e-CareManagement Blog
Archives for e-CareManagement Blog (2006-2021)
Next Generation Disease Management, ala Google
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Google Wants to Index Your DNA, Too Business Week; April 18, 2008
A few years ago I remember reading a vivid description of how much information is contained in one person’s genetic code: a stack of phone books high enough to reach the top of the Washington Monument.
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Is the Medical Establishment the Best Guardian of Your Medical Data?
David C. Kibbe, MD, MBA and Vince Kuraitis
Drs. Mandl and Kohane begin their recent article in NEJM with the statement that “large corporations are seeking an integral and transformative role in the management of health care information,” and then warn that this “will profoundly affect the biomedical research enterprise.”  Â
At issue for the authors is who controls the information about you and me, our health and healthcare data. Without coming right out and saying it directly, they worry that data in […]
NEJM and NYT Discuss “Tectonic Shifts” of a Personal Health Information Economy
Vince Kuraitis and David C. Kibbe, MD MBA
Tomorrow’s edition of the New England Journal of Medicine contains an article entitled “Tectonic Shifts in the Health Information Economy”. While we have not yet fully digested this article, it’s clear that the authors’ description of the “Health Information Economy” closely parallels our initial description of the Personal Health Information Network (PHIN).
The main thrust of the NEJM article is to discuss implications (good and bad) relating to clinical research. The NEJM article is also highlighted in a New York Times piece […]
Could a Linkage Between Amalga and HealthVault Become a Centerpiece of Microsoft’s Healthcare Strategy?
Writing in ZDNet, Mary Jo Foley ponders the question of whether it might make sense for Microsoft to link HealthVault (HV) and Amalga.
I’ll take this a step further and ask “Could a linkage between HealthVault and Amalga become a centerpiece of Microsoft’s broader health care strategy?”
Healthcare Informatics Webinar: Google, Microsoft, & Dossia Create the Personal Health Information Network
What are companies like Google, Microsoft, and Dossia (sponsored by Intel, Wal-Mart, AT&T and others) hoping to accomplish in health care?
What is the emerging Personal Health Information Network (PHIN) and why should you care?
What’s the Continuity of Care Record (CCR) Standard, and how is it destined to become an initial focal point of data exchange initiatives?
Why is the PHIN potentially disruptive to many business models? What types of companies or organizations could be affected the most?
What are opportunities and threats to major health care players — hospitals, […]
NYT Provides More “Enlightened Ambiguity” on Medicare Health Support
While not providing anything close to the “final answer”, The New York Times does a good job summarizing the onoging Medicare Health Support (MHS) fracas. To borrow from one of my colleagues, it’s more “enlightened ambiguity” about the ultimate fate of the MHS beached whale.Â
Medicare Finds How Hard It Is to Save Money, The New York Times; April 7, 2008
For One Company, Role in Medicare Experiment Has Hurt Stock, The New York Times; April 7, 2008
Medicine 2.0 Blog Carnival at “The Patient’s Doctor”
Our colleague Dr. Aniruddha Malpani, MD has posted a diverse and enlightening latest version of the Medicine 2.0 Blog Carnival.Â
Dr. M summarizes 4 major influences which will help patients to regain control over their healthcare:
1. Patients will keep their own medical records using a PHR ( Personal Health Record)
2. Information Therapy can be prescribed to them, tailored to their needs, based on their medical problems captured in the PHR
Read Post about Medicine 2.0 Blog Carnival at “The Patient’s Doctor”
Data Incompatibility Remains A Barrier to Remote Patient Monitoring (RPM) Devices Reaching the Mainstream
The Continua Health Alliance is doing a good job in getting remote patient monitoring (RPM) devices to become plug-n-play — where devices and peripherals from different manufacturers complying with Continua Guidelines will be able to talk to one another.
Continua’s work-to-date is a necessary, but not yet sufficient effort to make RPM devices mainstream.
Knocking down the barrier of device-incompatibilty exposes the bigger barrier of lack of data interoperability among RPM technologies and between RPM devices and health care IT systems. Jonathan Edwards, […]
Health Wonk Review by Brian Klepper
The ever-gracious and ever-eloquent Brian Klepper has written up the latest rendition of the Health Wonk Review. Check it out here on The Health Care Blog.
