How to save $40 billion in health care: implement health IT in hospitals
Electronic health records (EHRs) broaden access to patient data and provide the platform for pushing evidence-based decision support to clinicians at the point-of-care. This promotes optimal care for patients, reduces medical errors, optimizes the use of labor, reduces duplication of tests, and by the way, improves patient outcomes. When done in aggregate across all health providers, a team from McKinsey estimates that $40 billion of costs could be saved in the U.S. health system. Reforming hospitals with IT investment in the McKinsey Quarterly talks about the American Reinvestment and Recovery Act’s (ARRA) $20+ billion worth of stimulus funding under the HITECH Act
Broadband@home: one antidote to addressing health disparities
2 in 3 American adults use a broadband connection at home. Among those who don’t have high-speed access at home, most don’t go on the internet at home, and the others who do use dial-up connections (only 5% of adults). The Pew Internet & American Life Project knows more about Americans’ use of the internet than probably any other research organization, and their report, Home Broadband 2010, presents a comprehensive snapshot of how people in the U.S. are using the internet as of May 2010. The most striking statistic in Pew’s survey is that growth of broadband among African-Americans grew in double-digits
That’s Dr. Geek Squad to you
Best Buy is teaming up with Cardiac Science, targeting potential purchasers of electronic health records (EHRs) and noninvasive cardiac devices. The venture looks to take advantage of economic stimulus funding available through the HITECH Act aimed at motivating physicians to adopt EHRs. Cardiac Science is a medical device company focused on the noninvasive management of heart disease. Their products include defibrillators, ECG/EKG devices, stress testing equipment, Holter and vital sign monitors. These heart-hardware products are designed to connect with electronic health records systems in hospitals and physician offices. and are used in many settings outside of health institutions including schools, emergency
Mobile health and the FDA: what WellDoc’s approval means for mHealth
WellDoc received approval from the Food & Drug Administration (FDA) on August 2 2010 to market the company’s DiabetesManager system. This signals the regulator’s openness to mobile health solutions — a market moment that may usher in the new-and-improved era of personal health management. DiabetesManager uses the mobile phone as a platform for patients with Type 2 diabetes to gather, store and communicate personal health data such as blood glucose measurements; these data then feed into WellDoc’s algorithms that communicate personalized health coaching support back to patients in real-time. This process creates a closed-loop system that helps bolster patients’ decisions and behaviors throughout the day. Health
Partnering up for health @ home – the GE-Intel link-up
A decade ago, I was engaged by a consumer health company to lead a scenario planning exercise on the future of the health consumer. We developed four scenarios, one of which was called something like “MicrosoftMerckGEGenMills.” In that futureworld, several Big Organizations would come together to serve consumers in caring for themselves outside of traditional care settings, like hospitals, doctors’ offices, and nursing homes. The beauty of scenario planning when done well is that, if you’ve done it for a long time, you sometimes get one right. Witness the New Deal between GE and Intel, partnering up to develop solutions
People use the cloud for photos and e-mail, not health information
People trust the Internet “cloud” to manage many parts of their personal information, especially photos, e-mail correspondence, contacts, and videos. But personal health and financial information? Not so much. The chart illustrates that only 1 in 5 global citizens use the cloud to manage personal health information. KPMG‘s report, Consumers & Convergence IV, highlights peoples’ feelings about privacy and security of their personal information, from vacation pictures to 401(k) statements. The verdict: most people trust of the cloud to store and share most kinds of their information except for their medical and financial information. Two-thirds of people globally use cloud computing applications,
Health reform = meaningful use among health executives
Meeting meaningful use for inpatient EHRs is the top priority among the many challenges health executives face when considering how the Patient Protection and Affordable Care Act (PPACA) will impact their organizations. Overall, 2 in 3 health execs place MU for inpatient EHRs as the “highest priority;” among health IT executives, the proportion citing this as the highest priority is 84%. The second-most pressing PPACA priority for health executives is preparing for new models of payment, cited by 17% of health execs overall, and 31% of non-IT executives. CSC surveyed health executives in July to gauge their temperatures on several PPACA line-items including
