A blog covering the health/care ecosystem and people.

There’s a lot of chatter about Meaningful Use in the context of electronic health records adoption; if you Googled the term today you’d find millions of references to the concept. The Centers for Medicare and Medicaid Services (CMS)’s website offers three main components of Meaningful Use as specified in The American Recovery and Reinvestment Act of 2009: – The use of a certified EHR in a meaningful manner, such as e-prescribing – The use of certified EHR technology for electronic exchange of health information to improve quality of health care – The use of certified EHR technology to submit clinical quality and other

Target, fondly known as “Tar-zhay“ in my home, won the Design of the Decade award from the Industrial Designers Society of America for the innovation called ClearRx — a pill bottle. While a pill bottle might seem to be a commoditized sort of item, this bottle was designed to prevent medication mistakes committed by patients who take maintenance medications for chronic conditions. The National Coordinating Council for Medication Error Reporting and Prevention (NCCMERP) defines medication errors as preventable events that can cause or lead to inappropriate medication use or patient harm while the medication is in hands of patients or providers. The Institute of Medicine estimated that

In a nation where ‘no child left behind’ has been a mantra, it’s clear that in the U.S., many children are left behind when it comes to health. UNICEF’s Report Card #9 is out from the Innocenti Research Centre, providing the league table for child well-being in the world’s 24 richest countries. In health inequality — that is, the gap between kids who have ‘average’ well-being in the U.S. and those who fall below — the U.S. ranks #22 among the 24 wealthiest nations in the world. While an educated guess might put U.S. kids’ health inequality below Switzerland, Norway, and Denmark,

When four self-described health activists share their personal stories in the same physical (not virtual) room at the same time, in real time, it’s an exponentially moving and learning moment. WEGO Health convened a Socialpalooza event (#socialpalooza on Twitter) this week where an influential handful of health activists met face to face with some people who work in health industries. The result was a fruitful dialogue where both empowered patients and the suppliers who research, develop and market products serving those patients, learned a lot from each other. These Four Musketeers of health activism included  Alicia Staley (@stales on Twitter), who passionately shares her hard-won experiences in beating

The oracle (and I use the word here in the classic sense) of health internet statistics, Susannah Fox (@susannahfox on Twitter), along with the Pew Internet & American Life Project and the California HealthCare Foundation, find that 17% of mobile phone users look up health information online — and nearly 1 in 3 young adults 18-29 do so, while between 5-6% of people 50 and seek health information via mobile. The Mobile Health 2010 report tells the story. Beneath these macro statistics are the ones shown in the chart: people who have used cell phones to look up health information, which is a larger base

Sex, drugs, rock and roll, Victoria’s secret bras manufactured with formaldehyde, motivating kids to move about more, and texting potential sex partners your latest STD test results: the 2010 Health 2.0 Conference in San Francisco was more about real, whole health and the person-patient than about cool new tech. Furthermore, the Health 2.0 Conference turned a lot of preconceptions on their head on October 7 and 8, 2010, in a standing-room–only ballroom at the Hilton Union Square. Who could have predicted that government employees would light the room up with high energy and innovative thinking more than a panel of illustrious

8 in 10 people want companies to help them make changes to their own behavior, including getting more physical activity, eating healthier, and reducing their impact on the environment, according to the 2010 Cone Cause Evolution Study. Even more moms — 9 in 10 — are looking for this kind of support from companies with which they do business. Health is top-of-mind when it comes to cause marketing. 8 in 10 people think that companies should support health and disease. Cone’s study shows that cause marketing hasn’t just gone mainstream: it’s been absorbed into shoppers’ consciousness and figures into personal spending

The usual questions a rational health citizen might ask when selecting a physician based on quality aren’t consistently yielding the best choices, according to a study funded by The Commonwealth Fund, Associations Between Physician Characteristics and Quality of Care. Researchers found that individual physician-comparative parameters such as malpractice claims and disciplinary actions, years in practice or medical school ranking had no significant association with better quality performance. Female physicians (vs. male) and Board certification had small significance, 1.6 points and 3.3 points, respectively. This study’s results demonstrate that the metrics consumers assume should be useful proxies for physician quality aren’t as useful

The U.S. health system could conserve $170 billion in avoidable medical costs related to patients not taking prescription drugs as-prescribed. That’s known as “sub-optimal pharmacy care,” and it’s estimated that 3 in 4 prescription drug users fall into this category. In other words, only 1 in 4 patients on Rx drugs take their prescriptions as directed by their physicians (known as compliance) or weren’t prescribed the optima drug therapy in the first place. At least 1 in 4 patients never even fill their first prescription for a drug their physician has prescribed. CVS Caremark has found that health citizens can become more

