e-CareManagement Blog
Archives for e-CareManagement Blog (2006-2021)
Top 20 iPhone Medical Apps: No Connection to EHRs…Yet
iMedicalApps recently published its list of Top 20 Free iPhone Medical Apps for Healthcare Professionals.
What struck me about the list is that the state-of-the-art is stand alone applications — I didn’t see any that had any connection to an EHR (electronic health record). Here’s the top 5 to give you a flavor of what’s on the list:
Medscape
Micromedex
New England Journal of Medicine
Epocrates
[…]
Doctors Love iPads. What Does it Mean? What Does it Mean?
After attending the largest annual health IT conference of the year — HIMSS 11 – John Moore reported that “nearly every EHR vendor has an iPad App for the EHR [electronic health record], or will be releasing such this year.”
Doctors love iPads…not surprising? But, how might you explain this?
There are at least two different possibilities:
Coincidence Theory
Conspiracy Theory
The Coincidence Theory
So doctors want to access EHR software through the iPad…what’s the big deal?
Apple has built a great new hardware platform with the iPad. […]
Direct Project: Revisiting the Innovative Power of Push
Last May Fred Trotter wrote a brilliant blog post entitled The Power of Push. His essay described the latent power of the Direct Project (known then as NHIN-Direct).
At that time, the Direct Project was still being incubated and was not widely known or understood. Since then, it’s gone from being an idea to a project in full-speed implementation.
The simplest conceptualization of the Direct Project has been as a secure email alternative to medically-related transactions that today typically occur by fax, e.g., […]
Is Economic Credentialing A Tool for Primary Care to Lead ACOs?
Is economic credentialing — the use of economic factors such as loyalty and utilization rates in the physician credentialing process — a potential tool for primary care physicians to lead ACOs? and reestablish the vitality of primary care in American health care?
Keith Wright and Gregory Drutchas’ incisive article Economic Credentialing: A Prescription To Secure Shared Savings Under Accountable Care provides useful history and context about economic credentialing:
For many years, the use of economic factors by hospitals in making medical staff credentialing decisions […]
Getting DIRECTly to the Point: The Role of the Direct Project in Fast-Tracking Health IT Interoperability
By Rich Elmore and Arien Malec. Rich Elmore is the Direct Project Communication Workgroup leader and Vice President, Strategic Initiatives at Allscripts. Arien Malec is ONC’s Coordinator, Direct Project and Coordinator, S&I Framework.
A patient’s health records are no longer confined to a doctor’s office, shelved inside a dusty file cabinet. With the advent of the Nationwide Health Information Network, a framework of standards, services and policies that allow health practitioners to securely exchange health data, medical records digitized to be easily […]
HSR Study: Focus on High-Cost Medicare Beneficiaries
Following the Money: Factors Associated with the Cost of Treating High-Cost Medicare Beneficiaries. Health Services Research; February 9, 2011
Access to the full online article is currently available for free on the Center for Studying Health System Change website.
Key excerpts:
Conclusions. Health reform policies currently envisioned to improve care and lower costs may have small effects on high-cost patients who consume most resources. Instead, developing interventions tailored to improve care and lowering cost for specific types of complex and costly patients may hold […]
10 Reasons Why an Open IT Platform Strategy is the Right Long-Term Choice for an ACO
Many Physicians and Clinical Service Providers Will Not Be In Your ACO Contracting Network.
Expect Significant Patient Leakage (Migration) Out of Your ACO Network
Expect Patient Demands for Sharing Records.
Minimize Anti-Trust Concerns.
Expect Continuing Government Pressure for Broad Data Exchange.
Complimentary Issue of Accountable Care News
Click here for a complimentary copy of of the February 2011 issue of Accountable Care News.
Click here for more information about subscribing to Accountable Care News.
Complimentary Webinar — An Impending Marriage: Electronic Health Records (EHRs) and Care Management Software
Webinar Title: An Impending Marriage: Electronic Health Records (EHRs) and Care Management Software
The presentation will be geared at practicing clinical case managers in health plans, hospitals, disease management companies, and similar organizations:
Describe market forces driving integration of EHRs and care management software.
Review care management software survey data and stimulus funding for EHR adoption.
Describe a 3 stage framework for the evolution of EHRs and care management software.
Characterize benefits to patients and impacts on care manager responsibilities.
The event is sponsored by HealthSciences Institute […]
Crowdsourcing the Future: Health 2.0 and HIPAA
Deven McGraw is the Director of the Health Privacy Project at the Center for Democracy & Technology.
The Health 2.0 movement has seen incredible growth recently, with new tools and services continuously being released. Of course, Health 2.0 developers face a number of challenges when it comes to getting providers and patients to adopt new tools, including integrating into a health system that is still mostly paper-based. Another serious obstacle facing developers is how to interpret and, where appropriate, comply with […]
Comments to ONC: PCAST HIT Report Becomes a Political Piñata
The PCAST Report on Health IT has become a political piñata.
Early Feedback on PCAST
Like many of my colleagues, I was taken aback by the release of the Report in early December 2010 — I didn’t know quite what to make of it. Response in the first week of release was:
Limited. The first commentaries were primarily by technical and/or clinical bloggers. The mainstream HIT world had remarkably little initial reaction to the Report.
Respectful of the imprimatur of “The President’s” Report and noting some of the big names associated with the […]
Updates on Proposed Stage 2 and 3 Meaningful Use Criteria
The Health IT Policy Committee has published proposed Stage 2 and 3 Meaningful Use Recommendations and they’re open for public comment until February 25.
I’ll share a couple of particularly useful and well written analyses and commentaries by colleagues.
Health IT guru and thought leader Dr. John Halamka writes about The Proposed Stage 2 and 3 Meaningful Use Recommendations in his blog.
This is a great article to get a thumbnail overview of all the proposed recommendations. John lists 38 criteria and provides a quick […]
Will ACO IT Models Be Walled Gardens or Open Platforms?
Will ACO (accountable care organization) IT models be walled gardens or open platforms? i.e., will ACO IT platforms focus on exchanging information within the provider network of the ACO, or will they also be able to exchange information with providers outside the ACO network? (If the question still isn’t clear, click here for a further explanation.).
HITPC Meaningful Use Workgroup Offers First Draft of HITECH Stage 2 & 3 Objectives
At the December 13 meeting of the HITPC (Health IT Policy Committee), the MU (Meaningful Use) Workgroup proposed a first draft of HITECH Stage 2 and 3 objectives.
A full list of objectives for Stages 1, 2 & 3 is available in the PowerPoint presented to HITPC.
The proposed objectives contain a mix of items that are:
Unchanged from Stage 1
Similar MU criteria with higher implementation goals, e.g.,
Stage 1: CPOE for Rx orders 30%
Stage 2: CPOE for 60% of Rx, lab and radiology […]
Summarizing Early PCAST HIT Critiques: “Brilliant, but they didn’t do all their technical homework.”
Last week PCAST (The President’s Council of Advisors on Science and Technology) issued a major report — “Realizing the Full Potential of Health Information Technology to Improve Healthcare for Americans: The Path Forward”.
