e-Newsletter Archives

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.

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 […]

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 […]

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 […]

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 […]

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 […]

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 […]

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 […]

“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 […]

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 […]

“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 […]

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 […]

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? […]

“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 […]

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 […]

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. […]

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 […]

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 […]

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 […]

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 […]

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 […]

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 […]

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 […]

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 […]

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 […]

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 […]

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 […]

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 […]

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 […]