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What’s a Network Industry? Is Healthcare One?
This post is a foundational overview of characteristics of network industries. Much of the terminology will deserve deeper discussion, but we have to start somewhere.
In his book The Economics of Network Industries, Professor Oz Shy lists four characteristics of network industries.
The main characteristics of these markets which distinguish them from the market for grain, dairy products, apples, and treasury bonds are:
Complementarity, compatibility and standards
Consumption externalities [network effects]
Switching costs and lock-in
Significant economies of scale in production
In this essay, I’ll quote from Dr. Shy in explaining each […]
Intro to a New Series
  “We need to make care linkages a core competency of American health care.”Â
George Halvorson, Chairman and CEO, Kaiser Foundation Health Plan, Kaiser Foundation Hospital
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There’s a double meaning to the title of this new series: Healthcare Crosses the Chasm to the Network Economy
At the level of technology, it’s a reference to Geoffrey Moore’s bestselling business/technology book — “Crossing the Chasm”. The Chasm here is the huge gap between early adopters of technology and mainstream users. The book describes the process of bringing […]
“Meaningful Use” Criteria as a Unifying Force
by Vince Kuraitis, Steve Adams, and David C. Kibbe MD, MBA
Over the past several years, many diverse initiatives have arisen offering partial solutions to systemic problems in the U.S. health care non-system.Â
We see Meaningful Use Criteria recommended by the HIT Policy Committee as a unifying force for these previously disparate initiatives. These initiatives have included:
Patient Centered Medical Homes (PCMHs)
Regional Health Information Organizations (RHIOs)/Health Information Exchanges (HIEs)
Payer Disease/Care Management Programs
Personal Health Record Platforms — Google Health, Microsoft HealthVault, Dossia, health banks, more to come
State/Regional […]
Hope for Primary Care … from a Payer? A White Paper on the Collaborative Payer Model
by Tom Doerr, MD and Randy Bak, MD, JD
What if the health care payer were re-imagined as a service to the primary care doctor – supplying the tools, information and funding primary care physicians needed to meet the call to reform health delivery?
The structure of physician payment is considered one of the most problematic aspects of our health care system. Driven by volume instead of coordinated, proactive care and favoring procedures over cognitive work, the payment system has driven primary […]
Privacy Law Showdown? Legal and Policy Analysis.
#2 in a series — Modifications to HIPAA Privacy Laws: Impact on Microsoft HealthVault, Google Health, and other PHRs.Â
by Deven McGraw JD, MPH, Center for Democracy & Technology
Introduction
There has been considerable discussion lately about whether or not the stimulus legislation (ARRA) extends HIPAA coverage to commercial vendors of personal health records (PHRs) any time they contract with entities already covered by HIPAA like hospitals, health plans or physicians groups. (For those of you who don’t know, HIPAA is the Health Insurance Portability and […]
EHR 2.0: Thinking Outside the Cat Box
One of the potential dangers of limiting $17 B HITECH federal stimulus funds to electronic health records (EHRs) is the risk of locking-in outdated technologies. Let’s consider what this might mean.
If you think of today’s EHR technology as EHR 1.0, what might EHR 2.0 look like? This post presents a number of innovative ways to conceptualize EHR 2.0:
EHR as Platform + Applications
EHR as Clinical Groupware
EHR Integrated with PHR
EHR as Software-as-a-Service (SaaS)
EHR as a “Publish-Discover” Search Engine
EHR + Disease Management Services = […]
Stand for Quality Group: “Link HIT Investment to Quality Improvement”
On March 24, Stand for Quality — a new group representing 165 diverse health care organizations — called for a new era of quality in health care. Their white paper is titled Building a Foundation for High Quality, Affordable Health Care: Linking Performance Measurement to Health Reform .
The perspectives of Stand for Quality are a remarkable break from the past and have significant implications for future […]
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 […]
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 […]
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: […]