e-CareManagement Blog
Archives for e-CareManagement Blog (2006-2021)
Dogged Optimism: Five Innovative Aspects of HITECH
If you’re a dog (an innovator), what’s there to smile about over HITECH? Quite a bit.
In the first post of this series, I suggested that HITECH favors cats by about 60/40 and noted that the single most cat-like feature of HITECH is providing incentives for physicians and hospitals to acquire and implement EHRs — but only EHRs. Reader “Mark” commented:
“How does this work out to 60/40? Looks to me like 100% cats.”
Let’s look a bit deeper to see how HITECH […]
Will HITECH Lead to Innovation? The Continuing Cat/Dog Dialogue
Will the recently passed HITECH legislation — the federal stimulus funding for health IT — encourage innovation? or will it lock in outdated electronic health record (EHR) technology?
It’s a mixed bag — HITECH legislation is both dog-like (innovative) and catlike (protecting incumbents). I’ll refresh your memory below on more specific definitions of cats and dogs.
Among many other reasons, HITECH is dog-like primarily because it has ended the question of WHETHER the U.S. is really serious about health IT reform. HITECH spells out […]
How Much Health-Related Productivity Loss is Really Avoidable? And Why Should I Care??
by John E. Riedel
Study breaks new ground in calculating the "normal impairment factor."
We know that poor health accounts for a considerable amount of productivity loss-anywhere from 1 ½ to 3 times direct medical costs. The potential for disease prevention and disease management programs to reduce productivity loss has, for obvious reasons, caught the attention of healthcare purchasers. But let’s be careful about making big claims to "recapture" productivity loss. People find it tough to change health behaviors. And, […]
HITECH Overlap: Medical Home, Telehealth, Health IT/Exchange
What’s the commonality among Medical Home, Telehealth, and Health IT/Information Exchange initiatives?
They all relate to care coordination. As shown in the diagram below from the Kansas Health Policy Authority (KHPA), there’s a lot of overlap.
A larger copy of the slide is available in this March 2 PowerPoint presentation by Marcia Neilsen , Executive Director, KHPA.
What are some of the implications?
Medical Home “Model” Transmogrifies to: The Medical Home Movement
Part Medical Home 101, part strategy session to rescue primary care, part revival meeting — the National Medical Home Summit held earlier this week in Philadelphia was an amazing event.
The optimism, energy, and dogged persistence of attendees and presenters was pervasive. The event was standing room only with another 200 people tuning in to a live Internet video cast.
Dr. Joseph Scherger captured the mood of the day when he proclaimed:
The Medical Home “model” has […]
Dorothy Tillman Update: Vindication!
About a year ago, we read about about Dorothy Tillman’s heroic efforts to get a copy of her aunt’s medical records.
Here’s a recap: On a Saturday evening Dorothy took her 86 year old aunt to a hospital in Montgomery, Alabama. Frustrated after an overnight stay in the ER which she said yielded “little treatment”, she requested a copy of her aunt’s medical records before leaving. When she was told that it was hospital policy to request records “in writing”, Dorothy escalated her […]
Obama Budget: Hospitals Should Warrantee Admissions for 30 Days
Warrantee
War`ran*tee", noun. A written assurance that some product or service will be provided or will meet certain specifications.
Today when we buy practically any consumer item we expect a warrantee.
What’s the “warrantee” after you are discharged from a hospital?
Last September I wrote a post posing the question “What’s the Best Way to Get Hospitals Involved in Care Coordination? ” The short answer was: Pay them to do it, take money away when they don’t — make hospitals accountable for their […]
Spider Webs of Care Coordination Networks
We have learned that coordinating care of patients — particular care of Medicare patients — is complex and time consuming for physicians.
A breakthrough study quantifies just how complex and challenging care coordination really is. The study is reported in the February 17 issue of Annals of Internal Medicine and is entitled Primary Care Physicians’ Links to Other Physicians Through Medicare Patients: The Scope of Care Coordination :
We found that in a single year for just fee-for-service Medicare patients, the typical primary care physician needs […]
Why Clinical Groupware May Be the Next Big Thing in Health IT
by David C. Kibbe MD, MBA
What would you call health care software that:
Is Web-based and networkable, therefore highly scalable and inexpensive to purchase and use;
Provides a ‘unified view’ of a patient from multiple sources of data and information;
Is designed to be used interactively – by providers and patients alike – to coordinate care and create continuity;
Offers evidence-based guidance and coaching, personalized by access to a person’s health data as it changes;
Collects, for analysis and reporting, quality and performance measures as […]
How Should Fed HIT Dollars Be Spent? Cat vs. Dog POV.
