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Patients and “Their” Medical Records: Crossing the Chasm

Most physician practices and hospitals in the U.S. have installed electronic health records (EHRs). But in a classic Field of Dreams scenario, we have made patients’ medical records digital, but people aren’t asking for them or accessing them en masse. “How do we make it easier for patients to request and manage their own data?” asks a report from the Office of the National Coordinator of Health IT (ONC), Improving the Health Records Request Process for Patients – Highlights from User Experience Research. The ONC has been responsible for implementing the HITECH Act’s provisions, ensuring that health care providers have met Meaningful

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Digital Healthcare At the Inflection Point, Via Mary Meeker

Healthcare is at a digital inflection point, asserts   Internet Trends 2017 – Code Conference, by the iconic Mary Meeker of Kleiner Perkins. Published May 31, 2017, few tech-focused reports have the gravitas or generate the readership that this report does. I’m one of Meeker’s perennial readers, covering this report through my health/care lens here on Health Populi for several years (links to previous posts below). Of the report’s 355 pages, 22 are devoted to healthcare (pages 288-319), a section curated by Noah Kaufman of KP. This section of the report assembles data from a range of publicly available sources,

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Most Medicare Patients Haven’t Accessed Their EHR Information (Yet)

The HITECH Act, part of the Stimulus Bill (officially, the 2009 American Recovery and Reinvestment Act, ARRA) invested $35 billion of U.S. taxpayer funds to incentivize health care providers (doctors and hospitals) to acquire and use electronic health record systems (EHRs). Most providers have taken advantage of these financial incentives, so that EHRs are now part of mainstream medical practice and workflow among providers. For patients, and particularly those enrolled in the government programs of Medicare and Medicaid, personal access to their personal data in EHRs has been largely elusive. While nearly 9 in 10 doctors and hospitals have offered these

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Healthcare and the Autonomous Car: Setting the Stage for HIMSS17

The autonomous car is a metaphor for healthcare: that’s how my first interview kicking off the  HIMSS marathon began. The annual 2017 HIMSS conference isn’t your father’s or mother’s HIMSS of ten years ago, or even the HIMSS of 2010 — the year that financial incentives for EHR adoption began to stream from the HITECH Act of 2009, motivating thousands of healthcare providers to acquire and meaningfully use digital health records systems. Then, the HIMSS conference floor was abuzz with EHR frenzy. This week, over 43,000 people working at the intersection of healthcare and technology have converged in Orlando, Florida, for

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My $100 Flu Shot: How Much Paper Waste Costs U.S. Healthcare

An abbreviated version of this post appeared in the Huffington Post on 9 February 2017. This version includes the Health Populi Hot Points after the original essay, discussing the consumer’s context of retail experience in healthcare and implications for the industry under Secretary of Health and Human Services Tom Price — a proponent of consumer-directed healthcare and, especially, health savings accounts. We’ll be brainstorming the implications of the 2016 CAQH Index during a Tweetchat on Thursday, February 16, at 2 pm ET, using the hashtag #CAQHchat. America ranks dead-last in healthcare efficiency compared with our peer countries, the Commonwealth Fund

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Doctors See Benefits in Patient Engagement Via Health IT

A special report on patient engagement and digital technology was published this month in the New England Journal of Medicine (NEJM). Based on a survey of doctors and healthcare executives, the research found that clinicians and managers welcome the opportunity to use digital tech — when it makes financial sense. That conclusion inspired the title of the article, Patient Engagement Survey: Technology Tools Gain Support – But Cost Is a Hurdle. NEJM polled 595 members of the NEJM Catalyst Insights Council, which included healthcare executives and clinicians who deliver healthcare. Here is NEJM’s scenario on patient-engaging health IT, a Holy Grail of sorts:

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Health/Care Data Ecosystems E-merge at CES 2017

Digital health innovations were fast-proliferating at CES 2017. The bad news is there are so many of them, it’s dizzying and fragmented. The good news is that there are emerging health data ecosystems that will streamline consumers’ user experience so that people can derive knowledge, actionable advice and value out of using these tools. Walking miles of aisles in the Sands Convention Center in the first week of January 2017 can be a dizzying prospect, with hype and best-faces-forward in every single exhibitor at the show. In the health segment at CES, there’s a long list of digital tools to

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Evidence That Mainstream Consumers Growing Digital Health Muscles

About 1 in 2 patients in the US are accessing their electronic health records in early 2016, according to Accenture’s 2016 Consumer Survey on Patient Engagement, Patients Want a Heavy Dose of Digital. This post is based on a presentation I attended by Accenture’s Dr. Kipp Webb yesterday. Accenture conducted survey research with consumers in seven countries for this study. The data and insights shared in this post are based only on the survey results from 2,225 US patients. The proportion of US health consumers accessing their health records grew from 27% in 2014 to 45% in 2016 — an increase of

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Most Doctors With EHRs Still Not Taking Advantage of Their Benefits

