Here are three Greenes. Left to right Jeff (MedEncentive), Sarah (NY Times), Alan (DrGreene.com)
Above the Fold
Kaiser, Blues of Mass….health plans & consumers online
Kaiser Permanente put out a new survey updating one they did last year which says that more and more people are going online, and now a sizable minority had a preference for doctors using an EMR. (It’s not clear whether they’ll yet change a doctor based on that). It does seem that they’re more likely to expect it and want it from their health plan — 61% wanted EHR’s to come from their health plan. (Here’s the PDF of of the survey, which has lots of extra information for you nerds). But here’s probably the key results
Q. If two doctors had exactly the same qualifications, but one used an electronic record system and the other did not, which ONE would you choose? (ROTATE) The doctor using an electronic record system 47%The doctor NOT using an electronic record system 29%Don’t know/Unsure (Volunteered) 22% Q If two health insurance companies had exactly the same qualifications, but one provided their members with access to an electronic record system and the other did not, which ONE would you choose? (ROTATE)
The one using an electronic record system 60%The one NOT using an electronic record system 25% Don’t know/Unsure (Volunteered) 14%
So Kaiser Permanente has not only created its own health record via its big Epic project, but it’s decided to at least pilot with Microsoft HealthVault. (See a little more and some controversy about that here). And some other health plans are starting to notice.
Today, the big news is that BCBS Massachusetts has decided that it too needs to dive into this. They’ve decided to make their consumers records interoperable with Google Health by the end of the year.
So are Kaiser and BCBS Mass outliers, or are they first trickle of a torrent?
Denials, denials!
Health minister “denies she is crazy”. OK she’s Australian, so take that with a grain of salt.
What’s the fuss about? Using more allied professionals to replace primary care docs. Apparently that’s not certifiable, even in Australia.
Managing obesity, Japanese style
So after making cracks about Strength through Joy last week, it appears that plans to change the health of the nation are happening. Not here of course, but the NY Times tells us about Japan:
Under a national law that came into effect two months ago, companies and local governments must now measure the waistlines of Japanese people between the ages of 40 and 74 as part of their annual checkups. That represents more than 56 million waistlines, or about 44 percent of the entire population.
Those exceeding government limits — 33.5 inches for men and 35.4 inches for women, which are identical to thresholds established in 2005 for Japan by the International Diabetes Federation as an easy guideline for identifying health risks — and having a weight-related ailment will be given dieting guidance if after three months they do not lose weight. If necessary, those people will be steered toward further re-education after six more months.
To reach its goals of shrinking the overweight population by 10 percent over the next four years and 25 percent over the next seven years, the government will impose financial penalties on companies and local governments that fail to meet specific targets. The country’s Ministry of Health argues that the campaign will keep the spread of diseases like diabetes and strokes in check.
SNIP
Companies like Matsushita must measure the waistlines of at least 80 percent of their employees. Furthermore, they must get 10 percent of those deemed metabolic to lose weight by 2012, and 25 percent of them to lose weight by 2015.
NEC, Japan’s largest maker of personal computers, said that if it failed to meet its targets, it could incur as much as $19 million in penalties. The company has decided to nip metabo in the bud by starting to measure the waistlines of all its employees over 30 years old and by sponsoring metabo education days for the employees’ families.
Sounds like fairly vicious pay for performance to me!
Do worker wellness programs violate employee privacy?
Employees are split on whether employer wellness programs intrude on privacy, according to an Issue Brief from the Center for Studying Health System Change (CSHC).
The report details the results of interviews conducted in 2007 in 12 metropolitan American communities: Boston, Cleveland, Greenville, Indianapolis, Lansing, Little Rock, Miami, northern New Jersey, Orange County, Phoenix, Seattle, and Syracuse.
Employee wellness programs are growing in the marketplace as employers try to stem ever-increasing costs, both direct and indirect. This is real money: a report from the American Hospital Association estimated that three chronic diseases — asthma, diabetes and hypertension — accounted for 164 million days of absenteeism each year which cost cost employers $30 billion.
