The Health Care Blog – Page 993 – Everything you always wanted to know about the Health Care system. But were afraid to ask.

Above the Fold

Whose DNA is it anyway?

Jun 23, 2008• 3

By Sarah Arnquist Dna

News of the California Health Department’s mailing of cease and desist letters to 13 direct-to-consumer genetic testing firms, such as 23andMe, Navigenics and DeCodeMe, has sparked intense debate over balancing regulations to guarantee quality and individual rights to genetic data.

Here on THCB, Matthew Holt called the move the "first establishment challenge of Health 2.0."

"This is a case where the regulations are running way behind the technology, and the trade protection organizations of health care providers are, I’m sure, whispering in the ear of the regulators," Holt wrote.

Why all the fuss now?

CA regulators say doctors must be involved in ordering and deciphering the genetic tests, which currently are offered directly to consumers. Currently, customers pay about
$2,500 at Navigenics for an initial one-year membership — and then an
annual fee of $250.
23andMe and DecodeMe both charge about $1,000 for permanent access.

Untangling the electronic health date exchange

Jun 23, 2008• 12

By David Kibbe Kibbe

The purpose of this post is to help a non-technical audience untangle some of the confusion regarding health data exchange standards, and particularly come to a better understanding of the similarities and differences between the Continuity of Care Record (CCR) standard and the CDA Continuity of Care Document
(CCD). But what I’m most interested in is getting beyond the technical, political, or economic positions and interests of the proponents of any particular standard to arrive at some principles that demonstrate in plain language what we are trying to achieve by using such standards in the first place.

Frankly, I don’t give a hoot about what standardized XML format for
capturing clinical data and information about a person becomes the norm
in the health care industry over the next several years. I do care
that the decision is made by the people, institutions, and companies
who use the standards, and not made by a quasi-governmental panel or a
group of "industry experts" whose economic or political interests are
served by the outcome, and dominated by a particular standards
development organization with whom they are very cozy.

In other words,
I do want free and open market forces to be able to operate freely and
openly as health information exchange evolves, in part because I
believe market forces will work in the direction of continuously
improving health IT, whereas in my experience top-down efforts are
often protective of established interests and discouraging to
innovation.

Editor’s note: When republishing Kibbe’s post today, we accidentally deleted the great conversation going on in the comments section. If your comment was deleted, we encourage you to submit again.

Going Dutch for Health Reform Ideas

Jun 22, 2008• 12

By MAGGIE MAHAR & NIKO KARVOUNIS

Every now and then HealthBeat takes a look at health care systems in other countries So far we’ve tackled Germany and China. Next on our list was the Netherlands, but it turns out Health Affairs beat us to the punch. In May, Wynand van de Ven and Frederik T. Schut, two professors at Erasmus University in Rotterdam, authored an excellent profile of the Dutch health care.

Why should we care how they deliver health care in a tiny country most of us will never visit? Few European health care systems have garnered the kind of attention from Americans that the Dutch system has received — especially from folks not known for their Euro-philia, including the Bush Administration. In the fall, the White House sent a delegation to the Netherlands to learn more about the Dutch system. The Wall Street Journal also has praised the Dutch system for accomplishing “what many in the U.S. hunger to achieve: health insurance for everyone, coupled with a tighter lid on costs.”

What could make conservatives entertain the possibility that we might learn from Europeans? Under the Health Insurance Act of 2006, the Dutch have created a system of universal coverage delivered entirely through private insurers. In this, the Dutch plan is very much like the plan Dr. Ezekiel Emanuel proposes for the U.S. in his new book Healthcare, Guaranteed. (We wrote about Emanuel’s plan here and here), calling it a “fresh” proposal for reform.)

Diabetes reloaded

Jun 22, 2008

By THCB Staff

To mark the advancements and ongoing journey in diabetic care DiabetesMine, an online community and resource for diabetics, created this video.

The theme, Diabetes Reloaded, stands for "redefining not only the role of technology in managing chronic diseases, but also for the newfound self-confidence and ambitions of 21st century people living with health conditions. What’s special about this new web-enabled world of healthcare? It’s proactive, technology-based, empowered, revolutionary, against all odds, and – if needed – outside the establishment."

AMA endorses single-payer health care (sort of)

Jun 21, 2008• 12

By Michael Millenson

The American Medical Association has now added a second pillar to its
national health care reform plan. The first pillar, of course, has
always been “Don’t sue,” a sturdy principle that over the decades has
led the AMA to alliances with such notable victims of overzealous
attorneys as tobacco companies. (For historical perspective, see Howard
Wolinsky and Tom Brune’s 1994 book, The Serpent on the Staff.)

