The Health Care Blog – Page 351 – Everything you always wanted to know about the Health Care system. But were afraid to ask.

Above the Fold

Closer to a crisis

Sep 17, 2016• 4

By FRED TROTTER

Fred_Trotter How close to we need to get to cybersecurity crisis in healthcare before we, as an industry take deliberative action?
Should we approach cybersecurity in healthcare differently? What approaches will work best? What commonly repeated advice about cybersecurity is actually wrong in healthcare settings? What ideas that would be effective in healthcare cybersecurity are being ignored? What is being missed from discussions about healthcare cybersecurity? What are we too concerned about? What threats do not get enough attention?

These might sound like rhetorical questions, designed to engage the reader before the author knowingly reveals the “answer”. Sadly, these questions are no rhetorical device. No one has definitive answers, and we all desperately need them.

I sit on the Health Care Industry Cybersecurity Task Force and we are currently taking comments on these issues on this blog post. I cannot to presume speak for the Task Force as a whole, and the comments below represent only my personal perspective on the issues involved. Right now the only thing that the Task Force as a whole is comfortable saying is “we are asking for advice”, which is the purpose of the blog post. If you have a reaction to the personal opinions here, please comment on the blog post so that the whole Task Force can hear what you have to say.

Generally, there are two types of issues that we would like advice on:

“What are the best practices and correct strategies to defend healthcare technology from cybersecurity attacks?” and “What is the best way for US government agencies to coordinate with the healthcare industry to respond quickly and effectively to cybersecurity threats?”

Improving Diversity in Health Technology

Sep 16, 2016

By MATTHEW HOLT

I am thrilled that Health 2.0 is today announcing a new program aimed at improving diversity in the field of health technology. This will run all year (and hopefully beyond) and will start at the Health 2.0 10th Annual Fall Conference on Sept 25-8, where we will host a group drawn from populations that are underrepresented in the health technology field. There’ll also be a dedicated session on the topic on Sept 26 at 12.15pm that has been generously supported by the Robert Wood Johnson Foundation. Matthew Holt

The Problem: There is a lack of diversity among health technology innovators and a shortage of technologies that meet the needs of minority audiences. Technology is a powerful tool that can help improve health outcomes and alleviate problems within our current health system. As our society grows increasingly diverse and gaps in health among different populations increase, there is an urgency to develop solutions for underserved communities and diversify the population of innovators who are creating these solutions.

The Conference Support Program: The Diversity in Health Technology Conference Support Program, supported by the Robert Wood Johnson Foundation, encourages individuals interested in diversifying the health technology field and who are interested in, or currently engaged with, health technology, to attend Health 2.0’s 10th Annual Fall Conference (Sept 25-8). Individuals from populations that are underrepresented in the health technology field are particular encouraged to apply. The conference support will include complimentary access to the annual conference. Conference support recipients will be required to attend the “Diversity in Health Technology” workshop. The workshop will serve as the formal kickoff to a year-long campaign focused on engaging more diverse voices in health technology. Conference support recipients must also attend and participate in two webinars hosted by Health 2.0 to further review the diversity in technology issue, submit a post-conference summary to Health 2.0 of the individual’s conference experience that Health 2.0 may use for a white paper on the diversity issue and a summary about specific activities the individual plans to do over the next year to address diversity in technology.

For more information and to apply to join the program, visit the Diversity in Health Technology site.

The Levers We Have at Our Disposal to Reduce Spending on High Cost Claimants

Sep 16, 2016• 10

By CINDI SLATER

CindySweb

A new report out from the American Health Policy Institute and Leavitt Partners further quantifies what we already know: a handful of employees are responsible for the bulk of employers’ health care spending. The new report documented that among 26 large employers, 1.2 percent of employees are high cost claimants who comprise 31 percent of total health care spending. Interestingly enough, the report was released on the heels of news yet again that high deductible health plans continue to be more popular than ever as a strategy for employers to control costs, with employee cost sharing expected to rise yet again this year.

And yet high deductible health plans may do more to bend the cost trend for healthy employees by reducing spending on items like pharmaceuticals and lab testing but not on inpatient care.

The least heathy employees quickly blow through their deductible, and their health issues are so acute and their bills so large, they don’t shop around for care. So what is a large employer or any purchaser concerned about these high cost claimants to do?

