e-CareManagement Blog
Archives for e-CareManagement Blog (2006-2021)
I’ve Been Fired By My PHR. Now What?
I received this email in my inbox this morning:
Thank you for being a loyal user of the Revolution Health Personal Health Record. Unfortunately we will be discontinuing this service as of the end of February 2010 and removing all records, information, and data from the Revolution Health Web site.
So that you don’t lose the information you’ve entered into the system, we strongly suggest that you download your personal records as a PDF to print and save for future reference. To do […]
Pirate Talk With Mom
I just got off the phone with my mom. She’s a young 85. Mom told me about the cataract surgery she had this morning and the patch over one eye that she came home wearing.
“So Mom, are you learning to talk like a pirate? …like ‘aye, matey’”?
“I baby?” she asked.
“No, aye matey’”
“I-80?”
“…er, never mind Mom…how’s Benji?”
Vince’s mom (sans eyepatch) and Benji
An Avatar-Inspired Health Wonk Review
Check out the latest Health Wonk Review penned by Dr. Jaan Sidorov over at the Disease Management Care blog. I commend Dr. Sidorov for his selection of a new personal photo on his blog — very handsome, and certainly a better presentation than this earlier photo from his youth.
A Compendium of Resources on the Federal HIT Meaningful Use NPRM and Standards IFR
* = highly recommended
Descriptive Summaries and Documents
*Dissecting the Meaningful Use Proposed Rule PowerPoint
eHealth Initiative Policy Webinar; January 8, 2010
*What You Need to Know About the Meaningful Use Proposed Rule, Standards and Implementation Specification, and Interim Final Rule Certification Criteria PowerPoint
Is Gawande Right? Are Pilot Programs the Key to Delivery System Cost Reductions?
Atul Gawande’s most recent New Yorker article “Testing, Testing” addresses the critics who lament that there is no master plan to curb delivery system costs in pending health reform legislation.
Gawande retorts: “Is that a bad thing?”
…and he answers his own question by describing the value of pilot programs contained in both the Senate and House versions of health reform legislation.
Is Gawande correct? Yes and no….
Engage With Grace II
Happy Thanksgiving All!
by Alexandra Drane and the Engage With Grace team
Last Thanksgiving weekend, many of us bloggers participated in the first documented blog rally to promote Engage With Grace — a movement aimed at having all of us understand and communicate our end-of-life wishes. It was a great success, with over 100 bloggers in the healthcare space and beyond participating and spreading the word. Plus, it was timed to coincide with a weekend when most of us are with the very […]
Medicare Extends PHR Pilot — Big Mistake!
Medicare announced today that it is extending its Personal Health Record (PHR) pilot project for residents of Utah and Arizona.
This is a waste of time and taxpayer dollars. Those of you who read my blog know that I’m a big fan of PHRs, but you have to know when you’re backing the wrong approach.
What’s wrong with this pilot project? A lot:
Feedback Rolls in on Halamka’s New Stance on Standards: Cats Pissed, Dogs Thrilled
Continuing his stunning reversal of long held perspectives, Dr. John Halamka’s blog post today suggests Guiding Principles for HIT Standards Committee:
Keep it simple; think big, but start small; recommend standards as minimal as possible to support the business goal and then build as you go
Don’t let “perfect” be the enemy of “good enough”; go for the 80% that everyone can agree on; get everyone to send the basics (medications, problem list, allergies, labs) before focusing on the more obscure
Keep the implementation […]
The Real Secret Sauce of Medicare’s Participation in Regional Collaboratives — Network Effects
Last week I asked whether Medicare’s Biggest Change in 40 Years is on the horizon. That post described and discussed implications of Medicare’s new direction for the medical home — the shelving of Medicare Medical Home Demonstration (MMHD) and the refocusing on the recently announced Multi-Payer Advanced Primary Care Initiative (MAPCI).
In that post I touched briefly on the potential for MAPCI to create effective networks at multiple levels — contracting networks, health IT networks, social and collaborative care networks. I’d like to expand […]
Dr. Blumenthal, I Mistakenly Received Your Email Intended for Judy Faulkner, CEO, Epic
David Blumenthal, M.D., M.P.P. National Coordinator for Health Information Technology U.S. Department of Health & Human Services
Dear Dr. Blumenthal,
I was honored to receive a personal email from you today. However, after reading it, I conclude that you must have intended to send this email to Judith Faulkner, CEO of Epic Systems.