…and check out Brian’s own website here.
Three New Reports On Aging and Technology
Older Americans 2008: Key Indicators of Well-Being, AgingStats.gov, Federal Agency Forum on Aging-Related Statistics
Healthy@Home, commissioned by AARP and the Blue Shield of California Foundation
State of Technology in Aging Services, Center for Aging Services Technology (CAST)
These reports are succinctly profiled with links to the full studies at Profiles of older health care consumers: living longer, longing for technology on Jane Sarasohn-Kahn’s Health Populi blog. A great read!
Feds Call on Google and Microsoft to Breathe Life into the NHIN
Vince Kuraitis and David C. Kibbe, MD MBA
Who is the federal government calling on to breathe life into the Nationwide Health Information Network (NHIN)? Google and Microsoft.
In our first article of this series describing the Personal Health Information Network (PHIN), we noted early entrants as Google Health, Microsoft HealthVault, and Dossia. We also noted that the network could grow rapidly, and that others would want to join or link to the PHIN.
With Uncle Sam announcing plans to link to the PHIN, […]
Search Engines Using Your Personal Health Information: Creepy or Cutting Edge?
When using a search engine, should results be customized based on your personal health information (PHI)? Should your search engine of choice take into account your previous history of medical searches, or even provide results tailored from data about your personal medical history?
Two companies — Aetna and Microsoft — have come up with 180 degree different answers.
In this post, I will:
Describe how Aetna’s and Microsoft’s approaches differ
Speculate on why their approaches make strategic sense for the respective companies
Explore how technology and expectations about […]
Health Wonk Review — Fearless Leader Edition
Joe Paduda has posted the latest edition of the Health Wonk Review at his blogsite, Managed Care Matters.Â
Joe is one of the founders of the HWR, so a big THANK YOU goes out to our “Fearless Leader”.
The Medicare Health Support Saga: Opacity in Government Going Strong
 Vince Kuraitis and Thomas Wilson, PhD, DrPH
“If you aren’t confused you don’t know what’s going on.”
Jack Welch, former CEO, General Electric
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Thanks to the continuing opacity of the Centers for Medicare and Medicaid Serices (CMS), we remain confused about the future of Medicare Health Support (MHS).
It’s been over a month since we last commented on MHS. What’s MHS?  It’s JUST the Federal Government’s most significant and visible effort to deal with one of the American health system’s biggest challenges — managing care for patients with […]
4 Reasons Why Health Plans Struggle with PHRs
Aetna recently made another big announcement relating to their PHR. While the concept of what they’re doing is very appealing, it strikes me that health plans in general face an uphill battle in getting consumers to adopt and use personal health records (PHRs).
I’ll describe 4 factors behind my thinking:
Lack of Trust
Lack of Access to Clinical Data
Lack of Permission
Lack of Convenience in Consumer Workflow
How Will the HMO Stock Meltdown Affect Chronic Disease Management?
About three weeks ago Cain Brothers Investment Bankers released a report that foreshadowed the collapse of HMO stock prices that has occurred over the past few days. The report was entitled: FAREWELL TO A TIME OF PLENTY? Health Plan Strategies for Growth in a More Challenging Market.Â
Here are a few highlights from the report:
Eight Reflections From One Year of Blogging
Blogging started as an exercise in business development. It’s turned into an adventure in personal development.
Blogging is more work than I ever imagined.
Blogging is also more rewarding than I ever imagined.
Think book, not diary  (with gratitude to Guy Kawasaki, How to Change the World blog).
Putting up 1/2 baked ideas is a great way to have a dialogue; putting up 1/4 baked ideas is a great way to look stupid.
Blogging is addicting. I think of Jim Fixs’s book on running where he describes monks that ran for […]
Going to the Mat for Dorothy
by Jill KuraitisÂ
Vince gave me Dorothy’s story to read, and here’s what I said: GO DOROTHY!  ::::goofy little happy dance:::  Dorothy is my new hero. I love people who are willing to go to the mat for a cause, especially one having to do with the elderly, children, the disabled and less fortunate than we.
