In this part of the panel debate on the Role in a World of “Data Liberacion” founder of Chordoma Foundation Josh Sommer tells the story about how he was diagnosed with Chordoma and how he funded the Chordoma Foundation with his mother as a reaction to the lack of treatments available. Josh is working to help coordinate data sharing between different researchers.
Above the Fold
Interview: Blumenthal talks meaningful use
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Absolutely hot off the recorder, here’s my interview with David Blumenthal, the Obama administration’s National Coordinator for Health IT.
David and I discuss patient communication, why the percentages of certain criteria were reduced, and how to get the two Reginas on Oprah. Well, he didn’t have many ideas about that! …
Meaningful use, and cats & dogs
More than a year or so of squabbling is (sort of) over and today HHS announced its criteria for the first phase of meaningful use. Essentially the 25 criteria for qualifying for “meaningful use” (in other words who qualifies for the money) have been changed to 15 with a further 5 from a menu of 10. The details are here, and it looks like most of the percentages needed to qualify have been relaxed but not eliminated. The Dogs have clearly had a minor victory in that there are patient communication requirements in both the mandatory and optional criteria.
The most impressive part of the announcement (you can see it here) which included HHS Sec Sebelius, CMS head Berwick (not wearing his Che Guevara T Shirt) & ONC Director Blumenthal, was the two Reginas. First, Surgeon General Regina Benjamin explained how thrice her clinic was destroyed by nature, and how the second time she realized that while she had thought she couldn’t afford electronic records for her patients, she then realized that she couldn’t afford not to have them.
The other Regina was our friend Regina Holiday who made (to me) a surprise appearance and told the 73 Cents story in a heartfelt and powerful way. She’s really become the poster child for why access to health data matters to ordinary people, and we need to get her from the world of webinars, Health 2.0 Conferences and HHS announcements onto Oprah and the 6 O’Clock News right now.
And I’ll be suggesting that when I interview David Blumenthal in a little under 30 minutes.
And here's the 3mins audio of Regina Holiday at MU announcement
What Could Don Do?
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What is the important thing Don Berwick could do as head of CMS to improve quality and reduce the cost of health care? Let’s face it, as head of a humongous agency, it is hard to make changes. You have to pick your battles carefully, for every cause has a constituency and an opponent. Gridlock is a fact of life in Washington, DC: The system is designed for that result.
Let’s just say, though, that you had a chance to adopt one innovative regulation or proposal, one where even opponents would have little moral ground on which to get traction.
Here’s mine:
Announce that you are going to create a website in which each hospital is invited to input two or three real-time metrics with regard to reducing harm. Let’s start with central line infections. There is a common definition provided by the CDC. Many hospitals keep track of their rate of infection.
Provide a password-protected template and give each hospital CEO (yes,
CEO!) the opportunity to send in his or her hospital’s quarterly figure
for the world to see. Set up the web page so the accumulated sequence
of numbers is translated in a trend line, so anyone can watch a given
hospital’s progress over time.
Jamie Heywood Challenges Health 2.0
SUBTEXT: Jamie Heywood, Co-Founder and Chairman of PatientsLikeMe, spoke at the recent Health 2.0 DC conference. While on stage, Heywood issued a challenge to federal agencies to "change what we pay for."
Op Ed: Dr. No to Run CMS
By OHN GOODMAN, PhD
Let’s do a thought experiment. Suppose you were a U.S. Senator and the President’s nominee to head CMS appeared at his confirmation hearing:
- Wearing a Che Guevera t-shirt, sporting the image of a psychopath who apparently enjoyed killing people, or
- Fondly clutching a copy of Quotations from Chairman Mao, written by a man who presided over the genocidal murder of more people than any other person in the history of the world.
When I was at Columbia University, my fellow students did these sorts of things. I soon learned they were not evil. They simply could not think clearly about moral issues involving collectivism. I view Don Berwick in much the same way.
