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E-CareManagement News

February 28, 2003

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Stereotypes of two medical conditions -- heart disease and cancer -- are changing. Recent stories in The New York Times, The Washington Post, and The Wall Street Journal describe how mainstream thinking is being challenged.

The New York Times quotes Dr. Claude Lenfant, Director of the National Heart, Lung and Blood Institute. "In the old days, you had a heart attack and you died.... You were almost signing the death certificate in advance. Now you know you can get another 20 or maybe 25 years."

“We have converted heart disease from an acute illness to a chronic disease" states Dr. Eugene Braunwald, a cardiologist who is the chief academic officer at Harvard Medical School's Partners Health Care System.

A similar story is being told about cancer. The Wall Street Journal reports that “...the concept of managing cancer rather than curing it is gaining a foothold in the treatment of a wide range of cancers.”

“We’re moving from a paradigm that might be called ‘find it and kill it’ to the new paradigm of ‘target and control it’” says Andrew von Eschenbach, director of the National Cancer Institute and himself a two-time cancer survivor (as cited in The Washington Post).


Its time to change our own thinking about these conditions, their impact, and the type of health system needed to treat today’s patients with compassion and caring. Share the details with your colleagues...

Gains on Heart Disease Leave More Survivors, and Questions
New York Times; January 19, 2003

From Killer to Chronic Disease: Drugs Redefine Cancer for Many
Washington Post; January 29, 2003

Why Curing Your Cancer May Not Be the Best Idea
Wall Street Journal; February 11, 2003 (subscription required)

The Newest Chronic Illness: Cancer
Health Policy Wire; February 14, 2003


To date, most companies advancing remote patient monitoring (RPM) technology have aimed at bringing the equipment in through the front door of the patient’s home. These efforts have met with mixed success.

Sensitron is a company with a different approach -- a value proposition for HOSPITALS to be innovators in RPM. The approach is to bring remote monitoring in through the front door of the hospital, with the immediate benefit being “your nurses will save time and the hospital will save money by automating the process of taking patient vital signs with RPM.” Once the remote monitoring system is in place, Sensitron’s vision is to send it home with the patient through the back door of the hospital, i.e., “and after your inpatients are acquainted with the RPM system, they can take it home with them while they are recovering.”

Sensitron has some unique strengths:

  • Technology. Sensitron has developed a healthcare software platform that automates workflow and patient monitoring in hospital settings. The capability utilizes Bluetooth wireless technology and a proprietary data integration methodology to afford customers a compelling ROI and is priced at a fraction of the amount charged by other traditional vendors that are deploying comparatively antiquated technology.
  • Partnerships and Customers. Sensitron has established a distribution partnership with one of the world’s largest IT systems integrators. The company has new contracts in place with impressive flagship hospital customers. Sensitron has secured contracts with 2 U.S. Government agencies for initial implementations, both of which foreshadow much larger on-going relationships.
  • People. Sensitron remains on track with both its revenue and expense forecasts, and has assembled an impressive management and advisory team.

Sensitron is searching for a third partner for its $5 million round of Series B financing. Two name-brand venture capital firms have committed their support.

If you would be interested in exploring partnership or financing opportunities with Sensitron, please contact Rajiv Jaluria, President and CEO, (650) 358-0244 x102,


Medicare has just announced another disease management demonstration project.  Press Release, U.S. Department of Health and Human Services; February 27, 2003

Organizations participating in this initiative will receive a capitated payment rate for all Medicare-covered Part A and Part B services. Capitated payments are predetermined rates paid each month for each beneficiary enrolled in a health care program. This predetermined rate is based on the projected costs of the enrollee for the payment year, fully adjusted for their health status.

What’s noteworthy about this particular announcement?

  • The “C” Word -- Capitation. Did you think capitation was a dying form of payment? Not so fast.
  • Other “C” Words -- Chronic Care. Medicare continues to show its earnestness in confronting challenges of an aging population. The number of disease management demonstration projects announced in the past two years is impressive.


Alan Greenspan, Chairman of the Federal Reserve Board, recently set the stage in describing Medicare’s challenges: “the aging of the population in the United States will have significant effects on our fiscal situation. In particular, it makes our social security and Medicare programs unsustainable in the long run.” Special Committee on Aging, United States Senate; February 27, 2003

A number of recent reports and articles have highlighted Medicare’s opportunity to refocus on the needs of people with chronic conditions. Excerpts and summaries are presented below:

Making Chronic Care the Focus of Medicare Reform
Prepared Statement to the House Ways and Means Health Subcommittee
Jeff Lemieux, Progressive Policy Institute; February 25, 2003

Medicare is not well suited to provide disease management services at any level, for four reasons:

1) Medicare's fee-for-service program cannot pay for performance.
2) Medicare's benefits are inadequate.
3) Medicare's benefits are poorly structured and hard to change.
4) Medicare's HMO program is a mess.

Medicare in the 21st Century: Building a Better Chronic Care System
National Academy of Social Insurance, January 2003

The report offers six recommendations:

1) Provide beneficiaries with financial protection from chronic conditions.
2) Support the continuum of care beyond those services presently covered by Medicare.
3) Promote new models of care.
4) Strengthen CMS’ role as a purchaser of care.
5) Support enhanced information systems.
6) Implement and support funding for research and demonstration projects.

