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TECH: IOM reccomends ePrescribing by 2010

The IOM is out with another report on medication errors in which it recommends the use of ePrescribing for all scripts by 2010. And it’s made it into the news, at least into the AP Headlines where the tale is told that drug errors hurt 1.5 million.

Perhaps someone should let whoever took the ePrescribing mandate out of the final language in the MMA in 2003 (after it made it through in the House version of the bill) know that they’re killing people and costing payers a fortune. But then again I wouldn’t want to point fingers at anyone in particular.

 

THCB Update

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TECH: PHR has opportunity to go mainstream

Wellpoint is going to roll out the WebMD PHR based system which has been working at Empire Blues (Wellchoice) for about a year to the rest of its plans to the rest of its plans. So theoretically up to 34 million people will have access to a PHR. I wrote about the WebMD solution before, so I won’t go into it much, but there are two quick points beyond the fact that (at last!) PHRs have the opportunity to go mainstream.

1) This is a vindication of the ASP model—these records live on WebMD’s servers rather than on Wellpoint’s. I never thought that the big insurers would allow another company to take their consumers’ data for fear that they would also take their consumers as well. That was certainly a concern of the plans that we were trying to sell PHRs to at i-Beacon which was why we sold enterprise software rather than an ASP service. WellMed (the company who’s PHR is the core of WebMD’s current service) was always an ASP model. And the answer is, the lowered costs of the ASP model outweigh the fear that WebMD will make it easy for another plan to assume the members data. One WebMD insider told me that they will be introducing a way to move data between plans. So the member will find “data lock” is NOT a reason to avoid moving plans, and technically they may not even have to take it off the server, assuming that WebMD is the back end for both plans. And of course potentially WebMD can start offering other health plan services and even start competing with its clients. But that’s another story.

2) Just as the private sector starts to sort this out with providers using Epic’s MyHealth to give access to the records, and WebMD starting to make real strides, CMS is starting experimentation, and Foundations are getting into the mix too with grants to help figure out what applications are needed. Are they not a bit late to the party?

And finally—it’s about bloody time!!

DISEASE MANAGEMENT BOSTON JULY 30 – AUG 2At a three day conference in Boston MA, scheduled between July 31 and Aug 2, industry leaders from managed care companies, employer groups purchasing healthcare services, providers, third party administrators, physicians, healthcare technology players, nursing and pharmacy practitioners, disease management experts will meet at the 4th Annual Disease Management Conference. The event is posted online at www.srinstitute.com/ch142.  Learn about advertising on THCB.  

QUALITY/PHYSICIANS: Just what we need now, another grandstanding politician on end of life issues

I’ve been having a backchat email with the people from the Tenet Shareholders Committee. They are enjoying the legal  attack on the Louisiana physician who is supposed to have performed a mercy killing or provided ample pain medication at Tenet’s Memorial Hospital a little too much for my taste. Admittedly they are so opposed to Tenet that this one is too easy for them. But I doubt this one has anything to do with Tenet, which frankly didn’t do much to help its patients (HCA was a little more honorable).

But where the hell was the Louisiana or New Orleans AG (or for that matter any other level of government) when desperate physicians, nurses and patients needed help? Absolutely effing nowhere. A humane person wouldn’t leave a dog to slowly die or drown in the 105 degree heat, let alone another human. And it seems to me that in absolutely desperate circumstances, Dr Anna Pou did what she felt was best for those patients.Yet six months later a grandstanding DA gets his jollies off by sending physicians and nurses on trial for homicide.

This is total bullshit. A series of studies in the 1990s showed that physicians routinely ignored DNR orders. I don’t recall any of them being prosecuted, but they probably caused more harm and inflicted way more distress on patients than Dr. Pou would have done under any normal circumstances…..and let us not forget—those were anything but normal circumstances. If I was a patient there suffering with no water, no power,and no hope other than suffering a long agonizing death—I’d have been very grateful for the relief Dr. Pou’s care would have given me in my final hours.

And now we’re going to send her to jail?!

 

TECH: Tim keeping track of healthcare unbound

Over at Medical Connectivity Consulting Tim Gee is blogging up a storm about the Healthcare Unbound conference going on in Boston. For those of you who don’t know “Healthcare Unbound” is our friends at Forrester’s cute-sy way of talking about remote monitoring, but they’re good guys so let’s let them have their phrase and their fun!

 

POLITICS/POLICY/HEALTH PLANS: On the Blues’ political giving & CDHP complexity

Says here that Blues Plans Favor Republicans With Their 2006 Campaign Contributions. But I think what it means is that they’re favoring incumbents. Having said that and reading the polls and the tea leaves, I think the Blues might think about evening up those contributions given that the Congress is as likely to flip over his year as any since 1994, and that the Blue Dog Democrats are the crowd most traditionally aligned with their interests.

Meanwhile, Joe Paduda is showing that the CDHP is even more confusing to consumers than ordinary health plans. Well, when United bought the shysters at Golden Rule, you didn’t actually think that they were going to reform them, did you?

 

POLICY/THE INDUSTRY: Nice work if you can get it

So for rewriting Alain Enthoven’s lectures from the late 1980s and missing the main points, apparently Michael Porter is being paid $50,000 a day, and that is a discount from his apparently usual fee of $100,000! Damn, that’s nice work and yes I am very jealous. Hopefully I’ll soon have his co-author Elizabeth Teisberg on THCB to explain what I don’t understand about their book which I’m chunking through at the moment.

When I said he was sinking in the health care quagmire, I should have said that he would be rolling in it.

PHYSICIANS/INDUSTRY: Retail clinics

I recently met Michael Howe who is CEO of MinuteClinic, and he had the good graces to call me back and talk on the day that they sold out to CVS. Very classy as it would have been easy to blow me off.

So the rumor quoted here is that CVS paid $170m for the company—certainly an endorsement that they at least think that retail NP clinics are real. But if you want to really know more, look at this new report on retail clinics from the California Health Care Foundation written by Mary Kaye Scott. Very nice summary indeed.

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