In 2008, 2 in 3 people in the U.S. over 60 took 3 or more prescription drug medications in the past month, and 14% of kids 11 and under regularly took an Rx. The CDC’s National Center for Health Statistics latest issue brief on prescription drug use illustrates that prescription drugs are as much of American popular culture and life as fast-moving consumer goods. It’s the more intense use of Rx drugs, 5 or more, where the most significant growth has been since 1999-2000, when 6.3% of Americans took 5 or more prescription drugs in the past month. In 2007-8, the proportion

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

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

1 in 2 Baby Boomers born between 1948 and 1954 planning to retire in the first wave of Boomer retirements is at-risk of running out of money in retirement, according to the EBRI Retirement Readiness Rating. The Rating gauges just how prepared retirees are to finance their lives when they retire. This is defined as the percentage of pre-retirement households at-risk of not having enough money in retirement to pay for basic expenses such as housing, food, shelter, and uninsured health expenses. The net risk is determined as a function of retirement savings such as Social Security, IRAs, pensions, housing equity

“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

The 30 most developed countries, on average, allocated 9% of their national budgets to health care in 2008, up from 7.8% in 2000. The U.S., in contrast, spent 16% of GDP on health care, nearly one-half of which came from public treasury coffers. The graph illustrates the statistics for each OECD member nation and the share of health care paid by public and private sectors. Note that the light-blue bar segment for the U.S. is a far larger proportion of the total bar compared to other countries: that’s the private sector’s contribution to health spending versus the dark blue, government

What do Dora the Explorer, Scooby-Doo and Shrek have in common? They’re persuading kids to eat less nutritious food, according to a study in the July 2010 Pediatrics journal (Volume 126. Number 1). A team from The Yale Rudd Center for Food Policy and Obesity studied children’s taste for food that’s sold in cartoon-character themed packages, versus products in plain packaging. The verdict? Kids think the cartoon-themed food tastes better.  The study was done among 40 so-called “ethnically diverse” children 4-6 years old in New Haven, CT, preschools. Health Populi’s Hot Points: Since Vance Packard wrote the seminal book on advertising, The Hidden

Good luck to stakeholders in navigating the health-regulatory labyrinth once health reform is implementing in the U.S. A report from PricewaterhouseCoopers (PwC) predicts, “A number of existing regulators will also have expanded roles as a result of the legislation.” These will be in addition to the new regulators identified by the law, which include but won’t be limited to: CMS Innovation Center Independent Payment Advisory Board Health Insurance Reform Implementation Fund Patient-Centered Outcomes Research Institute National Prevention, Health Promotion and Public Health Council Task Forces on Preventive Services and Community Preventive Services Community-based Collaborative Care Network Program Community Living Assistance

  The health care cost crisis has hit at least 1 in 2 American families, based on the latest Kaiser Family Foundation Health Tracking Poll. KFF found that 30% of Americans have had trouble paying medical bills in the past 12 months. Challenges paying for health care increase if you’re black, Hispanic, earning under $40,000 a year, or….in poor health. There are two angles on dealing with the costs of health care dealt with in the KFF poll. First, looking to the government to regulate health costs: 42% of Americans said the government doesn’t regulate the cost of health insurance

 “Don’t be embarrassed by your body. Learn to love it,” the voice on the video positively commands. Comcast, are you listening?   Channel 4 in the United Kingdom hosts the television show, Embarrassing Bodies. There’s also a website providing health information that is detailed, audacious, graphic, and absolutely engaging.   On it, you’ll see close-ups of breasts, testicles, vulvae, and most other body parts in Grey’s Anatomy that are suitable for self-examination. The show launched in April 2008 and was watched by over 12 million people. Since there, Embarrassing Bodies has seen countless downloads of health videos, page views on

New Yorkers who frequent Au Bon Pain, KFC, McDonald’s and Starbucks who noticed calorie counts on menu labels ordered 106 fewer calories at the point-of-purchase than people who didn’t pay attention to the information.   Here’s evidence that labeling in fast-food destinations works.   At the annual meeting of the Obesity Society in Washington DC this week, researchers are presenting results on how transparency of calorie information motivates many health citizens to change their choices based on nutritional knowledge.   Reuters reports some details from the study. Researchers in New York polled 10,000 diners at 275 locations of the most

  Once again, the U.S. has earned a cup of goodwill from the world – and we can, once again, blow it, big time.   The 2009 Anholt-GfK Roper Nation Brands Index(NBI), which measures the brand equity of the world’s nations akin to product brand value, found that the U.S. is now #1 — rising to the top after languishing at #7 in 2008. Behind us are France, Germany, the U.K, Japan, Italy, and our sister to the north, Canada. Commenting on the study, Simon Anholt who founded the study observed, “What’s really remarkable is that in all my years

