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Thursday, August 15, 2013

"Start Spreading The News..."

Mana Health wins contract to design patient portal for New Yorkers
August 15, 2013

New York eHealth Collaborative held a design challenge earlier this year to spark some ideas and discussion on how to execute some of the goals of the patient portal for its statewide health information network. Mana Health, a digital health startup that won the competition, has now got a contract to design it, according to a press release.

One of the biggest challenges companies encountered was how best to bridge the gap between patient needs and health literacy. Mana Health’s design balancing important information with big colorful graphics is aimed at increasing patient engagement...
Interesting. Having been born on Long Island and raised in northern New Jersey, I follow regional developments routinely, developments in Health IT in particular. NYeC has a good rep as a leader.

Nice consumer-facing look to this product.
It's gonna have to be usable, stable, nimble, and secure. And, "sustainable." -- i.e., who pays? We shall see. I wish them the best.


Michigan doctor held on $9 million bond for misdiagnosing cancer patients in Medicare scam
Oncologist Farid Fata allegedly scammed $35 million from Medicare for giving unnecessary chemotherapy to patients who didn't need it and diagnosing cancer when patients didn't have it. The scheme took place over a two-year period.
[NY Daily News] An oncologist accused of intentionally misdiagnosing cancer patients to scam Medicare in Detroit had his bond set at $9 million by a federal judge...

Fata, who owns Michigan Hematology Oncology Centers, is accused of giving unnecessary chemotherapy to patients who didn't need it and diagnosing cancer when it wasn't apparent.

According to the complaint, Fata defrauded federally funded Medicare out of about $35 million over a two-year period.

He was arrested on Tuesday and taken to Wayne County Jail in Detroit, and federal agents raided his multiple offices in the Detroit area.

They also seized his medical records as they build a case against him.

Robert D. Foley, III, the FBI special agent in charge, said in a news release, "Violating a patient's trust and placing them at risk through fraudulent abuse of our nation's health care system is deplorable and a crime which the FBI takes most seriously."

The FBI remains committed to the arrest and prosecution of those who commit health fraud, he said.

According to ABC News, Angela Swantek, an oncology nurse who spent time at one of Fata's clinics, said she had first complained to investigators about his alleged wrongdoings in 2010.
"I don't know how he's gotten away with it for this long," she told ABC News...
We've been gumshoeing Medicare billing records for decades. We of late have "RACs" -- Recovery Audit Contractors -- for this sort of thing, but, could we expand this into "clinical forensics," perhaps using SOAP dx/tx fraud screening algorithms that probe HIT records and kick out suspect findings for expert "chart review," much of which could be done remotely by forensically trained telecommuting docs?

If this guy is convicted, he deserves a special place in Hell.


Just got notified of my press credential  approval for the 2013 Health 2.0 Conference.

The 2012 conference in San Francisco was great fun: e.g., as I covered here, here, here, and here. This year I'll be living in the Bay Area. My Vegas house is now under sales contract and is in Due Diligence, and we just put in an application for a leased house close to Cheryl's office in Walnut Creek.


From a current AthenaHealth white paper, the Physician Sentiment Index:

Lots of unhappiness in the Physicians' world these days. Dubiety and despair at every turn it seems. "ObamaCare" sux. All proposed payment reform models suck. Decreasing physician autonomy and reimbursements suck. Increasing regulation sux. Health IT sux...

e.g., from The Health Care Blog:

What, if anything, can be done that might garner the sustainable traction of consensus? One thoughtful proffer here:

A Blueprint for a More Effective, Physician-Directed Health System
Research funded by The Physicians Foundation, Jeff Goldsmith, Ph.D. May 2013

As it moves inexorably toward implementation, it is becoming clear that health reform, as envisioned in the Affordable Care Act of 2010, will not fix our health system. While providing coverage for perhaps 30 million Americans represents progress, fundamental flaws in the legacy health payment and care systems will result in squandering a lot of the new funding without improving Americans’ health.

The US healthcare system has been changing rapidly in anticipation of health reform. Specifically, it has been consolidating into regional hospital monopolies that are narrowing patients’ choices and driving up the price of healthcare to patients, businesses and health insurers. Hospital systems are also using their enhanced bargaining leverage with health plans and the resultant cash flow to absorb their physician communities, locking down healthcare markets. Further, in most American communities, two or fewer health insurers control half or more of the health insurance market. Patients and their physicians find themselves marginalized in an increasingly corporate and uncompetitive healthcare marketplace.

The central questions in health reform are how to obtain better value for the healthcare dollar and how to engage patients more effectively in improving their own health. Because they are the pivotal contact point for patients and their families, physicians can play a decisive role in achieving both better health for patients and a more effective health system overall – by helping patients manage their health risks and by finding the most cost-effective solutions to patients’ health problems when intervention is required. If patients and physicians are submerged in vast bureaucracies, however, that potential will never be realized...
Physicians have a crucial role to play not only in reforming the care system, but also in creating cost and quality accountability in the care system. Physician care remains a bargain compared to institutional alternatives. And because they know where the waste is in the system and how to avoid it, physicians can play a key role in organizing the most cost-effective care when patients need it.

Physicians wishing an alternative future to becoming employees or civil servants will need to do three things:

  1. Achieve the Mass and Scale to Organize Care More Effectively and Lower Costs
  2. Develop New Care Models that Better Meet Patients’ Needs
  3. Assume More Risk and Responsibility for Managing the Cost of Care
In order for these things to happen, public financing programs and private health plans must forge new working relationships with physicians – as well as simplify their financial relationships with physicians to support these new models and encourage better teamwork in care provision.    Physicians are the key to a more efficient, humane and effective US healthcare system.
Full paper here (pdf). I'll finish reading it prior to commenting further.

apropos of the issue:

The accompanying editorial by Ezekiel Emanuel and Andrew Steinmatz calls the current national debate about healthcare an “all hands on deck” moment in medical history. They wonder whether doctors will assume responsibility and step in to captain the ship, or stand aside, and let others navigate the future of healthcare while they swab the deck.

Only one-third of doctors in the survey felt that they themselves had a major responsibility for reducing costs. The news media jumped on this as doctors simply blaming others. But looking at it from a more human perspective may explain this seemingly callous response.

We doctors train in the scientific method and subscribe to evidence-based medicine. We calculate risk profiles and cite placebo-controlled studies. But we are not nearly as rational as we like to tell ourselves, or our patients. Past experiences, gut instincts, and emotional contradictions factor in just as much hard data, especially when we try to figure out how to steer the listing ocean liner that is our health care system today.

For the average practicing physician, the major goal of any given day is simply to stay afloat. The typical 15-minute office visit is rarely enough time to fully address the clinical needs of patients with multiple chronic illnesses, and the onerous documentation demands of electronic medical records ensure that doctors spend most of that visit interacting with the computer rather than with the patient.

 Many of these documentation requirements are, of course, important.. As a primary care internist, I wholeheartedly support the idea that we should be asking our patients about domestic violence, depression, and pain levels, that we should be on the lookout for barriers to communication, that we should be documenting efforts in patient education, that we should be rigorous about age-appropriate screening tests, that we should print and review the medication list at every visit.

But there are so many requirements—and the list keeps growing—that there’s hardly time in that 15-minute visit to talk to the patient about their actual medical conditions, let alone do a thorough...

More to come...

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