The reviews are filtering in and I’m seeing two major themes:
The vision is on target: “extraordinary”, “breathtakingly innovative”.
These guys didn’t do all their technical homework. The range varies, but the message is consistent.
Here are some early critiques of the PCAST report. Let the debate continue!
MGH Medicare Disease/Care Management Demo Shows Home Run Results!
Medicare has (finally) recently released a report showing home run results for a disease/care management demonstration project!
Evaluation of Medicare Care Management for High Cost Beneficiaries (CMHCB) Demonstration: Massachusetts General Hospital and Massachusetts General Physicians Organization (MGH)
Remind Me Again About the CMHCB Medicare Demo…
The CMHCB started in 2005. My recollection is that the demo requirements were extremely similar to the Medicare Health Support (MHS) project, with a few exceptions: 1) Applicants had to include direct care providers (delivery systems, physicians) in their program design, 2) patient populations […]
Things we are grateful for this year
This post was written by Alexandra Drane and the Engage With Grace team. To learn more please go to www.engagewithgrace.org.
For three years running now, many of us bloggers have participated in what we’ve called a “blog rally” to promote Engage With Grace – a movement aimed at making sure all of us understand, communicate, and have honored our end-of-life wishes.
The rally is timed to coincide with a weekend when most of us are with the very people with whom we […]
Is Physician EHR Adoption Getting Past the Penguin Problem?
Remember the penguin problem described by economists?
No one moves unless everyone moves, so no one moves.
Overcoming the penguin problem has a lot to do with creating expectations. A recent writing by Dr. James O’Connor in Physician Practice expresses a voice from the physician community that I’ve never heard before. His essay is entitled “Meaningful Use — Doctors Have No Choice”.
Is “CMS Innovation Center” an Oxymoron?
A press release earlier this week announced the new CMS Center for Medicare and Medicaid Innovation.
If you went to their Twitter feed today, here’s what you’d see:
This struck me as a great pictorial representation of the broader challenges the CMS Innovation Center faces:
They’ve kinda sorta figured out there’s a conversation going on out there — they’ve joined Twitter
They haven’t figured out that they need to listen: Following = 0
They haven’t figured out they they need to talk: Tweets = 0
I remain hopeful, […]
Testing Technology vs. Enabling a System of Chronic Care – Results of the NIH Tele-HF Trial
by Randy Williams, MD FACC, CEO of Pharos Innovations
The results from the National Institutes of Health (NIH)-sponsored Tele-HF trial are in, and the findings are worth considering . The results are counter to most of the findings of other studies examining telemonitoring for heart failure and at face value are disappointing to us, and the industry. Upon closer examination, however, this study offers us an excellent opportunity for further innovation, refinement of solutions and continuous improvement. It also provides a snapshot […]
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 […]
“Does This ACO Thing Really Mean We Need to be ‘Accountable’”
The American College of Physicians (ACP) just released a well-reasoned and thorough position paper, The Patient-Centered Medical Home Neighbor: The Interface of the Patient-Centered Medical Home with Specialty/Subspecialty Practices.
As I’ve written before, the Big Idea behind ACOs (Accountable Care Organizations) is the notion of accountability, not the specifics of organizational structure.
The purpose of the ACP position paper is to address the gaps that exist in care coordination when a physician refers a patient to a specialist. The obvious and logical answer proposed is to develop […]
Six First-Take Reactions to Surescripts Network Expansion
Yesterday Surescripts announced their new Clinical Interoperability Services:
Extended Network Connectivity – As a network of networks, Surescripts will support and enable the exchange of all types of clinical messages between EHRs, HIEs and health systems that, today, are not connected with each other.
Net2Net Connect – Allows health systems and technology vendors that already support clinical information sharing within their network to connect to Surescripts in order to receive and send clinical information outside their network (December 2010).
Message Stream – Secure messaging […]
Creating the “Blood Pressure Chart” App: An Independent Developer’s Story
by Mateusz Mucha. Mateusz is a freelance web application developer from Krakow, Poland. 31 y.o., married, enjoys rock climbing, sailing, skiing and having 6 meals a day. Contact him at muszek@gmail.com
This is a short story about Blood Pressure Chart – a web-based tool used to manage, analyze and share blood pressure records. The old saying, “necessity is a mother of invention”, is almost applicable here. Almost, because coming up with an idea to store whatever records in a web app […]
Webinar: Beacon Communities Reshaping Landscape for HIT and Population Health
Tuesday, Oct. 26, 1-2 p.m. Eastern Time — Presented by the Care Continuum Alliance
Federally supported “Beacon Communities” are at work now defining how health information technology will support accountable, evidence-based care in communities – especially for care of chronic conditions. Backed by $235 million in federal grants, 15 communities across the country are serving as Beacon Community pilots for eventual wide-scale, performance-based use of technology to improve our health care delivery system.
The goal of the webinar is to address
The fundamental nature […]
Healthcare IT News Highlights Mobile Health Expo Presentation
Mike Miliard did a great job in capturing highlights and key points of my presentation at the Mobile Health Expo conference earlier this week. You can read his story here.
Please write me at vincek@bhtinfo.com in you’d like a copy of the PowerPoint presentation.
Update: Neil Versel of FierceEMR also wrote up the presentation. Here’s a link to his concise, on-target article “HIE, mobility, open platforms start to knock down ‘walled gardens’ of proprietary EMRs.”
Care Coordination Metrics: One Can of Worms that NEEDS to be Opened
“Track who is on a care team — and share info with the patient.”
That’s just one of the summary recommendations coming from expert testimony given in a recent public hearing on how to improve care coordination through the use of health information technology. The Meaningful Use workgroup and Quality Measures workgroups are now wrestling with how to translate this recommendation into meaningful use criteria for HITECH Stages 2 and 3.
Seems like […]
Verizon Abandoning Walled Garden Network & Business Model: Implications for Healthcare
Wha…? why are we talking about Verizon…isn’t is a healthcare blog?
When a major, multinational company does a complete turnaround on its operating and business model, it’s worth noting and examining the reasons behind the switch.
Wireless Week reported on a presentation made at the CTIA conference this week by Verizon COO, Lowell McAdam:
In a nod to the future, McAdam also said Verizon Wireless will scratch its “walled garden” approach because “in a 4G world, we need to turn that guarded model inside out.” […]
A Dark Horse in ACO Formation: Large Physician Groups
Kudos to the AMGA (American Medical Group Association) for advancing the cause of physician-led accountable care organizations (ACOs)! A few days ago it “convened leadership teams from 22 leading medical groups and organized systems of care at the inaugural meeting of the AMGA ACO Development Collaborative”.
In many communities, hospitals (delivery systems) will be the “natural” organization to lead an ACO. Hospitals bring management expertise, IT, capital, and community relationships to the table as important assets.
Questions about Hospital-Led ACOs
I’ll try to keep an open mind, […]
Hospital Readmissions Avoidance “Programs” — Vendors and Hospitals Not All On the Same Wavelength
Last week I attended and participated in an excellent conference — the National Reducing Hospital Readmissions Forum sponsored by World Research Group.
One of my main take aways is to observe a simple — yet huge — difference in mindset between hospital executives and vendors.
