The Health Care Blog – Page 814 – Everything you always wanted to know about the Health Care system. But were afraid to ask.

Above the Fold

Patient Communities… at Walgreens?

Jun 18, 2010• 2

By Susannah Fox

In
May, I spoke at the Chronic Care and Prevention Congress about my most
recent report, “Chronic Disease and the Internet.”

I talked
about the social life of health information and the internet’s power to
connect people with information and with each other. Living with
chronic disease is associated with being offline – no surprise. What’s
amazing and new is our finding that if someone can get access to the
internet, chronic disease is associated with a higher likelihood to not
only gather health information but to share it, to socialize around it.

I built
my talk around two examples of how health care can either take advantage
of patients’ shared wisdom (and innovate) or ignore it (and fail).

My
innovation example was CureTogether’s crowd-sourced migraine findings: 147 treatments were evaluated
and ranked according to their effectiveness and popularity, with some
surprising results. My fail example was taken from Diana Forsythe’s
classic essay, “New Wine, Old Bottles.” Designers of a migraine
information resource asked a single doctor what he thought patients
should know, rather than going directly to the patients. Not
surprisingly, the number one question asked by newly diagnosed migraine
sufferers was not addressed: Am I
going to die from this? Ridiculous to a doctor, but
essential to a patient.

Care, Primarily

Jun 17, 2010• 18

By ROB LAMBERTS, MD

He came in for his regular blood pressure and cholesterol check. On the review of systems sheet he circled “depression.”

“I see you circled depression,” I said after dealing with his routine problems. ”What’s up?”

“I don’t think I am actually clinically depressed, but I’ve just been finding it harder to get going recently,” he responded. ”I can force myself to do things, but I’ve never have had to force myself.”

“I noticed that you retired recently. Do you think that has something to do with your depression?” I asked.

“I’m not really sure. I don’t feel like it makes me depressed. I was definitely happy to stop going to work.”

I have taken care of him for many years, and know him to be a solid guy. “I have seen this a lot in men who retire. They think it’s going to be good to rest, and it is for the first few months. But after a while, the novelty wears off and they feel directionless. They don’t want to spend the rest of their lives entertaining themselves or completing the ‘honey do’ list, but they don’t want to go back to work either.”

He looked up and me, “Yeah, I guess that sounds like me.”

“What I have seen work in people, especially men, in your situation is to get involved in something that is focused on other people. Volunteer work at the food pantry, work for Habitat for Humanity, or anything else that lets you help other people. I think the reason people get depressed is that they turn their focus completely on themselves, which is not what they are used to when they are working.” (I knew that this man had a job that helped disadvantaged people).

“That’s great advice, doc.” he said, with a brighter expression on his face.

“It’s from experience,” I responded. ”I’ve seen a lot of retirees start to feel like they are on a hamster wheel, just entertaining themselves until they die. I know I wouldn’t want to retire that way. Knowing you, I wouldn’t imagine you would either.”

We talked for about 15 minutes about the various groups around town that would need someone of his skills. I told him about how my parents went to Africa for a year after Dad retired. He actually taught physics over there, but that is what they needed. Of all the time I spent with him, over half of it was regarding his post-retirement “blues.” He wasn’t clinically depressed, so I couldn’t charge for depression as a diagnosis. The code I used? 99214 for Hypertension and Hyperlipidemia.

Healthcare Reform, Payment Models & Acquisitions

Jun 17, 2010• 5

By JOHN MOORE, CHILIMARK RESEARCH

Earlier this week, GE announced the release of Centricity Advance, their solution for the ambulatory market. Centricity Advance is basically a build-out/rebranding of MedPlexus an SaaS EHR solution vendor that GE acquired in March 2010. GE now joins others (see below) in the EHR market who are striving to provide a complete acute to ambulatory EHR portfolio.

Editor’s note: See also THCB founder Matthew Holt’s podcast interview this week with GE VP Mike Barber for more context on this story.

