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PODCAST/PHYSICIANS/QUALITY: Interview with David Seligman, CEO of Best Doctors

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Here’s the transcript of the interview earlier this week with David Seligman, CEO of Best Doctors. Pretty interesting especially for those of you thinking about how to improve health care quality on a national and perhaps nationally branded level. (By the way, the transcriptionists at Castingwords are getting really quick! They only got this 36 hours ago). For those of you who prefer listening to reading the audio is here.

Matthew Holt:  This is Matthew Holt. I’m here with The Health Care Blog, and I’m talking with David Seligman. David is the CEO of Best Doctors, based in Boston, Massachusetts, and is also a locational contributor to the Boston Globe, as I noticed the other day‑‑and I’ve just found out, a regular reader of The Health Care Blog, which always is a pleasing thing.

David Seligman:  [laughs]

Matthew:  David, good morning. How are you?

David:  Good morning, absolutely, Matthew. I enjoyed being with you down at the World Health Care Congress, and I understand you’re going to be there again this year.

Matthew:  I’ll be looking forward to it. Anybody that’s listening can come by. I’ll be doing some blogging from there all three days.

David:  Excellent.

Matthew:  Let’s start with the real basics. I know that Best Doctors is a referral service and a second opinion service, and it’s obviously a lot more than that, but that’s, I believe, what it is at its core. For those readers of The Health Care Blog who are a bit more casual, can you just give the basic introduction to what you do, what problem you’re solving, and how you solve it?

David:  Yes, absolutely. Best Doctors is a global organization located with a presence in 30 countries around the world. It was originated by physicians from Harvard Medical School in the late 80s. What these physicians were seeing were many patients coming from around the US, and from other countries, to the Boston area, in search of the best information or the best medical care. They realized, back in the late 80s, that nine out of 10 of these patients could’ve, should’ve, stayed home with their local providers. Again, what they were looking for was what they thought would be access to better a quality of care and treatment. What we pioneered was a database of 50,000 of the world’s leading physicians in over 420 sub‑specialties of medicine. We tap into these physicians to really help us provide a comprehensive clinical review of serious or complex medical cases, and we really identify a correct diagnosis or course of treatment over 60 percent of the times in the cases that we’re doing, particularly here in the US. Once again, Best Doctors, we’re a global resource‑‑a trusted resource‑‑to help people with serious illnesses access the best medical care, without having to leave their local physician or local environment.

Continue reading…

POLICY: And while it’s Jon Cohn week….Health Care Like The Europeans Do It

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Here’s his New Republic piece called Health Care Like The Europeans Do It republished on CBS news. Personally I think that he gives the American system too easy a ride, even though Ezra beats up the Cato boys on this too. When I looked at this issue of performance on particular disease categories a while back I found this quote.

Contrary to popular belief, the health care here isn’t always the best. Many other industrialized countries provide health care that is just as good and sometimes better. For instance, 30-day acute myocardial infarction case-fatality rates are below 7% in Denmark, Iceland, and Switzerland, compared with almost 15% in the United States. Incidence of major amputations among diabetic patients in Finland, Australia, and Canada is less than 10 per 10,000 compared with 56 per 10,000 in the United States. And Australia, Canada, England, and New Zealand all have a better 5-year kidney transplantation survival rate than the United States.

You’ll never hear that in a Cato/Manhattan/PRI/AEI press release—and it defies belief that they want to go down that path.

But the overall point is that health and medical services are only distantly related, and talking about outcomes in the context of different health systems is stupid. But there are two outcomes that it is not stupid to talk about, and those are the two on which America leads the world. High costs across the system, and poor (and middle income) people losing all their wealth due to medical care costs.

After spending his whole piece beating back the silliness about individual disease outcomes, Jon does get to the real point:

Not even conservatives dispute the one clear advantage other countries have over us: You don’t see their citizens choosing between prescriptions and groceries, or declaring bankruptcy, because of medical bills.

And that is the point. Universal health care insurance is not about health, it’s about wealth. As in not losing it when your sick because you didn’t have good health insurance. Because as I’ve said before on THCB good insurance is mostly a function of good employment, which is mostly a function of good education, which is mostly a function of how you choose your parents.

As John Edwards put it when he announced his health care plan, "It doesn’t have to be that way."

TECH: Baffling press releases #397

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This is why no one understands technology. I’ve interviewed the CEO of Click4Care Dave Blauer a while back and he managed to explain his business well enough. But honestly–read this press release and try to figure out who between these three software companies is doing what to whom!

CareGuide Selects HealthEdge™ for Next Generation Integrated Health Management Solution

HealthEdge’s HealthRules™ Provides Care/Disease Management Innovator Unprecedented Agility

BURLINGTON, Mass.–(BUSINESS WIRE)–HealthEdge, a pioneering healthcare software company, today announced that CareGuide, a leading innovator in population health management services, has purchased HealthRules™. HealthRules is HealthEdge’s revolutionary platform for health payors designed to deliver unprecedented levels of flexibility, scalability and ease-of-use in lowering costs while delivering better-quality, more-personalized healthcare.

