How are Web 2.0 technologies changing healthcare? What are the implications of trends like cloud-based computing for major healthcare players like pharma companies and large health systems? What about mobile computing? What are the practical implications for providers? What can healthcare providers learn from like dominant Web 2.o players like Google? Silicon Valley legend Tim O’Reilly (The Web 2.0 conference, O’Reilly publishing) gives an overview in this keynote from this years Health 2.0 conference in San Francisco in October.
Above the Fold
San Francisco Early Bird Price Ends This Week
The year may have just begun, but before you know it, the first Health 2.0 conference will be just around the corner! The Health 2.0 Spring Fling conference takes place in San Diego on March 21-22, 2011. In September, we will hold the 5th Annual Health 2.0 Fall Conference in San Francisco. Early Bird prices end on January, 14th at 5pm PST. To get your Early Bird tickets, please register here.
Get your San Diego Conference tickets today. Our Spring Fling will focus on three themes where Health 2.0 can make a difference: making health care cheaper; the evolution of research; and prevention, wellness, exercise and food. For each theme we’ll be showcasing new technologies, new services, and new partnerships, as well as catching up with leaders in health care, and Health 2.0. We'll also be highlighting winners of the Health 2.0 Developer Challenge. Sponsorship and Exhibiting opportunities are now available! For more details, see AGENDA.
We are happy to have best-selling author, Dean Ornish, President, Preventive Medicine Research Institute as the keynote speaker. We also are thrilled to announce that Todd Park, CTO, Health and Human Services, and J.D. Kleinke, author of the new novel “Catching Babies” will also be speaking.
Newly Confirmed Speakers:
- Brian Witlin, CEO, ShopWell
- Lindsey Volckmann, Director of Business Development, KEAS
- Carol Diamond, Managing Director, Markle Foundation
- Nikolai Kirienko, Project Director, Crohnology.MD
- Josh Sommer, Executive Director, Chordoma Foundation
- Deborah Estrin, Professor of Computer Science, UCLA
To get your tickets before it's too late, please REGISTER HERE.
Hospital Culture and Surviving the New Landscape
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A recent flight on Southwest reminded me of the importance of culture in navigating change in a rapidly evolving environment like we have in health care in the United States today. It is all too easy to focus on all the technical issues hospitals face in setting up Accountable Care Organizations to handle the inevitable global payments that will replace the current fee for service system. This blog is a plea for hospitals and doctors and consultants to pay attention to both the technical and the cultural or adaptive challenges we face in transforming a $2.5 trillion American industry.
Recent articles on companies outside of health care have highlighted how important culture has been to the success or failure of Southwest Airlines, QVC, and Zagat to respond to changing business conditions. Southwest’s COO states “our culture is our biggest competitive strength,” and the flight attendant and pilots’ union worry about how the recent purchase of AirTran will affect their unique culture. I have seen Southwest pilots help clean up the cabin, and the flight attendant on my recent trip told me she was giving up her day off because the company needed her help. QVC is trying to use the same methods and culture that made selling on TV popular with Internet customers. And Zagat, which had cultural troubles moving from book format to online, is now hoping that smart phone applications will reinvigorate their business model.
Harvard’s Ron Heifetz differentiates between technical and adaptive work and I have found this concept useful in working with health systems responding to payment reform. Everyone involved in hospital physician integration efforts will need to undergo a cultural (adaptive) shift because the healthcare reform law and the transition from fee for service to global payments mean the old ways of doing things are not sustainable.
Seeding the Cloud
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The newest new future of computing is floating your way. Lie back on the grass and enjoy. It is The Cloud. Not the corporate Cloud that is the trademarked provider of Wi-Fi services in Europe. But the broader Cloud that is the internet. The World Wide Web. The electronic blanket that invisibly but none-the-less completely shrouds us all. The cloud.
We are exhorted to upload it to the cloud. Store it in the cloud. Share it through the cloud. Download it from the cloud.
