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PHIN (Personal Health Information Network)

Hospitals or Health Plans: Who Do You Trust to “Connect” You with Your Health Records?

Over the past decade, I’ve seen a number of studies asking people whom they trust among various health care stakeholders. Nurses, pharmacists, and doctors always come out at the top.  Beyond that:

Trust of hospitals tends to be high (60–80%)
Trust of health plans is at the bottom of the heap (10–20%)

Is this written in stone for the future? I don’t think so…and the dynamics for change are in motion.  Please read on.

Here’s the emerging picture I’m seeing:

Hospitals are dragging their feet in […]

Walled Gardens vs. the Open Web: A Central Debate in Tech Finally Coming to Healthcare

The September issue of Wired magazine and an article in last Sunday’s New York Times illustrate a central debate in technology circles. The debate is not new — it’s being going on for two decades — but it has newfound vibrancy. The essence of the debate is about competing tech/business models: walled gardens vs. the open world wide web (web).

 

vs.

 

The debate is highly controversial and nuanced. There are “experts” on both sides.

My point today is not to take sides […]

We’re Building a REALLY BIG Health Internet!

How big a network will the Health Internet (aka National Health Information Network) be?

My BOTE (back-of-the-envelope) calculation is that this network could consist of about 301 million nodes.  Here’s my math (pls. clarify or amplify):

300 million individuals in U.S.
700 K doctors
5 K hospitals
295 K — other B2B healthcare entities

Very rough…but I hope you get the point.

So let’s put into perspective press releases from Google or Microsoft announcing that they have developed new “partnerships” (i.e.nodes in the network) for Google Health or Microsoft HealthVault. As an example, […]

The Third Rail in HITECH Implementation: “Please Don’t Make Us All Speak Latin”

By Vince Kuraitis and Steven Waldren MD, MS.  Dr Waldren is Director of the Center for Health Information Technology at the American Academy of Family Practice (AAFP).

Two issues have rightfully surfaced front and center in the public’s understanding of HITECH Act implementation:

” definition of “Meaningful Use” of EHRs, and
” definition of “certification” process for EHRs

…and we applaud the progress of the workgroups and the HIT Policy Committee in addressing these issues constructively.

However…a THIRD issue lurks – “Data harmonization at the […]

What’s a Network Industry? Is Healthcare One?

This post is a foundational overview of characteristics of network industries.  Much of the terminology will deserve deeper discussion, but we have to start somewhere.

In his book The Economics of Network Industries, Professor Oz Shy lists four characteristics of network industries.

The main characteristics of these markets which distinguish them from the market for grain, dairy products, apples, and treasury bonds are:

Complementarity, compatibility and standards
Consumption externalities [network effects]
Switching costs and lock-in
Significant economies of scale in production

In this essay, I’ll quote from Dr. Shy in explaining each […]

Intro to a New Series

  “We need to make care linkages a core competency of American health care.” 
George Halvorson, Chairman and CEO, Kaiser Foundation Health Plan, Kaiser Foundation Hospital

 

There’s a double meaning to the title of this new series: Healthcare Crosses the Chasm to the Network Economy

At the level of technology, it’s a reference to Geoffrey Moore’s bestselling business/technology book — “Crossing the Chasm”. The Chasm here is the huge gap between early adopters of technology and mainstream users. The book describes the process of bringing […]

Microsoft HealthVault is a Serious Business Strategy. Will Google Health Become More than a Hobby?

Google Health…please stick around….but please also get your stuff together.

Over the past few days, several of my respected colleagues have written excellent blog posts essentially asking “Does Google Health have life?”

Scott Shreeve — CLEAR! Shocking Google Health Back to Life
John Moore — Is Google Health Irrelevant?
Will Crawford — Future of Google Health

I share their observations and sentiments.  I see Microsoft HealthVault as a serious business strategy while Google Health is more like a hobby (one of probably hundreds at Google).

Are there reasons […]

Overcoming The Penguin Problem: Setting Expectations for EHR Adoption

 

 

 

 

 

 

 

 

Economists call it “The Penguin Problem”  — No one moves unless everyone moves, so no one moves. 

The role of user expectations is crucial in getting penguins to move off of ice floes and in the successful adoption of new network technologies.  I’ll cover two main points in today’s essay:

How “The Penguin Problem” Helps Explain Low EHR (electronic health record) Adoption To-Date
How Recent Federal Actions Are Setting Higher Expectations for EHR Adoption

The Penguin Problem and Low EHR Adoption To-Date

While not the only factor, […]

Blueprint for Change: From EMR 1.0 to Clinical Groupware (EHR 2.0)

by Vince Kuraitis JD, MBA and David C. Kibbe MD, MBA

The last article in this series — Time for EHRs to Become Plug-and-Play — used words to describe a major industry shift underway in health IT.

Sometimes pictures help to make a point. Here are several diagrams that you can also download as PowerPoint slides.

 Computer Industry 1983 to 2002

 

  Source: Venkatraman, N. Winning in a Network Centric Era, 2006

Blueprint for Health IT Shift

From EMR 1.0 — 2008…

…to Clinical Groupware/EHR 2.0 — 2012

Leavitt’s Framework Shoehorns the HIPAA Privacy Rule onto Your Personal Health Information

by Vince Kuraitis and David C. Kibbe MD, MBA

Have you ever heard anyone tell a happy story of how easy it is to get a copy of their paper medical records?

Departing Health and Human Services Secretary Mike Leavitt is laying the groundwork for this same story to apply to access to YOUR electronic personal health information.

Here’s an overview to what evolved into a long posting:

Analysis: The Leavitt Framework Uses the HIPAA Privacy Rule as a Baseline for Electronic Access to Personal Health Information
Implication: Extending […]