The Health Care Blog – Page 401 – Everything you always wanted to know about the Health Care system. But were afraid to ask.

Above the Fold

Key for Health IT Entrepreneurs: Don’t Disrupt the Wrong Thing

Oct 14, 2015• 2

By MICHAEL MILLENSON

Among the 200 demos, 60 exhibitors and more than 100 speakers at the annual Health 2.0 conference on digital health, a critical insight for succeeding in this burgeoning market might have gotten lost in the noise.

The crucial advice came on separate days from two of the savviest digerati doctors in Silicon Valley. Not coincidentally, both Dr. Robert Wachter and Dr. Michael Blumpractice at the University of California, San Francisco (UCSF) Medical Center.

Wachter, an internist, was an early and eloquent advocate of the potential of electronic health records (EHRs) to improve the safety and quality of care. Actual EHR implementation, however, brought not nirvana, but a jarring number of “side effects.” Not least was the way the technology often distracts, confuses and complicates the lives of clinicians, endangering patients in the process.

An October Surprise For Co-Ops

Oct 14, 2015• 3

By LEONARD KISH

Leonard Kish sits down with Julia Hutchins, CEO of the Colorado HealthOP, to talk about the recent surprise when Co-ops were informed the federal government would pay just 12.6 percent of the money they’d requested …

LK: Julia, tell me a little about the history of CO-OPs in general and the Colorado Health-OP in particular. When were they formed? Why were they formed?

JH: The CO-OP program was an important part of healthcare reform. The CO-OPs were part of a bipartisan compromise to ensure that there was competition in the individual and small group insurance markets and to ensure that there was competition on behalf of consumers. CO-Ops have enabled lower costs and more responsiveness to consumers as the market moves from one that was previously medically underwritten to one where anybody can buy health insurance regardless of their health status.

An Interview with InterSystems Clinical Advisor Nelson Le

Oct 14, 2015

By MICHELLE RONAN NOTEBOOM

An interview with Nelson Le, clinical advisor and senior product advisor for InterSystems

Michelle Noteboom: Give me an overview of InterSystems and clarify your role in the company.

Nelson Le: InterSystems is a global healthcare IT company and we have different products that we offer the market. We say that technology is the pathway to making an impact in healthcare. The team that I work on is focused on interoperability and our position is that in order to achieve clinical outcomes and to perform well as a healthcare system, you need to be able to be interoperable and connect all your different systems, your different stakeholders, and all the data that you have regarding your patients and your performance.

My role on the team is clinical adviser. What that means is that I look at our products and solutions, I look at our positioning, and I look at our customer base and figure out how we can use technology to drive strong clinical outcomes.Continue reading…

What Cardiologists Can Teach Economists

Oct 14, 2015• 7

By MICHEL ACCAD, MD

I had the great fortune and pleasure of studying under the late Kanu Chatterjee during my cardiology fellowship at the University of California San Francisco.

In the early 1970’s, Dr. Chatterjee was among the first to understand the benefits of “afterload reduction” for the treatment of congestive heart failure:

Prior to that time, giving medications that could lower the blood pressure was often seen as heretical. In fact, during the 1950’s and 1960’s, the treatment of heart failure sometimes consisted in applying measures to raise the blood pressure and increase the work of the heart.

The “90 Day Contract”

Oct 14, 2015

By TERRY M BENNETT, MD

At age 77, having been through all of the fun and games of dealing with the New Hampshire Board of Medicine, a predatory local Hospital CEO, and other adversaries, nothing should surprise me anymore. But, I am surprised that intelligent, well-educated physicians would sign a “welcome aboard” new employee contract, a contract that allows their employer hospital to fire them without stated cause and throw them, literally, out the door using the security guards to do so, and without even time to clean up their offices.

Most doctors, however, are now hospital employees, and have knowingly or unknowingly, signed exactly such a contract.Continue reading…

Scoring the Surgeon Scorecard

Oct 13, 2015• 4

By MARK W. FRIEDBERG

Mark W Friedberg is a researcher at the RAND Institute and a co-author of the recent RAND analysis of the Surgeon Scorecard. He posted this on THCB in response to Ashish Jha’s post “Misunderstanding ProPublica.”