Your photo albums and your diaries and your work product and your deepest darkest secrets are slowly migrating from your computer to for-profit warehouses that promise safekeeping for your life’s work and memories. Even our medical records are going to wind up in the cloud. And because they are in the cloud, they are theoretically available to me or to those I authorize to viewse them – anywhere in the world. Instant access. Anywhere. Safety. Security. Total redundancy and backup.
What else is in the cloud? The apps that power our smart phones. The programs that power our computers. Our phone calls. Our video streams. The social media that passes for communication. All are drawn from and sent back out through the cloud.
And as long as you have great wi-fi service or five bars on your cell phone, you will always have access to your stuff, Right?
Why Christians Should Support Health Care Rationing
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It’s coming. Health care reform, Round II.
Republicans pledged to do it as part of their manifesto during the midterm election campaigns. And House Speaker John Boehner, less than a day after the elections, vowed that the GOP would “do everything we can to try to repeal this bill and replace it with common sense reforms to bring down the cost of health care.”
But why was this such a high priority? The lack of cost controls? Unfunded state mandates? Questions surrounding federal funding of abortions? Well, yes, but the go-to critique of health care reform can be summed up in one word:
Rationing.
Recently, as part of a response to the FDA revoking its approval for a late-stage breast cancer drug, several key Republicans criticized this kind of rationing, but set their sights on a much bigger target:
“Unfortunately, this is only just the beginning,” they continued. “The new health reform law — the so-called Patient Protection and Affordable Care Act — creates 159 new boards, commissions and agencies that will destroy the doctor-patient relationship and replace it with federal bureaucrats deciding who gets care and what treatments they can receive,” The Hill’s Jason Millman reported.
And the GOP will have backing in this effort from a pro-life Christian base crying out against ‘euthanasia’ and ‘death panels’ in the new health care law.
But this attitude refuses to admit two undeniable truths about human existence:
We have virtually unlimited health care needs. (All of us will die some day.)
We have limited health care resources. (There is a finite amount of ‘stuff’ out there.)
We will never not be rationing health care. Any other conclusion misunderstands the human condition.
Ghosts of Health Reform Past
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I have not blogged for several weeks, mainly because I have been making sense of the curious events that transpired over the Christmas holiday. If you a regular reader of my blog, you know that I have had some harsh things to say about health reform. To criticize a law that brings joy to so many people, it must make me seem like a scrooge. But I really thought that most of the legislation was humbug. And then, in the days leading up to Christmas, I had a series of strange dreams that changed everything. I must tell you about them.
In my first dream, I was visited by a shriveled up old man who seemed to have already passed through death’s door.
I shuddered to see him. “Who are you? What do you want with me?” There was no response. He came closer and closer. I tried to move away but I was paralyzed with fear. Suddenly, he reached out and took me by his cold, clammy hand. As he held me tight we seemed to fly through space and time. Just as suddenly I seemed to be back in the real world. Only I wasn’t in my bedroom; instead I found myself in a conference room in a dreary office building. There was one window and if you craned your neck you could just make out the U.S. Capitol. Everyone attending the meeting wore the same uniform – gray dress slacks and powder blue dress shirts. But what I noticed most of all about their attire was that they all had pocket protectors filled with mechanical pens and pencils.
Then it occurred to me that I recognized a lot of those in attendance. I had seen them at healthcare conferences talking about the latest government initiatives to hold down healthcare spending. And here they were, hard at work. I listened closely and could hear them going on and on about diagnostic codes and relative values, and making exceptions for this drug and that hospital. They talked for hour after hour; it was becoming so excruciatingly boring that I begged my guide to leave. I wanted to go home. He refused and insisted that I listen carefully, for there were lessons to be learned. “Who are you,” I asked my guide again. “Why am I here?”
Healthcare Insurance Future: Brokers, Consultants, Agents
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When people and companies buy healthcare insurance, they usually go through a broker, a consultant, or an agent.
Agents sell insurance from one company, brokers from many companies; both make a commission—a percentage of the premium. Consultants take a fee from the client to help them set up their insurance situation, then typically turn around and hand the business to a broker or agent to handle the actual sale.
