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Interview with IPC The Hospitalist Company’s Adam Singer

I don't delve into the world of hospitals, physicians and health care operations as much as I should. So when I was asked to interview Adam Singer, the CEO of IPC The Hospitalist Company, the biggest company (and a publicly traded one at that) managing a group of hospitalists–the internists who run patient care in more and more big and small facilities, I thought I should!

What I didn't realize is that not only does Adam know lots about the present and future of hospitalists and how that role has emerged in recent years, he also has some pretty strong views on the relationship between hospitals and doctors (keep 'em separate), bundling (no, thanks) and also the supply of physicians (let in more international docs or we're in a big hole). So it's a wide ranging discussion and one I think you'll enjoy. Here it is.

The Health Industry’s Achilles Heel

“You never want a serious
crisis to go to waste.”

– Rahm Emanuel, White House Chief of Staff

ALP_H_BK_0010 Timing matters. The health industry has demonstrated steadfast
resistance to reforms, but its recently diminished fortunes offer the Obama
Administration an unprecedented opportunity to achieve meaningful change. The
stakes are high, though. The Administration’s health team must not miscalculate
the industry’s goals, or waver from goals that are in the nation’s interest.
The two are very different.

Aligning the forces of reform will be the first challenge. The White House and Congressional Democrats appear to be
collaborating
to develop a unified reform design. Even so,
the effort is hardly pure. Lawmakers have been receptive to industry influence.
The non-partisan Center for Responsive Politics
reports that, in 2009, health care interests have already spent $128 million on
Congressional lobbying contributions, more than any other sector
.
The tide now turned, most of that largess has gone to Democrats.

Continue reading…

Canadians? Not as good as us!

Several of my friends in the blogosphere are getting very excited because eHealth Ontario has pissed away a few million dollars and the now fired CEO got more bonus than was seemly. So she gave Accenture and Price Waterhouse Coopers low 7 figure no-bid contracts and it’s now transpired that consultants billed food and random travel for expenses. MrH at HISTalk gives it two separate mentions in his section of the news and Inga piles in as well.

But I must remind you that as in all things Canadians pale in comparison to how we do it here.Continue reading…

Matthew went to Redmond, 2–Bert van Hoof, HealthVault & devices

Continuing my tour around Microsoft’s HealthVault team I met with Bert van Hoof. Bert is the devices guy who showed me lots of ways to get data into HealthVault. If you’re interested in how a power user links devices and data (and if you excuse my amateurish video work), you’ll like this one!

If you’re having trouble with this video in IE, you may need to download the latest FlashPlayer version. (Sorry, our video service Vimeo is having some problems that appear to need the latest version of FlashPlayer. You can do that here. Alternatively Firefox seems to work fin (but don’t let the folks at Microsoft know that I told you that!)

Matthew went to Redmond, part 1– Bill Reid, Healthvault

Last week I went to a search summit in Seattle where Microsoft told us all about Bing, their latest attempt to do something about Google’s Windows-like market share in search. After a quick chat with Health search guru Alain Rappaport,  I ducked out early to go meet with the healthcare team in Redmond—focusing mostly on HealthVault.

Here’s the first of four interviews that THCB will be showing over the next four days. This is Bill Reid, who’s the Director of Product Management for HealthVault. (Excuse the shaky handheld!). Bill gives the latest view from Healthvault about how the roll out is going and what we can expect.

Gawande Nails It on Healthcare Costs

Wachter pic (informal)I just finished reading Atul Gawande’s June 1st New Yorker piece – it’s the Talk of the Health Policy Town – on healthcare’s “Cost Conundrum.” Like most of Atul’s work, the article is lyrical, powerful, insightful, and correct.