“Where’s the single best place to get up to speed on how the Feds should spend $20 billion to advance health information technology (HIT)?”
A colleague asked me this question a couple of days ago, and at first I hesitated. Then it struck me — Matthew Holt’s The Health Care Blog has become the focal point for discussion of this critical topic.
Matthew’s very recent article — Cats & dogs: Can we find unity on health care IT change? — summarizes the two […]
Great Lawyer Jokes
A friend sent me these in an email this morning and I could hardly stop laughing:
These hilarious exchanges are from a book called ‘Disorder in the American Courts’.
They were recorded verbatim and published by Court Reporters that had the torment of staying calm and remaining professional while these exchanges were actually taking place.
ATTORNEY: This myasthenia gravis, does it affect your memory at all?
WITNESS: Yes.
ATTORNEY: And in what ways does it affect your memory?
WITNESS: I forget.
ATTORNEY: You forget? Can you […]
Latest HWR Proves Dr. Sidorov Missed His True Calling
Dr. Jaan Sidorov conclusively demonstrates his love for showmanship and rock by performing the latest Health Wonk Review at the Disease Management Care Blog.
This unretouched file photo shows Dr. S in his more serious and younger days.
Complimentary Issue — Medical Home News
Would you like to receive a complimentary issue of a new publication — Medical Home News ? Click on the link and then on “Sample Issue” in the upper left corner.
Here’s a preview of the first issue:
Introducing Medical Home News
An Annotated Guide to the Medicare Medical Home Demonstration (MMHD)
Subscriber’s Corner
Johns Hopkins Lipitz Center to Assist Practices in Medical Home Demo
National Medical Home Summit to be Held March 2nd – 3rd 2009
Thought Leader’s Corner
Industry News
Catching Up With… Paul Grundy, MD
I’m honored […]
New NRC Report Finds “Health Care IT Chasm,” Seeks New Course Toward Quality Improvement and Cost Savings
by David C. Kibbe, MD MBA
Like the Institute of Medicine’s (IOM) 2001 counterpart report, "Crossing the Quality Chasm," a new report from the National Research Council of the National Academies is complex, full of new ideas assembled from multiple disciplines, and is likely to have seminal importance in framing public policy from now on . "Computational Technology for Effective Health Care: Immediate Steps and Strategic Directions " […]
HWR @ THCB
The latest Health Wonk Review is at The Health Care Blog. Brian Klepper ably hosts.
Medicare Health Support: 8 Takeaways on Building Better Bridges
by Thomas Wilson, PhD, DrPH and Vince Kuraitis
What’s the right metaphor for Medicare Health Support (MHS), CMS’ major experiment with disease management for Medicare beneficiaries? We prefer to look it as a bridge failure that presents an opportunity to improve future engineering and design.
We’ve now had the time to read, reread, and reread again the very recent report from Research Triangle Institute (RTI) — Evaluation of Phase I of the Medicare Health Support Pilot Program Under Traditional Fee-for-Service Medicare: […]
JAMA Article Asks: What About “The Other Medical Home”?
Dr. Steven H. Landers writes a thoughtful article in today’s JAMA . He asks why the term Medical Home doesn’t include the patient’s home:
“…the Medical Home initiative, as currently articulated, ironically fails to emphasize the complex chronically ill patient’s actual home. This represents a failure to recognize the profile of the highest-risk beneficiaries driving much of the high Medicare costs—that is those with or more chronic conditions and activity limitations…
“A promising way to strengthen and broaden the Medical Home initiative […]
CMS Releases 2nd Report on Medicare Health Support
by Vince Kuraitis and Thomas Wilson, PhD, DrPH
CMS has just released the 2nd Report to Congress evaluating the Medicare Health Support (MHS) program. MHS is Medicare’s most visible and significant demo focusing on chronic disease management.
We’ve been poring over the report and will provide more detailed analysis and implications later this week. This 2nd Report to Congress covers 18 months of data on this 3 year project. It provides far more details and substantiation than RTI’s first report, which only covered 6 […]
“The Innovator’s Prescription”: Christensen’s Book Offers Insightful Dx, Unrealistic Rx
by Vince Kuraitis and David C. Kibbe MD, MBA
Being big fans of Clay Christensen and his theory of disruptive innovation (DI), we have been awaiting his just-released book The Innovator’s Prescription: A Disruptive Solution for Healthcare . The book is co-authored by Dr. Jerome Grossman and Dr. Jason Hwang.