Health wonk review
Jane Hiebert-White compiled it over at Health Affairs blog.
Paul Wallace–Get the patients brain in the game
Paul Wallace, who is both Senior Medical Director at Kaiser Permanente and Chair of the Center for Information Therapy, has some sensible things to say about the transition from Health 0.0 to 1.0 and then includes some of the lessons of Health 2.0. He also wanted us to think about the links to the big building behind him in this picture.
Kaiser now has the EMR up everywhere — that’s 1.0 in his terms—information flow. The workflow change is a big deal and we have to think about it. Paul used to wait a few days before dictating notes. No more. That information is needed immediately, and his colleagues let him know about it!
Wallace on the deal with HealthVault—we now have the opportunity to “understand the operational implications of such an endeavor”. Ho, Ho. What does portability really mean? He can see his medical record in Berlin. How does that change care?
The Advisory Board’s David Bradley had earlier told a story earlier of tapping into early wisdom of the crowd to discover that he had shingles. An instructive story of 2.0–-sharing health information and discovering more than is known by the system.
What about engaging the employer. You spend 2000 hours at work each year and probably 1/100th of that with a doctor. Where can we have a bigger impact?
The 2.0 issue is to get the patients brain in the game….
He likes Susannah Fox’s phrase—"let’s design for what could be."
Lucas Merrow demos Eliza
Lucas is demoing today’s flashiest presentation at The Center for Information Therapy’s Wired.
Thank goodness; it’s 4:30 and there’s been no audience bleed out the door since Merrow took to the podium.
I missed Eliza’s presentation at the Health 2.0 Spring Fling, so this
is the first time I’ve viewed the platform. Eliza has my interest when
Merrow describes "how we converse with people with diabetes" rather
than "diabetics."
Sometimes it is all about semantics; in this case, Eliza shows respect
for each person’s health/wellness goals via the details, right down to
terminology, not limiting our identity to powerless ‘patienthood’.
And it works. People respond to requests with respect. Lucas shares a
case study. When Eliza took over for a client – 23 percent prescription
refill rate. They saw an increase right off the bat – 10% early –
"primarily due to the conversational nature of the service."
Eliza has it right here – Healthcare is a conversation. Let’s keep talking.
PCHIT and patients online…
Josh Seidman & Ted Eytan (he of the latest, latest Health 2.0 definition) have written a piece for CHCF called Helping Patients Plug In: Lessons in the Adoption of Online Consumer Tools.
Susannah Fox (all hail!) from Pew is talking about patients online. She gave some neat data Broadband is about 20 points below basic Internet access….at about 54% overall (up from 5% in 2000). It’s only pockets (those over 70s, Spanish speaking Hispanics). Health care is stuck in broadcast, not interactive. Susannah thinks that the option is to go mobile—especially for low income young minority males. I asked her about broadband….it’s growing but slowing she says, but there’s lots of potential to copy what’s happening elsewhere. Susannah’s quote of the day “Online banking may be softening people up for PHRs…”
My Group Health and “Killer Apps”
Here at the Center for Information Therapy’s Ix Conference,
transparency is the name of the game. Transparency in information transfer, information therapy, also literal transparency – we’re surrounded by tons of
glass and steel here, late-morning light is streaming in, and attendees zone out to a sweet view of the Washington Monument.
James Hereford, executive VP of Strategic Services
and Quality for Group Health Cooperative (Seattle), has the smooth
charm that tells you he has a sales background. He’s taking us on a tour of Group Health’s portal – My Group Health.
His pitch – "My Group Health" is a combo of killer apps, including:
1. EMRs
2.
Secure messaging (between doc and patient)…Group Health has
received/sent these from all over the world, every continent, including
Antarctica
3.
Automated results sharing (lab results)
4. After visit summary
5. Integrated health profile
Hereford’s thesis on the main difficulty of HIT adoption – it’s "completely
psychological." Providers (1k in the Group Health network) didn’t believe the patient should
have ANY information before they did. There’s a shocker.
But as James points out – "You don’t have to be a brain
surgeon to look at your lab results and figure out if they’re outside the
normal range."