I really liked what you said about working toward interoperability:
The HITECH Act calls for the “development of a nationwide health information technology infrastructure that allows for the electronic use and […]
Three Years Of Medical Home Demonstration Preparation Down the Drain?
Do you remember the scene in the movie Animal House where Bluto Blutarski laments “…seven years of college education down the drain?”
Why aren’t primary care physicians expressing similar laments about the shelving of the MMHD (Medicare Medical Home Demonstration) in favor of the MAPCI (Multi-Payer Advanced Primary Care Initiative).
My colleague Jaan Sidorov, MD and I pick up on no signs of discontent. Read our essay “Three Years of Medical Home Demonstration Preparation Down the Drain?” on Dr. Sidorov’s blog.
Read Post about Three Years Of Medical Home Demonstration Preparation Down the Drain?
John Halamka’s Stunning 180: “Dogs and Cats Should Live in Harmony”
The King of the Cats has just acknowledged that indeed cats and dogs should co-exist peacefully.
Dr. John Halamka — Vice Chair of the HIT Standards Committee of the ONC and one of the most vocal and influential figures in health IT — writes a blog post this morning entitled “The Genius of AND”. Halamka reasonably summarizes the essence of the debate about standards and interoperability as being between “the healthcare informatics crowd” (cats) and the “Internet crowd” (dogs):
He notes that the debate […]
Medicare’s Biggest Change in 40 Years on the Horizon?
Earlier this week CMS issued a typically cryptic Announcement indicating that they were shelving the Medicare Medical Home Demonstration (MMHD) and instead would focus on the recently announced Multi-Payer Advanced Primary Care Initiative (MAPCI). My blog post from Tuesday provides details and asks the question “What does all this mean?”
Today’s blog post will tackle:
Medicare’s biggest change in 40 years?
The rise of MAPCI
The fall of MMHD
Implications/discussion
Medicare’s Biggest Change in 40 Years?
Health Wonk Review at Boston Health News
Tinker Ready hosts the Halloween edition of Health Wonk Review at Boston Health News.
Read about the “the undead public option” or as Jon Stewart said, “It’s alive!”
CMS Shelves Medicare Medical Home Demonstration
I just received an email from CMS announcing the latest official word on the Medicare Medical Home Demonstration (MMHD):
10/26/2009 – In Washington, the efforts to reform health care and health insurance include proposed legislative language that would have an impact on the Medicare Medical Home Demonstration as described in section 204 of the Tax Relief and Health Care Act of 2006 and amended by section 133 of the Medicare Improvements for Patients and Providers Act of 2008. Specifically, section 1302 of […]
Senator Grassley: You’re on Track About EMR Problems, But Here Are Some More Questions to Ask
An article in today’s Washington Post links to a letter written by Senator Charles E. Grassley.
The letter is directed at 10 EMR (electronic medical record) vendors, and asks very pointed questions about whether the vendors have been negligent in not addressing patient safety issues in their technologies.
Senator Grassley, you have the scent and you’re on the trail. There are several other questions you should be asking these vendors:
Will Mobile/Wireless Apps Be the Breakthrough for Retail eHealth & Remote Monitoring?
Two slides from Mary Meeker’s presentation at Web 2.0 this week really caught my attention.
Compare the proportions that “users pay” for desktop Internet services vs. mobile Internet services (the area inside the red lines — click on the graphics to see larger versions).
What do these slides tell us?
Complimentary Webinar: Introduction to Clinical Groupware and the Clinical Groupware Collaborative
BrightTALK is sponsoring a complimentary Electronic Health Record Summit this Tuesday, October 20, 2009.
David C. Kibbe MD, MBA and I will be presenting “Introduction to Clinical Groupware and the Clinical Groupware Collaborative”
Clinical groupware is a new and evolving model for the development and deployment of health information technology (HIT) platforms and applications having the following characteristics:
Use of the Internet and the web for EHR technology.
