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Above the Fold

Three Wishes

Aug 19, 2010• 33

By ROB LAMBERTS, MD

So I was walking down the hallway in my office, mildly distracted,
when I kicked something. It was a USB “thumb drive.” I picked it up
and inspected it, trying to figure out who had dropped it. The side of
the drive had a picture that I couldn’t make out, as it was all smudged
with something. I pulled out a tissue and rubbed it, thinking it may be
a clue as to whose drive it was.

There was a sudden rushing sound and a strong wind. Out of the thumb drive emerged a large blue figure wearing a turban.

“Are you a genie?” I asked

“No, I am David Blumenthal, the health IT ‘czar.’” he responded.

I hung my head down, “I guess this is about the fact that I write the word healthcare instead of health care. I was wondering how long it would be before the feds came down on me for that.

“No, that’s not my realm. That would be the job of the Department of
Language Security, and they’ll be appearing in some creative way next
week to get on your case about the whole healthcare thing. It has Matthew Holt and Maggie Mahar in a big tiff.”

Announcement: eHealth Initiative Posts New Positions Experienced Applicants Encouraged to Apply

Aug 19, 2010

The eHealth Initiative (eHI) is growing! We encourage you to take a look at our new job openings and spread the news amongst your colleagues and friends. eHI is a Washington, D.C.-based independent, non-profit organization dedicated to improving the quality, safety and efficiency of healthcare through information technology.

Director of New Business Development
Senior Level Director of Programs
Manager Public Policy

As with all positions at the eHealth Initiative, applicants must have the ability to work in a fast-paced, entrepreneurial environment. The eHealth Initiative offers an excellent employer paid benefits package (health care, 401K, generous vacation time, flex time) and is an equal opportunity employer.

To view job descriptions or find out more go to http://www.ehealthinitiative.org/careers.html

Don Casey, CEO, West Wireless Health Institute on the Health 2.0 Developer Challenge

Aug 19, 2010• 2

We spoke with Don Casey, CEO, West Wireless Health Institute about the institute's commitment to cost effective solutions in health using wireless technology. But it's about more than just new sensors and devices. Don discusses the importance of mechanisms that will connect data from devices to social networking platforms so that the wireless revolution can be truly accelerated and applications built on top of social networking platforms can offer richer experiences. Listen as he describes their rationale for the Accelerating Wireless Health Adoption through a Standardized Social Network Platform and what's in it for the winner.

Interview with Don Casey, West Wireless Health Institute

Short answer, it's the Health 2.0 Developer Challenge's biggest prize to date, 10K! And a chance to showcase the solution at the Health 2.0 Conference this Fall.

If Reform Fails

Aug 19, 2010• 35

By MAGGIE MAHAR

If conservatives manage to kill health care reform legislation, what will happen next?

I really don’t want to go there.

First, I’m convinced that conservatives won’t be able to repeal the Affordable Care Act (ACA). Democrats will hold onto the Senate, and President Obama still has a veto. If necessary, he will use it to protect the bill. Meanwhile, the majority of the public either favors the legislation or want to “wait and see” how well it works. Most voters would be utterly disgusted if Congress returns to the health care debate this fall. It was ugly the first time around; virtually no one wants to watch re-runs on C-Span. In the months ahead, Americans hope that their elected representatives will do just three things: create jobs, create jobs, and create jobs.

Secondly, if conservatives somehow succeed in crippling the reform bill, we will find ourselves back in a world of laissez-faire health care where medical spending continues to spiral by 4.5% to 9% a year (just as it has for the past ten years), thanks to a combination of climbing prices and rising utilization.

Here, I’m not talking about how much insurance premiums rose: reimbursements that private insurers, Medicare and Medicaid paid out to hospitals, doctors and patients over the past ten years have been climbing by 4.5% to over 9% annually.

In some years, Medicare reimbursements were growing faster; in other years, payouts by private insurers levitated. Over the same span, Kaiser reports that premiums for a family plan rose by an average of 13.1% a year.

Job Post: THCB Editorial

Aug 19, 2010

THCB is looking for talented interns to
assist with editorial, research and web production tasks as our web
site undergoes a major expansion. Perfect for a grad or med student
with an interest in journalism, public policy, and/or the business of
health care. Work out of a great home
office location in the Princeton area or remotely, convenient to both Princeton
University and UMDNJ. Reasonable train ride from midtown Manhattan. Production and research
opportunities may also be available in our San Francisco offices for
qualified candidates.

How to save $40 billion in health care costs

Aug 18, 2010• 39

By JANE SARASOHN-KAHN

Electronic health records (EHRs) broaden access to patient data and provide the platform for pushing evidence-based decision support to clinicians at the point-of-care. This promotes optimal care for patients, reduces medical errors, optimizes the use of labor, reduces duplication of tests, and by the way, improves patient outcomes. When done in aggregate across all health providers, a team from McKinsey estimates that $40 billion of costs could be saved in the U.S. health system.

