The Health Care Blog – Page 921 – Everything you always wanted to know about the Health Care system. But were afraid to ask.

Above the Fold

The Role Speech Technology Can Play in Helping to Streamline the EHR Transition

Mar 10, 2009• 14

By Keith Belton

Early adopters – the approximately 15 percent of
doctors who use an electronic health record (EHR) system successfully –
are hitting a major speed bump ahead of their peers: EHRs can slow physicians
down.

Too much emphasis is being placed on EHR
deployment and not enough on utilization. In the rush to
computerize patient information, per Obama’s five-year goal that all
medical records go digital, it has been assumed that once EHRs are widely
deployed, patient records will automatically be more complete and shareable, administrative
costs will be cut and that universal quality of care will be enhanced. First,
we have to get doctors to meaningfully use the system…

In a study conducted by Fallon Clinic comparing EHR
technology used as is vs. with speech recognition technology (replacing traditional
transcription and keyboard-only control of the EHR), not only did speech
recognition prove to help doctors capture the patient encounter in more detail;
it helped to save $5,000 per doctor per year in transcription costs and generated
additional reimbursement per encounter.

Better Records On Our Cars Than Ourselves?

Mar 9, 2009• 20

By DOUG KLINGER

Did you ever stop to think that many people probably have better service records for their cars than for
their bodies and minds ?

Having spent many years involved with the collection and management of health data to facilitate predictive modeling, early intervention and disease management, it became clear that doctors, hospitals and insurers typically have far more information about our health than we do.

Maybe the time has come for the US healthcare establishment to follow President Obama’s lead and turn its collective attention to rapidly enabling the collection, storage and private and secure exchange of personal health information in a standardized, cost-effective and efficient manner.

Innovation + Economics: Keys to Successful Healthcare Reform

Mar 9, 2009• 56

By Dr. Albert Waxman

Now that the economic stimulus package has been negotiated and signed, healthcare is on deck. Not just for Congressional action, but also for the biggest wave of reform the industry has ever experienced. It *could* be a very good thing – not only for patients, providers and payers, but also for innovators and investors who contribute to the “new healthcare economy” that will emerge.

Everyone knows “change” will have to find its way into the hospitals, clinics, labs, doctor’s offices and insurance providers that make up our current healthcare “system” in America. The rate of healthcare inflation – which is currently twice the core inflation rate – can clearly no longer be supported, and changes are required to address the explosion in America’s aging population over the next two decades. Experts estimate that roughly one third of all medical care delivered in the United States is wasted or in error, suggesting there is ample room for improvement.

In spite of the bleak near-term indicators, we predict that the United States is poised to establish a new healthcare economy. Starting in 2009, we expect to see a ten-year transformational cycle that will re-define many dynamics of the American healthcare system. The new healthcare economy will depend on innovation to simultaneously drive down costs and improve quality of care – core criteria cited by President Obama in his inaugural address. It will also require better alignment of economic incentives across payers, providers and patients.

A Broker’s Lament: We Brought This On Ourselves

Mar 7, 2009• 63

By JOHN SINIBALDI

A huge segment of the American population is simply far too strapped to ever afford the premiums and costs associated with health insurance/health care as it is structured today.

It isn't the employees of government (local, county, state or federal) who will demand immediate change. It isn't the employees of institutional companies (the Motorolas, GEs, Microsofts of the country) who will demand change. It isn't those on Medicare or Medicaid or the VA who will demand change. It isn't the wealthy. It isn't the poor. And, it isn't the vast majority of health insurance agents who work with large group clients (because, while that market is becoming ever more difficult and the work more taxing, they're still selling SOMETHING to these bigger businesses and government entities).

Why don't these people see what I'm seeing? Simply because, while they are feeling the effects of the rise in health care/health insurance costs and the downturn in the economy, most of these businesses and their employees and dependents (and the affluent) have yet to have a clue about how expensive things really are (or in the case of the rich, they can still afford their out-of-pocket expenses). The agents who market to large employers are still making lots of money (I know, I rub elbows with them at my local Health Underwriters meetings once a month).

Online care….from Hawaii to Wall Street (journal only so far!)

Mar 7, 2009• 2

By Matthew Holt

Chris Lawton has an article in Thursday’s Wall Street Journal called (wait for it) Cough, Cough. Is There a
Doctor in the Mouse?

