THCB

Categories

Above the Fold

PCHIT and patients online…

• 1

By Matthew Holt

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@Wired 002

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”

• 4

By Jen McCabe Gorman

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."

Continue reading…

The Health IT politics overview (more from Ix)

By Matthew Holt

Up next at Information Therapy was Claudia Williams from Markle introducing Kavita Patel, Ted Kennedy’s staffer from the Health (et al) Senate sub-committee, and Joel White, a former Republican staffer now running the Health IT Now coalition. There was far too much agreement between Kavita and Joel for my liking!

Essentially they both agreed that the Federal government should pay something for Health IT, and Joel said that actually HHS is piloting spending up to $56,000 per physician to buy medical records.

Joel seemed OK with this—and like Newt Gingrich—seems to be OK with socialist mandates as the way to provide IT (that is, the government paying). On the other hand, Kavita wasn’t sure that the Feds should pay for everything and maybe the states and even consumers should be paying something. So I for one now don’t understand where ideology has gone in health politics!

But they were both confident that bipartisan legislation will pass encouraging Health IT (such as ePrescribing) via Medicare and other programs in the next Congress (but not this one) but both were a little concerned about the incentives problem. As Claudia said, Health IT leads to better quality, but Health IT won’t be widespread without a change in incentives.

CODA: Meanwhile and somewhat off topic, at the end Joel, (who’s now a fellow at Galen with Grace Marie Turner to give you a hint), went off on a rant about what was wrong with comparative effectiveness research. He recited PhRMA’s lines pretty well, but ran away before the mass ranks of Kaiser attendees surrounded him and pecked him to death. If you want to see some of the controversy about who has what to say about comparative effectiveness, look at what Merrill Goozner said about it last year.

The Massachusetts Question

• 6

By Robert Laszewski

Two years ago lawmakers in Massachusetts made the state the first in the nation to mandate that residents purchase health insurance. The proposal quickly caught on, inspiring similar efforts on the state level and eventually becoming the blueprint for the national health reform efforts of Democratic presidential candidates Sen.  Barack Obama and New York Sen. Hillary Rodham Clinton.

More than a year into the experiment the first returns are in.  And reviews are mixed. Not surprisingly, the program is costing far more than backers had initially predicted. On the other hand, the ranks of the uninsured in the state have dropped sharply. (See Matthew’s podcast with Jon Kingsdale, executive director of the Massachusetts Connector, the agency created to administer the program, for more on the back story.) The Massachusetts experiment  is clearly not something to be dismissed — nor is it something to
defend for the sake of argument.

In brief, the Massachusetts health care reform law appears on its way to:

  • Covering two-thirds of those who did not have health insurance on the day it was enacted — about 400,000 people by the end of 2009.
  • Covering most of those who were uninsured in households with incomes below 300 percent of the federal poverty level–below which the plan pays all or most health insurance premiums.
  • Offering health insurance plans to middle-income people that are still largely unaffordable for those families making less than $110,000 a year –– people for whom the state has generally canceled the individual mandate that they must buy coverage.
  • Racking up costs well above what was first estimated. The plan looks to be coming in 38 percent higher than originally estimated for its first year and the Governor is now estimating second year costs 50 percent higher than the original estimate –– from $725 million to $1.1 billion for the 2008-2009 fiscal year.
  • Developing an annual cost trend for the program’s insurance programs, Commonwealth Care and Commonwealth Choice, in the 10 percent to 15 percent range.

So, lots more people, particularly lower-income residents, are covered but the program’s costs are unsustainable.

Continue reading…

Information Therapy time (again)

By Matthew Holt

The Center for Information Therapy has—in a move aimed at upsetting me personally—moved its conference from Park City, Utah, to Washington DC. Today along with some other THCB regulars like star Health 2.0 Ranger Jen McCabe Gorman, and Craig Stoltz, I’m in the Newseum — the new Museum of news media and the First Amendment. Here the Center for Information Therapy is literally and figuratively moving the Information Therapy debate into the core of the Washington Policy process.

The Center’s President, Josh Seidman, drew parallels between the development of news media in the US and what we’re seeing in health care. Here compared the Royal Mail in the UK with the pony express, and noted that some American innovations were “so democratic as to be regarded as subversive.”

