Tag: Uncategorized

Humor: Voluntary Cost Control? Never Mind!

Michael Millenson

Health Care Stocks Hurt as “Promise” Spooks InvestorsNEW YORK – Major health care stocks plunged today as investors worried that a series of voluntary actions the industry pledged in order to control costs represented a serious threat to profits.“Leaders of drug, device and health insurance companies gave their solemn word to the president of the United States that they will cut costs,” said Pinocchio Paparazzi, an analyst with Bear, Bulle and Morbull.  “Simple math says if you trim two trillion dollars from spending, that’s two trillion dollars lower revenue. That reality should be reflected in stock prices.”Merck and Edwards Lifesciences, two companies whose CEOs personally attended a White House briefing announcing the coalition’s goals, led the decline with double-digit drops. Health insurance giants Wellpoint and UnitedHealth Group also slumped, as did the for-profit hospital sector, as investors decided that making the health care system “more affordable and effective for patients and purchasers” might be good politics but was bad for the bottom line.

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Healthcare as a Complex Adaptive System – Part 2: Eight Points

6a00d8341c909d53ef01157023e340970b-pi We can actually say what a better healthcare system would look like, if we look at healthcare in the United States as a complex adaptive system stuck in a Nash equilibrium.  The ideal reformed healthcare system would be universal, possible, understandable, cheaper, better, market savvy, incremental, and self-reinforcing.

  1. Universal: Giving everyone secure access to the system.
  2. Possible: Politically possible and financially workable.
  3. Understandable: Simple enough for people to understand, simple enough to sell politically.
  4. Cheaper: Aimed at (and with mechanisms for) lowering the cost of healthcare – for each of us as individuals and for all of us as a nation
  5. Better: Aimed at (and with mechanisms for) improving the quality of healthcare for each and for all
  6. Market savvy: Using smart market mechanisms to achieve these goals
  7. Incremental: Able to arise piecemeal, and improve as time goes on
  8. Self-reinforcing: Each element of the system rewarding improvement in each other element

Universal: Is healthcare a right? Getting good and timely medical care stands between you and death or a life of misery. So it is certainly a necessity, arguably one of the three “inalienable rights” set out in the Declaration of Independence, not arbitrarily afforded to some and not to others by race, class, age, location, or other division.

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Project HealthDesign and Health 2.0 Accelerator

Round 2 of Project HealthDesign, funded by the Robert Wood Johnson Foundation, builds on a key learning from round 1: people live with and manage their health every day, not in discrete and separate episodes. This may seem like an obvious realization to some; but the “traditional” health care system most of us use is not really designed with this in mind. Our system is getting better at enabling patients to do things such as view a version of their electronic medical record or lab results online and automate appointment scheduling or payments. And yet, most of this progress is still limited to clinical and administrative data that is generated based on episodes of care and limited to the institutional medical record. This is where “observations in daily living” (ODLs) come in. Project HealthDesign defines ODLs as “personal clues to health that might include sleep patterns, diet, exercise, mood and medication adherence, all of which are critically important to health but not collected in a clinical setting.” By understanding ODLs, patients can be empowered to create a more meaningful portrait of their health, to shape daily health decisions and facilitate better health.

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Op-Ed: Cost-Reduction Strategies Help Hospitals Weather Economic Uncertainty

David Markoski In today’s current economic climate, many hospitals are reducing staff to cut costs and balance their budgets. An even greater number are trying to reduce administrative costs to save money for the difficult days ahead and retain their employees.While reducing staff may help the bottom line, it may threaten a hospital’s long-term success by jeopardizing quality patient care and its reputation. Cutting non-salary costs, meanwhile, may save as much—or more—while kick-starting organizational recovery when the economy improves. Since these cost reductions do not compromise patient care or the level of support hospitals provide to their physicians, they create long-term efficiencies that will serve the hospitals into the future.Employee compensation accounts for the single largest item on a hospital’s budget, but the aggregated costs of goods and services are greater. These costs represent dozens of money-saving opportunities—from supply chain management and physician-preference items to service contracts and pharmacy—that can impact the bottom line without affecting patient care.

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Andy Hurd, CEO, CareFx

Matthew is away in Peru sampling the delights
of the Andes this week. He had a very busy month with conferences
in Hawaii, HIMSS in Chicago, WHCC in Washington DC, and of course
Health 2.0 Meets Ix in Boston. Lots and lots of video was taken during
all those trips, and we gnomes back at THCB are taking the opportunity
to show you some of it. This week we're presenting all the interviews Matthew had at HIMSS in Chicago that haven't already been shown.

Andy Hurd, CEO, CareFx, talks about his company, which provides a way
of viewing disparate systems, by sharing views into different hospital
departmental systems quickly and relatively cheaply. It's a fix for the
messy "different systems don't talk to each other" problem, and it's
catching on in the big hospital market, with explosive growth last year.

Luis Machuca, CEO, Kryptiq

By Luis Machuca, CEO, Kryptiq explains how his secure email solution is
mixing and matching data between different providers.

Of Healthcare and Toilets

Tobias Gilk “Any system produces exactly the results it was designed to produce,” or so goes the saying. If we don’t like the results we get, we need to re-examine the system and not simply individual inputs.

In the US, healthcare’s systemic complexity has gone from that of a grandfather clock to nuclear reactor over the course of the past 100 years. If we really wish to improve the results of US healthcare, we need to look at the totality of the system, the multitude of inputs and outputs.

EMR’s, reimbursement rates, pre-authorizations, universal coverage and each of the many hot-button topics swirling around the question of healthcare reform are all important inputs that effect quality, cost, access, but I’m very much a hands-on person and I want to know what these have to do with the physical points of distribution of healthcare… our doctors’ offices and hospitals?

We know that a hammer sees every problem as a nail. And I concede that my predisposition as a recovering architect is to see the problems inherent in the physical instruments of our healthcare delivery… namely hospitals.

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The Stimulus Package and Health Data Exchange

CapitalObama’s stimulus package allocates
tens of billions for healthcare IT, and that much expenditure by the 
Feds won’t happen twice; thus, we should ensure these stimulus funds
address key health information infrastructure needs. The package dangles
incentive payments in front of hospitals and physician offices to adopt
electronic medical records (EMRs) by 2011, as well as penalties if they
fail to use them by 2016. Providers will hopefully benefit from EMRs
through improving effectiveness and efficiency within their organization.
For the health system as a whole, however, the promise goes beyond gains
within practices to encompass improved teamwork among providers and
with patients. It is on this latter promise—system improvements through
sharing medical records—that I’d like to focus here.

The vision is for a community-wide
information system that allows Marie, a diabetic who is allergic to
penicillin, to show up unconscious at any emergency room, yet get care
from doctors who know her special medical needs.  Further, Marie’s
treatments in the ER are known immediately both to her family physician
and to her specialists. The full team—primary through tertiary care—have
access to complete medical records available in real time, integrating
their separate decisions through shared information. This vision promises
improved care quality through comprehensive and transparent information,
and it will reduce redundant diagnostic testing.

Does the stimulus package adequately
promote this vision? What we’ve seen so far disappoints.

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Calendar: Project HealthDesign

The Robert Wood Johnson Foundation (RWJF) has announced a new call for
proposals for Project HealthDesign: Rethinking the Power and Potential
of Personal Health Records, a $10-million national program to stimulate
innovations in personal health information technology.  Project
HealthDesign will host the second of its informational web seminars for
potential applicants on
May 7th.  For more information and to register:


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