Since Vince and I have been overwhelmed by the swamp of details of taking care of our family elderly for about, oh, 13 years – my […]
Birth Announcement: the Personal Health Information Network (PHIN)
Vince Kuraitis and David C. Kibbe, MD MBAÂ
The Internet and digital technologies have transformed many aspects of our lives over the past twenty years. We can get cash at ATMs all over the world; we can book our own airline reservations; we can shop and get best prices over the Internet.
Why hasn’t this happened in health care? Something is missing.
Recently, major global information and communication companies have announced their intention to bring their technologies and business models to health care. […]
“Give me Auntie’s medical records or put me in the slammer!”
We underestimate how much people REALLY want medical infomation about themselves and their loved ones.Â
Dorothy Tillman wanted it so badly that she was arrested! Read more at Jaz-Michael King’s blog, A Scanner Brightly.
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Hat tip to Jen McCabe Gorman for spotting this amazing story.
A First Comparison of Google Health and MS HealthVault
While details are thin, here’s a first pass at comparing and contrasting Google Health (GH) and Microsoft HealthVault (HV). Overall, there are many common features, some differences, and many common challenges between these two platforms.Â
A High Level Comparison
Google Health and Microsoft HealthVault Personal Health Information (PHI) Platforms
There’s still not much information available about the specifics of GH, although they did release sketchy information on the Official Google Blog.  I’ll comment on a few of the particulars.
Are HIEs a Dead Horse?
Do local Health Information Exchange (HIE) participants have the right economic motivations to make them work? Â
A report released this week raises strong doubts. The study — Creating Sustainable Local Health Information Exchanges: Can Barriers to Stakeholder Participation be Overcome? — was  funded by the U.S. Agency for Healthcare Research and Quality (AHRQ) and conducted by the Center for Studying Health System Change (CSHSC). The term HIE is often used interchangeably with RHIO (Regional Health Information Exchange).
What’s different about this study? The CSHSC report goes a step further than other recent reports […]
21 Surprising Ways Wal-Mart Clinics Will Affect US Healthcare
Jessica Hupp at RN Central writes a thought provoking article titled 20 Surprising Ways Wal-Mart Clinics Will Affect US Healthcare.
#20 is “Decreased Continuity of Care”. I think this one is debatable, and I’ll offer as #21 “Increased Continuity of Care”. Â
Jessica writes:
With traditional doctors, patients have charts and medical records, but at in-store clinics, diagnosis is a one-off deal. Problems that could be caught over multiple visits and diagnosis could go unearthed unless the patient works to inform practitioners.
I’m picking up […]
Podcast Part Deux: Medicare Health Support in Jeopardy
Here’s the link to Part II of the podcast in which Tom Wilson and I are interviewed by Les Masterson of HealthLeaders Media. If you want to start at the beginning, Part I is available here.
The Wrong Way and the Right Way to Frame PHR Privacy/Confidentiality Issues
 Vince Kuraitis and David C. Kibbe, MD MBAÂ
During the past week two reports were released discussing privacy/confidentiality issues surrounding PHRs. One of these reports did it the wrong way; one did it the right way.
The general public is just learning about Personal Health Records (PHRs). We believe that the appropriate way to frame the dialogue for the public is to acknowledge both the benefits and risks:
Benefits: PHRs (and EHRs) have the potential to save lives, reduce medical errors, improve patient […]
Latest Edition of the Health Wonk Review at GoozNews
The latest edition of the Health Wonk Review is up at Merrill Goozner’s blog, GoozNews. Merrill, who has worked as an investigative reporter and freelance journalist, brings a fresh, common-sense perspective to his writing. Check it out.
Medicare Health Support: “Do not go gentle into that good night”
Vince Kuraitis and Thomas Wilson, PhD, DrPH
“Do not go gentle into that good night.
Rage, rage against the dying of the light”
Dylan Thomas
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Despite CMS’ recent cocktail hour pronouncement that Medicare Health Support (MHS) is on its last legs, many are fighting to prolong its life.
