The Health Care Blog – Page 899 – Everything you always wanted to know about the Health Care system. But were afraid to ask.

Above the Fold

Clinical Groupware: When Not-As-Good Is Actually Better

Jun 15, 2009• 34

By DAVID C. KIBBE

In a February 13, 2009 blog post I introduced the idea of Clinical Groupware as a low cost, modular, and cloud computing alternative to traditional electronic health record technology for physicians and medical practices. Central to the concept of Clinical Groupware is IT support for care coordination and continuity, achieved through shared access to personal care plans and point-of-care decision supports. In this post I’d like to put a few more ideas on the table, specifically with respect to the market niche that Clinical Groupware may ultimately fill, including comments by several individuals whose opinions or work may be crucial to the success of Clinical Groupware over the next 1-3 years. (Anything farther out than that is simply dreaming.) Consider this an interim report on an emerging story with an indefinite timeline.

Interest in this topic has been, of course, heightened by the recently passed federal AARA/HITECH, provisions of which will provide incentive payments to physicians of as much as $44,000 over a five year period commencing in 2011, provided that the physicians can demonstrate the “meaningful use” of “certified EHR technology.” It’s always more exciting when there’s real money in the mix. Will Clinical Groupware qualify as “certified EHR technology?” Many physicians and developers are hoping it will. Here’s why.Continue reading…

President Obama Addresses the AMA

Jun 15, 2009• 1

President Barack Obama spoke today at the American Medical Association’s (AMA) 158th annual meeting in Chicago on the need for health care reform.

View more news videos at: http://www.nbcchicago.com/video.

FDA Regulation of Tobacco Called ‘Death Sentence’

Jun 15, 2009• 1

By MERRILL GOOZNER

Legislation
headed for President Obama's desk that would give the Food and Drug
Administration regulatory authority over tobacco was called a "death
sentence" for agency morale by longtime FDA observer Jim Dickinson,
editor of FDA Webview (subscription required).

The impact of this bill internally will be like a death
sentence, steadily killing the agency's old public health spirit and
replacing it with a strange hybrid. This new ethos will have to blend
public health and safety with toleration for and husbandry of
death-dealing products that have no plausible relationship to the
diverse family of other products regulated by FDA.

Obama vs Hillary at the AMA

Jun 15, 2009• 16

By Michael L. Millenson

Sixteen years and two days after then-First Lady and Health Care Czar Hillary Clinton went before the American Medical Association’s House of Delegates to sell her vision of national reform, President Barack Obama is treading the same path. I’m not sure how much greater eventual success Obama will have with the AMA, but having covered the Clinton speech as a reporter for the Chicago Tribune, I have three lingering memories.

The first was the invocation given before Clinton arrived. Its gist was, “Oh, Lord, you have taught us it is impolite to boo our guests, particularly in front of hordes of reporters.” The second memory was that Clinton finished her speech to a standing ovation. And the third is that she spoke fluently and passionately for 50 minutes without a prepared text, much to the chagrin of a national press corps accustomed to being spoon-fed a follow-along text before filing their stories. Fortunately, being a mere “regional reporter” (as the White House called us), I had taken notes.

Obama’s visit promises at least a few contrasts. He runs virtually no risk of being booed. He’s not only the President of the United States, and a very popular one, he’s also a president who has eschewed the perceived doctor-bashing engaged in at times by President and Mrs. Clinton. Obama most assuredly will not be speaking from notes, being as attached to the teleprompter as Ronald Reagan was to his 3×5 cards, but in the Internet Age anyone who cares to will be able to hear him live, anyway. A standing ovation? We’ll have to see.

To the amazement of her audience in 1993, Hillary went out of her way to hit all their hot buttons. For example, she praised the doctor-patient relationship and lashed out at the “excessive oversight” of insurance company reviewers and government bureaucrats who second-guess medical decisions. She talked sympathetically of the need for reforming malpractice laws and amending antitrust laws to allow medical professional societies to discipline poor-quality doctors on their own. (Here, I’m relying on a copy of my story I grabbed from an electronic archive.)

