The Health Care Blog – Page 708 – Everything you always wanted to know about the Health Care system. But were afraid to ask.

Above the Fold

Let’s Stop Bashing Profits and Business In Healthcare

Jul 12, 2011• 167

By MERLE J. BUSHKIN

I’m tired of profit-bashing and business-bashing in healthcare. And every American should be, too!

Well-run, profitable businesses, along with our sense of decency, democratic institutions, education and free enterprise systems, and adherence to the rule of law, have made the United States the most extraordinary nation in recorded history. Together they have unleashed the talents, creativity and productivity of our people, generated enormous sums of capital, and created unheard of social, economic, scientific and political advances.

Is there anything nobler than providing the environment and opportunity for people to fulfill their potential and achieve their dreams, and for providing the goods and services that enable people to raise their standard of living? Not even the practice of medicine can do so much good for so many people. But that’s precisely what businesses do. (That also may explain why far more Americans today are interested in job creation than restructuring healthcare.)

In our system, an individual has an idea, attracts capital, and hires people to build a product or provide a service. When they meet a need, they prosper – and attract more capital and hire more people. Everybody wins. If they fail, they alone suffer the consequences. That’s what capitalism is all about and that’s what has made America great.

Frances Dare, Cisco: Global Health Leaders’ Survey

Jul 12, 2011• 6

By Matthew Holt

Cisco’s Frances Dare is an occasional but regular and welcome guest on THCB. Frances spends a lot of time looking at the environment for Cisco’s products and services in health care both in the US and internationally–think demand and readiness bandwidth and live video! Earlier this year Cisco released the results of a survey done with numerous international leaders in health care about their problems in general and their readiness for telehealth solutions in particular. The overall verdict? It’s getting pretty close, especially outside of the US. For the longer story, grab a cup of coffee and watch this interview in which I bring chat and Frances brings data!

Interview: Insurance exchanges, ACOs? ACS tells you how…

Jul 11, 2011• 2

By Matthew Holt

We’ve been digging under the hood a little of Xerox since (much to my surprise) they started sponsoring THCB recently. The reason Xerox cares about health care is related to their purchase of ACS a couple of years back. ACS was best known for government (mostly Medicaid) claims processing but they also had a whole lot of other technologies and capabilities. One of those is actually running the Health Insurance Exchanges that are going to be in every state (or imposed on the states in 2013 if they’re not ready). Another ACS capability is working with incipient ACOs, or providers that backdoor into ACOs via Medicare Advantage or direct deals with private plans.

Last month I spoke with Michael Sandwith who runs Market Management at ACS. Why should a state or a provider use ACS to put the systems together to run health information exchanges or ACO information capture and management systems? Mike’s logic is simple–because they’ve done it before. They’re operating 7 state HIEs already and aren’t just bringing Powerpoint. And can ACOs work given the failure of PHOs in the 1990s? It all depends if we can independently manage the physicians within the system–i.e. don’t let the hospital management screw it up! Here’s the full video interview of someone who’s been there in two of the bigger health care IT challenges of the day.

What an exchange needs to do

Jul 11, 2011

HHS Secretary Kathleen Sebelius (who sat in front of me at a meeting last month–my brush with fame) is in the HuffPo writing about the benefits of the (coming) health insurance exchanges. I’m deeply disappointed that we ended up with state-based exchanges rather than the national exchange that was in the House version of the ACA, but I’ll spare you my diatribe on what States and the Senate are good for….Instead let’s focus on what the exchanges will need to do. Deliver accurate information about insurance choices to their users. That means real apples to apples comparisons of benefits, networks, out of pocket costs, etc, etc. This is all still buried on most private markets (e.g. HealthInsurance still doesn’t clearly explain max out of pocket costs–the most important number for most policies). The good news is that there won’t be any distinction between the polices sold to different business sizes and to sick and healthy people. The bad news is that when people see how little their subsidy will buy them, and that most plans will have high deductibles, the good news may get lost. But the exchanges are important advances–even if in some states they may get subverted.