We have mixed reactions.
The book is mistitled. It should have been titled "The Innovator’s Diagnosis". The book does a fantastic job at diagnosis (Dx) of problems in the U.S. health care […]
Leavitt’s Framework Shoehorns the HIPAA Privacy Rule onto Your Personal Health Information
by Vince Kuraitis and David C. Kibbe MD, MBA
Have you ever heard anyone tell a happy story of how easy it is to get a copy of their paper medical records?
Departing Health and Human Services Secretary Mike Leavitt is laying the groundwork for this same story to apply to access to YOUR electronic personal health information.
Here’s an overview to what evolved into a long posting:
Analysis: The Leavitt Framework Uses the HIPAA Privacy Rule as a Baseline for Electronic Access to Personal Health Information
Implication: Extending […]
Complimentary Webinar on Comparative Effectiveness Sponsored by Population Health Impact Institute (PHII)
The message is clear from Washington – “Comparative Effectiveness” has been proposed as the foundation for coverage decisions in Medicare. As the feds lead – this will more than likely "trickle down" to the commercial sector.
The Population Health Impact Institute (PHII) has convened national experts to develop a practical, comparative-based system to help purchasers and payers evaluate the methods and results used in all kinds of population health management programs – including medical, case and disease management, benefit design, value-based […]
An Open Letter to the Obama Health Team on Health IT Spending
By David C. Kibbe, MD MBA and Brian Klepper, PhD
It seems likely that the Obama administration and Congress will spend a significant amount on health IT by attaching it as a first-order priority to the fiscal stimulus package. We take the President-elect at his word when he recently said:
"…we must also ensure that our hospitals are connected to each other through the Internet. That is why the economic recovery plan I’m proposing will help […]
Health Wonk Review — The “Just the Facts, Ma’am” Edition
The story you are about to read is true. The names have been changed to protect the innocent.
This is the city: Los Angeles, California. I work here. I carry a badge blog. My name’s Friday.
Click here (short) or here (long) for Dragnet theme music.
A crime of disorderly conduct has been committed. The U.S. health care system is the prime suspect. My partner Gannon and I will investigate.
Engage With Grace
This wonderful project is written up in today’s Boston Globe . Happy Thanksgiving all!
Vince
by Alexandra Drane and the Engage With Grace team
We make choices throughout our lives – where we want to live, what types of activities will fill our days, with whom we spend our time. These choices are often a balance between our desires and our means, but at the end of the day, they are decisions made with intent. But when it comes to how we want to […]
LifeCOMM: Will the Newest Personal Health Information Platform Play Nicely with Google and Microsoft?
Please read my guest post over at the Center for Connected Health .
The Yabuts of Sharing Data Between Google Health and HealthVault
“What’s a yabut?” you ask.
Yabut is a term coined by my esteemed colleague, the late Paul Fetrow. It stands for “Yeah….but….”
Yabuts are the gotchas, the fine print, the details that affect the terms of any agreement. For example, the telecom companies will tell you its easy to switch carriers now that we have number portability. Yeah…but it will cost you $175 for an early termination fee.
Yesterday’s post ended with the optimistic observation that Google Health and Microsoft HealthVault have agreed […]
HWR at Colorado Health Insurance Insider
The Election Is Over Edition edition of the Health Wonk Review is now posted at Colorado Health Insurance Insider.
Thanks Louise!
Picturing the PHIN as One Interoperable Network
Will the Microsoft HealthVault, Google Health, and Dossia personal health information (PHI) platforms be able to exchange data? In our introductory essay announcing the Birth of the Personal Health Information Network (PHIN), Dr. David Kibbe and I posed a critical question:
What will the PHIN look like? Will there be multiple, non-interoperable, competing networks or just one interoperable network?
This question is being answered with the best possible answer: the PHIN is evolving as one, interoperable network.
Consider 3 scenarios:
Scenario One: Status Quo — […]
Disruption in the Neighborhood? The PCs Build the Medical Home.
There’s a new house being built in the vacant lot across the street. It’s the medical home, and it is going to be occupied by several primary care physician families (PCs).
From what’s been said, the PCs are nice folks and will make good neighbors. They’re friendly, many are Episcopalian, they like white picket fences, and they have barbeques on Sunday afternoons. The neighborhood they’re coming from is not as well off nor as pristine — they’re said to be suffering from […]
CCHIT Should Support BOTH the HL7 CCD and the ASTM CCR for PHRs.