Confronting the Barriers to Chronic Care Management in Medicare
Health Affairs; January 22, 2003

Grounded in indemnity insurance principles, the traditional Medicare program faces difficulty evolving to support of a chronic care model of health care practice. Although capitation may be the most desirable platform to support providing of care to beneficiaries with chronic conditions, there are some opportunities for incremental improvements in fee-for-service Medicare:

  • Increased payment for office visits
  • Clinical care management
  • A new home visit benefit

Healthy Aging v. Chronic Illness: Preparing Medicare for the New Health Care Challenge
Progressive Policy Institute; February 14, 2003
New research, new communications technology, and a new willingness on the part of individuals to participate in their own health care offer Medicare the best opportunity in a generation to redirect its energies toward the broad goal of healthy aging. By encouraging innovations responsive to the chronic care challenge, rather than just adding new benefits onto an outdated payment structure, Medicare can promote healthy aging, reduce disability, and produce better value for beneficiaries and taxpayers alike.


Physicians and Care Management: More Acceptance than You Think
Issue Brief, Center for Studying Health System Change, January 2003

                                               PERCENT AFFECTED       POSITIVE
CARE MANAGEMENT TOOL             BY TOOL                     VIEW
Practice Guidelines                                56%                         66%
Patient Satisfaction                                62                            77
Practice Profiling                                    34                            51


Partnership for Solutions, led by Johns Hopkins University and The Robert Wood Johnson Foundation, is an initiative to improve the care and quality of life for the more than 125 million Americans with chronic health conditions. Its recent book, “Chronic Conditions: Making the Case for Ongoing Care” takes a comprehensive look at chronic care in America today and in the future.

Chronic Conditions: Making the Case for Ongoing Care
Partnership for Solutions, December 2002

The Partnership recently has published two other reports:

Care Coordination for People with Chronic Conditions
Partnership for Solutions, January 2003

The Interdisciplinary Team in the Management of Chronic Conditions: Has Its Time Come?
Partnership for Solutions, January 2003


Priority Areas for National Action: Transforming Health Care Quality
Institute of Medicine, January 2003

“Care Coordination” is 1 of the 20 priority areas for national attention. About 60 million Americans live with multiple chronic conditions, such as hypertension and diabetes. Clinicians and institutions should actively collaborate and communicate to ensure an appropriate exchange of information and coordination of care. This is key in the effective treatment of chronic conditions.

For a listing of all 20 key areas, click here:

CGE&Y's TOP 10

Health Care’s 2003 Top 10 Business Issues and Impacts
Cap Gemini Ernst & Young; January 3, 2002

1) Transformations, big and small
2) Selective investments -- with a business case
3) A new view of care delivery
...providers will go beyond technology investments, recognizing that these goals can only be achieved by integrating process improvements and organizational change with the enabling information systems. Clinically oriented technology systems will become a priority for payors as well, who are redirecting medical management efforts to advanced care management, or population health management approaches. This involves the use of predictive modeling techniques and technology to identify “at risk” patients and offer support programs...
4) Outsourcing of non-core activities
5) A HIPAA hustle
6) A relentless search for staff
7) “New” technology adoption
8) Capacity management
9) Greater accountability for performance
10) A disaster preparedness agenda


Forrester's Top 10 Healthcare Predictions For 2003
Forrester Research; January 10, 2003

1) Medical error reduction will go outpatient, then hit a roadblock.
2) Side-by-side drug comparisons will ratchet up consumer clout.
3) ProAct Technologies will be a winner in the benefits portal market.
4) Inpatient physician orders will flow into the hospital supply chain.
5) Sen. Bill Frist will emerge as healthcare IT's most powerful friend -- ever.
6) Drug firms will move to thaw frosty relationships with AMCs.
7) Pharma's marketing woes will revive disease management. ...In 2003, expect disease management to be delivered by high-profile partnerships between big pharma and providers or plans, with Pfizer and GlaxoSmithKline out front in shaping the deals.
8) Health plans and vendors will rank physicians on consumer services.
9) Privacy breaches will not set off bombshells.
10) As staff shortages worsen, providers will substitute IT for labor.


The Graying of Kaiser Permanente
The Permanente Journal, Winter 2003

The UCLA Internet Report, Year 3
UCLA Center for Communication Policy; February 2003

Placing Faith in Technology to Improve Members' Choices
An Interview with Jack Lord, MD, Medical Director of Humana and previous President of the Disease Management Association of America
Managed Care, December 2002

Promising Practices in Chronic Disease Prevention and Control
U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; February 2003

Counting on the Internet
Most expect to find key information online, most find the information they seek, many now turn to the Internet first
Pew Internet Project; December 29, 2002

External Incentives, Information Technology, and Organized Processes to Improve Health Care Quality for Patients With Chronic Diseases
Journal of the American Medical Association; January 22/29, 2003

E-CareManagement News is a complimentary e-newsletter sent to over 3,000 worldwide readers courtesy of Better Health Technologies, LLC <>.

For business and clinical decision makers who are developing innovative approaches to managing chronic diseases, Better Health Technologies is an eHealth and disease management consulting company that can assist you with strategy/business planning, finding financing, finding initial customers, and developing key partnerships.  We are different from other advisors because of our depth and breadth of experience and our willingness to become long-term partners with your team.

 Disclosure -- Sensitron is a client of Better Health Technologies, LLC.

You may copy, reprint or forward all or part of this newsletter to friends, colleagues or customers, as long as the use is not for resale or profit and the following copyright notice is included intact. Copyright © 2003, Better Health Technologies, LLC. All rights reserved


We welcome your opinions and comments. Write or call Vince Kuraitis JD, MBA at, (208) 395-1197 or Harry Leider MD, MBA at, (410) 252-7361.

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