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CBO assesses return on investment of HIT

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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AHIP & Health 2.0 — caveat whatever the Latin is for movement

Last month, the trade group America’s Health Insurance Plans sponsored a seminar on Health 2.0 with Lynne Dunbrack at IDC Health Industry Insights and Roy Schoenberg from American Well. Any resemblance in Lynn’s presentation to the talk I’ve been giving since mid-2007 is I’m sure completely coincidental. (To be less snide, it’s all pretty obvious stuff, and many others are doing it, too). Meanwhile, next month at the big AHIP meeting in San Francisco, another analyst from a Massachusetts research outfit (Carlton Doty of Forrester) will be presenting on this “new” trend.

Now, I’m not exactly blaming these guys for getting into a good thing. Both American Well and David Sobel (who’s appearing with Doty) have been featured at Health 2.0 Conferences already, and Indu and I certainly didn’t discover them, the term Health 2.0, or the Internet. And given the “praise” I’ve heaped on AHIP and its President on THCB over the years, I wasn’t exactly sitting by the phone waiting for their call. Certainly slightly more, ahem, compliant pundits can do a great job instead — even if flying a guy from Boston to talk in San Francisco, when I could walk three blocks may not be the best use of their members’ money.

While it’s good that AHIP is introducing its member health plans to the potential of the Health 2.0 world, let’s not forget that the motivations of the organization don’t exactly square with where many of us think health care, including Health 2.0, should be going — and nor that matter do the Association’s  President’s public pronouncements fit with  the long-term interests of those of its members who do have something to offer society (e.g not Mega Life/HealthMarkets). Meanwhile, over the years, the quality of AHIP’s research and the veracity of its public statements about the value its members deliver to society have been laughable. So let’s be a little careful about AHIP’s role in Health 2.0

OK, rant over. You can all go back to Friday dog blogging

Charley

Vision for hospital’s future HIT

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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

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

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

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

Around the Web in 60 Seconds (Or Less)

The WSJ Health blog: Police shoot a man with a Taser gun and inadvertently correct his heart beat.

California proposed legislation would allow pharmacies to sell patient info to marketers.

NYT Well: Childhood obesity rates level off.

John McCain releases more than 1,000 pages of his medical records.

Health industry gives more to Democrats than Republicans.

Financial Times: Indian drugmakers threaten to stop production en masse.

Massachusetts docs sue state agency claiming it publishes faulty physician ratings.

Business Week asks if FDA regulations are preventing U.S. cancer patients from accessing advanced cancer drugs.

NYT: SEC allows shareholders to vote on proposals for universal health coverage.

CJR: Democrats waver on prospects of health reform.

Boston Globe: Former Harvard Med School dean discusses new doctors’ march away from primary care to lucrative sub-specialties.

AP: Half of all insured Americans take at least one daily prescription for a chronic ailment.

FDA proposes new drug labels for pregnant and breastfeeding women

Self diagnosis in military health care

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

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

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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