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Hoarding Patient Data is a Lousy Business Strategy: 7 Reasons Why

Oct 17, 2018• 18

By VINCE KURAITIS & LESLIE KELLY HALL

Among many healthcare providers, it’s been long-standing conventional wisdom (CW) that hoarding patient data is an effective business strategy to lock-in patients — “He who holds the data, wins”. However…we’ve never seen any evidence that this actually works…have you?

We’re here to challenge CW. In this article we’ll explore the rationale of “hoarding as business strategy”, review evidence suggesting it’s still prevalent, and suggest 7 reasons why we believe it’s a lousy business strategy:

Data Hoarding Doesn’t Work — It Doesn’t Lock-In Patients or Build Affinity
Convenience is King in Patient Selection of Providers
Loyalty is Declining, Shopping is Increasing
Providers Have a Decreasingly Small “Share” of Patient Data
Providers Don’t Want to Become a Lightning Rod in the “Techlash” Backlash
Hoarding Works Against Public Policy and the Law
Providers, Don’t Fly Blind with Value-Based Care

Background

In the video below, Dr. Harlan Krumholz of Yale University School of Medicine capsulizes the rationale of hoarding as business strategy.

We encourage you to take a minute to listen to Dr. Krumholz, but if you’re in a hurry we’ve abstracted the most relevant portions of his comments:

“The leader of a very major healthcare system said this to me confidentially on the phone… ‘why would we want to make it easy for people to get their health data…we want to keep the patients with us so why wouldn’t we want to make it just a little more difficult for them to leave.’ …I couldn’t believe it a physician health care provider professional explaining to me the philosophy of that health system.”

LIVE — #SPM2018

Oct 17, 2018

Here’s the live stream of today’s Society for Participatory Medicine’s conference in Boston:

Make Hackathons Fair Again

Oct 17, 2018• 3

By FRED TROTTER

On Oct 19, I will begin to MC the health equity hackathon in Austin TX, which will focus on addressing healthcare disparity issues. Specifically, we will be using healthcare data to try and make an impact on those problems. Our planning team has spent months thinking about how to run a hackathon fairly, especially after the release of a report that harshly criticized how hackathons are typically run.

A Wired article written earlier this year trumpets a study called “Hackathons As Co-optation Ritual: Socializing Workers and Institutionalizing Innovation in the ‘New’ Economy,” which criticizes the corporate takeover of hackathons. Hackathons are inherently unfair to participants according to these two sociologists.

They argue that hackathons have become a way for corporations to trick legions of technologists into working for free. To a sociologist, that looks like exploitation, and it is hard to see how they are wrong.

After reading the article, I was struck by how many things about typical hackathons are backward:

Hackathons romanticize workaholism and celebrate insomnia – With hackathons typically running 24-72 hours straight, sleep is for the weak. Those who don’t sleep are seen as heroes.
Junk food is the only option – Most hackathons provide unhealthy snacks, high in fructose and low in protein. Participants are expected to fuel their unpaid work sprints with sugar and caffeine. These are frequently the only eating options available.
Healthy work patterns ensure that there are breaks. Opportunities to chat, or walk and take a break from work. And the idea of encouraging people to get up and move, let alone stretch, is unheard of at these hackathons. Hundreds of geeks, unable to shower, or leave the room, can create a pretty bad smell.
Judging is at best arbitrary, and in some cases completely rigged, with winners sometimes chosen in advance.

On occasion, I have seen harder stimulants used. Although I have never seen anyone on cocaine win, it does make for super-engaging project presentations. The presentations were not good, mind you, just engaging… In the “Holy Moses, this guy is about to present when he is clearly high AF” sense.

Ensuring that the 21st Century Cures Act Health IT Provisions Promotes Interoperability and Data Exchange

Oct 16, 2018• 4

By KENNETH D. MANDL, MD; DAN GOTTLIEB MPA;
JOSH C. MANDEL, MD

The opportunity has never been greater to, at long last, develop a flourishing health information economy based on apps which have full access to health system data–for both patients and populations–and liquid data that travels to where it is needed for care, management and population and public health. A provision in the 21st Century Cures Act could transform how patients and providers use health information technology. The 2016 law requires that certified health information technology products have an application programming interface (API) that allows health information to be accessed, exchanged, and used “without special effort” and that provides “access to all data elements of a patient’s electronic health record to the extent permissible under applicable privacy laws.”

After nearly two years of regulatory work, an important rule on this issue is now pending at the Office of Management and Budget (OMB), typically a late stop before a proposed rule is issued for public comment. It is our hope that this rule will contain provisions to create capabilities for patients to obtain complete copies of their EHR data and for providers and patients to easily integrate apps (web, iOS and Android) with EHRs and other clinical systems.

