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HIT Newser: Will Stage 3 Meaningful Use Be Delayed?

Jun 8, 2015• 2

By MICHELLE RONAN NOTEBOOM

CMS Releases Final Update to ACO Program

CMS releases a final rule updating the Medicare Shared Savings Program, which includes a new higher-risk, higher-reward Track 3 option; streamlines data sharing between CMS and ACOs; and adds a requirement that ACOs applying for the program describe how they will promote the use of health IT to boost care coordination.

Organizations Urge Stage 3 Delay

The AMA and MGMA join the AHA and CHIME in calling for a delay in finalizing Stage 3 Meaningful Use requirements. The current version is largely viewed as too burdensome for providers with the potential to impede the use of health IT to improve quality and efficiency.

Quite simply, Stage 3 will not be successful without provider buy-in. There have been delays before; look for another oneContinue reading…

Productivity? In Healthcare?

Jun 5, 2015• 12

By JOE FLOWER

Obamacare is built on the assumption that healthcare can be more productive, that we can squeeze more health per dollar out to the system that is built to give it to us. Practically everything I write is based on the same idea — big time. I believe we could do healthcare better for half the money we pour into it now.

There is a widely-cited theory that this is fundamentally impossible, popularized by William Baumol, a New York University economist, in a 2012 book, The Cost Disease: Why Computers Get Cheaper and Health Care Doesn’t. Baumol trades on the idea that healthcare is mostly the individual labor of highly trained professionals (doctors, nurses, and technicians) whose labor cannot simply be baked into machines and software. So we can’t expect healthcare to become any more productive, especially as healthcare keeps getting more complex.

We can’t both be right. What’s the daylight between these two radically different points of view?

I believe that the Baumol argument assumes many things that are simply not true. These include:

o We are using doctors and other personnel at their highest and best use (when in fact we waste masses of clinician time on documentation and other processes that do not add value at all, let alone value that only they could add)

o The goal against which productivity should be measured is provision of healthcare processes, such as how efficiently one can do a gall bladder removal or an uncomplicated birth (as against, say, improvement in health of patients and patient populations)

o There is not much wasted motion within those processes (when in fact there is a great deal wasted, as anyone who has applied lean manufacturing principles to healthcare processes has discovered)

How I Built a Health App In Six Hours, Got 2.3 Million Downloads and Got Acquired

Jun 4, 2015• 4

By STUART HALL

Creating A Story

Rewind back to May 2013 and I was co-founder of a music app startup called Discovr. We had managed to achieve over 4 million downloads, raised over $1m and were perceived as ‘successful’ (unfortunately things didn’t end up that way) in our home town of Perth, Australia.

It was very common for people to come up to me and ask what the magic was to make a successful app. We’d fudged our way through and somehow made something people wanted to download, but could I recreate it?

I was lucky enough to be reading an advance copy of the amazing book The Fortune Cookie Principle which really opened my eyes to storytelling and products.

I was also inspired by reading this advice from the One More Thing conference about how to write a press release. Surely it’s impossible to stand out with a press release like that?

A Few Thoughts on “Culture” in Healthcare

Jun 3, 2015• 9

By MARC-DAVID MUNK, MD

The big news in Boston healthcare last month was the announcement that Tufts and Boston University Medical Centers were calling off their proposed merger. The Boston Globe wrote:

“Although they did not specify why the deal fell apart, the hospitals were apparently unable to overcome differences in culture, mission, and strategies for the future, analysts said. “Culture always trumps strategy,”said Ellen Lutch Bender, president of the consulting firm Bender Strategies LLC.

I don’t know any of the details about the proposed merger, and certainly can’t tell you if the deal made sense. But it also wouldn’t be the first partnership that failed due to perceived incompatibilities in organizational culture. In fact, one of the great healthcare case studies in business school is about the ultimately failed merger of Stanford and UCLA health systems– a marriage that came apart after two years. The cause, according to the Stanford Alumni Magazine?

The venture’s biggest downfall may have been that it never managed to bind the two institutions together with a common culture.

I’ve been thinking a lot about the concept of culture in healthcare. You hear the term used frequently– generally to describe either some sort of social incompatibility between one group and another. Besides mergers, the other time you hear the term used is to explain poor operational performance at healthcare organizations. People in healthcare often finger “culture” as the explanation for a litany of disappointing outcomes, failed initiatives and poor performance.