13% of the $2.4 trillion U.S. health economy could be saved by improving adherence to medication, according to an analysis from the New England Healthcare Institute (NEHI).   Poor medical adherence leads to poor outcomes and increased medical costs, as described in NEHI’s report, Thinking Outside the Pillbox: a System-wide approach to improving patient medication adherence for chronic disease..   NEHI identified poor medication adherence as a key component in the overall waste and inefficiency in American health care, where poor adherence leads to preventable worsening of disease and increasing health risks — especially among people with chronic disease(s). Since

Having grown up outside of Detroit, Berry Gordy and Hitsville, U.S.A., aka Motown Records, plays the core beat in the soundtrack of my younger life, and still to this day. The Jackson 5’s hits are woven into that musical quilt, and Michael Jackson’s work with Quincy Jones even more: in particular, Off the Wall and Thriller.   This brilliant force in our lives had much to teach us in life: Be a lifelong learner, and grow every day in your craft – whatever that might be. Reach beyond your grasp. Delight in what you do for a living. Give to

Every 1 additional prescription per 100 that is filled with a generic Rx in the Rochester NY region yields $82 million in annual cost savings to the community: specifically, to employers, consumers and health plans. The Blue Cross Blue Shield Association presented findings from a survey and featured best practices from member plans in a webinar, “Generic Drugs Can Be Good for Your Health and Your Wallet.” Blues Plans believe that implementing generic drug programs can help Americans access drugs at an affordable cost. In BCBSA’s health reform recommendations, Pathway to Covering America, there are 5 key points: four are

The most important elements of the economic stimulus package for health would be investing in health information technology, providing COBRA funding assistance for recently laid-off workers, and allowing unemployed Americans access to a public health insurance program. In the longer-run, getting to universal coverage while controlling costs and improving quality and efficiency should be the health care reform priorities for President Obama, according to 2 in 3 opinion leaders. These are the results of the 17th Commonwealth Fund/Modern Healthcare Health Care Opinoin Leaders Survey, conducted by Harris Interactive. The poll was conducted among 194 health care opinion leaders culled from

The average unemployment benefit across the U.S. is $1,278; COBRA monthly premiums for family coverage are $1,069.   In 9 of the 50 states, COBRA equals or is greater than the monthly unemployment benefit. Those states are Alaska, Arkansas, Arizona, Delaware, Florida, Louisiana, Mississippi, South Carolina, and West Virginia. These metrics are shown in the table above.   Families USA has appropriately titled its report on this situation, Squeezed: Caught Between Unemployment Benefits and Health Care Costs.   COBRA, the Consolidated Omnibus Budget Reconciliation Act, is the mechanism that allows laid-off workers to buy into their employer’s health plans when

The use of complementary and alternative medicine (CAM) by Americans has held steady since 2002; however, the types of therapies adopted have changed over five years. The Use of Complementary and Alternative Medicine in the United States, from the NIH’s National Center for Complementary and Alternative Medicine, follows up the agency’s 2002 report. This round, NCCAM offers more details on the use of CAM in kids, as well as CAM use by demographic factors including racial and ethnic groups.   CAM is “Complementary” when used with conventional medicine, and “Alternative” when used as a substitute. The most commonly used CAM

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

Seniors are acting like true, Adam Smith-style Rational Economic Man and Woman when it comes to their behavior as Medicare Part D enrollees. They go for the more expensive prescription drug brands when covered by the government; once getting to the ‘donut hole,’ though, seniors opt for lower-cost generics.   Medco Health discovered this in their latest study into Medicare drug trends. Their conclusion is that Medicare could save more money if seniors went for generics 100% of the time.   Rational selection, indeed. In a study from the Kaiser Family Foundation (KFF), Medicare Prescription Drug Plans in 2008 and

About $7 billion is spent each year on cosmetics. Another $1.5 billion is spent on breast augmentation, $1.3 billion on lipoplasty, and nearly $1 billion on abdominoplasty — aka, “tummy tucks.” Beauty At Any Cost is an important report from the YWCA. The organization has quantified the economic costs of the never-ending search for ‘beauty,’ and broken down the health implications, and impacts on interpersonal relationships — especially as these issues translate to young girls. One of the most serious behaviors cited in this report include that fact that over 1/2 of teenage girls use unhealthy weight control behaviors such