Over the past few months I’ve heard many vendors with diverse health care offerings talking about building readmission avoidance “programs” that they want to sell to hospitals. Their idea here is to put together a soup-to-nuts offering of technologies and services […]
The Achilles Heel of ACOs? Shared Savings Payment Model Unlikely to Motivate Hospitals
Sometimes you read something and the full impact doesn’t hit you until hours — perhaps days — later. As I was out mountain biking today, the importance of something I ran across yesterday suddenly hit me.
Accountable Care Organizations (ACOs) are today’s cure-du-jour for reforming the health care delivery system. Bob Berensen, MD of the Urban Institute strongly questions whether the shared savings model under current legislation provides enough economic incentive for hospitals to disrupt their existing core business of acute, inpatient care.
The dialogue […]
The State-of-the-Art of Care Management Software: Disconnected
Care management software is intended to help patients make critical connections across the health care delivery system. Today it’s used primarily by 3rd party care managers who are typically either employed directed or indirectly by payers. While not surprising, the state-of-the-art of care management software is that it continues to function as disconnected islands of information.
The 2010 Health Information Technology Survey (available at no charge) provides an insightful yet sobering snapshot of care management software. The study was sponsored by TCS Healthcare Technologies, the […]
“Disease Management” RIP
The Care Continuum Alliance has mercifully and wisely rebranded it’s name and eliminated the initials “DMAA”. See its press release: Care Continuum Alliance Launches New Brand for Population Health Improvement. (As a reminder, DMAA originally stood for Disease Management Association of America.)
I for one say “hurrah, and good riddance”.
Where Did the Term “Disease Management” (DM) Trip Up?
Status Report: HITPC and Workgroup Activities on HITECH Stages 2 & 3
OK, let me be the first to admit that today’s “just-the-facts-ma’am” post might be a little dry…but trust me, its really important stuff to know in understanding the process of how the Health IT Policy Committee (HITPC) and its workgroups are approaching formulating recommendations for HITECH Stages 2 and 3.
At this point at least two different workgroups are involved in developing recommendations for HITECH Stages 2 and 3.
A newly formed Quality Measures Workgroup. This group will “produce initial recommendations on […]
Megatrend Spotting: Health Plan Role of Having “Best Data About YOUR Medical Conditions” is Up for Grabs
Who has the most comprehensive data about YOUR clinical conditions?
For most people, the answer today is “your health plan”, but it’s not at all clear that health plans will continue to have this role in the future.
As physicians and hospitals adopt EHRs, it’s foreseeable that clinical data about patients will be far more available and accessible.
Will patient data become:
A jockeying point for control and business advantage between health plans and care providers,
A collaborative opportunity to optimize clinical care and care […]
Overview: Here Come Stages 2 and 3 of HITECH!
We’ve spent the past year creating the MU (meaningful use) requirements for Stage 1 of the HITECH act. As shown by the diagram above, Stage 1 focuses on Data Capture and Sharing. Now it’s time to begin to focus on Stage 2 (Advanced Clinical Processes) and Stage 3 (Improved Outcomes).
The current generation of EMRs (electronic medical records) were designed primarily to assist care providers with clinical documentation, billing, and maximizing revenues. They were not designed to enable care coordination and […]
Digital Medical Office of the Future Conference. Las Vegas, Sept. 9-10
CLICK HERE FOR THE CONFERENCE WEBSITE
Healthcare providers face critical choices in selecting and implementing Electronic Health Records (EHRs). In addition, physicians and hospitals will need to develop the capacity to exchange clinical information in order to meet Meaningful Use requirements. This program will offer detailed and practical information on EHR selection and implementation, as well as strategies for creating a sustainable health information exchange (HIE). The program also features sessions on legal/regulatory issues, clinical platforms and applications as […]
91% of Citizens Want All Their Healthcare Data Stored in One Place, in an EHR…
…Australian citizens, that is…not U.S. citizens. See Dr. David Moore’s writeup in Australian Health Information Technology.
Of course, you’d never see this type broad support for centralized EHRs in the U.S.
Is this good or bad? You can decide for yourself…but at the very least this caught my attention as illustrating communitarian vs. individualistic tendencies in different world nations.
A Manifesto for Healthcare’s Disruptive Innovation of the Decade: Open EHR Technology Platform(s) and Ecosystem
fyi, here’s a copy of my PowerPoint presentation at today’s Healthcare Unbound conference.
The Twitter hashtag for the event is #HCU10.
Medicare MAPCP Medical Home Demo: CMS Kicks Sands in the States’ Faces
by Jaan Sidorov, MD and Vince Kuraitis
The Medicare MAPCP (Multi-Payer Advanced Primary Care Practice) demo promised to be Medicare’s Biggest Change in 40 Years…
…but the emerging reality isn’t living up to the promise.
In this post, we’ll discuss:
The Promise
An Overview of the MAPCP Demo
Our Main Takeaway: Emerging Reality Suggests Medicare Will Be a “Difficult” Partner
Conclusion: Think Twice Before Signing Up
1) The Promise
The sandbox metaphor was first used by the National Academy for State Health Policy:
For the 10 or more […]
16 Capabilities Physicians Will Need to Implement New Payment Models
(click on the graphic to download the document)
Depending on the nature of the payment changes which are made, physicians may need to enhance their capabilities in some or all of the following sixteen areas:
Achieving sufficient patient volume to support a new or improved service.
Having sufficient upfront capital to design and implement a new or improved service.
Having the skills/experience to efficiently/effectively implement a new/improved service.
Having the ability to obtain and analyze data on the quality of services.
Having the skills/experience to […]
Is HITECH Working? #7: Where’s Plan B? Congress and ONC need to address major flaws in HITECH.
by Vince Kuraitis JD, MBA and David C. Kibbe MD, MBA
Pop quiz: Among early-stage companies that are successful, what percentage are successful with the initial business model with which they started (Plan A) vs. a secondary business model (Plan B)?
Harvard Business School Professor Clay Christensen studied this issue. He found that among successful companies, only 7% succeeded with their initial business model, while 93% evolved into a different business model.
So let’s take this finding and reexamine our human nature. In light of these statistics, […]
Nuggets
The Emerging Market in Health Care Innovation
Tilman Ehrbeck, Nicolaus Henke, and Thomas Kibasi
McKinsey Quarterly May 2010
McKinsey conducted research in partnership with the World Economic Forum to study the most promising novel forms of health care delivery and, in particular, to understand how these innovations changed its economics.
The Delineation of Home Healthcare: The Natural Evolution of a Healthy Industry
Wyatt Matas & Associates (investment bankers), April 2010
This whitepaper discusses the opportunity for home healthcare to become the center of chronic care disease […]
Is HITECH Working? #6: HITECH and Health Reform Objectives are Synergistic
by Vince Kuraitis JD, MBA and David C. Kibbe MD, MBA
.
….or to be more specific, HITECH is synergistic with payment reform that could come from the recently passed national health care reform legislation — the Patient Protection and Affordable Care Act (PPACA).
