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Sunday, October 2, 2011

National Health IT Hype Week, Sept 27th


I would have loved to have been there, actually (personal reasons aside), given that we're in a period of "
Let A Thousand VC-funded Flowers Bloom."

John Moore of Chilimark Research has a great cross-post up on The Health Care Blog ("Trickle Down Health") summarizing his reactions:
While Health 2.0 can get overwhelming with the number of rapid fire, albeit shallow demos from the multitudes of vendors who are all trying to make their mark in a market that has experienced a significant amount of churn, the event is invigorating for the passion that is shown. Sure, everyone is hoping to make a living on their next greatest innovation, but unlike virtually any other health IT related conference, those at Health 2.0 have passion. They are on a mission. They want to truly change healthcare. They want to make a difference. That passion is contagious. Unfortunately, that passion appears to be confined to the digerati.

Looking around at the Health 2.0 audience one sees a sea of almost exclusively upper, middle class professionals that are tapping away on their iPad, smartphone or laptop. When one sits back and thinks about the many demos seen, virtually all of them seem to be designed for this audience...

LOL. When I first read "a market that has experienced a significant amount of churn," my bleary pre-coffee Sunday morning eyes saw "chum." Apropos, I guess.

Unsurprisingly, HIT seems to be a new dot.com bubble arena to a great degree. I can't get those after-images of the old circa 2000 Superbowl TV ads out of my head.


See "8 Dot-Coms That Spent Millions On Super Bowl Ads And No Longer Exist."

My fav from those days is one I cannot find online anywhere. It was called "Mrs. Barky," wherein this too-young startup guy is trying to explain his vaporware concept to this wealthy bejeweled tea-sipping dowager mark, hoping to extract some big seed money. When she inquires as to the name of his company, he, seeing her yapping little spoiled lapdog, grins slyly and says without missing a beat, "Mrs. Barky."


John Moore continues:
...Maybe the most disturbing part of the event was the on-stage interview with a mother of eight kids (she was white, middle age and clearly upper middle class) showing how her family is tapped into the quantified self movement with the various Apps they use to track their health and fitness. This is not representative of the broad swath of the American populace who are the ones that will drive our healthcare system off the proverbial cliff. It is that grandmother in Indiana who is caring for her diabetic, overweight husband, two grandchildren, a daughter suffering from an addiction and a son-in-law who is unemployed and has no health insurance that we need to talk to, have up on stage to tell us what they need to better manage their health and interaction with the healthcare system. And we need not go to that extreme, how about just having someone from a safety-net clinic talk about their needs? Sadly, no such representatives were to be found at Health 2.0...

As I noted in the comments 'I am reminded of Gawande’s The Hot Spotters.'
...Every country in the world is battling the rising cost of health care. No community anywhere has demonstrably lowered its health-care costs (not just slowed their rate of increase) by improving medical services. They’ve lowered costs only by cutting or rationing them. To many people, the problem of health-care costs is best encapsulated in a basic third-grade lesson: you can’t have it all. You want higher wages, lower taxes, less debt? Then cut health-care services.

People like Jeff Brenner are saying that we can have it all—teachers and health care. To be sure, uncertainties remain. Their small, localized successes have not yet been replicated in large populations. Up to a fourth of their patients face problems of a kind they have avoided tackling so far: catastrophic conditions. These are the patients who are in the top one per cent of costs because they were in a car crash that resulted in a hundred thousand dollars in surgery and intensive-care expenses, or had a cancer requiring seven thousand dollars a week for chemo and radiation. There’s nothing much to be done for those patients, you’d think. Yet they are also victims of poor and disjointed service. Improving the value of the services—rewarding better results per dollar spent—could lead to dramatic innovations in catastrophic care, too...

More to come shortly. The second cup of coffee beckons...
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ASA RASKIN'S "MASSIVE HEALTH"


No denying the chops of this kid. We'll see what comes of this initiative. There's finally some content on the website.

With healthcare costs rising faster than inflation, a crisis looms on the horizon. Health happens between doctor visits. We need tools to address our health that we love to use. More than 750 people have applied to work with us, over half of them doctors and health professionals. Why? Because everyone knows change is necessary...

...we also help your docs by giving them better insight into trends and issues, by doing the statistical and visualization work for them. That lets them focus on helping you, rather than wasting time staring at numbers.

