The Health Care Blog – Page 402 – Everything you always wanted to know about the Health Care system. But were afraid to ask.

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Getting (to the Value) of Value In Health Care

Sep 11, 2015• 2

By SUSAN DENTZER

How would you judge the value of your health care? A longstanding definition of treatment holds that value is the health outcomes achieved for the dollars spent. Yet behind that seemingly simple formula lies much complexity.

Think about it: Calculating outcomes and costs for treating a short-term acute condition, such as a child’s strep throat, may be easy. But it’s far harder to pinpoint value in a long-term serious illness such as advanced cancer, in which both both the outcomes and costs of treating a given individual—let alone a population with a particular cancer—may be unknown for years. And then there’s the complicating issue of our individual preferences, since one person’s definition of a good outcome—say, another few years of life—may differ from another’s, who may be seeking a total cure.Continue reading…

The AMA’s Forgotten Fight Against Physician Greed

Sep 10, 2015• 8

By MICHAEL MILLENSON

Perhaps the most well-known part of the 1965 Medicare creation tale is the opposition by the American Medical Association (AMA) to “socialized medicine.” Yet with financial incentives assuming a new prominence for provider and patient alike, we shouldn’t overlook the AMA’s equally unsuccessful battle against the excesses of capitalistic medicine. The forgotten story of the professionalism’s failure to contain physician greed provides an important policy perspective.

The Myth Of Medicine’s ‘Golden Age’

Medical practice pre-1965 is often portrayed as a mythical “Golden Age.” The truth, as I found researching my 1997 book, Demanding Medical Excellence: Doctors and Accountability in the Information Age, was that the post-war years were a time when way too many doctors grasped for the gold.

The most common “entrepreneurial” excesses were fee splitting, where a specialist paid a kickback to the referring doctor, and ghost surgery, where a surgeon secretly paid a colleague to operate on an anesthetized patient. The first surgeon paid the “ghost” a small part of the total fee and pocketed the difference. Even worse was rampant surgical overuse, where common excesses included appendectomies for stomachaches and hysterectomies on young women with nothing more than back pain.

Although professional societies wielded far more influence than now, efforts by leaders of the AMA and the American College of Surgeons to stop these abuses repeatedly fell short. Doctors “display a consistent preoccupation with their economic insecurity,” a 1955 report by the AMA concluded with discomfiting bluntness.

Why Data Governance Needs a Henry Kissinger

Sep 10, 2015• 4

By DALE SANDERS

The number of mergers, acquisitions, and collaborative partnerships in healthcare continues to skyrocket. That’s not going to change for the next few years unless the FTC decides to be more restrictive. In all of these activities, older generation executives (I can say that because I’m older) have underestimated the importance and difficulties—technically and culturally—of integrating data and data governance in these new organizations, and the difficulties are exponentially more complicated in partnerships and collaboratives that have no formal overarching governance body. In 2014, 100 percent of Pioneer ACOs reported that they had underestimated the challenges of data integration and how the lack of data integration has had a major and negative impact on the performance of the ACOs.

Seamless Data Governance

After 33 years of professional observations and being buried up to my neck in this topic, especially the last two years as the topic finally matures in healthcare, I’m convinced that the role model organizations in data governance practice it seamlessly. That is, it’s difficult to point a finger directly at a thing called “Data Governance” in these organizations, because it’s completely engrained, everywhere. As I’ll state below, it reminds me of the U.S. transition in the early 1980s when organizations finally realized that product quality was not something that you could put in an oversight-driven Quality Department, operating as a separate function. Quality must be culturally embedded in every teammates’ DNA. Data governance is the same, especially data quality.Continue reading…

The World In 2016: Health Care Edition

Sep 10, 2015• 1

By MATTHEW HOLT

We’re taking your predictions for what 2016 will hold in store for health care. A President named Trump? The much-rumored Uber for Healthcare? The end of Meaningful Use? The beginning of the ACO era? New incentive payments? New penalties? Something else nobody has thought of yet?

You’re invited to a special online event hosted by athenahealth’s COO Ed Park (no he’s not his bro Todd whatever HIStalk may think), on Tuesday September 15, 2015 at noon. With a program created with doctors in mind, this is one event you won’t want to miss. Ed will talk about what 2016 is likely to bring for doctors, what probably won’t happen (despite what the skeptics say) and how health information technology is rapidly evolving to meet a new generation of pressing challenges. You’ll also get a rare insider’s look at athenahealth’s plans for 2016, including rumored new products and the company’s plans for expansion in the competitive electronic medical records space. If you track this much-talked about health IT company and its CEO Jonathan Bush and the broader health IT industry, you’ll want to be sure to mark your calendar.

The Wisdom of the Blog

Meanwhile, we want to know what THCB readers think is ahead in 2016. What do you expect to see? What’s next for Obamacare? What new technologies are poised to change everything? More importantly: What won’t we see? If you have a prediction for 2016, e-mail the editors at ed****@***************og.com or use the contact form at the top of the page. Write us a brief blog post. Submissions should be between 300 and 500 words in length. Tell us what you think will happen and why it’s important. Strong submissions will be published on THCB.

Is Obamacare working? Where’s the data?

