e-CareManagement blog

What do Amazon, Apple, Facebook and Google have in common?

Eric Schmidt, Chairman (and former President) of Google, coined the term “Gang of Four” in referring to the similar platform/application technical architecture and business models of these companies. In the case of Apple iOS and Google Android OS, much of the value is created by the 500K+ applications built on these platforms, not just by the platform themselves.

So four of the largest, most successful companies in the world are built on platforms — what does this imply for health care? Are “platforms” in health care a “Nice to Have” or a “Must Have”?

Continue reading ““Platforms” for Accountable Care, a “Must Have”, Not Just a “Nice to Have””

Please consider attending the inaugural eCollaboration Forum taking place at HIMSS12 on Thursday, February 23, 2012 in Las Vegas at the Venetian Sands Expo Center.

Theme — Collaborative Platforms and Applications in Health Care

This is the Health IT industry’s first-ever event focusing on collaborative health platforms and applications! We take an expansive view of platforms and will be exploring the required technologies, business ecosystems, and clinical care delivery needed to achieve accountable care.

Speakers

Sponsored by HIMSS and Collaborative Health Consortium (formerly the Clinical Groupware Collaborative), the inaugural eCollaboration Forum has scheduled the following speakers:

• John Mattison, MD – Chief Medical Information Officer, Kaiser Permanente, SCAL
• Farzad Mostashari, MD – National Coordinator for Health Information Technology
• Mark Blatt, MD, MBA – Worldwide Medical Director, Intel
• David S. Muntz, CHCIO, FCHIME, FHIMSS (tentative) – Principal Deputy, HHS/Office of the National Coordinator
• David Whitlinger – Executive Director, NY eHealth Collaborative
• Esther Dyson – Principal at EDventure Holdings
• David Kibbe, MD, MBA – The Kibbe Group and American Academy of Family Physicians
• Vince Kuraitis – Principal, Better Health Technologies
• Shahid Shah – CEO, Netspective and Blogger at HealthcareGuy.com
• Brian Ahier – “Health IT Evangelist”, Mid-Columbia Medical Center
• + many others

For the latest up-to-the-minute list of speakers, click here.

Continue reading “Announcing the Inaugural eCollaboration Forum at HIMSS12!”

Resources are finite. They just are. This is not an opinion, it is a law of the universe.

Yet, for my lifetime, I have been incredibly frustrated by medicine’s cultural and practical lack of acknowledgement of this law.

FINALLY, the American College of Physicians (ACP) got it. Kaiser Health News describes the revelation:

The American College of Physicians hit a nerve when it released an updated ethics manual calling for doctors to provide “parsimonious care” – in other words, “to practice effective and efficient health care and to use health care resources responsibly.”

This recommendation, included in the Jan. 3 Annals of Internal Medicine special supplement, drew immediate reaction – and not just because of its use of the infrequently heard “parsimonious.” It’s been viewed as a definitive statement of medical ethics directed at the organization’s 132,000 members – physicians who practice internal medicine and its related specialties, among them cardiology and oncology, that often involve expensive procedures. And, the guidance comes at a time when health care costs are central to the national policy debate.

My personal reactions to this are very mixed. Continue reading “Op-Ed: ACP Doctors, Thank You for Acknowledging a Law of the Universe”

The Care Continuum Alliance announces a timely new blog: Voice on Population Health.

Tracey Moorhead, President and CEO of the Care Continuum Alliance, writes today’s inaugural post. She persuasively notes the increasing importance of the full continuum of population health interventions – wellness, prevention and other approaches to improving health, reducing disease risk and raising productivity.

Bob Laszewski’s essay on today’s THCB resonated with me: 2012: A Year of Huge Uncertainty in Health Care Policy. In my 30 years in health care, I have never seen more uncertain and fluid times.

Yet in times of uncertainty and confusion, it’s important to focus on what IS certain and predictable. The need for population health approaches is one of those certainties. While care providers are recognizing the need to develop and invest in strong care management abilities, health plans are redoubling their efforts to develop these capabilities in-house.

Tracey’s first post includes a link to the CCA’s new white paper: Key Issues in Population Health Management: Key Industry Issues for 2012.  Check it out.

Check out the best of  health care policy punditry on the Wright on Health blog.  Brad Wright hosts the latest edition of the Health Wonk Review.

We need to be far more explicit in asking a subtle but critical question

What are acceptable bases of competition in health care?

My sense is that the distinctions here are not well understood and often go undiscussed, so I’ll quickly get to the point:

It’s OK for care providers to compete on the bases of quality, price, patient satisfaction, and many other factors

It’s NOT OK for care providers to compete on the basis of controlling or limiting access to patient health information. It’s just not right.

Today’s US healthcare system embraces market competition. For-profit and non-profit health care systems and care providers compete against one another. While we might or might not like this, all I’m asking you to do here is to recognize it.

Hospital based delivery systems work hard to keep patients within their network (walled garden) of providers. That’s understandable. But we need to probe deeper and examine how they are doing this — again, what are the bases of competition.

In many industries we accept the idea of creating proprietary, non-interoperable technology as a means of competitive differentiation. For example, the Apple iTunes system is not interoperable with MP3 players. This is an explicit and intentional part of Apple’s business strategy. I have no problem with this type of competition in digital entertainment.

Health care is different.

Continue reading “Getting An Epic Opinion Off My Chest”

Accountable Care Organizations (ACOs) have been likened to

a unicorn — a fantastic creature that is vested with mythical powers. But no one has actually seen one.

a camel — a horse designed by a committee, one that already has its nose in the tent

With this background, you can begin to appreciate the difficulty of conducting an accurate census of ACO animals in the wilderness.  Yet, this is exactly the task undertaken in the excellent Leavitt Partners report measuring ACO activity in the US.

As I will explain, the Leavitt report has the potential both to overestimate and underestimate ACO and accountable care-like activities. In my judgment, however, it’s far more likely to be understating just how much accountable care activity actually is going on.

Findings in the Leavitt Report

The Leavitt researchers “identified ACOs from news releases, media reports, trade groups, collaborations and interviews through the beginning of September 2011. Also included were entities that either self-identified as being an ACOs or specifically adopted the tenets of accountable care.”

The report counts 164 ACOs — 99 that are primarily sponsored by hospital systems, 38 by physician groups, and 27 by insurers.

Here’s how Leavitt summarized their results: Continue reading “Leavitt ACO Report: Overstating or Understating Accountable Care Activity?”

Yesterday’s announcement of  “Standard Health Data Connectivity Specifications” by the EHR|HIE Interoperability Workgroup (EHR|HIE WG) is potentially earth-shattering.

My mom would not know what I mean by “Standard Health Data Connectivity Specifications,” so I’ll try to write this in plain English.

Who Are These Guys? The EHR|HIE Interoperability Workgroup

The workgroup consists of HIEs (Health Information Exchanges) representing seven of the largest states, eight EHR vendors, and three HIE software/services vendors. Continue reading “The EHR|HIE Interoperability Workgroup — Potentially Earth-Shattering”

A just released study from Aon Hewitt and Polakoff Boland — 2011 Employer Driven Accountable Care Organizations Survey Report — examines employer attitudes toward ACOs.  The report provides useful insights into an area that hasn’t yet received much attention.

A couple tables in particular caught my attention.

(click on the graphic to view a larger version)

Key findings in this table include:

Continue reading “Employers Perceive that Health Plans Add Value to ACOs”