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Tag: Startups

TECH/POLICY: Yet another PHR, and some info on me speaking

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There’s a new PHR for university students in Nebraska only. Not that that really says much other than the buzz around them continues. In response to a question over at HISTalk, I want to remind y’all that many of my latest opinions on PHRs and Health2.0 will be given on Tuesday at the Center for Ix Therapy’s webinar on the topic starring  moi and Josh Seidman. It was so popular they were forced to triple the number of lines they’re using to over 150 sites. This may be my draw at the gate in action, but it’s more likely it’s the combination of the topic and the price (nada).

The price is because the session is a marketing piece for the Center–and if you are the
right kind of corporation/health care organization, I would highly
recommend membership and their annual conference in Park City, Utah, as it’s a deal. They never got around  to opening it up for THCB readers as they (probably rightfully!) suspected that some of you lot weren’t likely to pay up to join the center. But a recording of the webinar with the slides will be up on their site at some point.

Still if your organization would like to know more about PHRs or any other health care topic, you know that I can be persuaded to talk. More info behind the speaking link.

And on the speaking topic, this coming Wednesday I’ll be in Vegas on a panel at a conference on Transparency in Health Care which includes sensible libertarian Michael Cannon from Cato. He’s promised to spend the entire monthly contribution that Exxon-Mobile gives Cato on a big night out for me there….pity he doesn’t work for AEI.

TECH: More on Revolution Health

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Over at tech blog TechCrunch, there’s a piece on Revolution Health. What’s most interesting is the comment section, where the CEOs from DailyStrength, Organized Wisdom, and others and the Chief Medical Officer of Revolution itself all pitch in.

Frankly, the nit-picking over who does what best reminds me of the line about the fleas arguing about who owns the dog. For this Health2.0 stuff, these are such early days that the only people I really discount are the ones arguing that we shouldn’t rate doctors or allow patients to talk to each other in communities. (Yes, there are a few commenters saying exactly that).

Of course people will still be trying to close that door long after the horse has bolted.

TECH: Free eRx from Allscripts and friends, with UPDATE

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Allscripts, backed by a cast of friends, is going to let any physician in America sign up for its ASP-based eRx system (which links into Surescripts) for free. The coalition is called the National ePrescribing Patient Safety Initiative (NEPSI) and it has its own website and press release and everything!

Also in on the deal are two biggie health plans, Wellpoint and Aetna, several tech companies (Dell, Cisco, Fujitsu, Microsoft, Sprint, & Google), Surescripts (connection to pharmacies) and Wolters Kluwer (drug databases). I assume there is some money flowing around (presumably from the health plans) to cover the costs, but it’s not clear how much or to whom. I’ll endeavor to find out.

The old joke is that for physicians to adopt technology, free isn’t cheap enough. I guess that we’re about to find out.

UPDATE: Well I actually listened to the whole webcast (yes, my life is pretty sad!). The most interesting thing is the Glenn Tullman (Allscripts, CEO) said that the 5 years commitment was $100m. That’s real money, and the only real place that they can expect to get (most of that) is from the health plans—unless Glenn’s got the negatives of Bill Gates or Larry and Sergey with the goats. And it’s probably a similar amount that Wellpoint and the others have already spent on these initiatives, much of that with Allscripts—so there’s probably a migration of those regional projects going on.

The other thing mentioned was that the system would have interfaces with practice management systems—what that means in reality remains to be seen of course.

TECH: Nerd med student builds “the GMR, An EMR That Doesn’t Suck”

Graham Walker, Stanford med student and blogger, is such a nerd that he’s built what he thinks is a better interface for an EMR–trying to make it a true desktop work-tool using Web2.0 type tools.

I’m not an expert on EMR interfaces, other than knowing most docs don’t like them, so go to his web site, and take a look at the movie demo. This may be how progress gets made.

Anyway, go take a look if the EMR in actual use is your bag.

TECH/CONSUMERS/BLOGS: Information Therapy and Other Ways to Change the World

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Josh Seidman, the President of the Center for Information Therapy, and someone I must confess to knowing and liking, has descended into the mire and started his own blog. He told me that a friend had suggested it to him—I told him his friend can’t have liked him very much!

The blog is called Information Therapy…and Other Ways to Change the World. I must also confess that I’m partly responsible for the recent entry on PHRs as I’ll be a presenter with Josh at a webinar for the Center on PHRs and Information Therapy which is coming up on Tuesday January 23. The idea is that we’d generate a little interest and get a few potential new members for the Center to listen in. I was hoping to invite THCB readers to fill out the crowd. But within 12 hours of sending out the announcement, they’d had more than 100 sites sign up, which means that we’ll have to do it twice at least, and I’m not sure there’ll be room for any more.

I’d like to think that Josh and I are such a draw that we’re responsible for the crowd. But I tend to think that (in my view 6 years too late!) the PHR is finally starting to get the attention it deserves. If you are really keen to attend, send Dorothy Jeffress at the Ix Center an email, and she’ll see if she can squeeze you in.

TECH/CONSUMERS/HEALTH PLANS: Not much employer backing for HSAs

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Those of us who feel that the CDHP movement is largely being used as cover by employers for reducing the benefits (i.e. compensation) that they’re paying employees will not be too surprised by this new analysis. The source, Vimo, though is somewhat surprising for two reasons. First, it’s a little technology start-up that’s providing comparison shopping for health, and second—as is clear when you listen to the interview I did with CEO Chini Krishnan—they are more than favorably disposed to the notion of individuals doing their own shopping for not just health insurance but all types of medical goods and services. So it’s hard to imagine them benefiting from bad news about HSAs. Yet what they’ve discovered, confirming research done by the more usual suspects such as HSC,  is that as employers convert their benefit offerings over to the HDHPs, they are not funding their employees’ HSAs.

Here’s the key part from their analysis:

First, the difference (in numbers) between HDHP (3,168,000) and HSA (820,000) means that there are a lot of individuals within the group and individual markets who aren’t opening HSAs, even though they’re entitled to them. Second, HSA asset levels are also lackluster. The same AHIP study lists the average HDHP deductibles as HDHPs $2,378 for single coverage and $4,760 for family coverage. The average HSA balance in the Inside Consumer Directed Care survey ($1,180) is less than fifty percent of the average deductible for single coverage.The simple fact is that HSA creation and asset levels are lagging HDHP enrollment by a significant margin.

And realistically given that some people are funding their full HSAs, given that the average is well below half the maximum, the median HSA account probably contains close to $0. What’s going on then? Well Vimo knows the answer.

Certainly there are immediate and significant savings available when companies or individuals migrate to HDHPs. This cost differential can be pocketed as a one time gain, or it can be used to fund most or all of the HDHP deductible by depositing the difference into an associated Health Savings Account. It would seem that many employers are opting for the one time gain.

If you’re in a business which depends on these accounts and CDHPs being adopted by a bunch of happy consumers, you can see that there is plenty of potential for angst amongst employees who discover that the move to the CDHP is basically telling them that they have to dip into their own pocket for something the company used to provide. In what is a very considered and well  put-together report—which I’d recommend you read all of—Vimo discusses the impact of this “transfer” on both consumers and employers. And true to their business model they are squarely on the side of looking out for consumers and employees.

I approve of them telling the truth, even if it’s a truth that opponents of the CDHP movement will highlight. After all, if this thing is done wrong, the longer term political consequences may be a future in which there is no such thing as a high-deductible plan or HSA—and that will leave Vimo with a whole different business problem.

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