President Obama took advantage of a short Congressional recess to appoint him to run Medicare and Medicaid without even a hearing. Although the President blamed Republicans, even some Democrats were unhappy with his snubbing of normal Senate prerogatives — something Obama criticized George Bush for doing with the appointment of John Bolton as UN Ambassador.
Wellcare, yes there’s more even without(?) Regi
A few weeks back we welcomed John Goodman as a contributor at THCB. His first column was more than a tad critical of me for impugning the ethics of Harvard Business School Prof Regina Herzlinger. Herzlinger, you may recall made a boatload of money off her position on the board of directors of Wellcare. Wellcare was operating a Medicaid and Medicare HMO in Florida, while basically using that not-too-sacred trust as an excuse to defraud the taxpayer.
Due to the demands of reality cutting into my work-life, my blow-by-blow analysis of Wellcare’s bad behavior has waned a little, but here I instead commend to you the consistently great work of Roy Poses over at Health Care Renewal. Earlier this month Roy took a look at the latest chapter in the tawdry tale. I encourage you to read his article for the full tale, but essentially even despite the settling of the criminal and civil charges for theft of around $46m, there’s a brand new set of charges from the same period—this time theft is alleged of up to $600 million. This new set of allegations were collected by (FBI informant & Wellcare financial analyst) Sean Hellein who wore a wire for more than a year, and probably stands to make a packet in the qui tam suit.
And not that I’d further besmirch the reputation of Prof. Herzlinger, but the time period all this happened was while she was still on the board, and none of these were given as her expressed reasons for leaving. Then it struck me, is Regi in on the qui tam suit too? That would be the way to make serious money out of her insider knowledge.
PPACA: The Individual Mandate
The individual mandate is the single most controversial feature of the Patient Protection and Affordable Care Act. Everyone who can afford coverage—unless an undocumented immigrant or exempted on religious grounds—is required to have it or pay a penalty of $695 or 2.5 percent of income.
The rationale is straightforward: without a mandate, many people would wait until they needed care before buying insurance, driving up premiums for those with ongoing coverage, and potentially creating an “insurance death spiral” as the higher premiums lead to increasing numbers simply dropping their coverage. (This last part is basically what we have today, but will be magnified by PPACA’s ban on preexisting condition exclusions.)
The individual mandate was preferred for obvious reasons over the alternative of a general tax offset by credits for premiums paid. Democratic lawmakers had no wish to be blamed for imposition of a new tax—no matter how reasonable the arguments in its favor. In fact, as President Obama made clear in an ABC television interview “I absolutely reject that notion [that the penalty is a tax].”
The individual mandate has now become the centerpiece in Republicans’ legal fight against reform. Suits challenging PPACA have been filed by the attorneys general of twenty states (with the first, in Virginia, already being argued), with the constitutionality of the mandate a key issue in every case.
KP Innovation Workshop
At the Sidney R. Garfield Innovation Center, Kaiser Permanente's patients, doctors, nurses, architects and engineers use elements of human-centered design to improve and to innovate physical spaces, technologies and clinical operations in a unique, “movie-set”-style warehouse. Many of these innovations have been spread throughout Kaiser Permanente as well as to organizations nationally and internationally.
As a result, an inaugural workshop has been developed workshop to share the Kaiser Permanente methodology and some best practices. On August 3rd and 4th, a variety of health care providers, biotech and pharmaceutical companies, policy researchers, architects and more will get together in a hands-on session to explore and experience first-hand how Kaiser Permanente understands it’s users’ needs and ideate and prototype new processes, spaces and technologies. Participants will work in the same space where Kaiser Permanente employees and patients conduct deep-dives and collaborate on new idea generation.
Aneesh Chopra Gives Keynote Address
At the Health 2.0 Washington DC Conference Aneesh Chopra, Chief Technology Officer of the US Government, gave a keynote address on incorporating new capabilities into the nation’s healthcare system. One of the topics that he spoke to was the culture gap between consumers and government.