Phonecare works – remote health via phones for people with cancer
People with cancer can successfully manage their pain and depression through telephone contact with health providers and home monitoring, demonstrated by a clinical trial conducted among 405 patients in Indiana. The randomized trial findings are published in the July 14, 2010, issue of JAMA in, Effect of Telecare Management on Pain and Depression in Patients With Cancer. In the study, the Indiana Cancer Pain and Depression (INCPAD) trial assessed patients with pain, depression, and both depression and pain. Pain and depression are the most common physical and psychological symptoms in cancer patients, according to an AHRQ Evidence Report/Technology Assessment. These symptoms go largely untreated
Open notes: opens conversations and builds trust between people and their doctors
People foresee that, in the future, the most trusted ‘channel’ for their engaging in their health will be…conversations with my doctor. This was found in the 2008 Edelman Health Engagement Barometer survey of health citizens polled in five countries — China, Germany, Russia, the United Kingdom and the United States. Those health citizens favoring the physician-conversation channel will welcome OpenNotes into their doctor-encounters behind the exam room door. The July 20, 2010, issue of the Annals of Internal Medicine talks about an initiative to, literally, open up doctors’ notes to their patients. As Dr.Tom DelBanco, et. al., attest in the article, “‘open notes’
Meaningful use: mandates, menus and morality
“We are only as good in treating patients as the information we have,” opined Dr. David Blumenthal, the national coordinator for health information technology in the Department of Health and Human Services, during yesterday’s launch of the new regulations on the meaningful use (MU) of health information technology. In the health care world, yesterday featured a star-studded line-up (live and via webcast) that ushered in the long-awaited meaningful use regulations that provide the roadmap for the adoption of electronic health records (EHRs) for providers, hospitals and doctors alike. Simultaneously, Dr. Blumenthal’s 4-page summary of the reg’s was featured in a tidy, useful article in the New
Doctors and smartphones: implications for the mobile EHR
6 in 10 doctors in the U.S. have a smartphone, and most of them use the devices for email and accessing the mobile Internet. These findings come from a survey conducted among members in The Physicians Consulting Network. “Smartphones are quickly becoming a way of life for medical professionals,” PCN observes. PCN explored physicians’ views on various digital technologies, especially concerning digital health information which is top-of-mind for providers given the window of opportunity to exploit ARRA HITECH incentives for adopting electronic health records (EHRs). This survey found that 50% of PCPs and 52% of specialists keep patient records in an
The road to meaningful use has many bumps along the way, CIOs say
While 1 in 2 health CIOs say they’ll be prepared to apply for stimulus funding to adopt electronic health records in 2011, 80% are concerned about their ability to meet the requirements of meaningful use (MU). This lack of confidence on the road to MU is based on a host of challenges, from reporting requirements and lack of clarity of MU criteria to availability of IT talent and worries about access to capital. PricewaterhouseCoopers’ Health Research Institute (PwC) surveyed 120 health care CIOs and IT executives and published the detailed findings in the report, Ready or not: On the road to
On the Tiger Team and the insecurity of health information
Millions of health records for patients in the U.S. have been breached or compromised in the first half of 2010. Here’s a list derived from an ongoing search via Google News Alerts I monitor using the keywords, “health information and breach:” FedEx lost seven CDs of personal health information (PHI) from the Lincoln Medical and Mental Health Center in Bronx, NY, enroute to Siemens Medical Solutions, in March. This information affected 130,495 patients. The FAA believes that PHI for over 3 million U.S. pilots may be at-risk of breaching, according to a report published in June by the US Transportation Department. The FAA’s
Economics and health information technology are top challenges for physicians in 2010
While practice economics have always been the lifeblood for doctors’ businesses, this year, 7 of their top 10 challenges have to do with some aspect of finance: rising costs, uncertainty of Medicare reimbursement, managing compensation, negotiating payer contracts, and collecting payments from patients themselves. The other key hassle in 2010 for physicians is selecting and implementing an electronic health records system, #3 in the top-of-mind challenges for American doctors. The Medical Group Management Association, the advocacy group for physicians working in groups, published a survey this week conducted among its members in February and March 2010. Notice all the yellow shading in the chart?