I don’t disagree at all with the idea that providers should release their own performance data, to the extent that they have it. Free flow of accurate and understandable performance information is inherently good. If the ProPublica Surgeon Scorecard can create pressure for this to happen, fantastic.

But there is no tradeoff between recognizing the serious methodological problems in the Scorecard, improving the Scorecard, and encouraging providers to release their own data. All three can and should be done simultaneously.

Also, for frequenters of this blog, I think it’s important to clarify a few key things about the “RAND critique” (which I authored with individuals from many institutions, all of whom deserve credit for devoting considerable unpaid time to the effort).

1. Nowhere in the critique do we suggest that ProPublica – or anybody else for that matter – abandon efforts to generate and publicize reports that truly reflect provider performance. Far from it. If you look up the authors of our critique, you’ll see that all of us have devoted substantial time and effort to furthering the science and practice of performance measurement and transparency in health care.

Wellness 2.0: Better Health, Better Coverage

Oct 13, 2015• 19

By JIM PURCELL

Just what on earth are businesses thinking? Companies pay too much for poor quality health care coverage. If this were any other business expense, this wouldn’t be tolerated. Yet, expensive, sub-standard healthcare is something U.S. companies roll over and accept. There are many reasons why, all unacceptable.

Fortunately, there’s a path that companies can take now to address healthcare costs: fostering healthier employee lifestyles. This is perhaps the only avenue for immediate action that can lower healthcare costs for both employers and employees while cultivating a healthier, more productive workforce. Your cynical side laughs? Consider this:

“Only private business, not the federal government, can solve America’s epidemic of obesity, chronic disease, and runaway healthcare costs by investing in the health and fitness of their employees,” said Cleveland Clinic CEO Toby Cosgrove in an Affordable Care Act debate panel, a sentiment increasingly echoed inside and outside of healthcare.

Employers must move away from the adversarial, zero sum approach of increasing employees’ share of the cost of coverage to a more partnership-centered model of forging employer/workforce partnerships where both companies and employees support each other’s goals, not just in lowering coverage costs, but by improving health.

Increasing coverage in this day and age? Unheard of! But this is not a pipe dream. If companies are willing to make the investment, on the condition that employees undertake required behavior modifications and achieve positive outcomes, it truly can happen. And though may have heard this before, up to now we’ve not done it right.Continue reading…

Contextual Communication

Oct 13, 2015

An Interview with PatientSafe CEO Joseph Condurso

Oct 13, 2015

By MICHELLE RONAN NOTEBOOM

An interview with Joseph Condurso, president and CEO of PatientSafe Solutions

Michelle Noteboom: Give me a short overview of PatientSafe and your role in the company.

Joseph Condurso: I’m the president and chief executive officer of PatientSafe Solutions. I joined PatientSafe in 2011 with the focus of taking its skills and its core competencies as a mobile applications provider from the bedside to the enterprise to the home, which is my vision and goal for the company.

We provide a platform for creating and delivering an intelligent interactive workflow solution. We express those workflows through bedside applications that can be executed at the point of care by the frontline care team. We have also been building out an expression of those workflows to enable the patient to engage the care team as they discharge from the hospital and go into their home and into their daily life.Continue reading…

Trauma Room Two

Oct 12, 2015

By PHILIP ALLEN GREEN, MD

Sometimes when I am bored, when it is all sore throats and dental pains, when I feel more like I am a social worker and a hand-holder than an emergency medicine physician, I play a game.

I do not look at the chart before I go into a room. I walk in cold. I enter with no idea who is going to be in there or why. In that very first second, before anyone speaks, I try to guess what the story is, who the people in the room are, and why they are in my emergency room.

Here-maybe it would make more sense if I showed you.

I draw back the curtain and step into Trauma Room Two. My eyes scan quickly about, gathering as much information as they can.

There are three people in the room.

For a brief second, I intentionally do not look at the patient lying on the hospital bed, not yet. Two people accompany the patient, a man and a woman. The man sits on a hard plastic chair pushed back against the room’s wall, staring quietly ahead. I start with him. I know if I can just look closely enough, the story is there.