The Health Care Blog – Page 1051 – Everything you always wanted to know about the Health Care system. But were afraid to ask.

Above the Fold

POLICY: While Politicians Battle Over Expanding SCHIP, Children Are Dropped From the Program by Maggie Mahar

Oct 13, 2007• 10

At the moment, nearly everyone interested in the S-CHIP debate is focusing on October 18, the
day the US House of Representatives will try to override the President’s veto of an expanded State Children’s Health Insurance Program (SCHIP).

Unlike many of the critics, I favor the expanded program. Briefly, here are a few things to
keep in mind:

First, under the proposal, 70% to 80% of children in the program would be from
families earning less than twice the poverty level ($20,650 for a family
of four).

Granted families
of four earning up to $60,000 a year would qualify for the program
in most states. But given the fact that the average annual premium for
family coverage is now pushing $13,000, it is not at all unreasonable
to suggest that families earning $$60,000 before taxes cannot
afford private insurance.

In theory,
maybe these families could buy private insurance just for their children,
but it’s hard enough to buy individual coverage (when you don’t
belong to a group) –try finding individual insurance that covers
children only.

A Broad Vision of Health 2.0: Reformulating Data for Transparency, Decision Support & Revitalized Health Care Markets – Brian Klepper and Jane Sarasohn-Kahn

Oct 12, 2007• 8

Download health20_1011.ppt

Before you start reading, download the document above. It’s a single PowerPoint slide that’s animated to build. Go into presentation mode, then read along with the narrative below.

The term Health 2.0 refers to the concept, described by O’Reilly in September of 2005, of Web-based platforms that allow users to reformulate data for their own purposes. The Health 2.0 movement is rapidly gaining steam and traction, propelled by established and startup firms. The efforts displayed at the recent Health 2.0 meeting in San Francisco, convened by Matthew Holt and Indu Sabaiya, were both wide-ranging and narrowly focused. Even so, several end-of-day panelists noted that, at this early stage, Health 2.0’s definitions and translations into practice remain murky and fragmented.

We thought it might be useful to try to develop an image of how Health 2.0 MIGHT develop: what its working parts were, what kinds of information it would receive and generate, who its users would be and what its impacts might be. The image that has resulted is simplistic; it doesn’t try to explore any of the underlying mechanisms necessary to pull this off. But it does try to convey a vision of how innovators might come together to aggregate and reformulate large data sets from disparate sources to create tremendous new utility in the marketplace for patients, clinicians and purchasers of all types.

POLITICS: Forgotten children and unopened bills By Eric Novack

Oct 12, 2007• 8

On October 18th, the US House of Representatives will try to override the President’s veto of a greatly expanded State Children’s Health Insurance Program (SCHIP). As is so often the case, political rhetoric serves as a fog that obscures what the SCHIP legislation really is and who is most affected.

The Democrats believe that they win by losing. Republicans shout “socialized medicine”.

But the Democrats went even lower this past week by bringing out a 12 year old boy and his family to be the ‘poster child’ for SCHIP expansion.

POLICY: Michelle Malkin is really dumb

Oct 12, 2007

Yes, that headline is a blatant attempt to get some of the opprobrium Malkin and her nutty commenters are venting on Jon Cohn and Erza Klein.

A little background. Jon, being the sensible moderate, wrote a good article on why the SCHIP veto helps Universal Health Care, and then pointed out that the smearing of the kid from Baltimore whom the Dems put up to support S-CHIP was a dumb idea with lots on the far right failing to do basic fact checking. In fact the family in question was exactly the type that S-CHIP needs to help

In the NY Times today Paul Krugman puts this all into a little more narrow perspective. Suggesting that sliming Graeme Frost–the 12 year old kid in question, is just standard operating procedure for the Rush Limbaugh-types on the right, who have a pretty direct line into the Republican machine.

INTERNATIONAL: SWF seeking Canadian M

Oct 12, 2007• 1

A SWF, that’s a sick white female, is looking for a husband with Canadian health coverage.

Hospitals: Firing doctors by Paul Levy

Oct 10, 2007• 7

As one of the first CEOs in healthcare to author his own blog, Paul Levy of Beth Israel Deaconess Medical Center has established a cult following with outspoken posts tackling the issues he faces as the top manager at one of the most influential hospitals in the country, writing on everything from insider debates over the publication of hospital mortality and infection rates to negotiations with labor organizers and the wise use of information technology. Today he tackles a delicate subject sure to provoke debate – and enthusiasm – on the THCB discussion boards …