Fiscal unfitness: U.S. hospitals still suffer negative impacts from the recession in 2010
Bad debt and charity care as a proportion of hospitals’ total gross revenue increased for 9 in 10 hospitals in the U.S. according to the American Hospital Association’s press release, Hospitals Continue to Feel Lingering Effects of the Economic Recession. Today’s macroeconomic news that U.S. economic growth slowed in the first quarter of 2010 doesn’t bode well for hospitals or for patients, for whom the so-called “jobless recovery” in the nation creates financial insecurity and, more specifically, health care insecurity. Hospitals’ other negative economic impacts include depressed numbers of elective procedures (suffered by 72% of U.S. hospitals), depressed overall patient volumes
Health consumers like the idea of digital records, but few embracing them
While 8 in 10 Americans say that their physicians should have access to information contained in their electronic medical record, only 8% of people said an EMR is available to them but they don’t use it. Fully 37% of American adults are not sure their physicians even have an EMR, according to a HarrisInteractive/HealthDay survey on e-health records conducted in June 2010. As the chart indicates, health consumers aren’t very engaged with other aspects of information applications that may be available to them, from scheduling a doctor’s visit over the Internet to accessing the results of lab trests via email. As Humphrey
Clueless: Americans and electronic health records
Notwithstanding the inclusion of $20 billion (and counting) being allocated to incentives for providers to adopt electronic health records in the U.S. as part of the HITECH Act of 2009, the American public lacks an understanding about what EHRs really are. 26% of Americans ranked patients as the last among groups that would benefit from digital records, with the least to gain. This stunning datapoint comes from a survey conducted for Xerox, illustrated in the chart. 79% of adults with concerns about EHRs report stolen records as their top concern, followed by misuse of information (69%) and loss, damage, or corrupted records
Patient Power Through Data Liberación, and Private Sector to the Rescue – Health 2.0 DC Takeaways
The Health 2.0 Conference convened its first meeting in Washington, DC, today, with public sector health leaders and private sector innovators coming together in a Great Big Kumbayah. This conference featured two prominent and key players absent from previous Health 2.0 Conferences: patients on every panel, and the Federal government punctuating the start, the middle, and the end of the day’s agenda. The over-arching message: Data Liberación! says Todd Park, the DHHS Technology Officer. This follows last week’s launch by DHHS of the Community Health Data Initiative (which Park wants to rename with your help here). [More about the CHDI herefrom Health Populi]
Our Technology, Ourselves
PHRs can help bend the chronic health care cost curve
The U.S. spent $2.3 trillion on health care in 2008. 75% of that went to chronic conditions. How to move the needle on the long-term deficit challenge to the U.S. economy? Think: personal health records (PHRs). People with 2 or more chronic conditions find value in personal health records. So do people with less than a high school education, and those with household income under $50K. The California HealthCare Foundation conducted the most detailed survey into consumers’ use of personal health records, and what people value about the tool. Among many measures, the one I’m focusing on here is, “The PHR led me to do
The Gold Rush of Health IT – not a rush, but a marathon, in Health Affairs
As we journey through the health IT “gold rush,” what do we know we know about health information technology that can help us smooth the ride? That’s the theme of the April 2010 issue of Health Affairs, and the issue offers a rich compendium of learnings. Two HIT David’s, Blumenthal and Brailer, dialogue about health IT policy in the larger context of health policy overall. Brailer points to ARRA’s health IT stimulus funding in the HITECH Act as one of the spectacular events in the history of health policy which changed the world of health information technology overnight. Dr. Blumenthal emphasizes
