Healthcare Transformation: Coping With the Neutral Zone

I’m being asked the same series of questions a lot lately:

Do you think the changes occurring in US healthcare are real?  Are we truly moving away from rewarding volume of care under fee-for-service (FFS) and toward value-based payment and delivery? Are the changes past the point of no return? Will the economic interests of the powers-that-be prevent real change from happening, just as they have done in the past?

The phrasing of these questions assumes a split, dichotomous view of the world — that change has/hasn’t yet happened. The questions also mask the underlying and difficult process of transition that people and organizations are going through.

There’s a different way to think about the transformation of U.S. healthcare — transition as a 3-stage process:

William Bridges 3 Stage Transition Model


Here’s a summary of where I’m going with today’s essay:

  • Think of Transition as a 3 Stage Process
  • U.S. Healthcare—Entering the Neutral Zone
  • How Long Will the Neutral Zone Last? Quite a While.
  • So What? What are Implications and Actions? 

Healthcare Social Media: Real Engagement or Fluff?

Reprinted courtesy of mcol

Today’s Topic

Would your personal experiences and observations of healthcare social media indicate that real engagement is generally occurring, or to-date Is it mostly just promotion and marketing “fluff” that is being facilitated – and how can healthcare engagement objectives be better met?

Cyndy Nayer

Founder, Center for Health Value Innovation

As a person who uses social media to advance healthcare ideas, projects and policies, I’m obviously intrigued and excited about social media mean to the connected health. The opportunity to learn and share globally is huge, but it can be debilitating because of the vastness. So the question of “fluff” is excellent: who and how one interacts and is reciprocated is paramount to the success of healthcare social media, otherwise known as #HCSM or, often, socmed or somed. For those who understand the intent of each venue, harnessing and engaging the crowds is powerful. For those who don’t, here’s a quick primer:

Twitter is the headline, Facebook is the abstract, LinkedIn is the targeted focus on business (which, while it may seem more targeted, is actually broadening in scope everyday), YouTube is the movie trailer for coming attractions, Pinterest is the commercial, blogging is the foundational “home” that launches all of these apps, and it grows from here.

Social media shares information with those who care to tune in. Most definitely it’s not “fluff,” unless posts of any kind turn to deep, self-revelatory items or soundbites with little backup. Folks must choose their “channels” carefully, and even within, choose their “follows” even more carefully. I find that follow many, and many follow me, but I choose focus and interaction as my own work evolves.

The promise of social media lies in the interaction of the healthcare and healthy lifestyle systems with the end user, the consumer. With EHRs changing and merging along with the mergers and acquisitions within the healthcare delivery system, socmed can get confusing, cumbersome, and, in my efforts, often is turned off to the very persons who need the engagement: the patients and their families. That throws the consumerism into the user’s choice rather than a shared decision, where it would be more valuable.

10th Annual Healthcare Unbound Conference, Denver, July 11/12



This nationally recognized conference and exhibition focuses on technology-enabled consumer engagement and behavior change. Topics to be covered included innovative applications of remote monitoring, home telehealth, mHealth, eHealth, social media and gaming to help manage diseases, promote wellness and facilitate accountable care. The program features three new educational tracks:

Track A: Government – private sector collaboration in promoting consumer engagement through innovative technologies. Topics to be covered include Blue Button+, patient generated health data, Meaningful Use 2 and 3 criteria, patient-provider portals and view, download and transmit capabilities.

Track B: Entrepreneurship & innovation in the Healthcare Unbound space, featuring perspectives from thought leaders, financiers and innovative startup companies

Track C: Consumer engagement and accountable care – topics to be covered include remote monitoring, home telehealth, mHealth, eHealth, social media and gaming.

Speakers Include:

  • Steve Adams, Chairman & President, Collaborative Health Consortium
  • Mark Blatt, MD, Worldwide Medical Director, Enterprise Solution Sales, Intel
  • Sean Cassidy, GM, Enterprise Provider Analytics, Premier, Inc.
  • Leslie Kelly Hall, Senior Vice President of Policy, Healthwise
  • Vince Kuraitis, JD, MBA, Principal, Better Health Technologies, LLC
  • Daniel L. Newton, PhD, Staff VP Product/Solutions Development and Behavioral Economics, Anthem Care Management,WellPoint
  • Chuck Parker, Executive Director, Continua Health Alliance
  • Lygeia Ricciardi, Director of the Office of Consumer eHealth, Office of the National Coordinator for Health IT, US Department of Health and Human Services
  • Neal Sofian, MSPH, Director, Member Engagement, Premera Blue Cross

For more information, please visit:

My Health Information Should PRECEDE Me, Not Just Follow Me

To state the obvious, there are times when the value of information depends on timing. Sometimes information needs to be provided in advance.

Consider a few examples. How valuable would the following types of information be to you?

  • From your GPS car navigation device: “You should have turned off at the last freeway exit”.
  • From the National Weather Service: “A class four tornado is hitting your neighborhood right now”.
  • From an airline when you arrive at the gate: “We canceled your flight five hours ago because we needed the plane on another route. Sorry”.

The Federal ONC (Office of the National Coordinator for Health IT) website speaks to the value of creating a secure, interoperable nationwide health information network:

A key premise is that information should follow the patient, and artificial obstacles — technical, bureaucratic, or business related — should not be a barrier to the seamless exchange of information. (Emphasis added)

Quiz: Is Healthcare Next on the List?

Pop quiz:

What do address books, video cameras, pagers, wristwatches, maps, books, travel games, flashlights, home telephones, cash registers, Walkmen, day timers, alarm clocks, answering machines, The Yellow Pages, wallets, keys, transistor radios, personal digital assistants, dashboard navigation systems, newspapers and magazines, directory assistance, travel and insurance agents, restaurant guides and pocket calculators all have in common?

This question was posed by Paul Nunes and Larry Downes in their recent Forbes article “How Innovations Become Better and Cheaper“.

For today’s quiz, we’ll have 3 levels of scoring– 2 points for a good answer, 5 points for a better answer, and 10 points for the best answer.

The 2 point answer: each of these products or services is in the process of being disrupted by a new technological innovation.

The 5 point answer: each of these products or services  is being supplanted  by what Nunes and Downes refer to as a “Big Bang Disruption”.  Read their Harvard Business Review article for more details on Big Bang Disruption.

The 10 point answer?

3 Critical Elements of Clinical Collaboration

A colleague recently wrote to me and asked me my definition of “collaboration”.

It doesn’t mean that care providers need to hug each other and sing Kumbaya. Ideally, care providers will like each other, but that’s not foundational.

I see 3 critical elements to clinical collaboration:

Editorial: A Duty to Share Patient Information

by Vince Kuraitis and Leslie Kelly Hall, Senior Vice President, Policy, Healthwise.

The sharing of patient information in the US is out of whack — we lean far too much toward hoarding information vs. sharing it. While care providers have an explicit duty to protect patient confidentiality and privacy, two things are missing:

  • the explicit recognition of a corollary duty to share patient information with other providers when doing so is the patient’s interests, and
  • a recognition that there is potential tension between the duty to protect patient confidentiality/privacy and the duty to share — with minimal guidance on how to resolve the tension.

In this essay we’ll discuss

  1. A recent recognition in the UK
  2. The need for an explicit duty to share patient information in the US

  3. Implications of an explicit duty to share patient information in the US


1) A recent recognition in the UK

Last week a long-awaited study commissioned by the Department of Health was released. Here are a few key findings from The Information Governance Review Report (Caldicott Review):

…safe and appropriate sharing in the interests of the individual’s direct care should be the rule, not the exception.