We’ll keep this post fairly short and try to avoid many of the more divisive aspects of this topic. The need for healthcare payment reform is well understood on both sides of the aisle:
Realizing the full potential of health IT depends in […]
Is HITECH Working? #5: “Gimme my damn data!” The stage is being set to enable patient-driven disruptive innovation.
.
by Dave deBronkart (e-PatientDave), Vince Kuraitis, and David C. Kibbe
So far this series has looked at HITECH participation by hospitals (grumbling but in the game) and physicians (wary, on the sidelines), kudos for ONC’s three major policy points, and how HITECH is already moving the needle on the vendor side. Today we’re going to look at the reason the whole system exists: patients.
It’s possible to look at the patients issue from a moral or ethical perspective, or from a business […]
Is HITECH Working? #4: While most attention has been focused on demand side incentives (will doctors and hospitals buy EHRs?), the supply (vendor) side of HIT is already transforming.
by Vince Kuraitis JD, MBA and David C. Kibbe MD, MBA
Most of the press coverage and attention to HITECH has been to the “buy” side of the market: The central question here has been: “Will doctors and hospitals buy and use EHR technology?”
Meanwhile — and much more quietly — the sell (vendor) side of the EHR market is already dramatically different than it was a year ago. We observe change occurring at at least three levels:
HITECH […]
Health Wonk Review: Block That Metaphor!
The latest Health Wonk Review is up at David Harlow’s HealthBlawg. David employs metaphors galore: death, taxes, baseball, and many more.
Is HITECH Working? #3: ONC got it right on the 3 major policy interpretations: Meaningful Use, Certification, Standards
We concluded our last post in this series with a blunt prediction that “key physicians will sit on the sidelines” and that clinician non-adoption of EHR technology is a potential “deal-breaker for the success of HITECH”.
While this might sound like a criticism of the way HITECH has been implemented, it’s not intended that way — it’s a commentary on 1) the complexity and scope of change that will be required to make HITECH successful, and 2) the level of protective entrenchment existing American […]
PCMH and Healthcare Reform: Avoiding Drowning in an Ocean of Opportunity
This article appears in the April 2010 issue of Medical Home News.
First, the good news: There are a lot of pilot and demonstration projects potentially involving the Patient Centered Medical Home (PCMH) in newly enacted Federal health care reform legislation – the Patient Protection and Affordable Care Act (PPACA).
Then, the bad news: There are a lot of pilot and demonstration projects potentially involving the PCMH in the PPACA.
…so many that the PCMH risks being drowned in an ocean of opportunity.
I’d […]
Is HITECH Working? #2: Key physicians will sit on the sidelines (at least for now).
(click on any of the above graphics to be linked to the orginal source)
by Vince Kuraitis JD, MBA and David C. Kibbe MD, MBA
In the previous post in this series on “Is HITECH Working?”, we straightforwardly noted that hospitals are playing in the HITECH game. The issue of whether physicians will play is MUCH thornier.
As the headlines above succinctly convey — we conclude that for now there is too much fear, uncertainty, and doubt (FUD) to expect significantly increased EHR technology adoption by […]
Is HITECH Working? #1: Hospitals are grumbling but are playing in the game; success is not guaranteed.
by Vince Kuraitis JD, MBA and David C. Kibbe MD, MBA
The rationale for hospitals having to play in the HITECH game is straightforward: the financial carrots through 2015 are helpful, and the financial sticks after 2015 will be very painful.
We’ll discuss:
Financial Impacts on Hospitals
Survey Data Showing Hospitals Will Play
Why Success is Not Guaranteed
Financial Impacts on Hospitals
Even prior to HITECH, most hospital executives already had passed the threshold decision and concluded that they need to implement EHR technology. Thus, the issue for most […]
Is HITECH Working? 7 Observations Mom Could Understand
“Make everything as simple as possible, but not simpler.” Albert Einstein
by Vince Kuraitis JD, MBA and David C. Kibbe MD, MBA
If you’re like many folks we talk with, you understand the importance of the HITECH Act legislation — yet feel overwhelmed by the complexity and details.
This series of blog posts is for you. We address the question “Is HITECH working?” with seven straightforward observations. We’ve worked hard to boil down the complexity and make it understandable to the casual industry […]
“Pigs That Fly” Version of HWR Dissects Health Reform
There’s a new animal in the barnyard — pigs that fly. Rich Elmore of Healthcare Technology News ably summarizes the pundits’ perspectives on health reform in the latest version of the Health Wonk Review.
Complimentary Health 2.0 Webinar on EMRs, Meaningful Use, and Clinical Groupware
Tomorrow, March 30, 1 pm EST (archived version also will be available).
More information and registration here.
I’m honored to be a guest presenter, along with collaborators Lyle Berkowitz MD, Brian Klepper PhD, and Matthew Holt.
Pilots, Demonstrations & Innovation in the PPACA Healthcare Reform Legislation
Here’s a bit of trivia that will make you the hit of the next cocktail party you attend. How many times are the words “demonstration” and “pilot” mentioned in the newly passed Federal healthcare reform legislation — the Patient Protection and Affordable Care Act (PPACA)?
Answer:
“demonstration” — 312 mentions
“pilot” — 80 mentions
This weekend I’ve been trying to wrap my head around the question “Just what are these demos and pilots in the PPACA all about?” I have been boggled by the sheer number […]
A Compendium of Perspectives on the HITECH Certification NPRM
Just the Facts
Certification Programs NPRM (Notice of Proposed Rulemaking)
Health IT, U. S. Department of Health and Human Services; March 2, 2010
Certification NPRM
Facts-At-A-Glance
FAQ
Bookmarked version of Certification NPRM (much easier to navigate)
U. S. Department of Health and Human Services; March 2, 2010
HIMSS Commentary: Is HITECH Promoting Innovation?
There’s a great discussion going on on The Healthcare IT Guy’s blog: Innovation in healthcare IT is dead (hopefully only temporarily). Read BOTH the essay by Shahid Shah and the comments.
Chilmark Needs to Chill Out on CCR/CCD Findings
John Moore of Chilmark Research and I agree on things 90+ percent of the time. He even thanked me personally for our collegial relationship in a Thanksgiving Day essay on his blog.
However…I can’t help but comment on John’s misleading story “CCD Standard Gaining Traction, CCR Fading” in The Health Care Blog. He writes:
In a number of interviews with leading HIE [Health Information Exchange] vendors, it is becoming clear that the clinical standard, Continuity of Care Document (CCD) will be the dominant standard in […]
How Long Have We Known This?
Hospitals charge on a cost basis, which places no penalty on inefficient operations. Moreover, present systems of hospital management make it very difficult to maintain effective control over hospital costs. The Commission concluded:
“If the needs for health care are to be met, the health care system must be organized to employ its resources with more wisdom and effectiveness. The two areas which appear to offer the greatest potential for improvement are (1) reducing unnecessary (or unnecessarily […]
Appliance or Application? The Choice Finally is Coming to Health Care.
My wife Jill loves her iPhone…she raves about it. Last night she showed me an application she had recently acquired for her iPhone. She was able to explain and demonstrate the app and its functionality to me (yes, to ME!) in about 30 seconds.
