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E-CareManagement News

June 30, 2003



Consumer healthcare technologies are driving opportunities to serve patients in new ways and in new settings.  Forrester Research recently coined the term “Healthcare Unbound” to encompass the trends toward self care, mobile care, and home care.  More specifically, Forrester Research describes Healthcare Unbound as “technology in, on and around the body that frees care from formal institutions.”  

In addition to dramatically changing traditional healthcare delivery, Healthcare Unbound attracts a range of companies that previously have not been deeply involved in healthcare -- consumer electronics, telecom, and information technology companies to name a few. 

Better Health Technologies’ recent consulting work with Samsung Electronics highlights some of the dramatic benefits flowing from the convergence of consumer and healthcare technologies:

1) Improving patient adherence to clinical guidelines
2) Gathering vital sign data from patients remotely
3) Providing information to patients -- anywhere, anytime
4) Automating information flow among patients, healthcare providers, and payors -- reducing costs AND improving quality.
5) Keeping people in their own homes (rather than in hospitals or nursing homes)  

Are consumers interested?  In the enlightening report, “Consumer Healthcare Electronics: Consumer are Ready, Willing and Able”, Accenture found that consumers are eager to play an active role in managing their health and embracing emerging home healthcare technologies.

What are examples of converging consumer and healthcare technologies?

CONSUMER TECHNOLOGIES: smart houses, personal communications devices (PDAs, cell phones, smart phones, etc.), broadband (cable, DSL, satellite), digital cameras & video, wireless, etc.

HEALTHCARE TECHNOLOGIES:  remote patient monitoring, personal health records, electronic medical records, e-prescribing, e-disease management, e-clinical trials, telehealth/telemedicine, sensors, traditional medical devices (becoming smaller, internet enabled, implantable), call centers, customer relationship management technologies and Internet/web technologies (interactive web sites, doctor/patient email, virtual physician visits, etc.)


With assistance from Drapin & Co. and BHT, The Center for Business Innovation (TCBI) is organizing a conference:

 Healthcare Unbound:
 A Conference & Exhibition on the Convergence of Consumer and Healthcare Technologies

You can view a preliminary agenda for the conference. Are you interested in speaking?  Exhibiting?  Sponsoring?  Attending?  Call or write Satish Kavirajan, Managing Director, TCBI, (310) 265-2570,

Are you interested in discussing how your company can benefit from Healthcare Unbound?  Call or write Vince Kuraitis, Principal, Better Health Technologies at (208) 395-1197,

We will be bringing you more details over the coming months....stay tuned.


The Quality of Health Care Delivered to Adults in the United States
New England Journal of Medicine; June 26, 2003
Rand Organization Fact Sheet with link to full NEJM article

Results:  Participants received 54.9 percent...of recommended care. We found little difference among the proportion of recommended preventive care provided (54.9 percent), the proportion of recommended acute care provided (53.5 percent), and the proportion of recommended care provided for chronic conditions (56.1 percent).

Conclusions:  The deficits we have identified in adherence to recommended processes for basic care pose serious threats to the health of the American public. Strategies to reduce these deficits in care are warranted.


Private Payer Reimbursement Information Directory
American Telemedicine Association (ATA) and AMD Telemedicine, May 2003

Telemedicine Private Payer Reimbursement Insurance Survey
Mark Vanderwerf, President, AMD Telemedicine, Inc.
Presented at the ATA 8th Annual Meeting; April 30, 2003

There appears to be a critical mass for private payer reimbursement for telemedicine!

  • 38 programs in 25 states currently receive reimbursements from private payers

  • 3 programs receive reimbursement for store and forward

  • 7 Programs receive reimbursement for facility fees

  • Private payers appear to follow leadership of Blue Cross more than Medicare or Medicaid


Managed Care Measures: Results of the 2002 Managed Care Benchmarking Study
Cap Gemini Ernst & Young (CGE&Y), May 2003

Here are a few relevant findings relating to medical management benchmarks:

PMPM (per member per month) spending on Medical Management was up 34% over 1999 benchmarks, but reductions were noted in certain areas and plans were spending in a narrow range. In particular, utilization management (UM) staffing dropped by 50% and FTEs performing hospital precertification and referral authorization were less than one-third of 1999 levels.

Nonetheless, investment in focused medical management programs continue to demonstrate returns. Higher spending on medical management is strongly associated with lower medical loss ratios....

Overall utilization of disease management (DM) programs has remained steady, with the ratio of members in DM programs relatively unchanged between the 1999 to 2002 Benchmarking Studies. However, the programmatic focus changed.... Diabetes programs remained strong, but membership shifted out of high-risk obstetrics and into asthma and coronary artery disease (CAD) programs.


Home Telehealthcare: Process, Policy, and Procedures” is a new, 150- page, practical report for home care planners and providers embarking on the new frontier of home telehealth.