Physicians Cite Cost and "Not Being Ready" As Key Barriers to EMR Adoption
Two news stories this week highlight the fact that, even with a health reform bill signed and sealed by the President of the United States, and with $20 billion of ARRA stimulus funding on the books, electronic health records adoption will probably be slower than the go-go forecasts of one year ago. The head of Accenture’s clinical transformation practice was interviewed by Information Week this week. Dr. Kip Webb explained the results of an Accenture survey of small practices that found a “substantial number” of physicians in practices smaller than 10 doctors would not begin the process of EMR adoption. On the upside, Accenture
A Renaissance for U.S. health care: broadband as the canvas
I’m in a country this week where 66% of health providers have adopted 9 of 14 critical electronic health applications, according to a study from The Commonwealth Fund. According to the same study, only 26% of U.S. providers have opted into these functions. As I amble across cobblestoned and craggy streets, looking up to frescoe’d facades on 500 year old palazzi, church domes and the bluest sky ever, the signs of the Italian Renaissance are everywhere in walkable Florence, Italy. But it’s not all art and architecture, gelato and chianti for me this week. It’s also the techno-reality
Data security is Job 1 for health managers thinking mobile
As more health workers go mobile, whether telecommuting or as home health road warriors, managers are concerned, first and foremost, with mobile security as the top ranking required component of mobile user management tools. Data security in general ranks highly int he minds of health managers, 90% of whom told Forrester that this was a critical or high IT security priority as they were entering 2010. In a survey conducted for Fiberlink, a communications company, Forrester found that 89% of health care organizations have some employees working out of the office at least one day per week, and 87% of
Rent, Buy or Wait? A post-mortem of HIMSS ’10
It’s been a year since the American Recovery and Reinvestment Act and the HITECH Act got the president’s signature. Since then, there have been countless meetings of standards-setters, CIO experts and medical informatics pros, all opining on the meaning of “meaningful use,” the criteria for certifying electronic health records and the vision for a Nationwide Health Information Network. As they asked in “Seasons of Love” from Rent, “525,600 minutes…how do you measure a year?” The chorus’s response: “In cups of coffee, in inches, in miles, in laughter, in strife.” And 525,000 journeys to plan. That’s about the number of physicians
Designing for meaningful use
In the crush of crowds on the vendor floor at the HIMSS10 exhibition this week in Atlanta, booths are strategically designed with Pantone-matched colors and icons and clever taglines. Sales teams are festooned in corporate logo-emblazoned polo shirts (orange is popular this year). Colorful banners exclaim this year’s HIT mantras: lots of “HIE spoken here!” and “We are connectivity.” With all the thought and dollars allocated to health information technology sales and marketing, I wonder how much the line item known as “design” gets? As I spend a lot of time with pharmaceutical companies in the past two decades, I’m
Help wanted: primary care docs, nurses and health information professionals
In the coming months and years, I anticipate that Monster.com and other online job services will grow their revenues from the health industry. Three important studies this month confirm that, while health care eats up nearly one-fifth of the U.S. economy, there are shortages of professionals to fill two important jobs that are growing: primary care physicians (PCPs), nurses, and health information technology (HIT) workers. Let’s talk about the doctors, first. The Journal of the American Medical Association (JAMA) reports this week that doctors cut back their working hours since 1998 to 2008. At the same time, the second chart
Can GE, Intel and Mayo bring good things to home monitoring?