I’d describe the app as Garmin-like but running on the iPhone. You type in the address at which you’re going to start your drive and then you type in the address of the location where you want to drive […]
e-Newsletter Archives
Archives for e-CareManagement News (1999-2006)
Commentary – Lifemasters Pulls the Plug on Oklahoma Medicare Health Support Project
Christobel Selecky, Executive Chairman of Lifemasters, announced yesterday that Lifemasters was ending participation in its Oklahoma Medicare Health Support (MHS) project. The announcement was made to an audience at the Care Continuum Congress held in Washington, D.C.
The Next Big Thing – Hospital at Home
I hereby predict the Next Big Thing is hospital at home (HAH).
How do I know this? My primary source is my wife, Jill. Both of our children — now age 18 and 21 — were born by C-section during the golden era of indemnity insurance. I remember Jill practically begging her doctor to get the insurance company to authorize a few extra days in the hospital so that she could rest and recover.
I asked her how she would handle that […]
Will Physicians Collaborate or Compete with DM Companies?
Doctors, before you get mad, let me acknowledge that the word “compete” isn’t in most physicians’ vocabularies. Doctors relate much more to a culture rooted in service and professionalism rather than business competition.
The medical home concept being advanced by primary care physicians could wind up competing with disease management (DM) companies. Ironically, this occurs at a time when most DM companies are picking up the pace of improving relationships and communications with doctors.
While the medical home model isn’t new, it […]
Resources and Commentaries – Medicare’s Chronic Care Improvement RFP
It’s the event of the year — if not the decade — for U.S. organizations involved in disease management or chronic care. On April 23 the Center for Medicare and Medicaid Services (CMS) released a request for proposal (RFP) inviting organizations to bid on Chronic Care Improvement pilot projects under Section 721 of the Medicare Modernization Act.
While the RFP has generally been viewed very positively, there are many potential pitfalls, particularly for organizations that do not have significant experience at […]
Audioconference an Update on Medicare’s Chronic Care Improvement Program
Please participate in Tuesday’s audioconference on the new Medicare Chronic Care Improvement Program! fyi, you can review my PowerPoint presentation Strategies for Winning a Contract: The CMS Chronic Care Improvement Phase I RFP.
Best of health,
Vince Kuraitis
Principal
Better Health Technologies, LLC
Press Release:
CMS Provides Update on the New Medicare Chronic Care Improvement Program in National Disease Management Audioconference
Tuesday, May 25, 2004
1:00 pm – 2:30 pm (Eastern)
12:00 pm – 1:30 pm (Central)
11:00 am – 12:30 pm (Mountain)
10:00 am – 11:30 am (Pacific)
Press Release
Contact: Paul […]
The View Down the Road – Baby Boomers Will Benefit From “Healthcare Unbound” Technologies
Forrester Research recently coined the term “Healthcare Unbound” to encompass the technology-enabled shift toward self-care, mobile care, and home care. The Center for Aging Services Technologies recently facilitated a demo day for members of Congress and showed examples of “Healthcare Unbound” technologies beginning to enter the marketplace.
Skeptics might point out that “If you look in the rearview mirror at the road we’ve traveled over in the past few years, consumer technologies haven’t had much on impact on health care.”
….and they […]
E-CareManagement News
Disease Management News Reprint
Expect Greater Use of eHealth in DM in 2004
7 Key Trends Focus on Integration of Technologies,
Convergence of Devices
1) Cost Management Will Continue to Be the Primary Driver of DM Technology Adoption
2) Predictive Modeling Technologies Will Focus on “Impactability”
3) Information and Communication Technologies Will Enable DM Assembling as a Viable Business Strategy
4) Consumer Electronics Giants Will Bring DM into the Living Room
5) Remote Patient Monitoring and Wireless Technologies Will Enable “Healthcare Unbound”
6) Personalization Technologies Will Allow Patients to […]
“Expect Greater Use of eHealth in DM in 2004 – 7 Key Trends Focus on Integration of Technologies, Convergence of Devices” Disease Management News Reprint
Cost Management Will Continue to Be the Primary Driver of DM Technology Adoption
Predictive Modeling Technologies Will Focus on “Impactability”
Information and Communication Technologies Will Enable DM Assembling as a Viable Business Strategy
Consumer Electronics Giants Will Bring DM into the Living Room
Remote Patient Monitoring and Wireless Technologies Will Enable “Healthcare Unbound”
Personalization Technologies Will Allow Patients to “Have It Your Way”
The Electronic Health Record Will Break From the Pack
We hope you enjoy the digital reprint article (Adobe Acrobat format):
This article appeared in the […]
Evidence-Based Medicine is Pivotal in Advancing Care Management
Evidence-based Medicine and Managed Care: Applications, Challenges, Opportunities
Results of a National Program to Assess Emerging Applications of Evidence-based Medicine to Medical Management Strategies in Managed Care
Vanderbilt Center for Evidence-based Medicine, December 2003
Health plans touch all facets of healthcare and therefore have a unique opportunity to stimulate adherence to evidence-based practices….The purpose of this program was to explore how managed care is applying principles and concepts of evidence-based medicine to its delicate balancing of cost and quality management.
Some of the key […]
Today’s Great Idea – The Continuity of Care Record
While attending the Mobile Healthcare Alliance meeting earlier this month in Minneapolis, I was introduced to a brilliant, yet simple concept — the Continuity of Care Record (CCR).
The usefulness of the CCR struck me like a BFO — a blinding flash of the obvious. Two speakers — Peter Waegemann, CEO of the Medical Records Institute, and Claudia Tessier, Executive Director of the Mobile Healthcare Alliance — eloquently described and advocated for the CCR.
The CCR is a concept quietly being developed […]
Healthcare Unbound: Convergence of Consumer and Healthcare Technologies
The Opportunity
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 […]
Sustaining E-Health in Challenging Times
Report on the Fourth Annual eHealth Developers’ Summit, April 2003
This report summarizes the discussions held during the Third Annual eHealth Developers’ Summit in November 2002. Some key findings include:
Consumers and health care organizations are perceived to be the major eHealth players in the short-term, but government influence on eHealth seems to be increasing.
Consumers, with few exceptions, are still unwilling to pay for online health information or services, thus consumer-oriented eHealth products will need to incorporate incentives in their business models […]
Change Your 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 […]
Remote Patient Monitoring Inching Its Way into DM
Disease Management News Reprint
Remote patient monitoring (RPM) promises to be the next evolution of the digital age in health care. More than 75 companies are developing RPM offerings. While many of these are start-ups, the field has also attracted large, established companies such as Medtronic, GE, Phillips, Siemens, EDS, and others.
This article appeared in the October 10, 2002 print edition of Disease Management News.
The publisher of Disease Management News, National Health Information, will make FREE 4-issue trials available to the […]
Welcome to Our New Format!
For the first time, this edition of E-CareManagement News is being sent out in HTML (graphical) format. If your email program can read HTML, then you should be viewing this edition with color and graphics. If you are having trouble viewing this newsletter, it’s also available at the BHT website. Please bear with us while we fix any bugs and please let us know if you have problems reading the newsletter.