Me, Jen & maybe Craig will be back with more later. Here’s the agenda.

Podcast with Marston Alfred, founder and architect of SugarStats

By Jen McCabe Gorman

Marston Alfred, founder and chief architect of SugarStats.com chatted recently with me about his relatively new, Web-based program that allows diabetics to track their health statistics online.Sugarstats_2

Alfred described SugarStats as a portable PHR specifically for diabetics. He hopes diabetics use it to share their progress with others, such as family and doctors, and that by doing so it will improve their adherence to diet, exercise and medication schedules.

SugarStats launched publicly a year ago. It currently has about 4,000 users and gets an average of 10,000-20,000 unique visitors each month.

A diabetic himself, Alfred talks about the need for SugarStats and his hopes for the company’s future. Listen to the podcast.

Kaiser tiptoes into HealthVault & tells THCB about it, with UPDATE

• 11

By Matthew Holt

Kaiser Permanente signed on this morning for a pretty extensive pilot with Microsoft,
allowing its 159,000 employees to copy their online health records into HealthVault. This is a big coup for Microsoft and a fairly ambitious move for KP which to this point hasn’t said much publicly about the data transferability it was going to provide for its members. This is a clear signal.Kp

Assuming that the pilot is a success, presumably all Kaiser members using My Health Manager (over 2 million now and heading to 3 million at years end) will soon be able to move their data to HealthVault. We are potentially seeing the first real example of mass scale data interoperability onto a platform not connected to a health care organization. And obviously, Google is playing in this same space too.

Once the data is collected in HealthVault, there are lots of possibilities for what can be done with that data, and what services can be offered.

Back in the days when Justen Deal was causing havoc with HealthConnect, I had a somewhat unorthodox interview with Permanente’s Andy Wiesenthal — in which (without KP’s PR folks knowing) I called him in a taxi on a cell phone late on a Friday night. Perhaps it’s a mark of how far THCB has come (you decide if it’s good or bad) that in regular business hours on Friday, KP’s publicity machine lined me up for a pre-release interview with Peter Neupert, Corporate VP of Microsoft Health Solutions Group and Anne-Lisa Silvestre, VP of Online Services at KP.

Continue reading…

Sapping VistA’s soul

• 8

By Niko Karvounis

Niko Karvounis tracks the healthcare system for the Century Foundation. This post first appeared on the increasingly influential Healthbeat blog, one of our favorite healthcare reads.

In the past I’ve spoken highly of VistA, the Veteran’s Administration computerized
health records system, — and with good reason. VistA has a lot going for it. In 2006, it won an “Innovations in American Government Award” from Harvard. Studies show that use of VistA has improved VA productivity by 6 percent a year since nationalVa implementation was achieved in 1999. In a time of sky rocketing health care costs, VA care has become 32 percent less expensive than it was in 1996 in part thanks to VistA. The computerized system also has helped the VA reach an amazing prescription accuracy rate of over 99.997 percent. And last — but certainly not least — VistA is a flexible program that allows for much independent tinkering in the name of improvement, both by techies outside of the VA and those within the administration.

Given all these pluses, you’d think that the government would be happily throwing its weight behind VistA and ensuring that the system is firmly institutionalized for the long term. But in fact, just the opposite is happening. VistA is under attack; and it’s the federal government that’s leading the assault.

Continue reading…

Until the middle class truly cares, forget about health reform

• 9

By THCB Staff

Regular THCB contributor Michael Millenson published an op-ed piece in Sunday’s Washington Post, in which he says that until health insurance truly becomes an issue of the white middle-class, politically, nothing will happen.

Michael’s words:

"Here’s a cold truth: Despite much media hand-wringing on the subject, most of us give about as much thought to those who lack health coverage as we do to soybean subsidies.The major obstacle to change? Those of us with insurance simply don’t care very much about those without it. It’s only when health care costs spike sharply, the economy totters or private employers begin to cut back on benefits that the lack of universal health care comes into focus. Noticing the steadily growing ranks of the uninsured, the broad American public — ‘us’ — begins to worry that we’ll soon be joining the ranks of ‘them.’"

"The responses I’€™ve gotten by putting my personal email on the page have certainly been … educational," Michael told us. You won’t get his personal email here — you’ll have to visit the Post for that.

assetto corsa mods