Three major consumer and health industry brand names are coming together to launch a telehealth home monitoring project: GE, Intel and the Mayo Clinic. Each organization has a deep bench and history in the health vertical, covering different segments of the market. With this project, 3 industry leaders partner to learn about home health monitoring’s challenges and opportunities in real-life, with real people. The project goal is to evaluate the effectiveness of daily in-home monitoring technology measured in 2 ways: reduced hospital admissions and reduced visits to the emergency room. For the project, Intel brings its Health Guide into the
Health is contagious: the nature of connected-ness
The book Connected was recommended by my colleague, intellectual beacon and friend, Susannah Fox of the Pew Internet & American Life Project. In the midst of late nights analyzing health reform scenarios and medical microeconomics, I’ve made the time to read this book in its entirety. It’s been a worthwhile investment. Previously, the authors of Connected, Nicholas Christakis and James Fowler, found evidence on connectedness in health in the areas of obesity, smoking cessation, binge drinking, and other lifestyle behaviors that directly impact good or bad health. This week, another team of innovative thinkers led by John Caccioppo from the
Americans like mobile health, especially for exams, wellness, and monitoring
If mobile medical services were available to Americans today, 40% would use the service in addition to seeing their doctors.23% of people would replace the doctor with mobile medical services. 1 in 3 people wouldn’t use the service at all. Welcome to the era of “m”-everything — mobile-everything, 24×7. And health is a natural partner for “m.” These stats come from a survey released by CTIA-The Wireless Association, in conjunction with The Harris Poll. The poll was conducted among American adults in September 2009. The 23% of health citizens who would use mobile health services instead of going to the
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
A Tale of Two HIMSS – the dynamic of urgency vs. pragmatism
It was the best of times, and the worst of times. Well, perhaps not the worst, but a time to pause and reflect on the power and the money. Thus I turn to a Tale of Two Cities. As I depart Chicago and the 47th annual conference of the Healthcare Information and Management Systems Society, I recall two different meeting-experiences: the convention floor, with its mood of upbeat urgency, brightly colored booths and activity; and the education sessions and hallway conversations that featured pragmatic, real-world challenges. ARRA, the American Recovery and Reinvestment Act of 2009, with its $19+
Can Wal-Mart Mass Merchandise Electronic Health Records?
“We believe America can have high quality, affordable and accessible health care by 2012.” Who said that? If you guessed President Obama, Senator Edward Kennedy, or Hillary Clinton, you’re wrong. It’s Wal-Mart, on its Health and Wellness webpage. Wal-Mart’s got a new direct-to-physician strategy: selling electronic health records (EHRs). The world’s largest retailer, #1 on the Fortune 100, expands on the company’s experience with retail health clinics. The chain now has 30 clinics sprinkled throughout the south, and in each clinic, there’s an EHR system. The EHRs will be offered through Wal-Mart’s subsidiary, Sam’s Club, jointly with Dell and eClinicalWorks,
How to find $150 billion for health care: get rid of paper
Paper, Benjamin, Paper. The lowest-hanging fruit opportunity in reforming health care today is paper. Getting rid of it, that is. In their Recommndations to the Obama Administration and 111th Congress, Ingenix says that, “Administrative cost savings are win-win propositions, benefiting all stakeholders.” Health Populi’s Hot Points: As Congress continues to wrestle with what $20 billion can do for electronic medical data in the U.S., addressing administrative waste is in health is an opportunity to mine some found money which won’t require a 10-year wait for an ROI. The point here is to move toward administrative efficiency in parallel with migrating
Affordable care and better information: what Americans want from a new-and-improved US health system
Anxiety about health care costs tops American citizens’ concerns about health care in the U.S. Rich, poor, insured or un-, 2 in 3 Americans worry about the affordability of health care in America. So it follows, then, that among those without health insurance, 57% blame their uninsured state on the fact that they simply cannot afford it, as shown in the table on the right. Beyond this group, 30% of the uninsured cite the employer’s role in health insurance: 14% aren’t employed, 9% have employers who don’t offer coverage, and 7% are “between jobs.” These findings come from
Anytime, anywhere health: 2 new reports from CHCF
A very smart doctor told me, “there’s been a realization that the exam room is wherever the patient is.” That simple, elegant and insightful remark was offered by Dr. Jay Sanders, one of the godfathers of telehealth. I quote him here from my report published this week by the California Health Care Foundation. It’s called Right Here Right Now: Ten Telehealth Pioneers Make It Work. This report is coupled with another by Forrester, Delivering Care Anytime, Anywhere: Telehealth Alters the Medical Ecosystem. My colleagues at Forrester, Carlton Doty and Katie Thompson, have assembled a very current look into
Searching vs. using health information: the "just looking" mode of health search
Consumers, at least Californians, do a lot of looking for health information on the Internet — but very little health management. California HealthCare Foundation (CHCF) has taken a snapshot of Californians’ use of the Internet in health care. The profile is presented in CHCF’s report, Just Looking: Consumer Use of the Internet to Manage Care. Topline: insured, more affluent, and younger people use the Internet in health searching. The most popular care-related uses on the Internet include searching for information about conditions and drugs, finding a physician, checking ratings, and looking for claims and benefit information online.