If this issue of E-CareManagement News was forwarded to you […]
DMPC Realigns Its Business Model – A Major Step Forward!
Who’s really influential in the world of disease management (DM)? You don’t have to go very far before you bump into the name of Al Lewis, Executive Director of the Disease Management Purchasing Consortium (DMPC).
Don’t let his grin fool you. Alfred B. Lewis (Al) is a shrewd businessman….and getting shrewder every day. This article will describe how Al has recently realigned the DMPC business model and how this change will benefit both DM vendors and health plans.
In a nutshell, the […]
Broadband and E-Health: Joined at the Hip
“Slow broadband deployment is the key limitation in our high technology economy.” Andrew Grove, Chairman, Intel
Here’s a pop quiz — the answer might surprise you: What percentage of US households have high-bandwidth Internet connections? What percentage of South Korean households? (Answer below)
Several recent reports have examined the compelling advantages of broadband (high-speed) Internet and have highlighted some of the most promising health care applications. This brief reviews key excerpts and highlights some of the surprising findings.
Broadband: A 21st Century Technology […]
Cats and Dogs Living in Harmony? The CFO and CMO have Common Interests in Disease Management
A quiet, yet dramatic disconnect has existed in many health care organizations for the past decade. The disconnect relates to how the Chief Financial Officer (CFO) and the Chief Medical Officer (CMO) view disease management (DM).
This subtle dynamic has impacted the course of disease management development and implementation in many provider and health plan organizations. In many organizations CFOs took a predictable point of view — “Show me the money.” In other words, they would only endorse DM programs if […]
Client Spotlight – Cardiobeat Poised to Revolutionize Hemodynamic Monitoring
Cardiobeat is an early stage company with a revolutionary impedance cardiography system for non-invasive measurement of hemodynamic (blood flow) parameters. Impedance cardiography holds great promise for disease management of patients with congestive heart failure, hypertension (high blood pressure), and other conditions.
The Clinical Opportunity
There is a need for better tools to diagnose and manage heart disease. In the US alone, there are 5 million patients with CHF and over 50 million patients with hypertension.
Modern medications are complex and highly effective for […]
GE Buys E-Health Capabilities at Yard Sale Prices
Hardly anyone seems to have noticed, but General Electric has just completed its purchase of MedicaLogic (formerly Medscape), an eHealth medical record company.
“It’s a strategically important acquisition for us, said Greg Lucier, President and CEO of GE Medical Systems Information Technologies. “Our expansion into the ambulatory setting is a `first’ for GE, and because more patients experience care in this setting than any other in healthcare, it’s really an opportunity for us to make a major transformation in the healthcare […]
Adoption of E-Health Technologies – The Pace of a Turtle, The Intensity of a Steam Roller
“Taking the Pulse: Physicians and Emerging Information Technologies”
Deloitte Consulting, Deloitte & Touche; January 2002
Major Themes:
Time is Money. …the rate of adoption of information technology by practicing physicians is dependent on the relative impact on productivity and, by extension, on the economics of their practice.
Point of Care Information Technologies Remain Elusive (For Now).
Infrastructure Matters. …Value creation occurs when front-end applications and tools are integrated with robust backbone infrastructure–transaction systems and core databases.
Still Room to Master the Basics. …there is an abundance […]
Rewarding Physicians to Improve Quality of Chronic Care? What a Concept!!
Did you see the headline last week — “Six California Health Plans Formally Announce Quality Initiative”?
Eight million people are served by these six plans–Aetna, Blue Cross of California, Blue Shield of California, CIGNA Healthcare of California, Health Net, and PacifiCare. They have agreed to develop a common scorecard of quality measures and to pay physicians for achieving better scores.
Is the California initiative of Pay for Performance-Quality (PFP-Quality) a trend? Our commentary discusses four main points:
The PFP-Quality trend is here to […]
Mountains Beginning to Move? The Medicare Chronic Care Improvement ACt of 2001
One of the greatest barriers to delivering coordinated chronic care — perhaps THE greatest barrier — has been the lack of appropriate reimbursement.
With support from the National Chronic Care Consortium (NCCC) and the Chronic Care Coalition, Congressman Pete Stark and Senator Jay Rockefeller have introduced The Medicare Chronic Care Improvement Act of 2001. This legislation is designed to update and improve the Medicare health delivery system to meet better the needs of people with chronic health conditions.
The Institute of Medicine’s […]
Online Health Jeopardy
Are you familiar with the TV quiz show “Jeopardy” — the one where contestants are shown an answer and then have to come up with the right question?
Here’s today’s answer:
This recent government sponsored report makes recommendations in the following areas of online health:
Better management of clinical information to support care
Increased availability of online health services to provide direct clinical care
Increased use of online applications to support clinical practice
Facilitating the greater adoption of electronic commerce to produce a more efficient health […]
“Hospitals and Chronic Care Strategy: Stuck in the Middle”
Hospitals are an enigma when it comes to chronic disease management. While to-date most hospitals have watched from the sidelines, they have the POTENTIAL to become star players.
Key Questions for Hospitals to Consider
Are you in the chronic care business? Is it part of your mission to care for your patients’ ongoing chronic care needs? Are these questions even on your radar screen? If they’re not, they will be shortly.
How do Hospitals Fit into the Bigger Picture of Chronic Disease Management? […]
Patients Would Use E-mail to Communicate with Physicians
“E-mail Communications in Family Practice — What Do Patients Expect?”
The Journal of Family Practice, May 2001
Areas of Reported Interest Among Patients with E-mail Access
Communication with MD…… 89.9%
Request prescription refills… 86.7
Consult a nurse. …………….. 83.6
Obtain lab/test reports……… 81.2
Make/cancel appointments.. 77.6
Regardless of sex or race, patients have high expectations that these tasks can be completed within a relatively short time.
Pharmaceutical Trend Studies From Express Scripts
“2000 Drug Trend Report”
Express Scripts, June 2000
A 150-page report examining pharmaceutical utilization and spending trends.
The bottom line: Per […]
Five Critical Observations About Disease Management Assembling
“Build or buy?” is one of the most fundamental questions faced by any organization. A few years ago, it was unclear how this question should be answered in relation to chronic disease programs. The question is raised by a wide range of organizations involved in chronic disease management (DM) — including delivery systems, physicians, health plans, and DM support or outsourcing companies.
A third option — assembling — is making sense to an increasing number of organizations. Assembling is somewhere between […]
Gaining Physician Buy-In – The “Achilles Heel” of Disease Management
by Harry Leider MD, MBA
Why is achieving physician buy-in important to successful implementation of a disease management program?
It is my experience that programs that fail to gain widespread physician support have great difficulty enrolling patients and usually experience enrollment rates less than 40%. Conversely initiatives that enjoy strong physician sponsorship can achieve enrollment rates as high as 75%.
As a case in point, while I served as Medical Director of HealthNet (a regional managed care organization in Kansas City), we implemented […]
Health Plans and Physicians Agree on Clinical Guidelines – Minnesota Sets Standards for Best Practices!
Minnesota is becoming the first state in the nation where medical care is built around the systematic use of science-based best medical practice protocols developed by physicians and supported by major health plans. Collaboration, not competition, is the goal of Minnesota’s leading medical groups and health plans when it comes to quality health care.
