVault partner applications (an idea originally thought up by Grad Conn in the shower, so he says), and by MSFT Health Solutions Group’s head honcho Peter Neupert’s blog, Neupert On Health.

Peter will discover that the blog is a cruel mistress, but it’s great to see them getting more and more serious about Health (even in a week when some less successful non-health care projects have been trimmed).

FD. Peter will be back at Health 2.0 this fall, but sadly I won’t be in Seattle because I’ll be jetting to Ix Therapy in Washington DC instead.

Google Health — A view from the Inside

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By Robert Wachter

Google Health launched last Monday, which sent the world’s Google-watchers into a tizzy. I serve on Google Health’s Advisory Council – which met all day Tuesday – and so here’s a bit of inside dish, along with my impressions of the site and the company.Google Health pageFYI,
my work on the Council is covered by a Non-Disclosure Agreement, so I
won’t reveal anything that isn’t publicly known regarding Google’s
products or intentions. Also, in the interest of full disclosure, you
should know that I am compensated for my Google service. (No stock options, darn it.) With that as background, here’s the scoop. Google
began working on its version of the personal health record a couple of
years ago, after the company realized that a remarkably high percentage
of searches were for health information (I know, if that’s going to be
how priorities are set, you’re wondering if Google Sex is next). Google
put together an impressive team to develop the concept. One of the
leads is a former UCSF medicine resident, Dr. Roni Zeiger. Many of our
residents come to me for career advice, and I seem to recall Roni
asking me about pursuing his interests in informatics after residency
about a decade ago. Sage that I am, I probably told him that this
computer thing didn’t have legs. Luckily he didn’t listen, and now he’s
the top doc at Google. Go figure.

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Cerner immune to economic troubles, apparently …

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By Matthew Holt

Gathered at at hobnobbing summit in Tokyo, executives from high technology companies planned recently for economic troubles. And, apparently, troubles are mounting because consumers are running out of money, having to spend it on rising gas and food costs.

Virgin Mobile USA Inc (VM.N), the prepaid mobile phone service company, expects economic problems to last into the first half of next year for its mostly young customers.

Meanwhile apparently government spending isn’t guaranteed either.

Fujitsu Ltd (6702.T) Senior Executive Vice President Chiaki Ito said he was concerned that the costs of absorbing the crisis in subprime mortgages — the risky home loans that have gone bust for many U.S. and U.K. lenders — could divert government funds usually spent on technology." I am extremely worried about the indirect effects of the subprime problem," he said. Meanwhile, manufacturing faces risks from rising food and fuel costs. "If costs go up, this could trigger a recession," he added.

And even the ones that are doing well, such as IBM, are basing their success on infrastructure projects in the developing world.

"If I were in a business model where I needed double-digit growth out of the G7 to drive my performance, I would be in a cold sweat," said IBM Chief Financial Officer Mark Loughridge, referring to the Group of Seven nations.

But that’s apparently not the case in Kansas City, home of Cerner, the largest independent health care information technology company Indeed at their recent shareholders meeting Cerner’s two longtime leaders, Trace Devanny and Neal Patterson, said that things couldn’t be brighter.

Why such confidence? Either health care costs are going up very fast (from $2 trillion to $4 Trillion in the next ten years) in which case Cerner will get its share.

"The delivery of care and the spending around care delivery is relatively recession proof …," Cerner President Trace Devanny said. "There’s no way to slow down this train."

Or government will squeeze the health care industry, in which case Cerner will get more than its share.

Former U.S. Sen. John Danforth, a Cerner board member, agreed, saying the only way federal politicians attempt to rein in health care costs is by "putting the squeeze on providers." That will prompt doctors and hospitals to look for greater efficiency, which will make Cerner more valuable to them, Danforth said.

And not only is the U.S. market guaranteed, but foreign markets may also offer growth opportunities.

International business continues to account for a greater percentage of Cerner’s annual revenue, which hit $1.52 billion in 2007. Devanny said the company’s global revenue had grown tenfold to $290 million in 2007 from $29 million in 2002. "We hope to scare the daylights out of $400 million" in global revenue in 2008, Devanny said.

And even better, there is an open field in the relatively underserved ambulatory EMR market and other places

Cerner officials outlined several other areas of growth. They include expansion of Cerner’s core U.S. hospital market, where adoption of physician order entry software is still only 17.5 percent; the physicians office market; retail pharmacies; sales of aggregate patient data to big pharma companies and other clients; integration of care devices into hospital electronic medical record systems; and employer services, such as on-site clinics and regional health information exchanges that use Cerner software.

So what could possibly go wrong?

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