A couple of weeks back Andy Cohen, CEO and Founder of Caring.com stopped by Health 2.0’s offices to give us an update on the site. Having established itself as a go-to site for caregivers needing to figure out what to do when a loved one needs help, Caring has now branched out to develop assessment tools and communities. In this video interview you’ll get to hear and see a bit about that, and get more information about the company’s plans to be the “Babycenter” for the other end of life.
Above the Fold
Feds on the Web: Medicare relaunches caregiver site
I’ve been impressed by the efforts of CMS and others in the Federal government to develop helpful websites. Medicare has just relaunched its Caregivers website. It’s got a nice variety of stories, links and resources–including links to multiple partners offering support communities and other help. While the Physician Compare site had problems (and is a much more complex effort), I thought that Healthcare.gov was a good start to the complex world of finding health insurance, and the Health Indicators Warehouse is another good start at releasing masses of data in a usable format (FD Health 2.0’s Technology Guide is linked to as part of the site). Everything here can and will be improved, and much of this will be built on by the private sector–and that’s the way it should be. But given the scorn poured upon government, lets recognize the strides made.
The Kübler-Ross Model of EHR Adoption
For over a hundred years the paper chart has been a trusted partner and best friend to many physicians and nurses. The paper chart was born the day a new patient walked into the office, a pristine, crisp and neatly color-coded folder, with just the right markings in carefully shaped calligraphy on its covers. As the years went by, the paper chart grew in size, acquired meaning and wisdom, and like most of us, became a bit tattered around the edges and heftier in the middle. It felt good to hold the elderly paper chart in your hands and its voluminous physical presence inspired confidence and trust. The paper chart is dead. In some places the paper chart’s pages are still turning slowly, but we all know its long, productive life has come to an end and someone should pull the plug and call it. Or do we?
In 1969 Elisabeth Kübler-Ross proposed a 5 stage model for typical grieving behavior. The various reactions from the clinical community to the apparent demise of the paper chart exhibit almost textbook adherence to the Kübler-Ross model, with each clinician advancing through the five stages of grief at his/her own pace*.
Denial – This is a joke. These people don’t understand medicine and this entire Obamacare thing will soon go away and we’ll return to normalcy. My practice is doing just fine on paper and my patients get all this fancy medical home care right here and always had. They actually get better care. Besides, I have patients to see and I am too busy to tinker with these fads that come and go every five years or so.Continue reading…
There Aren’t Enough Rich People To Pay For Medicare And Medicaid
By ROBERT LASZEWSKI
I hear more and more of my progressive friends arguing, in the context of deficit reduction, that we should be raising taxes before getting aggressive about reducing the cost of Medicare and Medicaid — as well as Social Security.
To a point, I agree.
This country is in such a hole that it is senseless to deny that at least some new taxes will be needed to pay for all of the nation’s bailouts and accumulated debts.
For instance, progressives would like to end the $1 trillion cost over ten years of the Bush tax cuts for those making more than $250,000 a year.
I also believe that ending those tax cuts is necessary.
But if you’re looking to better understand the budget policy choices we face, I highly recommend the March 2011 Congressional Budget Office study, “Reducing the Deficit: Spending and Revenue Options.” The CBO prices out about all of the budget options.Continue reading…
The New Cost-Conscious Doctor
Doctors practicing in the U.S. are becoming increasingly conscious of the increasing costs of health care. Most consider themselves cost-conscious, and are considering the impact of their practice patterns — in terms of prescribing medicines, tests, and procedures — on the nation’s health bill. In fact, most physicians feel they have a responsibility to bring down health costs.
This perspective on physicians comes from the survey report, The new cost-conscious doctor: Changing America’s healthcare landscape, from Bain & Company, published in March 2011. Bain spoke with over 300 U.S. physicians to assess their perspectives on managing costs, drug and device usage, and standardized care protocols.