Interoperability of medical records across physician offices remained elusive in 2015, according to the latest data reported out by the Centers for Disease Control (CDC). About 8 in 10 U.S. physicians had an electronic health records system in 2015. One-third of these doctors electronically sent, received, integrated or searched for patient health information — indicating that most physicians still aren’t using EHRs to their fullest extent. These findings come from the NCHS Data Brief from the CDC, State Variation in Electronic Sharing of Information in Physician Offices: United States, 2015. The bar chart illustrates the percentage of U.S. office-based doctors

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Doctors Are Growing to Like Digital Health Tools, Says the AMA

Notwithstanding the head of the AMA recently referring to digital health technologies as “snake oil,” it appears that one-half of physicians is keen on digital health. And scale, not age, matters when it comes to doctors using digital health tools. The American Medical Association (AMA) surveyed physicians on their use of digital health tools, finding that primary care physicians (PCPs) and doctors working in larger and more complex practices tend to be more digital. In Physicians’ motivations and requirements for adopting digital clinical tools, the AMA’s digital health study, “Physicians are optimistic about digital health innovation and its game-changing potential

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Most Digital Health Consumers Say They Benefit from Connected Health

Managing stress, weight, mental health, sleep, and heart function are among the top-most desired reasons already-connected health consumers are interested in further connecting their health, according to The 2016 HealthMine Digital Health Report. The most popular tools people use to digitally manage their health deal with fitness and exercise (among 50% of connected health consumers), food and nutrition (for 46%), and weight loss (for 39%). 3 in 4 people who use digital health tools say they have improved their health by connecting to these tools. 57% of digital health users also say going health-digital has lowered their healthcare costs. The survey

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Most Hospitals Offer Patients Electronic Access to Medical Records

The number of hospitals offering patients electronic access to their health information grew seven times between 2013 and 2015. Electronic health records access has gone mainstream in America, according to the latest findings by The Office of the National Coordinator for Health Information Technology (ONC-HIT). The data are detailed in Electronic Capabilities for Patient Engagement among U.S. Non-Federal Acute Care Hospitals: 2012-2015, an ONC Data Brief. Two in three U.S. patients can now view, download, and transmit their personal health information, shown in the bar chart. This hockey-stick growth, from 10% in 2013 to 69% in 2015, results from the

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Consumers Seek Quality and Privacy In Tech-Enabled Healthcare

Consumers are open to technology-enabled healthcare, but look to providers to ensure quality and privacy of patients’ personal health information, according to Will Patients and Caregivers Embrace Tech-Enabled Healthcare?, based on the Deloitte 2016 Survey of US Health Care Consumers. Seven in 10 consumers would use at least one of the technologies Deloitte served up in its study, with telemedicine at the top of the list: 49% of people favor telemedicine for post-surgical care, 48% for chronic disease management, 36% for care while traveling, and 32% for minor health issues. While Millennials are generally keener across-the-board for tech-enabled health care,

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Most Americans Say Health IT’s Important – But Not Well-Used

Most Americans say accessing their lab tests, health history, prescription drug lists, and doctors’ notes is important. But patients in the U.S. do not universally have access to their electronic health information, and nor do all those who can access their personal health information do so, according to the Kaiser Health Tracking Poll: August 2016 from the Kaiser Family Foundation (KFF). In yesterday’s Health Populi blog, I focused on the Poll’s political findings — that Hillary Clinton is perceived by more American voters than Donald Trump to be trusted on health care issues. In today’s post, I’ll cover the poll’s findings on

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More Americans See Hillary Clinton As the 2016 Presidential Health Care Candidate

When it comes to health care, more American voters trust Hillary Clinton to deal with health issues than Donald Trump, according to the Kaiser Health Tracking Poll: August 2016 from the Kaiser Family Foundation (KFF). The poll covered the Presidential election, the Zika virus, and consumers’ views on the value of and access to personal health information via electronic health records. Today’s Health Populi post will cover the political dimensions of the August 2016 KFF poll; in tomorrow’s post, I will address the health information issues. First, let’s address the political lens of the poll. More voters trust Hillary Clinton to do

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More Hospitals Extend Online Patient Access to EHRs

A majority of U.S. hospitals could enable patients digital access to their personal medical records in 2015. Specifically, nearly all US hospitals offer patients the opportunity to view their medical records online in 2015. Eight in 10 hospitals were able to download patient information from their medical record as well as enable patients to request a change to that record, according to a Trendwatch report from the American Hospital Association (AHA), Individuals’ Ability to Electronically Access Their Hospital Medical Records, Perform Key Tasks is Growing. Over the past several years, hospitals have made significant capital investments in buying, adopting, and

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Retail Clinics Continue to Shape Local Healthcare Markets

Retail clinics are a growing source of primary care for more U.S. health consumers, discussed in a review of retail clinics published by Drug Store News in July 2016. There will be more than 2,800 retail clinics by 2018, according to Accenture’s tea leaves. Two key drivers will bolster retail clinics’ relevance and quality in local health delivery systems: Retail clinics’ ability to forge relationships with legacy health care providers (physicians, hospitals); and, Clinics’ adoption and effective use of information technology that enables data sharing (e.g., to the healthcare provider’s electronic health records system) and data liquidity (that is, securely moving