Consumerism in how we typically think of the concept doesn’t seem to be working. For example, according to McKinsey,most healthcare consumers are not doing their homework – they aren’t researching costs or their choice of providers. And even for the handful that do use price transparency tools, new research shows this doesn’t result in savings. It’s not that patients with serious health conditions don’t want to understand their condition, the latest evidence-based treatment options, who are the best physicians, and treatment costs. It’s just that they need assistance curating and interpreting this complex information.Continue reading…

The Politics of Hillary’s Pneumonia

Sep 14, 2016• 7

By SAURABH JHA, MD

Screen Shot 2016-09-14 at 3.15.10 PM

It is selfish of a leader of a nation to drop dead during office. Jawaharlal Nehru, India’s first prime minister, died suddenly at 74, apparently from a ruptured aneurysm. His aneurysm, allegedly, had something to do with Edwina Mountbatten – the wife of Lord Mountbatten, the last Viceroy of India. Shortly after Nehru’s death, Pakistan attacked India. Nehru’s replacement, Lal Bahadur Shastri, died mysteriously in Tashkent two years after Nehru’s death, and was succeeded by Indira, Nehru’s daughter. India’s future was forever changed by a burst aneurysm or, if rumors are to be believed, by a flagellating spirochaete which left the Raj in bliss.

Clearly, the death of a leader creates turmoil for a republic. So it is understandable that a nation obsessed with health is obsessed with the health of its presidential runners. Mr. Trump’s doctor declared he’s the healthiest presidential candidate ever. Mr. Trump has drawn attention to his super health by pointing to the size of his hands – by Mr. Trump’s standards a rather decorous allusion. It matters not what has hypertrophied Mr. Trump’s hands, what matters is that Mr. Trump’s large hands signal vigor and imagination. The American Psychiatric Association, to their credit, in ruling out a new diagnostic code for Mr. Trump’s colorful soundbites in the next edition of their Diagnostic and Statistical Manual, ended all hopes of banning Mr. Trump from the presidential race on health grounds.

Launch! at Health 2.0

Sep 14, 2016

Launch

By MATTHEW HOLT

Launch! is always one of the most fun and most exciting sessions at Health 2.0. Ten new companies demo their product on stage for the very first time during at the 10th Annual Fall Conference. Previous Launch! winners have included Castlight Health, Basis, and OM*Signal and last year’s winner MedWand, which just beat out Gliimpse–itself since bought by Apple.

This year’s finalists are:

Valeet Healthcare‘s platform gives patients personalized health information while allowing providers to have a rounding tool and giving healthcare systems a dashboard to track metrics.
gripAble is an innovative mobile technology that bridges the gap between functional therapy and objective measurement of upper-limb function.
Cricket Health works with payor and provider customers to slow the progression of chronic kidney disease (CKD), manage the transition from CKD to End Stage Renal Disease, and improve ESRD care.
Qidza is a population health mobile platform that enables parents work with their physicians to track their children’s developmental milestones
Docent Health guides health systems to embrace a consumer-centric approach to healthcare by curating patient experiences.
Albeado builds Healthcare prediction and optimization solutions based on proprietary data science platform which combines clinical AI and Graph-Based Machine Learning.
Siren Care offers temperature-sensing smart socks which provide health data on foot ulcers, hot spots, and more to prevent future injuries.
MDwithME integrates soft and hardware components in a suitcase enabling full remote physical exams with an option of instant or delayed physician’s consult with quality of testing that equals or exceeds the current state of art.
DayTwo maintains health and prevent disease utilizing a microbiome platform, starting with personalized nutrition based on gut bacteria, aiming to normalize blood sugar levels and cultivate a healthy gut microbiome.
Regeneration Health is a health ecosystem powered by artificial intelligence that collects and monitors health in real time and curates free personalized health info and recommendations based on integrative medicine.

You can see them on Wednesday, the last day of the Health 2.0 10th Annual Fall Conference Sept 25-8 in Santa Clara, CA.

Jess Jacobs, POTS & her bio

Sep 14, 2016• 1

By MATTHEW HOLT

As part of Health 2.0’s 10 Year Global Retrospective Awards (yes, winners to be celebrated at Health 2.0’s 10th Annual Fall Conference September 25-8), I wrote a bunch of bios. One patient and friend of mine Jess Jacobs has (as many of you know) recently died. Fellow POTS patient Greg Norman didn’t much care for the brief bio I wrote about Jess. So below the fold please read his tweet storm about it! And of course please comment.
Continue reading…

Cybersecurity Check In

Sep 13, 2016• 12

By the CYBERSECURITY TASK FORCE

No one likes to think about the possibility that patients might be hurt or killed as a result of cyber attacks. But all signs indicate that this is a real possibility and a serious problem. Attacks on Health IT systems such as EHRs or patient portals, electronic medical devices, or on standard healthcare digital systems can be a threat to patient safety.