The top-line finding is that, regardless of physician demographic — whether male or female, salaried or productivity-based, specialist or generalized, urban or rural, young or mature, doctors uniformly see that they must change clinical practice patterns to accommodate the realities of health economics.Continue reading…
THCB Live: Health Dialog
Matthew Holt interviews David Wennberg, Chief Scientist for Health Dialog, at the World Health Care Congress.
Are Decision Support Tools Turning Doctors into Idiots?
By DAVID WILLIAMS
A HealthLeaders article by Gienna Shaw notes that some physicians are reluctant to use computerized decision support (CDS) tools because they fear losing the respect of patients and colleagues. There’s some evidence to support this concern:
In one [study], even tech-savvy undergraduate and graduate computer science students preferred physicians who rely on intuition instead of computer aids.
“Patients object when they ask their doctor a question and then she or he immediately types in the question into their laptop and then reads back the answer. It gives patients the feeling that they just paid a $25 copay to have someone Google something for them,” [study author James] Wolf says.
Shaw argues that this is a transient phenomenon in any case because soon everyone will use CDS as payers demand it and the tools get built in to electronic medical records in a way that’s invisible to patients. She’s probably right, but she’s sparked some interesting thoughts.Continue reading…
And the Worst Health Care System in the World Is…
By EVAN FALCHUK
The United States, of course.
Oh, no, wait, it’s Canada.
Actually, I think it could be Germany.
Geez, now I think it might be the UK.
You could go on and on like this. But you know what?
No matter how good or bad your system is, there are certain universal truths.
Here are four of them that might make you look at global health care a little differently.
First, health care is getting more expensive, all over the world. A new study by the global consultant, Towers Watson (disclosure: Towers Watson is a Best Doctors client) found that the average medical cost trend around the world will be 10.5% in 2011. In the advanced economies costs will rise by an average of 9.3%. While Americans tend to think of rising medical costs as a uniquely American problem (they’ll rise by 9.9% here), it’s just not true. Canadian costs will rise by 13.3%. In the UK and Switzerland, they will increase by 9.5%, and in France by 8.4%.
Facebook Misstep Costs RI Physician Fine, Job
By DAVID HARLOW
In recent years many health care providers and managers have told me, time and again, that the health care world is accustomed to managing confidential patient information, and therefore doesn’t need much in the way of social media training and policy development. This week brings news that should make those folks sit up and take notice. A physician in Rhode Island, who was fired for a Facebook faux pas, has now been fined by the state medical board as well. The physician posted a little too much information on Facebook — information about a patient that, combined with other publicly available information, allowed third parties to identify the patient. The details of the story are available here and here.
The key takeaway from this story — and the Johnny-come-lately approach to health care social media taken by the Rhode Island hospital in question and the Boston teaching hospital that the Boston Globe turned to for comment — is that prevention is the best medicine.
Facebook and other social media are a fact of life, and cannot be ignored by health care providers and organizations. They can even be used as a force for good. As one example, take note of the recently-announced initiative by my colleague, Dr. Val, to start up a peer-reviewed tweetstream, @HealthyRT. At he very least, health care providers and organizations should be monitoring social media for mentions so that they can reach out, as may be necessary, to address health care and public relations issues.Continue reading…
IPAB — The New Punching Bag
By MERRILL GOOZNER
Remember death panels? Politicians have found a new way to use health care reform as a punching bag.
The Independent Payments Advisory Board (IPAB) will be a 15-member expert panel appointed by the president and approved by the Senate that is charged with coming up with ways of cutting Medicare spending when payments grow significantly faster than the rest of the economy.
Last week, President Obama, in his speech outlining his long-term plan for cutting the deficit, upped the ante for IPAB by ratcheting up the level of cuts the board could impose if the senior citizen health care program grew too fast. Congress, under the law, would have to substitute comparable cuts of its own, or the IPAB’s plan would go into effect.
It didn’t take long for the fireworks to start. The New York Times reported this morning that politicians from both sides of the aisle are lining up not only to deep-six the president’s latest IPAB proposal, but to get rid of it entirely. Republicans like Paul Ryan of Wisconsin cried rationing. Democrats like Pete Stark of California said such decisions are better left in the hands of Congress.Continue reading…