The Future of Telehealth, according to Philips
While fiscal, billing and back office technologies universally proliferate home care, only 17% of agencies use some type of telehealth systems. However, 32% of agencies with over $6mm in annual revenue provide telehealth services. Thus, size matters when it comes to home health adopting telehealth technologies. These are just a couple of many important benchmarks published in the National Study on the Future of Technology and Telehealth in Home Care. Billed as the largest telehealth study in the history of home care, Philips unveiled this report in conjunction with the 13th annual American Telemedicine Association conference in Seattle. Philips partnered
Prelude to HIMSS — follow the money, especially Medicare
On this eve of the annual meeting of the Healthcare Information and Management Systems Society (HIMSS) in Orlando, I’m meditating and getting myself prepared for the next three days at the Orange County Convention Center. Why? Medicare. Last week, President Bush has already announced a budget cutting hospital funding for fiscal year 2008. The President proposes cuts in Medicare and Medicaid spending by $196 billion over five years, with hospitals in the bulls’-eye of the reductions. Hospitals are a primary target audience attending HIMSS. HIMSS is akin to a shopping mall with stores featuring every conceivable aspect of health IT:
Google and Cleveland Clinic — a tidy project built for disruption, and a word on privacy
The Google–Cleveland Clinic health records venture has been announced. Cleveland Clinic is a leader among providers when it comes to health IT, so Google has chosen well. This is a small, quick pilot between two mega-brands in their respective spaces. Word is that the project will last only a couple of months. While Cleveland Clinic has electronic health records for over 100,000 patients, this project will have an N of 10,000. I will be exploring more about the project with Googlefolks at HIMSS next week. For now, I’m in research mode. I’ve already come across several useful posts
Health Populi’s Tea Leaves for 2008
I “leave” you for the year with some great, good, and less-than-sanguine expectations for health care in 2008. These are views filtered through my lens on the health care world: the new consumer, health information technology, globalization, politics, and health economics. Health politics shares the stage with Iraq. Health care is second only to Iraq as the issue that Americans most want the 2008 presidential candidates to talk about, according to the latest Kaiser Health Tracking Poll. Several candidates have responded to the public’s interest with significant health care reform proposals. But major health reform – such as universal access
Health Care IT by way of Hollywood and Hip-Hop
The double-barreled news of Dennis Quaids’ twins receiving heparin doses 1,000x the prescribed dose while receiving medical treatment at Cedars-Sinai Medical Center, coupled with the tragic death of Kanye West’s mother following cosmetic surgery, focuses this health care paparazzi’s lens squarely on the role of information technology in health care. The Cedars-Sinai Chief Medical Officer has termed the Quaid event a “preventable error.” Donda West’s doctor has been described by the likes of People magazine and the Los Angeles Times as a clinician with at least 2 DUI’s and an assortment of malpractice suits — as well as a recommendation
Interviewed live on BNN Bloomberg (Canada) on the market for GLP-1 drugs for weight loss and their impact on both the health care system and consumer goods and services -- notably, food, nutrition, retail health, gyms, and other sectors.
Looking forward to speaking at OSF Healthcare's first digital summit to highlight the growing movement of healthcare-to-home, empowering and supporting patients for self-care, and bolstering community health citizen-by-citizen, clinician-by-clinician.
As a proud Big Ten alum, I'm thrilled to be invited to meet with the OSU HSMP Alumni Society to share perspectives on health care innovation.