As you’ve probably heard, Gawande profiles the town of McAllen, Texas, whose healthcare costs are nearly double the national average. He swats away the usual explanations (our patients are sicker, more obese, more addicted, more Mexican; our lawyers are nastier; our quality is better…) to unblinkingly zoom in on the real culprit: a culture in which providers’ greed trumps the patients’ interests. He contrasts McAllen’s healthcare culture with that of El Paso, just 800 miles up the border, a town with similar demographics but whose healthcare costs are exactly half as high. He also describes the Mayo Clinic, which manages to deliver the best healthcare in the country, perhaps the world, at a fraction of McAllen’s costs.

His main point is that policymakers need to focus less on who pays (i.e., should there be a “public plan”?) and more on creating physician-led accountable entities that manage the dollars and possess the wherewithal and incentives to make rational choices about how to organize care – the ratio of primary care docs to specialists, the number of MRI scanners, the algorithm for the workup of chest pain or gallstones. Atul understands that we can’t snap our fingers and change culture, but that culture will change when structure and incentives are lined up correctly.Continue reading…

Commentology: The President’s Letter to Kennedy and Baucus

THE WHITE HOUSE Office of the Press SecretaryFor Immediate ReleaseJune 3, 2009

Dear Senator Kennedy and Senator Baucus:

The meeting that we held today was very productive and I want to commend you for your leadership — and the hard work your Committees are doing on health care reform, one of the most urgent and important challenges confronting us as a Nation.

In 2009, health care reform is not a luxury. It's a necessity we cannot defer. Soaring health care costs make our current course unsustainable. It is unsustainable for our families, whose spiraling premiums and out-of-pocket expenses are pushing them into bankruptcy and forcing them to go without the checkups and prescriptions they need. It is unsustainable for businesses, forcing more and more of them to choose between keeping their doors open or covering their workers. And the ever-increasing cost of Medicare and Medicaid are among the main drivers of enormous budget deficits that are threatening our economic future.

Continue reading…

Alex Drane — Engage with Grace

Alex Drane is at AHIP in San Diego and she’s talking not about Eliza, or health plans, but is talking about Engage with Grace. It’s a wonderful interview, although Alex knows that associating end of life care with reducing costs makes me very nervous. BUT the point is, talk about it, give people the tools to make the choice. And people’s choices will as she says dovetail in general with less rather than more care at the end-of-life. And if they want more rather than less, that’s fine—so long as it’s a purposeful decision.

Listen to Alex describe the movement, and what the topic’s meant to her family. And then visit the web site at Engagewithgrace.org.

Click here to watch the interview.

Launch! LiveStrong.com Calorie Tracker

LiveStrong is the second in our series of companies that presented at Launch! at the Health 2.0 Meets Ix conference in Boston in April. With the help of the Lance Armstrong Foundation, LiveStrong.com has created a way of setting goals and tracking calories on the go. And yes it’s new (which is the point of Launch!). Watch the short video below to get an idea and investigate further over at LiveStrong.com

HIT Adoption – Alignment & Simplification

Bio_Hartzband

David Hartzband is a Lecturer in Engineering
Systems at MIT, teaching courses in large-scale software systems and Director of Technology Research at the RCHN Community
Health Foundation. In his role at the Foundation, Dr. Hartzband spearheads the
organization’s continued evaluation, assessment and findings
dissemination related to health information technology.

As
if we didn't know already, most of the leadership of Health and Human
Services has now weighed in on the importance of health information
technology (HIT) in realizing goals for health care improvement and
reform. HHS Secretary Kathleen Sebelius said in a House Ways and means
Committee hearing on May 6th that “health IT is critical
to health reform”. To her credit, she also said that “just shifting
our paperwork to computers won't work, unless we make sure they can
talk to each other.” We also know that substantial amounts of money
will be available through the ARRA and other sources for acquisition
of electronic heath care records systems (EHR) as well as incentives
to Medicare and Medicaid providers for meaningful use of such systems.
Those of us who have worked in HIT, for even short amounts of time,
realize that there is a step missing in this progression: acquisition,—–,
meaningful use. That missing step is the adoption of technology, and
adoption is considerably more difficult than either of these other steps.

Continue reading…

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