Several years ago, before taking this job, I was asked to turn around a
relatively small clinical trials data processing company. I had to lay
off a number of people who were not critical to the company’s success,
and one of these included a doctor who had been hired to expand the
business into a certain area that we determined was no longer
appropriate. This was not a case of incompetence or lack of energy or
enthusiasm. He was great guy with terrific credentials, but we just
could not afford his particular expertise in that troubled little
company.Recently, we had a chance to meet, and he confessed to
me that my decision to lay him off had caused him to have a real crisis
of confidence. He had never been fired before and, as he put it, his
view of himself as a person and the job he did was one and inseparable.
Here, I had torn them apart, and it took him a while to remember and feel
that he was still as adept and valuable a physician as he had been
before he was fired. Indeed, he was able to thank me, years later, for
teaching him the important lesson that a particular job does not define
who he is.I replied to him that I thought that his initial
reaction explained to me why doctor-managers often find it difficult to
fire other doctors. They too quickly internalize how it would feel to
themselves to be fired, and they project this onto others. They
conclude that they cannot devalue the professional abilities of a
fellow physician by terminating his or her employment. They have
difficulty separating the business imperative from the degradation of
one’s self esteem.

TECH: Big deal in the RF location tracking world

Oct 10, 2007

I haven’t spent much time recently on the location tracking tools that I think will be a big part of hospital efficiency improvement in the future. The folks I met this weekend at LA County are thinking about them for next year when they move to a huge new emergency room, but the big fuss at HIMSS in 2006 around the asset and people location tracking has yet to really pan out.

But maybe the market is starting to take off. Yesterday one of the companies I’ve been following for a while, Ekahau, announced a big sale to big public hospital system Carolinas HealthCare System. Given that the inherent chaos that most hospitals appear to live with (to the uneducated eye—yes, I’m picking on LA County, but you know there’s some truth in that!), the potential for efficiency improvements from asset tracking and improved communications are very real.

CONSUMERS/TECH: Molly and Don write a Gray Paper

Oct 10, 2007• 2

So this morning and yesterday afternoon at the Ix Conference I’ve heard some really interesting technology presentations from Silverlink (disclosure Ix and THCB sponsors!) & Eliza, who are both in the voice automated outbound call space. Popped in on Resolution Health, which looks like it’s emerging as a big time competitor to Active Health Management, and saw an interesting lite-weight messaging system for docs to communicate with patients (and vice versa) called CareNav. Then quick look at how Healthways working with Pro-Change Behavioral Systems is really tailoring (that’s the big Ix word this year!) HRAs—although not all Americans have taken one or even know about HRAs!

CONSUMERS/TECH: David Sobel stars on Tuesday morning at the Ix Conference

Oct 9, 2007

Yesterday (Monday) there was a great session about advertising in health care—but actually impossible to blog about as it was mostly funny videos! Great stuff from Hollywood writer Marty Montgomery who works with Vic Stretcher, HealthMedia Inc, & also from Michelle Sobel, Emmi. Go look at their sites, but briefly, people are prepared to learn about stuff that they are interested in and entertained by!

Ix this morning started with Earl Steinberg from Resolution Health and Jim Prochaska from Pro-Change Behavioral Systems. Lots of data but shorter version is, targeting and tailoring data to those targeted patients works pretty well.

Next, an award for Susan Edgman-Levitan pioneer in patient information and advocacy who actually founded Picker Institute—the originally patient survey organization. Apparently finding out what patients actually thought and wanted was a new idea before Susan showed up!

HEALTH2.0/TECH: Athena Health: The History of the First Health 2.0 IPO By Scott Shreeve

Oct 9, 2007• 3

Scott Shreeve writes frequently about Health 2.0, open source and healthcare, topics that as the co-founder of Medsphere, one of the most-closely followed companies in the industry, he is extremely well qualified to write about. If you enjoy this piece, you will probably also enjoy his recent essay "Health 2.0 Business Model: "Payment Dependent on Results." For more on AthenaHealth have a listen to our podcast interview with always-entertaining CEO Jonathan Bush, one of the real stars of this industry.

Initial Public Offering (ĭ-nĭsh’əl pŭb’lĭk ô’fər-ĭng) n.

1. The first sale of stock by a private company to the public.

2. Stock issued typically to raise capital and gain access to public markets.

3. Sale of stock typically handled by underwriters who determine type, quantity, and price of stock sold.

I have previously written on several occasions about one of my all-time favorite companies – Athena Health.
It is appropriate to once again put finger to key to congratulate
Jonathon Bush, Todd Park, Nancy Brown, Ed Park, Jon Hallock, and the
rest of the Athenista’s for their recent IPO (September 20, 2007). It was the largest IPO of 2007 and bodes well for the ongoing wave of investment in healthcare information technology.

I
find the history, growth, and now the prosperity of Athena to be
fascinating. Athena was founded by my fellow IT co-conspirators,
Jonathon Bush and Todd Park, Athena has steadily advanced over the last
decade birthing the "software as a service"
(SaaS) model within healthcare industry. I say "birthing" because I
have watched the labor pains of Athena fairly closely over the last 5
years since first meeting Todd Park in Waterbury, CT on my first ever
presentation with Medsphere. We discussed then, and watched again and again, as Athena began to take a bigger and bigger swipe at the "healthcare hairball".