Recent Developments
DMAA is working with Sen. John Kerry to introduce legislation mandating the continuation of Medicare Health Support (MHS). Dr. Jaan Sidorov’s Disease Management Care Blog reprints the full announcement from the February 12 issue of […]
The Medical Home: Advancing, But Still Many Questions
Paul Keckley and colleagues at the Deloitte Center for Health Solutions have released an important contribution to advance the dialog about the medical home (MH). It’s entitled The Medical Home: Disruptive Innovation for a New Primary Care Model. The report offers a strategic perspective on the potential for the MH to address the challenge of chronic care management.
The biggest single contribution of this report is to create a back-of-the-envelope (BOTE) economic model of anticipated costs and benefits from implementing the medical home. […]
HealthSpring “Gets” Physician Engagement.
I’ve written a lot recently about Medicare Health Support (MHS). We are learning a lot from MHS about what DOESN’T work with the frail, elderly Medicare population.
But, what DOES work?
One key lesson emerging from MHS is the need to integrate and engage physicians and other local care providers…easier said than done.
Read Post about HealthSpring “Gets” Physician Engagement.
Guest Post: The CMS Announcement Of Medicare Health Support Program Cancellation — What It Means For Buyers
by Al Lewis, JD
Add the Centers for Medicare and Medicaid Services (CMS) to the growing list of people and organizations who cannot find financial savings through disease management. Weeks after “lowering the bar” on MHS program savings requirements to 0% from 5%, CMS cancelled the program altogether due to the unlikelihood that the much-reduced threshold for savings would be achieved in the remaining months of the three-year measurement period.
Yet even as CMS’ conclusion mirrors that of the Congressional Budget Office, and the RAND Corporation, other organizations and […]
Insufficient Evidence to End Medicare Health Support
Thomas Wilson, PhD, DrPH and Vince Kuraitis
Last Tuesday during the cocktail hour, CMS issued documents portending the end of the Medicare Health Support (MHS) project. Â
We initially used the word “bizarre” to describe the announcement from CMS’ staff. After further thought, “reckless” and/or “insubordinate” strike closer to home.
First, let’s have the head-honcho at CMS instruct us on how things should be done. In September 2007 Kerry Weems, the new CMS Administrator, declared that “cocktail hour press releases” from his agency […]
$389 M of Healthways’ Market Value Vaporizes After CMS Announcement. What Happened?
Healthways stock price declined today by $10.52 (15.9%) after CMS “announcement” about ending Medicare Health Support (MHS) Phase 1. This equates to a loss of $389 million in market capitalization…poof! Gone. Healthways is one of the remaining five participants in the MHS program.
Without pointing fingers, it’s obvious that investors were surprised by the news.  What happened?
CMS: “Rumors of Medicare Health Support’s Death Have Not Been Greatly Exaggerated”
Vince Kuraitis and Thomas Wilson, PhD, DrPH
Today’s POO (persistent obfuscatory orations) Award goes to the Centers for Medicare Services (CMS) for their posting of two bizarre documents updating progress on the Medicare Health Support (MHS) program. The documents “appeared” (no press release, no announcement, a reference to “today” but no date) on the web page for the MHS demonstration project.
While a casual reader would probably review these documents and scratch their head, we interpret them as a death knell for the Medicare Health Support […]
Health Wonk Review at e-CareManagement
Welcome!
Since this is my first time hosting the Health Wonk Review, I really didn’t know what to expect.  I have to say that I’ve learned a lot while poring over the insight and wisdom of my fellow bloggers. Fortunately, this week’s entries fell into neat categories:
In-Store Clinics
Physicians
Problems — U.S. & World Health Systems
Solutions — U.S. & World Health Systems
Cats, Dogs and Kangaroos
Just in case that last category, doesn’t look too familiar, let’s revisit the whole point of the Health Wonk Review:
Health Wonk […]
The PowerPoint — DM Megatrends 2008
Last week I did the major annual tune-up of my presentation on Disease Management Megatrends for the MCOL Future Care Web Summit.Â
I’m pleased to share a copy of the PowerPoint presentation with you, and I hope you find it useful and provocative. You can view and/or download a copy here (6MB). This version contains 77 slides, which would be about the length I’d use for a 3 hour workshop; you’d see a more compact version for a conference keynote, Board summary, or management […]
Hospital Economics Don’t Reward Chronic Disease Management
My colleague and friend Dr. Jaan Sidorov has recently started a blog — Disease Management Care Blog. Check it out and add it to your RSS feed. Jaan is eminently qualified to write on the topic — he spent 25 years at Geisinger Health System in Pennsylvania as a practicing physician and as an executive, and he just ended a term on the board of DMAA—the Care Continuum Alliance (formerly Disease Management Association of America).
