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THINKING ABOUT HEART DISEASE AND CANCER
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...
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
SENSITRON -- A
UNIQUE TWIST ON REMOTE PATIENT MONITORING
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.
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
- 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
ANNOUNCES CAPITATED DISEASE MANAGEMENT DEMONSTRATIONS
Medicare has just announced another
disease management demonstration project.
Release, U.S. Department of Health and Human Services; February
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
- 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
REFORM EFFORTS SHOULD AIM AT IMPROVING CARE FOR PEOPLE WITH CHRONIC
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
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
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
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
- 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.
EXPRESS SURPRISINGLY POSITIVE VIEWS TOWARD CARE MANAGEMENT TOOLS
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
FOR SOLUTIONS RELEASES REPORTS ON CHRONIC CONDITIONS
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
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
COORDINATION IS AMONG 20 KEY AREAS TO IMPROVE THE HEALTH CARE SYSTEM
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,
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
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
4) Inpatient physician orders will flow into the hospital supply
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
9) Privacy breaches will not set off bombshells.
10) As staff shortages worsen, providers will substitute IT for
The Graying of Kaiser Permanente
The Permanente Journal, Winter 2003
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
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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
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