"Statistical and visualization work"? Like, uh, Stratasan, whom I've mentioned before?


Or, Gapminder?



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Apropos of the foregoing:
The HIT of ACOs, part 2: Beyond HIE
September 29, 2011 | John W. Loonsk, MD, CMO CGI Federal

Will accountable care organizations follow the lead of HIEs in analyzing data across participating providers, or surpass them?

In this series, we are examining ways health IT can best support the goals of accountable care organizations (ACOs) for health reform.


In our first article we focused on how clinical care and administrative data, as well as software tools, can be arrayed to support quality and efficiency analytics and reporting for an ACO. Data analytic technology usually operates retrospectively on non-transactional data that can be accumulated from diverse systems. As such, while not easy it is perhaps the easiest part of architecting an ACO technical infrastructure. There are analytic challenges in accumulating, normalizing, linking and processing the “iceberg” of both data visible in measures and the greater quantities of less-visible, supportive data needed for analytics and reporting...

Indeed.

Of equal -- no, even more timely interest:
UnitedHealthcare sees lower ER use with data exchange
September 29, 2011 | Mary Mosquera, Government Health IT

MINNETONKA, MN – UnitedHealthcare is beginning to experience reduced hospital and emergency room use as a result of payers and providers sharing patient data through health information exchange in its eight patient-centered medical home pilots around the country.

What is emerging is that the exchange of clinical information for medical management is getting comprehensive enough at the point of care to be able to evaluate the cost effectiveness of the service, according to Sam Ho, MD, executive vice president and chief medical officer, UnitedHealthcare.

With that data, “medical necessity determinations can be made closer to real time and obviate the need for unnecessary diagnostic settings and unnecessary treatment referrals,” he said in a recent online presentation sponsored by the eHealth Initiative, a non-profit organization that promotes health IT...

Well, yes, but "reduced hospital and emergency room use" comes out of some entities' hides, 'eh?

Very interesting. New, sustainable business models must emerge.
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FIRST MONDAY IN OCTOBER

Obama's healthcare law tops new Supreme Court term

WASHINGTON (Reuters) - President Barack Obama's sweeping healthcare overhaul will top the agenda in the new Supreme Court term that opens on Monday and could be the most momentous in decades...

...Returning from its three-month recess, the nation's highest court will confront legal challenges seeking to strike down Obama's signature domestic policy achievement and a host of other charged issues in its 2011-12 term.

The healthcare law, Obama's signature and most controversial domestic achievement that figures to be a prominent issue in the U.S. elections in November 2012, already has overshadowed the term's other cases.

The law, which aims to provide more than 30 million uninsured Americans with medical coverage and to slow soaring costs, has wide ramifications for the health sector, affecting health insurers, drugmakers, device companies and hospitals.

"That of course would be the big enchilada," said former U.S. Attorney General Dick Thornburgh in discussing the healthcare cases and the new Supreme Court term at a briefing sponsored by the conservative Washington Legal Foundation.

RULING COULD GO EITHER WAY

Legal experts said it was impossible to predict how the Supreme Court might rule on the healthcare law and said a decision could hinge on whether Congress exceeded its powers by requiring that Americans buy insurance or face a penalty.

"It will be a close case," Jonathan Cohn, a former deputy assistant attorney general at the U.S. Justice Department in the George W. Bush administration, said at the briefing...

Well, like Yogi, "I never make predictions, especially about the future," but I've seen some intriguing ones by a number of pundits with SCOTUS-watching cred. Like, say, "5 to 3 to uphold, Kagan recusing."

Yeah, I know, that cuts against the assumed Roberts Court grain, but...
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UPDATE FROM THE "I'M IN THE WRONG BUSINESS" NEWSWIRE
ONC awards E-Consent Trial project to APP Design
October 03, 2011 | Molly Merrill, Associate Editor, HealthcareIT News

WASHINGTON – The Office of the National Coordinator for Health IT recently awarded a contract to APP Design, Inc., to be part of its electronic consent pilot project...

...[which] will seek to find an efficient, effective and innovative way to help patients better understand their choices regarding whether and when their healthcare provider can share their health information electronically, including sharing it with a health information exchange organization...

Contract No. HHSP23320110023WC, $1,239,908.99

Interesting.
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More to come...

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