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Most Wired Hospitals Spending on Cybersecurity, Telehealth and Population Health

Investing information technology dollars in telehealth and mobile platforms, patient engagement, and cybersecurity are major focuses for leading IT-savvy hospitals in America, according to the 2016 Most Wired survey of healthcare organizations, released in July 2016 sponsored by Hospitals and Health Networks and Health Forum, a division of the American Hospitals Association. This survey, in its 18th year, has become an important benchmark measuring the adoption of information technology tools and services among American hospitals and health systems. The complete list of Most Wired hospitals for 2016 can be found here. The most popular telehealth services offered by the Most Wired hospitals are

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The Promise of the Platform Economy for Health

There’s a lot of talk about the growing platform economy. If well-designed platforms get adopted in healthcare, they may help our ailing healthcare systems get better. The quality, safety, and convenience of healthcare in America suffer from a lack of patients’ personal health data being essentially locked in data siloes. The diagnosis is lack of data “liquidity:” the ability for our health information generated in various touch points in the healthcare system and in our personal lives each day to move outside of the locations where the bits and bytes were first created: to our clinicians, researchers, health providers, and to

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Are We Health Engaged Yet? Frost & Sullivan Responds “Meh”

The top health-related activities among U.S. adults include routinely taking vitamins and supplements, and prescription medicines, according to Frost & Sullivan’s report, Are We Engaged Yet? Their response to the titular question lies in in the subtitle: “US consumers appear confused or ambivalent about what it means to be proactive or engaged in their health.” 1 in 2 U.S. adults says they’re “somewhat engaged” in their healthcare, according to Reenita Das’s write-up on the study in Forbes magazine. She notes that: Consumers with higher incomes have more confidence in their access to health care services and quality of care Budget-constrained consumer

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What Health Care Can Learn from the Blood Clot Community

  “Our goal is to create an aware and engaged, irritating set of patients who create a dialogue with health care providers once they’ve had a [blood] clot,” explained Randy Fenninger, CEO of the National Blood Clot Alliance (NBCA). NBCA’s tagline and hashtag is “Stop the Clot.” Welcome to the multi-stakeholder community involved with deep vein thrombosis (DVT) and, clinically speaking, Venous Thromboembolism (VTE). We’re talking blood clots, and the public health burden of this condition is big: it’s a leading cause of death and disability. One in 4 people in the world die of conditions caused by thrombosis. I had

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Costs and Connection At the Core of Consumers’ Health-Value Equations

Cost ranks first among the factors of selecting health insurance for most Americans across the generations. As a result, most consumers are likely to shop around for both health providers and health plans, learned through a 2016 Xerox survey detailed in New Insights on Value-Based Care, Healthcare Attitudes 2016. The younger the consumer, the more important costs are, Xerox’s poll found, shown in the first chart. Thus, “shopping around” is more pronounced among younger health consumers — although a majority people who belong to Boomer and Greatest Generation cohorts do shop around for both health providers and health insurance plans —

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Paper and Fax, Not EHRs or Portals, Are Popular for Health Data Sharing

Faxing in health care ranks higher in patient data information sharing than using secure email, online portals, health information exchange (HIE), or leveraging electronic health records. Welcome to the American healthcare system in 2016, as described in a market spotlight published by IDC, The Rocky Road to Information Sharing in the Health System. IDC’s survey research among healthcare providers forecasts the “rocky road” to information sharing. That rocky road is built for medical errors, duplication of services, greater healthcare costs, and continued health il-literacy for many patients. “The holy grail of interoperability — lower-cost, better-quality care with an improved experience for

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Honoring the Doctor-Patient Relationship

  March 30 this week was National Doctors Day, which was proclaimed a national celebration by President George Bush in 1991. But as I’ve written through this week here on Health Populi, doctors may enjoy prestige on the outside, but they’re hurting on the inside — both economically in medical/business practices, and emotionally in their personal career-lives. Patients tend to like, even love, their personal physicians based on years of consumer polls on the topic (usually themed, “love my own doctor, hate the health care system”). But physicians and their patients aren’t on the same page, literally, when it comes

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The Growth of Digital Patient Engagement

9 in 10 people in the U.S. use some form of digital technology or electronic tools for health management, Accenture found in the company’s 2016 Consumer Survey on Patient Engagement. Younger people (18-34) tend to favor wearable technology, apps and social media for health. More older people (age 65-74) mine electronic health records (EHRs) for personal health data and more likely use tech for remote consultations with care providers. Overall, the percent of U.S. consumers accessing their EHR data grew by over 50% between 2014 and 2016, from 27% to 45% of people doing so, with older people indexing higher

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Yin and Yang: Doctors and Patients’ Bipolar Views on EHR Access

Patients are from Mars and Doctors from Venus when it comes to their views on whether consumers should have full access to their electronic health records (EHRs), according to a survey from Accenture released this week at the 2016 meeting of the HIMSS conference in Las Vegas. The vast majority of consumers are keen to access their full EHR, compared to a majority of doctors who advocate for limited access, as the circle diagram dramatically illustrates. The “old days” of patient information asymmetry — with a paper-based folder that got locked up in a health records cabinet — are gone.