Chronic disease management services and new and affordable tools are key areas of focus. Sample in-house policies and forms for patient and home assessments, equipment maintenance routines, and other management concerns are provided to help achieve the consistency needed for effective telehealthcare program planning and delivery. 

More information is available at or from the author, Audrey Kinsella, at 800-506-6587/301-581-0090.


Doctors Who Are Using E-mail With Their Patients: a Qualitative Exploration
Journal of Medical Internet Research, April-June 2003

The authors surveyed physicians currently using e-mail with their patients.  They found that chronic disease management is one area of consistent agreement for respondents. These physicians felt that e-mail is a very effective way of managing patients whom they know well. Many cited examples of using e-mail to manage conditions such as diabetes, hypertension, psoriasis, and even congestive heart failure


5 Obstacles To E-Prescribing: 5 Approaches To Overcoming Them
American Medical News; May 12, 2003

Obstacle 1: Physicians can't afford the technology.
Potential solution: Someone else must pay for or subsidize the up-front cost.

Obstacle 2: There is no direct benefit to doctors.
Potential solution: Those who do benefit could offer financial incentives to physicians.

Obstacle 3: The technology is poorly designed and more inefficient than the paper-based system it's supposed to replace.
Potential solution: Companies should design technology that reflects how doctors work and offers them many benefits in a seamless package.

Obstacle 4: There is a lack of interoperability.
Potential solution: Companies should seek a wider adoption of clinical data standards so different information systems will work with each other.

Obstacle 5: There are regulations that ban or can be interpreted to ban e-prescribing.
Potential solution: The federal government needs to develop laws facilitating both e-prescribing and a clearer understanding of the applicability of the Health Insurance Portability and Accountability Act.


The Business Case For Diabetes Disease Management At Two Managed Care Organizations: A Case Study
The Commonwealth Fund, April 2003

Diabetes care is often poorly managed, and the disease exacts a high toll on society in terms of health costs and lost productivity. Analysis of two health plans with established diabetes programs shows that the business case for diabetes disease management is weak. The initial costs for such programs are substantial, and plans may not be able to reap the potential savings until 10 years after a health plan member is enrolled in the program.

To make diabetes management more attractive to health plans, a financing system that pays plans and providers on the basis of quality of services would need to be put into place. For example, fee-for-service payments could add reimbursement for group visits and electronic communications. Moreover, the institutions that benefit from improved diabetes care, including Medicare, Medicaid, and employers, could contribute to the financing of diabetes disease management. 


The 2003 Aging Vulnerability Index: An Assessment of the Capacity of Twelve Developed Countries to Meet the Aging Challenge
Watson-Wyatt Worldwide, March 2003  

The rapid aging of developed countries will pose a major challenge for global prosperity and stability during the first half of the twenty-first century.  Watson-Wyatt analyzed characteristics of 12 developed countries and grouped them into low/medium/high vulnerability:

Low Vulnerability
1. Australia
2. United Kingdom
3. United States 

Medium Vulnerability
4. Canada
5. Sweden
6. Japan
7. Germany
8. Netherlands
9. Belgium 

High Vulnerability
10. France
11. Italy
12. Spain 

The Index was compiled from indicators in four basic categories, each dealing with a crucial dimension of the aging challenge:  1) Public-burden indicators, 2) Fiscal-room indicators, 3) Benefit-dependence indicators, and 4) Elder-affluence indicators. 


Connecting Healthcare in the Information Age
Markle Foundation; June 5, 2003 

Health Plans: The Next Wave
HealthLeaders: June 10, 2003 

Today’s system treats health crises, but it fails at chronic disease care
The Hill; June 18, 2003 

National Medical Spending Attributable To Overweight And Obesity:
How Much, And Who’s Paying?

Health Affairs; May 14, 2003 

New model gauges health risks
Employee Benefit News, May 2003 

How Does Quality Enter into Healthcare Purchasing Decisions?
The Commonwealth Fund, May 2003 

Disease Management: The Programs and the Promise
Milliman USA May 2003 

Ageism: How Healthcare Fails the Elderly
Alliance for Aging Research May 2003 

Value-Based Purchasing: A Review of the Literature
The Commonwealth Fund, May 2003 

Broadband Adoption at Home: A Pew Internet Project Data Memo
Pew Internet Project; May 18, 2003 

Investment in Population Health in Five OECD Countries
Organisation for Economic Co-operation and Development; April 22, 2003 

Use of the Internet and E-mail for Health Care Information
Results From a National Survey
Journal of the American Medical Association; May 14, 2003 

European Union citizens and sources of information about health
The European Opinion Research Group, March 2003 

Success Stories in Telemedicine: Some Empirical Evidence
Telemedicine Journal and e-Health, Spring 2003 

If Cars Can Have Microprocessors, Why Can't People?
Health IT World; May 27, 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.

Disclosure -- Samsung Electronics, South Korea, is a client of Better Health Technologies.

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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