Congrats. You’ve Just Been Named CTO of HHS. What’s Next? Yup. SELFIES!!!!!!

Jun 3, 2015• 1

THCBist

Screen Shot 2015-06-02 at 12.46.24 PM

What you were expecting serious policy statements? ; ) Newly inaugurated HHS CTO Susannah Fox captures the joy of federal service in one dramatic selfie at this week’s DataPalooza.

Building Healthy Communities 2.0

Jun 3, 2015

By SUSAN DENTZER

With its elegant homes, pleasant park and bustling stores, the Woodlawn section of Birmingham, Alabama was described in a 1950 news article as “a really great section of Birmingham…typical of the fine things in life.” Then came the racial unrest of the 1960s, disruption from urban renewal gone awry and white flight to Birmingham’s suburbs. Joblessness and poverty took root; the housing stock decayed. Today, median income in Woodlawn is just $21,000, less than half the level for Birmingham as a whole.But now Woodlawn is in the midst of a turnaround, aiming to become not just a neighborhood that prospers economically, but also one where people live healthier lives.

Why Large Scale Government IT Projects Fail and What To Do About It

Jun 2, 2015• 1

By KEVIN DE SOUZA and KENDRA SMITH

The volume of failed large-scale information technology (IT) projects in the public sector is troubling. These projects are failing at an alarming rate. The long history of public sector IT failures has seen billions of dollars lost, embarrassment, redundancy, waste, and a loss in public trust. In 2004, the U.S. Air Force (USAF) began work on the Expeditionary Combat Support System, a project designed to streamline and automate the USAF’s operations by consolidating over 200 legacy systems. The USAF contracted with Oracle and then Computer Sciences Corporation and by 2012, the project had spent $1.1 billion taxpayer dollars and was ultimately terminated. U.S. Senators Carl Levin and John McCain stated that this project was “one of the most egregious examples of mismanagement in recent memory.” The National Programme for IT in Great Britain has failed miserably after £12.7 billion was spent to create an online portal that would allow citizens access to their personal health information; the project will arrive four years late in 2015. In Victoria, Australia, a smartcard ticketing system for public transportation was started in 2005 and was flawed from conception. Eventually, the project was implemented years late, marred by various missteps, and went $500 million over budget.

Even though leaders are familiar with past failures, many in the public sector have failed to learn from these mistakes. Bent Flyvberg and his colleagues dubbed this phenomena the “megafailures paradox” where there is continued investment in IT projects while failing to understand the causes of failures.

Data Shows Large Rise In List Prices at Hospitals

Jun 2, 2015

By TWITTER BOT

Data Shows Large Rise in List Prices at Hospitals http://t.co/y89oxoN2ou #hdpalooza pic.twitter.com/wrybYb873g

— Brian Ahier (@ahier) June 2, 2015

Interoperability via Direct Exchange: A Brief Update Mid-2015

Jun 1, 2015• 4

By DAVID C. KIBBE, MD

Over the past three years it has been my good fortune to work with talented individuals and organizations dedicated to making sharing of health information ubiquitous, secure, inexpensive, and easy to use. Quietly and without much fanfare, they have built both technical and trust infrastructures that reach almost 40,000 health care organizations, interoperably connecting users of over 200 EHRs and PHRs from different vendors. What follows is a brief update of the current status of interoperability in health IT via Direct exchange.

Health Data – It’s a “Thing!”

Jun 1, 2015

By STEVEN FINDLAY

This year’s Datapalooza conference, June 1-3, in Washington, D.C. takes place as health data edges close to becoming “a thing” in the cultural landscape. Consumers may not know it yet, but all that fitbiting, medical social networking, and test result accessing through patient portals could soon swell into a full-fledged consumer movement.

You can almost hear it now: “Hey man, did you upload your stats after your knee surgery—you know, how much you’re walking, your pain levels, and all that?”

Or, to a newly diagnosed cancer patient: “Be sure to track your treatment experience online. It’s kind of cool to do and helps researchers figure out what works and doesn’t.”

Or: “Check this app out—you can enroll in a clinical trial in, like, 5 minutes.”

This is, of course, what many health data heads have forecast for years. It’s also now crystal clear that the use of big data to improve health care is no longer a research backwater. To be sure, there’s hype around the potential to dramatically alter physician and consumer behavior via big data analytics. We are still dealing with human beings, folks. As well, concern about privacy continues to vex health data entrepreneurs, researchers, and consumers.