Click here to read details about clinical improvements methods developed by the Institute for Clinical Systems Improvement (ICSI). An article in the New York Times further describes […]
IOM Report: Chronic Disease Management and E-Care Are Key Strategies to Improve U.S. Health Care Quality
“An elephant in the living room” is often used as a metaphor of what it’s like to live in a home with alcoholism — everyone knows it’s there, but no one talks about it. Admitting there is an elephant is a first step toward recovery.
Last week the Institute of Medicine (IOM) described the elephant in the living room of the U.S. health care system. The IOM issued a landmark report “Crossing the Quality Chasm: A New Health System for the […]
Next Generation Clinical and Business Models for Quality Driven Care Management
What’s All the Recent Commotion About Health Care Quality?
In the past several years, the issue of health care quality has received a great amount of press. Most of the news has focused on negatives — medical errors and patient safety issues that jeopardize lives.
Numerous studies have critiqued quality in the US health care system. For example, a report from the Institute of Medicine (IOM) — “To Err is Human: Building a Safer Health System” — was released in November 1999. […]
Emerging Themes: Physicians and the Internet
In the past several months numerous studies and analyses have examined physician adoption of Internet technology and tools.
With a dash of perspective tossed in, this essay synthesizes some major findings, conclusions, and wisdom from recent research.
1) Read the Fine Print – Studies Differ About Current Measurements of Physician Adoption of the Internet
How many physicians are online? 37%? 98%? ….somewhere in between? Whatever answer you pick, you will find “scientific” evidence supporting your guestimate in this provoking article in American Medical […]
The Cure is in Hand: Bringing Information Technology to Patient Care
Josh Fisher and Rosemary Wang of W.R. Hambrecht have issued a comprehensive 78 page report examining the wireless handheld market for physicians.
Here are a few highlights:
With less than 1% of U.S. physicians using handheld devices for transactional purposes today, we believe there are exceptional opportunities for companies developing handheld applications for the healthcare market.
We believe wireless handheld devices, which fit seamlessly into a physician’s workflow, will not only involve physicians but get them addicted to Internet technologies.
Already, approximately 15% of […]
E-Clinical Trials: A Boost for Disease Management Options
Two excellent recent studies provide in-depth and up-to-the-minute analyses of advancements in clinical trials. E-clinical trials promise to be a killer application of the Internet in health care.
Clinical trials research is a key aspect of improving disease management processes:
Clinical trials are a required step in taking promising pharmaceutical products and demonstrating their safety and efficacy.
Pharmaceutical products often can provide improved health and quality of life for patients.
Pharmaceutical products often (not always) are cost effective tools for disease management. Treating patients […]
Next Steps Taken in Medicare Coordinated Care Demonstration
Medicare is testing the cost-effectiveness of paying for case management and disease management (DM) services. The latest announcement from the Medicare Coordinated Care Demonstration describes plans to select at least eight demonstration projects by early 2001.
The demonstration is designed to:
Test proven models of coordinated care to improve the quality of services furnished to specific beneficiaries and manage expenditures under Parts A and B of the Medicare program;
Examine a variety of delivery and payment models applicable to the original Medicare fee-for-service […]
A First Look at Disease Management Under Defined Contribution
Just when you think all the acronyms in health care have been used up, along comes a new one. This one, however, is worth paying attention to. Defined Contribution (DC) promises to be as strong a force in the 00s as was managed care in the 80s and 90s.
What are Defined Contribution (DC) Health Benefits?
DefinedCare.com provides the following basic explanation of DC: Medical benefit defined contributions involve employers and other traditional purchasers of care providing an allowance, that empowers consumers […]
“E-Care: Internet Solutions Changing the Paradigms of Health”
Senior Analyst James Ackerman of Friedman, Billings, Ramsey & Co. has authored an excellent analysis of emerging e-care opportunities, a full 34 page report (dated June 1, 2000) and a 2 page summary.
The analysis includes discussion of
wireless, handheld physician automation tools,
home-based patient monitoring/disease management and
medical risk management by payors. A few highlights from the summary:
There are four key factors driving the widespread penetration of the Internet in healthcare. These include:
Spiraling costs and the imperative to find operating efficiencies.
Growth of healthcare […]
A Primer on Disease Management Terminology – is DM Like a Wall, a Spear, a Rope?
Remember the story about the blind men and the elephant? The first felt the side of the elephant and said it is “very like a wall”. The second touched the tusk and declared it is “very like a spear.” Another man held the elephant’s swinging tail and said it is “very like a rope.” And so on….
This is not unlike how people use the term “disease management” (DM). The meaning of the term DM depends very much on your knowledge […]
Lessons from History: Anticipating Implementation Challenges for eDM Programs
In the mid-1990s disease management (DM) outsourcing companies attempted to integrate their services into local delivery systems. They often encountered resistance from local providers (physicians and hospitals), who viewed the DM companies as outsiders.
Today a new wave of companies is beginning to develop Internet disease management (eDM) offerings. The challenge is similar: implementing and integrating eDM offerings into local delivery systems, which are often resistant to innovations of outsiders.
This essay will list and briefly describe some of the challenges experienced […]
An eDM Scorecard: Who’s Suiting up to Play in the Game?
A host of different organizations — some old, some new — are emerging from the wings to provide disease/care management services and tools utilizing the Internet!
…and they are approaching the Internet disease management (eDM) opportunity from very different angles.
Let’s categorize organizations scrutinizing eDM into four broad groupings:
Traditional Health Organizations
E-Health Companies: Business-to-Consumer (B2C)
E-Health Companies: Business-to-Business (B2B)
Other Technology Companies
How might each of these groups view the eDM opportunity?
Traditional Health Organizations
Traditional health organizations that have shown interest in eDM include DM outsourcing companies, […]
RWJF Report Forecasts Health Care in the U.S. Through 2010
A report entitled “Health and Health Care 2010” has been released by the Robert Wood Johnson Foundation and the Institute for the Future.
Here are a few summary findings from the section of the Executive Summary entitled “Care Processes and Medical Management”:
Medical management — the active management of the care of patients and populations — is currently applied sporadically, if at all. There are two main issues in the future of medical management. The first is the debate over which care […]
Healtheon/WebMD to Acquire Care Insite and Medical Manager – Good News for Advancing Care Management
The Richter scale shook again this week as Healtheon/WebMD announced an acquisition of CareInsite and Medical Manager. This mega-merger will bring together the #1 and #2 companies providing e-health connectivity. Details of the proposed deal can be reviewed at:
Healtheon to Buy Medical Manager
Healtheon-WebMD to CareInsite: “Be Mine!”
Online Health Firms Unite
Healtheon-WebMD Pops a Big Question
So what does the new HealtheonWebMD mean for those of us interested in disease management, care management, and clinical integration approaches?
Mostly it’s very good news.
Why? It avoids […]
“e-Care” Emerges as a Distinct Internet-Health Category
Internet health analysts initially divided the world of e-health into 3 or 4 “Cs” – usually Content, Connectivity, and Commerce (and sometimes Community).