Jaan’s sense of humor and articulateness shine […]
UnitedHealth a First Mover for “PHRs for Life”. Way to go!
CONGRATULATIONS to UnitedHealth! They’ve announced that they are making their personal health records (PHRs) transportable:
The OptumHealth and UnitedHealthcare units of Minneapolis-based UnitedHealth Group have made their personal health records service accessible for life.
That means an individual covered by UHC insurance or OptumHealth’s outsourced health and wellness services will be able to access their PHR–and continue to enter data into it–if they change jobs or insurance coverage.
Prediction: over time, the market will force all employers, payers, and providers to provide interoperable and […]
Podcast: The 20 Minute Version of “DM Megatrends”
Over the past week I’ve been doing a major tune-up of my presentation on Disease Management Megatrends for the annual MCOL Future Care Web Summit.Â
More typically, DM Megatrends is 45–90 minute presentation with accompanying PowerPoint slides.
As part of the Web Summit, the good folks at MCOL asked me to do a short podcast on highlights of this presentation. They’re allowing me to share it with you… click here to save or listen to the podcast.
fyi, the DM Megatrends are:
MAGNITUDE: We are just scratching the […]
How the AMA Undermined Chronic Disease Care in America
Over at The Health Care Blog, Brian Klepper has written an excellent article entitled “Bad Medicine: How The AMA Undermined Primary Care in America.”
His essay could just as easily been entitled “How the AMA Undermined Chronic Disease Care in America” — it’s very informative reading.
Hospital as Mainframe, Wireless Technology as Liberator
Sometimes the serendipity of airplane readings provides for insightful connections. I thought I’d share one from this week’s travels.
The aha of “hospital as mainframe” came from reading Eric Dishman’s epilogue in Dr. Mike Magee’s excellent recent book, Home-Centered Health Care:
As with mainframe computers only a couple of decades ago, today we have to make a pilgrimage to that hospital mainframe to wait ever so patiently as we time-share those miraculous modern medical capabilties that have been gathered there. In the midst of […]
POE Award: Linda Magno of CMS Acknowledges the Elephant in the Room with Medicare DM
Just about everybody in the world has been talking about problems that Medicare is having with chronic disease management (DM) demonstration projects…everybody except the folks at Medicare.
Well, that’s finally changing. Today’s POE (plain old English) award is presented to Linda Magno, Director, Medicare Demonstrations at CMS (Centers for Medicare and Medicaid Services).
Here are a couple of slides from Ms. Magno’s presentation at the Patient Centered Primary Care Collaborative Summit on November 7:
What Will Microsoft’s HealthVault Mean to the Telehealth Community?
My colleague Tim Gee and I are guest bloggers on the Get-Connected Forum at the Center for Connected Health. We speculate on:
What Will Microsoft’s HealthVault Mean to the Telehealth Community?
Our bottom line: HealthVault overall is a positive for telehealth industry growth and scale, even though it will speed the inevitable commoditization of remote patient monitoring (RPM) devices.
Latest Edition of the Health Wonk Review
Read the best recent efforts of health care bloggers! The latest edition of the Health Wonk Review is posted at Jason Shifrin’s Healthcare Economist blog. Thanks, Jason.
Four Misconceptions About HealthVault and the Emerging Personal Health Information Ecosystem (PHI-Ecosystem)
by Vince Kuraitis and David C. Kibbe, MD MBAÂ
The health care and technology worlds are still trying to figure out what Microsoft’s HealthVault (HV) is all about. We believe that there are a number of misconceptions out there about what HV is and isn’t:
Misconception #1: HealthVault is a personal health record (PHR).