Modern software systems use APIs to interact with each other and exchange data. APIs are fundamental to software made familiar to all consumers by Google, Apple, Microsoft, Facebook, and Amazon. APIs could also offer turnkey access to population health data in a standard format, and interoperable approaches to exchange and aggregate data across sites of care.

Health in 2 Point 00 Episode 54

Oct 15, 2018

On Today’s episode of healthin2point00, Jess asks me about the CVS & Aetna’s merger, CSweetner & HIMSS new partnership in women’s health care, HLTH’s new pledge with Parity.org, Noona Healthcare getting acquired by Varian Health Systems. And as Jess point out, all health tech deals somehow involve me! Jess also did an interview with AHIP, you can watch her here: If you are in Boston, join us at Society of Participatory Medicine’s conference at #CHC2018- Matthew Holt

Subscribe to Health in 2 Point 00: https://www.youtube.com/channel/UC25dVIoktnmSlhrjP4HZqqQ

Matthew Holt’s twitter: https://twitter.com/boltyboy

Jessica DaMassa’s twitter:https://twitter.com/jessdamassa?lang=en

Subscribe to our channel and tweet us your questions using the hashtag #healthin2point00

AMA to Health Tech: Call a Doctor

Oct 15, 2018• 1

By JESSICA DaMASSA, WTF Health

“That’s why we’re investing so heavily in the innovation space…we look at physicians and how they’re spending their days. The amount of time they’re spending clicking away on their EHRs, wasting time – we think we can help fix it. It’s been a lot of years of other people not fixing it. We think it’s time for physicians to actually be in the rooms helping to make those solutions.” — Dr. Jack Resneck, Chairman of the Board, AMA

Sounds to me like physicians are a little disappointed in health tech. Don’t get me wrong. This is not another ‘digital health snake oil’ controversy. (Although we do go there…)

Instead, my main takeaway from this conversation with Dr. Jack Resneck, Chairman of the Board for the AMA, is that physicians don’t exactly feel included or engaged in the tech revolution happening in healthcare.

In short, while docs are excited about innovation, it seems they don’t feel heard. So much so that the AMA has created its own Silicon Valley-based ‘business formation and commercialization enterprise’ called Health2047 to prioritize solution development for what physicians have deemed the biggest systemic issues in healthcare. What’s out there is just missing the mark and, in more instances than not, says Dr. Resneck, the practicing physician’s perspective on what problems need to be solved in the first place.

I open this interview by asking what digital health entrepreneurs and health tech startups can do to work more effectively with physicians. The answer, it seems, might be as simple as ‘just ask your doctor.’

Get a glimpse of the future of healthcare by meeting the people who are going to change it. Find more WTF Health interviews here or check out www.wtf.health.

Please support Charles Gaba at ACASignups

Oct 14, 2018

By CHARLES GABA

It’s pretty rare that I ask THCB readers to go over to another blog and support that blog with money BUT, today is the day to do that. Charles Gaba has been THE leading source of information about exactly who is signing up for ACA plans on which exchange, and what impact on the ACA Trump et al have had. He’s not in academia, not on some big company or foundation payroll, just a one man band web designer who has basically torpedoed his own business to deliver what I think is a vital service. I support him and anyone interested in health policy could do a lot worse than shove a few bucks a year his way. Read on for his story & how you can help—Matthew Holt

On October 11th, 2013, I posted the following in a blog entry over at Daily Kos, where I’d been a regular contributor since 2003:

“Seriously, though, HHS should really start releasing the official (accurate) numbers of actual signups for all 50 states (or at the very least, the 36 states that they’re responsible for) on a daily–or at least, weekly–basis. I don’t care if it’s a pitifully small number. 100,000? 10,000? 100? 10? Even if it’s in single digits, release the damned numbers. Be upfront about it. Everyone knows by now how f***** up the website is, so be honest and just give out the accurate numbers as they come in.”

Two days later, on October 13th, I registered “ObamacareSignups.net” (which soon changed to ACASignups.net, not because I had a problem with “Obamacare” but because it was easier to type) and posted an announcement over at dKos, asking for some crowdsourcing assistance.

This was supposed to be just a lark…a six-month thing which would combine my passion for data analysis, politics and website development into one nerdy hobby.

Instead…well, if you’ve been following my work for any length of time, you know the rest of the story. ACASignups.net soon caught the attention of major media outlets, and it’s been cited and used as a resource ever since by media outlets spanning the ideological spectrum including the Washington Post, Forbes, Bloomberg News, Vox.com, MSNBC, the New Republic, USA Today, the CATO Institute, National Review Online and The New York Times among others, and has even received a mention (albeit an obscure one) in prominent medical journals such as the New England Journal of Medicine and The Lancet.