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The Health Information Economy – Better With Patients

“Consumers expect to have their data available and shareable.” Two essays in two issues in the past two weeks of The New England Journal of Medicine point to the importance of patients – people, caregivers, consumers, all — in the morphing “health information economy,” a phrase used in the title of one of the published pieces. In Time for a Patient-Driven Health Information Economy, Dr. Ken Mandl and Dr. Isaac Kohane, who are both affiliated with the Department of Biomedical Informatics at Harvard, discuss peoples’ growing interest in engaging with their personal health information, noting frustrating barriers to doing so:

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In 2016 Reaching For The Triple Aim Will Drive Health IT Spending

Adoption of telehealth, remote health monitoring, patient engagement platforms, mobile and digital health applications, and the emergence of the Internet of Things in health care will all be bolstered in 2016 based on health care providers’ having to do more with less (money, labor, resources). The value-based healthcare world — the migration of payment “from volume to value” — requires greater investment in information and communications technology that moves care to lower-cost sites, with lower-priced labor (as appropriate), and shifting greater clinical self-care and financial skin-in-the-game to patients. My annual health IT forecast was published yesterday in iHealthBeat, 2016: Technology

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Getting to Connected Health Is A Marathon, Not A Sprint

Consumers may demand connected experiences in daily living, but there have been many barriers to health care industry stakeholders delivering on that expectation: among them, privacy and security concerns, and provider resistance. This demand-and-supply chasm is noted in Deloitte’s Center for Health Solutions’ latest look into the healthcare landscape, Accelerating the adoption of connected health. The objectives of connected health, or cHealth, are: To improve digital connectivity among consumers, providers, health plans and life sciences companies To facilitate self-managed care in a secure environment that protects privacy To deliver care outside of traditional institutional settings To enable chronic care management

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The Telephone Is As Digital As It Gets in Mainstream U.S. Health Care

The phone continues to be the platform technology used in this digital age of health care, according to Better Together: High Tech and High Touch, a survey report sponsored by the Bipartisan Policy Center and the Council of Accountable Physician Practices. Nielsen’s Strategy Health Perspectives project polled 5,014 U.S. adults in June and July 2015 for this study. According to the study sponsors, this is the largest consumer population studied conducted to-date on the topic of digital health use and demand. The first chart illustrates the reality of digital health in the U.S. 2015: that notwithstanding the availability of telehealth,

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More consumers expect a connected health experience

When most patients in the U.S. visit their doctors, they find their medical history missing or incomplete. 1 in 2 American patients say their doctors do not have a complete list of their medications. But the new health consumer expects a connected health experience the likes of which, as consumers, they expect and generally find in their everyday lives. One-half of consumers would prefer to get lab test results, access their medical records, and fill out paperwork from a doctor’s office ahead of a visit online versus via phone or in person. Surescripts conducted a survey with Kelton Global in

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It’s a retail health world: consumers at the helm of health/care

Retail health v1.0 encompassed the pharmacy, then embraced urgent care and retail health clinics co-located in brick-and-mortar pharmacy chain stores. In v2.0, retail health encompasses all health/care, really, because people, patients and consumers are essentially self-insured up to the point when their health plan kicks in some cash. The high-deductible health plan era is ushering in the retail health era, broadly writ. Hospitals & Health Networks magazine (HHN) ran a story titled Think Like a Retailer to Engage Patients, covering founder of WEGO Health Jack Barrette‘s and my panel presentation at the 2015 HIMSS conference in Chicago last week. Writer

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“What If 1 Million Americans Asked for Medical Records on the Same Day?”

This was not a theoretical question Dr. Farzad Mostashari, former head of the Office of the National Coordinator of Health IT in the Department of Health and Human Services, asked yesterday at the closing keynote of Day 1 of the Patient Engagement Forum. Dr. Mostashari issued a challenged to the community of mischief-makers in health/tech patient advocacy: tell everyone you know to contact their doctors — by phone, email, patient portal, or in-person, on one designated day which he called a “Day of Action.” Health IT journalist Neil Versel (disclosure: also a long-time friend in the field) covered this news

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The blurring landscape of digital health: the Health 2.0 team puts it in focus

They’re the team that built a brand with the phrase “Health 2.0” before the world barely recognized v 1.0 in healthcare. This week, those folks that brought you the Health 2.0 Conference unveiled the Market Intel database of over 3,000 companies, trying to make sense out of a very blurry and fast-morphing market landscape. I spoke with Matthew Holt and Kim Krueger of Health 2.0 earlier this week to discuss just what’s in this mine of information, and what they intend to do with it. In full disclosure, I have been a colleague and friend of Matthew Holt since his

