Tag: The Insider’s Guide To Health Care

Markle promotes a privacy standard

Jun 26, 2008• 1

By Matthew Holt

The Markle Foundation put together a group creating a road map over the last few years and today they announced their new policy framework for privacy in PHRs and personal health information. In general this is a great framework, and hopefully will help gain more consumer confidence in PHRs and other uses of personal health information online by consumers and doctors. (The AMA was on the call and was a “supporter” if not an “endorser”).

Overall I’m not sure that privacy is that big a deal (as I’ve written elsewhere). Given the choice between being private and being useful, most people pick useful. (You’ll give out your Social Security Number to just about anyone to make a credit check). So I think that PHR and consumer online services need to be useful first. It was a little telling that when someone asked if this would change any of the PHR vendors actual activity, they all said that they’d been adhering to these processes all along! But there is something to being publicly and loudly transparent about it.

Universal access to high speed Internet

Jun 26, 2008• 6

By Sarah Arnquist

Achieving universal Internet access may happen well before we see universal access to health care — at least if the advocacy group Internet for Everyone has its way.

The Mercury News reports that a "broad coalition of Internet business leaders, online gurus, community organizers and advocates across the political spectrum launched a campaign Tuesday with the lofty goal of universal high-speed Internet service."

The group is driven by the ideals that "Everyone must be connected to a fast, affordable and open Internet connection to prosper in today’s economy and participate in our democracy. The Internet is no longer a luxury. It’s a lifeline."

Increasing access to broadband Internet is obviously important to
expand the use of personal health records and other health 2.0
technologies, but on a more basic level it’s key to eliminating health
disparities.

Communicating and informing people about their health and major health care issues are integral parts of eliminating
health disparities. And that communication increasingly occurs
electronically on the Web. So expanding access to affordable Internet
and improving public health go hand in hand.The coalition will
hold forums around the nation and try to build support for plans that
improve access, choice and innovation. To learn more about the movement
or participate in upcoming hearings, you can email the organizers at co*****@*****************ne.org.

Online bullying care management works

Jun 25, 2008• 2

By Matthew Holt

So says a study out in JAMA today from Group Health of Puget Sound. They randomly divided high blood pressure patients into three groups. Being Group Health members they all had online access to the MyGroupHealth site and services, but the second group got blood pressure cuffs and training on the site. That made no difference. But the third group got all that and online counseling from pharmacists about every two weeks.

After 12 months, about one-third of the patients in the first two groups achieved normal blood pressure. However, with the Internet-based pharmacist care, more than half the patients got their blood pressure down to normal.

Which is both good and bad news. Good news because it’s somewhat scalable to have online counseling from clinicians, in that it’s more convenient for patients and clinicians. Bad news because it’s much, much more scalable to have computers do all the work. But currently computers alone, even when the patients are given more training and services don’t do much better than general medical treatment.

Much of what needs to be done to make care management effective is to figure out how to replace and augment the most precious resource (skilled humans) with a cheaper one (less skilled humans, possibly a long way away, and computers). But at least this combination has been shown to be effective.

Expanding consumer ratings to home caregivers

Jun 25, 2008• 4

By Chiara Bell

It seems that everyone is chasing after doctor and hospital ratings. From Revolution Health to Yelp, consumers are encouraged to rate hospitals and physicians in their communities. Hospitals and physicians are the two obvious providers to rate in our health care system. However, I think we have left out, the largest and, arguably the most important members of the health care profession — nurses, certified caregivers and home health aides.

Let’s compare the numbers.

Today, there are approximately 4,927 community hospitals and an average of 800,000 licensed physicians in the United States. Comparatively, there are 1.4 million registered nurses, 749,000 licensed practical nurses, and 1.8 million certified nursing assistants, home health aides and non-certified caregivers.

That is roughly 4.1 Million members of the health care community that we have left out of the ratings game.

Consumers seek health information to solve marketplace problems

Jun 24, 2008

By Jane Sarasohn-Kahn

Consumers, employers, payers and providers agree that information flows are critical to helping stem health care costs. While there is shared concern about health care costs, there is also a shared desire for more, accessible information and better online tools for managing it.

TriZetto’s report, Research Shows Healthcare Market Constituents Seek Information as Key to Solving the Affordability Crisis, surveys the landscape of stakeholders in American health care and lays out a rational approach to what the IT services firm calls integrated health care management.

TriZetto lays out five key themes that drive the imperative toward integrated health care management:

Health care affordability
Aligning incentives to change activities
Information access as king
The importance of leveraging information technology
Payers as change agents.

Whose DNA is it anyway?

Jun 23, 2008• 3

By Sarah Arnquist Dna

News of the California Health Department’s mailing of cease and desist letters to 13 direct-to-consumer genetic testing firms, such as 23andMe, Navigenics and DeCodeMe, has sparked intense debate over balancing regulations to guarantee quality and individual rights to genetic data.

Here on THCB, Matthew Holt called the move the "first establishment challenge of Health 2.0."

"This is a case where the regulations are running way behind the technology, and the trade protection organizations of health care providers are, I’m sure, whispering in the ear of the regulators," Holt wrote.

Why all the fuss now?