CareGuide will use the entire HealthRules suite, including HealthRules Payor™ and HealthRules CareManager™, powered by Click4Care. CareManager is an intuitive medical management application that supports the entire care continuum by providing care managers with a patient-centric data repository to help them manage member populations more efficiently.

“CareGuide is directly focused on building a model for health management that will allow our customers to provide for their members the kind of smart, integrated and personalized care they deserve, and set the standard for the next generation of disease and care management services,” said Chris E. Paterson, president and chief executive officer of CareGuide. “HealthEdge shares our vision for bringing 21st century technology and business practices to a healthcare system that is, in many ways, bogged down in decades-old approaches to managing care. Together, we will demonstrate that the future has already arrived for health plans that are ready to seize the initiative and start providing the kind of services that will be tomorrow’s norm.”

CareGuide will implement HealthRules enterprise-wide on an application service provider (ASP) basis and will deploy the complete HealthRules suite, supporting a wide range of critical functions, including claims processing, care management, business intelligence, benefit design and provider contract management.

“At HealthEdge, our mission is to bring an innovative, best-of-breed approach to care and benefit management and help payors deliver better quality care while effectively reducing costs,” said Rob Gillette, chief executive officer of HealthEdge. “The CareGuide relationship is exciting for us because we share a common vision and are eager to work together to bring innovation to the forefront of the healthcare system. Using HealthRules, CareGuide will be able to operate with a level of agility and flexibility the industry has never seen, allowing it to continue to raise the bar for care and disease management.”

HealthRules is a multi-module platform designed to allow flexible and scalable administration of health plan operations, from care management to analytics to contract and claims management. Based on a service-oriented architecture (SOA) that provides unprecedented levels of automation and seamless transactions between payors and their provider and member constituencies, HealthRules is the result of a six-year, $100 million state-of-the-art development effort. The platform offers a unique combination of enterprise-class scalability and reliability with the flexibility and functionality to support payors of all sizes as they deploy new business models in the increasingly consumer-driven healthcare industry. The system fully integrates care and disease management, benefit and provider contract design, and claims processing, enabling payors to meet the widest range of market requirements.

I hope you got that because I sure as heck didn’t. And they wonder why health care companies don’t understand what their products (or is it services) do!

TECH: #1 health care blogger gets on Apple’s case

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Amy Tenderich has written An Open Letter to Steve Jobs.  She wants the God of Silicon valley cool to get into the design of medical devices so that her insulin pump comes in pretty colors, just like the iPod.  Well I have an iPod (bought for me as a gift ) and I have one warning for Amy. Make sure that when Apple designs an insulin pump it:

1. Has an on/off switch (by far the most annoying feature of my iPod is the inability to turn it off without pressing about 15 times on the stop button…holding it down, hoping that it’s finally off, then it starting up again, and repeat)

2. Has a battery that lasts more than2 hours, and goes from indicating “fully charged” to “about to run out” via some other median stages. Mine doesn’t bother with telling you that.

3. Accepts blood types that are non-A(pple) and doesn’t try to convert it all into type Apple. (Worse on the video player)

4. doesn’t just randomly die, in the expectation that you’ll just go buy another one (read the iPod forums for lots of reports of this)

If you have to deal with all this to have an insulin pump that looks cool, I’m not sure it’s a trade-off I’d take. On the other hand, the current clunky insulin pumps might all have those problems already!

POLICY/HEALTH PLANS: I used to think the WSJ was good

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I used to think that the WSJ had good health care reporting (if not the best). But it looks like its reporting may be heading the way of its editorial page. In an article called High Deductible Policies Offer Savings to Firm and Its Workers  there’s a standard bunch of ra-ra tripe about how high deductible plans are good for employers (Duh!) and their workers (at least the healthy ones). (A summary version for those of you with no access is here). It’s a pretty uneducated piece, and I explained a while back over at Spot-on why what’s good for General Motors (or actually Intel) is in this case irrelevant for America. (The gist is that their sicker employees can afford to pay more into the “pool”, whereas America’s sicker citizens can’t).

But it beggars belief when I read this sentence:

ITAGroup joins a growing number of small businesses that are adding high-deductible plans in a push toward “consumer driven” health care. Fifteen percent of companies with between 100 and 499 employees have adopted them, according to a 2006 survey by the U.S. Chamber of Commerce.

So much so that I wrote this to the author:

You’ve clearly been hanging out on Wall Street far too long if you think that 450 employees constitutes a small business. It’s very clear from the data that the real problem with health insurance from employers is in the availability of employment-based insurance in sub-200 employee firms and even more so in sub 50 employee firms. (Click on the chart for the real data)
 
Insurance by company size
 
What benefit changes at the margin for a business that is at the least medium sized (and has completely different health insurance problems than genuine small businesses) has to do with “small business” health insurance escapes me. And how HSA/CDHP fix that problem is not something that the WSJ appears to want to talk about much in its editorial section. I’d hope that it would do better in the “news” section

POLICY: Sick, the book by Jonathan Cohn

Jonathan Cohn’s book Sick is out today. The early version of some of the chapters I read was fabulous, and I’m really looking forward to reading the whole thing. If you want to buy it follow this link and click on it here there & I get the odd shilling, I think

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