The health wonks behind the candidates

Jun 21, 2008• 8

By Sarah Arnquist

Leading up to the November election, the health reform proposals of presumptive presidential candidates John McCain and Barack Obama will be analyzed, compared and critiqued until absolutely nothing original is left to say about them.

The team of strategists corralled to draft the proposals are now defending and promoting them. Both sides have put Harvard professors and U.S. Representatives to work, but the similarities end there.

Here’s a brief look each candidates’ health wonk roster:

RWJF launches new Web section to share quality strategies

Jun 21, 2008

Rwjflogo2

The Robert Wood Johnson Foundation launched a new section on its Web site last
week aimed at sharing best practices for improving health care. The new Quality/Equality portion is full of engaging multimedia features and includes an expansive library of interventions and tools, resources and videos.

“We know that spreading the best practices and lessons learned from these programs will require a combination of several things, one of which had to do with creating useful, accessible content from these program experiences directly aimed at the people we want to make the change—the doctors, nurses, policymakers, and leaders who are at the front lines of improving health care," said Minna Jung, Foundation spokeswoman.

"We don’t know yet if offering this content will help engage bigger audiences in improving health care quality for all Americans," she said. "But we feel we’ve got to try to do this type of web outreach, and do it well,"

American Well: the first deal is with Hawaii Blues and HealthVault

Jun 21, 2008• 2

By Matthew Holt

When I left their party late Wednesday night my understanding was that that American Well had bought Microsoft and was moving all 85,000 employees to Hawaii.

Apparently that was MaiTai confusion, and the real story is that HMSA (Blues of Hawaii) is American Well’s first client. Ido and Roy Schoenberg, with their ace marketing whizzes headed by Yael Glassman, have been making lots of buzz with demonstrations of their tool—including a standing room only sponsored deep-dive at Health 2.0 in San Diego in March. We knew that there was at least one insurer in the works, and presumably there are many more, as the business model is dependent on working with insurers in state networks and allowing consumers to access the insurer’s PPO discounts.

Other than the leis and MaiTais that appeared at the party, Hawaii is a logical choice. Why? Well the Blues’ main competition in the state is Kaiser. Kaiser of course offers its members online appointments, asynchronous visits, and post-visit summaries from its HealthConnect system.

Essentially, with the addition of the American live online visit—with its inclusion of video, chat, patient summary, history and ability to order test and drugs—the Blues has now got part of those services. What most insurers don’t have is the storage of the data. That’s where HealthVault comes in—now that online activity can be stored and easily transferred.

From the AHIP fields….

Jun 20, 2008• 3

Fun and games were had by all at the America’s Health Insurance Plans
(AHIP) conference yesterday. (BTW Now I have a real journalist working
with me on THCB and she says I have to spell out those acronyms!!)

Outside a couple of thousand single payer advocates noisily demanded a ban on greedy health plans. Now I know that the AMA has a running battle with the insurers (Read Michael Millenson’s hilarious piece about that on THCB yesterday). It’s also the case that certain Democratic Senators have it in for them, although as Bob Laszweski notes, that too is "not quite yet" an issue. But it wasn’t them outside!

Still it was rather fun going to an event that had
a real rather than a software demo going on!

Now the single payer crowd’s time has not yet come, and there is a chance that the private health insurance industry won’t screw itself into oblivion. (Although my guess is that they’ll be ascendant in 10-15 years)

MA plans won this round but future looks bleak

Jun 20, 2008• 1

By Robert Laszweski

Congressional Democrats tried to take a big bite out of private Medicare last week in an attempt to pay for an 18-month fix to the upcoming July 1 10.6 percent reduction in Medicare physician payments.

The effort, led by Senate Finance Chair Max Baucus (D-MT) got only 54 of the 60 votes he needed to end debate and move the issue to a floor vote. While getting that floor vote would almost have certainly meant passage of the bill in the full Congress, President Bush would have vetoed any attempt to cut the payments to private Medicare plans and the Dems would not have had the votes in either chamber to override.

Now, Baucus and Senate Finance Committee ranking member Chuck Grassley (R-IA) will have to find a more modest way of fixing the doc problem––likely for just six months. The docs are not going to suffer a Medicare payment cut this summer.

All of this was expected and is what I have been saying for months would happen.