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Digital health love – older people who use tech like health-tech, too

As people take on self-service across all aspects of daily living, self-care in health is growing beyond the use of vitamins/minerals/supplements, over-the-counter meds, and trying out the blood-pressure cuff in the pharmacy waiting for a prescription to be filled. Today, health consumers the world over have begun to engage in self-care using digital technologies. And this isn’t just a phenomenon among people in the Millennial generation. Most seniors who regularly use technology (e.g., using computers and mobile phones) are also active in digitally tracking their weight, for example, learned in a survey by Accenture. Older people who use technology in daily

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Getting real about consumer demand for wearables: Accenture slows us down

Are you Feelin’ Groovy about wearables? Well slow down, you move too fast… …at least, according to Accenture’s latest survey into consumers’ perspectives on new technologies, published this week in conjunction with the 2015 Consumer Electronics Show in Las Vegas, the largest annual convention in the U.S. featuring technology for people. At #CES2015, we’re seeing a rich trove of blinged-out, multi-sensor, shiny new wearable things at the 2015 Consumer Electronics Show. Swarovski crystals are paired with Misfit Wearables, called the Swarovski Shine, shown here as a shiny new thing, indeed. Withings launched its Activite fitness tracking watch in new colors.

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People don’t know much about patient portals: Xerox’s 5th EHR study

The Field of Dreams works in nostalgic plotlines about baseball, but as I’ve pointed out since the advent of consumer-facing health technologies, there’s no Field of Dreams effect in health care when it comes to consumer health engagement. U.S. health consumers aren’t using the patient portals that health care providers have built as part of their efforts to bolster health engagement via EHRs and health IT, Xerox found in the company’s 5th annual survey on electronic health records. I spoke with Tamara St. Claire to discuss the implications of the consumer poll, which was conducted among 2,017 U.S. adults in

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Health IT Forecast for 2015 – Consumers Pushing for Healthcare Transformation

Doctors and hospitals live and work in a parallel universe than the consumers, patients and caregivers they serve, a prominent Chief Medical Information Officer told me last week. In one world, clinicians and health care providers continue to implement the electronic health records systems they’ve adopted over the past several years, respond to financial incentives for Meaningful Use, and re-engineering workflows to manage the business of healthcare under constrained reimbursement (read: lower payments from payors). In the other world, illustrated here by the graphic artist Sean Kane for the American Academy of Family Practice, people — patients, healthy consumers, newly insured folks,

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Power to the health care consumer – but how much and when?

Oliver Wyman’s Health & Life Sciences group names its latest treatise on the new-new health care The Patient-to-Consumer Revolution, subtitled: “how high tech, transparent marketplaces, and consumer power are transforming U.S. healthcare.” The report kicks off with the technology supply side of “Health Market 2.0,” noting that “the user experience of health care is falling behind” other industry segments — pointing to Uber for transport, Amazon for shopping, and Open Table for reserving a table. The authors estimate that investments in digital health and healthcare rose “easily ten times faster” than the industry has seen in the past. Companies like

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Crossing the digital health chasm between consumers and providers – talking with Dr. Eric Topol

More than twice as many patients than physicians are embracing consumers’ use of new digital technologies to self-diagnose medical conditions on their own. On the other hand, 91% of doctors are concerned about giving patients access to their detailed electronic health records, anticipating patients will feel anxious about the results; only 34% of consumers are concerned about anxiety-due-to-EHR-exposure. Welcome to the digital health chasm, that gap between what consumers want out of digital health, and what doctors believe patients can handle at this stage in EHR adoption in doctors’ offices and in patients’ lives. I have the video of Jack

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Health info disconnect: most people view accessing online records important, but don’t perceive the need to do so

There’s a health information disconnect among U.S. adults: most people believe online access to their personal health information is important, but three-quarters of people who were offered access to their health data and didn’t do so didn’t perceive the need to. The first two graphs illustrate each of these points. When people do access their online health records, they use their information for a variety of reasons, including monitoring their health (73%), sharing their information with family or care providers (44%), or downloading the data to a mobile device or computer (39%). In this context, note that 1 in 3

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Health economics in the exam room: doctors and patients discussing the costs of health care

A new conversation has begun between doctors and patients: talking about money and health care, and what treatments cost — specifically, what a particular treatment will cost a patient, out-of-pocket. Over a dozen physician professional societies are proponents of these discussions, and are providing support to doctors in their networks. Doctors already engaging in the topic of the cost of care with patients aren’t being altruistic about spending this precious time in the already-time-constrained patient encounter: these discussions are increasingly relevant to physicians’ financial outcomes. I’ll be addressing this new feature in the doctor’s office at the upcoming Point-of-Care conference,

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Inflection point for telehealth in 2014

The supply side of telehealth has been readying itself for nearly a decade. The demand side appears to be aligning in 2014 for adoption to grow and sustain (some) solid business models. On the demand side, Towers Watson’s 2014 survey of large employers forecasts growth among companies that will offer telemedicine in 2015. Towers found that 37% of employers planned to offer telemedicine to workers as a lower-cost site of care; 34% more employers were considering telemedicine in 2016 or 2017.  The health benefits adviser calculates that employers could save over $6 billion if industry replaces virtual health consultations with

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Do EHRs “chill” patient disclosures to clinicians?