Obama, by contrast, prides himself on seasoning the obligatory political pandering with a soupcon or two of hard, cold reality. While reducing red tape and the need for defensive medicine are sure to be high on his list of promises, I don’t think he’ll hesitate to invoke the harsh global economic challenges that make health care reform so urgent. Look for Obama to remind the doctors how many more uninsured patients they’re seeing today and how much more involved Medicare has become in setting doctor pay scales.

One more contrast: in 1993, the AMA shoved forward Nancy Dickey, the one woman on their nine-person executive committee, to be its public face during the Hillary visit. Today, the organization’s elected president is Nancy Nielsen, the second woman to head the group (Dickey went on to the top job) and, though not publicized, the first who came to the post after holding a senior position in one of those dread health plans.

The Right to Share

Jun 15, 2009• 8

By JAMIE HEYWOOD

Jamie-headshot-casual We do not live our lives alone. We live our lives in collaboration
with others. We communicate our needs and our goals, and together we
work to achieve them. This is exceptionally true for families and
individuals dealing with illness. Whether you’re dealing with
depression, or pain, or perhaps the fear and stigma of HIV, or the
impairment that comes from MS, Parkinson’s or ALS, what helps us the
most is when those around us reach out and share their support and
advice.

Interview with Hal Luft, author of Total Cure

Jun 15, 2009

By Matthew Holt

Hal Luft is a veteran policy analyst who's been looking at all aspects of the health care system. He's Professor Emeritus at UCSF and now is director of the Palo Alto Medical Foundation Research Institute.

His recent book Total Cure had a fabulous review from JD Kleinke in Health Affairs and essentially presents a combination of a universal insurance pool for chronic care and hospital care, and choice between independent physicians for routine primary care. It's a mix of universal care, and market solution. In this (long) interview I ask Hal about the idea, and he also goes on to explain how the central core of the idea–a public body that essentially re-routes payments to care delivery teams might well be part of the emerging legislation. Given that (as Robert Samuelson points out in the WaPo today), we haven't seen much of a mechanism for cost containment from the legislation proposed so far, yet all agree that we need one, Luft's ideas are becoming become influential rather quickly.

Video: Matthew went to Redmond, Part 3: Mike Raymer, Amalga

Jun 15, 2009

Continuing my series of interviews from my trip to Microsoft the week before last (before their conference) I met with Michael Raymer. Mike is a long time health IT veteran who’s been at Microsoft for about six months and is in charge of the Amalga product line. Amalga includes a standard HIT clinical product aimed mostly at the Asian market, and an enterprise integration product aimed at large hospital organizations in the US. What that means exactly, and how Amalga fits into the EMR ecosystem, Mike explains in this interview…

Technical note: If you’re having trouble with this video in IE, you may need to download the latest FlashPlayer version. Unfortunately 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!)

THCB alum going gone places

Jun 15, 2009

By Matthew Holt

Sarah Arnquist left THCB earlier this year to go work at a newspaper with a slightly higher journalistic profile and somewhat longer history. I'm very proud to tell you that below is a link to Sarah's first byline in The New York Times—even if it’s not typical THCB material!

In Some Swimming Pools, a Nasty Intestinal Parasite, by Sarah Arnquist

Quick Sunday roundup or “OMG I agree with Tyler Cowen”

Jun 14, 2009• 2

By Matthew Holt

I can’t say that I often agree with libertarian Tyler Cowen and I think it’s pretty appalling that the New York Times gives someone with such, as Republicans used to say, “out of the mainstream” views a regular place to air them. Like this column saying that our health care system is better than those of other nations because we’ve got more Nobel prizes for example.

But today in his column Cowen basically says the we should pay for the expansion to the uninsured through reallocating current government spending (mostly on Medicare).

The House Tri-Committee Bill—The Playing Field Just Moved Back to the Middle

Jun 14, 2009• 10

By ROBERT LASZEWSKI

Just when people were getting ready to write-off the Baucus bipartisan approach to a health bill the debate has swung back to the middle on a number of critical issues.