CA regulators say doctors must be involved in ordering and deciphering the genetic tests, which currently are offered directly to consumers. Currently, customers pay about
$2,500 at Navigenics for an initial one-year membership — and then an
annual fee of $250.
23andMe and DecodeMe both charge about $1,000 for permanent access.

Mckinsey smells opportunity in explaining health care

Jun 19, 2008• 5

By Scott Shreeve

McKinsey Quarterly released an interesting study this week under the moniker, “What Consumers Want in Health Care." The central theme of the publication was the large and growing opportunity for a new type of health care “infomediaries” (who traffic in the flow, enhancement, and interconnectivity of information) to have a large and sustained impact in the transformation of our current system to a next-generation system required to meet the health needs of the future.

A few relevant quotes:

Retail health consumers constitute a market worth hundreds of billions of dollars annually.
Currently 116 million consumers have a choice of health insurance (expected to be 151M by 2011).
Most consumers still do not “shop” for insurance — 74 percent will like purchase from current health insurer.
People who do “shop” do so during moments of considerable change — and a full 41 percent either considered or changed insurance.
Most people need additional guidance, education, and advice to make decisions.
Innovative, cross-industry products that assist with the complex decision making will be highly valued by an influx of consumers eager for options but unsure where to turn.

Trusera, out of beta & different enough to be interesting

Jun 17, 2008• 1

By Matthew Holt Trusera_copy

Keith Schorsch is a busy boy. Not only did he write a much commented piece about
Google Health and PHRs on this very station last week, but he also popped by last week to tell me about the new look for Trusera. Several of you saw Trusera launch at the Health 2.0 Conference last March. As of today they’ve removed the Beta tag, and have introduced a new look and new features.

The way Trusera is going about things is by collecting stories and journal entries, and then essentially parsing the keywords and text in those stories to connect people with others with similar situations. The distinction between this and most other social networking sites is that Trusera doesn’t have “forums
” or “channels” per se, but uses its search technology (somewhat inspired by Amazon where several of the founding team came from) to match lurkers and contributers with content and people relevant to them. There’s also some neat tools to help people build their stories with helpful suggestions appearing to the side as they’re being written — think of the Microsoft paper clip but done well! (At this stage it doesn’t take detailed self-reported patient clinical information a la PatientsLikeMe or PHRs).

So far there’s sizable activity on Trusera in autism, breast cancer and infertility, among other conditions. And of course Keith’s aim is to develop hundreds of thousands of members and millions of stories.

Trusera’s approach is different enough to be interesting as another option for community online. The technology is arguably better than others in the space, but as we know from other markets “better” technology doesn’t always mean most successful — as I tell many of my Mac using colleagues. But as was also pointed out to me this weekend, the vast majority of patients are not yet online in these communities. So it’ll be interesting as these numbers grow to see who will remain standing. Trusera clearly has a shot.

Paul Wallace–Get the patients brain in the game

Jun 12, 2008• 4

By Matthew Holt

Paul Wallace, Kaiser@Wired 002

Paul Wallace, who is both Senior Medical Director at Kaiser Permanente and Chair of the Center for Information Therapy, has some sensible things to say about the transition from Health 0.0 to 1.0 and then includes some of the lessons of Health 2.0. He also wanted us to think about the links to the big building behind him in this picture.

Kaiser now has the EMR up everywhere — that’s 1.0 in his terms—information flow. The workflow change is a big deal and we have to think about it. Paul used to wait a few days before dictating notes. No more. That information is needed immediately, and his colleagues let him know about it!

Wallace on the deal with HealthVault—we now have the opportunity to “understand the operational implications of such an endeavor”. Ho, Ho. What does portability really mean? He can see his medical record in Berlin. How does that change care?

The Advisory Board’s David Bradley had earlier told a story earlier of tapping into early wisdom of the crowd to discover that he had shingles. An instructive story of 2.0–-sharing health information and discovering more than is known by the system.

What about engaging the employer. You spend 2000 hours at work each year and probably 1/100th of that with a doctor. Where can we have a bigger impact?

The 2.0 issue is to get the patients brain in the game….

He likes Susannah Fox’s phrase—"let’s design for what could be."

My Group Health and “Killer Apps”

Jun 12, 2008• 4

By Jen McCabe Gorman

Here at the Center for Information Therapy’s Ix Conference,
transparency is the name of the game. Transparency in information transfer, information therapy, also literal transparency – we’re surrounded by tons of
glass and steel here, late-morning light is streaming in, and attendees zone out to a sweet view of the Washington Monument.

James Hereford, executive VP of Strategic Services
and Quality for Group Health Cooperative (Seattle), has the smooth
charm that tells you he has a sales background. He’s taking us on a tour of Group Health’s portal – My Group Health.

His pitch – "My Group Health" is a combo of killer apps, including:

1. EMRs

2.
Secure messaging (between doc and patient)…Group Health has
received/sent these from all over the world, every continent, including
Antarctica

3.
Automated results sharing (lab results)

4. After visit summary

5. Integrated health profile

Hereford’s thesis on the main difficulty of HIT adoption – it’s "completely
psychological." Providers (1k in the Group Health network) didn’t believe the patient should
have ANY information before they did. There’s a shocker.

But as James points out – "You don’t have to be a brain
surgeon to look at your lab results and figure out if they’re outside the
normal range."