Explicit design for information sharing and online communication among providers and patients/consumers.
A modular […]
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 Big Idea in Understanding “Accountable Care Organizations”
Here’s the big idea: accountable care organizations (ACOs) are about creating accountability.
ACOs of various types are being proposed in national health reform legislation. For all you ever wanted to know about ACOs, read How to Create Accountable Care Organizations from the Center for Healthcare Quality and Payment Reform. I spent an hour and a half poring over the details of this excellent report written by Harold Miller.
My mistaken impression has been to focus on the organizational form of ACOs, rather than their objectives. Organizational form is relevant […]
HITECH Health IT Legislation: Opportunities for the DMAA Community
Dr. Don Storey and I spoke at the at The Forum 09 conference in San Diego earlier this week. The DMAA publication “The Continuum” had an excellent writeup of our enthusiastically received presentation.
Here’s a copy of our PowerPoint slides…
HITECH Health IT Legislation: Opportunities for the DMAA Community
View more presentations from vincek.
and here’s DMAA’s writeup:
Helping physicians and hospitals meet the “meaningful use” criteria for federal support for health information technology under recently passed legislation represents a keen opportunity for the population health management industry, presenters at […]
Lifemasters Bankruptcy: Will CMS Earn Reputation as a Good Business Partner or Thug?
In my post from Monday on LifeMasters seeking Chapter 11, I dropped a BTW comment.
The part that’s puzzling to me is the statement that LifeMasters owes $125 M to CMS. That’s hard to figure…the company only participated in MHS for a few months, and to my knowledge MHS is the only Medicare demo that required guaranteed savings (i.e., payback if targets aren’t hit).
I really have to stretch my imagination to compute how CMS ran the tab to such an astronomical number. It raises […]
Latest Health Wonk Review at Healthcare Technology News
Rich Elmore plays tribute to Senator Kennedy in the latest edition of the Health Wonk Review. Read wonker perspectives on health care reform.
Meeting Announcement: “Introduction to the Clinical Groupware Collaborative”
by Steve Adams, CEO, RMD Networks and Acting President, Clinical Groupware Collaborative
I’m writing to extend a warm personal invitation to learn more about the Clinical Groupware Collaborative (CGC). To-date, purely through word-of-mouth over 40 companies have expressed interest in the CGC, and we expect that you’ll be hearing a lot more about us over the coming months.
Our meeting will take place next Tuesday, September 22, 6 PM in conjunction with The Forum 09, the annual meeting of DMAA: […]
Medicare Health Support (MHS) Claims Another Victim: LifeMasters Files for Chapter 11
Updated 6:10 pm, September 14, 2009
One bad deal can ruin your day.
Today, LifeMasters filed for Chapter 11 bankruptcy protection. According to its press release:
“The Chapter 11 filing is the most efficient path for the company to restructure liabilities that are a result of Demonstration Projects previously performed under contracts with the Centers for Medicare and Medicaid Services (CMS), ” said George D. Pillari, President of LifeMasters. Mr. Pillari, named President of LifeMasters today, is a Managing Director of Alvarez & Marsal […]
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 […]
CCHIT’s Latest Gambit
by Glen Laffel MD, PhD
Many of us have enjoyed a few good minutes of fun having our fortunes told by soothsayers who claim they can predict our future based on patterns of tea leaves in a cup or the playing cards we’ve pulled from a deck.
We pay a few dollars for the entertainment and if the fortune teller is skilled, we are temporarily impressed by his “insight.” But once we leave the carnival, we come back […]
Part II — The Medicare Medical Home Demonstration: Crawling Out From Under the Rock
In Part I of my guest post on The Collaborative Forum blog, I wrote that the Medicare Medical Home Demo is in BIG Trouble. Here’s a recap:
Political reality dictates that the MMHD must save costs.
As currently structured, the MMHD cannot achieve cost savings
In any given year, only a small percentage of patients account for the vast majority of costs
Lessons from previous Medicare disease/care management demonstrations has shown that effective care coordination interventions must be targeted at this population
Medicare has structured the […]
PR Blunder of the Year: Federation of American Hospitals Says Meaningful Use Should Not Tie to Quality Improvement
These guys really don’t get it, and they need to be called on the carpet, taken to the woodshed, or pick your own favorite cliche.