Wit Capital has recently another C to the list –- Clinical Care.
Wit’s excellent 58 page report “eHealth 2000: Healthcare and the Internet in the New Millennium” can be viewed in either HTML or Adobe Acrobat formats.
Wit Capital’s report identifies this new category as — Clinical Care: The Convergence of Disease Management, Health Management and the Internet.
“Relentlessly rising healthcare […]
Five Simple Truths About Employers and Disease Management
Employers are playing an increasingly active role in disease management (DM) initiatives for their employees. Employers are recognizing that a disproportionate amount of health costs are incurred by a small percentage of their employees (typically 5% of a group accounts for about 60% of health care costs). Many employers are frustrated by perceptions that health care premiums are rising faster than medical costs and that health plans and providers are not taking enough steps to manage clinical care.
Here are 5 […]
Will the Internet Connect – or Disconnect – Patients and Physicians?
It’s hardly news these days, but there’s another entrant into the Internet health portal race. However, this one brings some unique twists. Medem has opportunities to employ both push and pull strategies to promote its web site and to improve the patient-physician relationship.
Wall Street and Main Street Health Care
At the new millennium, U.S. health care is living in two different worlds.
The world of Wall Street recognizes the huge opportunities in bringing the Internet to health care. In 1999, market capitalization […]
B2B eDM: Revolutionary Opportunities!
“What’s B2B eDM?” you ask. It stands for business-to-business Internet disease management.
The Internet is receiving great attention for its potential to improve disease management processes. However, almost all the attention has been paid to business-to-consumer (B2C) applications, rather than business-to-business (B2B) applications.
This parallels the attention that all B2C Internet companies have received over the past several years. The explosive potential of the B2B Internet market is just emerging!
This article highlights some of the strategic opportunities relating to B2B eDM. In […]
United Healthcare Pulls MBAs Licenses to Practice Medicine
In a story making national headlines this week, UnitedHealthcare (UHC) has announced that it is giving doctors the final say on treatments for their patients.
Good Medicine and Good Business
It’s hard to overstate the significance of UHC’s move. This is a sentinel event in the shift from managing cost to managing care!
It’s the right thing to do AND will prove to be an excellent business decision.
It’s another sign of the ending of the era of “MBAs Practicing Medicine”.
UHC’s Care Coordinator Program
United […]
Finally! Three e-Health Companies Focusing on Clinical Management Preparing to go Public!
A first wave of e-health companies went public earlier this year. These e-health companies focus primarily on 1) Automating back-office transactions (Healtheon, CareInsite, Claimsnet.com) or 2) Patient and/or physician content (DrKoop.com, adam.com, Mediconsult.com, Medscape).
We’re gratified to see funding ready to flow to companies focusing on care management opportunities. Within about the past two months, three care management companies have filed S1 statements with the Securities and Exchange Commission, a required step in taking a company public. The companies (and citations […]
Accordant Health: A Prototype for Clicks and Mortar Disease Management
Explaining “Clicks and Mortar”
David Pottruck, the co-CEO of Charles Schwab, recently coined the phrase “clicks and mortar” to describe the formula for success in the new economy. An article by Jonathan Weber in the Industry Standard describes the essence of this new catchphrase:
“the basic concept…is that the most successful businesses of this remarkable era will combine the power of the Internet with the ability to operate effectively in the offline world.”
Pottruck uses the brokerage company Charles Schwab as his prime […]
What’s Up with ASPs?
Application service providers, or ASPs, was one of the hottest topics under discussion last week at the Microsoft Healthcare Users Group Conference in San Diego. In this article, we will briefly describe ASPs, explain why they will be important, and list some specific implications for care management approaches. While ASPs will be attractive to all health care organizations, we will focus on the unique advantages they can provide for physician offices.
Not a Poisonous Snake, But a Great Concept
ASPs are a […]
Care Management on the Internet: If We Build It, Will They Come?
There are two sides to being a pioneer. Some pioneers come back with stories about lands of milk and honey. Other pioneers come back with bullet holes in their hats, or they don’t come back at all.
Health care organizations can learn from Internet pioneers in other fields. In this issue, we will take a look at two types of Internet financial services applications.
Online Banking – Not a Field of Dreams
First, let’s take a look at folks with holes in their […]
Summer Vacation Issue
Care Management – Big Picture Perspectives
Here’s an excerpt from a recent (July 27) investment analyst report on Internet health opportunities. “The EVolution of Healthcare” is published by EOffering, the investment bank arm of E*Trade. You can download the full report, “The Next Generation of Managed Care–Clinical Management
“After nearly a decade of managed care and its emphasis on cost containment, we believe that the ‘low-hanging fruit’ has already been picked from the healthcare system and that HMOs will now need to […]
All Bets Are On: Physicians are Using and Accepting the Internet!
The early returns suggest that physicians are adopting Internet technologies! In this issue of our e-newsletter, we share results of early surveys, explain why we expect these trends to continue, and discuss implications for care management.
Survey Results
Three separate surveys show more doctors use and accept the Internet.
PSL Research led a study conducted in Spring/Summer 1998. Key findings about physicians across the world include:
80% of physicians across eleven North American, European, and Asian countries own a computer and 44% of these […]
The FedEx Truck Phenomenon: The Need for a Strong Care Management Value Chain
Health care organizations can learn a valuable lesson by understanding how a “value chain” applies to care management approaches. Implementing the best care management approaches will require a mindset and culture that understands and embraces the value chain process.
Most of our e-newsletter readers (currently about 1,100) have roots in clinical care, business or technology. The value chain concept is understood better in the business and tech worlds, and there’s no reason it can’t be understood by everyone in healthcare.
So what’s […]
Patient-Centered Care: Motherhood and Apple Pie?
Seventy percent of health care costs in the U.S. are spent on people who have one or more chronic condition. The Robert Wood Johnson Foundation’s “Chronic Care in America: A 21st Century Challenge” is a classic study that details the clinical and financial issues involved.
A new term in the vocabulary of health care and managed care is “patient-centered” care. In short, it refers to care focused on the needs and preferences of an individual patient (more below). Patient-centered care for […]
Physicians and Care Management: MBAs Practicing Medicine, or Doctors Controlling Their Own Destiny?
Nearly 7 out of 10 physicians consider themselves “anti-managed care”, according to a recent study.
Physicians tend to equate the old model of managed care (managing costs rather than managing patient care) with overpaid MBAs who tell them how to practice medicine, squeeze them for discounts, and randomly throw them out of provider networks.
How do physicians feel about new approaches of care management? Shouldn’t they be wildly supportive? Studies are mounting that disease management, medical management, demand management, and case management […]
Healtheon: Establishing a Beachhead for Care Management
Summary:
Healtheon is a company to put on your radar screen. Its Internet business model is easily adaptable for future care management applications (disease management, demand management, case management, population health). Depending on your organization’s role in care management, Healtheon might soon be your vendor, competitor or partner.
Background: Healtheon and Its Internet Business Model
The Internet promises two transformational improvements for healthcare applications:
transactions processing
communications (among providers, between providers and patients, and patient access to medical information)
Healtheon’s initial value proposition focuses on improved […]