Patients are concerned about private risks of personal health data, resulting in some patients not disclosing certain information to health providers to protect their perceived EHR privacy and security risks. Peoples’ mixed feelings about sharing personal health information with their providers and EHRs is explored in The double-edged sword of electronic health records: implications for patient disclosure, published in the July 2014 issue of JAMIA, the Journal of the American Medical Informatics Association (AMIA). “The perception of the [EHR] technology may elicit non-disclosure as a privacy-protecting behavior,” the authors warn. Celeste Campos-Castillo and Denise Anthony, the paper’s researchers who work in

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Big Data Come to Health Care…With Big Challenges – Health Affairs July 2014

“For Big Data, Big Questions Remain,” an article by Dawn Falk in the July 2014 issue of Health Affairs, captures the theme of the entire journal this month. That’s because, for every opportunity described in each expert’s view, there are also obstacles, challenges, and wild cards that impede the universal scaling of Big Data in the current U.S. healthcare and policy landscape. What is Big Data, anyway? It’s a moving target, Falk says: computing power is getting increasingly powerful (a la Moore’s Law), simpler and cheaper. At the same time, the amount of information applicable to health and health care

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Practice Fusion joins the open health data community with Insight

Open data is a growing trend in health care. Analyzing data sets across lots and lots of people can help researchers identify medical cures, anticipate epidemics, and solve knotty problems where social and behavioral issues complicate clinical questions and solutions. Joining the open health data community is the health IT company Practice Fusion, which is sharing with the public aggregated data on some 81 million patients collected through over 100,000 active users every month recording patient data in the company’s cloud-based electronic health records system. Insight, the searchable database, is freely available to people, researchers, policymakers, and anyone who wants to look at top line

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Privatizing health privacy in the US?

8 in 10 people in the U.S. believe that total privacy in the digital world is history, based on a survey from Accenture conducted online in March and April 2014 and published in the succinctly-titled report, Eighty Percent of Consumers Believe Total Data Privacy No Longer Exists. 84% of U.S. consumers say they’re aware what tracking personal behavior can enable – receiving customized offers and content that match one’s interests. At the same time, 63% of people in the U.S. also say they have a concern over tracking behavior. Only 14% of people in the U.S. believe there are adequate safeguards

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In a world of digital health data, more sick people trade off privacy risks

People managing chronic diseases are more likely to have accessed information in their electronic medical records — and are also less likely to worry about the privacy risks of their personal electronic health information compared with people who are healthy. Over 2,000 people, both those who say they’re healthy and those with chronic conditions, were surveyed by Accenture in February-March 2014, and their responses are summarized in the report, Consumers with Chronic Conditions Believe the Ability to Access Electronic Medical Records Outweighs Concern of Privacy Invasion. Slight more consumers are concerned about privacy risks related to online banking, online shopping,

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Your health score: on beyond FICO

Over one dozen scores assessing our personal health are being mashed up, many using our digital data exhaust left on conversations scraped from Facebook and Twitter, via our digital tracking devices from Fitbit and Jawbone, retail shopping receipts, geo-location data created by our mobile phones, and publicly available data bases, along with any number of bits and pieces about ‘us’ we (passively) generate going about our days. Welcome to The Scoring of America: How Secret Consumer Scores Threaten Your Privacy and Your Future. Pam Dixon and Robert Gellman wrote this well-documented report, published April 2, 2014 by The World Privacy Forum.

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Why a grocery chain supports health data liquidity

The CEO of a family-owned grocery store chain wrote a letter to New York State lawmakers to support $65 million worth of spending on a computer system for health information in the state. That grocer is Danny Wegman, and that project is the Statewide Health Information Network, aka SHIN-NY. In his letter beginning, “Dear New York Legislator,” Wegman identifies several benefits he expects would flow out of the health IT project: 1. Improve health care for all New Yorkers 2. Lower health care costs, through reducing hospital readmission rates and reducing duplicate testing. 3. Lead to health data “liquidity” (my

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Pharma warming up to the cloud to drive efficiencies and support analytics

Over the next few years, large global pharma companies will need to wring out an additional $35 billion worth of efficiencies in order to drive profitability. While the industry has most of the patent cliff challenge behind it, companies face price constraints with respect to health reform, static national economies, and access demands. As the pharmaceutical industry enters the value-based health care era, the industry must catch up with other vertical markets in adopting information technology. In particular, pharma has been slower to migrate to the cloud than other businesses, with concerns about security and health care particular needs. Today, the

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HIMSS14 Monday Morning Quarterback – The Key Takeaways