The Federation of American Hospitals (FAH) sent a letter to Dr. David Blumenthal (National Coordinator for Health IT) arguing that “Meaningful Use” funding should not be tied to achievement of quality measures. The FAH is the trade association for for-profit hospitals; the letter is dated August 26 and a copy is available on […]
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 […]
Health Wonk Review at Health Business Blog!
David Williams writes the latest Health Wonk Review…read about Health Reform, Get Fatty, Brain Spasm, and Questionable Practices.
HIT Policy Committee Recommends “Minimum” Certification of EHRs
At last Friday’s meeting, the HIT Policy Committee adopted the recommendations of the Certification and Adoption Workgroup.
Between the initial recommendations in July and the adopted recommendations in August, one critical word was added to the definition of “certification”. That one word is “minimum” — and this one word expresses the correct approach and philosophy for the government’s role in the certification process for EHRs.
In this post I’ll address why a “minimum” approach toward certification makes […]
“Meaningful Use” Criteria as a Unifying Force
by Vince Kuraitis, Steve Adams, and David C. Kibbe MD, MBA
Over the past several years, many diverse initiatives have arisen offering partial solutions to systemic problems in the U.S. health care non-system.
We see Meaningful Use Criteria recommended by the HIT Policy Committee as a unifying force for these previously disparate initiatives. These initiatives have included:
Patient Centered Medical Homes (PCMHs)
Regional Health Information Organizations (RHIOs)/Health Information Exchanges (HIEs)
Payer Disease/Care Management Programs
Personal Health Record Platforms — Google Health, Microsoft HealthVault, Dossia, health banks, more to come
State/Regional […]
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 […]
Health Wonk Review: August Recess and Dog Days of Summer Edition
While Congress is in recess and we all try to beat the heat, check out the latest edition of the Health Wonk Review.
Be sure to savor every word of Dr. Jaan Sidorov’s masterful witticisms!
Medical Home Savings Claims in Medicaid are Not Plausible
by Al Lewis, Disease Management Purchasing Consortium International, Inc.
Medical homes probably do save money in very controlled settings, where the entire team is literally or at least figuratively under one roof, such as Kaiser. However, the belief that one can overlay a traditional medical home model across an entire state and save money in the process turns out to be total fiction.
The poster child for that fiction, North Carolina’s Community Care program, turns out to cost state taxpayers probably $400 […]
Medicare Medical Home Demo (MMHD) is in BIG Trouble
Between the time the MMHD was authorized in 2006 and now, we’ve learned a lot about what works and what doesn’t work in Medicare care coordination programs. The MMHD is between a rock and a hard place — conflicted by two “must achieve” objectives that are diametrically opposed:
As a political matter, the MMHD must save money
As currently structured, the MMHD cannot save money
Please read my guest post
The Medicare Medical Home Demonstration (MMHD): Between a Rock and a Hard Place
over at […]
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, […]
Adieu, LifeCOMM
“Qualcomm pulls the plug on LifeComm” announced Brian Dolan of mobihealthnews recently.
As demonstrated by e-CareManagement blog readership, there has been a lot of interest in LifeCOMM. My first blog post on LifeCOMM in 2007 has been single the most commented on post and the second most widely read blog post.
It’s taken me a while to sift through my thoughts and feelings about saying “Goodbye” to LifeCOMM. At first I was deeply disappointed, but after further reflection think that LifeCOMM wasn’t the right […]
RHIOs Emerging From Coma
A subtle but profound shift is occurring in the world of RHIOs/HIEs (Regional Health Information Organizations/Health Information Exchanges).
…and the title of the eHealth Initiative’s Sixth Annual Survey of Health Information Exchange says it all:
Migrating Toward Meaningful Use
What’s happening here?
Geek Wisdom: “Interoperability” Must Include Process Collaboration
I know — you’re thinking that using “geek” and “wisdom” in the same sentence is an oxymoron. Bear with me — I’m trying to make a really important point in today’s posting.
Interoperability has multiple dimensions — and I’d bet that most of us have never thought of interoperabilty as involving “process” — people working together and collaborating; I know I hadn’t.