Misconception #2: People don’t trust Microsoft, so they won’t sign up for and use HV.
Misconception #3: Patients don’t understand PHRs, don’t want them, and don’t know what they’d do with them. […]
Microsoft’s HealthVault: User Manual = C-, Strategy to Create a New Ecosystem = A
Would you like to have the experience of being parachuted into a deep forest with no map of where you are or clues about how to get out? If so, I suggest that you go directly to Microsoft’s new PHR at www.healthvault.com and just TRY to figure out where you are or where you’re headed.
Initial confusion put aside, I think HealthVault is strategically brilliant. While I’d give Microsoft a C- for explaining HealthVault (HV), I’ll give them an A for […]
Health 2.0 Deserves Careful Watching
by David C. Kibbe, MD MBA
Dear Colleagues:
Thursday I attended a wonderful one day conference, entitled “Health 2.0 — User Generated Health Care.” One of the most interesting events of 2007. Held in San Francisco. I had a chance to talk with Adam Bosworth and Missy Krasner of Google, with Peter Neuport of Microsoft, and with David Brailer, among many others. It was particularly good to see Drs. Walter Lim and Rick Chan, with the Ministry of Health in Singapore, who came […]
Disease Management and the Medicare Health Support (MHS) Project: “Houston, we have a problem.”
Thomas Wilson, PhD, DrPH and Vince Kuraitis, JD, MBA
The conventional wisdom in the disease management (DM) community has been that the Medicare Health Support (MHS) project would provide the evidence to resolve two issues:
First, MHS would once-and-for-all resolve the issue of “does DM have ROI? (return on investment).” It was thought that the randomized control trial process employed in MHS would provide scientific evidence to prove that DM has a positive ROI, clearing the way for unqualified acceptance and widespread […]
Teleconference — New Health Plan Strategies for Disease Management: Lessons Learned From the Medicare Health Support Pilot
Please join me at a live teleconference next Tuesday, August 21 at 1 pm Eastern:
New Health Plan Strategies for Disease Management: Lessons Learned From the Medicare Health Support Pilot
Click the link for details about the agenda and registration.
The faculty includes:
CHRISTOBEL SELECKY, chairman, president and CEO of LifeMasters Supported SelfCare, Inc. She also is immediate past president of the Disease Management Association of America (DMAA).
JEAN BISIO, CEO of Green Ribbon Health LLC, a joint-venture company created by Humana Inc. and Pfizer Inc. […]
Cardiac Monitoring System: “Go Directly to the Nearest Hospital, Do Not Pass Go, You Are Having a Heart Attack”
NOT science fiction.
A Bluetooth heart monitor could text your local hospital if you are about to have a heart attack, according to research published in Inderscience’s International Journal of Electronic Healthcare. The device measures electrical signals from the heart, analyses them to produce an electrocardiogram (ECG) and sends an alert together with the ECG by cell phone text message. Portable heart monitor sends emergency alerts and ECG as text message, Virtual Medical Worlds, August 2007
Original article: Design of wearable cardiac […]
Ruminations on the 2007 Healthcare Unbound Conference
Although a bit late, I’d like to share perspectives from the latest Healthcare Unbound conference. The conference took place in San Francisco on July 16 and 17 and attracted 400 attendees with a rich blend of business, information technology, and clinical backgrounds.
PowerPoint from Opening Keynote
Here’s a copy of the PowerPoint for my opening keynote presentation. My colleague and fellow blogger Tim Gee did a great job summarizing key points on his blog. THANKS, Tim.
In a nutshell, my main theme is that the adoption of Healthcare Unbound […]
Disease Management and the Medical Home Model: Competing or Complementary?
I feel like handing out cigars.
My article — “Disease Management and the Medical Home Model: Competing and Complimentary” — has been published in the latest issue of Disease Management and Health Outcomes, a peer reviewed journal.
I’ve arranged with the publisher to make copies available through my website. You can download a copy here.
