Another incomplete but useful study from HSC on physician technology use. Essentially the investments made by big groups in EMRs are showing up in the data, with nearly half those in groups of 50 and above using ePrescribing—perhaps the key indicator of whether a doc is using a computer for a basic clinical function.
But for those in the 1–9 sized group the number went from 8% in 2001 to 13% in 2005. A big increase in percentage terms, but not exactly setting the world alight.
The number of CT studies is growing at 8% annually.
Here’s the transcript from last weeks podcast. It gives you a window into one of the hot areas at the moment, Health2.0 (perhaps I should trademark that quick!). The participants are three leaders of new online health focused companies, all of whom are relatively new and very ambitious. The original podcast post is here.
Matthew: Welcome to another THCB podcast. I’m Matthew Holt. Today is pretty exciting. I have got three of the leaders in what’s starting to be called the Health 2.0 movement. Those of us who were around the first time when things got crazy in Silicon Valley in the late 90’s when Netscape and Healtheon came on the scene are somewhat nostalgic for the days when you would go to parties and people would try to recruit you for a job just because you were standing around drinking. And those of us who have lived through the e-health bust are particularly upset about what happened next!But it looks like in the last couple of years, mostly in the last year or so, there’s a lot more interest in health care online, health care search, and health care information. And a lot of that has to do with what’s happened with the Google IPO and how successful Google has been creating a business out of search. Obviously a lot of the buzz in Silicon Valley and on the Internet in general has to do with that.But what I thought we’d do today is take a look at this Health 2.0 movement. So I’ve assembled three individuals who are leaders of companies, all of them at this stage relatively small companies, and all relatively new companies. But all of them are doing something very interesting in a slightly different segment of health care and health care online, or as it’s now starting to be called, Health2.0.And just before I introduce them, I’d also point out that just yesterday Dmitriy Kruglyak at HealthVoices started a manifesto called the Health Train, The Open Healthcare Manifesto, which is a new sort of manifesto promoting the idea of open health care. I’m one of the people who signed that, and I think it’s quite an exciting time in general for the concept of new types of open online heath care.So with that, let me tell you who I’ve got on the conference call with me. I have
- Dean Stephens, who is the president and CEO of Healthline, based in San Francisco,
- Tom Eng, who is the Chairman of Healia, based up in Seattle, and
- Chini Krishnan, who is the CEO and founder of Vimo.
And the good news here is that Vimo was until very recently called Healthia, but for the context of this conversation, thank God, changed it’s name. [laughter] And I had to let Chini come in because when I went to visit Vimo they gave me a T-shirt. And I’ll be expecting the other two of you guys to be sending one along soon. [laughter]Now with that, I want you each to give a brief introduction to your company.
My piece about RHIOs as ASPs is up at Digital Healthcare and Productivity
Gadlfy has been telling me that I’m MIA on the big Kaiser story, but luckily MrHISTalk has picked up the slack and has printed the Internal E-Mail Criticizing Kaiser’s HealthConnect Lands Employee in Hot Water. In addition in a presumably related move CIO Cliff Dodd has quit. Gadfly also tells me that the 25yr old malcontent Justen Deal (who I’d never heard of before yesterday) was previously a Kaiser cheerleader. Well nothing like a convert to preach a new religion. And his new faith is that Epic sucks, HealthConnect is a disaster responsible for a forthcoming financial crisis at KP, and that Halvorson is incompetent/a crook (take your pick)
I have no idea whether the Epic solution will or won’t work in the long run, but I suspect that it was rather better than the IBM/Colorado solution, given a conversation I had a while back with some internal KP tech savvy docs about the state of that code. The truth is presumably somewhere in the middle. Unless Halvorson actually has secret stock in Epic or is being paid off into some Swiss bank account, something that’s rather unlikely given the way Judy Faulkner runs that private company, then there doesn’t seem to be any direct conflict of interest. Lots of big IT projects don’t work as advertised—in fact few do! And Kaiser is a highly fragmented and political organization (always has been, always will be), so betting the farm on a one-stop EMR solution probably did require getting most of the board to leave. I’m amazed Halvorson got it done at all.
And I cannot believe that HealthConnect is by itself responsible for all the anticipated losses—the move towards HDHPs is far more likely to hurt KP’s bottom line, as they are just not set up for that type of an environment (in which the risk pools is destroyed). It’s just not in their nature.
And at least the attempt behind HealthConnect is to improve care. Much more concerning is the organization’s reaction to the kidney transplant scandal, which as some of my commenters mentioned at the time called into question the financial ethics of TPMG.
But I guess this new little outburst doesn’t help! And I have heard quite a few KP docs bitching about the new system. Any more want to chime in pro or con or neutral?
….and of course much more from a not exactly neutral source at Gadfly’s blog
Here’s the transcript from the recent podcast with Don Kemper. Interesting stuff from a real pioneer.
Matthew Holt: So welcome to another THCB podcast. Today we’re very lucky to have Don Kemper, who is the President, CEO and certainly the joint founder of Healthwise, and also, although he’d be too bashful to say it, probably the main individual in America who has been behind the information therapy movement, which now has its own separate Center for Information Therapy, the one that Don I believe founded. So Don, welcome to The Health Care Blog.