The Interoperability Work Group of HL7’s Electronic Health Record (EHR) Technical Committee was formed in April 2005 to attempt to define […]
Joe the Doctor: “…’scuse me, why do I want to bet-my-practice on an EMR?”
Blogger Fred Pennic writes a review of the (HIMSS) Healthcare Information and Management Systems Society 2008 Book of the Year Award. The book is entitled Keys to EMR Success: Selecting and Implementing an Electronic Medical Record and is written by Ronald Sterling, CPA, MBA.
There is no question,” says Sterling “that the selection and implementation of an EMR is a ‘bet-the-practice’ proposition. If you fail, you end up with more costs and greater frustration.…” (emphasis added)
PowerPoint Presentation — EHR 2.0
Click on the graphic to download a copy of today’s BrightTALK webcast.
“EHR 2.0″ Complimentary Webcast Presentation — BrightTALK e-Health Summit
BrightTALK is sponsoring a complimentary series of e-Health Summit webcasts this Wednesday, July 8.
Here’s a full listing of the six eHealth Summit topics (Eastern Time). Click on the links to attend any or all of the webcasts. The series will be recorded for future on-demand access.
EHR 2.0: Federal HITECH Act Creates Opportunities Beyond EMRs
Presenting Vince Kuraitis, Principal Better Health Technologies
Data Convergence in Life Sciences and Healthcare
Presenting Greg Nelson, President […]
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
Incentive to Innovate: Giving Health Reform a Rocket Boost
by Scott Shreeve, MD
We are entering an unprecedented season of change for the United States health care system. Americans are united by their desire to fundamentally reform our current system into one that delivers on the promise of freedom, equity, and best outcomes for best value. In this season of reform, we will see all kinds of ideas presented from all across the political spectrum. Many of these ideas will be prescriptive, and don’t harness the power of innovation to […]
Time for EHRs to Become Plug-and-Play
by David C. Kibbe MD, MBA
The remarkable report, “Initial Lessons From the First National Demonstration Project on Practice Transformation to a Patient-Centered Medical Home,” published in the May/June issue of Annals of Family Medicine, the Nutting Report, makes this point about the state of primary care IT offerings:
Technology needed in a PCMH is not “plug and play.” The hodge-podge of information technology marketed to primary care practices resembles more a pile of jigsaw pieces than components of an integrated and […]
Hope for Primary Care … from a Payer? A White Paper on the Collaborative Payer Model
by Tom Doerr, MD and Randy Bak, MD, JD
What if the health care payer were re-imagined as a service to the primary care doctor – supplying the tools, information and funding primary care physicians needed to meet the call to reform health delivery?
The structure of physician payment is considered one of the most problematic aspects of our health care system. Driven by volume instead of coordinated, proactive care and favoring procedures over cognitive work, the payment system has driven primary […]
Markle v. HIMSS: Differing Views of “Meaningful Use” and “Certification”
The forthcoming definition of the “meaningful use” of health information technology will set the direction of the Obama administration’s strategy for health IT adoption, said David Blumenthal, the new national coordinator for health IT. Government HealthIT, April 28, 2009
…but not everyone sees eye-to-eye on the definitions of “meaningful use” and “certification”. [See the first […]
Stunning Announcement: AMA Goes to the Dogs in Deal With Physician Web Portal Company
What’s stunning about this deal is who its NOT with. The AMA chose NOT to partner with any of the incumbent electronic medical record (EMR) companies, e.g., Allscripts, GE, Epic, NextGen, or many others.
For those of you who have not seen earlier posts in this series, please understand that the reference to “goes to the dogs” is a great compliment.
In a joint press release, the American Medical Association and Covisint unveiled an agreement yesterday:
Compuware Corporation (NASDAQ: CPWR) announced today that its Covisint subsidiary signed […]
Privacy Law Showdown? Legal and Policy Analysis.