For awhile I pretended that this was still a “hobby”…I accepted donations, sure, and even slapped some banner ads on the site to drum up a few bucks, but in my mind, I was still officially a website developer…even though I was spending 90% of my time posting updates here instead of maintaining my business. In April 2014, at the peak of the media attention and insanity over the crazy first open enrollment period, I even came down with a nasty case of shingles whch laid me up for over a month. I was in denial for years even as the business suffered, constantly thinking that as soon as this Open Enrollment Period was over, I’d wrap things up…

My ass was effectively saved by Markos and the Daily Kos community that year, who collectively raised enough money to not only make up for my lost business in 2014, but also to allow me to keep the site operating through 2015 as well. I’m eternally grateful for that support.

In the fall of 2016, things came to a head and I realized that I could no longer continue living with one foot in each world: I had to either mothball this site and refocus my efforts on building my web development business back up…or I had to try and earn a living at it.

At the time–and I swear on my life this is true–I was planning on doing the former. My reasoning was simple: If Hillary Clinton had become President, there probably wouldn’t be that much interest in my work here going forward. There’d still be plenty of healthcare stuff to write about, but the ACA would be safely embedded into the American landscape and interest in the day to day minutiae of its developments would fade over time.Continue reading…

10 Houses, 2 Days, 1 City SERENDIPITY Returns to SF and We’re Joining In!

Oct 12, 2018

By ANNE COCQUYT

On October 26-27 SERENDIPITY is coming back to San Francisco with an opportunity-packed, two-day personal and professional development conference. Hosted by the digital networking platform GUILD, this conference is not your average conference. With 40 half-day sessions, curated networking meetings, family-style dinners, and an opportunity-filled cocktail reception, it is uniting more than 500 women across experience and industries.

There’s magic to be had and we want you to join us! We’ll be sponsoring the Women’s Health House over the two days where speakers like Laura Kyriazis, Nimisha Gandhi, Jessica Da Massa, Zoya Khan, Medell Briggs, Meghan Conroy, and Lauren Weinger will empower women of all ages, across all industries to build their network and speak about topics that are not usually on an agenda at a tech conference. They are hosting panels on self-care, family planning, FemTech, public health, menopause, and kegel exercises.

Obesity Training and Reimbursement Should be a Higher Priority

Oct 11, 2018• 10

By HANNAH MARTIN MPH, RD; JENNY BOGARD; WILLIAM DIETZ, MD; ANNE VALIK; NICHOLE JANNAH; CHRISTINE GALLAGHER; ANAND PAREKH, MD, MPH; DON BRADLEY MD

The United States has been facing a mounting obesity epidemic for over a generation, but our health care system has struggled to keep up. Given the complexity of obesity and the pace of curricular change, obesity education for our health-provider workforce is still lacking. There are wide disparities in quantity and quality among programs and disciplines. Similarly, public and private payers have taken vastly different approaches towards coverage for obesity treatment and prevention, which even leaves the most educated providers unsure of what services each patient can access. Because coverage decisions are based partly on what providers are prepared to provide and curricula are based partly on what services are typically covered, these problems reinforce one another. Despite these challenges, several important steps have been taken recently to tackle both sides of the problem. The steps include the development of new Provider Competencies for the Prevention and Management of Obesity and the launch of the My Healthy Weight pledge to standardize coverage for obesity counseling services.

Why We Must Act

In the US, more than one-third of the adult population and nearly one-fifth of the children have obesity. Adult obesity prevalence is projected to reach nearly 50 percent by 2030. Adult diabetes prevalence currently hovers around ten percent and is further projected to affect one-third of the adult population by 2050. Estimates for the total annual medical cost of obesity in the U.S. range from $147 billion to $210 billion, with billions more lost in productivity due to absenteeism and presenteeism. Obesity is also a national security issue. As of 2010, 27 percent of young adults were disqualified for military service due to obesity.

Improving Obesity Education for Health Care Providers

Despite these shocking rates of obesity, fewer than one in four physicians feel that they received adequate training in counseling patients on diet or physical activity. Obesity concepts are underrepresented on medical licensing examinations and substantial gaps in provider knowledge related to obesity care have been recently documented. This is not surprising considering that less than 30 percent of medical schools meet the minimum recommended number of nutrition-related content hours.

Health in 2 Point 00 Episode 53

Oct 11, 2018

Where is Matthew Holt reporting from today? He is at the Novartis Biome Launch Event! And that’s not all, we have some special guest stars for you: Unity Stoakes from StartUpHealth and Zoya Khan from THCB & SMACK.health! Join Jessica Da Massa, as she asks Matthew about what the Novartis’s Biome Event is, updates from StartUp Health (they have a print magazine now!), and talks about JP Morgan Week coming up in January!