Don Kemper: Thank you, Matthew. I’m pleased to be here. You’re very kind.
Matthew: Those of you who’ve been reading the blog have noticed that over the years I’ve both been to a couple of information therapy conferences, partly because they’re held in Park City, Utah, which is a beautiful and lovely place to go where I have friends (even though I left most of my left knee there in the trees some years ago and am just steadily getting it put back together) but also because I’m pretty convinced and a firm believer that the concept of information therapy is one that is going to be of significant importance no matter what happens in the future health care reform debate. And it’s something that, as people are developing new and different forms of information technology to support those patients and physicians, information therapy is going to be an important part of that.
So, with that, Don, why don’t you take us back to the early days. Tell us a little about what Healthwise does, how that started, how the Healthwise Handbook got going, and then perhaps just tell us a bit about Information therapy to start off with.
Don: It all started, Matthew, when I was a lieutenant in the U.S. Public Health Service back in 1970, and I heard a talk by the assistant secretary for health education and welfare in those days, Vern Wilson. He said the greatest untapped resource in health care is the consumer. And that was at a time when nobody was thinking about what a patient could do for themselves, and I though, "That’s a good idea." I had a little baby at home and somebody had given me a Dr. Spock, and I thought, "Well, what the world needs is a Dr. Spock for the whole family," and began to try to get the federal government to write a basic self-care book that they could give to every family in America.
That idea didn’t get very far in my two year tenure with the Public Health Service, but I held onto the idea, and a few years later landed in Boise, Idaho with a pretty open book on what I could do, and we started to develop that idea. And so Healthwise was formed in 1975. We published the first copy of the Healthwise Handbook through Doubleday in 1976. And we have been growing toward the same mission that we established right then, which was to help people make better health decisions.
So over the last 31 years, we have been continually looking for ways to enrich this mission of helping people make better health decisions by giving them books, giving them workshops, giving them good web based information, and now finding ways to prescribe information to meet their specific needs in every moment of care.
Do you want to know more?
Matthew: Sure. Let me ask you some more specific questions. Healthwise is founded as a non-profit, and I guess that perhaps the first time I ran into Healthwise was back in early ’90s. Somewhere around that time you convinced the folks at Kaiser Permanente to give that book to every member, I believe. Maybe that was just Northern California. The thing that I as a health care economist policy guy that I sort of sat up and took a notice, was that actually, they showed that emergency room visits declined dramatically amongst people who had these books.
So tell me a little bit about how that evolved, and how, apart from being sort of a worthy organization giving out information to people, Healthwise started evolving into being a place where the health care system realized it could start having a positive impact on savings, as well as outcomes.
I must admit that I didn’t even know he was on trial, but it appears that he was and he just got away with it. Yup Charlie McCall who guilt up HBOC based on fraudulent accounting, and sold it to McKesson back in 1998 whereupon the fraudulent shit hit the fan, was acquitted on one charge and the jury was deadlocked on the others. Proving that you can get away with it even today (or perhaps that the Justice system works perfectly!).
So in a first for THCB I put together a 4 way skype call for a podcast. On the call are three Health care tech start-up leaders: Dean Stephens, President, Healthline; Tom Eng, Chairman, Healia; and Chini Krishnan, CEO, Vimo. The podcast is here, and I think you’ll find it pretty interesting.
Unfortunately the recording quality isn’t great. And worse there’s an ugly period between 29.30 and 32.00 mins when the others couldn’t hear me even though the recorder could (although Skype’s IM function did work and saved the day). So please wind on when your MP3 player gets to that part. (Someone who knows might want to help me with my recording setup and editing skills!) For those of you who can’t deal with the thrill/drawbacks of the new technology, the transcript will be up in a few days.
Cisco has produced a video on transforming patient care which includes discussion from “Crossing the Chasm” author Geoffrey Moore, Jeff Rideout, Cisco’s head honcho Medical Director, several hospitals execs, and a cameo from me. Go to this site to register and take a look. I’ll also be answering questions in the discussion segment for the next week.
UPDATE: Now I’ve seen it. So here’s my take! I may look wooden and my answers are sometimes to questions that I wasn’t asked (oh, the magic of editing!), but you only have to put up with literally a minute or two of me. The rest of the session is really interesting–everyone else is much more eloquent than I am and the technology featured-especially the instant translation services at San Mateo County hospital–is very interesting. Yes it’s product placement for Cisco, but well worth watching nontheless. Interesting that video-conferencing and PACS are what the hospital people view as the important changes, while I was talking mostly about IP telephony, automating vital signs recording (telelmetry) and location tracking. I must still be a futurist!
Yesterday saw the official launch of HealthTrain, the Open Healthcare Manifesto. Dmitriy Kruglyak has been working on this for some time with a large group of collaborators, and I have joined several others to sign on. The manifesto lays down some principles for how the new media of social networks and open access to publishing technology (e.g. blogging) ought to be used within health care. It’s an interesting and common sense filled set of guidelines which I hope will give the concept of “open healthcare” some visibility and some direction.
So instead of perusing my blog today, I hope that instead you’ll read the manifesto (It’s only about 12 pages).
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