The federal government sponsored Certification Commission for Healthcare Information Technology (CCHIT ) is undertaking a certification process for personal health records (PHRs) . The CCHIT PHR Work Group has invited public comment on the First Draft of the PHR Certification Criteria .
The current draft of the PHR Certification Criteria specifies use of the HL7 Continuity of Care Document (CCD) as the only endorsed standard for interoperable exchange of information to and from PHRs. This is extremely short-sighted.
I wrote a comment to […]
Empowering Health IT for the Medical Home
by David C. Kibbe, MD MBA
The basic premise of the medical home concept is continuous, uninterrupted care that is managed and coordinated by a personal provider with the right tools that will lead to better health outcomes.
In 2007, the American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians, and American Osteopathic Association, released the Joint Principles of the Patient-Centered Medical Home. In this document they state the characteristics of the Patient Centered Medical Home:
Personal Relationship
Team Approach
Comprehensive
Coordination
Quality […]
Finally! CMS Provides a Flood of Details About the Medicare Medical Home Demo
I’ve been critical in the past when CMS has been silent in explaining their thinking, so I’ll start this post by congratulating CMS on sharing a flood of details about the upcoming Medicare Medical Home Demonstration project.
An email from CMS arrived in my inbox this morning at 2 am. That email notified me that they have updated the MMHD homepage . A quick click lead me to 8 new documents containing 155 pages of newly available details on the MMHD.
If you have time to read […]
“Bail Out the Fat Cats” Edition of the Health Wonk Review
Jason Shafrin of Healthcare Economist provides “700 billion reasons to read the Health Wonk Review ”.
Read about how the bail out might affect health care from the POV of:
Wall Street
Health Insurers
Healthcare Reformers
Doctors
The Uninsured
Kids
Implementing a Medical Home — Akin to Do-It-Yourself Brain Surgery?
This morning the Disease Management Care Blog brought an interesting toolkit to my attention. It was published by AHRQ in August 2008, so it’s very recent.
This toolkit describes how to implement the Chronic Care Model (CCM) in your medical practice. The CCM is embedded in the Patient Centered Medical Home (PCMH) model and can be consider a foundational element of the PCMH.
I would call this toolkit “The Medical Home for Dummies, Vol. I”, but then I’m sure the Dummies […]
What’s the Best Way to Get Hospitals Involved in Care Coordination?
Pay them to do it, take money away when they don’t — make hospitals accountable for their role in avoiding unnecessary readmissions.
Mark E. Miller, Ph.D., Executive Director, Medicare Payment Advisory Commission testified recently in front of the U.S. Senate Committee on Finance. He opened his remarks by stating:
The health care delivery system we see today is not a true system: care coordination is rare, specialist care is favored over primary care, quality of care is often poor, and costs are high […]
Megatrend Spotting: Collaborative Care Management Networks
“Why can’t we all just get along?” Rodney King
The Megatrend: Collaborative Care Management Networks (CCMNs)
It’s been quite a while since I spotted a new Disease Management Megatrend, but here’s one that’s long overdue:
Collaborative Care Management Networks will be necessary to achieve optimal care coordination.
The trend in a nutshell: payers (and others) are recognizing that optimal care coordination will require collaboration among health care stakeholders. This CANNOT be achieved with yesterday’s proprietary IT and business models.
CCMNs will share many — perhaps all — […]
From PHRs to PHRSs
Personal health records (PHRs) are evolving toward becoming Personal Health Record Systems (PHRSs).
…that’s my key takeaway from attending the Robert Wood Johnson Foundation (RWJF) Project Health Design (PHD) conference in Washington D.C. on September 17. The conference was entitled A ‘Report Out’ from Project HealthDesign and Forum on Next-Generation PHRs .
A PHD Fact Sheet capsulizes the evolution from PHRs to PHRSs:
Attend the Best DM/Population Health Conference of the Year!
In a little less than three weeks, DMAA: The Care Continuum Alliance will open its 10th annual meeting , in Hollywood, Fla. – a notable milestone for an organization that has evolved with its membership over the past decade.
I’ll be there, presenting with Dr. Victor Villagra on the "March toward Data Interoperability" and the outlook for disease management.
The content this year promises to be among the best yet, with a new track on […]
Details “Emerge” on the Medicare Medical Home Demonstration
Where would one expect to find CMS’ latest thinking on the upcoming Medicare Medical Home Demonstration project? The obvious answer would be “on the Official CMS MMHD home page ”, but you’d be wrong.