Returning to terra firma following last week’s convening of the 2014 annual HIMSS conference…taking some time off for family, a funeral, the Oscars, and dealing with yet another snowstorm…I now take a fresh look back at #HIMSS14 at key messages. In random order, the syntheses are: Healthcare in America has entered an era of doing more, with less...and health information technology is a strategic investment for doing so. The operational beacon going forward is moving toward The Triple Aim: building population health, enhancing the patient’s experience, and lowering costs per patient. The CEO of Aetna, Mark Bertolini, spoke of the

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Patient engagement and mobile health – design and timing matter

Thinking about personal health information technology – the wearable devices, remote health monitors, digital weight scales, and Bluetooth-enabled medical equipment scaled for the home – there are two glasses. One is half-full and the other, half-empty. The half-full glass is the proliferation of consumer-facing devices like Fitbit, Jawbone and Nike, which comprise the lion’s market share in the health wearables segment; the mass adoption of mobile phones and tablets; consumers’ multi-screen media behavior (as tracked by Nielsen); and consumers’ growing share of medical spending, now about 40% of annual spending (or something north of $8,000 for a family of four

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Patients play a starring role at #HIMSS14 – Best In Show

Even before stepping into the Orlando Convention Center on Sunday 23 February 2014, my clairvoyant powers know the forecast of the Best in Show: the growing role of patients in health care, reflected in both the education session at the annual 2014 meeting of HIMSS as well as the product/service mix being proffered on the convention show floor. As a member of HIMSS Connected Patient Committee, I know first-hand the conscious effort and energy that the organization has committed to getting real about patients’-peoples’-caregivers’ central role in health care. The organization was built on providers and technology. When I first

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Watson goes wellness

IBM’s data analytics engine Watson, having cut its teeth on complex health care conditions like cancer, is now entering an even more challenging space: wellness. Why is wellness more challenging? Because understanding a person’s wellness goes beyond mining data from health care claims silos in hospitals, pharmacies, and physicians’ electronic health records. Wellness happens where we live, work, play and pray. Wellness is nurtured through choices made every day at home, in the workplace, and at moments-of-truth in the grocery store and restaurant where slick marketing messages planted in our subconscious compete with our more rational minds that tell us to

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Connected Health – the technology is ready, providers on the cusp

The convergence of technology developments – such as the internet, mobile phone adoption, cloud computing, sensors, electronic health records – with societal evolution including consumerism, demand for transparency, and “flatter” organizations – enable the phenomenon of Connected Health. Connected Health by definition includes mobile health (mHealth), telehealth and telemedicine, as presented in the February 2014 issue of Health Affairs which is dedicated to this theme. Why Connected Health’s time is Now relates to those factors cited above, and the underlying challenge of managing health care costs. While all nations in the developed world are facing difficult health economies, the U.S. spends so

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4 in 5 doctors in America use an EHR, but most not ready for Stage 2

The number of physicians using electronic health record systems (EHRs) rose by 50% since 2010, from 51% to 78% of office-based doctors. That equates to about 4 in 5 U.S. physicians now using any EHR system. This growing adoption of EHRs is evident in the first chart, published in Use and Characteristics of Electronic Health Record Systems Among Office-based Physician Practices: United States, 2001-2013. This survey was published by the National Center for Health Statistics in the NCHS Data Brief Series in January 2014. (The NCHS is part of the Centers for Disease Control, aka the CDC). This growth rate hasn’t

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mHealth will join the health ecosystem – prelude to the 2014 Consumer Electronics Show

The rise of digital health at the 2014 Consumer Electronics Show signals the hockey-stick growth of consumer-facing health devices for fitness and, increasingly, more medical applications in the hands of people, patients, and caregivers. This year at #CES2014, while the 40% growth of the CES digital health footprint will get the headlines, the underlying story will go beyond wristbands and step-tracking generating data from an N of 1 to tools that generate data to bolster shared-decision making between people and the health system, and eventually support population health. For example: – Aetna is partnering with J&J to deploy their Care4Today

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Don’t over-forecast mobile health in the short-run

The 2013 Mobile Health Summit was hosted by HIMSS at The Gaylord Resort in suburban Washington DC, taking place over 4 days during the mid-atlantic region’s iciest conditions in years. But inside the cocoon of this convention space, 5,000 conveners took in demonstrations of innovations using mobile platforms and standards that extend health services, knowledge and self-help tools to people and providers. Several themes emerged out of the meeting… Lots of apps, too few business models.  There are too many apps and not enough companies, Esther Dyson noted in a keynote session during which she dialogued with two Steve’s: Steven

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Data altruism: people more likely to share personal health data for the sake of others and to save money

While about 53% of people globally are willing to share various types of personal data overall, the kind of data willing-to-be-shared varies by type of information — and what country we’re from. When asked how likely they would be to anonymously share information if it could lead to improvements or innovations in that technology, Americans are less likely to be willing to share any type of personal data — except for gender. When it comes to sharing several specific types of health information, fewer Americans are likely to want to share it as Intel found in their survey published in the company’s Healthcare

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Crossing the consumer/provider HIT chasm – CHCF says “miles to go”