The Prevention Paradox

Jul 8, 2011• 1

By GLENN LAFFEL, MD

In the last month, the Obama administration announced programs to reduce racial disparities and increase prevention in health care. Neither program was funded with actual money, so they are about political showmanship as much as any real desire to tackle the worthy causes. After all, who would oppose such programs? I half-expect the administration to follow-up these announcements with one focusing on moms and apple pie.

But have a closer look at what Iowa Democrat Tom Harkin said at the press conference introducing the latter initiative. “For every dollar we invest in prevention, we save $6. We need to provide an approach that makes it easier to be healthy and harder to be unhealthy.”

I haven’t found the report on which Harkin bases his assertion about the returns on health prevention efforts, but my sense is its more complicated than Harkin would have us believe. Some screening and prevention programs are not effective at all. Others are effective, but prohibitively expensive. Any national program to improve prevention needs to evaluate each potential component to assure it reflects Harkin’s focus on cost-effectiveness.

HIT Trends Summary for June 2011

Jul 8, 2011

By MICHAEL LAKE

This is a summary of the HIT Trends report for June 2011. You can get the current issue or subscribe here.

EMRs in the cloud. There is additional validation this month by MarketsandMarkets that the EMR market has heated with compound annual growth rates over the next couple of years pegged at nearly 20%. Analysts report that EMRs delivered over the Internet are a fast growing segment appealing to small practices. One new example is the Allscripts’ MyWay EMR is being offered by Costco in a hosted version for as low at $499 per physician per month. This could be an emerging market price now-a-days for a low-end hosted or web-based solution. This leaves some room for disrupters underneath to position at a lower price or premium pricing with differentiating services. We saw a similar idea pursued by Sam’s Club and Dell last year without much success.

The AMA also clarified one of its ideas for this Internet EMR market by marrying e-prescribing and registry functions to meet stage 1 meaningful use. DrFirst is the e-prescribing app. DocSite and WellCentive are participating registry-oriented EMRs. It is a welcome new alternative that should get significant market attention.

EMRs and care coordination. Care plans have become the foundation for care coordination. This is one of the lessons learned from a report by eHI. Yet it finds that additional EMR functional support is needed. Oncology patients report they want to collaborate with their physicians. The report tracks two detailed case studies at Taconic IPA and Community Health Center in CT. The EMRs are useful but insufficient to support care coordination. Workarounds are available through increased staffing.

Stepping in Where Google Health Left Off

Jul 6, 2011• 1

By JOHN MOORE

A little over a week ago Google stated that it was putting a stake through the heart of their personal health platform (PHP) Google Health. We at Chilmark had been expecting this for some time, it was just a manner of when it would become official. Thus, we were somewhat taken aback by all the publicity surrounding this final chapter with our own post on the topic receiving well over 40 comments and link-backs (that may be a record – thanks everyone for contributing to the story). With the closing of Google Health, we postulated in that post that Microsoft really had no other worthy competitor that will challenge them to continuously make enhancements to HealthVault. We may have spoken prematurely.

Stepping in to take the place of Google, is none other than an ol’school EHR company (and one of the largest), Cerner, who provided their own commentaryon the demise of Google Health and their future intentions. Last week we had the opportunity to talk with the Cerner Health and learn more about those intentions but before getting to that, some quick background.

Taking a different tack:
Cerner has been in the HIT business now for 31+ years having grown to one of the leading EHR vendors in the market. You’ll usually find their systems (EHR: Millenium) in large healthcare organizations. This sector of the EHR market is seeing fierce competition as Epic seems to pick up one win after another at the expense of others, including Cerner. While continuing to go head-to-head with Epic, it appears that Cerner has also chosen to take a different tack, adopting a philosophy of: if you can’t beat them straight up, change the rules of the game.