CMS has issued a Medicare Medical Home Demonstration Payment Contractor RFP available on the Federal Business Opportunities website. Thanks to the Google Alert service for digging this out.
For the casual reader, the details of the MMHD are taking shape nicely. CMS and its advisors have obviously […]
Doctors Bat A Thousand in Year Two of PGP Medicare Demo
CMS announced today that all 10 participating groups in the Physician Group Practice (PGP) demonstration achieved quality targets, and that the groups are sharing $16.7 million in incentive payments. The program rewards providers for improved outcomes delivered to Medicare patients with congestive heart failure, coronary artery disease, and diabetes.
This goes a long way in explaining Medicare’s seeming lack of enthusiasm for past or future disease management demos with DM companies and/or health plans.
Congratulations doctors!
UPDATE: The doctors might have batted […]
Medical Home PowerPoint and Latest Perspectives
Last week my esteemed colleague Dr. Jaan Sidorov and I conducted a webinar for WRG on Patient Centered Medical Home (PCMH) developments.
The process of updating a PowerPoint forces one to collect one’s thoughts, and I’m glad to share with you the PowerPoint slides along with a few highlights about the evolution of the PCMH. The highlights:
Heartburn Relief: UnitedHealth Joining Google Health and MSFT HealthVault?
From the August 6 edition of HISTalk — Healthcare IT News and Opinion:
"Re: UHG. Was at the Healthcare Quality Conference yesterday in Boston. Got to talking to a United Health exec who informed me that they have signed an agreement with Google Health and have a pending agreement with HealthVault. This backs up UHG’s previous statement that member records would be made portable. Individual made mention that the Google Health relationship extends beyond just claims records transfer and includes a […]
Medical Home Webinar
On behalf of World Research Group, Dr. Jaan Sidorov and I will be conducting a webinar —
Patient-Centered Medical Home Model: Overview and Update.
The webinar takes place next Monday, July 28 at 12 Eastern. Click here for details. Hope you can join us.
The Day the Tide Started Shifting Against Greedy Healthcare
Mark the date — July 9, 2008.
Bob Laszewski describes it eloquently in his blog posting: Senate Votes 69-30 To Rescind Medicare Physician Fee Cuts and Cut Medicare Advantage to Pay For It .
Is healthcare more like schools, fire departments, and roads or is it more like TV sets, shampoo, and movies?
I do think of myself as a strong free market advocate. But, I’ve learned about how isolated, deficient, and expensive the U.S. approach to healthcare is compared to virtually every […]
AHIP “Adopts” Medical Home Principles: Huh?
On the surface, you might think that a press release issued by America’s Health Insurance Plans (AHIP) adopting principles for a patient centered medical home (PCMH) would advance the cause.
But, look further…
The principles endorsed by AHIP only vaguely resemble the Joint Principles of the PCMH endorsed by 4 major primary care physician groups . These groups represent over 300,000 physicians. (See below for a summary listings of AHIP and physicians’ principles supporting the PCMH).
Why?
Why didn’t AHIP didn’t just endorse the […]
Dr. Sidorov Serves Up the Latest Cornucopia of Health Wonk Blogging Cuisine
Dr. Jaan Sidorov serves up a cornucopia of blogging delicacies in the latest edition of the Health Wonk Review at Disease Management Care Blog. Sample the fare!
Goldilocks: “Markle’s Framework for Networked Personal Health Information is Just Right”
By Vince Kuraitis and David C. Kibbe, MD, MBA
Once upon a time, there was a little girl named Goldilocks. Like most Americans, Goldilocks had concerns about achieving just the right amount of data liquidity for her personal health information (PHI).
Until today Goldilocks felt between a rock and a hard place:
"I want my PHI to be appropriately liquid — just the right viscosity. My PHI should be viscous enough to flow to my trusted […]
Untangling the Electronic Health Data Exchange
by David C. Kibbe MD, MBA
The purpose of this post is to help a non-technical audience untangle some of the confusion regarding health data exchange standards, and particularly come to a better understanding of the similarities and differences between the Continuity of Care Record (CCR) standard and the CDA Continuity of Care Document (CCD). But what I’m most interested in is getting beyond the technical, political, or economic positions and interests of the proponents of any particular standard to arrive […]
Washington Edition of the Health Wonk Review…
….is posted at the Health Affairs blog. Jane Hiebert-White does a great job with a focus on current public policy issues.
(Apologies to any chimps offended by the comparison).