If Californians represent their American peers, then most people in the U.S. want to access their health information online, based on findings in Health Information Technology in California: Milestones and Miles to Go, a report from California HealthCare Foundation published on 6 November 2013. Interviews among 319 California residents conducted in February 2013 found that: 3 in 4 people believe an electronic health record (EHR) is a valuable tracking tool 85% of people say doctors should have access to a patient’s personal health information – but 49% say “my health records are for my own use and should not be

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Innovating and thriving in value-based health – collaboration required

In health care, when money is tight, labor inputs like nurses and doctors stretched, and patients wanting to be treated like beloved Amazon consumers, what do you do? Why, innovate and thrive. This audacious Holy Grail was the topic for a panel II moderated today at the Connected Health Symposium, sponsored by Partners Heathcare, the Boston health system that includes Harvard’s hospitals and other blue chip health providers around the region. My panelists were 3 health ecosystem players who were not your typical discussants at this sort of meeting: none wore bow ties, and all were very entrepreneurial: Jeremy Delinsky

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Health care and survey taking at the Big Box Store

Where can you shop the health and beauty aisles, pick up some groceries and a prescription, get a flu vaccine, and weigh in on Obamacare and what digital health tools you like? Why, at one of several thousand retail stores where you can find a SoloHealth kiosk. As of yesterday afternoon, over 32 million encounters were recorded on SoloHealth kiosks, based on an app I saw on the company CEO Bart Foster’s smartphone. Kiosks are locatted around the United States in retailers including Walmart and Sam’s Clubs, along with major grocery chains like Schnuck’s and Publix, and the CVS pharmacy

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The FDA Has Spoken, and It Will Regulate “Some” mHealth Apps

The FDA has spoken: there are 2 statutory definitions for a mobile health tool as a “medical device” that the Agency says it has regulatory oversight: To be used as an accessory to a regulated medical device, or To transform a mobile platform into a regulated medical device. On page 8 of the Guidance for Industry and Food and Drug Administration Staff, you can read the FDA’s expanded definition of a mobile health app as being: “…intended for use in performing a medical device function (i.e. for diagnosis of disease or other conditions, or the cure, mitigation, treatment, or prevention

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Healing the Patient-Doctor Relationship with Health IT

A cadre of pioneering Americans has been meaningfully using personal health information technology (PHIT), largely outside of the U.S. health care system. These applications include self-tracking and wearable health technologies, mobile health apps, and digital medical tracking devices like glucometers that streamline tracking and recording blood glucose levels. In the meantime, only 21% of doctors surveyed by Accenture currently allow patients to have online access to their medical summary or patient chart – very basic components of the electronic health record. We know what’s primarily driving health providers’ adoption of health IT: namely, the HITECH Act’s provisions for incentives. But

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Defining Mobile Health – the blur between health and health care

Mobilising Healthcare, a new report from Juniper Research, segments the mobile health sector into “healthcare” and “health & fitness” segments. The research summary notes that fitness is a relatively new market compared with health “care,” which has been around for eons. Fitness, the analysts say, “is exempt from government intervention.” Mobile healthcare (“mHealth”) applications explored include SMS health messaging, remote health provision such as cardiac monitoring, electronic health records and personal health records. In mFitness, Juniper looks into mobile tech for athletes and fitness conscious people, and activity tracking including heart function, distance, respiration, and perspiration, among other parameters. mHealth

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Health information search online, an hour a week. Time with a doctor? An hour a year.

In game-scoring unit terms, 52 is the number of hours an average American spends seeking health information online each year. The 1 (hour) is roughly equivalent to the approximate total time a patient spends with a physician (an average of 3 visits, with an average time per vision of 20 minutes). Thus, 52:1. This means that the average U.S. health consumer spends much more time DIYing her health using digital information resources than speaking face-to-face with their physician in the doctor’s office. Still, the physician continues to be a go-to source for health information, according to Makovsky, a health communications

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People with doctors interested in EMRs, but where’s the easy button?

1 in two people who are insured and have a regular doctor are interested in trying out an electronic medical record. But they need a doctor or nurse to suggest this, and they need it to be easy to use. The EMR Impact survey was conducted by Aeffect and 88 Brand Partners to assess 1,000 U.S. online consumers’ views on electronic medical records (EMRs): specifically, how do insured American adults (age 25 to 55 who have seen their regular physician in the past 3 years) view accessing their personal health information via EMRs? Among this population segment, 1 in 4 people (24%)

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HITECH Funding Is More Stick Than Carrot, Says PwC

Economic challenges have forced 8 in 10 hospital CIOs to cut IT spending by about 10%. At the same time, these CIOs realize that penalties are looking in 2011 if they fail to implement “meaningful use” of EHRs. This is the Rock and a Hard Place PricewaterhouseCoopers (PwC) describes in the report of the same name.  PwC believes that the “stick” of Medicare payment penalties will be more compelling than the “carrot” of HIT incentives provided by the HITECH funding: based on the firm’s calculations on modeling the funding for providers, the report asserts that, “the stimulus funding for health

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