Why is this an important topic? Here’s the big picture:
Current chronic disease management demonstration/pilot projects in Medicare are showing little evidence of success.
Physicians have woken up to […]
First “Official” Report on Medicare Health Support DM Pilot Finds Virtually No Evidence of Success
I know that I’m sounding like a broken record.
The first “official” results from the Medicare Health Support (MHS) disease management (DM) pilot projects were published last week. While the results are preliminary, there is virtually no evidence of any early success. Here are three key findings from the executive summary of the report:
“In God We Trust” is NOT an Option for Your PHR: 5 Responses to the Google Health Trust Issue
Dear readers,
Thanks for your interest and feedback on my recent posting Connecting the Dots…Google Health Promises to Create AND Dominate Next Generation PHRs.
Despite being over 3,500 words long, this essay has quickly become the #1 most widely read posting on my blog. It continues to generate several hundred views per day and has been linked to by over a dozen other bloggers and news sources.
Reader comments center around two primary themes:
1) Should I trust Google Health’s (GH’s) next generation personal health record (PHR) with my […]
Connecting the Dots…Google Health Promises to Create AND Dominate Next Generation PHRs
Google Health (GH) could be the event of the decade in advancing health care reform — not just healthcare information technology (HIT) reform, but health care system reform. GH promises simultaneously to create AND dominate the market for next generation personal health records (PHRs). There is nothing else in our solar system or in the entire universe like it.
While Google has not “officially” announced the details of GH, they’ve left a lot of clues. In this essay I’m going to […]
Latest Edition of the Health Wonk Review at the Health Business Blog
The ever concise and articulate David Williams is hosting the latest edition of the Health Wonk Review. Check it out at his Health Business Blog.
RKA for CDHPs?
One of the most valuable exercises I sometimes go through with clients is a road-kill autopsy (RKA) — examining what went wrong with a business model or a policy that has been driving down healthcare highway ahead of where we are today.
I hope we can learn a lesson from the progress (or lack thereof) of Consumer Driven Health Plans (CDHPs). More specifically, how did CDHPs get so politicized in the first place, and how can health care information technology (HCIT) and chronic disease management continue […]
Mathematica Researchers Summarize Disappointing Results Across 4 Medicare DM Demonstrations
Presenting at the Annual Academy Health Research Meeting earlier this week, representatives from Mathematica Research and CMS (Centers for Medicare and Medicare Services) presented findings across several Medicare disease management (DM) demonstration/pilot programs.
Again, the findings show minimal evidence of success in any of the Medicare DM programs. Several of the slides from Randall Brown of Mathematica cut to the chase:
Guaranteed Weight Loss 🙂 The Cell Phone Diet
From Christine Chen at the Foreign Policy Blog:
…a group of public health insurance officials in Osaka are trying a new way of combat in the battle of the bulge. Dieters can use their cell phones to take photos of meals they’re about to eat, and then send the photos to a health expert who can then evaluate the meal for calorie count and nutrition.
The only drawback is that it can take three days for the results to get back.
A Medicare Administrator’s “To Do” List: the EHR, Chronic Disease Management, Primary Care….
Let’s drop in on a top Medicare administrator as he reviews his “to do” list over a morning cup of coffee.
TO DO
1) George says everybody’s gotta have an EHR by 2014
tougher than getting a man to the moon in the 60s
stall — G will be gone by then
2) solve chronic disease crisis
chronic disease costs are killing us, 5% of seniors account for 50% of costs
baby boomers hit the fan in 2010
note to self — drop the cheeseburger at lunch
3) solve primary […]
20 Minutes of Questions Won’t Fit into a 7 Minute Doctor Visit
Greetings from Boston. I’ve been attending and speaking at the Inaugural Summit on Behavioral Telehealth: Technology for Behavior Change & Disease Management.
The conference chair is Dr. Steve Locke, Prof. of Psychiatry at Harvard. He opened the meeting yesterday with a thoughtful line of questioning to the audience.
Dr. Locke asked “How many of you audience members have participated in an ‘typical, average’ seven minute visit at one of the new retail doctor clinics?” About 75% of the people in the room raised their […]
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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 […]