To combat the cybersecurity threat, Congress and the Obama administration passed the Cybersecurity Information Sharing Act of 2015, which established mechanisms for the US Government to collaborate with private industry to respond to cybersecurity threats. Lawmakers recognized the unique problems with cybersecurity in health technology and created the Health Care Industry Cybersecurity Task Force, charged to make recommendations to Congress regarding specific cybersecurity issues. To paraphrase, we are to investigate:

What can the healthcare industry learn from other industries about cybersecurity?
What are the special challenges that we face with cybersecurity in healthcare?
What are the difficulties protecting electronic health record (EHR) systems and networked electronic medical devices?
What cybersecurity study materials should the healthcare industry be exposed to?
How should an organization designed to coordinate the sharing of cybersecurity threats between healthcare industry players and the US Federal Government operate?
Finally, we were asked give Congress a written report summarizing all of the above.

Our Task Force is asking the healthcare, patient and technology communities for help in this assignment. We are asking for discussion on these issues to be on platforms like The Health Care Blog, Reddit and Twitter, so the community may contribute new ideas as well as refine the ideas contributed by others. We are taking a crowdsourcing approach to cybersecurity ideation so we can aggregate and assess what people have to say about these issues.

An Update on Price / Cost Transparency + A Promising New Service

Sep 13, 2016• 1

By STEVEN FINDLAY

flying cadeucii Transparency for consumers on prices and costs is a bipartisan goal in healthcare. The good news is progress is afoot. The bad news: that progress is still painfully slow. This blog presents a quick status update with discussion of and links to some recent reports and events.

The Healthcare Incentives Improvement Institute (HCI3) and Catalyst for Payment Reform (CPR) have tracked state healthcare price transparency laws and their implementation for the past four years. In a July 2016 report they found the following: on an A to F scale, three states got As (Colorado, Maine, New Hampshire); one got a B (Oregon); two scored Cs (Virginia and Vermont), one got a D (Arizona), and 43 got Fs.

That’s an improvement over 2015 when only one state—New Hampshire—got an A.

The two groups primarily assessed whether the states’ price transparency web sites presented the information in an understandable and consumer-friendly way.

Despite the poor scores for most states, Francois de Brantes of HCI3 and one of the report’s authors told me: “We’re actually optimistic. A lot of states are beginning to pay more serious attention to this…we think a third to half of them could get As or Bs in the next few years… if they take the right steps.”

The Health 2.0 10 Year Global Retrospective Awards

Sep 12, 2016

By MATTHEW HOLT

Yup, more blowing the trumpet about Health 2.0! We’re celebrating our 10th conference in 2 weeks and over the summer we’ve been looking back at the people and organizations who’ve made a mark in health tech, digital health, Health 2.0, or whatever you want to call it. For ten years Health 2.0 has showcased and connected with thousands of technologies, companies, innovative thought leaders, and patient activists through our many events and conferences, challenges, code-a-thons, market research, blog posts, pilot programs and general industry promotion. Since our first conference in 2007, Health 2.0 has grown into a global movement and community of over 100,000 entrepreneurs, developers, and health care stakeholders, and 110+ chapters on six continents

As we prepare to usher in the 10th year of Health 2.0, we want to take this opportunity to reflect on and recognize the accomplishments of this powerful community and movement. To do this, we asked our community to nominate the top influencers from the world of Health 2.0. Over the summer thousands of people voted and now the finalists are showcased on Health 2.0’s 10 Year Global Retrospective Awards for all to see. It’s time to vote for the finalists, and the winners will be celebrated at Health 2.0’s 10th Annual Fall Conference on September 25-8 in Santa Clara, California.

Please go take a look at the finalists and vote for your favorites!

A Hole in the Heart, Part II

Sep 11, 2016• 3

By ANISH KOKA, MD

Click here for part 1 “A Hole in the Heart, Part I” If you have NOT read part I, we highly recommend that you go there now and then come back and read the continuation. – The Editors

Analysis of the Randomized Control Trials

The 3 randomized trials performed tested two closure devices – CLOSURE I tested the STARFLEX device (NMT Medical, Boston, MA). The PC and RESPECT trial tested the AMPLATZER device (St. Jude Medical, St. Paul, MN). Let’s look at each study closely.

CLOSURE I (Starflex device)

This study looked at patients between 18 and 60 years of age who had a prior stroke or a transient ischemic attack within the prior 6 months. This was a resoundingly negative study. At two years, the 12/447 patients in the closure group suffered a recurrent stroke, while 13/462 patients in the medical therapy suffered a recurrent stroke. The trial, however, reveals one of the important chinks in the armor of the randomized control trial (RCT). Randomized control trials are only as good as the patients they enroll. Enroll the wrong patients, and the results don’t tell you much. CLOSURE-1 didn’t provide closure because they included patients with transient ischemic attacks (TIAs).