Recent weeks have seen a number of intriguing developments in this space, including:

AllScripts’ acquisition last week of Eclipsys.

NextGen, a traditional ambulatory EHR vendor whose parent, Quality Systems Inc. acquired Sphere Health Systems and Opus Healthcare Solutions to target rural acute care facilities.

While some may argue that the HITECH Act and meaningful use requirements are core drivers for these acquisitions (e.g. tap future incentives payments in new markets), the real reason is the need for large healthcare organizations to more closely align smaller affiliated practices to their operations in anticipation of healthcare/payment reform (bundled payments, patient-centered medical home, etc.). These large institutions are increasingly seeking out such fully integrated acute to ambulatory solutions and is one of the core reasons that EPIC (they started in ambulatory and grew organically into acute) has seen success in the market. It remains to be seen if those pursuing an acquisition strategy will be as successful as EPIC for it often takes years for two systems to be combined in a truly integrated fashion.

Op-Ed: Defending Regi

Jun 17, 2010• 32

By JOHN GOODMAN, PhD

Matt you can’t have it both ways.

First you attack a well-known Harvard professor, Regina Herzlinger, for accepting an invitation to become a director at a company that only later was publicly accused of accounting problems. Then you denigrate her when she goes public with her attempts to get the board to move more aggressively to tackle those problems and ruffles the feathers of several board members who retaliate. You then insinuate that she profited while shareholders suffered and yet you dismiss it as sour grapes when she resigns before her term ends (costing her a significant sum of money in the process).

And while we’re at it, how can a site with the name “The Health Care Blog” routinely ignore the ideas of one of the most creative thinkers in health policy? This field is so completely dominated by unoriginal thinking; I don’t know why you don’t welcome with open arms someone who is not just parroting the latest fad.

And speaking of character, we have just been through a period when an embarrassingly large number of leading health policy analysts sold their souls, their self-respect, their reputations and whatever is left of their intellectual honesty to the highest bidders in what we loosely call “health care reform.” In the midst of all that, I would think that someone also has shown the unimpeachable rectitude and character Professor Herzlinger has is deserving of a THCB award.

John C. Goodman, PhD, is president and CEO of the National Center for Policy Analysis. He is also the Kellye Wright Fellow in health care. The mission of the Wright Fellowship is to promote a more patient-centered, consumer-driven health care system. Dr. Goodman’s Health Policy Blog is considered among the top conservative health care blogs on the internet where pro-free enterprise, private sector solutions to health care problems are discussed by top health policy experts from all sides of the political spectrum.

Monsters Inside of Me

Jun 16, 2010• 6

By MICHAEL TURPIN

Why do they lock gas station bathrooms? Are they afraid someone will clean them?” Anonymous

Growing up in the era of “Walk It Off” parenting, I was never
allowed to get too in touch with my hypochondria. Occasionally, I might
get my hands on a National Geographic magazine that would feature
Amazon explorers, tribes that had never been touched by the outside
world or an expedition into the heart of darkest Africa. To properly
frame the perilous nature of uncharted corners of the world, the
articles would relate the hazards associated with indigenous people,
nasty flora, unpredictable fauna and myriad microscopic predators that
could all kill a man – often in bizarre and horrific ways.

I did not just want to know about the 1000 ways in which I could die
– – I wanted to witness them. The fact that most of these diseases,
parasites and insidious bacteria were transmitted through unclean
drinking water, monkey bites, and unnatural encounters in dark,
forbidden places did not matter to me. I was certain these germs were
lingering everywhere.

Learn from Your Competitors’ Mistakes

Jun 16, 2010• 1

By MERRILL GOOZNER

The Wall Street Journal (subscription required) reported last week on a Food and Drug Administration-supported effort to encourage companies to share data about their failed Alzheimer's Disease drugs.

Comment: We need more of this unmarket-like behavior. Consumer advocates have long pushed for companies to reveal the data from clinical trials for drug candidates that failed. Their concern is safety. They hope that data from failed "me-too" drug experiments might provide early clues signaling an entire class of drugs may have rare but deadly side effects.