As premiums have skyrocketed, that’s been good for brokers and agents, since they get a percentage of that. As health insurance offerings have gotten both more expensive and complex, that’s been good for consultants; employers increasingly feel that they need a professional helping them sort out their choices.
How will their situation change under the looming reform—not to mention the deep reorganization that healthcare is going through at the same time? It’s a “Good News/Bad News” story.
There are five key factors here:
1. Market expansion: It’s got to be a good thing when your market gets tax credits for buying your product—let alone when everyone has to buy what you’re selling or get fined, right?
2. Less risk: One reason why people go to professionals for their insurance is that the consequences of making a mistake about what’s covered, can you get covered, or will you get kicked out “rescinded,” can be huge. If everyone can get covered for everything and you can’t get kicked out of the plan, signing up for healthcare insurance is less risky—so buyers may feel less need to involve a broker or consultant.
Definition of HIE: What’s Yours?
By JOHN MOORE
Trying something new here – soliciting your collective input, the proverbial wisdom of the crowd.
As you may have read in yesterday’s post, Chilmark is quickly approaching publication of the Health Information Exchange (HIE) report. One of the last tasks is final editing/polishing of report. Am now in the process of creating a definition for HIE that clearly articulates what the primary purpose of an HIE is, but also keeping that definition loose enough to reflect what a market that is evolving so quickly that in five years time, there will not be an HIE market as we know it today.
So, with that in mind, here’s the HIE definition for the report.
Definition of an HIE:
A Health Information Exchange (HIE) is a technology network infrastructure whose primary purpose is to insure the secure, digital exchange of clinical information among all stakeholders that are engaged in the care of a patient to promote collaborative care models that improve the quality and value of care provided.
Does this make sense to you? Does this definition resonate with your own view of the market? Any and all comments welcomed, but please be quick to get them in as we are on a fast track to have this report done within the week.
John Moore is an IT Analyst at Chilmark Research, where this post was first published.
Definition of HIE: What’s Yours?
By JOHN MOORE
Trying something new here – soliciting your collective input, the proverbial wisdom of the crowd.
As you may have read in yesterday’s post, Chilmark is quickly approaching publication of the Health Information Exchange (HIE) report. One of the last tasks is final editing/polishing of report. Am now in the process of creating a definition for HIE that clearly articulates what the primary purpose of an HIE is, but also keeping that definition loose enough to reflect what a market that is evolving so quickly that in five years time, there will not be an HIE market as we know it today.
So, with that in mind, here’s the HIE definition for the report.
Definition of an HIE:
A Health Information Exchange (HIE) is a technology network infrastructure whose primary purpose is to insure the secure, digital exchange of clinical information among all stakeholders that are engaged in the care of a patient to promote collaborative care models that improve the quality and value of care provided.
Does this make sense to you? Does this definition resonate with your own view of the market? Any and all comments welcomed, but please be quick to get them in as we are on a fast track to have this report done within the week.
John Moore is an IT Analyst at Chilmark Research, where this post was first published.
Early Experiences with Hospital Certification
By JOHN HALAMKA, MD
As one of the pilot sites for CCHIT’s EHR Alternative Certification for Hospitals (EACH), I promised the industry an overview of my experience.
It’s going very well. Here’s what has happened thus far.
1. Recognizing that security and interoperability are some of the more challenging aspects of certification, we started with the CCHIT ONC-ATCB Certified Security Self Attestation Form to document all the details of the hashing and encryption we use to protect data in transit via the New England Healthcare Exchange Network.
Next, I had my staff prepare samples of all the interoperability messages we send to patients, providers, public health, and CMS. Specifically, we created
CCD v.2.5 used to fulfill the Discharge summary criterion
HL7 2.51 Reportable lab
HL7 2.51 Syndromic surveillance
HL7 2.51 Immunizations
PQRI XML 2009 for hospital quality measures
We validated them with the HL7 NIST test site
and the HITSP C32 version 2.5 NIST test site.
CCHIT validated the PQRI XML as conforming.Continue reading…