#2 in a series — Modifications to HIPAA Privacy Laws: Impact on Microsoft HealthVault, Google Health, and other PHRs.
by Deven McGraw JD, MPH, Center for Democracy & Technology
Introduction
There has been considerable discussion lately about whether or not the stimulus legislation (ARRA) extends HIPAA coverage to commercial vendors of personal health records (PHRs) any time they contract with entities already covered by HIPAA like hospitals, health plans or physicians groups. (For those of you who don’t know, HIPAA is the Health Insurance Portability and […]
Privacy Law Showdown? Setting the Stage
Today’s post is the first in a series entitled:
Modifications to HIPAA Privacy Laws: Impact on Microsoft HealthVault, Google Health, and other PHRs.
We’ll explore how recent changes in privacy provisions of ARRA/HITECH Federal stimulus legislation affect personal health information (PHI) platform companies (e.g., HealthVault, Google Health, Dossia) and personal health record (PHR) companies.
Health IT expert and journalist Neil Versel described the issue in the April 7 issue of BNET Healthcare:
Although Google and Microsoft have gotten plenty of attention for their Web-based personal health records, both companies have long […]
Is the Health Data Liquidity Glass Half Empty or Half Full?
What a difference in attitude! Compare two press announcements from April 5:
1) CCHIT: Interoperability Isn’t Doable With Today’s Technology .
Certification Commission for Health Information Technology (CCHIT), Interoperability: Supplying the Building Blocks for a Patient-centered EHR , April 5, 2009
This report…(is) also an attempt to inject a dose of reality into the discussion of interoperability – from practical expectations for the near term and future years to the challenges of developing software architecture and implementation guides that can execute new […]
EHR 2.0: Thinking Outside the Cat Box
One of the potential dangers of limiting $17 B HITECH federal stimulus funds to electronic health records (EHRs) is the risk of locking-in outdated technologies. Let’s consider what this might mean.
If you think of today’s EHR technology as EHR 1.0, what might EHR 2.0 look like? This post presents a number of innovative ways to conceptualize EHR 2.0:
EHR as Platform + Applications
EHR as Clinical Groupware
EHR Integrated with PHR
EHR as Software-as-a-Service (SaaS)
EHR as a “Publish-Discover” Search Engine
EHR + Disease Management Services = […]
Stand for Quality Group: “Link HIT Investment to Quality Improvement”
On March 24, Stand for Quality — a new group representing 165 diverse health care organizations — called for a new era of quality in health care. Their white paper is titled Building a Foundation for High Quality, Affordable Health Care: Linking Performance Measurement to Health Reform .
The perspectives of Stand for Quality are a remarkable break from the past and have significant implications for future […]
Can Cats Think Outside the Box? Here’s a Role Model.
Even though I am a self-admitted dog person, Hoover is my buddy.
Hoover got a new shoebox as a Christmas present. While most cats are very tied to their existing surroundings and don’t like things to change, Hoover is not your average cat.
The following photos were taken over about a two week period. Hoover hopes you enjoy them!
Wait and See: What’s Unclear or To-Be-Determined (TBD) About HITECH.
Sometimes laws are passed and the statute itself represents 95% of the work — there aren’t many details to figure out or loose ends to tidy up.
That isn’t the case with HITECH. The HITECH statute is just the beginning.
Whether you’re a cat or a dog, you’ll have hopes and fears about aspects of HITECH that are unclear or yet to-be-determined (TBD).
These include:
Feline Foot-Dragging: Three Non-Innovative Aspects of HITECH
What do cats (incumbent EHR vendors and their supporters) have to smile about over HITECH?
A lot.
…and it’s not very complicated. HITECH directs $17 B to the cat community, and leaves scraps for the dogs.
(As a refresher, the cat POV is that HITECH stimulus funds should simply pay directly for electronic health record (EHR) technology — that providers will figure out how to use the technology to improve quality and outcomes; the dog POV is that HITECH should pay for improved […]
Landmark Report: “The Promise of Care Coordination” in Medicare
Download a copy here . Excerpts from the Executive Summary:
Effective Interventions
Three types of interventions have been demonstrated to be effective in reducing hospitalizations for Medicare beneficiaries with multiple chronic conditions who in general are not cognitively impaired:
Transitional care interventions in which patients are first engaged while in the hospital and then followed intensively over the 4 – 6 weeks after discharge
Self-management education interventions that engage patients for 4 -7 weeks in community-based programs designed to “activate” them in […]
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)
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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 […]