But industry would also profit by sharing knowledge about its failed experiments. Knowing where one company fails would allow other companies to avoid going down the same unfruitful path. As things now stand, secretive companies reproduce each other's errors, which only adds to the declining productivity of industry R&D. It's also more ethical, since enrolling patients in a clinical trial that is testing a hypothesis that has already failed (but the results were kept secret) subjects them to risks with no hope of benefit.

Of course, when it comes to Alzheimer's, failure is the norm. As usual, Ray Woosley of the Critical Path Institute, who was once touted as a possible leader for the FDA but is now encouraging industry-FDA collaboration, hit the nail on the head. "We really believe drugs are failing because we honestly don't understand the disease," he told the Journal.

What exactly is Healthymagination?

Jun 16, 2010• 5

By Matthew Holt

About a year ago GE started a campaign called Healthymagination. In the health care technology business GE had long been known for market leadership in big iron imaging like MRIs and CTs, as well as some diagnostics, and for a less prominent position in the growing market for health IT for doctors and hospitals (via some acquisitions, notably of IDX).

So then our TVs became flooded with adverts telling us this new buzzword. Some cynics scoffed, pointing out that GE’s advertising during the Olympics on NBC (its own property) was covering up for the global advertising shortfall. But Mike Barber the GE Vice President in charge of Healthymagination begs to differ!

He explained to me what Healthymagination is about and how it’s part of a real sea change in the health and health care strategy of one of the world’s biggest companies

Interview with Mike Barber, GE Healthymagination

EMR Ratings: How Relevant Is CCHIT Certification In the HITECH Era?

Jun 16, 2010• 18

By CHRIS THORMAN

For nearly four years, the Certification Commission for Health Information Technology (CCHIT) has been the lone entity recognized by the federal government to certify electronic health record systems. Since being named a recognized certifying body by Health and Human Services (HHS) in 2006, CCHIT has awarded certifications to nearly 200 EHR software products based on CCHIT’s standards of functionality, interoperability, usability and security.

However, CCHIT’s role in the EHR market is changing. The Office of the National Coordinator of Health IT (ONC) and the Center for Medicare & Medicaid Services (CMS) announced in early March 2010 that they would name more than one organization to certify EHR software, countering previous claims that CCHIT would become the sole certifying body. The certification requirements are in accordance with 2009’s Health Information Technology for Economic and Clinical Health (HITECH) Act.

As this news swirled around, one doctor called Software Advice and asked: “Is CCHIT dead?”

Dead? No. But it appears that the organization’s influence is waning.

Diabetes Mine Design Challenge winners

Jun 15, 2010• 3

By Matthew Holt

Our friend Amy Tenderich does a wonderful job every year with her ever-growing Diabetes Mine Design challenge. We’re late to the party (it was announced last week) but here are the winners!

WIHI On Imaging Practices

Jun 15, 2010• 2

By PAUL LEVY

Here's a notice about an upcoming WIHI program.

The Image of Better (Radiation) Imaging Practices

Thursday, June 17, 2010, 2:00 PM – 3:00 PM Eastern Time

Guests:
James R. Duncan, MD, PhD, Associate Professor of Radiology and Surgery, Washington University School of Medicine, St. Louis, Missouri.

Richard T. Griffey, MD, MPH, Associate Chief for Quality and Safety, Emergency Medicine, Washington University School of Medicine, St. Louis, Missouri.

Imagine an electronic card that has all your vital medical information on it. Not too farfetched. Now, imagine that this same “smart card” also contains your radiation exposure history. Who needs to know, you ask? Well, a growing number of global patient safety experts believe this is precisely the type of information patients and medical providers should be tracking to help prevent unnecessary CT scans and the like, especially as evidence mounts that all these tests begin to add up in ways that that can endanger people’s health. Cancer is being studied the most, which is of course ironic since powerful and advanced radiation imaging is what also helps diagnose cancerous tumors at their earliest and most treatable stages.