Reforming hospitals with IT investment in the McKinsey Quarterly talks about the American Reinvestment and Recovery Act’s (ARRA) $20+ billion worth of stimulus funding under the HITECH Act and estimates that 80% of existing hospital IT applications will be affected by the regulation. Hospitals will be spending about $120 billion to meet the adoption and meaningful use provisions of the Act. This equates to $80,000 to $100,000 per hospital bed. ARRA incentive payments will cover roughly 20% of this cash outlay, meaning that $60-80K won’t to covered.

But McKinsey says, “Hold on!” There are ways to recoup the spending gap between HITECH incentives and cash-out-of-the-hospitals-budget. McKinsey’s research calculates that optimizing labor, reducing adverse drug events and duplicate tests, and adopting revenue cycle management can help the average hospital save $25,000 to $44,000 per bed each year. That gets to the $40 billion in annual savings when multiplied across all hospital beds in the U.S.Continue reading…

Aneesh Chopra talking Health IT and innovation, SF 12 noon today

Aug 18, 2010• 1

By Matthew Holt

Today at 12 noon PST Aneesh Chopra, Federal CTO will be at the Commonwealth Club in San Francisco talking about health care and health care IT. Indu and I saw him last night talking about technology before a big crowd at the Silicon Valley Computer History Museum.

In today’s talk he’s going to be focused exclusively on health care, which means he won’t have to dodge the question on Net Neutrality that he got last night. And even better, if you don’t have a ticket yet you can get one free thanks to the California Health Care Foundation,

I’ve seen Aneesh talk several times. Last night was particularly good in that he really responded well in the Q&A session. Plus he gave several shout-outs to the Health 2.0 Developer Challenge even if he made Indu embarrassed,

So if you care at all about health care and IT, you should come to the Commonwealth Club in downtown San Francisco today. And as an added bonus the entire health 2.0 team down to the Norwegian interns will be there – except for Lizzie who is up at the Health 2.0 NorthWest Chapter Kick off meeting.

One Day in the Life of a Meaningful User

Aug 17, 2010• 58

By MARGALIT GUR-ARIE

All the laws have been passed and all the final rulings have been published. In the spirit of the times, you went out and got yourself an EHR. You did your due diligence and sat through many hours of vendor demonstrations. In the end they all started to blend together, so you talked to friends and colleagues and accepted the Hospital’s offer to pay a big chunk of your EHR costs if you picked the one they wanted you to pick.

Your biller quit in disgust, but other than that the implementation was uneventful and the Hospital folks helped a lot. After several hiccups, your Medicare payments are coming in regularly now and your office is adjusting well to the new software. The documentation templates leave a lot to be desired, but you type well and when you find some free time you may take a stab at customizing them a bit. Here and there you run into bugs and a couple of times the EHR was unavailable for a good two to three hours. Not sure exactly why. Maybe it was the Internet that was unavailable.

Anyway, if all goes according to plan, you will be retiring in 10 years and your much younger partner will be bringing in someone who is probably in Medical School right now. Everything seems under control. But today is different…

Today is January 2nd, 2011 and you are driving to work. Today has to be meaningfully different and your first patient is waiting in Exam Room 1.Continue reading…

The Other Medicare Report

Aug 17, 2010• 22

By JOHN GOODMAN, PhD

The release of this year’s Medicare Trustees report was unprecedented. As noted in previous posts here and at my blog here and here, Medicare’s chief actuary not only refused to sign off on it, he disowned it — encouraging readers to ignore it and focus instead on an alternative report, prepared by the office of the Medicare actuaries.

So what’s the difference in the two reports? It all relates to the health reform bill that passed last spring. The formal trustees report shows health reform dramatically reducing future Medicare spending. In fact, it is so dramatic that even the White House seems reluctant to talk about it — perhaps because it’s prima facie unbelievable.

Consider this: In 2009, the trustees reported that (looking indefinitely into the future) Medicare had an unfunded liability of $89 trillion. This year, the trustees report that number has fallen by more than half to $36.6 trillion. If the numbers are to be believed, health reform has already saved us $53 trillion — a sum more than three times greater than our entire gross domestic product!

RWJF’s Stephen Downs on a New Model for the Foundation – and the Health 2.0 Developer Challenge

Aug 17, 2010

Last week, we sat down with Steve Downs, Assistant Vice President, Health Group, Robert Wood Johnson Foundation to discuss the 3 New Challenges they’ve announced for the Health 2.0 Developer Challenge. Steve explains RWJF’s current areas of focus in health and how they are testing the Developer Challenge as a novel process to source and spur innovation.

Interview with Steve Downs, RWJF

From building real apps based on the Project Health Design PHR prototypes (in partnership with CHCF) to using County Health Rankings to build interactive tools for decision-making (in partnership with U. of Wisconsin) to working with the Markle Foundation and VA/CMS on the Blue Button initiative, RWJF has given the Health 2.0 innovator community lots of raw material and inspiration to work with.

And within just a couple of days, 5 Teams have already signed up to compete. For more on RWJF’sChallenges and to get involved with the Health 2.0 Developer Challenge, go to www.health2challenge.org.