Sep 8, 2015• 1

By FRED and ALMA TROTTER

As President Obama’s healthcare reform unfolds in the last years of his administration, critics and supporters alike are looking for objective data. Meaningful Use is a funding program designed to create health IT systems that, when used in combination, are capable of reporting objective data about the healthcare system as a whole. But the program is floundering. The digital systems created by Meaningful Use are mostly incompatible, and it is unclear whether they will be able to provide the needed insights to evaluate Obamacare.

Recent data releases from HHS, however, have made it possible to objectively evaluate the overall performance of Meaningful Use itself. In turn we can better evaluate whether the Meaningful Use program is providing the needed structure to Obamacare. This article seeks to make the current state of the Meaningful Use program clear. Subsequent articles will consider what the newly released data implies about Meaningful Use specifically, and about Obamacare generally.

ACA Database: How Do I Report a HIPAA Violation?

Sep 8, 2015• 2

By THCBist

I know my HIPAA rights were violated and would like to know the best recourse to settle the matter. By myself or via an attorney?Can you suggest a referral agency for attorneys?

Pilot Health Tech NYC 2015 Launches Today!

Sep 8, 2015• 1

By GRAEME OSSEY & JL NEPTUNE

The New York City Economic Development Corporation, in partnership with Health 2.0 and Blueprint Health, is proud to announce today’s kickoff of Pilot Health Tech NYC 2015. Pilot Health Tech NYC is a pioneering innovation initiative: a unique marketplace for digital health technologies, connecting buyers and sellers through curated matchmaking, technical assistance, and competitive commercialization awards.

Since launching in 2013 the Pilot Health Tech NYC program has been a resounding success, stimulating the growth of the digital health ecosystem in New York City and beyond. The program has provided $2,000,000 in funding grants to early-stage health care technology companies working in partnership with key NYC health care service organizations and stakeholders. Pilot Health Tech NYC grant awardees have gone on to raise $170M in venture funding, create more than 100 high-tech jobs, and impact the lives of countless patients in the city of New York.
Continue reading…

The Story of the Dying Doctor Who Saved a Patient’s Life

Sep 8, 2015

By TERRY BENNETT, MD

I have mentioned that in the past, often at times of great duress in my life, often in the midst of cacophony, some window in time and space opens, if only for a moment, but the moment becomes a moment of grace, and, in that moment, an extraordinary medical feat has been granted to me. I have no explanation for any of this, I admit freely that I “hear voices”, voices that others do not hear. I cannot complain about a gift, this gift, weird as it may sound to others

This year, while sick as a dog from the cancer chemotherapy I was receiving for the metastatic cancer that I had discovered in December, my wife having already bought advanced reservation tickets to the “Capital Steps” political spoof performance at the Portsmouth Music Hall, I went to the Music Hall.

I sat all the way back, next to the door, at the very back of the Hall, out of fear that my chemotherapy induced nausea and sudden overwhelming tendency to vomit, on little or no notice, might present, and that I would be able to bolt out the door ,make it to the nearest trash can, and barf there, rather than make a mess in the theater.Continue reading…

The Measure of a Physician: Albert Schweitzer

Sep 3, 2015• 1

By RICHARD GUNDERMAN, MD

There are different ways to take the measure of a life. John Rockefeller, the richest person in the history of mankind, once asked a neighbor, “Do you know the only thing that gives me pleasure? It’s to see my dividends come in.” Television magnate Ted Turner once said, “I don’t want my tombstone to read, ‘He never owned a network.’” And musical artist Lady Gaga has described her quest as “mastering the art of fame.” But wealth, power, and fame are not life’s only metrics, and September 4 marks the 50^th anniversary of the death of one of the 20^th century’s brightest counterexamples.

His name was Albert Schweitzer. Winston Churchill once referred to him as a “genius of humanity,” and a 1947 issue of Time magazine dubbed him “the greatest man in the world.” Though Schweitzer held four doctorates and achieved worldwide fame as a musician, theologian, medical missionary, and promoter of a philosophy of “reverence for life,” for which he received the 1952 Nobel Peace Prize, his most enduring contribution lies in his lifelong commitment — both theoretical and practical – to the suffering.

Schweitzer was born 1865 in the Alsace region of what is now eastern France, the son of a Lutheran pastor whose grandfathers were both accomplished organists. Though already a world-renowned musician and writer, at age 30 Schweitzer decided to answer a call to missionary work, spending the next seven years of his life studying medicine. Once he finished his medical studies, he and his new wife, Helene, traveled 4,000 miles to set up a missionary hospital in what is now Gabon in west central Africa. There he spent most of the rest of his life, eventually dying there in 1965.

Are Studies Overestimating the Cost of EHRs?

Sep 3, 2015• 1

By TOM GIANNULLI, MD

On August 6, this article was posted, Are Electronic Medical Records Worth the Costs of Implementation?, in the American Action Forum. The article stated that there is value in the use of EHRs but the cost is significant. They estimated nearly $164,000 for a single physician and over $233,000 for a five provider practice.

I was surprised in 2015 to see this piece. Why? Because they used data from 2009 to 2011 on practices largely using server-based EHRs. The landscape of the EHR market has radically changed in the last 5 years. There are a wide range of more affordable, cloud-based EHRs today, including some that are free.

A free EHR doesn’t mean no cost, but it does make a big dent in the vendor related costs around hardware, software and implementation. This is often true for cloud-based EHRs that do charge a monthly per provider feeas well.