Grands Rounds is up at Happy Hospitalist blog
Grand Rounds — a weekly medical blog carnival — is now posted at the Happy Hospitalist. Dr. Happy brings home the bacon!
Cerner Disses Google Health. Surprised?
Vince Kuraitis and David C. Kibbe, MD, MBA
We’re not.
From the Kansas City Business Journal :
Google Inc. has approached Cerner Corp. about a partnership, but Cerner officials don’t sound eager to entangle themselves with the Web-search Goliath.
That’s because […]
Latest Edition of the Health Wonk Review at InsureBlog
The latest edition of the Health Wonk Review has been posted at InsureBlog…it’s straightforward, concise, no schtick. Thanks to Hank Stern!
Extra: Will $87 Per Hour Rescue Primary Care?
Since the AMA has issued some “real” numbers relating to the RUC’s recommendations for valuing the Patient Centered Medical Home (PCMH), I’ve added a fourth part to this series.
The June 2 issue of American Medical News provides payment scenarios for a medical home:
The Medical Home: Pull the RUC Out
This third and final post in the series addresses questions about the future of the Patient Centered Medical Home (PCHM):
What’s problematic about using the RUC methodology with the PCMH?
What’s the optimal level for a PCMH care management fee?
Should primary care leaders pull the RUC out? How?
What’s Problematic About Using the RUC Methodology with the PCMH?
There are at least two reasons for not having the RUC methodology seen anywhere in the same county country as the PCMH. First, the RUC methodology doesn’t […]
The Medical Home Hits the RUC
Today’s post (#2 in a series) tackles several questions:
What is the American Medical Association/Specialty Society RVS Update Committee (RUC)?
What is the RUC’s role in the Medicare Medical Home Demonstration project?
How are people reacting to RUC recommendations for PCMH reimbursement levels?
What is the American Medical Association/Specialty Society RVS Update Committee (RUC)?
The AMA formed the RUC to act as an expert panel in making recommendations to CMS on the relative values of Current Procedural Terminology (CPT) codes using the Resource Based Relative Value […]
The Medical Home: Confusion Over Care Management Fees
The honeymoon is over.
Prior to April 29, 2008, reviews of the Patient Centered Medical Home (PCMH) model had been uniformly enthusiastic and positive.
Today the PCMH model is hitting reality — someone’s going to have to bring home money to pay the bills. On April 29 the American Medical Association/Specialty Society RVS Update Committee (RUC) released a report making recommendations relating to payment levels of care management fees for the PCMH.
This report has stirred cries of confusion and outrage. I’ll elaborate on these cries in the second posting of […]
Healthways Fights an Uphill Battle on Medicare Health Support Phase II
Earlier this week Healthways issued a press release describing their progress in pursuing a Phase II Medicare Health Support (MHS) project. Read Dr. Jaan Sidorov’s blog commentary for additional background.
In brief, Healthways position is that the Centers for Medicare and Medicaid Services (CMS) is statutorily required to expand into Phase II of MHS if Phase I is “successful”. While I’m very sympathetic with Healthways predicament and their frustration with CMS, I’m not optimistic that their tactics are likely to work.
In making the case, Healthways […]
Perspectives on the Upcoming 5th Annual Healthcare Unbound Conference
The Healthcare Unbound Conference is a highlight of my year and I always look forward to it!
What’s so special about this conference?
First, the caliber of the people attending. It’s a stimulating mix of high-level clinical, technical and business types. The energy is flowing and many people have told me how much they like to go just for the networking.
Second, the caliber of the conference organizer. I’ve worked with many conference planners, and Satish Kavirajan is not your ordinary conference organizer.
Satish […]
Health Wonk Review at the Medical Humanities Blog
Daniel Goldberg of the Medical Humanities Blog has posted the latest edition of the Health Wonk Review. Daniel puts a unique slant on his writing:
As I see it, the key role for a medical humanist – if they wish to be consistent with an ethos of medieval and Renaissance humanists – is to focus on the translation of theory into practice.
…and he throws in some humor to boot. Great reading!
Book Review: Good Health is Good Business
My colleague Dr. Dave Rearick asked me to review his recent book, Good Health is Good Business. I’m pleased to recommend it enthusiastically.
While the book is targeted at small to medium size employers, the lessons go far beyond this audience.
By the end of the 3rd chapter, Dr. Rearick had convinced me of two conclusions that I’d describe as indisputable, but uncomfortable:
The only way employers are going to control their health care costs is to influence the health of their workforce.
You (the employer) need […]
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 […]