Globally, prescription drug sales grew 6.1% between 2006 and 2007. In the U.S., Rx sales grew 3.8% in the same period. This is the weakest U.S. sales rate for prescription drugs since 1996.   These stats come to you from IMSHealth, whose annual U.S. Pharmaceutical Market Performance Review found over a 50% drop in Rx sales growth from the 8% rate reached in 2006.   The backstory to what’s slowing drug sales is a good-news/bad-news mix. The flood of many popular blockbuster drugs going off-patent means that generics spending is up. Now, 2 in every 3 prescribed drugs is a

In this season’s Health System Idol contest, the U.S. loses to most other developed countries. One in three Americans would like to “completely rebuild” the U.S. health system, according to The Harris Poll conducted in ten nations.   And another 50% believe that, “fundamental changes are needed to make it work better.”   Harris also measured ‘unpopularity’ with another metric: asking whether, “the system works pretty well and only minor changes are necessary.” Adding this yin to the other yang, the mash-up is still the same: the U.S. plays last fiddle to the rest of the world’s health system orchestra.

Growth in spending on Medicare and Medicaid is a function of (1) the aging of the population and (2) trends in the cost of health care. The Congressional Budget Office (CBO) has published an issue brief, Accounting for Sources of Projected Growth in Federal Spending on Medicare and Medicaid, which finds that health care cost growth per beneficiary relative to GDP growth will be a greater driver of health spending than the aging of the population.   The bottom-line: over half of the growth in federal spending on Medicare and Medicaid is attributable to health care costs per person growing

Younger people are way more stressed out than people over 65, according to a poll sponsored by the American Psychological Association.   HarrisInteractive has published data in its latest Healthcare Newsletter titled, “Adults Over 65 Experience Far Less Stress Than Adults in All Other Age Groups.” These findings are part of a deeper dive into the APA’s report published in October 2007, Stress in America. The highest levels of stress in America are in the 35-49 age cohort, followed by people aged 25-34.   6 in 10 people aged 35-49 say they are concerned about the level of stress in their

An outstanding commentary in this week’s Journal of the American Medical Association succinctly traces the history of U.S. health care in the context of “market justice.” Peter Budetti, MD, PhD, who teaches health policy at the University of Oklahoma, observes, “Fragmented and struggling to come to terms with externally imposed pressures, medicine is losing both its political force and moral compass.” Those so-called externally imposed pressures come from stakeholders behaving according to their own self-interest in the health market: employers, physicians, hospitals, suppliers, insurers, public officials, and of course, consumers. Dr. Budetti concludes that, “Market justice may have outlived its

The annual national hospital bill may reach $1 trillion by 2008. This forecast is brought to you in a new report from the Agency for Healthcare Research and Quality (AHRQ). Hospital charges in 2005 totalled $873 billion in 2005, nearly doubling in ten years. The hospital bill was covered primarily by three payor segments: Medicare, which paid nearly one-half of the total hospital bill; private insurance, covering nearly one-third; and Medicaid, at 14% of the total. What are we spending money on in hospitals? Putting aside pregnancy/childbirth and infant care, the top three conditions are heart-related: coronary artery disease ($46

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

In 2004, 20% of homicides were directly associated with intimate partner conflict (i.e., one in which an intimate partner killed another partner). Intimate partner violence resulting in death was most common among victims aged 40-44 years. Murder is the leading cause of death for pregnant women, according to the National Organization of Women. The National Center for Injury Prevention and Control, part of the Centers for Disease Control and Prevention, spends about $43 million a year on ways to reduce deaths and injuries from drowning, poisoning, suicide, industrial accidents, house fires and domestic violence. Of that sum, only $2.3 million

Pink is all around.    It’s October 1st. The annual proliferation of pink products promoting breast cancer awareness pervades purchasers’ prospective pickings. This year, there are lots of cosmetics to choose from, along with a Filofax, a vacuum cleaner, kitchen appliances, an iPod and various accessories to dress it up, foods, a Swiss army knife, and a set of pink knitting needles. Prevention Magazine online has several suggestions for “Beauty that Gives Back,” cosmetic companies offering products with some percentage of proceeds going to a variety of breast cancer charities. For example, La Mer Skin Creme can be purchased for

I’ve been researching the topic of therapeutic hypothermia (TH) for cardiac arrest in the past couple of weeks on behalf of a client (we at THINK-Health work with the full range of stakeholders, which keeps our thinking fresh and the practice continually fascinating). So when Buffalo Bills player Kevin Everett received TH immediately following severe spinal cord injury on the football field, I closely followed his story. I have a dear cousin who became spinal cord injured due to a diving accident several years ago, and so the topic is of very personal interest to me. It is great news