It’s a good general run down of American Well, TelaDoc & SwiftMD, which are the leaders in synchronous web-based care. Of course there’s also lots of asynchronous care going on online. In particular Kaiser Permanente has shown a huge amount of online communication between its clinicians and members, and RelayHealth has a similar service in which several health plans are paying doctors to communicate online with patients.

And this is all starting to come together and have an impact. The Health 2.0 Hawaii chapter will be having a meeting about this very topic on March 26.

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Calendar: Fourth National Pay For Performance Summit

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sponsored by Bridges to Excellence, Leapfrog Group, the National
Business Coalition on Health, the National Committee of Quality
Assurance and the National Quality Forum. March 9 – 11, 2009 San
Francisco, CA. .www.PFPSummit.com

Classified: Fair Managed Care

What's fair in managed care? Get involved. Join the conversation. FAIR
is an emerging national grassroots movement focused on changing the
debate about health care costs and holding managed care companies
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physicians, business owners and policy makers, FAIR brings a unified
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reform.

Five Recommendations for an ONC Head Who Understands Health IT Innovation

Mar 6, 2009• 14

By David C. Kibbe, Brian Klepper and John Moore. Kibbe

Now that the legislative language of the HITECH Act — the $20 billion health IT allocation within the economic stimulus package — has been set, it’s time to identify a National Coordinator (NC) for Health IT who can capably lead that office. As many now realize, the language of the Bill can be ambiguous, requiring wise regulatory interpretation and execution to ensure that the money is spent well and that desired outcomes are achieved. Among other tasks, the NC will influence appointments to the new Health Information Technology (HIT) Policy and Standards Committees, refine the Electronic Health Record (EHR) technology certification process, and oversee how information exchange grants and provider incentive payments will be handled.

Why and How Secretary Sebelius Should Avoid a Network Monopoly

Mar 5, 2009• 13

By ADRIAN GROPPER MD

Obama is smart. His signing of the Health Information Technology for Economic and Clinical Health

(HITECH) Act (as part of the Stimulus package) recognizes the
importance of health IT as the foundation for health care reform and
cost savings. Good data and good consumer experience is a way to drive
a policy consensus when payment reform and health reform come to a vote
on Capitol Hill.

Technology certification and meaningful health
records exchange are the cornerstones of the HITECH Act. Health IT
should be engineered to promote transparency in health care
effectiveness and to reduce regional differences. To achieve this, the
secretary of HHS must ensure that scope of the Certification Commission for Health Information Technology (CCHIT) does not extend beyond hospital health records.

HHS
must stimulate reform through systems and services innovation. As with
previous federal actions, such as the the break-up of the AT&T
monopoly, HHS can enable future generations of innovation by excluding
health information exchange and patient-controlled health records from
the domain of CCHIT, big hospital and big vendor interests.

Value-Based Insurance Design and Medicare Part D – A Perfect Match?

Mar 5, 2009• 2

By TANISHA CARINO

Medicare could immediately modernize its benefit structure by incorporating value-based insurance
design (VBID) into the Part D program. This benefit design tool maps directly to the new Administration’s goals of improving quality and preventing complications of illness—and, as I’ll point out, it can be implemented without any new legislation.

VBID abandons the traditional approach of uniformly applying cost sharing to health services regardless of their effect on a patient’s health. Instead, VBID tailors cost sharing—so, the more clinically beneficial the service is to a patient, the lower that individual’s cost sharing for the service. In some cases, employers such as Marriott and Pitney Bowes have actually eliminated cost sharing associated with diabetes medications and achieved positive cost and quality outcomes.

With more than 26 million enrollees, Medicare Part D is a large target for this type of innovative, quality-focused benefit design. The 23% of Medicare beneficiaries who have five or more chronic conditions account for 68% of the program’s spending, and there is heavy reliance on medication to treat chronic illness.

Google Health sharing–simple but potentially important

Mar 4, 2009• 11

By Matthew Holt

Today late afternoon PST Google flipped the switch on an important change/add to Google Health.

Recently they’ve been adding more and more little features, such as printing & graphing, and in the last month getting CVS retail pharmacies on the network (to join Walgreens), and sucking up device data. But this new one may be the most interesting, as Google Health has added the ability for users to invite others to see their records.

Anyone who’s used Google Docs (and that includes all of us working at Health 2.0) immediately gets addicted to sharing those spreadsheets and text documents with a wider team. It’s so easy, you just invite them to it, and then one day you wake up and you’re sharing hundreds of documents with everyone you work with and cannot imagine how you did it before.